178 - Impact of Sociodemographic Factors on Family Use of Remote Infant Viewing in the Neonatal Intensive Care Unit

Poster Number: 178
Publication Number: 178.234

Rahul Patel, Mayo Clinic Alix School of Medicine, Scottsdale, AZ, United States; Beth L. Kreofsky, Mayo Clinic, Rochester, MN, United States; Carrie Sanvick, Mayo Clinic Children's Center, Rochester, MN, United States; Katie M. Morgan, Mayo Clinic Children's Center, Zumbrota, MN, United States; Amy L. Weaver, Mayo Clinic Children's Center, Kasson, MN, United States; Jennifer Fang, Mayo Clinic Children's Center, Rochester, MN, United States; Jane E. Brumbaugh, Mayo Clinic, Rochester, MN, United States

Background: Remote infant viewing (RIV) uses a bedside camera to allow family members to view a livestream video of their neonate 24/7 from anywhere with internet access. There is concern that increased use of technology and telehealth widens the digital divide.

Objective: We aimed to determine whether the use of RIV in the Neonatal Intensive Care Unit (NICU) differed based on maternal sociodemographic factors.

Design/Methods: Use of RIV (AngelEye Health) was evaluated for patients in the NICU between 10/01/2019 and 3/31/2021. The date/time stamp of every RIV use was exported from the AngelEye database and combined with sociodemographic, maternal, and neonatal factors obtained from institutional NICU and obstetric databases. Among infants with RIV, we determined the total number of camera views and their total patient-days in the NICU.

Results: Among 980 neonates in the NICU during the study period, RIV was used for 74% (721/980). Compared to neonates with RIV, neonates without RIV were significantly more likely to have a mother who was married, had a higher education level, was non-English speaking, needed an interpreter, and were of higher birthweight or term gestation based on univariate analysis (Table 1). In a multivariable logistic model, marital status, need for interpreter, and birthweight retained statistical significance (p < 0.05). RIV use did not vary significantly by race, ethnicity, or insurance type. Among the 721 neonates with RIV, the median (IQR) number of views per patient-day was 12.5 (5.4, 26.0). The median number of views per patient-day was significantly lower for neonates who were singletons, who had a lower birthweight or gestational age, and whose mothers were multiparous, did not identify English as their preferred language, or needed an interpreter (Table 2). In a multivariable linear model, singleton status, gestational age, and parity retained statistical significance.Conclusion(s): The impact of sociodemographic factors on use of RIV is variable and complex. Certain factors may allow parents to spend more time in-person at the bedside thereby reducing the need for RIV (e.g., married couples). Other factors may create barriers to RIV use (e.g., need for an interpreter). Yet other factors may lead to less perceived need for RIV based on the neonate’s clinical stability (e.g., higher birthweight, term gestation). The mechanisms for how sociodemographic factors influence RIV use warrant investigation to address potential equity gaps, e.g., increased resources for non-English speaking families.
Table 1. Comparison of maternal and neonatal sociodemographic factors between neonates whose 
families utilized RIV versus those whose families did not utilize RIV during their NICU hospitalization.†Comparisons between the two groups were evaluated using the two-sample t-test for age, birthweight, and gestational age; the Wilcoxon rank sum test for the ordinal categories for educational level, birthweight, and gestational age; and the chi-square test for all other variables.
Table 2. Usage of RIV (camera views per patient-day) by maternal and neonatal
sociodemographic factors.† Camera views per patient-day were compared between the levels of each factor using the nonparametric Kruskal-Wallis test.