e-Parenting Program

About the program

The e-Parenting program is a multicomponent computer-based program combined with home visiting. It adopts elements of 3 evidence-based interventions to prevent child maltreatment: motivational interviewing, cognitive retraining and SafeCare.

Home visitors seek to promote positive outcomes by enhancing family functioning, promoting parent–child relationships, and supporting healthy child growth and development. The program is divided into 8 modules, designed to be implemented soon after birth until a child is 6 months old. The modules focus on key maltreatment risk factors using evidence-based intervention approaches.

The e-Parenting program features an animated talking narrator, full audio support using headphones, a high degree of synchronous interactivity, and videos.

Who does it work for?

The e-Parenting program is designed for families who are at risk for child maltreatment, including those with substance abuse problems, prior maltreatment reports, or intimate partner violence.

The program has only been evaluated in the USA (Ondersma et al. 2017).

A randomised control trial was conducted with 382 people (142 people were in the ePP intervention group, 141 people were in the services as usual intervention group, and 99 people were in the control group). On average, mothers were 23 years old. Around 50% of mothers were unemployed and 93% used government assistance. 36% of the intervention group were African American.

The program has not been tested in Australia or with Aboriginal Australians.

What outcomes does it contribute to?

Positive outcomes:

• Parent’s mental health: mothers’ who received the program had improved levels of depression.
• Parent’s substance abuse: mothers’ who received the program report reduced rates of substance use (such as alcohol, tobacco, or illicit drugs).

No effect:

• Harsh parenting: the program had no significant effect on rates of harsh parenting, such as shouting at, pinching, or hitting a child with an object.

Negative outcomes:

• No negative effects were found.

How effective is it?

Overall, the e-Parenting program has a mixed effect on client outcomes.

How strong is the evidence?

Mixed research evidence (with no adverse effects):

• At least one high-quality randomised controlled trial (RCT)/quasi-experimental design (QED) study reports statistically significant positive effects for at least one outcome, AND
• An equal number or more RCT/QED studies of similar size and quality show no observed effects than show statistically significant positive effects, AND
• No RCT/QED studies show statistically significant adverse effects.

How is it implemented?

The e-Parenting program is implemented as soon as possible after childbirth until either all sessions are completed or until an infant is 6 months old.

The program is provided in 8 sessions:

1. motivational interviewing on engagement in home visiting and goals
2. motivational interviewing on key maltreatment risk factors (substance use, partner violence, depression)
3. cognitive retraining on causes of infant crying and fussiness (facilitating nonpejorative attributions)
4. cognitive retraining on ways to soothe infant crying and fussiness (building efficacy) also shaking prevention
5. SafeCare on infant play/cognitive stimulation
6. SafeCare on home safety and accident prevention
7. SafeCare on appropriate medical decision-making
8. SafeCare on Booster (choice of content from above)/wrap-up

The software incorporates elements of three evidence-based interventions:

The motivational interviewing sessions are nonjudgmental, provide feedback, and help participants to identify their own reasons for participating in home visiting or making change in a key risk factor.

Cognitive retraining sessions provide video from actors portraying a pediatrician, grandmother, and young mothers, all teaching/modeling benign attributions for difficult infant behaviours as well as instruction in key soothing techniques (emphasising parental efficacy and problem-solving ability).

SafeCare sessions also involve video-based instruction and modeling.

Home visitors are welcome to discuss participants’ reactions to the software as part of their home visit, or to structure that day’s visit around the software’s content but are also free to focus on any other content. Home visitors are provided with infant choke tester devices, thermometers, and an infant health manual that are distributed to parents during the appropriate session (6 and 7, respectively).

How much does it cost?

Not reported

What else should I consider?

Each home visitor requires a tablet PC and mobile Wi-Fi device for wireless Internet access.

Where does the evidence come from?

One RCT conducted in the USA, with 382 participants (Ondersma et al. 2017).

Further resources

Ondersma et al. (2017), ‘Technology to augment early home visitation for child maltreatment prevention: A pragmatic randomized trial’, Child Maltreatment, vol. 22, no. 4, pp. 334-343.