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

描述（由申请人提供）：在美国，大约一半的青春期母亲在开始为人父母时，至少经历过一种严重的儿童社会心理发展不良风险因素，包括虐待和寄养安置。这些风险因素在这些“危险的青春期母亲”（AMARs）中造成多种问题行为，包括行为问题和药物滥用。大量研究表明，调节情绪的困难与儿童时期的风险因素有关，并可能成为日后行为问题的基础。情绪调节（ER）问题严重损害了AMARs参与敏感和反应性养育的能力。然而，目前还没有针对amar的经过严格测试的、有效的、可持续的行为干预措施，也没有干预措施关注amar的问题行为、有效的养育和急诊室问题之间的相互作用。我们的研究小组已经开始开发一种多组分、技术增强的、适合发展的预防干预（电源养育[PSP]）。PSP的主要目标是培养自主和适应性内质反应功能，以促进敏感、非虐待的养育方式，减少使AMARs及其后代处于危险中的行为，包括物质使用。PSP干预建立在基于证据的实践基础上，以增加积极的养育方式，并包括创新的移动技术组件：PSP在小组会议中训练amar正念冥想和社会认知技能，并集成了最先进的生物传感器腕带和智能手机应用程序，以帮助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上，在情绪唤起的那一刻，智能手机会发送量身定制的干预材料（文本、语音图像）。我们已经试点并探索了PSP干预组件与AMARs的可行性和可接受性。在R34应用程序中，本研究的目标是：(1)完善PSP干预的组成部分，进一步检查它们的可接受性、安全性和可行性，并收集初步证据，证明它们对研究主要结果的有效性；(a)提高积极的育儿态度、技能和知识；(b)减少孕产妇危险行为（如药物使用、犯罪）；(2)探讨干预的中介因素：情绪调节技能；(3)探索对次要结果的有效性的初步证据，提高适应性关系技能，以发展一个或多个支持性关系，这是有效育儿的重要方面。为了实现这些目标，我们将对AMAR进行探索性、组随机对照试验（12个团体之家，N=80个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、行为问题和儿童虐待，以及这些问题行为的代际传递。

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.