Participants were recruited through several parenting programs run by local authorities across the Midlands region of the United Kingdom. Recruitment was supported by parenting program practitioners who advertised the study by emailing the study invitation to parents who had recently completed a program or by directly inviting parents who attended their final sessions. Others were recruited by word of mouth around the local authority. A participant information leaflet was shared with interested parents. We aimed to establish a sample of 10 participants in keeping with other recent pilots of parenting apps and following the 10±2 rule in usability testing [22,23]. Included parents were aged 18 years and older and had a child aged 2‐10 years. Parents were included if they had sufficient concerns about their child’s behavior to be referred to a parenting skills program. By only including parents who had previously benefited from a parenting skills program, we ensured that they had received support with the basic components of parenting skills. The intervention is intended for use by parents who have attended a parenting skills program so this inclusion criterion was essential to the external validity of the intervention. Parents were excluded if they did not have an Android or iOS smartphone, which could use the app.

We previously developed a mobile app for iOS and Android through an iterative coproduction process involving 42 parenting skills practitioners reported elsewhere [24]. This app guided parents through using praise, mindfulness, and time-out or quiet time. It guided parents through using praise with a list of scrollable images with simple instructions on them. It guided parents through mindfulness by including a visual graphic helping children use “box breathing” as well as a guide walking parents through using a sensory grounding technique [25].

Each participant was interviewed twice in order to develop a rich understanding of how the digital microintervention fitted into family life [26]. At interview 1, participants completed a consent form, were offered a participant information form, and had the opportunity to ask any questions about the research. Then, they answered questions about their family composition, parenting style, and experience of parenting skills. They also talked about their child’s behavior problems and the strategies they use to manage these. Then, they were given a tour of the app and supported to download it to their own mobile device. They were asked about their initial responses to the app, including which features they thought could be useful or unhelpful. Topic guides are reported in Multimedia Appendix 1.

When they were shown the app, little specific psychoeducation was delivered, as they had already attended a parenting program. However, the app included suggestions to only use time-out or time in under circumstances of oppositional behavior or violence in keeping with best practice. Parents were encouraged to use the mindfulness activities with and without their children as they wished. They were encouraged to review the praise guidance, which offered very simple prompts to praise children frequently.

At the end of interview 1, participants received a US $32 shopping voucher and were invited to use the app and book a second interview about 3 weeks later following similar app pilots [27,28]. At interview 2, parents were asked whether they had used the app and how they had found the experience. Parents were prompted to talk about any features they had found helpful and any problems they had encountered. The whole incentive for participating was given during interview 1 to make it easier for parents to exit the study if they wished to.

All interviews were conducted remotely by NH and CT via Microsoft Teams or WhatsApp Voice Call and recorded with consent. All interviews were audio recorded and transcribed. If participants wished to have a friend or family member present during the interviews, this was accommodated. Transcripts were not returned to participants for comments.

Analysis was conducted by NH and JLS. Thematic analysis was conducted using NVivo (version 1.5; Lumivero) and followed the principles set out by Braun and Clarke [29,30] using an inductive approach with a theoretical underpinning in user-centered design. Analysis was also informed by a narrative lens in order to develop a richer understanding of how the digital microinterventions had interplayed with the dynamic stories of the families because “narratives provide us with access to people’s identity and personality” [31]. The narrative approach also helps present the uniqueness of each family’s story. Both NH and JLS read and reread the data before generating initial codes and searching for themes. Themes were reviewed discursively and named by NH. The coding framework is given in Table 1 and findings are discussed in detail below.

Full transcripts include extensive personal content relating to children so they are not presented. Instead, anonymized brief narrative case studies illustrate the individuality of each included family. Each relates to a specific interviewee and draws together examples of their family life. Two brief case studies are presented in the Results section (see Multimedia Appendix 2 for others). The results were presented in keeping with the COREQ (Consolidated Criteria for Reporting Qualitative Research) [32].

Ethics approval was obtained from the Biomedical and Scientific Research Ethics Committee at the University of Warwick (BSREC 34/22‐23). Informed consent was obtained from all participants, and data were anonymized.

NH and CT conducted the interviews, and participants were aware that NH was a psychiatrist with experience supporting parents concerned about their children’s behavior and well-being. Participants were referred to the research from a trusted source, the parenting team already supporting them, so participants may have expected the digital microintervention to be useful. NH and CT therefore actively sought to draw out the problems with the digital microintervention, but 2 participants nevertheless made apologetic comments including “I’m not saying that this is any reflection on the app at all” and “I looked through it like last night just kind of to refresh it. I wouldn’t say I look at it every, like every day.” When participants made comments along these lines, they were reminded that the aim of the research was to identify any problems, not just strengths.

The analysts who contributed to the thematic analysis and editing of the brief case studies, PW and JLS, had limited previous contact with these particular families but were involved in developing the app so they contributed a more technology-focused perspective than NH. DG was not directly involved in data collection or analysis or software development so he provided a different set of perspectives.

To address out main research question, we conducted a thematic analysis of the interviews in relation to parent’s experience of using the app. Table 1 shows the coding framework.

The case vignettes illustrated the way parents talked about their family life and the challenges they faced as well as capturing the personality of the parents and the way the relationships within their families impacted the response to the app. The vignettes draw attention to how siblings who display less prominent behavioral problems were sometimes able to use the app to regulate their emotions. The humor and closeness within families are highlighted by the way parents and children respond to the app. Textboxes 1 and 2 give illustrative examples of the case vignettes, and Multimedia Appendix 2 gives all 10 case vignettes.

