Project 467503

Addressing the impact of early childhood adversity (e.g. family violence, parental depression, low-income) can promote children's mental health and development, giving children the best start in life and reducing societal health inequities. Family violence, depression and low-income undermine parent-child relationship quality linked to mental health and developmental problems in children that tend to persist over the lifespan. Parents' reflective function (RF), i.e. capacity to understand their own and their child's thoughts, feelings, and mental states, can strengthen parent-child relationships, and buffer the negative impacts of early adversity on children. We have developed and tested an effective intervention program called ATTACH (Attachment and Child Health) for parents and their preschool-aged children at-risk from early adversity. In research with 90 families, we found the intervention significantly improved RF, parent-child relationship quality, and children's mental health and development. When COVID-19 prevented in-person intervention at the same time as demand soared for ATTACH, we developed and pilot tested (n=10) an Online Application or "App" with our community partners including parents, to deliver the program virtually. With 100 families, we propose to implement and evaluate the ATTACH Online App impacts on: (1a) children's mental health and development, as well as parent-child relationship quality (primary outcome), and parental reflective function immediately and 3 months after intervention, (1b) different patient populations (for whom program works best/worst), and (1c) health professionals' adherence to the clinical intervention protocol. With ~60 knowledge users (patients/parents, health care professionals and administrators), we will examine the feasibility of the ATTACH Online App via: (2a) knowledge users' perceptions and experiences of the App, (2b) App uptake, and (2c) App implementation benefits, facilitators, barriers, and challenges.