@Article{info:doi/10.2196/18292,
author="Hammons, Jean Amber
and Villegas, Elizabeth
and Olvera, Norma
and Greder, Kimberly
and Fiese, Barbara
and Teran-Garcia, Margarita
and ",
title="The Evolving Family Mealtime: Findings From Focus Group Interviews With Hispanic Mothers",
journal="JMIR Pediatr Parent",
year="2020",
month="Aug",
day="10",
volume="3",
number="2",
pages="e18292",
keywords="family mealtimes",
keywords="healthy eating",
keywords="technology at the table",
keywords="parenting and mealtimes",
keywords="Hispanic culture",
keywords="obesity prevention",
abstract="Background: Given the protective effects of shared family mealtimes and the importance of family in the Hispanic culture, this context should be explored further to determine how it can be leveraged and optimized for interventions. Objective: This study aimed to explore contextual factors associated with family mealtimes in Mexican and Puerto Rican families. Methods: A total of 63 mothers participated in 13 focus group interviews across 4 states. Thematic analysis was used to analyze transcripts. Results: Seven overarching themes were identified through the thematic analysis. Themes reflected who was present at the mealtime, what occurs during mealtime, the presence of television, the influence of technology during mealtime, and how mealtimes have changed since the mothers were children. Conclusions: Hispanic mothers may be adapting family mealtimes to fit their current situations and needs, keeping the television and other devices on during mealtimes, and making additional meals for multiple family members to appease everyone's tastes. All of these are areas that can be incorporated into existing culturally tailored obesity prevention programs to help families lead healthier lives. ",
doi="10.2196/18292",
url="http://pediatrics.jmir.org/2020/2/e18292/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32576547"
}


@Article{info:doi/10.2196/20913,
author="Saposnik, E. Florencia
and Huber, F. Joelene",
title="Trends in Web Searches About the Causes and Treatments of Autism Over the Past 15 Years: Exploratory Infodemiology Study",
journal="JMIR Pediatr Parent",
year="2020",
month="Dec",
day="7",
volume="3",
number="2",
pages="e20913",
keywords="autism",
keywords="infodemiology",
keywords="infoveillance",
keywords="informatics",
keywords="Google Trends",
abstract="Background: Ninety percent of adults in the United States use the internet, and the majority of internet users report looking on the web for health information using search engines. The rising prevalence of autism spectrum disorder (ASD), uncertainty surrounding its etiology, and variety of intervention approaches contribute to questions about its causes and treatments. It is not known which terms people search most frequently about ASD and whether web search queries have changed over time. Infodemiology is an area of health informatics research using big data analytics to understand web search behavior. Objective: The objectives were to (1) use infodemiological data to analyze trends in web-based searches about the causes and treatments of ASD over time and (2) inform clinicians and ASD organizations about web queries regarding ASD. Methods: Google Trends was used to analyze web searches about the causes and treatments of ASD in the United States from 2004 to 2019. The search terms analyzed for queries about causes of ASD included vaccines, genetics, environmental factors, and microbiome and those for therapies included applied behavior analysis (ABA), gluten-free diet, chelation therapy, marijuana, probiotics, and stem cell therapy. Results: Google Trends results are normalized on a scale ranging from 0 to 100 to represent the frequency and relative interest of search topics. For searches about ASD causes, vaccines had the greatest frequency compared to other terms, with an initial search peak observed in 2008 (scaled score of 81), reaching the highest frequency in 2015 (scaled score of 100), and a current upward trend. In comparison, searches about genetics, environmental factors, and microbiome occurred less frequently. For web searches about ASD therapies, ABA consistently had a high frequency of search interest since 2004, reaching a maximum scaled score of 100 in 2019. The analyses of chelation therapy and gluten-free diet showed trending interest in 2005 (scaled score of 68) and 2007 (scaled score of 100), respectively, followed by a steady decline since (scaled scores of only 10 and 16, respectively, in 2019). Searches related to ASD and marijuana showed a rise in 2009 (scaled score of 35), and they continue to trend upward. Searches about probiotics and stem cell therapy have been relatively low (scaled scores of 22 and 18, respectively), but are gradually gaining interest. Web search volumes for stem cell therapy in 2019 surpassed both gluten-free diet and chelation therapy as web-searched interventions for ASD. Conclusions: Google Trends is an effective infodemiology tool to analyze large-scale web search trends about ASD. The results showed informative variation in search trends over 15 years. These data are useful to inform clinicians and organizations about web queries on topics related to ASD, identify knowledge gaps, and target web-based education and knowledge translation strategies. ",
doi="10.2196/20913",
url="http://pediatrics.jmir.org/2020/2/e20913/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33284128"
}


@Article{info:doi/10.2196/22121,
author="Kling, MR Samantha
and Harris, A. Holly
and Marini, Michele
and Cook, Adam
and Hess, B. Lindsey
and Lutcher, Shawnee
and Mowery, Jacob
and Bell, Scott
and Hassink, Sandra
and Hayward, B. Shannon
and Johnson, Greg
and Franceschelli Hosterman, Jennifer
and Paul, M. Ian
and Seiler, Christopher
and Sword, Shirley
and Savage, S. Jennifer
and Bailey-Davis, Lisa",
title="Advanced Health Information Technologies to Engage Parents, Clinicians, and Community Nutritionists in Coordinating Responsive Parenting Care: Descriptive Case Series of the Women, Infants, and Children Enhancements to Early Healthy Lifestyles for Baby (WEE Baby) Care Randomized Controlled Trial",
journal="JMIR Pediatr Parent",
year="2020",
month="Nov",
day="24",
volume="3",
number="2",
pages="e22121",
keywords="early obesity prevention",
keywords="responsive parenting",
keywords="health information technology",
keywords="coordination of care",
keywords="clinical care",
keywords="pragmatic intervention",
keywords="data sharing",
abstract="Background: Socioeconomically disadvantaged newborns receive care from primary care providers (PCPs) and Women, Infants, and Children (WIC) nutritionists. However, care is not coordinated between these settings, which can result in conflicting messages. Stakeholders support an integrated approach that coordinates services between settings with care tailored to patient-centered needs. Objective: This analysis describes the usability of advanced health information technologies aiming to engage parents in self-reporting parenting practices, integrate data into electronic health records to inform and facilitate documentation of provided responsive parenting (RP) care, and share data between settings to create opportunities to coordinate care between PCPs and WIC nutritionists. Methods: Parents and newborns (dyads) who were eligible for WIC care and received pediatric care in a single health system were recruited and randomized to a RP intervention or control group. For the 6-month intervention, electronic systems were created to facilitate documentation, data sharing, and coordination of provided RP care. Prior to PCP visits, parents were prompted to respond to the Early Healthy Lifestyles (EHL) self-assessment tool to capture current RP practices. Responses were integrated into the electronic health record and shared with WIC. Documentation of RP care and an 80-character, free-text comment were shared between WIC and PCPs. A care coordination opportunity existed when the dyad attended a WIC visit and these data were available from the PCP, and vice versa. Care coordination was demonstrated when WIC or PCPs interacted with data and documented RP care provided at the visit. Results: Dyads (N=131) attended 459 PCP (3.5, SD 1.0 per dyad) and 296 WIC (2.3, SD 1.0 per dyad) visits. Parents completed the EHL tool prior to 53.2\% (244/459) of PCP visits (1.9, SD 1.2 per dyad), PCPs documented provided RP care at 35.3\% (162/459) of visits, and data were shared with WIC following 100\% (459/459) of PCP visits. A WIC visit followed a PCP visit 50.3\% (231/459) of the time; thus, there were 1.8 (SD 0.8 per dyad) PCP to WIC care coordination opportunities. WIC coordinated care by documenting RP care at 66.7\% (154/231) of opportunities (1.2, SD 0.9 per dyad). WIC visits were followed by a PCP visit 58.9\% (116/197) of the time; thus, there were 0.9 (SD 0.8 per dyad) WIC to PCP care coordination opportunities. PCPs coordinated care by documenting RP care at 44.0\% (51/116) of opportunities (0.4, SD 0.6 per dyad). Conclusions: Results support the usability of advanced health information technology strategies to collect patient-reported data and share these data between multiple providers. Although PCPs and WIC shared data, WIC nutritionists were more likely to use data and document RP care to coordinate care than PCPs. Variability in timing, sequence, and frequency of visits underscores the need for flexibility in pragmatic studies. Trial Registration: ClinicalTrials.gov NCT03482908; https://clinicaltrials.gov/ct2/show/NCT03482908 International Registered Report Identifier (IRRID): RR2-10.1186/s12887-018-1263-z ",
doi="10.2196/22121",
url="http://pediatrics.jmir.org/2020/2/e22121/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33231559"
}


