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Erdei C, Sunwoo J, Corriveau GC, Forde M, El-Dib M, Inder T. Effect of music-based interventions on physiologic stability of hospitalized preterm infants. A pilot study. J Perinatol 2024; 44:665-670. [PMID: 38418527 DOI: 10.1038/s41372-024-01907-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 02/06/2024] [Accepted: 02/12/2024] [Indexed: 03/01/2024]
Abstract
BACKGROUND AND OBJECTIVE Hospitalized preterm infants experience reduced meaningful auditory exposures during a critical period of brain development. Music-based interventions (MBI) may be beneficial, though it remains unclear which stimuli optimally enhance infant stabilization. We investigated the relationship between three conceptually-different MBIs and short-term responses in hospitalized preterm infants. STUDY DESIGN This is a case-crossover pilot study including 21 preterm infants between 30 and 35 weeks postmenstrual age. Participants listened to three MBIs and 'no music'; each condition was provided three times in random order. We monitored physiologic and behavioral parameters around each exposure and analyzed results using linear mixed models. RESULTS Respiratory rates decreased after each MBI compared with 'no music' (p = 0.02). The most notable decrease occurred following exposure to a low, repetitive musical pattern resembling a lullaby (p = 0.01). We noted no significant changes for the remaining parameters. CONCLUSION Specific MBI characteristics may preferentially enhance physiologic stabilization in hospitalized preterm infants.
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Affiliation(s)
- Carmina Erdei
- Division of Newborn Medicine, Department of Pediatrics, Brigham and Women's Hospital, 75 Francis St, Boston, MA, USA.
- Harvard Medical School, Pediatrics, 25 Shattuck St, Boston, MA, USA.
| | - John Sunwoo
- Harvard Medical School, Pediatrics, 25 Shattuck St, Boston, MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 149 13th St, Charlestown, MA, USA
| | - Gabriel Cote Corriveau
- Division of Newborn Medicine, Department of Pediatrics, Brigham and Women's Hospital, 75 Francis St, Boston, MA, USA
| | - Madison Forde
- Division of Newborn Medicine, Department of Pediatrics, Brigham and Women's Hospital, 75 Francis St, Boston, MA, USA
| | - Mohamed El-Dib
- Division of Newborn Medicine, Department of Pediatrics, Brigham and Women's Hospital, 75 Francis St, Boston, MA, USA
- Harvard Medical School, Pediatrics, 25 Shattuck St, Boston, MA, USA
| | - Terrie Inder
- Division of Newborn Medicine, Department of Pediatrics, Brigham and Women's Hospital, 75 Francis St, Boston, MA, USA
- Harvard Medical School, Pediatrics, 25 Shattuck St, Boston, MA, USA
- Division of Neonatology, Children's Hospital of Orange County and University of California Irvine, 1001, Health Sciences Rd, Irvine, CA, USA
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Sharman KM, Meissel K, Tait JE, Rudd G, Henderson AME. The effects of live parental infant-directed singing on infants, parents, and the parent-infant dyad: A systematic review of the literature. Infant Behav Dev 2023; 72:101859. [PMID: 37343492 DOI: 10.1016/j.infbeh.2023.101859] [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] [Received: 05/13/2022] [Revised: 05/29/2023] [Accepted: 06/14/2023] [Indexed: 06/23/2023]
Abstract
Singing to infants is widely accepted as an enjoyable, positive, and beneficial interaction between the parent and infant across cultures. Whilst the literature suggests that live infant-directed singing impacts the infant, the parent doing the singing and the dyad in powerful ways, no systematic review of the evidence has yet been conducted. To this end, this systematic review identified 21 studies that investigated the effect of live parental infant-directed singing. These impacts were categorized as either being directly related to the infant, the parent, or the parent-infant dyad. Three main themes - one for each of the impact categories considered - were identified using thematic analysis techniques; infant-directed singing impacts on: infants' emotional regulation, provides validation of the parent's role, and promotes affect attunement within the dyad. The findings reinforce the benefits of live parental infant-directed singing for all parties involved, particularly when parents sing to typically developing infants born at full term. In contrast, the findings were inconsistent for pre-term infants. The implications of these findings are discussed.
