Structured Video Chats for Child-Grandparent Relationships

Overseen By Mary Ellen Jackson

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: Lafayette College

Disqualifiers: Does not meet inclusion criteria

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 10

Duration: 8 weeks

540 Participants Needed

Trial Summary

What is the purpose of this trial?

During the Coronavirus (COVID-19) pandemic many families are using video chat (e.g., Zoom) to maintain relationships with distant relatives, including grandparents. While 67% of all grandparents reported liking the idea of video chatting with their grandchildren, only 28% did so regularly. Increasing this percentage could significantly improve grandparent-grandchild relationships because the Preliminary Study 1 showed that video chat frequency is a strong predictor of grandparent's ratings of closeness to their grandchild, even after controlling for the geographic distance between them. The overall goal of the past, ongoing, and future research is to understand the cognitive and social developmental challenges of video chat in order to support its use with children. As the next step towards this goal, the investigators propose to directly compare two approaches to instructing grandparents on how to improve video chats between grandparents and young grandchildren (18-72 months of age). Families will use video chat without the involvement of researchers during each video chat. Parent-child- grandparent triads (n=180; the largest multi-session observational study of young children and video chat to date) will record 10 video chats under one of three randomly-assigned conditions: structured play, structured reading, or when given no instructions (control). The overall hypothesis is that structured video chat will increase children's engagement and joint attention (primary outcome measures), as well as grandparents' enjoyment of video chat and closeness with their grandchild (secondary outcome measures). The investigators will use detailed behavioral coding of the video recordings of these chats to objectively assess many of the outcome measures. The Preliminary Study 2 showed that structured video chat facilitates more positive social interactions. The proposed work extends the preliminary work because it translates laboratory methods to a complementary ecologically-valid approach in families' naturalistic environments. In Aim 1, the investigators will determine whether and for whom structured video chat improves child engagement and increases child-initiated screen- based joint attention during video chats between grandparents and grandchildren. In Aim 2, the investigators will determine whether structured video chat increases grandparents' enjoyment of the video chats and leads to greater feelings of closeness to their grandchild. Both principal investigators, who are at R15-eligible institutions, are well-qualified to complete the proposed work. Since 2017, they have published 9 papers on video chat, 12 papers on reading, and collaboratively completed 3 preliminary studies and 2 papers. They have mentored 77 undergraduate students, many of whom were co-authors on conference posters or presentations (37 students in total; 22 as a presenter) or journal articles. Importantly, 17 students came from underrepresented groups (BIPOC, first- generation in college, LGBT). A total of 47 are pursuing or have completed graduate work in health-related sciences, including 15 for doctoral degrees. The proposed work addresses a National Institute for Child Health \& Development, Child Development and Behavior Branch's (CDBB) priority of advancing understanding of "Effects of Technology and Digital Media Use on Child and Adolescent Development."

Do I need to stop my current medications to join the trial?

The trial protocol does not specify whether you need to stop taking your current medications. It seems unlikely that you would need to stop, as the trial focuses on video chat interactions.

Will I have to stop taking my current medications?

The trial protocol does not specify whether you need to stop taking your current medications.

What data supports the idea that Structured Video Chats for Child-Grandparent Relationships is an effective treatment?

The available research shows that structured programs for grandparents, like the Grandparent Triple P, have been effective in improving child behavior, increasing parenting confidence, and reducing stress and depression among grandparents. In a study, grandparents who participated in a specific program reported significant improvements in these areas compared to those who did not participate. These positive changes were mostly maintained even six months after the program ended. This suggests that structured interventions can be beneficial for enhancing child-grandparent relationships and overall family well-being. ^{1 2 3 4 5}

What data supports the effectiveness of the treatment Instructions for family Zoom session in the clinical trial Structured Video Chats for Child-Grandparent Relationships?

Research shows that structured programs for grandparents, like the Grandparent Triple P, can improve child behavior, parenting confidence, and reduce stress and depression in grandparents. These findings suggest that structured interactions, such as video chats, may also enhance child-grandparent relationships. ^{1 2 3 4 5}

What safety data exists for structured video chats in child-grandparent relationships?

The provided research does not directly address safety data for structured video chats in child-grandparent relationships. However, it includes studies on video-based communication in healthcare settings, which highlight the importance of acceptability, risk management, and participant satisfaction. These studies suggest that video-based interventions can improve communication and satisfaction, but specific safety data for the structured video chats in question is not available. ^{6 7 8 9 10}

Is it safe for children and grandparents to participate in structured video chats for improving their relationship?

