Healing Hearts: A Mindfulness App for Parents Navigating Divorce or Separation

Participants receive the Healing Hearts program (HH) followed by the electronic New Beginnings Program (eNBP). The two interventions are received sequentially. HH is first offered after baseline randomization as a self-guided mindfulness app that contains four Parts, which contain five days of activities each (i.e., a total of 20 Days of activities). It has a recommended four-week completion period. Completing each Day's activities take about 20-30 minutes. Most activities are under 5 minutes, with other longer activities.

Participants will receive the second assessment (T2) at week 7. Upon completion, they will then receive the electronic New Beginnings Program (eNBP). The eNBP is a self-guided online parenting course requiring participants to spend about 30 minutes per module for a total of six modules. It is designed to be completed in 6 weeks (one module per week). Participants will receive the third assessment (T3) at week 14.

Four-Part self-guided web program with daily guided practices, lessons, journal and reflection activities.

Online parenting skills program containing six modules. Each module takes 30 minutes to complete and contains home practice outside of the program. Prior studies have evaluated the efficacy of this program.

Participants receive eNBP after baseline randomization. This is the only intervention they receive in this condition.

The eNBP is a self-guided online parenting course requiring participants to spend about 30 minutes per module for a total of six modules. It is designed to be completed in 6 weeks (one module per week).

Participants will receive the second assessment (T2) at week 7 and the third assessment (T3) at week 14.

Online parenting skills program containing six modules. Each module takes 30 minutes to complete and contains home practice outside of the program. Prior studies have evaluated the efficacy of this program.

Participants receive a curated list of online educational resources relevant to parenting and family wellbeing throughout the study period. They do not receive Healing Hearts or eNBP during the active comparison period. Assessments follow the same schedule as the other arms. Optional access after study assessments is outside the randomized intervention period.

Educational information comparator.

Number of eligible participants completing baseline assessment divided by months of active recruitment. Will also report the total number of participants randomized.

Percentage of all randomized participants completing the second assessment (T2) within the assessment window. The prior benchmark is at least 80%. The assessment window and completion rule require confirmation.

Using the 7-item subscale of the DASS-21 (Depression, Anxiety and Stress Scale - Short Form). Each item is rated on a 0-3 scale (raw score range: 0 - 21). Raw scores are multiplied by 2 to calculate a score that can be interpreted for severity. Higher scores indicate greater depressive symptoms. Depression: Normal 0-9, Mild 10-13, Moderate 14-20, Severe 21-27, Extremely Severe 28+.

Using the 7-item subscale of the DASS-21 (Depression, Anxiety and Stress Scale - Short Form). Each item is rated on a 0-3 scale (raw score range: 0 - 21). Raw scores are multiplied by 2 to calculate a score that can be interpreted for severity. Higher scores indicate greater depressive symptoms. Anxiety: Normal 0-7, Mild 8-9, Moderate 10-14, Severe 15-19, Extremely Severe 20+.

Stress symptoms will be measured using the seven-item Stress subscale of the Depression Anxiety Stress Scales, 21-item version (DASS-21). Each item is rated from 0 to 3, giving a raw subscale score of 0-21. The raw score is multiplied by 2, yielding a reported score of 0-42. Higher scores indicate more severe stress symptoms, a worse outcome. Conventional severity ranges for the multiplied score are normal (0-14), mild (15-18), moderate (19-25), severe (26-33), and extremely severe (34-42).

Parents rate their child's emotional and behavioral problems using the Achenbach System of Empirically Based Assessment Brief Problem Monitor Parent Form (BPM-P) for ages 6-18. The 19 items cover internalizing, attention, and externalizing problems. Each is rated 0 (not true), 1 (somewhat true), or 2 (very true). The Total Problems raw score ranges from 0 to 38; higher scores indicate more problems.

Using the 10-item Interpersonal Mindfulness in Parenting Scale to assess parents' attention, awareness, acceptance, and regulation during interactions with their children. Items are rated from 1 (never true) to 5 (always true). After reverse-scoring items where appropriate, the summed score ranges from 10 to 50; higher scores indicate greater mindful parenting.

Using the combined Acceptance/Rejection score from the parent-report Child Report of Parenting Behavior Inventory (CRPBI). Parents rate 16 acceptance items and 16 rejection items from 1 (almost never or never) to 5 (almost always or always). Rejection items are reverse-scored, and all 32 items are averaged for a score ranging from 1 to 5. Higher scores indicate greater acceptance and less rejection of the child.

Participants rate four statements about Healing Hearts using the Acceptability of Intervention Measure (AIM). Each item is scored from 1 (Strongly Disagree) to 5 (Strongly Agree). The four item scores are averaged, yielding a score from 1 to 5. Higher scores indicate greater perceived acceptability.

