The primary aim of this research is to evaluate if ParentText for Crisis helps improve the following outcomes among Palestinian caregivers living in Jordan: a.) Improving caregiver mental health; b.) Improving positive parenting practices; c.) Reducing violence against children
Investigators are conducting an individually randomised controlled trial (cRCT) with 250 Palestinian participants recruited from Jerash Camp. This research is an evaluation of Palestinian ParentText for Crisis in Jordan, a rule-based chatbot to provide tips to strengthen parental mental health, improve parenting practices, and help parents support children in crisis settings. This randomised controlled trial is conducted through a collaboration with the University of Oxford, Parenting for Lifelong Health (PLH), and Sanadak. ParentText for Crisis content is adapted from PLH and "Hope Groups", which is a mental health and parenting programme originally developed from PLH for war and crisis settings. Hope Groups, delivered either in-person, have demonstrated effectiveness in improving caregiver mental health and parenting practices in crisis settings among Palestinians in Jerash Camp, Jordan. This study aims to evaluate the effectiveness of delivering this mental health and parenting content via 9 chatbot-delivered lessons over WhatsApp to Palestinian families within the same camp (Jerash Camp, Jordan). The RCT includes an intervention arm consisting of individuals who are randomised to join CrisisText immediately (n=125), and a waitlist control arm consisting of individuals who are randomised to join CrisisText (n=125) in a second cohort. This is an individually randomised study, with each individual participant as the unit of randomisation. Randomisation will be deployed using the treatment\_assign function in the RCT package in R. The primary aim is to test the effectiveness of ParentText for Crisis 30-days after enrolment, using an individually randomised controlled trial design. Investigators hypothesise that CrisisText will lead to statistically significant improvements in caregiver mental health and positive parenting practices, and reductions in violence against children. * Timeline will be as follows: * Individuals who are randomised to the intervention arm will be invited to join an in-person onboarding session. At this session, participants will be given a trigger word to message to the chatbot's number on WhatsApp. Once participants send this message, CrisisText will guide them through informed consent, followed by a short (8 question) baseline survey. After this, the chatbot will begin delivering the first intervention session. Participants will be encouraged to complete this first session at the in-person event, then complete one addition session every day for the next 8 days. * After the intervention arm concludes the CrisisText intervention, survey questions will appear again. (This data is for exploratory pre-post comparisons.) * At +30 days after onboarding, the chatbot will message participants to complete a follow-up survey including the same survey questions. (This +30 days follow-up is considered trial endline.) * During the week of the +30-day follow-up for the intervention arm, the wait-list control arm will be gathered for an in-person meeting to begin the intervention. At this in-person meeting, participants will complete informed consent and a survey. This data from the control arm will be compared with the intervention arm at their +30 day follow up for the primary trial analysis. * Therefore, this trial's primary analysis will involve a single timepoint comparison: Estimating differences between the intervention arm at 30-day follow-up and the untreated control arm at this same calendar timepoint. To assess baseline balance in this randomised trial, investigators will compare non-time-varying participant demographic variables (e.g., age, sex, number of children) between arms. If there is imbalance, investigators will control for demographic variables in the trial analysis.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
198
A rule-based chatbot to provide tips to strengthen parental mental health, improve parenting practices, and help parents support children in crisis settings
Jerash Camp
Jerash, Jordan
Caregiver Depression
Caregiver depression is measured via Patient Health Questionnaire - 2 (PHQ-2). PHQ-2 includes two questions on depression, with likert scale answer options ranging 0-3. Higher scores indicate higher levels of depression.
Time frame: Intervention arm: Outcome is collected at trial baseline and +30 days post-baseline. Control arm: Outcome is collected at +30 days post-baseline.
Playful Parenting
Parenting Practices are measured via a positive parenting item adapted from Alabama Parenting Questionnaire, measuring frequency of playing with children in the past week. Survey responses are reported in days of occurrence within the past week (0-7), with higher scores indicating higher level of playful parenting.
Time frame: Intervention arm: Outcome is collected at trial baseline and +30 days post-baseline. Control arm: Outcome is collected at +30 days post-baseline.
Caregiver Hopefulness
Caregiver Hopefulness is measured through an item building on positive psychology theory, asking, "How many days in the past week did you feel hopeful about the future?" Answer options range from 0-7 to reflect days of occurrence in the past week. Higher scores indicate high levels of hopefulness.
Time frame: Intervention arm: Outcome is collected at trial baseline and +30 days post-baseline. Control arm: Outcome is collected at +30 days post-baseline.
Parenting Practices
Parenting Practices are measured through a parental involvement question adapted from Alabama Parenting Questionnaire and a Parental Supervision question adapted from Alabama Parenting Questionnaire. Answer options for both questions are reported in days of occurrence in the past week (0-7), with higher scores indicating higher levels of positive parenting practices.
Time frame: Intervention arm: Outcome is collected at trial baseline and +30 days post-baseline. Control arm: Outcome is collected at +30 days post-baseline.
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Violence Against Children
Violence Against Children is measured via 2 questions on physical and emotional violence actions from the ISPCAN Child Abuse Screening Tool for Trials (ICAST-Trial). Questions ask about frequency of occurrence in days in the past week, with answer options range from 0-7. Higher scores indicate higher frequency of violence against children.
Time frame: Intervention arm: Outcome is collected at trial baseline and +30 days post-baseline. Control arm: Outcome is collected at +30 days post-baseline.