Family Relations, Sibling Relations
Conditions
Keywords
Social Emotional Health
Brief summary
In the United States, over 32.7 million people have special health, developmental, and mental health concerns. Most of these people have typically developing brothers and sisters. Across the lifespan, siblings share high levels of involvement in each other's lives, and also many of the concerns that parents of children with special needs experience, including isolation, a need for information, concerns about the future, and caregiving demands. Brothers and sisters also face issues that are uniquely theirs including emotions (resentment, worry, embarrassment, guilt), peer issues, and family communication challenges. The team of researchers, developers, and consultants built and tested an assistive media enhanced web-application tool for developing knowledge, skills, and routines for attending to TD siblings' (ages 3-5) social-emotional health and well-being.
Detailed description
The investigators conducted a 4-week intervention to assess the English/Spanish, media-enhanced SIBTime web-application tool in terms of its relevance, acceptability, cultural appropriateness, and potential for efficacy to deliver a family-based intervention. The test used a within subjects pre-post design to detect changes in parent self-efficacy, family cohesion, and knowledge, and parent rating of sibling-parent relationship. Additionally, the investigators collected a post-test evaluation of consumer satisfaction and recommendations for modifications to the program.
Interventions
Parents used the dual-language SIBTime app to watch video stories about common sibling experiences, respond to question prompts, track connection routines, and listen to guided Acceptance and Commitment Therapy (ACT) exercises for parents. During the 4-week intervention period, parents used the app at their convenience.
Sponsors
Study design
Eligibility
Inclusion criteria
* Be the primary parent/guardian of a child with a disability * Also be the primary parent/guardian of a typically developing child, 3-5 years old * Speak English or Spanish * Have access to a computer, tablet, or smartphone
Exclusion criteria
• N/A
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| System Usability Scale (SUS) | Week 4 | The System Usability Scale (SUS) is a commonly used 10-item measure (with a 5-point scale) of subjective perceptions of technology usability. To calculate the total SUS score, the responses to all 10 SUS questions are re-scaled and/or re-scored in a way that all items had values from zero to 4 with 4 being the most positive. These converted scores are added and then multiplied by 2.5 to convert the range of possible values 0-100 (instead of from 0 to 40). Higher scores are better. |
| Self-Efficacy for Parenting Tasks Index (SEPTI) Emotional Availability Subscale | Enrollment, and at 4 weeks (after treatment completion) | The Self-Efficacy for Parenting Tasks Index (SEPTI; Coleman & Karraker, 2000) - Emotional Availability subscale measures parents' self-efficacy for providing emotional support to their typically developing child and meeting their child's emotional needs. Parents rate their agreement or disagreement with a series of statements. The SEPTI Emotional Availability subscale is measured with 7 items. Respondents answer on a 6-point scale (1=Agree strongly; 6=Disagree strongly); average scores range from 1 to 6, with higher scores indicating better outcomes. |
| Self-Efficacy for Parenting Tasks Index (SEPTI) Nurturance/Valuing/Empathic Responsiveness Subscale | Enrollment, and at 4 weeks (after treatment completion) | The Self-Efficacy for Parenting Tasks Index (SEPTI; Coleman & Karraker, 2000) - Nurturance/Valuing/Empathic Responsiveness subscale measures parents' self-efficacy for providing empathy, nurturance, and understanding to their typically developing child. Parents rate their agreement or disagreement with a series of statements. The SEPTI Nurturance/Valuing/Empathic Responsiveness subscale is measured with 8 items. Respondents answer on a 6-point scale (1=Agree strongly; 6=Disagree strongly); average scores range from 1 to 6, with higher scores indicating better outcomes. |
| Self-Efficacy for Parenting Tasks Index (SEPTI) Play Subscale | Enrollment, and at 4 weeks (after treatment completion) | The Self-Efficacy for Parenting Tasks Index (SEPTI; Coleman & Karraker, 2000) - Play subscale measures parents' self-efficacy for playing with and having fun with their typically developing child. Parents rate their agreement or disagreement with a series of statements. The SEPTI Play subscale is measured with 7 items. Respondents answer on a 6-point scale (1=Agree strongly; 6=Disagree strongly); average scores range from 1 to 6, with higher scores indicating better outcomes. |
