Setting

This project was undertaken at a Dudley Group of Hospitals NHS Trust, local district general hospital catering for approximately 4100 births per year in the Midlands. With the support of its Nurture and Resilience Steering Group, local Council, its local department of Public Health funded two part-time posts for support workers to work within the hospital’s neonatal in-patient setting, providing 1:1 education and empowerment for parents whose babies were admitted to its neonatal services. Additional support where needed for vulnerable families in the paediatric and maternity setting was offered, in delivering the messages around reducing the risks for infant mortality. Vulnerable families included those with a previous neonatal or infant death, recent immigrants or refugees to the UK, mothers under 18 years of age who had declined the family nurse partnership established to support teenage pregnancies, those mothers with learning difficulties, were smokers in pregnancy, experiences substance misuse, domestic violence, mental health issues, where there were safeguarding concerns, or concerns raised by health care professionals during pregnancy or after birth about parenting capabilities such as complex social lives or unsafe sleep practices. Approximately a third of the mothers and families who received the STORK programme in our hospital were classified as vulnerable, and a quarter, ethnic minority.

The support workers (STORK Trainers) were employed at the equivalent grade of band 4 nurses at the Trust. They had healthcare backgrounds, were educated to a minimum of degree level, and had previous experience in data capture in research. They were all educators prior to employment with the Hospital and had hands-on experience in patient counselling. A one day STORK programme-specific full day training was delivered at induction into the post, by the developer of the programme (TP) and supported by training for its individual components which are referenced in the app [8] and based on online NHS material for safe sleep, recognising signs of illness, and smoking cessation. Online training resources from the national centre for smoking cessation were utilised. Bystander life support and choking training were based on the algorithm supported by our BLISS our national charity for babies born preterm and ill [9], and St Johns Ambulance guidelines. A 2 day maternity-led breastfeeding training session, supporting the Unicef Baby Friendly Initiative [10], for which the hospital’s maternity services has received full accreditation, was also undertaken. Training to manage the crying baby (ICON) [11] was also included. All of these are referenced in the mobile app. STORK trainers observed an established STORK trainer for around 4 weeks before actively starting own teaching sessions.