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Background: Parenting strategies such as communicating clear expectations, providing calm directions, and teaching specific skills can strengthen young children's social-emotional development. Parenting programs for children with disruptive behavior often emphasize gaining compliance via effective directives, and less on how to facilitate child skill acquisition or on effective parenting for differing situations and task demands. Objective: We aimed to study how parenting strategies and associated child behavior vary by situational contexts. Specifically, we focused on the differential use of directives and guidance during different tasks. Method: This observation study utilized a microsocial coding system, the Parent-Child Play Task Observation System (PCPTOS), to closely examine parent and child interactions in multiple analogue task situations. The study drew on pre-intervention data for 224 parent-child dyads who participated in a parenting-focused intervention trial for children ages 3-7 who presented elevated levels of disruptive behaviors. Results: Interrater reliabilities were very good to excellent. Parents used directives more frequently during the clean-up task and guidance more frequently during the teaching task compared to the other tasks. Associations of parent use of directives and guidance with child behavior and affect differed by task. Observed parent directives were associated with child disruptive behavior during each task, whereas parent guidance was negatively associated with child disruptive behavior and positively associated with child positive affect during the teaching task. Conclusions: Parenting strategies that are well matched to the situational context and proactively consider task demands are more likely to facilitate children's social-emotional development.

BackgroundUse of smokeless tobacco (moist snuff and chewing tobacco) is a significant public health problem but smokeless tobacco users have few resources to help them quit. Web programs and telephone-based programs (Quitlines) have been shown to be effective for smoking cessation. We evaluate the effectiveness of a Web program, a Quitline, and the combination of the two for smokeless users recruited via the Web.ObjectivesTo test whether offering both a Web and Quitline intervention for smokeless tobacco users results in significantly better long-term tobacco abstinence outcomes than offering either intervention alone; to test whether the offer of Web or Quitline results in better outcome than a self-help manual only Control condition; and to report the usage and satisfaction of the interventions when offered alone or combined.MethodsSmokeless tobacco users (N= 1,683) wanting to quit were recruited online and randomly offered one of four treatment conditions in a 2×2 design: Web Only, Quitline Only, Web + Quitline, and Control (printed self-help guide). Point-prevalence all tobacco abstinence was assessed at 3- and 6-months post enrollment.Results69% of participants completed both the 3- and 6-month assessments. There was no significant additive or synergistic effect of combining the two interventions for Complete Case or the more rigorous Intent To Treat (ITT) analyses. Significant simple effects were detected, individually the interventions were more efficacious than the control in achieving repeated 7-day point prevalence all tobacco abstinence: Web (ITT, OR = 1.41, 95% CI = 1.03, 1.94, p = .033) and Quitline (ITT: OR = 1.54, 95% CI = 1.13, 2.11, p = .007). Participants were more likely to complete a Quitline call when offered only the Quitline intervention (OR = 0.71, 95% CI = .054, .093, p = .013), the number of website visits and duration did not differ when offered alone or in combination with Quitline. Rates of program helpfulness (p

Research Findings: This observation study investigated the prevalence and correlates of learning contexts provided to preschool-age children in 133 registered child care homes in below-average-income neighborhoods in the U.S. Pacific Northwest. On average, 30% of the observed proportion of time was spent in structured teacher-led activities, 51% in free-choice activities, 10% in routine activities, 1% in watching video/TV, and 7% in transition. Home-based child care providers gave significantly more positive recognition during structured teacher-led activities, and children engaged in more prosocial behavior during free-choice time. Directives and noncompliance occurred more often during transitions. A higher child-to-caregiver ratio was associated with more time spent in free-choice time, and caregiver experience and education were not associated with the time spent in specific learning contexts. Practice or Policy: Similar to preschool and center-based child care, current practice in home-based child care is to offer a mix of structured teacher-led and free-choice activities. To facilitate young children's skill development within these learning activities typically offered, it is necessary to increase research and provide empirically based professional development opportunities relevant to home-based child care settings. Attention to home-based child care will likely reach many young children and be particularly beneficial for those in low-income households.