@Article{info:doi/10.2196/21694,
author="Titgemeyer, Catrin Sarah
and Schaaf, Patrick Christian",
title="Facebook Support Groups for Rare Pediatric Diseases: Quantitative Analysis",
journal="JMIR Pediatr Parent",
year="2020",
month="Nov",
day="19",
volume="3",
number="2",
pages="e21694",
keywords="pediatric rare diseases",
keywords="rare diseases",
keywords="support group",
keywords="online support",
keywords="Facebook support group",
keywords="social media",
keywords="parent support",
keywords="support group privacy",
keywords="counseling",
abstract="Background: Loneliness, social isolation, and feeling disconnected from society are commonly experienced by parents of children with rare diseases and are, among others, important reasons for special supportive care needs. Social networking platforms are increasingly used for health communication, information exchange, and support. In the field of rare pediatric diseases, qualitative studies have shown that Facebook online support groups are utilized by and beneficial for persons affected by rare pediatric diseases. Nonetheless, the extent of this usage has not been investigated. Objective: This study aims to provide a comprehensive quantitative analysis of the extent of Facebook usage as a tool for rare pediatric disease support groups and to explore factors that influence a disease's representation on Facebook. These results potentially offer important insights for future public health initiatives and give direction to further research that can give much needed support to parents of children with rare diseases. Methods: We determined rare pediatric diseases using the inventory of the online portal Orphanet. Facebook support groups were identified by searching 5 synonymous disease descriptions using the group category search bar. Disease- and group-describing parameters were statistically analyzed using standard descriptive statistical methods. Results: 6398 Facebook support groups, representing 826 diseases (19.5\% of all searched diseases), were found. 69\% are private groups. Group type, size, activity (sum of posts, comments, and reactions calculated by Facebook), new memberships, and language varied largely between groups (member count: minimum 1, maximum 23,414; activity last 30 days: minimum 0, maximum 3606). The highest percentage of awareness and information groups was found for teratogenic diseases (18/68, 26\%). The odds of finding a Facebook group increased according to the level of information available about the disease: known prevalence (odds ratio [OR] 3.98, 95\% CI 3.39-4.66, P<.001), known disease type (OR 3.15, 95\% CI 2.70-3.68, P<.001), and known inheritance mode (OR 2.06, 95\% CI 1.68-2.52, P<.001) were all associated with higher odds of finding a Facebook group, as was dominant compared to nondominant inheritance (OR 2.05, 95\% CI 1.74-3.42, P<.001). The number of groups per disease increased with higher prevalence. Conclusions: Facebook is widely used as a tool for support groups for rare pediatric diseases and continues to be relevant. Two-thirds of the groups are private groups, indicating group participants' need for privacy, which should be further explored. The advantages and limitations of Facebook as a tool for support groups in the field of rare diseases should be further investigated as it will allow health professionals to use Facebook more meaningfully in their counseling and guidance of affected individuals and their family members. ",
doi="10.2196/21694",
url="http://pediatrics.jmir.org/2020/2/e21694/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33211019"
}


@Article{info:doi/10.2196/17044,
author="M{\"u}ssener, Ulrika
and Thomas, Kristin
and Bendtsen, Preben
and Bendtsen, Marcus",
title="High School Students' Preferences and Design Recommendations for a Mobile Phone--Based Intervention to Improve Psychological Well-Being: Mixed Methods Study",
journal="JMIR Pediatr Parent",
year="2020",
month="Jul",
day="9",
volume="3",
number="2",
pages="e17044",
keywords="mental health",
keywords="stress",
keywords="high school students",
keywords="intervention",
keywords="mHealth",
abstract="Background: Young adults' mental health is characterized by relatively high rates of stress and anxiety and low levels of help-seeking behavior. Mobile health (mHealth) interventions could offer a cost-effective and readily available avenue to provide personalized support to young adults. More research needs to be directed at the development of mHealth interventions targeting youths specifically, as well as at determining how to reach young people and how to effectively intervene to improve psychological well-being. Objective: The objective was to gather perceptions from high school students to inform the development of a prototype mHealth intervention aiming to promote psychological well-being. Methods: A mixed methods design was used to (1) investigate high school students' perceptions about stress and its consequences in daily life, as well as their ability to cope with stress, and (2) explore their preferences and design recommendations for an mHealth intervention to improve psychological well-being. Students from two high schools in the southeast of Sweden were invited to take part in the study. Recruitment of high school students was completed over a 6-week period, between October 25 and December 7, 2018. Recruitment entailed inviting students to complete a stress test (ie, screening and feedback) on their mobile phones. After completing the stress test, all participants were invited to complete a follow-up questionnaire and take part in telephone interviews. Results: A total of 149 high school students completed the stress test, of which 68 completed the questionnaire. There were 67 free-text comments distributed across the items. The majority of participants (55/68, 81\%) stated that they coped with stress better or in the same way after engaging in the stress test, due to time management, dialogue with others, and self-refection. A total of 4 out of 68 participants (6\%)---3 female students (75\%) and 1 male student (25\%)---took part in telephone interviews. Three main themes were identified from the interview data: perceptions about stress, design features, and intervention features. Conclusions: Stress was described by the students as a condition caused by high demands set by oneself and the social environment that impacted their physical health, personal relationships, school performance, and emotional well-being. Participants claimed that mHealth interventions need to be clearly tailored to a young age group, be evidence based, and offer varied types of support, such as information about stress, exercises to help organize tasks, self-assessment, coping tools, and recommendations of other useful websites, literature, blogs, self-help books, or role models. Mobile phones seemed to be a feasible and acceptable platform for the delivery of an intervention. ",
doi="10.2196/17044",
url="https://pediatrics.jmir.org/2020/2/e17044",
url="http://www.ncbi.nlm.nih.gov/pubmed/32673268"
}


@Article{info:doi/10.2196/21155,
author="Katapally, Reddy Tarun",
title="Smart Indigenous Youth: The Smart Platform Policy Solution for Systems Integration to Address Indigenous Youth Mental Health",
journal="JMIR Pediatr Parent",
year="2020",
month="Sep",
day="25",
volume="3",
number="2",
pages="e21155",
keywords="Indigenous youth",
keywords="mental health",
keywords="school policies",
keywords="health policy",
keywords="digital health interventions",
keywords="mHealth",
keywords="systems integration",
keywords="land-based learning",
keywords="physical activity",
doi="10.2196/21155",
url="http://pediatrics.jmir.org/2020/2/e21155/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32975527"
}


