Alberta family integrated careTM: a review of a family-integrated care model in neonatal intensive care.
Alberta Family Integrated CareTM (AB-FICareTM) is a standardized, theory-driven model that integrates parents as primary caregivers in neonatal intensive care units (NICUs); however, its clinical effectiveness, implementation determinants, and cross-setting applicability require systematic synthesis. This narrative review aims to evaluate the evidence on AB-FICareTM in Level II NICUs, focusing on neonatal and parental outcomes, implementation barriers and facilitators, and transferability to healthcare systems with distinct organizational and cultural contexts. Following SANRA guidelines, we systematically searched PubMed, Embase, Web of Science, and the Cochrane Library for studies published between January 2020 and June 2026. Ten reports from a single Canadian cluster randomized controlled trial met the inclusion criteria. The findings demonstrate that AB-FICareTM significantly reduced the adjusted length of stay by 2.55 days (95% CI: -4.44 to -0.66, P = 0.02) without increasing readmissions or emergency visits, and improved parental experiences, specifically enhancing trust, engagement, and discharge readiness. However, exclusive human milk feeding at 2 months was lower in the AB-FICareTM group (aOR = 0.51, 95% CI: 0.31-0.83, P = 0.01). Neurodevelopmental outcomes were mixed; while there was a signal for reduced communication delay at 6-24 months, this was not replicated at 18 months, whereas maternal parenting stress consistently predicted developmental delay (aORs > 1.03, P < 0.01). Key implementation facilitators included receptive organizational culture and stakeholder engagement, whereas barriers encompassed training burden and competing institutional priorities. Based on these findings, we propose that AB-FICareTM implementation should move from one-size-fits-all adoption toward context-sensitive adaptation, integrating robust lactation support, post-discharge mental health services, and system-level coordination into a comprehensive framework covering NICU stay through community-based follow-up. Future research should prioritize long-term neurodevelopmental follow-up, formal cost-effectiveness analyses adhering to CHEERS standards, and multi-site validation across diverse healthcare settings to establish the generalizability and sustainability of AB-FICareTM benefits beyond the Canadian context.