Proof-of-concept of a co-designed mobile game prototype to enhance parental mentalizing: Results from a single-group pretest-posttest feasibility trial (HelpingParentsMinds).

Parental stress, a key risk factor for child maltreatment, is rising. The Lighthouse Parenting Program (LPP) shows promise in improving mentalizing and reducing parental burden. However, numerous barriers can hinder participation in face-to-face prevention programs. Digital interventions might help overcome barriers, with serious games considered particularly suitable for promoting intervention adherence. This study evaluated the feasibility of a mobile game prototype to support parental mentalizing and reduce stress.

Feasibility was assessed in a one-group pretest-posttest study. The low-fidelity prototype was co-designed with burdened parents and based on the LPP and the Mediational Intervention for Sensitizing Caregivers. Parents are supported in reflecting on their own and their child's mental states in challenging parent-child interactions. Eligibility criteria included age ≥ 18 years, at least one child (age 0-14), an Android smartphone and sufficient language skills. Primary outcomes were recruitment, satisfaction, usability, and prototype use. Secondary outcomes include stress, depressive symptoms and mentalizing. Post-assessment followed a 10-day intervention phase.

Recruitment took four weeks, yielding N = 26, exceeding the target of N = 22. Usability was rated good (SUS: M = 77.76, SD = 10.96, grade B+), though satisfaction was low (CSQ-I: M = 18.74, SD = 4.47). Nineteen participants (73.1%) used the prototype for 11 min on average. Depressive symptoms and stress decreased from pre- to posttest.

Low satisfaction likely reflects the prototype's preliminary stage in this proof-of-concept study, with limitations regarding content, design, and gamification. Usability and feedback along with exploratory outcomes were promising, although feasibility has not been fully achieved. A high-fidelity version needs to be evaluated in future studies.
Mental Health
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Authors

Braun Braun, Bauer Bauer, Engelmann Engelmann, Rizzo Rizzo, Merkenschlager Merkenschlager, Volkert Volkert
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