Skip to content

Literacy Promotion Using Automated Hovering

Literary Promotion Using Automated Hovering to Improve Development in Young Low-Income Children

Status
Completed
Phases
NA
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT04576481
Acronym
LP
Enrollment
55
Registered
2020-10-06
Start date
2020-11-17
Completion date
2022-02-04
Last updated
2024-11-15

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

Conditions

Literacy, Parent-Child Relations, Parenting

Brief summary

The purpose of this study is to incorporate behavioral economics (BE) approaches to determine whether 3 novel interventions of varying intensity improve the frequency of parent-child reading behaviors among low-income families. In the first phase, 10 parents will be recruited to participate in rapid cycle interviews to determine the appropriateness of text messages. In the second phase, 45 participants will be randomized to comparative groups to test the effects of automated hovering and other BE approaches on frequency of parent-child shared reading. Investigators long-term goal is to test the effects of these approaches to promote child language and socio-emotional development.

Detailed description

Early childhood is a sensitive period in which young children develop language and socio-emotional skills foundational for school readiness. Unfortunately, poor vulnerable children experience disparities in these critical areas of development. Parent-child shared reading can help ameliorate these disparities, yet low-income parents do not consistently engage in this activity. Behavioral economics approaches utilizing automated hovering (AH) have the potential to increase parent-child shared reading through text messages and financial inducements. The study design is a two-phase study consisting of a qualitative component followed by a prospective, randomized comparative group trial to test the effects of AH approaches to increase parent-child shared reading. A total of 55 eligible children and their parents will be recruited from participating practices to achieve a diverse sample of children. In the first phase, 10 parents will be recruited to participate in brief rapid cycle interviews to assess the appropriateness of text message reminders. In the second phase, forty-five participants will be randomized 1:1:1 to receive one of the 3 AH interventions: 1) daily text message reminders (texting), 2) daily text message reminders with social comparisons (regret) or 3) daily text message reminders with social comparisons and weekly lottery entries (lottery). All interventions are related to principles of behavioral economics in order to provide external motivation. There will be 15 participants per group to adequately assess feasibility and acceptability, the primary outcome. Descriptive statistics for demographic, home reading environment, and parenting stress measured at baseline will be examined across the three groups to assess the success of the randomization. To assess feasibility and acceptability, Investigators will assess the proportion of participants who receive and report a daily reading behavior each week across all groups, the proportion of participants who access coaching content in group 2 & 3, and the proportion of participants who participate in the weekly lottery in group 3, and satisfaction scores in all groups. Secondary outcomes including differences between groups in weekly reading frequency, home reading environment, and child socio-emotional scores between groups will be assessed using standard inferential statistics and intention-to-treat analysis. The results of this study may assist health care providers and researchers in testing the feasibility of AH approaches to improve parent-child shared reading and prepare for a larger efficacy trial.

Interventions

BEHAVIORALTexting

Text Messages will be sent to participants using Penn's Way to Health Platform. Participants will be asked to reply to daily text messages on daily shared reading activities including the titles of books and time spent reading.

BEHAVIORALRegret

Personalized coaching content will be made available to participants through links in the text messages and will provide comparisons of their reading frequency with that of other participants.

BEHAVIORALLottery

Participants who reply to a text message that they read on a particular day will be entered into daily and weekly drawings to receive cash payments.

Sponsors

University of Pennsylvania
CollaboratorOTHER
Children's Hospital of Philadelphia
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Outcomes Assessor)

Masking description

Participants will not be blinded to their treatment assignment. However, research staff will be blinded to treatment assignment when collecting study data.

Intervention model description

The intervention consists of 3 intervention groups. Participants will be stratified by site and randomized 1:1:1 to receive one of the 3 AH interventions for an 8-week duration.

