Sociodemographic and Psychosocial Predictors of VIP Attendance in Smart Beginnings Through 6 Months: Effectively Targeting At-Risk Mothers in Early Visits
- 137 Downloads
Past research on predictors of participation in early childhood parenting programs suggest that families experiencing higher levels of sociodemographic adversity (e.g., younger maternal age, single parenthood, lower income or education) are less likely to participate in parenting programs. This is significant, as it may indicate that those most in need of additional support are the least likely to receive it. Data from a randomized control trial (RCT) of Smart Beginnings, an integrated, tiered model for school readiness, were used to explore predictors of attendance in Video Interaction Project (VIP) through 6 months. VIP is a primary preventive intervention delivered in tandem with pediatric well-child visits, aimed at reducing income-based disparities in early child development through promotion of responsive parent-child interactions. Using Poisson distribution models (N = 403; treatment arm, n = 201), we find that demographic, socioeconomic status (SES), and psychosocial variables are associated with program attendance but not always in the expected direction. While analyses show that first-time mothers have higher levels of program attendance as expected, we find that less-educated mothers and those with lower parenting self-efficacy have higher levels of attendance as well. The latter findings may imply that the VIP intervention is, by some indicators, effectively targeting families who are more challenging to engage and retain. Implications for pediatric-based interventions with population-level accessibility are discussed.
KeywordsParent-child Interactions Pediatric-based Participation
Research reported in this publication was supported by the Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health under Award Number R01HD076390-05. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.
Informed consent was obtained from all individual participants included in the study.
- Alker, J., & Chester, A. (2015). Children’s health insurance coverage rates in 2014: ACA results in significant improvements. Washington, DC: Georgetown University Health Policy Institute.Google Scholar
- Barnes J., & Freude-Lagevardi, A. (2002). From pregnancy to early childhood: Early interventions to enhance the mental health of children and families. London: Mental Health Foundation.Google Scholar
- Bauman, K. (1998). Direct measures of poverty as indicators of economic need: Evidence from the survey income and program participation. In Population Division Technical working Paper No. 30. Washington, DC: U.S. Bureau of the Census.Google Scholar
- Berkel, C., Sandler, I. N., Wolchik, S. A., Brown, C. H., Gallo, C. G., Chiapa, A., et al. (2018). “Home practice is the program”: Parents’ practice of program skills as predictors of outcomes in the new beginnings program effectiveness trial. Prevention Science, 19, 663–673. https://doi.org/10.1007/s11121-016-0738-0.CrossRefPubMedPubMedCentralGoogle Scholar
- Berkule, S. B., Cates, C. B., Dreyer, B. P., Huberman, H. S., Arevalo, J., Burtchen, N., et al. (2014). Reducing maternal depressive symptoms through promotion of parenting in pediatric primary care. Clinical Pediatrics, 53, 460–469. https://doi.org/10.1177/0009922814528033.CrossRefPubMedPubMedCentralGoogle Scholar
- Besharov, D. J., Germanis, P., Higney, C. A., & Call, D. M. (2011). Early head start—Research and evaluation project. In D. J. Besharov, P. Germans, C. A. Higney, & D. M. Call (Eds.), Assessments of twenty-six early childhood evaluations (Ch. 7). College Park: Welfare Reform Academy, University of Maryland.Google Scholar
- Canfield, C. F., Weisleder, A., Cates, C. B., Huberman, H. S., Dreyer, B. P., Legano, L. A., et al. (2015). Primary care parenting intervention effects on use of physical punishment among low-income parents of toddlers. Journal of Developmental and Behavioral Pediatrics, 36, 586–593. https://doi.org/10.1097/DBP.0000000000000206.CrossRefPubMedPubMedCentralGoogle Scholar
- Cassidy, J., Brett, B. E., Gross, J. T., Stern, J. A., Martin, D. A., Mohr, J. J., & Woodhouse, S. S. (2017). Circle of security—Parenting: A randomized control trial in head start. Development and Psychopathology, 29, 651–673. https://doi.org/10.1017/S0954579417000244.CrossRefPubMedPubMedCentralGoogle Scholar
