Evaluating the Effectiveness of the Supportive Parenting App on Parental Outcomes: Randomized Controlled Trial

Abstract

Background Adjusting to new or additional parenting responsibilities increases stress and affects parental well-being. Existing research has highlighted both parents’ desire to receive more support. It has also been found that receiving sufficient social support enhances parenting outcomes. With the increasing popularity of mobile health apps, a Supportive Parenting App (SPA) intervention was developed to fulfill the support needs of parents during the perinatal period. Objective This study aimed to examine the effectiveness of the SPA on parental outcomes during the perinatal period. Methods A 2-group pretest and repeated posttest randomized controlled trial was conducted wherein 200 couples (N=400 mothers and fathers) were recruited from 2 public health care institutions in Singapore. Parents were randomly assigned to intervention (100/200, 50%) or control (100/200, 50%) groups. The SPA intervention consisted of a mobile app–based psychoeducation and peer support program to support parents from pregnancy to 6 months post partum. The outcome measures included postnatal depression, anxiety, parental bonding, parental self-efficacy, perceived social support, and parenting satisfaction. Data were collected at baseline (at >24 weeks of gestation—age of viability in Singapore) and at the first, second, fourth, sixth, ninth, and 12th month post partum. Linear mixed models were used to compare parental outcomes between the groups, and a linear mixed model for repeated measures was used to examine within-group changes. Results Parents in the intervention group mostly showed better outcomes compared with those in the control group. Parents in the intervention group had higher perceived social support than those in the control group at the first (effect size=1.59, 95% CI 0.38-2.80; Cohen standardized effect size=1.31; P=.01), second (effect size=1.98, 95% CI 1.09-2.88; Cohen standardized effect size=2.21; P=.003), and fourth (effect size=2.57, 95% CI 1.62-3.51; Cohen standardized effect size=2.72; P=.048) months post partum. However, parents in the intervention group showed significantly poorer parental bonding (effect size=1.67, 95% CI 0.24-3.11; Cohen standardized effect size=1.16; P=.02). The other parental outcomes did not differ significantly between groups. The scores of mothers and fathers also differed significantly for all outcomes except parental self-efficacy. Conclusions Parents in the intervention group generally fared better, especially regarding perceived social support. However, the lack of statistical significance in most outcomes showed the limited effectiveness of the SPA intervention, which may be because of the COVID-19 pandemic. Parental differences in outcome scores suggest that mothers and fathers have different support needs; therefore, interventions should be tailored accordingly. Further improvements and evaluations are needed to examine the effectiveness of the SPA intervention in enhancing parental outcomes. Despite statistically insignificant results, limitations should be considered to further improve mobile health app–based interventions such as SPA, as they could serve as reliable and convenient sources of support for parents. Trial Registration Clinicaltrails.gov NCT4706442; https://clinicaltrials.gov/ct2/show/NCT04706442

Evaluating the Effects of the Supportive Parenting App on Infant Developmental Outcomes: Longitudinal Study

“…Expecting parents were recruited from 2 public health care institutions in Singapore. The study was part of a randomized controlled trial (RCT) investigating the effectiveness of SPA in improving perinatal parental outcomes such as postnatal depression and anxiety [24]. Along with their parents, the infants in this study were randomly allocated to either the SPA intervention group or standard care control group.…”

“…More infants from the control group fell under the at-risk category for motor skills than those from the intervention group. Findings from the main RCT reported a high attrition rate of 28.5% [24]. The outbreak of the COVID-19 pandemic in early February 2020 may have affected the parents' and infants' participation in the study, especially for the home visits.…”

“…This study aimed to examine whether the SPA intervention had any indirect effects on the developmental outcomes of the app users' infants from birth to 12 months of age. The direct effects on parenting outcomes have been reported separately [24]. It was hypothesized that infants in the intervention group would exhibit better language, motor, cognitive, and social skills than their counterparts in the control group.…”

“…In total, 200 couples and their infants were recruited for this study. However, owing to the attrition rate of 28.5% that was reported in the main RCT [24], only 79% (158/200) of infants were included in the analysis (the remaining 42/200, 21% parent-infant dyads dropped out of the study). The demographic characteristics of the participants are presented in Table 2.…”

Validação do instrumento “autoeficácia parental no cuidado ao recém-nascido a termo: versão brasileira”

“…Tornar-se pai ou mãe é um processo a ser construído, a partir da influência de expectativas geradas ao longo da vida, como o tipo de cuidado parental do qual se lembra durante sua infância e das metas traçadas pelo casal para seu futuro como família. Dessa maneira, a parentalidade não deve ser identificada apenas no momento do nascimento de uma criança (2) .…”