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

Implementing a Digital System of Parenting Support Within Government Services in South Africa: Protocol for a 1) Time Series Trial of ParentText and 2) Randomized Controlled Trial of an Additional Programme Module for Child Safety

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.

Study Overview

• Status: Active, not recruiting
• Conditions: Child Behavior Problem; Mental Health; Sexual Violence; Implementation Science; Implementation; Risky Sexual Behavior; Sexual Abuse; Parent Child Relationship; Implementation Research; Parenting Intervention; Parent Mental Health; Child Safety; Violence Against Children; Program Effectiveness; Positive Parenting; Program Implementation; Caregiver Mental Health; Digital Education Interventions; Adolescent Behavior Problem; Digital Health Intervention; Caregiver Child Relationship; Parent Education
• Intervention / Treatment: Behavioral: Module 1 - Improve My Relationship with My Teen/Child; Behavioral: Module 2 - Keep My Child/Teen Safe and Healthy

• Study Type: Interventional
• Enrollment (Actual): 4961
• Phase: Not Applicable

Contacts and Locations

Study Locations

• South Africa
  • Western Cape
    • Cape Town, Western Cape, South Africa, 7700
      • University of Cape Town (recruitment sites confidential)

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion criteria for clinic staff interview participants are:

• Have worked at one of the study site clinics, during the periods of recruitment
• Encouraged caregivers during this period

Inclusion criteria for this study* requires that programme users are:

• 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

Participants will be excluded from this research study if they do not meet any one of the inclusion criteria. Interested caregivers who do not meet the criteria will be directed to SAPPIN's ParentLine digital programme.

Inclusion criteria for adolescent participants are:

• 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

Inclusion criteria for referral interviews are:

• Have successfully enrolled in the study, therefore meets the eligibility criteria of the study (*as mentioned above)
• Have accessed at least one referral

Inclusion criteria for engagement interviews are:

• Have successfully enrolled in the study, therefore meets the eligibility criteria of the study (*as mentioned above)
• Have completed the baseline survey and received access to the programme content

Inclusion criteria for child safety interviews are:

• Have successfully enrolled in the study, therefore meets the eligibility criteria of the study (*as mentioned above)
• Have been assigned to the intervention group receiving the child safety module
• Have completed at least one component of the module

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Sequential Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Child Safety Module; 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; Module 1 aims to improve caregiver-child relationships. The module has 5 daily lessons. The lessons take 10 minutes a day. The lessons include: Spending One-on-One Time with My Child/Teen,; Giving Praise,; Creating a Routine for One-On-One Time,; Noticing Feelings During One-On-One Time,; Keeping Calm When We Are Stressed; Behavioral: Module 2 - Keep My Child/Teen Safe and Healthy; Module 2 aims to promote child safety. The module has 5 daily lessons. The lessons take 10 minutes a day. The lessons include: Community Safety; Responding to Crises; Knowing the Basics of Online Safety; Build Habits and Trust Online; For children: Teaching Safe Touch or For teens: Prevent Sexual Violence
Other: Waitlist Control; 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; Module 1 aims to improve caregiver-child relationships. The module has 5 daily lessons. The lessons take 10 minutes a day. The lessons include: Spending One-on-One Time with My Child/Teen,; Giving Praise,; Creating a Routine for One-On-One Time,; Noticing Feelings During One-On-One Time,; Keeping Calm When We Are Stressed

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
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 Outcome Measures

