Clinical trial NCT06071832: Using Structured Video Chat to Improve Relationships Between Young Children and Remote Grandparents
Official title: Using Structured Video Chat to Improve Relationships Between Young Children and Remote Grandparents
Study type: INTERVENTIONAL
Overall status: ACTIVE_NOT_RECRUITING
Phase: NA
Conditions: Child Development
Family Members
Grandparents
Keywords: child development
cognitive development
grandparents
screen time
video chat
family relationships
Lead sponsor: Lafayette College
Sponsor class: OTHER
Collaborators: name: University of South Dakota
First posted: 2023-10-10
Enrollment: 540
Sex: ALL
Minimum age (years): 18
Maximum age (years): 5
Standard ages: CHILD
Accepts healthy volunteers: yes
Allocation: NON_RANDOMIZED
Intervention model: FACTORIAL
Intervention model description: In Aim 1, we will focus on the effects of structured video chat on child engagement and initiations of joint attention during video chat with grandparents.

In Aim 2, we will determine whether structured video chat increases grandparents' enjoyment of the video chats and leads to greater feelings of closeness to their grandchild.
Primary purpose: SUPPORTIVE_CARE

Brief summary: During the Coronavirus (COVID-19) pandemic many families are using video chat (e.g., Zoom) to maintain relationships with distant relatives, including grandparents. While 67% of all grandparents reported liking the idea of video chatting with their grandchildren, only 28% did so regularly. Increasing this percentage could significantly improve grandparent-grandchild relationships because the Preliminary Study 1 showed that video chat frequency is a strong predictor of grandparent's ratings of closeness to their grandchild, even after controlling for the geographic distance between them. The overall goal of the past, ongoing, and future research is to understand the cognitive and social developmental challenges of video chat in order to support its use with children. As the next step towards this goal, the investigators propose to directly compare two approaches to instructing grandparents on how to improve video chats between grandparents and young grandchildren (18-72 months of age). Families will use video chat without the involvement of researchers during each video chat. Parent-child- grandparent triads (n=180; the largest multi-session observational study of young children and video chat to date) will record 10 video chats under one of three randomly-assigned conditions: structured play, structured reading, or when given no instructions (control). The overall hypothesis is that structured video chat will increase children's engagement and joint attention (primary outcome measures), as well as grandparents' enjoyment of video chat and closeness with their grandchild (secondary outcome measures). The investigators will use detailed behavioral coding of the video recordings of these chats to objectively assess many of the outcome measures. The Preliminary Study 2 showed that structured video chat facilitates more positive social interactions. The proposed work extends the preliminary work because it translates laboratory methods to a complementary ecologically-valid approach in families' naturalistic environments. In Aim 1, the investigators will determine whether and for whom structured video chat improves child engagement and increases child-initiated screen- based joint attention during video chats between grandparents and grandchildren. In Aim 2, the investigators will determine whether structured video chat increases grandparents' enjoyment of the video chats and leads to greater feelings of closeness to their grandchild. Both principal investigators, who are at R15-eligible institutions, are well-qualified to complete the proposed work. Since 2017, they have published 9 papers on video chat, 12 papers on reading, and collaboratively completed 3 preliminary studies and 2 papers. They have mentored 77 undergraduate students, many of whom were co-authors on conference posters or presentations (37 students in total; 22 as a presenter) or journal articles. Importantly, 17 students came from underrepresented groups (BIPOC, first- generation in college, LGBT). A total of 47 are pursuing or have completed graduate work in health-related sciences, including 15 for doctoral degrees. The proposed work addresses a National Institute for Child Health \& Development, Child Development and Behavior Branch's (CDBB) priority of advancing understanding of "Effects of Technology and Digital Media Use on Child and Adolescent Development."

Detailed description: During the Coronavirus (COVID-19) pandemic, many families are using video chat (e.g., Zoom) to maintain relationships with distant relatives, including grandparents. Even before the pandemic, grandparent-grandchild relationships were challenging because \>50% of grandparents had at least one grandchild who lived more than 200 miles away. While 67% of all grandparents reported liking the idea of video chatting with their grandchildren, only 28% did so regularly despite reporting technological self-efficacy and access to digital devices. Increasing this percentage could significantly improve grandparent-grandchild relationships because the Preliminary Study 1 showed that video chat frequency is a strong predictor of grandparent's ratings of closeness to their grandchild, even after controlling for the geographic distance between them. Video chat can be cognitively and socially challenging for young children. These challenges can lead to decreased child engagement during video chat, which in turn can decrease adult motivation to initiate video chat with (and therefore bond with) the child.

