Translating the Knowledge Gap Between Researchers and Communication Designers for Improved mHealth Research

Our industry insight focuses on the challenges for health researchers collaborating with communication designers during the development of an App for improving maternal mental health and parenting stress. We discuss the challenges around explicating and communicating tacit and domain knowledge across disciplinary boundaries. We believe this report can widen communication design’s traditional focus on users in mHealth research to consider partnerships with academic researchers. The lessons learned from our experience developing a mHealth program can be used to reduce challenges in future mHealth research, especially for collaborations between health researchers and communications designers. Considering the growth of interest in mHealth, this is extremely relevant for future team satisfaction, the optimal use of research funds and industry time, and faster development of effective mHealth tools.This is the accepted manuscript version of the following publication: Rioux, C., Weedon, S., MacKinnon, A. L., Watts, D., Salisbury, M. R., Penner-Goeke, L., Simpson, K. M., Harrington, J., Tomfohr-Madsen, L. M. & Roos, L. E. (2022). Translating the Knowledge Gap Between Researchers and Communication Designers for Improved mHealth Research. SIGDOC '22: The 40th ACM International Conference on Design of Communication, USA, 157–160. doi: 10.1145/3513130.3558997BEAM was funded by a Research Manitoba COVID-19 Rapid Response Operating Grant. CR was supported by a Postdoctoral fellowship from Research Manitoba and the Children’s Hospital Foundation of Manitoba. ALM was supported by a Social Sciences & Humanities Research Council (SSHRC) Banting Postdoctoral Fellowship (#01353-000).Ye

Feasibility of an Online Acute Stressor in Preschool Children of Mothers with Depression

Maternal depression is a risk factor for future mental health problems in offspring, with stress-system function as a candidate vulnerability factor. Here we present initial validation of an online matching-task paradigm in young children exposed to maternal depression (N=40), a first in stressor-paradigm research for this age group. Investigations of stress-system reactivity that can be conducted online are an innovative assessment approach, accelerated by the COVID-19 pandemic. Results indicate high feasibility, with ~80% success across measures, similar-to or better-than in-person success rates in young children. Overall, the online matching task elicited significant HR but not cortisol reactivity. Individual differences in child mental health symptoms were a moderator of reactivity to the stressor such that children with lower, but not higher, behavioural problems exhibited the expected pattern of cortisol reactivity to the online matching task. Results are aligned with allostatic load models, which suggest down-regulation of stress-system reactivity as a result of experiencing adversity and mental health vulnerability. Consistent with in-person research, this suggests an early phenotype for the emergence of behaviour problems may be linked to altered stress-system reactivity. Results hold potential clinical implications for intervention development and the future of online stress-system research

A Meta-Analysis of Group-Based Parenting Programs for Preschoolers: Exploring Moderation by Participants, Programs, and Time

Group-based parenting programs have been implemented for over 50 years as a cost-effective way to promote child mental health and reduce behavior problems. However, some evidence suggests that their effects are limited and inconsistent. To inform next steps in program development, more systematic examinations about the overall efficacy of programs for both parenting and child outcomes in early childhood is needed as well as the program and family level factors that predict for whom programs work more or less well. We conducted a systematic review and meta-analysis of randomized-controlled-trials in preschool aged children over the past 20 years (2000 to 2020). Sixty-five articles evaluating group-based parenting programs for 3 to 5-year-old children were included (N = 7658). Meta-analytic results indicated that programs had small overall effects on improving parenting quality and child behaviours. Significant heterogeneity was present with parent-report of child behaviour outcomes linked to greater effect sizes compared to teacher or observer reports. Moderator analyses showed that higher parental education and children’s clinically significant disruptive behaviour problems were linked to greater improvements in parenting quality. There were also significant effects of publication year on child behaviour outcomes, suggesting that program effects have been improving over time. Other moderator analyses were not possible due to limited reporting of theorized factors (e.g., parent mental health). Overall, group-based programs are linked to improvements in parenting and child outcomes during the preschool age. Continued innovation in program development is recommended to increase efficacy and tailor service type and intensity to specific family needs

Virtual assessment of stress reactivity in young children: Practical guidelines & lessons learned

