• guided participation;
  • health problems;
  • maternal competency;
  • premature infants

ABSTRACT Objective: Explore the feasibility, usefulness, and outcomes of a pilot program to support mothers in developing competencies for managing health problems of their very low birth-weight (VLBW) infants in partnership with the primary care clinician (PCC).

Design: In a randomized study, mothers who received guided participation (GP) and printed guidelines for managing VLBW infant health problems were compared with mothers who received only the guidelines and standard care (GL group).

Sample: All mothers (GP=20; GL=11) were at least 18 years old and English speaking. Infants were all VLBW (≤1,500 g).

Intervention: GP began during the infant's neonatal intensive care unit stay and continued with public health nurses (PHNs) and a family service clinician through the infant's first 4 postterm months.

Measurements: Intervention feasibility and usefulness were assessed with maternal and clinician feedback. Outcomes included maternal and clinician appraisal of mothers' use of clinical resources and mothers' perceptions of primary-care quality and the family-PCC relationship.

Results: Intervention feasibility and usefulness were supported. GP and GL groups did not differ significantly on outcomes.

Conclusions: Findings indicate a longer intervention period, GP organized by infant problem episodes, and enhancement of the PHN role in the context of interdisciplinary and interagency collaboration.