A mixed-method evaluation of video interaction guidance (VIG) delivered by early-years workers in a socially disadvantaged urban community. Issue 5 (4th August 2021) - Chakkalackal, Lauren
Abstract : Purpose: The transition to parenthood can pose challenges for women and men, and these are heightened in the context of social disadvantage (e.g. poverty, deprivation, social exclusion, housing instability and disabilities). There is mounting evidence that video-feedback approaches can provide a valuable buffer against such adverse outcomes. This study aims to evaluate the acceptability and preliminary clinical impact of video interaction guidance (VIG), delivered by health visitors and community support workers in a socially disadvantaged London borough, selected due to its multiple indices of deprivation predicting child and maternal adversity. Design/methodology/approach: The study followed a non-randomised, before-and-after evaluation design. Health visitors and community support workers were trained in VIG delivery following the VIG Association-UK protocol. Families with infants under 12 months were conveniently recruited and received six weekly home-based sessions of VIG. The primary outcome was the acceptability of the intervention, assessing parents' experiences using semi-structured interviews post-intervention. Clinical outcome measures were recorded pre-and post-intervention to yield preliminary evidence on intervention effectiveness. Findings: In total, 23 families partook in the study, of which 19 completed the pre- and post-VIG quantitative analysis and 6 also completed the post-VIG qualitative interviews. Qualitative analyses documented high rates of acceptability and perceived improvement in family well-being. Preliminary outcome data indicated that completing the VIG intervention was associated with decreased parental anxiety and depression and increased parental confidence, parent-infant relationship quality, as well as an improvement in infant social and emotional development. However, the selective nature of convenience sampling limits the generalisability of the findings. The non-randomised design of the evaluation implies that findings can only be interpreted as preliminary evidence of intervention effectiveness. These considerations are addressed in the discussion. Originality/value: The results of this study provide preliminary evidence of the acceptability and effectiveness of VIG delivery by health visitors and community support workers to new parents in socially disadvantaged urban communities. However, this study must be pursued further to be evaluated with larger, randomised samples to further explore the generalisability of VIG effectiveness in such settings.