Engagement in a Remote Intervention: Feedback from a text-based intervention to enhance parent-child talk

• In Event: Poster Session 01
  In Poster Session: PS 01 Topic - Methods, History, Theory

Abstract

Background. Randomized Controlled Studies (RCTs) are considered the gold standard for evaluating causal relationships. Few developmental studies report how people interact with materials during the course of an intervention (engagement), whether they followed the intervention protocols (adherence), and whether they found the intervention meaningful (subjective impacts).

Methods. In the Talk Together RCT rolled out during Singapore’s COVID-19 response, parents in the Intervention group are served daily WhatsApp messages with tips to enhance the quantity and quality of talk with their child (8-36m). A total of 23 tips are served over 4 weeks: Morning messages contain a tip and links to interactive materials. Afternoon messages ask parents if they used the tip, and to reply with a target emoji or a target word. A survey at the end of the intervention asks questions about adherence and subjective impacts. At the time of submission, 198 parents have consented to take part in the study, and 30 parents have completed the full 4 weeks of Intervention. The target sample size is 150, with data collection expected to conclude in February 2021.

Intervention Engagement. 23 of the 30 parents responded by text message at least once during the four-week intervention, with a daily response rate of 31.7% on tip days. Parents responded using a mix of target emojis (41.99%), alternative emojis (5.34%), target word (51.7%), and other responses (0.97%) indicating that parents were equally likely to reply using an emoji or a word. Figure 1 shows the tally of responses for each target item in the intervention, separated by thematic week. Responding was higher for items in the ‘Talk Wheel’ week, served at the start of the intervention. 60% of parents reported using tips on non-target days, or multiple tips in one day. 8 parents also responded to scheduled messages with questions or feedback. These results indicate that delivering frequent parenting tips via text messaging effectively engages the majority of participants, with responses acting as a proxy for program adherence.

Retrospective Adherence. Almost all parents said they used tips in each week of the intervention (Week 1: 73.1%, Week 2: 92.3%, Week 3: 76.9%, Week 4: 69.2%), and more than 50% reported that they continued using the tips after their focal week. In general, the Tips from Week 2 (‘Interactivity’) were evaluated to be more interesting, more useful and were liked more than the tips from the other weeks. These tips covered developmental science about eye contact, turn taking, joint attention, babbling and gestures.

Subjective Impact. 90% of parents reported that the tips had changed their thinking about the language they use with their children, and 93% reported that the tips had changed their language behaviour with their infants and toddlers.

Conclusion. This exploratory investigation of interim parental feedback reveals that the majority of parents engage with intervention materials presented via text messages, and while preference varied across different tips and topic, parents found the intervention meaningful, and reported that it changed their thinking and behaviour.

Authors

• Shaza Binte Amran, Nanyang Technological University
  Presenting Author

• Shamala Sundaray, Nanyang Technological University
  Non-Presenting Author

• Tuan Anh Le, Nanyang Technological University
  Non-Presenting Author

• Fei Ting Woon, Nanyang Technological University
  Non-Presenting Author

• Eshwaaree C Yogarrajah, Nanyang Technological University
  Non-Presenting Author

• Suzy J Styles, Nanyang Technological University, Singapore
  Non-Presenting Author