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- Baraldi, Erika, 1982-, et al.
(författare)
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Clinical Protocol & Research Process of Stockholm Preterm Interaction-Based Intervention, SPIBI
- 2019
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Ingår i: Pediatric Research. - : Springer Science and Business Media LLC. - 0031-3998 .- 1530-0447. ; 86:Suppl., s. 54-55
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundExtremely preterm (EPT) born children are at increased risk of cognitive and neurodevelopmental impairment, neuropsychiatric disorders and academic difficulties. Parents of EPT born children are extra vulnerable for anxiety, posttraumatic stress disorder and depression and the parent-child interaction is negatively affected by prematurity. There is some evidence that early interventions have beneficial effects on neurocognitive and motor outcomes (Spittle A et al 2015). Based on a previous intervention (Verkerk G et al 2012) and adjusted to the Swedish context with 480 days paid parental leave, we created a post–discharge intervention, SPIBI, for families of EPT born children.MethodThe aim of (SPIBI) is to improve the quality of the parent-child interaction, child development and parental mental health in families with EPT born children. . SPIBI is a randomized controlled beginning at discharge and lasting until the child is 12 months corrected age. The trial design is a two arm randomized trial with four recruiting sites in Stockholm. Intervention group (target, n=65) receives 10 visits and two telephone calls from a trained interventionist and the control group (target n=65) receives treatment as usual plus an extended follow-up program. The SPIBI-team has recruited and trained 6 multi-professional and NICU-experienced interventionists. The training takes one year (0.2 of full time) and the content was both theoretical and practical, including pilot-cases. ResultSPIBI is an ongoing research project, beginning the 1st of September 2018 and planning to end recruitment the 31st of August 2020 and finishing the home-visits in August 2021. By the end of April 2019, 33 eligible infants had been identified within the four neonatal units in Stockholm; of which 26 children approved and 7 children declined participation. At this stage, three children have dropped out of the study, because of severe social challenges and child death. Identified challenges have been social and medical vulnerability of the EPT-families, finding the optimal multi-professional balance of motoric, psychological, pedagogical and medical kernels of the intervention, ethical considerations when to ask families for participation, lack of long-term discharge-planning of the neonatal units and large geographical spread of NICUs as well as families.ConclusionIn conclusion, the protocol seem to be feasible and appreciated by parents in the target group. With regard to the small recruitment base, trials of this kind needs a long inclusion time. Since EPT-children and their parents displays a wide scope of difficulties and challenges, multi-professional cooperation is preferable, placing high demands of sensitivity, professional respect and time for long collaborative processes.
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| 2. |
- Baraldi, Erika, 1982-, et al.
(författare)
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Insights Gained from Stockholm Preterm Interaction-Based Intervention - A Critical View
- 2022
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Konferensbidrag (refereegranskat)abstract
- SPIBI is a strength-based early intervention targeting parent-child interaction amongst extremely preterm born infants, currently tested in an RCT in Sweden. Of 130 infants, 72% have reached 12 months of age. Based on interviews with 17 parents’ and 6 intervention providers we identified SPIBI strengths and shortcomings. SPIBI seems feasible, is possible to integrate it into home-visiting practice and is appreciated by parents. Identified challenges are geographical distance; recruitment obstacles including Covid-19, leading to longer-term implementation; service-provider fatigue; and social adversities amongst some eligible participants requiring ethical considerations. Future improvements include: reconsidering inclusion criteria, increasing use of e-health, and exploring the possibility of a tiered approach.
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| 3. |
- Baraldi, Erika, 1982-, et al.
(författare)
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Parent–child interaction after home-visiting intervention for children born extremely preterm–A randomised clinical trial
- 2024
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Ingår i: Acta Paediatrica. - 0803-5253 .- 1651-2227. ; 00, s. 1-9
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To determine whether a strength- based home-visiting program enhances par-ent–child interaction during the first year at home for children born extremely pre-term (gestational age < 28). Methods: A randomised controlled trial of 130 infants born extremely preterm 2018–2021 in Stockholm, allocated to either the Stockholm preterm interaction-based in-tervention (SPIBI) (n = 66) or an extended follow-up program (n = 64). The interventiongroup received ten home visits during the first year by a trained interventionist follow-ing SPIBI guidelines: an interaction- based intervention supporting sensitive parentalresponses to infants' signals. The primary outcome of emotional availability was as-sessed at 12 months corrected age (CA) using the emotional availability scales (EAS). Results: At 1-year CA, data were collected from 115/130 (89%) of the includedchildren. There were no significant group differences in emotional availability at12 months CA. A secondary analysis showed an effect modifier in families with moth-ers self-rated as depressed at discharge, with the outcome favouring intervention inthe EAS dimension of child involvement. Conclusion: The SPIBI had no significant main effect on emotional availability at12 months CA. Children of self-reported depressed mothers displayed superior in-volvement behaviour in the intervention group, prompting further research on riskgroups and potential modifications of post-discharge interventions.
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| 4. |
- Baraldi, Erika, 1982-, et al.
(författare)
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The development of a post-discharge intervention program in Sweden for extremely preterm infants and their caregivers, through home visits during their first year of life
- 2019
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Konferensbidrag (refereegranskat)abstract
- Sweden has a proactive neonatal intensive care, saving children born from gestation week 22, with a 90% survival rate in the extremely preterm (EPT) group. With increased survival rates, the long-term outcome of the EPT children has gained much research interest. Recent studies indicate that 1/3 of the EPT-children in Sweden show moderate to severe neurodevelopmental deficits when beginning school. An interdisciplinary research team has designed an intervention for EPT infants and their caregivers in their home-environment after hospital discharge and throughout the first year of life. The aim of the ongoing randomized controlled trial is to study intervention effects on the children’s cognitive, motor and psychosocial function, the parental mental health and the infant-parent interaction. This paper present the intervention’s theory of change, the validity considerations, and an overview of the syllabus of the training given to the interdisciplinary team of six clinicians who serve as interventionists.
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