Strengths and Limitations
’ disengagement
Using technological advancements to our advantage, a technology-based intervention consisting of both informational and emotional support was developed to fulfill the needs of parents during the perinatal period. The SPA intervention served as a one-stop support, offering various types of pregnancy- and parenting-related content as well as assigning trained peer volunteers to improve the mental well-being of parents. The findings of this study are based on the existing literature regarding how technology-based interventions can affect parental outcomes. Gender differences in outcome scores and trends also suggest that different interventions may be needed to meet the specific and unique needs of both mothers and fathers.Despite the ample sample size, there was still an overall attrition rate of 28.5%, which was higher than the 20% initially postulated. The long follow-up duration (up to 12 months postpartum) and the outbreak of COVID-19 might have caused this high attrition rate. Another reason for this attrition rate could be parents’ disengagement with the SPA intervention. However, this study did not obtain sufficient data on the SPA user engagement to distinguish between the 2 causes of the attrition rate. Recent literature [Another limitation of this study was that, owing to human error, there was no information on whether the parents recruited were new or experienced. This is a major limitation, as the experiences, struggles, and support needs of new and experienced parents can differ widely. Future studies need to include this information to provide a greater depth of understanding how the intervention impacts the differing needs of these parents. Such human errors occurred mainly because the majority of the study team members were clinicians who had to devote their attention to supporting their parents in clinical settings during the pandemic. Hence, the lack of regular meetings between team members has led to an increased incidence of human errors and compromised communication.No data on the parents’ use of other parenting apps were collected. This was also a limitation of this study, as the use of these other mobile apps could have provided greater insight into the interpretation of our results. Furthermore, we believe that because of the hectic duties juggled by parents, they might forget to access the SPA for information or advice from experts and peer volunteers, despite regular notifications. As the SPA was only programmed to send regular notifications depending on the stage of pregnancy or age of the newborn, some parents might have accidentally switched off receiving those notifications, or those who received them could have been preoccupied with settling other pressing demands around parenting during the evolving COVID-19 related restrictions. It is also possible that the notifications were not received if the parents did not update the SPA when prompted. Thus, more frequent robust ways of reaching out to parents beyond regular notifications may be needed so that parents can visit the app more actively to maximize the benefits they can reap from the SPA intervention.