Perspectives on ParentWorks: Learnings from the development and national roll-out of a self-directed online parenting intervention

Design of Digital Mental Health Platforms for Family Member Cocompletion: Scoping Review

BACKGROUND

The COVID-19 pandemic placed an additional mental health burden on individuals and families, resulting in widespread service access problems. Digital mental health interventions suggest promise for improved accessibility. Recent reviews have shown emerging evidence for individual use and early evidence for multiusers. However, attrition rates remain high for digital mental health interventions, and additional complexities exist when engaging multiple family members together.

OBJECTIVE

As such, this scoping review aims to detail the reported evidence for digital mental health interventions designed for family use with a focus on the build and design characteristics that promote accessibility and engagement and enable cocompletion by families.

METHODS

A systematic literature search of MEDLINE, Embase, PsycINFO, Web of Science, and CINAHL databases was conducted for articles published in the English language from January 2002 to March 2024. Eligible records included empirical studies of digital platforms containing some elements designed for cocompletion by related people as well as some components intended to be completed without therapist engagement. Platforms were included in cases in which clinical evidence had been documented.

RESULTS

Of the 9527 papers reviewed, 85 (0.89%) met the eligibility criteria. A total of 24 unique platforms designed for co-use by related parties were identified. Relationships between participants included couples, parent-child dyads, family caregiver-care recipient dyads, and families. Common platform features included the delivery of content via structured interventions with no to minimal tailoring or personalization offered. Some interventions provided live contact with therapists. User engagement indicators and findings varied and included user experience, satisfaction, completion rates, and feasibility. Our findings are more remarkable for what was absent in the literature than what was present. Contrary to expectations, few studies reported any design and build characteristics that enabled coparticipation. No studies reported on platform features for enabling cocompletion or considerations for ensuring individual privacy and safety. None examined platform build or design characteristics as moderators of intervention effect, and none offered a formative evaluation of the platform itself.

CONCLUSIONS

In this early era of digital mental health platform design, this novel review demonstrates a striking absence of information about design elements associated with the successful engagement of multiple related users in any aspect of a therapeutic process. There remains a large gap in the literature detailing and evaluating platform design, highlighting a significant opportunity for future cross-disciplinary research. This review details the incentive for undertaking such research; suggests design considerations when building digital mental health platforms for use by families; and offers recommendations for future development, including platform co-design and formative evaluation.

Preschool Programs that Help Families Promote Child Social-Emotional School Readiness: Promising New Strategies

Parents play a central role in supporting the early learning that positions young children for success when they enter formal schooling. For this reason, efforts to engage families in meaningful collaboration is a long-standing goal of high-quality early childhood education (ECE). Family-school engagement can take multiple forms; in this review, we focus on universal preschool-based outreach strategies that help parents support growth in child social-emotional and self-regulation competencies and prepare them for the transition into formal schooling. Recent research has expanded understanding of the neurodevelopmental processes that underlie child school readiness, and the impact of parenting (and the social ecology affecting parenting) on those processes. These new insights have fueled innovation in preschool-based efforts to partner with and support parents, expanding and shifting the focus of that programming. In addition, new approaches to intervention design and delivery are emerging to address the pervasive challenges of reaching and engaging families, especially those representing diverse racial, ethnic, cultural, and socioeconomic backgrounds. This paper reviews developmental research that underscores the importance of prioritizing child social-emotional learning (with attention to self-regulation and approaches to learning) in universal preschool-based parenting programs targeting young children. We highlight the intervention strategies used in programs with strong evidence of impact on child readiness and school adjustment based on randomized controlled trials (RCTs). New directions in intervention design and delivery strategies are highlighted, with the hope of extending intervention reach and improving family engagement and benefit.

Effectiveness-implementation hybrid-2 randomised trial of a collaborative Shared Care Model for Detecting Neurodevelopmental Impairments after Critical Illness in Young Children (DAISY): pilot study protocol

INTRODUCTION

In Australia, while paediatric intensive care unit (PICU) mortality has dropped to 2.2%, one in three survivors experience long-term neurodevelopmental impairment, limiting their life-course opportunities. Unlike other high-risk paediatric populations, standardised routine neurodevelopmental follow-up of PICU survivors is rare, and there is limited knowledge regarding the best methods. The present study intends to pilot a combined multidisciplinary, online screening platform and general practitioner (GP) shared care neurodevelopmental follow-up model to determine feasibility of a larger, future study. We will also assess the difference between neurodevelopmental vulnerability and parental stress in two intervention groups and the impact of child, parent, sociodemographic and illness/treatment risk factors on child and parent outcomes.

METHODS AND ANALYSIS

Single-centre randomised effectiveness-implementation (hybrid-2 design) pilot trial for parents of children aged ≥2 months and <4 years discharged from PICU after critical illness or injury. One intervention group will receive 6 months of collaborative shared care follow-up with GPs (supported by online outcome monitoring), and the other will be offered self-directed screening and education about post-intensive care syndrome and child development. Participants will be followed up at 1, 3 and 6 months post-PICU discharge. The primary outcome is feasibility. Secondary outcomes include neurodevelopmental vulnerability and parental stress. An implementation evaluation will analyse barriers to and facilitators of the intervention.