There is no specific safety data available for structured video chats between children and grandparents, but video-based research in healthcare communication is generally considered acceptable and efforts are made to manage and reduce any risks. ^{6 7 8 9 10}

Is the treatment in the trial 'Structured Video Chats for Child-Grandparent Relationships' promising?

Yes, structured video chats are promising because they help grandparents and grandchildren connect and communicate better, even when they can't be together in person. They support positive feelings and bonding, making family relationships stronger. ^{11 12 13 14 15}

How does the treatment of structured video chats for child-grandparent relationships differ from other treatments for improving family bonds?

Structured video chats are unique because they focus on enhancing intergenerational relationships through digital communication, allowing grandparents to maintain sensitivity and connection with their grandchildren despite physical distance. This approach is particularly novel as it leverages technology to support emotional bonding and positive interactions, which is different from traditional in-person or non-digital communication methods. ^{11 12 13 14 15}

Research Team

Lauren J Myers, Ph.D.

Principal Investigator

Lafayette College

Eligibility Criteria

This trial is for families with a child aged 18 months to 5 years, where all members speak English and have a stable internet connection. They must have access to a device capable of Zoom calls and be able to see and hear well enough for effective communication during these video chats.

Inclusion Criteria

stable internet connection for all parties

I have a child who is between 18 months and 5 years old.

I speak English.

Exclusion Criteria

does not meet any of the inclusion criteria

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Families engage in 10 video chat sessions under structured play, structured reading, or control conditions

8 weeks

10 video chat sessions

Follow-up

Participants are monitored for engagement, joint attention, and grandparent enjoyment and closeness

4 weeks

Treatment Details

Interventions

• Instructions for family Zoom session

Trial Overview The study tests two methods of improving video chat interactions between young children (18-72 months old) and their remote grandparents: structured play or reading versus no specific instructions. It aims to enhance engagement, joint attention, enjoyment, and feelings of closeness in these virtual family gatherings.

Participant Groups

Group I: Structured Reading Condition Experimental Treatment 1 Intervention

The following describes ONE intervention type with the following rationale. For our structured play condition, we chose to investigate the activities of playing show and tell, imitating with objects, and drawing because these are common activities derived from lab-based video chat experiments with children, many of which are authored by the PI and Co-I.

Group II: Structured Play Condition Experimental Treatment 1 Intervention

The following describes ONE intervention type with the following rationale. We chose to investigate shared book reading because it is a structured activity that is familiar, emotionally engaging, and supportive of general knowledge and language development. Adults report that shared reading is an important bonding activity that builds adult-child closeness through back- and-forth interactions. Importantly, the joint attention that occurs during shared book reading when adults and children share focus on the book may promote language and social emotional outcomes. Children are responsive and attentive during shared reading over video chat, but it is unknown whether a triadic interaction can be established during reading via video chat.

Group III: Control Condition Experimental Treatment 1 Intervention

The control families will be asked to do video chat as usual, with no specific instructions.

Who Is Running the Clinical Trial?

Lafayette College

Lead Sponsor

Trials

1

Recruited

540+

University of South Dakota

Collaborator

Trials

16

Recruited

2,000+

Findings from Research

This systematic review evaluated 21 grandparent-focused prevention programs over 31 years, highlighting that 13 programs showed feasibility and acceptability, while 8 programs demonstrated promising outcomes in randomized-controlled trials (RCTs).

The review identified six core components and 17 specific elements that contribute to the effectiveness of these programs, emphasizing the need for tailored programming to meet the unique needs of diverse grandparent caregivers.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Evaluation of Prevention Programs for Grandparent Caregivers: a Systematic Review. Chan, ACY., Piehler, TF.[2023]

The Grandparent Triple P intervention significantly improved grandparent-reported child behavior problems, parenting confidence, and reduced levels of depression, anxiety, and stress among grandparents, based on a study involving 54 grandparents and 48 parents.

Parents also observed significant reductions in child behavior problems, indicating that the benefits of the intervention extended beyond the grandparents to positively impact the entire family dynamic.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A randomized controlled trial evaluating a parenting program designed specifically for grandparents. Kirby, JN., Sanders, MR.[2018]

A six-month multimodal intervention for grandparents raising grandchildren, which included home visits and support group meetings, led to significant improvements in mental health and reduced psychological distress.

