Effects of the Creating Opportunities for Parent Empowerment (COPE) Intervention for Mothers of Preterm Infants Based on Maternal Age

Thursday, July 14, 2011: 10:15 AM

Bernadette Mazurek Melnyk, PhD, RN, CPNP/PMHNP, FAAN
Krista L. Oswalt, PhD
Darya McClain, PhD
College of Nursing & Health Innovation, Arizona State University, Phoenix, AZ

Learning Objective 1: To identify the key variables in the study, particularly how the intervention relates to the outcome variables (i.e. infant temperament, infant internalizing and externalizing behaviors).

Learning Objective 2: To evaluate the efficacy of the COPE(Creating Opportunities for Parent Empowerment)intervention for young mothers with premature infants in the Neonatal Intensive Care Unit.

Purpose: The purpose of this presentation will be to report the findings from a full-scale randomized controlled trial that tested the efficacy of COPE, an educational-behavioral parent intervention in the NICU, on child outcomes (temperament, internalizing and externalizing behavior problems) associated with younger and older mothers of premature infants.


A comparative descriptive study was conducted on data obtained from a larger randomized controlled trial with 246 mothers of low birth weight (LBW) premature infants from two hospitals in Upstate New York.  Internalizing and externalizing subscale scores from the Child Behavior Checklist (CBCL) at 12 months corrected age were compared for younger (≤21 years of age; n=58) and older mothers (>21 years of age; n=188).

Results: Multiple regression analyses indicated that there was a significant interaction between COPE and maternal age in the models predicting infant temperament, internalizing, and externalizing behavior problems. Follow-up analyses indicated that participating in the COPE Program was associated with reduced temperament, internalizing, and externalizing for both younger and older mothers. Further analyses indicated that being a younger mom was associated with higher levels of infant mood, distractibility, anxious/depressed symptoms, withdrawal, and aggression in the control group, but there were no significant differences based on maternal age in the intervention group.

Conclusion: Participation in the COPE program may help close the health disparities gap between infants of younger and older mothers by reducing temperament, internalizing, and externalizing behaviors in infants of younger mothers to rates similar to those of children of older mothers. The practice and policy implications of this research will be discussed.