title: If You Build It, Will They Come? Patterns of Internet-Based and Face-To-Face Participation in a Parenting Program for Military Families.
abstract: Some evidence suggests parents are drawn to media-based interventions over face-to-face interventions, but little is known about the factors associated with parents' use of Internet-based or Internet-enhanced programs, especially among military families. Research is needed to understand characteristics of parents who may be most likely to use online components or attend face-to-face meetings in order to ensure maximum engagement.
  
  
  
  In this study, we examined characteristics that predict various patterns of Internet use and face-to-face attendance in a parenting program designed for military families.
  
  
  
  An ecological framework guided analysis of differences in patterns of Internet-based use and face-to-face attendance by parents' demographic characteristics (gender, education, employment, and child age), incentives offered, and number of months the parent was deployed. We reported differences in the total number of online components completed over the 14 modules, total number of face-to-face sessions attended, and the use of different types of online components accessed (videos, downloadable handouts, mindfulness exercises, knowledge checks, and downloadable summaries). Then, we computed multinomial logistic regression accounting for nestedness (parents within families) to examine associations between demographic, programmatic, and military-related characteristics and patterns of engagement (use of online components and attendance at face-to-face sessions).
  
  
  
  Just over half (52.2%, 193/370) of the participants used the online components at least once, and the majority of participants (73.2%, 271/370) attended at least 1 face-to-face session. An examination of different patterns of participation revealed that compared with those who participated primarily in face-to-face sessions, parents who participated online but had little face-to-face participation were more likely to have received incentives than those who did not (95% CI 1.9-129.7). Among participants who had been deployed, those who had earned a 4-year degree (95% CI 1.0-2.2) and those who had been offered incentives to participate online (95% CI 2.1-58.6) were more likely to be highly engaged in online components and attend face-to-face compared with those who attended primarily face-to-face. However, those with a high number of months of deployment (95% CI 0.6-1.0) were less likely to be in the pattern of highly engaged in online components and face-to-face attendance. Compared with those who participated primarily face-to-face, deployed mothers were about 4 times more likely to engage in moderate online use with face-to-face attendance than deployed fathers (95% CI 1.21-11.83) and participate primarily online (95% CI 0.77-25.20).
  
  
  
  Results imply that parents may be drawn to different delivery options of a parenting program (online components vs face-to-face sessions) depending on their education level, incentives to engage in online components, and their military-related experience. Results suggest potential directions for tailoring Internet-based interventions.
authors.affiliation: University of Minnesota, Division of General Pediatrics & Adolescent Health, Department of Pediatrics, Minneapolis, MN, United States.
authors.forename: Jennifer L
authors.identifier: 0000-0001-8603-2721
authors.initials: JL
authors.lastname: Doty
authors.forename: Jessie H
authors.identifier: 0000-0002-5836-6254
authors.initials: JH
authors.lastname: Rudi
authors.forename: Keri L M
authors.identifier: 0000-0003-1785-374X
authors.initials: KL
authors.lastname: Pinna
authors.forename: Sheila K
authors.identifier: 0000-0001-6314-2848
authors.initials: SK
authors.lastname: Hanson
authors.forename: Abigail H
authors.identifier: 0000-0001-7376-2952
authors.initials: AH
authors.lastname: Gewirtz
mesh_terms: D000328:Adult; D002648:Child; D002675:Child, Preschool; D004522:Educational Status; D005191:Family Characteristics; D005260:Female; D006801:Humans; D007182:Income; D020407:Internet; D008297:Male; D066067:Military Family; D009042:Motivation; D016487:Parenting; D010290:Parents
keywords: Internet; evidence-based practice; interactive media; military; parenting; prevention