Prevention
Conditions
Keywords
Behavioral Health, Integrated Behavioral Health, Infant Self-Regulation, Parenting Skills
Brief summary
The purpose of the study is to evaluate the acceptability and preliminary efficacy of a universal prevention program delivered by psychologists in conjunction with pediatric primary care well-child visits.
Detailed description
Integrated behavioral health has emerged as an effective approach to addressing emotional and behavioral health needs of children in the pediatric setting, yet there is little evidence for a standardized model of care for providing universal preventive services in pediatric primary care. Current models are typically loosely constructed, inconsistently applied, and unspecified. Our aim is to evaluate a model of care developed to address these gaps. Integrated Behavioral Health-Prevention (IBH-P) is a collection of clinical strategies and structured approaches designed to promote emotional and behavioral health. IBH-P is delivered by psychologists in the pediatric setting as part of scheduled well-child visits. The overall objective of this study is to evaluate the efficacy of the intervention in promoting infant self-regulation. Maternal experience and satisfaction, adherence to well-child visits and immunizations will also be examined.
Interventions
BEHAVIORALIntegrated Behavioral Health - Prevention
IBH-P consists of 15-30 minute visits with mothers as part of the 1, 2, 4, and 6 month well-child visits. The intervention is delivered by doctoral level pediatric psychologists that are an integrated member of the primary care team.
BEHAVIORALBright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, 4th Edition
Bright Futures curriculum will be delivered by the pediatrician as part of the 1, 2, 4 and 6 month well-child visits.
Sponsors
Children's Hospital Medical Center, Cincinnati
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
DOUBLE (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 55 Years
Healthy volunteers
Yes
Inclusion criteria
* English speaking * Biological mother of a newborn infant presenting at the newborn well-child visit * Intends to continue to receive infant's pediatric care at one of the three participating clinics over the next year.
Exclusion criteria
* Infant diagnosed as failure to thrive * Infant exposure to illicit drugs in utero with the exception of THC * Extensive care in the Neonatal Intensive Care Unit (\>7 days) * Child has other serious medical condition or acute psychosocial circumstances that results in child not receiving medical clearance from the pediatrician or psychologist for randomization * mother or father of infant has received Building Futures intervention training
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Maternal parenting behaviors | 7-month follow-up | The Keys to Interactive Parenting Scale (KIPS) will be used to assess maternal parenting behaviors. KIPS is a structured observational measure and assesses 12 domains of parenting. The domains are scored on a 1 to 5-point scale with higher scores indicating higher quality parenting behaviors. |
| Infant self-regulation | 7-month follow-up | The Infant Behavior Questionnaire-Revised Very Short Form is a 36-item measure of three factors, positive affect, negative emotionality, and orienting/regulatory capacity. Scores range from 0 to 7, with higher scores representing greater positive affect, negative emotionality and orienting and regulatory capacity. |
| Parental knowledge of child development | 7-month follow-up | The Knowledge of Infant Development Inventory is 58-item measure of caregiver knowledge of infant development. The total score will be calculated as the percentage of correct answers out of 58 items. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Maternal feelings of efficacy in infant care | 7-month follow-up | The Maternal Self-Efficacy Scale is a 10-item self-report of feelings of efficacy in infant care. The total score will be used and ranges from 10 to 40 with higher scores representing greater maternal self-efficacy. |
| Parenting beliefs and practices | 7-month follow-up | The Baby Care Questionnaire is a 30-item measure of parenting belief and practices with 2 subscales, structure and attunement. Total scores range from 1 to 4 with higher scores indicating greater structure and attunement. |
| Maternal appraisement of life stress | 7-month follow-up | The Perceived Stress Scale is a 14-item self-report of the degree to which situations in one's life within the past month are appraised as stressful. Scores range from 0 to 56 with higher scores indicating greater perceived stress. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Maternal experiences of violence and adversity in childhood | Baseline | The Philadelphia Urban Adverse Childhood Experiences is a 22-item self-report that will be used to measure maternal experience of childhood violence and adversity. The total score is a tally of the 22 items endorsed with higher scores indicating more experiences of violence and adversity. |
| Health Service Utilization - Immunizations | Infants' birth through 5-months of age | Completion of immunizations at 5 months |
| Adherence to well-child visits in first 7 months of life | Infants' birth through 7-months of age | The American Academy of Pediatrics recommends preventive pediatric care is provided across 5 visits in an infant's first 7 months of life. Percentage of adherence to the 5 well-child visits will be calculated. |
Countries
United States
Outcome results
None listed