Digital tools to improve parenting behavior in low-income settings: A mixed-methods feasibility study

Introduction Digital parenting interventions could be potentially cost-effective means for providing early child development services in low-income settings. This 5-month mixed-methods pilot study evaluated the feasibility of using Afinidata , a comprehensive FBMessenger -based digital parenting intervention in a remote rural setting in Latin America and explored necessary adaptations to local context. Methods The study was conducted in three provinces in the Cajamarca region, Peru, from February to July 2021. 180 mothers with children aged between 2-24 months and regular access to a smartphone were enrolled. Mothers were interviewed three times in-person. Selected mothers also participated in focus groups or in-depth qualitative interviews. Results Despite the rural and remote study site, 88% of local families with children between 0-24 months had access to internet and smartphones. Two months after baseline, 84% of mothers reported using the platform at least once, and of those, 87% rated it as useful to very useful. After 5 months, 42% of mothers were still active on the platform, with little variation between urban and rural settings. Modifications to the intervention focused on assisting mothers in navigating the platform independently and included adding a laminated booklet with general information on child development, sample activities and detailed instructions on how to self-enroll in case of lost phones. Conclusions We found high access to smartphones and the intervention was well received and used in very remote areas of Peru, suggesting that digital parenting interventions could be a promising path forward for supporting low-income families in remote parts of Latin America. ### Competing Interest Statement Andreana Castellanos is CEO of Afinidata and has thus interest in the success of this platform. She was not involved with the analysis of the data and did not influence the way results were presented. All other authors declare no conflict of interest Financial disclosure: Andreana Castellanos is the CEO of Afinidata. All other authors have no financial interests to disclose. ### Clinical Trial NCT05202106 ### Funding Statement This study was funded by the Botnar Research Center for Child Health (BRCCH) through a multi-investigator grant. The sponsor had no role in the design, interpretation, or publication of this manuscript. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The ethics committees of the Universidad Peruana Cayetano Heredia (SIDISI: 202522-Ref 030-03-21) and the Ethics Commission for Northwest and Central Switzerland (EKNZ: AO_2021-00002)gave ethical approval for this work. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors