A Randomized Controlled Trial to Test the Effect of a Brief Dyadic Intervention on Factors Relevant to the Development of the Mother-Infant Relationship

Tuesday, 13 July 2010: 10:50 AM

Janice Goodman, PhD, RN
School of Nursing, MGH Institute of Health Professions, Boston, MA
Catherine Schappert, MS, RN, CAP
Healthy Beginnings Nurses, Palm Beach County Health Department, West Palm Beach, FL

Learning Objective 1: The learner will appreciate the role of nurses in providing interventions to promote optimal mother-infant relationships and the need to evaluate effectiveness of such interventions

Learning Objective 2: The learner will be able to understand the challenges of conducting research trials in the context of clinical practice


Nurses are in a critical position to promote development of optimal mother-infant relationships.  The Newborn Behavioral Observation (NBO) is an infant-focused developmental intervention designed to help clinicians sensitize parents to their infant’s competencies and uniqueness in order to promote positive parent-infant interactions and the early development of positive parent-infant relationships.  The purpose of this study was to test the effectiveness of the NBO, delivered in the context of a nurse home-visiting program, on maternal outcomes that the research literature has shown to be relevant to the development of the mother-infant relationship. 


A randomized, controlled trial of the NBO intervention was conducted with a diverse sample of 199 women, age 14 to 42 years (Mean 25, SD 6), recruited from the Healthy Start program of Palm Beach County, Florida.  Eligible women were randomized to intervention or control group.  Experienced perinatal home-visiting nurses who were trained and certified in administration of the NBO procedure conducted the NBO with mothers and infants at 1-2 weeks postpartum.  Control group mothers received a short structured presentation and discussion of basic infant health issues.  Mothers completed the Edinburgh Postnatal Depression Scale (EPDS) at baseline (2 weeks postpartum), and at 1 and 3 months postpartum.  At 1 and 3 months, they also completed the Maternal Attachment Inventory (MAI) and the Parenting Stress Index (PSI). 


Repeated measures analyses of variance showed no difference between intervention and control group mothers on maternal depression, parenting stress, or maternal attachment to the infant.


Several possibilities for lack of significant findings are examined, including design limitations and possible faulty theoretical assumptions.  Challenges of conducting research trials in the context of clinical practice are discussed.