Improving Future Thinking Among Mothers to Reduce Harsh Parenting and Improve Child Outcomes

February 22, 2025 updated by: Julia Felton, Henry Ford Health System

Reducing Maternal Delay Discounting as a Target Mechanism to Decrease Harsh Parenting and Improve Child Mental Health Outcomes in a Traditionally Underserved Community

Parents of children from impoverished communities are disproportionately more likely to engage in harsh physical discipline, which can lead to serious clinical outcomes, including suicidal ideation and attempts. One mechanism linking low resource environments and maladaptive parenting strategies is maternal delay discounting, or the tendency to value smaller, immediate rewards (such as stopping children's misbehavior via physical means) relative to larger, but delayed rewards (like improving the parent-child relationship). This study will examine the efficacy of implementing a low-cost, brief intervention targeting the reduction of maternal delay discounting to inform broader public health efforts aimed at improving adolescent mental health outcomes in traditionally underserved communities.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

Harsh parenting is associated with serious and costly mental health problems among youth, including substance use, mood disorders, and suicidal ideation and behaviors. Of concern, these parenting practices are most common among families from impoverished communities; however, many behaviorally-based parenting interventions do not take into account the unique mechanisms linking environmental disadvantage to parenting approaches. While the causes of harsh parenting are complex and varied, one such mechanism may be parents' tendencies to prioritize immediate rewards (such as stopping a child's misbehavior via physical punishment like spanking and hitting) relative to larger, but delayed rewards (including improved parent-child relationship quality), known as delay discounting. This case series will examine the efficacy of episodic future thinking (EFT) to target reduction of parenting-related delay discounting. Outcomes will evaluate the effect of EFT on reducing maternal delay discounting and harsh parenting, and improving child clinical outcomes.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
48

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Contact Backup

Study Locations

  • United States
    • Michigan
      • Flint, Michigan, United States, 48505
        • RL Jones Community Outreach Center

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  1. Be the mother from the Flint area of a child between the ages of 5-10 who can provide legal consent for that child to participate in this study
  2. Self-report that the child lives with them for at least 50% of the time
  3. Willing to participate in the study
  4. Able to participate in written assessments and an intervention conducted in English
  5. Have a working cell phone that can receive and send text messages and be willing to receive/send text messages as part of the study
  6. Have a phone or device that's able to use video conferencing software

Exclusion Criteria:

  1. Self-disclosed active suicidality/homicidality
  2. Self-disclosed current bipolar disorder, schizophrenia, or psychosis
  3. Current and ongoing involvement with child protective services

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Prevention
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Episodic Future Thinking
Mothers will receive episodic future thinking (EFT). Mothers will meet with a "peer mother" who will administer the EFT intervention, including generation of several specific future events reflecting positive interactions with their child. We will also teach each parent a behavioral parent training element called Special Play Time. Following this session, mothers will receive daily text messages over the course of two weeks including a reminder cue generated as part of the EFT and a prompt to remember these episodes in vivid detail.
Behavioral: Episodic Future Thinking
Episodic future thinking (EFT) includes a focus on generating detailed and vivid descriptions of future events. For the current intervention, EFT will be modified to have mothers describe specific events with their children.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Change in Monetary Choice Questionnaire
Time Frame: Baseline, 1 week, 4 weeks
The brief Monetary Choice Questionnaire (MCQ) is a 21-item binary-choice task that asks participants to select between two hypothetical monetary amounts: a smaller reward available immediately (e.g. $49 today) or a larger reward available after a delay (e.g. $60 in 89 days). "Larger later" amounts are separated into small, medium and large magnitudes. For the purposes of this study, to limit participant burden, we administered only small and large magnitude subscales, resulting in a total number of 14 items. The measure is scored to derive a single "total score" discounting rate k, with larger values reflecting greater preference for smaller sooner reward. Because k distributions are typically skewed, post-hoc natural logarithmic transformations were performed, resulting in normal distributions; thus, there is no maximum and minimum value. The MCQ has been shown to have strong psychometric properties among adults and correlates with real rewards, as well as real-world risk behaviors.
Baseline, 1 week, 4 weeks
Change in Consideration of Future Consequences Scale-Parenting Score
Time Frame: Baseline, 4 weeks
The Consideration of Future Consequences Scale-Parenting Adapted (CFCS-14-PA) is a 14-item self-report questionnaire composed of two subscales reflecting either immediate or future orientation related to parents interactions with their children. Items range from "not at all like me" (1) to "very much like me" (5) and are summed to create future or immediate orientation subscale, each composed of 7 items with score ranges from 7-35. Lower scores on the future orientation and higher scores on the immediate orientation subscales are associated with less future orientation and predictive of less engagement in health behaviors. The measure has been used extensively among adult samples and demonstrates strong reliability and validity. Change in CFCS-14-PA score is measured by comparing scores at the post-intervention assessment (approximately 4 weeks after baseline) with baseline scores.
Baseline, 4 weeks

