Open Access Highly Accessed Study protocol

The effectiveness of video interaction guidance in parents of premature infants: A multicenter randomised controlled trial

Anneke Tooten1*, Hannah N Hoffenkamp1, Ruby AS Hall1, Frans Willem Winkel12, Marij Eliëns3, Ad JJM Vingerhoets4 and Hedwig JA van Bakel45

Author Affiliations

1 International Victimology Institute Tilburg, Tilburg University, Tilburg, the Netherlands

2 Centre for Psychotrauma, Reinier van Arkel group, ’s, Hertogenbosch, the Netherlands

3 Association Interactionguidance and Treatment, Foundation and Combination Youth care, Eindhoven, the Netherlands

4 Department Developmental Psychology, Tilburg University, Tilburg, the Netherlands

5 Dimence Institute, Centre of Infant Mental Health, Deventer, the Netherlands

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BMC Pediatrics 2012, 12:76  doi:10.1186/1471-2431-12-76

Published: 18 June 2012



Studies have consistently found a high incidence of neonatal medical problems, premature births and low birth weights in abused and neglected children. One of the explanations proposed for the relation between neonatal problems and adverse parenting is a possible delay or disturbance in the bonding process between the parent and infant. This hypothesis suggests that due to neonatal problems, the development of an affectionate bond between the parent and the infant is impeded. The disruption of an optimal parent-infant bond -on its turn- may predispose to distorted parent-infant interactions and thus facilitate abusive or neglectful behaviours. Video Interaction Guidance (VIG) is expected to promote the bond between parents and newborns and is expected to diminish non-optimal parenting behaviour.


This study is a multi-center randomised controlled trial to evaluate the effectiveness of Video Interaction Guidance in parents of premature infants. In this study 210 newborn infants with their parents will be included: n = 70 healthy term infants (>37 weeks GA), n = 70 moderate term infants (32–37 weeks GA) which are recruited from maternity wards of 6 general hospitals and n = 70 extremely preterm infants or very low birth weight infants (<32 weeks GA) recruited by the NICU of 2 specialized hospitals. The participating families will be divided into 3 groups: a reference group (i.e. full term infants and their parents, receiving care as usual), a control group (i.e. premature infants and their parents, receiving care as usual) and an intervention group (i.e. premature infants and their parents, receiving VIG). The data will be collected during the first six months after birth using observations of parent-infant interactions, questionnaires and semi-structured interviews. Primary outcomes are the quality of parental bonding and parent-infant interactive behaviour. Parental secondary outcomes are (posttraumatic) stress symptoms, depression, anxiety and feelings of anger and hostility. Infant secondary outcomes are behavioral aspects such as crying, eating, and sleeping.


This is the first prospective study to empirically evaluate the effect of VIG in parents of premature infants. Family recruitment is expected to be completed in January 2012. First results should be available by 2012.

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