An Evaluation of the Online Universal Programme COPING Parent: A Feasibility Study

Engaging Parents in Technology-Assisted Interventions for Childhood Adversity: Systematic Review

BACKGROUND

Youth mental health problems are a major public health concern and are strongly associated with adverse childhood experiences (ACEs). Technology-assisted parenting programs can intervene with ACEs that are within a parent's capacity to modify. However, engagement with such programs is suboptimal.

OBJECTIVE

This review aims to describe and appraise the efficacy of strategies used to engage parents in technology-assisted parenting programs targeting ACEs on the behavioral and subjective outcomes of engagement.

METHODS

Using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) reporting guidelines, we conducted a systematic review of peer-reviewed papers that described the use of at least 1 engagement strategy in a technology-assisted parenting program targeting ACEs that are within a parent's capacity to modify. A total of 8 interdisciplinary bibliographic databases (CENTRAL, CINAHL, Embase, OVID MEDLINE, OVID PsycINFO, Scopus, ACM, and IEEE Xplore) and gray literature were searched. The use of engagement strategies and measures was narratively synthesized. Associations between specific engagement strategies and engagement outcomes were quantitatively synthesized using the Stouffer method of combining P values.

RESULTS

We identified 13,973 articles for screening. Of these, 156 (1.12%) articles were eligible for inclusion, and 29 (18.2%) of the 156 were associated with another article; thus, 127 studies were analyzed. Preliminary evidence for a reliable association between 5 engagement strategies (involving parents in a program's design, delivering a program on the web compared to face-to-face, use of personalization or tailoring features, user control features, and provision of practical support) and greater engagement was found. Three engagement strategies (professional support features, use of videos, and behavior change techniques) were not found to have a reliable association with engagement outcomes.

CONCLUSIONS

This review provides a comprehensive assessment and description of the use of engagement strategies and engagement measures in technology-assisted parenting programs targeting parenting-related ACEs and extends the current evidence with preliminary quantitative findings. Heterogeneous definition and measurement of engagement and insufficient engagement outcome data were caveats to this synthesis. Future research could use integrated definitions and measures of engagement to support robust systematic evaluations of engagement in this context.

TRIAL REGISTRATION

PROSPERO CRD42020209819; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=209819.

Development and initial evaluation of the COnfident Parent INternet Guide program for parents of 3-8 year olds

INTRODUCTION

Positive parenting promotes children's cognitive, social and emotional development and parenting programs based on social learning theory are effective in supporting parents to help reduce behavioral problems among high challenge children. However there is less evidence for programs with non-clinical populations. COPING (COnfident Parent INternet Guide) is a 10-week online universal program for parents of 3 - 8 year olds presenting evidence-informed principles based on social learning theory to support parents in addressing common challenges with their children. This study explored the development and feasibility of delivery of the program in terms of recruitment, retention and acceptability. It also reports on initial program effectiveness, evaluated via a pilot randomized controlled trial.

METHODS

Data on child behavior, parental skills and mental health were collected at baseline and three months later for all participants and six months post-baseline for the intervention group only.

RESULTS

Those parents who accessed the course provided very positive feedback however the trial experienced challenges with recruitment and initial engagement, particularly for parents referred by professionals. For parents who engaged with the program there were significant improvements in reported parenting skills with evidence of longer-term maintenance.

DISCUSSION

This paper provides limited evidence of effectiveness for the COPING program however further feasibility work, particularly around recruitment, is needed before conducting larger effectiveness trials.

Digital tools to improve parenting behaviour in low-income settings: a mixed-methods feasibility study

INTRODUCTION

Digital parenting interventions could be potentially cost-effective means for providing early child development services in low-income settings. This 5-month mixed-methods pilot study evaluated the feasibility of using Afinidata, a comprehensive Facebook Messenger-based digital parenting intervention in a remote rural setting in Latin America and explored necessary adaptations to local context.

METHODS

The study was conducted in three provinces in the Cajamarca region, Peru, from February to July 2021. 180 mothers with children aged between 2 and 24 months and regular access to a smartphone were enrolled. Mothers were interviewed three times in-person. Selected mothers also participated in focus groups or in-depth qualitative interviews.

RESULTS

Despite the rural and remote study site, 88% of local families with children between 0 and 24 months had access to internet and smartphones. Two months after baseline, 84% of mothers reported using the platform at least once, and of those, 87% rated it as useful to very useful. After 5 months, 42% of mothers were still active on the platform, with little variation between urban and rural settings. Modifications to the intervention focused on assisting mothers in navigating the platform independently and included adding a laminated booklet with general information on child development, sample activities and detailed instructions on how to self-enrol in case of lost phones.

CONCLUSIONS

We found high access to smartphones and the intervention was well received and used in very remote areas of Peru, suggesting that digital parenting interventions could be a promising path forward for supporting low-income families in remote parts of Latin America.

Little All Children in Focus (Little ACF), evaluation of a parental support program for parents of children aged 1-2 years: study protocol for a randomized controlled trial

BACKGROUND

Child health and development can be promoted by strengthening and supporting parents. Research on parental support programs based on positive psychology and a health-promoting approach aimed at all parents, and in particular parents of infants is limited. All Children in Focus (ACF) is a parental support program that has been evaluated in a randomized trial in parents of children 3-12 years. The ACF is based on health promotion aiming to increase parents' confidence and child's well-being. In the current study, we will study the effects of a revised version of the ACF called Little ACF adapted to parents with children aged 1-2 years.

METHODS

The study includes a randomized controlled trial (RCT) taking place at several Child Health Centers (CHCs) in Sweden. The RCT will evaluate the efficacy of Little ACF (intervention) in comparison with four digital lectures about child development and parenting (active control). Parents are recruited at the 10-, 12-, or 18-month visits to CHC by CHC-nurses. Data to assess changes in parental competencies and child socio-emotional development are collected through online questionnaires completed by parents at five time points: baseline, post-intervention, after 6 and 12 months, and when the child is 3 years old.

DISCUSSION

The paper describes a study protocol of a randomized controlled trial evaluating the effects of a parental support program during infancy. Several issues related to the methodology and implementation are discussed.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05445141. Registered on 6 July 2022.