Implementation Study With Embedded RCT of a Digital System of Parenting Support Within Government Services in South Africa

NCT07814261 | Active Not Recruiting DMC

• 1 other identifier: SWIFT_study
• Study Type: interventional
• Target: 4,961
• Locations: 1 country
• Sites: 1

Brief Summary

ParentText, a WhatsApp-based parenting support programme, is designed as a universal intervention to improve parent-child relationships (module 1) and promote child safety (module 2). The SWIFT study is an explanatory sequential time series design with an embedded randomised controlled trial. The time-series design aims to assess whether a digital parenting support programme, ParentText, can be embedded effectively into the regular services offered by the Department of Health and Wellness in the Western Cape, South Africa, and to explore factors affecting parent engagement. The embedded randomised controlled trial tests whether the second module affects sexual violence reduction against children. Participants include caregivers 18 years and older, living in South Africa, and caring for at least one child aged 2 to 17 years. The primary outcome measures of the study are both implementation 1): Assessing which of four approaches to advertising the ParentText programme leads to the highest rates of programme uptake, engagement, and completion; and programmatic: Testing the effectiveness of the additional Child Safety Module in 2) - reducing child sexual violence vulnerability, 3) - increasing child sexual violence risk planning and 4) - reducing child sexual violence exposure. The secondary outcomes assess changes in programme users' self-reported parenting behaviour in terms of 1) positive involvement, 2) positive parenting, 3) parent mental health, 4) parent support of education, 5) caregiver child/ adolescent communication, 6) online safety, 7) harsh parenting, 8) child or adolescent behavioural problems; and assessing users' experience of the 9) accessibility of the chatbot, 10) acceptability of the chatbot; and 11) adolescents' report of their sexual violence risk and safety planning communication.. In the first period of the time series design, participants will be recruited via posters, which provide a WhatsApp number for the programme, at their local clinic. Once they join, they will be provided with information on the study and be invited to consent to participate. If they consent, they will complete a baseline survey and then be able to move on to the first 5-day module. On consent to the study, participants will be placed randomly into either the group that receives the second module (intervention group) or a control group that will receive the module only after the study is completed. Both the intervention group and the control group receive the one-month and three-month surveys. In the second, third, and fourth time periods, everything remains the same except the encouragement method. In the first time period, only posters were used for recruitment. Within the second period, one month later, recruitment will be via both posters and additional encouragement from clinic staff. Clinic staff will encourage either verbally or by providing the caregiver with a flyer during their clinic visit. Throughout both these recruitment periods (1) and (2), caregivers who have completed the programme can share it on social media by posting predesigned tiles that include the joining information for the chatbot. Should our ideal sample size (4,000 participants) not be reached through these mechanisms, there will be an additional time period (3-4 weeks; time period three) during which the study team will advertise directly on Facebook. Finally, should our sample size not be reached in this third period, there will be a fourth time period of advertising that offers ZAR50 (approximately USD3) in airtime to those who sign up. This ZAR50 will be provided in sums of: ZAR15 for completing each of the baseline and one-month questionnaires, and ZAR20 for completing the three-month questionnaire. Once the three-month questionnaires are completed, participants will also be invited to a focus group discussion or telephonic interviews. Participants will be purposively selected from the group of participants who consent to the qualitative data collection phase. The focus groups will be conducted with participants residing in the Western Cape province, who completed one or both modules, and will discuss topics such as their experience of the ParentText programme, and the encouragement. For the telephonic interviews, participants will be purposely selected for interviews, looking at a) caregivers' experience of the child safety module, b) reasons for engaging/not engaging with the programme, and c) which referral services they accessed. Further, adolescents (over the age of 12 years) will be recruited via their caregivers - upon completion of the 3-month survey, parents or legal guardians will be asked to provide consent for the team to contact their adolescent to undertake a telephonic survey and, in some cases, a qualitative interview with them. Teens will complete informed assent.

Conditions

Program Effectiveness; Program Implementation; Parent Child Relationship; Caregiver Child Relationship; Parent Education; Parenting Intervention; Implementation; Implementation Science; Implementation Research; Sexual Violence; Sexual Abuse; Risky Sexual Behavior; Violence Against Children; Child Safety; Digital Education Interventions; Digital Health Intervention; Caregiver Mental Health; Parent Mental Health; Mental Health; Positive Parenting; Child Behavior Problem; Adolescent Behavior Problem

Keywords

Prevention; Digital Intervention; Parenting; Violence against Children; Sexual Violence Risk; Time Series Design; Randomised Controlled Trial; South Africa; Public Health System; Child Safety; Child Protection; Intervention; Low- and Middle-Income Countries

Outcome Measures

Primary Outcomes (2)

• Engagement with the Chatbot

  Uptake, engagement, and completion are measured using process data embedded within the chatbot, including programme uptake, frequency of logging in, duration of engagement, and completion rates of assigned content modules.

  Continuously throughout the three-month period that the chatbot is open.

• Sexual Violence Vulnerability

  Sexual violence vulnerability is assessed using caregiver-reported items from the Global Parenting Initiative, measuring children's and adolescents' exposure to unsafe situations in their communities. The measure includes five items for adolescents and four for children. Caregivers report how often in the past week their child or teen: spent time with untrusted friends; was unsupervised at home or outside (children) or went to taverns or drank with friends (teens); took a lift with someone unknown; or stayed away overnight without the caregiver knowing their whereabouts or returned late. Caregivers of adolescents also report their adolescents receiving sexual comments from older individuals. Responses are coded as (0) Never, (1) Sometimes (1-2 times), or (2) Often (3 or more times), with "I don't know" coded as 777 and "prefer not to say" coded as 888. Scores are summed for a total vulnerability score.

