Per protocol analyses
β=-1.09, PTSD, Stress Disorder, depression, Depression
INTERACTION
Per protocol analyses were conducted to determine whether specific intervention components were differentially associated with maternal mental symptoms based on the mother’s level of NICU-related stress (i.e., an interaction effect with NICU-related stress). For mothers who experienced high levels of NICU-related stress, participating at least twice in clinical rounds was associated with fewer PTSD symptoms after discharge. However, for mothers who experienced low levels of NICU-related stress, there was no apparent association. This differential association (β=-1.08 [between clinical rounds and NICU-related stress]; 95% CI -1.99, -0.16; p = .022; Table 
Interaction effect of parent NICU stress and attending mFICare clinical rounds on PTSD symptoms (a) and depression (b) after NICU discharge. Dotted lines indicate the 95% confidence interval for each group. Results were similar when examining if attending parental classes has a differential association with PTSD and depression symptoms after discharge. Among mothers who experienced high levels of NICU-related stress, those who attended at least one parent class experienced fewer PTSD symptoms (interaction β=-1.09, 95% CI -2.03, -0.16, p = .024) and fewer symptoms of depression (interaction β=-0.98, 95% CI -1.76, -0.20; p = .015) after discharge than similarly stressed mothers who did not attend parent classes. However, for mothers who had low levels of stress, there was no apparent association (Fig. 
Per protocol analysis of the main and interaction effects of the mFICare intervention components on maternal mental healthEPDS = Edinburgh Postnatal Depression Scale; PPQ = Perinatal Post-Traumatic Stress Disorder Questionnaire; PTSD = Post-Traumatic Stress Disorder; PSS:NICU = Parental Stressor Scale: NICU.* PTSD model adjusted for site, length of hospital stay, 5-minute Apgar score, and mother’s perception of FCC quality at enrollment.** Depression model adjusted for NICU site and infant gestational age.Note: Parent mentorship and We3health™ app usage were unrelated to maternal health outcomes (data not shown).
Interaction effect of mFICare parent classes and parent NICU stress and on PTSD symptoms (3a) and depression (3b) after NICU discharge. Dotted lines indicate the 95% confidence interval for each group. 