460 - Integrating a Bilingual Mobile Application into Nurse-Led Home Visiting: A Feasibility Study on Infant Communication Development

Publication Number: 4451.460

Ashley Darcy Mahoney, George Washington School of Nursing, Washington, DC, United States; Annalyn Velasquez, George Washington Univeristy School of Nursing, Pembroke Pines, FL, United States; Anne Larson, Minnesota State University, Mankato, MN, United States; Katalina Figueras, Florida International University Herbert Wertheim College of Medicine, Miami, FL, United States; Ashley M. Soto, Florida International University, Miami, FL, United States; Melissa Baralt, Florida International University, Miami, FL, United States; Karen Rojas Arronte, Florida International University, Miami, FL, United States; Natalie Brito, Columbia University, New York, NY, United States; Rafaella Chavez, Florida International University, Miami, FL, United States

Background: Early caregiver-child interactions sculpt neural circuitry supporting communication and language. Nurse-Family Partnership (NFP), an evidence-based home visiting program for first-time mothers, shifted to telehealth delivery during COVID-19, providing an opportunity to integrate Háblame Bebé, a bilingual mobile platform combining developmental milestone tracking with caregiver-child communication enrichment and sociolinguistic pride promotion, into virtual visits with Hispanic families.

Objective: To evaluate the feasibility of integrating Háblame Bebé into virtual NFP visits and assess its effects on infants' early communication outcomes.

Design/Methods: Using a continuous quality improvement framework, Miami-Dade County NFP implemented Háblame Bebé over 12 months with Hispanic first-time mothers. Six nurses used the app as a culturally responsive coaching tool during telehealth visits. Quantitative data included nurse knowledge and confidence measures, app engagement analytics, and pre/post infant assessments using a virtually adapted Early Communication Indicator (ECI). In the last PDSA cycle, eight mother-infant dyads (M infant age = 9.2 mos) completed ECI measures assessing gestures, vocalizations, and word use. Pre/post comparisons were conducted with Wilcoxon signed-rank tests.

Results: Implementation was feasible and well accepted. Nurses demonstrated significant increases in knowledge (Z = −2.04, p = .041) and confidence in coaching caregiver-child interaction. Infant analyses revealed significant improvements in gestures (M = 16.5 → 26.75; Z = −2.383, p = .017), vocalizations (M = 7.75 → 32.75; Z = −2.521, p = .012), and single-word use (M = 0 → 8.63; Z = −2.366, p = .018).

Conclusion(s): Integrating a bilingual, strengths-based mobile app into nurse-led home visits is feasible and associated with measurable gains in early communication. Pairing trusted nursing relationships with culturally affirming digital tools can enhance early neurodevelopmental outcomes and promote linguistic identity during critical periods of brain growth. Nurses also demonstrated significant increases in knowledge, confidence, and cultural responsiveness when coaching families, underscoring the dual impact of this model on both provider capacity and family outcomes.

Impact: Technology-enabled, nurse-delivered coaching offers a scalable model to extend early neurodevelopmental support from the NICU to the home, strengthening trajectories that underlie later learning, health, and well-being across diverse communities.

Figure X. Plan-Do-Study-Act (PDSA) framework for the Háblame Bebé + Nurse-Family Partnership (NFP) Precision Home Visiting study.
This figure depicts three iterative 10-week PDSA cycles (8 weeks implementation, 2 weeks analysis) used to co-design and refine integration of the Háblame Bebé bilingual language-promotion app within the Nurse-Family Partnership model. Each cycle includes team planning, data review, and action to improve implementation. Measures track nurses' knowledge, experience, and comfort using the app, as well as mothers' engagement and app use. Pre- and post-intervention assessments evaluate changes in nurses' knowledge of early brain development, serve-and-return, and bilingualism.

Figure X. Háblame Bebé app interface illustrating caregiver engagement and progress tracking.
Screenshot of the Háblame Bebé bilingual app, which promotes early language development and caregiver-child interaction. Parents earn "hearts" for activities like tracking milestones, adding new words, and watching learning videos. The progress vine displays cumulative engagement, encouraging continued participation and positive caregiver behaviors.