Engagement and Adherence With ezPARENT, an mHealth Parent-Training Program Promoting Child Well-Being

Abstract

Mobile health (mHealth) interventions use mobile technology (tablets and smartphones) delivery platforms for interventions to improve health outcomes. Despite growing acceptance, there is little understanding of how consumers engage with and adhere to mHealth interventions. This study analyzes usage data from the intervention arm ( n = 42) of a randomized clinical trial testing the efficacy of the ezPARENT program and provides recommendations for using engagement and adherence metrics. Engagement was measured by parent usage (duration, frequency, and activity) of ezPARENT and adherence using an adherence index (the sum of individual modules completed, number of visits to ezPARENT, and maximum time between visits). Parents spent M = 37.15 min per module and had M = 13.55 program visits in the 3-month intervention period. Parents visited the program over a period of M = 69.5 days and completed 82% of the modules. These data provide support that parents will use intervention programs delivered digitally; engagement and adherence metrics are useful in evaluating program uptake.

Use of Technology to Promote Child Behavioral Health in the Context of Pediatric Care: A Scoping Review and Applications to Low- and Middle-Income Countries

“…These types of interventions were usually adapted from existing EBIs (71%). eHealth strategies applied include web-based parenting modules (included 4 to 12 interactive or structured parenting sessions), with (44, 45, 52–53, 54, 56, 57) or without (42, 47, 48, 50, 55) additional e-communication or e-support for parents (e.g., phone coaching, e-reminders, feedback messaging, email, social media groups). There were also some studies focused on parent support interventions (including information and emotion support) and wellness promotion (purpose) for families of children with challenging behavior.…”

Parental mobile health adherence to symptom home monitoring for infants with congenital heart disease during the single ventricle interstage period: A concept analysis

“…Among the 16 publications selected for the in‐depth analysis were systematic reviews ( n = 7), mHealth narrative reviews ( n = 2), mHealth interstage intervention feasibility studies ( n = 4), mHealth interstage randomized crossover study ( n = 1), mHealth engagement intervention ( n = 1), and a single mHealth adherence randomized controlled trial. The primary focus of each publication was mHealth in the interstage period for five (Bingler et al, 2018; Black et al, 2014; Cross et al, 2012; Harahsheh et al, 2016; Shirali et al, 2016), pediatrics and mHealth for four (Breitenstein, Brager, Ocampo, & Fogg, 2017; Canter, Christofferson, Scialla, & Kazak, 2019; Niksch, 2015; Taki, Campbell, Russell, Appleton, & Denney‐Wilson, 2019), and the remainder were general mHealth (Alexander & Staggers, 2009; Hamine, Gerth‐Guyette, Faulx, & Green, 2015; Kumar et al, 2013; Marcolino et al, 2018; Shaw et al, 2016; Simblett et al, 2018; Subhi, Bube, Rolskov Bojsen, Skou Thomsen, & Konge, 2015). All intervention studies are outlined in Table 1 and were single site with only one completed outside of the United States, in the United Kingdom (Taki et al, 2019).…”

“…reported results from a randomized controlled trial of the ezPARENT program, an mHealth intervention for socioeconomically disadvantaged parents of young children to increase parent training to deter maltreatment and abuse. The engagement was a central element of the study's success, with usage rates showing 82% completion of education modules and parents logging in on 77% of days in the 3-month study period(Breitenstein et al, 2017). Although this group of infants were high risk in potentially different ways compared with infants with single ventricle congenital heart disease, the focus on engagement and a similar monitoring period of 3 months provide opportunities to extrapolate to the concept of parental mHealth adherence.Simblett et al (2018) reported a model of engagement based on their systematic review of mHealth remote monitoring where barriers and facilitators to engagement included changes in health status (hospitalization days where home monitoring is not needed), usability (technical malfunctions or broken devices), convenience (forgetting to use mHealth or weak cellular coverage), perceived utility (financial costs and poor data reliability of home monitoring), and internal parental or external motivation from the healthcare team.…”

Artificial Intelligence, Big Data, and mHealth: The Frontiers of the Prevention of Violence Against Children

“…There are also examples of mHealth parenting and parenttraining interventions (Breitenstein et al, 2017), which similarly intervenes directly through a technological platform, to change behavior. Among these parent interventions relevant to violence prevention are those which seek to address adult mental health problems.…”