The overall goal of the investigators' past, ongoing, and future research is to understand the cognitive and social developmental challenges of video chat in order to support its use with children. As the next step towards this goal, the investigators propose to directly compare two approaches to instructing grandparents on how to improve video chats between grandparents and young grandchildren (18-72 months of age). Families will use video chat in a more naturalistic way than most prior research (i.e., without the involvement of researchers during each video chat). Parent-child-grandparent triads (n=180; the largest multi-session observational study of young children and video chat to date) will record 10 video chats under one of three randomly assigned conditions: structured play, structured reading, or when given no instructions (control). The overall hypothesis is that structured video chat will increase children's engagement and joint attention (primary outcome measures), as well as grandparents' enjoyment of video chat and closeness with their grandchild (secondary outcome measures). The investigators will use detailed behavioral coding of the video recordings of these chats to objectively assess many of the outcome measures. The Preliminary Study 2 showed that structured video chat facilitates more positive social interactions. The investigators will also examine the effects of three parallel methods of enacting the structured activities (grandparent-led, collaborative, and shared on-screen), which are designed to change the amount and type of joint attention that grandparents and grandchildren engage in during video chat. The Preliminary Study 3 indicates that during structured reading with a researcher over video chat, children engaged in more joint attention behaviors when they had their own copy of the book to follow along with versus when the book only appeared on the screen. The proposed work extends preliminary work because it translates previously-used laboratory methods to a complementary ecologically-valid approach.

Aim 1: Determine whether and for whom structured video chat improves child engagement and increases child-initiated screen-based joint attention during video chats between grandparents and grandchildren. Hypothesis 1.1: Both structured play and structured reading will increase engagement and joint attention compared to when no instructions are given. Hypothesis 1.2: The method of enacting activities within the structured reading and structured play conditions will promote different levels of engagement and different types of screen-based joint attention. Hypothesis 1.3: Child age will positively predict child engagement and joint attention across conditions. Hypothesis 1.4: The method of enacting activities will affect younger children's engagement and joint attention more than older children's. Exploratory Hypothesis 1.5: Structured play will increase engagement and joint attention more for younger children than older children, but older children will benefit more from structured reading. Hypothesis 1.6: Grandparent sensitivity will positively predict child engagement and joint attention, and this effect may be the strongest for younger children.

Aim 2: Determine whether structured video chat increases grandparents' enjoyment of the video chats and leads to greater feelings of closeness to their grandchild. Hypothesis 2.1: Grandparents will report an increase in enjoyment of video chats and greater feelings of closeness in the structured conditions compared to when no instructions are given. Hypothesis 2.2: The different methods of enacting activities within the structured conditions will promote different feelings of grandparent enjoyment and closeness. Hypothesis 2.3: Child age will predict grandparent closeness but not enjoyment.

Both principal investigators are at R15-eligible institutions, are well-qualified to oversee the proposed work. Since 2017, they have published 9 papers on video chat, 12 papers on shared reading, and collaboratively completed 3 preliminary studies and 2 papers. They have mentored 77 undergraduate students, many of whom were co-authors on conference posters or presentations (37 students total; 22 as a presenter) or journal articles (12 students). Importantly, 17 came from underrepresented groups (BIPOC, first-generation in college, LGBT). A total of 47 are pursuing or have completed graduate work in health-related sciences, including 18 for doctoral degrees. The proposed work will also address the National Institute for Child Health \& Development, Child Development and Behavior Branch's (CDBB) priority of advancing understanding of "Effects of Technology and Digital Media Use on Child and Adolescent Development."

Eligibility criteria: Inclusion Criteria:

* have a child between the ages of 18 months and 5 years
* all parties speak English
* stable internet connection for all parties
* access to laptop, smart phone or tablet that can be used for Zoom interactions
* be able to hear to communicate effectively with partners in Zoom interactions
* see the screen well enough to communicate effectively on Zoom

Exclusion Criteria:

* does not meet any of the inclusion criteria

Primary outcomes:
measure: Child engagement
timeFrame: Through study completion, an average of 2 months
measure: Child initiation of within-screen joint attention
timeFrame: Through study completion, an average of 2 months
measure: Child initiation of across-screen joint attention
timeFrame: Through study completion, an average of 2 months
measure: Grandparent Sensitivity
timeFrame: Through study completion, an average of 2 months
measure: Parental Involvement
timeFrame: Through study completion, an average of 2 months
Secondary outcomes:
measure: Grandparent enjoyment
timeFrame: Through study completion, an average of 2 months
measure: Grandparent closeness
timeFrame: Through study completion, an average of 2 months
Other outcomes:
Locations:
city: Easton
country: United States
facility: Lafayette College
state: Pennsylvania
Study officials:
affiliation: Lafayette College
name: Lauren J Myers, Ph.D.
role: PRINCIPAL_INVESTIGATOR
References: