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| Name | Class |
|---|---|
| University of Maryland, College Park | OTHER |
| University of Kansas | OTHER |
| Michigan State University | OTHER |
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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.
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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Episodic Future Thinking | Experimental | Mothers will receive episodic future thinking (EFT). Mothers will meet with a "peer mother" who will administer the EFT intervention, including generation of several specific future events reflecting positive interactions with their child. We will also teach each parent a behavioral parent training element called Special Play Time. Following this session, mothers will receive daily text messages over the course of two weeks including a reminder cue generated as part of the EFT and a prompt to remember these episodes in vivid detail. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Episodic Future Thinking | Behavioral | Episodic future thinking (EFT) includes a focus on generating detailed and vivid descriptions of future events. For the current intervention, EFT will be modified to have mothers describe specific events with their children. |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Monetary Choice Questionnaire | 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. | Baseline, 1 week, 4 weeks |
| Change in Consideration of Future Consequences Scale-Parenting Score | 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. | Baseline, 4 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Dyadic Parent-Child Interaction Coding System Scores | Parents and their children will complete a 20-minute interaction task, including 5 min. of free play, a 10 min. "homework" task, and a 5 min. clean up task. Wualitvey of parent-childre interactions were coded using the Dyadic Parent-Child Interaction Coding System (DPICS). The task has 7 subscales, yielding 2 composite scores: positive parenting (a sum of: unlabeled praise, labeled praise, positive touch, reflection, and behavior description) and negative parenting (a sum of: negative talk and negative touch). Each instance of a behaviors described in the subscale (e.g., a parent giving unlabeled praise) is coded as one "point" and summed into a subscale (no max or min values). Higher values indicate greater positive or negative parenting. A score is given to the dyad (not individuals scores for parent/child). Change in parenting is calculated by comparing baseline scores with scores at the post-intervention sessions (approximately 4 weeks after baseline). |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| RL Jones Community Outreach Center | Flint | Michigan | 48505 | United States |
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24 mothers of children ages 5-10 provided informed consent for themselves and (n=24) their children.
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| ID | Title | Description |
|---|---|---|
| FG000 | Episodic Future Thinking | Mothers will receive episodic future thinking (EFT). Mothers will meet with a "peer mother" who will administer the EFT intervention, including generation of several specific future events reflecting positive interactions with their child. We will also teach each parent a behavioral parent training element called Special Play Time. Following this session, mothers will receive daily text messages over the course of two weeks including a reminder cue generated as part of the EFT and a prompt to remember these episodes in vivid detail. Episodic Future Thinking: Episodic future thinking (EFT) includes a focus on generating detailed and vivid descriptions of future events. For the current intervention, EFT will be modified to have mothers describe specific events with their children. |
| Title | Milestones | Reasons Not Completed | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
24 dyads (24 mothers of children 5-10 and reported on their n=24 children). Mothers reported demographic data for themselves and their children.
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| ID | Title | Description |
|---|---|---|
| BG000 | Episodic Future Thinking | Mothers will receive episodic future thinking (EFT). Mothers will meet with a "peer mother" who will administer the EFT intervention, including generation of several specific future events reflecting positive interactions with their child. We will also teach each parent a behavioral parent training element called Special Play Time. Following this session, mothers will receive daily text messages over the course of two weeks including a reminder cue generated as part of the EFT and a prompt to remember these episodes in vivid detail. Episodic Future Thinking: Episodic future thinking (EFT) includes a focus on generating detailed and vivid descriptions of future events. For the current intervention, EFT will be modified to have mothers describe specific events with their children. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Age data on mothers in sample. |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Change in Monetary Choice Questionnaire | 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. | Mothers who completed the the MCQ both at baseline and immediately following the intervention (approximately 1 week later). | Posted | Mean | Standard Deviation | score on a scale | Baseline, 1 week, 4 weeks |