Eligibility

Sex/Gender
ALL
Age
6 Months to 24 Months
Healthy volunteers
Yes

Inclusion criteria

* Parents who: * Have an infant aged 6-24 months * Have access to a smart phone with text messaging capabilities * Have completed an informed consent * Children who: * Are aged 6-24 months old

Exclusion criteria

* Parents who: \- Non-English speaking * Children who: * Were born premature (estimated gestational age \< 35 weeks) * Have been diagnosed with congenital malformations or genetic syndromes which place them at risk for developmental delays

Design outcomes

Primary

MeasureTime frameDescription
Acceptability Survey2 monthsTo determine acceptability, participants will be assessed on their overall satisfaction (5-point Likert scale 1=strong disagree, 2=disagree, 3=not sure, 4=agree and 5= strongly agree) with the study delivery intervention and answered survey questions regarding likes and dislikes concerning the intervention group they received following the intervention period.
Feasibility of Study2 monthsPercentage of study participants who completed the 2-month follow-up

Secondary

MeasureTime frameDescription
Change in Weekly Parent-Child Shared Reading Frequency2 monthsInvestigators will measure reading frequency as the average number of days per week of reported parent-child shared reading. This is a measure of parent's self-reported reading frequency using question 2 from Cognitive Stimulation Provided in the Home Measure Reading Subscales, Parents are asked How many days each week do you read children's books to your child?. Scores will be collected at baseline and at the 2-month follow-up. Change in reading frequency will be computed by subtracting the days reading at baseline from the days reading at follow-up.
Change in Score of Cognitive Stimulation Provided in the Home Measure - (StimQ-Read)2 monthsTo determine change in home reading environment, Investigators will examine differences in the Read subscale of the measure of Cognitive Stimulation provided in the home (StimQ) from baseline to 2 months. The Read subscale of the StimQ is a validated 14-item parent self-report questionnaire designed to measure of the home reading environment for children ages 5 to 72 months of age with a maximum score of 18 and a minimum score of 0. The higher score indicates a better home reading environment. The change in score from baseline to follow-up (2-months) will be used.
Measure of Child Language Development Using MacArthur Communicative Development Inventory (CDI) - Percentiles2 monthsInvestigators measured child language development at 2 months using the MacArthur Communicative Development Inventory (CDI), a validated parent report scale of early child language development for children 8-30 months of age. Parents are asked to indicate the words their child understands but does not yet say in the first column (understands). For words that their child understands, Parents are asked to indicate which words their child says in the second column (understand and says). The raw total scores are inputted into a norming table for the CDI where a production (understand and says) and comprehension (understands) scores are generated based on the child's age and gender. Total scores can range from (0-178) with higher scores on the norming chart correlating to a higher percentile in comprehension or production. Total score is calculated by using summed scores where: blank = 0, understands = 1 and understands and speaks=2. Total scores were converted to percentile scores.
Measure of Child Socio-Emotional Development Using Devereux Early Childhood Assessment (DECA)2 monthsInvestigators will measure child socio-emotional development at 2 months using the Devereax Early Childhood Assessment (DECA), a validated 33-item parent report of social emotional problems for children 9-36 months of age. All 33 items are used to calculate the raw total protective factor (TPF). 18/33 items are used to calculate raw Initiative sub scale (infant's ability to use independent thought and action to meet his/her needs). 15/33 items are used to calculate raw Attachment/Relationships sub scale (mutual, strong, long-lasting relationship between the infant and significant adults such as family members, and teachers). Higher scores indicate greater social emotional development. For all 33 items parents can report (Never 0, Rarely 1, Occasionally 2, Frequently 3, Very Frequently 4). Raw total scores can range from 0-132, with higher scores indicating a better outcome.
Change in Score for The Parenting Stress Index - Short Form (PSI-SF)2 monthsTo determine change in parenting stress, Investigators will examine differences in the Parenting Stress Index- Short Form (PSI-SF) from baseline to follow-up (2 months). The PSI-SF is a validated 36-item scale that measures parenting stress, and it has been shown to have excellent internal consistency and to be positively associated with maternal psychological distress. The scores can range from 36 to 180 with an higher scores overall indicating higher levels of parenting stress. The change in score from baseline to follow-up (2-months) will be used.

Countries

United States

Participant flow

Recruitment details

Study participants in phase 1were parents only and were enrolled between November 17, 2020-June 30,2022 at the two participating practices. Study participants in phase 2 were parent-child dyads and were enrolled from July 20, 2021-October 28, 2021 at the two participating practices.

Pre-assignment details

10 mothers of eligible children were enrolled in phase 1 and completed brief rapid cycle interviews. Demographic characteristics of these 10 participants were not collected.

