Longitudinal Study of Music Therapy's Effectiveness for Premature Infants and Their Caregivers

NCT ID: NCT03564184

Last Updated: 2022-11-22

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

213 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-08-25

Study Completion Date

2022-08-31

Brief Summary

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Background: Preterm birth has major medical, psychological and socio-economic consequences worldwide. A recent systematic review suggests positive effects of music therapy (MT) on physiological measures of preterm infants and maternal anxiety, but methodologically rigorous studies including long-term follow-up of infant and parental outcomes are missing. Drawing upon caregivers' inherent resources, this study emphasizes caregiver involvement in MT to promote attuned, developmentally-appropriate musical interactions that may be of mutual benefit to infant and parent. This study will determine whether MT, as delivered by a qualified music therapist during neonatal intensive care unit (NICU) hospitalization and/or in home/municipal settings following discharge, is superior to standard care in improving bonding between primary caregivers and preterm infants, parent well-being and infant development.

Methods: Design: International multi-center, assessor-blind, 2x2 factorial, pragmatic randomized controlled trial. A feasibility study has been completed; ethical approval for the main trial is pending. Participants: 250 preterm infants and their parents. Intervention: MT focusing on singing specifically tailored to infant responses, will be delivered during NICU and/or during a post-discharge 6-month period. Primary outcome: Changes in mother-infant bonding until 6 months corrected age (CA), as measured by the Postpartum Bonding Questionnaire. Secondary outcomes: Mother-infant bonding at discharge and over 12 months CA; child development over 24 months; and parental depression, anxiety, and stress, and infant re-hospitalization, all over 12 months.

Discussion: This study fills a gap by measuring the long-term impact of MT for preterm infants/caregivers, and of MT beyond the hospital context. Outcomes related to highly involving parents in MT will directly inform the development of clinical practice in Scandinavia and other contexts with similar social welfare practices. By incorporating family-centered care, continuity of care, user involvement, and cultural relevance, this study can potentially contribute to improved quality of care for premature infants and their parents worldwide.

Detailed Description

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Conditions

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Preterm Birth

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

FACTORIAL

2x2 factorial, multinational, single-blind trial
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors
Data collectors (for self-reports) and assessors (for observational measures) will be trained in assessment procedures and blinded to participant allocation. This will be ensured by using assessors from a different ward and by asking participants not to reveal their treatment assignments. Success of blinding will be verified.

Study Groups

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MT during and after NICU

Consists of music therapy during NICU hospitalization, and music therapy after discharge from initial NICU hospitalization, along with standard care.

Group Type EXPERIMENTAL

MT during NICU

Intervention Type BEHAVIORAL

Music therapy (MT) by trained music therapist, 3 times/week for 30-40 minutes/session during NICU hospitalization. Involves primary caregiver and infant in musical communication matched to infant post-menstrual age, family/cultural preferences, and infant readiness for stimulation. Music therapist assesses infant´s needs and behavior state, supports caregiver in using basic touch (e.g., hand lightly and statically on infant´s chest or back to perceive breathing pattern) and caregiver´s hummed/sung voice matched to infant behavioral responses, to promote infant state regulation and bonding. Music includes input from music therapist as needed, and multimodal aspects such as gentle dynamic touch when infant demonstrates readiness. MT may occur while infant is held in a static manner by caregiver or is resting in his/her isolette or basinet. MT may occur during skin-to-skin care, if such care is part of standard care.

MT after NICU

Intervention Type BEHAVIORAL

Music therapy offered by trained music therapist, 7 times for approximately 45 minutes/session across first 6 months following discharge from initial NICU hospitalization. Sessions include infant and caregiver, and siblings, if desired, and occur at home or in municipal settings. MT after NICU consists of a consult-to-parent model with each session including a brief verbal check-in regarding infant´s progress, musical interactions with music therapist modelling musical engagement, discussion of current challenges and strategies for using musical interactions to address needs in areas such as infant self-regulation, parent/infant interaction, and challenges with bonding. Caregivers will demonstrate techniques discussed during session, and form a brief plan for use of musical interaction in the interim before next session. Sessions will be adapted to infant developmental level and ongoing needs.

Standard care

Intervention Type OTHER

Includes necessary medical care and standard supportive interventions offered as part of care during hospitalization, and standard follow-up procedures post-hospitalization.

MT during NICU

Consists of music therapy during NICU hospitalization, along with standard care.

Group Type EXPERIMENTAL

MT during NICU

Intervention Type BEHAVIORAL

Music therapy (MT) by trained music therapist, 3 times/week for 30-40 minutes/session during NICU hospitalization. Involves primary caregiver and infant in musical communication matched to infant post-menstrual age, family/cultural preferences, and infant readiness for stimulation. Music therapist assesses infant´s needs and behavior state, supports caregiver in using basic touch (e.g., hand lightly and statically on infant´s chest or back to perceive breathing pattern) and caregiver´s hummed/sung voice matched to infant behavioral responses, to promote infant state regulation and bonding. Music includes input from music therapist as needed, and multimodal aspects such as gentle dynamic touch when infant demonstrates readiness. MT may occur while infant is held in a static manner by caregiver or is resting in his/her isolette or basinet. MT may occur during skin-to-skin care, if such care is part of standard care.