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Affiliation(s)
- Kirsten M Sharman
- School of Learning, Development and Professional Practice, Faculty of Education and Social Work, The University of Auckland, New Zealand
| | - Kane Meissel
- School of Learning, Development and Professional Practice, Faculty of Education and Social Work, The University of Auckland, New Zealand.
| | - Josie E Tait
- School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland, New Zealand
| | - Georgia Rudd
- School of Learning, Development and Professional Practice, Faculty of Education and Social Work, The University of Auckland, New Zealand
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Shin HJ, Park J, Oh HK, Kim N. Comparison of Effects of Mothers' and Mozart's Lullabies on Physiological Responses, Feeding Volume, and Body Weight of Premature Infants in NICU. Front Public Health 2022; 10:870740. [PMID: 35707055 PMCID: PMC9189372 DOI: 10.3389/fpubh.2022.870740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 05/04/2022] [Indexed: 12/02/2022] Open
Abstract
Objectives The purpose of this study was to compare the effects of mothers' and Mozart's lullabies on physiological parameters, feeding volume, and body weight of premature infants in a neonatal intensive care unit (NICU). Methods This study used a non-equivalent control group, non-synchronized design as a quasi-experimental study. Two intervention groups (recorded mother's lullaby and Mozart's lullaby) and a control group were formed from a total of 65 premature infants: a mother's lullaby group of 22 infants, a Mozart's lullaby group of 22 infants, and a control group of 21 infants not provided with any lullabies. Their physiological parameters included heart rate, blood pressure, respiratory rate, and O2 saturation. The infants' feeding volume and body weight were measured as indicators related to the growth of premature infants. The mother's and Mozart's lullabies were played on a speaker in an incubator for 15 min for 7 consecutive days per group. Results There were significant differences in the mean difference before and after intervention in neonatal heart rate (χ2 = 45.03, P < 0.001), systolic pressure (F = 43.29, P < 0.001), diastolic pressure (χ2 = 33.01, P < 0.001), respiratory rate (F = 76.06, P < 0.001), and O2 saturation (χ2 = 40.82, P < 0.001) between the three groups. The mean differences of both mother's and Mozart's lullaby groups were significantly higher than those of the routine care group in all physiological parameters, and those of the mother's lullaby group was significantly higher when compared with the Mozart's lullaby group. In repeated-measures ANOVA, there was a significant interaction between time and group in feeding volume (F = 2.46, P = 0.041). However, body weight did not significantly differ in an interaction between time and group (F = 1.75, P = 0.151). Conclusion This study showed beneficial effects of mother's lullaby and Mozart's lullaby on physiological parameters. Especially, the mother's lullaby was found to significantly improve all physiological parameters and feeding volume of premature infants in the NICU compared to Mozart's lullaby group. Therefore, we recommend the regular integration of the mother's lullaby into supportive care of premature infants in the NICU, as this intervention highlights the need for mothers to participate in their care. Trial Registration ClinicalTrials.gov, identifier: KCT0004842 (https://cris.nih.go.kr).
