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Implementing Parenting Programs with Diverse Families and Populations in Pediatric Care: the Video Interaction Project

Thu, March 21, 4:00 to 5:30pm, Hilton Baltimore, Floor: Level 2, Key 9

Integrative Statement

Parenting programs in pediatric primary care have the potential for widespread translation and implementation due to low cost, existing trusting relationships, and near universal access to US families with young children. Two such programs: Reach Out and Read (ROR) and Video Interaction Project (VIP) promote parent-child bookreading and play as primary prevention for income-related disparities in children’s school readiness. ROR is the most scaled pediatric program, reaching more than 25% of low-income families (4.7 million), with demonstrated benefits for parent-child bookreading and children’s vocabulary (Zuckerman, 2009). VIP, developed as an enhancement to ROR, adds one-on-one parent-interventionist sessions and videotaped parent-child interactions that are reviewed to highlight responsive parenting, in addition to provision of a toy/book. VIP has positive, sustained (at 4.5 yrs.) impacts on parents’ cognitive stimulation (reading, verbal responsivity) and children’s socioemotional development (Cates et al., 2018; Mendelsohn et al., 2018).

To broaden VIP reach, implementation science has been applied to guide VIP translation to reach families from diverse ethnic backgrounds and needs. Study 1 focuses on implementation of VIP as part of a citywide initiative in New York City, and a comprehensive pediatric public health plan in Flint, MI. We describe how partnership approaches with community leaders in the Flint Pediatric Public Health Initiative were applied to enhance cultural fit, extended family engagement, and community relevance of VIP. In addition, we present how partnership with programs and policymakers through City’s First Readers, which serves over 800,000 families in 32 communities across NYC, provides an entry opportunity to reach a large network of families throughout the city. Study 2 utilizes data from an RCT (Smart Beginnings; n=200), to examine VIP engagement/participation patterns to understand whether VIP was engaging the target population of Latino families with diverse risks. Preliminary results show good fit of the VIP intervention and implementation model. Of parents enrolled, 75% attended three of four possible sessions through age 6 months. Further, parents with additional risks, such as less education and lower self-efficacy, were more engaged than lower risk families (Table 1). Study 3 focuses on fit and acceptability of VIP for low-income Chinese immigrant families that tend to experience frequent parent-child separation and are at-risk for non-optimal parent-child interactions. Using a mixed method design (n=30), preliminary results show a good fit of VIP for the needs of Chinese immigrant families. The acceptability of VIP will be further examined using observational data.

Findings indicate that VIP is good fit for the needs of families from varying cultural backgrounds (e.g., Chinese, Latino). With systematic implementation studies and appropriate implementation strategies (i.e., partnership, community engagement), VIP can be taken up by policymakers and leaders in divergent communities (e.g., New York City, Flint), and can reach diverse at-risk families. Pediatric primary care is a unique platform for the implementation of parenting programs, and these results suggest VIP, as an evidence-based intervention with strong impacts on parenting and child development, can take advantage of this to reach families in high-need communities and improve children’s school readiness on a larger scale.

Authors