Parents as Teachers (PAT) and the USC School of Social Work (USC) TeleHealth Clinic will implement the PAT evidence-based model via live, web-based video sessions in seven different communities: Los Angeles, Irvine, Riverside, Antelope Valley, Chino, CA and St. Louis, Columbia MO. The PAT home visiting model works with parents of children from prenatal through five years to: increase knowledge of child development, early detection of health and wellness issues, and improve school readiness. PAT parent educators utilize evidence-based practice by partnering with families in their homes. This partnership will increase access to home visitation and psychotherapeutic services for underserved populations using interactive technology to serve more families at lower cost.
PAT will train 17 USC faculty and graduate students in the PAT model, facilitate access to the online parenting curriculum, and monitor structural and process fidelity. USC will implement the PAT model through their TeleHealth Clinic, ultimately providing home visitation services to 120 parents and 120 children. This commitment will be implemented in a two phase approach. In phase one, a grey paper will be written, including strategies to use virtual technology in home visitation programs, elements of PAT that need to be adapted for virtual technology, and evaluation questions.
A one-year pilot with 20 families will begin to ensure fidelity can be maintained using interactive technology. LA Best Babies Network and the St. Louis and Columbia, MO PAT school districts will support a recruitment plan of families not currently eligible for referrals because of current stringent funding requirements. A two-year efficacy study will follow with 100 families to evaluate outcomes determining whether PATTI is as effective as receiving on-ground home visitation services. Metrics here include maintaining a 60% increase in follow-up rates and 71% in referral rates, as measured by the PAT Annual Program Report.
June 2015: (1) PAT and USC School of Social Work TeleHealth commitment publicly launched at CGI America; (2) Presentation to Institute of Medicine Committee on Supporting Parents of Young Children
August 2015: Finalize grey paper detailing state of home visitation and PATTI
September December 2015: (1) Training of TeleHealth practitioners in PAT foundational curriculum and model; (2) Deliverable: Recruitment and enrollment plan
January December 2016: (1)Pilot test of PATTI with 20 families in Southern California; (2) Deliverable: Quarterly reports detailing outcomes of fidelity measures, parenting outcomes, and child development outcomes; (3) Deliverable: Application for large scale implementation trial
January 2017: Secure funding for an implementation and dissemination study of PATTI with 100 families in 5 geographic regions
January 2017 December 2018: (1) Large scale implementation trial of PATTI; (2) Deliverable: Quarterly reports detailing outcomes of fidelity measures, parenting outcomes, and child development outcomes.
Research continues to reinforce the effectiveness of early intervention through home visitation in improving parent-child interaction and relationships, newborn health outcomes, improved access to preventive medical care, early identification of developmental delays, reduction in child abuse risk, and overall improvement in child and family functioning. Parents as Teachers (PAT) is one of the largest family-serving, evidence-based home visitation programs in the United States. Multiple research studies have found that families who participate in PAT have children who: enter kindergarten better prepared academically; have better long term school achievement; are less likely to be engaged in the child welfare system; have greater parental involvement, and better health and developmental outcomes.
Given the evidence of the effectiveness of home visitation in general, and PAT in particular, on enhancing parenting, it is unfortunate that many high need families, most notably women, minorities, and the poor (NIMH, 2003), experience barriers that include: lack of access to services; limited reach within a community; program objectives that exceed their capacity or intensity; limited access to highly trained parenting and family well-being professionals; and psychological barriers to mental health services.
It is critically important that empirically supported interventions be adapted for nontraditional delivery systems in order to overcome barriers to treatment provision and utilization (NIMH, 2003). Telemedicine technologies hold great promise for extending the reach of home visiting programs too hard to reach families. Telemedicine approaches utilize information technologies in order to provide clinical services at a distance. These approaches can improve access to services that would not be readily available in many under-served communities. The greatest challenges facing these programs are issues related to implementation and bringing the intervention to scale. To date, no home visiting program has been delivered in a live format, entirely through virtual technology.