Type 1 Diabetes Mellitus
Conditions
Brief summary
Mothers of adolescents with type 1 diabetes experience high levels of depressive symptoms, which impair their ability to monitor and manage diabetes treatment effectively. Further, maternal depressive symptoms are one of the strongest predictors of negative outcomes in adolescents, including deteriorating glycemic control, problems with adherence, poorer quality of life, and greater risk for depression. Given that adolescents are a high-risk population for suboptimal glycemic control - with only 17% meeting treatment goals - there is a critical need for novel interventions to improve outcomes in adolescents with T1D. Yet, previous behavioral interventions for youth with diabetes have had only modest effects on glycemic control, and none have directly targeted maternal depressive symptoms. Building on effective interventions to treat depression in adults, and our own pilot work in this population, the proposed study will use a rigorous approach to evaluate the efficacy of a cognitive-behavioral intervention for mothers of adolescents with type 1 diabetes to promote the use of adaptive coping strategies and positive parenting practices. The aims of this study are to: 1) evaluate the effects of the Communication & Coping intervention on diabetes-related outcomes; 2) evaluate the effects of the Communication & Coping intervention on psychosocial outcomes; and 3) explore the differential impact of the intervention across demographic factors. Mothers who are randomized to the Communication & Coping Intervention will receive individual cognitive-behavioral therapy sessions by phone, as well as access to a Facebook group to augment the material covered in calls and provide social support. Mothers randomized to the Attention Control condition will receive educational materials and phone check-ins, as well as a Facebook group with educational posts. Adolescents and their mothers will be assessed at baseline and again post-intervention, at 3 months, 6 months, and 12 months.
Detailed description
Mothers of adolescents with type 1 diabetes experience high levels of depressive symptoms, which impair their ability to monitor and manage diabetes treatment effectively. The regimen recommended for type 1 diabetes is complex and demanding, and caregivers - especially mothers - experience stress related to the burden of treatment management. This stress is associated with increased risk for psychosocial problems in caregivers, with rates of clinically significant depressive symptoms evident in up to 61% of parents. Further, maternal depressive symptoms are one of the strongest predictors of negative outcomes in adolescents, including deteriorating glycemic control, problems with adherence, poorer quality of life, and greater risk for depression. Given that adolescents are a high-risk population for suboptimal glycemic control - with only 17% meeting treatment goals - there is a critical need for novel interventions to improve outcomes in adolescents with T1D. Yet, previous behavioral interventions for youth with diabetes have had only modest effects on glycemic control, and none have directly targeted maternal depressive symptoms. Responding to the American Diabetes Association's call to address the psychosocial needs of people with diabetes and their family members, the proposed project has the potential to improve outcomes in both adolescents with type 1 diabetes and their mothers. Building on effective interventions to treat depression in adults, and our own pilot work in this population, the proposed study will use a rigorous approach to evaluate the efficacy of a cognitive-behavioral intervention for mothers of adolescents with type 1 diabetes to promote the use of adaptive coping strategies and positive parenting practices. The aims of this study are to: 1) evaluate the effects of the Communication & Coping intervention on diabetes-related outcomes; 2) evaluate the effects of the Communication & Coping intervention on psychosocial outcomes; and 3) explore the differential impact of the intervention across demographic factors. Mothers who are randomized to the Communication & Coping Intervention will receive individual cognitive-behavioral therapy sessions by phone, as well as access to a Facebook group to augment the material covered in calls and provide social support. Mothers randomized to the Attention Control condition will receive educational materials and phone check-ins, as well as a Facebook group with educational posts. Adolescents and their mothers will be assessed at baseline and again post-intervention, at 3 months, 6 months, and 12 months. We hypothesize that the adolescents of mothers who receive the intervention will demonstrate improvements in diabetes outcomes (i.e., glycemic control, adherence), as well as psychosocial outcomes (i.e., improved quality of life, fewer depressive symptoms) compared to those in the attention control condition. This approach is innovative by targeting maternal depressive symptoms and the quality of parental involvement in mothers of adolescents with type 1 diabetes.
