Use of Videotaped Interactions During Pediatric Well-Child Care: Impact at 33 Months on Parenting and on Child Development

Mendelsohn, Alan L.; Valdez, Purnima; Flynn, Virginia; Foley, Gilbert M.; Berkule, Samantha B.; Tomopoulos, Suzy; Fierman, Arthur H.; Tineo, Wendy; Dreyer, Benard P.

doi:10.1097/dbp.0b013e3180324d87

Cited by 126 publications

(152 citation statements)

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“…13,[36][37][38] In a recent review of tools and strategies to improve WCC, we found evidence suggesting that inclusion of nonphysician providers into a health care team could improve receipt of anticipatory guidance and developmental and behavioral services. 16,17,[39][40][41][42] In Healthy Steps, a physician and child developmental specialist (typically a nurse, social worker, or early childhood educator) provide WCC in partnership. In a large, national, 3-year trial, intervention parents reported receiving more anticipatory guidance and more family-centered care and were more likely to be up-to-date on WCC.…”

Section: Discussionmentioning

confidence: 99%

A Parent Coach Model for Well-Child Care Among Low-Income Children: A Randomized Controlled Trial

et al. 2016

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OBJECTIVE: The goal of this study was to examine the effects of a new model for well-child care (WCC), the Parent-focused Redesign for Encounters, Newborns to Toddlers (PARENT), on WCC quality and health care utilization among low-income families. METHODS:PARENT includes 4 elements designed by using a stakeholder-engaged process:(1) a parent coach (ie, health educator) to provide anticipatory guidance, psychosocial screening and referral, and developmental/behavioral guidance and screening at each wellvisit; (2) a Web-based tool for previsit screening; (3) an automated text message service to provide periodic, age-specific health messages to families; and (4) a brief, problem-focused encounter with the pediatric clinician. The Promoting Healthy Development Survey-PLUS was used to assess receipt of recommended WCC services at 12 months' postenrollment. Intervention effects were examined by using bivariate analyses. RESULTS:A total of 251 parents with a child aged ≤12 months were randomized to receive either the control (usual WCC) or the intervention (PARENT); 90% completed the 12-month assessment. Mean child age at enrollment was 4.5 months; 64% had an annual household income less than $20 000. Baseline characteristics for the intervention and control groups were similar. Intervention parents scored higher on all preventive care measures (anticipatory guidance, health information, psychosocial assessment, developmental screening, and parental developmental/behavioral concerns addressed) and experiences of care measures (family-centeredness, helpfulness, and overall rating of care). Fiftytwo percent fewer intervention children had ≥2 emergency department visits over the 12-month period. There were no significant differences in WCC or sick visits/urgent care utilization. CONCLUSIONS:A parent coach-led model for WCC may improve the receipt of comprehensive WCC for low-income families, and it may potentially lead to cost savings by reducing emergency department utilization.

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Section: Discussionmentioning

confidence: 99%

A Parent Coach Model for Well-Child Care Among Low-Income Children: A Randomized Controlled Trial

et al. 2016

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“…39,40 Indeed, most existing parenting interventions shown to affect socioemotional outcomes in young children include direct teaching of discipline strategies. 23,41 Notably, VIP affects socioemotional development without teaching these strategies, instead focusing on promotion of responsive parent-child interactions in the context of activities such as reading aloud and play that are typically considered to be cognitively oriented.…”

