Despite the benefits of Neonatal Follow‐Up (
NFU) programs for infants at risk for developmental problems subsequent to preterm birth, non‐attendance continues to be a problem within Canada and beyond. This study investigated the barriersand facilitatorsto attendance at Canadian NFUprograms from mothers' and health care providers' ( HCP) perspectives. Methods
In this multi‐site qualitative descriptive study, we conducted semi‐structured individual interviews with 12 mothers, six from each of two
NFUprograms; and focus groups with 20 HCPs from nine NFUprograms. Interviews were audio‐recorded and transcribed and then subjected to thematic analysis. Results
The predominant barriers represented a complex interplay of cumulative factors: mothers' isolation and feeling overwhelmed, with limited support, experiencing difficulty attending because of limited resources, who viewed
NFUas not needed until problems arose for their child. Other barriers included vulnerability and fear of bad news. Mothers reported the need to protect their vulnerable child from risks, whereas HCPs reported creating vulnerability by monitoring the child's development over time. HCPs perceived fear of bad news as a barrier, whereas mothers viewed that impending bad news increased their need to attend to address the issue. The predominant facilitators were support, family centred‐care and mothers with adequate resources. Conclusions
Attendance is most problematic for mothers with limited support, capacity and resources. First and foremost, targeted approaches to
NFUservice provision are needed to address the cumulative barriers and improve experiences for mothers who find it difficult to attend NFU. A continuous relationship with a single point of contact is needed and merits further investigation – a provider who works across the traditional silos of neonatal intensive care, NFUand community services, minimizes duplication and navigates transitions.