ArticlePrevention science : the official journal of the Society for Prevention Research2024
Participation in Pediatric Primary Care Innovation, DULCE, Increases Caregiver Agency and Resilience and Decreases Impact of Stress.
Article in Prevention science : the official journal of the Society for Prevention Research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed, 2 citations in OpenAlex.
- Strengthening early relational health: strategies and system-level considerations for pediatric primary care.Frontiers in pediatrics · 2026Article
- Improving GPs' Emotional Intelligence and Resilience to Better Manage Chronic Respiratory Diseases Through an Experiential Online Training Intervention: A Mixed Methods Study.Healthcare (Basel, Switzerland) · 2024Article
Corrections and comments
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Authors and funding
3 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The purpose of the present study was to explore outcomes and heterogeneous effects of an evidence-based, cross-sector pediatric healthcare intervention for families with infants, Developmental Understanding and Legal Collaboration for Everyone (DULCE). DULCE is tailored to allow families' needs and desires to drive DULCE intensity. This is a longitudinal study following families involved with pediatric primary care clinics from infant's birth to 15 months. Multi-level longitudinal modeling was used to compare the program's influence on resilience, parent agency, and the impact of stress on parent functioning among program recipients (n = 172) and non-recipients (n = 170). Study participants were recruited from four health care clinics in California and Florida, and participants completed in-person survey interviews at baseline (infant age 0-6 months) and final (infant age 12-15 months) timepoints, with a minimum of 6 months between baseline and final interview required. Assignment of families to intervention (participated in DULCE) or comparison group (received clinic care as usual) varied by clinic. The cross-sector pediatric primary care intervention screened families at high rates (70-90%), along with referring and connecting families to resources. DULCE participation was associated with increases in parents' agency and resilience. DULCE's positive influence on parent agency and impact of stress was observed with low dosage, and higher-risk families saw additional improvements in resilience at high dosage (high and low risk defined with Latent Profile Analysis). Findings reinforce the importance of examining heterogeneous effects of evidence-based interventions. DULCE's influence on parent agency and impact of stress was observed with low dosage; strengthened resilience among higher-risk families was found at high dosage. These findings document the value of a universal approach to prevention services in pediatric settings with tailoring that allows families to drive their engagement with the intervention.
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Registered trials
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