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Participation in a Preventive Parenting Intervention among Low-Income Families During Multiple Public Health Crises

Wed, April 7, 2:45 to 4:15pm EDT (2:45 to 4:15pm EDT), Virtual

Abstract

Public health crises, like the COVID-19 pandemic (COVID-19), disproportionately impact low-income and racial/ethnic minority communities (e.g., Masozera et al., 2007; Masten et al, 2012), compounding existing risks, including systemic racism and chronic poverty (Bailey et al., 2017), and leading to mental/physical health problems and institutional distrust. This may be especially harmful to families with young children, impacting both parenting and child development (Silverman et al., 2002). Preventive interventions may buffer young children from effects of these adverse experiences, and, when delivered community-wide, may help build resilience following disasters (Jutte et al., 2015). However, systemic (e.g., access) and individual (e.g., low education, maternal mental health) barriers may interfere with families’ participation in such programs, and may change during crises. In late 2019, the Supporting Parents and Raising Resilient Kids (SPARRK) study was initiated in Flint, MI to improve school readiness among children whose families were impacted by the Flint Water Crisis (FWC) through implementation of the Video Interaction Project (VIP), a parent-child intervention seeking to improve early relational health and child outcomes. Due to COVID-19, SPARRK pivoted to virtual delivery of VIP, minimizing access barriers to participation. Thus, this study seeks to identify parent-level factors associated with VIP participation among SPARRK families experiencing both the FWC and COVID-19.
Families were recruited into the SPARRK study in the pediatric clinic at their first visit after the infant’s birth, and were randomized to receive standard well-child care (n=24) or VIP (n=32). Participation in VIP was evaluated as a proportion equaling the number of sessions attended out of the possible number of sessions, based on the infant’s age. These were further broken down based on the proportion attended prior to the onset of the COVID-19 crisis and the proportion attended post-COVID-19. Predictors of participation included maternal well-being (anxiety, stress), SES (maternal education), perceived water quality as a proxy for FWC impact, marital status, and whether the child was the firstborn (for demographics, see Table 1). All predictor variables were assessed via baseline interviews conducted with enrolled mothers within 3 months of their child’s birth. Because enrollment was interrupted by COVID-19 restrictions, data collection is ongoing, and will include additional information about economic, health, and parenting impacts of COVID-19.
Preliminary bivariate correlational analyses indicated that pre-COVID participation was related to maternal education, with more educated mothers attending more sessions, r=.37. This was also the case for post-COVID participation, r=.36. Interestingly, mothers with more anxiety symptoms were also more likely to attend VIP sessions post-COVID, r=.40 (Table 2). Based on this, a multivariate regression was conducted predicting post-COVID-19 attendance from these two variables. Maternal education and anxiety were both significant independent predictors post-COVID-19, β=.38, p<.05, and β=.43, p<.05, respectively.
Results indicate that, in the context of multiple public health crises and broad institutional distrust, parent-level barriers like low maternal education remain critical indicators of intervention participation. However, that mothers with increased anxiety were more likely to attend sessions in this context provides some evidence for effective support of especially high-risk families.

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