Grow Online: feasibility and proof of concept study
| Published date | 03 December 2019 |
| Pages | 25-42 |
| Date | 03 December 2019 |
| DOI | https://doi.org/10.1108/JCS-10-2018-0026 |
| Author | Ryan P. Chesnut,Melina Czymoniewicz-Klippel,Jennifer M. DiNallo,Daniel F. Perkins |
| Subject Matter | Health & social care,Vulnerable groups,Children's services,Sociology,Sociology of the family,Children/youth,Parents,Education,Early childhood education,Home culture,Social/physical development |
Grow Online: feasibility and proof of
concept study
Ryan P. Chesnut, Melina Czymoniewicz-Klippel, Jennifer M. DiNallo and
Daniel F. Perkins
Abstract
Purpose –Digitally delivered, parent-focused interventions (DD-PFIs) are viewed as an important
method for supporting child well-being. Few DD-PFIs include health-promotion and general-parenting
content, and only some are intendedfor a universal audience. The purpose of this paper is to focus on a
preliminaryevaluation of Grow Online, which wasdesigned to address this gap.
Design/methodology/approach –A mixed-methods design, including pretests and posttests and
semi-structured interviews, was employed to evaluate program feasibility and demonstrate proof of
concept.
Findings –Feasibility findings were favorable, which indicates participants were satisfied with the
program, likedthe main program features, found the content helpful and had a positive experienceusing
the website. Initial recruitment was strong, and engagement with the sessions was high; however,
retention was poor with a 73.5 percent attrition rate. Significant pre- to post-changes were found on
measures of over-reactive discipline, parenting efficacy, emotion coaching, coping socialization, child
physicalactivity support, rewarding eatingand child externalizing and internalizingbehaviors.
Research limitations/implications –Study design and high attrition limit the ability to infer causality
and generalizebeyond the sample.
Practical implications –Providing support to parents througha universal health-promoting DD-PFI is
viable,though issues involving retention needto be given full consideration.
Originality/value –Parents use of technology to access child careinformation is increasing, but most
information online is not evidence-informed. Grow Online fills an important gap in the research and
practiceof DD-PFIs, and this study’s findingssuggest a more rigorous evaluationis merited.
Keywords Health promotion, Feasibility, Child well-being, Digital delivery methods,
Parent-focused interventions, Proof of concept
Paper type Research paper
Introduction
Several factors (e.g. peers, media and school environment) influence child health and well-
being, but parents continue to be the primary agents of change for their child’s behaviors
and lifestyle (Bornstein, 2015;National Academies of Sciences, Engineering and Medicine,
2016). Parents can be empowered in this role through parent-focused interventions (PFIs),
which center on enhancing parents’ competencies and strengthening the parent-child
relationship (Prinz, 2016).
An extensive evidence base demonstrates the effectiveness of PFIs for improving parent
and child outcomes (Finders et al.,2016;Shah et al.,2016). Thus, the National Academies
of Sciences, Engineering andMedicine’s (2016) Committee on supporting parents of young
children strongly recommended that the US Department of Health and Human Services
continues to advocate for the utilization of evidence-based PFIs and supports efforts to
expand them for wide-spread delivery. This second recommendation noted reach as a
major limitation of PFIs (MacDonnelland Prinz, 2017;Prinz and Sanders, 2007).
Ryan P. Chesnut is based
at the Clearinghouse for
Military Family Readiness,
Pennsylvania State
University, University Park,
Pennsylvania, USA.
Melina Czymoniewicz-Klippel
and Jennifer M. DiNallo are
both based at the
Biobehavioral Health
Department, Pennsylvania
State University, University
Park, Pennsylvania, USA.
Daniel F. Perkins is based
at the Clearinghouse for
Military Family Readiness
and the Department of
Agricultural Economics,
Sociology and Education,
Pennsylvania State
University, University Park,
Pennsylvania, USA.
Received 24 October 2018
Revised 17 September 2019
24 October 2019
Accepted 6 November 2019
DOI 10.1108/JCS-10-2018-0026 VOL. 15 NO. 1 2020,pp. 25-42, ©Emerald Publishing Limited, ISSN 1746-6660 jJOURNAL OF CHILDREN’S SERVICES jPAGE 25
Digitally delivered PFIs and their current limitations
Within the PFI public-health framework, there has been growing interest in using digital
delivery methods (e.g. online platforms and mobile devices; Baker et al., 2017;Breitenstein
et al.,2017
). These digital delivery methods are thought to be especially useful for
optimizing reach and overcoming several key program participation barriers (e.g.
transportation, schedules and child care; MacDonnell and Prinz, 2017). Furthermore,
mobile devices and access to the internet are fairly commonplace in modern society.
Recent estimates suggest 77 percent of US adults own a smartphone, and 89 percent use
the Internet (Pew Research Center, 2018a, b).
Multiple reviews (Breitenstein et al.,2014;Hall and Bierman, 2015;Nieuwboer et al., 2013)
concluded that digitally delivered PFIs (DD-PFIs) are feasible and yield favorable program
satisfaction and usability results. Furthermore, several reviews have reported DD-PFIs to
have significant impacts on parent and child outcomes (e.g. parenting practices and youth
behavioral problems; Breitensteinet al.,2014;Baumel et al.,2017;Hall and Bierman, 2015;
MacDonnell and Prinz, 2017;McGoron and Ondersma, 2015;Nieuwboer et al.,2013).
The current state of the evidence suggests there is utility to delivering PFIs digitally, yet
limited research has been conductedon universal programs (Owen et al.,2017). Given that
universal prevention focuses on providing support to the general population regardless of
risk level (IOM, 2009), the dearth of research studies on this type of programming creates a
gap, especially since the use of digital delivery methods has been described as one
essential strategy for implementinga public-health approach to PFIs (Baker et al.,2017).
Another limitation of the current DD-PFI literature base is that a lack of programs exist that
include health-promotion alongside general-parenting content. Given the important role
parents play in fostering all aspects of their child’s health(National Academies of Sciences,
Engineering and Medicine, 2016), a logical next step for DD-PFIs would be to begin
including health-promotion content. This is particularly relevant considering the prevalence
of childhood obesity in the USA (Ogden et al.,2014) and research findings that suggest US
children are not meeting national recommendations for physical activity (Fakhouri et al.,
2013), fruit and vegetable intake (National Cancer Institute, 2015), sugar-sweetened
beverage consumption (Rosinger et al.,2017) and screen time usage (US National Library
of Medicine, 2017).
The Grow Online parenting program, examined in this study, was developed to address
the identified gaps in the extant literature on DD-PFIs. Grow Online is a universal health-
promoting PFI, developed for US military and civilian parents with elementary school-
age children, that teaches parents about positive parenting, stress management and
health promotion in an effort to promote child well-being. The feasibility of Grow Online
is investigated by examining program recruitment, engagement, acceptability,
appropriateness and website usability. Proof of concept is explored by examining pre-
to post-program change in participants on parenting, stress management and health-
promotion measures. Because Grow Online is a newly developed program, this
exploratory study is required to determine if this program warrants further and more
rigorous evaluation (Czajkowski et al., 2015).
Method
Study design
Data were drawn from a small mixed-methods study (n¼59) that employed a sequential
explanatory design. Specifically, a two-phase design was used where quantitative data
were collected first using a single-group pretest and posttest design. This was followed by
the collection of qualitative interview data that further explained and helped us interpret the
findings from the survey answers (Creswell and Plano Clark, 2017). Conductedin 2017, the
PAGE 26 jJOURNAL OF CHILDREN’S SERVICES jVOL. 15 NO. 1 2020
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