JMIR Publications

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  Screen Time for Children and Adolescents

  Jan 21, 2019

  “If You Let Them, They Will Be on It 24 Hours a Day”: Qualitative Study Conducted in the United States Exploring Brazilian Immigrant Mothers’ Beliefs,...

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  Authors List:

  • Ana Cristina Lindsay  
  • Carlos André Moura Arruda  
  • Márcia MT Machado  
  • Mary L Greaney  

  Abstract:

  Background: The increasing prevalence of excessive screen time (ST) among children is a growing public health concern, with evidence linking it to an increased risk of overweight and obesity among children. Objective: This study aimed to explore the beliefs, attitudes, and practices of Brazilian immigrant mothers living in the United States related to their preschool-age children’s ST behaviors. Methods: A qualitative study comprising 7 focus group discussions (FGDs) was conducted with Brazilian immigrant mothers living in the United States. All FGDs were audio-recorded and professionally transcribed verbatim. The Portuguese transcripts were analyzed using thematic analysis. Results: In total, 37 women participated in the FGDs. Analyses revealed that although most mothers expressed concerns for their preschool-age children’s ST, nearly all viewed ST as an acceptable part of their children’s daily lives. Furthermore, mothers perceived that ST has more benefits than disadvantages. The mothers’ positive beliefs about (eg, educational purposes and entertainment) and perceived functional benefits of ST (eg, ability to keep children occupied so tasks can be completed and facilitation of communication with family outside the United States) contributed to their acceptance of ST for their preschool-age children. Nevertheless, most mothers spoke of needing to balance their preschool-age children’s ST with other activities. Mothers reported using several parenting practices including monitoring time and content, setting limits and having rules, and prompting their children to participate in other activities to manage their preschool-age children’s ST. Conclusions: This study provides new information on the beliefs, attitudes, and practices of Brazilian immigrant mothers living in the United States related to their preschool-age children’s ST. Study findings revealed several potentially modifiable maternal beliefs and parenting practices that may provide important targets for parenting- and family-based interventions aimed at limiting preschool-age children’s ST.

  • JMIR Pediatr Parent 2019;2(1):e11791

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  Mobile Health and Apps for Maternal...

  Jan 16, 2019

  Procedures to Select Digital Sensing Technologies for Passive Data Collection With Children and Their Caregivers: Qualitative Cultural Assessment in South...

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  Authors List:

  • Brandon A Kohrt  
  • Sauharda Rai  
  • Khanya Vilakazi  
  • Kiran Thapa  
  • Anvita Bhardwaj  
  • Alastair van Heerden  

  Abstract:

  Background: Populations in low-resource settings with high childhood morbidity and mortality increasingly are being selected as beneficiaries for interventions using passive sensing data collection through digital technologies. However, these populations often have limited familiarity with the processes and implications of passive data collection. Therefore, methods are needed to identify cultural norms and family preferences influencing the uptake of new technologies. Objective: Before introducing a new device or a passive data collection approach, it is important to determine what will be culturally acceptable and feasible. The objective of this study was to develop a systematic approach to determine acceptability and perceived utility of potential passive data collection technologies to inform selection and piloting of a device. To achieve this, we developed the Qualitative Cultural Assessment of Passive Data collection Technology (QualCAPDT). This approach is built upon structured elicitation tasks used in cultural anthropology. Methods: We piloted QualCAPDT using focus group discussions (FGDs), video demonstrations of simulated technology use, attribute rating with anchoring vignettes, and card ranking procedures. The procedure was used to select passive sensing technologies to evaluate child development and caregiver mental health in KwaZulu-Natal, South Africa, and Kathmandu, Nepal. Videos were produced in South Africa and Nepal to demonstrate the technologies and their potential local application. Structured elicitation tasks were administered in FGDs after showing the videos. Using QualCAPDT, we evaluated the following 5 technologies: home-based video recording, mobile device capture of audio, a wearable time-lapse camera attached to the child, proximity detection through a wearable passive Bluetooth beacon attached to the child, and an indoor environmental sensor measuring air quality. Results: In South Africa, 38 community health workers, health organization leaders, and caregivers participated in interviews and FGDs with structured elicitation tasks. We refined the procedure after South Africa to make the process more accessible for low-literacy populations in Nepal. In addition, the refined procedure reduced misconceptions about the tools being evaluated. In Nepal, 69 community health workers and caregivers participated in a refined QualCAPDT. In both countries, the child’s wearable time-lapse camera achieved many of the target attributes. Participants in Nepal also highly ranked a home-based environmental sensor and a proximity beacon worn by the child. Conclusions: The QualCAPDT procedure can be used to identify community norms and preferences to facilitate the selection of potential passive data collection strategies and devices. QualCAPDT is an important first step before selecting devices and piloting passive data collection in a community. It is especially important for work with caregivers and young children for whom cultural beliefs and shared family environments strongly determine behavior and potential uptake of new technology.

