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Cooray N, Ho C, Bestman A, Adams S, Nassar N, Keay L, Brown J. Exploring the Potential of a Behavior Theory-Informed Digital Intervention for Infant Fall Prevention: Mixed Methods Longitudinal Study. JMIR Pediatr Parent 2024; 7:e47361. [PMID: 38170580 PMCID: PMC10794959 DOI: 10.2196/47361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 10/16/2023] [Accepted: 10/17/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Falls are the most common hospitalized injury mechanism in children aged ≤1 years, and currently, there are no targeted prevention interventions. The prevention of falls in children of this age requires changes in the behavior of their caregivers, and theoretically informed digital behavior change interventions (DBCIs) may provide a unique mechanism for achieving effective intervention. However, user acceptance and the ability of DBCIs to effect the required changes in behavior are critical to their likelihood of success. OBJECTIVE This study aims to evaluate a behavior theory-informed digital intervention developed following a user-centered approach for user experience, the potential for this intervention to prevent infant falls, and its impact on behavioral drivers underpinning fall risk in young children. METHODS Parents of infants aged <1 year were recruited and asked to use the intervention for 3 months. A pre-post longitudinal design was used to examine the change in the potential to reduce the risk of falls after a 3-month exposure to the intervention. Postintervention data on behavioral drivers for fall prevention, user acceptability, and engagement with the app were also collected. Interviews were conducted to explore user experiences and identify areas for further improvement of the intervention. RESULTS A total of 62 parents participated in the study. A statistically significant effect on the potential to reduce falls was observed after the intervention. This effect was higher for new parents. Parents agreed that the intervention targeted most of the target behavior drivers. The impact of behavior drivers and intervention on the potential for fall prevention had a positive correlation. The intervention demonstrated good levels of acceptability. Feedback from participants was mostly positive, and the primary area identified for further improvement was widening the scope of the intervention. CONCLUSIONS This study demonstrated the promise of a newly developed digital intervention to reduce the risk of infant falls, particularly among new parents. It also showed a positive influence of the DBCI on the drivers of parental behaviors that are important for fall reduction among infants. The acceptability of the app was high, and important insights were gained from users about how to further improve the app.
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Affiliation(s)
- Nipuna Cooray
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales Sydney, Barangaroo, Australia
| | - Catherine Ho
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales Sydney, Barangaroo, Australia
| | - Amy Bestman
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales Sydney, Barangaroo, Australia
| | - Susan Adams
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales Sydney, Barangaroo, Australia
- Department of Paediatric Surgery, Sydney Children's Hospital, Randwick, Australia
| | - Natasha Nassar
- Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Lisa Keay
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales Sydney, Barangaroo, Australia
- School of Optometry and Vision Science, Faculty of Medicine and Health, University of New South Wales Sydney, Sydney, Australia
| | - Julie Brown
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales Sydney, Barangaroo, Australia
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Tiwari A, Recinos M, Garner J, Self-Brown S, Momin R, Durbha S, Emery V, O’Hara K, Perry E, Stewart R, Wekerle C. Use of technology in evidence-based programs for child maltreatment and its impact on parent and child outcomes. Front Digit Health 2023; 5:1224582. [PMID: 37483318 PMCID: PMC10357009 DOI: 10.3389/fdgth.2023.1224582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 06/26/2023] [Indexed: 07/25/2023] Open
Abstract
Introduction Technology has been used in evidence-based child maltreatment (CM) programs for over a decade. Although advancements have been made, the extent of the application of technology in these programs, and its influence on parental and child outcomes, remains unclear within the context of changes that emerged because of the COVID-19 pandemic. This scoping review provides a contextualized overview and summary of the use of technology in evidence-based parenting and child programs serving families impacted by child maltreatment and the effects of technology-enhanced programs on target outcomes. Materials and methods Using Arksey and O'Malley's methodological framework, we searched seven databases to identify peer-reviewed and grey literature published in English from 2000 to 2023 on evidence-based programs, according to the California Evidence-Based Clearinghouse (CEBC), that included technological supports for two populations: at-risk parents for child maltreatment prevention, and children and youth 0-18 years exposed to child maltreatment. All study designs were included. Results Eight evidence-based parenting programs and one evidence-based child trauma program were identified as using technology across a total of 25 peer-reviewed articles and 2 peer-reviewed abstracts meeting inclusion criteria (n = 19 on parent-level programs; n = 8 on child-level programs). Four studies were published in the context of COVID-19. Two main uses of technology emerged: (1) remote programmatic delivery (i.e., delivering all or part of the program virtually using technology) and (2) programmatic enhancement (i.e., augmenting program content with technology). Improvements across parenting and child mental health and behavioral outcomes were generally observed. Discussion Technology use in evidence-based child maltreatment programs is not new; however, the small sample since the start of the COVID-19 pandemic in this review that met inclusion criteria highlight the dearth of research published on the topic. Findings also suggest the need for the inclusion of implementation outcomes related to adoption and engagement, which could inform equitable dissemination and implementation of these programs. Additional considerations for research and practice are discussed.