Background: Adolescence and early adulthood are pivotal stages for the onset of mental health disorders and the development of health behaviors. Digital behavioral activation interventions, with or without coaching support, hold promise for addressing risk factors for both mental and physical health problems by offering scalable approaches to expand access to evidence-based mental health support. Objective: This 2-arm pilot randomized controlled trial evaluated 2 versions of a digital behavioral health product, Vira (Ksana Health Inc), for their feasibility, acceptability, and preliminary effectiveness in improving mental health in young adults with depressive symptoms and obesity risk factors. Methods: A total of 73 participants recruited throughout the United States were randomly assigned to use Vira either as a self-guided product (Vira Self-Care) or with support from a health coach (Vira+Coaching) for 12 weeks. The Vira smartphone app used passive sensing of behavioral data related to mental health and obesity risk factors (ie, activity, sleep, mobility, and language patterns) and offered users personalized insights into patterns of behavior associated with their daily mood. Participants completed self-reported outcome measures at baseline and follow-up (12 weeks). All study procedures were completed via digital communications. Results: Both versions of Vira showed strong user engagement, acceptability, and evidence of effectiveness in improving mental health and stress. However, users receiving coaching exhibited more sustained engagement with the platform and reported greater reductions in depression (Cohen d=0.45, 95% CI 0.10-0.82) and anxiety (Cohen d=0.50, 95% CI 0.13-0.86) compared to self-care users. Both interventions also resulted in reduced stress (Vira+Coaching: Cohen d=-1.05, 95% CI -1.57 to -0.50; Vira Self-Care: Cohen d=-0.78, 95% CI -1.33 to -0.23) and were perceived as useful and easy to use. Coached users also reported reductions in sleep-related impairment (Cohen d=-0.51, 95% CI -1.00 to -0.01). Moreover, participants increased their motivation for and confidence in making behavioral changes, with greater improvements in confidence among coached users. Conclusions: An app-based intervention using passive mobile sensing to track behavior and deliver personalized insights into behavior-mood associations demonstrated feasibility, acceptability, and preliminary effectiveness for reducing depressive symptoms and other mental health problems in young adults. Future directions include (1) optimizing the interventions, (2) conducting a fully powered trial that includes an active control condition, and (3) testing mediators and moderators of outcome effects. [ABSTRACT FROM AUTHOR]

Background: Little is known about factors that influence home-based child care providers' participation in professional development. Factors that predict participation in activities that are designed to promote the utilization and maintenance of skills taught are of particular interest. Objective: Our aim was to examine factors in the home-based child care context that might influence participation in professional development, including demographic variables, working conditions, preintervention skills and training, perceptions of workshop usefulness, and interpersonal factors such as job-related stress and depressive symptoms. Methods: In this exploratory study, we examined predictors of participation among 67 home-based child care providers in Oregon, USA, who took part in the intervention group of a randomized efficacy study on a multiphase professional development program to promote preschoolers' positive social development. Results: Latent class analysis of participation resulted in three distinct groups: those who participated in the initial three workshops (WS), those who participated in workshops plus maintenance activities (consultation and a booster session, WS+), and those with little to no participation (NP). The NP group was too small to include in further analysis. A multivariate logistic regression model with child care provider education, number of preschool-age children enrolled in care, child-to-caregiver ratio, and self-reported stress included as predictors significantly improved classification in the WS+ group compared to the WS group. Conclusions: These findings offer a preliminary look at the unique factors influencing home-based child care providers' participation in extended professional development. Relevancy of content to child care providers' situations appears to be important.

This study uses ecological momentary assessment (EMA) to simultaneously capture youths' perceptions of peer affiliates and social contexts to determine their association with youths' current and future mood states. A sample of 82 seventh grade students (36 at risk for developing or escalating rule breaking and substance use and 46 randomly selected) from 4 schools participated. Using EMA methodology, we had students report their peer affiliations, perceptions of peer affiliates, moods, activities, location, and behaviors during their free time. Data from 3 assessment waves were collected; each wave consisted of 27 randomly prompted assessments during a week. Youths spent a large portion of their free time watching television, on the computer, or playing video games. Being "out and about" increased over the school year, whereas adult supervision decreased, showing an increase in potentially risky situations. Happiness was associated with affiliating with peers who were perceived to be popular. Negative moods were associated with affiliating with peers by whom they were teased or treated meanly. Multilevel models found that both levels and lability of negative moods (i.e., sadness, anxiety) were predicted by risk status and affiliation with peers who tease them. Compared with boys, girls who affiliated more with peers who teased them and were classified as at risk had more extreme negative moods and negative mood lability. EMA methodology has demonstrated the ways in which salient intrapersonal and peer processes are associated over time, which can inform efforts to prevent the development and escalation of behavior problems, substance use, and mood disorders in adolescence. (Contains 3 tables and 2 figures.)

Home-based child caregivers face unique stressors related to the nature of their work. One hundred and fifty-five home-based child care providers in Oregon, USA, participated in this cross-sectional correlational study. We investigated associations between indicators of caregiver stress and child care working conditions, the quality of caregiver practices, frequency of child behaviour challenges, and caregivers' tolerance for those behaviours. Levels of stress in this sample were moderate to low. Significant associations were found between greater caregiver stress with higher child-caregiver ratio, working in isolation, less frequently observed caregiver positive attention, more caregiver-reported child problem behaviours and lower tolerance for problem behaviours. A multiple regression analysis with these variables significantly contributed to 23% of the variance of caregiver stress. Number of hours worked, observed caregiver negative attention, and responsiveness to children were not associated with caregiver stress. Implications of these findings and the need for future studies are discussed.

