Project Details -

Ongoing

The experience of having an infant hospitalized in a neonatal intensive care unit (NICU) is extremely stressful for parents. Up to 70 percent of NICU parents experience clinically significant levels of anxiety, depression, and trauma symptoms. This contributes to impaired parental functioning, poor parent-infant attachment, and long-term infant development issues. As such, it is critical to identify and support at-risk parents. Universal mental health screening and ongoing assessment for all NICU parents is one recommended approach, but numerous barriers exist, such as a lack of infrastructure for such screening in many hospital settings, and competing demands on parents’ time that include not only participating in their infant’s care in the NICU, but also job demands and the care of their other children. Staff availability for screening is also limited.

This research will codesign and develop, evaluate, and test the efficacy of Empower NICU – A Bridge to Resources for Adjusting and Coping with Emotions (EmBRACE), a mobile health application (app) for NICU parents. EmBRACE will be used in the NICU to screen and monitor psychological symptoms in parents and connect them with hospital- and community-based services and support based on their risk level. The app would reduce the burden on busy staff of screening and allow parents to complete assessments at a time and place of their convenience. The app also provides relevant tools and resources on a range of topics, including navigating NICU hospitalization, stress management, and anxiety reduction.

The specific aims of the research are as follows:

Conduct formative research with NICU parents and healthcare providers (HCPs) to develop the EmBRACE prototype.
Evaluate the feasibility of EmBRACE.
Revise the EmBRACE platform based on feedback and findings.
Conduct a multisite pilot randomized controlled trial (RCT) to test EmBRACE’s efficacy.

The research will be completed in two phases. The first will be the codesign and development of a prototype of the app informed by input from parents and HCPs and an evaluation of its usability, acceptability, and clinical applicability with 20 current NICU parents. In the second phase, the EmBRACE platform will be revised based on information gleaned during phase 1, followed by a multisite RCT with 120 current NICU parents in NICUs across the United States, measuring the efficacy of EmBRACE compared to the state of current practice. The app will provide brief daily check-ins and weekly screening for ongoing monitoring. Tailored, short videos will be available via the app, providing psychoeducation opportunities with low time commitment from the parents. In addition, the app will facilitate referrals for those in need.

The availability of a mobile app will shift the current paradigm of virtually no consistent or standardized mental health screening for NICU parents to the provision of universal standardized screening that addresses current barriers. EmBRACE has the potential to reduce the current gap in mental health care for NICU parents, while assisting overburdened NICU HCPs and optimizing parent and infant outcomes.

Connecting NICU Parents with Mental Health Support via a Mobile App

Theme:

Engaging and Empowering Patients

Subtheme:

Technology Solutions to Engage Patients and Their Families in Care

A novel mobile application may improve NICU parents’ mental health by providing screening and connecting parents with customized referrals and resources.

Parental support is needed in the NICU

Parents of newborn babies who are in the neonatal intensive care unit (NICU) often experience chronic stress and trauma, which can have a detrimental impact on their mental health and their child’s development. NICU staff often do not have the time or resources to clinically screen parents for depression, anxiety, or trauma symptoms, leaving parents without mental health support. With a clinical psychology background in maternal and perinatal health, Dr. Pamela Geller wants to provide an accessible tailored mental health solution to families of babies in the NICU.

Families need resources at their fingertips

Dr. Geller, in partnership with clinical psychologists Dr. Chavis Patterson and Dr. Mona Elgohail, Tony Ma, cofounder of Benten Technologies, and their team of collaborators, will develop EmBRACE: Empower NICU—A Bridge to Resources for Adjusting and Coping with Emotions.

The mobile health (mHealth) application will be developed and tested for mental health screening and monitoring of all NICU parents. EmBRACE will connect parents with customized referral information, resources, and “microlearning” opportunities within the mHealth app. The application resources will be designed to improve health and safety outcomes for both parents and babies by providing a range of mental health support, including stress management skills, psychoeducation on bonding with their baby, and psychoeducation on effective patient–provider communication.

“We know that families don’t want to leave the bedside to go and get support. The app will have things that they can do while they’re sitting right there in the NICU, where there’s a lot of downtime—including education and resources where they can go and get help.” – Dr. Pamela Geller

EmBRACE application can support parents along the NICU journey

The EmBRACE application will improve mental health care for NICU parents by providing standardized universal screening, ongoing monitoring, access to tailored psychoeducation, and referrals, if needed. Additionally, EmBRACE promotes best practices in parental mental health care and offers relief for overburdened NICU staff by filling critical gaps in care for NICU parents who are in need of mental health services.