JMIR Publications

ABSTRACT

Background:

Conduct disorder (CD) increases risks of educational dropout, future mental illness, and incarceration if untreated. First-line treatment of CD involves evidence-based parenting skills programs. Time out, a frequent tool in these programs, can be effective at improving behaviour and recent apps have been developed to aid this process. However, these apps promote the use of time out in inconsistent or developmentally-inappropriate ways, potentially worsening behaviour problems. Digital micro interventions like these apps could guide parents through high-quality time out in the moment but current time out applications lack features promoting adherence to the evidence-based best practice. Agile Scrum is a respected approach in the software development industry.

Objective:

To explore the feasibility of using the Agile Scrum approach to build a digital micro intervention to help parents deliver an evidence-based time out.

Methods:

Agile Scrum was used. 4 sprints were conducted. Figma software was used for app design and wireframing. 42 expert stakeholders were included in 3 sprint reviews. Experts were recruited from councils around the Midlands region of the UK and charities through personal contacts and a snowballing approach.

Results:

Over four development sprints from August 2022 to March 2023, the app was iteratively designed, tested, and refined based on feedback from a diverse group of 42 stakeholders. Modifications made throughout the process resulted in significant app enhancements, including tailored timer algorithms, enhanced readability, and an onboarding zone, mindfulness module, and pictorial information to increase inclusivity. By the end of the fourth sprint, the app was deemed ready for home use by stakeholders, demonstrating the effectiveness of our Agile Scrum development approach.

Conclusions:

We developed an app to support parents to use the evidence-based time out technique. We recommend that researchers aiming to create mobile health applications adopt the Agile Scrum approach. Our findings highlight the valuable role that frontline health and social care professionals, particularly those working with vulnerable families, can play as stakeholders in Scrum. Further research should evaluate the impact of digital micro interventions on child behavioural change and also create digital micro interventions that cater to non-English speakers and individuals who participate in parenting programs in settings outside the UK.