Skip to content

Using Mobile Technology to Enhance Multisystemic Therapy (MST) Outcomes

Phase I - Using Mobile Technology to Enhance MST Outcomes (VillageWhere)

Status
Completed
Phases
NA
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT02320903
Acronym
VillageWhere
Enrollment
88
Registered
2014-12-19
Start date
2014-04-30
Completion date
2016-03-31
Last updated
2018-02-14

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Child Behavior Disorders

Keywords

Criminal Justice, Juvenile Delinquency

Brief summary

The goal of the current trial is to assess the feasibility of a newly developed prototype of a cell phone app called VillageWhere. VillageWhere is designed to improve clinical outcomes of youth with externalizing behavioral problems by improving parental monitoring of youth whereabouts and activities while increasing the delivery of rewards to teens for good behavior. This Phase I Small Business Innovation Research (SBIR) proposal seeks to develop and conduct initial feasibility testing of the VillageWhere prototype. The primary features of the prototype include location monitoring via smartphones' global positioning system (GPS) functionality as well as facilitating teen self-appraisal of meeting behavioral expectations. Good behavior is rewarded with points that are tracked by the app and can be used to redeem for real-world rewards. The investigators will conduct an 45-day open trial (N=20 caregiver/teen dyads) to assess use, feasibility and acceptability for teens involved in the juvenile justice system or otherwise struggling with externalizing behavioral problems. Caregivers and teens will be assessed at baseline, before receiving the app, and at the end of the app use period (45 days). The therapist of each caregiver/teen dyad will also be assessed at the end of the app use period. Primary outcomes include: use of app features, monitoring of teen behavior and whereabouts, delivery of real-world rewards, and feasibility and acceptability. Secondary outcomes include: parenting behaviors, externalizing teen behaviors and internalizing teen behaviors.

Detailed description

VillageWhere was pilot tested with a sample of 16 youth and their primary caregiver participating in an EST for a serious conduct problem (Mean age 14.6 years, 52% male, 56% African American, 33% were previously arrested). After completing baseline self-report measures, dyads used the app as desired for 4 weeks, then participated in a post-assessment and qualitative interviews. App usage by both parents and youth was high with little diminished use over the four weeks of the trial. All parents set and used reinforcers for functional behavior and used the find my teen feature; 84% set geolocation expectations for youth's whereabouts at specific times; and 88% set other expectations for the youth (e.g., finish homework), viewed notifications, and regularly used the Find My Teen feature. As expected, parents interacted with the app frequently: 2.4 times per day. Youth used the app on average four times per day. All youth earned and redeemed points for complying with their parent's expectations and routinely viewed their behavior plans (93.3%) and feedback notification messages (86.7%). Parents did not on average use coaching videos (20%). Although the study was not powered to detect statistical significance, a series of paired t-tests were conducted to examine pre- to post-changes on self-report measures. Changes for parents and youth all were in predicted directions, with effect sizes ranging from small to high (average d = .42, range .21-.80). Parents reported greater use of positive parenting behaviors (i.e., rewards and praise), greater discipline consistency, lower overall perceived stress, a higher feeling of influence over youth behavior, and greater parenting efficacy. Youth reported increases in parent use of positive behaviors, consistency, and knowledge of whereabouts. Parent- and youth-reported change in youth aggression and rule-breaking (as measured by the CBCL/YSR). Qualitative results were also positive. Using 7-point scales, parents and youth reported on app satisfaction three times/week. Parent ratings were high (M = 6.0) across items (e.g., The app was helpful today, I have ways to intervene with my teen). Youth satisfaction scores were also high (M = 6.1; e.g., My parent is noticing & rewarding my good behavior; I liked getting app prompts & reminders). Parents reported that the app helped them trust their youth, increase their use of rewards, and made giving rewards easier; they also reported a reduction in youths' excuse-making. Youth perceived that the app allowed them more freedom, because parents had an objective way of verifying their whereabouts. Nearly all youth (89%) liked that their parent was more consistent in paying attention to their positive behaviors and rewarding them for it (versus only being punitive). Both parents and youth described significant improvements in their relationship. In addition, 16 therapists working with the parent-youth dyads also gave qualitative feedback that was highly positive. Therapists stated that they liked the extra accountability the app afforded to teens and the reduction in parent-youth communication issues.

