Connecting families to improve parental self-efficacy and parent psychosocial and infant health outcomes in the NICU using an eHealth solution: a stepped wedge cluster randomized controlled trial (The CONNECT study)

Preterm infants, 1 in 12 Canadian births, are at a significant increased risk of poor health outcomes, resulting in high healthcare burden. Parents of these infants report lower self-efficacy and worse mental health when compared to parents of term infants. There is an urgent need to find effective ways to improve parental self-efficacy and associated parent psychosocial and infant health outcomes. To improve parent and baby outcomes, our team will build on our existing eHealth solution to create Chez NICU Home+, which offers web-based, parent targeted, interactive educational tools, virtual communication, and text message support during their baby's NICU stay. We will evaluate whether Chez NICU Home+ improves parental self-efficacy (primary outcome), parent psychosocial and infant health outcomes, in parents of babies requiring a NICU stay. We also aim to understand the ease and uptake of using Chez NICU Home+. This study will be a multicentre, stepped wedge cluster randomized controlled trial across four Canadian NICUs. At the beginning of the study, data regarding current care will be collected from all sites to determine a baseline. Following baseline data collection, every six months one of the sites will start using the Chez NICU Home+ solution. A total of 1000 parents and their babies, who are expected to stay at least 5 days in the NICU, will be recruited. Parents will complete a survey on their psychosocial adjustment and infant outcomes when they begin the study as well as at 14 and 21 days after enrollment, at discharge, and at 6-months post-discharge. Infant health and development outcomes will be collected at discharge, 6 and 18-months post-discharge via health records. We predict that Chez NICU Home+ will be a positive, interactive care option, combining virtual parent education, tailored communication, and support, which will improve parental self-efficacy and parent psychosocial and infant health outcomes, and have long-term benefits for families.