For the RCT, the investigators will recruit Head Start participants with help from the
home visitors (using procedures that are similar to phase 1 recruitment procedures). The
home visitors will read a short script about the study to eligible clients; it will be
emphasized that the Head Start services they receive will not be impacted by their
decision about whether or not to participate. Interested caregivers will sign a release
form for the home visitors to provide the caregiver's contact information to study
personnel. A Graduate Research Assistant (GRA) will then call the caregivers and will
read a recruitment script. If the caregiver is interested in participating, the GRA will
set up a meeting in the caregiver's home to complete consent and baseline measures.
Caregivers will be eligible to participate if they are the primary caregiver (male or
female) for at least one child in the target age range (3-4 years-of-age), the caregiver
can speak and read English, and the caregiver did not participate in the focus group
study. The investigators will exclude families in which the target child has been
diagnosed with a pervasive developmental disorder or is blind or deaf because such
conditions often result in specialized supervision requirements, and the investigators
have not tailored the intervention to be appropriate for such families. Later research
may examine whether the intervention or a modified version of it, is appropriate for such
families. If there is more than one child in the home who is attending Head Start and is
between the ages of 3-4 years, the investigators will use a random procedure to choose
the target child. Participants who consent will be randomly assigned to either the
treatment or control condition by the primary investigator after the consent appointment.
A blinded design will be used so the GRA who will collect data will not know who is in
the treatment group.
A GRA and URA will administer baseline, post-test, and follow-up assessments at
participants' homes. Baseline assessments will include three self-report measures of
caregiver supervision beliefs and practices, a measure of caregivers' injury beliefs, and
a measure of children's injury history. The investigators will also conduct an
observation of in-home supervision and collect data on current injuries. The baseline,
post, and follow-up sessions will take approximately one hour. If needed, the GRA will
assist caregivers with low literacy to complete the measures by reading the measures
aloud or by answering questions about the measures. The investigators have used this
approach successfully in previous studies (Damashek & Corlis, 2017; Damashek, Hughes,
Chahin, & Corlis, 2017). After the baseline session, primary caregivers randomized to the
treatment condition will participate in one-hour intervention sessions in their home for
5 weeks. Those randomized to the treatment group will receive the tailored SHS
intervention in addition to their Head Start home visiting services (SHS+SAU); those
randomized to the control group will only receive the Head Start home visiting services
(SAU). A GRA will deliver the intervention to the treatment group and will be assisted by
an Undergraduate Research Assistant (URA). The GRA will be trained by the co-investigator
to deliver SHS and will use a manual to guide delivery (based on previous work,
Morrongiello et al., 2017).
A week after the last intervention session (or an equivalent time period for the control
group), the GRA and URA will return to the participant's home and will re-administer the
same measures taken at baseline, in addition to questionnaires assessing their
satisfaction with the intervention and perception of the intervention's cultural
acceptability. The investigators will conduct a 1-month follow-up to assess for
sustainability of effects during which the investigators will administer the same
supervision and injury measures as at baseline.
In addition to self-report measures, the investigators will conduct pre-, post-, and
follow-up observational assessments of maternal supervision, based on an innovative
testing protocol developed by Morrongiello and her colleagues (Morrongiello, McArthur,
Goodman, & Bell, 2015). During the data collection appointments, the investigators will
set up a situation in which the investigators will observe caregivers' supervision of
their child while they are distracted and while their child is exposed to an interesting
and potentially hazardous object (a "gadget", see Measures).
The investigators will also collect data on children's minor everyday injury frequencies
using a structured injury interview that will be administered weekly via telephone; this
measure has been used in previous research by the PI (Damashek & Corlis, 2017). The first
interview will be administered in person during the baseline data collection session. A
second baseline injury interview will occur 1 week before caregivers participate in their
first intervention session. Additional administrations will occur weekly via telephone
through the follow-up data collection appointment.