Outcome Measure	Measure Description	Time Frame
Caregiver Positive Involvement	Positive involvement refers to the amount of caregiver participation in games and activities with their child or teen, and is measured using the one item from the positive involvement subscale of the Alabama Parenting Questionnaire (APQ; Essau et al., 2006), namely "How often in the past week did you play games or do other fun activities with your child/teen?" Response items include (0) Never, (1) Sometimes (1-2 times), (2) Often (3 or more times), or "prefer not to say" coded as 888.	Baseline pre-intervention, 1 month post-baseline, 3 months post-baseline. Participants have one week to complete each questionnaire.
Positive Parenting	Positive parenting is measured using the one item from the positive parenting subscale of the Alabama Parenting Questionnaire (APQ; Clerkin et al., 2007), namely "How often in the past week did you praise your child/teen when they behaved well?" Response items include (0) Never, (1) Sometimes (1-2 times), (2) Often (3 or more times), or "prefer not to say" coded as 888.	Baseline pre-intervention, 1 month post-baseline, 3 months post-baseline. Participants have one week to complete each questionnaire.
Parent Mental Health	Parent mental health is measured using the Patient Health Questionnaire (PHQ-2; Löwe et al., 2005). The PHQ-2 measures depressed mood and anhedonia, and consists of the last two items of the PHQ-4 (Kroenke et al., 2009). The two items include, "How often in the past week have you felt down, depressed, or hopeless?" and "How often in the past week did you have little interest or pleasure in doing things?" The response options for this study range from 0 (Never) to 2 (Often - 3 or more times), with an option for "prefer not to say" coded as 888, to fit the responses of the other measures. The total score is calculated by summing the two responses. The validity of the PHQ-2 has been recognised in South African studies among patients attending primary health facilities (Bhana et al., 2015; Levis et al., 2020). Previous studies indicate that the PHQ-2 has sound reliability, with Cronbach alpha scores ranging from 0.78 to 0.92 (Löwe et al., 2005; Staples et al., 2019; Lee et al., 2026).	Baseline pre-intervention, 1 month post-baseline, 3 months post-baseline. Participants have one week to complete each questionnaire.
Caregiver Safety Planning Communication	Safety planning communication is assessed using locally derived items from the Global Parenting Initiative by asking caregivers of a child: "Have you talked to your child in the past week about keeping safe?" Caregivers of teens are presented with two questions: "Have you talked to your teen in the past week about keeping safe in any of these situations?" and "Have you talked to your teen in the past week about keeping safe from situations such as sexual violence?" The safety planning communication questions are presented immediately after the items on sexual violence vulnerability; thus, "any of these situations" refers to the risky situations mentioned on sexual violence vulnerability items. Response items include (0) No, (1) Yes, or "prefer not to say" coded as 888. The sum of the item scores is used to obtain a total score.	Baseline pre-intervention, 1 month post-baseline, 3 months post-baseline. Caregivers have one week to complete each questionnaire.
Child Sexual Violence Exposure	Sexual violence exposure is assessed in the survey, within the chatbot, using four items for caregivers of children and teens. Caregivers are asked how often their child/teen has been exposed to four instances of sexual violence in the past month. These instances include whether their child/teen displayed inappropriate sexual behaviour, was touched sexually, was shown something sexual, or was made to do anything sexual. These occurrences provided are a combination of sexual violence items retrieved from the Sexual Abuse subscale of the International Society for the Prevention of Child Abuse and Neglect (ISPCAN) Child Abuse Screening Tool-Trial Version (ICAST-T; Meinck et al., 2018). Response items include (0) Never, (1) Sometimes (1-2 times), or (2) Often (3+ times), with "I don't know" coded as 777 and "prefer not to say" coded as 888. The sum of the item scores is used to obtain a total score.	Baseline pre-intervention, 1 month post-baseline, 3 months post-baseline. Participants have one week to complete each questionnaire.