@Article{info:doi/10.2196/20976,
author="Thabrew, Hiran
and Kumar, Harshali
and Goldfinch, Mary
and Cavadino, Alana
and Goodyear-Smith, Felicity",
title="Repeated Psychosocial Screening of High School Students Using YouthCHAT: Cohort Study",
journal="JMIR Pediatr Parent",
year="2020",
month="Oct",
day="26",
volume="3",
number="2",
pages="e20976",
keywords="mass screening",
keywords="mental health",
keywords="school health services",
keywords="eHealth",
abstract="Background: Psychosocial problems are common during adolescence and can have long-lasting effects on health and on academic and social functioning. YouthCHAT, an electronic HEEADSSS (home, education, eating, activities, drugs and alcohol, suicide and depression, sexuality and safety)-aligned instrument, has recently been demonstrated to be an acceptable and effective school-based psychosocial screener for 13-year-old (Year 9) high school students. Objective: This study aims to compare acceptability and detection rates with repeated YouthCHAT screenings of high school students when they are 13 years old (Year 9) and 14 years old (Year 10). Methods: We invited all Year-10 students to complete a YouthCHAT screening in 2018. Rates of positively identified issues were compared between the subset of students screened in both 2017 and 2018. Student acceptability toward YouthCHAT was investigated through focus group sessions. Onward clinical referral rates in 2018 were also investigated to explore the potential referral burden following screening. Data analysis for rates of positively identified issues were conducted with the McNemar test. Chi-square, Fisher exact test, and Kruskal-Wallis test were used to analyze the focus group data. Results: Of 141 eligible Year-10 students, 114 (81\%) completed a YouthCHAT screening during 2018, and 97 (85\%) of them completed it for a second time. Apart from depression, which increased (P=.002), and perceived life stress, which decreased (P=.04), rates of identified issues were broadly similar between 13 and 14 years of age. Repeated screenings via YouthCHAT was acceptable to students and time-efficient (mean, 6 minutes and 32 seconds) but did not reduce the overall number of individuals with identified issues. Onward clinical referrals from positive screens were mostly managed by school-based health services without the need for external referrals. Conclusions: Although further evaluation is needed, our results support the value of YouthCHAT as an acceptable and effective instrument with which to achieve routine identification of psychosocial issues and early intervention within a high school environment. ",
doi="10.2196/20976",
url="http://pediatrics.jmir.org/2020/2/e20976/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33104007"
}


@Article{info:doi/10.2196/24536,
author="Puzia, Megan
and Laird, Breanne
and Green, Jeni
and Huberty, Jennifer",
title="Parents' Perceptions of Their Children's Engagement in a Consumer-Based Meditation Mobile App: Cross-Sectional Survey Study",
journal="JMIR Pediatr Parent",
year="2020",
month="Nov",
day="13",
volume="3",
number="2",
pages="e24536",
keywords="mindfulness",
keywords="meditation",
keywords="children",
keywords="mental health",
keywords="sleep",
keywords="mHealth",
abstract="Background: In the United States, nearly half (48\%) of school-aged children experience sleep disturbance that results in less than the recommended sleep duration, which may negatively impact mental health and behavior. Mindfulness interventions may improve sleep and mental health in youth. However, there are gaps in the literature regarding how children (2-12 years) and adolescents (13-17 years) practice mindfulness and the extent to which they benefit from these practices. Objective: The purpose of this study was to determine parents' perceptions of their children's engagement with a consumer-based mindfulness meditation app and the extent to which they believe their children have benefitted from using the app, particularly with regard to sleep. Methods: This study is a secondary analysis of a cross-sectional survey in adult subscribers (N=11,108) to the mindfulness meditation mobile app Calm. Participants who indicated that they had a child or children younger than 18 years (2944/11,108) who used the Calm app were asked additional questions related to their perceptions of their children's engagement with Calm. Descriptive statistics were used to assess children's app engagement, and chi-square tests and binary logistic regression models were used to assess differences in children's usage based on gender and age. Results: Among the survey respondents, approximately half of the parents (1537/2944, 52.21\%) reported that their children used Calm. Children used Calm mostly for (1) sleep (1168/1537, 75.99\%), (2) stress (491/1537, 31.95\%), (3) depression or anxiety (430/1537, 27.98\%), and (4) improvement of overall health (215/1537,13.99\%). Older children were more likely to begin using Calm to reduce stress, depression, or anxiety, whereas younger children were more likely begin using Calm to improve sleep. Most children used Calm when lying down to go to bed (1113/1529, 72.79\%). Children were most likely to use sleep stories at night (1144/1207, 94.78\%), followed by music and soundscapes (749/1114, 67.24\%), meditations (736/1120, 65.71\%), and breathing exercises (610/1092, 55.86\%). Nearly all parents believed that using sleep stories was helpful for their children's sleep (1090/1128, 96.63\%), and the majority of parents felt that the other components were also helpful for their children's sleep (music and soundscapes [570/728, 78.30\%], meditations [445/696, 63.94\%], and breathing exercises [610/1092, 55.86\%]). Conclusions: To our knowledge, this is the first study to explore parents' perceptions of how their children or adolescents use a popular consumer-based mindfulness mobile app (ie, Calm). As the majority of children use the app for sleep, mindfulness meditation mobile apps should consider incorporating age-appropriate sleep content to meet the needs of this audience. More research is needed to confirm the feasibility and effectiveness of mindfulness meditation apps for improving sleep and mental health in children and adolescents. ",
doi="10.2196/24536",
url="http://pediatrics.jmir.org/2020/2/e24536/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33185564"
}


@Article{info:doi/10.2196/19749,
author="Tinner, Elizabeth Laura
and Kaner, Eileen
and Garnett, Claire
and Mitchell, Siobhan
and Hickman, Matthew
and Campbell, Rona
and MacArthur, Georgina",
title="Qualitative Evaluation of Web-Based Digital Intervention to Prevent and Reduce Excessive Alcohol Use and Harm Among Young People Aged 14-15 Years: A ``Think-Aloud'' Study",
journal="JMIR Pediatr Parent",
year="2020",
month="Dec",
day="15",
volume="3",
number="2",
pages="e19749",
keywords="public health",
keywords="adolescent",
keywords="mobile phone",
keywords="alcoholic intoxication",
keywords="internet",
abstract="Background: In the United Kingdom, despite some downward trends in alcohol use among young people, over one-fifth of young people reported excessive alcohol use in the past month, which is associated with short- and long-term harm to health. Digital interventions to reduce alcohol use, such as websites, among young people present an appealing and cost-effective mode of intervention that can be integrated into the education system. However, relatively few school-based digital alcohol-focused interventions have been developed and evaluated for young people in the United Kingdom. Objective: This study aims to develop a novel web-based intervention, Rethink Alcohol, to prevent and reduce excessive alcohol use and related harm among young people aged between 14 and 15 years, and explore the views of young people, teachers, and youth workers in relation to the content, design, and usability of the intervention. Methods: Intervention development followed the person-based approach, using theories of social norms and social influence. Qualitative ``Think-Aloud'' interviews, either one-to-one or paired, were conducted while participants perused and worked through the web-based intervention, talking aloud. Participants included 20 young people (12 female, 8 male), 5 youth workers (4 female, 1 male), 3 teachers (2 male, 1 female), and 1 (male) clinical professional, recruited via youth groups and professional networks. Interviews were audio recorded, transcribed verbatim, and analyzed thematically. Results: The prototype web-based intervention included normative feedback, information, a quiz, interactive activities, and scenarios. On a rating scale of impressions from poor (1) to excellent (5), participants gave an average score of 3.6/5. A total of 5 themes were identified: content, credibility of the website, making the website easy to understand, design and navigation, and suitability for the audience. These themes reflected views that the content was interesting, credible, informative, and embodied a neutral and nonjudgmental tone, but stronger messaging was needed regarding social pressures and short-term risks regarding safety and risk behavior alongside clarity around pathways of risk; credibility and trustworthiness of information were critical features, determined in part, by the professionalism of design and referencing of sources of information provided; and messages should be succinct and come to life through design and interactive features. Conclusions: Together, the data illustrated the importance and challenge of communicating nuanced alcohol-focused public health messages to young people in concise, clear, nonjudgmental, and appealing ways. Young people report interest in clear, credible, neutral, and interactive messages regarding social pressures and short-term risks of alcohol use via a web-based intervention. There is scope for optimization and feasibility testing of the Rethink Alcohol intervention. ",
doi="10.2196/19749",
url="http://pediatrics.jmir.org/2020/2/e19749/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33320100"
}


