# Promoting Emotional Development Among Young Children Facing Adversity: An Effectiveness Implementation Study in St. Louis Schools

> **NIH NIH R01** · WASHINGTON UNIVERSITY · 2024 · $759,275

## Abstract

Project Summary
Children facing adversity are at high risk for poor socio-emotional and cognitive outcomes and
later psychopathology. However, there is increasing evidence that these negative developmental
trajectories can be significantly improved by enhancing nurturing caregiving early in development.
Despite numerous empirically supported early interventions, these programs are not readily
accessible to the majority of US children most in need. Based on this, there is an urgent need to
make these interventions feasible and readily available to these communities. To do this we
propose to test the effectiveness of a brief 6 session parent-child preventive intervention
conducted by video conference in the family's home and study two implementation methods within
3 high-risk school districts. The intervention, entitled “THRIVE,” is a previously tested early parent
child intervention piloted in a St. Louis county district which proved feasible, acceptable and
appeared effective. Caregiver-child dyads aged 4.0-6.11 meeting inclusion criteria will be
randomized to a THRIVE condition or an established online parenting education of comparable
length. Although the use of schools as a service delivery platform will increase accessibility, this
system presents unique and complex challenges for implementation of a mental health
prevention. Therefore, we will use a hybrid effectiveness-implementation design to test the
effectiveness of THRIVE compared to Parenting Wisely, while also assessing the impact of two
forms of implementation (coaching vs. no coaching) on study outcomes. Assessments of key
outcome measures, including child behavior, social, and emotional functioning, child
psychopathology, parenting stress, optimism, and depressive symptoms, and changes in
parenting and the parent-child dyadic relationship (observational and neural using functional near
infrared spectroscopy' fNIRS) will be measured at baseline, post-treatment (P1), and 12-weeks
post-treatment (P2). We will also test how the preventive intervention mechanistically targets the
quality of the caregiver-child relationship by enhancing caregiver responsiveness and sensitivity
via baseline, mid-treatment and post-treatment (P1) assessments. This project provides the first
test of a brief parent-child early prevention accessed through schools and delivered in home by
video conference with minimal therapist training to enhance access to care. It further examines
the cost-effectiveness of therapist coaching as a means to improve implementation and clinical
outcomes.

## Key facts

- **NIH application ID:** 10890878
- **Project number:** 5R01MH130621-02
- **Recipient organization:** WASHINGTON UNIVERSITY
- **Principal Investigator:** Patricia Lynn Kohl
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $759,275
- **Award type:** 5
- **Project period:** 2023-08-01 → 2025-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10890878

## Citation

> US National Institutes of Health, RePORTER application 10890878, Promoting Emotional Development Among Young Children Facing Adversity: An Effectiveness Implementation Study in St. Louis Schools (5R01MH130621-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10890878. Licensed CC0.

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