Participants by arm

ArmCount
Phase 2 Texting Arm: Text Messaging
Consist of daily text messages on shared reading Text Messaging: Text Messages will be sent to participants using Penn's Way to Health Platform. Participants will be asked to reply to daily text messages on daily shared reading activities including the titles of books and time spent reading.
15
Phase 2 Regret Arm: Text Messaging + Coaching
Will consist of Group 1 plus personalized coaching. Text Messaging: Text Messages will be sent to participants using Penn's Way to Health Platform. Participants will be asked to reply to daily text messages on daily shared reading activities including the titles of books and time spent reading. Coaching: Personalized coaching content will be made available to participants through links in the text messages and will provide comparisons of their reading frequency with that of other participants.
15
Phase 2 Lottery Arm: Text Messaging + Coaching + Lottery
Will consist of Group 2 plus availability of a weekly lottery. Text Messaging: Text Messages will be sent to participants using Penn's Way to Health Platform. Participants will be asked to reply to daily text messages on daily shared reading activities including the titles of books and time spent reading. Coaching: Personalized coaching content will be made available to participants through links in the text messages and will provide comparisons of their reading frequency with that of other participants. Lottery: Participants who reply to a text message that they read on a particular day will be entered into daily and weekly drawings to receive cash payments.
15
Total45

Withdrawals & dropouts

PeriodReasonFG000FG001FG002FG003
Randomized Controlled Trial (Phase 2)Lost to Follow-up0131

Baseline characteristics

CharacteristicPhase 2 Texting Arm: Text MessagingPhase 2 Lottery Arm: Text Messaging + Coaching + LotteryPhase 2 Regret Arm: Text Messaging + CoachingTotal
Age, Continuous29.5 Years
STANDARD_DEVIATION 6.7
28.2 Years
STANDARD_DEVIATION 3.9
11.9 Months
STANDARD_DEVIATION 3.3
11.8 Months
STANDARD_DEVIATION 4
Children per caregiver2.3 avg. number children per caregiver
STANDARD_DEVIATION 1.8
2.2 avg. number children per caregiver
STANDARD_DEVIATION 1.1
1.8 avg. number children per caregiver
STANDARD_DEVIATION 1.2
2.1 avg. number children per caregiver
STANDARD_DEVIATION 1.4
Education
Grades 9-11
0 Participants1 Participants2 Participants3 Participants
Education
High School/GED
6 Participants10 Participants5 Participants21 Participants
Education
Post-college
0 Participants1 Participants1 Participants2 Participants
Education
Some college/ college graduate
9 Participants3 Participants5 Participants17 Participants
Ethnicity (NIH/OMB)
Ethnicity of Caregiver Enrolled
Hispanic or Latino
1 Participants1 Participants0 Participants2 Participants
Ethnicity (NIH/OMB)
Ethnicity of Caregiver Enrolled
Not Hispanic or Latino
14 Participants14 Participants13 Participants41 Participants
Ethnicity (NIH/OMB)
Ethnicity of Caregiver Enrolled
Unknown or Not Reported
0 Participants0 Participants0 Participants0 Participants
Ethnicity (NIH/OMB)
Ethnicity of Children Enrolled
Hispanic or Latino
1 Participants1 Participants0 Participants2 Participants
Ethnicity (NIH/OMB)
Ethnicity of Children Enrolled
Not Hispanic or Latino
14 Participants14 Participants13 Participants41 Participants
Ethnicity (NIH/OMB)
Ethnicity of Children Enrolled
Unknown or Not Reported
0 Participants0 Participants0 Participants0 Participants
Income
<$25,000
4 Participants8 Participants7 Participants19 Participants
Income
$25,000 - $54,999
7 Participants3 Participants3 Participants13 Participants
Income
>$55,000
2 Participants1 Participants2 Participants5 Participants
Marital Status
Married/Living together
6 Participants4 Participants5 Participants15 Participants
Marital Status
Single, never married
9 Participants11 Participants8 Participants28 Participants
Measure of Cognitive Stimulation Provided in the Home (Reading Subscale)12.9 units on a scale
STANDARD_DEVIATION 3.2
15 units on a scale
STANDARD_DEVIATION 3.6
12.8 units on a scale
STANDARD_DEVIATION 4.5
13.6 units on a scale
STANDARD_DEVIATION 3.8
Parenting Stress Index-Short Form (PSI-SF)56.3 units on a scale
STANDARD_DEVIATION 18.6
53.6 units on a scale
STANDARD_DEVIATION 13.3
62.6 units on a scale
STANDARD_DEVIATION 22.5
57.5 units on a scale
STANDARD_DEVIATION 18.5
Race (NIH/OMB)
Caregiver
American Indian or Alaska Native
0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Caregiver
Asian
0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Caregiver
Black or African American
13 Participants14 Participants8 Participants35 Participants
Race (NIH/OMB)
Caregiver
More than one race
1 Participants1 Participants5 Participants7 Participants
Race (NIH/OMB)
Caregiver
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Caregiver
Unknown or Not Reported
0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Caregiver
White
1 Participants0 Participants0 Participants1 Participants
Race (NIH/OMB)
Child
American Indian or Alaska Native
0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Child
Asian
0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Child
Black or African American
14 Participants13 Participants8 Participants35 Participants
Race (NIH/OMB)
Child
More than one race
0 Participants0 Participants5 Participants5 Participants
Race (NIH/OMB)
Child
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Child
Unknown or Not Reported
0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Child
White
1 Participants2 Participants0 Participants3 Participants
Recruitment Site
Cobbs Creek
3 Participants1 Participants2 Participants6 Participants
Recruitment Site
Karabots
12 Participants14 Participants13 Participants39 Participants
Sex: Female, Male
Sex of caregiver enrolled
Female
14 Participants15 Participants13 Participants42 Participants
Sex: Female, Male
Sex of caregiver enrolled
Male
1 Participants0 Participants2 Participants3 Participants
Sex: Female, Male
Sex of child enrolled
Female
8 Participants4 Participants8 Participants20 Participants
Sex: Female, Male
Sex of child enrolled
Male
7 Participants11 Participants7 Participants25 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
EG003
affected / at risk
deaths
Total, all-cause mortality
0 / 100 / 150 / 150 / 15
other
Total, other adverse events
0 / 100 / 150 / 150 / 15
serious
Total, serious adverse events
0 / 100 / 150 / 150 / 15

