Randomized Controlled Trial of Primary Care Pediatric Parenting Programs

Mendelsohn, Alan L.; Dreyer, Benard P.; Brockmeyer, Carolyn; Berkule-Silberman, Samantha B.; Huberman, Harris S.; Tomopoulos, Suzy

doi:10.1001/archpediatrics.2010.266

Cited by 36 publications

(27 citation statements)

References 27 publications

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“…Parenting stress about the parent-child relationship was assessed at four timepoints, when children were 6, 14, 24, and 36 months of age using the Parent-Child Dysfunctional Interaction (P-CDI) subscale of the Parenting Stress Index- Short Form (PSI-SF), a widely used measure that has been shown to be reliable and valid for use with diverse populations (Abidin, 1997). Additionally, sociodemographic information, and other data characterizing the sample, was collected via parent interview, as described elsewhere (Mendelsohn et al, 2011a, 2011b), at the time of enrollment in the study.…”

Section: Methodsmentioning

confidence: 99%

“…We performed comparisons of group means at each time point using t-tests; effect sizes were calculated using Cohen’s d. We also performed comparisons of trajectories of parenting stress over time using multilevel modeling with age (both linear and quadratic), group, and group x age included as predictors of mean percentile P-CDI scores. These models were also used to test for moderation of maternal literacy/education (9 th grade or higher literacy; education used as proxy for 79 cases missing literacy (Mendelsohn et al, 2011a) and social risk. For purposes of analyses, mean percentile P-CDI scores were log transformed due to non-normal (Kolmogorov-Smirnov Z=3.42, p<.001), positively skewed distribution (skewness=1.54, SE=0.2).…”

Section: Methodsmentioning

confidence: 99%

“…This setting offers the possibility of working with families population-wide, with early onset, and at low-cost for reasons enumerated by Mendelsohn and colleagues (Mendelsohn et al, 2011a, 2011b), including: (1) the frequency and near universality of visits; (2) the close relationship between parents and primary care providers; (3) the ability to utilize existing health care infrastructure; and (4) the lack of need for additional travel. Some of the first evidence documenting the potential of impacting parenting behavior and child development in the context of this setting comes from studies demonstrating success of Reach Out and Read (ROR), a program in which health care professionals provide families with children’s books, model shared reading activities, and provide guidance about the benefits of shared reading at well child visits beginning at age 6 months.…”

Section: Introductionmentioning

confidence: 99%

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Leveraging Healthcare to Promote Responsive Parenting: Impacts of the Video Interaction Project on Parenting Stress

et al. 2015

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We sought to determine impacts of a pediatric primary care intervention, the Video Interaction Project, on 3-year trajectories of parenting stress related to parent-child interactions in low socioeconomic status (SES) families. A randomized controlled trial (RCT) was conducted, with random assignment to one of two interventions (Video Interaction Project [VIP]; Building Blocks [BB]) or control (C). As part of VIP, dyads attended one-on-one sessions with an interventionist who facilitated interactions in play and shared reading through review of videotaped parent-child interactions made on primary care visit days; learning materials and parenting pamphlets were also provided to facilitate parent-child interactions at home. Parenting stress related to parent-child interactions was assessed for VIP and Control groups at 6, 14, 24, and 36 months using the Parent-Child Dysfunctional Interaction subscale of the Parenting Stress Index- Short Form, with 378 dyads (84%) assessed at least once. Group differences emerged at 6 months with VIP associated with lower parenting stress at 3 of 4 ages considered cross-sectionally and an 17.7% reduction in parenting stress overall during the study period based on multi-level modeling. No age by group interaction was observed, indicating persistence of early VIP impacts. Results indicated that VIP, a preventive intervention targeting parent-child interactions, is associated with decreased parenting stress. Results therefore support the expansion of pediatric interventions such as VIP as part of a broad public health strategy to address poverty-related disparities in school-readiness.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Leveraging Healthcare to Promote Responsive Parenting: Impacts of the Video Interaction Project on Parenting Stress

et al. 2015

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“…VIP, which has been previously described 27-31,33,34 , takes place from birth to three years, with sessions taking place primarily on the same day as regularly-scheduled well-child primary care visits. Families in the current study received up to four possible visits by infant age 6 months.…”

