Optimizing an Evidence-Based, Disseminable, Free Internet-Based Parenting Program

New York University (NYU)

Status: Completed

Conditions: Parenting Practices

Treatments: Behavioral: Essentials for Parenting Toddlers and Pre-schoolers (EFP); Behavioral: Simplification; Behavioral: Motivational Enhancement; Behavioral: Gamification; Behavioral: Low Engagement Nudges

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT05689736

1R01HD101634

Details and patient eligibility

About

The CDC's Essentials for Parenting Toddlers and Preschoolers program (EFP) is a free Internet resource with the potential to break down barriers to population-wide access to scientifically-based parenting interventions. EFP has considerable promise, but parental engagement, a major issue in the success of universal parenting interventions, remains a challenge. The objective of the proposed research is to optimize EFP by identifying engagement-focused intervention elements to add to EFP that enhance its effects on parenting skills.

Full description

The study is a longitudinal factorial optimization trial in a community sample of 800 parents with 1.5- to 3-year-old children. There are 4 experimental factors; each corresponds to the presence vs. absence of an engagement-focused intervention element. This experiment enables the estimation of the individual and combined effects of each element. The specific aims follow.

Aim 1: Optimize the effects of EFP on parenting skills by determining which combination of the four experimental engagement-focused intervention elements results in the greatest success of EFP, as reflected in increasing parent warmth and reducing corporal punishment, overreactive and lax discipline.

Aim 2: Determine the extent to which boosted meaningful parent engagement in EFP is the mechanism driving the effects of the four engagement-focused intervention elements on parenting skills, and which aspect(s) of engagement (e.g., content consumption; behavioral skills practice) are the key mediators that translate the effects of the four engagement-focused intervention elements into improved parenting.

Aim 3: Examine parent (e.g., change readiness; race) and child characteristics (e.g., externalizing behavior; sex) to determine if the optimal intervention package differs among subgroups. Cracking the code of providing parents with an intervention that they actually use, and that improves parenting, could have far-reaching effects (e.g., improving population-level child outcomes).

Enrollment: 859 patients

Sex: All

Ages: 18 to 99 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

1. 18- to 36-month-old child
2. ≥18-year-old parent
3. Internet access
4. willingness to commit to intervention/assessment procedures
5. proficiency in speaking and reading English

Exclusion criteria

1. child older than 36 months
2. parent younger than 18 years
3. no access to internet
4. not willing to commit to intervention/assessment procedures OR
5. not proficient with speaking and reading English

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Factorial Assignment

Masking: Single Blind

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859 participants in 16 patient groups

Motivational Enhancements + Simplification + Gamification + Low Engagement Nudge

Experimental group

Description:

Participants will receive the Core Essentials for Parenting (EFP) intervention and all additional engagement-focused intervention elements: motivational enhancements, simplification, gamification, and low engagement nudges.

Treatment:

Behavioral: Low Engagement Nudges

Behavioral: Gamification

Behavioral: Simplification

Behavioral: Motivational Enhancement

Behavioral: Essentials for Parenting Toddlers and Pre-schoolers (EFP)

Motivational Enhancements + Simplification + Gamification

Experimental group

Description:

Participants will receive the Core EFP intervention and motivational enhancement, simplification, and gamification intervention elements.

Treatment:

Behavioral: Gamification

Behavioral: Simplification

Behavioral: Motivational Enhancement

Behavioral: Essentials for Parenting Toddlers and Pre-schoolers (EFP)

Motivational Enhancements + Simplification + Low Engagement Nudge

Experimental group

Description:

Participants will receive the Core EFP intervention and motivational enhancement, simplification, and low engagement nudges as intervention elements.

Treatment:

Behavioral: Low Engagement Nudges

Behavioral: Simplification

Behavioral: Motivational Enhancement

Behavioral: Essentials for Parenting Toddlers and Pre-schoolers (EFP)

Motivational Enhancements + Simplification

Experimental group

Description:

Participants will receive the Core EFP intervention and motivational enhancement and simplification as intervention elements.

