JMIR Publications

ABSTRACT

Background:

Children’s conduct and emotional problems increased during the COVID-19 pandemic.

Objective:

We tested whether a smartphone parenting support application, Parent Positive, reversed these effects in a cost-effective way.

Methods:

SPARKLE, a randomised controlled trial (NCT04786080) was embedded in the UK-wide Co-SPACE longitudinal study of families’ mental health during the pandemic. Parents of 4–10-year-olds were randomised 1:1 to Parent Positive or Follow-up As Usual (FAU) between 19/05/2021-26/07/2021. Parent Positive provides advice on common parenting challenges, evidence-based online resources, and facilitated parent-to-parent/expert-to-parent support. Child conduct and emotional problems and family wellbeing were measured before randomisation (T1), and one- (T2), and two-months (T3) post-randomisation. Service utilisation, costs and adverse events were measured, along with app use and satisfaction. The primary outcome was T2 parent-reported child conduct problems, analysed using linear mixed regression models.

Results:

320 were randomised to Parent Positive and 326 to FAU. The primary outcome analysis included 512 (dropout – Parent Positive 26%, FAU 15%). There were no statistically significant intervention effects on conduct problems at either T2 (standardised effect (SE)=-0.01) or T3 (secondary outcome; SE=-0.09), and no moderation by baseline conduct problems. Significant intervention-related reductions in emotional problems were observed at T2 and T3 (secondary outcomes; both SE=-0.13). Parent Positive, relative to FAU, was associated with more parental worries at T3 (SE=0.14). Few intervention-attributable adverse events were reported. Parent Positive was cost-effective once four outliers with extremely high health-care costs were excluded.

Conclusions:

Parent Positive reduced child emotional problems and was cost-effective compared to FAU once outliers were removed. Clinical Trial: NCT04786080