Participants reported increased social support and better legal relationships with their grandchildren, along with enhanced access to public benefits, indicating the intervention's effectiveness in addressing both emotional and practical needs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A multimodal intervention for grandparents raising grandchildren: results of an exploratory study. Kelley, SJ., Yorker, BC., Whitley, DM., et al.[2019]

Grandparents are increasingly important in raising their grandchildren, especially in families where the traditional nuclear family structure is less common.

The study of twelve grandparent-headed families highlighted the need for a multi-modal and intergenerational approach to effectively address therapeutic issues and improve treatment outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Grandparent-headed families: new therapeutic challenges. O'Reilly, E., Morrison, ML.[2019]

A randomized clinical trial involving 343 custodial grandmothers showed that both behavioral parent training (BPT) and cognitive-behavioral therapy (CBT) significantly reduced psychological distress and improved parenting practices compared to an information-only control group.

The interventions were effective in addressing the internalizing and externalizing difficulties of grandchildren aged 4 to 12, with effect sizes comparable to those seen in traditional parent interventions, indicating that these evidence-based approaches can be beneficial for custodial grandfamilies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A randomized clinical trial of interventions for improving well-being in custodial grandfamilies. Smith, GC., Hayslip, B., Hancock, GR., et al.[2023]

In a study of 155 pediatric clinic visits, only 0.59% of observed behaviors indicated awareness of being recorded, suggesting minimal impact on communication during visits.

Younger children were more likely to show awareness of the camcorder, but overall, this awareness did not significantly affect the quality of communication or the perceived quality of the visits.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Audio-video recording of health care encounters for pediatric chronic conditions: observational reactivity and its correlates. Antal, H., Hossain, MJ., Hassink, S., et al.[2022]

A blended research-design approach was used to co-create multimedia informed consent prototypes for pediatric vaccine trials, which involved surveys and participatory design workshops with children and their families.

Participants found that the new multimedia prototypes communicated necessary information more effectively than traditional text documents, suggesting that this method could enhance understanding and engagement in clinical trials.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Improving Informed Consent for Novel Vaccine Research in a Pediatric Hospital Setting Using a Blended Research-Design Approach. Jackson, SM., Daverio, M., Perez, SL., et al.[2023]

The study reviewed 36 publications to understand the acceptability and risks of video-based research in healthcare communication, providing a comprehensive synthesis of empirical research, regulations, and guidance.

The recommendations generated aim to enhance participant acceptability and manage risks in non-covert video-based studies, supporting ethical considerations in healthcare communication research.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Acceptability and design of video-based research on healthcare communication: Evidence and recommendations. Parry, R., Pino, M., Faull, C., et al.[2018]

The use of an educational video on an iPad significantly improved patients' knowledge about warfarin, with post-video test scores rising from a median of 10 to 12, indicating effective learning.

Patients reported high satisfaction with the iPad educational tool, and the study showed a 94.1% adherence rate to warfarin, suggesting that this method of education could enhance patient engagement and safety in managing their medication.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Impact of an electronic medium delivery of warfarin education in a low income, minority outpatient population: a pilot intervention study. Heinrich, K., Sanchez, K., Hui, C., et al.[2020]

A study involving 62 parents of children requiring procedural sedation in the emergency department found that those who watched an informational video had significantly higher knowledge scores (91.67) compared to those who received conventional information from physicians (73.33).

Parents who viewed the video also reported greater satisfaction with the informed consent process, suggesting that educational videos can enhance understanding and satisfaction for parents during pediatric procedures.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Parental Educational Intervention to Facilitate Informed Consent for Pediatric Procedural Sedation in the Emergency Department: A Parallel-Group Randomized Controlled Trial. Lin, YK., Yeh, YS., Chen, CW., et al.[2022]

The Intergenerational Grandparent-Grandchild Reminiscence Program, involving 12 grandchildren and their grandparents over 6 weeks, fostered stronger connections and engagement, allowing grandchildren to learn more about their grandparents' life experiences.

Participants faced challenges such as language barriers and the need for structured discussion strategies, but overall, the program showed promise in enhancing bonding and understanding between generations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Learning about Grandparents' Past Life: Reflections of Grandchildren in an Intergenerational Reminiscence Project for Asian American Families. Xu, L., Hagedorn, A., Raval, M.[2023]

Grandchildren who experienced supportive communication (accommodative chatter) from their grandparents were more likely to engage positively in discussions about aging, which correlated with higher life satisfaction and lower depressive symptoms.

