The effectiveness of the parent buddy program for mothers of very preterm, hospitalised infants: a cohort study with control group comparison

The main objective of this study was to evaluate the effectiveness of the parent buddy program, a social work intervention for mothers of very preterm infants hospitalised in a neonatal intensive care unit (NICU). This study was conducted to contribute to the knowledge base of effective social work practice using a quasi-experimental design, specifically a cohort study with control group comparison. Very preterm infants who are born at less than 30 weeks gestation usually have multiple medical problems related to their preterm birth and undergo intensive medical intervention in order to survive. Parents often experience very preterm birth and the environment of the NICU as stressful. This social work intervention, the parent buddy program, was specifically designed to help parents deal with this experience. In the parent buddy program, mothers who had given birth to an infant less than 30 weeks gestation and less than 1500 grams, were matched to individual peer support. The parent buddy program consisted principally of telephone support from a trained parent, experienced with preterm birth and the NICU. Mothers and support buddies were matched on similarity of language, ethnicity, characteristics of the infant such as similarities in medical problems, and geographical proximity where possible. Intervention mothers (n = 32) were recruited from Mount Sinai Hospital and control mothers (n = 28) were recruited from Sunnybrook and Women's College Health Sciences Centre. Primary outcome data consisted of self-reported, standardised measures of perceived parental stress, state anxiety and depression. Secondary measures included self-reported measures of perceived social support and trait anxiety. Intervention mothers completed additional questionnaires related to their perceptions of support from the buddy. Outcome data were analysed with Analysis of Covariance. One statistically significant difference at baseline, the number of days from giving birth to entry into the study, was included in the analyses as a covariate. The Parental Stress Scale: NICU was analysed with the Mann-Whitney U test. At pretest, there were no statistically significant differences in outcome measures. At four weeks post-test, intervention mothers reported less stress than control mothers (U = 28.5, p (less than) 0.001). At four months post-test, intervention mothers reported less state anxiety (F(1,47) = 3.87, p (less than) 0.05), less depression (F(1,47) = 10.40, p (less than) 0.01) and greater perceived social support (F(1,47) = 12.48, p (less than) 0.01) than control mothers. There was no difference between groups on the measure of trait anxiety, which indicates that the two groups were similar in their tendency to experience state anxiety in response to stressful events. This social work intervention was found to be effective for helping mothers of very preterm infants deal with the stressfulness of the situation. How this social support intervention may have exerted its effect (mechanism of action) is discussed from the intrapersonal, interpersonal and environmental theoretical perspectives. The implications for social work practice are that this social support intervention could potentially be expanded to other hospitals' NICUs, and perhaps to other spouses or family members dealing with stressful situations in other hospital settings, such as trauma units and pediatric intensive care units.