Scholarship & Research
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Item Implementation of a tummy time protocol: a quality improvement project in a level 3B NICU(Montana State University - Bozeman, College of Nursing, 2024) Chaffin, Taylor Christine; Chairperson, Graduate Committee: Benjamin J. Miller; This is a manuscript style paper that includes co-authored chapters.Background: Infants who spend prolonged periods in the supine position, particularly in the NICU, face an increased risk of plagiocephaly and developmental delays. Supine sleeping is recommended by the American Academy of Pediatrics, "Back to Sleep" campaign, which has successfully reduced sudden infant death syndrome by 40-60%. However, an increase in cranial abnormalities was observed following the widespread adoption. Daily tummy time supports motor development, reduces the risk of plagiocephaly, and promotes parental bonding. Methods: A six-week tummy time protocol was implemented in a level 3b NICU for infants who were 32 weeks corrected gestational age and medically stable. Brief 1-2-minute tummy time sessions were completed in the infant's bed or while holding with a parent. Tummy time sessions, education, and return demonstrations were documented on a bedside tracker. Pre- and post-implementation surveys were distributed to staff to gather perspectives. Parent surveys were distributed at discharge to evaluate readiness to complete tummy time at home. Results: Between January 15th and February 25th, only 23 out of 42 eligible infants had tracker sheets returned (55%). Out of 504 eligible days, tummy time sessions were recorded on 214 days, accounting for 42%. Post-implementation staff surveys showed positive results regarding their confidence in educating parents (M=4.7, sd=0.47) and the ease of implementation (M=4.38, sd=0.65). Comparing the results of the pre-and post-implementation surveys using a t-test yielded no significance. Obstacles to compliance included difficulty integrating new workflows, time constraints for education completion, tummy time, and documentation. Conclusion: Implementing the Tummy Time Protocol was crucial in changing practice patterns to align with best practices for infants admitted to the NICU. However, more work must be done to integrate tummy time sessions, early education, and documentation into a new workflow. Suggestions for improvement were provided, focusing on incorporating documentation into the electronic health record (EHR) system to improve compliance and reduce the risk of losing tracking sheets. In addition, future research is necessary to evaluate the long-term effects of tummy time implementation within the NICU. Specifically, research should focus on rates of plagiocephaly and outpatient therapy referrals following discharge from the NICU.Item Father-specific education in the inpatient setting(Montana State University - Bozeman, College of Nursing, 2019) Smith, Pamela Alejandra; Chairperson, Graduate Committee: Sandra Benavides-VaelloThe early postpartum period is an important period of time to prepare mothers and fathers for parenthood. Father's involvement in children's lives has shown to be beneficial for the child's health and the entire family dynamics too. Evidence shows that parental education increases knowledge and confidence levels in parents. Currently, the majority of educational efforts and programs target mothers, leaving men with none or minimal tools to succeed as fathers of a newborn. A major goal of Healthy People 2020 in relation to children's health is a ten percent reduction in infant and neonatal deaths. One key approach for reaching this goal includes increasing the amount of educational and community based programs for infant and child health to increase knowledge in parents (both mothers and fathers) of safe practices with infants and children. This pre/post-quasi-experimental project was designed to evaluate gender specific education and changes in parental confidence level when exposed to educational literature. The project was implemented in the maternity unit at St. Vincent's Healthcare in Billings, Montana. With a total of 32 fathers as participants. Results of the project indicated an overall maintenance or improvement of parent confidence level evidenced by a maintenance or increase in Karitane Parenting Confidence Scale scores. Results of the project are expected to facilitate fathers' responsiveness to baby and better bonding of baby to father in the immediate future. Outcomes are expected to lead to positive consequences in children's health and development. Results also indicate the educational intervention with fathers was overall successful in fulfilling the purpose of this scholarly project.Item Male migration and family-related outcomes(Montana State University - Bozeman, College of Agriculture, 2017) Noray, Savannah Grace; Chairperson, Graduate Committee: Sarah JanzenThe income benefits of out-migrant work in developing countries are well established. However, much less is known about changes in women's empowerment that might occur during spousal migration spells. Two main questions motivate this research. First, during a spouse's absence, does a woman gain more control over household resources? Second, does