%0 Journal Article
%@ 2561-6722
%I JMIR Publications
%V 7
%N 
%P e53864
%T Moderators of the Effects of a Digital Parenting Intervention on Child Conduct and Emotional Problems Implemented During the COVID-19 Pandemic: Results From a Secondary Analysis of Data From the Supporting Parents and Kids Through Lockdown Experiences (SPARKLE) Randomized Controlled Trial
%A Pokorna,Nikola
%A Palmer,Melanie
%A Pearson,Oliver
%A Beckley-Hoelscher,Nicholas
%A Shearer,James
%A Kostyrka-Allchorne,Katarzyna
%A Robertson,Olly
%A Koch,Marta
%A Slovak,Petr
%A Day,Crispin
%A Byford,Sarah
%A Waite,Polly
%A Creswell,Cathy
%A Sonuga-Barke,Edmund J S
%A Goldsmith,Kimberley
%+ Institute of Psychiatry, Psychology & Neuroscience, King’s College London, 16 De Crespigny Park, London, SE5 8AB, United Kingdom, 44 020 7848 0002, edmund.sonuga-barke@kcl.ac.uk
%K parenting
%K intervention
%K smartphone app
%K randomized controlled trial
%K COVID-19 pandemic
%K moderators
%K conduct problems
%K emotional problems
%D 2024
%7 8.10.2024
%9 Original Paper
%J JMIR Pediatr Parent
%G English
%X Background: A smartphone app, Parent Positive, was developed to help parents manage their children’s conduct and emotional problems during the COVID-19 pandemic. A randomized controlled trial, Supporting Parents and Kids Through Lockdown Experiences (SPARKLE), found Parent Positive to be effective in reducing children’s emotional problems. However, app effectiveness may be influenced by a range of child, family, socioeconomic, and pandemic-related factors. Objective: This study examined whether baseline factors related to the child, family, and socioeconomic status, as well as pandemic-related disruption circumstances, moderated Parent Positive’s effects on child conduct and emotional problems at 1- and 2-month follow-up. Methods: This study was a secondary exploratory analysis of SPARKLE data. The data set included 646 children (4-10 years of age) with parents randomized to either Parent Positive (n=320) or follow-up as usual (n=326). Candidate baseline moderators included child age, gender, attention-deficit/hyperactivity disorder symptoms, parental psychological distress, family conflict, household income, employment status, household overcrowding, and pandemic-related disruption risk (ie, homeschooling, lockdown status, and isolation status). Child conduct and emotional problem outcomes measured at 1- (T2) and 2-months (T3) post randomization were analyzed using linear mixed-effects analysis of covariance models adjusting for baseline (T1) measure of outcome and including intervention and intervention by time point interaction terms allowing for different effects at the 2 time points. Moderation of intervention effects by baseline factors was assessed by replacing the intervention by time interaction terms with intervention by time point by baseline moderator interaction terms. Results: Child gender was a significant moderator of the Parent Positive versus follow-up as usual effect on emotional problems (B=0.72, 95% CI 0.12-1.33; P=.02). Specifically, the effect of Parent Positive was close to significant (T2: B=–0.41, 95% CI –0.82 to 0.0004; P=.05) or significant (T3: B=–0.76, 95% CI –1.22 to –0.30; P<.001) in males only when compared with females, and males experienced a significantly larger reduction in emotional problems than females in the Parent Positive arm at the 2-month post randomization time point. None of the other investigated baseline factors moderated effects on emotional problems, and no factors moderated effects on conduct problems. Conclusions: This study highlights Parent Positive’s potential for effectively reducing emotional problems in primary school-aged male children across a wide range of families. However, due to limited variability in the demographic background of the families, cautious interpretation is required, and replications are necessary in diverse samples with longer follow-up times. Trial Registration: ClinicalTrials.gov NCT04786080; https://clinicaltrials.gov/ct2/show/NCT04786080 
%M 39378100
%R 10.2196/53864
%U https://pediatrics.jmir.org/2024/1/e53864
%U https://doi.org/10.2196/53864
%U http://www.ncbi.nlm.nih.gov/pubmed/39378100