Conference Agenda

Background: Insensitive caregiving predicts insecure parent-child relationships, and the intertwined conditions of poorer executive functioning, externalizing problems, and overweight/obesity. As such, a worthwhile goal is the careful examination of interventions to improve sensitive care and their impact on downstream child outcomes. One important consideration for such research is whether to include an active control arm, as this decision may impact subject adherence and the specificity of intervention effects. This presentation discusses the inclusion of a purposefully designed “Neuroeducation for Parents (E)” control-arm within the context of the LOVING research program, which will culminate in a 624-family randomized controlled trial.

Methods: Twenty-five parents (see Table 1 Demographics) of young children living in Singapore participated in the online, bi-weekly E program, containing videos about young children’s Brain Basics, Seven Senses, Learning and Memory, Emotion, Curiosity and Creativity, Thinking, and Friendships. Sensitive caregiving is not discussed explicitly. Viewer metrics were recorded. Acceptability questionnaires were administered following each session and after program completion.

Results: The overall completion rate was 92.69% (88.24% to 98.32% per video). Parents most frequently endorsed the Emotions (n = 9) or Socioemotional Learning (n = 8) sessions as most useful, and Brain Basics as least useful (n =17). All but one parent reported being motivated to complete the programme due to reasons including; topic interest and relevance, animation/video engagement, easy access and program reminders.

Conclusion: The program was acceptable to parents and is unlikely to lead to participant dropout if implemented as an active control in trials of conceptually distinct interventions. Based on participant recommendations, a slightly modified version is currently being used in LOVING’s pilot RCT, and its impact upon change in parental knowledge, as well as sensitivity, is being investigated.

Purpose: Sensitive caregiving predicts mental health, executive function, and increasingly, physical well-being. Meta-analytic findings demonstrate that VIPP-SD improves sensitive caregiving, but there is limited knowledge on its efficacy in Asia nor upon its downstream effects in enhancing physical health. In preparation for a large randomized controlled trial, this study examined the feasibility and acceptability of the VIPP-SD Adapted for the Singapore Context with a Health Component (VIPP-SD-SingH)

Method: Five interveners delivered the program to 25 parents (see Table 1) in Singapore. The intervention included seven home visits scheduled 2-4 weeks apart. Interveners filmed recordings of parent-child interactions in Visits 1-6 and provided feedback in Visits 2-7. Home visit activities and feedback were adapted to include health-related themes of physical activity, feeding, and relaxation. Within one month of completing the intervention, parents and interveners participated in one-on-one semi-structured interviews with trained researchers, and parents rated the perceived helpfulness of program components and activities on a 1–5 scale. Analyses included descriptive statistics and thematic analysis.

Results: All parents completed seven home visits with no dropouts.. Items on interactions with interveners received the highest ratings from parents (M = 4.56, SD = 0.55). . In interviews, parents shared they felt supported in learning about their own parenting behaviors, which they perceived to have positive behavioral, psychological, and emotional effects on themselves and their child. Parents appreciated the convenient home setting, relevant materials, helpful video feedback, and interactions with skillful interveners. Interveners reported sufficient training and advanced preparation facilitated effective program delivery. Barriers to parent participation included managing distractions during visits and initial discomfort with filming. Among interveners, barriers to program delivery included challenges with filming, scripting, and accommodating parents’ schedules.

Conclusion: This study provides preliminary evidence VIPP-SD-SingH is feasible to deliver and acceptable to parents of young children in Singapore.

Purpose

Culturally adapted, scalable interventions to improve sensitive caregiving remain scarce in Asia. Caregiver Awareness of Relationships through E-learning for Sensitivity and Discipline (CARE-SD) is a standardized, digitally delivered parenting program using vicarious video examples and comments derived from the VIPP-SD program. CARE-SD includes scenarios and comments for generalizability to physical activity, feeding, and relaxation, using authentic local videos. This study evaluated CARE-SD’s feasibility and acceptability.

Method

Twenty-five parents (see Table 1 Demographics) completed one of two versions of a seven self-paced online module over 14 weeks. Parents of older (4+-to- 6) and younger children (2-to-less-than-4) received parallel modules. Each session featured annotated videos and home activity suggestions. Culturally relevant infographics were provided in sessions 1 and 5. Adherence was tracked via self-reports. Acceptability was assessed through session specific feedback surveys and post-program interviews (n = 24) were analyzed thematically.

Results

All participants completed the program with no attrition. Across sessions, 96–100% watched all videos, approximately 92–100% read materials, and 52–92% reported implementing suggested activities, often within three days. Parents described the program as accessible, practical, and culturally resonant, highlighting local examples, clear annotations, and flexible learning time. Interviews revealed parents felt empowered and validated in their parenting. They felt they had gained practical strategies for communication and child-led play and had become more intentional in creating quality time. They reported greater social skills and emotional regulation in children, and observed improvements in family relationships, including stronger bonding, increased parental patience, and enhanced child cooperation, expressiveness, and independence. Reported challenges included time constraints, occasional technical issues, and perceived repetition in later sessions

Conclusion

Preliminary evidence suggests CARE-SD is feasible and highly acceptable. High participant adherence and rich positive feedback support further development and rigorous evaluation of this scalable intervention to strengthen parenting sensitivity and child well-being.

Intervention development stage research is important to ensure intervention and prevention programs are well received by the communities they wish to serve and able to address their specific needs. The research papers in this symposium have focused upon parenting programs adapted and developed for Singapore's ethnic Chinese, Malay, and Tamil communities. Still, the basic principles underlying these programs and the hypothesized mechanistic effects can also be seen through a universalist lense. Not just in Singapore, but in other cultures as well, design choices must consider both universal constructs, cultural norms, and population needs. This discussion highlights similarities and differences between the papers presented in the LOVING project and work within the MAGIC project, also aimed at enhancing child outcomes such as executive functioning and metabolic health via changes in caregiving. However, MAGIC differs in that it includes parents of infants (not 2-5 year olds), who are primarily Latin X American immigrants (rather than primarily southeast Asian Singaporean citizens), and, in appreciation of local intersts, utilizes a "physical safety" (e.g., carseat safety; rather than neuroeducation) control program. The extent to which these differences in populations and design may also impact program efficacy is considered.