A factorial randomized controlled trial to optimize user engagement with a chatbot-led parenting intervention: protocol for the ParentText optimisation trial

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dc.contributor.authorAmbrosio, Maria Da Gracaen_US
dc.contributor.authorLachman, Jamie M.en_US
dc.contributor.authorZinzer, Paulaen_US
dc.contributor.authorGwebu, Hlengiween_US
dc.contributor.authorVyas, Seemaen_US
dc.contributor.authorVallance, Ingeen_US
dc.contributor.authorCalderon, Francisco
dc.contributor.authorGardner, Frances
dc.contributor.authorMarkle, Laurie
dc.contributor.authorStern, David
dc.contributor.authorFacciola, Chiara
dc.contributor.authorSchley, Anne
dc.contributor.authorDanisa, Nompumelelo
dc.contributor.authorBrukwe, Kanyisile
dc.contributor.authorMelendez-Torres, G. J.en_US
dc.date.accessioned2026-08-30T17:32:19Z
dc.date.available2026-08-30T17:32:19Z
dc.date.issued2024en_US
dc.description.abstractBackground: Violence against children (VAC) is a serious public health concern with long-lasting adverse effects. Evidence-based parenting programs are one effective means to prevent VAC; however, these interventions are not scalable in their typical in-person group format, especially in low- and middle-income countries where the need is greatest. While digital delivery, including via chatbots, offers a scalable and cost effective means to scale up parenting programs within these settings, it is crucial to understand the key pillars of user engagement to ensure their effective implementation. Objective: This study aims to investigate the most effective and cost-effective combination of external components to optimize user engagement with ParentText, an open-source chatbot-led parenting intervention to prevent VAC in Mpumalanga, South Africa. Methods: This study will use a mixed methods design incorporating a 2 × 2 factorial cluster-randomized controlled trial and qualitative interviews. Parents of adolescent girls (32 clusters, 120 participants [60 parents and 60 girls aged 10 to 17 years] per cluster; N=3840 total participants) will be recruited from the Ehlanzeni and Nkangala districts of Mpumalanga. Clusters will be randomly assigned to receive 1 of the 4 engagement packages that include ParentText alone or combined with in-person sessions and a facilitated WhatsApp support group. Quantitative data collected will include pretest-posttest parent- and adolescent-reported surveys, facilitator-reported implementation data, and digitally tracked engagement data. Qualitative data will be collected from parents and facilitators through in-person or over-the-phone individual semistructured interviews and used to expand the interpretation and understanding of the quantitative findings. Results: Recruitment and data collection started in August 2023 and were finalized in November 2023. The total number of participants enrolled in the study is 1009, with 744 caregivers having completed onboarding to the chatbot-led intervention. Female participants represent 92.96% (938/1009) of the sample population, whereas male participants represent 7.03% (71/1009). The average participant age is 43 (SD 9) years. Conclusions: The ParentText Optimisation Trial is the first study to rigorously test engagement with a chatbot-led parenting intervention in a low- or middle-income country. The results of this study will inform the final selection of external delivery components to support engagement with ParentText in preparation for further evaluation in a randomized controlled trial in 2024.
dc.identifier.citationAmbrosio MDG, Lachman JM, Zinzer P, Gwebu H, Vyas S, Vallance I, Calderon F, Gardner F, Markle L, Stern D, Facciola C, Schley A, Danisa N, Brukwe K, Melendez-Torres GJ A Factorial Randomized Controlled Trial to Optimize User Engagement With a Chatbot-Led Parenting Intervention: Protocol for the ParentText Optimisation Trial JMIR Res Protoc 2024;13:e52145
dc.identifier.issn1929-0748
dc.identifier.urihttp://hdl.handle.net/20.500.11837/5067
dc.languageenen_US
dc.publisherJMIR Publications
dc.relation.ispartofseriesJMIR Research Protocols
dc.subjectImplementation science
dc.subjectParenting
dc.subjectChatbots
dc.titleA factorial randomized controlled trial to optimize user engagement with a chatbot-led parenting intervention: protocol for the ParentText optimisation trialen_US
dc.typeArticleen_US

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