  • JMIR Pediatr Parent 2019;2(1):e12366

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  Children and Young People With...

  Dec 21, 2018

  Assessing the Usability of an Automated Continuous Temperature Monitoring Device (iThermonitor) in Pediatric Patients: Non-Randomized Pilot Study

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  Authors List:

  • Sujay S Kakarmath  
  • Emily de Redon  
  • Amanda Jayne Centi  
  • Ramya Palacholla  
  • Joseph Kvedar  
  • Kamal Jethwani  
  • Stephen Agboola  

  Abstract:

  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, leading to fever phobia. 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: The objective of this pilot study was to assess the feasibility of using the iThermonitor, an automated temperature measurement device, for continuous temperature monitoring in postoperative and postchemotherapy 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 and 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 questionnaire was also used to assess caregiver anxiety at enrollment and closeout. Results: Overall, 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 caregivers did so six or more times per day. Of all participants, 74% (14/19) 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% (4/9) 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 study results reveal that the iThermonitor is a highly feasible and easy-to-use device for continuous temperature monitoring in pediatric oncology and surgery patients. Trial Registration: ClinicalTrials.gov NCT02410252; https://clinicaltrials.gov/ct2/show/NCT02410252 (Archived by WebCite at http://www.webcitation.org/73LnO7hel)

  • JMIR Pediatr Parent 2018;1(2):e10804

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  Perinatal Education for Parents

  Dec 18, 2018

  How Women Evaluate Birth Challenges: Analysis of Web-Based Birth Stories

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  Authors List:

  • Yasmine L Konheim-Kalkstein  
  • Talya Miron-Shatz  
  • Leah Jenny Israel  

  Abstract:

  Background: Birth stories provide an intimate glimpse into women’s birth experiences in their own words. Understanding the emotions elicited in women by certain types of behaviors during labor and delivery could help those in the health care community provide better emotional care for women in labor. Objective: The aim of this study was to understand which supportive reactions and behaviors contributed to negative or positive emotions among women with regard to their labor and delivery experience. Methods: We sampled 10 women’s stories from a popular blog that described births that strayed from the plan. Overall, 90 challenging events that occurred during labor and delivery were identified. Each challenge had an emotionally positive, negative, or neutral evaluation by the woman. We classified supportive and unsupportive behaviors in response to these challenges and examined their association with the woman’s emotional appraisal of the challenges. Results: Overall, 4 types of behaviors were identified: informational inclusion, decisional inclusion (mostly by health care providers), practical support, and emotional support (mostly by partners). Supportive reactions were not associated with emotional appraisal; however, unsupportive reactions were associated with women appraising the challenge negatively (Fisher exact test, P=.02). Conclusions: Although supportive behaviors did not elicit any particular emotion, unsupportive behaviors did cause women to view challenges negatively. It is worthwhile conducting a larger scale investigation to observe what happens when patients express their needs, particularly when challenges present themselves during labor, and health care professionals strive to cater to them.

  • JMIR Pediatr Parent 2018;1(2):e12206

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  Asthma Education and Self-Management...

  Dec 14, 2018

  “How Is My Child’s Asthma?” Digital Phenotype and Actionable Insights for Pediatric Asthma

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  Authors List:

  • Utkarshani Jaimini  
  • Krishnaprasad Thirunarayan  
  • Maninder Kalra  
  • Revathy Venkataraman  
  • Dipesh Kadariya  
  • Amit Sheth  

  Abstract:

  Background: In the traditional asthma management protocol, a child meets with a clinician infrequently, once in 3 to 6 months, and is assessed using the Asthma Control Test questionnaire. This information is inadequate for timely determination of asthma control, compliance, precise diagnosis of the cause, and assessing the effectiveness of the treatment plan. The continuous monitoring and improved tracking of the child’s symptoms, activities, sleep, and treatment adherence can allow precise determination of asthma triggers and a reliable assessment of medication compliance and effectiveness. Digital phenotyping refers to moment-by-moment quantification of the individual-level human phenotype in situ using data from personal digital devices, in particular, mobile phones. The kHealth kit consists of a mobile app, provided on an Android tablet, that asks timely and contextually relevant questions related to asthma symptoms, medication intake, reduced activity because of symptoms, and nighttime awakenings; a Fitbit to monitor activity and sleep; a Microlife Peak Flow Meter to monitor the peak expiratory flow and forced exhaled volume in 1 second; and a Foobot to monitor indoor air quality. The kHealth cloud stores personal health data and environmental data collected using Web services. The kHealth Dashboard interactively visualizes the collected data. Objective: The objective of this study was to discuss the usability and feasibility of collecting clinically relevant data to help clinicians diagnose or intervene in a child’s care plan by using the kHealth system for continuous and comprehensive monitoring of child’s symptoms, activity, sleep pattern, environmental triggers, and compliance. The kHealth system helps in deriving actionable insights to help manage asthma at both the personal and cohort levels. The Digital Phenotype Score and Controller Compliance Score introduced in the study are the basis of ongoing work on addressing personalized asthma care and answer questions such as, “How can I help my child better adhere to care instructions and reduce future exacerbation?” Methods: The Digital Phenotype Score and Controller Compliance Score summarize the child’s condition from the data collected using the kHealth kit to provide actionable insights. The Digital Phenotype Score formalizes the asthma control level using data about symptoms, rescue medication usage, activity level, and sleep pattern. The Compliance Score captures how well the child is complying with the treatment protocol. We monitored and analyzed data for 95 children, each recruited for a 1- or 3-month-long study. The Asthma Control Test scores obtained from the medical records of 57 children were used to validate the asthma control levels calculated using the Digital Phenotype Scores. Results: At the cohort level, we found asthma was very poorly controlled in 37% (30/82) of the children, not well controlled in 26% (21/82), and well controlled in 38% (31/82). Among the very poorly controlled children (n=30), we found 30% (9/30) were highly compliant toward their controller medication intake—suggesting a re-evaluation for change in medication or dosage—whereas 50% (15/30) were poorly compliant and candidates for a more timely intervention to improve compliance to mitigate their situation. We observed a negative Kendall Tau correlation between Asthma Control Test scores and Digital Phenotype Score as −0.509 (P<.01). Conclusions: kHealth kit is suitable for the collection of clinically relevant information from pediatric patients. Furthermore, Digital Phenotype Score and Controller Compliance Score, computed based on the continuous digital monitoring, provide the clinician with timely and detailed evidence of a child’s asthma-related condition when compared with the Asthma Control Test scores taken infrequently during clinic visits.

  • JMIR Pediatr Parent 2018;1(2):e11988

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  Asthma Education and Self-Management...

  Dec 13, 2018

  Home to Hospital Live Streaming With Virtual Reality Goggles: A Qualitative Study Exploring the Experiences of Hospitalized Children

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  Authors List:

  • Aafke Bakker  
  • Lindy Janssen  
  • Cees Noordam  

  Abstract:

  Background: Being separated from home and relatives is a major stressor for children and adolescents when hospitalized. Children long for a manner to be distracted, pleasured, and socially connected during hospitalization. Different technological devices have been applied in health care to answer those needs. Both virtual reality (VR) and videoconferencing have proven their value in hospital wards and pediatrics. VisitU combines these 2 technologies innovatively. VisitU is a recently launched VR product enabling users to be virtually at home during hospitalization. Objective: This study aims to explore the experiences of hospitalized patients with the VR intervention of VisitU in addition to standard care. Methods: Over a 3-month period, a purposive sample of 10 patients hospitalized in the Radboudumc Amalia Children’s Hospital was included in this qualitative study. Semistructured interviews were performed, one before and one after the use of the VR device. Patients were asked open-ended questions concerning their experiences with VisitU on practical, cognitive, emotional, and social domains. The interviews were audiorecorded and transcribed verbatim. Atlas.ti was used to support the qualitative analysis. Furthermore, the inductive thematic analysis was done according to the 6-step procedure described by Braun and Clarke. Results: The following 6 main themes were the result of the qualitative analysis: “Being hospitalized,” “Expectations of VisitU,” “VisitU in use,” “VisitU, the benefits,” “The impact of VisitU,” and “Barriers when using VisitU.” The way VisitU was used by patients varied. The main benefits of VisitU were being somewhere else, being at home, and facilitating social connection. Limitations were experienced on the technical abilities, physical side effects, and complexity of use. Despite that, patients were positive about VisitU and unanimous in the view that they would like to use it again and advise other patients to use it. Conclusions: This study shows the positive experiences of pediatric patients with VR live streaming. VisitU brings together the needs of patients and possibilities of VR and videoconferencing; it offers patients a way out of the hospital. Nevertheless, practical and technical obstacles must be overcome and side effects are an area of further research.