Interventions

Sponsors

National Institute of Mental Health (NIMH)
CollaboratorNIH
Medical University of South Carolina
CollaboratorOTHER
Evidence-Based Practice Institute, Seattle, WA
Lead SponsorINDUSTRY

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
13 Years to No maximum
Healthy volunteers
Yes

Inclusion criteria

* Teen: English speaking, between ages of 13 and 17, juvenile justice involvement and/or externalizing behavioral problems, currently in treatment and will remain in treatment for duration of trial * Caregiver: English speaking, owns Android smart phone, currently in treatment with their teen and will remain in treatment for duration of trial

Exclusion criteria

* N/A

Design outcomes

Primary

MeasureTime frameDescription
App Satisfaction - I Like Getting Prompts and Remindersup to 45 daysYouth/teens in the study were prompted 3 times/week during period of app usage to rate, on a scale of 1 (strongly disagree) to 7 (strongly agree), I like getting prompts and reminders from the app.
App Usage - Parent Set up / Modified an App-based Behavior Plan for the Teenup to 45-daysPercent of parents who set up a behavior plan for teen using app features.
App Usage - Set up and Allocated / Earned Points (Rewards) for Positive Teen Behaviorup to 45-daysHow many parents/caregivers set up a reward system and redeemed at least some points for the teen.
App Usage - Parent Set Geolocation Expectations for the Teen.up to 45-daysPercentage of parent/caregivers who set either required or off-limits locations for their teens.
App Usage - Viewed Notifications Regarding Behavioral Expectations Met/Not Metup to 45 daysThe percentage of participants who viewed notifications that the teen was or was not meeting a behavioral expectation. Both parents and teens had this capability.
App Usage - Viewed Parent Coaching Videosup to 45 daysThe app included 5 brief video vignettes depicting an effective parenting technique.
App Usage - View Progress Graph (Points Earned Over Time)up to 45 daysYouth/teen points earned over time were depicted on a graph for each day of use. To view the graph, caregivers/parents and youth/teens had to click on an app button.
App Satisfaction Rating - the App Was Helpful Todayup to 45 daysParent/caregiver was prompted randomly 3 times each week to rate on a scale of 1 (strongly disagree) to 7 (completely agree), how helpful was the app to you today?
App Satisfaction Rating - I Have Ways to Intervene With my Teen.up to 45 daysParent/caregiver was prompted randomly 3 times each week to rate on a scale of 1 (strongly disagree) to 7 (completely agree), the app gives me new ways of intervening with my teen.
App Satisfaction Rating - Overall Satisfactionup to 45 daysParent/caregiver and teen was prompted randomly 3 times each week to rate on a scale of 1 (totally unsatisfied) to 7 (completely satisfied), overall, how satisfied are you with the app today?
App Satisfaction Rating - Parent is Noticing and Rewarding Good Behaviorup to 45 daysThree times each week, at random, youth/teens were asked to rate on a scale of 1 (strongly disagree) to 7 (strongly agree), my parent is noticing and rewarding good behavior. All ratings were averaged across full period of app use.

