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JMIR Pediatrics and Parenting

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Journal Description

JMIR Pediatrics and Parenting (JPP) is a new sister journal of JMIR (the leading open-access journal in health informatics (Impact Factor 2016: 5.175), with a unique focus on technologies, medical devices, apps, engineering, informatics applications for patient/parent education in pediatrics, training/counselling and behavioral interventions, preventative interventions and clinical care for children and adolescent populations or child-parent dyads. JPP recognizing that pediatrics in the 21st century should be a participatory process, involving parents and informal caregivers, and using information and communication technologies.

As open access journal we are read by clinicians and patients alike and have (as all JMIR journals) a focus on readable and applied science reporting the design and evaluation of health innovations and emerging technologies. We publish original research, viewpoints, and reviews (both literature reviews and medical device/technology/app reviews).

During a limited period of time, there are no fees to publish in this journal. Articles are carfully copyedited and XML-tagged, ready for submission in PubMed Central.

Be a founding author of this new journal and submit your paper today!


 

Recent Articles:

  • Source: Pxhere.com; Copyright: Pxhere.com; URL: https://pxhere.com/en/photo/938233; License: Public Domain (CC0).

    Combining Activity Trackers With Motivational Interviewing and Mutual Support to Increase Physical Activity in Parent-Adolescent Dyads: Longitudinal...

    Abstract:

    Background: An essential component of any effective adolescent weight management program is physical activity (PA). PA levels drop dramatically in adolescence, contributing to the rising prevalence of adolescent obesity. Therefore, finding innovative interventions to address this decline in PA may help adolescents struggling with weight issues. The growing field of health technology provides potential solutions for addressing chronic health issues and lifestyle change, such as adolescent obesity. Activity trackers, used in conjunction with smartphone apps, can engage, motivate, and foster support among users while simultaneously providing feedback on their PA progress. Objective: The objective of our study was to evaluate the effect of a 10-week pilot study using smartphone-enabled activity tracker data to tailor motivation and goal setting on PA for overweight and obese adolescents and their parents. Methods: We queried enrolled adolescents, aged 14 to 16 years, with a body mass index at or above the 85th percentile, and 1 of their parents as to behaviors, barriers to change, and perceptions about exercise and health before and after the intervention. We captured daily step count and active minutes via activity trackers. Staff made phone calls to dyads at weeks 1, 2, 4, and 8 after enrollment to set daily personalized step-count and minutes goals based on their prior data and age-specific US national guidelines. We evaluated dyad correlations using nonparametric Spearman rank order correlations. Results: We enrolled 9 parent-adolescent dyads. Mean adolescent age was 15 (SD 0.9) years (range 14-16 years; 4 female and 5 male participants); mean parent age was 47 (SD 8.0) years (range 36-66 years). On average, adolescents met their personalized daily step-count goals on 35% (range 11%-62%) of the days they wore their trackers; parents did so on 39% (range 3%-68%) of the days they wore their trackers. Adolescents met their active-minutes goals on 55% (range 27%-85%) of the days they wore their trackers; parents did so on 83% (range 52%-97%) of the days. Parent and adolescent success was strongly correlated (step count: r=.36, P=.001; active minutes: r=.30, P=.007). Parental age was inversely correlated with step-count success (r=–.78, P=.01). Conclusions: Our findings illustrate that parent-adolescent dyads have highly correlated PA success rates. This supports further investigation of family-centered weight management interventions for adolescents, particularly those that involve the parent and the adolescent working together.

  • Source: Flickr; Copyright: Royalty-Free/Corbis; URL: https://www.flickr.com/photos/stiel/6976622479/; License: Creative Commons Attribution + Noncommercial + ShareAlike (CC-BY-NC-SA).

