Karen Benzies

The University of Calgary | HBI · Faculty of Nursing

Background First-time motherhood is characterized by high psychosocial distress, which untreated, has serious consequences. Informal social support provided by specially trained mentors may be protective against postpartum depressive symptoms but may vary by women’s social relationship with the mentor. The objective of this study was to evaluate th...

Background: Evidence-based Practice for Improving Quality (EPIQ) is a collaborative quality improvement method adopted by the Canadian Neonatal Network that led to decreased mortality and morbidity in very preterm neonates. The Alberta Collaborative Quality Improvement Strategies to Improve Outcomes of Moderate and Late Preterm Infants (ABC-QI) Tr...

Objectives: Unplanned extubations are an infrequent but life-threatening adverse event in pediatric critical care. Due to the rarity of these events, previous studies have been small, limiting the generalizability of findings and the ability to detect associations. Our objectives were to describe unplanned extubations and explore predictors of unp...

Aim: To examine the association between breastfeeding self-efficacy (BSE) and breastmilk feeding at discharge from the neonatal intensive care unit among mothers of preterm infants. Design: Secondary analysis of the Family Integrated Care (FICare) cluster randomized controlled trial. Methods: Data from 221 mothers of preterm infants who partic...

Background An unplanned extubation is the uncontrolled and accidental removal of a breathing tube and is an important quality indicator in pediatric critical care. The objective of this review was to comprehensively synthesize literature published on quality improvement (QI) practices implemented to reduce the rate of unplanned extubations in criti...

Objective To conduct a scoping review to examine the evidence on education provided to women about when to return to driving after abdominal surgery and to assess variation in this education by type of abdominal surgery and source of education. Data Sources We searched MEDLINE, Cochrane Central Register of Controlled Trials, Embase, Scopus, and CI...

Design, implementation, and evaluation of effective multicomponent interventions typically take decades before value is realized even when value can be measured. Value-based health care, an approach to improving patient and health system outcomes, is a way of organizing health systems to transform outcomes and achieve the highest quality of care an...

The purpose of this study was to describe the care of intubated patients in pediatric critical care. Acknowledging there are several perceived factors that contribute to unplanned extubations, a secondary objective was to describe how practice variation may relate to observed differences in unplanned extubation rates. A survey about practices relat...

Structural and systemic inequalities can contribute to susceptibility to COVID-19 disease and limited access to vaccines. Recognizing that Racialized and Indigenous Peoples may experience unique barriers to COVID-19 vaccination, this study explored early COVID-19 vaccine accessibility, including barriers and potential solutions to vaccine access, f...

BACKGROUND Digital interventions help address barriers to traditional healthcare services. Fathers play an important parenting role in their family and father involvement is beneficial for family well-being. Although digital interventions are a promising avenue to facilitate father involvement during the perinatal period, most are oriented to mater...

Background: Digital interventions help address barriers to traditional health care services. Fathers play an important parenting role in their families, and their involvement is beneficial for family well-being. Although digital interventions are a promising avenue to facilitate father involvement during the perinatal period, most are oriented tow...

Background: The Family Integrated Care (FICare) program adapted for Alberta (AB) level II neonatal intensive care units (NICUs) aims to increase parental involvement and support during their NICU stay. The experience of fathers of preterm infants in a FICare program is currently unknown. Purpose: To describe the experiences of fathers of preterm...

Objectives Food insecurity is inadequate or insecure access to food due to financial constraints. Individuals experiencing food insecurity tend to have poorer diet quality compared to their food secure peers. Given the importance of maintaining healthful dietary patterns for optimal glycemic control, food insecurity is a considerable barrier to man...

Globally, one in ten infants is born preterm. Most preterm infants require care in a level II Neonatal Intensive Care Unit (NICU), which are highly technological critical care environments that can be overwhelming for parents. Alberta Family Integrated Care (AB-FICare™) is an approach to care that provides strategies to integrate parents into their...

Objective To investigate COVID-19 vaccine uptake and intent among pregnant people in Canada, and determine associated factors. Methods We conducted a national cross-sectional survey among pregnant people from May 28 through June 7, 2021 ( n = 193). Respondents completed a questionnaire to determine COVID-19 vaccine acceptance (defined as either re...

Background: Integrating parents into the care of their infants in the neonatal intensive care unit (NICU) is vital for both parents and infants. Yet, parents are often not fully involved in important decision-making and care, even when practices are family- and patient-centered. Alberta Family Integrated Care (FICare) is a model of care designed t...

Preterm infants are at increased risk for developmental delays. Family integrated care (FICare) is a novel care delivery model that integrates parents into their infant’s care in the neonatal intensive care unit. Two follow-up studies are presented to identify effects of Alberta FICare™ on the development of preterm infants born between 32 and 34 w...

Background An unplanned extubation is the uncontrolled and accidental removal of a breathing tube. The health impact of an unplanned extubation ranges from minimal to life-threatening, but this is an important quality indicator in pediatric critical care. Objective To comprehensively synthesize literature published on quality improvement (QI) prac...

Family-Integrated Care (FICare) empowers parents to play an active role as a caregiver for their infant in the neonatal intensive care unit (NICU). This model of care is associated with improved neonatal outcomes, such as improved weight gain and higher breastfeeding rates at discharge in infants admitted to level III NICUs; however, its effectiven...

Objective The study objective was to identify the top 10 research priorities for expectant parents and caregivers of children up to age 24 months. Design A priority setting partnership using a modified James Lind Alliance approach was implemented. First, a core steering committee was formed, consisting of 17 parents, clinicians and community agenc...

Background: Medical care advancements have increased the survival rates of children with complex medical conditions (CMC). Parents/caregivers of these children experience a range of positive and negative emotional experiences as a result. This population experiences an increased risk of mental health concerns, versus the public; however, there is a...

The objective of this study was to describe executive skills in clients experiencing social vulnerability in the context of COVID‐19 from the perspective of social service agency staff. COVID‐19 has required transformational changes to livelihood and day‐to‐day living. Socially vulnerable individuals are likely to be disproportionally impacted beca...

Prevention-focused parenting education programs (P-FPEPs) provide knowledge and support to parents to strengthen parent–child relationships, enhance parental and family well-being, and promote healthy child development. The positive impact of such programs on child health and development is well documented. Yet, how P-FPEPs influence parents remain...

Parents of hospitalized Medically Fragile Infants (MFI) experience stressors and mental health difficulties and Health-Care Professionals (HCP) who care for MFI experience burnout and stress. A constructivist grounded theory study was conducted among parents of MFI (N = 19) and HCP (N = 26) to understand their experiences caring for MFI in pediatri...

Background Vaccinating children (≤17 years old) is important for controlling the COVID-19 pandemic. As parents are primary decision makers for their children, we aimed to assess parents’ perceptions and intentions regarding COVID-19 vaccination for their children, including for some underserved populations (e.g., newcomers, Indigenous peoples, and...

Objective To evaluate the barriers and facilitators to implementing Alberta Family Integrated Care (AB-FICare [2019 Benzies]), a model of care for integrating parents into level II neonatal intensive care units (NICUs) care teams, from the perspective of healthcare providers (HCP) and hospital administrators. Design Qualitative process evaluation...

This study explored social service providers’ perceptions of risk and resilience while caring for their vulnerable clients during COVID-19. Participants (N = 68) from two agencies completed an online survey. Over half of participants had shifted to virtual service delivery; about 30% continued to have direct contact with clients. Using regression m...

Focus of Presentation Multivariable regression models can be used to answer a variety of clinical questions. The two main objectives of regression models are to either 1) understand an association between one or more exposures and an outcome; or 2) predict future outcomes based on certain exposures or variables. To simplify this, we will consider t...

Study objectives: This study evaluated the effect on infant sleep of a novel intervention (Play2Sleep) that combined infant sleep information with self-modeled video feedback on parent-infant interactions. Methods: An explanatory sequential mixed methods design consisting of a randomized controlled trial with 63 mother-father-infant triads rando...

Objectives To explore attitudes about adding genomic content to an undergraduate nursing curriculum. Genomic knowledge is essential to nursing education, but challenges exist for curriculum innovation. Few countries have guiding documents from national nursing organizations on genomic competencies for practice or education. Information on attitudes...

Becoming a mother is a fundamental life-transforming event characterized by high psychosocial distress. Most prenatal programming leaves women feeling unprepared for the realities of early parenthood. The purpose of this study was to design, implement, and evaluate a brief enhancement to existing prenatal programming, Welcome to Parenthood® (W2P)....

Introduction Extensive evidence indicates that the quality of parent-child attachment is related to later socio-emotional and physical health outcomes. Yet, despite its clinical relevance, the parent-child attachment concept has been inconsistently applied across the disciplines of nursing, medicine and psychology and is often conflated with parent...

Nurses play an important role in promoting positive childhood development via early interventions intended to support parenting. Despite recognizing the need to deliver vital parenting programs, monitoring fidelity has largely been ignored. Fidelity refers to the degree to which healthcare programs follow a well-defined set of criteria specifically...

Background Failed peripheral intravenous catheterizations result in multiple painful skin punctures, diagnostic and treatment delays, and increased morbidity and mortality. Incorporating gaze behavior training may increase success rates. Method Using eye tracking glasses with simulated catheterizations, we compared novice (n = 12) and expert nurse...

Reflective function (RF) is defined as an individual’s ability to understand human behavior in terms of underlying mental states including thoughts, feelings, desires, beliefs, and intentions. More specifically, the capacity of parents to keep their child’s mental states in mind is referred to as parental RF. RF has been linked to adult mental heal...

Background Parents of infants in neonatal intensive care units (NICUs) are often unintentionally marginalized in pursuit of optimal clinical care. Family Integrated Care (FICare) was developed to support families as part of their infants’ care team in level III NICUs. We adapted the model for level II NICUs in Alberta, Canada, and evaluated whether...

Deficit models of care for clients experiencing social vulnerability have become increasingly unsustainable; and there is a shift towards models of care that promote and protect resiliency for lifelong health. We defined clients as socially vulnerable if they were living with poverty, mental health problems and addictions, disability, and social is...

Objectives Contemporary nurses require genomic literacy to engage in genomics-informed health care. Little is known about the genomic literacy of undergraduate nursing students and faculty in many countries. Concept inventories can be used to assess levels of knowledge and inform curriculum development. Methods The 31-item Genomic Nursing Concept...

Precision health is the integration of personal genomic data with biological, environmental, behavioral, and other information relevant to the care of a patient. Genetics and genomics are essential components of precision health. Genetics is the study of the effects of individual genes, and genomics is the study of all the components of the genome...

Background Advances in care have increased survival and improved outcomes of infants with complex and chronic diseases. These medically fragile infants require long-term hospitalization and depend on technology for survival. Parents of these infants experience stress and difficulties adapting to their parental role. Purpose To present an account o...

Central venous access devices (CVADs) are the standard of care in pediatric oncology. Occlusion is a common complication that can lead to delays in therapy, readmission, and CVAD removal and reinsertion. Early treatment of partial occlusions using a standardized protocol may restore patency and increase life span of CVADs. The objective of this stu...

Abstract Purpose To understand contemporary experiences of pediatric health care professionals' (HCPs) caring for hospitalized Medically Fragile Infants (MFI) and their parents. Design and methods Convenience sampling was adopted to recruit 26 HCPs who provided care to MFI and their parents on inpatient units at a large tertiary pediatric hospital...

Background Breastmilk feeding reduces morbidities and improves outcomes related to prematurity. However, breastmilk feeding rates in preterm infants are substantially lower than in term infants. Breastfeeding self‐efficacy theory is a social change theory, which is predictive of exclusive breastmilk feeding at 2 months postpartum in mothers of full...

After publication of our article [1], the authors have reported mathematical errors made in the sample size calculation for this cluster randomized controlled trial (cRCT) (Benzies et al. 2017).

Background Young children living in families experiencing social vulnerability, including low income, mental illness, addictions, social isolation, and/or homelessness, are at risk of developmental delay. Two-generation programs can improve outcomes for preschool children, but underlying mechanisms and outcomes for younger children remain unclear....

Background: Exposure to chronic stressors (poverty, addiction, family violence) in early life can derail children's development. Interventions focused on parental reflective function may promote parents' abilities to regulate their feelings and behaviors toward their children and buffer the impact of chronic stressors on children's development by...

Background: Prenatal anxiety is associated with child behavioral problems. Prenatal anxiety is predictive of postnatal anxiety which can interfere with the security of maternal-child attachment and further raise the risk of child behavior problems. Secure maternal-child attachment is essential for optimal emotional health. Sex influences the type...

Background: Fathers are under-represented in research and programs addressing early childhood health and development. Recruiting fathers into these interventions can be hampered for multiple reasons, including recruitment and retention strategies that are not tailored for fathers. The primary aim of this systematic review and meta-analysis is to d...

Background Person-centered care (PCC) can benefit patients, clinical staff, and health care organizations, but has not yet been widely adopted into practice. Hemodialysis is a unique care environment in which clinical staff can be involved with patients for protracted periods of time each week and often over a number of years. While kidney care is...

Aim: To synthesize and summarize evidence from published research articles regarding parental experiences caring for their hospitalized medically fragile infant. Methods: We searched four electronic databases in April 2018 using three main concepts individually and in combination: infant, medically fragile, parents. We examined articles about ex...

Transitioning from pregnancy to parenthood is particularly challenging for women living with low income and experiencing social isolation, mental illness, addiction, and/or family violence. The purpose of this qualitative study was to evaluate one component of Welcome to Parenthood, a two-generation multiple intervention program including neuroscie...

Objectives To determine the effect of an enhanced information package, the Welcome to Parenthood® (W2P) Kit, given at birth on (a) early parenting experiences and (b) use of educational resources and community services. Methods Two-group, post-test only design, with parents (mothers and fathers) in comparison group (n = 186; received standard disch...

Objective Evidence of the association between childhood obesity and neighborhood crime is inconclusive. Most previous studies have included children of all ages, and few have examined different types of crime. The objective of this study was to investigate the association between obesity and eight different types of crime (i.e., commercial robbery,...

Background: Existing literature on the impact of the course of maternal distress symptoms in the perinatal period and beyond has mainly focused on one source of distress (e.g., anxiety or depression) and only selected aspects of child development. This study examined the relative impact of trajectories of maternal depression, anxiety, and stress sy...

Links between adverse childhood experiences (ACEs) and threats to health and well-being later in life are well established. The current study extends those findings into younger populations of pregnant women and their children; investigating how ACEs relates to maternal postpartum well-being, coping, and parenting, as well as child outcomes. Partic...

This project evaluates the acceptability and utilityof a storybook, entitled Unexpected: Parents’ Experience of Preterm Birth , as an educational resource for parents in the neonatal intensive care unit (NICU). Forty-nine parents were recruited from Level II and Level III NICUs and completed several questionnaires; a subset of 11 parents also parti...

Introduction: Pregnancy and childrearing can be an exciting and stressful time for new parents. The maternal-child health landscape has changed dramatically over the last few decades and research priorities need to address these rapid changes. There have been limited attempts to engage and collaborate with members of the public to develop research...

