Integrated model for promoting parenting and early school readiness in pediatrics

描述(由申请人提供)：我们的拟议研究测试了一种全面的方法，以促进低收入家庭的就学准备，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做法(如果存在，减少心理社会压力)。为此，我们整合了两种循证干预措施：1)普遍的一级预防战略(视频互动项目[VIP])；1、2和2)有针对性的二级/三级预防战略(家庭体检[FCU])3，适用于有额外风险的婴幼儿家庭。VIP为父母提供一名发育专家，他将父母和孩子拍摄下来，并在每次儿科初级保健访问时指导父母有效的育儿实践。FCU是一种以家庭为基础、以家庭为中心的干预措施，它利用最初以生态为重点的评估来促进父母改变子女养育行为的动机，并就育儿和影响育儿质量的因素进行后续会议。我们将利用为纽约市、纽约和宾夕法尼亚州匹兹堡的低收入社区服务的两个初级保健环境来测试我们在以医院为基础的诊所中的综合干预措施，提供有关以前仅使用两种干预措施之一的地点之间的翻译信息。此外，我们还将利用由一项名为联系和阅读(ROR)4的倡议开发的实践网络，为以后的传播提供基础设施。我们计划对500个家庭(200个接受VIP/FCU，200个接受常规护理，100个单独接受VIP)进行随机试验，利用父母调查、亲子互动观察数据和干预后续关键点对儿童发展的直接评估来测试VIP/FCU模型。分析将解决综合计划对所有家庭和关键分组的计划影响问题，以及FCU对VIP的附加值。这项研究的最大贡献是测试在儿科初级保健中实施的综合初级和二级/三级预防策略是否可以对早期入学准备结果产生影响，包括社会情绪、学业前期和自我调节。因此，这项研究有可能为科学界和实践界提供有关在低收入儿童中促进入学准备技能的创新方法的信息。

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.