Randomized control trial of an internet-based parenting intervention for mothers of infants

Feil, Edward G.; Baggett, Kathleen M.; Davis, Betsy; Landry, Susan H.; Sheeber, Lisa; Leve, Craig; Johnson, Ursula

doi:10.1016/j.ecresq.2018.11.003

Cited by 46 publications

(51 citation statements)

References 32 publications

(31 reference statements)

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“…The PHQ-9 possesses strong psychometric properties for assessing depression severity; a score at or above 20 is suggestive of severe depression [39]. Participants were also administered the Knowledge of Infant Social communication Development and Competency Promotion, which has demonstrated high internal consistency and sensitivity to intervention change [40].…”

Section: Methodsmentioning

confidence: 99%

Minding the Gatekeepers: Referral and Recruitment of Postpartum Mothers with Depression into a Randomized Controlled Trial of a Mobile Internet Parenting Intervention to Improve Mood and Optimize Infant Social Communication Outcomes

Baggett

Davis

Sheeber

et al. 2020

IJERPH

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Mothers in the United States (U.S.) who are of non-dominant culture and socioeconomically disadvantaged experience depression during postpartum at a rate 3 to 4 times higher than mothers in the general population, but these mothers are least likely to receive services for improving mood. Little research has focused on recruiting these mothers into clinical intervention trials. The purpose of this article is to report on a study that provided a unique context within which to view the differential success of three referral approaches (i.e., community agency staff referral, research staff referral, and maternal self-referral). It also enabled a preliminary examination of whether the different strategies yielded samples that differed with regard to risk factors for adverse maternal and child outcomes. The examination took place within a clinical trial of a mobile intervention for improving maternal mood and increasing parent practices that promote infant social communication development. The sample was recruited within the urban core of a large southern city in the U.S. and was comprised primarily of mothers of non-dominant culture, who were experiencing severe socioeconomic disadvantage. Results showed that mothers self-referred at more than 3.5 times the rate that they were referred by either community agency staff or research staff. Moreover, compared to women referred by research staff, women who self-referred and those who were referred by community gatekeepers were as likely to eventually consent to study participation and initiate the intervention. Results are discussed with regard to implications for optimizing referral into clinical intervention trials.

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Section: Methodsmentioning

confidence: 99%

Minding the Gatekeepers: Referral and Recruitment of Postpartum Mothers with Depression into a Randomized Controlled Trial of a Mobile Internet Parenting Intervention to Improve Mood and Optimize Infant Social Communication Outcomes

Baggett

Davis

Sheeber

et al. 2020

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“…Following assessment, mothers were randomized to 1 of 2 mobile internet interventions with identical structures. For both groups, the number of sessions and structural components of each session included (1) a web-based self-directed learning program through video-based teaching with check-in questions and provision of immediate corrective feedback, (2) an action plan outlining daily activity practice (homework) based on session content, (3) parent-recorded video and secure upload of session skill practice during interaction with her infant, and (4) a video-based coach call to coview the parent-recorded video of interaction with her infant [ 20 ]. For both intervention groups, meaningful access to a mobile internet intervention was operationalized as (1) mothers’ completion of an in-home intervention session in which mothers were fully guided and scaffolded to interact with each mobile intervention component (ie, video modeling content, review questions, action plan, video creation, and coach call) and (2) mothers’ completion of each of the above content components of the remote intervention session with on-demand scaffolding provided through messaging, phone, or video call.…”

Section: Methodsmentioning

confidence: 99%

“…The cost of home visiting intervention programs is particularly prohibitive because of state budget crises that often result in the rationing of state-funded home visiting services [ 9 , 19 ]. When home visiting programs are available, the barriers to parent engagement include unpredictable work schedules; shift work outside the 9 to 5 workday; transient housing; and living with relatives, friends, or landlords who are gatekeepers to the home and unamenable to home visits [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

“…Mobile internet interventions, particularly those with remote coaching, afford substantial advantages for overcoming logistical challenges that often prevent mothers who are poor and of nondominant culture from accessing EI [ 20 ]. The advantages of mobile internet interventions include around-the-clock accessibility to program content, greater ease and flexibility in scheduling and rescheduling remote visits, less stigma, and greater parental autonomy to select and share video-recorded interactions at any time of day for the purpose of obtaining EI support [ 20 ]. Although advantages for mobile interventions are known to exist, the bridge from a NICU exit referral to a mobile internet intervention has been virtually unexamined in published studies.…”

Section: Introductionmentioning

confidence: 99%

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Understanding the Steps Toward Mobile Early Intervention for Mothers and Their Infants Exiting the Neonatal Intensive Care Unit: Descriptive Examination

