<?xml version="1.0" encoding="UTF-8"?><!DOCTYPE article PUBLIC "-//NLM//DTD Journal Publishing DTD v2.0 20040830//EN" "journalpublishing.dtd"><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" dtd-version="2.0" xml:lang="en" article-type="letter"><front><journal-meta><journal-id journal-id-type="nlm-ta">JMIR Pediatr Parent</journal-id><journal-id journal-id-type="publisher-id">pediatrics</journal-id><journal-id journal-id-type="index">30</journal-id><journal-title>JMIR Pediatrics and Parenting</journal-title><abbrev-journal-title>JMIR Pediatr Parent</abbrev-journal-title><issn pub-type="epub">2561-6722</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">v8i1e72675</article-id><article-id pub-id-type="doi">10.2196/72675</article-id><article-categories><subj-group subj-group-type="heading"><subject>Letter to the Editor</subject></subj-group></article-categories><title-group><article-title>Pediatric Hearts and Minds: Reimagining Health Education Through Play and Narrative</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name name-style="western"><surname>Yang</surname><given-names>Alina</given-names></name><xref ref-type="aff" rid="aff1"/></contrib></contrib-group><aff id="aff1"><institution>Scarsdale High School</institution><addr-line>1057 Post Road</addr-line><addr-line>Scarsdale</addr-line><addr-line>NY</addr-line><country>United States</country></aff><contrib-group><contrib contrib-type="editor"><name name-style="western"><surname>Gandhi</surname><given-names>Kirti</given-names></name></contrib><contrib contrib-type="editor"><name name-style="western"><surname>Cardoso</surname><given-names>Taiane de Azevedo</given-names></name></contrib></contrib-group><author-notes><corresp>Correspondence to Alina Yang, Scarsdale High School, 1057 Post Road, Scarsdale, NY, United States; <email>alinayang5@gmail.com</email></corresp></author-notes><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>13</day><month>3</month><year>2025</year></pub-date><volume>8</volume><elocation-id>e72675</elocation-id><history><date date-type="received"><day>14</day><month>02</month><year>2025</year></date><date date-type="accepted"><day>24</day><month>02</month><year>2025</year></date></history><copyright-statement>&#x00A9; Alina Yang. Originally published in JMIR Pediatrics and Parenting (<ext-link ext-link-type="uri" xlink:href="https://pediatrics.jmir.org">https://pediatrics.jmir.org</ext-link>), 13.3.2025. </copyright-statement><copyright-year>2025</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 (<ext-link ext-link-type="uri" xlink:href="https://creativecommons.org/licenses/by/4.0/">https://creativecommons.org/licenses/by/4.0/</ext-link>), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Pediatrics and Parenting, is properly cited. The complete bibliographic information, a link to the original publication on <ext-link ext-link-type="uri" xlink:href="https://pediatrics.jmir.org">https://pediatrics.jmir.org</ext-link>, as well as this copyright and license information must be included.</p></license><self-uri xlink:type="simple" xlink:href="https://pediatrics.jmir.org/2025/1/e72675"/><related-article related-article-type="commentary article" ext-link-type="doi" xlink:href="10.2196/64814" xlink:title="Comment on" xlink:type="simple">https://pediatrics.jmir.org/2025/1/e64814</related-article><kwd-group><kwd>congenital heart disease</kwd><kwd>children health literacy</kwd><kwd>health education</kwd><kwd>health education interventions</kwd><kwd>patient-centered care</kwd><kwd>design</kwd><kwd>pediatric</kwd><kwd>PRISMA</kwd></kwd-group></article-meta></front><body><p>As a student advocate actively involved in heart health promotion among youth, I was interested in the study entitled &#x201C;Exploring Health Educational Interventions for Children With Congenital Heart Disease: Scoping Review&#x201D; [<xref ref-type="bibr" rid="ref1">1</xref>]. The authors identified a gap in age-appropriate educational tools for younger children in the interventions, highlighting the importance of using playful, developmentally tailored strategies to engage them in learning about their cardiac condition.</p><p>This insight dovetails precisely with the broader realm of pediatric health literacy, wherein the convergence of cognitive development and medical comprehension calls to attention unique barriers. Children with congenital heart disease (CHD) face difficulties in understanding abstract medical concepts and their condition [<xref ref-type="bibr" rid="ref2">2</xref>]. Considering this, narrative medicine holds great potential in increasing the relatability, digestibility, and applicability of knowledge by reframing biomedical concepts into metaphorical storytelling. Thus, children with CHD may be able to internalize their medical journey in ways that align with their developmental stage and personal experiences, gaining a sense of agency and coherence.</p><p>Similarly, the role of ludic and entertaining pedagogical tools emerges as a pivotal mediator of developmental trajectories across cognitive, social, and emotional domains. Health care providers, especially pediatricians and family physicians, must actively ensure that play is healthy and safe [<xref ref-type="bibr" rid="ref3">3</xref>]. Whether it be a story-driven game or a cardiac-themed toy, interactive tools may significantly advance educational interventions through tangible learning modalities that convert abstract principles into concrete experiences. As such, the cardiac health journey becomes one of engagement, where the child becomes a conscious, active participant in their medical education rather than a mere recipient of information.</p><p>The teddy bear hospital concept in particular exemplifies this symbiotic relationship between play and education, demonstrating efficacy in reducing children&#x2019;s health care&#x2013;related anxiety, improving their health care knowledge, and enhancing their well-being through playful role-playing in a health care setting [<xref ref-type="bibr" rid="ref4">4</xref>]. By softening the edges of medical procedures, this model dismantles the intimidating walls of the clinical environment, transforming it into a less foreign and more approachable space for younger children who are not as impacted by traditional educational interventions.