JMIR Publications

ABSTRACT

Background:

Excessive crying/sleeping/feeding problems in infancy are significant stressors for families that can result in parents’ feelings of social isolation and low self-efficacy. Infants of parents who experience these problems are at increased risk for being maltreated and for developing emotional and behavioral problems. Thus, development of an innovative, interactive psychoeducational app for parents of children with crying/sleeping/feeding problems may provide a low-threshold access to scientifically based information and alleviate the negative outcomes for parents and infants.

Objective:

We investigated whether parents of children with crying, sleeping and/or feeding problems following the use of the newly developed psychoeducational app experience less parenting stress (1), gain more knowledge about crying/sleeping/feeding problems (2), perceive themselves as more self-effective (3), and as better socially supported (4) and whether their child’s symptoms decrease more (5) than parents who did not use the app.

Methods:

Our clinical sample consisted of N = 136 parents of children (age 0 – 24 months) who contacted a cry baby outpatient clinic in Bavaria (Southern Germany) for an initial consultation. A randomized controlled design was used. For the usual waiting time until their consultation (average 3 weeks), families were randomly allocated to either an intervention group who used the app (IG, n=73) or to a waitlist control group (WCG, n=63). The IG was given a psychoeducational app that includes evidence-based information via text and videos, a child behavior diary-function, a parent chat forum, tips on relaxation as well as a regional directory of specialized counseling centers. Outcome variables were assessed using validated questionnaires at baseline (t1) and post-test (t2). Both groups were compared at post-test regarding changes in parenting stress (primary outcome) and secondary outcomes, namely knowledge about crying/sleeping/feeding problems, perceived self-efficacy, perceived social support as well as child symptoms.

Results:

The individual study duration was mean 23.41(SD 10.42) days. The IG reported significantly lower levels of parenting stress (mean 83.18, SD 19.94) after app use compared to the WCG (mean 87.46, SD 16.67; P =.03, d=.23). Furthermore, parents in the IG reported a higher level of knowledge about crying/sleeping/feeding (mean 62.91, SD 4.30) than those who were in the WCG (mean 61.15, SD 4.46; P<.001, d=0.38). No differences in change were found between the intervention and the WCG in terms of parental efficacy (P=.34, d=0.05), perceived social support (P=.66, d=0.28), and child symptoms (P=.35, d=0.10).

Conclusions:

This study provides initial evidence for efficacy of a psychoeducational app for parents with infant crying/sleeping/feeding problems. The app has the potential to contribute to the prevention of child maltreatment via reduction of parental stress and increased knowledge about child’s symptoms. Additional large-scale studies are needed to investigate long-term benefits. Clinical Trial: German clinical trial register DRKS00019001; https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00019001