Exploring the Potential of a Behavior Theory-Informed Digital Intervention for Infant Fall Prevention: Mixed Methods Longitudinal Study

Nipuna Cooray; Catherine Ho; Amy Bestman; Susan Adams; Natasha Nassar; Lisa Keay; Julie Brown

doi:10.2196/47361

Exploring the Potential of a Behavior Theory-Informed Digital Intervention for Infant Fall Prevention: Mixed Methods Longitudinal Study

JMIR Pediatr Parent. 2024 Jan 3:7:e47361. doi: 10.2196/47361.

Authors

Nipuna Cooray¹, Catherine Ho¹, Amy Bestman¹, Susan Adams^{1

2}, Natasha Nassar³, Lisa Keay^{1

4}, Julie Brown¹

Affiliations

¹ The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales Sydney, Barangaroo, Australia.
² Department of Paediatric Surgery, Sydney Children's Hospital, Randwick, Australia.
³ Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
⁴ School of Optometry and Vision Science, Faculty of Medicine and Health, University of New South Wales Sydney, Sydney, Australia.

PMID: 38170580
PMCID: PMC10794959
DOI: 10.2196/47361

Abstract

Background: Falls are the most common hospitalized injury mechanism in children aged ≤1 years, and currently, there are no targeted prevention interventions. The prevention of falls in children of this age requires changes in the behavior of their caregivers, and theoretically informed digital behavior change interventions (DBCIs) may provide a unique mechanism for achieving effective intervention. However, user acceptance and the ability of DBCIs to effect the required changes in behavior are critical to their likelihood of success.

Objective: This study aims to evaluate a behavior theory-informed digital intervention developed following a user-centered approach for user experience, the potential for this intervention to prevent infant falls, and its impact on behavioral drivers underpinning fall risk in young children.

Methods: Parents of infants aged <1 year were recruited and asked to use the intervention for 3 months. A pre-post longitudinal design was used to examine the change in the potential to reduce the risk of falls after a 3-month exposure to the intervention. Postintervention data on behavioral drivers for fall prevention, user acceptability, and engagement with the app were also collected. Interviews were conducted to explore user experiences and identify areas for further improvement of the intervention.

Results: A total of 62 parents participated in the study. A statistically significant effect on the potential to reduce falls was observed after the intervention. This effect was higher for new parents. Parents agreed that the intervention targeted most of the target behavior drivers. The impact of behavior drivers and intervention on the potential for fall prevention had a positive correlation. The intervention demonstrated good levels of acceptability. Feedback from participants was mostly positive, and the primary area identified for further improvement was widening the scope of the intervention.

Conclusions: This study demonstrated the promise of a newly developed digital intervention to reduce the risk of infant falls, particularly among new parents. It also showed a positive influence of the DBCI on the drivers of parental behaviors that are important for fall reduction among infants. The acceptability of the app was high, and important insights were gained from users about how to further improve the app.

Keywords: acceptability; accidental fall; accidental falls; accidents; app; behavior; child injury; children; development; digital behavior change interventions; digital intervention; fall prevention; fall risk; falls; infancy; infant; infant behavior; infant fall; injury; internet; longitudinal design; maternal, paternal; mixed methods; mixed methods longitudinal study; mobile app; mobile phone; parent; parents; user experience; users.

©Nipuna Cooray, Catherine Ho, Amy Bestman, Susan Adams, Natasha Nassar, Lisa Keay, Julie Brown. Originally published in JMIR Pediatrics and Parenting (https://pediatrics.jmir.org), 03.01.2024.