Literacy Promotion Using Automated Hovering (LP)

Children's Hospital of Philadelphia (CHOP)

Status: Completed

Conditions: Parenting; Literacy; Parent-Child Relations

Treatments: Behavioral: Regret; Behavioral: Lottery; Behavioral: Texting

Study type: Interventional

Funder types: Other

Identifiers

NCT04576481

19-017199

Details and patient eligibility

About

The purpose of this study is to incorporate behavioral economics (BE) approaches to determine whether 3 novel interventions of varying intensity improve the frequency of parent-child reading behaviors among low-income families. In the first phase, 10 parents will be recruited to participate in rapid cycle interviews to determine the appropriateness of text messages. In the second phase, 45 participants will be randomized to comparative groups to test the effects of automated hovering and other BE approaches on frequency of parent-child shared reading. Investigators long-term goal is to test the effects of these approaches to promote child language and socio-emotional development.

Full description

Early childhood is a sensitive period in which young children develop language and socio-emotional skills foundational for school readiness. Unfortunately, poor vulnerable children experience disparities in these critical areas of development. Parent-child shared reading can help ameliorate these disparities, yet low-income parents do not consistently engage in this activity. Behavioral economics approaches utilizing automated hovering (AH) have the potential to increase parent-child shared reading through text messages and financial inducements.

The study design is a two-phase study consisting of a qualitative component followed by a prospective, randomized comparative group trial to test the effects of AH approaches to increase parent-child shared reading. A total of 55 eligible children and their parents will be recruited from participating practices to achieve a diverse sample of children.

In the first phase, 10 parents will be recruited to participate in brief rapid cycle interviews to assess the appropriateness of text message reminders. In the second phase, forty-five participants will be randomized 1:1:1 to receive one of the 3 AH interventions: 1) daily text message reminders (texting), 2) daily text message reminders with social comparisons (regret) or 3) daily text message reminders with social comparisons and weekly lottery entries (lottery). All interventions are related to principles of behavioral economics in order to provide external motivation. There will be 15 participants per group to adequately assess feasibility and acceptability, the primary outcome.

Descriptive statistics for demographic, home reading environment, and parenting stress measured at baseline will be examined across the three groups to assess the success of the randomization. To assess feasibility and acceptability, Investigators will assess the proportion of participants who receive and report a daily reading behavior each week across all groups, the proportion of participants who access coaching content in group 2 & 3, and the proportion of participants who participate in the weekly lottery in group 3, and satisfaction scores in all groups. Secondary outcomes including differences between groups in weekly reading frequency, home reading environment, and child socio-emotional scores between groups will be assessed using standard inferential statistics and intention-to-treat analysis.

The results of this study may assist health care providers and researchers in testing the feasibility of AH approaches to improve parent-child shared reading and prepare for a larger efficacy trial.

Enrollment: 55 patients

Sex: All

Ages: 6 to 24 months old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Parents who:

  • Have an infant aged 6-24 months
  • Have access to a smart phone with text messaging capabilities
  • Have completed an informed consent

• Children who:

  • Are aged 6-24 months old

Exclusion criteria

• Parents who:

  • Non-English speaking

• Children who:

  • Were born premature (estimated gestational age < 35 weeks)
  • Have been diagnosed with congenital malformations or genetic syndromes which place them at risk for developmental delays

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

---

55 participants in 3 patient groups

Group 1: Texting

Active Comparator group

Description:

Consist of daily text messages on shared reading

Treatment:

Behavioral: Texting

Group 2: Regret

Experimental group

Description:

Will consist of Group 1 plus social comparisons.

Treatment:

Behavioral: Texting

Behavioral: Regret

Group 3: Lottery

Experimental group

Description:

Will consist of Group 2 plus availability of a weekly lottery.

Treatment:

Behavioral: Texting

Behavioral: Lottery

Behavioral: Regret