| Self-Efficacy for Parenting Tasks Index (SEPTI) Teaching Subscale | Enrollment, and at 4 weeks (after treatment completion) | The Self-Efficacy for Parenting Tasks Index (SEPTI; Coleman & Karraker, 2000) - Teaching subscale measures parents' self-efficacy for explaining things and teaching their typically developing child about the world in a way that their child can understand. Parents rate their agreement or disagreement with a series of statements. The SEPTI Teaching subscale is measured with 9 items. Respondents answer on a 6-point scale (1=Agree strongly; 6=Disagree strongly); average scores range from 1 to 6, with higher scores indicating better outcomes. |
| Parenting & Family Adjustment Scales (PAFAS) Parent/Child Relationship Subscale | Enrollment, and at 4 weeks (after treatment completion) | The Parenting & Family Adjustment Scales (PAFAS; Sanders et al., 2014) Parent/Child Relationship subscale measures the quality of the parent-child relationship, asking how true various statements have been over the past 4 weeks. The Parent/Child Relationship subscale is measured with 5 items, answered on a 5-point scale (0=Not at all; 4=Very much). Average scores range from 0 to 4, with higher scores indicating worse outcomes. |
| Parenting & Family Adjustment Scales (PAFAS) Parental Adjustment Subscale | Enrollment, and at 4 weeks (after treatment completion) | The Parenting & Family Adjustment Scales (PAFAS; Sanders et al., 2014) measures change in parenting practices, family cohesion, parent-child relationship quality, and parents' stress. The 30 items on the PAFAS sort into 7 subscales: Parental consistency, Coercive parenting, Positive encouragement, Parent-child relationship, Parental adjustment/stress, Family relationships, and Parental teamwork with partner. Items are rated on a 5-point scale (0-4) with higher scores worse. |
| Parenting & Family Adjustment Scales (PAFAS) Family Relationships Subscale | Enrollment, and at 4 weeks (after treatment completion) | The Parenting & Family Adjustment Scales (PAFAS; Sanders et al., 2014) measures change in parenting practices, family cohesion, parent-child relationship quality, and parents' stress. The 30 items on the PAFAS sort into 7 subscales: Parental consistency, Coercive parenting, Positive encouragement, Parent-child relationship, Parental adjustment/stress, Family relationships, and Parental teamwork with partner. Items are rated on a 5-point scale (0-4) with higher scores worse. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Engagement in Target Activities With Child - Self-efficacy | Enrollment, and at 4 weeks (after treatment completion) | The Engagement in Target Activities with Child - Self-Efficacy subscale measures parents' self-efficacy for engaging in specific connection routine activities with their typically developing child in the past month, across 17 items reflecting a range of program-targeted parenting behaviors. Respondents answer on a 10-point scale of how confident they are that they can carry out these behaviors (1=Not at all confident; 10=Highly confident); average scores range from 1 to 10, with higher scores indicating better outcomes. |
| Family Usage of the SIBTime App - Number of Sessions | At 4 weeks (after treatment completion) | Measure the families' usage of the SIBTime app using metrics and transcripts collected on the back-end database, including activation of the app; which elements are accessed; frequency, timing, and duration of engagements; and points of difficulty or failure. |
| Family Usage of the SIBTime App - Program Exposure | At 4 weeks (after treatment completion) | Measure the families' usage of the SIBTime app using metrics and transcripts collected on the back-end database, including activation of the app; which elements are accessed; frequency, timing, and duration of engagements; and points of difficulty or failure. |
| Engagement in Target Activities With Child - Frequency | Enrollment, and at 4 weeks (after treatment completion) | The Engagement in Target Activities with Child - Frequency subscale measures the frequency with which parents report engaging in specific connection routine activities with their typically developing child in the past month, across 17 items reflecting a range of program-targeted parenting behaviors. Respondents answer on a 7-point frequency scale (0=Never in the past month; 6=6 or more times per day); average scores range from 0 to 6, with higher scores indicating better outcomes. |
Countries
United States
Participant flow
Recruitment details
Participants were parents who were enrolled between 6/9/21 and 3/30/22. Participants were recruited through Advisory Board contacts, and social media.