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Affiliation(s)
- Ashwini Tiwari
- Institute of Public and Preventive Health, Augusta University, Augusta, GA, United States
| | - Manderley Recinos
- Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, United States
| | - Jamani Garner
- Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, United States
| | - Shannon Self-Brown
- Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, United States
| | - Rushan Momin
- Department of Psychiatry and Behavioral Sciences, Medical College of Georgia, Augusta University, Augusta, GA, United States
| | - Sadhana Durbha
- Department of Psychiatry and Behavioral Sciences, Medical College of Georgia, Augusta University, Augusta, GA, United States
| | - Vanessa Emery
- Institute of Public and Preventive Health, Augusta University, Augusta, GA, United States
| | - Kathryn O’Hara
- Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, United States
| | - Elizabeth Perry
- Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, United States
| | - Regan Stewart
- Medical University of South Carolina, Charleston, SC, United States
| | - Christine Wekerle
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, ON, Canada
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Ranney ML, Stettenbauer EG, Delgado MK, Yao KA, Orchowski LM. Uses of mHealth in Injury Prevention and Control: a Critical Review. CURR EPIDEMIOL REP 2022; 9:273-281. [PMID: 36404873 PMCID: PMC9644389 DOI: 10.1007/s40471-022-00312-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2022] [Indexed: 11/10/2022]
Abstract
Purpose of Reviews The purpose of this review was to summarize the current state of the literature on the use of "mHealth" (the use of mobile devices for health promotion) for injury prevention and control. Recent Findings mHealth is being used to measure, predict, and prevent the full spectrum of injuries. However, most literature remains preliminary or in a pilot stage. Use of best-of-class design principles (e.g., user-centered design, theory-based development) is uncommon, and wide-scale dissemination of effective monitoring or intervention tools is rare. Summary mHealth for injury prevention holds promise, but further work is needed across the full spectrum of development and translation.
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Affiliation(s)
- Megan L. Ranney
- Department of Emergency Medicine, Alpert Medical School Brown University, Providence, USA
- Brown-Lifespan Center for Digital Health, Providence, USA
- Department of Behavioral and Social Science, School of Public Health, Brown University, Providence, USA
| | - E. G. Stettenbauer
- Department of Health Services, Policy and Practice, School of Public Health, Brown University, Providence, USA
| | - M. Kit Delgado
- Department of Emergency Medicine and Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, USA
| | | | - Lindsay M. Orchowski
- Brown-Lifespan Center for Digital Health, Providence, USA
- Department of Psychiatry and Human Behavior, Rhode Island Hospital, Providence, RI USA
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Guarini A, Sansavini A, Suttora C, Bortolotti S, Fort M, Iorio D, Monfardini C, Bigoni M. Mindful Parenting Intervention MinUTo App for Parents of Preschool Children: Study Protocol of a Randomised Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137564. [PMID: 35805222 PMCID: PMC9265946 DOI: 10.3390/ijerph19137564] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/13/2022] [Accepted: 06/16/2022] [Indexed: 02/04/2023]
Abstract
Background: Mindful parenting and the use of technology for parenting intervention have expanded separately from one another with promising results, but their relationship is underexplored. The current study protocol proposes a new universal intervention via app, MINd Us TOghether (MinUTo), based on mindful parenting for parents of typically developing children of 4–5 years of age. Methods: The effect of the intervention is evaluated using a randomised controlled trial. Around 2000 parents are enrolled and randomised to the intervention and control groups. Data are collected in three different waves from parents at baseline and endline; APP usage data allow for the analysis of intervention adherence. The MinUTo app proposes contents and activities for five dimensions of mindful parenting. Each dimension is presented within a two-week distance, explaining its importance, providing information, and offering activities for parents and children. Expected results: We hypothesise a positive effect of the intervention on primary outcomes (mindful parenting, parenting stress, parent behaviours and parental time investment), increasing parents’ skills and promoting a positive parent–child relationship. We also test possible effects on secondary outcomes (parenting attitudes and beliefs) at an explorative level. Conclusions: The study will add new considerations about the psychological and economic impact of technologies in implementing parenting interventions in non-clinical populations.
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Affiliation(s)
- Annalisa Guarini
- Department of Psychology “Renzo Canestrari”, University of Bologna, 40126 Bologna, Italy; (A.S.); (C.S.)
- Correspondence: (A.G.); (M.B.)
| | - Alessandra Sansavini
- Department of Psychology “Renzo Canestrari”, University of Bologna, 40126 Bologna, Italy; (A.S.); (C.S.)
| | - Chiara Suttora
- Department of Psychology “Renzo Canestrari”, University of Bologna, 40126 Bologna, Italy; (A.S.); (C.S.)
| | - Stefania Bortolotti
- Department of Economics, University of Bologna, 40126 Bologna, Italy; (S.B.); (M.F.); (D.I.); (C.M.)
| | - Margherita Fort
- Department of Economics, University of Bologna, 40126 Bologna, Italy; (S.B.); (M.F.); (D.I.); (C.M.)
| | - Daniela Iorio
- Department of Economics, University of Bologna, 40126 Bologna, Italy; (S.B.); (M.F.); (D.I.); (C.M.)
| | - Chiara Monfardini
- Department of Economics, University of Bologna, 40126 Bologna, Italy; (S.B.); (M.F.); (D.I.); (C.M.)
| | - Maria Bigoni
- Department of Economics, University of Bologna, 40126 Bologna, Italy; (S.B.); (M.F.); (D.I.); (C.M.)
- Correspondence: (A.G.); (M.B.)
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