@Article{info:doi/10.2196/19269,
author="Stiles-Shields, Colleen
and Potthoff, M. Lauren
and Bounds, T. Dawn
and Burns, S. Maureen T.
and Draxler, M. Janel
and Otwell, H. Caitlin
and Wolodiger, D. Emily
and Westrick, Jennifer
and Karnik, S. Niranjan",
title="Harnessing Phones to Target Pediatric Populations with Socially Complex Needs: Systematic Review",
journal="JMIR Pediatr Parent",
year="2020",
month="Aug",
day="26",
volume="3",
number="2",
pages="e19269",
keywords="underserved youth",
keywords="digital mental health",
keywords="mHealth",
keywords="telehealth",
keywords="health disparities",
abstract="Background: Mobile and smartphones are owned and accessed by many, making them a potentially optimal delivery mechanism to reach pediatric patients with socially complex needs (ie, pediatric populations who face overlapping adversities). Objective: To address the specialized needs of youth from such groups, this review synthesized the literature exploring the use of phone-based delivery to access pediatric populations with socially complex needs, targeting mental and behavioral health outcomes. The purpose of this synthesis was to provide recommendations for future research developing phone-based interventions for youth with socially complex needs. Methods: A trained medical librarian conducted the search strategy in the following databases: PubMed, Scopus, CINAHL, PsycINFO, Cochrane CENTRAL Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Google Scholar. Studies targeting youth with socially complex needs were defined by recruiting samples that were primarily from traditionally underserved populations (ie, sex/gender minorities, racial/ethnic background, low socioeconomic status, rural/remote location, and sexual orientation). A systematic narrative framework was utilized and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed (registration number CRD42020141212). Results: A total of 14 studies met the inclusion criteria, with 3 depicting the use of phones to complete assessment and tracking goals and 11 to intervene on mental and behavioral health targets. Conclusions: The literature indicates important directions for future research, including (1) involving diverse and representative teens (ie, the likely users of the interventions), stakeholders, and clinical/research staff; (2) integrating evidence-based therapies with minority-focused theories; (3) harnessing mobile device capabilities; and (4) considering and assessing for potential costs in phones as delivery mechanisms. Trial Registration: PROSPERO CRD42020141212; https://www.crd.york.ac.uk/prospero/display\_record.php?RecordID=141212 ",
doi="10.2196/19269",
url="http://pediatrics.jmir.org/2020/2/e19269/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32845244"
}


@Article{info:doi/10.2196/22329,
author="Lau, Nancy
and Waldbaum, Shayna
and Parigoris, Ryan
and O'Daffer, Alison
and Walsh, Casey
and Colt, F. Susannah
and Yi-Frazier, P. Joyce
and Palermo, M. Tonya
and McCauley, Elizabeth
and Rosenberg, R. Abby",
title="eHealth and mHealth Psychosocial Interventions for Youths With Chronic Illnesses: Systematic Review",
journal="JMIR Pediatr Parent",
year="2020",
month="Nov",
day="10",
volume="3",
number="2",
pages="e22329",
keywords="pediatrics",
keywords="chronic illness",
keywords="mHealth",
keywords="eHealth",
keywords="psychosocial interventions",
keywords="mental health",
abstract="Background: An estimated 12.8\% of children and adolescents experience chronic health conditions that lead to poor quality of life, adjustment and coping issues, and concurrent mental health problems. Digital health deployment of psychosocial interventions to support youth with chronic illness has become increasingly popular with the advent of the technological advances in the digital age. Objective: Our objectives were to systematically review published efficacy studies of eHealth and mHealth (mobile health) psychosocial interventions for youths with chronic illnesses and review intervention theory and treatment components. Methods: PubMed, Embase, Web of Science, PsycInfo, and Cochrane Database of Systematic Reviews were searched for studies published from 2008 to 2019 of eHealth and mHealth psychosocial interventions designed for children and adolescents with chronic illnesses in which efficacy outcomes were reported. We excluded studies of interventions for caregivers, healthy youth, disease and medication management, and telehealth interventions that function solely as a platform to connect patients to providers via phone, text, or videoconference. Results: We screened 2551 articles and 133 relevant full-text articles. Sixteen efficacy studies with psychosocial and health outcomes representing 12 unique interventions met the inclusion criteria. Of the included studies, 12 were randomized controlled trials and 4 were prospective cohort studies with no comparison group. Most interventions were based in cognitive behavioral theory and designed as eHealth interventions; only 2 were designed as mHealth interventions. All but 2 interventions provided access to support staff via text, phone, email, or discussion forums. The significant heterogeneity in intervention content, intervention structure, medical diagnoses, and outcomes precluded meta-analysis. For example, measurement time points ranged from immediately postcompletion of the mHealth program to 18 months later, and we identified 39 unique outcomes of interest. The majority of included studies (11/16, 69\%) reported significant changes in measured health and/or psychosocial posttreatment outcomes, with small to large effect sizes. Conclusions: Although the available literature on the efficacy of eHealth and mHealth psychosocial interventions for youth with chronic illnesses is limited, preliminary research suggests some evidence of positive treatment responses. Future studies should continue to evaluate whether digital health platforms may be a viable alternative model of delivery to traditional face-to-face approaches. ",
doi="10.2196/22329",
url="http://pediatrics.jmir.org/2020/2/e22329/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33075743"
}


@Article{info:doi/10.2196/15833,
author="Butler, Sonia
and Sculley, Dean
and Santos, Santos Derek
and Fellas, Antoni
and Giron{\`e}s, Xavier
and Singh-Grewal, Davinder
and Coda, Andrea",
title="Usability of eHealth and Mobile Health Interventions by Young People Living With Juvenile Idiopathic Arthritis: Systematic Review",
journal="JMIR Pediatr Parent",
year="2020",
month="Dec",
day="1",
volume="3",
number="2",
pages="e15833",
keywords="juvenile idiopathic arthritis",
keywords="child",
keywords="adolescence",
keywords="eHealth",
keywords="mHealth",
keywords="systematic review",
keywords="mobile phone",
keywords="pain",
keywords="physical activity",
keywords="self-management",
keywords="quality of life",
abstract="Background: Considering the changing landscape of internet use and rising ownership of digital technology by young people, new methods could be considered to improve the current model of juvenile idiopathic arthritis (JIA) management. Objective: This systematic review aims to evaluate the usability of eHealth and mobile health (mHealth) interventions currently available for young people living with JIA. Methods: The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were used to oversee this review. We systematically searched 15 databases for 252 potential studies; 2 authors independently screened all quantitative studies reporting the use of eHealth and mHealth interventions for young people (aged 1-18 years) diagnosed with JIA. Studies were excluded if they did not report outcome measures or were reviews, commentaries, or qualitative studies. Study methodological quality was scored using the Down and Black (modified) checklist. A narrative descriptive methodology was used to quantify the data because of heterogeneity across the studies. Results: A total of 11 studies were included in this review, reporting 7 eHealth and mHealth interventions for young people (aged 4-18 years) living with JIA, targeting health issues such as pain, health-related quality of life, physical activity, and chronic disease self-management. The usability of the interventions was facilitated through training and ongoing support. The engagement was promoted by a combination of persuasive influences, and barriers preventing adherence were removed through personal reminders and flexible program schedules to cater to JIA and non-JIA illnesses or other commonly seen activities in childhood. The feedback obtained was that most young people and their parents liked the interventions. Conclusions: The results of this review need to be considered cautiously because of the lack of rigorous testing and heterogeneity, which limits the detailed descriptions of data synthesis. Further research is needed to consider gender differences, associated costs, and the effectiveness of the interventions on health outcomes to better support young people living with JIA. ",
doi="10.2196/15833",
url="http://pediatrics.jmir.org/2020/2/e15833/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33258786"
}


