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Johnson LC, McManus B, Blanchard Y, Nugent JK. The newborn behavioural observations system: A relationship-building intervention to support families in the neonatal intensive care unit. Acta Paediatr 2024. [PMID: 38850088 DOI: 10.1111/apa.17314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 05/08/2024] [Accepted: 05/27/2024] [Indexed: 06/09/2024]
Abstract
AIM Relationship-based interventions for neonatal intensive care unit families have potential to improve parent and infant outcomes; yet, their implementation has been modest within systems of care for high-risk newborns. The purpose of this paper is to describe a relationship-building intervention, the newborn behavioural observation system, summarise the evidence supporting its use, and address its clinical application for high-risk parent-infant dyads in the neonatal intensive care unit. METHODS We summarise the extant literature describing the use of the newborn behavioural observation system in high-risk populations. RESULTS While the body of literature supporting the use of the newborn behavioural observation system is modest, several randomised controlled studies have highlighted statistically significant and clinically meaningful gains in infant development and parental mental health. In these studies, the intervention was often integrated into existing systems of care and included high-risk parent-infant dyads. CONCLUSION The newborn behavioural observation system is a promising intervention designed to support the early challenges of high-risk infants and their parents. Future research should examine its effects in diverse neonatal intensive care unit populations and professionals, strive for continuity of care from inpatient to post-discharge follow-up and developmental support services, and include more longitudinal studies.
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Affiliation(s)
- Lise C Johnson
- Division of Developmental Medicine, Boston Children's Hospital, Brazelton Institute, Boston, Massachusetts, USA
- Department of Pediatrics, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Beth McManus
- Department of Health Systems, Management, and Policy, Colorado School of Public Health, Aurora, Colorado, USA
- Children's Hospital Colorado, Aurora, Colorado, USA
| | - Yvette Blanchard
- Division of Developmental Medicine, Boston Children's Hospital, Brazelton Institute, Boston, Massachusetts, USA
| | - J Kevin Nugent
- Division of Developmental Medicine, Boston Children's Hospital, Brazelton Institute, Boston, Massachusetts, USA
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Ahun MN, Ali NB, Hentschel E, Jeong J, Franchett E, Yousafzai AK. A meta-analytic review of the implementation characteristics in parenting interventions to promote early child development. Ann N Y Acad Sci 2024; 1533:99-144. [PMID: 38354095 DOI: 10.1111/nyas.15110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Abstract
This review summarizes the implementation characteristics of parenting interventions to promote early child development (ECD) outcomes from birth to 3 years. We included 134 articles representing 123 parenting trials (PROSPERO record CRD42022285998). Studies were conducted across high-income (62%) and low-and-middle-income (38%) countries. The most frequently used interventions were Reach Up and Learn, Nurse Family Partnership, and Head Start. Half of the interventions were delivered as home visits. The other half used mixed settings and modalities (27%), clinic visits (12%), and community-based group sessions (11%). Due to the lack of data, we were only able to test the moderating role of a few implementation characteristics in intervention impacts on parenting and cognitive outcomes (by country income level) in the meta-analysis. None of the implementation characteristics moderated intervention impacts on cognitive or parenting outcomes in low- and middle-income or high-income countries. There is a significant need in the field of parenting interventions for ECD to consistently collect and report data on key implementation characteristics. These data are needed to advance our understanding of how parenting interventions are implemented and how implementation factors impact outcomes to help inform the scale-up of effective interventions to improve child development.
