Parent-Adolescent Interpersonal Processes in the Science of Behavior Change

摘要 响应RFA-RM-17-028，本R21旨在检查一个新的人际目标;即，父母-青少年 关于青少年健康行为改变的对话。科学的前提是父母对孩子的成长 关于青少年的风险和脆弱性然而，父母在对话的要素方面接受的培训很少， 最佳地激励他们的孩子参与健康的行为。一个理论上的接地和可靠的 行为改变技术（BCT）的分类将被用来科学地推导出会话 元素，或微观机制，减少父母-青少年的胁迫和冲突，并促进向上的螺旋式上升， 健康的行为改变。我们建立在最近完成的NICHD资助的R 01，其中行为医学 促进健康睡眠行为的方案改善了睡眠，降低了选择性睡眠障碍的风险。 在10-18奥尔兹之间的结果。这种行为医学方案是通过6个单独管理的 50分钟的会议，被称为睡眠和昼夜节律的跨诊断干预（transdiagnosis Intervention for Sleep and Circadian Rhythms，transS-C）。 在这项研究的进行过程中，对青年行为改变的一个重大障碍是强迫， 与一个或多个父母发生冲突。我们将招募父母和青少年的配对，其中青少年表现出睡眠问题， 并编码两个家长-青少年对话：（1）每次治疗的最后10分钟，称为 “治疗结束对话”和（2）讨论涉及青少年的经常出现分歧的话题 行为改变，称为“热点话题任务”。目标1涉及一个迭代的过程， 改进方法以实验性地操纵BCT的父母使用（n = 8）。该产品将被称为 父母行为改变干预（PBC-I）目标2涉及PBC-I的小型开放试验（n = 36）， 验证目标参与并测试目标参与是否产生行为改变。目标3考察潜力 BCT频率和参与睡眠促进行为之间关系的介导剂， 解决父母使用BCT的潜在调节因素（青少年的年龄/性别、父母/照顾者性别、父母一方或双方 家庭）。来自方法中的SOBC储存库特征的测定（例如，“热点问题任务”是一项 夫妻冲突任务的适应）和结果（即，亲子强迫量表）。此外，措施 被选择来代表不同层次的解释，包括自我报告，行为任务和活动记录。在 根据实验医学方法，目标是改善父母之间的人际关系过程 和青少年在父母与青少年关于青少年行为改变的对话中，父母越来越多地使用BCT， 操纵检查。用于验证靶标接合的测定包括亲子胁迫量表。的 目标将通过发展一种实验性的目标操纵来实现， 新的干预（即，PBC-I）。这个为期2年的R21将为更大规模的研究提供试点数据 它利用了一个新的人际目标--父母在促进可持续健康方面的重要作用 他们十几岁的孩子的行为。

Abstract Responding to RFA-RM-17-028, this R21 seeks to examine a novel interpersonal target; namely, parent-teen conversations about teen health behavior change. The scientific premise is that parents have profound impacts on teen risk and vulnerability. Yet parents receive minimal training in the elements of conversations that optimally inspire their children toward engaging in healthy behaviors. A theoretically grounded and reliable taxonomy of behavior change techniques (BCTs) will be used to scientifically derive the conversational elements, or micro-mechanisms, that reduce parent-teen coercion and conflict and facilitate upward spirals of healthy behavior change. We build on a recently completed NICHD-funded R01, in which a behavioral medical regimen to promote engagement in healthy sleep behaviors improved sleep and reduced risk on selected outcomes among 10-18 year olds. This behavioral medical regimen is delivered via 6 individually administered 50 minute sessions, known as the Transdiagnostic Intervention for Sleep and Circadian Rhythms (TranS-C). During the conduct of this research a significant impediment to youth behavior change was coercion and conflict with one or more parent/s. We will recruit parent-teen dyads in which the teen exhibits sleep problems and code two parent-teen conversations: (1) the last 10 minutes of each treatment session, referred to as the `End of Treatment Conversation' and (2) the discussion of a topic of frequent disagreement involving teen behavior change, referred to as the `Hot Topics Task'. Aim 1 involves an iterative process of developing and refining a method to experimentally manipulate parent use of BCTs (n = 8). The product will be referred to as the Parent Behavior Change Intervention (PBC-I). Aim 2 involves a small open trial of the PBC-I (n = 36) to verify target engagement and test if target engagement produces behavior change. Aim 3 examines potential mediators of the relationship between BCT frequency and engagement in sleep promoting behavior and address potential moderators of parent use of BCTs (age/sex of teen, parent/caregiver sex, one or two parent households). Assays from the SOBC repository feature in the methods (e.g., the `Hot Topics Task' is an adaptation of the Couples Conflict Task) and outcomes (i.e., Parent-Child Coercion Scale). Also, the measures are selected to represent various levels of explanation including self-report, behavioral tasks and actigraphy. In terms of the experimental medicine approach, the target is improved interpersonal process between parent and teen. Increased use of BCTs by parents in parent-teen conversations about youth behavior change is a manipulation check. The assays to verify target engagement include the Parent-Child Coercion Scale. The target will be engaged via the development of an experimental manipulation of the target in the form of a novel intervention (i.e., the PBC-I). This 2-year R21 will provide pilot data to prepare for larger scale research that harnesses a novel interpersonal target—the important role of parents in promoting sustainable health behaviors among their teenage children.