Secondary

MeasureTime frameDescription
Achenbach System of Empirically-Based Assessment, Depression SubscaleBaseline and Post assessment (end of 45-day app use period)The Achenbach System of Empirically-Based Assessment is a measure of youth problem behavior and psychiatric symptomatology that has parallel parent (report of teen) and youth (self-report) versions to allow for different perspectives on the problem. The parent version is called the Child Behavior Checklist (CBCL) and the youth version is called the Youth Self Report (YSR). Selected subscales from the CBCL and the YSR were administered before and after the 4 weeks of app usage, in this case, the depression subscale. Higher values indicate worse symptoms. Possible range on this subcale is 0 - 26; a score of 8 or higher indicates clinically significant depression, defined as depressive symptoms higher than that of 93% of teens in the United States.
Achenbach System of Empirically-Based Assessment, Rule-breaking SubscaleBaseline and Post assessment (end of 45-day app use period)The Achenbach System of Empirically-Based Assessment is a measure of youth problem behavior and psychiatric symptomatology that has parallel parent (report of teen) and youth (self-report) versions to allow for different perspectives on the problem. The parent version is called the Child Behavior Checklist (CBCL) and the youth version is called the Youth Self Report (YSR). Selected subscales from the CBCL and the YSR were administered before and after the 4 weeks of app usage, in this case, the rule-breaking subscale. Higher values indicate worse symptoms. Possible range on this subcale is 0 - 34; a score of 9 or higher indicates clinically significant rule-breaking, defined as rule-breaking that is higher than that of 93% of teens in the United States.
Loeber Parental Supervision ScaleBaseline and Post assessment (end of 45-day app use period)This measure of extent to which parents supervise and monitor youth whereabouts was administered to parents/caregivers and to youth/teens before and after the 4 weeks of app usage.This 8-item scale has a scored range of 0 (minimum score) - 16 (maximum score), with high scores indicating more or better parental supervision/monitoring.
Loeber Positive Parenting ScaleBaseline and Post assessment (end of 45-day app use period)This measure of extent to which parents express warmth and encouragement to youth was administered to parents/caregivers and to youth/teens before and after the 4 weeks of app usage.This 9-item scale has a scored range of 0 (minimum score) - 18 (maximum score), with high scores indicating more parental positivity.
Loeber Parental Consistency ScaleBaseline and Post assessment (end of 45-day app use period)This measure of extent to which parents are consistent in their rules, expectations, and discipline techniques with youth was administered to parents/caregivers and to youth/teens before and after the 4 weeks of app usage. This 5-item scale has a scored range of 0 (minimum score) - 10 (maximum score), with high scores indicating more consistent / better parental discipline follow-through.
Loeber Parental Effectiveness ScaleChange over 30 days of app usage (baseline to post-assessment)Degree to which parents feel that their parenting techniques are working in terms of managing teen behavior challenges. This 3-item scale has a scored range of 0 (minimum score) - 8 (maximum score), with high scores indicating better discipline effectiveness (e.g., I feel like the punishment I give works in curbing youth behavior).
Perceived Stress Scale (PSS)Change over 30 days of app usage (baseline to post-assessment)Degree to which parents are experiencing stress related to parenting. This 10-item scale has a scored range of 0 (minimum score) - 40 (maximum score), with high scores indicating more stress related to parenting.
Parental Locus of Control ScaleChange over 30 days of app usage (baseline to post-assessment)Degree to which parents feel efficacious and confident in managing parenting challenges. This 20-item scale has a scored range of 0 (minimum score) - 40 (maximum score), with high scores indicating that the parent has a higher sense of feeling efficacious in their role as a parent.
Loeber Parental Knowledge Scaleover 30 days of app usageYouth report of how much parents actually know about the youth's whereabouts/activities. This 5-item scale has a scored range of 0 (minimum score) - 15 (maximum score), with high scores indicating that the parent knows more about what teens are actually doing.
Achenbach System of Empirically-Based Assessment, Aggression SubscaleBaseline and Post assessment (end of 45-day app use period)The Achenbach System of Empirically-Based Assessment is a measure of youth problem behavior and psychiatric symptomatology that has parallel parent (report of teen) and youth (self-report) versions to allow for different perspectives on the problem. The parent version is called the Child Behavior Checklist (CBCL) and the youth version is called the Youth Self Report (YSR). Selected subscales from the CBCL and the YSR were administered before and after the 4 weeks of app usage, in this case, the aggression subscale. Higher values indicate worse symptoms. Possible range on this subcale is 0 - 36; a score of 13 or higher indicates clinically significant aggression, defined as aggression that is higher than that of 93% of teens in the United States.

Countries

United States

Participant flow

Recruitment details

We completed a four-week within-subjects pre-post trial to determine the usability, acceptability, and feasibility. MST therapists in Seattle, New York City, Hartford, and Washington, DC referred families to the study. Parents contacted the study team to indicate their interest. Therapists of referred families also were enrolled in the study.