Disengaged-joking communicators, who had less supportive interactions, reported lower life satisfaction and greater loneliness, suggesting that the quality of intergenerational communication can significantly impact the well-being of grandchildren.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Role of Grandchildren's Own Age-Related Communication and Accommodation From Grandparents in Predicting Grandchildren's Well-Being. Bernhold, QS., Giles, H.[2021]

In a study of 286 university students in Germany, face-to-face and phone communication were the most frequently used methods for maintaining relationships with grandparents, with 85% of participants engaging in these interactions at least a few times a year.

While non-digital communication methods were perceived as higher quality than digital ones, innovative technologies like augmented reality and social robots were met with skepticism regarding their effectiveness, despite participants having high expectations for their potential to enhance communication.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Digital media in intergenerational communication: Status quo and future scenarios for the grandparent-grandchild relationship. Döring, N., Mikhailova, V., Brandenburg, K., et al.[2022]

In a study involving 48 families during COVID-19, it was found that grandparents maintained sensitivity during video chats with their infant grandchildren, which positively influenced the infants' emotional responses.

Grandparent sensitivity was the key factor predicting positive infant affect, regardless of whether the interaction was through video chat or in-person, highlighting the importance of emotional connection even in remote communication.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Presence at a distance: Video chat supports intergenerational sensitivity and positive infant affect during COVID-19. Roche, E., Rocha-Hidalgo, J., Piper, D., et al.[2022]

A new educational program for grandparents was developed after weekly meetings with 400 participants, focusing on building family relationships and adjusting to their roles.

A field test is currently being conducted with several hundred participants to evaluate the effectiveness of this program in enhancing family development.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Grandparents and learning. Strom, R., Strom, S.[2017]

References

1. United States pubmed.ncbi.nlm.nih.gov

Evaluation of Prevention Programs for Grandparent Caregivers: a Systematic Review. [2023]

2. England pubmed.ncbi.nlm.nih.gov

A randomized controlled trial evaluating a parenting program designed specifically for grandparents. [2018]

3. United States pubmed.ncbi.nlm.nih.gov

A multimodal intervention for grandparents raising grandchildren: results of an exploratory study. [2019]

4. United States pubmed.ncbi.nlm.nih.gov

Grandparent-headed families: new therapeutic challenges. [2019]

5. United States pubmed.ncbi.nlm.nih.gov

A randomized clinical trial of interventions for improving well-being in custodial grandfamilies. [2023]

6. United States pubmed.ncbi.nlm.nih.gov

Audio-video recording of health care encounters for pediatric chronic conditions: observational reactivity and its correlates. [2022]

7. Switzerland pubmed.ncbi.nlm.nih.gov

Improving Informed Consent for Novel Vaccine Research in a Pediatric Hospital Setting Using a Blended Research-Design Approach. [2023]

8. Ireland pubmed.ncbi.nlm.nih.gov

Acceptability and design of video-based research on healthcare communication: Evidence and recommendations. [2018]

9. England pubmed.ncbi.nlm.nih.gov

Impact of an electronic medium delivery of warfarin education in a low income, minority outpatient population: a pilot intervention study. [2020]

10. Switzerland pubmed.ncbi.nlm.nih.gov

Parental Educational Intervention to Facilitate Informed Consent for Pediatric Procedural Sedation in the Emergency Department: A Parallel-Group Randomized Controlled Trial. [2022]

11. Switzerland pubmed.ncbi.nlm.nih.gov

Learning about Grandparents' Past Life: Reflections of Grandchildren in an Intergenerational Reminiscence Project for Asian American Families. [2023]

12. United States pubmed.ncbi.nlm.nih.gov

The Role of Grandchildren's Own Age-Related Communication and Accommodation From Grandparents in Predicting Grandchildren's Well-Being. [2021]

13. N/A pubmed.ncbi.nlm.nih.gov

Digital media in intergenerational communication: Status quo and future scenarios for the grandparent-grandchild relationship. [2022]

14. United States pubmed.ncbi.nlm.nih.gov

Presence at a distance: Video chat supports intergenerational sensitivity and positive infant affect during COVID-19. [2022]

15. United States pubmed.ncbi.nlm.nih.gov

Grandparents and learning. [2017]