This study aimed to evaluate the subjective experience of parents using a digital microintervention to support evidence-based parenting skills. In total, 11 parents of 33 children were interviewed before and after using a mobile app hosting 3 digital microinterventions, and thematic analysis was performed. Many parents used the app in ways they found convenient rather than strictly following the instructions they were given. Several parents experienced barriers to using the app including not having the phone to hand, forgetting about the app, the situation being too urgent, or not finding they were getting good results. Parents and children responded differently to the use of the phone; some were surprised, others explained nuanced concerns, and others wholeheartedly embraced the convenience of mobile technology. Future digital microintervention developers should keep in mind that parents are likely to use the app pragmatically rather than following instructions, may struggle to use a complex app under pressure, and are likely to hold complex feelings about parenting with an app.

The main problems parents noticed related to user interface problems including occasional freezing and navigation problems. Similar problems have been described in depth by MacKinnon et al [33], who described many practical challenges that arise in the implementation of an app for parents. As in their study, the app contained bugs due to the rapid build of the app under cost pressure. However, we suggest it is more efficient to run early tests of rapidly developed apps, which may contain bugs, in order to evaluate whether the underlying theory of behavior change works well rather than build a perfect app before testing it, in keeping with the principle of continuous innovation [34].

Many parents used the app in ways that were unexpected by researchers and out of keeping with the instructions they were given. Our intervention differed from common modes of parenting skills training, such as facilitator-led groups or e-learning videos, in that our intervention could be used in different ways [8,35]. We suggest digital microinterventions aiming to empower parents with digital tools are likely also to benefit from a group facilitator.

Parents held diverse views over whether using their phones to support their child’s behavioral and emotional well-being was appropriate, both in terms of whether they supported or opposed it and how far their views were nuanced or rigid. Previous research has revealed wide heterogeneity of attitudes throughout digital parenting, but there is little previous research on attitudes to using parenting apps, partly because the rapid pace of technological change precludes the formation of social norms [36]. Given the complex interaction of difficult family circumstances and shifting social norms, it is perhaps unsurprising that attitudes to technology have been uncorrelated with parenting app uptake [37]. The case vignettes illustrated how included parents had explored many other solutions in the past but maintained hope that the next solution would improve family life, and this is valuable in itself, in that when parents are more hopeful, there is greater parental well-being, child adjustment, and family resilience [38].

This study provides novel insights into how parents use an app with in-the-moment advice for supporting children through behavioral and emotional challenges. The use of qualitative analysis captured the diversity of views and uncovered some unexpected results. The use of illustrative case summaries illustrated how the app fitted into the wider context of family life, a feature often missing from pilot studies. However, app use was all self-reported, and no objective analytics were used, and as such, there is a risk that social desirability bias could lead to upwardly biased reports. Moreover, the way parents used the app in unexpected ways would have confounded objective analytics. The sample size was appropriate to evaluate the way parents used the app and to inform future development, but it was too small to draw conclusions about the proportions of parents who used the app in different ways or to make inferences about changes in child behavior [22,23]. This study used a self-selecting sample who may be more open to parenting apps than the general population of parents seeking parenting support, potentially leading to greater reported enthusiasm for the app than would be found with a general population sample. In addition, we were unable to recruit any fathers into this study, limiting the generalizability of this study to mothers.

This study has implications for people developing apps to support parenting skills. Scholars should expect some resistance from parents who are wary of digital interventions but should also anticipate that other parents will nevertheless be open to using an app. Apps should facilitate several different levels of engagement (perhaps covering information, reflection, and in-the-moment guidance) that would allow parents with some qualms to begin to benefit from the app. This way, the largest number of parents can be supported by digital parenting interventions in a way they feel comfortable with. Alternatively, insights from behavioral science such as reminder notifications and incentives may be incorporated to prompt people to use parenting apps in keeping with suggestions, as has been attempted elsewhere in mental health care [39].

For a range of reasons, some parents occasionally found it impractical to use the phone in the heat of the moment. Some parents found a workaround in the use of home speakers. We suggest that future digital parenting skills programs incorporate home speakers. Although individual parenting skills have been built into home speaker apps in the past, families would benefit more from support integrating home speakers, smartwatches, and tablets with mobile apps [16].

Similarly, parenting apps should be designed to make it easy for parents to achieve their own personal goals, otherwise, parents will use the app in unintended ways that suit their family. Incorporating more personalization into parenting apps can support parents to use generic digital tools in ways that target the particular challenges affecting their families. Apps should provide evidence-based advice alongside useful tools.

Future studies should explore whether the finding that parents use digital microinterventions differently than guided is replicated among other groups of parents.

This study has described how a sample of mothers used an app designed to support evidence-based parenting skills following previous attendance at a parenting program. Digital parenting support is a rapidly growing area, and it is important that a wide range of possible interventions are offered to parents so they can find an approach that suits the needs of their families. Rapid pilots, such as this study, offer a comparatively cheap way of evaluating whether an app is suitable for parents and provide an opportunity to screen for areas to improve the intervention. In the future, we recommend researchers ensure parents’ preferred approaches match up with the directions they are nudged toward by digital interventions.