VoiceLove: NICU Utilization of Remote voice Technology to improve mateRnal Experience (NURTURE)

Postpartum depression (PPD) is the most frequent major depressive disorder following childbirth and is associated with adverse outcomes and poor quality of life for the mother and child. Separation during the initial postpartum period, such as infant admission to the neonatal intensive care unit (NICU), impacts maternal- infant bonding and increases PPD risk by 40%. Feeling disconnected from their infant is a major risk factor for NICU parents developing PPD. The sense of parents not feeling constantly connected to their infants during a NICU stay, and low social support create a high emotional burden on the mother and her partner. PPD risk is decreased when parents have more contact with their infant and a higher perceived social support system. When physical contact is not possible, voice contact may help to foster feelings of connectedness. The medical team is another critical source of social support that can alter parental mental health. Mothers of infants in the NICU report increased depressive symptoms when their perception of nurse support is low, while increased communication between parents and the medical team improves parental well- being. Increased social support from loved ones and the medical care team could significantly reduce PPD severity in parents of babies in the NICU. However, NICU units are primarily focused on infant care and are ill- equipped to address parental mental health. Facilitating communication between parents and healthcare providers, as well as between their friends and family, without increasing work burden for healthcare providers could dramatically impact the mental health and well-being of parents during their baby’s NICU admission. VoiceLove LLC is developing a novel HIPAA-compliant mobile application that enables expanded family engagement by providing an electronic venue for direct patient-family-provider interactions that mitigates barriers to communication. The VoiceLove app is a safe and time-efficient tool for direct communication with absent family members, allowing more time for direct patient care. A pilot study with ICU patients at New York- Presbyterian Hospital demonstrated thousands of direct family messages exchanged without any additional nursing burden. In this Fast-Track STTR, we will refine the VoiceLove prototype and evaluate the new application among parents and NICU providers. Phase I will optimize the VoiceLove app for NICU families and providers. Phase II will include a randomized control trial (RCT) comparing VoiceLove implementation to usual care control to evaluate the impact of the VoiceLove app on maternal PPD scores and on patient-family- provider communication and engagement. This Fast-Track STTR represents a major step forward in bringing a novel technology to the NICU to expand family engagement, empower the clinical experience, and decrease the prevalence of PPD.