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Affiliation(s)
- Hyo-Jin Shin
- College of Nursing, Keimyung University, Daegu, South Korea
| | - Jooyeon Park
- Department of Nursing, Daegu University, Daegu, South Korea
| | - Hye-Kyung Oh
- Department of Nursing, Daegu University, Daegu, South Korea
| | - Nahyun Kim
- College of Nursing, Keimyung University, Daegu, South Korea
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Hinesley J, Cunningham S, Charles R, Olsen K, Masho S, Kornstein S. The Lullaby Project: A Musical Intervention for Pregnant Women. WOMEN'S HEALTH REPORTS 2020; 1:543-549. [PMID: 33786520 PMCID: PMC7785064 DOI: 10.1089/whr.2020.0084] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 10/21/2020] [Indexed: 11/19/2022]
Abstract
Background: This pilot study investigated the impact of a musical intervention on maternal/fetal attachment, psychiatric symptoms, and perceived stress in two centers. Materials and Methods: Forty-four pregnant women participated from the Virginia Commonwealth University in Richmond, VA, and Jacobi Medical Center in Bronx, NY. Participants were assigned to a lullaby intervention or control group. The Maternal Fetal Attachment Scale, Perceived Stress Scale (PSS), and Symptom Checklist (SCL-27) were completed at baseline and follow-up. Results: Although no significant differences were found in maternal/fetal attachment between control and intervention groups, there were within-group differences in both groups from baseline to follow-up. No statistically significant differences in change from baseline occurred on the SCL-27 and PSS. Conclusions: Exposure to a lullaby intervention was not statistically associated with maternal/fetal attachment, mental health, and perceived stress in this pilot study. Future studies with larger samples and different outcomes are suggested.
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Affiliation(s)
- Jennifer Hinesley
- Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Sarah Cunningham
- Office of Research and Strategic Partnerships, Rhode Island School of Design, Providence, Rhode Island, USA
| | - Rashel Charles
- Institute for Women's Health, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Kirsten Olsen
- Department of Obstetrics and Gynecology, and Virginia Commonwealth University, Richmond, Virginia, USA
| | - Saba Masho
- Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Susan Kornstein
- Institute for Women's Health, Virginia Commonwealth University, Richmond, Virginia, USA.,Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia, USA
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Williamson S, McGrath JM. Neonatal Nurses' Self-reported Practices, Knowledge, and Attitudes Toward Use of Maternal Voice for Preterm Infants. Adv Neonatal Care 2020; 20:415-422. [PMID: 32868592 DOI: 10.1097/anc.0000000000000715] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND/SIGNIFICANCE Infants born extremely premature (<1500 g) often experience lengthy stays in the challenging environment of the neonatal intensive care unit (NICU) separated from their parents. PURPOSE The purpose of this study was to explore nurses' knowledge, attitude, and use of maternal voice as a therapeutic intervention for preterm infants in the NICU. METHODS Neonatal nurses (n = 117) completed an online survey about the use of maternal voice in their individual units. Questions included: (1) previous knowledge surrounding use of maternal voice in the NICU; (2) their attitudes about using maternal voice recordings and/or live maternal speech as an intervention; (3) whether their unit had the necessary equipment and environment conducive to using the therapy; (4) average amount of time parents were in the NICU with their neonate; and (5) in what situations they would personally encourage the use of maternal recordings (during procedures, rounds, etc). RESULTS Of those responding, 73.3% of nurse (n = 117) respondents agreed they were willing to incorporate maternal recordings into caregiving, with 80.8% indicating they were open to learning and employing different therapies to improve parental involvement in infant care. IMPLICATIONS FOR PRACTICE When the appropriate equipment is available, neonatal nurses are interested and willing to use alternative therapies that incorporate parental participation into direct caregiving as well as utilizing maternal voice recordings. IMPLICATIONS FOR RESEARCH Further research with larger, more diverse samples is needed to determine the current knowledge, attitudes, and practices of maternal voice recordings by NICU nurses. Future research can also focus on barriers to utilization of the therapy during daily care.
