What are the effects of supporting early parenting by newborn behavioral observations (NBO)? A cluster randomised trial
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RESEARCH ARTICLE
Open Access
What are the effects of supporting early parenting by newborn behavioral observations (NBO)? A cluster randomised trial Ingeborg Hedegaard Kristensen1* , Svend Juul2 and Hanne Kronborg1
Abstract Background: Professional support to enhance the early parent-infant relationship in the first months after birth is recommended, but little is known about the effect of universal interventions. The objective was to investigate the effect of health visitors’ use of the Newborn Behavioral Observations system in new families. Methods: A cluster-randomised study was conducted in four Danish municipalities. Health visitors’ geographical districts constituted the units for randomisation (n = 17). In the intervention group, 1332 families received NBO from 3 weeks after birth; in the comparison group, 1234 received usual care. Self-administered questionnaires were collected at baseline one to two weeks after birth, and at follow-up three and nine months postpartum. The outcomes were change over time measured by The Karitane Parenting Confidence Scale (KPCS), The Major Depression Inventory (MDI), The Ages and Stages Questionnaire: social-emotional (ASQ:SE) and The Mother and Baby Interaction Scale (MABIC). Data were analysed with mixed-effects linear regression using the intention-to-treat approach. Results: At baseline, no significant differences between the two groups were seen regarding maternal and infant factors. At follow-up three and nine months after birth, the change in maternal confidence and mood, infant’s socioemotional behaviour, and early parent-infant relationship moved in a slightly more positive direction in the intervention group than in the comparison group, though not statistically significant. The only significant effect was that the intervention mothers reported higher level of knowledge about infant’s communication skills, response to cues, and how to sooth and establish a relation with the infant, compared to the comparison group. Conclusions: We found no effect of the NBO system delivered in a universal context to all families in a community setting. The only significant difference between groups was a higher maternal degree of knowledge regarding early parenting in the intervention group. Trial registration: ClinicalTrials.gov ID: NCT03070652. Registrated February 22, 2017. Keywords: Parenting intervention, Newborn behavioral observations, NBO, Early intervention, Universal intervention, Health visitor, Parent-infant relationship, Community setting, CARE-index
* Correspondence: [email protected] 1 Nursing and Health Care, Department of Public Health, Aarhus University, Bartholins Allé 2, 8000 Aarhus C, Denmark Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provid
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