SSHFT is a distance intervention for high-risk preterm, low birth weight infants admitted to the NICU and their caregivers who live in the Maritime provinces. SSHFT consists of two distinct components; an online education and support modules with the support of a trained coach.

Preterm infants are at serious risk for developmental and behavioral difficulties. Despite widespread health promotion campaigns to reduce the behaviors associated with preterm births, the Canadian rates are either increasing or remaining stable. Families of preterm infants face multiple strains including concerns over the health of the neonate, caregiver stress, and financial worries. Added to these strains, is the greater likelihood of a preterm infant being born to parents of lower socio-economic status increasing the likelihood of developmental delay above and beyond single parenthood, parental education or occupation, or ethnicity. Families of preterm infants report more psychological distress and more long-term stress than families of full-term infants with more maternal anxiety and depression. However, interventions designed to support the caregivers of these infants have been very effective. Early interventions in the NICU reduce maternal stress, and improve mothers’ positive affect, perceptions of the child as more normal, and sensitivity to the infant’s cues. Programs that are implemented in the home after discharge produce marked improvements in the home environment and behavioural changes in mother-infant interactions and parenting behaviour. They improve maternal role satisfaction, self-confidence and perception of infant temperament, and significantly decrease maternal depression, and reduce the occurrence of childhood injury and medical visits. Researchers have called for inclusion of the secondary caregiver in programs.

While the existing interventions have proven to be beneficial, there are many families potentially unable to participate due to the distance from their home to the hospital where their infant receives treatment. In addition to the geographic barrier to participation in an intervention, those families at social and economic risk may not have access to an in-hospital program. The cost associated with traveling to the hospital to participate in a program, including childcare for their infant, may be prohibitive. In addition, the delivery of an intervention post-discharge would help parents balance the responsibilities of caring for their infant with family life. Distance interventions using the Web, coaches, manuals, and telephone contact are relatively recent, but they are effective in managing a variety of health concerns. The Family Help program at the IWK Health Centre has had success in treating a variety of pediatric health problems and postpartum depression.

A further consideration in developing a support program for families of preterm infants is that prolonged hospital stays may mean that the family, including the mother, may have to make the difficult decision to return home in order to work or to provide care for other children. Maternal attachment declines as severity of perinatal risks increased. The proposed research has the potential to greatly improve the caregiver health and family functioning in families with a preterm infant, as well as providing benefits to the neonate through education of the primary caregiver and increased attachment through educational support and support from a trained coach.

The Team: