{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:34:30Z","timestamp":1760060070310,"version":"build-2065373602"},"reference-count":28,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T00:00:00Z","timestamp":1753920000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: Preterm infants and their families face a challenging experience during their stay in the neonatal intensive care unit (NICU). Family-centered care emphasizes the importance of welcoming parents, involving them in their baby\u2019s daily care, and supporting the development of parenting skills. NICU staff should support parents in understanding their baby\u2019s needs and in strengthening the parent\u2013infant bond. Although many tools outline what parents should learn, there is a limited structured framework to monitor their involvement in the infant\u2019s care. Tracking parental participation in daily caregiving activities could support professionals in effectively guiding families, ensuring a smoother transition to discharge. Aims: The aim of this study was to evaluate the adherence to and effectiveness of a structured tool for parental involvement in the NICU. This tool serves several key purposes: to track the progression and timing of parents\u2019 autonomy in caring for their baby, to support parents in building caregiving competencies before discharge, and to standardize the approach of NICU professionals in promoting both infant care and family engagement. Methods: A structured template form for documenting parental involvement (\u201ctogether TO-CARE template\u201d, TTCT) was integrated into the computerized chart adopted in the NICU of Modena. Nurses were asked to complete the TTCT at each shift. The template included the following assessment items: parental presence; type of contact with the baby (touch; voice; skin-to-skin); parental involvement in care activities (diaper changing; gavage feeding; bottle feeding; breast feeding); and level of autonomy in care (observer; supported by nurse; autonomous). We evaluated TTCT uploaded data for very low birth weight (VLBW) preterm infants admitted in the Modena NICU between 1 January 2023 and 31 December 2024. Staff compliance in filling out the TTCT was assessed. The timing at which parents achieved autonomy in different care tasks was also measured. Results: The TTCT was completed with an average of one entry per day, during the NICU stay. Parents reached full autonomy in diaper changing at a mean of 21.1 \u00b1 15.3 days and in bottle feeding at a mean of 48.0 \u00b1 22.4 days after admission. The mean length of hospitalization was 53 \u00b1 38 days. Conclusions: The adoption of the TTCT in the NICU is feasible and should become a central component of care for preterm infants. It promotes family-centered care by addressing the needs of both the baby and the family. Encouraging early and progressive parental involvement enhances parenting skills, builds confidence, and may help reduce post-discharge complications and readmissions. Furthermore, the use of a standardized template aims to foster consistency among NICU staff, reduce disparities in care delivery, and strengthen the support provided to families of preterm infants.<\/jats:p>","DOI":"10.3390\/children12081007","type":"journal-article","created":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T06:37:47Z","timestamp":1754030267000},"page":"1007","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Together TO-CARE: A Novel Tool for Measuring Caregiver Involvement and Parental Relational Engagement"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-0093-2612","authenticated-orcid":false,"given":"Anna","family":"Insalaco","sequence":"first","affiliation":[{"name":"Department of Medical and Surgical Sciences for Mother, Children and Adults, Postgraduate School of Pediatrics, University of Modena and Reggio Emilia, 41124 Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0513-9373","authenticated-orcid":false,"given":"Natascia","family":"Bertoncelli","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, Women\u2019s and Children\u2019s Health Department, University Hospital of Modena, 41100 Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luca","family":"Bedetti","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, Women\u2019s and Children\u2019s Health Department, University Hospital of Modena, 41100 Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna Cinzia","family":"Cosimo","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, Women\u2019s and Children\u2019s Health Department, University Hospital of Modena, 41100 Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8141-5317","authenticated-orcid":false,"given":"Alessandra","family":"Boncompagni","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, Women\u2019s and Children\u2019s Health Department, University Hospital of Modena, 41100 Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federica","family":"Cipolli","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, Women\u2019s and Children\u2019s Health Department, University Hospital of Modena, 41100 Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3534-7499","authenticated-orcid":false,"given":"Alberto","family":"Berardi","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, Women\u2019s and Children\u2019s Health Department, University Hospital of Modena, 41100 Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2149-0083","authenticated-orcid":false,"given":"Licia","family":"Lugli","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, Women\u2019s and Children\u2019s Health Department, University Hospital of Modena, 41100 Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Bertoncelli, N., Lugli, L., Bedetti, L., Lucaccioni, L., Bianchini, A., Boncompagni, A., Cipolli, F., Cosimo, A.C., Cuomo, G., and Di Giuseppe, M. 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Care"}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/12\/8\/1007\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:19:37Z","timestamp":1760033977000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/12\/8\/1007"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,31]]},"references-count":28,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,8]]}},"alternative-id":["children12081007"],"URL":"https:\/\/doi.org\/10.3390\/children12081007","relation":{},"ISSN":["2227-9067"],"issn-type":[{"type":"electronic","value":"2227-9067"}],"subject":[],"published":{"date-parts":[[2025,7,31]]}}}