Smartphone app may increase discharge preparedness for parents of VLBW infants

A smartphone app specifically designed to support parents of very low birth weight (VLBW) premature infants as they transition home from the neonatal intensive care unit (NICU) may increase parenting self-efficacy and discharge preparedness, according to a pilot randomized controlled trial at Ann & Robert H. Lurie Children's Hospital of Chicago that was published in the journal Internet Interventions.

VLBW infants are born weighing less than 1500 grams, or just over three pounds. They comprise 18 percent of the premature births and have the longest average length of hospital stay, as well as highest rates of illness and re-hospitalization in the first year.

"Parents of these vulnerable preemies experience major stress and uncertainty as they get ready to care for their baby at home," says Craig Garfield, MD, first author on the study and Director of Research, Hospital Based Medicine at Lurie Children's and Associate Professor of Pediatrics and Medical Social Sciences at Northwestern University Feinberg School of Medicine. "We found that parents who used the app felt more prepared for discharge. With more use of the app, parents felt more competent and sure of themselves. In our study, the above average app users also saw the shortest overall hospital stay for their infants."

The app, called NICU-2-Home, was designed for this study based on Garfield's previous findings of the needs of parents with VLBW babies who had transitioned home. Features include a self-guiding hospital discharge checklist, multimedia educational information on NICU infant care, a tracker for daily activities and a mood tracker.

The four-week study, which occurred over the transition home, included 90 parents of VLBW infants who were randomized to receive the usual support or usual support plus the app intervention. Usual support involved NICU care handouts and nurse education. Parenting Sense of Competence Scale was used to assess parental self-efficacy at baseline, day after discharge and two weeks post-discharge.

"Our study offers scientific basis to the usefulness of mobile health technology to empower parents caring for the smallest infants," says Garfield. "This intervention holds promising potential."