Pilot RCT of the use of video interactive guidance with preterm babies

Abstract

Objective: To assess the potential of video interaction guidance (VIG) to increase sensitivity in parents of preterm infants. Background: Parental sensitivity has been identified as explaining some but not all of the capacity of full-term infants for later affect-regulation via its impact on the infant’s attachment system. Video interaction guidance (VIG) appears to be a promising intervention to improve parental sensitivity. Methods: A pilot randomised control trial was undertaken of the effectiveness of VIG in improving parental sensitivity using the CARE-Index as a primary outcome measure. Secondary outcomes included parenting stress, depression and anxiety, and post-traumatic stress. Data were collected at baseline and post-intervention, and analysed on an intent-to-treat basis, using analyses of covariance. Results: Thirty-one parents of an infant born at 32 weeks or less gestation were recruited from a city neonatal intensive care unit (NICU). The results show large but non-significant differences favouring the intervention group for both parental sensitivity (d = 0.86; p = 0.069) and infant cooperativeness (d = 0.78; p = 0.10). There were also medium to large non-significant differences favouring the intervention group for depression (d = 0.33; p = 0.41), anxiety (d = 0.38; p = 0.30), and parenting stress (d = 0.87; p = 0.14). There was no difference between groups in the proportion of parents with post-traumatic stress disorder (RR: 1.05; 95% CI: 0.85–1.37). Conclusion: VIG appears to be a promising intervention with which to increase parental sensitivity in parents of preterm infants, but additional components explicitly targeting parental trauma may also be needed.

Keywords:

• Preterm
• RCT
• video interaction guidance
• maternal sensitivity

Acknowledgements

We would like to thank Linda Chetwind who collected all baseline data and Angela de Mille who coded the parent–infant interaction video-tapes. Hilary Kennedy supervised the delivery of the VIG intervention.