@Article{info:doi/10.2196/21863,
author="Pletta, H. Karen
and Kerr, R. Bradley
and Eickhoff, C. Jens
and Allen, S. Gail
and Jain, R. Sanjeev
and Moreno, A. Megan",
title="Pediatric Asthma Action Plans: National Cross-Sectional Online Survey of Parents' Perceptions",
journal="JMIR Pediatr Parent",
year="2020",
month="Nov",
day="9",
volume="3",
number="2",
pages="e21863",
keywords="pediatric asthma",
keywords="asthma action plan",
keywords="parent",
keywords="online survey",
keywords="self-efficacy",
keywords="daily living factors",
keywords="parental work",
keywords="school absence",
keywords="school management",
keywords="caregiver management",
keywords="child activity",
keywords="primary care provider",
keywords="pediatrician",
keywords="asthma specialist",
abstract="Background: Asthma Action Plans (AAPs) are recommended for pediatric patients to help improve asthma control. Studies have shown variable results for unscheduled doctor and emergency room visits. AAPs may have an impact on parental self-efficacy for asthma management as well as on other daily living factors that are valuable for patients and families, such as the number of missed school days and parental workdays, and on school and caregiver management. Objective: The purpose of this study is to understand parent perceptions of AAPs. The goals of this analysis were threefold, including examining (1) the association between pediatric AAPs and parental self-efficacy, (2) parent perceptions of the helpfulness of an AAP for daily living factors, and (3) associations with the type of provider who gave the AAP (a primary care provider or an asthma specialist). Methods: A national cross-sectional online survey was completed in October 2018 by parents of children with asthma aged 0-17 years. Survey questions included the presence or absence of a pediatric AAP, the Bursch Parental Self-efficacy for Asthma scale, parental perceptions of the AAP's helpfulness with regard to daily living factors ranked on a 5-point Likert scale, and the provider type who gave the AAP. Survey responses were summarized in terms of percentages or means and standard deviations. A 2-sample t test and analysis of covariance were used to compare self-efficacy for asthma and parental-perception-of-helpfulness scores between subjects with an AAP versus subjects without an AAP. All reported P values were 2-sided. Results: A total of 704 parents with a child with asthma completed the survey. The parents had a mean age of 37.5 years (SD 10.9), and 82\% (577/704) were women and 18\% (127/704) were men. Most (564/704, 80\%) parents had an AAP for their child; 65\% (367/564) were written, 51\% (286/564) were online, and 84\% (474/564) were available at school. The Bursch Self-efficacy scale was significantly higher for parents with an AAP (mean 57.7, SD 8.6) versus no AAP (mean 55.1, SD 9.9; P<.001). Parents reported that they agreed/strongly agreed that an AAP was helpful for daily living factors, including managing asthma (446/544, 82\%), decreased parental missed workdays (367/544, 68\%), decreased child missed-school days (396/542, 73\%), and for when a child is at school (422/541 78\%), with other caregivers (434/543, 80\%), doing normal activities (421/540 78\%), and leading a normal life (437/540 81\%). Parents agreed/strongly agreed that an AAP was helpful from all provider types: a pediatric provider (583/704, 82.8\%), a family practice provider (556/704, 79\%), and an asthma specialist (594/704, 84.4\%). There was no significant difference (P=.53) between the type of provider who gave the AAP. Conclusions: Parents who had pediatric AAPs for their children reported increased parental self-efficacy compared to those who did not have AAPs. Parents found AAPs helpful for decreasing missed time from work and school, and for asthma management when at home, school, and with other caregivers. Significant AAP helpfulness was seen regardless of the provider who gave the AAP, the parent's education, and income level. Findings support the usefulness of pediatric AAPs for families and the development of easily sharable electronic AAPs for children. ",
doi="10.2196/21863",
url="https://pediatrics.jmir.org/2020/2/e21863",
url="http://www.ncbi.nlm.nih.gov/pubmed/33164900"
}


@Article{info:doi/10.2196/22102,
author="Yoshizaki, Arika
and Mohri, Ikuko
and Yamamoto, Tomoka
and Shirota, Ai
and Okada, Shiho
and Murata, Emi
and Hoshino, Kyoko
and Kato-Nishimura, Kumi
and Matsuzawa, Shigeyuki
and Kato, Takafumi
and Taniike, Masako",
title="An Interactive Smartphone App, Nenne Navi, for Improving Children's Sleep: Pilot Usability Study",
journal="JMIR Pediatr Parent",
year="2020",
month="Dec",
day="1",
volume="3",
number="2",
pages="e22102",
keywords="infant sleep",
keywords="app",
keywords="mHealth",
keywords="behavioral intervention",
keywords="sleep health, PDCA cycle",
abstract="Background: Healthy sleep is important not only for physical health but also for brain development in children. Several reports have revealed that Japanese adults and children have later bedtimes and shorter sleep durations compared with those in other countries, possibly because of Japanese culture and lifestyles. Therefore, an intervention tool that is suitable to the Japanese sociocultural environment is urgently needed to improve children's sleep problems in their early years. Objective: To provide appropriate sleep health literacy to caregivers and change their parenting behavior, we developed a smartphone app that allows reciprocal interaction between caregivers and pediatric sleep experts. This paper describes a preliminary study to examine the app's basic design and functions and to establish its acceptability and usability in a small sample. Methods: A total of 10 caregivers and 10 infants (aged 18-28 months; 4/10, 40\% boys) living in Japan participated in the study. At the start of the trial, the e-learning content regarding sleep health literacy was delivered via a smartphone. Thereafter, caregivers manually inputted recorded data about their own and their infant's sleep habits for 8 consecutive days per month for 2 months. After pediatric sleep experts retrieved this information from the Osaka University server, they specified the problems and provided multiple sleep habit improvement suggestions to caregivers. Caregivers then selected one of the feasible pieces of advice to practice and reported their child's sleep-related behaviors via the app. Actigraphy was used to monitor children's sleep behaviors objectively. The concordance between the information provided by caregivers and the actigraphy data was assessed. The acceptability and usability of the app were evaluated using self-report questionnaires completed by caregivers; qualitative feedback was obtained via semistructured interviews after the intervention. Results: There was no significant difference between the information provided by the caregivers and the actigraphy data for bedtimes and wake-up times (P=.13 to P=.97). However, there was a difference between the actigraphy data and the caregivers' reports of nighttime sleep duration and nighttime awakenings (P<.001 each), similar to prior findings. User feedback showed that 6 and 5 of the 10 caregivers rated the app easy to understand and easy to continue to use, respectively. Additionally, 6 of the 10 caregivers rated the app's operativity as satisfactory. Although this was a short-term trial, children's sleep habits, caregivers' sleep health consciousness, and parenting behaviors improved to some extent. Conclusions: The present findings suggest that the app can easily be used and is acceptable by Japanese caregivers. Given the user feedback, the app has the potential to improve children's sleep habits by sending individualized advice that fits families' backgrounds and home lives. Further studies are needed to confirm the efficacy of the app and facilitate social implementation. ",
doi="10.2196/22102",
url="http://pediatrics.jmir.org/2020/2/e22102/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33122163"
}


