Maternal and infant predictors of attendance at Neonatal Follow-Up programmes

Authors

  • M. Ballantyne,

    1. School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
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  • B. Stevens,

    1. Lawrence S Bloomberg Faculty of Nursing and Faculty of Medicine, University of Toronto, Toronto, ON, Canada
    2. The Hospital for Sick Children Research Institute, Toronto, ON, Canada
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  • A. Guttmann,

    1. The Hospital for Sick Children Research Institute, Toronto, ON, Canada
    2. Institute for Clinical Evaluative Sciences (ICES), Toronto, ON, Canada
    3. Department of Paediatrics, University of Toronto, Toronto, ON, Canada
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  • A. R. Willan,

    1. The Hospital for Sick Children Research Institute, Toronto, ON, Canada
    2. Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
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  • P. Rosenbaum

    1. Department of Paediatrics, McMaster University, Hamilton, ON, Canada
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  • Contributors: Marilyn Ballantyne was the principal investigator and conducted this research for her PhD dissertation at the University of Toronto. Dr Bonnie Stevens was Dr Ballantyne's PhD supervisor. Drs Rosenbaum, Guttmann, and Willan were on her thesis committee. All authors contributed, in varying degrees to the conceptualization and design of the study, analysis and interpretation of the data, and the manuscript.

Correspondence:

Marilyn Ballantyne, RN (EC), PhD, School of Nursing, Faculty of Health Sciences, McMaster University, Health Sciences Centre, Rm. 3N28A, 1280 Main St. West, Hamilton, ON, Canada L8S 4K1

E-mail: mballan@mcmaster.ca

Abstract

Background

Neonatal Follow-Up (NFU) programmes provide health services for families of infants at high risk of developmental problems following difficult or extremely premature birth: yet, up to 30% of families do not attend these programmes with their infants.

Methods

The study objective was to determine maternal and infant factors that predicted attendance at NFU programmes. Utilizing Andersen's Behavioural Model of Health Services Use, a prospective two-phase multi-site descriptive cohort study was conducted in three Canadian Neonatal Intensive Care Units (NICU) that refer to two affiliated NFU programmes. In Phase 1, 357 mothers completed standardized questionnaires that addressed maternal and infant factors, prior to their infants’ NICU discharge. In Phase 2, attendance at NFU was followed at three time points over a 12-month period. Factors of interest included predisposing factors (e.g. demographic characteristics and social context); enabling factors (e.g. social support, travel distance, and income); and infant illness severity (i.e. needs factors). Multivariate logistic regression was used to estimate the odds ratio for each independent factor.

Results

Mothers parenting alone, experiencing higher levels of worry about maternal alcohol or drug use, or at greater distances from NFU were less likely to attend. Mothers experiencing higher maternal stress at the time of the infant's NICU hospitalization were more likely to attend NFU. No infant factors were predictive of NFU attendance.

Conclusions

Mothers at risk of not attending NFU programmes with their infants require better identification, triage, referral and additional support to promote engagement with NFU programmes and improved quality of life for their high-risk infants.

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