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  • Clinical Research Article
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Supporting responsive parenting in real-world implementation: minimal effective dose of the Video Interaction Project



The Video Interaction Project (VIP) is a healthcare-based intervention that provides real-time video-feedback of parent-child play and reading interactions to families with children aged 0 to 36 months. Although evidence from randomized controlled trials demonstrates improved early relational health, including responsive parenting, after three to five VIP visits, the minimal effective dose in real-world implementations is unknown. This study aimed to determine the minimal effective dose of VIP during a real-world implementation for changing responsive parenting behaviors.


We performed a longitudinal prospective study of 183 dyads at a public hospital pediatric clinic. Responsive parenting behaviors were assessed with an observational checklist utilized as part of standard VIP practice at baseline and two follow-up VIP visits.


Multilevel models adjusted for baseline sociodemographics (child’s sex and age, and maternal education) and time between visits showed that responsive parenting behaviors during parent-child reading and play significantly increased after a single VIP visit (Cohen’s d = 0.52, p < 0.05) with additional impact following completion of a second visit (cumulative for 2 visits: d = 0.76, p < 0.05).


A single VIP visit is associated with increased responsive parenting behaviors. Findings support offering VIP widely, regardless of capacity to ensure attendance at multiple visits.


  • This is the first study showing the minimal effective dose of the Video Interaction Project (VIP) for increasing responsive parenting behaviors.

  • Responsive parenting behaviors increased by over 22% following a single VIP visit, with a cumulative increase of 37% following the second visit compared to baseline.

  • Findings have important implications for implementation and scalability of pediatric-based preventive programs that support early relational health through activities such as reading and play.

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Fig. 1: Adjusted means of number of observed responsive parenting behaviors after first and second VIP follow-up visits.

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Data availability

The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.


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We would like to thank the VIP coaches and evaluation team for making the study possible. We are also thankful to the participating families.


Tiger Foundation. Marks Foundation. New York City Council.

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Authors and Affiliations



The authors confirm contribution to the paper as follows: study conception and design: L.R.P., E.R., A.M.S., C.F.C., and A.L.M.; draft manuscript preparation: L.R.P., E.R., C.F.C., A.M.S., C.B.C., L.T., and A.L.M.; data collection: C.F.C., A.M.S., A.W., M.M., and A.C.; analysis and interpretation of results: L.R.P., E.R., C.F.C., A.M.S., A.W., C.B.C., M.M., A.C., L.R., and A.L.M.; intervention design and implementation: A.W., C.B.C., A.M.S., M.M., A.C., L.R., and A.L.M. All authors approved the final manuscript as submitted. If accepted, this paper will not subsequently be published in the same or similar form in any language without the consent of publishers.

Corresponding author

Correspondence to Alan L. Mendelsohn.

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The authors declare no competing interests.

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Informed consent was obtained from the mothers at enrollment.

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Piccolo, L.R., Roby, E., Canfield, C.F. et al. Supporting responsive parenting in real-world implementation: minimal effective dose of the Video Interaction Project. Pediatr Res 95, 1295–1300 (2024).

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