An mHealth Intervention to Support Parenting Self-efficacy in the NICU from Admission to Home

Published:January 13, 2022DOI:


      To test whether parents of premature infants <37 weeks gestation provided with a unique smartphone app designed to support parents had greater parenting self-efficacy, a key element in parenting confidence, compared with controls.

      Study design

      Using a quasi-experimental, time-lagged study design, parents were assigned to either usual care (control) or NICU2HOME app (intervention) groups. Both groups completed the validated Parenting Sense of Competence scale (PSOC) at four time points (∼day of life 7, 1 day before discharge, and 14- and 30- days post-discharge) representing NICU, discharge and home contexts. App usage was described and categorized. Univariate group differences were assessed, and linear mixed effect regression models were used to assess treatment group effect on PSOC score across time, adjusted for covariates and controlling for overall family effect.


      298 parents were enrolled (123 control, 175 intervention) with 256 completing >=1 PSOC screening. The intervention group had sustained higher PSOC scores than those of the control group (estimate=4.3, p=0.0042) from first measurement onward with no significant change in PSOC score across time for either group. Average app usage was 15 taps per average day; average- and above-average users had significantly higher PSOC scores (estimate=5.16, p=0.0024; estimate=5.16, p=0.014) compared with controls or below-average users.


      Compared with controls, parents assigned to the NICU2HOME app reported higher parenting self-efficacy while in the NICU and this continued once discharged to home. Novel technologies such as point-of-care smartphone applications may hold promise for supporting parents in difficult and stressful situations.



      Neonatal Intensive Care Unit (NICU), Parental Sense of Competence (PSOC), Parenting Self-Efficacy (PSE), Randomized Control Trial (RCT), Very Low Birth Weight (VLBW), Length of Stay (LOS), Gestational Age (GA)
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