%0 Journal Article %@ 2561-6722 %I JMIR Publications %V 8 %N %P e65826 %T Digital Interventions for Patients With Juvenile Idiopathic Arthritis: Systematic Review and Meta-Analysis %A Ren,Zihan %A Chen,Yawen %A Li,Yufeng %A Fan,Panyu %A Liu,Zhao %A Shen,Biyu %K juvenile idiopathic arthritis %K digital intervention %K application %K children health care %K pediatrics %D 2025 %7 21.3.2025 %9 %J JMIR Pediatr Parent %G English %X Background: Juvenile idiopathic arthritis (JIA) is a chronic rheumatic condition requiring long-term, multidisciplinary treatment, which consumes significant health care resources and family energy. This study aims to analyze the effectiveness of digital interventions on patient outcomes in individuals with JIA. Objective: This meta-analysis aimed to evaluate the impact of digital interventions on alleviating symptoms and improving overall well-being in children and adolescents with JIA. Methods: A systematic search of 5 databases identified randomized controlled trials assessing the impact of digital interventions on physiological and psychological outcomes in adolescents and children (average age ≤19 y). Outcomes included pain, physical activity, health-related quality of life, self-efficacy, and disease-related issues. A total of 2 reviewers independently screened papers and extracted data on intervention functionalities and outcomes, assessing the risk of bias. A meta-analysis using a random-effects model synthesized the results. Results: The review included 11 studies involving 885 patients with JIA. Digital interventions included educational (eg, self-management training), therapeutic (eg, pain management), and behavioral (eg, promoting physical activity) approaches. These were delivered through websites, telephone consultations, video conferences, apps, and interactive games, with durations ranging from 8 to 24 weeks and no clear link observed between intervention length and outcomes. Compared with conventional control groups, digital interventions were significantly effective in alleviating pain (standardized mean difference [SMD] −0.19, 95% CI −0.35 to −0.04) and enhancing physical activity levels (SMD 0.37, 95% CI 0.06-0.69). Marginal improvements in health-related quality of life, self-efficacy, and disease-related issues were observed, but these did not reach statistical significance (SMD −0.04, 95% CI −0.19 to 0.11; SMD 0.05, 95% CI −0.11 to 0.20; and SMD 0.09, 95% CI −0.11 to 0.29, respectively). The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach rated the quality of evidence for pain, health-related quality of life, self-efficacy, and disease-related issues as moderate, while the evidence quality for physical activity was assessed as low. Conclusions: Digital interventions can alleviate pain and enhance physical activity in patients with JIA. However, given the limited sample size and high risk of bias in some studies, further high-quality research is needed to improve the treatment and management of JIA. Trial Registration: PROSPERO CRD42023471223; https://www.crd.york.ac.uk/PROSPERO/view/CRD42023471223 %R 10.2196/65826 %U https://pediatrics.jmir.org/2025/1/e65826 %U https://doi.org/10.2196/65826 %0 Journal Article %@ 2561-6722 %I JMIR Publications %V 8 %N %P e72675 %T Pediatric Hearts and Minds: Reimagining Health Education Through Play and Narrative %A Yang,Alina %K congenital heart disease %K children health literacy %K health education %K health education interventions %K patient-centered care %K design %K pediatric %K PRISMA %D 2025 %7 13.3.2025 %9 %J JMIR Pediatr Parent %G English %X %R 10.2196/72675 %U https://pediatrics.jmir.org/2025/1/e72675 %U https://doi.org/10.2196/72675 %0 Journal Article %@ 2369-1999 %I JMIR Publications %V 11 %N %P e65820 %T Assisted Reproductive Technology and Risk of Childhood Cancer Among the Offspring of Parents With Infertility: Systematic Review and Meta-Analysis %A Song,Gao %A Zhang,Cai-qiong %A Bai,Zhong-ping %A Li,Rong %A Cheng,Meng-qun %K assisted reproductive technology %K childhood cancer %K infertility %K subfertile %K risks %K systematic review %D 2025 %7 12.3.2025 %9 %J JMIR Cancer %G English %X Background: The relationship between assisted reproductive technology (ART) and childhood cancer risk has been widely debated. Previous meta-analyses did not adequately account for the impact of infertility, and this study addresses this gap. Objective: Our primary objective was to assess the relative risk (RR) of childhood cancer in infertile populations using ART