Virtual Mentorship to Support Maternal and Infant Health and Wellbeing: Assessing the Impact and Efficacy of NurturePA

We will adapt the Opinions about Babies questionnaire which was developed by Stephanie Reich as a criterion-referenced knowledge questionnaire for use in a 2005 study (Reich, 2005). The content comes from the Bright Futures Guidelines for Health Supervision, and the American Academy of Pediatrics Guidelines for Health Supervision III (Reich, 2005). It has been used to measure the effects of an educational baby book intervention on maternal knowledge and was shown to be sensitive to intervention effects (Reich et al, 2010). Under the advisement of NurturePA, we selected items that target the types of developmental and self-care knowledge that the program aims to impart. We also edited the wording of some items to more closely target these topics of interest. The edited questionnaire includes 11true/false items. Items are scored 0 if incorrect and 1 if correct and then the items are summed resulting in a final score between 0 and 11. A higher score indicates a better outcome.

We will measure the mother's level of engagement in activities that support the development of their child's language and literacy activities at 4 months after study start using a self-administered questionnaire. We will report individual scores rather than change over time. The items on the questionnaire are drawn from three sources. Many of the items are taken from a survey administered during the Metro Baby Study, a longitudinal study of low-income minority families in New York City conducted by The Center for Research on Culture, Development, and Education at New York University. Additional items were added based on items from Early Head Start parent surveys and the Ages and Stages 12-month questionnaire (Squires \& Bricker, 2009). The 4-month measure will include 8 items scored from 1 (rarely/not at all) to 4 (every day) for a total score range of 8 to 32 where higher scores indicate a better outcome.

We will measure the mother's level of engagement in activities that support the development of their child's language and literacy activities at 18 months after study start using a self-administered questionnaire. We will report individual scores rather than change over time. The items on the questionnaire are drawn from three sources. Many of the items are taken from a survey administered during the Metro Baby Study, a longitudinal study of low-income minority families in New York City conducted by The Center for Research on Culture, Development, and Education at New York University. Additional items were added based on items from Early Head Start parent surveys and the Ages and Stages 12-month questionnaire (Squires \& Bricker, 2009). The 18-month measure will include 11 items scored from 1 (rarely/not at all) to 4 (every day) for a total score range of 11 to 44 where higher scores indicate a better outcome.

We will measure child development at 4 months after study start using a self-administered questionnaire asking mothers to report whether their baby has reached particular developmental milestones. We will report individual scores rather than change over time. At 4 months after study start the questionnaire will include 5 items scored from 1 (not yet) to 3 (yes) for a total score range of 5 to 15 where higher scores indicate a better outcome.

We will measure child development at 18 months after study start using a self-administered questionnaire asking mothers to report whether their baby has reached particular developmental milestones. We will report individual scores rather than change over time. At 18 months after study start the questionnaire will include 10 items scored from 1 (not yet) to 3 (yes) for a total score range of 10 to 30 where higher scores indicate a better outcome.

We will measure WIC usage at 4 months after study start and 18 months after study start by using data from the Allegheny County Integrated Data Systems. WIC usage will be measured in the length of time receiving WIC benefits.

We will measure usage of early language and development screening services 4 months after study start and 18 months after study start by using data from the Allegheny County Integrated Data Systems. Screening usage will be measured with a binary indicator of whether or not a mother has used screening services.

This is a 10-question self-rating scale for assessing perinatal depression. The scale is administered at approximately 4 months post-partum during the course of a well-baby doctor's office visit. Each of the 10 items is scaled on a 0-3 scale and then these item scores are summed for an overall score. Overall scores are interpreted as follows: 0-8 (low probability of depression); 8-12 (most likely just dealing with a new baby or the baby blues); 13-14 (signs leading to possibility of post-partum depression); 15+ (high probability of experiencing clinical depression).