Enhancing the Outcomes of a Behavioral Parent Training Intervention

Study Overview
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Brief Summary
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This study is a feasibility trial, testing the hypothesis that among sedentary mothers of behaviorally at-risk preschool-aged children, those who receive behavioral parent training (BPT) programs and concurrently increase their physical activity levels will demonstrate improved parenting and child behavior outcomes compared to those who receive BPT but remain sedentary.

Detailed Description
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The investigators will randomly assign 20 participants to two groups: behavioral parent training plus contingency management to increase steps (BPT+CM) or behavioral parent training alone (BPT). Contingency management procedures will involve monetary rewards for meeting weekly step-count goals. The specific aims of the proposed project are to: 1) assess the feasibility of the study design and procedures, 2) assess the acceptability of the BPT+CM condition to participants, and 3) determine whether a signal of an effect of increased physical activity exists (via preliminary comparisons of measures of fatigue, perceived energy, parenting behaviors, parenting sense of competence, parenting stress, and child behavior ratings between participants in the two conditions). This innovative pilot study will prepare us for a fully powered trial to test the efficacy of this approach.

Official Title
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Enhancing the Outcomes of a Behavioral Parent Training Intervention

Conditions
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Disruptive Behavior Disorder, Parenting

Intervention / Treatment
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* Behavioral: Fitbit activity tracker
* Behavioral: Monetary rewards
* Behavioral: BPT training sessions


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Female Age 18 years or older Custodial caregiver of a child aged 2-5 years who lives full-time in the caregiver's home Reports that her child has behavioral problems Never or rarely engages in regular physical activity Able to understand, speak, and read English Exclusion Criteria: The child has been diagnosed with a severe developmental condition (e.g., extreme developmental delay, severe autism, debilitating neurological conditions) Participant reports a condition that may contraindicate physical activity (e.g., asthma)

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Behavioral Parent Training (BPT)<br>The control group will include 10 participants who will 1) wear Fitbit activity trackers daily for 12 weeks and 2) attend 12 weekly BPT training sessions. | Behavioral: Fitbit activity tracker<br>* Wear a Fitbit daily for 12 weeks and meet with a research assistant once per week to download data<br>Behavioral: BPT training sessions<br>* Complete 12 BPT training sessions delivered by supervised clinical child psychology doctoral students, with each session lasting approximately 60 minutes. The BPT is based upon the existing, evidence-based Everyday Parenting intervention.<br>|
| Experimental: BPT + Contingency Management (BPT+CM)<br>The experimental group will include 10 participants who will 1) wear Fitbit activity trackers daily for 12 weeks, 2) attend 12 weekly BPT training sessions, and 3) receive monetary rewards for achieving weekly step-count goals. | Behavioral: Fitbit activity tracker<br>* Wear a Fitbit daily for 12 weeks and meet with a research assistant once per week to download data<br>Behavioral: Monetary rewards<br>* Set weekly step-count goals based on the previous week's performance and receive monetary rewards for meeting the goals. The schedule of rewards increases as step-count goals increase.<br>Behavioral: BPT training sessions<br>* Complete 12 BPT training sessions delivered by supervised clinical child psychology doctoral students, with each session lasting approximately 60 minutes. The BPT is based upon the existing, evidence-based Everyday Parenting intervention.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Proportion of participants who complete study procedures within study timeframe |  | 14 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Time required per participant to complete all instruments |  | 14 months | 
| Participant satisfaction of both control and experimental arms |  | 1 week after completion of final BPT session | 
| Step counts |  | end of 2-week screening period, and once per week for 12 weeks | 
| 2-minute step test |  | baseline and 1 week after completion of final BPT session | 
| Parenting behaviors | Parenting Young Children instrument | baseline and 1 week after completion of final BPT session | 
| Child behaviors | Child Behavior Checklist/1.5-5 instrument | baseline and 1 week after completion of final BPT session | 
| Parenting stress | Parenting Stress Index/Short Form instrument | baseline and 1 week after completion of final BPT session | 
| Parenting sense of competence | Parenting Sense of Competence Scale | baseline and 1 week after completion of final BPT session | 
| Parent depression | Beck Depression Inventory-II | baseline and 1 week after completion of final BPT session | 
| Self-reported physical activity level | Godin Leisure-Time Exercise Questionnaire | baseline and 1 week after completion of final BPT session | 
| Visual Analog Scale-Fatigue |  | baseline and 1 week after completion of final BPT session |