Disparities in Kangaroo Care for Premature Infants in the Neonatal Intensive Care Unit

Abstract

AbstractOBJECTIVESThe aim of this study was to investigate whether preterm infants whose families have lower socioeconomic status (SES) or communicate with clinical staff in a language other than English experience differences in the total amount, frequency, and duration of Kangaroo Care (KC) compared to preterm infants of higher SES or primarily English-speaking families.METHODSParticipants were infants born <32 weeks gestational age (GA), N=116. We defined family SES by the infants’ health insurance (private/higher vs. public/lower) and family language by the language mothers used to communicate with clinical staff (English vs. Other language). Family SES or family language groups were compared on: (1) the total amount of KC infants experienced during hospitalization; (2) frequency of KC per visitation days; and, (3) duration of KC events per day.RESULTSInfants in the lower SES and Other language groups experienced KC in reduced amounts, lower frequencies, and shorter durations than infants in either the higher SES or English language groups. SES and language group differences remained significant after controlling for family visitation and GA at birth. After controlling for SES, language group differences in KC duration remained significant.CONCLUSIONSOur findings revealed disparities in the total amount, frequency, and duration of KC in the neonatal intensive care unit as a function of both family SES and language families used to communicate with clinical staff. These disparities reduced infants’ access to this developmental care practice shown to stabilize clinical status and promote neurodevelopment. We recommend that hospital nurseries implement policies that minimize such disparities.Table of Contents SummaryTotal amount, frequency, and duration of Kangaroo Care for preterm infants in the NICU varied as a function of family’s socioeconomic status and language.What’s Known on This SubjectIn the United States, disparities in health care delivery and medical outcomes have been identified on the basis of patient or family socioeconomic status and the language patients or families use to communicate with clinical staff.What This Study AddsExtending to the NICU, the amount, frequency, and duration of Kangaroo Care experienced by preterm infants differed both by family’s socioeconomic status and the language families use to communicate with clinical staff. Policy changes are needed to reduce these disparities.Contributors’ Statement PageDr. Brignoni-Pérez conceptualized and designed the study, acquired data from the electronic medical record, analyzed the data, drafted the initial manuscript, and reviewed and revised the manuscript. Drs. Scala, Marchman, Feldman, and Travis conceptualized and designed the study, supervised data abstraction and analysis, and critically reviewed and revised the manuscript for important intellectual content. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.