  • JMIR Pediatr Parent 2018;1(2):e10

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  Social Media for Parenting

  Dec 11, 2018

  Social Media Content About Children’s Pain and Sleep: Content and Network Analysis

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  Authors List:

  • Michelle E Tougas  
  • Christine T Chambers  
  • Penny Corkum  
  • Julie M Robillard  
  • Anatoliy Gruzd  
  • Vivian Howard  
  • Andrea Kampen  
  • Katelynn E Boerner  
  • Amos S Hundert  

  Abstract:

  Background: Social media is often used for health communication and can facilitate fast information exchange. Despite its increasing use, little is known about child health information sharing and engagement over social media. Objective: The primary objectives of this study are to systematically describe the content of social media posts about child pain and sleep and identify the level of research evidence in these posts. The secondary objective is to examine user engagement with information shared over social media. Methods: Twitter, Instagram, and Facebook were searched by members of the research team over a 2-week period using a comprehensive search strategy. Codes were used to categorize the content of posts to identify the frequency of content categories shared over social media platforms. Posts were evaluated by content experts to determine the frequency of posts consistent with existing research evidence. User engagement was analyzed using Netlytic, a social network analysis program, to examine visual networks illustrating the level of user engagement. Results: From the 2-week period, nearly 1500 pain-related and 3800 sleep-related posts were identified and analyzed. Twitter was used most often to share knowledge about child pain (639/1133, 56.40% of posts), and personal experiences for child sleep (2255/3008, 75.00% of posts). For both topics, Instagram posts shared personal experiences (53/68, 78% pain; 413/478, 86.4% sleep), Facebook group posts shared personal experiences (30/49, 61% pain; 230/345, 66.7% sleep) and Facebook pages shared knowledge (68/198, 34.3% pain; 452/1026, 44.05% sleep). Across platforms, research evidence was shared in 21.96% (318/1448) of pain- and 9.16% (445/4857) of sleep-related posts; 5.38% (61/1133) of all pain posts and 2.82% (85/3008) of all sleep posts shared information inconsistent with the evidence, while the rest were absent of evidence. User interactions were indirect, with mostly one-way, rather than reciprocal conversations. Conclusions: Social media is commonly used to discuss child health, yet the majority of posts do not contain research evidence, and user engagement is primarily one-way. These findings represent an opportunity to expand engagement through open conversations with credible sources. Research and health care communities can benefit from incorporating specific information about evidence within social media posts to improve communication with the public and empower users to distinguish evidence-based content better. Together, these findings have identified potential gaps in social media communication that may be informative targets to guide future strategies for improving the translation of child health evidence over social media.

  • JMIR Pediatr Parent 2018;1(2):e11193

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  Mobile Health and Apps for Maternal...

  Dec 10, 2018

  Clinical Adoption of mHealth Technology to Support Pediatric Cystic Fibrosis Care in Sweden: Qualitative Case Study

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  Authors List:

  • Meghan Longacre  
  • Stuart Grande  
  • Andreas Hager  
  • Meera Montan  
  • Rikard Palmer Bergquist  
  • Maria Martensson  
  • Greg Kotzbauer  

  Abstract:

  Background: Mobile health (mHealth) technologies have potential to improve self-management and care co-ordination of pediatric chronic diseases requiring complex care, such as cystic fibrosis (CF). Barriers to implementation include the lack of support and infrastructure to use mHealth in the clinical microsystem. Coproducing mHealth technology with patients, clinicians, and designers may increase the likelihood of successful integration into the clinical setting. Objective: This study explored the development, adoption, and integration of a new, co-produced mHealth platform (Genia) for the management of pediatric CF in Sweden. Methods: A retrospective, qualitative case study approach was used. The case was defined as the process of introducing and using Genia at the Pediatric Cystic Fibrosis Center at Skåne University Hospital in Lund, Sweden. Data sources included interviews, presentations, meeting notes, and other archival documents created between 2014 and 2017. To be included, data sources must have described or reflected upon the Genia adoption process. Iterative content analysis of data source materials was conducted by 2 qualitatively trained researchers to derive themes characterizing the mHealth clinical adoption process. Results: In total, 4 core themes characterized successful clinical integration of Genia in Lund: cultural readiness to use mHealth; use of weekly huddles to foster momentum and rapid iteration; engagement in incremental “Genia Talk” to motivate patient adoption; and co-design approach toward pediatric chronic care. Conclusions: Principles of quality improvement, relational co-ordination, user-centered design, and coproduction can facilitate the integration of mHealth technology into clinical care systems for pediatric CF care.

