Currently submitted to: Journal of Medical Internet Research
Date Submitted: Jun 11, 2026
Open Peer Review Period: Jun 12, 2026 - Aug 7, 2026
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Make the Connection: An Analysis of Enrollment and Adherence in an Online Parenting Intervention
ABSTRACT
Background:
Online parenting interventions provide a unique opportunity to increase access and scalability to evidence-based parenting information that can enhance parenting practices, caregiver well-being, and child developmental outcomes. While online parenting programs can reduce access barriers, less is known about who enrolls in such programs, how participants engage with them, and whether engagement is sustained over time. This knowledge could help inform parenting program usability and engagement strategies.
Objective:
This study explored the demographic characteristics of caregivers who enrolled (registered) and adhered (completed) to an online parenting intervention protocol and examined sociodemographic factors associated with engagement.
Methods:
Data were drawn from a larger pragmatic randomized controlled trial evaluating the online Make the Connection® (MTC) program, which aims to promote healthy parent-child relationships. This secondary analysis focused on participants assigned to the intervention group (N = 215). Baseline sociodemographic characteristics were collected using an online survey prior to enrolling in the intervention. Descriptive statistics and logistic regression models were used to examine correlates of enrollment and adherence.
Results:
Participants were predominantly women (91.6%, 197/215), with a mean age of 35.6 years (SD = 5.19), and their children were a mean age of 13.9 months (SD = 10.7). Of the 215 participants assigned to the intervention, 107 (49.7%) enrolled in the program, while 108 (50.2%) did not. Younger child age was associated with a higher likelihood of enrollment (OR= 0.96, 95% CI 0.93-0.98, P =.002). Older caregiver age was associated with greater likelihood of enrollment (OR= 1.07, 95% CI 1.01-1.14, P =.017) and adherence (OR= 1.11, 95% CI 1.02-1.22, P=.020). Caregiver social isolation was associated with a lower likelihood of adherence (OR= 0.30, 95% CI 0.11-0.84, P =.022), but not enrollment (OR = 1.12, 95% CI 0.62-2.03, P = .706). Depressive symptoms were not significantly associated with program adherence (OR = 1.21, 95% CI 0.45-3.28, P =.708) or enrollment (OR = 0.97, 95% CI 0.90-1.05, P =.457).
Conclusions:
Results suggest that different factors influence enrollment and adherence in online parenting programs. Although digital delivery may reduce barriers to access, additional strategies, such as goal setting tools, personalised feedback, tailored reminders, and opportunity for peer-connection may be needed to support sustained engagement, particularly among caregivers at risk of disengagement. In this study, sociodemographic factors have been identified that can inform strategic interventions to improve engagement from caregivers most vulnerable to disengagement. Clinical Trial: NCT05770414
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Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.