Parent Support of Education	Parent support of education is measured using caregiver-reported items from prior research (Ceballo et al., 2014) and applied in Parenting for Lifelong Health (PLH) studies. The scale includes two items each for caregivers of children and adolescents, assessing engagement in education-related activities. Caregivers report how often in the past week they praised their child or teen for working hard at school. Caregivers of teens also report how often they supported their teen's schoolwork, while caregivers of children indicate how often they named, counted, or drew with their child, based on the Family Care Indicators from the UNICEF Multiple Indicator Cluster Survey (Kariger et al., 2012). Responses are coded as (0) Never, (1) Sometimes (1-2 times), or (2) Often (3 or more times), with "prefer not to say" coded as 888. The sum of the item scores is used to obtain a total score.	Baseline pre-intervention, 1 month post-baseline, 3 months post-baseline. Parents have one week to complete each questionnaire.
Caregiver Child/ Adolescent Communication	This outcome assesses changes in programme users' perceived openness in communication with their children. Caregiver-Child/Adolescent Communication is measured using one item for caregivers of children and two items for caregivers of teens. Caregivers of children and teens are asked, "How often in the past week did your child/teen let you know what is bothering them?", while caregivers of teens are also asked "How often in the past week could you talk about personal things like boyfriends, girlfriends, or sexual behaviour, with Your Teen?". These items are adapted from a subscale of the Parent-Child Communication (PCC) scale, which was used in the Fast Track Intervention Study (McCarty & Doyle, 2001). Response items include (0) Never, (1) Sometimes (1-2 times), (2) Often (3 or more times), or "prefer not to say" coded as 888.	Baseline pre-intervention, 1 month post-baseline, 3 months post-baseline. Parents have one week to complete each questionnaire.
Caregiver Monitoring of Child's Online Safety	Online safety assesses programme user changes in their engagement with their children regarding their children's use of the internet and/or mobile devices. It is assessed for caregivers of children and teens using two items, namely "How often in the past week did you know what your child was doing when they were using the internet, cellphone, or other device?" from the the Global Kids Online survey (GKO; 2020) and "How often in the past week did you talk to your child about their use of the internet or device?" from the EU Kids Online Survey (Šmahel et al., 2020). Response items include (0) Never, (1) Sometimes (1-2 times), (2) Often (3 or more times), or "prefer not to say" coded as 888. Sores on the items are summed to obtain a total score for online safety.	Baseline pre-intervention, 1 month post-baseline, 3 months post-baseline. Participants have one week to complete each questionnaire.
Caregiver Involvement	Caregiver involvement is assessed with three items from the Family Care Indicators (FCI) subscale of the UNICEF Multiple Indicator Cluster Survey (MICS; Kariger et al., 2012). Caregiver involvement items assess caregivers' perceptions of their involvement with their children, including active participation in activities and decision-making processes. The three items ask how often in the past week a caregiver actively participated in activities with their child/teen, such as playing, sharing books, or helping with homework; were involved in making decisions regarding their child/teen's education, health, and overall well-being; and showed their child/teen affection or love. Response items include (0) Never, (1) Sometimes (1-2 times), (2) Often (3 or more times), or "prefer not to say" coded as 888. The three items will be summed to create a total score.	Baseline pre-intervention, 1 month post-baseline, 3 months post-baseline. Participants have one week to complete each questionnaire.
Other Caregiver Involvement	If applicable, the caregiver completing the programme also responds to similar items to those they completed for themselves, reflecting their perspective on another caregiver's involvement in their child's life. Other caregiver involvement is assessed with three items from the Family Care Indicators (FCI) subscale of the UNICEF Multiple Indicator Cluster Survey (MICS; Kariger et al., 2012). The three items include how often the other caregiver actively participated in activities with the child/teen, such as playing, sharing books, or helping with homework; was involved in making decisions regarding the child/teen's education, health, and overall well-being; and showed the child/teen affection or love. Response items include (0) Never, (1) Sometimes (1-2 times), (2) Often (3 or more times), or "prefer not to say" coded as 888. The three items will be summed to create a total score.	Baseline pre-intervention, 1 month post-baseline, 3 months post-baseline. Participants have one week to complete each questionnaire.
