Background: Up to 6 years after the 2011 Christchurch earthquakes, approximately one-third of parents in the Christchurch region reported difficulties managing the continuously high levels of distress their children were experiencing. In response, an app named Kākano was co-designed with parents to help them better support their children’s mental health. Objective: The objective of this study was to evaluate the acceptability, feasibility, and effectiveness of Kākano, a mobile parenting app to increase parental confidence in supporting children struggling with their mental health. Methods: A cluster-randomized delayed access controlled trial was carried out in the Christchurch region between July 2019 and January 2020. Parents were recruited through schools and block randomized to receive immediate or delayed access to Kākano. Participants were given access to the Kākano app for 4 weeks and encouraged to use it weekly. Web-based pre- and postintervention measurements were undertaken. Results: A total of 231 participants enrolled in the Kākano trial, with 205 (88.7%) participants completing baseline measures and being randomized (101 in the intervention group and 104 in the delayed access control group). Of these, 41 (20%) provided full outcome data, of which 19 (18.2%) were for delayed access and 21 (20.8%) were for the immediate Kākano intervention. Among those retained in the trial, there was a significant difference in the mean change between groups favoring Kākano in the brief parenting assessment (F1,39=7, P=.012) but not in the Short Warwick-Edinburgh Mental Well-being Scale (F1,39=2.9, P=.099), parenting self-efficacy (F1,39=0.1, P=.805), family cohesion (F1,39=0.4, P=.538), or parenting sense of confidence (F1,40=0.6, P=.457). Waitlisted participants who completed the app after the waitlist period showed similar trends for the outcome measures with significant changes in the brief assessment of parenting and the Short Warwick-Edinburgh Mental Well-being Scale. No relationship between the level of app usage and outcome was found. Although the app was designed with parents, the low rate of completion of the trial was disappointing. Conclusions: Kākano is an app co-designed with parents to help manage their children’s mental health. There was a high rate of attrition, as is often seen in digital health interventions. However, for those who did complete the intervention, there was some indication of improved parental well-being and self-assessed parenting. Preliminary indications from this trial show that Kākano has promising acceptability, feasibility, and effectiveness, but further investigation is warranted. Trial Registration: Australia New Zealand Clinical Trials Registry ACTRN12619001040156; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377824&isReview=true
A video of a presentation by Professor David Johnston during the fourth plenary of the 2016 People in Disasters Conference. Johnston is a Senior Scientist at GNS Science and Director of the Joint Centre for Disaster Research in the School of Psychology at Massey University. The presentation is titled, "Understanding Immediate Human Behaviour to the 2010-2011 Canterbury Earthquake Sequence, Implications for injury prevention and risk communication".The abstract for the presentation reads as follows: The 2010 and 2011 Canterbury earthquake sequences have given us a unique opportunity to better understand human behaviour during and immediately after an earthquake. On 4 September 2010, a magnitude 7.1 earthquake occurred near Darfield in the Canterbury region of New Zealand. There were no deaths, but several thousand people sustained injuries and sought medical assistance. Less than 6 months later, a magnitude 6.2 earthquake occurred under Christchurch City at 12:51 p.m. on 22 February 2011. A total of 182 people were killed in the first 24 hours and over 7,000 people injured overall. To reduce earthquake casualties in future events, it is important to understand how people behaved during and immediately after the shaking, and how their behaviour exposed them to risk of death or injury. Most previous studies have relied on an analysis of medical records and/or reflective interviews and questionnaire studies. In Canterbury we were able to combine a range of methods to explore earthquake shaking behaviours and the causes of injuries. In New Zealand, the Accident Compensation Corporation (a national health payment scheme run by the government) allowed researchers to access injury data from over 9,500 people from the Darfield (4 September 2010) and Christchurch (22 February 2011 ) earthquakes. The total injury burden was analysed for demography, context of injury, causes of injury, and injury type. From the injury data inferences into human behaviour were derived. We were able to classify the injury context as direct (immediate shaking of the primary earthquake or aftershocks causing unavoidable injuries), and secondary (cause of injury after shaking ceased). A second study examined people's immediate responses to earthquakes in Christchurch New Zealand and compared responses to the 2011 earthquake in Hitachi, Japan. A further study has developed a systematic process and coding scheme to analyse earthquake video footage of human behaviour during strong earthquake shaking. From these studies a number of recommendations for injury prevention and risk communication can be made. In general, improved building codes, strengthening buildings, and securing fittings will reduce future earthquake deaths and injuries. However, the high rate of injuries incurred from undertaking an inappropriate action (e.g. moving around) during or immediately after an earthquake suggests that further education is needed to promote appropriate actions during and after earthquakes. In New Zealand - as in US and worldwide - public education efforts such as the 'Shakeout' exercise are trying to address the behavioural aspects of injury prevention.
