Optimizing an Evidence-Based, Disseminable, Free Internet-Based Parenting Program

Not Applicable

Completed

• Conditions: Parenting Practices
• Interventions: Behavioral: Motivational Enhancement; Behavioral: Simplification; Behavioral: Gamification; Behavioral: Low Engagement Nudges; Behavioral: Essentials for Parenting Toddlers and Pre-schoolers (EFP)

• Registration Number: NCT05689736
• Lead Sponsor: New York University

Brief Summary

The CDC's Essentials for Parenting Toddlers and Preschoolers program (EFP) is a free Internet resource with the potential to break down barriers to population-wide access to scientifically-based parenting interventions. EFP has considerable promise, but parental engagement, a major issue in the success of universal parenting interventions, remains a challenge. The objective of the proposed research is to optimize EFP by identifying engagement-focused intervention elements to add to EFP that enhance its effects on parenting skills.

Detailed Description

The study is a longitudinal factorial optimization trial in a community sample of 800 parents with 1.5- to 3-year-old children. There are 4 experimental factors; each corresponds to the presence vs. absence of an engagement-focused intervention element. This experiment enables the estimation of the individual and combined effects of each element. The specific aims follow.

Aim 1: Optimize the effects of EFP on parenting skills by determining which combination of the four experimental engagement-focused intervention elements results in the greatest success of EFP, as reflected in increasing parent warmth and reducing corporal punishment, overreactive and lax discipline.

Aim 2: Determine the extent to which boosted meaningful parent engagement in EFP is the mechanism driving the effects of the four engagement-focused intervention elements on parenting skills, and which aspect(s) of engagement (e.g., content consumption; behavioral skills practice) are the key mediators that translate the effects of the four engagement-focused intervention elements into improved parenting.

Aim 3: Examine parent (e.g., change readiness; race) and child characteristics (e.g., externalizing behavior; sex) to determine if the optimal intervention package differs among subgroups. Cracking the code of providing parents with an intervention that they actually use, and that improves parenting, could have far-reaching effects (e.g., improving population-level child outcomes).

Study Timeline

• Study First Submitted: 2022-12-19
• Study First Submitted QC: 2023-01-10
• Study First Posted: 2023-01-19
• Study Start: 2023-09-16
• Status Verified: 2024-06
• Primary Completion: 2024-06-14
• Study Completion: 2024-08-26
• Last Update Submitted: 2025-04-02
• Last Update Posted: 2025-04-06

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 859

Inclusion Criteria

1. 18- to 36-month-old child
2. ≥18-year-old parent
3. Internet access
4. willingness to commit to intervention/assessment procedures
5. proficiency in speaking and reading English

Exclusion Criteria

1. child older than 36 months
2. parent younger than 18 years
3. no access to internet
4. not willing to commit to intervention/assessment procedures OR
5. not proficient with speaking and reading English

