Evaluation of an Early Language and Literacy Program for Parents of Infants in the NICU

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Publication year

2019

study description

Mixed-Methods

core topic(s)

Early Literacy

Population Characteristics

Infant/Newborn , Neonatal/NICU

Exposures, Outcomes, Other

Clinic-Based Programs and Interventions , Implementation and Evaluation , Language and Literacy Development , Mother Goose on the Loose-Gooselings , Parent Behaviors and Skills , Parent Knowledge, Attitudes, and Beliefs , Parent-Child Relationships/Interactions

objectives

To evaluate the effect of a NICU parent education program on parents’ early language and literacy practices, and on their confidence interpreting and responding to infant signals.

exposure

Mother Goose on the Loose-Gooslings program (MGOL), a NICU Parent Education intervention

outcomes evaluated

Parent early literacy and language practices and confidence interpreting and responding to infant signals

setting

Level IV SFR NICU located in a large, urban city in the mid-Atlantic region of the United States. All parents and relatives of infants cared for in this NICU were eligible.

methods

Design: Single group, pre- and post-test, mixed-methods evaluation design. Sample: One hundred and four parents and other caregivers completed questionnaires before and after the one-hour program. Ten parents participated in follow-up interviews. Main Outcome Variables: Before and after sessions, participants reported on frequency of their current and intended early language and literacy practices, and their confidence interpreting and responding to infant signals. Participants also reported program satisfaction. Interview participants reported their behavior change one to two weeks later.

sample size

n=104 (family members completed questionnaires); n=91 (infants); n=10 (parents completed interviews)

measures

Pre-Program Questionnaire: asked participants about demographic information, frequency of engagement with several early literacy and language activities with their infant, and confidence on caring for and understanding their infant’s needs.   Post-Program Questionnaire: asked participants about their satisfaction with the program and how it met its intended learning objectives, frequency of engagement with several early literacy and language activities with their infant, and open ended questions about what they liked most and what they would change about the program.   Semi Structured Interview: followed up about frequency of engagement with several early literacy and learning activities with their infant since attending the program, how the program impacted their knowledge and engagement in these activities, describing their interactions with their infant, and how the program impacted their confidence and comfort engaging in these activities and responding to their infant’s signals.

results

The program significantly increased intention to engage in more early language and literacy practices, and increased parent-reported knowledge of how and when to interact with their infants. The majority of interviewed parents reported engaging in these practices one to two weeks later.

conclusions

In general, the success of Goslings provides support for its continuation in this NICU and shows promise for possible extension to other NICUs. This program served the unique needs of families in the NICU by providing guidance and materials to promote early language and literacy in ways that are responsive to infants’ signals and medical status. Empowering parents with knowledge and skills can be a powerful tool for promoting sensitive and responsive parent– infant interaction in the NICU and in the months and years following discharge.

limitations

First, an inherent limitation of this evaluation is the exclusion of a comparison group of families who did not attend the Goslings program A similar limitation related to generalizability is that this program was implemented in a SFR NICU, where parents had more privacy to use these tools and strategies with their infants. Another limitation is that most parents reported on intended behavior change; we were only able to follow up with a small sample of parents who reported their actual behavior change a few weeks later. Further, we relied exclusively on parent self-report, which poses the threat of social desirability bias. We also did not conduct any long-term follow-up with families to learn whether they implemented strategies when their infants became medically ready or whether the program had any long-term effects on child development.