Pre-assignment details
Participants were parents who were enrolled in the study. Parents completed study measures. Parents engaged in activities with their child, but children were not enrolled and no data were collected from children.
Participants by arm
| Arm | Count |
|---|---|
| SIBTime 43 primary parents were assessed at enrollment, then provided the dual-language, media-enhanced SIBTime technology for 4 weeks, and then re-assessed at 4 weeks (after treatment completion).
SIB-Time Web-Application Tool: Parents used the dual-language SIBTime app with their children to watch video stories about common sibling experiences, respond to question prompts, track connection routines, and listen to guided ACT exercises for parents. During the 4-week intervention period, parents used the app at their convenience. | 43 |
| Total | 43 |
Withdrawals & dropouts
| Period | Reason | FG000 |
|---|---|---|
| Overall Study | Withdrawal by Subject | 6 |
Baseline characteristics
| Characteristic | SIBTime |
|---|---|
| Age, Categorical <=18 years | 0 Participants |
| Age, Categorical >=65 years | 0 Participants |
| Age, Categorical Between 18 and 65 years | 43 Participants |
| Ethnicity (NIH/OMB) Hispanic or Latino | 11 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 31 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 1 Participants |
| Parent Demographic Form | 43 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants |
| Race (NIH/OMB) Asian | 4 Participants |
| Race (NIH/OMB) Black or African American | 1 Participants |
| Race (NIH/OMB) More than one race | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 12 Participants |
| Race (NIH/OMB) White | 26 Participants |
| Region of Enrollment United States | 43 participants |
| Sex: Female, Male Female | 42 Participants |
| Sex: Female, Male Male | 1 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 0 / 43 |
| other Total, other adverse events | 0 / 43 |
| serious Total, serious adverse events | 0 / 43 |
Outcome results
Parenting & Family Adjustment Scales (PAFAS) Family Relationships Subscale
The Parenting & Family Adjustment Scales (PAFAS; Sanders et al., 2014) measures change in parenting practices, family cohesion, parent-child relationship quality, and parents' stress. The 30 items on the PAFAS sort into 7 subscales: Parental consistency, Coercive parenting, Positive encouragement, Parent-child relationship, Parental adjustment/stress, Family relationships, and Parental teamwork with partner. Items are rated on a 5-point scale (0-4) with higher scores worse.
Time frame: Enrollment, and at 4 weeks (after treatment completion)
Population: Primary parents of a child with a disability and a preschool age typically developing child.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| SIBTime | Parenting & Family Adjustment Scales (PAFAS) Family Relationships Subscale | Pretest | 0.99 score on a scale | Standard Deviation 0.59 |
| SIBTime | Parenting & Family Adjustment Scales (PAFAS) Family Relationships Subscale | Posttest | 0.94 score on a scale | Standard Deviation 0.58 |
Parenting & Family Adjustment Scales (PAFAS) Parental Adjustment Subscale
The Parenting & Family Adjustment Scales (PAFAS; Sanders et al., 2014) measures change in parenting practices, family cohesion, parent-child relationship quality, and parents' stress. The 30 items on the PAFAS sort into 7 subscales: Parental consistency, Coercive parenting, Positive encouragement, Parent-child relationship, Parental adjustment/stress, Family relationships, and Parental teamwork with partner. Items are rated on a 5-point scale (0-4) with higher scores worse.
Time frame: Enrollment, and at 4 weeks (after treatment completion)
Population: Primary parents of a child with a disability and a preschool age typically developing child.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| SIBTime | Parenting & Family Adjustment Scales (PAFAS) Parental Adjustment Subscale | Pretest | 1.17 score on a scale | Standard Deviation 0.71 |
| SIBTime | Parenting & Family Adjustment Scales (PAFAS) Parental Adjustment Subscale | Posttest | 1.07 score on a scale | Standard Deviation 0.64 |
Parenting & Family Adjustment Scales (PAFAS) Parent/Child Relationship Subscale
The Parenting & Family Adjustment Scales (PAFAS; Sanders et al., 2014) Parent/Child Relationship subscale measures the quality of the parent-child relationship, asking how true various statements have been over the past 4 weeks. The Parent/Child Relationship subscale is measured with 5 items, answered on a 5-point scale (0=Not at all; 4=Very much). Average scores range from 0 to 4, with higher scores indicating worse outcomes.
