5-day ParentText user experience evaluation study in South Africa

Parenting interventions play a crucial role in promoting positive parent-child interactions and mitigating adverse outcomes in children. However, reaching parents and caregivers with evidence-based interventions, particularly in low-resource settings, remains a challenge. Digital platforms offer a promising avenue for scalable and accessible interventions, yet there is a need for rigorous evaluations of their effectiveness and cost-effectiveness, especially in diverse cultural contexts like South Africa.

The primary objective of this study is to assess the effectiveness and cost-effectiveness of a brief digital-only playful parenting chatbot intervention (5-Day ParentText) in promoting positive parent-child interaction in comparison to those receiving an active-control hygiene and sanitation chatbot intervention (WASHText) among parents and caregivers of children aged 2 to 17 in South Africa. By evaluating the impact of 5-Day ParentText, the study aims to contribute to the development of evidence-based strategies for VAC prevention.

The study will take place in South Africa, encompassing various regions, both urban and rural, with a specific focus on Gauteng and KwaZulu Natal provinces. Recruitment efforts will primarily target potential participants through social media platforms like Facebook and Instagram. The intervention will be delivered digitally, leveraging technology to reach parents and caregivers across diverse communities in South Africa.

The 5-Day ParentText User Experience RCT will evaluate the effectiveness of 5-Day ParentText in guiding parents and caregivers over a 5-lesson course. The trial, running from June to December 2024, targets parents of children aged 2 to 17. Using a parallel-group RCT framework with crossover, it compares 5-Day ParentText, 5-Day ParentText-PLUS, and a WASHText control group. Randomisation allocates participants to each group (N = 5,000). The study aims to demonstrate 5-Day ParentText's superiority in promoting positive parenting outcomes while exploring the impact of booster engagement via 5-Day ParentText-PLUS, where participants will have access to an additional child development module.

The primary beneficiaries of this study are parents and caregivers of children aged 2 to 17 in South Africa. By participating in 5-Day ParentText, parents and caregivers will gain access to valuable resources, support, and guidance aimed at enhancing their parenting skills and promoting child well-being. Through the acquisition of effective parenting strategies, participants will contribute to the prevention of VAC, thereby fostering healthier family dynamics and safer communities. Additionally, children in South Africa stand to benefit from the study's outcomes. By improving parenting practices and reducing the risk of VAC, 5-Day ParentText aims to create safer and more supportive environments conducive to the physical, emotional, and social development of children. Ultimately, the study aims to empower families and communities to disrupt the cycle of violence, fostering a more hopeful future for the next generation of South African children.

The study will recruit 15,000 parents and caregivers of children aged 2 to 17 in South Africa. Participants will be randomly assigned to receive one of the three intervention groups via WhatsApp (5-Day ParentText, 5-Day ParentText-Plus or WASHText). Data collection will take place at baseline, 1-month follow-up, and 3-month follow-up. In addition to quantitative surveys, in-depth interviews will be conducted to gain insights into participants' experiences and perceptions of the interventions.

Safeguarding measures will be implemented to ensure participant safety and well-being throughout the study. The digital platform will incorporate mechanisms to detect and respond to high-risk situations, with referral pathways established to connect participants with local support services. Furthermore, research staff will receive training on safety protocols. Moreover, the study will be overseen by an independent Trial Steering Committee (TSC), ensuring adherence to protocol and participant safety. Adverse events will be promptly reported to the TSC and managed in accordance with ethical guidelines, with provisions for post-trial care. Regular data quality checks will be conducted to maintain integrity throughout the study.

The study involves collaboration between academic institutions, research organisations, and local community partners in South Africa. Collaborators will contribute expertise in research methodology, digital technology, child protection, and community engagement to facilitate the successful implementation of the study.

Research activities will be tailored to the cultural and linguistic context of South Africa, with materials translated into isiZulu to ensure accessibility for participants from diverse linguistic backgrounds. Community engagement strategies will prioritise cultural sensitivity and inclusion, fostering trust and rapport with participants and stakeholders.

The study will generate evidence to inform the scale-up and implementation of digital parenting interventions to improve playful and nurturing parent-child interaction in South Africa and beyond. Findings will be disseminated to policymakers, healthcare providers, and community organisations to support the integration of evidence-based interventions into existing service delivery systems.

A comprehensive research uptake strategy will be employed to ensure the effective dissemination and utilisation of study findings. Engagement with stakeholders, including policymakers, practitioners, and advocacy groups, will facilitate the translation of research evidence into policy and practice. Dissemination activities will include scientific publications, policy briefs, webinars, social media platforms, and community forums.

This study holds significant implications for efforts to improve playful parenting and learning through play in South Africa and globally. The findings will inform policy and practice, ultimately leading to improved outcomes for children and families in South Africa and beyond.