@Article{info:doi/10.2196/15786,
author="Rabba, Stacey Aspasia
and Dissanayake, Cheryl
and Barbaro, Josephine",
title="Development of a Web-Based Resource for Parents of Young Children Newly Diagnosed With Autism: Participatory Research Design",
journal="JMIR Pediatr Parent",
year="2020",
month="Sep",
day="30",
volume="3",
number="2",
pages="e15786",
keywords="autism",
keywords="diagnosis",
keywords="parents",
keywords="support",
keywords="co-design",
keywords="eHealth",
abstract="Background: The internet provides an ideal avenue to share information, advice, and support regarding autism. However, many websites lack quality control and rarely provide a one-stop resource for families to access necessary, evidence-based information. Objective: This study aims to use participatory action research (PAR) with end users (ie, parents) and clinicians to develop a web-based resource (Pathways Beyond Diagnosis) to improve timely access to quality, evidence-based information, and support for families after their child is diagnosed with autism. Methods: The PAR approach involves 4 phases: (1) cooperative researcher-stakeholder planning, (2) cooperative researcher-stakeholder--based action, (3) stakeholder observation, and (4) cooperative researcher-stakeholder reflection. A total of 15 participants (parents, n=3; clinicians, n=9; and researchers, n=3) attended individual or group participatory design workshops. This was followed by the translation of knowledge and ideas generated during the workshops to produce mockups of webpages and content, rapid prototyping, and one-on-one consultations with end users to assess the usability of the website developed. Results: A total of 3 participatory design workshops were held with the participants, each followed by a knowledge translation session. At the end of the PAR cycle, an alpha prototype of the website was built and a series of one-on-one end user consultation sessions were conducted. The PAR cycle revealed the importance of 6 key topic areas (understanding autism, accessing services, support, gaining funding, putting it all together, and looking into the future) associated with the time of diagnosis, which were incorporated into the beta version of the website. Conclusions: The development of the Pathways Beyond Diagnosis website using PAR ensures that families have ready access to practical and evidence-based information following a young child's diagnosis. The website guides families to access relevant, reputable, and evidence-based information in addition to summarizing key challenges encountered after diagnosis (ie, grief, sharing the diagnosis) and the importance of self-care. ",
doi="10.2196/15786",
url="http://pediatrics.jmir.org/2020/2/e15786/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32996890"
}


@Article{info:doi/10.2196/19669,
author="Buteau-Poulin, Anabel
and Gosselin, Camille
and Bergeron-Ouellet, Andr{\'e}a
and Kiss, Jocelyne
and Lamontagne, Marie-{\`E}ve
and Maltais, D{\'e}sir{\'e}e
and Trottier, Christiane
and Desmarais, Chantal",
title="Availability and Quality of Web Resources for Parents of Children With Disability: Content Analysis and Usability Study",
journal="JMIR Pediatr Parent",
year="2020",
month="Nov",
day="10",
volume="3",
number="2",
pages="e19669",
keywords="disabled child",
keywords="parents",
keywords="health knowledge",
keywords="internet-based intervention",
keywords="validation study",
abstract="Background: The internet is a valuable resource for parents of typical children, who are looking for information about their children's growth and development and how to boost them. However, for parents of children with special needs, especially for non--English-speaking parents, there are anecdotal reports stating that specific and accurate information is not available on the internet. Objective: This study aims to describe the type of information available on the internet for French-speaking parents of children with disability as well as assess the quality of the information collected. Methods: We carried out a search of the existing relevant websites targeted at parents of children with disability. We used a validated instrument to extract structural, textual, and visual characteristics of these websites and evaluate their usability. Results: In all, 42 websites were analyzed; of these, the information had been validated by a trustworthy source in only 18 (43\%) websites. Networking opportunities for parents were available in only 7 (17\%) websites. Most websites provided information related to autism spectrum disorder (20/42, 42\%) and learning disabilities (19/42, 45\%), and only a few websites discussed other disability types such as behavorial disorders and developmental language disorders (4/42, 10\% each). Community, social, and civic life (9/42, 22\%); domestic life (12/42, 29\%); and mobility (15/42, 36\%) were the less frequently covered topics. With regard to the usability evaluation, 22 of the 42 (52\%) websites received a global score <70\%, whereas 20 (48\%) scored ?70\% Conclusions: Although the internet is an infinite source of information, it is not necessarily actionable for parents of children with disability. Some information remains difficult to find online, and networking opportunities with other parents dealing with similar challenges are scarce. ",
doi="10.2196/19669",
url="http://pediatrics.jmir.org/2020/2/e19669/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33170127"
}


@Article{info:doi/10.2196/16367,
author="Kelleher, F. Erin
and Giampietro, F. Philip
and Moreno, A. Megan",
title="Social Media Use Among Young Adults With Connective Tissue Disorders: Cross-Sectional Pilot Study",
journal="JMIR Pediatr Parent",
year="2020",
month="Oct",
day="30",
volume="3",
number="2",
pages="e16367",
keywords="connective tissue disorders",
keywords="social media",
keywords="adolescents",
keywords="young adults",
keywords="Marfan syndrome",
keywords="Ehlers-Danlos syndrome",
keywords="Alport hereditary nephritis",
keywords="Beals congenital contractual arachnodactyly",
keywords="internet",
abstract="Background: Young people with genetic conditions often face challenges coping with their health condition. It can be difficult for them to meet someone with a similar condition, which is important for reinforcement of chronic illness management recommendations. Social media is used by 97\% of young people in the United States and may provide those with these disorders a space for emotional expression and support. However, there is a scarcity of literature related to the use of social media among adolescents with genetic conditions as an indicator of their perception regarding their own condition. Objective: The purpose of this pilot study was to obtain preliminary data to assess and understand social media use by young people with connective tissue disorders and determine whether they use social media to connect with patients with similar conditions or whether they would be interested in doing so. Methods: We undertook a pilot study of selected connective tissue disorders occurring in young people between the ages of 11 and 25 years, including Marfan syndrome; Ehlers-Danlos syndrome subtypes classical, classical-like, cardiac-valvular, and vascular; Beals congenital contractual arachnodactyly; and Alport hereditary nephritis. The study took place within one pediatric clinical system. Patients were identified through electronic medical record search and International Classification of Diseases, Ninth Revision, coding at a Midwest university--based clinical system. Study subjects completed a short survey describing their experiences with their connective tissue disorders, their means of self-expression, their existing network of persons to communicate with, and their use of social media. Data analysis included nominal and bivariate regressions to compare social media use in relation to age. Results: Our 31 participants (42\% response rate) were 55\% female (17/31) and their average age was 18 years (SD 5). All participants used social media and there were no statistically significant differences between social media use and age. The majority of participants (25/30, 83\%) reported that they never used social media to discuss their condition (P=.09), and only 17\% (5/30) knew someone online with a similar condition (P=.50). Most participants (19/30, 63\%) said they would communicate with someone with a similar disorder (P=.64). Conclusions: We found that young individuals with connective tissue disorders use at least one type of social media. A majority did not use social media to discuss their condition or know someone online with a similar condition. However, many persons were interested in finding others similarly affected. Social media could serve as a platform for young people with connective tissue disorders to connect. Peer support is important in disease management and adolescent development. Future studies should aim at understanding social media use among young people with connective tissue disorders and helping them connect with other people who have similar conditions. ",
doi="10.2196/16367",
url="http://pediatrics.jmir.org/2020/2/e16367/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33124992"
}


@Article{info:doi/10.2196/18174,
author="Brief, James
and Chawla, Anupama
and Lerner, Diana
and Vitola, Bernadette
and Woroniecki, Robert
and Morganstern, Jeffrey",
title="The Impact of a Smartphone App on the Quality of Pediatric Colonoscopy Preparations: Randomized Controlled Trial",
journal="JMIR Pediatr Parent",
year="2020",
month="Nov",
day="10",
volume="3",
number="2",
pages="e18174",
keywords="colonoscopy",
keywords="app",
keywords="pediatrics",
keywords="prep",
keywords="smartphone",
keywords="mobile phone",
keywords="mHealth",
abstract="Background: Smartphone apps have been successfully used to help adults prepare for colonoscopies. However, no study to date has investigated the effect of a smartphone app on pediatric colonoscopy preparation. Objective: The aim of this study is to determine if an app (SB Colonoscopy Prep) designed to educate and guide patients through their colonoscopy preparation will yield benefits over paper-based instructions and information. Methods: In total, 46 patients aged 5-18 years received either app-based or written material with instructions on how to take their prep medications as well as information about the colonoscopy procedure. Prep quality, the number of calls to the gastroenterology service, and patient arrival time were recorded. After the procedure, a questionnaire was given to each patient through which they graded their knowledge of the procedure both before and after receiving the app or written material. Results: App users had higher mean Boston scores versus control subjects receiving written instructions (7.2 vs 5.9, P=.02), indicating better colonoscopy preps. In total, 75\% (15/20) of app users and 41\% (9/22) of written instruction users had preps categorized as ``excellent'' on the Boston scale. We found no significant differences in knowledge about the procedure (app users: 10/20 [50\%], written instruction users 8/22 [36\%]; P=.37), phone calls to the gastroenterology clinic (n=6 vs n=2; P=.27), or arrival times at the endoscopy suite (44 min vs 46 min before the scheduled procedure time; P=.56). Conclusions: Smartphone app use was associated with an increased number of colonoscopy preps classified as ``excellent'' on the Boston scale. There was no significant difference between app users and the control group regarding the number of calls to the gastroenterology clinic, patient arrival time, or patient knowledge about the procedure. Trial Registration: ClinicalTrials.gov NCT04590105; https://clinicaltrials.gov/ct2/show/NCT04590105 ",
doi="10.2196/18174",
url="https://pediatrics.jmir.org/2020/2/e18174",
url="http://www.ncbi.nlm.nih.gov/pubmed/33170131"
}