Pre-assignment details

Initial App Set Up: Clinicians were solely responsible for assisting families to set up their app; however, many clinicians were uncomfortable with this because they were not tech savvy. Solution: Phase II will include a self-guided setup tool that will empower users (parents, youth) to complete the set up independently.

Participants by arm

ArmCount
Therapists
In this study, all enrolled caregivers and teens will be referred to the study by their participating therapists. All caregiver/teen dyads will use the VillageWhere App Prototype that has been developed for this study. They are requested to use it as often as they would like throughout the duration of the trial. The app is designed to be used several times throughout each day. VillageWhere App
24
Parents/Caregivers
In this study, all enrolled caregivers and teens will be referred to the study by their participating therapists. All caregiver/teen dyads will use the VillageWhere App Prototype that has been developed for this study. They are requested to use it as often as they would like throughout the duration of the trial. The app is designed to be used several times throughout each day. VillageWhere App
32
Youth/Teens
In this study, all enrolled caregivers and teens will be referred to the study by their participating therapists. All caregiver/teen dyads will use the VillageWhere App Prototype that has been developed for this study. They are requested to use it as often as they would like throughout the duration of the trial. The app is designed to be used several times throughout each day. VillageWhere App
32
Total88

Withdrawals & dropouts

PeriodReasonFG000FG001FG002
Overall StudyExited therapy; no longer eligible822
Overall StudyLost to Follow-up055
Overall StudyWithdrawal by Subject099

Baseline characteristics

CharacteristicParents/CaregiversTotalYouth/TeensTherapists
Age, Continuous
Age
41.7 Years
STANDARD_DEVIATION 0
24.15 Years
STANDARD_DEVIATION 0
14.6 Years
STANDARD_DEVIATION 1.6
Ethnicity (NIH/OMB)
Hispanic or Latino
3 Participants8 Participants3 Participants2 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
12 Participants43 Participants11 Participants20 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
17 Participants37 Participants18 Participants2 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Asian
0 Participants1 Participants0 Participants1 Participants
Race (NIH/OMB)
Black or African American
5 Participants11 Participants5 Participants1 Participants
Race (NIH/OMB)
More than one race
1 Participants2 Participants1 Participants0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
17 Participants52 Participants18 Participants17 Participants
Race (NIH/OMB)
White
9 Participants22 Participants8 Participants5 Participants
Region of Enrollment
United States
32 Participants88 Participants32 Participants24 Participants
Sex: Female, Male
Female
15 Participants46 Participants9 Participants22 Participants
Sex: Female, Male
Male
1 Participants10 Participants7 Participants2 Participants

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
0 / 32
other
Total, other adverse events
0 / 32
serious
Total, serious adverse events
0 / 32

Outcome results

Primary

App Satisfaction - I Like Getting Prompts and Reminders

Youth/teens in the study were prompted 3 times/week during period of app usage to rate, on a scale of 1 (strongly disagree) to 7 (strongly agree), I like getting prompts and reminders from the app.

Time frame: up to 45 days

Population: Only teens were provided with this question.

ArmMeasureValue (MEAN)Dispersion
Parents/CaregiversApp Satisfaction - I Like Getting Prompts and Reminders5.62 units on a scaleStandard Deviation 1.27
Primary

App Satisfaction Rating - I Have Ways to Intervene With my Teen.

Parent/caregiver was prompted randomly 3 times each week to rate on a scale of 1 (strongly disagree) to 7 (completely agree), the app gives me new ways of intervening with my teen.

Time frame: up to 45 days

Population: Only parent/caregivers were given this question.

ArmMeasureValue (MEAN)Dispersion
Parents/CaregiversApp Satisfaction Rating - I Have Ways to Intervene With my Teen.6.00 units on a scaleStandard Deviation 1.09
Primary

App Satisfaction Rating - Overall Satisfaction

Parent/caregiver and teen was prompted randomly 3 times each week to rate on a scale of 1 (totally unsatisfied) to 7 (completely satisfied), overall, how satisfied are you with the app today?