versus non-ART offspring, with a secondary focus on comparing frozen embryo transfer (FET) and fresh embryo transfer (fresh-ET). Methods: A literature review was conducted through PubMed, Embase, Cochrane, and Web of Science, with a cutoff date of July 10, 2024. The study was registered with the International Platform of Registered Systematic Review and Meta-Analysis Protocols (INPLASY 202470119). Inclusion criteria were based on the PICOS (Population, Intervention, Comparison, Outcomes, and Study Design) framework: infertile or subfertile couples (population), ART interventions (in vitro fertilization [IVF], intracytoplasmic sperm injection [ICSI], FET, and fresh-ET), non-ART comparison, and childhood cancer risk outcomes. Data abstraction focused on the primary exposures (ART vs non-ART and FET vs fresh-ET) and outcomes (childhood cancer risk). The risk of bias was assessed using the Newcastle-Ottawa Quality Assessment Scale, and the evidence quality was evaluated with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Pooled estimates and 95% CIs were calculated using random effects models. Results: A total of 18 studies were included, published between 2000 and 2024, consisting of 14 (78%) cohort studies and 4 (22%) case-control studies, all of which were of moderate to high quality. The cohort studies had follow-up periods ranging from 3 to 18 years. Compared with non-ART conception, ART conception was not significantly associated with an increased risk of childhood overall cancer (RR 0.95, 95% CI 0.71‐1.27; GRADE quality: low to moderate). Subgroup analyses of IVF (RR 0.86, 95% CI 0.59‐1.25), ICSI (RR 0.76, 95% CI 0.26‐2.2), FET (RR 0.98, 95% CI 0.54‐1.76), and fresh-ET (RR 0.75, 95% CI 0.49‐1.15) showed similar findings. No significant differences were found for specific childhood cancers, including leukemia (RR 0.99, 95% CI 0.79‐1.24), lymphoma (RR 1.22, 95% CI 0.64‐2.34), brain cancer (RR 1.22, 95% CI 0.73‐2.05), embryonal tumors (RR 1, 95% CI 0.63‐1.58), retinoblastoma (RR 1.3, 95% CI 0.73‐2.31), and neuroblastoma (RR 1.02, 95% CI 0.48‐2.16). Additionally, no significant difference was observed in a head-to-head comparison of FET versus fresh-ET (RR 0.99, 95% CI 0.86‐1.14; GRADE quality: moderate). Conclusions: In conclusion, this study found no significant difference in the risk of childhood cancer between offspring conceived through ART and those conceived through non-ART treatments (such as fertility drugs or intrauterine insemination) in infertile populations. While infertility treatments may elevate baseline risks, our findings suggest that whether individuals with infertility conceive using ART or non-ART methods, their offspring do not face a significantly higher risk of childhood cancer. Further research, especially comparing infertile populations who conceive naturally, is needed to better understand potential long-term health outcomes. Trial Registration: INPLASY 202470119; https://inplasy.com/?s=202470119 %R 10.2196/65820 %U https://cancer.jmir.org/2025/1/e65820 %U https://doi.org/10.2196/65820 %0 Journal Article %@ 2561-6722 %I JMIR Publications %V 8 %N %P e64814 %T Exploring Health Educational Interventions for Children With Congenital Heart Disease: Scoping Review %A Barbazi,Neda %A Shin,Ji Youn %A Hiremath,Gurumurthy %A Lauff,Carlye Anne %+ Department of Design Innovation, College of Design, University of Minnesota, Twin Cities, 13 Rapson Hall, 89 Church Street SE, Minneapolis, MN, 55455, United States, 1 724 889 5511, carlye@umn.edu %K congenital heart disease %K children health literacy %K health education %K health education interventions %K patient-centered care %K design %K pediatric %K PRISMA %D 2025 %7 24.1.2025 %9 Review %J JMIR Pediatr Parent %G English %X Background: Congenital heart disease (CHD) is the most common birth defect, affecting 40,000 births annually in the United States. Despite advances in medical care, CHD is often a chronic condition requiring continuous management and education. Effective care management depends on children’s understanding of their condition. This highlights the need for targeted health educational interventions to enhance health literacy among children with CHD. Objective: This scoping review aims to map and explore existing health educational interventions for children with CHD. The review identifies the types of interventions, target populations, delivery methods, and assessed outcomes. The goal is to consolidate fragmented research, identify gaps, and establish future research