  • JMIR Pediatr Parent 2018;1(2):e11080

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  Parent and Child Education on...

  Dec 6, 2018

  Mobile Device Use Among Rural, Low-Income Families and the Feasibility of an App to Encourage Preschoolers’ Physical Activity: Qualitative Study

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  Authors List:

  • Morgan L McCloskey  
  • Darcy A Thompson  
  • Barbara Chamberlin  
  • Lauren Clark  
  • Susan L Johnson  
  • Laura L Bellows  

  Abstract:

  Background: As mobile devices are becoming ubiquitous, technology-based interventions provide a promising strategy to positively influence health behaviors of families with young children. However, questions remain about the feasibility and acceptability of intervention delivery via mobile apps in low-income, rural settings and among families with preschoolers. Objective: The aims of this study were to understand the content and context of mobile device use for preschoolers; explore parent beliefs on this topic, including the acceptability of intervention delivery via mobile devices; and test a prototype of an app to encourage preschoolers’ physical activity with both parents and children. Methods: Parents (n=29) were recruited from 5 preschool centers in eastern, rural Colorado to complete a semistructured telephone interview regarding preschoolers’ mobile device use. A second sample of parents (n=31) was recruited from the same preschool centers to view the app prototype independently and provide feedback. A third sample of preschool children (n=24) was videotaped using the app in small groups to measure engagement and record their responses to the app. Results: Five key content areas emerged from the telephone interviews: (1) mobile devices are an important part of families’ everyday routines, and parents have parameters governing their use; (2) parents often use mobile devices as a tool for behavior management; (3) parents clearly distinguish between mobile device use for learning versus entertainment; (4) parents have an overarching desire for balance in regard to their child’s mobile device use; and (5) parents were generally supportive of the idea of using mobile apps for intervention delivery. From the app prototype testing with parents, participants reacted positively to the app and felt that it would be useful in a variety of situations. Testing with preschoolers showed the children were highly engaged with the app and a majority remained standing and/or actively moving through the entire length of the app. Conclusions: Mobile devices are already integrated into most families’ daily routines and appear to be an acceptable method of intervention delivery in low-income families in rural Colorado. The physical activity app represents an innovative way to reach these families and, with further improvements based on participant feedback, will provide children with a unique opportunity to practice key movement skills.

  • JMIR Pediatr Parent 2018;1(2):e10858

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  Parenting with Health/Mental...

  Dec 4, 2018

  Substance Use Among Young Mothers: An Analysis of Facebook Posts

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  Authors List:

  • Daniel Oram  
  • Golfo Tzilos Wernette  
  • Lauren P Nichols  
  • VG Vinod Vydiswaran  
  • Xinyan Zhao  
  • Tammy Chang  

  Abstract:

  Background: Substance use among young pregnant women is a common and significant public health concern associated with a number of adverse outcomes for both mothers and infants. Social media posts by young women can provide valuable, real-world insight into their perceptions of substance use immediately before and during pregnancy. Objective: The aim of this study was to characterize the frequency and content of posts regarding substance use in the year before pregnancy and during pregnancy among young mothers. Methods: Facebook posts were mined from young pregnant women (age, 16-24 years) who consented from 2 Midwest primary care clinics that serve a predominantly low-income community. Natural language processing was used to identify posts related to substance use by keyword searching (eg, drunk, drugs, pot, and meth). Using mixed-methods techniques, 2 investigators iteratively coded and identified major themes around substance use from these mined Facebook posts. Outcome measures include the frequency of posts and major themes expressed regarding substance use before and during pregnancy. Results: Women in our sample (N=43) had a mean age of 21 (SD 2.3) years, and the largest subgroup (21/43, 49%) identified as non-Hispanic black; 26% (11/43) identified as non-Hispanic white; 16% (7/43) as Hispanic; and 9% (4/43) as non-Hispanic mixed race, Native American, or other. The largest subgroup (20/43, 47%) graduated high school without further education, while 30% (13/43) completed only some high school and 23% (10/43) completed at least some postsecondary education. Young women discussed substance use on social media before and during pregnancy, although compared with the year before pregnancy, the average frequency of substance-related posts during pregnancy decreased. Themes identified included craving alcohol or marijuana, social use of alcohol or marijuana, reasons for abstaining from substance use, and intoxication. Conclusions: Facebook posts reveal that young pregnant women discuss the use of substances, predominantly alcohol and marijuana. Future work can explore clinical opportunities to prevent and treat substance use before and during pregnancy among young, at-risk mothers.