    Adolescents’ Perspectives on Using Technology for Health: Qualitative Study

    Abstract:

    Background: Adolescents’ wide use of technology opens up opportunities to integrate technology into health visits and health care. In particular, technology has the potential to influence adolescent behavior change by offering new avenues for provider communication and support for healthy choices through many different platforms. However, little information exists to guide the integration of technology into adolescent health care, especially adolescents’ perspectives and preferences for what they find useful. Objective: This qualitative study aimed to take a broad approach to understanding adolescents’ use of technology for supporting their overall health and to understand whether and how adolescents envision using technology to enhance their health and clinical care, particularly in communicating with their provider. Methods: Adolescents (13-18 years) were recruited to participate in semi-structured, in-depth individual interviews. Potential participants were approached in-person through the Seattle Children's Hospital Adolescent Medicine Clinic while they were waiting for consultation appointments, through outreach to youth who expressed interest in other local research study activities, and via flyers in waiting rooms. Interviews were recorded, transcribed, and analyzed using a thematic analysis approach. Results: Thirty-one adolescents (58% female, mean age 15.2 years) were interviewed and described 3 main uses of technology: (1) to gather information, (2a) to share their own experiences and (2b) view others’ experiences in order to gain social support or inspiration, and (3) to track behaviors and health goals. Perceived benefits and potential downsides were identified for technology use. Teens desired to use technology with their provider for 3 main reasons: (1) have questions answered outside of visits, (2) have greater access to providers as a way to build relationship/rapport, and (3) share data regarding behaviors in between visits. Social media was not a preferred method for communicating with providers for any of the youth due to concerns about privacy and intrusiveness. Conclusions: Although youth are avid users of technology in general, in regard to technology for health, they display specific use preferences especially in how they wish to use it to communicate with their primary care provider. Health care providers should offer guidance to youth with regard to how they have used and plan to use technology and how to balance potential positives and negatives of use. Technology developers should take youth preferences into account when designing new health technology and incorporate ways they can use it to communicate with their health care provider.

  • Source: Flickr; Copyright: Metropolitan Transportation Authority of the State of New York; URL: https://www.flickr.com/photos/mtaphotos/22161337553/in/photolist-h7vAAg-h7vNGw-h7wZqR-h7vPhE-h7wWAV-AHd9xp-AEUYn1-AG1R3j-AG1Rij-AG1Rss-AJcDt2-AJcDA6-AG1Qyo-zLjDyM-AEUZ6f-AJcDNF-AHd9kR-AJcDdx-AJcDw8-h7vNNd-ejG4uX-h7vVT3-dTrw4p-h7vANR-h7vATk-AqAMaL; License: Creative Commons Attribution (CC-BY).

    Theoretically-Based Emotion Regulation Strategies Using a Mobile App and Wearable Sensor Among Homeless Adolescent Mothers: Acceptability and Feasibility Study

    Abstract:

    Background: Many adolescent mothers are parenting young children under highly stressful conditions as they are managing first-time parenthood, poverty, lack of housing, school and work, and challenging peer and familial relationships. Mobile health (mHealth) technology has the potential to intervene at various points in the emotion regulation process of adolescent mothers to provide them support for more adaptive emotional and behavioral regulation in the course of their daily life. Objective: The goal of this study was to examine the acceptability, feasibility, use patterns, and mechanisms by which a mobile technology used as an adjunct to in-person, provider-delivered sessions fostered adolescent mothers’ adaptive emotion regulation strategies under real-life conditions. Methods: Participants (N=49) were enrolled in the intervention condition of a larger pilot study of homeless adolescent mothers living in group-based shelters. The mHealth technology, Calm Mom, consisted of a mobile app and a wrist-worn sensorband for the ambulatory measurement and alerting of increased electrodermal activity (EDA), a physiological measurement of stress. We examined logs of mobile app activity and conducted semistructured qualitative interviews with a subsample (N=10) of participants. Qualitative data analysis was guided by the theoretical frames of the intervention and a technology acceptance model and included an analysis of emerging themes and concepts. Results: Overall, participants indicated that one or more of the elements of Calm Mom supported their ability to effectively regulate their emotions in the course of their daily life in ways that were consonant with the intervention’s theoretical model. For many adolescent mothers, the app became an integral tool for managing stress. Due to technical challenges, fewer participants received sensorband alerts; however, those who received alerts reported high levels of acceptability as the technology helped them to identify their emotions and supported them in engaging in more adaptive behaviors during real-life stressful situations with their children, peers, and family members. Conclusions: Calm Mom is a promising technology for providing theoretically driven behavioral intervention strategies during real-life stressful moments among a highly vulnerable population. Future research efforts will involve addressing technology challenges and refining tailoring algorithms for implementation in larger-scale studies.

