Top 10 Research Lessons Learned From a Digital Child-Rearing Program in Low- and Middle-Income Countries: Multicase Study.

backgroundExtensive literature highlights the effectiveness of parenting programs for early childhood and parental outcomes globally. Increasing evidence shows that digital parenting programs are as effective as those delivered in person and that digital delivery is acceptable to parents. However, parenting programs cannot be one-size-fits-all but rather need to be developed, adapted, and refined to account for the context, culture, attitudes, behaviors, and expectations of the intended target audience.

objectiveThis study aimed to identify the key research lessons learned from Minderoo Foundation's Thrive by Five International Program, a large-scale digital and nondigital child-rearing program, including how they relate to research and development (R&D) processes and sociocultural context. The "core elements" of R&D identified in the Medical Research Council's framework for developing and evaluating complex interventions served as a guide to synthesize the data from this 3-year (2021-2024) program.

methodsWe used a multicase study design to build a deep understanding of the program, including how it varied across and was influenced by diverse sociocultural and contextual factors across 10 low- and middle-income countries. Data analysis for each case occurred over 3 phases, including qualitative data analysis and reporting, data synthesis to inform the transfer of learnings to the program, and, finally, a secondary analysis relating to program theory, stakeholder engagement, and the refinement of the program as they related to, interacted with, and were influenced by context.

resultsThe analysis resulted in five themes: (1) the role and value of partnerships, including the importance of selecting partners with strong and broad networks; (2) building collaborative practice with partners, which identifies strategies to foster collaboration; (3) honing a target audience, which emphasizes the importance of identifying the end user at the start of R&D; (4) navigating the digital landscape, including the use of context-specific dissemination strategies; and (5) managing linguistic diversity and translation, including the value of embedding a translator on the project team. Learnings regarding context and cultural diversity were integrated throughout the results.

conclusionsDigital parenting programs must be appropriate for and accessible to the target audience, aligned with information and communications technology infrastructure and policies, and fill a need in the digital health marketplace. When this is not feasible, a multichannel approach to dissemination using digital and nondigital strategies is necessary. While likely to increase project complexity, cross-sectoral partnerships, including with government bodies, are likely to broaden the program's reach. To facilitate digital parenting projects, it is critical that sufficient time be allocated to build meaningful collaborative partnerships centered on respect, cultural understanding, and open communication and grounded by a shared vision.