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Strengthening Bonds: a remote video coaching parenting program

A remote video coaching parenting program to strengthen positive parent-child interactions by sending video clips to their smartphones.

Photo of Maria Beatriz Martins Linhares
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Updates: How has your idea changed or evolved throughout the Prize? What updates have you made to this submission? (1500 characters)

We update our project. Nowadays, we have a prototype of one video model in English language. We also participated in the 2018 Frontiers of Innovation Convening, in Boston, and discuss many advances in the project, as example: develop a fidelity tracking for the intervention program, enhance the guide of implementation including a specific topic for training new facilitators, develop a more friendly and online material with videos and images besides the written material for training new facilitators. To reach a greater number of facilitators we are planning to use an online course. This resource will be used to prepare for the new information, to engage the facilitators in a learning community and as a consolidation and retrieval strategy. Also, after the nice webinar with the mentor Amanda C Lim we get new ideas about marketing and technology support for the intervention program. New potential solutions to enhance the technological aspects of the program could be more easy accomplished!

Name or Organization

The main institution is named Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (USP)/ Ribeirão Preto Medical School, University of São Paulo. The institution that will administrate the funding is the FUSP - Fundação da Universidade de São Paulo.

Geography

Southeast of Brazil, State of São Paulo.This program can be also implemented in other countries.

What is your stage of development?

  • Advanced Innovator with 3 to 10+ years of experience in ECD

Type

  • University

What is the stage of your proposal?

  • Piloting: I have started to implement my solution as a whole with a first set of real users.

Describe how your solution could be a game-changer for your selected Opportunity Area (600 characters)

The Strengthening Bonds aims to strengthen parenting practices, focusing positive interactions (responsiveness, reciprocity, and directivity) between mothers and their 1-to-3 year old children. We will promote changes on mothers-children relationships, offering evidence-based knowledge and models using mainly technology (smartphone) to ensure accessibility, via apps that parents already use (e.g whastapp and youtube).

Select an Innovation Target

  • Product: A new or enhanced physical product that creates value for end beneficiaries.

Tell us more about your innovation (1500 characters)

A remote video coaching universal parenting program that aims to strengthen positive mothers-children interactions and to enhance the mothers' awareness about the power of positive interactions during play situations in their home setting. The innovation includes video clips, using the methodology of self-observation with positive feedbacks (subtitles and emojis) associated with animation explaining the constructs about positive interactions, such as responsiveness, reciprocity, and directivity. The six video clips are sent weekly to the mothers' smarthphone. The target population is mothers of children at 1-to-3 years old, of both sexes, who will be recruited in the Ribeirão Preto city, Brazil. The mothers will be recruited in different settings, such as: health family centers, day care centers, and pediatric outpatient clinics. Considering the universal approach of the intervention program, it can be implemented in different settings and also in different countries.

What problem are you aiming to solve? (3 sentences)

The families present disadvantages regarding the environmental context characteristics, such as: poor structure and functioning of the family, low income families, abusive and violent familial contexts, violent neighborhood, and/or poor resources in the communities. In face of these problems, the Strengthening Bonds aim to support mothers to interact in a positive way with their children and to stimulate early child development in play situations, in the natural context of the family`s home.

Explain your idea (5000 characters)

The Strengthening Bonds aims to support mothers to interact in a positive manner with their children and to stimulate child early development in several play situations, in the natural context of the family home. The support is sent via smartphone and using remote videocoaching. The program includes 3 phases: Phase 1) A home visit to record a 20 minutes video of mothers playing with their children in two moments, such as free playing and structured playing situations. Phase 2) A one hour face-to-face session for the mothers to explain parenting, child development, positive interactions and how to avoid negative manners of interacting with the child. The session includes facilitators explanations, group activities, role-play, and videos. Phase 3) Sending weekly short video clips (2 minutes) to the mothers´ smartphones during 6 weeks, 6 videos in total. Each vídeo clip includes two parts: i) animated videos explaining the constructs; ii) the parents' own personalized video with positive feedbacks presented through subtitles and emojis. We standardized templates in the Imovie software. Each video is uploaded on YouTube in an unlisted way, to ensure parents' privacy. The link is sent to the mothers' smartphone in an app that they already use (e.g. whatsapp).

