A free parking trial to increase visitation and improve extremely low birth weight infant outcomes.

OBJECTIVE: Frequent parental visits are likely to benefit infants in a neonatal intensive care unit (NICU), particularly extremely low birth weight (ELBW; ⩽1000 g) survivors. Parking costs (⩾$10 per visit in our center) may deter visitation, especially for low-income parents. We assessed whether free parking (FP) decreased survivors' length of stay (LOS). STUDY DESIGN: Parents (N=138) of ELBW infants (7 to 14 days old) were randomized to usual care (UC; n=66) or FP (n=72). The primary outcome was LOS. RESULTS: Among survivors (n=116), LOS was not significantly less with FP than UC (means: FP=89, UC=102 days, P=0.22; medians: FP=82, UC=84 days, P=0.30). Groups did not differ significantly on proportion of visit days (FP=0.69, UC=0.72, P=0.47), parental involvement, knowledge/skills and satisfaction. Post hoc analyses found that parents with a greater income, a car and fewer children visited more. CONCLUSION: More potent interventions than FP are needed to increase parental visits and reduce LOS for ELBW infants in disadvantaged urban populations.

Feasibility and efficacy of an intervention to reduce secondhand smoke exposure among infants discharged from a neonatal intensive care unit.

OBJECTIVE: To examine the feasibility and efficacy of a hospital-based, motivational intervention to reduce secondhand smoke exposure (SHSe) with mothers of infants in a neonatal intensive care unit (NICU). STUDY DESIGN: One-hundred and forty-four mothers with infants ( ≤ 1500 g at birth or ≥ 12 h ventilation) in a NICU who reported a smoker in the household were randomized to two sessions of motivational interviewing (MI) conducted in the hospital, usual care (UC) or usual care-reduced measurement (UC-RM); follow-up occurred at 1- and 6-months post discharge. RESULT: For households that did not have a total smoking ban at baseline, 63.6% of those in the MI group instituted a ban by 1-month post discharge compared with 20% of the UC group, P<0.02. Six months post discharge, fewer smoking bans were noted in the UC-RM group relative to MI and UC, P<0.01. CONCLUSION: A need for SHSe interventions among NICU parents exists and initial evidence suggests MI can impact SHSe after discharge.