Time frame: up to 45 days

Population: Parent/caregiver and teen participants were analyzed separately on this measure.

ArmMeasureValue (MEAN)Dispersion
Parents/CaregiversApp Satisfaction Rating - Overall Satisfaction5.91 units on a scaleStandard Deviation 1.21
Youth/TeensApp Satisfaction Rating - Overall Satisfaction6.14 units on a scaleStandard Deviation 0.72
Primary

App Satisfaction Rating - Parent is Noticing and Rewarding Good Behavior

Three times each week, at random, youth/teens were asked to rate on a scale of 1 (strongly disagree) to 7 (strongly agree), my parent is noticing and rewarding good behavior. All ratings were averaged across full period of app use.

Time frame: up to 45 days

Population: Only youth/teens were provided this question.

ArmMeasureValue (MEAN)Dispersion
Parents/CaregiversApp Satisfaction Rating - Parent is Noticing and Rewarding Good Behavior6.19 units on a scaleStandard Deviation 1.15
Primary

App Satisfaction Rating - the App Was Helpful Today

Parent/caregiver was prompted randomly 3 times each week to rate on a scale of 1 (strongly disagree) to 7 (completely agree), how helpful was the app to you today?

Time frame: up to 45 days

Population: Only parent/caregivers were administered this measure.

ArmMeasureValue (MEAN)Dispersion
Parents/CaregiversApp Satisfaction Rating - the App Was Helpful Today5.95 units on a scaleStandard Deviation 0.999
Primary

App Usage - Parent Set Geolocation Expectations for the Teen.

Percentage of parent/caregivers who set either required or off-limits locations for their teens.

Time frame: up to 45-days

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Parents/CaregiversApp Usage - Parent Set Geolocation Expectations for the Teen.14 Participants
Primary

App Usage - Parent Set up / Modified an App-based Behavior Plan for the Teen

Percent of parents who set up a behavior plan for teen using app features.

Time frame: up to 45-days

Population: All parent/caregiver and teen participants analyzed.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Parents/CaregiversApp Usage - Parent Set up / Modified an App-based Behavior Plan for the Teen16 Participants
Primary

App Usage - Set up and Allocated / Earned Points (Rewards) for Positive Teen Behavior

How many parents/caregivers set up a reward system and redeemed at least some points for the teen.

Time frame: up to 45-days

Population: Percent of caregivers who set and allocated points to the teen (teens who had points redeemed).

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Parents/CaregiversApp Usage - Set up and Allocated / Earned Points (Rewards) for Positive Teen Behavior16 Participants
Primary

App Usage - Viewed Notifications Regarding Behavioral Expectations Met/Not Met

The percentage of participants who viewed notifications that the teen was or was not meeting a behavioral expectation. Both parents and teens had this capability.

Time frame: up to 45 days

Population: All parent/caregiver and teen participants analyzed

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Parents/CaregiversApp Usage - Viewed Notifications Regarding Behavioral Expectations Met/Not Met14 Participants
Youth/TeensApp Usage - Viewed Notifications Regarding Behavioral Expectations Met/Not Met14 Participants
Primary

App Usage - Viewed Parent Coaching Videos

The app included 5 brief video vignettes depicting an effective parenting technique.

Time frame: up to 45 days

Population: Only the parent/caregiver version of the app had this feature.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Parents/CaregiversApp Usage - Viewed Parent Coaching Videos3 Participants
Primary

App Usage - View Progress Graph (Points Earned Over Time)

Youth/teen points earned over time were depicted on a graph for each day of use. To view the graph, caregivers/parents and youth/teens had to click on an app button.