Who benefits? (1500 characters)

The program has a universal approach. Firstly, the innovation will be implemented with mothers of children at 1-to-3 years old living in a developing country (Brazil), however it fits to the early childhood context in the United States of America and other countries. When mothers see themselves interacting in a positive way with their children they feel their potential to maximize their child development. The professionals positive feedback together with the mothers´ self observation empower their parental sense of competence and self-esteem. The Strengthening Bonds team has a lot of experience in intervention programs, assistance, teaching, and research on early child development. All the members are Psychologys, specialists on child development with expertise in conducting interventions with parenting groups and assessment using psychometric instruments, questionnaires, and systematic observation of child development, behavioral problems, parenting practices, and mother-child interactions. The coordinator is professor and researcher in this field, since 1989, with also a large experience on training professionals and graduate students in child development, research and intervention projects in early child development, parenting, and Pediatric Psychology, with financial support from the main funding agencies in Brazil. She is a researcher level 1-A (CNPq) in Brazil.

What kind of impact will your idea have? (1500 characters)

Impact: i) To obtain a valid model of universal preventive program for strengthen mothers-children positive interactions and positive parenting practices with them; ii) Improve mothers' self awareness about their interactions, improve their behavior and parental sense of competence. Targets: i) Improve knowledge on child development, parenting and mother-child positive interactions; ii) Improve positive behavior during mother-child interactive context; iii) Improve knowledge on the importance of play to improve positive mother-child interaction in daily activities. The program has the potential to promote wider positive changes: i) improve mothers´ sense of competence and self-regulation, enable social connections; ii) reduce child internalizing and externalizing behavior problems and improve self-regulation; iii) improve mother-child interactions; improve family dynamic. To measure our impact we have an evaluation plan. The evaluation will be conducted during the two home visiting, pre- and post-intervention. An assessment of mother-child interactions will be performed by systematic structured observation of mother child-interactions in the natural setting of the home; video recorder and later analysis of a validated categorical system of analysis. We are also going to use questionnaires, including the Parenting and Family Adjustment Scales, the Parenting Sense of Competence Scale, the Strengths and Difficulties Questionnaire, and other complementary measures.

How does or how could your idea impact low-income children? (1500 characters)

The present innovative technology tool address challenges of low-income families facing adversity. The program has a low cost and is accessible by low-income families. Considering that the program is mainly conducted using remote technology, accessible for low income families, it facilitates the participation and adherence to the program.

Innovation: What makes your concept innovative? (5000 characters)

The big idea of our project is an universal intervention program using the remote video coaching approach with videoclips personalized sending via smartphone. Usually, the intervention programs use face-to-face video coaching. Our program advances being remote and combining animated an real mother and children interactions aiming to enhance mothers' self-awareness, behavior change and parental self of competence. Additionally, the intervention was designed based on the Ideas Framework of the Frontiers of Innovation of the Center on Developing Child of University of Harvard. The three components of Theory of Change, Materials, and Evaluation was well defined in the Strengthening Bons Program. The program follow a concept of Modularity, that can be used alone or combined with other evidence-based programs. We have used the preliminary prototype of the with ACT-Raising Safe Kids. The results of the preliminary tests showed promising findings.

Scale: Describe how your idea could reach a significant number of end-users. (1500 characters)

If we obtain positive evidence-based using model proposed, we have a potential model to generalize for other new and similar populations. The model of intervention will provide implementation guide to train and support facilitators of the programs. It is important to note that the proposal has a sustained impact at scale. The Strengthening Bonds program is easy to train and is a low-cost program. Additionally, the program could be implemented in different contexts of Health, Education, Social assistance, and Legal sectors. The use of apps (e.g. Whatsapp and YouTube) via smartphone to send the video clips about parent-child interactions can be used on a large scale. An option to facilitate, broaden and reach a larger number of people would be the families themselves record play situations of parent-child interactions and send to the facilitators prepare the remote video-coaching.

