Maternal Parenting Electronic Diary in the Context of a Home Visit Intervention for Adolescent Mothers in an Urban Deprived Area of Sao Paulo, Brazil: Randomized Controlled Trial

Author(s)

Fatori, Daniel ^[1] ; Argeu, Adriana ^[1] ; Brentani, Helena ^[1] ; Chiesa, Anna ^[2] ; Fracolli, Lislaine ^[2] ; Matijasevich, Alicia ^[3] ; Miguel, Euripedes C. ^[1] ; Polanczyk, Guilherme ^[1]

Affiliation

^[1] Univ Sao Paulo, Med Sch, Dept Psychiat, 785 R Dr Ovidio Pires Campos, Sao Paulo - Brazil

^[2] Univ Sao Paulo, Sch Nursing, Collect Hlth Nursing Dept, Sao Paulo - Brazil

^[3] Univ Sao Paulo, Med Sch, Dept Prevent Med, Sao Paulo - Brazil

• Document type: Journal article
• Source: JMIR MHEALTH AND UHEALTH; v. 8, n. 7 JUL 28 2020.
• Web of Science Citations: 0

Abstract

Background: Pregnancy during adolescence is prevalent in low- and middle-income countries (LMICs), which is associated with various adverse outcomes that can be prevented with home visiting programs. However, testing these interventions in LMICs can be challenging due to limited resources. The use of electronic data collection via smartphones can be an alternative and ideal low-cost method to measure outcomes in an environment with adverse conditions. Objective: Our study had two objectives: to test the efficacy of a nurse home visiting intervention on maternal parenting and well-being measured by an electronic daily diary (eDiary), and to investigate the compliance rate of the eDiary measurement method. Methods: We conducted a randomized controlled trial to test the efficacy of Primeiros Lagos, a nurse home visiting program, for adolescent mothers living in an urban deprived area of Sao Paulo, Brazil. A total of 169 pregnant adolescents were assessed for eligibility criteria, 80 of whom were included and randomized to the intervention (n=40) and control group (care as usual, n=40). Primeiros Lagos is a home visiting intervention delivered by trained nurses tailored to first-time pregnant adolescents and their children, starting during the first 16 weeks of pregnancy until the child reaches 24 months of age. Participants were assessed by blind interviewers at 8-16 weeks of pregnancy (baseline), 30 weeks of pregnancy, and when the child was 3, 6, and 12 months of age. At 18 months, participants were assessed regarding maternal parenting and parental well-being using a 7-consecutive-thy eDiary. The smartphone app was programmed to notify participants every day at 9:00 PM over a period of seven days. Results: We were able to contact 57/80 (71%) participants (29 from the intervention group and 28 from the control group) when the child was 18 months of age. Forty-eight of the 57 participants (84%) completed at least one day of the eDiary protocol. The daily compliance rate ranged from 49% to 70%. Our analyses showed a significant effect of the intervention on parental well-being (B=0.32, 95% CI {[}0.06, 0.58], P=.02) and the maternal parenting behavior of the mother telling a story or singing to the child (odds ratio=2.33, 95% CI {[}1.20, 4.50], P=.01).Our analyses showed a significant effect of the intervention on parental well-being (B=0.32, P=.02) and the maternal parenting behavior of the mother telling a story or singing to the child (odds ratio=2.33, P=.01). Conclusions: The Primeiros Lagos intervention improved maternal parenting and parental well-being, demonstrating its promise for low-income adolescent mothers. The compliance rate of the eDiary assessment showed that it was generally accepted by adolescent mothers with limited resources. Future studies can implement ambulatory assessment in LMICs via smartphones to measure mother and child behaviors. (AU)

• FAPESP's process: 16/13451-9 - Developing ecological and frequent measures of cognitive and psychosocial stimulation in childhood in the context of a home visitation program for pregnant youth
• Grantee: Daniel Graça Fatori de Sá
• Support Opportunities: Scholarships in Brazil - Post-Doctoral