Parent coaches’ in-vivo feedback predicts improvement in parenting behaviors among low-income, predominantly Latina mothers

• In Event: 1-159 - Leveraging a major component of Attachment and Biobehavioral Catch-up to ensure successful community dissemination

Integrative Statement

Introduction: Implementation science emphasizes the importance of elucidating interventions’ core components in order understand mechanisms of change and how best to support them (Fixsen et al., 2009). Building on previous evaluations of parenting interventions that have highlighted interventionists’ in-vivo feedback as a key change agent (Barnett et al., 2015), the current study examined parent coaches’ in-the-moment (ITM) commenting as a core component of the ABC program in 87 low-income, predominantly Latina mothers and their infants. We drew on a randomized controlled trial (RCT) in which ABC (10 sessions) was provided as a supplement to home-based Early Head Start services. This RCT has demonstrated positive effects of the “Early Head plus ABC” model on three important parenting behaviors: sensitivity/responsiveness, (reduced) intrusiveness, and positive regard (Blinded, in press). In the current within-group analysis, we examined ITM commenting as a predictor of these three parenting behaviors observed shortly after completion of ABC. Participants were low-income, predominantly (87%) Latina mothers and their infants randomly assigned to receive Early Head Start plus ABC from one of two trained, certified, bilingual/bicultural parent coaches. At enrollment, mean maternal age was 31 (SD = 6.5), 53% had completed high school or a GED, and most (84%) described their marital status as married or partnered. Mean infant age was 13 months (SD = 4); 47% were girls.
In-the-Moment (ITM) Commenting: For each participant, one of two trained and reliable coders rated four 5-minute video clips, two clips from session 3, and two clips from session 9. The coders rated (a) the frequency of the parent coaches’ comments; (b) the frequency and proportion of comments that were “on target” (appropriate); and (c) the ABC-specific parenting behaviors targeted by the coaches’ ITM comments: nurturance, expressing delight, following the lead with delight, and avoiding frightening behavior. The parent coaches made an average of 2.18 comments per minute (SD = 0.42), 2.16 per minute in session 3 (SD = 0.57) and 2.19 in session 9 (SD = 0.51). Almost all of their comments (92%) were observed to be on target. Following the lead with delight was the most frequently targeted parenting behavior (M = 31.13, SD = 7.82), followed by expressing delight (M = 3.49, SD = 2.65). Nurturance was targeted too infrequently to analyze (M = 1.54, SD = 1.89). Frightening behaviors were never targeted. Following the lead with delight was targeted with approximately equal frequency in session 3 and session 9, as was expressing delight.
Associations between ITM Commenting and Post-Intervention Parenting Behaviors: Parent coaches’ on-target comments per minute during session 3 -but not 9- predicted post-intervention maternal sensitivity, (reduced) intrusiveness, and positive regard (Table 1). Similarly, parent coaches’ targeting of following the lead with delight during session 3 -but not 9- significantly predicted all three post-intervention parenting behaviors (Table 2). Parent coaches’ targeting of expressing delight during session 9 only negatively predicted post-intervention maternal sensitivity. Findings will be discussed in terms of their implication that ITM commenting during earlier ABC sessions may hold the greatest potential for driving parenting change.

Authors

• Lisa Berlin, University of Maryland
  Presenting Author

• Katherine Endy, University of Maryland
  Non-Presenting Author

• Brenda Jones-Harden, University of Maryland
  Non-Presenting Author

• Tiffany L Martoccio, University of Maryland
  Non-Presenting Author