Summary of best evidence on parental involvement in neonatal intensive care units: integrating family-centered and family-integrated care models

Glob Health Action. 2026 Dec;19(1):2653286. doi: 10.1080/16549716.2026.2653286. Epub 2026 May 5.

Abstract

Family-Centered Care (FCC) and Family-Integrated Care (FICare) are widely adopted models in Neonatal Intensive Care Units (NICUs), designed to foster parental involvement and support both neonatal and family outcomes. This review synthesizes and critically appraises the best available evidence on FCC and FICare interventions to inform their implementation, adaptation, and scale-up across diverse health systems and cultural contexts. Guided by the 6S evidence model, a top-down search identified relevant guidelines, best practices, evidence summaries, expert consensus statements, systematic reviews, and meta-analyses published up to 20 May 2025. Two reviewers independently performed study selection, methodological appraisal, and data extraction, with evidence graded using the Joanna Briggs Institute system. A total of 25 publications were included: three clinical guidelines, three best practice documents, four expert consensus statements, and fifteen systematic reviews and meta-analyses. Synthesis revealed seven key domains: core components of FCC/FICare models, implementation strategies, clinical outcomes, safety considerations, cultural adaptability, ethical considerations, and digital health applications. From these, 28 high-quality recommendations were formulated. Overall, FCC and FICare consistently improved neonatal outcomes and enhanced family well-being. Structured parent education, psychosocial support, environmental optimization, and interdisciplinary collaboration emerged as essential elements for effective implementation. Digital health tools may serve as valuable adjuncts but should complement rather than replace relational and presence-based care. Addressing cultural, ethical, and organizational barriers is critical to achieving equitable and sustainable integration. These findings reinforce FCC/FICare as a foundational model for advancing neonatal care globally.

Keywords: Parental involvement; best evidence; family-centered care; family-integrated care; neonatal intensive care units.

Plain language summary

Main findings: This review synthesizes high-level evidence on FCC and FICare in NICUs, highlighting seven key domains for effective implementation. Structured parental involvement consistently improves neonatal outcomes and parental competence and reduces psychological stress.Added knowledge: Integrating clinical guidelines, best practice documents, expert consensus statements, and systematic reviews/meta-analyses using the 6S model and the JBI grading framework, the review generates 28 actionable recommendations, offering a consolidated framework for effective, safe, and culturally adaptable FCC/FICare implementation.Global health impact for policy and action: The findings offer actionable guidance for policymakers and health system leaders to support the adaptation and scaling up of FCC/FICare across diverse health system and cultural contexts. These recommendations can inform workforce training, service design, and resource allocation, contributing to more equitable and family-centered neonatal care globally.

Publication types

  • Review

MeSH terms

  • Delivery of Health Care, Integrated* / organization & administration
  • Humans
  • Infant, Newborn
  • Intensive Care Units, Neonatal* / organization & administration
  • Parents* / psychology