Adapting a Parenting Intervention to Promote Healthy Screen Time Habits in Young Children With Behavior Problems

Not Applicable

Completed

Conditions: Parenting
Behavior Problem

Interventions: Behavioral: Screen media adapted School Readiness Parenting Program
Behavioral: School Readiness Parenting Program

Registration Number: NCT05287685

Lead Sponsor: Florida International University

Brief Summary: This project is a study funded by the National Institute of Child Health and Human Development to develop and pilot test an adapted parenting intervention to decrease excessive/inappropriate screen media use in young children with externalizing behavior problems.

Detailed Description: The goal of this study is to develop and pilot test an adapted screen time intervention for parents of young children with externalizing behavior problems. As young children's access and exposure to different types of screen media devices has increased, so has public health concern around the links between unhealthy early screen media use (including excessive use and exposure to inappropriate content) and poor child outcomes. Research shows that exposure to screen media and externalizing behavior problems in young children are linked. Externalizing behavior problems also present a significant barrier to parents attempting to adhere to screen media use recommendations. Despite these public health concerns, screen media use interventions have not yet specifically targeted children with externalizing behavior problems. To address this need, the investigators propose to explore a novel approach to intervening around screen time, by adapting a behavioral parenting intervention designed for parents of children with externalizing behavior problems to integrate content around screen time. Leveraging an existing evidence-based parenting intervention will allow for the intervention to target parenting generally, as well as screen time specific parenting, without requiring additional resources. This study will focus on adapting a group-based parenting intervention, the School Readiness Parenting Program (SRPP). The SRPP is an 8-week parenting intervention based on a group Parent-Child Interaction Therapy model. In total, 55 parents of preschool-aged children with externalizing behavior problems will be recruited. Following a development phase, the investigators will conduct a small open trial (n = 15) to assess the feasibility of the screen time adapted intervention and families' satisfaction and response to treatment. At this phase, the investigators will also pilot a multimodal method of tracking child screen use using objective data from mobile devices and parent-completed media use logs. Upon making modifications based on results of the open trial and feedback from an external advisory panel of experts and community stakeholders, a pilot randomized controlled trial (n = 40) will follow. Parents will be randomly assigned to receive either the screen time adapted SRPP (n = 20) or the original SRPP (n = 20) program. Assessment measures will be completed at prettest, posttest, and at a 1 month follow up. The investigators will examine feasibility and acceptability of the screen time adapted intervention in the randomized controlled trial. The investigators will also examine children's screen use patterns, including overall screen time, proportion of screen time that is educational, and frequency of parent-child co-use of screen media. In an exploratory fashion, the investigators will examine the effect of the intervention on child externalizing behavior problems.

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 44

Inclusion Criteria

eligible child who is 54 to 66 months old at Spring intake (i.e. will be entering Kindergarten after the summer)
parent-reported externalizing behavior problems on the Kiddie-Disruptive Behavior Disorder Schedule (parent report) or the Disruptive Behavior Disorder Rating Scale (teacher report) that meet criteria for a disruptive behavior disorder diagnosis
child general cognitive ability score 70 or above on the Differential Abilities Scales-II, - caregiver willing and able to attend weekly parent groups conducted in English.

Exclusion Criteria

Families with children with major sensory impairments (e.g., deafness, blindness) or severe problems that impair mobility (e.g., cerebral palsy)are excluded.

Study & Design

Study Type: INTERVENTIONAL

Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Screen media adapted School Readiness Parenting Program	Screen media adapted School Readiness Parenting Program	Screen media adapted School Readiness Parenting Program (Once weekly session of 1.5 hours for 8 weeks)
Original School Readiness Parenting Program	School Readiness Parenting Program	Original School Readiness Parenting Program (Once weekly session of 1.5 hours for 8 weeks)

Primary Outcome Measures

Name	Time	Method
Child Screen Media Use (Time)	Change from baseline (week 0) to posttest (week 8) and follow-up (week 16)	Child screen media use will be measured with parent-reported data on screen use duration (including TV and other screen devices) and content. The outcome variable will be total screen use per weekend day.
Child Screen Media Use (Proportion Educational)	Change from baseline (week 0) to posttest (week 8) and follow-up (week 16)	The proportion of child screen media use that parents report is educational.
Treatment Attitude Inventory (TAI)	Posttest (Week 8)	The TAI is a parent-report measure that assesses parent satisfaction with treatment. Test-retest reliability over 4 months and correlations between the TAI and both parent-rating scales and observational measures of treatment change have been demonstrated. The TAI total score will be administered to assess parent satisfaction with the intervention. The minimum value is 0 and the maximum is 50, with higher scores indicating better satisfaction.
Perceived Parental Efficacy Scale	Change from baseline (week 0) to posttest (week 8) and follow-up (week 16).	Parents' perceived efficacy in managing children's screen time will be assessed using the Perceived Parental Efficacy subscale of the Parent Perceptions of Technology Scale (PPTS), which assesses parents' self-efficacy in using electronic media and managing children's screen time (e.g., "I won't bother setting parental controls or passwords because my kids will "hack" around them."). The 5 items are rated on a Likert scale from 1 (strongly disagree) to 5 (strongly agree). Items were reverse scored and averaged to create the overall scale score, with higher scores meaning better perceived efficacy.
Technology-related Parenting Scale	Change from baseline (week 0) to posttest (week 8) and follow-up (week 16)	The Technology-related Parenting Scale is an 8-item self-report survey assessing parents' use of rules (e.g., "I set limits on the amount of time") and enforcement strategies ("I use passwords on these devices") for children's technology use on a 3-point scale from 0 (not true) to 2 (very true). Items will be averaged to create an overall score, with higher scores meaning more limit setting.