Hybrid Delivery to Increase Access and Sustainability: Evaluating ezParent Implementation

PROJECT SUMMARY/ABSTRACT Positive parenting practices (e.g., supportive, consistent, responsive) buffer the negative effects of early adverse experiences by developing safe, stable, and nurturing environments. Positive parenting practices are important in strengthening and creating positive childhood and supporting optimal child social and behavioral development. Parent training (PT) is the gold standard for supporting and strengthening parenting practices and preventing and treating child behavior problems. The primary method of delivering PT involves face-to- face, in-person sessions. Although effective, there are multiple limitations with in person PT delivery affecting access and reach (time; schedule conflicts; access to childcare, transportation, trained facilitators; stigma). The PT program proposed in this study is the web-based adaptation of the evidence-based based Chicago Parent Program (CPP), called ezParent. There is evidence suggesting web-based programs are more effective when paired with human support, known as hybrid delivery. The overall purpose of this STTR fast-track project is to develop and test tools to support implementation of hybrid ezParent using a community organization dedicated to serving low-income families and young children (Head Start and Early Head Start (HS/EHS)) as a test site. The proposed ezParent implementation bundle (ezParent program for parents, asynchronous web-based facilitator training, and the ezParent dashboard) will be refined and usability tested in Phase I and parent, child, and implementation outcomes evaluated in a cluster randomized trial in Phase II. In Phase I and in collaboration with a Community Advisory Board (CAB) of HS/EHS stakeholders, specific metrics, components, and features to include in the dashboard will be developed with the goal to enable robust tracking of program use and support program tailoring. Then, in partnership with the CPP/ezParent developers, a 2-module prototype of the hybrid facilitator training will be developed and evaluated by trained parent training facilitators. In Phase II, the 4-module facilitator training and the ezParent bundle website with custom views for parents, facilitators, and administrators will be completed. The ezParent bundle will be tested using a cluster randomized trial in 16 HS/EHS sites (8 ezParent bundle/8 usual care) with HS/EHS personnel facilitators (n=16-32; ~2 facilitators/8 intervention sites) and 516 parents (258/arm) of children aged 2-5 years old. The ezParent bundle implementation outcomes will be examined from the site, facilitator, and parent levels using RE-AIM (Reach, Effectiveness of implementation, Adoption, Implementation, and Maintenance). This study addresses the NICHD STTR priority of developing and adapting technologies and products that support healthy social and behavioral development and targeting underserved populations.