Disparities in Kangaroo Care for Premature Infants in the Neonatal Intensive Care Unit.
Edith Brignoni-Pérez, Melissa Scala, Heidi M Feldman and 2 others
PMID 34723932WHAT IT FOUND
Infants born under 32 weeks whose families used public insurance or a language other than English received less Kangaroo Care.
The public insurance gap remained after language was considered; some language gaps did not remain once insurance type was considered.
Key findings
01Infants whose families had public insurance, used as the lower SES proxy, received significantly less Kangaroo Care by rate, frequency, and duration than infants whose families had private insurance.
02Infants whose mothers communicated with clinical staff in a language other than English received significantly less Kangaroo Care by rate, frequency, and duration than infants whose mothers communicated in English.
03After adjustment, the public insurance gap remained significant; the language gap in KC duration remained significant, but the language gap in rate and frequency did not remain significant once SES was controlled.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study looked at one hospital's records, so the results may not apply to other NICUs. It was a convenience sample of 116 infants, and the groups were not evenly balanced, so small group differences may be unstable. SES was proxied only by insurance type, and language was proxied by a chart field, so neither captures the full social or communication context. Kangaroo Care data were charted by staff, so omissions or inconsistent recording could affect the counts. Race could not be fully examined because many records had unknown or refused race data. The study is observational and cannot show that insurance type or language caused lower Kangaroo Care. The authors say more study is needed to know whether the findings are specific to their center or to locations where English is dominant. The study did not test interventions to reduce the disparity.
Declared interests
The authors declared no conflict of interest. The paper is tagged as NIH extramural research support.
The easy way to misread this
Do not conclude that the Kangaroo Care gap was only because families visited less. The KC measures were calculated per visitation day, and the public insurance gap remained after language and gestational age were considered.