title: Primary care strategies for promoting parent-child interactions and school readiness in at-risk families: the Bellevue Project for Early Language, Literacy, and Education Success.
abstract: OBJECTIVE
  To determine the effects of pediatric primary care interventions on parent-child interactions in families with low socioeconomic status.
  
  
  METHODS
  In this randomized controlled trial, participants were randomized to 1 of 2 interventions (Video Interaction Project [VIP] or Building Blocks [BB]) or the control group.
  
  
  METHODS
  Urban public hospital pediatric primary care clinic.
  
  
  METHODS
  Mother-newborn dyads enrolled post partum from November 1, 2005, through October 31, 2008.
  
  
  METHODS
  In the VIP group, mothers and newborns participated in 1-on-1 sessions with a child development specialist who facilitated interactions in play and shared reading by reviewing videos made of the parent and child on primary care visit days; learning materials and parenting pamphlets were also provided. In the BB group, parenting materials, including age-specific newsletters suggesting interactive activities, learning materials, and parent-completed developmental questionnaires, were mailed to the mothers.
  
  
  METHODS
  Parent-child interactions were assessed at 6 months with the StimQ-Infant and a 24-hour shared reading recall diary.
  
  
  RESULTS
  A total of 410 families were assessed. The VIP group had a higher increased StimQ score (mean difference, 3.6 points; 95% confidence interval, 1.5 to 5.6 points; Cohen d, 0.51; 0.22 to 0.81) and more reading activities compared to the control group. The BB group also had an increased overall StimQ score compared with the control group (Cohen d, 0.31; 95% confidence interval, 0.03 to 0.60). The greatest effects for the VIP group were found for mothers with a ninth-grade or higher reading level (Cohen d, 0.68; 95% confidence interval, 0.33 to 1.03).
  
  
  CONCLUSIONS
  The VIP and BB groups each led to increased parent-child interactions. Pediatric primary care represents a significant opportunity for enhancing developmental trajectories in at-risk children.
  
  
  BACKGROUND
  clinicaltrials.gov Identifier: NCT00212576.
authors.affiliation: Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, New York University School of Medicine and Bellevue Hospital Center, New York, NY 10016, USA. alm5@nyu.edu
authors.forename: Alan L
authors.initials: AL
authors.lastname: Mendelsohn
authors.forename: Harris S
authors.initials: HS
authors.lastname: Huberman
authors.forename: Samantha B
authors.initials: SB
authors.lastname: Berkule
authors.forename: Carolyn A
authors.initials: CA
authors.lastname: Brockmeyer
authors.forename: Lesley M
authors.initials: LM
authors.lastname: Morrow
authors.forename: Benard P
authors.initials: BP
authors.lastname: Dreyer
mesh_terms: D002657:Child Development / Q000502:physiology; D002675:Child, Preschool; D016001:Confidence Intervals; D018479:Early Intervention, Educational / Q000458:organization & administration*; D005260:Female; D006293:Health Promotion / Q000458:organization & administration*; D054624:Health Status Disparities; D006786:Hospitals, Urban; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007804:Language Development; D007858:Learning; D008297:Male; D009519:New York City; D010287:Parent-Child Relations; D010372:Pediatrics / Q000379:methods; D010989:Play Therapy / Q000379:methods; D010988:Play and Playthings; D011203:Poverty; D011320:Primary Health Care / Q000458:organization & administration*; D015397:Program Evaluation; D012016:Reference Values; D018570:Risk Assessment; D012959:Socioeconomic Factors; D013664:Teaching Materials; D013997:Time Factors; D014741:Video Recording / Q000379:methods