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Welch Emotional Connection Screen (WECS) in the NICU

Not Applicable
Completed
Conditions
Obstetric Labor, Premature
Premature Birth
Interventions
Behavioral: Welch Emotional Connection Screen for Neonatal Intensive Care Unit
Other: NICU WECS Training
Registration Number
NCT04922242
Lead Sponsor
Columbia University
Brief Summary

The purpose of this study is to assess knowledge about emotional connection, attitude about relational health, and efficacy of Welch Emotional Connection Screen (WECS) training in the NICU. The investigators seek to discern if through this didactic training, frontline NICU clinicians can be taught to reliably use the WECS to rate parent-child relational health. Additionally, the investigators seek to learn if there is construct and theoretical validity of the hospitalized infant preterm WECS by correlating WECS scores to physiological, behavioral and mental health markers for parent and infant.

Detailed Description

The Welch Emotional Connection Screen (WECS) is an investigational developmental screening tool that was developed to rate the quality of the emotional connection that formed between mother and child. When administered at 4 months of age, the scale has predictive value in determining which children will show higher risk for developmental problems at 18 months of age. The scale is administered in 2-3 minutes by observing a brief interaction between mother and child and requires the rater to critically assess 4 domains of emotional connection.

The present study will introduce an educational module for teaching NICU clinicians to critically observe mother-child interactions through use of a standardized didactic experience and structured use of the brief clinical screening tool, the WECS, and the theories around nurturing and emotional connection. In one module training session, participants will view a pre-recorded webinar on the WECS developed by the Nurture Science Program at Columbia University. During the second part of the training, participants will view and rate a set of pre-recorded parent-child interactions using the WECS. Clinicians will complete a survey and participate in a focus group discussion about their experiences with the training process and utility of the WECS in clinical practice. Determining if the WECS can be used easily and reliably by NICU clinicians will help to create new strategies that better meet the needs of all professionals involved in NICU care, as well as the families they serve.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
193
Inclusion Criteria
  • Population 1: Consenting Interdisciplinary Professional Clinical Staff who are employed to work in the NICU as a:

    • Nurse
    • Therapist
    • Social worker
    • Physician
  • Population 2: Consenting parents and infants whose parents give consent by guardianship and whose physicians approve inclusion in the study.

Exclusion Criteria
  • Both populations: Refusal to consent

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Population 2: Mother-infant dyads in NICUWelch Emotional Connection Screen for Neonatal Intensive Care UnitParent and infant dyads admitted to a NICU for over 72 hours.
Population 1: NICU Study StaffNICU WECS TrainingInterdisciplinary Professional Clinical Staff who are employed to work as a nurse, therapist, social worker or physician in the NICU.
Primary Outcome Measures
NameTimeMethod
Acceptance rate of NICU WECS and WECS Training: Staff SurveyUp to 6 months

Assess staff opinions of NICU WECS using a survey. Responses will be coded utilizing a grounded theory hypothesis to find thematic evidence to assess the feasibility, utility, acceptability, and efficacy of the WECS in clinical practice.

Acceptance rate of NICU WECS and WECS Training: Focus GroupUp to 6 months

Assess staff opinions of NICU WECS using focus groups. Responses will be coded utilizing a grounded theory hypothesis to find thematic evidence to assess the feasibility, utility, acceptability, and efficacy of the WECS in clinical practice.

Secondary Outcome Measures
NameTimeMethod
Intra-Class Correlations of Welch Emotional Connection Screen (WECS) NICU ScoresUp to 6 months

Reliability of NICU staff WECS scoring will be calculated via intra-class correlations with key scores during training, and clinically coded WECS scores will be correlated with scores generated by a Nurture Science Program staff member. The WECS is scored on intervals of 0.5, with a minimum of 1 (rarely--low level of connection) and maximum of 3 (mostly--high connection). Scores are used to determine the level of need for intervention.

Correlation of WECS scores with Edinburgh Postnatal Depression Scale ScoreNear discharge (up to 40 weeks)

The Edinburgh Postnatal Depression Scale is a 10-item questionnaire that was developed to identify women who have postpartum depression. Items of the scale correspond to various clinical depression symptoms, such as guilt feeling, sleep disturbance, low energy, anhedonia, and suicidal ideation. Overall assessment is done by total score, which is determined by adding together the scores for each of the 10 items. Higher scores indicate more depressive symptoms.

Correlation of WECS scores with CES-DNear discharge (up to 40 weeks)

The CES-D is a 20 item self-report inventory designed to assess current but nonspecific distress rather than clinically diagnosed depression (Radloff 1977). It is the most frequently used measure in the field of infant research and maternal depression. Items probe for depressive symptoms and attitudes within the past week. Criteria are based on DSM-IV criteria for depressive disorders. A score of 16+ is traditionally used to select a depressed group. A more stringent cut-off for depression is 23+. Consistent with previous literature we will examine a low-scoring group CES-D = 0, 1, who endorse no distress.

Parent Stressor Scale (PSS): Neonatal Intensive Care Unit (NICU)Near discharge (up to 40 weeks)

The PSS: NICU is a 26-item self-report measure of stress assessing three dimensions of parental experience during NICU stay: Sight and Sounds, Infant Behavior and Appearance, Parental Role Alteration. Parents are asked to rate each item on a five-point Likert scale from 'not stressful' to extremely stressful'

Correlation of WECS scores with STAI ScoreNear discharge (up to 40 weeks)

The State-Trait Anxiety Inventory (Spielberger et al, 1983) comprises 2 separate self-report scales of 20 items each that measure state and trait anxiety.

Trial Locations

Locations (1)

The Valley Hospital

🇺🇸

Ridgewood, New Jersey, United States

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