071 - Measuring family adherence to SPEEDI intervention key principles delivered to families of extremely preterm infants at term age or 3 months adjusted age

Publication Number: 71.5994

Rebecca Molinini, Virginia Commonwealth University School of Medicine, Richmond, VA, United States; Radhika Attal, University of Southern California, Los Angeles, CA, United States; Christine M. Spence, Virginia Commonwealth University, Richmond, VA, United States; Richard D. Stevenson, University of Virginia School of Medicine, Charlottesville, VA, United States; Jennifer Burnsed, University of Virginia School of Medicine, Charlottesville, VA, United States; Stacey Dusing, University of Southern California, Los Angeles, CA, United States

Background: Considering family activities outside of intervention is critical to understanding intervention efficacy.

Objective: This analysis quantifies and compares family adherence in two groups receiving the same intervention at different ages.

Design/Methods: Twenty-three caregiver-extremely preterm infant dyads receiving the SPEEDI intervention were included. Nine families received SPEEDI earlier (infant age=-0.30 months) and 14 received SPEEDI later (infant age=3.09 months). SPEEDI is a 4-month caregiver-therapist collaborative intervention where caregivers learn the skills to implement and scaffold therapeutic activities that are challenging yet attainable at least 4-5 days a week for 20 minutes a day. Family adherence was conceptualized as 1) number of therapeutic activities (THER-ACT) families performed, 2) proportion of therapeutic activities in which caregivers appropriately scaffolded activities to be challenging yet attainable (SCAFFOLD) and 3) family report of meeting the recommended dosage of performing activities (DOSAGE). Data was collected at 5 SPEEDI visits over 3 months. Generalized and linear mixed effects logistic regression models were run for THER-ACT, SCAFFOLD and DOSAGE with predictors of visit, SPEEDI group, or visit*SPEEDI group. All models controlled for child level random intercepts.

Results: There were no significant effects of visit, SPEEDI group, or visit*SPEEDI group on THER-ACT. Visit had a significant effect on SCAFFOLD (p=.01) with visits 4 (ß=.13, p=.04) and 5 (ß=.14, p=.03) significantly higher than visit 1. Neither SPEEDI group nor visit*SPEEDI group were significant predictors of SCAFFOLD. DOSAGE varied by visit with the likelihood of meeting activity recommendations being significantly higher at visits 3 (ß=4.33, p=.03), 4 (ß=4.05, p=.04), and 5 (ß=4.42, p=.02) than visit 1. The effect of visit on DOSAGE varied as a function of SPEEDI group at visit 5, with caregivers in SPEEDI delivered earlier being more likely to meet DOSAGE recommendations than caregivers in SPEEDI delivered later (ß=4.66, p=0.03).

Conclusion(s): The timing of SPEEDI may influence family adherence to dosage recommendations. The significant effect of visit on family adherence supports that families need time to incorporate recommendations into practice. Future analyses will consider risk of cerebral palsy and other medical complications common to preterm infants as covariates of family adherence to SPEEDI.

Primary family adherence outcomes aggregated and stratified by SPEEDI intervention group and visit
PAS abstract table.pdf