Section: Figurementioning

confidence: 99%

Promotion of Positive Parenting and Prevention of Socioemotional Disparities

et al. 2016

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OBJECTIVE: The goal of this study was to determine what effects pediatric primary care interventions, focused on promotion of positive parenting through reading aloud and play, have on the socioemotional development of toddlers from low-income, primarily immigrant households. METHODS:This randomized controlled trial included random assignment to 1 of 2 interventions (Video Interaction Project [VIP] or Building Blocks [BB]) or to a control group. Mother-newborn dyads were enrolled postpartum in an urban public hospital. In VIP, dyads met with an interventionist on days of well-child visits; the interventionist facilitated interactions in play and shared reading through provision of learning materials and review of videotaped parent-child interactions. In BB, parents were mailed parenting pamphlets and learning materials. This article analyzes socioemotional outcomes from 14 to 36 months for children in VIP and BB versus control. RESULTS:A total of 463 dyads (69%) contributed data. Children in VIP scored higher than control on imitation/play and attention, and lower on separation distress, hyperactivity, and externalizing problems, with effect sizes ∼0.25 SD for the sample as a whole and ∼0.50 SD for families with additional psychosocial risks . Children in BB made greater gains in imitation/play compared with control. CONCLUSIONS:These findings support the efficacy of VIP, a preventive intervention targeting parent-child interactions, for enhancing socioemotional outcomes in low-income toddlers. Given the low cost and potential for scalability of primary care interventions, findings support expansion of pediatric-based parenting programs such as VIP for the primary prevention of socioemotional problems before school entry. Medicine/Bellevue Hospital Center, New York, New York; b Department of Psychology, Marymount Manhattan College, New York, New York; and c Department of Pediatrics, SUNY Downstate Medical Center, Brooklyn, New York Dr Weisleder drafted the initial manuscript, conceptualized and designed the study, conducted statistical analyses, and reviewed and revised the manuscript; Dr Mendelsohn conceptualized and designed the study, conducted statistical analyses, designed the data collection instruments, and reviewed and revised the manuscript; Drs Seery and Canfi eld conducted statistical analyses and critically reviewed the manuscript; Drs Brockmeyer Cates and Berkule Johnson conceptualized and designed the study, designed the data collection instruments, coordinated and supervised data collection, and critically reviewed the manuscript; and Drs Dreyer and Huberman conceptualized and designed the study and critically reviewed the manuscript. All authors approved the fi nal manuscript as submitted. a Department of Pediatrics, New York University School ofThis trial has been registered at www. clinicaltrials. gov (identifi er NCT00212576). WHAT'S KNOWN ON THIS SUBJECT: Differences in socioemotional development are an important contributor to poverty-related disparities in school readines...

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“…In a randomized controlled trial of VIP among lowincome Latina mothers, positive intervention effects were seen for cognitive development scores at 21 and 33 months. 51,91 Further evaluation of such programs in a variety of settings is warranted.…”

Section: Video Interaction Projectmentioning

confidence: 99%

Determinants of Health and Pediatric Primary Care Practices

Beck

Tschudy²,

Coker

et al. 2016

Pediatrics

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More than 20% of children nationally live in poverty. Pediatric primary care practices are critical points-of-contact for these patients and their families. Practices must consider risks that are rooted in poverty as they determine how to best deliver family-centered care and move toward action on the social determinants of health. The Practice-Level Care Delivery Subgroup of the Academic Pediatric Association's Task Force on Poverty has developed a roadmap for pediatric providers and practices to use as they adopt clinical practice redesign strategies aimed at mitigating poverty's negative impact on child health and well-being. The present article describes how care structures and processes can be altered in ways that align with the needs of families living in poverty. Attention is paid to both facilitators of and barriers to successful redesign strategies. We also illustrate how such a roadmap can be adapted by practices depending on the degree of patient need and the availability of practice resources devoted to intervening on the social determinants of health. In addition, ways in which practices can advocate for families in their communities and nationally are identified. Finally, given the relative dearth of evidence for many poverty-focused interventions in primary care, areas that would benefit from more in-depth study are considered. Such a focus is especially relevant as practices consider how they can best help families mitigate the impact of povertyrelated risks in ways that promote long-term health and well-being for children.abstract

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Use of Videotaped Interactions During Pediatric Well-Child Care: Impact at 33 Months on Parenting and on Child Development

Abstract: This study provides evidence that a pediatric primary care-based intervention program can have an impact on the developmental trajectories of at-risk young preschool children.

Cited by 126 publications

References 30 publications

A Parent Coach Model for Well-Child Care Among Low-Income Children: A Randomized Controlled Trial

A Parent Coach Model for Well-Child Care Among Low-Income Children: A Randomized Controlled Trial

Promotion of Positive Parenting and Prevention of Socioemotional Disparities

Determinants of Health and Pediatric Primary Care Practices

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