Baggett, K., Davis, B., Feil, E., Sheeber, L., Landry, S., Leve, C. & Johnson, U. (2017). A randomized controlled trial examination of a remote parenting intervention: Engagement and effects on parenting behavior and child abuse potential. Child Maltreatment, 22(4), 315-323.
The current study uses a randomized controlled, intent-to-treat trial to evaluate an online delivery of the parenting intervention – Play and Learning Strategies (PALS) – among high-risk families. Baby-Net is an adaptation of the PALS program for internet delivery among low-income English- and Spanish-speaking population. This program includes skills training, daily activity practice, video recordings of mother-infant interactions, and phone coaching with individualized support.
Participants were recruited from service providers providing early intervention and family support programs to low-income families. The inclusion criteria specified that participants were at or below 130% of the federal poverty guideline. The sample was further divided into subsamples of high- (n = 34) and low-risk (n = 125) mothers using a clinical cut-off score of 166 on the Child Abuse Potential Inventory. Maternal parenting behaviour was assessed and coded by blind raters using the Landry Parent-Child Interaction Scales during a 30-minute recording of mother-infant interactions. Child abuse potential was measured using the 77-item Abuse subscale of the Child Abuse Potential Inventory (CAPI). Participants were then randomly assigned to one of the two conditions: the treatment condition to evaluate the efficacy of a remote parenting program with skills training and weekly coaching (n = 83), or the control condition, an internet-based, attention-control program on children’s developmental milestones (n = 76).
Data analysis included between-group comparisons to investigate engagement relative to intervention type, as well as multiple regression models to determine the impact of intervention condition and dosage levels to predict change in parenting practices and child abuse risk. Findings indicated a high level of engagement among the majority of participants, with 76% of lower risk mothers and 68% of higher risk mothers completing at least 9 (out of 11) sessions of the intervention. Investigators also examined whether the intervention would result in positive parenting behaviours and reduced potential for child abuse. Results demonstrated that high-risk mothers in the treatment condition who demonstrated higher engagement in the intervention showed increased positive parenting behaviour and reduced child abuse potential when compared to other mothers. The model explained 31% of the total variance in post-intervention parenting behaviour.
Remote parenting interventions are becoming increasingly popular for their ability to reach at-risk families who have limited access to traditional family support services such as home visiting programs. Therefore, it is important to investigate participant engagement and satisfaction with online delivery interventions, as well as their effectiveness in parenting and maltreatment outcomes. The use of a randomized controlled trial in this study provides a strong methodological merit. Furthermore, double-blinding reduced performance bias on the part of the participants and assessment bias from the raters. However, as this was an efficacy trial, the participants were provided with cellular activated laptops and therefore, the results may not reflect the degree of engagement found in the “real world”. Further contributing to the limited generalizability of the findings, the coaching was provided by researchers with a strong focus on fidelity. Community agencies using paraprofessional staff may not have the resources or training to provide comparable levels of program implementation on a larger scale.