Outcome results

Primary

Acceptability Survey

To determine acceptability, participants will be assessed on their overall satisfaction (5-point Likert scale 1=strong disagree, 2=disagree, 3=not sure, 4=agree and 5= strongly agree) with the study delivery intervention and answered survey questions regarding likes and dislikes concerning the intervention group they received following the intervention period.

Time frame: 2 months

Population: A total of 42 participant completed the measure. 3 participants were lost to follow-up

ArmMeasureValue (MEAN)Dispersion
Phase 2 Texting Arm: Text MessagingAcceptability Survey4 score on a scaleStandard Deviation 1.1
Phase 2 Regret Arm: Text Messaging + CoachingAcceptability Survey3.3 score on a scaleStandard Deviation 1.3
Phase 2 Lottery Arm: Text Messaging + Coaching + LotteryAcceptability Survey3.8 score on a scaleStandard Deviation 1.2
Primary

Feasibility of Study

Percentage of study participants who completed the 2-month follow-up

Time frame: 2 months

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Phase 2 Texting Arm: Text MessagingFeasibility of Study14 Participants
Phase 2 Regret Arm: Text Messaging + CoachingFeasibility of Study13 Participants
Phase 2 Lottery Arm: Text Messaging + Coaching + LotteryFeasibility of Study15 Participants
Phase 1Feasibility of Study10 Participants
Secondary

Change in Score for The Parenting Stress Index - Short Form (PSI-SF)

To determine change in parenting stress, Investigators will examine differences in the Parenting Stress Index- Short Form (PSI-SF) from baseline to follow-up (2 months). The PSI-SF is a validated 36-item scale that measures parenting stress, and it has been shown to have excellent internal consistency and to be positively associated with maternal psychological distress. The scores can range from 36 to 180 with an higher scores overall indicating higher levels of parenting stress. The change in score from baseline to follow-up (2-months) will be used.

Time frame: 2 months

ArmMeasureValue (MEAN)Dispersion
Phase 2 Texting Arm: Text MessagingChange in Score for The Parenting Stress Index - Short Form (PSI-SF)2.2 score on a scaleStandard Deviation 18.2
Phase 2 Regret Arm: Text Messaging + CoachingChange in Score for The Parenting Stress Index - Short Form (PSI-SF)5.3 score on a scaleStandard Deviation 16.4
Phase 2 Lottery Arm: Text Messaging + Coaching + LotteryChange in Score for The Parenting Stress Index - Short Form (PSI-SF)9 score on a scaleStandard Deviation 34.5
p-value: 0.78ANOVA
Secondary

Change in Score of Cognitive Stimulation Provided in the Home Measure - (StimQ-Read)

To determine change in home reading environment, Investigators will examine differences in the Read subscale of the measure of Cognitive Stimulation provided in the home (StimQ) from baseline to 2 months. The Read subscale of the StimQ is a validated 14-item parent self-report questionnaire designed to measure of the home reading environment for children ages 5 to 72 months of age with a maximum score of 18 and a minimum score of 0. The higher score indicates a better home reading environment. The change in score from baseline to follow-up (2-months) will be used.

Time frame: 2 months

ArmMeasureValue (MEAN)Dispersion
Phase 2 Texting Arm: Text MessagingChange in Score of Cognitive Stimulation Provided in the Home Measure - (StimQ-Read)1.8 score on a scaleStandard Deviation 2.8
Phase 2 Regret Arm: Text Messaging + CoachingChange in Score of Cognitive Stimulation Provided in the Home Measure - (StimQ-Read)3.2 score on a scaleStandard Deviation 4
Phase 2 Lottery Arm: Text Messaging + Coaching + LotteryChange in Score of Cognitive Stimulation Provided in the Home Measure - (StimQ-Read)1.3 score on a scaleStandard Deviation 2.7
Comparison: Analysis of Variance statistical testing.p-value: 0.32ANOVA
Secondary

Change in Weekly Parent-Child Shared Reading Frequency

Investigators will measure reading frequency as the average number of days per week of reported parent-child shared reading. This is a measure of parent's self-reported reading frequency using question 2 from Cognitive Stimulation Provided in the Home Measure Reading Subscales, Parents are asked How many days each week do you read children's books to your child?. Scores will be collected at baseline and at the 2-month follow-up. Change in reading frequency will be computed by subtracting the days reading at baseline from the days reading at follow-up.

Time frame: 2 months

ArmMeasureGroupValue (MEAN)Dispersion
Phase 2 Texting Arm: Text MessagingChange in Weekly Parent-Child Shared Reading FrequencyDays per week reading at 2-month follow-up3.9 days per week readingStandard Deviation 2
Phase 2 Texting Arm: Text MessagingChange in Weekly Parent-Child Shared Reading FrequencyDays per week reading at baseline4.1 days per week readingStandard Deviation 1.8
Phase 2 Texting Arm: Text MessagingChange in Weekly Parent-Child Shared Reading FrequencyChange in reading frequency (days per week-0.3 days per week readingStandard Deviation 2.2
Phase 2 Regret Arm: Text Messaging + CoachingChange in Weekly Parent-Child Shared Reading FrequencyDays per week reading at 2-month follow-up4.2 days per week readingStandard Deviation 1.7
Phase 2 Regret Arm: Text Messaging + CoachingChange in Weekly Parent-Child Shared Reading FrequencyDays per week reading at baseline4.0 days per week readingStandard Deviation 1.8
Phase 2 Regret Arm: Text Messaging + CoachingChange in Weekly Parent-Child Shared Reading FrequencyChange in reading frequency (days per week0.2 days per week readingStandard Deviation 2.6
Phase 2 Lottery Arm: Text Messaging + Coaching + LotteryChange in Weekly Parent-Child Shared Reading FrequencyDays per week reading at baseline4.8 days per week readingStandard Deviation 1.5
Phase 2 Lottery Arm: Text Messaging + Coaching + LotteryChange in Weekly Parent-Child Shared Reading FrequencyChange in reading frequency (days per week0.1 days per week readingStandard Deviation 1.7
Phase 2 Lottery Arm: Text Messaging + Coaching + LotteryChange in Weekly Parent-Child Shared Reading FrequencyDays per week reading at 2-month follow-up4.9 days per week readingStandard Deviation 1.5
p-value: 0.19ANOVA
Secondary

