Innovative delivery of newborn anticipatory guidance: a randomized, controlled trial incorporating media-based learning into primary care

Abstract

Objective: Recent initiatives seek to incorporate efficient, evidence-based practices into primary care. This study tested the feasibility, impact, and acceptance of incorporating a DVD of newborn anticipatory guidance into routine well-child care.

Methods: This randomized trial tested a 15-minute educational DVD intervention versus control condition with paper handouts on newborn anticipatory guidance. We recruited parents of newborns ≤1 month old presenting for their first visit. Blinded research assistants conducted telephone follow-up 2 weeks later and medical chart reviews 2 months after enrollment. Clinic staff and providers completed semistructured surveys to rate the intervention. Primary outcomes included parent knowledge of infant development, self-efficacy with infant care skills, and problem-solving competence.

Results: We enrolled 137 subjects (response rate 82%). Scores on knowledge, self-efficacy, and problem solving were high at baseline for both groups and did not significantly change. More parents in the DVD group reported feeling prepared to care for their baby after the visit (94% vs 81%, P = .03), feeling high confidence bathing their baby (93% vs 78%, P = .01), and recognizing congestion (70% vs 52%, P = .03) compared to the control group. Those in the DVD group also had fewer additional office visits between birth and 2 months (P = .01). Staff and providers agreed the DVD was useful for patients (88%) and did not disrupt patient flow (93%).

Conclusions: A DVD of newborn anticipatory guidance was feasible, well accepted, and had a positive impact in a pediatric practice. Video and other technologies represent an efficient, innovative way to reach parents as part of the office encounter.

Trial registration: ClinicalTrials.gov NCT00820677.