Feasibility: Where are you with understanding the feasibility of your idea? Describe what you’ve done so far and your plans. (3000 characters)

We concluded the test of feasibility of the remote video-coaching Strengthening Bonds and the first two cicles of pilot test, in the context of the I-Lab, grant of the Fundação Maria Cecília Souto Vidigal, associated with the Frontiers of Innovation of the Harvard University. The Strengthening Bonds is a low cost program, that presents the characteristic of MODULARITY. As proposed in IDEAS framework (Frontiers of Innovation; Center on the Developing Child, Harvard University), "Modular programs can be implemented with ease in existing programs or service structures because teams can incorporate the specific components that make sense for their programs. This approach offers a practical and cost-effective pathway to targeted scaling. Understanding why different programs or their components are effective for different populations can help us identify a program’s “key ingredients,” which can then be incorporated, in suitable mixes, into broader service systems. We already conducted a pilot test with the Strengthening Bonds alone (cycle 1) and as a modularity with an evidence based parenting program, named ACT Raising safe Kids Program, developed by the American Psychological Association (cicle 2). On both ways, the program showed to be applicable. Health professionals, from the Family Health Center, where the program was tested, evaluated positively the program. The low income participants uses smarthpone daily and using this strategy was easy and accessible for them. The use of apps that the parents already used (e.g. whatsapp) to send the links of the videos was also adequate. Uploading the videos on YouTube in an unlisted way proved to be easily accessible. We verified that all the pilot participants mothers accessed the videos and viewed more than once, as was verified in the YouTube records, and according to the mothers´report. The mothers also reported that they shared the link with other relatives (e.g., the father of the child) and with the children. In addition to providing information to mothers about positive interactions with children, this innovative technology tool provides an opportunity for self-observation and self-assessment to become more awareness and to strengthen the early relationships and caregivers´responsiveness to children´s needs.

Business Viability: How viable is your business model? (5000 characters)

The Strengthening Bonds Program has a business viability. After the conclusion the last steps to advance in the training of edition of videos procedure of new facilitators and in the fidelity tools, we can have a low-cost program of positive mother-child interactions. The program has a potential scalability in public and private setting of families with 1-3 year old children, because is easy implemented. The potential barriers are the recruitment and retainment of low-income population in the program, requiring strategies to retain the users. Also, we have to maintain a center of training to better guarantee the fidelity of content and procedures of the intervention program.

HCD: How have you used human centered design to build or refine your concept? (5000 characters)

During the prototyping of the intervention the procedures were human centered-based. An ethnographic study, including home visit and interviews with 10 mothers was conducted to understand the mothers' environmental contexts and needs. Also, feasibility tests were carried out including interviews to obtain users` feedback about the intervention program using remote video coaching. The feedback focused the content, the materials, and the procedure for sending the videos via smartphone. Additionally, the professionals of the Family Health Center participated in the face-to-face session for discussing the concepts and examples of positive mother-child interactions and the program viable. Bellow are some feedbacks of mothers who participated in the program: 1) "The first time I saw the video I found it very cute and funny. It is a very important thing because it teaches us how to treat our children and how we should play more. It is a new experience and I was very surprised when I saw it, and I showed to my husband and my son. I asked my son if he liked it and he told me that it was beautiful. We watched it 4, 5 times, every time we watched it. We liked it a lot". 2) "I really liked the videos and it helped me realize how enjoyable it is to play with my child, because we often do not play with him and I've seen where I can improve". 3) "I liked the videos very much, because I did not know that I played well and I saw how important it is to always play with the child and always interact, talk and encourage the child to talk. For example, today when my daughter asked for help was really cool, and it is important in the life of every mother and father, because when we play for the children is happiness. It's very good".

Tell us more about you (3000 characters)

The Strengthening Bonds team members are from the Laboratory of Research on Prevention of Child Development and Behavior Problems (LAPREDES; http://lapredes.fmrp.usp.br). The Strengthening Bonds Program was developed in the context of the I-Lab, grant of the Fundação Maria Cecília Souto Vidigal (http://www.fmcsv.org.br/pt-br/o-que-fazemos/ncpi/Paginas/iLab.aspx), associated with Frontiers of Innovation (FOI) of the Center on the Developing Child Harvard University (Latin American Innovation Clusters; https://developingchild.harvard.edu/innovation-application/innovation-approach/latin-american-innovation-clusters/). The Theory of Change hypothesizes that in order to achieve breakthrough outcomes for children, we must actively build the self-regulation skills, executive functioning, and mental health of the adults who care for them. The program is linked with an Integrated Innovation approach, considering that it coordinates application scientific/technological, psicossocial and policies innovations to develop solutions in poor parenting interactions and practices. This innovation idea emerged after an ethnographic study with mothers, who participated in a evidence based parenting program (ACT - Raising Safe Kids). After this study and the participation of team members on the FOI Learning Community workshops, we observed a need for an additional tool where mothers could self-observe and receive a feedback of their interaction with the children. Additionally, we identified that parent-facing technology resources could facilitate the mediation of information for parents to improve parent-child positive interactions outcomes. In this context, we developed the first version of the materials for intervention (animated videos, handouts) and the Implementation Guide for facilitators, which include the description of the following topics: theoretical framework, objective, material, general procedures and instructions, edition videos procedures, recommendations, and training of facilitators.

