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JMIR Pediatrics and Parenting (JPP) is a new sister journal of JMIR (the leading open-access journal in health informatics (Impact Factor 2017: 4.671), 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 an 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!
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Background: Over 20,000 parents in the United States face the extraordinary challenge of participating in decisions about whether to use life support for their infant(s) born on the cusp of viability....
Background: Over 20,000 parents in the United States face the extraordinary challenge of participating in decisions about whether to use life support for their infant(s) born on the cusp of viability. Clinicians must help these families grasp complex medical information about their baby’s immediate prognosis as well as the risk for significant long-term morbidity. Patients faced with this decision desire supplemental information and frequently seek medical information on the internet. Empiric evidence about the quality of websites, however, is lacking. Objective: We sought to evaluate the quality of online information available about periviable birth and treatment options for infants born at the cusp of viability. Methods: We read a counseling script that included information typically provided by obstetrical and neonatal providers when periviable birth is imminent to twenty pregnant women. The women were then asked to list terms they would use to search the internet if they wanted additional information. Using these search terms, two reviewers evaluated the content of websites obtained via a GoogleTM search. We used two metrics to assess the quality of websites. The first was the DISCERN instrument, a validated questionnaire designed to assess the quality of patient-targeted health information for treatment choices. The second metric was the Essential Content Tool (ECT), a tool designed to address all the key components of counseling around periviable birth as outlined by professional organizations. Scores ≥6 using ECT and ≥4 using DISCERN were considered "high quality”. Inter-reviewer agreement was assessed by calculated kappa statistic. Results: A total of 97 websites were reviewed. Over half (58%) were for-profit sites, new stories or personal blogs, 28% were government or medical sites, and 13% were non-profit or advocacy sites. The majority of sites scored poorly in DISCERN questions designed to assess the reliability of information presented. For example only 27% (n=26) presented a range of treatment options for infants born during periviable period and over half (n=62) did not cite the sources that informed their website. Only 10% of websites were “high quality” as defined by the DISCERN tool. The majority of sites did not address the essential content defined by the ECT. Importantly, only 18% of websites (n=17) indicated that there are often a number of reasonable approaches to newborn care when faced with periviable birth. Agreement was strong with ᴋ ranging from 0.72-0.91. Conclusions: Most information about periviable birth found on the internet using common search strategies is of low quality. News stories highlighting positive outcomes are disproportionately represented. Few websites discuss comfort-care or how treatment decisions impact quality of life.
Background: Youth with disabilities are more likely to live in poverty and to be unemployed compared to youth without a disability. Such trends are often a result of a lack of supports, inaccessible j...
Background: Youth with disabilities are more likely to live in poverty and to be unemployed compared to youth without a disability. Such trends are often a result of a lack of supports, inaccessible jobs, environmental barriers, and discriminatory attitudes towards people with disabilities. Youth with disabilities also face barriers in accessing vocational preparation programs. One encouraging way that could help to address challenges that youth encounter is by providing support through electronic mentoring. Objective: The objective of this study was to assess the feasibility of a 4-week online peer electronic mentoring employment intervention for youth with physical disabilities. Methods: We conducted a pilot randomized control trial (RCT) to evaluate our intervention, Empowering youth towards employment. Participants included youth aged 15-25 who were randomly assigned to an experimental (mentored) or control (non-mentored group). Our employment preparation intervention involved having trained youth mentors (i.e., near peers who also had a disability) lead online discussion forums while offering peer support and resources. The intervention involved 12 modules (3 topics a week for 4 weeks). Primary outcomes focused on implementation (i.e., feasibility and acceptability) while secondary outcomes focused on effectiveness (i.e., measures of self-determination, career maturity and social support). Results: Twenty-eight youth (mean age 19.62 3.53 (SD), 50% female) completed the RCT, in three intervention groups and two control groups (intervention n= 17, control n=9). Participants reported satisfaction with the program and that it was feasible and acceptable. Youth’s mean engagement level with the program was 6.44/10 (SD 2.33) for the experimental group and 5.56 3.53 for controls. Participants in the intervention did not demonstrate any significant improvements in social support, career maturity or self-determination compared to the control group. No adverse events were reported. Conclusions: The ‘Empowering youth towards employment’ electronic mentoring intervention needs further testing with a larger sample and different length of formats to understand how it may have an impact on employment outcomes youth with disabilities. Clinical Trial: Clinicaltrials.gov NCT02522507;
Background: African-American youth (8 to 14 years old) do not adhere to national dietary and physical activity guidelines. Non-adherence to these recommendations contributes to disproportionate rates...
Background: African-American youth (8 to 14 years old) do not adhere to national dietary and physical activity guidelines. Non-adherence to these recommendations contributes to disproportionate rates of obesity compared to their White counterparts. Culturally tailored e-health solutions are needed to communicate nutrition and physical activity messages that resonate with this target population. Objective: This study aimed to identify the impact of exposure to a website hosting culturally tailored cartoons to inspire fruit and vegetable uptake and physical activity levels in African-American mother-child dyads. Methods: Statistical analysis included paired sample t-tests to evaluate knowledge gains, self-efficacy, and readiness to change. Adapted items from Prochaska’s Stages of Change towards the four behaviors: 1.fruit and vegetable selection on my plate; 2.meal preparation; 3. fruit and vegetable selection outside of home, and 4.physical activity were assessed with pre and post-test surveys. Open-ended comments on videos from mother-child dyads were used to determine user acceptance. Observations of repeated responses during content analysis informed coding and development of key themes. Results: A final sample size of ninety-three mother-child dyads completed the study. Mothers reported significant improvement from pre-contemplation or contemplation stages to preparation or action stages for: 1) fruit and vegetable selection on her plate (p=.034); 2) meal preparation for her family (p=.010); 3) fruit and vegetable selection outside the home (p=.000); and, 4), and physical activity (p=.000). Significant improvements were found in knowledge, stage of change and self-efficacy for the four target behaviors of interest (p=.000). Children’s open-ended commentary reported vicarious learning and positive character identification with brown-skinned cartoons exhibiting healthful food and exercise behaviors. Mothers commented on the lack of accessible produce in their neighborhoods not depicted in the cartoon videos. Conclusions: Culturally adapted cartoons that incorporate tailored preferences by African-American families, such as race or demography, may help increase adherence to target health behaviors when developing e-health behavior solutions.
Background: Pediatric medical conditions have the potential to result in challenging psychological symptoms (e.g., anxiety, depression, posttraumatic stress-PTSS) and impaired health-related quality o...
Background: Pediatric medical conditions have the potential to result in challenging psychological symptoms (e.g., anxiety, depression, posttraumatic stress-PTSS) and impaired health-related quality of life in youth. Thus, effective, accessible interventions are needed to prevent and / or treat psychological sequelae associated with pediatric medical conditions. eHealth interventions may help to meet this need, with the capacity to reach more children and families than in-person interventions. Many of these interventions are in their infancy, and we do not yet know what key components contribute to successful eHealth interventions. Objective: The primary aim of this study is to conduct a systematic review to summarize current evidence on the efficacy of eHealth (web- and mobile-based) interventions designed to prevent or treat psychological sequelae in youth with medical conditions. Methods: MEDLINE (PubMed) and PsycINFO databases were searched for studies published between February 2, 1998 and February 1, 2018 using pre-defined search terms. Two authors independently reviewed titles and abstracts of search results to determine which studies were eligible for full-text review. Reference lists of studies meeting eligibility criteria were reviewed. If the title of a reference suggested that it might be relevant for the current review, the full manuscript was retrieved and reviewed. Inclusion criteria required that eligible studies had 1) conducted empirical research on the efficacy of a web or mobile-based intervention for youth with a medical condition, 2) assessed outcomes of psychological sequelae (i.e., symptoms of posttraumatic stress, anxiety, depression, internalizing symptoms or quality of life) in youth (0-18 years) and / or their caregivers, 3) included assessments at two or more time points, and 5) was available in the English language. Results: 67 studies were reviewed for inclusion based on their title and abstracts; 23 articles qualified for full-text review. 15 studies met inclusion criteria for the systematic review. Of the 15 included studies, 9 reported results indicating that eHealth interventions significantly improved psychological sequelae in participants. Common characteristics among interventions which showed an effect included content on problem-solving, education, communication, and behavior management. Studies most commonly reported on child and caregiver depression, followed by child PTSS and caregiver anxiety. Conclusions: Early research is mixed but suggests that eHealth interventions may be helpful in alleviating and /or preventing problematic psychological sequelae in youth with medical conditions and their caregivers. Additional research is needed to advance understanding of the most powerful intervention components and to determine when and how to best disseminate eHealth interventions, with the goal of extending the current reach of psychological interventions
Background: Low milk production is one of the main reasons for premature breastfeeding cessation. Smartphone apps have the potential to assist mothers with tracking milk production and learning how to...
Background: Low milk production is one of the main reasons for premature breastfeeding cessation. Smartphone apps have the potential to assist mothers with tracking milk production and learning how to establish and maintain milk production. It is not known if app developers take into account health behavior or education theory when developing content and features in breastfeeding apps. Objective: The primary objective was to develop and validate a scale grounded in Social Cognitive Theory to evaluate the educational content and tracking features related to milk production within breastfeeding smartphone apps. The secondary objective was to determine whether apps developed by for-profit companies or large businesses were more likely to be free and contain evidence-based educational content with diverse representations of the breastfeeding experience. Methods: Breastfeeding apps were identified in the App Store (iOS). If the app fit the inclusion criteria, then all features that assist mothers with tracking or interpreting milk production in the first zero to six months postpartum were noted. Every screen containing educational information about milk production was identified and saved review. A two-part scale grounded in Social Cognitive Theory was created to evaluate all features that assist mothers with tracking milk production and the quality of the educational content about milk production, as measured by scope, references, multimedia, and diverse representations of the breastfeeding dyad. Results: Forty-one breastfeeding apps were reviewed. Only seven contained both tracking features and educational content related to milk production. Breast pump companies created many of the the top scoring apps in tracking, education, and hybrid categories. There were no differences in scores between apps that were free and not free. Very few apps contained evidence-based content or images of non-White breastfeeding dyads. Conclusions: Breastfeeding smartphone apps were evaluated using a novel two-part scale grounded in Social Cognitive Theory to determine which apps could comprehensively assist mothers with tracking milk production and interpreting their results through evidence-based educational content. Very few apps contained both tracking features and high-quality, engaging educational content with images of diverse caretakers. Thus, it is clear that parents, especially those from minority or low-income groups, have limited options to choose from when selecting an app to reach their breastfeeding goals.