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: FACTORIAL

Arm && Interventions

Group	Intervention	Description
Motivational Enhancements + Simplification + Gamification + Low Engagement Nudge	Simplification	Participants will receive the Core Essentials for Parenting (EFP) intervention and all additional engagement-focused intervention elements: motivational enhancements, simplification, gamification, and low engagement nudges.
Motivational Enhancements + Simplification + Gamification + Low Engagement Nudge	Motivational Enhancement	Participants will receive the Core Essentials for Parenting (EFP) intervention and all additional engagement-focused intervention elements: motivational enhancements, simplification, gamification, and low engagement nudges.
Motivational Enhancements + Simplification + Gamification + Low Engagement Nudge	Low Engagement Nudges	Participants will receive the Core Essentials for Parenting (EFP) intervention and all additional engagement-focused intervention elements: motivational enhancements, simplification, gamification, and low engagement nudges.
Motivational Enhancements + Simplification	Motivational Enhancement	Participants will receive the Core EFP intervention and motivational enhancement and simplification as intervention elements.
Motivational Enhancements + Simplification	Simplification	Participants will receive the Core EFP intervention and motivational enhancement and simplification as intervention elements.
Motivational Enhancements + Simplification + Gamification	Motivational Enhancement	Participants will receive the Core EFP intervention and motivational enhancement, simplification, and gamification intervention elements.
Motivational Enhancements + Simplification + Gamification	Simplification	Participants will receive the Core EFP intervention and motivational enhancement, simplification, and gamification intervention elements.
Motivational Enhancements + Simplification + Gamification	Gamification	Participants will receive the Core EFP intervention and motivational enhancement, simplification, and gamification intervention elements.
Motivational Enhancements + Simplification + Low Engagement Nudge	Low Engagement Nudges	Participants will receive the Core EFP intervention and motivational enhancement, simplification, and low engagement nudges as intervention elements.
Motivational Enhancements + Simplification + Gamification + Low Engagement Nudge	Gamification	Participants will receive the Core Essentials for Parenting (EFP) intervention and all additional engagement-focused intervention elements: motivational enhancements, simplification, gamification, and low engagement nudges.
Motivational Enhancements + Simplification + Gamification + Low Engagement Nudge	Essentials for Parenting Toddlers and Pre-schoolers (EFP)	Participants will receive the Core Essentials for Parenting (EFP) intervention and all additional engagement-focused intervention elements: motivational enhancements, simplification, gamification, and low engagement nudges.
Motivational Enhancements + Simplification + Gamification	Essentials for Parenting Toddlers and Pre-schoolers (EFP)	Participants will receive the Core EFP intervention and motivational enhancement, simplification, and gamification intervention elements.
Motivational Enhancements + Simplification + Low Engagement Nudge	Motivational Enhancement	Participants will receive the Core EFP intervention and motivational enhancement, simplification, and low engagement nudges as intervention elements.
Motivational Enhancements + Simplification + Low Engagement Nudge	Simplification	Participants will receive the Core EFP intervention and motivational enhancement, simplification, and low engagement nudges as intervention elements.
Motivational Enhancements + Simplification	Essentials for Parenting Toddlers and Pre-schoolers (EFP)	Participants will receive the Core EFP intervention and motivational enhancement and simplification as intervention elements.
Motivational Enhancements + Gamification + Low Engagement Nudge	Gamification	Participants will receive the Core EFP intervention and motivational enhancement, gamification, and low engagement nudge as intervention elements.
Simplification + Gamification + Low Engagement Nudge	Gamification	Participants will receive the Core EFP intervention and simplification, gamification, and low engagement nudge as additional intervention elements.
Gamification + Low Engagement Nudge	Low Engagement Nudges	Participants will receive the Core EFP intervention and gamification and low engagement nudge as additional intervention elements.
Motivational Enhancements + Simplification + Low Engagement Nudge	Essentials for Parenting Toddlers and Pre-schoolers (EFP)	Participants will receive the Core EFP intervention and motivational enhancement, simplification, and low engagement nudges as intervention elements.
Motivational Enhancements + Gamification + Low Engagement Nudge	Essentials for Parenting Toddlers and Pre-schoolers (EFP)	Participants will receive the Core EFP intervention and motivational enhancement, gamification, and low engagement nudge as intervention elements.
Motivational Enhancements + Low Engagement Nudge	Motivational Enhancement	Participants will receive the Core EFP intervention and motivational enhancement and low engagement nudge as intervention elements.
Motivational Enhancements + Low Engagement Nudge	Essentials for Parenting Toddlers and Pre-schoolers (EFP)	Participants will receive the Core EFP intervention and motivational enhancement and low engagement nudge as intervention elements.
Motivational Enhancements	Motivational Enhancement	Participants will receive the Core EFP intervention and motivational enhancement as an additional intervention element.
Motivational Enhancements + Gamification + Low Engagement Nudge	Low Engagement Nudges	Participants will receive the Core EFP intervention and motivational enhancement, gamification, and low engagement nudge as intervention elements.
