Providing care for children with mental illness is associated with significant caregiver
burden that manifests in physical, psychological, and social ways. Caregiver burden is
largely associated with child symptom severity. As such, reducing child symptom severity
should reduce caregiver burden. Yet, caregiver burden is not commonly assessed as an
outcome of mental health interventions and little is known about the impact of
child-focused novel digital mental health interventions on caregiver burden.
Mightier is an app-based biofeedback video game platform that utilizes heart rate (HR)
monitoring during game play to teach and facilitate practice of emotional regulation
skills in children. The effectiveness of Mightier has been supported through several
studies in children ages 8-18, specifically reducing symptoms of aggression, oppositional
behavior, and parental stress. While prior work has supported that Mightier as a
child-based intervention also decreases parent stress, we have not examined if child use
of Mightier meaningfully impacts caregiver wellbeing, or if these changes translate to
changes in work engagement or absenteeism. The proposed study will be a single arm trial
where parents and caregivers who have purchased Mightier will complete baseline and
follow up self-report measures assessing presenteeism, absenteeism, parenting stress, and
overall wellbeing.
For this proposed study we hypothesize the following:
Participants will report significant reduction in parent stress and absenteeism and
a significant increase in overall wellbeing and presenteeism.
Changes in participant stress will be negatively associated with child minutes of
Mightier use and changes in participant wellbeing will be positively associated with
child minutes of Mightier use.
Children of participants who report positive change in work productivity (increases
in presenteeism or decreases in absenteeism) will have used Mightier significantly
more than those who do not report positive change.
For the duration of the 8-12 week intervention period, participants will play Mightier
and engage with Mightier parent content ad libitum. They will not receive any special
instructions or recommendations outside of those provided to all Mightier families.
Consistent with any other family using Mightier, participating families will be free to
engage with or deny all programming associated with Mightier (e.g. email updates and
other support). All individuals engaging with participating families to facilitate the
standard Mightier experience will be blinded to their participation in research.
Participating families will be contacted via email to complete follow-up measures. These
emails will be sent 1) 8 weeks after participants complete the first assessment and 2) 12
weeks after participants complete their first assessment. Participants will be sent the
12 week follow up email regardless of 8 week follow up assessment completion.
Participants will only be sent these emails if they are customers of Mightier at the time
of follow up.