Parenting for Lifelong Health ‘ParentApp Teen’ Program, Tanzania, 2023-2024

The 2009 Tanzania Violence Against Children and Youth Survey (VACS) showed that 27.9% of girls and 13.4% of boys experienced sexual violence during childhood.

ParentApp Teen [1] is a cost-effective digital intervention designed to empower caregivers with positive parenting strategies to prevent and respond to violence against children in contexts in which there may be significant barriers to accessing in-person interventions. 

What it is and how it works

ParentApp Teen is a remote version of the Parenting for Lifelong Health for Parents and Teens program. It is a mobile, open-source, and offline application that targets caregivers of adolescents in low and middle-income countries (LMICs). The innovative approach, developed collaboratively by the University of Oxford and the National Institute for Medical Research in Tanzania, includes new locally co-developed content focused on childhood sexual violence prevention and material adapted from No Means No Worldwide. 

App content addresses high levels of childhood violence in rural and peri-urban communities in Tanzania by enhancing parenting skills and improving parent-adolescent relationships through sessions that address parental self-care and stress reduction, one-on-one time, praise and positive reinforcement, positive instructions, managing stress, family budgeting, rules, consequences and accepting responsibility, problem-solving, teen safety, and guidance for dealing with crises. It uses an accessible digital platform based on principles of behavior change. The app provides interactive content, videos, and problem-solving modules and includes features such as reminders, tips, quizzes, and goal-setting to help users integrate learned practices into daily life. 

The program combined in-person sessions to build relationships and trust and facilitated WhatsApp groups (with 50 families each) to encourage interaction and support. 

Key elements of ParentApp Teen include:

• Evidence-based content derived from evidence developed by parenting for lifelong health 
• Interactive, user-friendly design tailored to low-literacy populations.

• Multi-language support to increase accessibility [2, 3].

   

Evaluation and program outcomes

ParentApp Teen is the first digital parenting intervention to be rigorously tested in an LMIC. It was tested in a cluster randomised trial [4] in urban and peri-urban areas of Mwanza Tanzania from 2023-2024. A total of 80 communities were assigned to use either ParentApp Teen or a digital water, sanitation, and hygiene (WASH) app as a control and were placed in facilitated Whats App groups of 30 caregivers of adolescents ages 10-17 years. The evaluation included surveys using standardized measures from I-Cast and Violence Against Children and Youth Surveys, conducted pre-program and one-month post-program. A 12-month post-program evaluation is also in process [4]. 

The ParentApp Teen program has engaged 4,800 caregiver/adolescent pairs. Early results demonstrate that the program is associated with:

• Reduced physical and verbal violence by caregivers.
• Significant increase in knowledge of child development and effective discipline methods.
• Decrease in self-reported parental stress and improved mental well-being [4].

Challenges

• Cultural resistance: Some communities initially resisted non-traditional parenting strategies promoted by ParentApp.
• Digital literacy barriers: Older caregivers and those with limited exposure to mobile technology required additional support to use the app effectively.
• Sustainability: Maintaining digital engagement post-program remains uncertain.

Lessons learned

• Cultural sensitivity: The need for context-specific materials was critical in sustaining caregiver engagement.
• Offline access: Pre-installed features for offline access improved usability in low-connectivity areas.
• Inclusive approach: Future iterations must be intentional to involve fathers and other guardians to create holistic family engagement.
• Community partnerships: Partnering with community organizations enhanced trust and uptake.
• Social support: The creation of moderated WhatsApp groups facilitated program completion and is envisioned to improve sustainability.
• Accessibility: The app works on basic smartphones, which most families already own.
• Engagement: Teens actively helped older caregivers navigate the app.
• Agency: Caregivers and adolescents can navigate the app freely, selecting content that best meets their needs rather than following a fixed module sequence.
• Flexibility: Families can engage with the app at their leisure, such as after dinner, which may facilitate organic family connections and impact compared to in-person sessions.