Visits to the pediatric outpatient clinic are often accompanied by stress and anxiety, not only in the child but also within the parents. Within current trends in healthcare, parents are becoming more and more involved in the treatment of their child. The Hospital Hero Foundation, that already developed an app to reduce hospital related fear and anxiety in children, therefore showed interest in the question of how to support parents with this more engaged role.

IMPORTANCE OF PARENTAL SUPPORT
Literature showed that outside of the hospital context, when healthcare professionals are not present, children depend on their parents to provide the needed support. Also, during the outpatient visit parents play a very important role: children tend to look at their parents in stressful situations to determine an appropriate response. For parents to be able to execute existing strategies to reduce stress in their child, they need to possess the necessary knowledge and skills. More importantly, parents need to be able to manage their own stress, to not transmit this stress onto their child.

CHALLENGS OF PARENTS
Observations in pediatric outpatient clinics and interviews with parents and healthcare professionals confirmed and added to the previously described findings. According to this research, parents would ideally be honest, calm and radiate trust when supporting their child. The outpatient trajectory of their child, though, comes with an increase in (perceived) responsibilities of the parent possibly causing parents to be stressed. In this context, parents are generally fully focused on their child, making them unaware of their own increasing stress levels. Challenges parents experience in the context of the pediatric outpatient trajectory of their child are (1) Engaging with their social environment, (2) Gaining information, (3) Taking care of oneself, (4) Seeing their child in pain, (5) Supporting their child and (6) Working together with healthcare professionals. Support mechanisms to help parents deal with these challenges are limited and often not received by parents.

MANAGING PARENTAL STRESS
To manage parental stress, an intervention that supports parents of pediatric patients (aged 4-10 years old) with their challenges in the context of outpatient visits was designed. The focus thereby was to help parents to take care of themselves. Several brainstorming activities were executed in the ideation phase. The created bulk of ideas converged into 3 concepts, which were compared based on insights gained in this project and interviews with stakeholders. The most favorable concept was further developed into the Final Concept: the Care Companion app.

THE CARE COMPANION APP
The Care Companion app is a standalone app offered to parents by the Hospital Hero Foundation. It offers parents both affirmations as well as general tips for situations and challenges they can possibly encounter in the outpatient trajectory of their child. Each tip consists of advice from an expert and an experience from another parent. The provided tips can be read, saved and shared. A short evaluation with parents and an expert showed promising results for the concept of the Care Companion app.