Reducing Maternal Delay Discounting as a Target Mechanism to Decrease Harsh Parenting and Improve Child Mental Health Outcomes in a Traditionally Underserved Community
Overview
- Phase
- N/A
- Intervention
- Not specified
- Conditions
- Behavioral Health
- Sponsor
- Henry Ford Health System
- Enrollment
- 48
- Locations
- 1
- Primary Endpoint
- Change in Monetary Choice Questionnaire
- Status
- Completed
- Last Updated
- last year
Overview
Brief Summary
Parents of children from impoverished communities are disproportionately more likely to engage in harsh physical discipline, which can lead to serious clinical outcomes, including suicidal ideation and attempts. One mechanism linking low resource environments and maladaptive parenting strategies is maternal delay discounting, or the tendency to value smaller, immediate rewards (such as stopping children's misbehavior via physical means) relative to larger, but delayed rewards (like improving the parent-child relationship). This study will examine the efficacy of implementing a low-cost, brief intervention targeting the reduction of maternal delay discounting to inform broader public health efforts aimed at improving adolescent mental health outcomes in traditionally underserved communities.
Detailed Description
Harsh parenting is associated with serious and costly mental health problems among youth, including substance use, mood disorders, and suicidal ideation and behaviors. Of concern, these parenting practices are most common among families from impoverished communities; however, many behaviorally-based parenting interventions do not take into account the unique mechanisms linking environmental disadvantage to parenting approaches. While the causes of harsh parenting are complex and varied, one such mechanism may be parents' tendencies to prioritize immediate rewards (such as stopping a child's misbehavior via physical punishment like spanking and hitting) relative to larger, but delayed rewards (including improved parent-child relationship quality), known as delay discounting. This case series will examine the efficacy of episodic future thinking (EFT) to target reduction of parenting-related delay discounting. Outcomes will evaluate the effect of EFT on reducing maternal delay discounting and harsh parenting, and improving child clinical outcomes.
Investigators
Julia Felton
Assistant Scientist
Henry Ford Health System
Eligibility Criteria
Inclusion Criteria
- •Be the mother from the Flint area of a child between the ages of 5-10 who can provide legal consent for that child to participate in this study
- •Self-report that the child lives with them for at least 50% of the time
- •Willing to participate in the study
- •Able to participate in written assessments and an intervention conducted in English
- •Have a working cell phone that can receive and send text messages and be willing to receive/send text messages as part of the study
- •Have a phone or device that's able to use video conferencing software
Exclusion Criteria
- •Self-disclosed active suicidality/homicidality
- •Self-disclosed current bipolar disorder, schizophrenia, or psychosis
- •Current and ongoing involvement with child protective services
Outcomes
Primary Outcomes
Change in Monetary Choice Questionnaire
Time Frame: Baseline, 1 week, 4 weeks
The brief Monetary Choice Questionnaire (MCQ) is a 21-item binary-choice task that asks participants to select between two hypothetical monetary amounts: a smaller reward available immediately (e.g. $49 today) or a larger reward available after a delay (e.g. $60 in 89 days). "Larger later" amounts are separated into small, medium and large magnitudes. For the purposes of this study, to limit participant burden, we administered only small and large magnitude subscales, resulting in a total number of 14 items. The measure is scored to derive a single "total score" discounting rate k, with larger values reflecting greater preference for smaller sooner reward. Because k distributions are typically skewed, post-hoc natural logarithmic transformations were performed, resulting in normal distributions; thus, there is no maximum and minimum value. The MCQ has been shown to have strong psychometric properties among adults and correlates with real rewards, as well as real-world risk behaviors.
Change in Consideration of Future Consequences Scale-Parenting Score
Time Frame: Baseline, 4 weeks
The Consideration of Future Consequences Scale-Parenting Adapted (CFCS-14-PA) is a 14-item self-report questionnaire composed of two subscales reflecting either immediate or future orientation related to parents interactions with their children. Items range from "not at all like me" (1) to "very much like me" (5) and are summed to create future or immediate orientation subscale, each composed of 7 items with score ranges from 7-35. Lower scores on the future orientation and higher scores on the immediate orientation subscales are associated with less future orientation and predictive of less engagement in health behaviors. The measure has been used extensively among adult samples and demonstrates strong reliability and validity. Change in CFCS-14-PA score is measured by comparing scores at the post-intervention assessment (approximately 4 weeks after baseline) with baseline scores.
Secondary Outcomes
- Change in Dyadic Parent-Child Interaction Coding System Scores(Baseline, 4 weeks)
- Change in Alabama Parenting Questionnaire Score(Baseline, 4 weeks)
- Change in Emotion Regulation Checklist(Baseline, 4 weeks)
- Client Satisfaction Questionnaire(4 weeks)