Interventions
BEHAVIORALCommunication & Coping Intervention
Mothers receive a treatment manual and participate in individual phone calls aimed at reducing depressive symptoms and improving the quality of parental involvement. A concurrent secret Facebook group will have daily posts to reinforce concepts.
BEHAVIORALEducation & Check Ins
Mothers receive educational materials and participate in individual phone calls related to these materials. A concurrent secret Facebook group will have daily educational posts.
Sponsors
University of Connecticut
Vanderbilt University Medical Center
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* Female caregiver of an adolescent with type 1 diabetes * Adolescent age 11-17 * Adolescent diagnosed with type 1 diabetes for at least 12 months * Caregiver reports mild to moderate depressive symptoms (PHQ-9 score of 5-19) OR OR caregiver reports diabetes distress (Parent/Teen Relationship Distress Subscale score of 2 or higher) * English speaking
Exclusion criteria
* Caregiver reports minimal depressive symptoms (PHQ-9 score less than 5) * Caregiver reports severe depressive symptoms (PHQ-9 score 20 or higher) * Caregiver reports history of severe psychopathology (bipolar disorder or schizophrenia) * Caregiver reports that adolescent has history of severe psychopathology (bipolar disorder or schizophrenia)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Glycemic Control (A1C) | 12 months | Hemoglobin A1c measured as part of clinic visit indicates the amount of glucose attached to hemoglobin. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Mothers' Diabetes Distress | 3 months | Parent Diabetes Distress Scale (PDDS) is a measure consisting of 20 items to rate diabetes-related stress for parents of children with type 1 diabetes. A mean total score will be calculated, ranging from 0-5, with higher scores indicating greater distress. |
| Adolescent Psychosocial Functioning - Parent Report | 3 months | Child Behavior Checklist (CBCL) is a parent-reported measure of behavior problems in children ages 6-18. Raw scores are converted to age- and sex-normed T-Scores (mean = 50, SD = 10). Higher scores indicate greater problem behaviors. |
| Adolescent Psychosocial Functioning - Self Report | 3 months | Youth Self Report (YSR) is a measure of self-reported behavior problems in youth ages 11-18. The Child Behavior Checklist was completed by caregivers as a proxy report of adolescent's behaviors. Raw scores are converted to age- and sex-normed T-Scores (mean = 50, SD = 10). Higher scores indicate greater problem behaviors. |
| Adolescent Quality of Life | 3 months | Pediatric Quality of Life (PedsQL) is a self-reported measure of diabetes-related quality of life in youth. Scaled scores range from 0-100, with higher scores indicating better quality of life. |
| Diabetes-related Family Conflict - Parent Report | 3 months | Diabetes-specific family conflict was measured with the Revised Diabetes Family Conflict Scale (DFCS), which consists of 19 items regarding how much adolescents and parents argue about diabetes management. Scores range from 19-57, with higher scores indicating higher levels of conflict. |
| Maternal Depressive Symptoms | 3 months | Depressive symptoms measured using the Patient Health Questionnaire (PHQ-9), a 9-item measure. Scores range from 0-27; scores 0-4 indicate minimal depression, scores 5-9 indicate mild depression, scores 10-14 indicate moderate depression, scores 15-19 indicate moderately severe depression, and scores 20-27 indicate severe depression. |
| Adolescent Diabetes Distress | 3 months | Problem Area in Diabetes - Teen (PAID-T) consists of 14 items measuring adolescents' diabetes distress. Scores range from 14-84, and scores of 44 or higher are considered clinically meaningful. |
| Diabetes Knowledge | 3 months | Revised Brief Diabetes Knowledge Test is a measure of parents' diabetes knowledge. It consists of 23 items that ask about diabetes-related information. Scores range from 0-23, with higher scores indicating greater diabetes knowledge. |
| Parental Involvement | 3 months | Collaborative Parent Involvement (CPI) is a 12-item scale completed by adolescents to assess parental involvement in diabetes care. Mean scores range from 1-5, with higher scores indicating more collaborative parental involvement. |
