1. Control n = 27 Treatment n = 37 Parent’s Age M41.1838.88 SD7.638.19 Parent’s Marital Status Married45 Single2332 Parent’s Education <12 th grade35 HS grad/GED914 Some college1216 College grad32 Income per Year$18,227$22,001.29 Child’s Race Euro American65 Afro American2132 Child’s Age M12.0411.92 SD1.291.27 Child Gender Female1114 Male1623 Research Goals Using a family-centered intervention previously used in preventing problem behavior from early childhood through adolescence (Connell et al., 2008; Shaw et al., 2006), the current study tests an adaption of the Family Check-Up (FCU) in promoting sleep, physical activity and emotion regulation skills with a one-year follow-up to test for intervention effects. Using a randomized controlled design, it was hypothesized that families assigned to the intervention would show enhanced sleep quality, physical activity and emotion regulation skills relative to controls at the one-year follow-up, as well as improvements in problem behavior and peer relationships. Participants and Procedures Rationale Early adolescence is a time of great challenges, including physical changes, more challenging social environments, and increasing school demands. Three areas that are critical for successfully meeting these challenges are sleep, physical activity, and emotion regulation. Results Analyses were computed using two groups (Control and Intervention) and three groups (Control, Engaged-Intervention*, and Nonengaged-Intervention). Repeated Measure ANOVAS revealed that: In the domain of emotion regulation: (1) Adolescents in the Engaged-Intervention Group reported improvements in Impulsivity behavior relative to control youth (d =.5), (2) Regardless of the level of engagement in the intervention, adolescents in the intervention group reported improvements in Disinhibited/Impersistent behavior (d =.43) compared to control youth. As per parent report in the domain of sleep, a trend was found for adolescents in the intervention group to have reduced sleep onset delay relative to controls (d =.5). In the domain of physical activity: (1) No differences were evident on various indices of physical activity between youth in the intervention and control conditions. *The Engaged-Intervention group required that the family complete at least one Feedback session with a Family Coach. Table 1-- Demographic characteristics of participants Study Candidates Screened N = 256 Study Candidates Qualified N = 191 Study Candidates Participated N = 165 Participants in Wave 1 Assessment Assigned to Control Condition N = 82 Participants in Wave 1 Assessment Assigned to Treatment Condition N = 83 Participants in Wave 2 Assessment Assigned to Control Condition (In Progress) N = 27 Participants in Wave 2 Assessment Assigned to Treatment Condition (In Progress) N = 37 Sample of 64 parents participated with their child (aged 10-13) At-risk: Low income, 83% Non-White, screened from pediatric clinics on the basis of SES and child risk in Sleep, Emotion Regulation or Physical Activity Two data collection points approximately 1 year apart Conclusions The results suggest that the intervention is associated with some improvements in youth reports of sleep onset and emotion regulation (e.g., impulsivity). In contrast, no group differences were found for physical activity. Although some findings were consistent with hypotheses, the modest findings for physical activity and for some measures of emotional regulation and sleep may be related to the relatively few numbers of families who engaged in the intervention after the feedback (i.e., only 7 of the 37 families participated in multiple intervention sessions), which may prove pivotal in improving youth skills in sleep, emotion regulation, and physical activity. As engagement practices were improved midway through the first wave of the intervention, data will be re-examined with the full sample in the near future where more consistent and positive results are expected to occur. For more information, please contact Flannery E. O’Rourke, Dept. of Psychology, University of Pittsburgh (feo3@pitt.edu). The Health Promotion Project has been supported by grants to Ronald Dahl and Daniel Shaw from the National Institute of Child Health and Human Development. Intervention The Family Check-Up (FCU) is an ecological, family-centered intervention (EcoFIT; Dishion & Stormshak, 2007). The