Time frame: up to 45 days

Population: Analyses performed separately for parents and teens.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Parents/CaregiversApp Usage - View Progress Graph (Points Earned Over Time)10 Participants
Youth/TeensApp Usage - View Progress Graph (Points Earned Over Time)8 Participants
Secondary

Achenbach System of Empirically-Based Assessment, Aggression Subscale

The Achenbach System of Empirically-Based Assessment is a measure of youth problem behavior and psychiatric symptomatology that has parallel parent (report of teen) and youth (self-report) versions to allow for different perspectives on the problem. The parent version is called the Child Behavior Checklist (CBCL) and the youth version is called the Youth Self Report (YSR). Selected subscales from the CBCL and the YSR were administered before and after the 4 weeks of app usage, in this case, the aggression subscale. Higher values indicate worse symptoms. Possible range on this subcale is 0 - 36; a score of 13 or higher indicates clinically significant aggression, defined as aggression that is higher than that of 93% of teens in the United States.

Time frame: Baseline and Post assessment (end of 45-day app use period)

Population: Parent/caregivers and youth/teens results were analyzed separately.

ArmMeasureGroupValue (MEAN)Dispersion
Parents/CaregiversAchenbach System of Empirically-Based Assessment, Aggression SubscaleMean at Time 1 (baseline)13.75 units on a scaleStandard Deviation 8.8
Parents/CaregiversAchenbach System of Empirically-Based Assessment, Aggression SubscaleMean at Time 2 (post-usage)12.31 units on a scaleStandard Deviation 8.8
Youth/TeensAchenbach System of Empirically-Based Assessment, Aggression SubscaleMean at Time 1 (baseline)11.29 units on a scaleStandard Deviation 4.82
Youth/TeensAchenbach System of Empirically-Based Assessment, Aggression SubscaleMean at Time 2 (post-usage)10.14 units on a scaleStandard Deviation 5.43
Comparison: Paired sample T tests were used to measure change for parents over time.Paired samples T test (change over time)
Comparison: Paired sample T tests were used to measure change over time for teens.Paired samples T test (change over time)
Secondary

Achenbach System of Empirically-Based Assessment, Depression Subscale

The Achenbach System of Empirically-Based Assessment is a measure of youth problem behavior and psychiatric symptomatology that has parallel parent (report of teen) and youth (self-report) versions to allow for different perspectives on the problem. The parent version is called the Child Behavior Checklist (CBCL) and the youth version is called the Youth Self Report (YSR). Selected subscales from the CBCL and the YSR were administered before and after the 4 weeks of app usage, in this case, the depression subscale. Higher values indicate worse symptoms. Possible range on this subcale is 0 - 26; a score of 8 or higher indicates clinically significant depression, defined as depressive symptoms higher than that of 93% of teens in the United States.

Time frame: Baseline and Post assessment (end of 45-day app use period)

Population: Parent/caregivers and youth/teens results were analyzed separately. Least squares means show amount of difference from pre- to post-testing in paired samples T tests.

ArmMeasureGroupValue (MEAN)Dispersion
Parents/CaregiversAchenbach System of Empirically-Based Assessment, Depression SubscalePre-test mean6.93 units on a scaleStandard Deviation 5.36
Parents/CaregiversAchenbach System of Empirically-Based Assessment, Depression SubscalePost-test mean5.80 units on a scaleStandard Deviation 5.17
Youth/TeensAchenbach System of Empirically-Based Assessment, Depression SubscalePre-test mean6.29 units on a scaleStandard Deviation 4.81
Youth/TeensAchenbach System of Empirically-Based Assessment, Depression SubscalePost-test mean4.71 units on a scaleStandard Deviation 3.91
Comparison: Paired sample T tests were used to measure change for parents over time.Paired samples T test (change over time)
Comparison: Paired sample T tests were used to measure change for teens over time.
Secondary

Achenbach System of Empirically-Based Assessment, Rule-breaking Subscale

The Achenbach System of Empirically-Based Assessment is a measure of youth problem behavior and psychiatric symptomatology that has parallel parent (report of teen) and youth (self-report) versions to allow for different perspectives on the problem. The parent version is called the Child Behavior Checklist (CBCL) and the youth version is called the Youth Self Report (YSR). Selected subscales from the CBCL and the YSR were administered before and after the 4 weeks of app usage, in this case, the rule-breaking subscale. Higher values indicate worse symptoms. Possible range on this subcale is 0 - 34; a score of 9 or higher indicates clinically significant rule-breaking, defined as rule-breaking that is higher than that of 93% of teens in the United States.