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Affiliation(s)
- Selena Williamson
- School of Nursing, University of Connecticut, Storrs, and Hartford Hospital, Connecticut (Ms Williamson); and School of Nursing, University of Texas Health Science Center at San Antonio (Dr McGrath)
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Abstract
BACKGROUND/SIGNIFICANCE Premature infants often experience extended stays in the neonatal intensive care unit (NICU) as opposed to home with parents. This prolonged separation creates a strain for both parents and infants, decreasing attachment and parental caregiving. One strategy to combat this shared stress is increasing parental participation, particularly through the use of their voices whether parents are present or not. PURPOSE This Evidence-Based Practice Brief column explores the connection between mother and child, specifically the effects of maternal voice on infant autonomic stability, weight gain, and behavioral states. METHODS A systematic search of CINAHL, PubMed, and PsycInfo was used to identify studies involving the use of maternal voice intervention with preterm infants in the NICU. RESULTS Fifteen studies were identified. Three intervention categories emerged: (1) live maternal speech, (2) recorded maternal speech (subcategories included whether intervention content was prescribed or not), and (3) recorded maternal speech that was combined with biological maternal sounds (heart rate). Within each category, studies were organized chronologically to reflect how knowledge has changed overtime. IMPLICATIONS FOR PRACTICE Maternal voice has physiological as well as behavioral and emotional effect on preterm infants. Several studies found that maternal voice increased autonomic stability improving (heart rate and respirations) as well as weight gain. No negative effects were identified. Given these findings, incorporating different types of maternal voice into routine care by the bedside nurse can assist the mother in feeling more involved in her infant's care without seemingly being a distraction or obstacle to providers. IMPLICATIONS FOR RESEARCH A major limitation for generalizability was sample size; more research is needed with larger sample sizes replicating interventions types to discern best outcomes.Video Abstract available at https://journals.lww.com/advancesinneonatalcare/Pages/videogallery.aspx?videoId=31&autoPlay=true.
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Effect of Unimodal and Multimodal Sensorimotor Interventions on Oral Feeding Outcomes in Preterm Infants: An Evidence-Based Systematic Review. Adv Neonatal Care 2019; 19:E3-E20. [PMID: 30339552 DOI: 10.1097/anc.0000000000000546] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Preterm infants often experience difficulty with the transition from tube to oral feeding. While many unimodal and multimodal sensorimotor interventions have been generated to optimize oral feeding skills, there has been little cohesion between interventions. PURPOSE The aims of this systematic review were to examine the effect of sensorimotor interventions on oral feeding outcomes and to determine whether multimodal interventions lead to better oral feeding performances than unimodal interventions. SEARCH STRATEGY A systematic search of CINAHL, Embase, MEDLINE, and PsycINFO databases was conducted. Studies were reviewed to assess the types of interventions used to improve transition to full oral feeding, volume intake, weight gain, and length of hospital stay. RESULTS The search identified 35 articles. Twenty-six studies examined a unimodal intervention, with the majority focusing on oral sensorimotor input and the others on tactile, auditory, and olfactory input. Nine studies assessed multimodal interventions, with the combination of tactile and kinesthetic stimulation being most common. Results varied across studies due to large differences in methodology, and caution is warranted when interpreting results across studies. The heterogeneity in the studies made it difficult to make any firm conclusions about the effects of sensorimotor interventions on feeding outcomes. Overall, evidence on whether multimodal approaches can lead to better oral feeding outcomes than a unimodal approach was insufficient. IMPLICATIONS FOR PRACTICE The use of sensorimotor interventions to optimize feeding outcomes in preterm infants varies based on methods used and modalities. These factors warrant caution by clinicians who use sensorimotor interventions in the neonatal intensive care unit. IMPLICATIONS FOR RESEARCH Large randomized clinical trials using a standardized approach for the administration of sensorimotor input are needed to further establish the effects on feeding outcomes in preterm infants.