agendas. Methods: Comprehensive searches were conducted in February 2024 using the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) framework across multiple databases: APA PsycINFO, MedlinePlus via Ovid, Web of Science, ACM Digital Library, Scopus, and EBSCOhost (CINAHL Complete, CINAHL Ultimate, Health Source: Nursing/Academic Edition, and ERIC). The search covered health care, design, and human-computer interaction disciplines to capture the interdisciplinary nature of CHD health educational interventions. There was no predefined time limit due to the limited number of relevant studies. Eligible studies were in English, published in peer-reviewed journals, and focused on primary data about educational health interventions for children with CHD. We extracted and synthesized data using thematic analysis. Results: The review identified 11 studies: 9 randomized controlled trials and 2 observational studies. These used 6 educational strategies: 3D patient-specific models (n=3), habit formation interventions (n=2), empowerment-based health education programs (n=2), rehabilitation interventions (n=2), web-based portals (n=1), and videotape presentations (n=1). Interventions ranged from brief outpatient sessions to 1.5-year programs, with follow-up from none to 24 months. Studies aimed to improve coping, self-management, and knowledge for children with CHD and their families. The most frequently used assessment method was the independent samples t test (n=4) for pre- and postassessments, and all 11 studies used questionnaires, 8 of which incorporated qualitative feedback. The target participants for these interventions were children aged 13 years and older (n=3), parents (n=2), and children of various ages and their parents (n=6). Outcomes included improved children’s health literacy, reduced parental burden, and increased health care provider efficiency. Conclusions: This review underscores the critical need for tailored educational interventions for children with CHD. Current research mainly focuses on adolescents and relies heavily on parental involvement, possibly overlooking the specific needs of younger children younger than 13 years of age. It is essential to develop engaging, age-appropriate interventions that actively involve children with CHD in their health care journey. Effective health educational interventions are crucial in empowering these young patients and improving their long-term health outcomes. %M 39854065 %R 10.2196/64814 %U https://pediatrics.jmir.org/2025/1/e64814 %U https://doi.org/10.2196/64814 %U http://www.ncbi.nlm.nih.gov/pubmed/39854065 %0 Journal Article %@ 2561-6722 %I JMIR Publications %V 8 %N %P e68372 %T Assessing and Enhancing Nutrition and Physical Activity Environments in Early Childhood Education and Care Centers: Scoping Review of eHealth Tools %A Hayek,Joyce %A Dickson,Kelsi %A Lafave,Lynne M Z %+ Department of Health and Physical Education, Mount Royal University, 4825 Mount Royal Gate SW, Calgary, AB, T3E 6K6, Canada, 1 403 440 5967, llafave@mtroyal.ca %K eHealth %K early childhood educators %K ECE %K early childhood education and care %K ECEC %K knowledge synthesis %K digital technology %K health technology %K digital public health %K eating %K diet %D 2025 %7 22.1.2025 %9 Review %J JMIR Pediatr Parent %G English %X Background: Early childhood is a critical period for shaping lifelong health behaviors, making early childhood education and care (ECEC) environments ideal for implementing nutrition and physical activity interventions. eHealth tools are increasingly utilized in ECEC settings due to their accessibility, scalability, and cost-effectiveness, demonstrating promise in enhancing educators’ practices. Despite the potential effectiveness of these eHealth approaches, a comprehensive collection of available evidence on eHealth tools designed to assess or support best practices for nutrition or physical activity in ECECs is currently lacking. Objective: The primary objective of this scoping review is to map the range of available eHealth tools designed to assess or deliver interventions aimed at improving nutrition or physical activity in ECEC settings, while evaluating their components, theoretical foundations, and effectiveness. Methods: This scoping review adhered to the Joanna Briggs Institute methodology, in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) checklist. The objectives, inclusion criteria, and methods for this review were predefined and specified. Eligibility criteria were (1) early childhood educators (population); (2) eHealth (digital) technologies, such as websites, smartphone apps, emails, and social media; and (3) tools designed to assess or deliver interventions aimed at improving best practices for nutrition, physical activity, or both within ECEC settings (context). A search was conducted across 5 electronic databases (PubMed, Scopus, CINAHL Plus, ERIC, and Embase) to identify white literature, and 3 electronic databases (ProQuest, Google Scholar, and targeted Google search), along with hand-searching of reference lists, were used to identify gray literature. All literature was reported in English or French, with the search extending until May 2024. Separate data charting tools were used for white and gray literature. Results: The search strategy identified 3064 results for white literature, yielding 2653 unique citations after duplicates were removed. Full texts for 65 citations were retrieved and screened for inclusion, resulting in 30 studies eligible for data extraction and analysis. The most common study design was a randomized controlled trial, comprising 16 studies (53%). The largest proportion of studies were conducted in the United States (11 studies, 37%). In total, 19 eHealth tools were identified, targeting nutrition (8 tools, 42%), physical activity (5 tools, 26%), or both nutrition and physical activity (6 tools, 32%). All tools were web based (19 tools, 100%). The gray literature search yielded 1054 results, of which 17 were moved to full-text screening, and 7 met the eligibility criteria for data extraction and analysis. The tools identified in the gray literature originated in Canada (4 tools, 57%) and the United States (3 tools, 43%). The majority targeted nutrition (4 tools, 57%) and were primarily web based (6 tools, 86%), with 1 mobile app (1 tool, 14%). Conclusions: This scoping review mapped the available eHealth tools designed to improve nutrition or physical activity environments in ECEC settings, highlighting the growing emphasis on web-based tools and the need for psychometric testing. Future research should systematically evaluate the effectiveness of these tools, particularly those addressing both nutrition and physical activity, to identify the key factors that contribute to long-term behavior change. Trial Registration: Open Science Framework XTRNZ; https://osf.io/xtrnz International Registered Report Identifier (IRRID): RR2-10.2196/52252 %R 10.2196/68372 %U https://pediatrics.jmir.org/2025/1/e68372 %U https://doi.org/10.2196/68372 %0 Journal Article %@ 2561-6722 %I JMIR Publications %V 7 %N %P e58403 %T Digital Health Innovations for Screening and Mitigating Mental Health Impacts of Adverse Childhood Experiences: Narrative Review %A White,Brianna M %A Prasad,Rameshwari %A Ammar,Nariman %A Yaun,Jason A %A Shaban-Nejad,Arash %K digital health %K digital technology %K digital intervention %K digital health technology %K artificial intelligence %K machine learning %K adverse childhood experience %K ACE %K positive childhood experiences %K children’s mental health %K mental health %K mental illness %K mental disorder %K pediatric mental health %K disease surveillance %D 2024 %7 16.10.2024 %9 %J JMIR Pediatr Parent %G English %X Background: Exposures to both negative and positive experiences in childhood have proven to influence cardiovascular, immune, metabolic, and neurologic function throughout an individual’s life. As such, adverse childhood experiences (ACEs) could have severe consequences on health and well-being into adulthood. Objective: This study presents a narrative review of the use of digital health technologies (DHTs) and artificial intelligence to screen and mitigate risks and mental health consequences associated with ACEs among children and youth. Methods: Several databases were searched for studies published from August 2017 to August 2022. Selected studies (1) explored the relationship between digital health interventions and mitigation of negative health outcomes associated with mental health in childhood and adolescence and (2) examined prevention of ACE occurrence associated with mental illness in childhood and adolescence. A total of 18 search papers were selected, according to our inclusion and exclusion criteria, to evaluate and identify means by which existing digital solutions may be useful in mitigating the mental health consequences associated with the occurrence of ACEs in childhood and adolescence and preventing ACE occurrence due to mental health