Randomized Controlled Trial of an Online Professional Development Course for Home Visitors in Brazil

• In Event: Parenting Programs for Young Children Around the Globe: Advances in Modalities, Culturally Sensitive Content, and Effects

Abstract

Responsive interactions for learning (RIFL) are characterized by a sensitivity to children’s interests, needs, and ability levels, as well as the use of stimulating language in back-and-forth exchanges. Caregivers who frequently engage their children in these types of interactions make a powerful difference in their children’s health and developmental outcomes (Madigan et al., 2019; Yousafzai et al., 2016). One way to enhance caregivers’ capacities to engage in RIFL is through home visiting programs. While many such programs exist, particularly in low- and middle-income countries, many of them do not emphasize responsive caregiving (Paulsell, Avellar, Martin, & Del Grosso, 2010). For example, the Care for Child Development framework used in Brazil’s nationwide home-visiting program promotes play and communication activities, but does not necessarily teach parents to support the type of child-led interactions that best contribute to children’s cognitive and language development (Mermelshtine & Barnes, 2016). To address this missed opportunity, we designed a 15-hour online course to train home-visiting professionals on how to support disadvantaged parents to engage in RIFL. We evaluated the effectiveness of this course in a cluster randomized controlled trial of 181 home-visiting professionals in the Northeastern Brazilian State of Piaui. To assess participants’ experience in the course and knowledge of child development and responsivity, we asked them to complete online surveys before and after the course. In addition, after taking the course, we conducted online interviews during which we presented videos of parent-child interactions and asked participants to describe what they noticed about the interactions and how they would coach the parents to improve the quality of the interactions. We developed a reliable coding scheme to assess their responses. Results demonstrate that the online course is viable, even in rural and low-income communities: participants were extremely satisfied with their experience in the course (4.7/5.0) and found that the content was new (3.9/5.0), relevant to their job (4.6/5.0), and improved their ability to support families (4.7/5.0). Furthermore, taking the course improved home-visiting professionals’ knowledge about responsivity and capacity to coach parents effectively. As compared to participants in the waitlist control group, those who took the course had significantly stronger understanding of why responsivity is important for child development (β = 0.24, p < 0.001), what responsive interactions consist of (β = 0.69, p < 0.001), and how important it is to let children lead during these interactions (β = 0.24, p = 0.02). They also recommended using more effective coaching strategies to improve mothers’ responsivity (β = 0.23, p = 0.02). Thus, this brief and easy-to-scale online course can be used to enhance professional capacities in home-visiting programs, including in low- and middle-income settings. By ensuring home-visiting professionals are equipped to promote the quality of parent-child interactions, we can enhance the impact of home-visiting programs that reach the most vulnerable children and families.

Authors

• Nina Sokolovic, University of Toronto
  Non-Presenting Author

• Alessandra Schneider, University of Toronto
  Presenting Author

• Michal Perlman, University of Toronto
  Non-Presenting Author

• Jennifer Jenkins, University of Toronto
  Non-Presenting Author