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Latest Submissions Open for Peer-Review:

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  • Feasibility of Using an Automated Device (iThermonitor) for Continuous Temperature Monitoring in Pediatric Patients

    Date Submitted: Apr 17, 2018

    Open Peer Review Period: Apr 19, 2018 - Jun 14, 2018

    Background: Fever is an important vital sign and often the first one to be assessed in a sick child. In acutely ill children, caregivers are expected to monitor a child’s body temperature at home af...

    Background: Fever is an important vital sign and often the first one to be assessed in a sick child. In acutely ill children, caregivers are expected to monitor a child’s body temperature at home after an initial medical consult. Fever literacy of many caregivers is known to be poor, and coupled with fever phobia, results in unnecessary healthcare utilization. In children with a serious illness, the responsibility of periodically monitoring temperature can add substantially to the already stressful experience of caring for a sick child. Objective: We conducted a pilot study to assess the feasibility of using the iThermonitor, an automated temperature measurement device, for continuous temperature monitoring in post-operative and post-chemotherapy pediatric patients. Methods: We recruited 25 patient-caregiver dyads from the Pediatric Surgery Department at the Massachusetts General Hospital (MGH), and the Pediatric Cancer Centers at the MGH & the Dana Farber Cancer Institute. Enrolled dyads were asked to use the iThermonitor device for continuous temperature monitoring over a 2-week period. Surveys were administered to caregivers at enrollment and at study closeout. Caregivers were also asked to complete a daily event monitoring log. The Generalized Anxiety Disorder-7 item (GAD-7) questionnaire was used to assess caregiver anxiety at enrollment and closeout. Results: 19 participant dyads completed the study. All 19 caregivers reported to have viewed temperature data on the study provided iPad tablet at least once per day, and more than a third did so 6 or more times per day. 74% of participants reported experiencing an out-of-range temperature alert at least once during the study. Majority of caregivers reported that it was easy to learn how to use the device, and that they felt confident about monitoring their child’s temperature with it. Only 21% of caregivers reported concurrently using a device other than the iThermonitor to monitor their child’s temperature during the study. Continuous temperature monitoring was not associated with an increase in caregiver anxiety. Conclusions: The iThermonitor is a highly feasible and easy to use device for continuous temperature monitoring in pediatric oncology and surgery patients. Clinical Trial: ClinicalTrials.gov Identifier: NCT02410252 (March 30, 2015)

  • Usability and Acceptability of a Text Message-based Developmental Screening Tool for Young Children

    Date Submitted: Apr 18, 2018

    Open Peer Review Period: Apr 19, 2018 - Apr 26, 2018

    Background: Only 30% of parents of children 9-35 months old report that their child had a developmental screening in the previous year – despite American Academy of Pediatrics’ recommendations for...

