Faculty Bibliography

BACKGROUND AND OBJECTIVES/OBJECTIVE:Heterogeneity in risk among low-income families suggests the need for tiered interventions to prevent disparities in school readiness. Smart Beginnings (SB) integrates two interventions: Video Interaction Project (VIP) (birth to 3 years), delivered universally to low-income families in pediatric primary care, and Family Check-Up (6 months to 3 years), targeted home visiting for families with additional family risks. Our objective was to assess initial SB impacts on parent-child activities and interactions at 6 months, reflecting early VIP exposure. METHODS:Two-site randomized controlled trial in New York City (84% Latinx) and Pittsburgh (81% Black), with postpartum enrollment and random assignment to treatment (SB) or control. At 6 months, we assessed parent-child interactions through surveys (StimQ, Parenting Your Baby) and observation (video-recorded play, coded by using Parent-Child Interaction Rating Scales - Infant Adaptation). RESULTS:< .001). Thus, significant effects emerged across a broad sample by using varied methodologies. CONCLUSIONS:Findings replicate and extend previous VIP findings across samples and assessment methodologies. Examining subsequent assessments will determine impacts and feasibility of the full SB model, including potential additive impacts of Family Check-Up for families at elevated risk.

Poverty remains a critical predictor of children's school readiness, health and longer term outcomes. Early relational health (ERH) (i.e., parenting practices and relationship quality) mediates the impact of poverty on child development, and thus has been the focus of many parenting interventions. Despite the documented efficacy of parenting interventions at reducing poverty-related disparities in child health and development, several key barriers prevent achieving population-level reach to families with young children. In the current paper we highlight several of these barriers including gaining population-level access to young children and families, reaching families only through single points of access, addressing the significant heterogeneity of risk that exists among families living in poverty, as well as addressing each of these barriers in combination. We suggest that understanding and confronting these barriers will allow family-centered interventions to more effectively address issues related to ERH at a population level, which in turn will reduce poverty-related disparities in child development.

Children in low- and middle-income countries (LMICs) are at risk for adverse early development and school readiness outcomes; low parent literacy is common and an important contributing factor. While prevention programs have sought to improve child outcomes by promoting positive parenting practices such as reading aloud, there has been limited evidence of whether such programs have impacts for parents with low literacy in LMICs. This study investigated: (1) whether parent literacy is associated with parent-child reading aloud interactions, the overall cognitive home environment, and child language and cognitive outcomes; and (2) whether impacts of a toddler/preschool reading aloud program differ depending on parent literacy among low-income families in northern Brazil. We performed a secondary analysis of a single-blind cluster randomized controlled trial (RCT) of a parenting intervention (Universidade do Bebe [UBB]) implemented in educational childcare centers in Boa Vista, Brazil. UBB consisted of: (1) a lending library in which children's books were borrowed weekly; and (2) monthly parent workshops focused on reading aloud. Control families received usual care without the reading aloud program. Five hundred and six mother-infant dyads (279 intervention; 287 control) were enrolled at mean (SD) child age 37.4 (6.5) months. Parents and children were evaluated at baseline/enrollment and approximately 6-9 months later. Measures: (1) Predictor/moderator: parent literacy; (2) Parent outcomes: parent-child interaction during shared storybook reading; cognitive home environment; (3) Child outcomes: expressive and receptive vocabulary; IQ; working memory and short-term phonological memory. Analyses accounted for baseline performance, sociodemographics, and clustering within centers and sites. Parent literacy was positively associated with parent-child verbal/reading interactions and child developmental outcomes, supporting our first hypothesis, that low parent literacy would be associated with lower quantity and quality of parent-child reading and lower scores on assessments of child development. UBB had positive impacts on parent-child interaction, cognitive stimulation, IQ, and receptive vocabulary for both high and low literacy parents, contrary to our second hypothesis, that low parent literacy would be associated with reductions in impacts of the reading aloud intervention. The comparable impacts of a reading aloud program on parent-child verbal/reading interactions and child cognitive outcomes regardless of parent literacy level suggest that preventive interventions in LMICs should consider promotion of shared reading even for low-literacy families. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

OBJECTIVE:Literacy promotion is a pediatric standard of care in which clinicians provide guidance on shared reading. Latino parents are more likely to hear advice to read with children but are less likely to do so. We sought to understand literacy promotion from the perspective of Latino parents and to identify facilitators and barriers. METHODS:We purposively sampled Latino parents who participated in Reach Out and Read (ROR) for a qualitative, semistructured interview study. We identified themes using immersion/crystallization and achieved thematic saturation after 21 interviews. RESULTS:Two thirds of participants had less than high school education; half of whom had not completed eighth grade. The mean child age was 16.4 months. Primary facilitators of engagement were advice from a pediatrician during a clinical encounter and receipt of the ROR book. Barriers identified included: 1) parents' perceptions that their children were not developmentally ready and that their children's behavior (eg, activity) indicated they were not interested in shared reading; 2) self-perceived limited literacy and/or English proficiency; 3) parenting demands occurring in the context of poverty; and 4) continued child media use despite advice from pediatricians to choose alternate activities such as shared reading instead. CONCLUSIONS:Parent-clinician relationships are central to ROR's impact but clinicians need to pay more attention to factors in a child's broader environment to strengthen literacy promotion. Specifically clinicians should emphasize skill building during the clinical encounter (eg, sharing knowledge about child development and modeling) and work collaboratively with other stakeholders to address poverty-related stressors.

OBJECTIVES/OBJECTIVE:To determine impact of a primary care-based child obesity prevention intervention beginning during pregnancy on early childhood weight outcomes in low-income Hispanic families. METHODS:-scores (WFAzs) from clinical anthropometric measures, obesity prevalence (weight for age ≥95th percentile), and excess weight gain (WFAz trajectory) from birth to age 3 years. Secondary outcomes included dose effects. RESULTS:= .02) decreased as attendance increased with low, medium, and high attendance. CONCLUSIONS:Mean WFAz and growth trajectories were lower for the intervention group through age 2 years, but there were no group differences at age 3. Further study is needed to enhance sustainability of effects beyond age 2.

Play offers rich opportunities for toddlers to develop motor, social, cognitive, and language skills, particularly during interactions with adult caregivers who may scaffold toddlers to higher levels of play than toddlers achieve on their own. However, research on play has narrowly focused on children from White, middle-income backgrounds, leaving a dearth of knowledge about dyadic play in diverse cultural communities. We videorecorded 222 Mexican-American mothers playing with their 2-year-old toddlers with a standard set of toys. Play behaviors were coded as nonsymbolic or symbolic (play type) and as expressed through manual, verbal, or multiple channels (play modality). Play between toddlers and mothers was frequent, high in symbolic content, and toddler play closely corresponded with mother play in type and modality: Toddlers' nonsymbolic play related to mothers' nonsymbolic play; toddlers' symbolic play related to mothers' symbolic play; toddlers' manual play related to mothers' manual play; and toddlers' multimodal play related to mothers' multimodal play. Play in Mexican-American mothers and toddlers is frequent, multimodal, and symbolically rich, offering new directions for future research and practice.