The BABY AMOR Project (PI: Lianne Woodward & Lise Johnson & Jessica Bartlett)
Preterm birth is a serious public health issue, with 1 in 10 infants born preterm in the U.S. alone. Three quarters of these infants are born late-preterm (LP), or between 34 0/7 and 36 6⁄7 weeks’ gestation. Mothers of LP infants are at increased risk for postpartum stress and depression, which may lead to serious difficulties in the mother-infant relationship, including lower levels of emotional connection, maternal insensitivity, and less optimal infant health care practices. Currently, research is lacking to address the specific needs of LP infants and their families. Further, data on the effectiveness of interventions for maternal stress and depression are scarce, and increased investments are needed in two-generation models that include both parents and children and that are culturally informed and accessible to vulnerable populations. The proposed project seeks to advance the fields of maternal and child health by addressing current gaps in knowledge about such interventions through rigorous study. Specifically, we will use a randomized controlled trial (RCT) design to test the impact of the Newborn Behavioral Observations-Family Wellness (NBO-FW) Intervention. The NBO-FW is a relatively low-cost, short-term, preventive intervention to promote the well-being of LP newborns and their mothers that can be integrated into multiple settings.
Participants will be 200 first-time mothers and their LP newborns (100 intervention dyads and 100 control dyads) at Brigham and Women’s Hospital, an urban teaching hospital of Harvard Medical School and largest maternity care provider in the Boston area. The NBO-FW intervention will take place over a 12-week period with data collected at three time points: Time 1, at the hospital in the newborn unit or NICU unit within a week of birth; Time 2, at the Center for Child Development (CCD; a clinic at the hospital) during the 4-6 follow-up medical visit; and Time 3 at CCD during a research visit 10-12 weeks after birth. The study will use standardized measures of maternal stress (Parenting Stress Index-Short Form; PSI-SF), maternal depression (Center for Epidemiological Studies Revised; CESD-R), and maternal parenting confidence (Karitane Parenting Confidence Scale; KPCS); medical records on maternal infant health care practices (safe sleep; breastfeeding; injury prevention; participation in well-child visits); and, videotaped and coded observations of mother-infant interactions (Parent-Child Early Relational Assessment; PCERA). We hypothesize that, compared to mothers in the control group, first-time mothers of LP infants who receive the NBO-FW will (a) have lower levels of stress and depression; (b) have more confidence in their parenting skills; (c) demonstrate more positive interactions with their infants (e.g., breastfeeding, use of safe sleep practices, participation in well-child visits, injury prevention); and (d) engage in better infant health care practices (i.e., breastfeeding, safe sleep practices, well-child visit participation, injury prevention). The focal outcomes of the project align with Health Resource and Services Administration/Maternal and Child Health Bureau goals, Healthy People 2020 objectives, Title V Maternal and Child Health Block Grant National Performance Domains, and U.S. Department of Health and Human Services clinical priorities.
BRAZELTON CENTER UK
Madeleine Cassidy’s report on the UK Forum:
It's 9:30pm on Friday night just after our Charity Forum Day and I am so excited that I had to write to you.
We had a lovely day and your welcome was just so perfect. Everyone loved your video, especially your comments that we were the jewel in the crown, that Berry would have been proud of us and how our have a unique offering gave something special to the world. Your inspiring poem was just so lovely and perfectly pitched.
We also played the film tribute to Dr Brazelton, which was accompanied by addresses from Susan, our Chair and Prof Lesley Page, our patron. The launch of our new strategy was well received - it centers on improving our reach, strengthening our operations, building up our charity's brand and improving our sustainability through diversifying our income base.
Our guest speaker was Jane Imperato of Flying Start Wales, who spoke about how NBO revolutionised their Home Visiting practice. It was incredibly powerful. And then Susana Nicolau ended the morning session by showing us examples of NBO in antenatal and postnatal services, which was very exciting. The morning session ended on a high, with everyone asking for the Forum Day to be an annual event.
In the afternoon it was a trainer-focused session and we concentrated entirely on NBO. Our talks and slides have been improved with our new branding, with updated references and beautiful photographs. Our Master Trainers, Susana, Susan Pawlby, Maggie and other trainers had all worked so hard on this and the trainers were very pleased and inspired that the changes you and they suggested last year had been implemented. To ensure they felt reassured and equipped to use the refreshed course, they were given all new training materials (workbook and games etc), in a branded bag.
I feel really confident that NBO and our charity will continue to go from strength to strength. My thanks to you for being so supportive to us all and to me in my first year. I am very grateful.
With kind regards, Madeleine