Augmenting Parenting Programs With the Pause Mobile App: Mixed Methods Evaluation

Parenting programs are the recommended treatment for common mental health problems of childhood such as conduct disorder. In the United Kingdom, local authorities have responsibility for providing or commissioning these programs through face-to-face and video call weekly groups and e-learning style asynchronous offerings. However, there has been a shortage of research into the potential of digital resources to augment and enhance parenting groups.

This pilot study aimed to explore whether providing digital microinterventions in a mobile app (Pause) to augment parenting programs is a feasible strategy. Pause fits into parenting programs and prompts and supports parents to use each week's new parenting skill at home. Specifically, we want to understand (1) whether parents use Pause, (2) what type of features or tools in Pause are most frequently used for support, and (3) what are the perceived strengths and weaknesses of Pause.

Pause was provided to parents attending 3 of the most common parenting programs delivered across 3 local authorities in the United Kingdom. During weekly sessions, parents were supported to add "tools" in the app, which mapped onto the training in their session, for example, distracting their child, setting age-appropriate consequences, and using praise. Preprogram surveys were obtained at the first session. After programs were completed, postprogram surveys were administered to measure app use, gather which tools parents used, and explore the strengths and weaknesses of the app. Participants and practitioners were invited for interviews, where the strengths and weaknesses of augmenting parenting programs with Pause were discussed in more detail.

In total, 53 parents were recruited from groups. A total of 25 of 53 (47%) parents completed postsurveys distributed at their final parenting group session, in keeping with typical rates of attrition in parenting programs. In addition, 7 parents and 3 practitioners agreed to interviews after the program. Most of the parents (23/25, 92%) had used Pause. Other than the journal, used by 17 parents, the most popular tools were the relax tool and praise tool, each used by 10 parents. Survey data revealed specific strengths and weaknesses of the tools in Pause, particularly highlighting that parents wanted Pause to provide more ideas for distraction or relaxation activities. Interviews revealed the challenges parents attending programs face, the range of family members using Pause, and the diverse settings where it was used. Interviews also revealed specific opportunities for improving the user interface and for addressing challenges in the journaling function.

This pilot study found good acceptability and engagement with Pause. Interviews revealed promising evidence, suggesting that Pause may improve family life and aid child behavior change. Future research should evaluate whether adding Pause to parenting programs increases their positive effects on children's behavior and mental health.