  Baseline pre-intervention, 1 month post-baseline, 3 months post-baseline. Participants have one week to complete the questionnaire.

Secondary Outcomes (16)

• Caregiver Positive Involvement

  Baseline pre-intervention, 1 month post-baseline, 3 months post-baseline. Participants have one week to complete each questionnaire.

• Positive Parenting

  Baseline pre-intervention, 1 month post-baseline, 3 months post-baseline. Participants have one week to complete each questionnaire.

• Parent Mental Health

  Baseline pre-intervention, 1 month post-baseline, 3 months post-baseline. Participants have one week to complete each questionnaire.

• Caregiver Safety Planning Communication

  Baseline pre-intervention, 1 month post-baseline, 3 months post-baseline. Caregivers have one week to complete each questionnaire.

• Child Sexual Violence Exposure

  Baseline pre-intervention, 1 month post-baseline, 3 months post-baseline. Participants have one week to complete each questionnaire.

Other Outcomes (2)

• Number and type of referral services accessed

  From baseline to up to 6 months post-baseline.

• Cost of implementation of the intervention.

  From set-up through duration that chatbot is open to participants.

Study Arms (2)

Child Safety Module

EXPERIMENTAL

The experimental group received a five-day module intended to educate parents about keeping their child safe from online and offline sexual violence (in addiion to a foundational relationship strengthening module).

Behavioral: Module 1 - Improve My Relationship with My Teen/Child; Behavioral: Module 2 - Keep My Child/Teen Safe and Healthy

Waitlist Control

OTHER

Those randomized to the waitlist control will be offered the child safety module after all data has been collected (but will still be able to access the same foundational relationship strengthening module as the experimental group).

Behavioral: Module 1 - Improve My Relationship with My Teen/Child

Interventions

Module 1 - Improve My Relationship with My Teen/Child BEHAVIORAL

Module 1 aims to improve caregiver-child relationships. The module has 5 daily lessons. The lessons take 10 minutes a day. The lessons include: 1. Spending One-on-One Time with My Child/Teen, 2. Giving Praise, 3. Creating a Routine for One-On-One Time, 4. Noticing Feelings During One-On-One Time, 5. Keeping Calm When We Are Stressed

Child Safety Module; Waitlist Control

Module 2 - Keep My Child/Teen Safe and Healthy BEHAVIORAL

Module 2 aims to promote child safety. The module has 5 daily lessons. The lessons take 10 minutes a day. The lessons include: 1. Community Safety 2. Responding to Crises 3. Knowing the Basics of Online Safety 4. Build Habits and Trust Online 5. For children: Teaching Safe Touch or For teens: Prevent Sexual Violence

Child Safety Module

Eligibility Criteria

• Age: 18 Years - 99 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Have worked at one of the study site clinics, during the periods of recruitment
• Encouraged caregivers during this period
• Parents or caregivers of any child aged 2-17 years old
• Aged 18 years or older.
• Residing in South Africa
• Willing to provide informed consent to participate in the study
• Sufficiently fluent in English, Afrikaans, or IsiXhosa
• Be an adolescent of a caregiver who has started the 3-month follow-up survey
• Aged 12-17 years old for the surveys and qualitative interviews
• Have received consent from their parent/caregiver to partake in the study
• Are willing to provide informed assent to participate
• Residing in South Africa
• Sufficiently fluent in English, Afrikaans or IsiXhosa
• Have successfully enrolled in the study, therefore meets the eligibility criteria of the study (\*as mentioned above)
• Have accessed at least one referral

Sponsors & Collaborators

• University of Cape Town: lead
• University of Oxford: collaborator
• UNICEF: collaborator
• LEGO Foundation: collaborator
• Oak Foundation: collaborator
• Parenting for Lifelong Health: collaborator
• IDEMS International: collaborator
• Clowns Without Borders South Africa: collaborator
• City of Cape Town: collaborator
• Western Cape Department of Health and Wellness: collaborator
• Childline: collaborator
• South African Parenting Programme Implementers Network: collaborator

Study Sites (1)

University of Cape Town (recruitment sites confidential)

Cape Town, Western Cape, 7700, South Africa

Location

Related Publications (13)

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Related Links

• Related Info

MeSH Terms

Conditions

Psychological Well-Being

Condition Hierarchy (Ancestors)

Personal Satisfaction; Behavior

Study Officials

• Catherine L Ward, PhD

  University of Cape Town

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: SEQUENTIAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Model Details: This study will adopt an explanatory sequential model (Creswell \& Creswell, 2017). The quantitative phase employs a time series design with an embedded randomised controlled trial. Quantitative data collection will be gathered using surveys and process data (both collected within the chatbot). The results of the quantitative data will be used to inform the groups who will be qualitatively interviewed and the questions asked of them. Although tentatively designed, the qualitative interviews will explore results from the quantitative surveys. Focus groups and interviews (telephonic and in-person) will be conducted with caregivers, their adolescents, and clinic staff.

Study Record Dates

• First Submitted: August 26, 2026
• First Posted: September 10, 2026
• Study Start: February 2, 2026
• Primary Completion (Estimated): October 31, 2026
• Study Completion (Estimated): October 31, 2026
• Last Updated: September 10, 2026

Record last verified: 2026-08

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, ICF, ANALYTIC CODE

Locations

ZA (1)