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The Nurse-Family Partnership (NFP) pairs low income, first-time mothers with home-visiting
nurses from pregnancy to the child’s second birthday. NFP shows improved pregnancy outcomes, reduced child abuse and neglect, and improved life-course outcomes over 35+ years. To improve program engagement and retention, NFP partnered with Hopelab, a non-profit social innovation lab, to design and evaluate efficacy and implementation of a goal coaching mobile application. In a randomized trial, we hypothesized that moms assigned to use the app would be more likely to set and achieve their goals, report higher goal-related self-efficacy, and demonstrate higher program engagement and retention than those in the control group.
Methods:
Using a human centered co-design process with moms and nurses, Hopelab and NFP created Goal Mama, a mobile app and companion nurse dashboard that moms can use with their nurses to set, track, and reach their goals.
Moms receiving NFP services (n=297) were recruited via 5 sites across the nation and randomized to the experimental group (receive the Goal Mama intervention, n = 148) or to the control group (n = 147), stratified by site. Both groups received surveys at weeks 1, 2, 7, and 11 around target psychosocial outcomes, and home visits were tracked through 24 weeks. The experimental group received Goal Mama after two surveys and were asked to use as desired during the study.
Results:
As of Oct 31st, overall, moms show retention rate above 75% for both surveys at week 7 and 11. For the experimental group, 68% of moms downloaded Goal Mama and 59% created at least one goal. Preliminary data show that on average nurses (N=42) rate the app highly acceptable (86%), feasible (88%), and helpful to moms (76%), and have high self-efficacy for use (79%). About 76% of nurses rated the nurse dashboard as highly acceptable and feasible. Qualitative data provide converging evidence on high acceptability and feasibility for the app and concrete suggestions for the improvement of the nurse dashboard.
Multi-level regression models will be used to examine the outcome differences in moms’ self-efficacy, nurse-mom relationship satisfaction, visit attendance, and engagement between the experimental and control groups, controlling for demographics. Within the experimental group, app engagement will be examined.
Conclusions:
Preliminary data show high feasibility and acceptability from nurses for the Goal Mama intervention. Further analyses will provide insights on the target outcomes, as well as recommendations and implementation strategies for disseminating a mobile intervention for low-income moms at large scale.