Smart Beginnings Predicts Reduced Externalizing Behavior Via Parental Negative Demeanor During Discipline.

The goal of this study was to examine the impacts of the Smart Beginnings (SB) intervention, a tiered model that combines universal primary prevention and targeted secondary prevention, on parental negative affect during discipline and children's externalizing behavior. Analyses included 273 families who were randomly assigned to SB or control groups at birth. Parental negative affect during discipline and child externalizing behavior were assessed through parent report at age four and six, respectively.

Impacts of the Smart Beginnings Parenting Program on Early Childhood Special Education Evaluation and Service Referral.

Objective: Little is known about how parenting interventions might influence families' access to related health care services during early childhood. This study describes the effects of a parenting intervention, Smart Beginnings (SB), on referrals to early intervention (EI) or early childhood special education (ECSE) after evaluation within a predominantly Black/Latine sample with low incomes. SB is a tiered intervention integrating a universal parenting program delivered in primary care clinics (PlayReadVIP) with a targeted home-visiting program (Family Check-Up).

Parenting Styles from Infancy to Toddlerhood in Black/African American and Latina Mothers with Low Incomes.

Parenting in very early childhood (0-2 years) provides important context for children's socioemotional development. The present study aims to address limitations of extant parenting literature, namely the reliance on white, middle-class samples and use of variable-centered approaches that often mask the rich heterogeneity of parenting styles. Using data from an efficacy trial of a tiered parenting program to promote school readiness, the current study examined parenting styles across three waves when children were 6, 18, and 24 months with a sample of Black/African American and Latina mothers with low incomes using person-oriented, latent class analysis.

Association between Teacher Depressive Symptoms and Rural Children's Cognitive Outcomes: Indirect Relations with Early Care and Education Quality.

A subset of extant data (=423) from the Family Life Project, a population-based study of Black and White families with low incomes from rural communities, were used to test for associations between teacher depressive symptoms and children's cognitive outcomes at 36 months. A second aim tested whether early care and education (ECE) quality mediated such relations. Results indicated that although the associations were in the expected negative direction, teacher depressive symptoms were not directly significantly related to any child cognitive outcome.

Economic hardships during COVID-19 and maternal mental health: Combining samples with low incomes across three cities.

The COVID-19 pandemic increased maternal depression and anxiety, imperiling both mothers' own wellbeing and that of their children. To date, however, little is known about the extent to which these increases are attributable to economic hardships commonly experienced during the pandemic: income loss, job loss, and loss of health insurance. Few studies have examined the individual impacts of these hardships, and none have lasted beyond the first year of the pandemic.

Maternal Literacy Skills and Children's Kindergarten Outcomes in Rural Communities with Low Incomes: The Moderating Role of Hours in Child Care.

Based on theoretical premises of ecological systems theory and the compensatory hypothesis, a subset of data from the Family Life Project ( = 773), a population-based study of rural families with low incomes, were used to test for associations between maternal literacy in infancy and children's academic outcomes and teacher-reported problem behaviors in kindergarten. A second aim tested whether increased time in child care averaged from 6-36 months moderated such relations. Results indicated that maternal literacy was significantly positively related to academic outcomes ( = .

The influence of early childhood education and care on the relation between early-life social adversity and children's mental health in the environmental influences for Child Health Outcomes Program.

Early adversity increases risk for child mental health difficulties. Stressors in the home environment (e.g.

Cognitive Stimulation and Maternal Feeding Styles in Families with Low Incomes: Impacts from a Randomized Clinical Trial.

Objective: To examine associations between cognitive stimulation in the home at 6 months and maternal feeding styles at 24 months, direct intervention effects of Smart Beginnings (SB) on feeding styles, and potential indirect effects of SB on feeding styles via earlier intervention effects on cognitive stimulation.

Methods: Single-blind, two-site randomized clinical trial (RCT) of the SB intervention. SB integrates PlayReadVIP, a universal, pediatric primary care-based program, and Family Check-Up (FCU), a targeted secondary home-based parenting intervention.

Influence of early childhood parental hostility and socioeconomic stress on children's internalizing symptom trajectories from childhood to adolescence.

Introduction: Children and adolescents with elevated internalizing symptoms are at increased risk for depression, anxiety, and other psychopathology later in life. The present study examined the predictive links between two bioecological factors in early childhood-parental hostility and socioeconomic stress-and children's internalizing symptom class outcomes, while considering the effects of child sex assigned at birth on internalizing symptom development from childhood to adolescence.

