A hybrid digital parenting programme to prevent abuse of adolescents in Tanzania: study protocol for a pragmatic cluster-randomised controlled trial

Lauren Baerecke, Abigail Ornellas, Joyce Wamoyi, Mwita Wambura, Jonathan Klapwijk, Angelique N. Chetty, Ashlin Simpson, Roselinde Janowski, Kristen de Graaf, David Stern, Lily Clements, Esmee te Winkel, Laetitia Christine, Gervas Mbosoli, Kija Nyalali, Onduru Gervas Onduru, Anna Booij, Sussie N. Mjwara, Sibongile Tsoanyane, Gerry MshanaMbutolwe Esther Mwakitalu, G. J. Melendez-Torres, Francisco Calderon, Isang Awah, Ohad Green, Inge Vallance, Oluwaseyi Somefun, Frances Gardner, Lorraine Sherr, Mackenzie Martin, Jamie M. Lachman, Lucie D. Cluver

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background: Evidence-based parenting programmes have strong evidence in preventing and mitigating violence, but in-person programmes are challenging to deliver at scale. ParentApp is an open-source, offline-first app-based adaptation of the Parenting for Lifelong Health for Parents and Teens programme to promote playful and positive parenting, reduce risks for sexual violence victimisation, and prevent violence against adolescents. This study aims to evaluate the effectiveness and cost-effectiveness of ParentApp compared to an attention-control group. Methods: This study is a two-arm pragmatic cluster-randomised controlled trial to test whether ParentApp reduces adolescent physical abuse, emotional abuse, and sexual violence risks and victimisation at 1 month and 12 months post-intervention. Caregivers of adolescents aged 10–17 years and their adolescent children (N = 2400 caregiver-adolescent dyads) will be recruited in urban and peri-urban communities in the Mwanza region of Tanzania. A total of 80 study clusters will be stratified and randomised (1:1) to the intervention group, who will receive ParentApp with support through a WhatsApp group, or to an attention-control group, who will receive a water, sanitation, and hygiene app. Quantitative data will be collected through outcomes questionnaires with caregivers and adolescents, administered at baseline, 4 months post-baseline, and 16 months post-baseline, as well as through routine implementation data and ParentApp engagement data. Qualitative data will be collected through individual interviews and focus groups with caregivers, adolescents, and implementing partner staff. Discussion: App-based interventions have the potential to expand access to evidence-based parenting support, but currently lack rigorous evidence in low- and middle-income countries. This is the first known randomised control trial of a hybrid digital parenting programme to prevent the abuse of adolescents in low- and middle-income settings. Trial registration: The trial was registered on the Open Science Framework on 14 March 2023, registration: OSF.IO/T9FXZ.

Original languageEnglish
Article number119
JournalTrials
Volume25
Issue number1
DOIs
StatePublished - 13 Feb 2024
Externally publishedYes

Bibliographical note

Publisher Copyright:
© The Author(s) 2024.

Funding

We are grateful to IDEMS International and INNODEMS Kenya, who provided IT and technical leadership and conceptual partnership on the development of the intervention and control apps, including design and coding, building online data collection and monitoring tools and user testing. We thank facilitators from Investing in Children and Strengthening their Societies for leading the delivery of the intervention in Tanzania. We also thank all the staff at Clowns Without Borders South Africa, in addition to those who are authors, who played a key role in conducting local adaptation and contextualisation, curriculum development for facilitators and training of facilitators. We would like to thank the many caregivers and children, across Africa, who have contributed their time and expertise to the development of ParentApp. We thank No Means No Worldwide and Khululeka Grief Support for generous sharing of their evidence-based manuals, and Tonya Thurman (USAID South Africa) for sharing the Let’s Talk programme. We thank Vodacom Tanzania for support with low-cost smartphones and data. Content and delivery for the Tanzanian version of ParentApp were jointly developed and adapted through the steps outlined above by the Universities of Oxford and Cape Town, IDEMS International, Tanzania’s National Institute for Medical Research (NIMR), PLH, and Clowns Without Borders South Africa (CWBSA). Implementation was supported by Tanzania-based NGO Investing in Children and Strengthening their Societies (ICS).

FundersFunder number
INNODEMS Kenya
Tonya Thurman
UK Research and Innovation Engineering and Physical Sciences Research CouncilEP/X039307/1
United States Agency for International Development
Oak FoundationOFIL-21–212
UK Research and InnovationES/S008101/1
World Childhood Foundation
LEGO Foundation
European Research Council

    Keywords

    • Adolescents
    • Child abuse
    • Digital
    • Low- and middle-income countries
    • Parenting
    • Violence against children

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