Supporting Rural Parents and Children: WIC Office Community Health Workers Delivery of Brief Parenting Education

Context: Reaching rural or low-income pregnant and postpartum women with parenting education designed to support healthy child development is difficult for a range of logistic reasons. Leveraging an existing program that serves this target population can alleviate the access barrier. An innovative and brief intervention, Baby & Me, was developed to provide critical parenting information timed to align with parents’ visits to Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) offices.

Objective: The objectives of this study are twofold: (1) to report the development and implementation of Baby & Me and (2) to ascertain the feasibility of integrating parenting education into the WIC system by examining the impact of Baby & Me.

Study Design and Analysis: Descriptive statistics and chi-square tests were used to examine participant characteristics and retention. Pre- and post-intervention differences in parent knowledge and behavior were collected through surveys and examined using paired-sample t-tests for each education module.

Setting: 17 WIC clinics in a rural southern state.

Population Studied: WIC clients in their 3rd trimester or with children < 1 month of age.

Intervention: Baby & Me was developed collaboratively between experts in child development and practitioners leading WIC programs. Participants were recruited to attend brief (20-30 min) seven monthly one-on-one parenting education modules (safe sleep, infant crying, routines, stress, home safety, discipline, and child development) provided by community health workers.

Outcome Measures: (a) Parent knowledge and (b) parent-reported behaviors assessments on content of each of the 7 modules. Assessments were developed based on existing research tools including Family Map Inventories.

Results: 587 participants were recruited with 245 (42%) of the women completing 5-7 modules. Parenting knowledge demonstrated significant improvements from baseline to post-intervention in all seven constructs with effect sizes ranging from .28 to 1.29. Self-reported parenting behaviors significantly improved from baseline to post-intervention in six of eight constructs with effect sizes ranging from .19 to .38.

Conclusions: These findings demonstrate that Baby & Me was associated with improved parenting knowledge and behavior. Our study supports the feasibility of incorporating a brief intervention in existing service settings, which could include behavioral health support in primary care.