Abstract
Objectives
Economical, operational, and employment strains present challenges for widespread implementation of parent-directed interventions. We designed Sit Down and Play (SDP) with the aim of creating a brief primary care-based program that encourages positive parenting practices through take-home play activities. To develop a sustainable model of implementation in real-world settings, we explored the use of university student volunteers as a potential solution for employment strains. Guided by Proctor and colleagues’ implementation outcome framework, this study focused on understanding the following implementation outcomes: acceptability, feasibility, fidelity, and service penetration. Exploratory analysis on the limited-efficacy of the program on parental behavior was also assessed.
Methods
Student facilitators were trained utilizing a train-the-trainer model. During the study period, facilitators delivered SDP to caregivers attending their well-child visits (WCVs) in a primary care clinic serving predominantly low-income families. Implementation data was gathered from clinic records, student facilitator surveys, and caregiver surveys.
Results
Student facilitators delivered SDP interventions to 99/146 (67.8%) eligible families. Caregivers overwhelmingly found the program helpful (M = 4.70, SD = 0.82), enjoyable (M = 4.88, SD = 0.32), and were highly satisfied with individuals who delivered it (M = 4.97, SD = 0.16). Student facilitators successfully delivered the program with high fidelity.
Conclusions for Practice
Implementation findings suggest that delivery of SDP by student volunteers combined with the use of a train-the-trainer model is a feasible model to integrate strategies that support positive parenting behaviors into existing systems, such as the primary care setting. This study yields promising results that suggest the benefit of utilizing university partnerships with healthcare settings for wider dissemination and adaptations for other subgroups and contexts.
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Data Availability
We have included electronic supplementary material which contains data that was collected as part of the baseline and follow-up surveys collected for natural control and intervention participants. The data was modified to include only total scores rather than item-level responses. Supplementary material is titled “Online Resource 1”.
Code Availability
R code for data cleaning and analysis can be provided upon request.
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Acknowledgements
This study was based upon work supported by the National Institute of Health under award No. K23HD086295. We would like to acknowledge all of the clinic staff that welcomed us into their space, and we would like to thank all of the families that participated in the study.
Funding
This study was based upon work supported by the National Institute of Health under Award No. K23HD086295.
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LT drafted the initial manuscript, developed tables/figures, conducted the statistical analysis, interpreted the data, and reviewed and revised the manuscript. AC and AM performed the literature search, developed the framework of the literature review and reviewed and revised the manuscript. RS conceptualized the study design, reviewed and provided critical revision of the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.
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10995_2021_3210_MOESM1_ESM.xls
Online Resource 1. This electronic supplementary material contains the data that was collected as part of the baseline and follow-up surveys collected for natural control and intervention caregivers. The data was modified to include only total scores rather than item-level responses. (XLS 27 kb)
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Torres, L.M., Camarena, A.E., Martin, A. et al. Examining Implementation Outcomes of Sit Down and Play, a Primary Care-Based Intervention, in a Large Urban Primary Care Clinic. Matern Child Health J 25, 1744–1756 (2021). https://doi.org/10.1007/s10995-021-03210-7
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DOI: https://doi.org/10.1007/s10995-021-03210-7