Harsh Parenting	To assess programme user changes in harsh parenting, items adapted from the physical abuse (1 item) and emotional abuse (1 item) subscales of the International Society for the Prevention of Child Abuse and Neglect (ISPCAN) Child Abuse Screening Tool-Trial Version (ICAST-T; Meinck et al., 2018) are used. These items measure caregivers' behaviours towards their children, indicative of maltreatment. The two items include: "How often in the past week did you discipline your child/teen physically, such as hitting with your hand, belt, or another object?" (physical abuse) and "How often in the past week did you shout or scream at your child/teen?" (emotional abuse). Response items include (0) Never, (1) Sometimes (1-2 times), (2) Often (3 or more times), or "prefer not to say" coded as 888. The sum of the item scores is used to obtain an overall score for harsh parenting.	Baseline pre-intervention, 1 month post-baseline, 3 months post-baseline. Participants have one week to complete each questionnaire.
Child or Adolescent Behavioural Problems	This outcome assesses whether programme users report changes in their child or adolescent's behavioural problems (externalising symptoms). Child or Adolescent Behavioural Problems are measured using one item, namely "How often in the past week did your child/teen not obey, or it was difficult to make them obey?" from the Child and Adolescent Behaviour Inventory (CABI; Cianchetti et al., 2013), which assesses caregivers' perceptions of externalising behaviours in their children (Cianchetti et al., 2013). Response items include (0) Never, (1) Sometimes (1-2 times), (2) Often (3 or more times), or "prefer not to say" coded as 888.	Baseline pre-intervention, 1 month post-baseline, 3 months post-baseline. Participants have one week to complete each questionnaire.
Chatbot Accessibility	The accessibility of the ParentText programme will be measured using a single question embedded in the chatbot: "What did you mainly use to connect to ParentText?" with response options (0) "Mobile data", (1) "WiFi at home", (2) "WiFi at work", (3) "Hotspot in the community", (4) "Other", or "prefer not to say" coded as 888.	1 month post-baseline; participants have one week to complete the questionnaire.
Chatbot Acceptability	The acceptability of the ParentText programme will be measured using the following question embedded in the chatbot: "How helpful was ParentText to you and your family?" with response options (0) "Not helpful", (1) "A bit helpful", (2) "Very helpful", or "prefer not to say" coded as 888.	1-month post-baseline; participants have one week to complete the questionnaire.
Adolescent Report of Sexual Violence Vulnerability	This outcome aims to assess adolescent-reported sexual violence vulnerability via a brief individual telephonic survey. Adolescents' sexual violence vulnerability is measured with the questions: In the past week (7 days), how often: Did you spend time with friends that your parent doesn't know or doesn't trust? Did you go to a tavern or drink alcohol with your friends? Were you out of the house at night alone, or your parent didn't know where you were, or you came home later than your parent expected? Did you get a lift in a car with someone you don't know? Did you receive sexual comments from men or women who are older than you? Did your parent know what you were doing when you were using the internet or using the cell phone? Item responses include (0) Never, (1) Sometimes (1-2 times), (2) Often (3 or more times), or "prefer not to say/skip" coded as 888. Item responses are summed to compute a total score.	After completion of 3-month post-baseline survey, we will have a 3-month window in which to collect this data.
Adolescents' Report of their Safety Planning Communication (Risk Planning)	Questions include: In the past week (7 days), did your parent talk to you about: Spending time with friends that they don't know or trust? Going to a tavern or drinking alcohol with friends? Being out of the house at night alone, or somewhere where they didn't know where you were, or about coming home later than your parent expected? Getting a lift in a car with someone you don't know? Receiving sexual comments from men or women who are older than you? Keeping safe from situations such as sexual violence? Responses to these items are coded as (0) No, (1) Yes, or "prefer not to say/skip" coded as 888. In the past week (7 days): How often could you talk to your parent about personal things like boyfriends, girlfriends, or sexual behaviour? How often did your parent talk to you about using your cell phone or being on the internet? These two items are coded as (0) Never, (1) Sometimes (1-2 times), (2) Often (3 or more times), or "prefer not to say/skip" coded as 888.	After completion of 3-month post-baseline survey, over a three-month data collection window.

