Adaptation and Acceptability of a Digitally Delivered Intervention for Parents of Very Low Birth Weight Infants

Nurs Res. 2020 Sep/Oct;69(5S Suppl 1):S47-S56. doi: 10.1097/NNR.0000000000000445.


Background: Very low birth weight (VLBW) infants are at elevated risk for behavioral problems as early as the second year of life. The purpose of this feasibility study was to evaluate the adaptation and acceptability of an existing digitally delivered behavioral parent training program-the ezParent program, with the addition of weekly coaching calls-for parents of former VLBW infants in their second year of life.

Objectives: To assess the adaptation of ezParent for this population, we assessed parent access and use of ezParent and coaching calls, parent learning of strategies from ezParent, and changes in parenting practices or child behavior after using ezParent plus coaching calls. For acceptability, we assessed if parents viewed ezParent content as applicable to their experiences of parenting a former VLBW infant and how parents viewed coaching calls.

Methods: Ten parents of VLBW infants (20 months of age adjusted for prematurity) were recruited from a neonatal intensive care follow-up clinic. Parents completed the six modules of ezParent plus weekly coaching calls over 10-week intervention period. ezParent usage data were electronically uploaded to secure servers. Completion and timing of coaching calls were monitored using a tracking log. Parents completed child behavior and parenting belief and practice questionnaires pre- and postintervention. Calls were recorded and transcribed to assess for learning of parenting strategies, acceptability with the VLBW population, and acceptability of coaching calls.

Results: On average, parents completed 85% of the ezParent modules and 89% of the scheduled coaching calls, respectively. Parents spontaneously introduced 44% of the ezParent strategies during their coaching calls. Modest within-group effect sizes were detected for improvement in parenting self-efficacy and child externalizing behavior. Parents felt the ezParent content applied to their experiences parenting a preterm infant and had high satisfaction with coaching calls as a method of reinforcing program content and assessing knowledge and supporting accountability for program participation.

Discussion: ezParent with coaching calls is a feasible method of delivering behavioral parent training to parents of former VLBW infants in their second year of life. Coaching calls have high potential to be a low-cost, time-efficient component of digitally delivered programs that would allow for rapid integration into clinical practice.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cohort Studies
  • Feasibility Studies
  • Female
  • Health Promotion / methods
  • Health Promotion / standards
  • Health Promotion / statistics & numerical data
  • Humans
  • Infant
  • Infant, Newborn
  • Infant, Very Low Birth Weight / growth & development*
  • Male
  • Mentoring / methods*
  • Mentoring / statistics & numerical data
  • Mobile Applications / standards*
  • Mobile Applications / statistics & numerical data
  • Parents / psychology*
  • Self Report
  • Surveys and Questionnaires