Burnout, Parents
Conditions
Keywords
VIPP-SD online, maternal sensitivity, parental burnout, infant attachment, parental limit-setting
Brief summary
The goal of this randomized controlled trial is to test whether the online Video-feedback Intervention to Promote Positive Parenting and Sensitive Discipline (VIPP-SD) can reduce parental burnout and improve parenting practices, in mothers of young children in Chile. The main questions it aims to answer are: * Does the online VIPP-SD increase maternal sensitivity and the use of consistent but gentle limit setting? * Does it reduce parental burnout? * Does it improve parental stress and child attachment security and reduce child conduct problems? Researchers will compare families who receive the online VIPP-SD to families in a waitlist control group with dummy treatment to see if VIPP-SD has benefits for parents and children. Participants will be mothers of children aged 11-16 months at the start of the study who report elevated levels of parental burnout. Mothers in the intervention group will: * Take part in 12 weekly online sessions with a trained intervener * Receive video-feedback on their own interactions with their child * Learn strategies to respond sensitively to their child's needs and to use positive discipline The study will also measure potential moderators such as maternal mental health, child temperament, and family sociodemographic factors.
Interventions
BEHAVIORALVideo Intervention to Promote Positive Parenting and sensitive discipline (VIPP-SD)
The intervention is delivered through a videoconference platform that allows 1) to record the parent-child tasks and 2) to simultaneously share the previously recorded parent- child interaction and provide feedback. The intervener provides directions in the recording sessions that ensure clearly capturing parent and child facial expressions during the task. Moreover, considering the delivery format, it is essential that both parents and interveners have access to good-quality internet and an electronic device (mobile phone, computer, tablet) with camera. To prevent fatigue arising from the delivery format, it was decided to shorten the sessions, with 30-minute sessions for recording the parent-child task and 40-60-minute sessions for video reviewing and feedback. Thus, Online-VIPP has 12 sessions with alternating recording sessions and video feedback sessions.
Sponsors
Universidad San Sebastián
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Mothers \>18 years * Child age between 11 - 16 months old at first contact * Mothers scoring in the top 30% of our sample on the Parental Burnout Scale (BPPS) * Written informed consent of mothers as participants and guardians * Internet connection at mother's home.
Exclusion criteria
* Child or parent with severe sensory impairment, learning disability, or language limitation * Sibling already participating in the trial * Family participating in active family court proceedings * Parent participating in another closely related research trial and/or receiving an individual video-feedback intervention.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Maternal sensitivity | Pre-test (pre-intervention for the experimental group and at the same time for the control group), and post-test (1 month after the end of the intervention). | The Ainsworth et al. sensitivity scale will be used to measure maternal sensitivity in a 10-minute free play session. Trained observers code the caregiver's behavior using two rating scales: Sensitivity vs. Insensitivity and Cooperation vs. Intrusiveness, on a scale ranging from 1 to 9, with high values indicating greater sensitivity and cooperation. The procedure will be applied twice, first in the pre-test at home and again in the post-test in the laboratory. |
| Maternal Limit Setting | Pre-test (pre-intervention for the experimental group and at the same time for the control group), and post-test (1 month after the end of the intervention). | Parental limit-setting will be observed in a don't touch task. The task is video-taped and parental limit- setting is coded for positive discipline, using an adapted version of the revised Erickson 7-point rating scale for supportive presence, physical interference, rated on a 5-point scale, and Laxness, rated on a 5-point scale. |
| Parental Burnout | Pre-test (pre-intervention for the experimental group and at the same time for the control group), and posttest (1 month after the end of the intervention). | The Parental Burnout Assessment (PBA) is a 23-item questionnaire measuring the four dimensions of parental burnout: exhaustion - physical and emotional tiredness, contrast - the perceived discrepancy between the ideal caregiver they would like to be and the one they are currently, a comparison that produces guilt, feelings of being fed up - feeling tired of the parental role, and emotional distancing - putting an affective distance between themselves and their children). The Likert scale response options are: "never" (0), "a few times a year or less" (1), "once a month or less" (2), "a few times a month" (3), "once a week" (4), "a few times a week" (5), "every day" (6). High scores imply high levels of parental burnout. |