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Palazzi A, Nunes CC, Piccinini CA. Music therapy and musical stimulation in the context of prematurity: A narrative literature review from 2010-2015. J Clin Nurs 2017; 27:e1-e20. [DOI: 10.1111/jocn.13893] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Ambra Palazzi
- Federal University of Rio Grande do Sul - Psychology Institute; Porto Alegre Brazil
| | - Camila Canani Nunes
- Federal University of Rio Grande do Sul - Psychology Institute; Porto Alegre Brazil
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Filippa M, Panza C, Ferrari F, Frassoldati R, Kuhn P, Balduzzi S, D'Amico R. Systematic review of maternal voice interventions demonstrates increased stability in preterm infants. Acta Paediatr 2017; 106:1220-1229. [PMID: 28378337 DOI: 10.1111/apa.13832] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 01/19/2017] [Accepted: 03/07/2017] [Indexed: 12/16/2022]
Abstract
We systematically reviewed how effectively maternal voice interventions supported the clinical outcomes and development of preterm infants. A total of 512 preterm infants were included in 15 studies with different designs, from January 2000 to July 2015. Live and recorded maternal voice interventions were associated with the physiologic and behavioural stabilisation of preterm infants, with fewer cardiorespiratory events, but the evidence was insufficient to evaluate the long-term effects. Well-defined determinants and clear setting conditions are needed for such interventions. CONCLUSION Further research that investigates the long-term efficacy and effects of live maternal voices on preterm infant development is needed.
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Affiliation(s)
- Manuela Filippa
- Department of Neonatology and Intensive Neonatal Care University; University of Modena and Reggio Emilia; Modena Italy
| | | | - Fabrizio Ferrari
- Department of Neonatology and Intensive Neonatal Care University; University of Modena and Reggio Emilia; Modena Italy
| | - Rossella Frassoldati
- Department of Neonatology and Intensive Neonatal Care University; University of Modena and Reggio Emilia; Modena Italy
| | - Pierre Kuhn
- Médecine et Réanimation du Nouveau-né Hôpital de Hautepierre; CHU Strasbourg France
| | - Sara Balduzzi
- Department of Diagnostics; Clinical and Public Health Medicine; University of Modena and Reggio Emilia; Modena Italy
| | - Roberto D'Amico
- Department of Diagnostics; Clinical and Public Health Medicine; University of Modena and Reggio Emilia; Modena Italy
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Ettenberger M, Rojas Cárdenas C, Parker M, Odell-Miller H. Family-centred music therapy with preterm infants and their parents in the Neonatal Intensive Care Unit (NICU) in Colombia – A mixed-methods study. NORDIC JOURNAL OF MUSIC THERAPY 2016. [DOI: 10.1080/08098131.2016.1205650] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Shoemark H, Arnup S. A survey of how mothers think about and use voice with their hospitalized newborn infant. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/j.jnn.2013.09.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Chorna OD, Slaughter JC, Wang L, Stark AR, Maitre NL. A pacifier-activated music player with mother's voice improves oral feeding in preterm infants. Pediatrics 2014; 133:462-8. [PMID: 24534413 PMCID: PMC3934339 DOI: 10.1542/peds.2013-2547] [Citation(s) in RCA: 86] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES We conducted a randomized trial to test the hypothesis that mother's voice played through a pacifier-activated music player (PAM) during nonnutritive sucking would improve the development of sucking ability and promote more effective oral feeding in preterm infants. METHODS Preterm infants between 34 0/7 and 35 6/7 weeks' postmenstrual age, including those with brain injury, who were taking at least half their feedings enterally and less than half orally, were randomly assigned to receive 5 daily 15-minute sessions of either PAM with mother's recorded voice or no PAM, along with routine nonnutritive sucking and maternal care in both groups. Assignment was masked to the clinical team. RESULTS Ninety-four infants (46 and 48 in the PAM intervention and control groups, respectively) completed the study. The intervention group had significantly increased oral feeding rate (2.0 vs. 0.9 mL/min, P < .001), oral volume intake (91.1 vs. 48.1 mL/kg/d, P = .001), oral feeds/day (6.5 vs. 4.0, P < .001), and faster time-to-full oral feedings (31 vs. 38 d, P = .04) compared with controls. Weight gain and cortisol levels during the 5-day protocol were not different between groups. Average hospital stays were 20% shorter in the PAM group, but the difference was not significant (P = .07). CONCLUSIONS A PAM using mother's voice improves oral feeding skills in preterm infants without adverse effects on hormonal stress or growth.