Abstract Background: Breastmilk is the ideal nutrition for preterm infants. Yet, breastmilk feeding rates among preterm infants are substantially lower than those of full-term infants. Barriers incurred through hospital care practices as well as the physical environment of the neonatal intensive care unit (NICU) can result in physical and emotional...

Although well positioned to work with families of young children, nurses do not yet have a theory that guides practice and research by relating infant sleep to child and family development. The authors of this paper describe a proposed theory that combines Bronfenbrenner’s bioecological theory of human development with the Barnard model of parent-c...

Aim: To describe the perspectives of health care providers and hospital administrators on their experiences of providing care for infants in Level II neonatal intensive care units and their families. Research methods: We conducted 36 qualitative interviews with neonatal health care providers and hospital administrators and analysed data using a...

Background Most evidence of the association between maternal depression and children’s development is limited by being cross-sectional. To date, few studies have modelled trajectories of maternal depressive symptoms from pregnancy through the early postpartum years and examined their association with social emotional and behavior functioning in pre...

Background: One in four Canadian families struggle with infant sleep disturbances. The aim of this study is to evaluate Play2Sleep in families of infants with sleep disturbances. In addition to parental education on infant sleep, Play2Sleep uses examples from a video-recorded, structured play session with mothers and fathers separately to provide...

Background: Existing literature on maternal distress has focused on stress and anxiety during the pregnancy or postnatally and their relationship with child development. However, few studies have investigated the association between maternal stress and anxiety symptoms over time and child development in preschool children. The aim of this study wa...

Background Prenatal depression, anxiety, and stress (prenatal psychosocial distress) are common, and several environmental risk factors have been implicated in their development. Variation in genes, specifically single nucleotide polymorphisms (SNPs), may explain why some women develop maternal mental health concerns while others do not. Purpose T...

Early intervention programmes are designed to address complex inequities for Canadian families living with low income, affecting social relationships, well-being and mental health. However, there is limited understanding of resiliency and change in families living with low income over time. We conducted a mixed methods study with recent immigrant,...

The aim of this mixed-methods study was to investigate attrition at the age 10-year follow-up in a study of vulnerable children and their families living with low income following a two-generation preschool program in Calgary, Alberta, Canada. Quantitative factors associated with attrition included: (a) food bank use; (b) unstable housing; (c) chil...

Background Every year, about 15 million of the world’s infants are born preterm (before 37 weeks gestation). In Alberta, the preterm birth rate was 8.7% in 2015, the second highest among Canadian provinces. Approximately 20% of preterm infants are born before 32 weeks gestation (early preterm), and require care in a Level III neonatal intensive car...

Background Approaches to screening can influence the acceptance of and comfort with mental health screening. Qualitative evidence on pregnant women’s comfort with different screening approaches and disclosure of mental health concerns is scant. The purpose of this study was to understand women’s perspectives of different mental health screening app...

Despite large government expenditures and the implementation of mental health-related initiatives and strategies, the social, emotional, and behavioral concerns about children remain a significant issue in Canada. Accordingly, our group has undertaken a three-arm cluster school-based field study in Western Canada to examine interventions intended t...

Introduction Infant sleep consolidation is an important developmental milestone that may support optimal child outcomes. The objective of this study was to evaluate if maternal history of child abuse (CA) was associated with infant sleep consolidation in the first year of life and identify modifiable psychosocial mediators of the association. Metho...

This prospective, longitudinal cohort study examined longitudinal patterns of early development in Canadian children born late preterm. A convenience sample of 82 mothers and their healthy, singleton, late preterm children participated. Mothers completed the Ages and Stages Questionnaires at 4, 8, and 18 months corrected age. Concerns were most com...

Aim: To identify interventions associated with peripheral intravenous catheterization first attempt success in pediatric inpatients and emergency department patients who require vascular access for therapeutic interventions. Background: Unsuccessful peripheral intravenous catheterization puts children at risk for increased pain and treatment del...