this shift in power affect children's welfare, indicating that women have different preferences for children's welfare than do their husbands? In this paper I identify causally each step in this sequence using unique panel data from rural Nepal, a country known for high rates of male migrant work. This research makes contributions to two bodies of literature, the first being the migration literature. The majority of the past migration research has been quite narrow in scope, covering mainly how migrant households use remittances. Consequently, any discussion on the benefits of migration often centers on remittances with little regard to other potential sources of economic development. This research is a critical addition to the migration literature, as it unlocks more discussion on the effects of migration holding economic resources constant. Second, this paper contributes to the intersection between intra-household bargaining and international development literature. Many development programs give cash or in-kind transfers to women in poor families, motivated by the common belief that women spend resources in a more pro-child way than do men. This makes sense theoretically: if household members have unique preferences and bargain over control of household resources, then the effectiveness of a transfer depends on the recipient's preferences and bargaining power. The common assumption is that women have less bargaining power and stronger preferences for children's welfare than men. Yet the literature on this issue is not as conclusive as this commonly-held belief would suggest. As development programs continue to choose beneficiaries, more research in this area is certainly warranted in order to maximize effectiveness of transfers. Furthermore, we might expect that outcomes vary with local context, perhaps due to cultural differences. Therefore, evaluating this claim in rural Nepal provides useful policy implications for programs focused in rural South-East Asia.Item The evocative effect of children's physiologocial stress reactivity on intrusive parenting(Montana State University - Bozeman, College of Letters & Science, 2017) Najjar, Reema; Chairperson, Graduate Committee: Rebecca BrookerSelf-regulatory processes, such as effortful control, are important facets of development for children's long term adjustment. Effortful control is known to be influenced by biological processes that enable regulatory function. Specifically, better biological regulation is associated with better effortful control. The direction of environmental effects, however, is less clear. Although theoretical perspectives support the possibility that parent-child influences are bidirectional, studies of self-regulation -- both physiological regulation and effortful control -- have almost exclusively focused on a parent-to-child direction of effects. Almost no research has investigated the influence of children's physiological and behavioral regulation on parenting behaviors. My thesis explored one process by which physiological regulation, indexed through measures of neuroendocrine reactivity, and behavioral regulation, indexed as effortful control, may evoke intrusive behaviors in parents. I hypothesized that greater cortisol reactivity would predict lower levels of effortful control, which would subsequently predict greater intrusive parenting. I tested my hypothesis in a sample of preschool-aged children and their parents, capitalizing on a critical period for the development of self-regulation. Results indicate that cortisol reactivity did not work through effortful control to predict parent intrusiveness. However, effortful control did moderate the association between child cortisol reactivity and parent intrusiveness. Specifically, when children were high in effortful control, greater cortisol reactivity predicted greater intrusive parenting. This work sheds light the importance of considering bidirectional effects in the development of self-regulation in early childhood.Item Social responsibility in high tech custody cases : surrogate parenthood(Montana State University - Bozeman, 1988) Cunningham, Elaine Eula; Chairperson, Graduate Committee: Richard L. HainesItem An investigation of the relationship of student achievement and parental attitude toward education(Montana State University - Bozeman, 1971) Taylor, Kenneth Allen; Chairperson, Graduate Committee: S. Gordon SimpsonItem Behavior modification of children by parents in the home : a modified case study approach(Montana State University - Bozeman, College of Professional Schools, 1971) Slaughter, Constance LawrenzItem Parents of hearing impaired children : a model for the study of attitudinal changes following group interaction(Montana State University - Bozeman, 1976) Rigg, Phyllis Ruth ReiserItem Effects of quality of parent/adolescent communication and discussion of contraception on adolescents' use of contraceptives at first intercourse(Montana State University - Bozeman, 1986) Dover, Carwin Burnett; Chairperson, Graduate Committee: Margaret BriggsItem The relationship between parental child-rearing attitudes and child adjustment : a critical review of research, 1960-1976(Montana State University - Bozeman, 1977) Button, Sally Jo