P2.F117: Culturally concordant NICU peer groups impact on parental stress and sense of belonging

Background: NICU hospitalization is stressful with parents experiencing perinatal mood and anxiety disorders (PMADs) at a 3-4 fold greater rate compared to birthing-people overall. Birthing-people of color are at higher risk for PMADs and families experiencing social marginalization are less likely to have access to mental health services. Mental health challenges influence parent-infant interactions and adversely affect the infant’s health and development. While NICU family support groups provide emotional benefit and increased parental empowerment, marginalized families continue to experience less access to resources, inadequate mental health support, and poorer communication and inclusion. Favorable outcomes have been shown for racially concordant support groups for breastfeeding and cancer survivorship (increased breastfeeding; and improved stress, quality of life, and access to support, respectively). Our objective was to evaluate the effectiveness of culturally concordant parental support groups on parental stress and sense of belonging.

Methods: We conducted a community-based participatory prospective pre-post study of culturally concordant peer groups for Black and Latino parents who had or have an infant in the NICU from 8/2023 to 3/2024. Inclusion criteria included: self-identified as Black/African American or Hispanic/Latino, preferred language English or Spanish, planned to attend the session, and have/had an infant in a NICU in our collaborative. Monthly culturally concordant peer groups were hybrid format, open to current and former NICU families, and parent-led with culturally concordant community organization members and mental health providers present for support. The Parental Stress Scale:NICU (PSS:NICU; a validated survey) and a belonging survey were completed within 5 days before and after the session. Descriptive statistics were performed.

Results: Nineteen peer groups were hosted during the study period; 8 for Black families and 8 for Spanish-preferred and 3 for English-preferred Latino families. Sessions averaged 79 minutes, 51% of participants currently had an infant in the NICU, and 55% attended virtually.
Of 74 attendances (Black group n=31, Spanish-language Latino group n=44, English-language Latino group n=4), 27 completed pre-session surveys and 16 completed post-session surveys. While parental stress on the PSS:NICU remained unchanged before and after the peer group (mean 3.1 SD 0.9 and mean 2.9 SD 1, respectively based on 5-point Likert scale of 1 “not at all stressful” to 5 “extremely stressful”) sense of belonging in community increased (2.8 and 3.1, respectively on 5-point Likert scale of 1 “very weak”, to 5 “very strong”) as did feeling welcome in the NICU (4.2 and 4.5, respectively on 5-point Likert scale of 1 “not at all welcome” to 5 “extremely welcome”).

Conclusion: Culturally concordant peer support groups for families may be a method to improve sense of belonging and feeling welcome in the NICU. Additional results suggest the hybrid format is valuable and attendance should continue to be offered to families after infant discharge.