| Adolescent Adherence | 3 months | Self Care Inventory (SCI) is a 14-item measure completed by adolescents to assess their diabetes self-management behaviors. Mean scores range from 1-5, and higher scores indicate better adherence to the diabetes regimen. |
| Quality of Parental Involvement | 6 months | Mothers and adolescents will participate in a videotaped conversation, which will be scored by objective raters using the Iowa Family Interaction Rating Scales (IFIRS). The collaborative parenting composite includes the following codes: Communication; Positive Reinforcement; and Child Centered. Scores on the collaborative parenting composite range from 3-27, with higher scores indicating higher levels of collaborative parenting. The overinvolved/intrusive parenting composite includes: Parental Influence; Intrusiveness; and Lecture/Moralize. Scores on the overinvolved scale range from 3-27, with higher scores indicating higher levels of observed behavior. |
| Diabetes-related Family Conflict - Adolescent Report | 3 months | Diabetes-specific family conflict will be measured with the Revised Diabetes Family Conflict Scale (DFCS), which consists of 19 items regarding how much adolescents and parents argue about diabetes management. Scores range from 19-57, with higher scores indicating higher levels of conflict. |
Countries
United States
Participant flow
Recruitment details
Recruited from the Children's Diabetes Program at Vanderbilt, as well as the Vanderbilt Research Notifications Distribution List.
Pre-assignment details
Caregiver-adolescent dyads were enrolled and randomized. After enrollment, maternal caregiver participants were required to connect to the study Facebook account prior to randomization. Protocol Enrollment, Number Started, and Completed reflect participants. 3 dyads were enrolled but not randomized: Two caregivers completed baseline data but did not connect to the study Facebook account. One dyad consented and started baseline surveys but decided not to continue.
Participants by arm
| Arm | Count |
|---|---|
| Communication & Coping Intervention A cognitive behavioral intervention for mothers of adolescents with type 1 diabetes to improve coping and the quality of parental involvement.
Communication & Coping Intervention: Mothers receive a treatment manual and participate in individual phone calls aimed at reducing depressive symptoms and improving the quality of parental involvement. A concurrent secret Facebook group will have daily posts to reinforce concepts. | 150 |
| Education & Check Ins The comparison group receives educational materials on diabetes management and phone calls, as well as access to a secret Facebook group with daily posts on diabetes management.
Education & Check Ins: Mothers receive educational materials and participate in individual phone calls related to these materials. A concurrent secret Facebook group will have daily educational posts. | 152 |
| Total | 302 |
Baseline characteristics
| Characteristic | Communication & Coping Intervention | Education & Check Ins | Total |
|---|---|---|---|
| Age, Continuous Adolescent Age | 14 years | 14 years | 14 years |
| Age, Continuous Caregiver Age | 42 years | 41 years | 42 years |
| Ethnicity (NIH/OMB) Adolescent Ethnicity Hispanic or Latino | 3 Participants | 2 Participants | 5 Participants |
| Ethnicity (NIH/OMB) Adolescent Ethnicity Not Hispanic or Latino | 72 Participants | 74 Participants | 146 Participants |
| Ethnicity (NIH/OMB) Adolescent Ethnicity Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| Ethnicity (NIH/OMB) Maternal Caregiver Ethnicity Hispanic or Latino | 2 Participants | 2 Participants | 4 Participants |
| Ethnicity (NIH/OMB) Maternal Caregiver Ethnicity Not Hispanic or Latino | 73 Participants | 74 Participants | 147 Participants |
| Ethnicity (NIH/OMB) Maternal Caregiver Ethnicity Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| Hemoglobin A1c | 8.2 percentage of glycated hemoglobin | 8.7 percentage of glycated hemoglobin | 8.5 percentage of glycated hemoglobin |
| Household Income $100,000 or more | 27 Participants | 27 Participants | 54 Participants |
| Household Income <$19,999 | 4 Participants | 4 Participants | 8 Participants |
| Household Income $20-$39,999 | 5 Participants | 8 Participants | 13 Participants |
