JMIR Publications

ABSTRACT

Background:

Six years after the Christchurch earthquakes in 2011, approximately one-third of parents in the Christchurch region reported continued high levels of distress in their children and limited access to mental health services. In response, an online resource, Kākano, was co-designed with parents to help them better support their children’s mental health.

Objective:

The objective of this study was to evaluate the effectiveness of Kākano, a fully automated parenting app to increase parental confidence in supporting their children.

Methods:

A cluster-randomized delayed access-controlled trial was carried out in the Christchurch region between July 2019 and January 2020. Parents were recruited through schools and block randomized to receive immediate or delayed access to Kākano. Participants were given access to the Kākano app for four weeks and encouraged to use it weekly. Web-based pre-intervention and post-intervention measurements were undertaken.

Results:

231 participants enrolled in the Kākano trial with 205 participants completing baseline measures and being randomized (101 in the intervention group and 104 in the delayed access control group). Of these, 41 provided full outcome data (19 delayed access, 21 Kākano). On those retained in the trial, there was a significant difference in the mean change between groups favoring Kākano in the brief assessment of parenting (F(1,39) = 7.0, p=0.012). But not in the Short Warwick-Edinburgh Wellbeing Scale (F(1,39) = 2.9, p=0.099), parenting self-efficacy (F(1,39) = 0.1, p=0.805), family cohesion (F(1,39) = 0.4, p=0.538), or parenting sense of confidence (F(1,40) = 0.6, p=0.457). Waitlisted participants who completed the app after the waitlist period (n=16) showed similar trends for the outcome measures with significant changes in the brief assessment of parenting and Short Warwick-Edinburgh Wellbeing Scales. No relationship between the level of app usage and outcome was found. Although the app was designed with parents, the low rate of completion of the trial was disappointing.

Conclusions:

Kākano, is an app co-designed with parents to help manage their children’s big emotions. There was a high rate of attrition as is often seen in digital health interventions but for those who did complete it, there was some indication of improved parental wellbeing and self-assessed parenting Clinical Trial: ACTRN1261900104156