Evidence map›Paper›PMID 41945917›Full record

ArticleJournal of medical Internet research2026

Telehealth Delivery of the Homeostasis-Enrichment-Plasticity Approach for Premature Infants With Developmental Risks: Exploratory Feasibility Study.

Aymen Balikci, Gamze Cagla Sirma, Izgi-Miray Demirbag, Teresa A May-Benson, Hatice Gulhan Sozen, Ayse Firdevs Aracikul Balikci, Gul Ilbay

Abstract read
In one paragraph

Article in Journal of medical Internet research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Aymen BalikciSense On Ltd, Istanbul, Turkey.ORCID https://orcid.org/0000-0002-7552-8235
Gamze Cagla SirmaDepartment of Occupational Therapy, Faculty of Health Sciences, Fenerbahçe University, Istanbul, Istanbul, Turkey.ORCID https://orcid.org/0000-0003-2976-9035
Izgi-Miray DemirbagSense On Ltd, Istanbul, Turkey.ORCID https://orcid.org/0000-0002-0431-3480
Teresa A May-BensonTMB Education, Norristown, PA, United States.ORCID https://orcid.org/0000-0001-5926-5722
Hatice Gulhan SozenDepartment of Child Health and Diseases, Faculty of Medicine, Bahcesehir University, Istanbul, Turkey.ORCID https://orcid.org/0000-0002-3613-0814
Ayse Firdevs Aracikul BalikciDepartment of Special Education, Faculty of Education, Istanbul Medipol University, Istanbul, Turkey.ORCID https://orcid.org/0000-0003-1516-2021
Gul IlbayDepartment of Physiology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey.ORCID https://orcid.org/0000-0003-2287-8140

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPreterm delivery is an increasing worldwide health concern linked to increased neurodevelopmental risks. Early intervention is crucial for harnessing neuroplasticity to enhance developmental and functional performance outcomes; however, access to early intervention is frequently hindered by logistical, financial, and labor constraints. The Homeostasis-Enrichment-Plasticity (HEP) Approach is a family-centered early intervention model based on enriched environments, designed to improve infants' sensory-motor, cognitive, and socio-emotional development.

objectiveThis study aimed to assess the feasibility, safety, acceptability, and outcomes sensitivity to change of implementing the HEP Approach through telehealth for premature infants at developmental risk.

methodsA pre-post exploratory feasibility study was performed, including 16 preterm infants (aged 4-12 months corrected age), of whom 14 completed the study. The 12-week intervention included weekly remote sessions focused on environmental enrichment, active exploration, and parental guidance. The feasibility and acceptability were evaluated using a 24-item questionnaire. Developmental outcomes were assessed with the Young Children's Participation and Environment Measure, Ages and Stages Questionnaire (ASQ), Alberta Infant Motor Scale, Infant Motor Profile, and Depression Anxiety Stress Scales.

resultsHigh adherence (14/14, 100%) and retention (14/16, 87.5%) rates demonstrated robust feasibility. Parents indicated 86%-100% agreement across all feasible criteria, affirming safety, satisfaction, and acceptability. No adverse incidents were reported. Changes were identified in participation (Young Children's Participation and Environment Measure), motor development (Alberta Infant Motor Scale, Infant Motor Profile, and ASQ), communication and social-emotional domains (ASQ), and caregiver well-being (Depression Anxiety Stress Scales) (P<.05).

conclusionsThe telehealth implementation of the HEP Approach demonstrated feasibility, safety, and strong acceptance among families, along with quantifiable developmental and psychosocial changes. These initial findings endorse the model's viability as an accessible, family-oriented telehealth framework for infants born preterm. Future randomized controlled and longitudinal studies are necessary to validate intervention efficacy and scalability.

Indexed as

Child DevelopmentHomeostasisInfant, PrematureNeuronal PlasticityTelemedicineFeasibility StudiesFemaleHumansInfantInfant, NewbornMaleadherenceearly interventionenvironmental enrichmentpremature infantsretentiontelehealth

Identifiers

PMID41945917
PMCPMC13100579

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.