Improving Caregiver Self-Efficacy and Child Development via FIND Video Coaching Intervention: A Randomized Controlled Trial

• In Event: Supporting Children, Parents, and Educators in Different Settings and Problem Areas: Innovations in Video Feedback

Abstract

Introduction
Caregiving experiences are a key determinant of socioemotional and cognitive functioning and brain development in early childhood (Blair & Raver, 2016). Many existing preventive intervention programs focus on promoting responsive parenting practices to facilitate optimal child development (e.g., Mountain et al., 2017). However, parenting intervention programs are often resource-intensive (Duncan et al., 2017) and less effective for socially and economically marginalized families facing adversity (Leijten et al., 2013). Recent research indicates that video coaching can be an effective intervention strategy, where naturally occurring, developmentally supportive parenting behaviors are highlighted through video feedback (Axberg et al., 2006). These intervention strategies are usually strength-based, giving caregivers more confidence and ability to consistently address child needs, and thus particularly benefiting at-risk families. Filming Intervention to Nurture Development (FIND) is this type of intervention program that uses video coaching to strengthen developmentally supportive “serve and return” interactions, a pattern characterized by attuned, reciprocal, and well-regulated interactions fundamental to child brain development (Fisher et al., 2016). In this study, we leveraged data from a randomized controlled trial (RCT) to test the effectiveness of this brief (10-session) program among low-income families.
Hypotheses
FIND is hypothesized to effectively enhance caregivers’ self-efficacy, child socioemotional outcomes, and child language development. With the strength-based nature, we hypothesized caregivers with high adverse childhood experiences to benefit more from FIND.
Methods
We used data from an RCT with low-income, at-risk families with young children (4-36 months old; 41.8% female) enrolled in Early Head Start in the Denver metropolitan area (N=91). Caregivers were mostly female (98.9%) and Hispanic/Latino(a) (80.2%). The majority (88.8%) of families were below 200% FPL. During the pre-intervention assessment, parental self-efficacy was assessed through PSOC (Johnson & Mash, 1989) and SEPTI-TS (Coleman & Karraker, 2003). Child socioemotional outcomes were measured via parent-reported CBCL/1.5-5 (Achenbach & Rescorla, 2001) and BITSEA-Preschool (Carter & Briggs-Gowan, 2005). Child language outcomes were assessed using the PLS-5 (Zimmerman et al., 2011) Spanish (68.1%) or English (31.9%) versions. Caregivers’ early adverse experiences were measured using ACE (Felitti et al., 1998). After pre-intervention assessment, families were randomly assigned to active control (EHS; n=37) or intervention (FIND+EHS; n=54) groups. After completing the intervention, a post-intervention assessment was conducted, where caregiver self-efficacy and child outcomes were assessed again using the same measures as pre-intervention.
Results
Multilevel structural equation model in Mplus indicated that FIND significantly improved caregivers’ overall sense of competence (PSOC; β=0.73, p<0.001) and self-efficacy in teaching tasks (β=0.87, p<0.001), as well as child auditory comprehension (β=0.91, p<0.001) and expressive communication (β=0.94, p<0.001) language skills (Figure 1 for interpretation). The direct intervention effects on child internalizing (β=-0.68, p=0.21) & externalizing (β=-0.19, p<0.64) symptoms were not significant; however, FIND indirectly reduced child internalizing symptoms through improving caregivers’ SEPTI teaching skills (α*β=-0.25, p<0.05). Lastly, the effectiveness of FIND in improving caregiver self-efficacy in teaching tasks was more profound among caregivers with high ACE scores (Figure 2).
Conclusion
Results support the effectiveness of the FIND intervention in improving child and caregiver outcomes among ethnically diverse low-income families of young children.

Authors

• Sihong Liu, Stanford University
  Presenting Author

• Andrea Imhof, University of Oregon

• Sarah E Watamura, University of Denver

• Tiffany Phu, University of Denver

• Lisa Schlueter, Colorado Department of Human Services, Office of Early Childhood

• Amy Dominguez, University of Denver

• Eliana Hurwich-Reiss

• Andrew (Drew) B. McGee, University of Denver

• Philip Fisher, Stanford University