FCU differs from other family-focused interventions by: (1) incorporating motivational interviewing to stimulate parents to modify caregiving practices (Miller & Rollnick, 2002), (2) being heavily driven by a thorough assessment of the child’s family and community ecology, and (3) adopting a health maintenance approach that involves annual contact with the families to provide support for them through multiple developmental transitions. Structured feedback is provided to the family based on results from the assessment, highlighting both family strengths and potential areas of improvement. Depending on the family’s needs and motivation to change, children and parents are offered an opportunity to engage in additional intervention in varying formats (e.g., therapy sessions, phone check- ups, community referrals). Measures Emotion Regulation: Adult-Child Relationship Scale (ACRS): This 15-item form is designed to measure the parent –child relationship quality (ACRS, Pianta & Steinberg, 1991). Children’s Affective Dysregulation Scale (CADS): This 30-item form is designed to assess frequency of emotionally dysregulated behaviors in aggression, irritability, anger, mood lability and impulsivity (Kolko, et al. 2001). Children’s Affective Lability Scale (CALS): This 20-item scale is designed to measure behavior reflective of emotional dysregulation. Reliability has been demonstrated among controls and psychiatric samples (Gerson et al., 1996). Child Depression Inventory (CDI): This 10-item short form of the CDI is designed to measure depression symptoms (Kovacs et al., 1992). Multidimensional Anxiety Scale (MASC): This 10-item short form of the MASC is designed to measure anxiety (March et al., 1997). Sleep: Sleep Habits Questionnaire (SHQ;SSR): This 33 item measure provides an overview of the child's sleep habits, sleepiness and fatigue. Physical Activity: Modifiable Activity Questionnaire for Adolescents (MAQA): The MAQA is a measure of adolescents’ activity level over the past year. (Aaron, et al. 1995) SenseWear® Body Monitoring System (SW): The SW acts as a metabolic wearable monitor, allowing convenient collection of metabolic data for determination of physical activity and sleep over multiple days in natural environments. Testing an Adaptation of the Family Check Up to Promote Sleep, Physical Activity, and Emotion Regulation Skills Flannery E. O'Rourke, Loren Schleiden, Daniel S. Shaw, Ronald E. Dahl, Brittany L. Miller, Louis C. Cianni, Tina Goldstein, Dana Rofey and Anne Gill Results ScaleFactor Time 1 Raw Scores Control Time 2 Raw Scores Control Time 1 Raw Scores Tx - Engaged Time 2 Raw Scores Tx - Engaged Time 1 Raw Scores Tx – Non- engaged Time 2 Raw Scores Tx – Non- engaged xsdx x x x x Emotion Regulation ACRS Conflict 16.467.5617.897.9917.087.3019.609.2214.175.4413.675.10 Openness 12.043.4111.523.1512.002.4511.962.0711.833.5112.003.10 CADS – Child Report Irritability 2.202.061.671.443.961.703.121.392.421.832.171.70 Explosiveness 3.042.732.411.854.843.213.642.783.332.432.752.30 Impulsivity** (d=.5) 6.083.195.742.469.242.547.483.206.423.036.673.98 CALS – Child Report Angry, Depressed 10.119.019.267.3712.889.7611.167.7014.179.6811.2510.88 Disinhibited, Impersistent* (d=.43) 7.524.967.074.479.284.957.845.1112.086.117.174.53 CALS – Parent Report Angry, Depressed 6.677.656.567.548.726.9410.809.707.256.597.177.20 Disinhibited 5.895.245.304.016.605.087.245.886.504.215.675.09 CDITotal 1.071.571.562.282.162.5123.671.08 1.34 MASCTotal Sum Score 10.415.268.814.2911.045.3711.287.0311.755.2911.185.06 Sleep SHQ Sleep Onset Delay** (d=.84) 1.630.631.890.641.760.831.760.781.920.671.670.49 Sleep Duration 4.561.484.371.524.681.774.681.734.751.914.671.37 Sleep Anxiety* (d=.64) 7.041.236.620.696.291.366.561.016.931.156.330.83 Night Wakings 3.891.223.811.004.361.223.721.144.081.164.081.24 SSRSleep Anxiety 4.741.384.671.574.641.254.401.004.831.994.501.24 Physical Activity SenseWear Sedentary Time (Min) Mean 824.17288.08845.00258.63854.92236.46774.09207.72805.24260.25857.77265.19 Moderate Pa Time (Min) Mean 115.2267.3598.0661.61111.3757.1991.5134.7993.0957.6479.6756.76 Vigorous Pa Time (Min) Mean 14.338.6713.4510.4415.3017.4512.759.609.669.757.419.05 Very Vigorous Pa Time (Min) Mean 1.572.061.451.880.971.861.161.441.752.130.45 Measured Sleep (Min) Mean 260.26105.87269.5283.82266.1474.83226.4167.64254.4774.87265.5992.16 *p ≤.05 **p<.1