Cunningham Maureen A, Gorman Carol, McNulty Monica C, Chavez Catia, Luna-Asturias Claudia, Dixon Cinnamon A, Bull Sheana, Berman Stephen, Allison Mandy A
The Center for Global Health, Colorado School of Public Health, Aurora, CO, USA.
Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO, USA.
Mhealth. 2023 Jan 28;9:4. doi: 10.21037/mhealth-22-13. eCollection 2023.
Mobile applications (apps) exist to promote early child development; however, few studies have examined use of these apps among low-income families. Our objectives were to measure engagement with the Engage, Develop, Learn (EDL) app and determine if it promoted engagement and behavior change among low-income caregivers.
We conducted a pilot study among English and Spanish-speaking, low-income families with children ages 12 to 15 months who received either the EDL app or injury prevention text messages. Baseline data were collected and interventions delivered over two home visits. App engagement was measured using messages opened. Caregiver development-promoting behaviors were measured with STIMQ score changes from baseline to follow-up at child age 2 years. We conducted key informant interviews among families randomized to receive the EDL app to identify barriers and facilitators to app use.
A total of 100 caregivers were recruited at their children's preventive care visit with 50 randomized to receive the EDL app and 50 to receive the injury prevention text messages; however, only 25 in the development app and 34 in the injury prevention group completed both home visits. Follow-up data were collected from 14 in the development app group and 30 in the injury prevention group. Over 10 weeks, 24% (6/25) remained engaged with the development app. STIMQ scores did not differ between groups. Barriers included technical difficulties accessing the app, social stressors, and 'forgetting' to use it.
Our pilot randomized trial of a child development app suggests that it may not be effective for promoting behavior change among low-income caregivers due to low engagement.
This pilot trial was registered with ClinicalTrials.gov (ID NCT02717390).
存在一些促进儿童早期发展的移动应用程序（应用）；然而，很少有研究调查这些应用在低收入家庭中的使用情况。我们的目标是衡量对“参与、发展、学习”（EDL）应用的参与度，并确定它是否能促进低收入家庭照顾者的参与度和行为改变。
我们在讲英语和西班牙语的低收入家庭中进行了一项试点研究，这些家庭的孩子年龄在12至15个月之间，他们要么收到EDL应用，要么收到预防伤害的短信。在两次家访期间收集基线数据并实施干预措施。使用打开的消息来衡量应用参与度。通过比较孩子2岁时从基线到随访的STIMQ评分变化来衡量照顾者促进发展的行为。我们对随机分配接收EDL应用的家庭进行了关键信息提供者访谈，以确定应用使用的障碍和促进因素。
共有100名照顾者在其孩子的预防保健就诊时被招募，其中50名被随机分配接收EDL应用，50名接收预防伤害的短信；然而，只有25名接收发展应用的照顾者和34名预防伤害组的照顾者完成了两次家访。从发展应用组的14名照顾者和预防伤害组的30名照顾者那里收集了随访数据。在10周内，24%（6/25）的人仍在使用发展应用。两组之间的STIMQ评分没有差异。障碍包括访问应用的技术困难、社会压力源以及“忘记”使用它。
我们对一款儿童发展应用的试点随机试验表明，由于参与度低，它可能对促进低收入家庭照顾者的行为改变无效。
该试点试验已在ClinicalTrials.gov注册（ID NCT02717390）。