Standard care

Intervention Type OTHER

Includes necessary medical care and standard supportive interventions offered as part of care during hospitalization, and standard follow-up procedures post-hospitalization.

MT after NICU

Consists of music therapy after discharge from initial NICU hospitalization, along with standard care.

Group Type EXPERIMENTAL

MT after NICU

Intervention Type BEHAVIORAL

Music therapy offered by trained music therapist, 7 times for approximately 45 minutes/session across first 6 months following discharge from initial NICU hospitalization. Sessions include infant and caregiver, and siblings, if desired, and occur at home or in municipal settings. MT after NICU consists of a consult-to-parent model with each session including a brief verbal check-in regarding infant´s progress, musical interactions with music therapist modelling musical engagement, discussion of current challenges and strategies for using musical interactions to address needs in areas such as infant self-regulation, parent/infant interaction, and challenges with bonding. Caregivers will demonstrate techniques discussed during session, and form a brief plan for use of musical interaction in the interim before next session. Sessions will be adapted to infant developmental level and ongoing needs.

Standard care

Intervention Type OTHER

Includes necessary medical care and standard supportive interventions offered as part of care during hospitalization, and standard follow-up procedures post-hospitalization.

No MT

Consists of standard care.

Group Type EXPERIMENTAL

Standard care

Intervention Type OTHER

Includes necessary medical care and standard supportive interventions offered as part of care during hospitalization, and standard follow-up procedures post-hospitalization.

Interventions

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MT during NICU

Music therapy (MT) by trained music therapist, 3 times/week for 30-40 minutes/session during NICU hospitalization. Involves primary caregiver and infant in musical communication matched to infant post-menstrual age, family/cultural preferences, and infant readiness for stimulation. Music therapist assesses infant´s needs and behavior state, supports caregiver in using basic touch (e.g., hand lightly and statically on infant´s chest or back to perceive breathing pattern) and caregiver´s hummed/sung voice matched to infant behavioral responses, to promote infant state regulation and bonding. Music includes input from music therapist as needed, and multimodal aspects such as gentle dynamic touch when infant demonstrates readiness. MT may occur while infant is held in a static manner by caregiver or is resting in his/her isolette or basinet. MT may occur during skin-to-skin care, if such care is part of standard care.

Intervention Type BEHAVIORAL

MT after NICU

Music therapy offered by trained music therapist, 7 times for approximately 45 minutes/session across first 6 months following discharge from initial NICU hospitalization. Sessions include infant and caregiver, and siblings, if desired, and occur at home or in municipal settings. MT after NICU consists of a consult-to-parent model with each session including a brief verbal check-in regarding infant´s progress, musical interactions with music therapist modelling musical engagement, discussion of current challenges and strategies for using musical interactions to address needs in areas such as infant self-regulation, parent/infant interaction, and challenges with bonding. Caregivers will demonstrate techniques discussed during session, and form a brief plan for use of musical interaction in the interim before next session. Sessions will be adapted to infant developmental level and ongoing needs.

Intervention Type BEHAVIORAL

Standard care

Includes necessary medical care and standard supportive interventions offered as part of care during hospitalization, and standard follow-up procedures post-hospitalization.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* born below 35 weeks gestational age
* determined by medical staff to have achieved sufficient medical stability to start MT
* likely to be hospitalized longer than 2 weeks from time of recruitment


* willing to engage in at least 2 of 3 MT sessions per week during NICU and/or in 5 of 7 MT post-discharge sessions, if randomized to receive MT
* live with reasonable commuting distance from the treating NICU
* sufficient understanding of the respective national language(s) to answer questionnaires and participate in MT

Exclusion Criteria

* documented mental illness or cognitive impairment that prevents them from being able to complete the study intervention or outcome assessments
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Haukeland University Hospital

OTHER

Sponsor Role collaborator

University Hospital, Akershus

OTHER

Sponsor Role collaborator

Oslo University Hospital

OTHER

Sponsor Role collaborator

Meir Medical Center

OTHER

Sponsor Role collaborator

Clinica de La Mujer

OTHER

Sponsor Role collaborator

University of Haifa

OTHER

Sponsor Role collaborator

University of Gdansk

OTHER

Sponsor Role collaborator

King's College London

OTHER

Sponsor Role collaborator

Universidad de Ciencias Empresariales y Sociales

UNKNOWN

Sponsor Role collaborator

Szpital Miejski w Rudzie Śląskiej

UNKNOWN

Sponsor Role collaborator

SONO - Centro de Musicoterapia

UNKNOWN

Sponsor Role collaborator

Hospital Materno Infantil Ramón Sardá

NETWORK

Sponsor Role collaborator

Hospital Fernandez

OTHER

Sponsor Role collaborator

NORCE Norwegian Research Centre AS

OTHER

Sponsor Role lead

Responsible Party

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Christian Gold

Research Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Christian Gold, PhD

Role: STUDY_CHAIR

NORCE Norwegian Research Centre

Claire Ghetti, PhD

Role: PRINCIPAL_INVESTIGATOR

Grieg Academy, University of Bergen

Locations

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Hospital Materno Infantil Ramón Sardá

