Clinical trial NCT06145919: Parent-Child Memory Study: Improving Future Thinking Among Mothers
Official title: Parent-Child Memory Study: Improving Future Thinking Among Mothers From a Traditionally Underserved Community to Reduce Harsh Parenting and Improve Child Outcomes - A Randomized Controlled Trial
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Behavior, Health
Keywords: episodic future thinking
episodic recent thinking
delay discounting
parent-child relations
low resource
Flint, Michigan
special play time
Lead sponsor: Henry Ford Health System
Sponsor class: OTHER
Collaborators: name: University of Kansas
name: University of Maryland, College Park
name: Michigan State University
First posted: 2023-11-24
Enrollment: 144
Sex: FEMALE
Minimum age (years): 5
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: PREVENTION

Brief summary: Parents of children from impoverished communities are disproportionately more likely to engage in harsh physical discipline, which can lead to serious clinical outcomes, including suicidal ideation and attempts. One mechanism linking low resource environments and maladaptive parenting strategies is maternal delay discounting, or the tendency to value smaller, immediate rewards (such as stopping children's misbehavior via physical means) relative to larger, but delayed rewards (like improving the parent-child relationship). This study will examine the efficacy of implementing a low-cost, brief intervention targeting the reduction of maternal delay discounting to inform broader public health efforts aimed at improving adolescent mental health outcomes in traditionally underserved communities.

Detailed description: Harsh parenting is associated with serious and costly mental health problems among youth, including substance use, mood disorders, and suicidal ideation and behaviors. Of concern, these parenting practices are most common among families from impoverished communities; however, many behaviorally-based parenting interventions do not take into account the unique mechanisms linking environmental disadvantage to parenting approaches. While the causes of harsh parenting are complex and varied, one such mechanism may be parents' tendencies to prioritize immediate rewards (such as stopping a child's misbehavior via physical punishment like spanking and hitting) relative to larger, but delayed rewards (including improved parent-child relationship quality), known as delay discounting.

The aims of the current study are to conduct a Stage 1 parent-child dyad randomized control trial (RCT) (n = 72) examining the effectiveness of a brief, episodic future thinking (EFT) intervention in a community setting serving low-income mothers and additional implementation data. Participants will be randomized to receive either Episodic Future Thinking (EFT) or Episodic Recent Thinking (ERT) intervention arms. This case series will examine the efficacy of episodic future thinking (EFT) compared to episodic recent thinking (ERT) to target reduction of parenting-related delay discounting. Outcomes will evaluate the effect of EFT on reducing maternal delay discounting and harsh parenting and improving child clinical outcomes.

Eligibility criteria: Parent Inclusion Criteria:

1. A mother and or grandmother from the Flint area with a child/grandchild between the ages of 5-10 who can provide legal consent for that child
2. Self-report that they have consistent contact with the child/grandchild
3. Willing to participate in the study
4. Able to participate in written assessments and an intervention conducted in English
5. Have a working cell phone that can receive and send text messages and be willing to receive/send text messages as part of the study
6. Have a phone or device that's able to use video conferencing software if interested in virtual participation

Parent Exclusion Criteria:

1. Self-disclosed active suicidality/homicidality
2. Self-disclosed current bipolar disorder, schizophrenia, or psychosis
3. Self-reported current and ongoing involvement with child protective services

Child Inclusion Criteria:

1. Children must be between the ages of 5-10 and have a mother/grandmother willing to provide consent for their participation
2. Willing to participate in parent-child observation sessions
3. Elementary proficiency in English
4. Willing to participate in study surveys

Child Exclusion criteria:

1. Self-disclosed active suicidality/homicidality
2. Self-disclosed current bipolar disorder, schizophrenia, or psychosis

Primary outcomes:
measure: Change in Monetary Choice Questionnaire
timeFrame: Baseline, Intervention, Week 2, Month 3, Month 6, Month 9
measure: Change in Consideration of Future Consequences Scale Score
timeFrame: Baseline, Intervention, Week 2, Month 3, Month 6, Month 9
Secondary outcomes:
measure: Change in Alabama Parenting Questionnaire Score
timeFrame: Baseline, Intervention, Week 2, Month 3, Month 6, Month 9
measure: Change in Emotion Regulation Checklist
timeFrame: Baseline, Intervention, Week 2, Month 3, Month 6, Month 9
Other outcomes:
Locations:
city: Flint
country: United States
facility: Mothers of Joy Institute for Parenting and Family Wellness, Inc
state: Michigan
Study officials:
References:
citation: Felton JW, Collado A, Cinader M, Lejuez CW, Chronis-Tuscano A, Yi R. Exposure to maternal depressive symptoms and growth in adolescent substance use: The mediating role of delay discounting. Dev Psychopathol. 2021 Oct;33(4):1279-1289. doi: 10.1017/S0954579420000486.
citation: Dassen FC, Houben K, Jansen A. Time orientation and eating behavior: Unhealthy eaters consider immediate consequences, while healthy eaters focus on future health. Appetite. 2015 Aug;91:13-9. doi: 10.1016/j.appet.2015.03.020. Epub 2015 Mar 23.
citation: Felton JW, Collado A, Ingram KM, Doran K, Yi R. Improvement of Working Memory is a Mechanism for Reductions in Delay Discounting Among Mid-Age Individuals in an Urban Medically Underserved Area. Ann Behav Med. 2019 Oct 7;53(11):988-998. doi: 10.1093/abm/kaz010.
citation: Lin H, Epstein LH. Living in the moment: effects of time perspective and emotional valence of episodic thinking on delay discounting. Behav Neurosci. 2014 Feb;128(1):12-9. doi: 10.1037/a0035705.
citation: Moreland, A.M., Felton, J.F., Hanson, R.F., Jackson, C., & Dumas, J.E. (2016). The relation between parenting stress and parenting locus of control: Mechanisms of change in parenting interventions. Journal of Child and Family Studies, 25, 2046-2054.
citation: Snider SE, DeHart WB, Epstein LH, Bickel WK. Does delay discounting predict maladaptive health and financial behaviors in smokers? Health Psychol. 2019 Jan;38(1):21-28. doi: 10.1037/hea0000695. Epub 2018 Nov 26.
citation: Stein JS, Wilson AG, Koffarnus MN, Daniel TO, Epstein LH, Bickel WK. Unstuck in time: episodic future thinking reduces delay discounting and cigarette smoking. Psychopharmacology (Berl). 2016 Oct;233(21-22):3771-3778. doi: 10.1007/s00213-016-4410-y. Epub 2016 Aug 23.