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  <front>
    <journal-meta>
      <journal-id journal-id-type="publisher-id">IPROC</journal-id>
      <journal-id journal-id-type="nlm-ta">iproc</journal-id>
      <journal-title>Iproceedings</journal-title>
      <issn pub-type="epub">2369-6893</issn>
      <publisher>
        <publisher-name>JMIR Publications</publisher-name>
        <publisher-loc>Toronto, Canada</publisher-loc>
      </publisher>
    </journal-meta>
    <article-meta>
      <article-id pub-id-type="publisher-id">v8i1e39285</article-id>
      <article-id pub-id-type="pmid"/>
      <article-id pub-id-type="doi">10.2196/39285</article-id>
      <article-categories>
        <subj-group subj-group-type="heading">
          <subject>Abstract</subject>
        </subj-group>
        <subj-group subj-group-type="article-type">
          <subject>Abstract</subject>
        </subj-group>
      </article-categories>
      <title-group>
        <article-title>A Technology-Based Intervention to Help Health Care Provider Parents Manage Stress During the COVID-19 Pandemic: Findings From a Pilot Microrandomized Trial</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="editor">
          <name>
            <surname>Pagoto</surname>
            <given-names>Sherry</given-names>
          </name>
        </contrib>
      </contrib-group>
      <contrib-group>
        <contrib id="contrib1" contrib-type="author" corresp="yes">
          <name name-style="western">
            <surname>Lee</surname>
            <given-names>Sun-Kyung</given-names>
          </name>
          <degrees>PhD</degrees>
          <xref rid="aff1" ref-type="aff">1</xref>
          <address>
            <institution>REACH Institute</institution>
            <institution>Department of Psychology</institution>
            <institution>Arizona State University</institution>
            <addr-line>900 S. McAllister Ave. Room</addr-line>
            <addr-line>ASU Psychology North Building</addr-line>
            <addr-line>Tempe, AZ, 85287</addr-line>
            <country>United States</country>
            <phone>1 6124588519</phone>
            <email>sunkyung.lee@asu.edu</email>
          </address>
          <ext-link ext-link-type="orcid">https://orcid.org/0000-0003-4830-3417</ext-link>
        </contrib>
        <contrib id="contrib2" contrib-type="author">
          <name name-style="western">
            <surname>Cai</surname>
            <given-names>Qiyue</given-names>
          </name>
          <degrees>MA</degrees>
          <xref rid="aff1" ref-type="aff">1</xref>
        </contrib>
        <contrib id="contrib3" contrib-type="author">
          <name name-style="western">
            <surname>Basha</surname>
            <given-names>Sydni</given-names>
          </name>
          <degrees>BSc</degrees>
          <xref rid="aff1" ref-type="aff">1</xref>
        </contrib>
        <contrib id="contrib4" contrib-type="author">
          <name name-style="western">
            <surname>Gupta</surname>
            <given-names>Aditi</given-names>
          </name>
          <degrees>MA</degrees>
          <xref rid="aff1" ref-type="aff">1</xref>
        </contrib>
        <contrib id="contrib5" contrib-type="author">
          <name name-style="western">
            <surname>Gewirtz</surname>
            <given-names>Abigail</given-names>
          </name>
          <degrees>PhD</degrees>
          <xref rid="aff1" ref-type="aff">1</xref>
        </contrib>
      </contrib-group>
      <aff id="aff1">
        <label>1</label>
        <institution>REACH Institute</institution>
        <institution>Department of Psychology</institution>
        <institution>Arizona State University</institution>
        <addr-line>Tempe, AZ</addr-line>
        <country>United States</country>
      </aff>
      <author-notes>
        <corresp>Corresponding Author: Sun-Kyung Lee <email>sunkyung.lee@asu.edu</email></corresp>
      </author-notes>
      <pub-date pub-type="collection">
        <season>Jan-Dec</season>
        <year>2022</year>
      </pub-date>
      <pub-date pub-type="epub">
        <day>22</day>
        <month>6</month>
        <year>2022</year>
      </pub-date>
      <volume>8</volume>
      <issue>1</issue>
      <elocation-id>e39285</elocation-id>
      <history>
        <date date-type="received">
          <day>5</day>
          <month>5</month>
          <year>2022</year>
        </date>
        <date date-type="accepted">
          <day>3</day>
          <month>6</month>
          <year>2022</year>
        </date>
      </history>
      <copyright-statement>©Sun-Kyung Lee, Qiyue Cai, Sydni Basha, Aditi Gupta, Abigail Gewirtz. Originally published in Iproceedings (https://www.iproc.org), 22.06.2022.</copyright-statement>
      <copyright-year>2022</copyright-year>
      <license license-type="open-access" xlink:href="https://creativecommons.org/licenses/by/4.0/">
        <p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in Iproceedings, is properly cited. The complete bibliographic information, a link to the original publication on https://www.iproc.org/, as well as this copyright and license information must be included.</p>
      </license>
      <self-uri xlink:href="https://www.iproc.org/2022/1/e39285" xlink:type="simple"/>
      <abstract>
        <sec sec-type="background">
          <title>Background</title>
          <p>The COVID-19 pandemic has increased the stress levels of parents, especially health care workers and other COVID-19 frontline workers. Nonetheless, little is known about stress management for this population.</p>
        </sec>
        <sec sec-type="objective">
          <title>Objective</title>
          <p>This pilot study tested the impact of a mobile app <italic>apt.mind</italic> in reducing stress in health care provider parents by delivering a 30-day microrandomized intervention.</p>
        </sec>
        <sec sec-type="methods">
          <title>Methods</title>
          <p>Participants included 102 parents who work in health care and their coparenting partners. They were given smartwatches and access to a mindfulness app. Each day, all parents were randomly assigned to (1) brief stress reduction messages, (2) meditation audio activities via the app, or (3) no intervention. Stress was evaluated using a self-reported COVID-19 Family Stressor Screener (10 items; 5-point Likert scale) to rate levels of stress regarding food security, job stability, family conflict, mental health, and social isolation. Dosage was measured by the percentage of parents who received any of the activities (app or messages; mean 66%, SD 9.8%), and parents were divided into 3 groups by dosage level: low (below 60%), middle (61%-70%), and high (above 71%).</p>
        </sec>
        <sec sec-type="results">
          <title>Results</title>
          <p>Using a pre-post test, this study assessed changes in mental health symptoms and parenting by individuals’ dosage levels. Participants who received high levels of intervention reported significant decreases in COVID-19–related family stress (<italic>t</italic>=–2.50; <italic>P</italic>=.02) and a significant increase in parenting efficacy (<italic>t</italic>=2.39; <italic>P</italic>=.03), while those who received low or middle levels of the intervention did not show those changes.</p>
        </sec>
        <sec sec-type="conclusions">
          <title>Conclusions</title>
          <p>This study supports the feasibility and efficacy of technology-based tools to reduce stress and the need to examine just-in-time interventions. Future studies can improve by focusing on microchanges in the parents’ stress level on a daily basis and including physiological data such as heart rate variability to include objective stress data.</p>
        </sec>
        <sec>
          <title>Conflicts of Interest</title>
          <p>None declared.</p>
        </sec>
      </abstract>
      <kwd-group>
        <kwd>stress</kwd>
        <kwd>parenting</kwd>
        <kwd>meditation</kwd>
        <kwd>microrandomized trial</kwd>
        <kwd>smartwatches</kwd>
        <kwd>mobile application</kwd>
        <kwd>app</kwd>
        <kwd>COVID-19</kwd>
      </kwd-group>
    </article-meta>
  </front>
</article>
