Acutely Sick Kid Digital Interventions for Parents in under-represented Communities: a modified grounded theory study (ASK DIPaC)

Background Increasingly we are expected to use digital health interventions (DHIs) (websites, mobile apps) to access health information and services.

Yet parents do not always know when to seek help for a sick child or care for their child at home, particularly for marginalised communities who are under-represented in research and whose children are more likely to die.

DHIs have been identified as an important way to address this problem but there is a lack of evidence to inform their development for these under-represented communities. Parent includes parents, carers and guardians of children under five. The proposed project builds on extensive prior research of the team.

Aim To understand the digital health experiences of parents from under-represented communities when their children, under five years of age, are acutely ill.

Research Questions How, and to what extent, do parents with children under five years, from under-represented communities, use digital health information for a sick child?

What are the barriers and enablers to using digital health interventions for acute childhood illness (access, acceptability, utility) for parents with children under five years, from under-represented communities?

How would parents from under-represented communities like digital health interventions for acute childhood illness to work (access, design, content, functionality, interactivity)?

Methodology and Methods An explanatory grounded theory (GT) methodology will be used as there is no existing evidence to inform more quantitative approaches.

Three Barnardo s Children's Centres have been selected in areas of multiple deprivation and high levels of child poverty in ethnically different under-represented communities: Plymouth, Brent and Newcastle-upon-Tyne.

In each Centre a Parent Volunteer Co-ordinator (PVC) will disseminate project information and identify potential parent participants. Barnardo s will provide translation services.

Data collection methods and analysis Parent focus groups Two focus groups (FGs) of 5-8 parents on each study site: one virtual and one face-to-face. Discussions will explore parents experiences of using DHIs.

Think-aloud interviews with parents Up to five volunteers from each FG will be invited to participate in think-aloud interviews (30 parents). We will ask parents to show us how they used DHIs during a recent episode of acute childhood illness.

GT informed constant comparative analysis will be used from the first FG onwards to develop a grounded theory explaining parent s use/non-use of DHIs. Timelines for delivery A 15 month project from 1st February 2024.

Outputs, Anticipated Impact and Dissemination The resulting explanatory theory will explain how, when and why parents from under-represented communities use (or do not use) DHIs during acute childhood illness in children under five, identifying enablers and barriers to access, acceptability, useability, and desirability and how parents want these DHIs to work.

Findings will be used to create a toolkit for the development and assessment of DHIs for under-represented communities. Project progress and findings will be disseminated through parent and professional media.

The next project will apply the toolkit to adapt a mobile app in development and evaluate its impact on child health outcomes, parent s knowledge, confidence and health service use in under-represented communities – directly measuring patient benefit.