Smart Beginnings

  • Funding Source: National Institute of Child Health and Human Development/NIH

  • Years of Funding: 2014 - 2024

  • Primary Investigators: Daniel Shaw, Pamela Morris (New York University), Alan Mendelsohn (New York University)

    • Co-investigators: Perri Klass (New York University), Carolyn Cates (New York University), Samantha Berkule (New York University), Benard Dreyer (New York University), Anne Gill (University of Pittsburgh), Debra Bogen (University of Pittsburgh)

The Smart Beginnings 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: a universal primary prevention strategy (Video Interaction Project [VIP]) and a targeted secondary/tertiary prevention strategy (Family Check-up [FCU]) 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 (Bellevue Hospital) and Pittsburgh, PA (Magee Women’s Hospital and Children’s Hospital) 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. We are currently testing the VIP/FCU model in a randomized trial of 400 families (200 to VIP/FCU, 200 to routine care) utilizing parent surveys, observational data on parent-child interactions, and direct assessments of children’s development, at key points during intervention follow-up.

Assessments have been completed at birth, 6, 18, and 24 months, with ongoing assessments at child ages 4 and 6 years. To date finding support the use of our tiered model, indicating intervention effects on parenting that supports children’s cognitive and language development, and strong engagement in both VIP and FCU. Moreover, engagement in VIP supports higher engagement in FCU, and engagement in FCU promotes higher rates of engagement in subsequent VIP sessions for parents who previously demonstrated low engagement in VIP.

 

Pittwire article:  Bridging the Gap: Helping Parents and Kids in Poverty