| Fidelity of the Online VIPP-SD | Immediately after the intervention | Based on written and audio-recorded feedback of sessions, fidelity will be coded in terms of the delivery of key components of the treatment, as well as global adherence to the manual. Note that fidelity is promoted by regular intervision and supervision sessions. We will randomly select 10% of audio recordings for two assessors trained in the intervention to rate the adherence to the VIPP-SD manual using a 5-point scale (1 = Did not follow the manual at all, 2 = Adapted most of the material, did not follow the manual closely, 3 = Sometimes adapted the material, followed manual somewhat, 4 = Adapted only minor elements, followed the manual quite closely, and 5 = Followed the manual very closely and delivered the session as specified). A score of 3 will be set as the acceptable fidelity threshold, as to receive this score most core components of the intervention are present in the feedback. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Hair Cortisol Concentrations | Pre-test (pre-intervention for the experimental group and at the same time for the control group), and post-test (1 month after the end of the intervention). | Hair samples will be collected by a trained research assistant. As hair grows approximately 1 cm per month (4 cm at least per sample), every 1 cm segment of hair represents the past month. To collect hair samples, a strain of hair at the base of the vertex posterior of the scalp is selected and cut right at the scalp. Hair samples will be put into foil and stored at a dark location at room-temperature until sent to the lab for analysis. |
| Child Conduct Problems | Pre-test (pre-intervention for the experimental group and at the same time for the control group), and post-test (1 month after the end of the intervention) | Child conduct problems will be measured using the parent-reported Child Behavior Checklist (CBCL) at the pre- and posttest. The CBCL is a 100-item questionnaire that asks parents to rate how true the behavior is of their child over the last two months on a three-point scale (0 = not true, 1 = somewhat true, or 2 = very true or often true). The measure gives a total score, and scores for externalizing and internalizing behavior problems. The externalizing score is made up of scores for attention problems and aggressive behaviors. We will use the aggresive behaviors subscale to evaluate child conduct problems. This measure will additionally be used in the economic evaluation. |
| Infant attachment security | Post-test (1 month after the end of the intervention). | The Strange Situation Procedure (SSP), considered the "gold standard measure" for the assessment of infant attachment pattern in a laboratory procedure, will be used at the post-test. The SSP consists of a series of eight episodes in which the child is exposed to stressful situations such as the entry of a stranger into the room and brief separation from the caregiver, alternating with meetings with the caregiver. The procedure is conducted in a one-way laboratory room set up as a living room with toys and requires recording for later coding. For the attachment outcome, the coding will be based on the continuous scale of security, secure v/s insecure dichotomic classifications, and the D-scale. |
| Health and social care service use | Pre-test (pre-intervention for the experimental group and at the same time for the control group), and post-test (1 month after the end of the intervention) | Health and social care service use in experimental and control groups will be measured using the Child and Adolescent Service Use Schedule (CA-SUS). Parents report their own and their child's use of accommodation, hospital, community health and social services, and prescribed medication. This measure will be used for economic evaluation. |
| Parent's quality of life | Pre-test (pre-intervention for the experimental group and at the same time for the control group), and post-test (1 month after the end of the intervention) | Quality of life will be measured with the 36-Item Short Form Health Survey questionnaire (SF-36). The SF-36 is a self-report questionnaire assessing health-related quality of life across eight physical and mental health domains. This measure will be used for economic evaluation. |
Contacts
CONTACTRODRIGO A. CARCAMO LEIVA, Ph.D.
CONTACTJessica Vidal, Ph.D.
PRINCIPAL_INVESTIGATORRodrigo A. Cárcamo, Ph.D.
Facultad de Psicología y Humanidades, Universidad San Sebastián
Outcome results
None listed