Buenos Aires, Buenos Aires F.D., Argentina

Site Status

Sanatorio Mater Dei

Buenos Aires, Buenos Aires F.D., Argentina

Site Status

Hospital Fernandez

Buenos Aires, , Argentina

Site Status

Clinica de la Mujer

Bogotá, , Colombia

Site Status

Fundación Santa Fe de Bogotá

Bogotá, , Colombia

Site Status

Meir Medical Center

Kfar Saba, , Israel

Site Status

Haukeland University Hospital, Barne-og ungdomsklinikken

Bergen, Hordaland, Norway

Site Status

Akershus University Hospital

Oslo, Lørenskog, Norway

Site Status

Oslo University Hospital, Rikshospitalet

Oslo, , Norway

Site Status

Szpital Miejski w Rudzie Śląskiej

Ruda Śląska, , Poland

Site Status

Countries

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Argentina Colombia Israel Norway Poland

References

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Bieleninik L, Ghetti C, Gold C. Music Therapy for Preterm Infants and Their Parents: A Meta-analysis. Pediatrics. 2016 Sep;138(3):e20160971. doi: 10.1542/peds.2016-0971. Epub 2016 Aug 25.

Reference Type BACKGROUND
PMID: 27561729 (View on PubMed)

Ghetti C, Bieleninik L, Hysing M, Kvestad I, Assmus J, Romeo R, Ettenberger M, Arnon S, Vederhus BJ, Soderstrom Gaden T, Gold C. Longitudinal Study of music Therapy's Effectiveness for Premature infants and their caregivers (LongSTEP): protocol for an international randomised trial. BMJ Open. 2019 Sep 3;9(8):e025062. doi: 10.1136/bmjopen-2018-025062.

Reference Type BACKGROUND
PMID: 31481362 (View on PubMed)

Bieleninik L, Kvestad I, Gold C, Stordal AS, Assmus J, Arnon S, Elefant C, Ettenberger M, Gaden TS, Haar-Shamir D, Havardstun T, Lichtensztejn M, Mangersnes J, Wiborg AN, Vederhus BJ, Ghetti CM. Music Therapy in Infancy and Neurodevelopmental Outcomes in Preterm Children: A Secondary Analysis of the LongSTEP Randomized Clinical Trial. JAMA Netw Open. 2024 May 1;7(5):e2410721. doi: 10.1001/jamanetworkopen.2024.10721.

Reference Type DERIVED
PMID: 38753331 (View on PubMed)

Ettenberger M, Bieleninik L, Stordal AS, Ghetti C. The effect of paternal anxiety on mother-infant bonding in neonatal intensive care. BMC Pregnancy Childbirth. 2024 Jan 11;24(1):55. doi: 10.1186/s12884-023-06179-z.

Reference Type DERIVED
PMID: 38212696 (View on PubMed)

Ghetti CM, Gaden TS, Bieleninik L, Kvestad I, Assmus J, Stordal AS, Aristizabal Sanchez LF, Arnon S, Dulsrud J, Elefant C, Epstein S, Ettenberger M, Glosli H, Konieczna-Nowak L, Lichtensztejn M, Lindvall MW, Mangersnes J, Murcia Fernandez LD, Roed CJ, Saa G, Van Roy B, Vederhus BJ, Gold C. Effect of Music Therapy on Parent-Infant Bonding Among Infants Born Preterm: A Randomized Clinical Trial. JAMA Netw Open. 2023 May 1;6(5):e2315750. doi: 10.1001/jamanetworkopen.2023.15750.

Reference Type DERIVED
PMID: 37234006 (View on PubMed)

Gaden TS, Gold C, Assmus J, Kvestad I, Stordal AS, Bieleninik L, Ghetti C. Treatment fidelity in a pragmatic clinical trial of music therapy for premature infants and their parents: the LongSTEP study. Trials. 2023 Mar 3;24(1):160. doi: 10.1186/s13063-022-06971-w.

Reference Type DERIVED
PMID: 36869392 (View on PubMed)

Gaden TS, Ghetti C, Kvestad I, Bieleninik L, Stordal AS, Assmus J, Arnon S, Elefant C, Epstein S, Ettenberger M, Lichtensztejn M, Lindvall MW, Mangersnes J, Roed CJ, Vederhus BJ, Gold C. Short-term Music Therapy for Families With Preterm Infants: A Randomized Trial. Pediatrics. 2022 Feb 1;149(2):e2021052797. doi: 10.1542/peds.2021-052797.

Reference Type DERIVED
PMID: 34988583 (View on PubMed)

Other Identifiers

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RCN 273534

Identifier Type: -

Identifier Source: org_study_id

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