Creating Connections: A Feasibility Study of a Technology-Based Intervention to Support Mothers of Newborns During Pediatric Well-Visits

Access: Institutional Access

Publication year

2023

study description

Feasibility study.

core topic(s)

Early Relational Health , Pediatric Primary Care

Population Characteristics

Infant/Newborn , Medical Providers , Poverty/Low-Income , Pregnancy/Postpartum , Urban

Exposures, Outcomes, Other

Clinic-Based Programs and Interventions , Creating Connections , Implementation and Evaluation , Parent Knowledge, Attitudes, and Beliefs , Parent-Provider Relationships/Interactions , Social-Emotional , Technology and Digital/Screen-Based Media , Validity, Reliability, Feasibility, and Acceptability

objectives

This study reports the initial feasibility of the Creating Connections intervention, a technology-based intervention developed to support mothers of newborns, and feasibility of evaluating the intervention through a randomized clinical trial in pediatric primary care.

exposure

Creating Connections

outcomes evaluated

Intervention feasibility.

setting

Mothers of newborns participated at their initial well-child check-up… Recruitment took place in an ambulatory care pediatric center that is part of a hospital in a large, Midwestern city.

methods

The intervention includes: (a) a brief tablet-based intervention delivered during a newborn well-child pediatric checkup, and (b) tailored text messages delivered thereafter to boost intervention content. Intervention content includes empirically-supported aspects of parenting behaviors known to positively influence children’s social-emotional development. Project recruitment took place in an ambulatory care pediatric clinic in a large Midwestern city. Mothers received information about infant soothing, book sharing, or both.

sample size

n=73 (parents)

measures

Measure of Program Participation: Research assistants tracked how many mothers were given the opportunity to participate (i.e., how many mothers were told about the project by the pediatrician) and how many declined/accepted participation.

 

Measure of Goals and Struggles: As part of the tablet-based program, mothers initially selected their main struggle since bringing their infant home; 10 response options were provided. Mothers were then asked about their most important goal for the upcoming year and seven response options were provided.

 

Measure of Receipt of Text Messages: Records of whether text messages were successfully delivered to participating mothers were kept. If mothers chose to end text messages, they could respond “STOP.” The rate at which mothers discontinued texts was recorded.

 

Measure of Text Message Ratings: At follow-up, mothers were asked three questions regarding their experience of receiving study related texts. Items were:

• • How often did you read the entire text message that you received?
  • How helpful was the content of the text messages?
  • Would you be interested in receiving text messages like this for other projects?

results

One-hundred and three parents learned about the program and 72 participated. Mothers were primarily Black/African American with incomes at or below $30,000. Only 50% of mothers that received text messages through the program completed follow-up, but these mothers gave overall positive ratings of text messages.

conclusions

Program engagement and ratings of parents support feasibility, but retention rates need improvement. Based on barriers and successes of this investigation, lessons learned about feasibility and acceptability are discussed.

limitations

Of note, compensation for being in this research study may have influenced program uptake...Regulations about research made approaching mothers in the waiting room impossible, but we suggest exploring this approach in the future. Moreover, not all physicians at the practice were engaged in the Creating Connections project, which ultimately affected parent engagement...However, it is unclear why some participants did not receive texts. While the protocol for delivering the intervention included having research assistants check to see if mothers received a welcome text, this was a challenge due to poor cellular reception in the clinic. Another challenge may be cellphone service disruptions, which are common (Mitchell et al., 2014). Cell phones disruption may have led to low retention. Using empirically supported strategies to improve retention in a future RCT is needed.