535 - Caregiver Engagement, Relational Mechanisms, and Satisfaction in Remote Delivery of PlayReadVIP among Families Participating in The Pittsburgh Study

Publication Number: 4523.535

Jinjoo Kim, New York University Grossman School of Medicine, New York, NY, United States; Erin Roby, NYU Grossman School of Medicine, Hawthorne, NJ, United States; Anne Seery, New York University Grossman School of Medicine, New York, NY, United States; Caitlin F. Canfield, NYU Grossman School of Medicine, New York, NY, United States; Xochitl Arechiga, New York University Grossman School of Medicine, Brooklyn, NY, United States; Chelsea Krug, University of Pittsburgh, Pittsburgh, PA, United States; Daniel S. S. Shaw, University of Pittsburgh, Pittsburgh, PA, United States; Alan L. Mendelsohn, New York University Grossman School of Medicine, New York, NY, United States

Background: PlayReadVIP (formerly Video Interaction Project) is an early relational health (ERH) intervention originally designed for pediatric visits that uses real-time video feedback to identify and reinforce parent-child strengths, supporting early development and school readiness. Following the pandemic onset, a remote adaptation of PlayReadVIP was implemented within The Pittsburgh Study, a population-level, tiered ERH initiative. Caregiver engagement with program materials may be an important contributor to satisfaction and impact, especially during remote delivery when in-person contact is limited.

Objective: To examine behavioral and relational mechanisms underlying caregiver satisfaction with remote PlayReadVIP delivery, with a focus on pathways through relational factors such as parental confidence and stress reduction in a diverse pediatric cohort.

Design/Methods: TPS enrolled English-speaking families with children between birth to 4 years. From 2022-2025, 425 surveys from 265 caregivers (44% completed multiple surveys) assessed satisfaction, engagement, and relational constructs using thirteen items (α=0.84). Confirmatory factor analysis supported the scale's structure (RMSEA=0.06, CFI=0.95, TLI=0.94). The cohort was predominantly biological mothers (97%), with 45% White, 34% Black, and 15% multiracial; 54% reported income <$30K, and 47% were single parents. Multilevel mediation models (accounting for clustered repeated measures and demographics including maternal and child race, child sex, household income, and maternal employment) tested engagement (use of materials, intentional time, increased frequency) as predictors of satisfaction, with parental confidence and reduced stress as mediators.

Results: Most caregivers reported being "very satisfied" (77%) and would "definitely recommend" (82%) the program. Higher engagement-use of PlayReadVIP materials (β=.07, p<.01) and frequent reading/play (β=.13, p<.05)-was significantly associated with greater satisfaction. The effect of engagement on satisfaction was partially explained (Figure 1) by increased parent confidence (β=.02, p=.01), while mediation via stress reduction was positive but not statistically significant. Mediation model fit was supported (LR χ²(2)=20.6, p<.001); bootstrap confirmed robustness (β=.74, SE: 0.17, z=4.34, p<.001).

Conclusion(s): This study is the first to evaluate caregiver satisfaction with remote PlayReadVIP. Parent confidence was the key link between engagement and satisfaction. Remote delivery supported ERH engagement and satisfaction while lowering barriers and advancing equity for underserved families.

Multilevel Mediation: Engagement Behaviors Predict PlayReadVIP Program Satisfaction via Confidence and Stress Pathways