RNQualitativeAdvances in neonatal care : official journal of the National Association of Neonatal Nurses2025

Parents' Experiences With an Early Behavioral Intervention, H-HOPE, in the NICU and at Home: A Qualitative Study.

Marin Schmitt, Kathleen F Norr, Rosemary White-Traut and 5 others

PMID 40609008

WHAT IT FOUND

Parents of preterm infants described H-HOPE, including massage and parent cue coaching, as building confidence, helping them read infant cues, and easing NICU-to-home transition.

Nurse teaching, time, and infant condition shaped participation.

Key findings

01Nearly all parents described increased confidence in handling and caring for their infant after H-HOPE.

02Parents reported that H-HOPE helped them recognize infant cues, including hunger, tiredness, and likes or dislikes, and that this helped the transition home.

03Nurse teaching and support were the most frequently reported facilitator, while nurse availability and inconsistent communication were common barriers.

STILL TO COME

How it was doneWhat they foundWhat it means for RNs

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What it does not show

This is a qualitative study of parents' experiences, not a test of whether H-HOPE improves infant outcomes. The interviews were a convenience sub-sample, and most parents who consented to the larger study did not take part in the interview component. The interview was optional, and no additional incentive was offered, which may have selected for parents with more time or more positive experiences. The sample was mostly mothers, with only 2 fathers, so it gives little information about fathers' experiences. Input was overwhelmingly positive, and parents may have been reluctant to criticize the program. Stressful NICU stays and unpredictable discharge dates may have affected what parents remembered and when they were interviewed. Some parents had minimal or no training, and interview length varied from 6 to 30 minutes, so experiences were not uniform. H-HOPE included both Massage+ and Parents+, so the contribution of each component cannot be separated. The research team was predominantly female and White, and the authors noted this may have affected parents' comfort in sharing experiences.

Declared interests

None of the authors declared competing interests. The supplied text does not report a funding source.

The easy way to misread this

Do not conclude that H-HOPE improves infant outcomes or that Massage+ alone caused the reported benefits. This study reports parents' experiences, not measured infant outcomes, and H-HOPE included both Massage+ and Parents+, so the contribution of each component cannot be separated.

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