Video Tools for Mental Health Interventions: an RCT Pilot Study of Infant-Net, Presentation at Medicine 2.0 conference, November 2010, in Maastricht, the Netherlands.

1. Video Tools for Mental Health Interventions:
an RCT Pilot Study of Infant-Net
Ed Feil, Ph.D, Kathleen M. Baggett, PhD, Betsy Davis, Ph.D.,
Lisa Sheeber, Ph.D., Susan Landry, Ph.D. & Judith J. Carta, Ph.D.
Oregon Research Institute , University of Kansas & University of Texas
Medicine 2.0, Maastricht, NL, November 29, 2010
Funded by National Institutes of Health (R34 MH073756 & R01 HD064870)
For more information: edf@ori.org
1

2. Barriers to mental health services
in rural areas:
• Distance
• Few professionals
• Higher risk due to
• poverty & isolation
2

3. http://www.pewinternet.org/Data-Tools/Download-Data/~/media/Infographics/Trend%20Data/January 3
%202009%20updates/Internet%20Diffusion%201%206%2009.jpg

4. 4

5. 5

6. 6

7. Conceptual and Practical Advantages and
Promises
• Convenience
cost, scheduling, transportation
• Availability
24 hours, there when needed
• Accessibility
home, work, libraries, community centers
• Ease of use
even my mother uses it
7

8. Methodological Features
• Control over exposure to intervention
• Extensive online data on utilization, participant
preferences, & content of all messages
• Multiple measures of key processes and
outcomes
8

9. Virtual Community
Social Support Group
Focus Forums
Social Networking
9

10. Home visiting program for mothers of
infants at risk (very low birth weight)
• Can we adapt for computer & Internet?
• Ease of use acceptable?
• Will moms use it?
• Can we create a similar personal connection
with “coach” as in in-vivo intervention.
10

11. Website Components
• Play & Learning Program
• Internet or hybrid -hard drive display
• Record video
• Weekly Coach Call for concepts & video
review
• Moderated peer support
• Internet access
Link to parenting websites
11

12. Play and Learning Series
(Landry & Smith, 1996)
12

13. Session Organization
• Discover
– Presentation of concepts, behaviors, and examples
• Check-in questions
• Make 5 minute mom-infant video
• Summary
• Daily Activity
– Homework
• Feedback
• Coach Call
13

14. Demonstration
website
video_demo/standalone.html
.
14

15. 15

16. 16

17. 17

18. 18

19. 19

20. 20

21. 21

22. 22

23. 23

24. Participants
• Recruited from flyers, WIC office,
nurse home visitors
• Not receiving other services (e.g.
Healthy Start & net income with WIC
guidelines
• N=38 (2 drops) randomized to
Experimental or Control
• Mother’s Age ave=25.7 (SD=4.8)
24
• Infant’s Age ave=4.8 month (SD=2.4)

25. Participants
• Mother’s Race/Ethnicity
– 12.5% Hispanic, 2.5% American
Indian, 5% Black, 12.5% Other
• Infant’s Race/Ethnicity
– 22.5% Hispanic, 5% American Indian,
2.5% Asian, 5% Black, 20% Other
25

26. Participants
• Education
– 27.5% HS/GED & 42% Some College
• Employment
– 30% working (17.5% part)
– 12.5% Looking for work
– 55% not working by choice
• Marital Status
– 15% single, 45% married, 35% living together
26

27. Participants
• Computer Familiarity
– 2.5% not at all
– 15% somewhat
– 30% moderately &
– 50% Very
• Computer Comfortability
– 2.5% Not at all
– 27.5 moderately &
– 65% very
• 77.5% Computer Ownership
27

28. Satisfaction
90%
80%
70%
60%
50%
Do you think the videos in
40%
the training sessions helped
30%
you learn the information?
20%
Would you recommend this
10% website to a friend?
0%
No,
During calls: coach
definitely
No, understood me and baby
not
probably
not Uncertain
yes,
Probably
Yes,
Definitely
28

29. Satisfaction
How easy was it for you
90%
to use the InfantNet
80% website to find
70% information?
60%
50% How easy was it for you
40% to understand the
30% information (audio and
20% text) provided in the
10%
training?
0%
How easy was it for you
Very Difficult to use the camera to
Somewhat
difficult Uncertain videotape your baby and
Somewhat
easy Very easy you?
29

30. Infant Positive Behaviors
Landry Observation
Experimental
Control
p<.05
Medium/large effect size
Eta-squared (η2)=.107
.01 ~ small
.06 ~ medium
.14 ~ large
Pre Post
30

31. Parent Positive Behaviors
Landry Observation
Experimental
p>.05 (ns)
Medium effect size
Control
Eta-squared (η2)=.049
.01 ~ small
.06 ~ medium
.14 ~ large
Pre Post 31

32. Usage: 393 hours (20.67 ave per parent)
Mid-4am
5am-11am
noon-5pm
6pm-11pm
32

33. Usage Hours by Participant
50.0
46.1
44.4
45.0
40.0
35.0
29.0 29.6 29.1
30.0
27.1
25.0
22.0
20.6 20.2
19.3
20.0
17.2
14.8 15.3
14.3
15.0 13.4
11.6 12.1
10.0
5.0 3.3 2.9
0.4
0.0
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
33

34. Usage Hours by Type and Session
100%
90%
80%
70%
60%
50% Coach Call
Video
40%
Discover
30% Check-in Ques.
Summary
20%
Daily Activity
10%
0%
01
02
03
04
05
06
07
08
09
10
11 34

35. Implications for the Future
• Results very promising
• Need RCT with adequate power
• Extending the reach and penetration of
parenting interventions
• Emerging technologies
Handheld mobility
iPhone & Wireless Internet access
Voice recognition
Convergence among technologies 35

36. Discussion and Questions
36