Juggling Roles: A Study of Diverse Neonatal Intensive Care Unit Parents and Their Work-Family Transition

PROJECT SUMMARY / ABSTRACT

Preterm infants are at a heightened risk for developing neuromotor, cognitive, and psychiatric disorders that

persist through adulthood. Infants born very preterm (62% of families with

children include two working parents. Further, low-income families in particular return to paid work as soon as

four weeks after childbirth which can have implications for their ability to visit the NICU. Regrettably there is

virtually no research on NICU parents transition to parenthood from a work-family lens. The proposed

study will use a unique method, Ecological Momentary Assessment (EMA), to monitor parents’ daily mental

health, NICU involvement, and work/family demands during their infants’ NICU hospitalization in a racially and

ethnically diverse sample of 250 families (defined as a mother, a secondary caregiver, and their infant). We aim

to 1) examine stable and dynamic associations between work factors, NICU involvement, and caregiver

mental health utilizing a longitudinal EMA burst design; and 2) examine how work, NICU involvement,

and caregiver mental health are related to infant neurodevelopment. We hypothesize that caregivers with

ideal work policies and conditions (e.g., shorter work hours, more job flexibility, more job autonomy, more paid

leave) will have better mental health and more NICU involvement, which, in turn, will be associated with better

infant neurodevelopmental outcomes at NICU discharge and 1-year follow-up. Additionally, given the differential

NICU experience for Black and low SES families, we hypothesize that the associations between work, mental

health, NICU involvement, and infant neurodevelopment will be exacerbated for Black and low SES families.

Results from this study will address the important public health concern of prematurity in diverse families from a

unique work-family lens that may help identify family-level and state/federal policy-level intervention targets to

support parent NICU involvement and mitigate the long-term neurodevelopmental consequences of prematurity.