To examine whether an integrated developmental intervention for mothers and their premature infants results in lower levels of healthcare utilization (HCU) between hospital discharge and 6-week corrected age (CA).
Prospective randomized clinical trial.
Two community hospital neonatal intensive care units.
Sample included (N = 145) otherwise healthy infants, 29- to 34-week gestational age at birth, whose mothers reported at least two of 10 social-environmental risk factors, for example, poverty, minority status.
The Impacts of Hospital-Home Transition: Optimizing Prematures’ Environment (H-HOPE) was tested. The intervention included infant remediation using a multisensory approach; and maternal redefinition and re-education using maternal participatory guidance. Maternal report of infant HCU after hospital discharge is measured at 6-week CA. t-Tests and multivariable log-binomial regression models (α = .05) were used to estimate the effect of the intervention on HCU.
At 6-week CA, H-HOPE infants had a significantly lower number of healthcare visits than control infants (H-HOPE mean = 3.3, SD = 1.42, n = 68 vs. control mean = 3.8, SD = 1.41, n = 77). H-HOPE infants were significantly less likely to have visited a provider for an illness than control infants (30.9% vs. 46.8%, respectively). After controlling for maternal and infant factors, mothers in the H-HOPE group were 35% less likely to have taken their infants to one or more acute care visits by 6-week CA compared to control group mothers (adjusted prevalence ratio = 0.65, 95% CI 0.43-0.98, p = .04).
Conclusion/Implications for Nursing Practice
H-HOPE infants were less likely to see a provider for an illness between hospital discharge and 6-week CA. Costs of care for subsequent illness among preterm infants may be reduced as a result.