# Empower NICU - A Bridge to Resources for Adjusting and Coping with Emotions (EmBRACE)

> **NIH AHRQ R21** · DREXEL UNIVERSITY · 2024 · $110,573

## Abstract

Project Summary Abstract
The extreme emotional strain of parenting an infant in the fast-paced medicalized Neonatal Intensive Care Unit
(NICU) setting can be detrimental to mental health and functioning with up to 70% of parents experiencing
clinically significant levels of depression, anxiety and trauma symptoms. Poor parental mental health contributes
to maladaptive coping and can impair parental functioning, parent-infant attachment, and long-term infant
development. Therefore, early identification of and support for parents at-risk for clinical distress is of paramount
importance. Clinical and research experts have recommended universal screening and ongoing mental health
assessment for all NICU parents to identify specific needs and offer appropriate levels of support. Unfortunately,
widespread implementation of a clinically practical approach has not been achieved. Barriers to screening
include competing demands on parents’ time and focus during daytime hours, such as participating in infant
care, pumping/breastfeeding, meeting with health care providers (HCPs), and making complex decisions about
life-threatening medical procedures, as well as job demands and caretaking for their other children. Obstacles
such as staff availability (e.g., to screen and treat during evenings and weekends) and staff burden limit service
implementation to parents given the focus on medically complex infants receiving intensive care. Mobile health
(mHealth) interventions offer an innovative approach to tackle these barriers. The overarching goal of the current
proposal is to develop and test a novel mHealth app entitled, EmBRACE (Empower NICU – A Bridge to
Resources for Adjusting and Coping with Emotions) to establish: 1. Universal mental health screening while
giving NICU parents control over when and where assessments are completed; 2. Ongoing mental health
monitoring using a set of quick daily assessments (via ecological momentary assessment) and weekly
screenings; 3. Provision of customized microlearning education (e.g., 1-3 minute videos) tailored to assessment
results and referrals in a stepped-care approach; and 4. Use of a sustainable contingency management
approach to increase parent compliance with assessments, microlearning, and referral follow-up. In the R21
phase, we aim to 1) conduct formative research with NICU parents and HCPs that leverages a user-centered
design and the PRECEDE-PROCEED theoretical model to develop the EmBRACE prototype; and 2) evaluate
the feasibility (usability, acceptability, and clinical applicability) of EmBRACE with 20 current NICU parents. In
the R33 phase, we aim to 1) revise the EmBRACE platform; and 2) conduct a multisite, pilot randomized
controlled trial in NICUs located across the U.S. with 120 current NICU parents to test EmBRACE’s efficacy
relative to an active comparator group. EmBRACE has the potential to reduce the significant gaps in mental
health care for NICU parents by providing universal screening, ongoin...

## Key facts

- **NIH application ID:** 10916492
- **Project number:** 5R21HS029554-02
- **Recipient organization:** DREXEL UNIVERSITY
- **Principal Investigator:** PAMELA A GELLER
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2024
- **Award amount:** $110,573
- **Award type:** 5
- **Project period:** 2023-09-01 → 2025-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10916492

## Citation

> US National Institutes of Health, RePORTER application 10916492, Empower NICU - A Bridge to Resources for Adjusting and Coping with Emotions (EmBRACE) (5R21HS029554-02). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10916492. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*