Moving from Research to Community: Understanding the Feasibility of an Internet-Based Adaptation of an Empirically-Validated Home-Based Intervention for Spanish-Speaking Mothers of Infants and Toddlers Living in Economic Disadvantage.

Early parenting home-visiting interventions have been found to be highly effective in promoting child development. The Play and Learning Strategies (PALS) program is a good example of an empirically-supported media-enhanced home visiting intervention. Yet, there are many obstacles in the implementation of home-visiting programs, including travel and access to trained providers. Internet-based interventions can reach many parents to overcome these barriers, especially in distal areas. Telehealth has been found to have a positive impact on social support, compliance, education, behavior change and better self-management, and reduced burden on the individual and services. Given internet and technology penetration, participant reach seems more feasible for serving families from non-dominant cultural/linguistic groups living in the United States who also experience unequal socioeconomic conditions.

This paper will present results from (a) a randomized controlled trial pilot and a qualitative community project both understanding the effects and use of an Internet-adaption Play and Learning Series (ePALS) and (b) consumer evaluation of ePALS with agencies delivering services to parents of young children (e.g., Early Head Start).

The RCT of ePALS was conducted with mothers (N = 24) of toddlers who were randomized to either the 15-session, Internet-facilitated parenting intervention (ePALS; the ePALS model included independent user curriculum learning through the app + weekly coaching calls with a bilingual ePALS certified coach) or to an Internet-facilitated attention control condition: developmental awareness intervention (DAS).

The community project included providers (N = 2) of early intervention working in a local agency delivering home visits and mothers (N =2) of toddlers that received ePALS (the ePALS model included self-paced curriculum, which only included home services for 5 sessions). Home visitors were not trained in the ePALS curriculum. All participants identified themselves as Latinx, and spoke Spanish at home. Approximately half had a high-school diploma or less but 85% reported being moderately or very comfortable using a computer and half had a computer at home.

Pilot RCT results suggested that compared to DAS participants, ePALS participants demonstrated significantly greater increases in observed language-supportive parenting behaviors (medium effect). For the consumer evaluation of ePALS, we loaned tablets to home-visiting staff and parents to ascertain the acceptability, navigability, feasibility and sustainability of the ePALS program as well as the barriers to adoption, appropriateness and implementation cost for agencies.

Results suggest that the ePALS program is effective as a remotely delivered intervention for the participant families to strengthen early parenting behaviors that promote infant social communication. The inaccessibility and underutilization of empirically supported mental health and other support services by families, is currently a significant and growing public health concern encouraging the adaptation for easy access for preventive services. Implications for dissemination will be explored from a research to community practice perspective.