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The Trauma-informed Age-appropriate Care Program Development for Very
Preterm Infants: An Intervention Mapping Protocol

S. Srisawet, J. Mesukko, S. Niyomkar, and N. Namprom 1
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Faculty of Nursing, Chiang Mai University, Thailand
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Background: Very preterm infants have fragile and immature developed organs that need hospitalization
in neonatal intensive care unit. However, environment in this unit is non-optimal for these infants due to
exposure to various stimuli that lead to trauma, which affects growth and development.

Objective: To describe the intervention mapping protocol in development of a Trauma-Informed
Age-Appropriate Care Program for growth and development of very preterm infants in neonatal
intensive care unit.

Methods: The program development was based on six key stages of intervention mapping framework:
1) needs assessment from literature review related to very preterm infants hospitalized in neonatal intensive
care unit, 2) performance objectives to promote growth and development, 3) theory-based intervention,
4) intervention plan by determining strategies, materials, and duration, 5) implementation in neonatal
intensive care units, and 6) evaluation through a randomized control trial.

Results: The needs assessment highlighted key barriers to growth and development of very preterm infants
in neonatal intensive care unit, including trauma from hospitalization in this unit, lacking parent-infant
attachment, and parents’ low competence and confidence to be involved in infant care. The program was
guided by the trauma-informed age-appropriate care concept with eight sessions in four weeks with three
strategies: 1) knowledge and skills training, 2) social support, and 3) partnership in care. The program was
reviewed and revised following expert suggestions. The program will be implemented and evaluated in a
Oral Presentation Abstracts
randomized control trial involving 34 very preterm infant-parent dyads born between 28 and 32 weeks of
gestational age admitted to the neonatal intensive care unit in a province in central Thailand.

Conclusion: The program is expected to increase parents’ competence and confidence to be involved
in infant care, which improves parent-infant attachment that can prevent or reduce trauma, thereby
promoting infants’ growth and development. Further research is warranted to evaluate its effectiveness in
clinical practice.

Keywords: trauma-informed age-appropriate care, growth, development, very preterm infants

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Correspondence: Jutarat Mesukko, Faculty of Nursing, Chiang Mai University, Thailand
E-mail: jutarat.m@cmu.ac.th

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