Research AppraisalSystematic Review

Impact of parent education programmes on confidence and self-efficacy in parents of preterm infants: a systematic review

BMJ paediatrics openPadbidri, Puja, Joshi, Veena, Hix-Small, Hollie et al.3 Apr 2026DOI

Clinical Snapshot

70CEBM
Evidence: ModerateSystematic Review

PICO Framework

P — PopulationParents of preterm infants in neonatal intensive care units
I — InterventionParent education programmes delivered in NICU settings
C — ComparatorStandard care or control groups (where applicable)
O — OutcomesParent confidence and self-efficacy measured by quantitative surveys

Bottom Line

This systematic review suggests parent education programmes in NICUs can improve parental confidence and self-efficacy, though the evidence quality is low due to study heterogeneity and methodological limitations. The most effective programmes combined information delivery with hands-on parent-infant engagement opportunities. While only 8 of 14 studies showed statistically significant between-group differences, all interventions demonstrated baseline improvements. Both unit-developed and commercial programmes showed promise. For Australian NICUs, these findings support integrating structured parent education into standard care, particularly programmes emphasising practical skill development and parent-infant interaction time. However, clinicians should interpret these results cautiously given the acknowledged low evidence quality and significant variability in programme characteristics, duration, and facilitator training across studies.

Evidence: Moderate

Key Findings

  • P Value: 6 of 14 studies showed non-significant between-group differences

  • Effect Size: Not reported - narrative synthesis only

  • Primary Outcome: Parent confidence and self-efficacy scores on quantitative surveys

  • Nnt Or Sensitivity: All interventions showed baseline improvements regardless of statistical significance

  • Confidence Interval: Not provided

Clinical Application

Both unit-specific and commercial programmes appear feasible for implementation in standard NICU care Aligns with Australian Commission on Safety and Quality in Health Care standards for family-centred care in neonatal services and NHMRC guidelines for preterm infant care Parents of preterm infants in Australian NICUs, particularly relevant given family-centred care emphasis

Abstract

OBJECTIVE: Families of preterm infants can experience high stress during neonatal intensive care unit (NICU) hospitalisation, which interferes with the development of parenting confidence and self-efficacy through active engagement with their infants. Parent NICU support programmes provide guidance and education to build this connection. This systematic review examined the effects of parent education programmes on confidence and self-efficacy among parents of preterm infants. DESIGN: Systematic review in PubMed/Medline, PsycINFO, CINAHL, Google Scholar and Web of Science. SETTING: NICU. PARTICIPANTS: Parents of preterm infants. INTERVENTION: Education programmes offered to parents in the NICU. MAIN OUTCOME MEASURES: Quantitative surveys measuring parent confidence or self-efficacy. RESULTS: 14 studies met inclusion criteria from an initial 220 identified. Five were randomised controlled trials and nine were non-randomised studies. Programmes combining information delivery with opportunities for parent-infant engagement were most effective. Infant access and time to practise skills were key factors in transferring programme knowledge to increase parent confidence and self-efficacy. While 6 of the 14 studies did not show statistically significant differences between groups, all interventions demonstrated improvements in parental confidence or self-efficacy from baseline. Vast variability in duration of intervention, proper descriptions of facilitator trainings, methodological limitations and potential confounding factors reduced the overall quality of evidence to a low level. CONCLUSION: Both unit-specific programmes developed within individual NICUs and commercially available, copyrighted parent education programmes hold value. They are generally effective in building parent confidence and self-efficacy among parents of preterm infants. Integrating either type of programme into standard NICU care may hold promise for strengthening parental competence and promoting family-centred outcomes. Clarity on content/topics of programmes, duration and level of facilitator trainings can strengthen the process of supporting parents in the NICU, even in low resource settings. PROSPERO REGISTRATION NUMBER: CRD42024524063.

References

  1. 1.Padbidri, P., Joshi, V., Hix-Small, H., & Dekhane, P. B. (2026). Impact of parent education programmes on confidence and self-efficacy in parents of preterm infants: a systematic review. BMJ Paediatrics Open. https://doi.org/10.1136/bmjpo-2025-004454
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