Motivational Enhancements + Gamification	Gamification	Participants will receive the Core EFP intervention and motivational enhancement and gamification as intervention elements.
Simplification + Low Engagement Nudge	Essentials for Parenting Toddlers and Pre-schoolers (EFP)	Participants will receive the Core EFP intervention and simplification and low engagement nudge as intervention elements.
Simplification	Simplification	Participants will receive the Core EFP intervention and simplification as an additional intervention element.
Motivational Enhancements + Gamification + Low Engagement Nudge	Motivational Enhancement	Participants will receive the Core EFP intervention and motivational enhancement, gamification, and low engagement nudge as intervention elements.
Motivational Enhancements + Gamification	Essentials for Parenting Toddlers and Pre-schoolers (EFP)	Participants will receive the Core EFP intervention and motivational enhancement and gamification as intervention elements.
Motivational Enhancements + Low Engagement Nudge	Low Engagement Nudges	Participants will receive the Core EFP intervention and motivational enhancement and low engagement nudge as intervention elements.
Simplification + Gamification + Low Engagement Nudge	Low Engagement Nudges	Participants will receive the Core EFP intervention and simplification, gamification, and low engagement nudge as additional intervention elements.
Simplification + Gamification	Simplification	Participants will receive the Core EFP intervention and simplification and gamification as additional intervention elements.
Motivational Enhancements + Gamification	Motivational Enhancement	Participants will receive the Core EFP intervention and motivational enhancement and gamification as intervention elements.
Motivational Enhancements	Essentials for Parenting Toddlers and Pre-schoolers (EFP)	Participants will receive the Core EFP intervention and motivational enhancement as an additional intervention element.
Simplification + Gamification + Low Engagement Nudge	Essentials for Parenting Toddlers and Pre-schoolers (EFP)	Participants will receive the Core EFP intervention and simplification, gamification, and low engagement nudge as additional intervention elements.
Simplification + Gamification + Low Engagement Nudge	Simplification	Participants will receive the Core EFP intervention and simplification, gamification, and low engagement nudge as additional intervention elements.
Simplification + Low Engagement Nudge	Simplification	Participants will receive the Core EFP intervention and simplification and low engagement nudge as intervention elements.
Low Engagement Nudge	Essentials for Parenting Toddlers and Pre-schoolers (EFP)	Participants will receive the Core EFP intervention and low engagement nudge as an additional intervention element.
EFP Only	Essentials for Parenting Toddlers and Pre-schoolers (EFP)	Participants will receive the Core EFP intervention and not be exposed to any additional intervention elements.
Simplification + Gamification	Gamification	Participants will receive the Core EFP intervention and simplification and gamification as additional intervention elements.
Simplification + Gamification	Essentials for Parenting Toddlers and Pre-schoolers (EFP)	Participants will receive the Core EFP intervention and simplification and gamification as additional intervention elements.
Simplification + Low Engagement Nudge	Low Engagement Nudges	Participants will receive the Core EFP intervention and simplification and low engagement nudge as intervention elements.
Simplification	Essentials for Parenting Toddlers and Pre-schoolers (EFP)	Participants will receive the Core EFP intervention and simplification as an additional intervention element.
Gamification + Low Engagement Nudge	Gamification	Participants will receive the Core EFP intervention and gamification and low engagement nudge as additional intervention elements.
Gamification	Gamification	Participants will view the Core EFP and will be exposed only to gamification as an additional intervention element.
Gamification + Low Engagement Nudge	Essentials for Parenting Toddlers and Pre-schoolers (EFP)	Participants will receive the Core EFP intervention and gamification and low engagement nudge as additional intervention elements.
Gamification	Essentials for Parenting Toddlers and Pre-schoolers (EFP)	Participants will view the Core EFP and will be exposed only to gamification as an additional intervention element.
Low Engagement Nudge	Low Engagement Nudges	Participants will receive the Core EFP intervention and low engagement nudge as an additional intervention element.

Primary Outcome Measures

Name	Time	Method
Parenting Scale, item average of Overreactivity subscale	6 months	Parents' use of harsh or otherwise overreactive discipline (i.e., angry discipline) will be measured by parent completing the 10-item self-report Overreactivity subscale of the Parenting Scale.
Parenting Scale, item average of Laxness subscale	6 months	Use of permissive or lax discipline (e.g., failure to enforce rules) will be measured by parent completing the 11-item self-report Laxness subscale of the Parenting Scale
Parent Behavior Inventory, item average of Supportive/Engaged subscale	6 months	Parental warmth (e.g., physical affection) will be measured by parent completing the 10-item self-report Supportive Engaged subscale of the Parent Behavior Inventory.
Parent-Child Conflict Tactics Scale, item average of Corporal Punishment subscale	6 months	Corporal punishment (noninjurious physical discipline, e.g., spanking) will be measured by parent completing the 6-item self-report corporal punishment subscale of the Parent-Child Conflict Tactics Scale

Trial Locations

Locations (1)

Westat, Inc.; 🇺🇸 Rockville, Maryland, United States