User engagement as a catalyst for success

ParentText (Jamaica, Malaysia, Philippines, South Africa)

ParentText is an automated messaging service developed by Parenting for Lifelong Health (PLH) designed to provide personalized information to parents and caregivers in low- and middle-income countries. The messaging service’s content, derived from PLH’s evidence-based parenting programs, aims to promote positive parent-child relationships, enhance child development and early learning, prevent violence, and improve caregiver mental health and well-being, as well as positive partner relationships. The content is tailored to local contexts, translated into multiple languages, and easily accessible through common messaging services like WhatsApp and Facebook Messenger. Currently, the tool has been soft launched in Malaysia, South Africa, Philippines, and Jamaica, with plans to expand its reach to Mexico, Thailand, Sri Lanka, and other Global South countries.

An important aspect of user engagement is ensuring that users with diverse abilities, backgrounds, and languages can utilize the tool. One way that ParentText enhances accessibility is by enabling users to choose whether they would like to receive text-based messages or a combination of text-based and multimedia messages (such as images, GIFs, and videos), depending on their preferences and data usage capabilities. Users can also select what time of day they would like to receive messages. Built on RapidPro, an open-source software, ParentText can also be accessed through the most popular messaging platforms in the country where it is implemented, including WhatsApp, Telegram, and Viber, or SMS in areas with restricted internet access. This approach particularly benefits families with limited internet connectivity or low smartphone accessibility.

Customization can also enhance the user experience and make a tool more personalized and relevant to the user’s needs and preferences. ParentText users have opportunities to select a goal and receive tailored messages which are gender and age responsive. There are six goal areas to choose from: relationship building, behavioral management, early learning and engagement in school, intimate partner violence prevention, keeping children safe, and emotional well-being for caregivers. After conducting an assessment to gather more information about the child or caregiver, customized messages are provided.

Customization can also enhance the user experience and make a tool more personalized and relevant to the user’s needs and preferences.

To further encourage user engagement, ParentText also uses gamification and brief check-in surveys. Users are awarded with badges and trophies after accomplishing different tasks and completing modules. Moreover, interactive quizzes and an emoji-based progress tracker keep users engaged. While initially PLH utilized weekly surveys to gather data, it now prioritizes brief check-ins and reflective questions to engage users and improve their experience while using the tool. Finally, ParentText tracks usage data which feed into efforts to innovate and improve its offerings so that they better support parents and caregivers. The PLH team is currently working on offering more targeted support to male caregivers, caregivers of children with disabilities, and families in migration. Furthermore, the organization is exploring potential ways for parents to receive real-time assistance, such as referrals to hotlines, community WhatsApp groups, or in-person onboarding, while also investigating how cultural determinants impact engagement in South Africa.

Thinking Healthy (Pakistan)

The Thinking Healthy program supports non-specialist service providers referred to as “peers” to deliver mental health interventions to mothers experiencing perinatal depression from pregnancy through one year postpartum. To help peers implement key ingredients of the program with expected quality, the Thinking Healthy app was developed in consultation with a 18-member design team comprised of three distinct groups:

1. an ‘expert’ group with mental health practitioners
2. a ‘user’ group with women who experienced perinatal depression, their husbands, and community health workers
3. a ‘technology’ group with a software developer and graphic designer.

The design team applied principles of Human Centered Design (HCD), an approach that centers the end user in the design process, to design and test the tool in real-world settings. The three-step design process included:

• Step 1: To understand user requirements and preferences, the design team prepared a detailed storyboard with illustrations, scripts, and interface mockups. The team made rapid iterations to incorporate user requirements and arrive at a prototype for further testing.
• Step 2: The design team conducted “Cognitive walkthroughs,” the technique of implementing tasks with a focus on the cognitive processes required to identify and address problems encountered while carrying out tasks required of the app and arrive at an advanced prototype.
• Step 3: A group of carefully selected end-users who represented the target population in real-world settings tested the prototype. A trained, independent team of researchers monitored and observed users interacting with the technology through short test cycles.

User feedback collected and incorporated along the way ensured that the final product was reflective of user needs and requirements. For example, upon the suggestion of the user group that the intervention should also bring in family members to support the mother, the design team modified the content of the intervention to be inclusive and promote messages of shared responsibilities in child care activities.