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Published on: November 12, 2009

Family Engagement in a Digital Intervention Targeting Risk for Anxiety in Parent-Child Dyads: Mixed Methods Study.

Isaac A Mirzadegan^1,2,3, Ericka M Lewis⁴, Sally L Cole¹

¹Department of Psychology, Florida State University, Tallahassee, FL, United States.

JMIR Pediatrics and Parenting

|April 9, 2026

Summary

Digital mental health programs show promise for children's anxiety prevention. Effective family engagement involves more than just adherence, focusing on cognitive and affective investment for better outcomes.

Keywords:

adherence anxiety cognitive behavioral therapy digital health eHealth engagement fidelity mHealth mobile health parenting intervention perfectionism preschool prevention single-session intervention

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Area of Science:

Digital health
Child psychology
Mental health interventions

Background:

Digital health programs are crucial for child mental health but require effective family engagement.
Family engagement in digital mental health is complex and not fully understood.
Barriers and facilitators for engaging at-risk families are largely unknown.

Purpose of the Study:

To examine parent and child engagement in the "Making Mistakes" digital program.
To identify barriers and facilitators to engagement in a preventive anxiety program.
To explore perceived outcomes of family involvement in digital mental health.

Main Methods:

Mixed-methods study with 87 parent-child dyads.
Quantitative analysis of adherence and sustained engagement.
Qualitative thematic analysis of interviews and activity journals.

Main Results:

Strong positive correlation between parent and child adherence (r=0.95).
Low adherence to weekly modules (average 20% completion), declining over time.
Qualitative data revealed high content investment and psychosocial benefits.

Conclusions:

Rote adherence is insufficient; cognitive and affective engagement are key for positive outcomes.
Prioritize assessing behavioral, cognitive, and affective engagement beyond adherence.
"Making Mistakes" is a promising, low-cost strategy for reducing intergenerational anxiety risk.