Using WhatsApp support groups to promote responsive caregiving, caregiver mental health and child development in the COVID-19 era: A randomised controlled trial of a fully digital parenting intervention.

Journal: Digital health

Volume: 9

Issue: 

Year of Publication: 

Affiliated Institutions:  Institute for Life Course Health Research, Stellenbosch University, Tygerberg, South Africa. Department of Psychiatry and Mental Health, University of Cape Town, Rondebosch, South Africa. Peninsula Technology Assessment Group (PenTAG), University of Exeter, Exeter, UK. Regional Psychosocial Support Initiative (REPSSI) Regional, Randburg, South Africa. Regional Psychosocial Support Initiative (REPSSI), Dar es Salaam, Tanzania. Regional Psychosocial Support Initiative (REPSSI), Lusaka, Zambia. Regional Psychosocial Support Initiative (REPSSI), Kampala, Uganda. Department of Global Health, Centre for Evidence-Based Health Care, Stellenbosch University, Tygerberg, South Africa.

Abstract summary 

Digital interventions hold important potential for supporting parents when face-to-face interventions are unavailable. We assessed the feasibility and effectiveness of a digital parenting intervention in Zambia and Tanzania.Using a randomised controlled trial, we evaluated the Sharing Stories digital parenting intervention for caregivers of children aged 9-32 months with access to a smartphone in their household. Caregivers were stratified based on child age and randomly assigned to the intervention or waitlist control arm. The intervention was delivered via facilitated WhatsApp groups over 6 weeks to promote caregiver wellbeing and responsive caregiving through shared reading activities. Primary outcomes were caregiver-reported responsive caregiving, child language and socio-emotional development. Secondary outcomes were caregiver mental health and parental stress. Masked assessors conducted assessments at baseline and immediate follow-up.Between October 2020 and March 2021, we randomly assigned 494 caregiver-child dyads to the intervention ( = 248) or waitlist control ( = 246) arm. Caregivers in the intervention group reported more responsive caregiving (OR = 2.55, 95% CI: 1.15-5.66, = 0.02), time reading or looking at books (β = 0.45, = 0.04) and telling stories (β = 0.72, = 0.002). Intervention caregivers reported significantly lower symptoms of depression (β = -0.64, = 0.05) and anxiety (β = -0.65, = 0.02). Child development and parental stress did not differ significantly between groups.Digital parenting interventions using WhatsApp can effectively promote responsive caregiving and caregiver mental health in low-resource settings, with great potential for scalability.ISRCTN database, ISRCTN77689525.

Authors & Co-authors:  Skeen Sarah S Marlow Marguerite M du Toit Stefani S Melendez-Torres G J GJ Mudekunye Lynette L Mapalala Edwick E Ngoma Kelvin K Ntanda Byamukama Michael BM Maketha Moroesi M Grieve Caitlin C Hartmann Laura L Gordon Sarah S Tomlinson Mark M

Study Outcome 

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Statistics
Citations :  Britto PR, Lye SL, Prouxl K, et al. Nurturing care: promoting early childhood development. Lancet 2017; 389: 91–102.
Authors :  13
Identifiers
Doi : 20552076231203893
SSN : 2055-2076
Study Population
Male,Female
Mesh Terms
Other Terms
COVID-19;Digital;child development;mental health;parenting;responsive caregiving
Study Design
Study Approach
Country of Study
Zambia
Publication Country
United States