consequences. We also highlighted a few knowledge gaps or barriers to DHT implementation and usability. Results: Findings from the search suggest that the incorporation of DHTs, if implemented successfully, has the potential to improve the quality of related care provisions for the management of mental health consequences of adverse or traumatic events in childhood, including posttraumatic stress disorder, suicidal behavior or ideation, anxiety or depression, and attention-deficit/hyperactivity disorder. Conclusions: The use of DHTs, machine learning tools, natural learning processing, and artificial intelligence can positively help in mitigating ACEs and associated risk factors. Under proper legal regulations, security, privacy, and confidentiality assurances, digital technologies could also assist in promoting positive childhood experiences in children and young adults, bolstering resilience, and providing reliable public health resources to serve populations in need. %R 10.2196/58403 %U https://pediatrics.jmir.org/2024/1/e58403 %U https://doi.org/10.2196/58403 %0 Journal Article %@ 2561-6722 %I JMIR Publications %V 7 %N %P e50370 %T Categorization of mHealth Coaching Technologies for Children or Adolescents With Type 1 Diabetes: Systematic Review %A Trnka,Pavel %A Aldaghi,Tahmineh %A Muzik,Jan %K type 1 diabetes %K adolescents %K children %K parents %K mHealth %K information technology %K PRISMA %D 2024 %7 10.10.2024 %9 %J JMIR Pediatr Parent %G English %X Background: Managing type 1 diabetes in children and adolescents can be difficult for parents, health care professionals, and even patients. However, over the last decades, the quality of services provided to patients with diabetes has increased due to advances in IT. Objective: This study aims to comprehensively document the range of IT tools used in the management of diabetes among children and adolescents, with a focus on identifying the technologies most commonly used based on their frequency. In addition, the study aims to explore relevant methodologies for developing diabetes technology and provide valuable information to developers by delineating essential phases of the design process. Methods: The literature search was focused on MEDLINE (PubMed), Web of Science, and Google Scholar for relevant studies. Keywords such as “type 1 diabetes,” “adolescents,” “kids,” “mHealth,” “children,” and “coaching” were combined using Boolean operators. The inclusion criteria were open access, English-language papers published between 2012 and 2023 focusing on patients younger than 18 years and aligned with our research goal. The exclusion criteria included irrelevant topics and papers older than 18 years. By applying the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) method, 2080 studies were recognized, and after selection, 33 papers were agreed upon between the researchers. Results: Four primary categories were defined: types of IT, methodology identification, purpose identification, and feature determination. Among these, mobile health (mHealth) apps emerged as the predominant type of information, garnering 27 mentions. In particular, user-centered design was identified as the most prevalent methodology, cited 22 times. The primary purpose of self-monitoring blood glucose values was mentioned 20 times, while patient education was the highest among common characteristics, with 23 mentions. Conclusions: Based on our research, we advocate for developers to focus on creating an mHealth app that integrates gamification techniques to develop innovative diabetes management solutions. This app should include vital functionalities such as blood glucose monitoring, strategies to improve hemoglobin A1c levels, carbohydrate tracking, and comprehensive educational materials for patients and caregivers. By prioritizing these features, developers can enhance the usability and effectiveness of the technology, thereby better supporting children or adolescents with diabetes in their daily management endeavors. %R 10.2196/50370 %U https://pediatrics.jmir.org/2024/1/e50370 %U https://doi.org/10.2196/50370 %0 Journal Article %@ 2561-6722 %I JMIR Publications %V 7 %N %P e55726 %T The Feasibility and Acceptability of Using a Digital Conversational Agent (Chatbot) for Delivering Parenting Interventions: Systematic Review %A Klapow,Max C %A Rosenblatt,Andrew %A Lachman,Jamie %A Gardner,Frances %+ Department of Experimental Psychology, University of Oxford, Anna Watts Building, Woodstock Road, Oxford, OX2 6GG, United Kingdom, 