NCT06324318

Brief Summary

This research study will test the effectiveness of a culturally grounded parenting intervention called Parenting in 2 Worlds (P2W). This intervention is designed for American Indian / Alaska Native (AI) parents/guardians of adolescents who reside in urban areas. This will be a multi-regional effectiveness trial across four regions: Northeast (Buffalo/Niagara), Midwest (St. Paul/Minneapolis), Mountain (Denver), and Southwest (Phoenix). There are four specific aims. First, this study will test the effectiveness of Parenting in Two Worlds (P2W) as compared to an informational family health intervention, Healthy Families in 2 Worlds (HF2W), in improving parenting and family functioning. Second, this study will test if the relative effectiveness of P2W, compared to HF2W, varies by parent's/guardian's level of socioeconomic vulnerability, experiences of historical loss, or AI cultural identity. Third, this study will examine if P2W can reduce adolescent (ages 12 - 17) risky health behaviors including substance use, depressive symptoms, suicidality, and risky sexual behaviors. Fourth, this study will examine whether positive changes in parenting and family functioning that result from P2W lead to positive changes in adolescent's health behaviors.

Trial Health

77
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
1,440

participants targeted

Target at P75+ for phase_2

Timeline
25mo left

Started Sep 2023

Longer than P75 for phase_2

Geographic Reach
1 country

4 active sites

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress56%
Sep 2023Jun 2028

Study Start

First participant enrolled

September 14, 2023

Completed
6 months until next milestone

First Submitted

Initial submission to the registry

March 15, 2024

Completed
6 days until next milestone

First Posted

Study publicly available on registry

March 21, 2024

Completed
3.1 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

May 1, 2027

Expected
1.1 years until next milestone

Study Completion

Last participant's last visit for all outcomes

June 1, 2028

Last Updated

April 29, 2026

Status Verified

April 1, 2026

Enrollment Period

3.6 years

First QC Date

March 15, 2024

Last Update Submit

April 27, 2026

Conditions

Keywords

family functioningrisky sexual behavior

Outcome Measures

Primary Outcomes (15)

  • Change from baseline in family functioning and cohesion

    Caregiver and adolescent self-report about supportiveness, closeness, togetherness and cooperation among family members. Scale: Minimum = 1 and Maximum = 5 \[1 = Almost never, 2 = Once in a while, 3 = Sometimes, 4 = Frequently, 5 = Almost always\]. Higher is better outcome.

    10 week and 12 month follow up

  • Change from baseline in parental involvement

    Caregiver and adolescent self-report about caregiver's involvement in adolescent's daily activities. Scale: Minimum = 1 and Maximum = 4 \[1 = More than 1 month ago, 2 = Within the last month, 3 = Within the last week, 4 = Yesterday or today\]. Higher is better outcome.

    10 week and 12 month follow up

  • Change from baseline in parental supervision

    Caregiver and adolescent self-report about caregiver's direct supervision such as established curfews. Scale: Minimum = 1 and Maximum = 5 \[1 = Almost never, 2 = Once in a while, 3 = Sometimes, 4 = Frequently, 5 = Almost always\]. Higher is better outcome.

    10 week and 12 month follow up

  • Change from baseline in parental monitoring

    Caregiver and adolescent self-report about caregiver's knowledge of adolescent's activities, friends and whereabouts. Scale: Minimum = 1 and Maximum = 5 \[1 = Almost never, 2 = Once in a while, 3 = Sometimes, 4 = Frequently, 5 = Almost always\]. Higher is better outcome.

    10 week and 12 month follow up

  • Change from baseline in positive parenting practices

    Caregiver and adolescent self-report about caregiver's encouragement for good adolescent behavior. Scale: Minimum = 1 and Maximum = 5 \[1 = Almost never, 2 = Once in a while, 3 = Sometimes, 4 = Frequently, 5 = Almost always\]. Higher is better outcome.

    10 week and 12 month follow up

  • Change from baseline in relational warmth

    Caregiver self-report aspects of the parent-adolescent relationship like caring and responsiveness. Scale: Minimum = 1 and Maximum = 5 \[1 = Almost never, 2 = Once in a while, 3 = Sometimes, 4 = Frequently, 5 = Almost always\]. Higher is better outcome.

    10 week and 12 month follow up

  • Change from baseline in relational hostility

    Caregiver self-report aspects of the parent-adolescent relationship like anger, and demandingness. Scale: Minimum = 1 and Maximum = 5 \[1 = Almost never, 2 = Once in a while, 3 = Sometimes, 4 = Frequently, 5 = Almost always\]. Higher is worse outcome

    10 week and 12 month follow up

  • Change from baseline in family conflict

    Caregiver and adolescent self-report about positive and negative interactions in the parent-adolescent relationship. Scale: Minimum = 1 and Maximum = 5 \[1 = Not at all, 2 = Only a little, 3 = Sometimes, 4 = Almost always, 5 = Almost\]. Higher is worse outcome.

    10 week and 12 month follow up

  • Change from baseline in parental self-agency

    Caregiver self-reports on confidence in their ability to parent successfully and solve child rearing challenges. Scale: Minimum = 1 and Maximum = 5 \[1 = Never, 2 = Rarely, 3 = Sometimes, 4 = Very often, 5 = Always\]. Higher is better outcome.