| Household Income $40-$59,999 | 13 Participants | 11 Participants | 24 Participants |
| Household Income $60-$79,999 | 14 Participants | 13 Participants | 27 Participants |
| Household Income $80-$99,999 | 11 Participants | 12 Participants | 23 Participants |
| Household Income Missing | 1 Participants | 1 Participants | 2 Participants |
| Marital Status Married/Partnered | 60 Participants | 62 Participants | 122 Participants |
| Marital Status Single/Divorced/Widowed | 15 Participants | 14 Participants | 29 Participants |
| Race (NIH/OMB) Adolescent Race American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Adolescent Race Asian | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Adolescent Race Black or African American | 5 Participants | 9 Participants | 14 Participants |
| Race (NIH/OMB) Adolescent Race More than one race | 6 Participants | 2 Participants | 8 Participants |
| Race (NIH/OMB) Adolescent Race Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Adolescent Race Unknown or Not Reported | 1 Participants | 0 Participants | 1 Participants |
| Race (NIH/OMB) Adolescent Race White | 63 Participants | 65 Participants | 128 Participants |
| Race (NIH/OMB) Maternal Caregiver Race American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Maternal Caregiver Race Asian | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Maternal Caregiver Race Black or African American | 5 Participants | 7 Participants | 12 Participants |
| Race (NIH/OMB) Maternal Caregiver Race More than one race | 2 Participants | 0 Participants | 2 Participants |
| Race (NIH/OMB) Maternal Caregiver Race Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Maternal Caregiver Race Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Maternal Caregiver Race White | 68 Participants | 69 Participants | 137 Participants |
| Region of Enrollment United States | 75 participants | 76 participants | 151 participants |
| Sex: Female, Male Adolescent Sex Female | 45 Participants | 39 Participants | 84 Participants |
| Sex: Female, Male Adolescent Sex Male | 30 Participants | 37 Participants | 67 Participants |
| Sex: Female, Male Caregiver Sex Female | 75 Participants | 76 Participants | 151 Participants |
| Sex: Female, Male Caregiver Sex Male | 0 Participants | 0 Participants | 0 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 75 | 0 / 76 |
| other Total, other adverse events | 7 / 75 | 5 / 76 |
| serious Total, serious adverse events | 2 / 75 | 3 / 76 |
Outcome results
Primary
Glycemic Control (A1C)
Hemoglobin A1c measured as part of clinic visit indicates the amount of glucose attached to hemoglobin.
Time frame: 12 months
Population: Only adolescents participants have the A1C value.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Communication & Coping Intervention | Glycemic Control (A1C) | 8.4 Percentage of glycated hemoglobin |
| Education & Check Ins | Glycemic Control (A1C) | 8.5 Percentage of glycated hemoglobin |
Secondary
Adolescent Adherence
Self Care Inventory (SCI) is a 14-item measure completed by adolescents to assess their diabetes self-management behaviors. Mean scores range from 1-5, and higher scores indicate better adherence to the diabetes regimen.
Time frame: 3 months
Population: Only adolescent participants completed this measure.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Communication & Coping Intervention | Adolescent Adherence | 3.6 score on a scale |
| Education & Check Ins | Adolescent Adherence | 3.7 score on a scale |
Secondary
Adolescent Diabetes Distress
Problem Area in Diabetes - Teen (PAID-T) consists of 14 items measuring adolescents' diabetes distress. Scores range from 14-84, and scores of 44 or higher are considered clinically meaningful.
Time frame: 3 months
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Communication & Coping Intervention | Adolescent Diabetes Distress | 74 score on a scale | Standard Deviation 30 |
| Education & Check Ins | Adolescent Diabetes Distress | 64 score on a scale | Standard Deviation 27 |
Secondary
Adolescent Psychosocial Functioning - Parent Report
Child Behavior Checklist (CBCL) is a parent-reported measure of behavior problems in children ages 6-18. Raw scores are converted to age- and sex-normed T-Scores (mean = 50, SD = 10). Higher scores indicate greater problem behaviors.
