UCLA Parent-Child Health and Wellness Program: Prevention of Injuries by Parents with Intellectual Disabilities

Abstract

The University of California, Los Angeles Parent-Child Health and Wellness Program was an evaluated home-based intervention created to explore ways to extend health care and home safety education research to community settings with families at high risk for injuries. The purpose of this program was to establish a community-based model for the provision of self and child health safety/well-being preparatory and preventive education to young or expectant minor or adult parents with cognitive impairments. The program was inclusive and purposively tried to obtain people from the agency identified as having functional parenting needs regardless of a disability label. Statistical analysis showed that maternal health, safety knowledge, and skill scores in both groups improved significantly at post-testing; however, mothers who received interventions in their homes did better on all maternal knowledge outcome variables. In addition, both groups did not return to their baseline, and the differences between the two groups were maintained which demonstrated the validity of procedures for general use.

Appendices

BRIO Model: The UCLA Parent-Child Health and Wellness Program

Group Served: Low-income and underserved adults and teen parents with intellectual disabilities and other learning difficulties.

Goal: To support parents with intellectual disabilities in learning health and safety skills by focusing on parental strengths as well as exploring ways to extend health care and home safety education.

Background	Resources	Implementation	Outcome
Parenting information in the areas of health and home safety is commonly presented in complex language and format, making it difficult for parents with mild cognitive limitations or individual learning needs to learn and apply Strategies take into account the interplay of the host, agent, and the environment at the pre-event (prevention of occurrence), event (severity), and post-event (remediation) level of injury prevention Education intervention model is based on the principles of empowerment education	Funded by California Wellness Foundation through a 4-year grant Additional financial resources through in-kind contributions Operated under UCLA, department of psychiatry of School of Medicine. Employed multidisciplinary, multiethnic, bilingual staff Over the course of 4 years, program materials were multidisciplinary validated with people who are practicing nurses, social workers, psychologists, physicians, teachers, direct care staff, administrators, and students Evolved through Dr. Tymchuk’s own clinical and community research for over three decades	Multidisciplinary in its approach to injury prevention Two phases of implementation: initial re-examination of all previously developed procedures (pilot) and clinical random trial phase The program incorporates a perspective that is both flexible and adaptable to address changing needs in diverse populations of parents in families at risk	Significant increase in parental knowledge and skills on functional measures The full curriculum has been adopted and instituted across California and pilot tested across sites in Colorado Replicated as random control trial study at University of Sydney, Australia The complete program with accompanied CD was published in 2006 by the Brookes Publishing Inc.

Life Space Model : The UCLA Parent-Child Health and Wellness Program

Sociocultural: civilization/community	Interpersonal: primary and secondary relationships	Physical environments: where we live	Internal states: biochemical/genetic and means of coping
Substantial evidence shows that low-income mothers with or without intellectual disabilities do not have basic information about injury prevention. Need for supportive programs that provide accurate information and skills regarding how to act in the event of a child injury. Need for empirically developed program materials addressing parental adequacy at prescriptive level Free, bilingual, community out-reach program, tailored for families with preschool children at high risk for injuries. Nationally and internationally replicated Intervention model is based on the principles of social inclusion and empowerment education Created to explore ways to extend health care and home safety education research to community settings with families headed by parent(s) with intellectual disability	Introduced the memoranda of understanding as formal collaborative relationships between university and at least one agency representing health care, child protective service, disability/social services, and education Successful implementation requires multidisciplinary team coordination including disability, private and public health, welfare, child protection, parenting education, early intervention, mental health, the courts, and other social services The Positive Parenting Attention System (+PAS) has been devised in which those materials and processes that are most rewarding to the parent have been identified	Intervention strategies take into account the transaction of the host, agent, and the environment at the pre-event (prevention of occurrence), event (severity), and post-event (remediation) level of injury prevention Home-safety curriculum is a part of the overall Wellness Program Both in vivo and in vitro identifications of the antecedents (circumstances to injury) and consequences (remediation) of the actual injury event are critical for effective home-safety program implementation since parents may not be aware of either	Intervention addresses changes in parental/maternal information processing A focus on enabling factors is done in order to redirect focus on risk factors only Empirically-based curricula, prescriptive assessment tools, and other educational materials are specifically designed to promote competence in adequate parenting Program efforts were directed to the provision of supports to the parent/mother in order to facilitate self-growth and actualization