Peer-Reviewed Research Articles
Theoretically-Based Emotion Regulation Strategies Using a Mobile App and Wearable Sensor Among Homeless Adolescent Mothers: Acceptability and Feasibility Study
By: Noelle R Leonard, PhD; Bethany Casarjian, PhD; Richard R Fletcher, PhD; Cathleen Prata, MPH; Dawa Sherpa, BA; Anna Kelemen, EdM; Sonali Rajan, EdD; Rasheeda Salaam, BS; Charles M Cleland, PhD; Marya ViorstGwadz, PhD
Abstract: Many adolescent mothers are parenting young children under highly stressful conditions as they are managing first-time parenthood, poverty, lack of housing, school and work, and challenging peer and familial relationships. Mobile health (mHealth) technology has the potential to intervene at various points in the emotion regulation process of adolescent mothers to provide them support for more adaptive emotional and behavioral regulation in the course of their daily life. The goal of this study was to examine the acceptability, feasibility, use patterns, and mechanisms by which a mobile technology used as an adjunct to in-person, provider-delivered sessions fostered adolescent mothers’ adaptive emotion regulation strategies under real-life conditions. Participants (N=49) were enrolled in the intervention condition of a larger pilot study of homeless adolescent mothers living in group-based shelters. The mHealth technology, Calm Mom, consisted of a mobile app and a wrist-worn sensorband for the ambulatory measurement and alerting of increased electrodermal activity (EDA), a physiological measurement of stress. We examined logs of mobile app activity and conducted semistructured qualitative interviews with a subsample (N=10) of participants. Qualitative data analysis was guided by the theoretical frames of the intervention and a technology acceptance model and included an analysis of emerging themes and concepts. Overall, participants indicated that one or more of the elements of Calm Mom supported their ability to effectively regulate their emotions in the course of their daily life in ways that were consonant with the intervention’s theoretical model. For many adolescent mothers, the app became an integral tool for managing stress. Due to technical challenges, fewer participants received sensorband alerts; however, those who received alerts reported high levels of acceptability as the technology helped them to identify their emotions and supported them in engaging in more adaptive behaviors during real-life stressful situations with their children, peers, and family members. Calm Mom is a promising technology for providing theoretically driven behavioral intervention strategies during real-life stressful moments among a highly vulnerable population. Future research efforts will involve addressing technology challenges and refining tailoring algorithms for implementation in larger-scale studies.
Ambulatory Autonomic Activity Monitoring Among At-Risk Adolescent Mothers
By: Sonali Rajan, Noelle Leonard, Richard Fletcher, Bethany Casarjian, Robin Casarjian, Cathleen Cisse, Marya Gwadz
Abstract: Many adolescent mothers experience significant challenges in regulating emotions due to adverse life experiences, which can place adolescent mothers and their children at risk for poor developmental outcomes. Ambulatory monitoring of stress that also provides immediate feedback using wearable biosensors has the potential to enhance clinician-delivered parenting interventions and help young mothers develop emotion regulatory skills. We conducted a pilot study to assess the acceptability, ease of use, and preliminary efficacy of a wearable biosensor, the iCalm sensor band, among a sample of four mothers, ages 15-18 years. Mothers wore the biosensor for a period of 24-36 hours while engaging in normal, daily tasks (e.g. caring for their child, attending school). Both quantitative electrodermal activity (EDA) data (via the iCalm sensor band) and qualitative data (via individual semi-structured interviews) were collected. The adolescent mothers were able to comfortably use and wear the iCalm sensor band. EDA data were collected and corresponded with stressful daily life events described by the mothers during qualitative interviews. The iCalm biosensor is acceptable to use among high-risk adolescent mothers and appears to help mothers with the development of emotion regulatory skills.
Poster Presentation — Enhancing Adolescent Mothers Positive Parenting through EMA- A feasibility study.
By: Rogowsky, R. and Leonard, N.
Pilot Results: Pilot testing of Power Source Parenting spanned three years, with iterative field test of these intervention session components with several groups of (AMARs) residing in group homes in Massachusetts. Although the group intervention sessions AMARs received was an iterative process and varied in number of sessions, content, and methods of delivery, we found a significant decrease in self-reported parenting stress (Parenting Stress Index; Abidin, 1995; t(26) = 1.991, p = .057), as well as increases on items measuring positive parenting attitudes (Adult Adolescent Parenting Inventory-2 (AAPI-2; Bavolek & Keene, 1999) including increased empathic awareness of children’s needs (t(25) = -2.28, p = .031); increased appropriate developmental expectations of child (t(24) = -2.45, p = .02); and a decrease in the endorsement of corporal punishment (t(26) = 2.45, p = .02). On a computerized facial emotion recognition task (GNG, Casey et al., 2011), AMARs were better able to recognize sadness (F(8, 16) = 3.526, p = .015). Qualitative acceptability data indicated that among AMARs, a desire to increase their parenting skills is a powerful motivator for intervention engagement. AMARs gave us specific feedback regarding comprehensibility of the material and made useful suggestions for increasing the “buy-in” among their peers of concepts such as appropriate developmental expectations and positive discipline techniques. Importantly, AMAR’s enjoyed the text messages and asked that we increase the frequency because this reinforcement was extremely helpful in their daily life. While more work is required to move PSP along the continuum toward becoming an established, evidence-based program, results from preliminary investigations have been promising.