Parent-Adolescent Interpersonal Processes in the Science of Behavior Change

Study Overview
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Brief Summary
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This study seeks to examine a novel interpersonal target; namely, parent-teen conversations about youth health behavior change. The rationale is that parents have profound impacts on teen risk and vulnerability. Yet parents receive minimal training in the elements of conversations that optimally inspire their children toward engaging in healthy behaviors. A theoretically grounded and reliable taxonomy of behavior change techniques (BCTs) will be used as a basis for scientifically deriving the conversational elements, or micro-mechanisms, that reduce parent-teen conflict and facilitate upward spirals of healthful behavior change. This proposal builds on pilot data from a recently completed NICHD-funded R01 in which a sleep treatment improved sleep and reduced risk on selected outcomes in youth. While sleep-related health behaviors will be the focus of this R21, the research is designed to be relevant to a broad range of health behavior change. As part of an Administrative Supplement to the R21 awarded in Fall, 2019, two changes are made. First, measures of psychophysiology have been added to the Hot Topics Task. Second, an independent sample of teens who are healthy sleepers (n = 20), and their parents, will be tested on the protocol twice, 9 weeks apart. This comparison group is included to control for the passage of time and for completing the protocol twice. They do not receive an intervention.

Official Title
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Parent-Adolescent Interpersonal Processes in the Science of Behavior Change

Conditions
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Sleep Deprivation, Adolescent Behavior

Intervention / Treatment
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* Behavioral: Parent Behavior Change Intervention (PBC-I) and Transdiagnostic Sleep and Circadian Intervention (TranS-C)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age between 10 and 18 and living with a parent or guardian Lowest quartile of the widely used and well-validated Children's Morningness-Eveningness Preferences Scale (CMEP; 27 or lower) and Youth self-reported weekday sleep onset time for the past month later than 10:40 pm for 10- to 13-year- olds; 11:00pm for 14-16 year olds, and later than 11:20 for 17-18 year olds at least 3 nights per week; English language fluency; able and willing to give informed assent; at least one parent/primary caregiver who lives in the same household as the teen for at least 50% of the week must participate in all study sessions. Exclusion Criteria: An active, progressive physical illness directly related to the onset and course of the sleep disturbance; evidence of sleep apnea, restless legs or periodic limb movements; significantly impairing pervasive developmental disorder; history of substance dependence in the past six months; suicide risk; bipolar disorder or schizophrenia or another current Axis I disorder if there is a significant risk of harm and/or decompensation if treatment of that comorbid condition is delayed as a function of participating in any stage of this study; Participants will not be excluded if medications are stable (> 4 weeks). Inclusion criteria (control group): Age between 10 and 18 and living with a parent or guardian (CMEP; 28 or higher) on Children's Morningness-Eveningness Preferences Scale Item #6 on the Pittsburgh Sleep Quality Index (PSQI) rated 'fairly' or 'very good' English language fluency; able and willing to give informed assent; at least one parent/primary caregiver who lives in the same household as the teen for at least 50% of the week must participate in all study sessions. Exclusion Criteria (control group) An active, progressive physical illness directly related to the onset and course of the sleep disturbance; evidence of sleep apnea, restless legs or periodic limb movements; significantly impairing pervasive developmental disorder; history of substance dependence in the past six months; suicide risk; bipolar disorder or schizophrenia or another current Axis I disorder if there is a significant risk of harm and/or decompensation if treatment of that comorbid condition is delayed as a function of participating in any stage of this study; Participants will not be excluded if medications are stable (> 4 weeks).

Ages Eligible for Study
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Minimum Age: 10 Years
Maximum Age: 18 Years

Sexes Eligible for Study
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All

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: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: PBC_I plus TranS-C<br>The Parent Behavior Change Intervention (PBC-I) is a behavioral intervention intended to teach parent behavior change techniques to better support their adolescents to improve sleep health behavior. The Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TranS-C) is comprised of cross-cutting interventions, 'core modules' and 'optional modules'. TranS-C is derived and adapted from our previous disorder-focused research, firmly grounded in basic science and treatment literature. | Behavioral: Parent Behavior Change Intervention (PBC-I) and Transdiagnostic Sleep and Circadian Intervention (TranS-C)<br>* PBC-I will be administered to the parent and TranS-C will be administered to the teenager. Both interventions are cognitive-behavioral and comprised of six weekly sessions. Parent and teenager sessions will be held in parallel.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of BCTs used by parent coded from the Hot Topics Task | Parent measure. | Change from baseline to post-treatment, which is an average of 9 weeks after the beginning of treatment | 
| Parent perception of general conflict between parent and child measured via Conflict Behavior Questionnaire | Parent measure. 20 items each on a true/false scale. Total score ranges from 0 to 20 and is computed by adding up total score points. Higher scores indicate more general conflict. | Change from baseline to post-treatment, which is an average of 9 weeks after the beginning of treatment | 
| Decisional balance proportion | Measured by Decision Balance Worksheet. Youth measure. | Change from baseline to post-treatment, which is an average of 9 weeks after the beginning of treatment | 
| Subjective sleep quality measured via Pittsburgh Sleep Quality Index global score | Youth measure. 19 items each on a 4-point scale. Global score ranges from 0 to 21 and is computed by totaling seven component scores. Lower scores indicate healthier sleep quality. | Change from baseline to post-treatment, which is an average of 9 weeks after the beginning of treatment | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Type of BCTs used by parent coded from the Hot Topics Task | Parent measure. | Change from baseline to post-treatment, which is an average of 9 weeks after the beginning of treatment | 
| Number of negative and positive communication behaviors coded from the Hot Topics Task | Parent measure. | Change from baseline to post-treatment, which is an average of 9 weeks after the beginning of treatment | 
| Youth's perception of general conflict between parent and child measured via Conflict Behavior Questionnaire. | Youth measure. 20 items each on a true/false scale. Total score ranges from 0 to 20 and is computed by adding up total score points. Higher scores indicate more general conflict. | Change from baseline to post-treatment, which is an average of 9 weeks after the beginning of treatment | 
| Youth self-reported motivation of participating in TranS-C/making sleep behavior changes via the Intrinsic Motivation Questionnaire | Youth measure. 18 items on a 7-point Likert scale, with three subscales being used: Interest/Enjoyment, Perceived Competence, and Effort/Importance. Total score ranges from 3 to 21 (1-7 for each subscale score) and is computed by averaging items within each subscale and adding the 3 subscale scores. | Change from baseline to post-treatment, which is an average of 9 weeks after the beginning of treatment | 
| Regularity in sleep midpoint across the week measured via daily sleep diary | Youth measure. | Change from baseline to post-treatment, which is an average of 9 weeks after the beginning of treatment | 
| Regularity in sleep midpoint across the week measured via actigraphy | Youth measure. | Change from baseline to post-treatment, which is an average of 9 weeks after the beginning of treatment | 
| Morningness/eveningness preference measured via Children's Morningness Eveningness Preference Scale | Youth measure. 10 items are weighed on either 4- or 5-point scales. Total score ranges from 10 to 43 and is computed by adding up total points. Scores between 10 and 20 indicate eveningness, scores between 28 and 42 indicate morningness, scores between 21 and 27 are categorized as neither. | Change from baseline to post-treatment, which is an average of 9 weeks after the beginning of treatment |