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Am J Perinatol 2025; 42(09): 1152-1161
DOI: 10.1055/a-2463-4327
Original Article

Integrating Stakeholder Priorities for the Optimization of Care of the Preterm Infant in a Safety-Net NICU

Elizabeth Sewell   *
1   Department of Pediatrics, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia
,
Miguel Locsin   *
2   Department of Pediatrics, University of North Carolina, Chapel Hill, North Carolina
,
George Bugg
1   Department of Pediatrics, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia
,
Kimarie Bugg
3   Reaching Our Sisters Everywhere, Inc., Atlanta, Georgia
,
Kate McGinnis
1   Department of Pediatrics, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia
,
Mary Jackson
3   Reaching Our Sisters Everywhere, Inc., Atlanta, Georgia
,
Nathalie Maitre
1   Department of Pediatrics, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia
,
Sierra Peagler
4   NICU Parent, Atlanta, Georgia
,
Dana Robinson
4   NICU Parent, Atlanta, Georgia
,
Andrea Serano
3   Reaching Our Sisters Everywhere, Inc., Atlanta, Georgia
,
Jessica Roberts
1   Department of Pediatrics, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia
› Author Affiliations
Funding This work was funded by the Emory Medical Care Foundation Service, Education, and Advocacy Grant Program.
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Abstract

Objective

This study aimed to engage clinical and community stakeholders to create a prioritization matrix of interventions to reduce neonatal brain injury and improve neurodevelopmental outcomes.

Study Design

We collaborated with our community partner to establish a Lived Experience Advisory Group (LEAG). Faculty performed a literature review to identify neonatal neuroprotective interventions; additional priorities from the LEAG were also included. Project leaders scored and presented intervention bundles for impact. Stakeholder priorities for value/feasibility were obtained via questionnaire. Mean values were incorporated into a prioritization matrix.

Results

Themes from discussions with LEAG members included the role of the neonatal intensive care unit (NICU) parent, the experience of trauma, shared decision-making, communication and trust with the health care team, and bias in medical care. Five interventions were placed in the highest priority quadrant of the prioritization matrix: thermoregulation, maternal antepartum steroids, delayed cord clamping, optimized oxygen delivery, and optimized glucose regulation.

Conclusion

It is feasible to incorporate community and parent values into clinically oriented neuroprotective intervention bundles for preterm infants. This clinical–community collaboration is vital to ensure that our project objectives meet the needs and priorities of the population it is intended to serve.

Key Points

  • Including input from parent advisory groups supports interventions that meet the needs of families.

  • Collaboration between clinical and community stakeholders can improve neuroprotective and neurodevelopmental strategies.

  • Incorporation of clinical interventions into a prioritization matrix improves resource utilization.

  • Five perinatal interventions were ranked highly for impact and feasibility in the prioritization matrix.

Keywords

neonatal brain injury - neurodevelopment - intervention bundle - community stakeholders - Lived Experience Advisory Group - prioritization matrix

Authors' Contributions

E.S. made substantial contributions to the conceptualization, methodology, and investigation of the study, and co-drafted the initial manuscript. M.L. contributed to the investigation of the study and co-drafted the initial manuscript. N.M. and J.R. made substantial contributions to the conceptualization, methodology, and investigation of the study, and critically reviewed the manuscript. G.B., K.B., K.M., M.J., S.P., D.R., and A.S. participated in the investigation of the study and critically reviewed the manuscript. All authors have reviewed and approved the final version of the submitted manuscript.


* These are co-first authors.




Publication History

Received: 19 June 2024

Accepted: 04 November 2024

Article published online:
04 December 2024

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