The first 3 years of a child’s life are critical in setting the stage for future learning, behavior, and health. Children living in poverty during these formative years are exposed to environments characterized by insufficient human service resources and greater exposure to multiple forms and frequency of adverse events, which can undermine their developmental potential. Home visiting has become a critical resource nation-wide for enhancing parents’ competencies in strengthening their children’s social-emotional and school readiness development. Early Head Start (EHS) home visitor programs are intentionally positioned to enhance children’s natural support systems (including parent-child relationships) and establish a long-lasting network of supports benefiting children’s development and school readiness. In 2020, EHS provided 4,632,050 home visits to over 160,000 infants/toddlers and their families nationally. A significant gap persists in the EHS home visitor field. There is an unmet need for training in coaching and professional reflective practice targeted to the intersection of occupational health and HV competencies. Targeted training in coaching and facilitation of reflective practices would strengthen HVs provision of evidence-based, parent-mediated interventions promoting healthy infant/toddler social, emotional, and language growth. This training would also provide a needed pathway to career advancement, and prepare them as coaches for the EHS home visiting system. These resources do not now exist. This STTR Phase I application is designed to help close this gap. We will develop a training program in coaching and reflective practice, called Practice WellnessTM, to meet EHS’s need for an engaging, effective, skill-based professional practice tool for HVs. Practice Wellness will draw on our expertise in home visitor and intervention research, and employ a unique parallel training process to: (a) empower HVs to identify and resolve their own occupational wellness needs and expand their competencies with coaching skills, and (b) strengthen HV parent coaching interactions with the goal of enhancing child development outcomes. The two goals of this study are to (1) develop a prototype for Practice Wellness HV eLearning coaching and reflective practices skill training, using iterative development in consultation with a 6-member Advisory Board; and (2) evaluate the usability and feasibility of Practice Wellness with a user group of 12 home visitors and 6 supervisors. If Phase I benchmarks are met , we plan to submit a Phase II application in which we will modify Practice Wellness according to feedback obtained from the Phase I Advisory Board and user group participants and evaluate the efficacy of Practice Wellness via a randomized control trial with HVs on their coaching and reflective practice knowledge, self-efficacy, practices, and parent engagement and child outcomes in under-resourced families.

Project Narrative Early childhood is a critical time in children’s development to intervene for preventing emergent health disparities in physical, psychological, social, and language development. Home visiting programs have become a critical resource for enhancing parents’ competencies to strengthen the early social-emotional and language development of their children. The proposed project seeks to develop and evaluate an evidence-based training tailored to the needs of home visitors that will develop coaching skills and reflective practices capable of improving parent-mediated child development outcomes among low-resourced families.