    10 week and 12 month follow up

  • Change from baseline in effective discipline

    Caregiver self-reports about difficulty in deciding and establishing effective rules and discipline for their adolescent. Scale: Minimum = 1 and Maximum = 6 \[1 = Strongly disagree, 2 = Disagree, 3 = Disagree slightly, 4 = Agree slightly, 5 = Agree, 6 = Strongly agree\]. Higher is better outcome.

    10 week and 12 month follow up

  • Change from baseline in parental communication about sex

    Caregiver self-reports about how open, responsive, and positive the communication is between parents and adolescents regarding safe sexual behaviors. Scale: Minimum = 1 and Maximum = 4 \[1 =Never, 2 = A few times, 3 = Occasionally, 4 = Frequently\]. Higher is better outcome.

    10 week and 12 month follow up

  • Change from baseline in child problem behaviors.

    Caregiver self-reports about their child's problem behaviors like being withdrawn/depressed, rule-breaking behavior, and aggressive behavior. Scale: Minimum = 0 and Maximum = 2 \[0 = Not true, 1 = Somewhat or sometimes true, 2 =Very true or often true\]. Higher is worse outcome.

    10 week and 12 month follow up

  • Change from baseline in decision making about risk behaviors

    Caregiver and adolescent self-report about both positive (e.g., leave the situation) and negative (e.g., react with anger) strategies they use to resist engaging in risk behaviors. Scale: Minimum = 0 and Maximum = 2 \[0 = Never, 1 = Sometimes, 2 =Always. Higher is better outcome.

    10 week and 12 month follow up

  • Change from baseline in substance use

    Adolescent self-reports about their use of alcohol, tobacco, marijuana and other drugs in the past 30 days. Single items: Minimum = 0 and Maximum = 6 \[0 = None, 1 = Once, 2 = 2-3 times, 3 = 4-9 times, 4 = 10-19 times, 5 = 20-39 times, 6 = 40 or more times\]. Higher is better outcome.

    10 week and 12 month follow up

  • Change from baseline in risky sexual behaviors

    Adolescent self-reports about risky sexual behaviors like not using a condom or consuming alcohol before sexual intercourse. Single items: Minimum = 0 and Maximum = 1 \[0 = No, 1 = Yes\]. Higher is worse outcome.

    10 week and 12 month follow up

Secondary Outcomes (2)

  • Change from baseline in depressive symptoms

    10 week and 12 month follow up

  • Change from baseline in suicidality

    10 week and 12 month follow up

Study Arms (2)

Parenting in 2 Worlds (treatment)

EXPERIMENTAL

A 10-week parenting intervention focused on improving overall family functioning and strengthen parenting skills to communicate with adolescents to avoid risk behaviors.

Behavioral: Parenting in 2 Worlds (P2W)

Healthy Families in 2 Worlds

ACTIVE COMPARATOR

A 10-week parenting intervention curriculum focused on improving parental knowledge of family health topics.

Behavioral: Healthy Families in 2 Worlds (HF2W)

Interventions

P2W is a culturally-adapted parenting intervention designed specifically for urban American Indian families. It is a 10-week, 10-lesson manualized curriculum with accompanying videos, designed to be facilitated by American Indians from the local communities. The workshop lessons cover topics like the identification of family values, culturally influenced child rearing values and traditions, sources of support for parents, and ways to improve parenting skills to communicate with, monitor, and guide adolescents to avoid substance use, unprotected sex and other risk behaviors

Parenting in 2 Worlds (treatment)

HF2W is a 10-week informational family health program. The workshop lessons cover topics such as oral health, CPR and first aid, dating safety, and teen mental health.

Healthy Families in 2 Worlds

Eligibility Criteria

Age12 Years+
Sexall
Healthy VolunteersYes
Age GroupsChild (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

  • Adult participants:
  • Must be American Indian parents or guardians of American Indian children aged 12 to 17 who attend urban schools
  • Must reside in the service areas of the four urban Indian centers who are participating in this study
  • Self-identifies as American Indian
  • Must be primary caregiver responsible for day-to-day decisions for an American Indian child ages 12 to 17
  • Child Participants:
  • Aged 12 - 17
  • Identified by their parent/guardian as American Indian
  • Attends an urban school

You may not qualify if:

  • Not applicable

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (4)

Phoenix Indian Center

Phoenix, Arizona, 85012, United States

RECRUITING

Denver Indian Center

Denver, Colorado, 80219, United States

RECRUITING

Ain Dah Yung Center

Saint Paul, Minnesota, 55104, United States

RECRUITING

Native American Community Services Erie and Niagara Counties

Buffalo, New York, 14207, United States

RECRUITING

MeSH Terms

Conditions

Substance-Related DisordersHealth Risk Behaviors

Condition Hierarchy (Ancestors)

Chemically-Induced DisordersMental DisordersHealth BehaviorBehavior

Central Study Contacts

Stephen S Kulis, PhD

CONTACT

Christine McCaleb, MA

CONTACT

Study Design

Study Type
interventional
Phase
phase 2
Allocation
RANDOMIZED
Masking
NONE
Purpose
PREVENTION
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

March 15, 2024

First Posted

March 21, 2024

Study Start

September 14, 2023

Primary Completion (Estimated)

May 1, 2027

Study Completion (Estimated)

June 1, 2028

Last Updated

April 29, 2026

Record last verified: 2026-04

Data Sharing

IPD Sharing
Will not share

Locations