Participants rate four statements about the appropriateness of Healing Hearts Intervention with Intervention Appropriateness Measure (IAM). Each item is scored from 1 (Strongly Disagree) to 5 (Strongly Agree). Item scores are averaged to produce a score from 1 to 5; higher scores indicate greater perceived appropriateness.

Participants rate 10 statements about the usability of Healing Hearts on a scale from 1 (Strongly Disagree) to 5 (Strongly Agree). Responses are scored using the standard System Usability Scale (SUS) procedure, including adjustment of negatively worded items, to produce a total score from 0 to 100. Higher scores indicate greater perceived usability.

Parenting stress will be measured using the Parenting Stress Index (PSI) short form. Each item is rated from 1 to 5. A total of 36 items are divided into three domains (Parental Distress, Parent-Child Dysfunctional Interaction, and Difficult Child). Higher scores indicate higher parenting stress.

Mindful self-regulation will be measured using the 10-item Cognitive and Affective Mindfulness Scale-Revised (CAMS-R). Each item is rated from 1 ("rarely/not at all") to 4 ("almost always"). After reverse-scoring the applicable item, responses are summed to yield a total score from 10 to 40. Higher scores indicate greater dispositional mindfulness, a better outcome.

Executive functioning will be assessed using the 27-item Executive Function Index (EFI). Items are rated from 1 to 5. After reverse-scoring negatively worded items, responses are summed for a total score ranging from 27 to 135; higher scores indicate better executive functioning.

Using the 14-item Maternal Emotional Style Questionnaire (MESQ). Each item is rated from 1 (strongly disagree) to 5 (strongly agree). Items are summed for a score ranging from 7 to 35. Higher scores indicate greater endorsement of an emotion-coaching parenting style.

Using the 5-item Prosocial Behavior subscale of the Strengths and Difficulties Questionnaire (SDQ). Each item is rated on a 3-point scale from 0 (Not True) to 2 (Certainly True). The five items are summed to produce a score ranging from 0 to 10. Higher scores indicate greater prosocial behavior.

Parents report conflict with their ex-partner during the past two weeks using 13 items adapted for parent report Children's Perception of Interparental Conflict Scale (CPICS): six assessing conflict frequency and seven assessing conflict intensity. Responses are "False," "Sort of True," or "True." Items are coded and reverse coded as appropriate, then combined into an overall score ranging from 13 to 39. Higher scores indicate greater parent reported interparental conflict. "Not applicable" and "Prefer not to say" are treated as missing responses.

Parents complete a six-item questionnaire about their emotional responses before and after communicating with their ex-partner. The questions are developed for this study. Each item is rated from 1 (Strongly Disagree) to 5 (Strongly Agree). The two items describing not taking interactions personally and feeling confident are reverse scored. Item scores are averaged to produce a score from 1 to 5; higher scores indicate greater emotional distress related to communication with the ex-partner.

Parents rate 16 statements adapted from the Laxness domain of the Parenting Scale (Arnold et al., 1993), referring to the past two weeks. Each statement is rated from 1 (Strongly Disagree) to 7 (Strongly Agree). Items describing consistent limit setting are reverse scored, and the item scores are averaged to produce a score from 1 to 7. Higher scores indicate more lax or inconsistent discipline.

Parents rate 17 statements adapted from the Overreactivity domain of the Parenting Scale (Arnold et al., 1993), referring to the past two weeks. Each statement is rated from 1 (Strongly Disagree) to 7 (Strongly Agree). Items describing calm responses are reverse scored, and the item scores are averaged to produce a score from 1 to 7. Higher scores indicate more reactive discipline. The physical punishment item is excluded.

Using a shortened version of the Coping with Children's Negative Emotions Scale (CCNES), parents rate how likely they would be to respond in six ways across 12 situations in which their child experiences a negative emotion. Each response is rated from 1 (very unlikely) to 7 (very likely). Higher scores indicate a greater likelihood of the reaction named by that subscale. Items worded in the opposite direction are reverse-scored according to the instrument's scoring key.

Participants complete the 39-item Five Facet Mindfulness Questionnaire (FFMQ), which assesses observing, describing, acting with awareness, nonjudging of inner experience, and nonreactivity to inner experience. Items are rated from 1 (Never or Very Rarely True) to 5 (Very Often or Always True). Specified items are reverse scored, then the 39 item scores are averaged to produce a mean score from 1 to 5. Higher scores indicate greater self-reported dispositional mindfulness.

Three E-prime go tasks will be administered to participants who have access to PC. These tasks will be installed on their computer and assess their response accuracy and reaction time. The tasks are: Wisconsin Card Sorting, Counting Backwards, and Stroop. Higher accuracy and faster reaction time within accurate trials indicate better executive functions.