Time frame: 3 months
Population: Only maternal caregiver participants completed this measure.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Communication & Coping Intervention | Adolescent Psychosocial Functioning - Parent Report | Internalizing Problems | 55.4 T-Score | Standard Deviation 8.7 |
| Communication & Coping Intervention | Adolescent Psychosocial Functioning - Parent Report | Externalizing Problems | 51.2 T-Score | Standard Deviation 9.9 |
| Communication & Coping Intervention | Adolescent Psychosocial Functioning - Parent Report | Depressive Problems | 58.5 T-Score | Standard Deviation 7.9 |
| Education & Check Ins | Adolescent Psychosocial Functioning - Parent Report | Internalizing Problems | 57.3 T-Score | Standard Deviation 12.6 |
| Education & Check Ins | Adolescent Psychosocial Functioning - Parent Report | Externalizing Problems | 52.4 T-Score | Standard Deviation 10.2 |
| Education & Check Ins | Adolescent Psychosocial Functioning - Parent Report | Depressive Problems | 60.8 T-Score | Standard Deviation 10.1 |
Secondary
Adolescent Psychosocial Functioning - Self Report
Youth Self Report (YSR) is a measure of self-reported behavior problems in youth ages 11-18. The Child Behavior Checklist was completed by caregivers as a proxy report of adolescent's behaviors. Raw scores are converted to age- and sex-normed T-Scores (mean = 50, SD = 10). Higher scores indicate greater problem behaviors.
Time frame: 3 months
Population: Only adolescent participants completed this measure.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Communication & Coping Intervention | Adolescent Psychosocial Functioning - Self Report | Internalizing Problems | 53.6 T-Score | Standard Deviation 12.3 |
| Communication & Coping Intervention | Adolescent Psychosocial Functioning - Self Report | Externalizing Problems | 48.9 T-Score | Standard Deviation 10.9 |
| Communication & Coping Intervention | Adolescent Psychosocial Functioning - Self Report | Depressive Problems | 58.5 T-Score | Standard Deviation 9 |
| Education & Check Ins | Adolescent Psychosocial Functioning - Self Report | Internalizing Problems | 54.4 T-Score | Standard Deviation 12.5 |
| Education & Check Ins | Adolescent Psychosocial Functioning - Self Report | Externalizing Problems | 48.6 T-Score | Standard Deviation 10.2 |
| Education & Check Ins | Adolescent Psychosocial Functioning - Self Report | Depressive Problems | 58.4 T-Score | Standard Deviation 8.3 |
Secondary
Adolescent Quality of Life
Pediatric Quality of Life (PedsQL) is a self-reported measure of diabetes-related quality of life in youth. Scaled scores range from 0-100, with higher scores indicating better quality of life.
Time frame: 3 months
Population: Only adolescent participants completed this measure.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Communication & Coping Intervention | Adolescent Quality of Life | 67 score on a scale | Standard Deviation 15 |
| Education & Check Ins | Adolescent Quality of Life | 69 score on a scale | Standard Deviation 14 |
Secondary
Diabetes Knowledge
Revised Brief Diabetes Knowledge Test is a measure of parents' diabetes knowledge. It consists of 23 items that ask about diabetes-related information. Scores range from 0-23, with higher scores indicating greater diabetes knowledge.
Time frame: 3 months
Population: Only maternal caregiver participants completed this measure.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Communication & Coping Intervention | Diabetes Knowledge | 69 percentage of items correct | Standard Deviation 37 |
| Education & Check Ins | Diabetes Knowledge | 82 percentage of items correct | Standard Deviation 27 |
Secondary
Diabetes-related Family Conflict - Adolescent Report
Diabetes-specific family conflict will be measured with the Revised Diabetes Family Conflict Scale (DFCS), which consists of 19 items regarding how much adolescents and parents argue about diabetes management. Scores range from 19-57, with higher scores indicating higher levels of conflict.