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Affiliation(s)
- Marilyn N Ahun
- Department of Medicine, Faculty of Medicine and Health Sciences, McGill University, Montréal, Quebec, Canada
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Nazia Binte Ali
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Elizabeth Hentschel
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Yale Child Study Center, Yale School of Medicine, New Haven, Connecticut, USA
| | - Joshua Jeong
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Emily Franchett
- Department of Applied Psychology, New York University Steinhardt School of Culture, Education, and Human Development, New York, New York, USA
| | - Aisha K Yousafzai
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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Tazza C, Ioverno S, Pallini S. Home-visiting programs based on the Brazelton approach: a scoping review. Eur J Pediatr 2023; 182:3469-3479. [PMID: 37285070 PMCID: PMC10460298 DOI: 10.1007/s00431-023-05048-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 05/26/2023] [Accepted: 05/29/2023] [Indexed: 06/08/2023]
Abstract
This review maps and summarizes the quantitative studies on the main outcomes associated with home visiting (HV) programs using Brazelton methods aimed at supporting expectant and new parents. One hundred thirty-seven records were identified, and 19 records were selected. The design of our study was based on the methodological framework for conducting scoping reviews. Quality was assessed through the Jadad scale. Studies were coded for participant characteristics (number, mean age, and risk status), methodology (recruitment, home visit frequency, age of the child, Brazelton method, and research design), and intervention outcomes (on infants, parents, and home visitors). The studies mostly focused on the impact of Brazelton HV programs on infant development, the mother's psychological well-being, mother-infant interaction, and home visitor satisfaction. Experimental and quasi-experimental studies consistently have shown that parents receiving the intervention have greater knowledge of their children. Results are less conclusive regarding the intervention's impact on other domains of child development, mothers' psychological well-being, and mothers' sensitivity to the relationship with the child. Overall, the results suggest that the improvements associated with the intervention are mainly influenced by the risk status of families. Further research is needed to better understand the benefits of HV based on the Brazelton approach and the target population that may benefit most from this intervention. CONCLUSION Although the impact of the Brazelton home visiting intervention is not yet fully understood, there is promising evidence of its positive effects on child development, maternal well-being, and parental knowledge. Further research with consistent methodologies and larger sample sizes is needed to strengthen our understanding. However, existing findings in the literature underscore the importance of preventive interventions such as the Brazelton program in improving family well-being, with potential long-term benefits. WHAT IS KNOWN • Home visiting programs based on the Brazelton approach aim to increase parents' knowledge and sensitivity to their children. • There is no clear picture in the literature of the effectiveness of these programs. WHAT IS NEW • Existing studies consistently show the effectiveness of these programs to improve parents' knowledge of their children. • Findings on the impact of these programs on child development, mothers' psychological well-being and sensitivity to their child are inconclusive and may be influenced by the risk status.
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Affiliation(s)
- Cecilia Tazza
- Department of Education, Roma Tre University, Via del Castro Pretorio 20, Rome, 00185, Italy
| | - Salvatore Ioverno
- Department of Education, Roma Tre University, Via del Castro Pretorio 20, Rome, 00185, Italy.
| | - Susanna Pallini
- Department of Education, Roma Tre University, Via del Castro Pretorio 20, Rome, 00185, Italy
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Yago S, Takahashi Y, Tsukamoto E, Saito A, Saito E. Use of the Newborn Behavioral Observations System as an early intervention for infants and their parents: A scoping review. Early Hum Dev 2023; 183:105811. [PMID: 37385114 DOI: 10.1016/j.earlhumdev.2023.105811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 05/26/2023] [Accepted: 06/14/2023] [Indexed: 07/01/2023]
Abstract
BACKGROUND The Newborn Behavioral Observations (NBO) system is an infant-focused, family-centered, relationship-based tool designed to help parents become aware of their baby's abilities and to promote a positive parent-child relationship from the very beginning of birth. AIMS The aim of this scoping review was to provide an overview of the key characteristics of the research and evidence accumulated over the past 17 years on the early NBO intervention for infants and their parents to identify the existing research gaps and to inform the future direction of research on the NBO System. STUDY DESIGN A scoping review guided by Arksey and O'Malley's methodological framework and the PRISMA-ScR Checklist was conducted. This review used six databases (PubMed, CINAHL, MEDLINE, Google Scholar, Ichushi-Web, and CiNii) and was limited to English and Japanese language articles from January 2006, when the NBO was developed, to September 2022. Reference lists were also hand-searched to further identify relevant articles from the NBO site. RESULTS A total of 29 articles were selected. Through the analysis of included articles, four overarching themes were identified: (1) usage pattern of the NBO; (2) participants, setting, duration, and frequency of the NBO intervention; (3) outcome measures and effects of the NBO intervention; and (4) findings from a qualitative perspective. The review suggested that early NBO intervention had a positive impact on maternal mental health and sensitivity to the infant, confidence and knowledge of practitioners, and infant development. CONCLUSIONS This scoping review shows that the early NBO intervention has been implemented in a variety of cultures and settings and by professionals of various disciplines. However, research to evaluate the long-term effects of this intervention on a wider range of subjects is needed.
