Validation and psychometric properties of the neonatal intensive care unit parental beliefs scale.

BACKGROUND: Parental perception of their infants and confidence/beliefs about their parenting are among the most salient factors influencing outcomes of preterm infants. OBJECTIVES: The purpose of this study was to assess the psychometric properties of scores on the Neonatal Intensive Care Unit Parental Beliefs Scale (NICU PBS) in a sample of mothers and fathers of preterm infants receiving intensive care. The NICU PBS is a rating instrument designed to assess parental beliefs about their premature infant and their role during hospitalization. METHODS: The sample consisted of 245 mothers and 143 fathers. As part of the Creating Opportunities for Parent Empowerment trial, participants completed the NICU PBS 4-8 days after NICU admission and again approximately 4 days before discharge. Validation data were obtained at various times throughout the study. Confirmatory factor analysis was used to evaluate the NICU PBS factor structure. RESULTS: A three-factor solution was accepted (Parental Role Confidence, Parent-Baby Interaction, and Knowledge of the NICU). Reliability of scores on the total scale and subscales was high; Cronbach's alpha ranged from .75 to .91. Test-retest correlations ranged from .84 to .92. Younger maternal age; birth of another child; return to work within the past 12 months; and lower stress, depression, and anxiety were all significantly associated with higher scores on all subscales and the total score. Lower education, lower household income, receipt of Medicaid, and non-White race were associated with higher scores on the parent role confidence subscale and total. Lower household income and receipt of Medicaid were associated with higher Parent-Baby Interaction scores. DISCUSSION: The NICU PBS can be used reliably with mothers and fathers of premature infants who are hospitalized in the NICU, and it may be a useful scale in predicting parental stress, depression, and anxiety.

Outcomes of a massage intervention on teen mothers: a pilot study.

The difficulties that adolescent mothers encounter as a result of the combined stress of adolescence, parenthood, maintaining peer relationships, and establishing positive relationships with their infants have been identified in the literature, and these characteristics are often associated with poor infant outcomes. This study was designed to examine the effects of an infant massage intervention on adolescent mothers' attitudes and perceptions of their infants. Twenty-five African-American adolescent mothers (mean age 16.13 years), who were enrolled in a parent training program for high school students in a southern state, participated in the project. The mothers were assigned randomly to an intervention (9) or control group (16). After a brief training session, participants in the intervention group practiced massage with their infants for approximately 2 months. Data analysis was based on the 15 participants who completed both baseline and 2-month follow-up measures (8 in the control group and 7 in the intervention group). This study found some support for teaching infant massage to adolescent mothers as a way of enhancing maternal-infant physical contact and lowering depression, as well as positively influencing mothers' perceptions of infant temperament. Results indicate that infant massage training may lead to improvements beyond those achieved with a typical parent education curriculum and shows potential as a low-cost supplement to current teen mother education in high schools.

Reducing anxiety among children born preterm and their young mothers.

PURPOSE: To examine the efficacy of COPE on maternal and child anxiety associated with younger mothers of premature infants. The COPE program provides instruction and practice in parenting behaviors specific to the NICU, in combination with information that reduces ambiguity about their infant's appearance and behaviors. STUDY DESIGN AND METHODS: Secondary data analysis was conducted on data obtained from a larger randomized controlled trial with 253 mothers of low birthweight premature infants to examine the efficacy of the Creating Opportunities for Parent Empowerment (COPE) program, an educational-behavioral parent intervention in the NICU, on maternal and child anxiety based on maternal age. For these analyses, child and maternal anxiety were assessed using the Child Behavior Checklist for Ages 2 to 3 and the State-Trait Anxiety Inventory collected at 24 months and 2 to 4 days postintervention, respectively. To test study hypotheses, we conducted multiple regression models using the structural equation modeling approach to path analysis. RESULTS: Multiple regression results for the full model indicated that there was a significant COPE × mothers' age interaction effect on both mothers' anxiety and child anxiety. Participation in the COPE program significantly predicted lower levels of mothers' anxiety at postintervention as well as lower levels of child anxiety at 24 months for younger mothers (18-21 years old), but not for mothers over 21 years old. CLINICAL IMPLICATIONS: Participating in COPE was associated with more favorable mental health outcomes for younger mothers and their children than mothers over 21 years old. Participation in the COPE program may help close the health disparities gap by improving behaviors in infants of younger mothers to rates similar to those of children of mothers over 21 years old.

The contraceptive needs of incarcerated women.

OBJECTIVES: We assessed the contraceptive needs of women incarcerated in jails in the southeastern United States to determine feasible and effective birth control interventions based on the needs of this population. METHODS: Participants were recruited from local jails around a medium-sized metro area. Participants completed a survey of demographics, sexual health, contraceptive use, and preferred method of contraception. RESULTS: The survey was completed by 188 women in jail. Participants reported high rates of sexually transmitted diseases (STDs) (50.5%), inconsistent use of birth control (36.5%), and use of unreliable and user-dependent methods of birth control. The majority did not desire to become pregnant in the future (61.5%) but intended to have sex after release from jail (76.9%). Women who were able to bear children were more likely to report intentions to use birth control or STD protection after release (77.9%). Additionally, significant racial differences were found. Specifically, nonwhites were more likely to be single and have more STDs and less use of a variety of birth control methods than whites. CONCLUSIONS: Women in this sample were at high risk for unplanned pregnancies. Therefore, a primary contraceptive need for this population appeared to be education about longer lasting, user-independent forms of contraception. Many of these women would be ideal candidates for such forms of contraception, especially if it was provided prior to release.