The Pittsburgh Study: A Tiered Model To Support Parents During Early Childhood

Access: FREE/Open Access

Publication year

2023

study description

Feasibility Study

core topic(s)

Early Relational Health

Population Characteristics

Infant/Newborn

Exposures, Outcomes, Other

Clinic-Based Programs and Interventions , Parent-Child Relationships/Interactions

objectives

The Pittsburgh Study's (TPS) Early Childhood Collaborative was designed to test the feasibility of implementing a population-level, community-partnered initiative aimed at promoting relational health through accessible preventive parenting programs for families with young children.

outcomes evaluated

Feasibility of implementing The Pittsburgh Study's (TPS) Early Childhood Collaborative

setting

Community agencies serving families in Allegheny County, Pennsylvania

methods

Participants were assigned to 1 of 4 tiered groups based on identified needs: (1) universal, (2) targeted/universal, (3) secondary/tertiary, or (4) tertiary programs. Parents were offered choices in empirically supported parenting programs within group ranging from texting programs to intensive home visiting. Program selection was optional. Chi-square tests were conducted to examine the likelihood of selecting a program by group.

sample size

N=878 parents of 1040 children 4-years-old and under.

measures

Examined likelihood of selecting a program by group

results

About 25% of participants were assigned to each tiered group; 78% of parents chose to enroll in a parenting program. In general, parents with higher levels of adversity were more likely to select a parenting program compared with those reporting less adversity, including secondary/tertiary vs targeted/universal groups (81.4% vs 72.8%), and tertiary vs universal and targeted/universal groups (83% vs 74.1% and 72.8%, respectively; P < .001).

conclusions

Our high program enrollment rate supports the feasibility of TPS. TPS successfully engaged families in the study by offering choices in, and optimizing accessibility to, parenting programs. TPS is highly aligned with recent recommendations by the American Academy of Pediatrics for tiered approaches as part of a broad public health strategy for supporting early relational health.

limitations

First, risk stratification was based on self-reports, relying on participants to disclose adverse experiences. Future research could consider using healthcare records to identify program needs and provide more objective estimates, especially for parents experiencing toxic stress who may be reticent to divulge their challenges. Next, TPS was implemented within largely urban and suburban Allegheny County limiting generalizability to other racial or ethnic groups and geographic locations.