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Interventions | ATVV vs KC vs Control group | Intervention group (joint observation method, infant massage provided by both parents) vs Standard support group | Massage intervention group vs Control group | Massage therapy group vs Control group |
No of participants | 240 infant-mother dyads (ATVV→N = 78, KC→N = 81 and Control group→N = 81) | 42 parent-infant dyads (intervention group→N = 21, standard support group→ N = 21) | 25 infant-mother dyads (massage intervention group→ N = 9, control group→N = 16) | 30 cocaine-exposed preterm neonates (massage therapy group→N = 15, control group→N = 15) |
Study duration | During hospitalization until 12 months of age | During the first week of life until the 36th week post-menstrual age of the infant | Approximately 2 months and 2-month follow-up measures | 10 days (massage therapy was provided for three 15-minute periods for three consecutive hours each day) |
Mean age | Mothers: ATVV→26.3 years, KC→28.1 years, Control group→26.6 years Infants: ATVV→27.0 weeks, KC→27.2 weeks, Control group→27.4 weeks | Mother’s age (years): Intervention group→34.95 Standard group→35.14 Father’s age (years): Intervention group→37.95 Standard group→38.35 Infant’s Gestational Age (GA) (weeks): Intervention group→29.35 Standard group→29.10 | Teen mothers’ age (years): 16.13 Infants’ age (days): 52.71 | GA (weeks): 30.0 |
Effect size | No change among the groups on any maternal distress variable. Infant social behaviors→significant overall intervention effect (p < 0.05), but neither ATVV nor KC differed from the Control group. Infant Developmental maturity→ significant overall intervention effect (p < 0.01), KC was higher than the other groups (p < 0.05). Mothers who performed a form of massage→more rapid decline in depressive symptoms (p < 0.05). Mothers who performed either a form of massage (p < 0.05) or both interventions (p < 0.05)→higher HOME scores than mothers who engaged in neither. Parenting stress→lower for mothers engaged in any intervention than those who did not (a form of massage only→p < 0.001 , KC only→ p < 0.01, both→ p < 0.01). | At discharge: Intervention group parents→significantly lower levels of stress related to infant’s appearance/ behaviour and to Parental Role Alteration (PRA) than those of the Standard support group (p = 0.000). Mothers→more stress in comparison with fathers (p ≤ 0.05). The intervention→ effective in the reduction of stress-role alteration in mothers (p < 0.05), but not in fathers. | No significant difference between intervention and control groups in maternal confidence, parental stress, or ongoing feelings about physical contact with people. Teen mothers in the intervention group (after the massage intervention)→more positive and comfortable feelings about physical contact with their current relationships in comparison with those in the control group (p < 0.05). The massage intervention exhibited a medium effect size on feelings of physical contact with current relationships (d = 0.59). Teen mothers trained in infant massage→significantly lower depression scores than teen mothers without massage training (p < 0.05). A large effect size of massage intervention was found for both depression and maternal confidence (d = 0.91 and 1.10). Teen mothers in the intervention group reported significantly more adaptive temperament of their infant than those in the control group (p < 0.05). The massage intervention exhibited a large effect size on parental stress, maternal perception of infant temperament, and positive feelings related to physical contact (d = 0.92, 1.34, and 0.62). | Improvement in orientation behaviors and significantly fewer stress behaviors for the massaged group (p = 0.05). More mature motor behaviors for the infants that received massage treatment (p < 0.005). |
Level of evidencea | 2b | 2b | 2b | 2b |