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SMART Beginnings

Overview

The SMART Beginnings project 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: 1) a universal primary prevention strategy (Video Interaction Project [VIP]); and 2) a targeted secondary/tertiary prevention strategy (Family Check-up [FCU]) for families 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 individualized follow-up sessions on parenting and factors that compromise parenting quality.

Two pediatric primary care settings serving low-income communities in New York City, NY and Pittsburgh, PA are utilized to test the integrated intervention in hospital-based clinics, providing information about translation across venues where one of the two interventions has been previously used alone.

The VIP/FCU model is tested in a randomized control trial, utilizing parent surveys, observational data on parent-child interactions, and direct assessments of children’s development, at key points during intervention follow-up. Analyses will address questions of program impact for the integrated program across all families and by key subgroups.

The largest single contribution made by this study is to test whether an integrated primary and
secondary/tertiary prevention strategy implemented in pediatric primary care can produce impacts on early school readiness outcomes, including social-emotional, pre-academic, and self-regulation. As such, this study has the potential to provide the scientific and practice communities with information about an innovative and strategic approach to promoting school readiness skills among low-income children.

Drs. Pamela Morris-Perez (NYU), Alan Mendelsohn (NYU School of Medicine), and Daniel Shaw (University of Pittsburgh) have received support and funding for this project from the National Institutes of Health.

Dissemination Activities

  • Guyon-Harris, K. L., Rosas, J., Dolcini-Catania, L., Mendelsohn, A., Morris, P., Gill, A., & Shaw, D. S. (2023). Validation of Parenting Your Baby and Parenting Your Toddler and Associations with Engagement in Parenting Intervention. Journal of Child and Family Studies32(6), 1789-1804. https://doi.org/10.1007/s10826-022-02484-x
  • Canfield, C. F., Miller, E. B., Zhang, Y., Shaw, D., Morris, P., Galan, C., & Mendelsohn, A. L. (2023). Tiered universal and targeted early childhood interventions: Enhancing attendance across families with varying needs. Early Childhood Research Quarterly63(2), 362-369. PMCID: PMC9937541
  • Miller, E. B., Roby, E., Zhang, Y., Coskun, L., Rosas, J. M., Scott, M. A., Gutierrez, J., Shaw, D. S., Mendelsohn, A. L., & Morris-Perez, P. A. (2022). Promoting cognitive stimulation in parents across infancy and toddlerhood: A randomized cslinical trial. The Journal of Pediatrics. PMID: 36481243 PMCID Journal - In Process.
  • Miller, E. B., Whipps M. D. M., Bogen, D. L., Morris, P. A., Mendelsohn, A. L., Shaw, D. S., & Gross, R.S. (2022). Collateral benefits from a school readiness intervention on breastfeeding: A cross-domain impact evaluation. Maternal and Child Nutrition. PMCID: PMC9749611
  • Miller, E. B., Canfield, C. F., Wippick, H., Shaw, D. S., Morris, P. A., & Mendelsohn, A. L. (2022). Predictors of television at bedtime and associations with toddler sleep and behavior outcomes in a Medicaid-eligible, racial/ethnic minority sample. Infant Behavior and Development. PMCID: PMC9177719
  • Reno, R., Whipps, M., Wallenborn, J.T., Demirci, J., Bogen, D.L., Gross, R.S., Mendelsohn, A.L., Morris, P.A., & Shaw, D.S. (2022). Housing insecurity, housing conditions, and breastfeeding behaviors for Medicaid-eligible families in urban settings. Journal of Human Lactation: Official Journal of International Lactation Consultant Association, 38(4), 760-770. PMCID: PMC9596949
  • Gross R.S., Messito M.J., Klass P., Canfield C.F., Yin H.S., Morris P.A., Shaw D.S., Dreyer B.P., & Mendelsohn A.L. (2021). Integrating health care strategies to prevent poverty- related disparities in development and growth: Addressing core outcomes of early childhood. Academic Pediatrics, Poverty Supplement. PMCID: PMC8574213
  • Hails, K. A., Whipps, M. D., Gross, R. S., Bogen, D. L., Morris, P. A., Mendelsohn, A. L., & Shaw, D. S. (2021). Breastfeeding and responsive parenting as predictors of infant weight change in the first year. Journal of Pediatric Psychology, 46(7), 768-778. PMCID: PMC8502476
  • Roby, E., Miller, E. B., Shaw, D. S., Morris, P., Gill, A., Bogen, D. L., Rosas, J., Canfield, C. F., Hails, K. A., Wippick, H., Honoroff, J., Cates, C. B., Weisleder, A., Chadwick, K. A., Raak, C. D., & Mendelsohn, A. L. (2021). Improving parent-child interactions in pediatric health care: A two-site randomized controlled trial. Pediatrics147(3), e20201799. PMCID: PMC7924140
  • Roby, E., Shaw, D. S., Morris, P., Canfield, C. F., Miller, E. B., Dreyer, B., Klass, P., Ettinger, A., Miller, E., & Mendelsohn, A. L. (2021). Pediatric primary care and partnerships across sectors to promote early child development. Academic Pediatrics21(2), 228-235. PMCID: PMC808384
  • Shaw D.S., Mendelsohn,A.L., & Morris, P.A., (2021). Reducing Poverty-Related Disparities in Child Development and School Readiness: The Smart Beginnings tiered prevention strategy that combines pediatric primary care with home visiting. Clinical Child and Family Psychology Review. PMCID: PMC8428206
  • Canfield, C. F., Miller, E. B., Shaw, D. S., Morris, P., Alonso, A., & Mendelsohn, A. L. (2020). Beyond language: Impacts of shared reading on parenting stress and early parent-child relational health. Developmental Psychology, 56(7), 1305. PMCID: PMC7319866
  • Miller, E. B., Canfield, C. F., Morris, P. A., Shaw, D. S., Cates, C. B., & Mendelsohn, A. L. (2020). Sociodemographic and psychosocial predictors of VIP attendance in Smart Beginnings through 6 months: Effectively targeting at-risk mothers in early visits. Prevention Science, 1-11. PMCID: PMC6960338
  • Whipps, M. D. M., Miller E. B., Bogen, D. L., Mendelsohn, A. L., Morris, P. A., Shaw, D., & Gross,. (2020). Breastfeeding behaviors and maternal interaction quality in a low- income, ethnic minority population. Journal of Developmental and Behavioral Pediatrics, 41(3), 180-186. PMCID: PMC712498

Team

The SMART Beginnings teams

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