Integrating Behavioral Skills with a Mobile Biosensor for At-Risk Teen Mothers

将行为技能与移动生物传感器相结合，帮助高危青少年母亲

• 批准号: 8244235
• 负责人: Marya Gwadz
• 金额: $ 21.98万
• 依托单位: NEW YORK UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-03-15 至 2015-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8244235
• 关键词: Address; Adolescent; Adolescent Development; Adopted; Affect; Age; Alcohol or Other Drugs use; Arousal; Attitude; Behavior; Behavior Therapy; Behavioral; Biosensor; Birth; Child; Child Abuse and Neglect; Childhood; Cognitive; Conduct Disorder; Criminal Justice; Development; Discipline; Eligibility Determination; Emotional; Emotions; Empathy; Event; Evidence based practice; Exhibits; Fostering; Future; Goals; Group Homes; Healthy People 2020; Image; Individual; Intervention; Knowledge; Literature; Live Birth; Mediator of activation protein; Medical Research; Mental Health; Modeling; Motivation; Parenting behavior; Physiological; Power Sources; Pregnancy in Adolescence; Prevalence; Preventive Intervention; Problem behavior; Process; Public Health; Randomized; Randomized Controlled Trials; Regulation; Research; Risk; Risk Behaviors; Risk Factors; Safety; Staging; Substance abuse problem; Technology; Telephone; Testing; Text; Time; Training; Treatment Efficacy; United States National Institutes of Health; Voice; Vulnerable Populations; Work; Wrist; adverse outcome; base; behavior change; emotion regulation; expectation; experience; follow up assessment; foster care; improved; in vivo; innovation; innovative technologies; intergenerational; maltreatment; mindfulness meditation; offspring; peer; primary outcome; programs; psychosocial; secondary outcome; skills; social; social cognitive theory; socioeconomics; standard care; stressor; teenage mother; transmission process; trend; young woman

DESCRIPTION (provided by applicant): Approximately half of adolescent mothers in the U.S. begin parenting having experienced at least one serious childhood risk factor for poor psychosocial development including maltreatment and foster care placement. These risk factors contribute to multiple problem behaviors including conduct problems and substance abuse among these "adolescent mothers at risk" (AMARs). A robust body of research indicates that difficulties in regulating emotions are associated with childhood risk factors and underlie later behavior problems. Emotional regulation (ER) problems severely compromise AMARs' abilities to engage in sensitive and responsive parenting. However, there are currently no rigorously tested, efficacious, sustainable behavioral interventions targeted for AMARs, and no interventions have yet focused on the interplay of AMARs' problem behaviors, effective parenting, and ER problems. Our research team has begun to develop a multi-component, technology-enhanced, and developmentally appropriate prevention intervention (Power Source Parenting [PSP]). The primary goal of PSP is to foster autonomous and adaptive ER functioning to promote sensitive, non-abusive parenting and the reduction of behaviors, including substance use, that place AMARs and their offspring at risk. The PSP intervention builds on evidence-based practices for increasing positive parenting and includes innovative mobile technology components: PSP trains AMARs in mindfulness meditation and social cognitive skills in group sessions and integrates a state-of-the-art biosensor wrist band and smart phone application to assist AMARs to use these skills in vivo. The biosensor band communicates physiological states wirelessly to a smart phone sending individually tailored intervention material (text, voice images) at the moment of emotional arousal. We have piloted and explored the feasibility and acceptability of the PSP intervention components with AMARs. The proposed study builds on this promising formative work to accomplish the following aims in this R34 application: (1) refine the components of the PSP intervention and further examine their acceptability, safety, feasibility, and gather preliminary evidence of their efficacy with respect to the study's primary outcomes: (a) increasing positive parenting attitudes, skills, and knowledge; and (b) decreasing maternal risk behaviors (e.g., substance use, delinquency); (2) explore the putative mediator of the intervention: emotional regulation skills; and (3) explore preliminary evidence of efficacy on a secondary outcome, increasing adaptive relational skills for the development of one or more supportive relationships, a vital aspect of effective parenting. To accomplish these aims, we will conduct an exploratory, group randomized controlled trial with AMARs (12 group homes, N=80 AMAR). The study has high potential significance because it addresses critical public health problems including substance abuse, conduct problems, and child maltreatment, and the intergenerational transmission of these problem behaviors. PUBLIC HEALTH RELEVANCE: Relevance Statement Adolescent parenthood is a serious and increasing public health concern. Adolescent mothers experience multiple risk factors that put them at risk for developing poor emotion regulation abilities, which later affect their capacity to engage in sensitive and responsive parenting. This proposal seeks to examine the efficacy of an intervention for adolescent mothers at-risk that builds skills in effective parenting, regulating emotions, avoiding risk behaviors, and building supportive relationships.

描述（由申请人提供）：美国大约一半的青少年母亲在开始养育孩子时经历过至少一种导致社会心理发展不良的严重儿童期危险因素，包括虐待和寄养安置。这些风险因素导致了这些“高危青少年母亲”(AMAR) 中的多种问题行为，包括行为问题和药物滥用。大量研究表明，情绪调节困难与儿童时期的危险因素有关，并且是日后行为问题的根源。情绪调节（ER）问题严重影响了 AMAR 进行敏感和反应性养育的能力。然而，目前还没有针对 AMAR 的经过严格测试、有效、可持续的行为干预措施，也没有针对 AMAR 问题行为、有效养育和 ER 问题之间相互作用的干预措施。我们的研究团队已开始开发一种多成分、技术增强且适合发育的预防干预措施（Power Source Parenting [PSP]）。 PSP 的主要目标是促进自主和适应性 ER 功能，以促进敏感、非虐待的养育方式，并减少使 AMAR 及其后代面临风险的行为，包括药物使用。 PSP 干预措施以增强积极育儿的循证实践为基础，并包括创新的移动技术组件：PSP 在小组课程中训练 AMAR 的正念冥想和社交认知技能，并集成了最先进的生物传感器腕带和智能手机应用程序协助 AMAR 在体内使用这些技能。生物传感器带将生理状态无线传输到智能手机，在情绪唤醒时发送单独定制的干预材料（文本、语音图像）。我们已经试点并探索了 PSP 干预措施与 AMAR 的可行性和可接受性。拟议的研究建立在这项有希望的形成性工作的基础上，以在 R34 申请中实现以下目标：（1）完善 PSP 干预的组成部分，并进一步检查其可接受性、安全性、可行性，并收集其有效性的初步证据。研究的主要成果：(a) 提高积极的养育态度、技能和知识； (b) 减少孕产妇危险行为（例如药物滥用、犯罪）； （2）探索干预的假定中介：情绪调节技能； (3) 探索对次要结果的有效性的初步证据，提高适应关系技能以发展一种或多种支持性关系，这是有效养育的一个重要方面。为了实现这些目标，我们将利用 AMAR 进行一项探索性分组随机对照试验（12 组家庭，N=80 AMAR）。这项研究具有很高的潜在意义，因为它解决了关键的公共卫生问题，包括药物滥用、行为问题和虐待儿童，以及这些问题行为的代际传播。 公共卫生相关性：相关性声明 青少年为人父母是一个严重且日益严重的公共卫生问题。青春期母亲面临多种风险因素，使她们面临情绪调节能力差的风险，从而影响她们的能力 进行敏感和反应灵敏的养育。该提案旨在研究针对高危青少年母亲的干预措施的有效性，该干预措施旨在培养有效养育子女、调节情绪、避免危险行为和建立支持性关系的技能。