Parenting in a pandemic: An innovative virtual support forum forfamilies living in homeless shelters

ABSTRACT

Background: Over 700,000 children experience abuse in the US annually. Reported and substantiated cases ofchild abuse increase in the months following disasters. The COVID-19 pandemic has increased known riskfactors for child abuse, including financial hardship, unemployment, increased anxiety, increased caregiverresponsibilities, and decreased access to behavioral health services and community resources. Children andfamilies already facing homelessness prior to the pandemic may be at especially heightened risk of childmaltreatment. The Homeless Health Initiative (HHI) was developed by pediatrics residents and is now amultifaceted advocacy network supporting local, urban homeless shelters that is funded and staffed by ourinstitution. PriCARE is a positive parenting program also funded and staffed by our institution. Both HHI andPriCARE had to suspend in-person services due to the COVID-19 pandemic at a time when families may mostneed additional support. Online parenting support programs have demonstrated significant reductions innegative parent-child interactions, problematic child behaviors, negative disciplinary methods, parent stressand depression, and child anxiety. Therefore, the multidisciplinary team members that serve families throughHHI and PriCARE sought to develop a virtual platform to provide their support. Methodology: The goal of thisinitiative is to establish a multidisciplinary virtual program for families experiencing homelessness thatprovides trauma-informed, positive parenting support, promotion of healthy parent-child relationships,relevant illness and injury prevention tips, and anticipatory guidance for families coping during a pandemic.We completed a needs assessment through ongoing communication with families and workers at the shelters.Various stakeholders, including experts in child abuse prevention, intimate partner violence, and positiveparenting, worked together to develop supportive materials for families related to the above topics. Weconducted virtual sessions including members of each participating stakeholder in an open-ended formatguided by participants' concerns, both previously submitted and in real-time, to provide support and developfamily-centered programming. Our platform was compatible with phones distributed to shelter residents bythe city during the pandemic to facilitate open access. To supplement virtual content, we also distributedaccompanying resources for reinforcement. Further development of this initiative is ongoing with iterativeplan/do/study/act (PDSA) cycles. Anonymous feedback from shelter residents and session leader debriefs areintegral in guiding our modifications. Discussion: The delivery of our material via video conferencing andwritten handouts is practical, feasible, and respectful of physical distancing recommendations. We arecontinuing to improve this initiative in response to feedback. In addition, we plan to integrate thisinterdisciplinary model focusing on positive parenting into our in-person sessions when it is appropriate toresume them. Conclusions: By working with all relevant stakeholders, we developed a plan to provide servicesto families living in homeless shelters via a virtual platform that responds to and is flexible to their needs.