Materials And Methods: The study used a sample of 1,534 children to test the predictive effects of socioeconomic stress at ages 18 and 27 months; hostile parenting measured at child ages 4-5; and sex assigned at birth on children's internalizing symptom latent class outcomes at child ages 7-9, 10-12, 13-15, and 16-19.

Enhancing early language and literacy skills for racial/ethnic minority children with low incomes through a randomized clinical trial: The mediating role of cognitively stimulating parent-child interactions.

Parenting is a critical mediator of children's school readiness. In line with this theory of change, data from the randomized clinical trial of Smart Beginnings (tiered Video Interaction Project and Family Check-Up; N = 403, treatment arm n = 201) were used to examine treatment impacts on early language and literacy skills at child age 4 years (n = 168, n = 198, n = 203), as well as indirect impacts through parental support of cognitive stimulation at child age 2 years. Although results did not reveal direct effects on children's early skills, there were significant indirect effects for early literacy (β = .

Impacts of a tiered intervention on child internalizing and externalizing behavior in the context of maternal depression.

Greater maternal depressive symptoms are consistently associated with higher levels of behavioral difficulties in children, emerging in early childhood and with long-lasting consequences for children's development. Interventions promoting early relational health have been shown to have benefits for children's behavior; however, these impacts are not always realized in the context of maternal depression. This study examined whether tiered programs could address this limitation by focusing on both parenting, through universal primary prevention, and psychosocial stressors and parent mental health, through tailored secondary prevention.

Life satisfaction for adolescents with developmental and behavioral disabilities during the COVID-19 pandemic.

Background: This study aimed to identify contextual factors associated with life satisfaction during the COVID-19 pandemic for adolescents with mental, emotional, behavioral, and developmental (MEBD) disabilities.

Methods: Data were collected from a sample of 1084 adolescents aged 11-21 years from April 2020 to August 2021. This cross-sectional study used a sequential machine learning workflow, consisting of random forest regression and evolutionary tree regression, to identify subgroups of adolescents in the Environmental influences on Child Health Outcomes (ECHO) consortium who demonstrated enhanced vulnerability to lower life satisfaction as described by intersecting risk factors, protective factors, and MEBD disabilities.

The Children, Caregivers, and Community (C3) study of together growing strong: A protocol for an observational, place-based initiative in Sunset Park, Brooklyn.

Reaching population-level impact for families in poverty requires moving beyond a sole focus on individuals, to a wider focus on interactions between individuals and their broader environmental contexts. Place-based initiatives have emerged as a policy response to promote community-level change around these broader interactions between individuals and their local communities through addressing long-standing disparities in housing, employment, education, and health. Together Growing Strong (TGS) is one such place-based initiative focused on transforming the health, wellbeing, and development of young children and their families in Sunset Park, Brooklyn.

Promoting Cognitive Stimulation in Parents Across Infancy and Toddlerhood: A Randomized Clinical Trial.

Objective: To test the impact of the fully integrated Smart Beginnings model on parental support of cognitive stimulation from 6 to 24 months across infancy and toddlerhood.

Study Design: This was a single-blind, 2-site randomized clinical trial of the Smart Beginnings intervention. Enrollment took place at birth in postpartum units of hospitals in New York City and Pittsburgh, Pennsylvania, with a consecutive sample of 403 mother-infant dyads.

Collateral benefits from a school-readiness intervention on breastfeeding: A cross-domain impact evaluation.

This study evaluated the collateral, or unanticipated, impacts of Smart Beginnings (SB), a two-site, tiered intervention designed to promote responsive parenting and school readiness, on breastfeeding intensity in a low-income sample. Impact analyses for the SB intervention were conducted using an intent-to-treat design leveraging a two-arm random assignment structure. Mothers assigned to the SB intervention group were more than three times more likely to give breastmilk as the only milk source at infant age 6 months than mothers assigned to the control group at one site, an effect not evident at the other study site.

Predictors of television at bedtime and associations with toddler sleep and behavior in a medicaid-eligible, racial/ethnic minority sample.

This study examined predictors of TV use at bedtime and associations with toddlers' sleep and behavior using data from the Smart Beginnings study with 403 Medicaid-eligible, racial/ethnic minority participants from two cities in the United States. We first estimated predictors of TV use at bedtime at 18 months. We then examined whether TV at bedtime was associated with concurrent parent-report of nighttime sleep duration and quality, and later problem behavior at 24 months.

Improving Parent-Child Interactions in Pediatric Health Care: A Two-Site Randomized Controlled Trial.

Background And Objectives: Heterogeneity in risk among low-income families suggests the need for tiered interventions to prevent disparities in school readiness. Smart Beginnings (SB) integrates two interventions: Video Interaction Project (VIP) (birth to 3 years), delivered universally to low-income families in pediatric primary care, and Family Check-Up (6 months to 3 years), targeted home visiting for families with additional family risks. Our objective was to assess initial SB impacts on parent-child activities and interactions at 6 months, reflecting early VIP exposure.

