Performing Department
(N/A)
Non Technical Summary
In recent years, there has been a growing number of children identified as having speech, language, and literacy challenges. The field of speech-language pathology cannot meet the rising demand for speech and language services, and faces a critical shortage of speech-language pathologists nationwide. This has led to considerable and costly delays in the initiation of treatment for children in need, including those in the crucial developmental phase from birth to 3 years of age who require early intervention services. When children fall behind in these early stages, it can lead to long-term educational challenges and wider economic impacts, as these children may require additional support throughout their schooling and many never 'catch-up'. Furthermore, in rural areas, where resources and specialists like speech-language pathologists are often scarce, or non-existent, these developmental delays can go unaddressed, widening the gap in educational and health equity.To tackle this problem, our project introduces an innovative approach that involves training Community Health Workers (CHWs), individuals from these very communities, to provide tailored support to families. These CHWs will receive virtual training that has been customized to their exact communities, equipping them with the tools and knowledge to assist caregivers in fostering early language and literacy development. We plan to create and distribute easy-to-understand, culturally relevant content for both CHWs and caregivers, ensuring it resonates with the diverse needs of rural families. The idea is not just to teach, but to empower caregivers with practical skills and knowledge they can apply in their daily interactions with their children.Our goal is to bridge the gap in early developmental support in rural areas. By equipping local health workers and caregivers with the right tools and knowledge, we aim to foster a nurturing environment for young children's growth. The success of this project could lead to more children entering school ready to learn and succeed, reducing the long-term educational and social costs. In essence, we're not just enhancing individual children's lives; we're investing in the future of our communities by laying a stronger foundation for our youngest members.
Animal Health Component
50%
Research Effort Categories
Basic
(N/A)
Applied
50%
Developmental
50%
Goals / Objectives
Major Goal:The overarching goal of our Phase I proposal is to establish and validate an innovative content creation and service delivery model that leverages Community Health Workers (CHWs) to provide crucial support to underserved families in rural communities. This model aims to empower CHWs through comprehensive virtual training, enabling them to offer culturally and linguistically tailored online content to at risk populations. Our aim is to create a cost-effective, culturally responsive, repeatable process for developing resources for caregivers of children at risk for developmental delays, augmenting traditional services, and narrowing health disparities and inequities in underserved communities.Objectives:Develop Culturally and Linguistically Tailored Content: We will demonstrate the feasibility of creatingcontent for caregivers that is both culturally and linguistically appropriate, and replicable in terms of process and cost-efficiency. This involves overcoming challenges related to diverse parental preferences, cultural backgrounds, and linguistic needs, and establishing strategies for cost-effective content creation.Develop Comprehensive Virtual Training for CHWs: Our second objective is to create an effective virtual training program for CHWs. This includes understanding CHW preferences and requirements for virtual training and integrating various multimedia elements to enhance engagement. Accessibility for a diverse range of learners will be a key focus.Pilot Study to Test Feasibility and Acceptability: The third objective involves conducting a pilot study to test the overall feasibility and acceptability of the service delivery model. This will measure parent participation levels and assess the acceptability of the tailored content among families with diverse backgrounds.In conclusion, our project ambitiously seeks to innovate in the realm of content creation and delivery methods. Our goal is to develop, test, and refine a model that enables the rapid generation of effective, tailored training and resources. This approach is designed to cater to a wide variety of communities and peoples, addressing their unique cultural and linguistic needs. By doing so, we aim to significantly enhance the reach and impact of early intervention services, particularly in underserved rural areas. This initiative represents not just a step forward in service delivery, but a leap towards inclusivity, responsiveness, and adaptability in meeting the diverse needs of families requiring developmental support.