Time frame: 3 months
Population: Only adolescent participants completed this measure.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Communication & Coping Intervention | Diabetes-related Family Conflict - Adolescent Report | 30.1 score on a scale | Standard Deviation 9.8 |
| Education & Check Ins | Diabetes-related Family Conflict - Adolescent Report | 30.2 score on a scale | Standard Deviation 10.7 |
Secondary
Diabetes-related Family Conflict - Parent Report
Diabetes-specific family conflict was measured with the Revised Diabetes Family Conflict Scale (DFCS), which consists of 19 items regarding how much adolescents and parents argue about diabetes management. Scores range from 19-57, with higher scores indicating higher levels of conflict.
Time frame: 3 months
Population: Only maternal caregiver participants completed this measure.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Communication & Coping Intervention | Diabetes-related Family Conflict - Parent Report | 28.2 score on a scale | Standard Deviation 4.9 |
| Education & Check Ins | Diabetes-related Family Conflict - Parent Report | 28.8 score on a scale | Standard Deviation 6.8 |
Secondary
Maternal Depressive Symptoms
Depressive symptoms measured using the Patient Health Questionnaire (PHQ-9), a 9-item measure. Scores range from 0-27; scores 0-4 indicate minimal depression, scores 5-9 indicate mild depression, scores 10-14 indicate moderate depression, scores 15-19 indicate moderately severe depression, and scores 20-27 indicate severe depression.
Time frame: 3 months
Population: Only maternal caregiver participants completed this measure.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Communication & Coping Intervention | Maternal Depressive Symptoms | 6.4 score on a scale | Standard Deviation 4.6 |
| Education & Check Ins | Maternal Depressive Symptoms | 5.1 score on a scale | Standard Deviation 4.6 |
Secondary
Mothers' Diabetes Distress
Parent Diabetes Distress Scale (PDDS) is a measure consisting of 20 items to rate diabetes-related stress for parents of children with type 1 diabetes. A mean total score will be calculated, ranging from 0-5, with higher scores indicating greater distress.
Time frame: 3 months
Population: Only maternal caregiver participants completed this measure.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Communication & Coping Intervention | Mothers' Diabetes Distress | 1.58 score on a scale | Standard Deviation 0.8 |
| Education & Check Ins | Mothers' Diabetes Distress | 1.72 score on a scale | Standard Deviation 0.84 |
Secondary
Parental Involvement
Collaborative Parent Involvement (CPI) is a 12-item scale completed by adolescents to assess parental involvement in diabetes care. Mean scores range from 1-5, with higher scores indicating more collaborative parental involvement.
Time frame: 3 months
Population: Only adolescent participants completed this measure.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Communication & Coping Intervention | Parental Involvement | 4.1 score on a scale | Standard Deviation 0.8 |
| Education & Check Ins | Parental Involvement | 4.0 score on a scale | Standard Deviation 0.9 |
Secondary
Quality of Parental Involvement
Mothers and adolescents will participate in a videotaped conversation, which will be scored by objective raters using the Iowa Family Interaction Rating Scales (IFIRS). The collaborative parenting composite includes the following codes: Communication; Positive Reinforcement; and Child Centered. Scores on the collaborative parenting composite range from 3-27, with higher scores indicating higher levels of collaborative parenting. The overinvolved/intrusive parenting composite includes: Parental Influence; Intrusiveness; and Lecture/Moralize. Scores on the overinvolved scale range from 3-27, with higher scores indicating higher levels of observed behavior.
Time frame: 6 months
Population: Analysis conducted if participants had baseline and 6 month videos.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Communication & Coping Intervention | Quality of Parental Involvement | Collaborative Parent Behaviors | 14.8 score on a scale | Standard Deviation 3.6 |
| Communication & Coping Intervention | Quality of Parental Involvement | Intrusive Parent Behaviors | 9.6 score on a scale | Standard Deviation 4.2 |
| Education & Check Ins | Quality of Parental Involvement | Collaborative Parent Behaviors | 13.1 score on a scale | Standard Deviation 3.6 |
| Education & Check Ins | Quality of Parental Involvement | Intrusive Parent Behaviors | 9.9 score on a scale | Standard Deviation 4 |