Using Internet-based Video Tools to Deliver Mental Health Interventions: Development and Results from a Randomized Control Trial Pilot Study of Infant-Net
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Abstract
Background
A growing body of literature indicates the effectiveness of early intervention in improving parent-child interactions, promoting childrens'language and social development, and decreasing the likelihood for child maltreatment. In a recent review of 17 home-based, early interventions, Brooks-Gunn et al. (2000) reported that 11 of the programs yielded positive effects on parent-child interactions. Overall, the interventions promoted more sensitive parenting behavior, with individual investigations noting reductions in negative or harsh parenting and increases in positive parenting behaviors (Barrera et al., 1990; Jacobson & Frye, 1991; Olds et al., 2002).
One of the most promising early intervention programs aimed at teaching effective parent-child interaction strategies is the PALS (Playing and Learning Strategies) program (Landry & Smith, 1996; Smith et al. 2000; Landry et al, 2001). The PALS curriculum targets young parents’ ability to interact with their infants and young children using behaviors that have been found to support optimal social/emotional and cognitive development.
Objective: This study is a randomized trial comparing an Internet website for parent training and support based upon a digitalized version of the video-based Play and Learning Strategies program (PALS; Landry & Smith, 1996) to a computer-only control condition.
Methods: The adapted remotely-delivered interactive Internet intervention includes three components: (a) the PALS course; (b) video feedback and coaching from a professional; and (c) professional and peer social support. We recruited 40 low-income mothers of infants three to six months old and randomly assigned mother-infant dyads to either Internet-based parenting program (experimental) or computer with Internet access (control) condition.
Results: The adapted program was developed using open source software for the majority of components. Preliminary results of this a randomized control trial demonstrated significant improvements in infant social engagement and engagement with the environment as well as trends indicating increases in parent responsiveness and decreases in parent intrusiveness, yielding medium effect sizes for both infant and parent behavior. In addition, parents reported high rates of satisfaction with the program and a strong sense of “being understood†by their coach. Overall results provide a good evidence base for further evaluation.
Conclusions: The inaccessibility and under-utilization of empirically supported mental health and other support services by families experiencing isolation, due to rural location or linguistic barriers, are currently significant and growing public health concerns encouraging the adaptation for easy access for preventive services. As described, interventions that rely on computer and telecommunication technologies, including those that use the Internet to facilitate service delivery, are increasingly being viewed as valuable in this regard. This paper concludes with a presentation of future research directions.
A growing body of literature indicates the effectiveness of early intervention in improving parent-child interactions, promoting childrens'language and social development, and decreasing the likelihood for child maltreatment. In a recent review of 17 home-based, early interventions, Brooks-Gunn et al. (2000) reported that 11 of the programs yielded positive effects on parent-child interactions. Overall, the interventions promoted more sensitive parenting behavior, with individual investigations noting reductions in negative or harsh parenting and increases in positive parenting behaviors (Barrera et al., 1990; Jacobson & Frye, 1991; Olds et al., 2002).
One of the most promising early intervention programs aimed at teaching effective parent-child interaction strategies is the PALS (Playing and Learning Strategies) program (Landry & Smith, 1996; Smith et al. 2000; Landry et al, 2001). The PALS curriculum targets young parents’ ability to interact with their infants and young children using behaviors that have been found to support optimal social/emotional and cognitive development.
Objective: This study is a randomized trial comparing an Internet website for parent training and support based upon a digitalized version of the video-based Play and Learning Strategies program (PALS; Landry & Smith, 1996) to a computer-only control condition.
Methods: The adapted remotely-delivered interactive Internet intervention includes three components: (a) the PALS course; (b) video feedback and coaching from a professional; and (c) professional and peer social support. We recruited 40 low-income mothers of infants three to six months old and randomly assigned mother-infant dyads to either Internet-based parenting program (experimental) or computer with Internet access (control) condition.
Results: The adapted program was developed using open source software for the majority of components. Preliminary results of this a randomized control trial demonstrated significant improvements in infant social engagement and engagement with the environment as well as trends indicating increases in parent responsiveness and decreases in parent intrusiveness, yielding medium effect sizes for both infant and parent behavior. In addition, parents reported high rates of satisfaction with the program and a strong sense of “being understood†by their coach. Overall results provide a good evidence base for further evaluation.
Conclusions: The inaccessibility and under-utilization of empirically supported mental health and other support services by families experiencing isolation, due to rural location or linguistic barriers, are currently significant and growing public health concerns encouraging the adaptation for easy access for preventive services. As described, interventions that rely on computer and telecommunication technologies, including those that use the Internet to facilitate service delivery, are increasingly being viewed as valuable in this regard. This paper concludes with a presentation of future research directions.
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