Conference Coverage

App found to improve quality of life for families of premature infants

 

Key clinical point: Parents generally embraced the idea of an app to provide education and engage them at the bedside of their premature infant.

Major finding: In all, 35 of the 44 families showed increased quality of life functionality, based on the PedsQL Family Impact Module (P = .001).

Study details: A two-center study of 44 families with premature infants intended to assess readiness for using mobile technologies at the bedside.

Disclosures: Funding for the study was provided by the Bucksbaum Institute for Clinical Excellence. Ms. Whitney was supported by a grant from the National Institute of Diabetes and Digestive and Kidney Diseases.


 

REPORTING FROM PAS 2018

– Significant improvement in quality of life was observed in neonatal ICU families using the PreeMe+You app, preliminary results from a two-center study showed.

“NICU time is stressful,” one of the study authors, Abigail Whitney, said at the Pediatric Academic Societies annual meeting. “With the birth of a preterm infant, parents are often quickly transitioned into the role of becoming a parent much sooner and in much different circumstances than they might have anticipated. Parents have reported feelings of isolation, alienation, and insecurity in the parental role while in the NICU. Studies have shown that interventions that engage parents in their infant’s progress can decrease parental stress and anxiety, increase positive parent-infant interaction, and even reduce the infant’s length of stay. Also, with advancing technology there has been a push to find ways to use mobile technology to help parents balance engaging with their infant with the rest of their busy lives.”

Newborn baby in incubator Metin Kiyak/Thinkstock

Newborn baby in incubator

One such technology, the PreeMe+You app, was created by a social benefit health startup of the same name to help parents follow the progress of their infant while in the NICU and to help them engage at the bedside, said Ms. Whitney, a second-year medical student at the University of Chicago. The app centers on a maturation framework using a proprietary neonatal algorithm that follows the baby’s medical progress in five different categories: breathing, sleeping, eating, temperature, and growth. It assigns the baby one of four colors in each of these categories based on the baby’s current medical state. Purple represents the highest acuity and the longest time to go in the NICU, while yellow represents the closest to discharge. “Babies may begin at different colors in each of the different categories, but the eventual progression is purple to blue to orange to yellow,” Ms. Whitney said. “The idea is, once you have a full yellow circle you’re almost ready to go home.”

In a study overseen by PreeMe+You’s chief medical expert, Bree Andrews, MD, MPH, Ms. Whitney and her associates administered the app to 48 families at either the University of Chicago Medicine Comer Children’s Hospital NICU or the Evanston Hospital NICU to assess readiness for using mobile technologies at the bedside. All families were recommended by a child life specialist who identified families who might be interested in using something like PreeMe+You. They excluded any families that were currently involved with child and family services, those with an infant younger than 7 days old, those whose child required escalation of care or upcoming surgeries, and those whose infant was over 37 weeks’ gestation.

First, the researchers briefed NICU staff about the study at charge nurse meetings, faculty meetings, and daily huddles for 2 weeks before first enrollment. “We did this knowing that parents might go to their nurses or doctors about how to answer specific questions within the app, or maybe want to learn more about a certain topic they learned from PreeMe+You,” Ms. Whitney said.

Data measurements included the PreeMe+You composite survey, which pulled questions from the Fragile Infant Parent Readiness Evaluation (FIPRE) and the NICU Parent Risk Evaluation and Engagement Model and Instrument (PREEMI). “We also included additional questions about technology use and capacity, as well as the PedsQL [Pediatric Quality of Life Inventory] Family Impact Module to assess parental quality of life throughout the study,” she said.

Abigail Whitney, University of Chicago, Pritzker School of Medicine

Abigail Whitney

At study enrollment, the researchers asked families to complete both the PreeMe+You composite survey and the PedsQL Family Impact Module. “They created a PreeMe+You login and we would help them engage with the app and tell them what it was all about,” Ms. Whitney explained. “Follow-up occurred about once a week or based on parent availability. At each follow-up, they would reengage with the PreeMe+You App if they hadn’t updated the questions recently. We also would readminister the PedQL Family Impact Module survey.” Study closure occurred either by parental choice or by upcoming discharge, at which time they would engage with PreeMe+You one last time, and repeat the PreeMe+You composite survey and the PedQL Family Impact Module survey.

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