Development, Implementation, and Assessment of a Brief Behavioral Interventions Curriculum: A Pilot to Promote Positive Parenting

Abstract

Background: All pediatric trainees must know how to address common childhood behavior problems (BP). Previous educational interventions demonstrated improved knowledge and self-efficacy as well as decreased problem behaviors in children, but were limited by implementation barriers. We developed and implemented an online spaced education curriculum for the assessment and management of common BP in children. Aims: Our aims were to determine if the curriculum is associated with (1) improved confidence in assessment and management of common BP; (2) increased knowledge acquisition, and (3) self-reported behavior change. Methods: We delivered the pilot curriculum to first year pediatric residents in a large tertiary care program during a required 12-week longitudinal rotation with development, adolescent, and advocacy experiences. During the initial workshop, residents were introduced to the AAP’s “Brief Behavioral Interventions” materials and were enrolled in a team-based individualized adaptive “spaced education” game. To assess knowledge, an expert working group identified 20 validated questions mapped to learning objectives from ABP board content specifications and AAP behavioral mental health competencies. Residents completed surveys before and after the intervention, as well as semi-structured interviews. Results: 11 pediatric interns participated in the pilot intervention. Confidence was initially low across all behavioral health competencies with the exception of eliciting parent/patient concerns about BP. Confidence in managing all targeted BP addressed as well as recommending evidence based behavioral management strategies significantly improved. There were statistically significant improvements in self-reported behavioral assessment practices including inquiring about hearing/vision concerns, sleep quality, child’s temperament traits, parent-infant attachment patterns, situational/environmental changes, and parental mental health issues. 100% of participants were satisfied with the quality of the overall curriculum content, amount of time required, and quality of provided resources. Many noted the curriculum motivated them to learn about behavioral/ mental health problems and filled a curricular gap. Key instructional design features highlighted by residents included gamification, social learning, retrieval practice, immediate feedback, flexibility and mobile accessibility, and inclusion of parent education materials and resources for use in clinical practice. Conclusions: An online self-directed adaptive learning curriculum can be an effective, time-efficient, and well-received instructional method to teach behavioral health competencies to pediatric residents.