Parents' Experiences With an Early Behavioral Intervention, H-HOPE, in the NICU and at Home: A Qualitative Study.

Background: Early parent involvement in an infant's neonatal intensive care unit (NICU) stay has positive benefits for the parent, the preterm infant, and the parent-infant relationship. H-HOPE (Hospital to Home: Optimizing the Preterm Infant's Environment) is an early behavioral intervention that provides an innovative developmental approach and contributes to parents' opportunity to provide care for their infant in the NICU.

Purpose: To explore parents' experience with H-HOPE.

Methods: This qualitative study consists of one-on-one interviews with parents as part of a larger study investigating H-HOPE's implementation and effectiveness. Data from 38 parents encompassing 54 interviews are included in this analysis.

Results: Parents report experiencing many benefits from participating in H-HOPE, including an increase in confidence, understanding of infant cues, promotion of bonding, infant benefits, and improvement in relationships with staff. Facilitators to participation include teaching and support in the NICU, being able to be present regularly, family support, and positive infant responses. Barriers to participating in the NICU were infant condition and readiness, family and economic limitations, lack of parent training or readiness, and nurse availability and communication. A lack of time and infant readiness were barriers at home.

Implications for practice and research: Our findings highlight the importance of early behavioral interventions like H-HOPE that support parent-partnered care, which promotes parents' participation in their infants' care. NICU nurses play a critical role in facilitating parent participation and confidence. Future research should examine policies and programs to help enhance NICU nurses' readiness and ability to engage with and support parents.