Research Goals

1
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
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.

• 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).
• Childrens 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).
• Childrens 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 (SHQSSR)
• This 33 item measure provides an overview of the
  child's sleep habits, sleepiness and fatigue.
• Physical Activity
• Modifiable Activity Questionnaire for Adolescents
  (MAQA)

Results
Scale Factor Time 1 Raw Scores Control Time 1 Raw Scores Control Time 2 Raw Scores Control Time 2 Raw Scores Control Time 1 Raw Scores Tx - Engaged Time 1 Raw Scores Tx - Engaged Time 2 Raw Scores Tx - Engaged Time 2 Raw Scores Tx - Engaged Time 1 Raw Scores Tx Non-engaged Time 1 Raw Scores Tx Non-engaged Time 2 Raw Scores Tx Non-engaged Time 2 Raw Scores Tx Non-engaged
x sd x sd x sd x sd x sd x sd
Emotion Regulation Emotion Regulation
ACRS Conflict 16.46 7.56 17.89 7.99 17.08 7.30 19.60 9.22 14.17 5.44 13.67 5.10
ACRS Openness 12.04 3.41 11.52 3.15 12.00 2.45 11.96 2.07 11.83 3.51 12.00 3.10
CADS Child Report Irritability 2.20 2.06 1.67 1.44 3.96 1.70 3.12 1.39 2.42 1.83 2.17 1.70
CADS Child Report Explosiveness 3.04 2.73 2.41 1.85 4.84 3.21 3.64 2.78 3.33 2.43 2.75 2.30
CADS Child Report Impulsivity (d.5) 6.08 3.19 5.74 2.46 9.24 2.54 7.48 3.20 6.42 3.03 6.67 3.98
CALS Child Report Angry, Depressed 10.11 9.01 9.26 7.37 12.88 9.76 11.16 7.70 14.17 9.68 11.25 10.88
CALS Child Report Disinhibited, Impersistent (d.43) 7.52 4.96 7.07 4.47 9.28 4.95 7.84 5.11 12.08 6.11 7.17 4.53
CALS Parent Report Angry, Depressed 6.67 7.65 6.56 7.54 8.72 6.94 10.80 9.70 7.25 6.59 7.17 7.20
CALS Parent Report Disinhibited 5.89 5.24 5.30 4.01 6.60 5.08 7.24 5.88 6.50 4.21 5.67 5.09
CDI Total 1.07 1.57 1.56 2.28 2.16 2.51 2 3.67 1.08 1.08 1.08 1.34
MASC Total Sum Score 10.41 5.26 8.81 4.29 11.04 5.37 11.28 7.03 11.75 5.29 11.18 5.06
Sleep Sleep
SHQ Sleep Onset Delay (d.84) 1.63 0.63 1.89 0.64 1.76 0.83 1.76 0.78 1.92 0.67 1.67 0.49
SHQ Sleep Duration 4.56 1.48 4.37 1.52 4.68 1.77 4.68 1.73 4.75 1.91 4.67 1.37
SHQ Sleep Anxiety (d.64) 7.04 1.23 6.62 0.69 6.29 1.36 6.56 1.01 6.93 1.15 6.33 0.83
SHQ Night Wakings 3.89 1.22 3.81 1.00 4.36 1.22 3.72 1.14 4.08 1.16 4.08 1.24
SSR Sleep Anxiety 4.74 1.38 4.67 1.57 4.64 1.25 4.40 1.00 4.83 1.99 4.50 1.24
Physical Activity Physical Activity
SenseWear Sedentary Time (Min) Mean 824.17 288.08 845.00 258.63 854.92 236.46 774.09 207.72 805.24 260.25 857.77 265.19
Moderate Pa Time (Min) Mean 115.22 67.35 98.06 61.61 111.37 57.19 91.51 34.79 93.09 57.64 79.67 56.76
Vigorous Pa Time (Min) Mean 14.33 8.67 13.45 10.44 15.30 17.45 12.75 9.60 9.66 9.75 7.41 9.05
Very Vigorous Pa Time (Min) Mean 1.57 2.06 1.45 1.88 0.97 1.86 1.16 1.44 1.75 2.13 0.45 0.45
Measured Sleep (Min) Mean 260.26 105.87 269.52 83.82 266.14 74.83 226.41 67.64 254.47 74.87 265.59 92.16
p .05 plt.1 p .05 plt.1 p .05 plt.1 p .05 plt.1 p .05 plt.1 p .05 plt.1 p .05 plt.1 p .05 plt.1 p .05 plt.1 p .05 plt.1 p .05 plt.1 p .05 plt.1 p .05 plt.1 p .05 plt.1
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

• 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

• 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 childs 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 familys
  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).

Table 1-- Demographic characteristics of
participants
Control n 27 Treatment n 37
Parents Age
M 41.18 38.88
SD 7.63 8.19
Parents Marital Status
Married 4 5
Single 23 32
Parents Education
lt12th grade 3 5
HS grad/GED 9 14
Some college 12 16
College grad 3 2
Income per Year 18,227 22,001.29
Childs Race
Euro American 6 5
Afro American 21 32
Childs Age
M 12.04 11.92
SD 1.29 1.27
Child Gender
Female 11 14
Male 16 23

• 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/Impers
  istent 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.

• 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.
ORourke, Dept. of Psychology, University of
Pittsburgh (feo3_at_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.