This article describes the use of an observation system to measure middle school staff practices, environment characteristics, and student behavior in the school common areas. Data were collected at baseline from 18 middle schools participating in a randomized controlled trial of school-wide Positive Behavior Support. The observations were reliable and showed sensitivity to differences between school settings and between schools. Multilevel models with students nested in schools were used to examine the associations of staff practices and the school environment with student behavior. Less effective behavior management and more staff criticism, graffiti, and percentage of low-income students were associated with student problem behaviors. Greater use of effective behavior management and positive attention, and fewer low-income students were associated with positive student behavior. The use of data-based feedback to schools for intervention planning and monitoring is illustrated. Implications for school-wide efforts to improve student behavior in middle schools are discussed. (Contains 6 tables and 1 figure.)

Intensive longitudinal research—including experience sampling and smartphone sensor monitoring—has potential for identifying proximal risk factors for psychopathology, including suicidal thoughts and behaviors (STB). Yet, missing data can complicate analysis and interpretation. This study aimed to address whether clinical and study design factors are associated with missing data and whether missingness predicts changes in symptom severity or STB. Adolescents ages 13- to 18 years old (N = 179) reporting depressive, anxiety, and/or substance use disorders were enrolled; 65% reported current suicidal ideation and 29% indicated a past-year attempt. Passively acquired smartphone sensor data (e.g., global positioning system, accelerometer, and keyboard inputs), daily mood surveys, and weekly suicidal ideation surveys were collected during the 6-month study period using the effortless assessment research system smartphone app. First, acquisition of passive smartphone sensor data (with data on ∼80% of days across the whole sample) was strongly associated with survey data acquisition on the same day (∼44% of days). Second, STB and psychiatric symptoms were largely not associated with missing data. Rather, temporal features (e.g., length of time in study, weekends, and summer) explained more missingness of survey and passive smartphone sensor data. Last, within-participant changes in missing data over time neither followed nor predicted subsequent change in suicidal ideation and psychiatric symptoms. Findings indicate that considering technical and study design factors impacting missingness is critical and highlight several factors that should be addressed to maximize the validity of clinical interpretations in intensive longitudinal research. General Scientific Summary: Missing data poses substantial challenges to longitudinal research on mental health. This study worked to characterize patterns of missing data among adolescents with psychiatric disorders and at risk for suicide, in particular missingness of smartphone-based surveys and measurements passively collected from participants' smartphones (e.g., global positioning system, accelerometer, and keyboard). Findings highlight key technical and study design factors that should be considered to minimize missing data and maximize the validity of results in future longitudinal studies using smartphones. [ABSTRACT FROM AUTHOR]

Background: The impact of digital device use on health and well-being is a pressing question. However, the scientific literature on this topic, to date, is marred by small and unrepresentative samples, poor measurement of core constructs, and a limited ability to address the psychological and behavioral mechanisms that may underlie the relationships between device use and well-being. Recent authoritative reviews have made urgent calls for future research projects to address these limitations. The critical role of research is to identify which patterns of use are associated with benefits versus risks and who is more vulnerable to harmful versus beneficial outcomes, so that we can pursue evidence-based product design, education, and regulation aimed at maximizing benefits and minimizing the risks of smartphones and other digital devices., Objective: The objective of this study is to provide normative data on objective patterns of smartphone use. We aim to (1) identify how patterns of smartphone use impact well-being and identify groups of individuals who show similar patterns of covariation between smartphone use and well-being measures across time; (2) examine sociodemographic and personality or mental health predictors and which patterns of smartphone use and well-being are associated with pre-post changes in mental health and functioning; (3) discover which nondevice behavior patterns mediate the association between device use and well-being; (4) identify and explore recruitment strategies to increase and improve the representation of traditionally underrepresented populations; and (5) provide a real-world baseline of observed stress, mood, insomnia, physical activity, and sleep across a representative population., Methods: This is a prospective, nonrandomized study to investigate the patterns and relationships among digital device use, sensor-based measures (including both behavioral and physiological signals), and self-reported measures of mental health and well-being. The study duration is 4 weeks per participant and includes passive sensing based on smartphone sensors, and optionally a wearable (Fitbit), for the complete study period. The smartphone device will provide activity, location, phone unlocks and app usage, and battery status information., Results: At the time of submission, the study infrastructure and app have been designed and built, the institutional review board of the University of Oregon has approved the study protocol, and data collection is underway. Data from 4182 enrolled and consented participants have been collected as of March 27, 2023. We have made many efforts to sample a study population that matches the general population, and the demographic breakdown we have been able to achieve, to date, is not a perfect match., Conclusions: The impact of digital devices on mental health and well-being raises important questions. The Digital Well-Being Study is designed to help answer questions about the association between patterns of smartphone use and well-being., International Registered Report Identifier (irrid): DERR1-10.2196/49189., (©Daniel McDuff, Andrew Barakat, Ari Winbush, Allen Jiang, Felicia Cordeiro, Ryann Crowley, Lauren E Kahn, John Hernandez, Nicholas B Allen. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 14.05.2024.)