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Change in Dyadic Parent-Child Interaction Coding System Scores
Time Frame: Baseline, 4 weeks
Parents and their children will complete a 20-minute interaction task, including 5 min. of free play, a 10 min. "homework" task, and a 5 min. clean up task. Wualitvey of parent-childre interactions were coded using the Dyadic Parent-Child Interaction Coding System (DPICS). The task has 7 subscales, yielding 2 composite scores: positive parenting (a sum of: unlabeled praise, labeled praise, positive touch, reflection, and behavior description) and negative parenting (a sum of: negative talk and negative touch). Each instance of a behaviors described in the subscale (e.g., a parent giving unlabeled praise) is coded as one "point" and summed into a subscale (no max or min values). Higher values indicate greater positive or negative parenting. A score is given to the dyad (not individuals scores for parent/child). Change in parenting is calculated by comparing baseline scores with scores at the post-intervention sessions (approximately 4 weeks after baseline).
Baseline, 4 weeks
Change in Alabama Parenting Questionnaire Score
Time Frame: Baseline, 4 weeks
The Alabama Parenting Questionnaire (APQ) is a 42-item self-report measure of parenting behaviors which yields five subscales: (1) positive involvement with children (range 10-50, higher = more involvement), (2) use of positive parenting strategies (range 6-30, higher = more positive strategies), (3) poor parental monitoring/supervision (range 10-50, higher = worse supervision), (4) inconsistent discipline (range 6-30, higher = more inconsistent discipline), and (5) use of corporal punishment (higher = more corporal punishment). Items are summed to create subscale scores. Change in each of the five APQ subscale scores will be measured by comparing post-intervention scores (approximately 4 weeks after baseline) with baseline scores.
Baseline, 4 weeks
Change in Emotion Regulation Checklist
Time Frame: Baseline, 4 weeks
Parents will report on children's emotion regulation using the Emotion Regulation Checklist (ERC). Items are rated from 1 to 4 and summed to create subscales. The ECR includes 24 items. 23 items are used in computing two subscales: (1) emotion regulation (range 8 to 32, higher = greater emotion regulation) and (2) lability/negativity (range 15 to 60, higher = greater lability/negativity); the 24th item does not load onto either subscale and is not used in the current analyses. The measure is widely used and validated for parent-report of older children and young adolescents.
Baseline, 4 weeks
Client Satisfaction Questionnaire
Time Frame: 4 weeks
Following the completion of the intervention, mothers will complete the Client Satisfaction Questionnaire (CSQ), which evaluates participant satisfaction with the intervention. Nine items are ranked from 1 to 4 and summed to create a total score (range 9-36, higher = greater satisfaction). The measure is used across a number of intervention studies and has been shown to be reliable and valid in adult samples.
4 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Henry Ford Health System

Collaborators

Collaborators

An organization other than the sponsor that provides support for a clinical study. This support may include activities related to funding, design, implementation, data analysis, or reporting.
Michigan State University
University of Kansas
University of Maryland, College Park

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
June 2, 2022

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
November 21, 2023

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
November 21, 2023

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
January 18, 2022

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
January 27, 2022

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
February 8, 2022

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
March 25, 2025

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
February 22, 2025

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
February 1, 2025

More Information

Terms related to this study

Keywords

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • NHP: 15407-31

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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