ETHICS AND DISSEMINATION

The study is expected to lead to a full trial, which will provide much-needed guidance about the clinical effectiveness and implementation of follow-up models of care for children after critical illness or injury. The Children's Health Queensland Human Research Ethics Committee approved this study. Dissemination of the outcomes of the study is expected via publication in a peer-reviewed journal, presentation at relevant conferences, and via social media, podcast presentations and open-access medical education resources.

REGISTRATION DETAILS

The trial was prospectively registered with the Australian New Zealand Clinical Trials Registry as 'Pilot testing of a collaborative Shared Care Model for Detecting Neurodevelopmental Impairments after Critical Illness in Young Children' (the DAISY Pilot Study).

TRIAL REGISTRATION NUMBER

ACTRN12621000799853.

From the Cradle to the Web: The Growth of “Sharenting”—A Scientometric Perspective

“Sharenting” is an internet trend in which parents report detailed information or repeatedly post pictures, videos, and other content about their children on social media. Due to the duality of sharenting, which takes place online but has offline consequences, it is essential to understand the implications of sharenting for real-world parenting and child development. The present work analyzes references in the existing literature and links among published articles to better understand sharenting, evidence for it, and major topics associated with it and to uncover the gaps in the literature. Citation analysis of the current literature mainly focuses on risks and benefits related to sharenting practices, especially for the children, and on ethical and privacy concerns. Future studies should investigate the psychological mechanisms that drive sharenting-related behaviors in parents and multidisciplinary approaches to the phenomenon. With a broader perspective on these issues, practitioners and professionals in family studies will be able to delineate guidelines for informative interventions to increase awarenes about the causes and consequences of publicly sharing child content.

Physician-driven or self-directed safe firearm storage guidance: Which one is best?

BACKGROUND/PURPOSE

Access to firearms is a preventable cause of unintentional injury and suicide in children. Pediatric physicians provide injury prevention guidance, but firearm safety may not routinely be included. The purpose of this pilot study was to evaluate the effectiveness of firearm safety guidance (FSG) provided by a physician.

METHODS

Prospective, randomized-controlled, trial assessing physician-delivered FSG at two pediatric clinics in Houston, Texas. Firearm-owning parents were randomized to physician guidance (PG) versus control (CG) groups. The CG received a handout with firearm safety facts and a free cable lock. The PG additionally received FSG by a physician. Pre- and post-intervention surveys were conducted. Results were analyzed using descriptive statistics and Chi square analysis.

RESULTS

Thirty-two families participated; most (70%) were satisfied with the guidance. Pre-intervention safe firearm storage was high in both groups, and the intervention did not lead to improved habits in either group [PG: Pre 93% vs. Post 89%, p = 0.7 and CG: Pre 82% vs. 78%, p = 0.7].There was no difference in use of the free cable lock among groups (44% vs. 22%, p = 0.9). The PG demonstrated improved knowledge of the state child access protection law (PG: Pre 60% vs. Post 100% vs. CG: Pre 29% vs. Post 67%; p = 0.02).

CONCLUSIONS

For firearm-owning parents, physician-delivered safe storage guidance may not be more effective than self-directed guidance provided by a handout. A larger trial is underway to confirm the findings of this pilot study.

The Therapist-assisted Online Parenting Strategies (TOPS) program for parents of adolescents with clinical anxiety or depression: Development and feasibility pilot

OBJECTIVE

To develop a Therapist-assisted Online Parenting Strategies (TOPS) program that is acceptable to parents whose adolescents have anxiety and/or depressive disorders, using a consumer consultation approach.

METHODS

The TOPS intervention was developed via three linked studies. Study 1 involved content analysis of feedback from participants (N = 56) who received a web-based preventive parenting intervention called Partners in Parenting (PiP), as part of a randomised controlled trial. Study 2 involved stakeholder consultations with: (i) parents of adolescents aged 12-17 years (N = 6), and (ii) mental health professionals (N = 28), to identify adaptations to PiP that are required to make it appropriate for parents of adolescents with anxiety and depressive disorders. Study 3 was a pilot of the resulting TOPS program with professionals (N = 10) and a small sample of parents (N = 3) to assess the acceptability of the program content and format that involved online modules and videoconferencing coaching.

RESULTS

Study 1 indicated a need for an enhanced program for parents whose adolescents are experiencing anxiety and depressive disorders, while findings from Study 2 informed the content of the new TOPS program. In Study 3, mental health professionals endorsed the structure and content, while parents affirmed the acceptability of the TOPS program. Feedback from Studies 2 and 3 indicated that the therapist-coach was a valuable resource to (i) provide parents with strategies that are associated with the alleviation of adolescent anxiety and depression, (ii) discuss difficulties in implementing these strategies, (iii) assist parents with overcoming these difficulties; and (iv) support the development of a relapse prevention plan. Professionals felt that the TOPS program would broaden parental knowledge about how to recognise and respond to symptoms of clinical anxiety and depression in their adolescent.

CONCLUSIONS

This study provided preliminary support for the feasibility, acceptability and perceived usefulness of the TOPS program.