JMIR Publications

ABSTRACT

Background:

Approximately 1 in 6 U.S. children a developmental disability. Early detection is crucial but often delayed, especially in families with limited access to resources. Current paper-based screening methods, like the Ages and Stages Questionnaire, face challenges such as cultural barriers and timing issues. Digital tools can improve parent engagement and screening accuracy. This research explores new technologies to enhance long-term parent involvement in developmental screening.

Objective:

To understand if features of a digital intervention specifically designed to engage parents in developmental screening are effective over long-term period.

Methods:

A randomized controlled trial with 139 families over 20 months was conducted, along with follow up interviews and surveys. The intervention consisted of an interactive web portal that combined developmental and sentimental record-keeping, family-friendly visualizations, and the ability to answer screening questions via multiple modalities (e.g., text messaging, web). The control condition consisted of an online portal with no specific engagement features, modeled after standard online developmental screening tools.

Results:

Several parent engagement strategies we deployed in the study were effective in increasing milestone questionnaire completion, with text messaging standing out as the most impactful and efficient, offering the highest return relative to the effort required for its development and implementation. Overall, the experimental group demonstrated a 44% higher average response rate compared to controls (t(125) = -3.32, P < .01). Participants in the experimental group submitted significantly more timely and valid responses, after text messaging was introduced (Phase 2: 95% vs. Phase 1: 71%; t(107) = -4.44, P < .01), which is a critical factor for effective and timely tracking of child development. The experimental group participants responded to more questions on average (M = 127.60, SD = 49.01) than those in the control group (t(70) = -7.23, P < .01) in Phase 2 as well. Additionally, study completion rates were significantly higher in the experimental group (83% vs. 30%; t(119) = -8.40, P < .01), indicating greater long-term engagement. Sentimental record-keeping features showed promise but limited use, suggesting the need for integration with tools parents already use.

Conclusions:

This study demonstrates that a human-centered design approach for technology-based interventions can significantly enhance parent engagement and completion rates of developmental screening questionnaires. However, further research is needed with a larger sample to determine if such features effectively prompt parents to seek early intervention services. Future studies should focus on engaging more diverse and underserved populations to validate these findings. Clinical Trial: This research project was funded by the National Science Foundation. Because the work was intended to investigate technology design features, was not conducted in a clinical setting, and the National Science Foundation did not require clinical trial registration, our study was not registered as a clinical trial.