The overall goal of this proposed Mentored Patient-Oriented Career Development Award (K23) is for the candidate, Dr. Reshma Shah, to become an independent clinical investigator with a focus on primary care- based strategies to improve early child development in low-income families. Recognized by the NICHD as a target for research to improve early child development and school readiness among at-risk families, the primary care setting offers an ideal opportunity to reach the millions of children who live in poverty. To develop, implement, and evaluate preventive primary care delivered strategies that support early child development the candidate requires additional formal training in the following important areas: 1) the design, execution, and analysis of clinical trials in the primary care setting, 2) qualitative methods and longitudinal data analysis for intervention development, 3) childhood development and its social determinants, and 4) professional development through scientific publications and presentations. The proposed research plan will integrate these training objectives and be implemented with the support of the candidate's mentorship team, which includes experts in each of these areas. The overall objective of the proposed research plan is to develop and pilot test a brief, theory-based intervention delivered in the primary care setting. Grounded in social cognitive theory and modeled after the widely disseminated literacy program Reach Out and Read, the intervention aims to enrich positive parenting behaviors and promote early child development in low-income families. By pursuing the following specific aims, the candidate will gather data essential to test its efficacy on parental and child outcomes (to be proposed in a subsequent R01).
In Aim 1, the candidate will utilize qualitative methods and conduct focus groups and semi-structured interviews with key stakeholders (i.e., parents, clinicians, clinical staff and administrators of the proposed intervention) to inform intervention development and identify barriers to implementation.
In Aim 2, the developed intervention will be tested via a pilot longitudinal randomized controlled trial to determine the feasibility of protocol implementation and to investigate the potential impact on parental outcomes. The training and research plan will complement the candidate's strong clinical background in developmental-behavioral pediatrics, serve as a framework to develop accessible and sustainable clinical interventions that seek to enhance early child development, and prepare the candidate for long-term independence as a clinical researcher.
Poverty-related educational disparities are set forth in the first three years of a child's life. The proposed research is relevant to public health in that it is offers a population-level approach to encourage positive parenting behaviors and promote early child developmental outcomes in low-income families, precursors of later educational achievement. This project is directly responsive to the NICHD's call for the primary care setting as a target for research to improve early school readiness among at-risk families.
