Efficacy of Family Programs for Improving Child and Family Health and Development

Preventative interventions involving video-feedback programs to promote parenting (VIPP) have
been shown to be successful in improving maternal sensitivity and infant-mother attachment
security. However, interventions might be substantially more effective if broader elements of
family systems were also addressed, including father-child and inter-parental relationships,
particularly given the growing body of evidence that highlights the importance of father
involvement and positive engagement in children's socio-emotional development. Infancy is a
particularly sensitive and vulnerable period not only for the child but also for the parents
who often experience heightened daily stress, parenting demands, work-family role strain, and
inter-parental discord associated with changes in the family.The proposed longitudinal study
addresses major gaps by testing the effectiveness of family-wide preventative interventions
designed to promote healthy development and functioning in infants, mothers, and fathers,
including low-income families. This three-phase study involves a rigorous randomized clinical
trial (RCT) approach and will involve a demographically diverse sample of 400 families. Phase
I involves a lab and home pre-test (infants 6 months of age) and 8-week intervention period;
Phase II (12 months) includes an initial post-test, and Phase III (16-18 months) involves a
second post-test. Families will be randomly assigned to one of four conditions: sensitivity
intervention (SI), couples intervention (CI), both (SI + CI) or control. Specific aims of the
study include: (1) An evaluation of the effectiveness of the SI, CI, and SI+CI interventions
at improving parental sensitivity, parental efficacy, parenting stress, inter-parental
conflict, infant affective development, attachment security, behavior problems, and
socio-emotional competence; (2) A test of the mechanisms through which change in behavior
occurs. For example, relations between SI participation in Phase I and child attachment in
Phase III may be mediated by enhanced parent sensitivity in Phase II.

Relations between CI participation and child outcomes may be mediated by inter-parental
functioning and more effective communication skills; (3) An examination of factors that
moderate the effectiveness of the interventions, determining which families benefit the most.
Potential moderators include demographic characteristics, family (dis)organization, parents'
own caregiving history, parents' depressive and anxious systems, and infant negative
temperament; (4) Mother-father comparisons on direct effects, mediating mechanisms and
moderating processes. This study builds upon past research towards increasing children's
emotional security in multiple family relationships by testing new directions in preventative
interventions in infancy, addressing the mother-child, father-child, and mother-father
relationships. The goal is to foster children's socio-emotional development and security
through cost-effective family-wide interventions in infancy that promote sensitive
parent-infant interactions and improved inter-parental communication.

Inclusion Criteria:

- Parents cohabiting

- Both mothers and fathers agree to participate

- Healthy infants with no known health problems

Exclusion Criteria:

- Discovery of developmental delays or health problems in infants