Integrated model for promoting parenting and early school readiness in pediatrics

描述（由申请人提供）：我们提议的研究测试了一种促进低收入家庭入学准备的综合方法，从孩子出生后不久开始，通过在儿科初级保健平台内加强积极的育儿实践（如果存在，减少心理社会压力源）。我们通过整合两种基于证据的干预措施来做到这一点：1)普遍初级预防战略（视频互动项目[VIP]）；1、2和2)有针对性的二级/三级预防战略（家庭检查[FCU]） 3，针对有确定存在额外风险的婴儿/幼儿的家庭。VIP为家长提供一名发展专家，他在每次儿科初级保健就诊时为家长和孩子录像，并指导家长进行有效的育儿实践。FCU是一项以家庭为基础、以家庭为中心的干预措施，利用以生态为重点的初步评估来促进父母改变养育子女行为的动机，并就养育子女和影响养育子女质量的因素进行后续会议。两个服务于纽约市低收入社区和宾夕法尼亚州匹兹堡的初级保健机构将被用来测试我们在医院诊所的综合干预措施，提供关于两种干预措施中一种以前单独使用的场所的翻译信息。同样，我们将利用一个被称为Reach Out and Read （ROR）的计划开发的实践网络，4为以后的传播提供基础设施。我们计划在一项随机试验中对500个家庭（200个VIP/FCU， 200个常规护理，100个单独VIP）进行测试，利用家长调查、亲子互动观察数据和直接评估儿童发展，在干预随访的关键点进行测试。分析将解决方案对所有家庭和关键子群体的综合方案的影响问题，以及FCU对VIP的附加价值。本研究最大的贡献是测试在儿科初级保健中实施的综合初级和二级/三级预防策略是否会对早期入学准备结果产生影响，包括社会情绪、学业前和自我调节。因此，这项研究有可能为科学和实践社区提供有关创新方法的信息，以提高低收入儿童的入学准备技能。

DESCRIPTION (provided by applicant): 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.