    Background: Only 30% of parents of children 9-35 months old report that their child had a developmental screening in the previous year – despite American Academy of Pediatrics’ recommendations for early screening, when interventions can be most beneficial. Seeking to build on the dramatic growth of text messaging to increase access to screening, the founders of Text4baby, a national perinatal texting program, created an interactive text message-based version of PEDS:DM (Parents’ Evaluation of Developmental Status: Developmental Milestones) – a validated screening tool. The study team worked with the Maryland Department of Health and Mental Hygiene (MDHMH) and Prince George’s County Women, Infants and Children (WIC) Program and Infant and Toddlers Program (ITP) to pilot the tool. Objective: This study assesses the usability and acceptability of a text message-based developmental screening tool among low-income mothers. Methods: Low-income mothers of infants 8-10 months old were recruited in WIC clinics. After a background survey, participants used their mobile phones to trigger and respond to six developmental screening questions. After confirming their responses, they received results. Project staff called and surveyed participants about their experience and invited a subset to attend focus groups. Data were collected between August 2014 and April 2015. Descriptive and thematic analyses were conducted on system, survey and focus group data. Results: Eighty-one mothers enrolled in the study and most reported that their infants received Medicaid. Forty-nine percent were classified as Hispanic/Latina (40/81) and 42% were Black (34/81). Eighty percent participated in follow-up surveys (65/81); 14 mothers attended focus groups. All participants initiated the screening and responded to all questions. Seventy-nine percent immediately confirmed their responses (64/81); 21% wanted to make one or more changes (27/81). Mothers completing the screening on their first attempt averaged 4:44 minutes total time compared to 9:23 minutes for those who made two attempts. Based on final responses, 63% received a text that baby was “doing well” in all six developmental domains (51/81); 37% received texts listing domains where “baby was doing well” and one or more domains where “baby may be behind (30/81).” All mothers received a text with resources for follow-up. All participants surveyed post screening said they wanted to answer screening questions again when their baby was older (65/65); all but one would recommend the tool to a friend; and 98% (64/65) rated the experience of answering questions and getting feedback by text as “very good” or “good.” Conclusions: Low-income mothers were able to use a mobile text version of a validated developmental screening tool. Mothers could enroll, respond to screening questions, and receive results and resources via text messages. Results may inform future research and options for scalable, mobile text-based developmental screening, such as an offering within Text4baby.

  • Leveraging Family to Promote Digital Health: Findings from the Pokémon GO Mixed Methods Study of Children and Families

    Date Submitted: Apr 9, 2018

    Open Peer Review Period: Apr 11, 2018 - Jun 6, 2018

    Background: Pokémon GO illuminated the potential for mobile gaming apps to engage users and promote health. However, much work is needed to fully understand mechanisms through which digitally support...

    Background: Pokémon GO illuminated the potential for mobile gaming apps to engage users and promote health. However, much work is needed to fully understand mechanisms through which digitally supported behavior change intervention operate, particularly for children and families. Objective: The goal of the current study was to explore the user-experience and changes in physical activity since playing Pokémon GO from a family perspective and within the greater context of family health. Specifically, factors related to engagement, user trends over time, and health were examined from the perspective of parents, adult caregivers, and children/teen Pokémon GO players. Methods: In January-February 2017, congruent with one of the largest anticipated Pokémon GO updates “Gen 2,” a retrospective pre-post design was used to investigate changes in physical activity in parents and adult caregivers since playing Pokémon GO. Additional descriptive data was collected via a survey that incorporated both closed and open-ended questions from parents and adult caregivers who were impacted by a child/teen that played Pokémon GO. Children/teens who played Pokémon GO were also invited to participate. Results: Self-reported data from 160 adults and 31 children were included in the final analyses (representing 129 adults and 31 parent-child dyads). Gameplay most often occurred between mothers and sons ≤10 years old. “Spending time together” was the most cited reason for gameplay by both adults (76.3%) and children (77.4%), followed by “it helped me go outdoors” (70.1%) for adults and “I am a Pokémon fan” (67.7%) by children. Playing Pokémon GO also helped to satisfy the top three identified family goals: having fun, spending more time/quality time with child, and exercising more. Unique to this population, open-ended responses indicated child gameplay could trigger both positive and negative emotional parent response. Boredom was the most cited reason for app disengagement, while in-app events most contributed to reengagement. For adults, there were significant increases in minutes spent in mild (M=23.36, SD = 66.02; t(97)=3.50, P=.001) and moderate (M=21.76, SD 53.04; t(130)=4.70, P=.000) physical activity per week after playing Pokémon GO. However, dyadic data indicated that child perceptions of parental influence on physical activity most significantly associated with parents who reported weekly strenuous physical activity both before (rs =.514, P=.003) and after (rs =.536, P=.003) Pokémon GO uptake. Conclusions: Pokémon GO transcended traditional understanding of digital health and uniquely reached across generations to engage users. Findings from this study highlight that, for a period of time, Pokémon GO fostered social and physical well-being for children and families through a multifaceted approach.