Measure of Child Language Development Using MacArthur Communicative Development Inventory (CDI) - Percentiles

Investigators measured child language development at 2 months using the MacArthur Communicative Development Inventory (CDI), a validated parent report scale of early child language development for children 8-30 months of age. Parents are asked to indicate the words their child understands but does not yet say in the first column (understands). For words that their child understands, Parents are asked to indicate which words their child says in the second column (understand and says). The raw total scores are inputted into a norming table for the CDI where a production (understand and says) and comprehension (understands) scores are generated based on the child's age and gender. Total scores can range from (0-178) with higher scores on the norming chart correlating to a higher percentile in comprehension or production. Total score is calculated by using summed scores where: blank = 0, understands = 1 and understands and speaks=2. Total scores were converted to percentile scores.

Time frame: 2 months

Population: A total of 7 participants were unable to be used in CDI calculations. 3 participants were lost to follow-up and an additional 4 participant scores were dropped due to aging out of measure's age range (\>18 mo at time survey was completed).

ArmMeasureValue (MEAN)Dispersion
Phase 2 Texting Arm: Text MessagingMeasure of Child Language Development Using MacArthur Communicative Development Inventory (CDI) - Percentiles84.6 Score Percentiles (%)Standard Deviation 29.7
Phase 2 Regret Arm: Text Messaging + CoachingMeasure of Child Language Development Using MacArthur Communicative Development Inventory (CDI) - Percentiles78.5 Score Percentiles (%)Standard Deviation 33.2
Phase 2 Lottery Arm: Text Messaging + Coaching + LotteryMeasure of Child Language Development Using MacArthur Communicative Development Inventory (CDI) - Percentiles63.1 Score Percentiles (%)Standard Deviation 42.6
p-value: 0.3ANOVA
Secondary

Measure of Child Socio-Emotional Development Using Devereux Early Childhood Assessment (DECA)

Investigators will measure child socio-emotional development at 2 months using the Devereax Early Childhood Assessment (DECA), a validated 33-item parent report of social emotional problems for children 9-36 months of age. All 33 items are used to calculate the raw total protective factor (TPF). 18/33 items are used to calculate raw Initiative sub scale (infant's ability to use independent thought and action to meet his/her needs). 15/33 items are used to calculate raw Attachment/Relationships sub scale (mutual, strong, long-lasting relationship between the infant and significant adults such as family members, and teachers). Higher scores indicate greater social emotional development. For all 33 items parents can report (Never 0, Rarely 1, Occasionally 2, Frequently 3, Very Frequently 4). Raw total scores can range from 0-132, with higher scores indicating a better outcome.

Time frame: 2 months

Population: A total of 7 participants did not complete DECA. 3 participants were lost to follow-up and 4 participant scores were dropped (\>18 mo at time of measure completion).

ArmMeasureGroupValue (MEAN)Dispersion
Phase 2 Texting Arm: Text MessagingMeasure of Child Socio-Emotional Development Using Devereux Early Childhood Assessment (DECA)Initiative Score77.6 score on a scaleStandard Deviation 18.7
Phase 2 Texting Arm: Text MessagingMeasure of Child Socio-Emotional Development Using Devereux Early Childhood Assessment (DECA)Attachment/Relationship Score79.4 score on a scaleStandard Deviation 19.4
Phase 2 Regret Arm: Text Messaging + CoachingMeasure of Child Socio-Emotional Development Using Devereux Early Childhood Assessment (DECA)Initiative Score64.3 score on a scaleStandard Deviation 27.3
Phase 2 Regret Arm: Text Messaging + CoachingMeasure of Child Socio-Emotional Development Using Devereux Early Childhood Assessment (DECA)Attachment/Relationship Score66.6 score on a scaleStandard Deviation 31.2
Phase 2 Lottery Arm: Text Messaging + Coaching + LotteryMeasure of Child Socio-Emotional Development Using Devereux Early Childhood Assessment (DECA)Initiative Score72.1 score on a scaleStandard Deviation 28.6
Phase 2 Lottery Arm: Text Messaging + Coaching + LotteryMeasure of Child Socio-Emotional Development Using Devereux Early Childhood Assessment (DECA)Attachment/Relationship Score75.6 score on a scaleStandard Deviation 27.8
p-value: 0.46ANOVA

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