Primary Care Strategies for Promoting Parent-Child Interactions and School Readiness in At-Risk Families: The Bellevue Project for Early Language, Literacy, and Education Success | Child Development | JAMA Pediatrics | JAMA Network
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Article
January 3, 2011

Primary Care Strategies for Promoting Parent-Child Interactions and School Readiness in At-Risk Families: The Bellevue Project for Early Language, Literacy, and Education Success

Author Affiliations

Author Affiliations: Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, New York University School of Medicine and Bellevue Hospital Center, New York (Drs Mendelsohn, Huberman, Berkule, Brockmeyer, and Dreyer); Division of Child Development, Department of Pediatrics, State University of New York Downstate, and University Hospital of Brooklyn (Dr Huberman); Department of Psychology, Manhattanville College, Purchase, New York (Dr Berkule); and Graduate School of Education, Rutgers University, New Brunswick, New Jersey (Dr Morrow).

Arch Pediatr Adolesc Med. 2011;165(1):33-41. doi:10.1001/archpediatrics.2010.254
Abstract

Objective  To determine the effects of pediatric primary care interventions on parent-child interactions in families with low socioeconomic status.

Design  In this randomized controlled trial, participants were randomized to 1 of 2 interventions (Video Interaction Project [VIP] or Building Blocks [BB]) or the control group.

Setting  Urban public hospital pediatric primary care clinic.

Participants  Mother-newborn dyads enrolled post partum from November 1, 2005, through October 31, 2008.

Interventions  In the VIP group, mothers and newborns participated in 1-on-1 sessions with a child development specialist who facilitated interactions in play and shared reading by reviewing videos made of the parent and child on primary care visit days; learning materials and parenting pamphlets were also provided. In the BB group, parenting materials, including age-specific newsletters suggesting interactive activities, learning materials, and parent-completed developmental questionnaires, were mailed to the mothers.

Main Outcome Measures  Parent-child interactions were assessed at 6 months with the StimQ-Infant and a 24-hour shared reading recall diary.

Results  A total of 410 families were assessed. The VIP group had a higher increased StimQ score (mean difference, 3.6 points; 95% confidence interval, 1.5 to 5.6 points; Cohen d, 0.51; 0.22 to 0.81) and more reading activities compared to the control group. The BB group also had an increased overall StimQ score compared with the control group (Cohen d, 0.31; 95% confidence interval, 0.03 to 0.60). The greatest effects for the VIP group were found for mothers with a ninth-grade or higher reading level (Cohen d, 0.68; 95% confidence interval, 0.33 to 1.03).

Conclusions  The VIP and BB groups each led to increased parent-child interactions. Pediatric primary care represents a significant opportunity for enhancing developmental trajectories in at-risk children.

Trial Registration  clinicaltrials.gov Identifier: NCT00212576

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