44 01865 271444, maxwell.klapow@psy.ox.ac.uk %K chatbot %K parenting intervention %K feasibility %K acceptability %K systematic review %K implementation %D 2024 %7 7.10.2024 %9 Review %J JMIR Pediatr Parent %G English %X Background: Parenting interventions are crucial for promoting family well-being, reducing violence against children, and improving child development outcomes; however, scaling these programs remains a challenge. Prior reviews have characterized the feasibility, acceptability, and effectiveness of other more robust forms of digital parenting interventions (eg, via the web, mobile apps, and videoconferencing). Recently, chatbot technology has emerged as a possible mode for adapting and delivering parenting programs to larger populations (eg, Parenting for Lifelong Health, Incredible Years, and Triple P Parenting). Objective: This study aims to review the evidence of using chatbots to deliver parenting interventions and assess the feasibility of implementation, acceptability of these interventions, and preliminary outcomes. Methods: This review conducted a comprehensive search of databases, including Web of Science, MEDLINE, Scopus, ProQuest, and Cochrane Central Register of Controlled Trials. Cochrane Handbook for Systematic Review of Interventions and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were used to conduct the search. Eligible studies targeted parents of children aged 0 to 18 years; used chatbots via digital platforms, such as the internet, mobile apps, or SMS text messaging; and targeted improving family well-being through parenting. Implementation measures, acceptability, and any reported preliminary measures of effectiveness were included. Results: Of the 1766 initial results, 10 studies met the inclusion criteria. The included studies, primarily conducted in high-income countries (8/10, 80%), demonstrated a high mean retention rate (72.8%) and reported high acceptability (10/10, 100%). However, significant heterogeneity in interventions, measurement methods, and study quality necessitate cautious interpretation. Reporting bias, lack of clarity in the operationalization of engagement measures, and platform limitations were identified as limiting factors in interpreting findings. Conclusions: This is the first study to review the implementation feasibility and acceptability of chatbots for delivering parenting programs. While preliminary evidence suggests that chatbots can be used to deliver parenting programs, further research, standardization of reporting, and scaling up of effectiveness testing are critical to harness the full benefits of chatbots for promoting family well-being. %M 39374516 %R 10.2196/55726 %U https://pediatrics.jmir.org/2024/1/e55726 %U https://doi.org/10.2196/55726 %U http://www.ncbi.nlm.nih.gov/pubmed/39374516 %0 Journal Article %@ 2561-6722 %I JMIR Publications %V 7 %N %P e59171 %T Psychological Interventions and Those With Elements of Positive Psychology for Child and Youth Mental Health During the COVID-19 Pandemic: Literature Review, Lessons Learned, and Areas for Future Knowledge Dissemination %A Lyzwinski,Lynnette %A Zwicker,Jennifer D %A Mcdonald,Sheila %A Tough,Suzanne %+ Department of Pediatrics, Cumming School of Medicine, University of Calgary, 3330 Hospital Drive, Calgary, AB, T2N4N1, Canada, 1 1 403 220 6843, lynnette.lyzwinski@ucalgary.ca %K positive psychology %K mindfulness %K resilience %K mental health %K flourishing %K knowledge translation %K depression %K anxiety %K stress %D 2024 %7 13.9.2024 %9 Review %J JMIR Pediatr Parent %G English %X Background: There was a marked decline in child and teenage mental health worldwide during the pandemic, with increasing prevalence of depression, anxiety, and suicide. Research indicates that positive psychological interventions may be beneficial for mental health. Objective: The aims of this review were to evaluate positive psychological interventions for child and youth mental health implemented during the COVID-19 pandemic and assess overall effectiveness for mental health and knowledge. Methods: We undertook a literature search of PubMed, MEDLINE, and Google Scholar for all eligible studies on digital and hybrid in-person psychological interventions for youth mental health during the COVID-19 pandemic. A particular emphasis was placed on positive psychological interventions or interventions that had components of positive psychology, including gratitude, acceptance, positive emotions, or resilience building. Results: A total of 