About

Debra Huffman Brandon is a Professor in the School of Nursing at Duke University, having joined the faculty in 1999. She served as the Director of the PhD Program in Nursing from July 2011 until January 2018 and is currently the Division Chair for the Division of Women, Children, and Families. Dr. Brandon also practiced as a Neonatal Clinical Nurse Specialist in the Intensive Care Nursery of Duke University Medical Center from 1993 to 2012. Her research focuses on understanding the impact of the environment of care on the health and development of high-risk infants and young children, with the overall goal of implementing interventions to improve both short- and long-term outcomes for infants and their families. She is an active member of the National Association of Neonatal Nurses (NANN) and the International Society for Infant Studies (ISIS), and she serves as Co-editor in Chief for the journal Advances in Neonatal Care.

Research topics

• Medicine
• Nursing
• Psychology
• Clinical psychology
• Developmental psychology
• Internal medicine
• Family medicine
• Pediatrics

Selected publications

• Working With Large Qualitative Datasets: Key Processes From an Implementation Study in a Complex Clinical Setting

  International Journal of Qualitative Methods · 2026-01-19

  articleOpen access

  Collecting and analyzing qualitative research with large datasets is inherently complex and often difficult to convey in traditional manuscripts. Contemporary guidance on managing such datasets, especially those with multiple data sources, is limited. Implementation science, which studies and tests methods to promote uptake of evidence-based practices into routine use, often requires complex qualitative data and analysis and faces unique challenges. These challenges include multiple data collection time points and the need for rapid analysis and feedback to sites. In this paper we reflect on the data collection, management, and analysis of over 400 pieces of qualitative data from three different sources (semi-structured interviews, meeting minutes, and open-ended survey responses) as part of a large implementation study. The data discussed are derived from a type 3 Hybrid-design study of H-HOPE (Hospital to Home: Optimizing the Preterm Infant’s Environment) in six diverse neonatal intensive care units (NICUs). We first thoroughly outline the methods our team used in collecting and analyzing our large qualitative dataset. We then discuss four key processes that aided our data collection, management, and analysis: structure and consistency, prompt responsive alterations to site specific procedures, an iterative and extensive analysis approach led by case summaries, and utilization of both an initial ‘quick’ and more in-depth traditional qualitative analysis approaches. Recommendations for future studies working with large qualitative data sets with multiple sources of data are discussed.

  PublisherDOI

• Parents+: An Early Behavioral Intervention as a Pathway for Parent-Partnered Care

  Advances in Neonatal Care · 2025-09-23 · 2 citations

  articleOpen access

  BACKGROUND: Neonatal nurses have a major role in helping parents engage with their infant. A high level of parent participation, called Parent-Partnered Care, integrates parents as full partners in the delivery of hospital care to their infants. One parent-partnered intervention that improves infant, parent, and parent-infant outcomes is H-HOPE (Hospital to Home: Optimizing the Preterm Infant Environment). H-HOPE has 2 components: Massage+ and Parents+. PURPOSE: The purpose of this article is to present an evidence-based guide showing how to deliver Parents+ and the implications for nursing practice. METHODS: The nursing approach to Parents+ includes participatory guidance and social support, which fosters a partnership with parents. The guidelines for using participatory guidance include a detailed description of each teaching/learning session along with implications for nursing practice. RESULTS: Parents' experienced many benefits from participating in the Parents+ sessions. They reported feeling more confident in the care of their infant and more satisfied with learning and delivering Massage+. Additionally, parents also reported less fears handling their infants, increased feelings of bonding/attachment, and a sensitivity/responsiveness to their infant's behavioral cues. IMPLICATIONS FOR PRACTICE: Parents+ presents an opportunity for nurses to help parents engage with their infants and increase their confidence and competence. Parents' desire a neonatal intensive care unit culture that embraces a comprehensive collaborative approach with healthcare professionals that is individualized to their infant's health and well-being.

