Expanding the Reach of Preventive Interventions

Abstract

There are major obstacles to the effective delivery of mental health services to poor families, particularly for those families in rural areas. The rise of Internet use, however, has created potentially new avenues for service delivery, which, when paired with the many recent advances in computer networking and multimedia technology, is fueling a demand for Internet delivery of mental-health services. We report on the adaptation of a parenting program for delivery via the Internet, enhanced with participant-created videos of parent-infant interactions and weekly staff contact, which enable distal treatment providers to give feedback and make decisions informed by direct behavioral assessment. This Internet-based, parent-education intervention has the potential to promote healthy and protective parent-infant interactions in families who might not otherwise receive needed mental health services.Child maltreatment is one of our nation's most significant public-health problems (National Center for Injury Prevention and Control, 2004). Though it is difficult to arrive at firm prevalence rates, the Department of Health and Human Services [DHHS] (2005) indicates that in 2005 (the most recent year for which National Child Abuse and Neglect Data System summary statistics are available), 899,000 children in the U.S. and its territories were victims of abuse or neglect. This statistic very likely under-estimates the true prevalence rate (DHHS, 2005; Goldman, Salus, Wolcott, & Kennedy, 2003). Infants and young children are particularly vulnerable. Children under 3 years of age are the most frequent victims of substantiated maltreatment (Goldman, et al.;Wu et al., 2004), and over 40% of maltreatment-related fatalities

Parent education interventions designed to support the transition to parenthood: A realist review

“…Parents were expected to attend the entire series of classes (typically 5-8). Other designs included booklet or printed material (Adachi et al, 2009;Jackson and Dickinson, 2009;McKellar et al, 2008), DVD or film-based (Brown, 2006) and Internet-based sessions (Brown, 2006;Feil et al, 2008;Kuo et al, 2009;Salonen et al, 2008). There was littleevidence to suggest that alternate forms of parent education were any more or less effective than traditional face-to-face methods (Salonen et al, 2008).…”

“…However, this is not typically the design of most parenting classes, where it is more usual for the facilitator to cover a comprehensive list of topics delivered over a number of weeks that may or may not pertain to issues actually being experienced by the parents at the time. In fact, in the interest of maintaining fidelity, programmes frequently dissuaded facilitators from modifying content (e.g., Feil et al, 2008;Hiscock et al, 2008;Rowe and Fisher, 2010;Sanders et al, 2002). In contrast, Svensson et al (2006) proposed that parents may engage in educational initiatives when they can choose topics that they find relevant.…”

A Randomized Controlled Trial Examination of a Remote Parenting Intervention: Engagement and Effects on Parenting Behavior and Child Abuse Potential

“…The Baby-Net adaptation of PALS (Feil et al, 2008, 2014), replicating the original PALS in-home learning structure, includes the following key component structure in each intervention session: (a) self-directed learning of PALS skills through video-based examples and nonexamples, with check-in questions using immediate individualized feedback; (b) action plan outlining daily activity practice (homework) based on skills taught; (c) video-recorded practice creating a 5-min, computer-collected, mother–infant interaction video demonstrating skills learned and uploaded to a project server; and (d) coach call involving mothers and coaches coviewing weekly mother-created videos to provide individualized support for conceptual learning and skill acquisition. Prior to each coach call, coaches prepare by accessing weekly mother-created video and auto generated reports that display the amount of time mothers spend in the program and their responses to check-in questions.…”

“…To address financial and geographical barriers to intervention access (Katz, La Placa, & Hunter, 2007), we adapted the evidence-based PALS program (Landry et al, 2008) for Internet delivery with remote coaching for low-income mothers (e-PALS: Infant-Net; Baggett et al, 2010; Feil et al, 2014; Feil et al, 2008). Examination of Infant-Net within a randomized controlled pilot trial with 40 low-income mothers and their infants showed high retention and engagement with medium to large effects on maternal parenting practices and infant behavior (Baggett et al, 2010).…”

Using a Digital Frame and Pictorial Information to Enhance the SafeCare® Parent-Infant Interactions Module With a Mother with Intellectual Disabilities: Results of a Pilot Study

“…Technology gives individuals greater freedom in how they choose to participate and fit an intervention into their daily routine. As a result, practitioners may spend less time rescheduling canceled or missed appointments (Feil et al, 2008;Self-Brown & Whitaker, 2008). Utilizing technological media, through which parents are becoming increasingly familiar, can potentially be cost-effective because many of these devices are already used in the home.…”