41 interventions were included in this review. Most of the interventions were digital. Overall, most of the interventions assisted with one or more mental health or psychological indicators, such as depression, anxiety, posttraumatic stress disorder, stress, and resilience. However, findings were mixed when it came to targeting both depression and anxiety together. The interventions that promoted youth mental health most often had a range of diverse positive psychology components and were evidence based. Not all studies measured changes in mindfulness. Few studies examined knowledge acquired on mental health self-care, managing mental health problems, knowledge of positive psychological techniques, mindfulness knowledge, or mental health self-efficacy. Conclusions: Diverse multicomponent interventions appear to assist with youth mental health overall, although their effects on both depression and anxiety are less clear. There is also a need for more research on knowledge gains to determine whether the interventions improved knowledge on mental health–supportive behaviors, which may be sustained beyond the intervention. Finally, more studies need to evaluate whether the interventions assisted with increasing self-efficacy for practicing positive psychological techniques as well as changes in mindfulness levels. Future studies should not only assess effectiveness for mental health outcomes but also assess knowledge translation, with valid measures of knowledge and self-efficacy for mental health–supportive behaviors and positive psychological skills acquired (eg, the ability to practice mindfulness). %M 39269752 %R 10.2196/59171 %U https://pediatrics.jmir.org/2024/1/e59171 %U https://doi.org/10.2196/59171 %U http://www.ncbi.nlm.nih.gov/pubmed/39269752 %0 Journal Article %@ 1929-073X %I JMIR Publications %V 13 %N %P e50047 %T Requirements for and Barriers to Rehabilitation Services for Children With Disabilities in Middle- and High-Income Countries: Scoping Review %A Xie,Yijun %A Wu,Jing %A Li,Yao %A Liu,Hui %A Peng,Yanyan %A Zhou,Ping %A Sun,Yizhou %A Kang,Luyan %A Jiang,Chenghua %A Wu,Hengjing %+ Clinical Center for Intelligent Rehabilitation Research, Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, No.2209 Guangxing Road, Songjiang District, Shanghai, 201619, China, 86 15821525700, whjdata@126.com %K children with disabilities %K barriers %K health services %K middle- and high-income countries %K child %K low income %K middle income %K disability %K children %K disabilities %K income %K barrier %K rehabilitation %K suitability %K availability %K affordability %K support system %K support %K awareness %K policy %D 2024 %7 7.8.2024 %9 Review %J Interact J Med Res %G English %X Background: The rehabilitation of children with disabilities has received considerable attention from the United Nations. However, the state of rehabilitation services for children with disabilities worldwide remains far from optimistic, even in economically affluent middle- and high-income countries. Objective: This scoping review aimed to identify the rehabilitation needs of children with disabilities and their barriers to rehabilitation services in middle- and high-income countries. Methods: A systematic search was conducted using MEDLINE and Web of Science for papers published from January 2013 to December 2023. Studies were included if they were peer-reviewed, full-text articles related to children with disabilities, reporting on their access to rehabilitation services, and conducted in countries classified by the World Bank 2023 as middle- and high-income economies. Exclusion criteria included duplicates, unavailable full texts, and studies without distinct outcomes. A total of 27 studies were selected following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, focusing on children, their families, or service providers. Results: The suitability, availability, and affordability of rehabilitation services were identified as the major needs and barriers for children with disabilities in middle- and high-income countries. This included communication barriers, a need for more personnel and facilities, and the stagnation and inadequacy of economic subsidies. Conclusions: Middle- and high-income countries have relatively well-established rehabilitation infrastructure and support systems. They are nevertheless insufficient for meeting the needs of children with disabilities. More attention should be paid to these issues to improve the well-being of children with