Organizational Barriers to and Facilitators of the Successful Implementation and Sustainability of the Supporting and Enhancing NICU Sensory Experiences (SENSE) Program

Abstract

Abstract Importance: The Supporting and Enhancing NICU Sensory Experiences (SENSE) program is an evidence-based intervention that promotes daily, positive sensory exposures for infants in the neonatal intensive care unit (NICU). Understanding program implementation across sites may aid in optimizing strategies for uptake of the program and subsequently improve outcomes for infants and families. Objective: To investigate health care professionals’ perceptions of implementing the SENSE program. Design: The SENSE Program Implementation Survey was developed using Proctor et al.’s model and the BARRIERS scale to probe organizational practices across sites worldwide. Setting: Survey distributed to 211 hospitals with a SENSE program license obtained before March 2020. Participants: One hundred fourteen NICU personnel (response rate = 54%). Outcomes and Measures: The survey sought to understand barriers and facilitators, adaptations during implementation, and associated costs. Results: Of the 53% (n = 57 of 107) of respondents who had implemented the SENSE program, many (n = 14; 31%) experienced quick timing (<1 mo) to use, including spread to nearly all infants in their NICU within 6 mo (n = 18; 35%). Most reported the program was used to educate families ≤3 days of birth (n = 20/59; 34%). Most of the sensory interventions in the program were performed by parents (n = 38; 67%) and therapists (n = 44; 77%). Barriers and facilitators at the organizational and individual levels were identified. No additional staff were hired to implement the program. Conclusions and Relevance: Given perceived successes and challenges, strategic enhancement of implementation can inform future administrations of the SENSE program. Plain-Language Summary: This study provides occupational therapists who are interested in implementing the SENSE program (Supporting and Enhancing NICU Sensory Experiences) with an understanding of common barriers, facilitators, costs, and adaptations, which can be used to advocate for program implementation in NICUs to improve outcomes for preterm infants worldwide.