  • JMIR Pediatr Parent 2018;1(2):e10261

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  Children and Young People With...

  Nov 28, 2018

  Fertility Preservation in Children and Adolescents With Cancer: Pilot of a Decision Aid for Parents of Children and Adolescents With Cancer

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  Authors List:

  • Catherine Allingham  
  • Lynn Gillam  
  • Maria McCarthy  
  • Margaret Zacharin  
  • Sadunee Jayasuriya  
  • Yves Heloury  
  • Lisa Orme  
  • Michael Sullivan  
  • Michelle Peate  
  • Yasmin Jayasinghe  

  Abstract:

  Background: Future infertility is a significant concern for survivors of childhood and adolescent cancer. Children and adolescents may have the opportunity to undergo fertility preservation (FP) procedures (which preserve gonadal tissue or gametes for future use) prior to the cancer treatment. However, the decision is very complex, as it is often made by parents as proxy decision makers at the time of cancer diagnosis, and is time-sensitive (needing to occur before the cancer treatment begins). Furthermore, FP procedures in children and adolescents are experimental and cannot guarantee future fertility. An uninformed decision may result in future decision regret. Objective: This study aimed to assess the acceptability, usability, and feasibility of a Web-based FP decision aid (DA) in parents of children and adolescents with cancer and clinicians. Fertility knowledge and decision regret were compared in families who reviewed the DA compared with those who did not. Methods: The Web-based DA was developed according to the International Patient Decision Aid Standards. A cross-sectional study of parents of patients with cancer, who discussed fertility, and clinicians at a tertiary children’s hospital was undertaken. The acceptability, usability, and feasibility of the DA were assessed using a pre-post survey design. Measures included the validated Decision Regret Scale, a purpose-designed fertility-related knowledge scale, questions regarding satisfaction with the DA, and open-ended responses for additional feedback. Furthermore, clinicians involved in FP were also invited to review the DA. Results: We enrolled 34 parents and 11 clinicians in this study. Participants who reviewed the DA (15 parents and 11 clinicians) expressed satisfaction with its content and functionality. Parents reported an improved understanding of cancer treatments, infertility, and FP procedures and did not report greater decision regret after DA review. Most parents (13/15, 86%) would recommend the DA to other parents. All clinicians had a consensus that this was a valid and relevant information source for all involved in fertility care. Conclusions: It is an international standard of care to discuss the impact of cancer treatment on fertility before cancer treatment. This is the first fertility DA for parents of children and adolescents with cancer and is found to be relevant and acceptable by parents and clinicians. This DA has the potential to help support parents to make informed fertility-related decisions for their children and adolescents. However, future research is needed to assess the impact of the DA on prospective decision making.

  • JMIR Pediatr Parent 2018;1(2):e10463

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  Social Media for Parenting

  Nov 27, 2018

  Exploring the Transition to Fatherhood: Feasibility Study Using Social Media and Machine Learning

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  Authors List:

  • Samantha J Teague  
  • Adrian BR Shatte  

  Abstract:

  Background: Fathers’ experiences across the transition to parenthood are underreported in the literature. Social media offers the potential to capture fathers’ experiences in real time and at scale while also removing the barriers that fathers typically face in participating in research and clinical care. Objective: This study aimed to assess the feasibility of using social media data to map the discussion topics of fathers across the fatherhood transition. Methods: Discussion threads from two Web-based parenting communities, r/Daddit and r/PreDaddit from the social media platform Reddit, were collected over a 2-week period, resulting in 1980 discussion threads contributed to by 5853 unique users. An unsupervised machine learning algorithm was then implemented to group discussion threads into topics within each community and across a combined collection of all discussion threads. Results: Results demonstrated that men use Web-based communities to share the joys and challenges of the fatherhood experience. Minimal overlap in discussions was found between the 2 communities, indicating that distinct conversations are held on each forum. A range of social support techniques was demonstrated, with conversations characterized by encouragement, humor, and experience-based advice. Conclusions: This study demonstrates that rich data on fathers’ experiences can be sourced from social media and analyzed rapidly using automated techniques, providing an additional tool for researchers exploring fatherhood.

  • JMIR Pediatr Parent 2018;1(2):e12371

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