PreTerm Birth Clinical Trial
Preterm birth is the leading contributor to mortality among children younger than 5 years.
One effective and inexpensive intervention is providing skin-to-skin care (STSC) whereby the
mother of a preterm baby provides skin-to-skin contact to the newborn for at least a few
hours, ideally every day. This intervention can make breastfeeding easier and can improve
the health and development of the baby.
Unfortunately, despite the large health benefits, mothers in low-resource communities are
often unable to practice STSC due to a range of institutional and economic barriers. STSC
requires substantial time and financial commitments from mothers; they must travel from home
each day to the hospital to engage in STSC and provide expressed breast milk. Low-income
women with access only to limited federally provided unpaid family leave may have to choose
between returning to work while their baby is in the NICU and being able to stay at home
with their newborn after discharge from the NICU. Families of preterm infants also face
direct financial costs of practicing STSC and breastfeeding (such as fees for parking and
childcare for older children).
This trial aims to examine the impact of providing additional support to low-income mothers
of babies born preterm in a hospital in Boston, Massachusetts to help them provide STSC.
Half of the participants will be randomized to receive an additional financial support
intervention while their infant is in the NICU. The study will examine how this intervention
impacts mothers' health behavior while their child is in the NICU and up to three months
after.
Most of the current and past policy efforts to increase STSC have focused on the delivery of
STSC at hospitals, focusing on supply-side related challenges such as the lack of trained
and informed staff. However, interventions that focus exclusively on hospitals are unlikely
to be sufficient for low-income women if there are significant opportunity costs or
transportation costs to simply being present at the hospital. This study aims to provide
more evidence to determine whether removing these financial barriers has the potential to
mitigate the poor outcomes of preterm babies born to lower socioeconomic status households.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Caregiver), Primary Purpose: Health Services Research
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