Participants were involved in the study for approximately four weeks. Thus, four weeks is the period of time used below.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Episodic Future Thinking | Mothers will receive episodic future thinking (EFT). Mothers will meet with a "peer mother" who will administer the EFT intervention, including generation of several specific future events reflecting positive interactions with their child. We will also teach each parent a behavioral parent training element called Special Play Time. Following this session, mothers will receive daily text messages over the course of two weeks including a reminder cue generated as part of the EFT and a prompt to remember these episodes in vivid detail. Episodic Future Thinking: Episodic future thinking (EFT) includes a focus on generating detailed and vivid descriptions of future events. For the current intervention, EFT will be modified to have mothers describe specific events with their children. |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr. Julia Felton | Henry Ford Health | 313-598-0841 | jfelton4@hfhs.org |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot | Yes | No | No | Study Protocol | Apr 21, 2023 | Nov 18, 2024 | Prot_000.pdf |
| SAP | No | Yes | No | Statistical Analysis Plan | Sep 10, 2024 | Nov 18, 2024 | SAP_001.pdf |
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| Baseline, 4 weeks |
| Change in Alabama Parenting Questionnaire Score | The Alabama Parenting Questionnaire (APQ) is a 42-item self-report measure of parenting behaviors which yields five subscales: (1) positive involvement with children (range 10-50, higher = more involvement), (2) use of positive parenting strategies (range 6-30, higher = more positive strategies), (3) poor parental monitoring/supervision (range 10-50, higher = worse supervision), (4) inconsistent discipline (range 6-30, higher = more inconsistent discipline), and (5) use of corporal punishment (higher = more corporal punishment). Items are summed to create subscale scores. Change in each of the five APQ subscale scores will be measured by comparing post-intervention scores (approximately 4 weeks after baseline) with baseline scores. | Baseline, 4 weeks |
| Change in Emotion Regulation Checklist | Parents will report on children's emotion regulation using the Emotion Regulation Checklist (ERC). Items are rated from 1 to 4 and summed to create subscales. The ECR includes 24 items. 23 items are used in computing two subscales: (1) emotion regulation (range 8 to 32, higher = greater emotion regulation) and (2) lability/negativity (range 15 to 60, higher = greater lability/negativity); the 24th item does not load onto either subscale and is not used in the current analyses. The measure is widely used and validated for parent-report of older children and young adolescents. | Baseline, 4 weeks |
| Client Satisfaction Questionnaire | Following the completion of the intervention, mothers will complete the Client Satisfaction Questionnaire (CSQ), which evaluates participant satisfaction with the intervention. Nine items are ranked from 1 to 4 and summed to create a total score (range 9-36, higher = greater satisfaction). The measure is used across a number of intervention studies and has been shown to be reliable and valid in adult samples. | 4 weeks |
| Count of Participants |
| Participants |
|
| Age, Continuous | Continuous age data is reported separately for mothers and their children. | Mean | Standard Deviation | years |
|
| Sex: Female, Male | Sex data is reported separately for mothers and children. | Count of Participants | Participants |
|
| Ethnicity (NIH/OMB) | Ethnicity data is reported for mothers and children separately. | Count of Participants | Participants |
|
| Race (NIH/OMB) | Race data is reported for mothers and children separately. | Count of Participants | Participants |
|
| ID | Title | Description |
|---|
| OG000 | Episodic Future Thinking | Mothers will receive episodic future thinking (EFT). Mothers will meet with a "peer mother" who will administer the EFT intervention, including generation of several specific future events reflecting positive interactions with their child. We will also teach each parent a behavioral parent training element called Special Play Time. Following this session, mothers will receive daily text messages over the course of two weeks including a reminder cue generated as part of the EFT and a prompt to remember these episodes in vivid detail. Episodic Future Thinking: Episodic future thinking (EFT) includes a focus on generating detailed and vivid descriptions of future events. For the current intervention, EFT will be modified to have mothers describe specific events with their children. |
|
|
|
| Primary | Change in Consideration of Future Consequences Scale-Parenting Score | 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. | All mothers (participants) that completed this measure at baseline assessment (one participant did not complete this measure). | Posted | Mean | Standard Deviation | score on a scale | Baseline, 4 weeks |
|
|
|
|
| Secondary | Change in Dyadic Parent-Child Interaction Coding System Scores | Parents and their children will complete a 20-minute interaction task, including 5 min. of free play, a 10 min. "homework" task, and a 5 min. clean up task. Wualitvey of parent-childre interactions were coded using the Dyadic Parent-Child Interaction Coding System (DPICS). The task has 7 subscales, yielding 2 composite scores: positive parenting (a sum of: unlabeled praise, labeled praise, positive touch, reflection, and behavior description) and negative parenting (a sum of: negative talk and negative touch). Each instance of a behaviors described in the subscale (e.g., a parent giving unlabeled praise) is coded as one "point" and summed into a subscale (no max or min values). Higher values indicate greater positive or negative parenting. A score is given to the dyad (not individuals scores for parent/child). Change in parenting is calculated by comparing baseline scores with scores at the post-intervention sessions (approximately 4 weeks after baseline). | 11 dyads , including mothers (n=11) and their children (n=11), participated in the parent child interaction task at both the pre-intervention and post-intervention assessment. Please note that scores are given at the dyadic level (in other words, there is a single score for each dyad). | Posted | Mean | Standard Deviation | score on a scale | Baseline, 4 weeks |