- Cates, C. B., Weisleder, A., Dreyer, B. P., Johnson, S. B., Vlahovicova, K., Ledesma, J., & Mendelsohn, A. L. (2016a). Leveraging healthcare to promote responsive parenting: Impacts of the video interaction project on parenting stress. Journal of Child and Family Studies, 25, 827–835. https://doi.org/10.1007/s10826-015-0267-7.CrossRefPubMedGoogle Scholar
- Cates, C. B., Weisleder, A., Johnson, S. B., Seery, A. M., Canfield, C. F., Huberman, H., et al. (2018). Enhancing parent talk, reading, and play in primary care: Sustained impacts of the video interaction project. The Journal of Pediatrics, 199, 49–56. https://doi.org/10.1016/j.jpeds.2018.03.002.CrossRefPubMedPubMedCentralGoogle Scholar
- Dishion, T. J., Connell, A., Weaver, C., Shaw, D., Gardner, F., & Wilson, M. (2008). The family check-up with high risk indigent families: Preventing problem behavior by increasing parents’ positive behavior support in early childhood. Child Development, 79, 1395–1414. https://doi.org/10.1111/j.1467-8624.2008.01195.x.CrossRefPubMedPubMedCentralGoogle Scholar
- Escudero, V., Friedlander, M. L., Varela, N., & Abascal, A. (2008). Observing the therapeutic alliance in family therapy: Associations with participants’ perceptions and therapeutic outcomes. Journal of Family Therapy, 30, 194–214. https://doi.org/10.1111/j.1467-6427.2008.00425.x.CrossRefGoogle Scholar
- Garcia, E., & Weiss, E. (2017). Education inequalities at the school starting gate: Gaps, trends, and strategies to address them. Washington, DC: Economic Policy Institute.Google Scholar
- Hagan, J. F., Shaw, J. S., & Duncan, P. M. (2017). Bright futures: Guidelines for health supervision of infants, children, and adolescents. Elk Grove Village: American Academy of Pediatrics (AAP).Google Scholar
- Heinicke, C. M., Goorsky, M., Levine, M., Ponce, V., Ruth, G., Silverman, M., & Sotelo, C. (2006). Pre-and postnatal antecedents of a home-visiting intervention and family developmental outcome. Infant Mental Health Journal, 27, 91–119. https://doi.org/10.1002/imhj.20082.CrossRefPubMedGoogle Scholar
- Leslie, L. K., Mehus, C. J., Hawkins, J. D., Boat, T., McCabe, M. A., Barkin, S., ... Brown, R. (2016). Primary health care: Potential home for family-focused preventive interventions. American Journal of Preventive Medicine, 51, S106-S118. doi: https://doi.org/10.1016/j.amepre.2016.05.014.CrossRefGoogle Scholar
- Malmberg, L.-E., Lewis, S., West, A., Murray, E., Sylva, K., & Stein, A. (2016). The influence of mothers’ and fathers’ sensitivity in the first year of life on children’s cognitive outcomes at 18 and 36 months. Child: Care, Health and Development, 42, 1–7. https://doi.org/10.1111/cch.12294.CrossRefGoogle Scholar
- Mauricio, A. M., Mazza, G. L., Berkel, C., Tein, J.-Y., Sandler, I. N., Wolchik, S. A., & Winslow, E. (2018). Attendance trajectory classes among divorced and separated mothers and fathers in the new beginnings program. Prevention Science, 19, 620–629. https://doi.org/10.1007/s11121-017-0783-3.CrossRefPubMedPubMedCentralGoogle Scholar
- Mendelsohn, A. L., Dreyer, B. P., Flynn, V., Tomopoulos, S., Rovira, I., Tineo, W., … Nixon, A. F. (2005). Use of videotaped interactions during pediatric well-child care to promote child development: A randomized, controlled trial. Journal of Developmental and Behavioral Pediatrics, 26, 34–41.Google Scholar
- Needlman, R., Fried, L. E., Morley, D. S., Taylor, S., & Zuckerman, B. (1991). Clinic-based intervention to promote literacy: A pilot study. American Journal of Diseases in Children, 145, 881–884. https://doi.org/10.1001/archpedi.1991.02160080059021.CrossRefGoogle Scholar
- Research Supporting ABC. (n.d.). Retrieved from http://www.abcintervention.org/researchsupport. Accessed 15 May 2018
- Shaw, D. S., Dishion, T. J., Supplee, L., Gardner, F., & Arnds, K. (2006). Randomized trial of a family-centered approach to the prevention of early conduct problems: 2-year effects of the family check-up in early childhood. Journal of Consulting and Clinical Psychology, 74, 1–9. https://doi.org/10.1037/0022-006X.74.1.1.CrossRefPubMedGoogle Scholar
- Shonkoff, J. P., & Phillips, D. A. (Eds.). (2000). From neurons to neighborhoods: The science of early childhood development. Washington, DC: National Academy Press.Google Scholar
- Smith, J. D., Berkel, C., Hails, K. A., Dishion, T. J., Shaw, D. S., & Wilson, M. N. (2018). Predictors of participation in the family check-up program: A randomized trial of yearly services from age 2 to 10 years. Prevention Science, 19, 652–662. https://doi.org/10.1007/s11121-016-0679-7.CrossRefPubMedPubMedCentralGoogle Scholar