Time frame: Enrollment, and at 4 weeks (after treatment completion)
Population: Primary parents of a child with a disability and a preschool age typically developing child.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| SIBTime | Parenting & Family Adjustment Scales (PAFAS) Parent/Child Relationship Subscale | Pretest | 0.26 score on a scale | Standard Deviation 0.32 |
| SIBTime | Parenting & Family Adjustment Scales (PAFAS) Parent/Child Relationship Subscale | Posttest | 0.26 score on a scale | Standard Deviation 0.35 |
Self-Efficacy for Parenting Tasks Index (SEPTI) Emotional Availability Subscale
The Self-Efficacy for Parenting Tasks Index (SEPTI; Coleman & Karraker, 2000) - Emotional Availability subscale measures parents' self-efficacy for providing emotional support to their typically developing child and meeting their child's emotional needs. Parents rate their agreement or disagreement with a series of statements. The SEPTI Emotional Availability subscale is measured with 7 items. Respondents answer on a 6-point scale (1=Agree strongly; 6=Disagree strongly); average scores range from 1 to 6, with higher scores indicating better outcomes.
Time frame: Enrollment, and at 4 weeks (after treatment completion)
Population: Primary parents of a child with a disability and a preschool age typically developing child.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| SIBTime | Self-Efficacy for Parenting Tasks Index (SEPTI) Emotional Availability Subscale | Pretest | 2.07 score on a scale | Standard Deviation 0.69 |
| SIBTime | Self-Efficacy for Parenting Tasks Index (SEPTI) Emotional Availability Subscale | Posttest | 1.93 score on a scale | Standard Deviation 0.51 |
Self-Efficacy for Parenting Tasks Index (SEPTI) Nurturance/Valuing/Empathic Responsiveness Subscale
The Self-Efficacy for Parenting Tasks Index (SEPTI; Coleman & Karraker, 2000) - Nurturance/Valuing/Empathic Responsiveness subscale measures parents' self-efficacy for providing empathy, nurturance, and understanding to their typically developing child. Parents rate their agreement or disagreement with a series of statements. The SEPTI Nurturance/Valuing/Empathic Responsiveness subscale is measured with 8 items. Respondents answer on a 6-point scale (1=Agree strongly; 6=Disagree strongly); average scores range from 1 to 6, with higher scores indicating better outcomes.
Time frame: Enrollment, and at 4 weeks (after treatment completion)
Population: Primary parents of a child with a disability and a preschool age typically developing child.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| SIBTime | Self-Efficacy for Parenting Tasks Index (SEPTI) Nurturance/Valuing/Empathic Responsiveness Subscale | Pretest | 1.93 score on a scale | Standard Deviation 0.5 |
| SIBTime | Self-Efficacy for Parenting Tasks Index (SEPTI) Nurturance/Valuing/Empathic Responsiveness Subscale | Posttest | 1.75 score on a scale | Standard Deviation 0.37 |
Self-Efficacy for Parenting Tasks Index (SEPTI) Play Subscale
The Self-Efficacy for Parenting Tasks Index (SEPTI; Coleman & Karraker, 2000) - Play subscale measures parents' self-efficacy for playing with and having fun with their typically developing child. Parents rate their agreement or disagreement with a series of statements. The SEPTI Play subscale is measured with 7 items. Respondents answer on a 6-point scale (1=Agree strongly; 6=Disagree strongly); average scores range from 1 to 6, with higher scores indicating better outcomes.
Time frame: Enrollment, and at 4 weeks (after treatment completion)
Population: Primary parents of a child with a disability and a preschool age typically developing child.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| SIBTime | Self-Efficacy for Parenting Tasks Index (SEPTI) Play Subscale | Pretest | 2.98 score on a scale | Standard Deviation 1.17 |
| SIBTime | Self-Efficacy for Parenting Tasks Index (SEPTI) Play Subscale | Posttest | 2.64 score on a scale | Standard Deviation 0.89 |
Self-Efficacy for Parenting Tasks Index (SEPTI) Teaching Subscale
The Self-Efficacy for Parenting Tasks Index (SEPTI; Coleman & Karraker, 2000) - Teaching subscale measures parents' self-efficacy for explaining things and teaching their typically developing child about the world in a way that their child can understand. Parents rate their agreement or disagreement with a series of statements. The SEPTI Teaching subscale is measured with 9 items. Respondents answer on a 6-point scale (1=Agree strongly; 6=Disagree strongly); average scores range from 1 to 6, with higher scores indicating better outcomes.
