Developmental and Behavioral Pediatrics: Parenting
52 - Predictors of Engagement in Remote Delivery of the Family Check-Up for Children 0-2 from The Pittsburgh Study: A Community-Partnered Implementation Trial
Saturday, April 23, 2022
3:30 PM – 6:00 PM US MT
Poster Number: 52 Publication Number: 52.203
Sonia N. Rowley, University of Pittsburgh, Pittsburgh, PA, United States; Chelsea M. Weaver Krug, University of Pittsburgh, Pittsburgh, PA, United States; Luciano G. Dolcini-Catania, University of Pittsburgh, Department of Psychology, Pittsburgh, PA, United States; Erin Roby, New York University Grossman School of Medicine, New York, NY, United States; Anne M. Gill, University of Pittsburgh, Pittsburgh, PA, United States; Alan L. Mendelsohn, New York University Grossman School of Medicine, New York, NY, United States; Daniel S. Shaw, University of Pittsburgh, Pittsburgh, PA, United States
Doctoral Student University of Pittsburgh Pittsburgh, Pennsylvania, United States
Background: Family Check-Up (FCU) is a strengths-based home visiting program offered in multiple healthcare settings to promote positive parenting and child school readiness. Predictors of higher in-person FCU engagement among low-income families with toddlers include maternal depression and living above the poverty line. FCU has recently been adapted for remote delivery and included in a menu of interventions offered to families enrolled in The Pittsburgh Study (TPS). To date, no research has investigated predictors of engagement in FCU delivered remotely to families with infants and chosen by caregivers from a menu of interventions aligned with family strengths and challenges.
Objective: To identify predictors of initial (attendance in at least 1 FCU session) and sustained (3 sessions including Feedback) engagement in remote-delivery FCU in the context of TPS.
Design/Methods: Recruitment took place in-person or remotely in healthcare settings (birthing hospitals, pediatric primary care, WIC). FCU was offered with 1-2 other interventions for families with moderate to serious levels of risk based on 25-minute screen assessing family strengths (social support) and challenges (well-being). FCU consists of three sessions: initial interview, assessment, and feedback, with optional follow-up treatment sessions; all were delivered via Zoom. Predictors of engagement included income, child age, and primary caregiver (PC) age, race, education, depression (CES-D), and anxiety (GAD-7).
Results: 99 primary caregivers (PCs) elected to receive FCU (Table 1). 86 PCs (86.9%) completed at least 1 FCU session, and 69 PCs (69.7%) completed 3 FCU sessions including Feedback. PC CES-D scores (36.4% of sample above clinical cutoff) were negatively associated with initial engagement. PC Black race (40.4% of sample) was negatively associated with sustained engagement (Table 2).Conclusion(s): Our findings suggest that remote delivery may be suboptimal for promoting initial engagement among depressed caregivers and sustaining engagement for Black caregivers. As these findings conflict with prior research using in-person FCU with depressed and Black caregivers of young children, they suggest additional methods are needed to improve engagement among these populations for remote delivery. Rapport building with Black caregivers, who may be less trusting of researchers due to historic marginalization, may be more difficult during remote sessions than during home visits. Differences in engagement by race and mental health status are essential to identify and address in order to reduce health disparities. Table 1Demographic and clinical characteristics of primary caregivers (PC). Table 2Logistic regression models predicting FCU engagement outcomes.