Effectiveness of Hospital-Based Video Interaction Guidance on Parental Interactive Behavior, Bonding, and Stress After Preterm Birth: A Randomized Controlled Trial

Objective: This study examined the effectiveness of hospital-based Video Interaction Guidance (VIG; Eliëns, 2010; Kennedy, Landor, & Todd, 2011) for mothers and fathers of infants born preterm (25-37 weeks of gestation). Method: VIG is a preventive video-feedback intervention to support the parent-infant relationship. One hundred fifty families (150 infants, 150 mothers, 144 fathers) participated in a pragmatic randomized controlled trial to evaluate the effects of VIG as adjunct to standard hospital care. Primary outcome was parental interactive behavior (sensitivity, intrusiveness, and withdrawal) as observed in videotaped dyadic parent-infant interaction. Secondary outcomes comprised parental bonding, stress responses, and psychological well-being based on self-report. The intervention effects were assessed at baseline, mid-intervention, 3-week, 3-month, and 6-month follow-ups. Data were analyzed on an intention-to-treat basis, using multilevel modeling and analyses of covariance. Results: VIG proved to be effective in enhancing sensitive behavior and diminishing withdrawn behavior in mothers (Cohen's d range = .24-.44) and in fathers (d range: .54-.60). The positive effects of VIG were particularly found in mothers who experienced the preterm birth as very traumatic (d range = .80-1.04). The intervention, however, did not change parents' intrusive behavior. Analyses additionally revealed positive effects on parental bonding, especially for fathers, yet no significant effects on stress and well-being were detected. Conclusions: The results indicate that VIG is a useful addition to standard hospital care, reducing the possible negative impact of preterm birth on the parent-infant relationship. VIG appeared particularly beneficial for fathers, and for mothers with traumatic birth experiences. High levels of parental intrusiveness, however, need complementary intervention. What is the public health significance of this article? This study suggests that hospital-based Video Interaction Guidance is an effective intervention to support the early parent-infant relationship after preterm birth, especially after traumatic preterm birth. For parents with highly intrusive behavior, additional support may be necessary.