Time frame: Baseline and Post assessment (end of 45-day app use period)

Population: Parent/caregivers and youth/teens results were analyzed separately.

ArmMeasureGroupValue (MEAN)Dispersion
Parents/CaregiversAchenbach System of Empirically-Based Assessment, Rule-breaking SubscaleMean at Time 1 (baseline)9.71 units on a scaleStandard Deviation 6.34
Parents/CaregiversAchenbach System of Empirically-Based Assessment, Rule-breaking SubscaleMean at Time 2 (post-usage)9.07 units on a scaleStandard Deviation 6.49
Youth/TeensAchenbach System of Empirically-Based Assessment, Rule-breaking SubscaleMean at Time 1 (baseline)10.07 units on a scaleStandard Deviation 4.2
Youth/TeensAchenbach System of Empirically-Based Assessment, Rule-breaking SubscaleMean at Time 2 (post-usage)9.21 units on a scaleStandard Deviation 4.61
Comparison: Paired sample T tests were used to measure change for parents over time.Paired samples T test (change over time)
Comparison: Paired samples T tests were used to measure change over time for teens.
Secondary

Loeber Parental Consistency Scale

This measure of extent to which parents are consistent in their rules, expectations, and discipline techniques with youth was administered to parents/caregivers and to youth/teens before and after the 4 weeks of app usage. This 5-item scale has a scored range of 0 (minimum score) - 10 (maximum score), with high scores indicating more consistent / better parental discipline follow-through.

Time frame: Baseline and Post assessment (end of 45-day app use period)

Population: Parent/caregivers and youth/teens results were analyzed separately.

ArmMeasureGroupValue (MEAN)Dispersion
Parents/CaregiversLoeber Parental Consistency ScaleMean at Time 1 (baseline)1.87 units on a scaleStandard Deviation 1.64
Parents/CaregiversLoeber Parental Consistency ScaleMean at Time 2 (post-usage)2.27 units on a scaleStandard Deviation 2.02
Youth/TeensLoeber Parental Consistency ScaleMean at Time 1 (baseline)5.21 units on a scaleStandard Deviation 2.01
Youth/TeensLoeber Parental Consistency ScaleMean at Time 2 (post-usage)5.57 units on a scaleStandard Deviation 2.87
Comparison: Paired sample T tests were used to measure change for parents over time.
Comparison: Paired samples T tests were used to measure within-groups change over time for teens.
Secondary

Loeber Parental Effectiveness Scale

Degree to which parents feel that their parenting techniques are working in terms of managing teen behavior challenges. This 3-item scale has a scored range of 0 (minimum score) - 8 (maximum score), with high scores indicating better discipline effectiveness (e.g., I feel like the punishment I give works in curbing youth behavior).

Time frame: Change over 30 days of app usage (baseline to post-assessment)

Population: All parents/caregivers who completed the study.

ArmMeasureGroupValue (MEAN)Dispersion
Parents/CaregiversLoeber Parental Effectiveness ScaleMean at Time 1 (baseline)4.20 units on a scaleStandard Deviation 1.9
Parents/CaregiversLoeber Parental Effectiveness ScaleMean at Time 2 (post-usage)4.40 units on a scaleStandard Deviation 1.88
Comparison: Paired sample T tests were used to measure change for parents over time.
Secondary

Loeber Parental Knowledge Scale

Youth report of how much parents actually know about the youth's whereabouts/activities. This 5-item scale has a scored range of 0 (minimum score) - 15 (maximum score), with high scores indicating that the parent knows more about what teens are actually doing.

Time frame: over 30 days of app usage

Population: Youth/teens who used app only

ArmMeasureGroupValue (MEAN)Dispersion
Parents/CaregiversLoeber Parental Knowledge ScaleMean at Time 1 (baseline)8.07 units on a scaleStandard Deviation 2.73
Parents/CaregiversLoeber Parental Knowledge ScaleMean at Time 2 (post-usage)9.00 units on a scaleStandard Deviation 3.09
Comparison: Paired sample T tests were used to measure change for teens over time.
Secondary

Loeber Parental Supervision Scale

This measure of extent to which parents supervise and monitor youth whereabouts was administered to parents/caregivers and to youth/teens before and after the 4 weeks of app usage.This 8-item scale has a scored range of 0 (minimum score) - 16 (maximum score), with high scores indicating more or better parental supervision/monitoring.