Baggett¹,

Davis²,

Landry³

et al. 2020

J Med Internet Res

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Background Neonatal intensive care unit (NICU) history, combined with systemic inequities for mothers of nondominant cultures and mothers who are socioeconomically disadvantaged, places infants at an extraordinary risk for poor developmental outcomes throughout life. Although receipt of early intervention (EI) is the best single predictor of developmental outcomes among children with and at risk for early developmental delays, mothers and infants with the greatest needs are least likely to receive EI. Mobile internet-based interventions afford substantial advantages for overcoming logistical challenges that often prevent mothers who are economically disadvantaged from accessing EI. However, the bridge from the NICU to a mobile internet intervention has been virtually unexplored. Objective This study aims to examine progression flow from NICU exit referral to an early mobile internet intervention to increase EI access and promote parent mediation of infant social-emotional and communication development. Methods Three NICUs serving the urban poor in a Midwestern city were provided support in establishing an electronic NICU exit referral mechanism into a randomized controlled trial of a mobile internet intervention for mothers and their infants. Measurement domains to reflect the bridge to service included each crucial gateway required for navigating the path into Part C EI, including referral, screening, assessment, and intervention access. An iterative process was used and documented to facilitate each NICU in establishing an individualized accountability plan for sharing referral materials with mothers before their NICU exit. Subsequent to the referral, progression flow was documented on the basis of a real-time electronic recording of service receipt and contact records. Mother and infant risk characteristics were also assessed. Descriptive analyses were conducted to summarize and characterize each measurement domain. Results NICU referral rates for EI were 3 to 4 times higher for open-shared versus closed-single gatekeeper referral processes. Of 86 referred dyads, 67 (78%) were screened, and of those screened, 51 (76%) were eligible for assessment. Of the 51 assessment-eligible mothers and infants, 35 dyads (69%) completed the assessment and 31 (89%) went on to complete at least one remote coaching intervention session. The dyads who accessed and engaged in intervention were racially and ethnically diverse and experiencing substantial adversity. Conclusions The transition from the NICU to home was fraught with missed opportunities for an EI referral. Beyond the referral, the most prominent reason for not participating in screening was that mothers could not be located after exiting the NICU. Stronger NICU referral mechanisms for EI are needed. It may be essential to initiate mobile interventions before exiting the NICU for maintaining post-NICU contact with some mothers. In contrast to a closed, single point of referral gatekeeper systems in NICUs, open, shared referral gating systems may be less stymied by individual service provider biases and disruptions.

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“…A similar approach would be beneficial for supporting families and language development. First, access to interventions that are universal in scope and embedded within community-based organizations already engaging with parents can increase the reach and impact of early language interventions, while also taking a more preventative approach (e.g., Feil, Baggett, Davis, Landry, Sheeber, Leve & Johnson, 2020; Mahoney et al, 2020; Pontoppidan, Klest, Patras & Rayce, 2016). Some families may need additional supports and resources; these can be provided through tier two and three services, which become increasingly more individualized to a family's needs (e.g., Leung et al, 2020; Seven & Goldstein, 2020).…”

Section: Introductionmentioning

confidence: 99%

Parent education to improve early language development: A preliminary evaluation of LENA Start^TM

et al. 2020

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Parents play an important role in creating home language environments that promote language development. A nonequivalent group design was used to evaluate the effectiveness of a community-based implementation of LENA Start™, a parent-training program aimed at increasing the quantity of adult words (AWC) and conversational turns (CT). Parent-child dyads participated in LENA Start™ (n = 39) or a generic parent education program (n = 17). Overall, attendance and engagement in the LENA StartTM program were high: 72% of participants met criteria to graduate from the program. Within-subject gains were positive for LENA Start™ families. Comparison families declined on these measures. However, both effects were non-significant. Between-group analyses revealed small to medium-sized effects favoring LENA Start™ and these were significant for child vocalizations (CV) and CT but not AWC. These results provide preliminary evidence that programs like LENA StartTM can be embedded in community-based settings to promote quality parent-child language interactions.

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Randomized control trial of an internet-based parenting intervention for mothers of infants

Cited by 46 publications

References 32 publications

Minding the Gatekeepers: Referral and Recruitment of Postpartum Mothers with Depression into a Randomized Controlled Trial of a Mobile Internet Parenting Intervention to Improve Mood and Optimize Infant Social Communication Outcomes

Minding the Gatekeepers: Referral and Recruitment of Postpartum Mothers with Depression into a Randomized Controlled Trial of a Mobile Internet Parenting Intervention to Improve Mood and Optimize Infant Social Communication Outcomes

Understanding the Steps Toward Mobile Early Intervention for Mothers and Their Infants Exiting the Neonatal Intensive Care Unit: Descriptive Examination

Parent education to improve early language development: A preliminary evaluation of LENA Start^TM

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Randomized control trial of an internet-based parenting intervention for mothers of infants

Cited by 46 publications

References 32 publications

Minding the Gatekeepers: Referral and Recruitment of Postpartum Mothers with Depression into a Randomized Controlled Trial of a Mobile Internet Parenting Intervention to Improve Mood and Optimize Infant Social Communication Outcomes

Minding the Gatekeepers: Referral and Recruitment of Postpartum Mothers with Depression into a Randomized Controlled Trial of a Mobile Internet Parenting Intervention to Improve Mood and Optimize Infant Social Communication Outcomes

Understanding the Steps Toward Mobile Early Intervention for Mothers and Their Infants Exiting the Neonatal Intensive Care Unit: Descriptive Examination

Parent education to improve early language development: A preliminary evaluation of LENA StartTM

Contact Info

Product

Resources

About

Parent education to improve early language development: A preliminary evaluation of LENA Start^TM