Smart Beginnings: Integration of Video Interaction Project and the Family Check-up to Promote School Readiness with Low-Income Infants in Pediatric Care

Introduction: The current study tests a comprehensive approach to the promotion of school readiness in low-income families, beginning shortly after a child’s birth, through enhancement of positive parenting practices (and when present, reduction of psychosocial stressors) within the pediatric primary care platform.

Methods: We do so by integrating two evidence-based interventions: 1) a universal primary prevention strategy (Video Interaction Project [VIP]); and 2) a targeted secondary/tertiary prevention strategy (Family Check-up [FCU]) for families with family and/or child risk factors at child age 6 and 18 months. VIP provides parents with a developmental specialist who video records the parent and child and coaches the parent on effective parenting practices at each pediatric primary care visit. FCU is a home-based, family-centered intervention that utilizes an initial ecologically-focused assessment to promote motivation for parents to change child-rearing behaviors, with follow-up sessions on parenting and factors that compromise parenting quality.

Two primary care settings serving low-income communities in NYC and Pittsburgh, PA are being utilized to test this integrated intervention in hospital-based clinics, providing information about translation across venues where one of the two interventions has been previously used alone. The current trial tests the integrated VIP/FCU model in a randomized trial of 400 families (200 to VIP/FCU, 200 to routine care) utilizing parent surveys, observational data on parent-child interactions, and direct assessments of children’s development at key points during intervention follow-up. Whereas all families in the intervention group will be assigned to receive VIP, only those families with significant family and/or child stressors at the 6 and/or 18 month assessments (e.g., low literacy, maternal depression, child disruptive behavior) will also receive the FCU. Analyses will address questions of program impact for the integrated program across all families and by key subgroups.

Results: As recruitment and follow-up data collection is ongoing, this presentation will describe the study design, report on engagement rates into VIP at both sites, and provide preliminary comparisons between control and treatment groups at baseline. Parent reports on depressive symptoms (Edinburgh Scale), satisfaction with social support (General Life Satisfaction Scale), and parent-child relationship quality (Adult-Child Relationship Scale) will be used to assess parenting and parent well-being.

Conclusions: The study and preliminary results will be discussed with respect to taking advantage of pediatric care platforms for providing preventive parenting skills for children at risk because of poverty and related family stressors.