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Affiliation(s)
| | | | - Lulu Wang
- Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Ann R. Stark
- Division of Neonatology, Department of Pediatrics, and
| | - Nathalie L. Maitre
- Division of Neonatology, Department of Pediatrics, and,Department of Physical Medicine and Rehabilitation, Vanderbilt University, Nashville, Tennessee; and
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Park JS, Hong KJ, Bang KS. Effects of the 'Intervention - Mother's Song' on Physical Response and Behavioral State of Low-Birth Weight Infants in a Neonatal Intensive Care Unit. CHILD HEALTH NURSING RESEARCH 2013. [DOI: 10.4094/chnr.2013.19.3.198] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Ji-Sun Park
- College of Nursing, Seoul National University, Seoul, Korea
| | - Kyung-Ja Hong
- College of Nursing, Seoul National University, Seoul, Korea
| | - Kyung-Sook Bang
- College of Nursing & The Research Institute of Nursing Science, Seoul National University, Seoul, Korea
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Haslbeck FB. Music therapy for premature infants and their parents: an integrative review. NORDIC JOURNAL OF MUSIC THERAPY 2012. [DOI: 10.1080/08098131.2011.648653] [Citation(s) in RCA: 240] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Abstract
PURPOSE To provide an overview of developmental and medical benefits of music therapy for preterm infants. DESIGN Meta-analysis. SAMPLE Empirical music studies with preterm infants in the neonatal intensive care unit (NICU). MAIN OUTCOME Evidence-based NICU music therapy (NICU -MT ) was highly beneficial with an overall large significant effect size (Cohen's d = 0.82). Effects because of music were consistently in a positive direction. RESULTS Results of the current analysis replicated findings of a prior meta-analysis and included extended use of music.(1) Benefits were greatest for live music therapy (MT ) and for use early in the infant's NICU stay (birth weight <1,000 g, birth postmenstrual age <28 weeks). Results justify strong consideration for the inclusion of the following evidence-based NICU -MT protocols in best practice standards for NICU treatment of preterm infants: music listening for pacification, music reinforcement of sucking, and music pacification as the basis for multilayered, multimodal stimulation.
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Affiliation(s)
- Jayne Standley
- College of Music, The Florida State University, Tallahassee, 32306-1180, USA.
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Carolan M, Barry M, Gamble M, Turner K, Mascareñas Ó. The Limerick Lullaby project: An intervention to relieve prenatal stress. Midwifery 2012; 28:173-80. [DOI: 10.1016/j.midw.2010.12.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2010] [Revised: 12/04/2010] [Accepted: 12/22/2010] [Indexed: 12/15/2022]
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Abstract
This paper describes evidence-based kernels, fundamental units of behavioral influence that appear to underlie effective prevention and treatment for children, adults, and families. A kernel is a behavior-influence procedure shown through experimental analysis to affect a specific behavior and that is indivisible in the sense that removing any of its components would render it inert. Existing evidence shows that a variety of kernels can influence behavior in context, and some evidence suggests that frequent use or sufficient use of some kernels may produce longer lasting behavioral shifts. The analysis of kernels could contribute to an empirically based theory of behavioral influence, augment existing prevention or treatment efforts, facilitate the dissemination of effective prevention and treatment practices, clarify the active ingredients in existing interventions, and contribute to efficiently developing interventions that are more effective. Kernels involve one or more of the following mechanisms of behavior influence: reinforcement, altering antecedents, changing verbal relational responding, or changing physiological states directly. The paper describes 52 of these kernels, and details practical, theoretical, and research implications, including calling for a national database of kernels that influence human behavior.
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