</p><p>Yet another crucial dimension of children&#x2019;s play surfaces through physical activity. Children with CHD and their parents recognize the importance of physical activity, but uncertainty in their health environment contributes to inactivity despite minimal professional restrictions [<xref ref-type="bibr" rid="ref5">5</xref>]. An area ripe for intervention, physical activity guidelines could incorporate real-time feedback mechanisms that build confidence and ensure safety to promote physical exercise as an act of healing and empowerment, rather than a source of anxiety.</p><p>In tailoring educational messaging by age, we can raise the effectiveness of CHD interventions, recognizing and respecting that children are not simply &#x201C;mini teenagers&#x201D; and much less &#x201C;mini adults.&#x201D; Such an approach must, therefore, incorporate elements of embodied cognition, experiential learning, and psychological support to create a comprehensive educational framework that addresses the specific cognitive and emotional needs of children with CHD. Only in this way can we create immersive and engaging learning environments that make complex cardiac concepts accessible to the young minds often underrepresented while fostering psychological resilience and physical confidence.</p></body><back><fn-group><fn fn-type="con"><p>AY wrote, edited, revised, and reviewed this manuscript.</p></fn><fn fn-type="conflict"><p>None declared.</p></fn><fn fn-type="other"><p><bold>Editorial Notice</bold></p><p>The corresponding author of &#x201C;Exploring Health Educational Interventions for Children With Congenital Heart Disease: Scoping Review&#x201D; declined to respond to this letter.</p></fn></fn-group><glossary><title>Abbreviations</title><def-list><def-item><term id="abb1">CHD</term><def><p>congenital heart disease</p></def></def-item></def-list></glossary><ref-list><title>References</title><ref id="ref1"><label>1</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Barbazi</surname><given-names>N</given-names> </name><name name-style="western"><surname>Shin</surname><given-names>JY</given-names> </name><name name-style="western"><surname>Hiremath</surname><given-names>G</given-names> </name><name name-style="western"><surname>Lauff</surname><given-names>CA</given-names> </name></person-group><article-title>Exploring health educational interventions for children with congenital heart disease: scoping review</article-title><source>JMIR Pediatr Parent</source><year>2025</year><month>01</month><day>24</day><volume>8</volume><fpage>e64814</fpage><pub-id pub-id-type="doi">10.2196/64814</pub-id><pub-id pub-id-type="medline">39854065</pub-id></nlm-citation></ref><ref id="ref2"><label>2</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Barbazi</surname><given-names>N</given-names> </name><name name-style="western"><surname>Shin</surname><given-names>JY</given-names> </name><name name-style="western"><surname>Hiremath</surname><given-names>G</given-names> </name><name name-style="western"><surname>Lauff</surname><given-names>CA</given-names> </name></person-group><article-title>Developing assessments for key stakeholders in pediatric congenital heart disease: qualitative pilot study to inform designing of a medical education toy</article-title><source>JMIR Form Res</source><year>2025</year><month>01</month><day>27</day><volume>9</volume><fpage>e63818</fpage><pub-id pub-id-type="doi">10.2196/63818</pub-id><pub-id pub-id-type="medline">39869901</pub-id></nlm-citation></ref><ref id="ref3"><label>3</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Dag</surname><given-names>NC</given-names> </name><name name-style="western"><surname>Turkkan</surname><given-names>E</given-names> </name><name name-style="western"><surname>Kacar</surname><given-names>A</given-names> </name><name name-style="western"><surname>Dag</surname><given-names>H</given-names> </name></person-group><article-title>Children&#x2019;s only profession: playing with toys</article-title><source>North Clin Istanb</source><year>2021</year><month>08</month><day>20</day><volume>8</volume><issue>4</issue><fpage>414</fpage><lpage>420</lpage><pub-id pub-id-type="doi">10.14744/nci.2020.48243</pub-id><pub-id pub-id-type="medline">34585080</pub-id></nlm-citation></ref><ref id="ref4"><label>4</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Rashid</surname><given-names>AA</given-names> </name><name name-style="western"><surname>Cheong</surname><given-names>AT</given-names> </name><name name-style="western"><surname>Hisham</surname><given-names>R</given-names> </name><name name-style="western"><surname>Shamsuddin</surname><given-names>NH</given-names> </name><name name-style="western"><surname>Roslan</surname><given-names>D</given-names> </name></person-group><article-title>Effectiveness of pretend medical play in improving children&#x2019;s health outcomes and well-being: a systematic review</article-title><source>BMJ Open</source><year>2021</year><month>01</month><day>20</day><volume>11</volume><issue>1</issue><fpage>e041506</fpage><pub-id pub-id-type="doi">10.1136/bmjopen-2020-041506</pub-id><pub-id pub-id-type="medline">33472781</pub-id></nlm-citation></ref><ref id="ref5"><label>5</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Longmuir</surname><given-names>PE</given-names> </name><name name-style="western"><surname>Corey</surname><given-names>M</given-names> </name><name name-style="western"><surname>McCrindle</surname><given-names>BW</given-names> </name></person-group><article-title>Interactions with home and health environments discourage physical activity: reports from children with complex congenital heart disease and their parents</article-title><source>Int J Environ Res Public Health</source><year>2021</year><month>05</month><day>4</day><volume>18</volume><issue>9</issue><fpage>4903</fpage><pub-id pub-id-type="doi">10.3390/ijerph18094903</pub-id><pub-id pub-id-type="medline">34064527</pub-id></nlm-citation></ref></ref-list></back></article>