disabilities. The data provided by this review can help raise awareness of rehabilitation needs and barriers at the policy level. %M 39110502 %R 10.2196/50047 %U https://www.i-jmr.org/2024/1/e50047 %U https://doi.org/10.2196/50047 %U http://www.ncbi.nlm.nih.gov/pubmed/39110502 %0 Journal Article %@ 2561-6722 %I JMIR Publications %V 7 %N %P e54788 %T Internet-Based Interventions for Preventing Premature Birth Among Pregnant Women: Systematic Review %A Kim,Sun-Hee %A Park,Jin-Hwa %A Jung,Sun-Young %A De Gagne,Jennie C %+ College of Nursing, Research Institute of Nursing Science, Daegu Catholic University, Duryugongwon-ro 17-gil 33, Nam-gu, Daegu, 42472, Republic of Korea, 82 53 650 4977, syjung@cu.ac.kr %K anxiety %K body weight %K depression %K gestational diabetes mellitus %K high-risk behavior %K internet-based interventions %K neonatal outcomes %K pregnancy %K premature birth %K pregnancy outcomes %K stress %K systematic review %D 2024 %7 2.4.2024 %9 Review %J JMIR Pediatr Parent %G English %X Background: Premature birth rates have slightly increased globally, making its prevention critical for both short-term and long-term health outcomes. Various interventions have been developed in response to the multifaceted risk factors for premature birth, including internet-based programs. These programs offer accessibility and enhanced engagement; however, their overall efficacy in preventing premature births requires thorough evaluation. Objective: This systematic review aims to identify the study designs and assess the effectiveness of internet-based interventions in preventing premature birth among pregnant women. Methods: A comprehensive search of the MEDLINE, Embase, CINAHL, and Cochrane Library databases was conducted to identify randomized trials and quasi-experimental studies evaluating internet-based interventions for premature birth prevention in pregnant women. The search was inclusive, with no restrictions based on language or geographical location, allowing for a comprehensive global perspective. The time frame for the inclusion of studies extended until February 2023. The risk of bias (RoB) in each study was independently assessed by 3 authors forming pairs, using the revised Cochrane RoB tool (RoB 2) for randomized trials, as per the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Owing to heterogeneity in populations, measurements, and interventions, a meta-analysis was not conducted. Results: This review included 26 articles, comprising 12 intention-to-treat and 14 per-protocol studies. The overall RoB was high in most intention-to-treat studies and of some concern in most per-protocol studies. The target populations varied, including nonspecific pregnant women, those with gestational diabetes mellitus (GDM) or those at risk of GDM, individuals with anxiety or depression, and those experiencing preterm labor. Psychosocial, physiological, and wellness health outcomes were evaluated. Internet-based interventions effectively reduced stress/distress in nonspecific pregnant women but not in those experiencing preterm labor. Their effectiveness in reducing anxiety and depression varied, with inconsistent results among different groups. In women with GDM or those at risk of GDM, interventions successfully controlled fasting plasma glucose and 2-hour postprandial plasma glucose levels but did not consistently manage glycated hemoglobin levels. These interventions did not reduce the incidence of premature births across the various populations studied. The effectiveness of these internet-based interventions in addressing substance or alcohol abuse and insomnia also varied. Conclusions: Internet-based interventions show promise in improving psychosocial health and managing blood sugar to prevent premature birth, highlighting variability in effectiveness across different risk factors. Further research, including clinical trials, is vital for developing, evaluating, and disseminating effective, safe internet-based interventions. Establishing standardized measurement tools and rigorous evaluation processes is crucial for enhancing these interventions’ effectiveness and reliability in clinical practice, significantly contributing to preventing premature births and improving maternal health outcomes. Trial Registration: PROSPERO CRD42021278847; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021278847 %M 38564247 %R 10.2196/54788 %U https://pediatrics.jmir.org/2024/1/e54788 %U https://doi.org/10.2196/54788 %U http://www.ncbi.nlm.nih.gov/pubmed/38564247