Pediatric Primary Care and Partnerships Across Sectors to Promote Early Child Development.

Poverty remains a critical predictor of children's school readiness, health and longer term outcomes. Early relational health (ERH) (ie, parenting practices and relationship quality) mediates the impact of poverty on child development, and thus has been the focus of many parenting interventions. Despite the documented efficacy of parenting interventions at reducing poverty-related disparities in child health and development, several key barriers prevent achieving population-level reach to families with young children.

Beyond language: Impacts of shared reading on parenting stress and early parent-child relational health.

This study examined the interrelated and longitudinal impacts of parent-child shared book reading, parenting stress, and early relational health, as measured by both parental warmth and parent sensitivity, from infancy to toddlerhood. To extend findings from previous studies of collateral effects that have been conducted in parenting interventions, we examined parenting behaviors in a broader context to determine whether shared book reading would confer collateral benefits to the parent and parent-child relationship beyond those expected (i.e.

Breastfeeding Behaviors and Maternal Interaction Quality in a Low-Income, Ethnic Minority Population.

Objective: To examine the associations between breastfeeding intensity and underexplored features of maternal-child interaction quality over and above the influence of breastfeeding initiation.

Methods: The current study leveraged an on-going, multisite randomized controlled trial of a tiered parenting program for 462 Medicaid-eligible mothers and their infants in the United States. We examined whether breastfeeding intensity and exclusivity was associated with observed maternal sensitivity, intrusiveness, and detachment, as well as self-reported maternal verbal responsiveness, 6 months infant age.

Sociodemographic and Psychosocial Predictors of VIP Attendance in Smart Beginnings Through 6 Months: Effectively Targeting At-Risk Mothers in Early Visits.

Past research on predictors of participation in early childhood parenting programs suggest that families experiencing higher levels of sociodemographic adversity (e.g., younger maternal age, single parenthood, lower income or education) are less likely to participate in parenting programs.

Spanish Instruction in Head Start and Dual Language Learners' Academic Achievement.

Data from the Head Start Impact Study ( = 1,141) and the Head Start Family and Child Experiences Survey, 2009 Cohort ( = 825) were used to investigate whether Spanish instruction in Head Start differentially increased Spanish-speaking Dual Language Learners' (DLLs) academic achievement. Although hypothesized that Spanish instruction would be beneficial for DLLs' early literacy and math skills, results from residualized growth models showed there were no such positive associations. Somewhat surprisingly, DLL children instructed in Spanish had higher English receptive vocabulary skills at the end of the Head Start year than those not instructed, with children randomly assigned to Head Start and instructed in Spanish having the highest scores.

IV. TESTING FOR DOSAGE-OUTCOME ASSOCIATIONS IN EARLY CARE AND EDUCATION.

In this chapter, we turn to the question of whether there is evidence of an association between children’s development and the quantity or dosage of ECE across several large studies. As follow-up to the results summarized in the literature review, it is important to control adequately for selection effects in studying effects of dosage. There is also a need to examine different measures of dosage to see if consistent patterns of findings emerge across different measurement approaches.

Child Care Enrollment Decisions Among Dual Language Learner Families: The Role of Spanish Language Instruction in the Child Care Setting.

Data from the Head Start Impact Study ( = 1,141) and the Head Start Family and Child Experiences Survey, 2009 Cohort ( = 825) were used to describe child care enrollment decisions among Spanish-speaking Dual Language Learner (DLL) families. In particular, logistic regression models tested which child, family, and institutional characteristics predicted enrollment in early care and education (ECE) settings that used Spanish for instruction versus enrollment in settings that did not use Spanish. Results showed that whether the child's first language was exclusively Spanish and whether other DLL families previously attended the ECE arrangement strongly predicted whether that child enrolled.

Does Head Start differentially benefit children with risks targeted by the program's service model?

Data from the Head Start Impact Study ( = 3540) were used to test for differential benefits of Head Start after one program year and after kindergarten on pre-academic and behavior outcomes for children at risk in the domains targeted by the program's comprehensive services. Although random assignment to Head Start produced positive treatment main effects on children's pre-academic skills and behavior problems, residualized growth models showed that random assignment to Head Start did not differentially benefit the pre-academic skills of children with risk factors targeted by the Head Start service model. The models showed detrimental impacts of Head Start for maternal-reported behavior problems of high-risk children, but slightly more positive impacts for teacher-reported behavior.