The effectiveness of Parentbot - a digital healthcare assistant - on parenting outcomes: A randomized controlled trial

IF 7.5 1区 医学 Q1 NURSING International Journal of Nursing Studies Pub Date : 2024-09-13 DOI:10.1016/j.ijnurstu.2024.104906
Joelle Yan Xin CHUA , Mahesh CHOOLANI , Cornelia Yin Ing CHEE , Huso YI , Yiong Huak CHAN , Joan Gabrielle LALOR , Yap Seng CHONG , Shefaly SHOREY
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Abstract

Background

Transitioning to parenthood is a stressful period that makes parents more prone to depression and anxiety. Mobile application-based interventions and chatbots could improve parents' well-being across the perinatal period. Hence, the Parentbot - a Digital healthcare Assistant was developed to support parents across the perinatal period.

Objective

To evaluate the effectiveness of the Parentbot - a Digital healthcare Assistant in improving parenting self-efficacy (primary outcome), stress, depression, anxiety, social support, parent–child bonding, and parenting satisfaction (secondary outcomes) among parents across the perinatal period.

Methods

A two-group pre-test and repeated post-test randomized controlled trial was used where 118 heterosexual couples (118 mothers and 118 fathers) were recruited from a public tertiary hospital in Singapore. Couples were randomly assigned to the intervention group receiving the Parentbot - a Digital healthcare Assistant and standardized care (59 couples) and a control group receiving the standard care only (59 couples). Data collection occurred at baseline (> 24 weeks of gestation – age of viability in Singapore) and at one month (post-test 1) and three months (post-test 2) postpartum. Linear mixed models were used to compare parental outcomes between groups and a linear mixed model with repeated measures was used to analyze within-group differences. General linear models were used to conduct subgroup analyses of mothers and fathers between groups.

Results

After adjusting for baseline values and sociodemographic covariates, parents in the intervention group had higher parenting self-efficacy compared to the control group at one-month postpartum (mean difference = 1.22, 95 % CI: 0.06 to 2.39, p = 0.04; Cohen standardized effect size = 0.14), and mothers had lower state-anxiety compared to the control group at three-months postpartum (mean difference = − 2.21, 95 % CI: − 4.18 to − 0.24, p = 0.03; Cohen standardized effect size = − 0.22). Non-statistically significant differences between groups were reported for the other parental outcomes.

Conclusions

This study showed that the Parentbot - a Digital healthcare Assistant is feasible and promising in supporting parents especially enhancing their self-efficacy across the perinatal period. The lack of statistical significance in most outcomes showed that further evaluation of the intervention is required among varied populations of parents across different cultural and geographical contexts. The intervention could be enhanced to support more diverse groups of parents including single parents, parents with high-risk pregnancies and infants with medical complications, and parents with limited English language skills. Future trials could explore the cost-effectiveness of such interventions and investigate infant outcomes for a more comprehensive assessment of mobile application-based perinatal interventions.

Trial registration

Clinicaltrails.gov (NCT05463926).
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数字医疗保健助手 Parentbot 对育儿效果的影响:随机对照试验
背景介绍转变为父母是一个充满压力的时期,这使父母更容易患上抑郁症和焦虑症。基于移动应用的干预措施和聊天机器人可以改善父母在整个围产期的幸福感。因此,我们开发了数字医疗保健助理 Parentbot,为围产期的父母提供支持:评估数字医疗保健助理 Parentbot 在改善围产期父母育儿自我效能(主要结果)、压力、抑郁、焦虑、社会支持、亲子关系和育儿满意度(次要结果)方面的有效性:从新加坡一家公立三级医院招募了 118 对异性夫妇(118 位母亲和 118 位父亲),采用两组前测和重复后测随机对照试验。夫妇们被随机分配到接受 Parentbot(数字医疗助理)和标准化护理的干预组(59 对夫妇)和仅接受标准护理的对照组(59 对夫妇)。数据收集时间为基线(妊娠大于 24 周--新加坡的存活年龄)、产后一个月(测试 1 后)和三个月(测试 2 后)。线性混合模型用于比较组间父母的结果,重复测量的线性混合模型用于分析组内差异。一般线性模型用于对各组间的母亲和父亲进行分组分析:结果:在对基线值和社会人口学协变量进行调整后,干预组的父母在产后一个月的育儿自我效能感高于对照组(平均差异 = 1.22,95 % CI:0.06 至 2.39,p = 0.04;科恩标准化效应大小 = 0.14),与对照组相比,母亲在产后三个月的焦虑状态较低(平均差异 = -2.21,95 % CI:-4.18 至 -0.24,p = 0.03;科恩标准化效应大小 = -0.22)。其他家长结果的组间差异无统计学意义:这项研究表明,在围产期为父母提供支持,尤其是提高他们的自我效能方面,数字医疗保健助理 Parentbot 是可行且有前景的。大多数结果缺乏统计学意义,这表明需要在不同文化和地域背景下的不同父母群体中对干预措施进行进一步评估。干预措施可以得到加强,以支持更多不同的父母群体,包括单亲父母、高危妊娠父母和患有并发症的婴儿,以及英语水平有限的父母。未来的试验可以探讨此类干预措施的成本效益,并调查婴儿的预后,以便对基于移动应用的围产期干预措施进行更全面的评估:试验注册:Clinicaltrails.gov (NCT05463926)。
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来源期刊
CiteScore
15.00
自引率
2.50%
发文量
181
审稿时长
21 days
期刊介绍: The International Journal of Nursing Studies (IJNS) is a highly respected journal that has been publishing original peer-reviewed articles since 1963. It provides a forum for original research and scholarship about health care delivery, organisation, management, workforce, policy, and research methods relevant to nursing, midwifery, and other health related professions. The journal aims to support evidence informed policy and practice by publishing research, systematic and other scholarly reviews, critical discussion, and commentary of the highest standard. The IJNS is indexed in major databases including PubMed, Medline, Thomson Reuters - Science Citation Index, Scopus, Thomson Reuters - Social Science Citation Index, CINAHL, and the BNI (British Nursing Index).
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