  • Fertility Preservation in Children and Adolescents with Cancer: Development and Pilot of a Decision Aid for Parents of Children with Cancer

    Date Submitted: Mar 21, 2018

    Open Peer Review Period: Mar 22, 2018 - May 17, 2018

    Background: As more than 86% of child and adolescent-young-adult cancer patients survive into adulthood and childbearing age, the impact of long term side effects of life-saving cancer treatments are...

    Background: As more than 86% of child and adolescent-young-adult cancer patients survive into adulthood and childbearing age, the impact of long term side effects of life-saving cancer treatments are now emerging. Research has shown that infertility, due to gonadotoxic cancer treatments, has a significant impact on future quality of life. The incidence of childhood cancers is growing; future infertility in this cohort is a significant concern. Pre-treatment fertility preservation in this population is complex due to time limitations, the experimental nature of some fertility preservation procedures, and the role of parents as proxy decision-makers. Objective: This article outlines the development and pilot of a novel, online fertility preservation DA (an international first) for patients’ parents that aims to support decision-making in this vulnerable cohort. Methods: The electronic DA was developed according to International Patient Decision Aid Standards. A study of parents of cancer patients who had a discussion regarding fertility, and clinicians at a tertiary children’s hospital was undertaken to assess satisfaction with the DA, parental knowledge regarding fertility, Decision Regret around their fertility decision, before and after review of the DA. Results: 34 parents and 11 clinicians participated. All participants who viewed the DA (15 parents, 11 clinicians) expressed satisfaction with its content and functionality. Most parents (86%) would recommend the decision aid for other parents. Conclusions: The DA was relevant and acceptable to parents and clinicians. Future research is needed to assess the impact of the DA on prospective decision-making. It is an international standard of care to discuss the impact of cancer treatment on fertility before cancer treatment. Fertility preservation in children is experimental and ethically complex. This is the first fertility DA for parents of children with cancer, which has the potential to support informed fertility-related decision-making for their children. Clinical Trial: N/A

  • Parent Preferences for Methods and Content of Technology Based Asthma Risk Communication

    Date Submitted: Mar 7, 2018

    Open Peer Review Period: Mar 8, 2018 - May 3, 2018

    Background: Interventions to improve preventive care delivery to children with asthma are increasingly designed around mobile technology. Objective: Our objective was to develop insight into parent us...

    Background: Interventions to improve preventive care delivery to children with asthma are increasingly designed around mobile technology. Objective: Our objective was to develop insight into parent use of mobile technology and their preferences for methods and content of an asthma risk communication intervention. Methods: Using qualitative methods, interviews of parents of children with asthma were conducted. The open-ended, semi-structured interview guide included questions about current mobile technology use, barriers to controller medication adherence, and preferences for methods and content of a mobile technology based asthma risk communication intervention. Using grounded theory methodology, we coded the transcripts and identified emerging themes. Results: 20 parents of children with asthma completed interviews. 80% had public insurance. 40% had been in the ICU for their asthma at some point. 35% were currently on a combined ICS/LABA. 3 major themes were identified: Room for improvement/welcoming help, distinct preferences for risk communication, and electronic reachability. Room for improvement/welcoming help includes caretakers recognizing that busy lifestyles contribute to adherence challenges and welcoming a program to help them manage their child’s asthma. Distinct preferences for risk communication includes a need for two-way communication, preference for electronic communication as well as acceptable communication frequency. Electronic reachability includes parents’ electronic habits and specific preferences for electronic communication. Conclusions: Parents of children with asthma are open to communicating with asthma healthcare providers through mobile technology. There is a strong preference for two-way communication. This will inform the development of future mobile technology based interventions to improve care for children with asthma. Clinical Trial: NA

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