Time frame: Enrollment, and at 4 weeks (after treatment completion)
Population: Primary parents of a child with a disability and a preschool age typically developing child.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| SIBTime | Self-Efficacy for Parenting Tasks Index (SEPTI) Teaching Subscale | Pretest | 2.39 score on a scale | Standard Deviation 0.74 |
| SIBTime | Self-Efficacy for Parenting Tasks Index (SEPTI) Teaching Subscale | Posttest | 2.23 score on a scale | Standard Deviation 0.68 |
System Usability Scale (SUS)
The System Usability Scale (SUS) is a commonly used 10-item measure (with a 5-point scale) of subjective perceptions of technology usability. To calculate the total SUS score, the responses to all 10 SUS questions are re-scaled and/or re-scored in a way that all items had values from zero to 4 with 4 being the most positive. These converted scores are added and then multiplied by 2.5 to convert the range of possible values 0-100 (instead of from 0 to 40). Higher scores are better.
Time frame: Week 4
Population: Primary parents of a child with a disability and a preschool age typically developing child.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| SIBTime | System Usability Scale (SUS) | 81.99 score on a scale | Standard Deviation 14.47 |
Engagement in Target Activities With Child - Frequency
The Engagement in Target Activities with Child - Frequency subscale measures the frequency with which parents report engaging in specific connection routine activities with their typically developing child in the past month, across 17 items reflecting a range of program-targeted parenting behaviors. Respondents answer on a 7-point frequency scale (0=Never in the past month; 6=6 or more times per day); average scores range from 0 to 6, with higher scores indicating better outcomes.
Time frame: Enrollment, and at 4 weeks (after treatment completion)
Population: Primary parents of a child with a disability and a preschool age typically developing child.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| SIBTime | Engagement in Target Activities With Child - Frequency | Pretest | 3.62 score on a scale | Standard Deviation 0.8 |
| SIBTime | Engagement in Target Activities With Child - Frequency | Posttest | 3.88 score on a scale | Standard Deviation 0.87 |
Engagement in Target Activities With Child - Self-efficacy
The Engagement in Target Activities with Child - Self-Efficacy subscale measures parents' self-efficacy for engaging in specific connection routine activities with their typically developing child in the past month, across 17 items reflecting a range of program-targeted parenting behaviors. Respondents answer on a 10-point scale of how confident they are that they can carry out these behaviors (1=Not at all confident; 10=Highly confident); average scores range from 1 to 10, with higher scores indicating better outcomes.
Time frame: Enrollment, and at 4 weeks (after treatment completion)
Population: Primary parents of a child with a disability and a preschool age typically developing child.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| SIBTime | Engagement in Target Activities With Child - Self-efficacy | Pretest | 7.65 score on a scale | Standard Deviation 1.46 |
| SIBTime | Engagement in Target Activities With Child - Self-efficacy | Posttest | 8.56 score on a scale | Standard Deviation 1.1 |
Family Usage of the SIBTime App - Number of Sessions
Measure the families' usage of the SIBTime app using metrics and transcripts collected on the back-end database, including activation of the app; which elements are accessed; frequency, timing, and duration of engagements; and points of difficulty or failure.
Time frame: At 4 weeks (after treatment completion)
Population: Primary parents of a child with a disability and a preschool age typically developing child.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| SIBTime | Family Usage of the SIBTime App - Number of Sessions | 5.6 Number of sessions | Standard Deviation 4.2 |
Family Usage of the SIBTime App - Program Exposure
Measure the families' usage of the SIBTime app using metrics and transcripts collected on the back-end database, including activation of the app; which elements are accessed; frequency, timing, and duration of engagements; and points of difficulty or failure.
Time frame: At 4 weeks (after treatment completion)
Population: Primary parents of a child with a disability and a preschool age typically developing child.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| SIBTime | Family Usage of the SIBTime App - Program Exposure | 69.9 Percentage of program exposed to | Standard Deviation 34.3 |