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. 2018 Sep 15:17:41.
doi: 10.1186/s12912-018-0310-2. eCollection 2018.

Design and evaluation of the StartingTogether App for home visits in preventive child health care

Olivier Anne Blanson Henkemans  1 , Marjolein Keij  2 , Marc Grootjen  3 , Mascha Kamphuis  4 , Anna Dijkshoorn  1
Affiliations

Design and evaluation of the StartingTogether App for home visits in preventive child health care

Olivier Anne Blanson Henkemans et al. BMC Nurs. .

Abstract

Background: The StartingTogether program (in Dutch SamenStarten) is a family-centred method for early identification of social-emotional and behavioural problems in young children. Nurses in preventive child health care find it challenging to: determine family issues and need for care; provide education; refer to social services; increase parent empowerment. To mitigate these challenges, we developed and evaluated the StartingTogether App, offering nurses and parents conversational support, tailored education and information on social services.

Methods: A mixed method design, consisting of a qualitative evaluation of the StartingTogether App, with group discussions with nurses (N = 14) and a pilot test (N = 5), and a randomized controlled trial, evaluating the effectiveness of the app. Nurses (N = 33) made home visits to parents (N = 194), in teams with or without the app. Nurses were surveyed on the challenges experienced during visits. Parents (N = 166) were surveyed on their satisfaction with health care and app. Nurses were interviewed on the benefits and barriers to use the app.

Results: Parents with the StartingTogether App were more satisfied with the visits than parents without (p = .002). Parents with a high educational level were more satisfied with the visits than the parents with a low educational level. With the app, their satisfaction level was similar (p < .001). Nurses using the app felt more equipped to communicate with parents (p = .012) and experienced that parents were more knowledgeable and skilled (p = .001). Parents felt that with the app the nurse was more polite (p = .02), listened more carefully (p = .03), and had more time (p = .02). Nurses with the app gave parents more opportunity to ask questions (p = .001) and gave clearer answers (p < .001). The qualitative evaluation indicated that some nurses needed extra time to develop the habit of using the app.

Conclusions: The StartingTogether App contributes to parents' satisfaction with home visits. An interaction effect between parents' educational level and rating of home visits indicated that the app has an additional value for parents with a lower educational level. Applying mobile applications, such as the StartingTogether App, potentially has a positive effect on communication between nurses and parents about the family situation in relation to parent empowerment and the child's development.

Trial registration: The study is registered with ISRCTN under the number ISRCTN12491485, on August 23, 2018. Retrospectively registered.

Keywords: Family-centred care approach; Parent empowerment; Randomized controlled trial; Self-management; mHealth intervention.

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Conflict of interest statement

The study protocol was approved by the ethics committee of TNO (Netherlands Organisation for Applied Scientific Research) and registered with ISRCTN under the number ISRCTN12491485, on August 23, 2018. Retrospectively registered. Parents, nurses and their team leaders gave their informed written consent for participating in the study. The audit complied with the privacy law and administration of patient data.Not applicable.The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Flow chart of quantitative and qualitative evaluation
Fig. 2
Fig. 2
ST app: Conversational support
Fig. 3
Fig. 3
ST app: Tailored education (websites, flyers, videos) and information on social services
Fig. 4
Fig. 4
Flowchart of RCT
Fig. 5
Fig. 5
Evaluation of home visit by parents with high and low educational level with and without StartingTogether App
See this image and copyright information in PMC

References

    1. Reijneveld SA, Brugman E, Verhulst FC, Verloove-Vanhorick SP. Identification and management of psychosocial problems among toddlers in Dutch preventive child health care. Arch Pediat Adol Med. 2004;158(8):811–817. doi: 10.1001/archpedi.158.8.811. - DOI - PubMed
    1. Rutherford RB, Jr, Quinn MM, Mathur SR. Handbook of research in emotional and behavioral disorders. New York: The Guilford Press; 2004.
    1. Beauchaine TP, Neuhaus E, Brenner S, Gatzke-Kopp L. Ten good reasons to consider biological variables in prevention and intervention research. Dev Psychopathol. 2008;20:745–774. doi: 10.1017/S0954579408000369. - DOI - PMC - PubMed
    1. Dijkstra N, Detmar S, Schoenmakers A, Öry F. Samen Starten: ondersteunings-behoefte van ouders bij het opvoeden van jonge kinderen [StartingTogether: needs for parental support in parents with young children] Leiden: TNO Preventie en Gezondheid; 2004.
    1. Dunst CJ, Trivette CM, Hamby DW. Meta-analysis of family-centered help giving practices research. J Ment Retard Dev Disabil Res Rev. 2007;13:370–378. doi: 10.1002/mrdd.20176. - DOI - PubMed

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