Project Methods
Our approach centers on task-shifting to address the healthcare gaps in underserved communities, aiming to provide equitable access to care. The model advocates for educating both Community Health Workers (CHWs) and parents of young children. While the Tutela Institute has existing online content for parents, the project seeks to enhance the service delivery model by creating a comprehensive training program tailored to the unique needs of CHWs. This training equips CHWs to effectively deliver developmental content, complemented by culturally and linguistically tailored materials for parents to ensure optimal support and engagement. In Phase I, the project aims to establish the feasibility of both training modalities by assessing requirements, preferences, and implementing content. Feedback from both CHWs and parents will guide the refinement of the program for a more robust Phase II. The approach leverages CHWs, a proven public health solution, and integrates evidence-based practices for early language development and principles of Parent-Implemented Interventions. We will collaborate with a nonprofit organization serving families in Eastern Colorado. The organization currently provides regular home visits from CHWs trained in evidence-based parenting programs, and works with a significant proportion of Spanish-speaking parents. CHWs in this program currently do not focus specifically on speech and language development, and families are facing extended wait times for speech and language services.Our project focuses on the following objectives:Objective 1: Demonstrate the feasibility of developing culturally and linguistically tailored content through a cost-effective and replicable content creation process.To achieve the first objective, we will begin by assessing the feasibility of developing culturally and linguistically tailored content. The study involves 10 parents currently working with our partner nonprofit program, representing both English-speaking and Spanish-speaking backgrounds. We will utilize semi-structured focus groups to gather insights on experiences and preferences related to early language and literacy development. Outcomes of interest include themes generated by focus group participants regarding their preferences for the delivery of online parent training content (e.g., length of videos, format of content, cultural perspectives on early language development). Data will be analyzed using thematic analysis to identify common themes and patterns across the discussions. This will inform the creation of 24 videos, addressing naturalistic interventions, produced in both English and Spanish. The iterative content development process integrates feedback from focus groups to ensure cultural relevance and engagement.Objective 2: Demonstrate the feasibility of developing a comprehensive virtual training that enables CHWs to provide tailored content for parents.In the second objective, the project focuses on empowering CHWs through a comprehensive virtual training program. Ten CHWs from rural Eastern Colorado counties participate in a Successive Approximation Model (SAM)-guided process. Learning objectives will be defined and prototypes will be developed. After an iterative content creation process, we will develop the full virtual course which will include a diverse array of multimedia elements such as videos, interactive activities, and case studies. The course will then transition into an evaluative phase, in which 4 CHWs will be invited to engage with the course in its near-final form. The course will undergo a revision process, aimed at addressing any shortcomings and incorporating suggestions. Finally, the course will transition into active engagement. All 10 CHWs will enroll in the course. We will measure the course's effectiveness in achieving the learning objectives by assessing learners' knowledge, attitudes, and practices related to the content (via online metrics and pre/post surveys), as well as their experience in completing the training (via focus groups).Objective 3: Prove the feasibility and acceptability of the proposed service delivery model via a pilot study.In the final objective, we will pilot the proposed service delivery model, involving both parents and CHWs. CHWs will deliver training content during home visits over three months, utilizing tablets preloaded with training videos. Primary outcomes of interest include feasibility and acceptability. Measures of feasibility include: (a) Percent of content viewed by the parent which will be self-reported by the parent at each session (target: 60% completed) and (b) Feedback from semi-structured focus groups from CHWs and parents and (c) collection of survey data. Parents and CHWs will complete a survey following the study including questions related to CHW-parent interaction, usability of training materials, and strategy use (target: 70% satisfaction). Acceptability will be measured by (a) Feedback from semi-structured focus groups for CHWs and parents and (b) collection of survey data. Parents and CHWs will complete a survey at the end of the study period including questions related to their satisfaction with the content and overall experience of the program (target: 70% satisfaction). To measure both feasibility and acceptability, semi-structured focus groups will be completed separately for CHWs and parents. Questions for all groups will focus on ease of use, relevance, perceived benefits, perceived barriers, facilitators, and suggestions for improvement related to the delivery model. We will also collect CHW perspectives on the potential for workforce development utilizing this model. As a secondary measure, the Focus on the Outcomes of Communication Under Six (FOCUS-34) will be used to assess initial child outcomes. This measure provides a change score that is used to determine whether the child has made clinically meaningful change, indicated by a shift of 11 or more points.40 Our target is for 6 out of 10 children to demonstrate meaningful change.In this Phase I project we aim to demonstrate successful content creation and dissemination, evaluate parental and CHW involvement and satisfaction, and establish a scalable protocol that can be used with diverse populations, paving the way for a novel service delivery model. Throughout the 12-month Phase I period, we anticipate delivering 48 parent training videos, a 3-hour CHW virtual training, and a pilot protocol for the combined early language program. The timeline reflects a systematic approach to achieving project objectives, ensuring the creation of impactful and culturally relevant resources for enhancing early language development in underserved communities