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. 2025 Aug 1;25(4):401-410.
doi: 10.1097/ANC.0000000000001282. Epub 2025 Jul 30.

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

Marin Schmitt  1 , Kathleen F Norr, Rosemary White-Traut, Debra Brandon, Karen Gralton, Patricia Gillette, Christina Rigby-McCotter, Karen Kavanaugh
Affiliations

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

Marin Schmitt et al. Adv Neonatal Care. .

Abstract

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.

Keywords: behavioral intervention; communication; engagement; infant care; neonatal intensive care units; parent perspective; parent-infant relationship; parents; premature; qualitative.

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Conflict of interest statement

Competing Interests Statement: None of the authors have any competing interests to declare.

Figures

Figure 1:
Figure 1:. Qualitative Themes and Subthemes.
Three columns summarizing the themes and sub-themes found through analysis.
Figure 2.
Figure 2.
Description of H-HOPE.
See this image and copyright information in PMC

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