Supporting parents of premature infants transitioning from the NICU to home: A pilot randomized control trial of a smartphone application

• Parents of premature infants experience stress when transitioning home from the Neonatal Intensive Care Unit (NICU).
• This randomized study tested the ability of NICU-2-Home, a smartphone app, to support parent self-efficacy during this time.
• NICU-2-Home parents had increased parenting self-efficacy and improved discharge preparedness compared to controls.
• A smartphone application may provide support to parents of vulnerable premature infants as they leave the NICU.

ObjectiveTo determine whether parents of Very Low Birth Weight (VLBW) infants in the Neonatal Intensive Care Unit (NICU) transitioning home with the NICU-2-Home smartphone application have greater parenting self-efficacy, are better prepared for discharge and have shorter length of stay (LOS) than control parents.MethodsA four-week pilot randomized controlled trial during the transition home with 90 VLBW parents randomized to usual care (n = 44) or usual care plus NICU-2-Home (n = 46), a smartphone application designed for VLBW parents. Parenting Sense of Competence Scale (PSOC) was assessed at baseline, day after discharge, and two weeks post-discharge. Preparedness for discharge and length of stay (LOS) were secondary outcomes. Analyses by usage were also included.ResultsWhile parents of VLBW infants in the intervention group did not show an improvement in PSOC during the transition when compared directly to controls, after accounting for actual mean app usage, PSOC improved 7% (2.71 points/time greater; 95% CI = 1.45, 6.27) for intervention versus controls. Compared to controls, above-average users increased their PSOC score by 14% (6.84 points/time; 95% CL = 5.02, 8.67), average users by 11% (4.58 points/time; 95% CL = 2.89, 6.27) and below-average users by 6% (2.41 points/time; 95% CL = 0.04, 4.79). Moderate evidence showed LOS was shorter for above-average users compared to the control group (β = 12.2. SE = 6.9, p = 0.085).ConclusionA smartphone application used by parents of VLBW infants during the transition home from the NICU can improve parenting self-efficacy, discharge preparedness, and LOS with improved benefits based on usage.