  PublisherOA PDFDOI

• Development and Implementation of a Protocol for NICU Discharge With Nasogastric Tube Feedings

  Advances in Neonatal Care · 2025-03-26

  articleSenior author

  BACKGROUND: There is sufficient evidence to support safe discharge from the neonatal intensive care unit (NICU) with nasogastric tube (NGT) feedings when appropriate caregiver education, outpatient support, and feeding therapy are available. PURPOSE: We sought to identify infants eligible for safe discharge with NGT feedings to reduce NICU length of stay and avert unnecessary surgical gastrostomy tube (GT) placement. METHOD: A protocol with infant eligibility criteria for NICU discharge with NGT feedings was developed and implemented. A focus group was conducted to identify perceived successes, barriers and lessons learned. RESULTS: There was low uptake of the new protocol. Barriers to implementation included inconsistent protocol adoption by NICU providers, concerns about lack of outpatient support, and significant language barriers for non-English speaking families. IMPLICATIONS: Outpatient multidisciplinary support is crucial to successfully implement home NGT feedings upon NICU discharge. A well-developed protocol provides eligibility standards and decision support.

  PublisherDOI

• Observational Video Study of Maternal Sleep During the 24 Hours Before Hospital Discharge After Childbirth

  Journal of Obstetric, Gynecologic & Neonatal Nursing · 2025-05-15 · 1 citations

  articleOpen access
  PublisherOA PDFDOI

• A Caregiver–Infant Interaction Framework to Guide Nursing Approaches to Supporting Early Relational Health

  Advances in Nursing Science · 2025-05-08

  articleSenior author

  Early Relational Health, as prioritized by the American Academy of Pediatrics, emphasizes relationships that are safe, stable, and nurturing. The mechanisms that cultivate or harm such relationships are moment-to-moment caregiver–infant interactions (eg, actions or behaviors between 2 partners), which are influenced by the larger socioecological environment. The concepts that explore caregiver–infant interaction are plentiful, but how these concepts relate to each other and to the emerging field of early relational health remains underexplored. This theory development paper responds to this gap, proposing a framework grounded in Chinn and Kramer’s (2023) theory generation and evaluation process. Additionally, the manuscript explores how nurses can support caregiver–infant dyads during their interactions, meaning-making processes, relational outcomes, and socioecological realities.

  PublisherDOI

• Feasibility of an Intervention to Support Shared Decision-Making for Critically Ill Infants

  The Journal of Pediatrics · 2025-05-02

  articleOpen access
  PublisherOA PDFDOI

• Parents’ Experiences With an Early Behavioral Intervention, H-HOPE, in the NICU and at Home

  Advances in Neonatal Care · 2025-07-03 · 4 citations

  articleOpen access

  BACKGROUND: Early parent involvement in an infant's neonatal intensive care unit (NICU) stay has positive benefits for the parent, the preterm infant, and the parent-infant relationship. H-HOPE (Hospital to Home: Optimizing the Preterm Infant's Environment) is an early behavioral intervention that provides an innovative developmental approach and contributes to parents' opportunity to provide care for their infant in the NICU. PURPOSE: To explore parents' experience with H-HOPE. METHODS: This qualitative study consists of one-on-one interviews with parents as part of a larger study investigating H-HOPE's implementation and effectiveness. Data from 38 parents encompassing 54 interviews are included in this analysis. RESULTS: Parents report experiencing many benefits from participating in H-HOPE, including an increase in confidence, understanding of infant cues, promotion of bonding, infant benefits, and improvement in relationships with staff. Facilitators to participation include teaching and support in the NICU, being able to be present regularly, family support, and positive infant responses. Barriers to participating in the NICU were infant condition and readiness, family and economic limitations, lack of parent training or readiness, and nurse availability and communication. A lack of time and infant readiness were barriers at home. IMPLICATIONS FOR PRACTICE AND RESEARCH: Our findings highlight the importance of early behavioral interventions like H-HOPE that support parent-partnered care, which promotes parents' participation in their infants' care. NICU nurses play a critical role in facilitating parent participation and confidence. Future research should examine policies and programs to help enhance NICU nurses' readiness and ability to engage with and support parents.

