Improving Access to Early Parent Education and Support

DESCRIPTION (provided by applicant): During the first 3 years, children's long-term developmental trajectories are established, and the quality of parenting the child receives on a daily basis profoundly influences these trajectories. The transition to parenthood is a difficult one for many parents, however, and can lead to parental stress and social isolation and a lack of parenting competence and confidence. These difficulties can then interfere with optimal social, emotional, and cognitive development in the child and increase the risk for child maltreatment. The high cost and limited reach of home visiting and group-based parenting programs for families of young children mean that most new families receive no services at all. Self-administered parenting programs offer an attractive alternative for the general population of families, including those at moderate risk. They are typically low in cost, overcome barriers to attendance at parenting groups, and have shown promising effects in increasing parents' knowledge, confidence, and skill, and in reducing stress. Little attention has been paid, however, to the potential value of low-cost, self-administered, interactive multimedia approaches for parents of young children. This project proposes to develop and evaluate an interactive internet-based program that integrates automated email, video streaming, and interactive website technologies to deliver frequent, ongoing parent education and support services to parents of infants and toddlers. The First 3 Years Online (F3Y Online) series will be comprised of three programs: Incredible Infants Online for parents of infants, Wonderful Ones Online for parents of one-year-olds, and Terrific Twos Online for parents of two-year-olds. Each program will involve a series of attractive email messages that provide educational content as well as links to an interactive website with (a) video vignettes that model targeted skills for each topic, (b) interactive exercises for practicing skills, (c) printable tip sheets and worksheets, and (d) a discussion forum where parents can interact with each other. In Phase I, a prototype for the Incredible Infants Online program was developed and its feasibility evaluated in a randomized controlled trial with 65 mothers of infants. It was well-received and achieved positive effects on parenting knowledge, self-efficacy, pleasure in parenting, and social support. This Phase II project will refine the Incredible Infants Online program, develop the Wonderful Ones Online and Terrific Twos Online programs, and evaluate the efficacy of all three in a randomized controlled trial with 300 mothers of first-born infants and toddlers. Mothers will be randomized to receive the age-appropriate F3Y Online program immediately or to wait 6 months. The efficacy of F3Y Online in improving mothers' parenting knowledge, skills, social support, self-efficacy, stress, and pleasure in parenting, and toddlers' socio-emotional adjustment, will be examined relative to the waitlist control condition at post-test and at 3-month follow-up. Potential moderators of these effects, such as child temperament, maternal depression, and income, will be explored. The degree to which mothers use the program and are satisfied with its appeal, usefulness, relevance, and usability will also be examined. PUBLIC HEALTH RELEVANCE: The innovative, low-cost, interactive, and email-driven approach of the First 3 Years Online series has the potential to bring evidence-based parent education and support to a broad population of parents of young children who would otherwise receive no parent support services. Therefore, if proven effective, this program could contribute to an increased prevalence of competent and confident parents and positive social-emotional adjustment among young children.