Section: Methodsmentioning

confidence: 99%

Reducing Maternal Depressive Symptoms Through Promotion of Parenting in Pediatric Primary Care

Berkule

Cates

Dreyer

et al. 2014

Clin Pediatr (Phila)

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We studied associations between two pediatrics primary care interventions promoting parental responsiveness and maternal depressive symptoms among low-income mothers. This RCT included two interventions (Video Interaction Project [VIP], Building Blocks [BB]) and a control group. VIP is a relationship-based intervention, using video-recordings of mother-child dyads to reinforce interactional strengths. BB communicates with parents via parenting newsletters, learning materials and questionnaires. At mean (SD) child age 6.9 (1.2) months, depressive symptoms were assessed with the PHQ-9, parental responsiveness was assessed with StimQ-I. 407 dyads were assessed. Rates of mild depressive symptoms were lower for VIP (20.6%) and BB (21.1%) than Controls (32.1%, p=.04). Moderate depressive symptoms were lower for VIP (4.0%) compared to Controls (9.7%, p=.031). Mean PHQ-9 scores differed across 3 groups (F=3.8, p=.02): VIP mothers scored lower than controls (p=.02 by Tukey hsd). Parent-child interactions partially mediated VIP-associated reductions in depressive symptoms (indirect effect −.17, 95% CI −.36, −.03).

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“…32,33 Participation in VIP was also associated with enhancements in child cognitive and language development through first grade. 30,31,34 In a subsequent RCT, these findings have been replicated and extended, showing continued effects on parenting and cognitive stimulation, 35 including enhancements in observed parent verbal input in the context of shared book reading, 36 reduced electronic media exposure, 37 and reductions in harsh discipline, 38 as well as enhancements in child socioemotional development 39 and some reductions in referral to Early Intervention Services. Additionally, effects of VIP have also been shown on a number of psychosocial factors known to affect quality of parent–child interactions such as maternal depressive symptoms 40 and parenting stress.…”

Section: Models Of Intervention In Pediatric Primary Carementioning

confidence: 90%

Mitigating the Effects of Family Poverty on Early Child Development through Parenting Interventions in Primary Care

Cates

Weisleder

Mendelsohn

2016

Academic Pediatrics

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Poverty related disparities in early child development and school readiness are a major public health crisis, the prevention of which has emerged in recent years as a national priority. Interventions targeting parenting and the quality of the early home language environment are at the forefront of efforts to address these disparities. In this article we discuss the innovative use of the pediatric primary care platform as part of a comprehensive public health strategy to prevent adverse child development outcomes through the promotion of parenting. Models of interventions in the pediatric primary care setting are discussed with evidence of effectiveness reviewed. Taken together, a review of this significant body of work shows the tremendous potential to deliver evidence-based preventive interventions to families at risk for poverty related disparities in child development and school readiness at the time of pediatric primary care visits. We also addresss considerations related to scaling and maximizing the effect of pediatric primary care parenting interventions and provide key policy recommendations.

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Randomized Controlled Trial of Primary Care Pediatric Parenting Programs

Cited by 36 publications

References 27 publications

Leveraging Healthcare to Promote Responsive Parenting: Impacts of the Video Interaction Project on Parenting Stress

Leveraging Healthcare to Promote Responsive Parenting: Impacts of the Video Interaction Project on Parenting Stress

Reducing Maternal Depressive Symptoms Through Promotion of Parenting in Pediatric Primary Care

Mitigating the Effects of Family Poverty on Early Child Development through Parenting Interventions in Primary Care

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