@Article{info:doi/10.2196/19867,
author="Ye, Jiancheng",
title="Pediatric Mental and Behavioral Health in the Period of Quarantine and Social Distancing With COVID-19",
journal="JMIR Pediatr Parent",
year="2020",
month="Jul",
day="28",
volume="3",
number="2",
pages="e19867",
keywords="pediatrics",
keywords="mental health",
keywords="stay-at-home orders",
keywords="health technology",
keywords="digital interventions",
keywords="social distancing",
keywords="COVID-19",
doi="10.2196/19867",
url="http://pediatrics.jmir.org/2020/2/e19867/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32634105"
}


@Article{info:doi/10.2196/19924,
author="Caze II, Todd
and Knell, P. Gregory
and Abt, John
and Burkhart, O. Scott",
title="Management and Treatment of Concussions via Tele-Concussion in a Pediatric Setting: Methodological Approach and Descriptive Analysis",
journal="JMIR Pediatr Parent",
year="2020",
month="Aug",
day="13",
volume="3",
number="2",
pages="e19924",
keywords="brain concussion",
keywords="athletic injuries",
keywords="sports injuries",
keywords="telemedicine",
keywords="eHealth",
keywords="mHealth",
keywords="telehealth",
keywords="mobile health",
keywords="adolescent",
keywords="child",
keywords="COVID-19",
abstract="Background: Approximately 2 million children in the United States sustain a concussion annually, resulting in an economic impact as high as US \$20 billion. Patients who receive treatment at concussion specialty clinics, versus primary care, experience faster recovery, thereby reducing patient burden and subsequent medical-related costs. Accessibility to specialty clinics is typically limited by the availability of in-office visits. This is particularly relevant in light of the severe acute respiratory syndrome coronavirus 2 pandemic and subsequent guidance to eliminate all non--medically necessary in-clinic visits. Telehealth has been used to effectively deliver in-clinic care across several disciplines including psychiatry, psychology, and neuropsychology. However, a model of telehealth delivered concussion assessment, treatment, and management has not been established. Objective: The purposes of this paper are to describe a pediatric concussion specialty clinic's experiences in delivering telehealth concussion services and to provide preliminary descriptive data on a sample of pediatric telehealth patients with concussions. Methods: The specialty pediatric concussion clinic described here began providing telehealth services in 2019 and is part of the largest and fastest-growing telehealth hospital network in the United States. The clinical care process will be described, including accessing the telehealth platform, assessment during the initial appointment, injury management including communication with relevant patient stakeholders (eg, parent or guardians, athletic trainers), dissemination of rehabilitation exercises, and nature of follow-up visits. Descriptive data will include patient demographics, the radius of care, the time between the date of injury and initial visit, the average number of follow-up visits, and days until medically cleared for return-to-learn and return-to-play. Results: The analytic sample included 18 patients with concussions who were seen for all of their visits via telehealth between August 2019 and April 2020. The mean age of the sample was 14.5 (SD 2.5) years. The radius of care was a median of 17 (IQR 11.0-31.0) miles from the clinic with a median time between injury and the first visit of 21 (IQR 6.0-41.5) days. The mean number of visits was 2.2 (SD 0.8) with a median days between visits of 5.4 (IQR 3.0-9.3) to manage and treat the concussion. Of the 18 patients, 55.6\% (n=10) were medically cleared for return-to-learn or -play in a median of 15.5 (IQR 11.0-29.0) days. Conclusions: Limited access to health care is a well-understood barrier for receiving quality care. Subsequently, there are increasing demands for flexibility in delivering concussion services remotely and in-clinic. This is the first paper to provide a clinically relevant framework for the assessment, management, and treatment of acute concussion via telehealth in a pediatric population. ",
doi="10.2196/19924",
url="https://pediatrics.jmir.org/2020/2/e19924",
url="http://www.ncbi.nlm.nih.gov/pubmed/32634106"
}


@Article{info:doi/10.2196/23463,
author="Stull, W. Samuel
and McKnight, R. Erin
and Bonny, E. Andrea",
title="Patient and Clinician Perspectives on Adolescent Opioid Use Disorder Treatment During a Pandemic: One Step Back, but Two Forward?",
journal="JMIR Pediatr Parent",
year="2020",
month="Oct",
day="9",
volume="3",
number="2",
pages="e23463",
keywords="adolescent",
keywords="opioid use disorder",
keywords="treatment",
keywords="telehealth",
keywords="drug",
keywords="perspective",
keywords="opioid",
keywords="COVID-19",
keywords="young adult",
doi="10.2196/23463",
url="http://pediatrics.jmir.org/2020/2/e23463/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33016885"
}


@Article{info:doi/10.2196/23057,
author="Serlachius, Anna
and Badawy, M. Sherif
and Thabrew, Hiran",
title="Psychosocial Challenges and Opportunities for Youth With Chronic Health Conditions During the COVID-19 Pandemic",
journal="JMIR Pediatr Parent",
year="2020",
month="Oct",
day="12",
volume="3",
number="2",
pages="e23057",
keywords="COVID-19",
keywords="coronavirus",
keywords="pandemic",
keywords="chronic illness",
keywords="youth",
keywords="adolescents",
keywords="children",
keywords="psychosocial",
keywords="anxiety",
doi="10.2196/23057",
url="http://pediatrics.jmir.org/2020/2/e23057/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33001834"
}


@Article{info:doi/10.2196/21644,
author="Biernesser, Candice
and Montano, Gerald
and Miller, Elizabeth
and Radovic, Ana",
title="Social Media Use and Monitoring for Adolescents With Depression and Implications for the COVID-19 Pandemic: Qualitative Study of Parent and Child Perspectives",
journal="JMIR Pediatr Parent",
year="2020",
month="Dec",
day="8",
volume="3",
number="2",
pages="e21644",
keywords="social media",
keywords="adolescent",
keywords="parents",
keywords="depression",
keywords="disclosure",
keywords="qualitative research",
keywords="COVID-19",
abstract="Background: Although youth report many positive experiences with social media (SM) use in their daily lives, adolescents with depression are more vulnerable to the risks of SM use than adolescents without depression. Parents protect adolescents with depression from the risks of SM use by monitoring their child's SM activity; however, this comes into conflict with the adolescent's need for autonomy in their web-based communication. The implications of SM use and monitoring for adolescents with depression and their parents are of particular relevance to the COVID-19 pandemic, as rates of SM use have increased in response to physical distancing measures. Objective: This study aims to explore parent and child perspectives regarding the use and function of SM in the daily lives of adolescents with depression and parents' perceptions of and experience with monitoring their child's SM use. Methods: We conducted qualitative interviews with adolescents with depression (n=23) and one parent of each adolescent (n=23) between July 2013 and September 2014. The adolescents were patients seeking treatment for depression in Pittsburgh, Pennsylvania. Data analysis included dyadic analysis of the adolescents' and parents' perspectives and qualitative descriptions of individual parent interviews to explore their experiences with SM use and monitoring. The construct of parental knowledge and factors hypothesized to contribute to parental knowledge, including adolescent disclosure, parental solicitation, and parental control, were used to guide the codebook and dyadic data analysis. Results: Dyadic analyses showed that parents and their children disagreed on the use and function of SM in the daily lives of adolescents with depression, with adolescents viewing SM as a forum for honest expression of their emotions, whereas parents felt that their children's posts were inconsequential and interfered with the adolescents' lives. Furthermore, parents reported using a wide range of strategies to gain knowledge of their child's SM use to monitor their safety on SM, including direct solicitation and indirect solicitation, such as keeping the child's passwords, asking friends or siblings about their child's SM use, and restricting SM behavior and access to devices. Conclusions: Clinicians should support adolescents with depression and their parents in finding common ground for an effective and acceptable monitoring approach. Resources are provided for clinicians navigating conversations about SM use and monitoring with adolescents with depression and their parents during the COVID-19 pandemic. ",
doi="10.2196/21644",
url="http://pediatrics.jmir.org/2020/2/e21644/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33289678"
}


