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Research Project

Promoting Early Child Development in Primary Care for Low-Income Families

Principal Investigator
Shah, Reshma
Start Date
End Date


This research project examines mechanisms through which early social interactions impact a child’s early learning in the delivery of an intervention, called Sit Down and Play, in pediatric primary care clinics.

The intervention aims to increase positive parenting of infants and toddlers in low-income families.

Poverty-related educational disparities are established in the first three years of a child’s life. This research offers a population-level approach to encourage positive parenting behaviors and promote early child development in low-income families, which are precursors of later educational achievement.

Recognized by the National Institute on Child Health and Human Development as a target for research to improve early child development and school readiness among at-risk families, the primary care setting offers an ideal opportunity to reach the millions of children who live in poverty.

In this study, we develop and pilot-test a brief, theory-based intervention for delivery in the primary care setting.

Grounded in social cognitive theory and modeled after the widely disseminated literacy program Reach Out and Read, the intervention aims to enrich positive parenting behaviors and promote early child development in low-income families.

The investigator will gather data essential to test the intervention’s efficacy on parental and child outcomes (to be proposed in a subsequent R01 application) by pursuing these aims:

  1. Utilize qualitative methods and conduct focus groups and semi-structured interviews with key stakeholders (i.e., parents, clinicians, clinical staff and administrators of the proposed intervention) to inform intervention development and identify barriers to implementation.
  2. Test the developed intervention via a pilot longitudinal randomized controlled trial to determine the feasibility of protocol implementation and to investigate the potential impact on parental outcomes.

This research builds upon Dr. Shah’s strong clinical background in developmental-behavioral pediatrics, serves as a framework to develop accessible and sustainable clinical interventions that seek to enhance early child development, and prepares her for long-term independence as a clinical researcher. The grant also supports Dr. Shah’s training in the design, execution, and analysis of clinical trials in the primary care setting; qualitative methods and longitudinal data analysis for intervention development; childhood development and its social determinants; and professional development through scientific publications and presentations.

The Researchers Explain

In the video on the right, Reshma Shah and Erika Gustofson discuss their study, "Parental Attitudes and Beliefs Surrounding Play Among Predominantly Low-Income Urban Families: A Qualitative Study," published in the Journal of Developmental & Behavioral Pediatrics.

Read the article.

About this grant

This Mentored Patient-Oriented Research Career Development Award (K23) supports the training of Dr. Shah as an independent clinical investigator.

Her mentors are Marc Atkins, PhD, and Alan Schwartz, PhD, at UIC, and Michael Msall, MD, at the University of Chicago.

Funding Source

Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health (Grant No. K23HD086295)

Total Award


Related Publications

Shah R, Gustafson E, Atkins M. Parental Attitudes and Beliefs Surrounding Play Among Predominantly Low-income Urban Families: A Qualitative Study. J Dev Behav Pediatr. 2019 Oct/Nov;40(8):606-612. doi: 10.1097/DBP.0000000000000708. (via PubMed)

Shah R, Isaia A, Schwartz A, Atkins M. Encouraging Parenting Behaviors That Promote Early Childhood Development Among Caregivers From Low-Income Urban Communities: A Randomized Static Group Comparison Trial of a Primary Care-Based Parenting Program. Matern Child Health J. 2019 Jan;23(1):39-46. doi: 10.1007/s10995-018-2589-8. (via PubMed)

Shah R, DeFrino D, Kim Y, Atkins M. Sit Down and Play: A Preventive Primary Care-Based Program To Enhance Parenting Practices. J Child Fam Stud. 2017 Feb;26(2):540-547. doi: 10.1007/s10826-016-0583-6. (via PubMed)

Shah R, Kennedy S, Clark MD, Bauer SC, Schwartz A. Primary Care-Based Interventions to Promote Positive Parenting Behaviors: A Meta-analysis. Pediatrics. 2016 May;137(5). pii: e20153393. doi: 10.1542/peds.2015-3393. (via PubMed)

Shah R, Sobotka SA, Chen YF, Msall ME. Positive Parenting Practices, Health Disparities, and Developmental Progress. Pediatrics. 2015 Aug;136(2):318-26. doi: 10.1542/peds.2014-3390. (via PubMed)