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Investigating caregiver mental health and user engagement during a digital parenting intervention (parentapp) in Tanzania with caregivers of adolescents
Mental health conditions pose a significant global health challenge, disproportionately affecting low- and middle-income countries (LMICs) where access to care is limited. Caregivers of adolescents face unique pressures, balancing their own psychological well-being with the demands of parenting duri...
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| Format: | Thesis |
| Language: | English English |
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Department of Psychiatry and Mental Health
2026
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| Summary: | Mental health conditions pose a significant global health challenge, disproportionately affecting low- and middle-income countries (LMICs) where access to care is limited. Caregivers of adolescents face unique pressures, balancing their own psychological well-being with the demands of parenting during a crucial developmental phase. ParentApp, a culturally adapted, offline digital parenting intervention designed to promote positive parenting and support caregiver mental health, offers a preventive approach to reach underserved populations. This study aimed to: (1) evaluate changes in caregiver mental health symptoms following ParentApp use; (2) identify psychosocial and user engagement factors associated with caregiver mental health at follow-up; and (3) explore whether baseline caregiver mental health, demographics, and psychosocial variables predict user engagement with the intervention. Methods: Secondary data were analysed from a cluster randomised controlled trial involving 1200 Tanzanian caregivers of adolescents. Participants completed baseline and follow-up assessments measuring depression, anxiety, social support, and parenting stress. Automated app engagement metrics were also collected. Descriptive statistics summarised sample characteristics. Changes in caregiver mental health between baseline and follow-up were assessed using Wilcoxon Signed Rank Tests. Multiple linear regression identified psychosocial and engagement factors associated with mental health outcomes at follow-up. A logistic regression explored baseline predictors of app engagement, considering social support, parenting stress, and sociodemographic factors. Results: Caregivers showed significant improvements in mental health symptoms post-intervention (Z = -12.39, p < 0.001). Regression analyses indicated that better self-reported health predicted greater mental health improvement, while higher parental stress was linked to poorer outcomes. Social support and engagement metrics were not independently associated with changes in mental health symptoms. No baseline factors significantly predicted user engagement, suggesting that initial characteristics did not differentiate those who completed the intervention from those who did not. Discussion: Findings suggest that digital parenting interventions like ParentApp, with offline functionality and local cultural adaptation, may effectively support caregiver mental health in LMIC settings. Addressing infrastructural barriers and tailoring content to local needs remain crucial to maximise reach and intervention impact. However, limitations in the measurement of engagement highlight the need for improved metrics in future research. Conclusion: This study demonstrates the feasibility and potential benefits of the ParentApp intervention in improving caregiver mental health in Tanzania. Leveraging technology adapted to local contexts offers a scalable approach to enhancing family well-being in LMICs. Future research should focus on larger trials, integration with health systems, and strategies to improve digital access, cultural relevance, and engagement measurement to optimise outcomes. |
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