Engagement, Acceptability, and Impact of a Parenting App to Support Infant Sleep and Parent Well-Being: Quasi-Experimental Study

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Abstract
Background: Many parents today use digital or mobile health (mHealth) resources for parenting information and support. Thus, interventions or programs to support parenting delivered in this way are a rapidly growing area of innovation and research. Evidence indicates that face-to-face interventions that provide education and support for parents about infant sleep can have positive impacts on both infant sleep and maternal mood. However, there is limited research on the delivery of such interventions via digital or mHealth platforms. SleepWellBaby is an infant sleep mobile app for parents with infants and young children. The app provides parents with a 7-day program that may be repeated according to individual user demand, with information and interactive features aimed at supporting parents to understand infant sleep, and providing advice about strategies to support sleep in a responsive way. Objective: The study objectives were (1) to determine engagement with, and acceptability of, an mHealth-delivered parenting program to support infant sleep and (2) to investigate the impact of the program on parental fatigue, emotional health, and parenting competence, confidence, and self-efficacy. Methods: A multimethod quasi-experimental pre-post study design was used. Participants were parents of infants aged under 6 months, recruited through online advertising. Participants completed baseline questionnaires, then 2 further follow-up questionnaires at 7 days and 30 days post baseline. These questionnaires captured participant demographics (baseline) and perceptions of the program (follow-up), in addition to measuring parental fatigue (Fatigue Severity Scale), parent sense of competence, confidence, and self-efficacy (Me as a Parent Scale), and symptoms of anxiety (Generalized Anxiety Disorder 7-item scale) and depression (Edinburgh Postnatal Depression Scale) at all time points. Open-ended text responses were also collected at the 2 follow-up surveys. Questionnaire data were linked with participants’ engagement with the program (Engagement Index), measured using app analytics. Results: Participants’ (baseline: n=700; 7-d follow-up: n=339; and 30-d follow-up: n=220) engagement with the program varied; however, the majority reported cessation of app use by 1 month. Most participants were broadly satisfied with the program, finding the app easy to use and understand, and reported they could trust the information on the app. Those participants who had higher engagement or found the program most helpful for their sleep and their infant’s sleep showed the greatest improvement in their fatigue. Qualitative feedback from participants noted that while many found the app a lifeline with helpful information and features, others noted unintended negative impacts, such as spending too much time on their phone. Conclusions: Delivery of an infant sleep program via mHealth is effective for and acceptable to many parents. While not preferred by all parents, mHealth is an accessible, low-cost, and high-reach mode of providing information and management strategies for parents experiencing early parenting difficulties.

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