Full project title: A Mobile Web-Based Parenting Intervention to Strengthen Social-Emotional Development of Very Low Birth Weight Infants


Very low birth weight (VLBW) infants are at significantly elevated risk for a host of detrimental outcomes including cognitive, language, and social delays and disabilities, which persist into adulthood. An important protective factor for mitigating risk is sensitive and responsive parenting, as demonstrated in descriptive longitudinal studies of development and experimental intervention studies to promote social-emotional, language, and cognitive development. While evidence-based home visiting interventions exist and were developed specifically for VLBW infants, such as the Play and Learning Strategies program (PALS), parents face major obstacles in obtaining these interventions. In general, interventions demonstrated to be effective through federal research are very slow to migrate to community service delivery systems.

Exacerbating this problem currently is the fact that while VLBW has been increasing, and disproportionately so for those who are poor an of minority status, home visiting programs have sustained some of the largest cuts in their histories. Consequently, there is high demand for effective interventions that can be delivered remotely. Through prior, work we addressed this need by adapting the evidence-based PALS program for web-based delivery using laptop computers with streaming video of in-home parent child interactions and weekly remote coaching (InfantNet). We then rigorously tested its effects in a sample of low-income mothers and infants with typical birth histories. Results of this randomized controlled study showed pre-post growth in maternal sensitivity behaviors and significant increases in infants’ social engagement with their mothers, with moderate to large effect sizes for the intervention group as compared to the control group.

These encouraging results provide a strong empirical basis for the enhanced web-based delivery method of the PALS program. Although PALS was originally developed and tested with VLBW infants, the web-based version, InfantNet, has not yet been tested with this population. Moreover, emergent trends show that young Latino and Black women most often access the Internet through smart phones, not laptops. Consequently, there is great demand for improving access to evidence-based interventions by making them available on mobile devices such as smart phones.

To address the need for more accessible evidence-based interventions, we will overlay the InfantNet program onto the iPhone and rigorously test its effects with 60 low- income mothers and their VLBW infants through a 2-arm, 3 cohort, randomized-controlled design. Outcomes will be assessed with the Parenting Stress Index, the Indicator of Parent Child Interaction observation coding system, and the Knowledge of Infant Development Inventory. Additional measures include the Post-Partum Depression Screening Scale, the Infant Behavior Questionnaire (assessing temperament), and the Personal Relationships Inventory (Social Support). Through real-time streamed data we will assess implementation fidelity, feasibility, use, and satisfaction.