# Evaluating the Impact of Digital Support on Parental Stress in Swedish Child Health Care: Results From an Intervention Study

## TL;DR

This study evaluated a digital support program for parents in Sweden's child health care system and found limited changes in parental stress or satisfaction.

## Contribution

The study introduces a novel digital intervention approach in the context of Swedish child health care to reduce parental stress.

## Key findings

- No significant changes in parental stress or satisfaction were observed between the intervention and control groups.
- Both groups showed improvement in eHealth literacy, with the control group scoring higher at baseline.
- Satisfaction with child health care, accessibility, and support showed a crossover pattern at the 8-month follow-up.

## Abstract

Introduction: The Swedish child health care (CHC) program provides voluntarily, at no cost, services for children from birth to 5 years old. Participation rates are 99% of Swedish parents enrolling their children in some form of CHC program. Parental groups, comprising parents with similar experiences, can help reduce parental stress and foster the development of effective coping strategies. The study is aimed at evaluating a digital support intervention involving parents, child health nurses, and researchers.

Methods: This cluster-randomized, prospective pilot intervention study, conducted in northern Sweden, had three follow-up points: baseline, 4 months, and 8 months. Data were collected from autumn 2022 to late spring 2023 and evaluated effects on parental stress and satisfaction, eHealth literacy, and satisfaction with CHC, accessibility, and support. The 18-item Parental Stress Scale was used to assess parental stress and satisfaction. eHealth literacy was measured using the 10-item eHEALS scale, and parental satisfaction and opinions on accessibility to CHC were measured using a three-item Visual Analogue Scale. The intervention group was offered to participate in various digital activities, while the control group received the usual CHC.

Results: Parental satisfaction and stress levels within and between the intervention and control groups showed no significant changes from baseline to 8 months. Regarding eHealth literacy, differences were observed between the groups; however, both groups demonstrated improvement at the 8-month follow-up. The control group scored higher in eHealth literacy from baseline. The same pattern was identified regarding the parents' perceptions of internet usability and importance. Concerning satisfaction with CHC, accessibility, and support, the control group scored higher at baseline. Interestingly, the lines of the intervention and control groups crossed over at the 8-month follow-up.

Conclusion: Despite a limited outcome change, the results showed a tendency to benefit some parents. Our findings suggest that further evaluation, possibly with other more suitable measurements or questionnaires, an extended intervention period, and a larger sample, is necessary to understand the implications of these results fully.