P0081 - Supporting Evidence-based Parenting Behaviors in Primary Care Clinics Serving Low-Income Communities: RCT of Sit Down and Play

Background: Recognized by public health agencies as a target to promote developmental and educational equity, the primary care setting offers an ideal opportunity to reach millions of children who live in low-income communities. However, how to more efficiently leverage the primary care setting to deliver a sustainable and effective preventive intervention to promote positive parenting behaviors that encourage early childhood development remains a challenge. We designed Sit Down and Play (SDP) to be a brief, population-level, primary care-based program that aims to optimize developmental and health outcomes for children seen at clinics serving predominantly low-income communities.

Objective: To conduct a 12-month pilot randomized control study of SDP in a primary care setting serving low-income families to assess feasibility and evaluate potential impacts on self-reported parenting behaviors that promote early childhood development.

Method: Caregivers of 2-month-old children were enrolled, interviewed, and randomized to intervention (n = 40) or control (n = 40) groups. Intervention families received SDP at recruitment and at each subsequent well-child visit until the child was 12 months of age. Control families were provided handouts. One month after the 6- (T2) and 12-month (T3) well-child visit, all families were reinterviewed. Using standardized measures, parents were asked about parenting behaviors central to children’s development. Potential impacts on perceived parenting confidence and parenting knowledge were also explored. Analyses were conducted using chi square tests and analysis of variance.

Results: 71 families contributed data for T2 analyses (35 intervention; 36 control); 64 (33 intervention, 31 control) for T3. Higher mean parent-child verbal interaction quality was reported by SDP vs. non-SDP parents at T2 (8.8 vs. 7.4; p=.048) and T3 (8.1 vs. 6.4; p=.048). SDP parents had increased participation in learning activities at T3 (3.9 vs. 3.6; p=0.029).

Conclusion: The results demonstrate promise for leveraging the primary care setting to deliver a brief, low-intensity program to promote key parenting behaviors that support early childhood development. Additional analyses including assessing parenting behavior based upon observational assessments and evaluating differences in effects based upon sociodemographic factors are important next steps to inform future adaptations.