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number and type of referral services accessed	Data embedded in the chatbot will track the number of referral requests made and the types of referral services selected throughout the programme.	From baseline to up to 6 months post-baseline.
Cost of implementation of the intervention.	The total cost of the intervention, including set-up and operating costs, as well as the average cost to engage with the intervention per participant (unit cost), will be calculated. These calculations will be based on detailed project budgets including all set-up, ongoing, and expected expenses associated with the rollout of the intervention.	From set-up through duration that chatbot is open to participants.

Collaborators and Investigators

• Sponsor: University of Cape Town
• Collaborators: University of Oxford; UNICEF; Oak Foundation; LEGO Foundation; IDEMS International; Western Cape Department of Health and Wellness; Parenting for Lifelong Health; Clowns Without Borders South Africa; City of Cape Town; Childline; South African Parenting Programme Implementers Network
• Investigators: Principal Investigator: Catherine L Ward, PhD, University of Cape Town

Publications and helpful links

General Publications

• Kroenke K, Spitzer RL, Williams JB, Lowe B. An ultra-brief screening scale for anxiety and depression: the PHQ-4. Psychosomatics. 2009 Nov-Dec;50(6):613-21. doi: 10.1176/appi.psy.50.6.613.
• Lowe B, Kroenke K, Grafe K. Detecting and monitoring depression with a two-item questionnaire (PHQ-2). J Psychosom Res. 2005 Feb;58(2):163-71. doi: 10.1016/j.jpsychores.2004.09.006.
• Staples LG, Dear BF, Gandy M, Fogliati V, Fogliati R, Karin E, Nielssen O, Titov N. Psychometric properties and clinical utility of brief measures of depression, anxiety, and general distress: The PHQ-2, GAD-2, and K-6. Gen Hosp Psychiatry. 2019 Jan-Feb;56:13-18. doi: 10.1016/j.genhosppsych.2018.11.003. Epub 2018 Nov 22.
• Meinck F, Boyes ME, Cluver L, Ward CL, Schmidt P, DeStone S, Dunne MP. Adaptation and psychometric properties of the ISPCAN Child Abuse Screening Tool for use in trials (ICAST-Trial) among South African adolescents and their primary caregivers. Child Abuse Negl. 2018 Aug;82:45-58. doi: 10.1016/j.chiabu.2018.05.022. Epub 2018 May 31.
• Clerkin SM, Marks DJ, Policaro KL, Halperin JM. Psychometric properties of the Alabama parenting questionnaire-preschool revision. J Clin Child Adolesc Psychol. 2007 Mar;36(1):19-28. doi: 10.1080/15374410709336565.
• Kariger P, Frongillo EA, Engle P, Britto PM, Sywulka SM, Menon P. Indicators of family care for development for use in multicountry surveys. J Health Popul Nutr. 2012 Dec;30(4):472-86. doi: 10.3329/jhpn.v30i4.13417.
• Šmahel, D., Macháčková, H., Mascheroni, G., Dědková, L., Staksrud, E., Ólafsson, K., Livingstone, S., & Hasebrink, U. (2020). EU Kids Online 2020: Survey results from 19 countries. https://researchonline.lse.ac.uk/id/eprint/103294/1/EU_Kids_Online_2020_March2020.pdf
• Bhana A, Rathod SD, Selohilwe O, Kathree T, Petersen I. The validity of the Patient Health Questionnaire for screening depression in chronic care patients in primary health care in South Africa. BMC Psychiatry. 2015 May 23;15:118. doi: 10.1186/s12888-015-0503-0.
• Cianchetti C, Pittau A, Carta V, Campus G, Littarru R, Ledda MG, Zuddas A, Fancello GS. Child and Adolescent Behavior Inventory (CABI): A New Instrument for Epidemiological Studies and Pre-Clinical Evaluation. Clin Pract Epidemiol Ment Health. 2013;9:51-61. doi: 10.2174/1745017901309010051. Epub 2013 Feb 22.
• Creswell, J. W., & Creswell, J. D. (2017). Chapter 10: Mixed methods procedures. In Research design: Qualitative, quantitative, and mixed methods approaches (5th ed., pp. 213-246). SAGE Publications.
• Lee GY, Latimer MC, Kelly SM, Verinumbe T, Agee T, Hutton H, Lesko C, Jones J, Schwartz S, Hsu J, Falade-Nwulia O. Utility of the brief Patient Health Questionnaire-2 and Generalized Anxiety Disorder-2 screeners for depression and generalized anxiety symptom identification in people with human immunodeficiency virus. HIV Res Clin Pract. 2026 Dec 31;27(1):2616103. doi: 10.1080/25787489.2026.2616103. Epub 2026 Jan 21.
• McCarty, C.M., & Doyle, S.R. (2001). Parent-Child Communication (Child) (Technical Report). http://www.fasttrackproject.org/
• Ceballo R, Maurizi LK, Suarez GA, Aretakis MT. Gift and sacrifice: parental involvement in Latino adolescents' education. Cultur Divers Ethnic Minor Psychol. 2014 Jan;20(1):116-27. doi: 10.1037/a0033472. Epub 2013 Jul 8.

Helpful Links

• Related Info

Study record dates

Study Major Dates

• Study Start (Actual): February 2, 2026
• Primary Completion (Estimated): October 31, 2026
• Study Completion (Estimated): October 31, 2026

Study Registration Dates

• First Submitted: August 26, 2026
• First Submitted That Met QC Criteria: September 9, 2026
• First Posted (Actual): September 10, 2026

Study Record Updates

• Last Update Posted (Actual): September 10, 2026
• Last Update Submitted That Met QC Criteria: September 9, 2026
• Last Verified: August 1, 2026

More Information

Terms related to this study

• Keywords: Prevention; South Africa; Intervention; Parenting; Digital Intervention; Randomised Controlled Trial; Child Protection; Violence against Children; Sexual Violence Risk; Time Series Design; Public Health System; Child Safety; Low- and Middle-Income Countries
• Additional Relevant MeSH Terms: Behavior; Personal Satisfaction; Psychological Well-Being
• Other Study ID Numbers: SWIFT_study

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: The quantitative (chatbot survey and adolescent telephonic survey) data will be deidentified and published on UCT's open access portal, ZivaHub. Qualitative data will not be published due to deductive disclosure.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP; ICF; ANALYTIC_CODE

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No