Time frame: Baseline and Post assessment (end of 45-day app use period)

Population: Parent/caregivers and youth/teens results were analyzed separately.

ArmMeasureGroupValue (MEAN)Dispersion
Parents/CaregiversLoeber Parental Supervision ScaleMean at Time 1 (baseline)13.00 units on a scaleStandard Deviation 2.25
Parents/CaregiversLoeber Parental Supervision ScaleMean at Time 2 (post-usage)13.38 units on a scaleStandard Deviation 2.45
Youth/TeensLoeber Parental Supervision ScaleMean at Time 1 (baseline)10.86 units on a scaleStandard Deviation 3.32
Youth/TeensLoeber Parental Supervision ScaleMean at Time 2 (post-usage)11.50 units on a scaleStandard Deviation 2.44
Comparison: Paired sample T tests were used to measure change for parents over time.Paired samples T test (change over time)
Comparison: Paired sample T tests were used to measure change for teens over time.
Secondary

Loeber Positive Parenting Scale

This measure of extent to which parents express warmth and encouragement to youth was administered to parents/caregivers and to youth/teens before and after the 4 weeks of app usage.This 9-item scale has a scored range of 0 (minimum score) - 18 (maximum score), with high scores indicating more parental positivity.

Time frame: Baseline and Post assessment (end of 45-day app use period)

Population: Parent/caregivers and youth/teens results were analyzed separately.

ArmMeasureGroupValue (MEAN)Dispersion
Parents/CaregiversLoeber Positive Parenting ScaleMean at Time 1 (baseline)8.87 units on a scaleStandard Deviation 4.97
Parents/CaregiversLoeber Positive Parenting ScaleMean at Time 2 (post-usage)11.39 units on a scaleStandard Deviation 2.95
Youth/TeensLoeber Positive Parenting ScaleMean at Time 1 (baseline)8.57 units on a scaleStandard Deviation 2.24
Youth/TeensLoeber Positive Parenting ScaleMean at Time 2 (post-usage)8.93 units on a scaleStandard Deviation 2.79
Comparison: Paired sample T tests were used to measure change for parents over time.Paired samples T test (change over time)
Comparison: Paired sample T tests were used to measure change over time for teens.
Secondary

Parental Locus of Control Scale

Degree to which parents feel efficacious and confident in managing parenting challenges. This 20-item scale has a scored range of 0 (minimum score) - 40 (maximum score), with high scores indicating that the parent has a higher sense of feeling efficacious in their role as a parent.

Time frame: Change over 30 days of app usage (baseline to post-assessment)

Population: All parents/caregivers who completed the study.

ArmMeasureGroupValue (MEAN)Dispersion
Parents/CaregiversParental Locus of Control ScaleMean at Time 1 (baseline)15.25 units on a scaleStandard Deviation 6.22
Parents/CaregiversParental Locus of Control ScaleMean at Time 2 (post-usage)18.63 units on a scaleStandard Deviation 8.72
Comparison: Paired sample T tests were used to measure change for parents over time.
Secondary

Perceived Stress Scale (PSS)

Degree to which parents are experiencing stress related to parenting. This 10-item scale has a scored range of 0 (minimum score) - 40 (maximum score), with high scores indicating more stress related to parenting.

Time frame: Change over 30 days of app usage (baseline to post-assessment)

Population: All parents/caregivers who completed the study.

ArmMeasureGroupValue (MEAN)Dispersion
Parents/CaregiversPerceived Stress Scale (PSS)Mean at Time 1 (baseline)18.09 units on a scaleStandard Deviation 8.14
Parents/CaregiversPerceived Stress Scale (PSS)Mean at Time 2 (post-usage)12.73 units on a scaleStandard Deviation 4.45
Comparison: Paired sample T tests were used to measure change for parents over time.

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026