Do you have the people and partners you need to do what you’ve described? (600 characters)

Yes, we have team members qualified working on the project, since 2016. However, we need financial support to facilitate the implementation of the program, including: i) technical support on information technology to improve the procedure of video editing and elaboration of a platform for this purpose; ii) support for an e-learning course to prepare new facilitators; iii) support for communication and marketing of the program. Therefore, we need this additional resources to reach a significant number of end-users for enlarge to scale.

As you consider your next steps, what kinds of help could you use? Is there a type of expertise that would be most helpful? (1800 characters)

We need help on expertises on development of online video editing platforms and communication and marketing.

Would you like mentoring support?

  • Yes

If so, what type of mentoring support do you think you need? (1200 characters)

We need help on expertises on e-learning training, development of online video editing platforms, and communication and marketing of the program.

Are you willing to share your email contact information submitted on OpenIDEO with Gary Community Investments?

  • Yes, share my contact information

[Optional] Biography: Upload your biography. Please include links to relevant information (portfolio, LinkedIn profile, organization website, etc).

LAPREDES - http://lapredes.fmrp.usp.br/equipe-2 - Maria Beatriz Martins Linhares, Psy, PhD, Professor and Researcher (Coordinator) https://scholar.google.com/citations?user=Gs6CO3oAAAAJ&hl=en; http://lattes.cnpq.br/7958311766450761 - Claudia Maria Gaspardo, Psy, PhD, Researcher https://scholar.google.com/citations?user=k9fu3BYAAAAJ&hl=en - Elisa Rachel Pisani Altafim , Psy, PhD, Researcher https://scholar.google.com/citations?user=J-z- - Rebeca C. de Oliveira, Psy, Assistant R

[Optional] Attachments: Please upload relevant attachments or graphics or show us how you prototyped.

This is our Theory of change, based on the IDEAS Framework (Frontiers of Innovation - Harvard), to explain the impacts of our program.

[Optional] Video: You are invited to submit a 30-60 second video that introduces you and/or your team and your idea.

This video attached is an example of the video clips sent for the mothers´smartphones. Each video clip includes the following: i) Three animations explaining the constructs; and ii) Three small clips of mothers' own personalized video with positive feedbacks presented through subtitles and emojis.

Geography

We are located in the state of São Paulo in Brazil, Latin America. The innovation that we prototyped fit in different countries that have chid rearing centered in mothers as main provider. The mother-child interactions with reciprocity, responsiveness, and directivity are universal positive relations to promote early childhood development. The smartphone, as a media to send the videos and messages about positive interactions, is an great advance. The program could be implemented in USA.

Mentorship: How was your idea supported? [Relevant only for our early submission participants] (1500 characters)

We had a nice video call with the mentor Amanda C Lim. We get new ideas about marketing and technology support for the intervention program. For the video call we made a presentation that is attached and explain better our idea. Together with our mentor, the team could have many brainstorm ideas and insights from her suggestions aiming to improve our proposal. New potential solutions to enhance the technological aspects of the program could be more easily accomplished! We also have expanded the recruitment sites to different locations where mothers can be found. We also held meetings with three other outside mentors to improve our idea. We had a meeting with a computer engineer to discuss the development of an online platform and existing programs that could help us expand the program. We also talked to two coordinators of large-scale intervention programs. In one meeting we learned more about facilitator training and an exclusive online platform for facilitators for training, support, consolidation and retrieval strategies. With the other coordinator we talked more about video editing and team training.

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