Designing and optimising a parent-based digital intervention to improve the health of socio-economically disadvantaged adolescents in Australia

Abstract

Background: Physical inactivity, poor diet, alcohol use, smoking, sedentary behaviours, and poor sleep are major chronic disease risk factors, particularly among low socio-economic status (SES) adolescents. Parent-based digital interventions have the potential to address these disparities among youth and are currently underutilised in digital health. This study aims to co-design and optimise a new parent-based intervention targeting low SES youth, guided by the Multiphase Optimisation Strategy (MOST).   Methods: Phase 1 involved partnering with low SES parents and youth to co-design components for a parent-based intervention (Health4Life Parents & Teens) and adapt the existing Health4Life school-based program to meet the needs of low SES adolescents. In Phase 2, a 24 factorial design will be employed, involving ~500 low SES parents in NSW. All parents will receive six online modules alongside a combination four additional components: tailored feedback, stress management, text messages, and health coaching.   Results: Two co-design workshops were held with 12 low-SES parents in mid-2024. Parents supported brief online modules with tailored feedback, goal-setting, and health coaching. A parent/teen advisory board was formed, and student focus groups will be conducted at two low-SES high schools (anticipated n=90 students) in late 2024. Recruitment for Phase 2 will commence in early 2025 following ethics approval.   Conclusion: This is the first study using the innovative MOST framework to co-design a parent-based intervention to improve the health of low SES adolescents, aiming for maximum effectiveness with the least burden. A cluster randomised controlled trial will follow in 2026 to evaluate the effectiveness of the optimised intervention.