A SUPPORT GROUP FOR FAMILIES WITH A CHILD IN A NEONATAL INTENSIVE CARE UNIT (NICU): A GRANT PROPOSAL

1. A SUPPORT GROUP FOR FAMILIES WITH A CHILD IN A NEONATAL INTENSIVE CARE UNIT (NICU): A GRANT PROPOSAL By Joyce Witcher California State University, Long Beach May, 2013

2. Introduction There are over 500,000 children born prematurely in the United States each year, 75% of these children require an admission into the neonatal intensive care unit (NICU; Muraskas & Parsi, 2008). Upon the newborn’s admittance to the NICU parents feel fearful and anxious about the illness of their child (Lefkowitz, Baxt, & Evans, 2010). A common theme across several studies, regarding the parental experience while children are in the NICU, is the sense of incompetence an individual feels in their role as parent (Dusing, Van Drew, & Brown, 2012 ; Lefkowitz et al., 2010; Obeidat, Bond, & Callister, 2009 ). With the high number of children being admitted to the NICU and the negative impact this can have on parents, the purpose of this thesis project was to write a grant proposal to secure funding for a support group for families with a child in the NICU. This support group will be based on the principles of the Strengths-Based Perspective (Saleebey, 2009). The overarching goals of this project will be for families to identify the individual strengths they possess as caregivers and reduce the level of stress and anxiety associated with having a child in a NICU.

3. Social Work Relevance A social support group would be a means for a social worker to promote relationships between family members who are faced with similar circumstance in the NICU. The social work profession also recognizes the importance of incorporating evidence-based research into practice (Comer & Meier, 2011). Therefore, a support group for families with children in the NICU utilizing the strengths-based perspective would align itself with the acting principles of the NASW’s Code of Ethics.

4. Cross-cultural Relevance The admission of a newborn into the NICU impacts many families across all cultures The ethnicity of a child’s family can impact the mother’s prenatal care and the likelihood of the infant being admitted to the NICU (Esakoff, Caughey, Block-Kurbisch, Inturrisi, & Cheng, 2011). With the knowledge that newborn infants from various cultures will be admitted to the NICU, it is essential for a social worker to be culturally competent and recognize the ways in which culture can impact a family’s willingness to seek and receive support.

5. Methods Target Population: The target population for this support groups is families living in Kern County, who are currently experiencing the admission of a child into a NICU. Identifying and Selecting a Funding Source: Thorough research was conducted on the local, state and national level. Using several key terms www.grants.org and www.grantmanship.org were accessed. The Beale Memorial Library was utilized to access a grant database in order to select an appropriate funder. Funding Source: Due to the ability to gain grant access and the foundation’s mission, The California Endowment was selected as the most appropriate funder for this proposed project. This statewide foundation’s mission is to serve California by offering funding to programs and communities that are designed to provide access to health care, especially in marginalized and underrepresented communities

6. Methods Needs Assessment: This writer primarily utilized a group development approach that is both “top down” (researcher developed ideas) along with “bottom-up” (consumer and provider input) to accurately determine the material, topics and eventual utility of this type of group so it is useful and relevant for families, based on the stated needs of this population. Project Budget: : The estimated budget for the proposed program and subsequent evaluation is $44,200. The funding will include the salary for a MSW social worker, direct program costs, and indirect program costs. With this funding this support group will be developed, facilitated, evaluated and maintained for one fiscal year.

7. Grant Proposal Program Summary and Description:. A professional with a master’s degree in social work will facilitate this support group. This facilitator will provide direct knowledge about various facets that are integrated into a child’s admission to the NICU, during the course of a 4-week cycle. This support will incorporate the principles of the strengths-based perspective. Crisis intervention will be provided as needed. Population Served: The population that will be served are parents and caregivers in Kern County, who experience that experience the hospitalization of a child in a NICU. Sustainability: This program has been developed to be continually implemented, so long as funding is secured each year.

8. Grant Proposal Program Objectives: Objective 1: At the completion of the 4-week support program there will be a 80% decrease in the level of stress. Objective 2: Each family member and/or unit will be able to clearly identify two strengths that they have acquired or recognized as a result of weekly meeting attendance.  Objective 3: Families that participate in this groups will have a 80% decrease in feeling a loss of control over their ability to parent and nurture a child that is admitted to the NICU. Program Evaluation: Two methods will be employed to evaluate the overall success of this program: (a) weekly attendance sheet and; (b) an evaluation questionnaire that will be distributed on the last meeting of the 4-week program cycle.

9. Lessons Learned/Implications for Social Work Relevant literature is essential to support the creation of an evidence-based support group. Parents that experience the admission of a child in a NICU can develop acute stress disorder or posttraumatic stress disorder. One of the most fundamental lessons learned about the grant writing process was the importance of ensuring the grant project aligned with the mission of the funding organization. Secondly, many foundations look to partner with non-profit agencies; therefore the partnership with a non-profit agency is essential. Social Work Implications: The social work professional must continue to utilize evidence-based practice to create and implement support groups. Social workers must recognize the stressors that families can experience as a result of child’s hospitalization in a NICU and provide preventive interventions and empowerment to families

10. References Comer, E., & Meier, A. (2011). Using evidence-based practice and intervention research with treatment groups for populations at risk. In G. Greif & P. Ephross (Eds.), Group work with populations at risk (3rded., pp. 89-95). New York, NY: Oxford University Press. Dusing, S.C., Van Drew, C.M., & Brown, S.E. (2012). Instituting parent education practices in the neonatal intensive care unit: An administrative case report of practice evaluation and statewide action. Physical Therapy, 92(7), 967-975. Esakoff, T. F., Caughey, A. B., Block-Kurbisch, I., Inturrisi, M., & Cheng, Y. W. (2011). Perinatal outcomes in patients with gestational diabetes mellitus by race/ethnicity. Journal of Maternal-Fetal & Neonatal Medicine, 24(3), 422-426. Lefkowitz, D.S., Baxt, C., & Evans, J.R. (2010). Prevalence and correlates of posttraumatic stress and postpartum depression in mother of infants in the neonatal intensive care unit (NICU). Journal of Clinical in Medical Settings, 17, 230-237. Muraskas, J., & Parsi, K. (2008). The cost of saving the tiniest lives: NICU’s versus prevention. Virtual Mentor, 10(10), 655-658. Obeidat, H. M., Bond, E. A., & Callister, L.C. (2009). The parental experience of having an infant in the newborn intensive care unit. The Journal of Perinatal Education, 18(3), 23-29. Saleebey, D. (2009). Introduction: Power in the people. In D. Saleebey (Ed.), The strengths perspective in social work practice (5th ed., pp. 1-23). New York, NY: Pearson.