Adapting a Parenting Intervention to Promote Healthy Screen Time Habits in Young Children with Externalizing Behavior Problems

项目概要/摘要 此开发/探索性R21应用程序的目标是开发和试点测试适应的屏幕时间 对有外化行为问题的幼儿家长进行干预。作为幼儿的通道 接触不同类型的屏幕媒体设备的机会增加了， 不健康的早期屏幕媒体使用（包括过度使用和暴露于不适当的 内容）和不良儿童的结果。研究表明，接触屏幕媒体和外化行为 幼儿的问题是相互关联的。外化行为问题也是一个重大障碍， 父母试图坚持使用屏幕媒体的建议。尽管存在这些公共卫生问题， 屏幕媒体使用干预措施尚未专门针对具有外化行为的儿童 问题为了满足这一需求，我们建议探索一种新的方法来干预屏幕时间， 调整为具有外化行为的儿童的父母设计的行为养育干预 在屏幕时间整合内容的问题。利用现有的基于证据的育儿方法 干预将允许干预以一般的育儿为目标，以及特定的屏幕时间 育儿，不需要额外的资源。此R21应用程序将侧重于调整基于组的 家长干预，学校准备家长计划（SRPP）。SRPP是一项为期8周的育儿计划， 基于亲子互动治疗模式的团体干预。共有55名学龄前儿童的父母 有外化行为问题的儿童将被招募。在开发阶段之后，我们将 一项小型开放试验（n = 15），评估屏幕时间适应性干预的可行性和家庭的 对治疗的满意度和反应。在这一阶段，我们还将试行一种多模式跟踪儿童的方法， 使用来自移动的设备的客观数据和父母完成的媒体使用日志进行屏幕使用。一旦做出 根据公开试验的结果和外部专家咨询小组的反馈进行修改， 社区利益相关者，随后将进行一项试点随机对照试验（n = 40）。家长会随机 被分配接收屏幕时间适配的SRPP（n = 20）或原始SRPP（n = 20）节目。 将在预测试、后测试和1个月随访时完成评估措施。我们将研究 筛选时间适应性干预在随机对照试验中的可行性和可接受性我们将 还研究了儿童的屏幕使用模式，包括整体屏幕时间，屏幕时间的比例， 教育，以及父母和孩子共同使用屏幕媒体的频率。在探索性的方式，我们将研究 干预对儿童外化行为问题的影响。拟议研究的结果将 为R 01应用奠定基础并提供关键的试验数据，以检验这种适应性的 在不同的育儿计划中进行干预。

Project Summary/Abstract The goal of this developmental/exploratory R21 application is to develop and pilot test an adapted screen time intervention for parents of young children with externalizing behavior problems. As young children's access and exposure to different types of screen media devices has increased, so has public health concern around the links between unhealthy early screen media use (including excessive use and exposure to inappropriate content) and poor child outcomes. Research shows that exposure to screen media and externalizing behavior problems in young children are linked. Externalizing behavior problems also present a significant barrier to parents attempting to adhere to screen media use recommendations. Despite these public health concerns, screen media use interventions have not yet specifically targeted children with externalizing behavior problems. To address this need, we propose to explore a novel approach to intervening around screen time, by adapting a behavioral parenting intervention designed for parents of children with externalizing behavior problems to integrate content around screen time. Leveraging an existing evidence-based parenting intervention will allow for the intervention to target parenting generally, as well as screen time specific parenting, without requiring additional resources. This R21 application will focus on adapting a group-based parenting intervention, the School Readiness Parenting Program (SRPP). The SRPP is an 8-week parenting intervention based on a group Parent-Child Interaction Therapy model. In total, 55 parents of preschool-aged children with externalizing behavior problems will be recruited. Following a development phase, we will conduct a small open trial (n = 15) to assess the feasibility of the screen time adapted intervention and families' satisfaction and response to treatment. At this phase, we will also pilot a multimodal method of tracking child screen use using objective data from mobile devices and parent-completed media use logs. Upon making modifications based on results of the open trial and feedback from an external advisory panel of experts and community stakeholders, a pilot randomized controlled trial (n = 40) will follow. Parents will be randomly assigned to receive either the screen time adapted SRPP (n = 20) or the original SRPP (n = 20) program. Assessment measures will be completed at prettest, posttest, and at a 1 month follow up. We will examine feasibility and acceptability of the screen time adapted intervention in the randomized controlled trial. We will also examine children's screen use patterns, including overall screen time, proportion of screen time that is educational, and frequency of parent-child co-use of screen media. In an exploratory fashion, we will examine the effect of the intervention on child externalizing behavior problems. The results of the proposed research will lay the foundation and provide critical pilot data for an R01 application to examine the efficacy of this adapted intervention across different parenting programs.