Measures of stress reactivity and coping are critical in developmental research in children. Such measures assist in identifying psycho-physiological abnormalities and aid in developing interventions to avoid outcomes associated with prolonged stress. Prior to the COVID-19 pandemic, measures of stress reactivity and coping were almost exclusively assessed through in-person laboratory studies. Given the importance of stress reactivity research on mitigating adverse developmental outcomes in children it was crucial to continue this research during the pandemic through pivoting to online virtual assessments. The current paper presents guidelines and lessons learned from our team’s transition from in person to virtual assessments with young children. Key learnings across a variety of areas, such as family engagement, optimal logistics of virtual assessments, and how to best adapt stress-reactivity measures at a distance are presented

Supporting Families to Protect Child Health: Parenting Quality and Household Needs During the COVID-19 Pandemic

Background: Supportive parenting is critical for promoting healthy child development in the face of stressors, such as those occurring during COVID-19. Here, we address a knowledge gap regarding specific household risk factors associated with parenting quality during the pandemic and incorporate first-person accounts of family challenges and needs. Methods: Mixed methods were applied to data collected between April 14th - 28th, 2020 from the “Parenting During the Pandemic” survey. Participants included 656 primary caregivers (e.g., mothers, fathers, foster parents) of least one child age 1.5-8 years of which 555 (84.6%) responded to at least one parenting questionnaire. Parenting quality was assessed across stressful, negative, and positive parenting dimensions. Household risk was examined across pandemic-linked (e.g., caregiver depression, unmet childcare needs) and stable factors (i.e., annual income, mental illness history). Significant correlates were examined with regressions in Mplus. Thematic analysis identified caregiver challenges and unmet needs from open-ended questions. Findings: Caregiver depression, higher child parity, unmet childcare needs, and relationship distress predicted lower-quality parenting. Caregiver depression was the most significant predictor across every parenting dimension, with analyses indicating medium effect sizes, ds = .39 - .73. Qualitative findings highlighted severe strains on parent capacities including managing psychological distress, limited social supports, and too much unstructured time. Interpretations: Lower quality parenting during COVID-19 is associated with multiple household and pandemic risk factors, with caregiver depression consistently linked to parent-child relationship disruptions. Focused efforts are needed to address caregiver mental health to protect child health as part of the pandemic response

Digital Parent Training RCT Meta-Analysis and Systematic Review

Background. Disruptive behavior disorders have increased during the pandemic and are associated with family conflict and child risk of child maltreatment. While parent training interventions are a best-practice intervention to treat a range of disruptive behavior disorders and family dysfunction concerns, there are limited and mixed findings on the efficacy of telehealth or digital parent training interventions. As the field of digital therapeutics continues to expand, it is imperative we seek to understand the program and client factors linked to differential efficacy. Objective. Our objective was to compare digital therapies to their “best-practice” in-person counterparts (i.e. non-inferiority trials), as well as comparing the relative benefits of a given program to waitlists, other ehealth programs, or treatment as usual. Furthermore, we aimed to interrogate which types and components of digital therapeutics are most efficacious and for whom. Methods. We conducted a systematic review and meta-analysis (k = 24, total number of intervention participants = 1654 and control participants = 1001) of the impact of digital parent training interventions on parent skill, parent mental health, and child externalizing outcomes from 2000 to 2021, among children 2-12 years old, across four databases. Exclusionary criteria include programs targeted for parents of children with intellectual disabilities, autism, brain injury, nutrition/health/dental needs or primary medical diagnosis. Results. Across outcomes, digital parent training interventions had a modest effect size (g = .27 to .33), compared to controls. The effects of digital parent training on parent skills and child outcomes were stronger if the intervention was evidence-based, combined interactive platforms with a therapist and was compared to an inactive control. Conclusions. Together, these findings suggest digital parent training interventions are an effective approach linked to modest improvements in reducing child disruptive behavioral symptoms and improving parenting skills. Such scalable and accessible approaches hold high potential to reduce burdens of child and adolescent mental illness, particularly when applied in a stepped care model. We call on future studies to provide standardized sociodemographic reporting to aide in future knowledge synthesis work that can inform tailored interventions to different populations and provide templates for shared measurement. Preregistration and open data files: https://osf.io/e35bt/