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Affiliation(s)
- Satoshi Yago
- Department of Child and Family Nursing, Graduate School of Health Care Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan.
| | - Yuki Takahashi
- Department of Integrated Health Sciences, Graduate School of Medicine, Nagoya University, 1-1-20 Daiko-Minami, Higashi, Nagoya, Aichi 461-8673, Japan
| | - Emi Tsukamoto
- Department of Nursing Science, Faculty of Health and Welfare Science, Okayama Prefectural University, 111 kuboki, Soja, Okayama 719-1197, Japan
| | - Asuka Saito
- Department of Nursing, Graduate School of Health Sciences, Gunma University, 3-39-22 Showa-machi, Maebashi, Gunma 371-8514, Japan
| | - Eiko Saito
- Graduate School of Nursing, International Health Care and Midwifery, Japanese Red Cross College of Nursing, 4-1-3 Hiroo, Shibuya, Tokyo 150-0012, Japan
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Neel ML. Parenting Style Interventions in Parents of Preterm and High-Risk Infants: Controversies, Cost, and Future Directions. Clin Perinatol 2023; 50:179-213. [PMID: 36868705 DOI: 10.1016/j.clp.2022.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
Abstract
This review highlights the current state of evidence on interventions whose primary purpose is to change parenting style in parents of preterm, and other-high risk, infants. To date, interventions for parents of preterm infants are heterogeneous with variability in intervention timing, measured outcomes, program components, and cost. Most interventions target parental responsivity/sensitivity. Most reported outcomes are short-term, measured at age less than 2 years. The few studies that report later child outcomes in prekindergarten/school-aged children are encouraging, overall indicating improved cognition and behavior in the children of parents who received a parenting style intervention.
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Affiliation(s)
- Mary Lauren Neel
- Division of Neonatology, Emory University School of Medicine, Children's Healthcare of Atlanta, 1405 Clifton Road Northeast, Atlanta, GA 30322, USA.
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Prime H, Andrews K, Markwell A, Gonzalez A, Janus M, Tricco AC, Bennett T, Atkinson L. Positive Parenting and Early Childhood Cognition: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Clin Child Fam Psychol Rev 2023; 26:362-400. [PMID: 36729307 PMCID: PMC10123053 DOI: 10.1007/s10567-022-00423-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2022] [Indexed: 02/03/2023]
Abstract
This review examines the effectiveness of positive parenting interventions aimed at improving sensitivity, responsiveness, and/or non-harsh discipline on children's early cognitive skills, in four meta-analyses addressing general mental abilities, language, executive functioning, and pre-academics. The objectives are to assess the magnitude of intervention effectiveness and identify moderators of effectiveness. We include randomized controlled trials of interventions targeting positive parenting to improve cognition in children < 6 years. Studies that include children with neurodevelopmental and/or hearing disorders were excluded. MEDLINE, PsycINFO, ERIC, and ProQuest Dissertations & Theses (October 2021) and citation chaining identified relevant records. Five reviewers completed screening/assessments, extraction, and risk of bias. Pooled analysis in Comprehensive Meta-Analysis (Version 3) used random effects modeling, with moderation via Q-statistics and meta-regression. Positive parenting interventions led to significant improvements in mental abilities (g = 0.46, N = 5746; k = 33) and language (g = 0.25, N = 6428; k = 30). Effect sizes were smaller and nonsignificant for executive functioning (g = 0.07, N = 3628; k = 14) and pre-academics (g = 0.16, N = 2365; k = 7). Robust moderators emerged for language and cognition. For cognition, studies with higher risk of bias scores yielded larger intervention effects. For language, studies with younger children had larger effect sizes. Studies mitigated selection and detection bias, though greater transparency of reporting is needed. Interventions that promote parental sensitivity, responsiveness, and non-harsh discipline improve early mental abilities and language. Studies examining executive functioning and pre-academics are needed to examine moderators of intervention effectiveness. Trial registration Systematic review PROSPERO registration. CRD42020222143.
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Affiliation(s)
- Heather Prime
- Department of Psychology, York University, Toronto, Canada. .,LaMarsh Centre for Child & Youth Research, York University, Toronto, Canada.