Treatment:

Behavioral: Simplification

Behavioral: Motivational Enhancement

Behavioral: Essentials for Parenting Toddlers and Pre-schoolers (EFP)

Motivational Enhancements + Gamification + Low Engagement Nudge

Experimental group

Description:

Participants will receive the Core EFP intervention and motivational enhancement, gamification, and low engagement nudge as intervention elements.

Treatment:

Behavioral: Low Engagement Nudges

Behavioral: Gamification

Behavioral: Motivational Enhancement

Behavioral: Essentials for Parenting Toddlers and Pre-schoolers (EFP)

Motivational Enhancements + Gamification

Experimental group

Description:

Participants will receive the Core EFP intervention and motivational enhancement and gamification as intervention elements.

Treatment:

Behavioral: Gamification

Behavioral: Motivational Enhancement

Behavioral: Essentials for Parenting Toddlers and Pre-schoolers (EFP)

Motivational Enhancements + Low Engagement Nudge

Experimental group

Description:

Participants will receive the Core EFP intervention and motivational enhancement and low engagement nudge as intervention elements.

Treatment:

Behavioral: Low Engagement Nudges

Behavioral: Motivational Enhancement

Behavioral: Essentials for Parenting Toddlers and Pre-schoolers (EFP)

Motivational Enhancements

Experimental group

Description:

Participants will receive the Core EFP intervention and motivational enhancement as an additional intervention element.

Treatment:

Behavioral: Motivational Enhancement

Behavioral: Essentials for Parenting Toddlers and Pre-schoolers (EFP)

Simplification + Gamification + Low Engagement Nudge

Experimental group

Description:

Participants will receive the Core EFP intervention and simplification, gamification, and low engagement nudge as additional intervention elements.

Treatment:

Behavioral: Low Engagement Nudges

Behavioral: Gamification

Behavioral: Simplification

Behavioral: Essentials for Parenting Toddlers and Pre-schoolers (EFP)

Simplification + Gamification

Experimental group

Description:

Participants will receive the Core EFP intervention and simplification and gamification as additional intervention elements.

Treatment:

Behavioral: Gamification

Behavioral: Simplification

Behavioral: Essentials for Parenting Toddlers and Pre-schoolers (EFP)

Simplification + Low Engagement Nudge

Experimental group

Description:

Participants will receive the Core EFP intervention and simplification and low engagement nudge as intervention elements.

Treatment:

Behavioral: Low Engagement Nudges

Behavioral: Simplification

Behavioral: Essentials for Parenting Toddlers and Pre-schoolers (EFP)

Simplification

Experimental group

Description:

Participants will receive the Core EFP intervention and simplification as an additional intervention element.

Treatment:

Behavioral: Simplification

Behavioral: Essentials for Parenting Toddlers and Pre-schoolers (EFP)

Gamification + Low Engagement Nudge

Experimental group

Description:

Participants will receive the Core EFP intervention and gamification and low engagement nudge as additional intervention elements.

Treatment:

Behavioral: Low Engagement Nudges

Behavioral: Gamification

Behavioral: Essentials for Parenting Toddlers and Pre-schoolers (EFP)

Gamification

Experimental group

Description:

Participants will view the Core EFP and will be exposed only to gamification as an additional intervention element.

Treatment:

Behavioral: Gamification

Behavioral: Essentials for Parenting Toddlers and Pre-schoolers (EFP)

Low Engagement Nudge

Experimental group

Description:

Participants will receive the Core EFP intervention and low engagement nudge as an additional intervention element.

Treatment:

Behavioral: Low Engagement Nudges

Behavioral: Essentials for Parenting Toddlers and Pre-schoolers (EFP)

EFP Only

Experimental group

Description:

Participants will receive the Core EFP intervention and not be exposed to any additional intervention elements.

Treatment:

Behavioral: Essentials for Parenting Toddlers and Pre-schoolers (EFP)