Design and evaluation of the StartingTogether App for home visits in preventive child health care

Abstract

Background: The StartingTogether program (in Dutch SamenStarten) is a family-centred method for early identification of social-emotional and behavioural problems in young children. Nurses in preventive child health care find it challenging to: determine family issues and need for care; provide education; refer to social services; increase parent empowerment. To mitigate these challenges, we developed and evaluated the StartingTogether App, offering nurses and parents conversational support, tailored education and information on social services. Methods: A mixed method design, consisting of a qualitative evaluation of the StartingTogether App, with group discussions with nurses (N=14) and a pilot test (N=5), and a randomized controlled trial, evaluating the effectiveness of the app. Nurses (N=33) made home visits to parents (N=194), in teams with or without the app. Nurses were surveyed on the challenges experienced during visits. Parents (N=166) were surveyed on their satisfaction with health care and app. Nurses were interviewed on the benefits and barriers to use the app. Results: Parents with the StartingTogether App were more satisfied with the visits than parents without (p=.002). Parents with a high educational level were more satisfied with the visits than the parents with a low educational level. With the app, their satisfaction level was similar (p