Self‐guided behavioral skills training: A public health approach to promoting nurturing care environments

Abstract

The World Health Organization identified the promotion of "Nurturing Care Environments" as a global health priority. Responsive caregiving, 1 of 5 domains describing nurturing care, is critical for healthy child development. Relatively little research has evaluated population-level interventions aimed to increase responsive caregiving during the first 1,000 days of an infant's life. In this pilot study, we evaluated an intervention designed for population-level dissemination that targeted responsive caregiving. The self-guided behavioral skills training aimed to teach mothers to imitate infant vocalizations. The intervention was delivered within an on-line asynchronous training. All 3 mothers increased vocal imitative behavior following training without receiving coaching or behavior-specific feedback from an implementer. The results offer a preliminary proof of concept with implications for population-level intervention design and evaluation.

Leveraging applied behavior analysis research and practice in the service of public health

“…Vladescu et al (2020) reviewed behavioral research on safe infant positioning, which is the primary way to prevent the public-health problem of sudden infant death. Shea et al (2020) evaluated a self-paced online intervention to teach caregivers to respond contingently to infant vocalizations, a practice included in what the World Health Organization (WHO) calls responsive caregiving. Although Shea et al was a proof-of-concept study with only three participants, the online self-paced nature of the program lends itself to wider dissemination (see more on this in "Harness Technology").…”

“…It stands to reason that harnessing technology to deliver effective, highfidelity behavioral treatments will be useful in the future. Of course, technology is not the only method to scale up interventions with fidelity, but the advantages of technology are formidable (Dallery et al, , 2019Shea et al, 2020). One recent example with the potential for widespread dissemination is Shea et al's (2020) online intervention to teach caregivers to respond to infant vocalizations.…”

“…Another unique feature of an ABA approach to enlist technology is the focus on the consequences of behavior change, and the substantial science underlying this focus. For example, although Shea et al's (2020) online intervention to teach caregivers to respond to infant vocalizations did not arrange explicit consequences, the authors were careful to explicate the importance of the "interlocking contingencies and bi-directional influences on behavior" (p. 1898).…”

An Evaluation of a Telehealth Caregiver Training Package to Treat Food Selectivity

“…In this study, caregiver training also involved video models rather than in vivo models as done in most in-person caregiver training research (Shea et al, 2020). Future research should compare the use of in vivo models to video models as well as other ways videos could be incorporated into caregiver training.…”

Broadening the participant pool: A novel approach for remote research

“…No previous examples of this approach could be located within the published literature. The closest design match is in health research where participants often take part individually via online self-guided interventions (e.g., Anderson-Bill, 2011;Epton et al, 2013;Shea et al, 2020). In these cases the entire involvement is computer-based; in the current study the internet was used as a tool to deliver the instructions and intervention for a task that took place offline.…”