  PublisherOA PDFDOI

• Maternal Psychological Symptom Trajectories From 2 to 24 Months Postpartum

  Nursing Research · 2024-02-06 · 2 citations

  articleOpen access

  BACKGROUND: Postpartum women experience an array of psychological symptoms that are associated with adverse health behaviors and outcomes including postpartum suicidal ideation and long-term depression. To provide early management of postpartum psychological symptoms, it is important to understand how the symptom experiences change over time. OBJECTIVE: The aim of this study was to examine maternal psychological symptom trajectories over 2, 6, 15, and 24 months postpartum using latent class growth analysis and to examine how each trajectory is associated with maternal depression outcome at 24 months. METHODS: We used secondary data from the Family Life Project ( N = 1,122) and performed multitrajectory latent class growth analysis based on four observed symptom variables (depression, anxiety, somatization, and hostility). After the final model was identified, bivariate analyses were conducted to examine the association between each trajectory and (a) individual characteristics and (b) outcome (Center for Epidemiologic Studies Depression Scale [CES-D]) variables. RESULTS: A four-class model was selected for the final model because it had better fit indices, entropy, and interpretability. The four symptom trajectories were (a) no symptoms over 24 months, (b) low symptoms over 24 months, (c) moderate symptoms increasing over 15 months, and (d) high symptoms increasing over 24 months. More postpartum women with the trajectory of high symptoms increasing over 24 months (Trajectory 4) were in low economic status (92.16%), unemployed (68.63%), or did not complete 4-year college education (98.04%). Most postpartum women (95.56%) in Trajectory 4 also had higher CES-D cutoff scores, indicating a possible clinical depression at 24 months postpartum. DISCUSSION: Postpartum women who experience increasing symptom trajectories over 15-24 months (Trajectories 3 and 4) could benefit from tailored symptom management interventions provided earlier in the postpartum period to prevent persistent and worsening symptom experiences.

  PublisherOA PDFDOI

• Exploring Differences in Intraoperative Medication Use Between African American and Non-Hispanic White Patients During General Anesthesia: Retrospective Observational Cohort Study

  Clinical Nursing Research · 2024-05-20

  articleSenior author

  This study aimed to explore whether differences exist in anesthesia care providers’ use of intraoperative medication between African American and non-Hispanic White patients in adult surgical patients who underwent noncardiothoracic nonobstetric surgeries with general anesthesia. A retrospective observational cohort study used electronic health records between January 1, 2018 and August 31, 2019 at a large academic health system in the southeastern United States. To evaluate the isolated impact of race on intraoperative medication use, inverse probability of treatment weighting using the propensity scores was used to balance the covariates between African American and non-Hispanic White patients. Regression analyses were then performed to evaluate the impact of race on the total dose of opioid analgesia administered, and the use of midazolam, sugammadex, antihypotensive drugs, and antihypertensive drugs. Of the 31,790 patients included in the sample, 58.9% were non-Hispanic Whites and 13.6% were African American patients. After adjusting for significant covariates, African American patients were more likely to receive midazolam premedication ( p < .0001; adjusted odds ratio [aOR] = 1.17, 99.9% CI [1.06, 1.30]), and antihypertensive drugs ( p = .0002; aOR = 1.15, 99.9% CI [1.02, 1.30]), and less likely to receive antihypotensive drugs ( p < .0001; aOR = 0.85, 99.9% CI [0.76, 0.95]) than non-Hispanic White patients. However, we did not find significant differences in the total dose of opioid analgesia administered, or sugammadex. This study identified differences in intraoperative anesthesia care delivery between African American and non-Hispanic White patients; however, future research is needed to understand mechanisms that contribute to these differences and whether these differences are associated with patient outcomes.

  PublisherDOI

• Why it is Important to Develop Your Personal and Professional Identity

  Advances in Neonatal Care · 2024-11-26 · 1 citations

  articleSenior author
  PublisherDOI

Recent grants

• MSN Nursing Program Partnership for Bridges to the Doctorate

  NIH · $1.2M · 2012–2018

• NIH Grant R01NR008044

  NIH · $1.6M · 2009

• NIH Grant F31NR007180

  NIH · $45k

Frequent coauthors

• Sharron L. Docherty

  Duke University

  72 shared

• Monica E. Lemmon

  Duke University

  69 shared

• Angel Barnes

  Duke University

  53 shared

• Diane Holditch‐Davis

  Duke University

  52 shared

• Donna J. Ryan

  52 shared

• Mary Carol Barks

  Washington State University Spokane

  48 shared

• Peter A. Ubel

  Duke University

  48 shared

• Kathryn I. Pollak

  Duke University

  47 shared

Awards & honors

• Six Honored by Cook Society for Leadership & Community Activ…