@Article{info:doi/10.2196/24827,
author="Zhang, Chun Ke
and Fang, Yuan
and Cao, He
and Chen, Hongbiao
and Hu, Tian
and Chen, Qi Ya
and Zhou, Xiaofeng
and Wang, Zixin",
title="Parental Acceptability of COVID-19 Vaccination for Children Under the Age of 18 Years: Cross-Sectional Online Survey",
journal="JMIR Pediatr Parent",
year="2020",
month="Dec",
day="30",
volume="3",
number="2",
pages="e24827",
keywords="parental acceptability",
keywords="COVID-19 vaccination",
keywords="children under the age of 18 years",
keywords="theory of planned behavior",
keywords="social media influence",
keywords="China",
abstract="Background: It is expected that COVID-19 vaccines will become available in China by the end of 2020. Vaccinating children against COVID-19 would contribute to the control of the pandemic and the recovery of the global economy. For children under the age of 18 years, parents are usually the decision makers regarding their children's vaccination. Objective: The goal of this study was to investigate parental acceptability of free COVID-19 vaccination for children under the age of 18 years in China. Methods: This is a secondary analysis of a cross-sectional, closed online survey among 2053 factory workers in Shenzhen, China, implemented from September 1 to 7, 2020.  Participants of the online survey were full-time employees aged 18 years or over who had resumed work in factories in Shenzhen. Factory workers in Shenzhen are required to receive physical examinations once a year. Eligible workers attending six designated physical examination sites were invited to complete an online survey. This study was based on a subsample of those who had at least one child under the age of 18 years (N=1052). After being briefed that COVID-19 vaccines developed by China are likely to be available by the end of 2020, participants were asked about their likelihood of having their children under the age of 18 years take up free COVID-19 vaccination provided by the government, if it existed. Multivariate logistic regression models were fitted to examine the associations of perceptions related to COVID-19 vaccination based on the theory of planned behavior (TPB) and exposure to information related to COVID-19 through social media with parental acceptability, after controlling for significant background characteristics. Results: The prevalence of parents' acceptability of COVID-19 vaccination for their children was 72.6\% (764/1052). After adjusting for significant background characteristics, positive attitudes toward COVID-19 vaccination (adjusted odds ratio [AOR] 1.70, 95\% CI 1.50-1.91), the perception that a family member would support them in having their children take up COVID-19 vaccination (ie, perceived subjective norm) (AOR 4.18, 95\% CI 3.21-5.43), and perceived behavioral control to have the children take up COVID-19 vaccination (AOR 1.84, 95\% CI 1.49-2.26) were associated with higher parental acceptability of COVID-19 vaccination. Regarding social media influence, higher exposure to positive information related to COVID-19 vaccination was associated with higher parental acceptability of COVID-19 vaccination (AOR 1.35, 95\% CI 1.17-1.56). Higher exposure to negative information related to COVID-19 vaccination was negatively associated with the dependent variable (AOR 0.85, 95\% CI 0.74-0.99). Conclusions: Parents' acceptability of COVID-19 vaccination for their children under 18 years of age was high in China. The TPB is a useful framework to guide the development of future campaigns promoting COVID-19 vaccination targeting parents. Transparency in communicating about the vaccine development process and vaccine safety testing is important. Public health authorities should also address misinformation in a timely manner. ",
doi="10.2196/24827",
url="http://pediatrics.jmir.org/2020/2/e24827/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33326406"
}


@Article{info:doi/10.2196/20312,
author="Casilang, G. Clarisse
and Stonbraker, Samantha
and Japa, Ingrid
and Halpern, Mina
and Messina, Luz
and Steenhoff, P. Andrew
and Lowenthal, D. Elizabeth
and Fleisher, Linda",
title="Perceptions and Attitudes Toward Mobile Health in Development of an Exclusive Breastfeeding Tool: Focus Group Study With Caregivers and Health Promoters in the Dominican Republic",
journal="JMIR Pediatr Parent",
year="2020",
month="Aug",
day="21",
volume="3",
number="2",
pages="e20312",
keywords="global health",
keywords="breast feeding",
keywords="mHealth",
keywords="mobile phone",
abstract="Background: Despite growing interest in the use of technology to improve health outcomes in low- and middle-income countries (LMICs), local attitudes toward mobile health (mHealth) use in these settings are minimally understood. This is especially true in the Dominican Republic, where mHealth interventions are starting to emerge. This information is critical for developing effective mHealth interventions to address public health issues, such as low exclusive breastfeeding (EBF) rates, which can lead to poor outcomes. With an EBF rate of 5\% in the first 6 months of life, the Dominican Republic has one of the lowest EBF rates worldwide. Objective: This study aims to describe the current use of information and communication technology (ICT) and to analyze the attitudes and perceptions related to using mHealth interventions among caregivers of children aged ?5 years and health promoters in the Dominican Republic. Findings can inform mHealth strategies aimed at improving EBF in this, and other, LMICs. Methods: Participants were recruited from 3 outpatient sites: the Ni{\~n}os Primeros en Salud program at Centro de Salud Divina Providencia in Consuelo (rural setting) and Cl{\'i}nica de Familia La Romana and its program M{\'o}dulo de Adolescentes Materno Infantil in La Romana (urban setting). Focus groups were conducted with caregivers and community health promoters to identify the use, attitudes, perceptions, and acceptability of mHealth as well as barriers to EBF. Discussions were conducted in Spanish, guided by semistructured interview guides. All sessions were audio-recorded and later transcribed. Thematic content analysis was conducted in Spanish by two bilingual researchers and was structured around a hybrid behavioral theory framework to identify salient themes. Results: All participants (N=35) reported having a mobile phone, and 29 (83\%) participants had a smartphone. Sources for obtaining health information included the internet, physicians and clinic, family and friends, health promoters, and television. Barriers to mHealth use included the cost of internet service, privacy concerns, and perceived credibility of information sources. Participants indicated the desire for, and willingness to use, an mHealth intervention to support breastfeeding. The desired features of a possible mHealth intervention included offering diverse methods of information delivery such as images and video content, text messages, and person-to-person interaction as well as notifications for appointments, vaccines, and feeding schedules. Other important considerations were internet-free access and content that included maternal and child health self-management topics beyond breastfeeding. Conclusions: There is a high level of acceptance of ICT tools for breastfeeding promotion among caregivers in urban and rural areas of the Dominican Republic. As mHealth tools can contribute to increased breastfeeding self-efficacy, identifying desirable features of such a tool is necessary to create an effective intervention. Participants wanted to receive trusted and reliable information through various formats and were interested in information beyond breastfeeding. ",
doi="10.2196/20312",
url="http://pediatrics.jmir.org/2020/2/e20312/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32821063"
}