Resilient Families (R-FAM): A dyadic resiliency intervention for parents of babies in neonatal intensive care

PROJECT SUMMARY

This K23 proposal details a 5-year training program that will help launch my career as an independent clinical investigator

who develops, tests, adapts, and implements resiliency interventions for families managing stressful reproductive life events.

I propose an innovative and clinically meaningful research and training plan consistent with my career development goals. Background: With 400,000 U.S. newborns admitted to Neonatal Intensive Care Units (NICU) annually, up to 50% of their

parents experience emotional distress (depression, anxiety, posttraumatic stress) during and after hospitalization. Emotional

distress can negatively impact couple and family adjustment, and in turn, child health and development. Building resiliency

in parents early during the NICU journey is key to improve family and child outcomes. Specific aims and research design:

My goal is to develop, refine, and test the feasibility and acceptability of an innovative, resiliency intervention (“Resilient

Families;” R-FAM) for parental dyads (couples) with babies in the NICU. To achieve this goal, my aims are three-fold: (1) develop R-FAM using stakeholder input from interviews with parent dyads (N=20) and focus groups with NICU staff (N=4); (2) optimize R-FAM through an open pilot (N=5 dyads) with pre/post assessments and exit interviews; and (3) test R-FAM

for feasibility and acceptability (N=50 dyads) through a pilot randomized clinical trial of R-FAM compared with a minimally enhanced usual control (MEUC). Findings will inform a subsequent R01 hybrid efficacy-effectiveness trial (R-FAM versus MEUC) and future R01 mechanistic, adaptation, and implementation trials. Training and mentoring: My research aims

are supported by three training goals: (1) qualitative methods, including longitudinal, dyadic interviews and focus groups; (2) intervention design and optimization using mixed methods; and (3) conduct dyadic randomized clinical trials. My research and training goals are supported by: (1) expert mentors (Vranceanu & Lerou) and advisors (Patterson, Kaimal, &

Parker); (2) a rich and supportive institutional environment; and (3) targeted coursework, scientific meetings, trainings, and

planned publications. Relevance to NICHD. This K23 directly aligns with NICHD’s funding priorities to improve treatment and wellness of women and families who experience high-risk pregnancy-related morbidities (Strategic Plan 3). Impact:

This K23 award will provide me with the research experience, collaborations, mentorship, and training I need to become an

independent and successful clinical investigator in perinatal-neonatal health. I hope to develop, adapt, test, and implement

resiliency interventions that aim to improve emotional distress and relationships in families during the perinatal-neonatal

period. If successful, this work can help inform future adaptations of R-FAM (R01s) that meet the unique needs of different families, such as single parents, parents coping with loss, non-romantic dyads, and families from diverse cultural backgrounds. R-FAM has the potential to set a new standard of NICU psychosocial care—therefore improving the outcomes

and culture of these healthcare units across the globe.