Susan London – Major Finding: Of new parents who were shown a DVD on newborn care, 39% made extra office visits in their infant’s first months of life, compared with 63% of their counterparts who were given printed materials on newborn care.
Data Source: A randomized trial among 137 parents bringing their newborn to an urban pediatric primary care practice for the first time. Disclosures: Dr. Paradis reported that she had no conflicts of interest related to the study.
VANCOUVER, B.C. – A DVD covering the basics of newborn care helps new parents feel more prepared to care for their infant and reduces health care use in the first few months of life, one study found. In a randomized trial among 137 parents bringing their newborns in for a first pediatric office visit, parents who were shown and given the DVD during their visit felt more confident in bathing their infants and recognizing congestion, compared with parents who were given printed materials. In addition, only 39% of parents in the DVD group made more than one additional office visit with their newborn before the 2-month well-child check, whereas 63% of parents in the control group did. Most parents who watched the DVD were satisfied with the information they received, and staff and providers felt that this intervention was helpful and easy to integrate in the clinic.
“Media-based learning in the primary care office is feasible [and] well accepted, and can have a positive impact on its target audience,” lead investigator Dr. Heather A. Paradis said, summing up the findings. Research has shown that parents welcome anticipatory guidance and want their pediatrician to provide this type of information, she noted. But current strategies are not meeting all of their educational needs. “Prior studies have shown promise to impact parental behavior with targeted video messages,” said Dr. Paradis, a pediatrician at the University of Rochester (N.Y.) “However, little is known about the use of media-based learning in the primary care setting.” She and her co investigators recruited parents who were bringing their newborn younger than 1 month of age for a first visit to a large, urban, pediatric primary care practice.
Parents were assigned to a control group or an intervention group. Those in the former group were given a packet of printed materials on newborn care. Parents in the latter group were shown a DVD on newborn care while they waited in the examination room and were given it to take home. The DVD, which was produced locally, lasted 15 minutes and featured a pediatrician and several newborns of diverse ethnicities. “It covered basic aspects of newborn care as endorsed by the AAP [American Academy of Pediatrics] and Bright Futures guidelines,” Dr. Paradis explained. In all, 70 parents were assigned to the DVD group and 67 to the control group. Most were the infants’ mothers (92%), were aged 21 years or older (74%), and had at least a high school education (60%). In 43% of cases, the newborn was their first child. The newborns were 6 days old, on average. Most were of minority races (89%) and had public health insurance (82%).
Study results showed that parents in the two groups did not differ significantly with regard to changes from baseline in overall scores for knowledge of infant development, self-efficacy in infant care, and problem solving in infant care, she reported. However, scores were high in both groups at baseline. When individual self-efficacy measures were assessed, relative to parents in the control group, those in the DVD group were more likely to report feeling very confident in bathing their newborn (93% vs. 78%) and recognizing congestion (70% vs. 52%). Between the first visit and the 2-month well-child visit, parents in the DVD group had fewer total consultations of any kind with a professional about their newborn (2.9 vs. 4.0) and were less likely to make more than one additional visit (39% vs. 63%). The latter finding persisted in multivariate analysis. “In fact, parents in the control group were 2.6 times more likely to have more than one additional office visit between birth and 2 months, compared with parents in the DVD group,” commented Dr. Paradis. Parent satisfaction with information and support was high in both groups. However, parents in the DVD group were more likely to agree or strongly agree that they felt better prepared to care for their baby after the first visit (94% vs. 81%). As for feasibility, she said, “the incorporation of this video was a low-cost intervention that was fully integrated into the function of our hectic and sometimes chaotic clinic.” Most or all staff and providers agreed that the DVD was not disruptive to patient flow (93%), was not difficult to incorporate into the daily routine (100%), and was helpful for delivering anticipatory guidance (86%).
“Video represents an efficient way to reach new parents as part of an office encounter, and may impact their health care utilization,” Dr. Paradis concluded.