Parent-child Interaction
Conditions
Keywords
Attachment theory, Parent- child relationship, Child mental health, Behavioral health
Brief summary
The purpose of this study is to to conduct a randomized controlled trial comparing an intervention group and a control/wait list group to evaluate the feasibility of the Promoting First Relationships method in an American Indian community through their tribal Maternal and Child Health program, and to assess the efficacy of the method in this community.
Interventions
BEHAVIORALImmediate Group
The intervention consists of delivering the Promoting First Relationship (PFR) program. PFR comprises 10 sessions and lasts approximately 12 weeks. Each session lasts approximately 30 minutes, and begins with brief (\ 10 min) discussions and education on the target topic for that week . The remaining 20 minutes will alternate between video recording a structured interaction between the caregiver and child or viewing the previous session's recording and engaging in reflective discussion about successful caregiving strategies and child's response to caregiver behavior. Trained PFR specialists who are community members use the 5 consultation strategies, labeled Joining, Positive Feedback, Instructive Feedback, Reflective Questions and Comments, and Instruction with Handouts.
BEHAVIORALWait-List group
The intervention consists of delivering the Promoting First Relationship (PFR) program. PFR comprises 10 sessions and lasts approximately 12 weeks. Each session lasts approximately 30 minutes, and begins with brief (\ 10 min) discussions and education on the target topic for that week . The remaining 20 minutes will alternate between video recording a structured interaction between the caregiver and child or viewing the previous session's recording and engaging in reflective discussion about successful caregiving strategies and child's response to caregiver behavior. Trained PFR specialists who are community members use the 5 consultation strategies, labeled Joining, Positive Feedback, Instructive Feedback, Reflective Questions and Comments, and Instruction with Handouts.
Sponsors
National Institute on Minority Health and Health Disparities (NIMHD)
Washington State University
University of Washington
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Healthy volunteers
Yes
Inclusion criteria
1. Primary caregiver for a child aged 10 to 30 months 2. Caregiver lives with the child full time for the past three months and plans to continue for at least 6 more months. 3. Child is an American Indian or Alaska Native living on or near the Tribe's reservation. 4. Caregiver has telephone access 5. Caregiver is willing to have researchers come to their house 6. Caregiver is English speaking 7. Caregiver is willing to participate in a home-visiting program which includes video-recorded sessions of caregivers and their children playing
Exclusion criteria
--Caregiver is 1. hospitalized or imprisoned 2. living in a Treatment facility or shelter 3. unable to give consent 4. live in a household that already has a dyad enrolled in the study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Quality of caregiver-child interactions from baseline at 3 months and 6 months | Baseline, 3-month and 6-month follow-ups | We are using the Nursing Child Assessment Satellite Training Teaching Scales to assess quality of caregiver-child interactions. Caregivers select an activity that their child cannot perform, such as drawing, and spend up to 5 minutes teaching this activity to the child. The interaction is video-recorded and coded for the caregiver's sensitivity to cues, response to distress, and fostering of social, emotional, and cognitive growth, as well as for the child's clarity of cues and responsiveness to the caregiver. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Caregiver helplessness from baseline at 3 months and 6 months | Baseline, 3-month and 6-month follow-ups | Caregiver helplessness is measured by the Caregiving Helplessness Questionnaire, comprising 45 items specific to interactions with the child. We evaluate 2 subscales for this study: Mother-Child Frightened and Mother Helplessness (mother is changed to caregiver) |
| Change in Caregiver stress from baseline at 3 months and 6 months | Baseline, 3-month and 6-month follow-ups | Caregiver stress is measured by the Parenting Stress Index/Short Form, a 36-item questionnaire with 3 subscales: caregiver distress, caregiver-child dysfunctional interaction, and difficult child. |
| Change in Child Social-emotional Competence from baseline at 3 months and 6 months | Baseline, 3-month and 6-month follow ups | Children's social-emotional competencies are measured with the Infant-Toddler Social Emotional Assessment, a caregiver-report questionnaire |
Countries
United States
Outcome results
None listed