Integrated model for promoting parenting and early school readiness in pediatrics

项目总结/摘要 我们提出的研究测试了一种全面的方法，以促进低收入国家的入学准备。 家庭，从孩子出生后不久开始，通过加强积极的育儿做法（以及 当存在时，减少心理社会压力）在儿科初级保健平台。我们这样做是通过 整合两种循证干预措施：1）普遍初级预防战略（视频互动 项目[VIP]）;1、2和2）针对家庭的二级/三级预防战略（家庭检查[FCU]）3 婴儿/幼儿被确定为具有额外风险。VIP为父母提供发展专家 在每个儿科诊所， 初级保健访问。FCU是一个以家庭为基础，以家庭为中心的干预措施，利用最初的生态- 重点评估，以促进父母改变育儿行为的动机，并采取后续行动 关于养育子女和影响养育子女质量的因素的会议。 两个服务于纽约州纽约市和宾夕法尼亚州匹兹堡低收入社区的初级保健机构将 用于测试我们在医院诊所的综合干预，提供有关翻译的信息 在两种干预措施中的一种以前单独使用过的场所。此外，我们将利用 由一个名为“延伸阅读”（ROR）的倡议开发的实践网络，4提供了一个基础设施， 以便以后传播。 我们计划在500个家庭的随机试验中测试VIP/FCU模型（200个家庭接受VIP/FCU，200个家庭接受常规护理， 100至VIP单独），利用父母调查，观察数据的亲子互动，并直接 在干预措施后续行动的关键时刻评估儿童的发展情况。分析将解决 综合方案对所有家庭和关键亚组的方案影响问题， FCU对VIP的附加值。 这项研究的最大贡献是测试一个综合的小学和 在儿科初级保健中实施的二级/三级预防策略可能会对早期 入学准备结果，包括社会情感，学前教育和自我调节。因此，这项研究 有可能为科学界和实践界提供有关创新的信息， 提高低收入儿童入学准备技能的方法。

Project Summary/Abstract Our proposed study tests a comprehensive approach to the promotion of school readiness in low-income families, beginning shortly after the birth of the child, through enhancement of positive parenting practices (and when present, reduction of psychosocial stressors) within the pediatric primary care platform. We do so by integrating two evidence-based interventions: 1) a universal primary prevention strategy (Video Interaction Project [VIP]);1, 2 and 2) a targeted secondary/tertiary prevention strategy (Family Check-up [FCU])3 for families with infants/toddlers identified as having additional risks. VIP provides parents with a developmental specialist who videotapes the parent and child and coaches the parent on effective parenting practices at each pediatric primary care visit. FCU is a home-based, family-centered intervention that utilizes an initial ecologically- focused assessment to promote motivation for parents to change child-rearing behaviors, with follow-up sessions on parenting and factors that compromise parenting quality. Two primary care settings serving low-income communities in New York City, NY and Pittsburgh, PA will be utilized to test our integrated intervention in hospital-based clinics, providing information about translation across venues where one of the two interventions has been previously used alone. Also, we will leverage the practice network developed by an initiative known as Reach Out and Read (ROR),4 providing an infrastructure for later dissemination. We plan to test the VIP/FCU model in a randomized trial of 500 families (200 to VIP/FCU, 200 to routine care, 100 to VIP alone) utilizing parent surveys, observational data on parent-child interactions, and direct assessments of children's development, at key points during intervention follow-up. Analyses will address questions of program impact for the integrated program across all families and by key subgroups, and the added value of FCU to VIP. The largest single contribution made by this study is to test whether an integrated primary and secondary/tertiary prevention strategy implemented in pediatric primary care can produce impacts on early school readiness outcomes, including social-emotional, pre-academic, and self-regulation. As such, this study has the potential to provide the scientific and practice communities with information about an innovative approach to promoting school readiness skills among low-income children.