|
|
|
|
| Secondary | Change in Alabama Parenting Questionnaire Score | The Alabama Parenting Questionnaire (APQ) is a 42-item self-report measure of parenting behaviors which yields five subscales: (1) positive involvement with children (range 10-50, higher = more involvement), (2) use of positive parenting strategies (range 6-30, higher = more positive strategies), (3) poor parental monitoring/supervision (range 10-50, higher = worse supervision), (4) inconsistent discipline (range 6-30, higher = more inconsistent discipline), and (5) use of corporal punishment (higher = more corporal punishment). Items are summed to create subscale scores. Change in each of the five APQ subscale scores will be measured by comparing post-intervention scores (approximately 4 weeks after baseline) with baseline scores. | Mothers who completed the APQ measure at baseline and at follow-up (approximately four weeks later). | Posted | Mean | Standard Deviation | score on a scale | Baseline, 4 weeks |
|
|
|
|
| Secondary | Change in Emotion Regulation Checklist | Parents will report on children's emotion regulation using the Emotion Regulation Checklist (ERC). Items are rated from 1 to 4 and summed to create subscales. The ECR includes 24 items. 23 items are used in computing two subscales: (1) emotion regulation (range 8 to 32, higher = greater emotion regulation) and (2) lability/negativity (range 15 to 60, higher = greater lability/negativity); the 24th item does not load onto either subscale and is not used in the current analyses. The measure is widely used and validated for parent-report of older children and young adolescents. | Mothers who completed Emotion Regulation Checklist and pre- and post-intervention (approximately 4 weeks later). | Posted | Mean | Standard Deviation | score on a scale | Baseline, 4 weeks |
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|
|
| Secondary | Client Satisfaction Questionnaire | Following the completion of the intervention, mothers will complete the Client Satisfaction Questionnaire (CSQ), which evaluates participant satisfaction with the intervention. Nine items are ranked from 1 to 4 and summed to create a total score (range 9-36, higher = greater satisfaction). The measure is used across a number of intervention studies and has been shown to be reliable and valid in adult samples. | Participants who completed the CSQ measure at follow-up (approximately 4 weeks after the intervention). | Posted | Mean | Standard Deviation | score on a scale | 4 weeks |
|
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|
| 0 |
| 48 |
| 0 |
| 48 |
| 0 |
| 48 |
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| Black or African American |
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| White |
|
| More than one race |
|
| Unknown or Not Reported |
|
|
| Follow-up Immediate Orientation Subscale |
|
| t-test, 2 sided |
No adjustments were made. DF = 15. |
| .488 |
| Mean Difference (Final Values) |
| -.711 |
| 2-Sided |
| Superiority |
|
| Negative Parenting Composite Score Post-Intervention |
|
Performed a one-sided paired-samples t-test to compare negative parenting before and after the intervention.
| t-test, 1 sided |
No adjustments were made. DF = 10. |
| .362 |
| Mean Difference (Final Values) |
| -.363 |
| 1-Sided |
| Superiority |
|
| Positive Parenting Subscale Post-Intervention |
|
| Inconsistent Parenting Subscale Pre-Intervention |
|
| Inconsistent Parenting Subscale Post-Intervention |
|
| Corporal Punishment Subscale Pre-Intervention |
|
| Corporal Punishment Subscale Post-Intervention |
|
| Poor parental monitoring Subscale Pre-Intervention |
|
| Poor parental monitoring Subscale Post-Intervention |
|
Used a one-sided paired samples t-test to examine changes in the positive parenting subscale from pre-intervention to post-intervention (approximately 4 weeks later).
| t-test, 1 sided |
| .137 |
| Median Difference (Final Values) |
| -1.14 |
| 1-Sided |
| Superiority |
| Used a one-sided paired samples t-test to examine changes in the inconsistent discipline subscale from pre-intervention to post-intervention (approximately 4 weeks later). | t-test, 1 sided | No adjustments; DF = 15. | .018 | Mean Difference (Final Values) | 2.31 | 1-Sided | Superiority |
| Used a one-sided paired samples t-test to examine changes in the use of corporal punishment subscale from pre-intervention to post-intervention (approximately 4 weeks later). | t-test, 1 sided | No adjustments; DF = 15. | .015 | Mean Difference (Final Values) | 2.39 | 1-Sided | Superiority |
| Used a one-sided paired samples t-test to examine changes in the poor parental monitoring/supervision subscale from pre-intervention to post-intervention (approximately 4 weeks later). | t-test, 1 sided | .021 | Mean Difference (Final Values) | 2.23 | 1-Sided | Superiority |
|
| Lability/Negativity Subscale Post-Intervention |
|
Used a one-sided paired-samples t-test to examine changes in lability/negativity subscale from pre-intervention to post-intervention.
| t-test, 1 sided |
No adjustments, DF = 15. |
| .203 |
| Mean Difference (Final Values) |
| .857 |
| 1-Sided |
| Superiority |