| | - Krysta Andrews
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Alexandra Markwell
- Department of Psychology, York University, Toronto, Canada.,LaMarsh Centre for Child & Youth Research, York University, Toronto, Canada
| | - Andrea Gonzalez
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Magdalena Janus
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Andrea C Tricco
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michaels Hospital, Unity Health Toronto, Toronto, Canada.,Epidemiology Division and Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Queen's Collaboration for Health Care Quality Joanna Briggs Institute Centre of Excellence, Queen's University, Kingston, Canada
| | - Teresa Bennett
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Leslie Atkinson
- Department of Psychology, Toronto Metropolitan University, Toronto, Canada
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Landsem IP, Cheetham NB. Infant sleep as a topic in healthcare guidance of parents, prenatally and the first 6 months after birth: a scoping review. BMC Health Serv Res 2022; 22:1135. [PMID: 36076290 PMCID: PMC9454198 DOI: 10.1186/s12913-022-08484-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 08/23/2022] [Indexed: 11/26/2022] Open
Abstract
Background This scoping review focuses on infant sleep-related factors and themes that are relevant when health practitioners provide preventive health services to expectant and new parents. Methods A systematic literature search in CINAHL, PubMed, and PsycINFO, published in 2010 or later, identified 1661 records. The search was further narrowed to focus on sleep in healthy term-born infants until the second half of the first year of life. A blinded review by both authors covered 136 papers, of which 43 papers were reviewed in the full text. Finally, 38 articles were included in the data extraction. Results The analysis process showed that the selected studies formed three main information categories: 11 studies thematised safe infant sleep issues, 10 studies described design and findings from sleep-related intervention studies, and 17 studies focused on different parent-child interactive aspects that may influence the quality and duration of infant sleep in the first six months of life. The main finding is that knowledge about early infant sleep is very complex, and includes both child, parent, and environmental factors. Several studies have shown that the concepts and factors related to safe infant sleep also influence the development of healthy infant sleep patterns. Thus, these aspects are interwoven with each other and should be addressed together in communication with parents. Conclusions Health practitioners with different professional backgrounds need to search for an agreement on when and how different aspects of sleep-related knowledge should be communicated to new and expectant parents to enable the design of national follow-up programs. Parents want coherent and personalized services regarding infant sleep issues that may allow them to choose sleeping arrangements, routines, and behaviors that fit in with their sociocultural attitudes and traditions. Many different sources and formats may be used to empower parents regarding infant sleep issues. Studies have described the use of group or individual meetings, videos, and written materials. The key issue is the importance of consistent and seamless knowledge-based services.
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Affiliation(s)
- Inger Pauline Landsem
- The Arctic University of Norway, The Health Research Faculty, Institute of Health and Caring Science, Hansine Hansens veg 18, 9019, Tromsø, Norway. .,Child and Adolescent Department, University Hospital of North Norway, Sykehusvegen 38, 9019, Tromsø, Norway.
| | - Nina Bøhle Cheetham
- The Arctic University of Norway, The Health Research Faculty, Institute of Health and Caring Science, Hansine Hansens veg 18, 9019, Tromsø, Norway
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Nicolson S, Carron S, Paul C. Supporting early infant relationships and reducing maternal distress with the Newborn Behavioral Observations: A randomized controlled effectiveness trial. Infant Ment Health J 2022; 43:455-473. [PMID: 35531961 PMCID: PMC9324818 DOI: 10.1002/imhj.21987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 01/27/2022] [Indexed: 11/29/2022]
Abstract
Research points to the significant impact of maternal distress on the parent‐infant relationship and infant development. The Newborn Behavioral Observations (NBO) is a brief intervention supporting the infant, the parent and their relationship. This randomized controlled trial examined the effectiveness of the NBO in a population with antenatal distress and risk of postnatal depression (PND). Pregnant, first‐time mothers with current anxiety or depression symptoms or past mental illness were recruited from two Australian hospitals. Participants received three NBO sessions in the first month of life plus treatment as usual (TAU), or, TAU‐only. Outcomes assessed at infant age 4 months included mother‐infant interaction quality; maternal anxiety and depression symptoms; and depression diagnosis. Of 111 pregnant individuals randomized, 90 remained eligible and 74 completed the trial (82.2% retention). There were intervention effects on emotional availability F(6, 67) = 2.52, p = .049, Cohen's d = .90, with higher sensitivity and non‐intrusiveness in the intervention group (n = 40) than the comparison group (n = 34). There was an intervention effect approaching significance for anxiety symptoms at 4 months (p = .06), and a significant effect over time (p = .014), but not for depression symptoms. Anxiety and depression symptoms significantly reduced to sub‐clinical levels within the intervention group only. There were fewer depression diagnoses (n = 6) than expected across groups, with no observed intervention effect. No adverse intervention effects were seen. Exploratory analysis of sensory processing sensitivity suggested differential susceptibility to distress and intervention benefits. The NBO was accepted and exerted meaningful effects on relationship quality and distress; and may enhance the infant's interaction experience and maternal emotional adjustment in at‐risk populations.
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Affiliation(s)
- Susan Nicolson
- Department of Psychiatry University of Melbourne Parkville Victoria Australia
- Department of General Practice University of Melbourne Parkville Victoria Australia
- Women's Mental Health Service Royal Women's Hospital Melbourne Victoria Australia
| | | | - Campbell Paul
- Department of Psychiatry University of Melbourne Parkville Victoria Australia
- Women's Mental Health Service Royal Women's Hospital Melbourne Victoria Australia
- Royal Children's Hospital Melbourne Victoria Australia
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