%0 Journal Article %@ 2561-6722 %I JMIR Publications %V 3 %N 1 %P e13552 %T Implementation Effectiveness of a Parent-Directed YouTube Video (“It Doesn’t Have To Hurt”) on Evidence-Based Strategies to Manage Needle Pain: Descriptive Survey Study %A Chambers,Christine T %A Dol,Justine %A Parker,Jennifer A %A Caes,Line %A Birnie,Kathryn A %A Taddio,Anna %A Campbell-Yeo,Marsha %A Halperin,Scott A %A Langille,Jennifer %+ Department of Psychology and Neuroscience, Dalhousie University, 5850/5980 University Ave, Halifax, NS, Canada, 1 9024708877, christine.chambers@dal.ca %K pain management %K child %K knowledge translation %K social media %D 2020 %7 4.3.2020 %9 Original Paper %J JMIR Pediatr Parent %G English %X Background: Despite the availability of high-quality evidence and clinical practice guidelines for the effective management of pediatric pain, this evidence is rarely used in practice for managing children’s pain from needle procedures such as vaccinations. Parents are generally unaware of pain management strategies they can use with their children. Objective: This study aimed to develop, implement, and evaluate the implementation effectiveness of a parent-directed YouTube video on evidence-based strategies to manage needle pain in children. Methods: This was a descriptive study. Analytics were extracted from YouTube to describe video reach. A Web-based survey was used to seek parent and health care professional (HCP) feedback about the video. The 2-minute 18-second video was launched on YouTube on November 4, 2013. In the video, a 4-year-old girl tells parents what they should and should not do to help needles hurt less. The key evidence-based messages shared in the video were distraction, deep breathing, and topical anesthetic creams. A group of parents (n=163) and HCPs (n=278) completed the Web-based survey. Measures of reach included number of unique views, country where the video was viewed, sex of the viewer, and length of watch time. The Web-based survey assessed implementation outcomes of the video, such as acceptability, appropriateness, penetration, and adoption. Results: As of November 4, 2018 (5 years after launch), the video had 237,132 unique views from 182 countries, with most viewers watching an average of 55.1% (76/138 seconds) of the video. Overall, both parents and HCPs reported strong acceptance of the video (ie, they liked the video, found it helpful, and felt more confident) and reported significant improvements in plans to use distraction, deep breathing, and topical anesthetic creams. Conclusions: This parent-directed YouTube video was an acceptable and appropriate way to disseminate evidence about the procedure of pain management to a large number of parents. %M 32130190 %R 10.2196/13552 %U http://pediatrics.jmir.org/2020/1/e13552/ %U https://doi.org/10.2196/13552 %U http://www.ncbi.nlm.nih.gov/pubmed/32130190 %0 Journal Article %@ 2561-6722 %I JMIR Publications %V 3 %N 1 %P e14355 %T Hidden Communities of Practice in Social Media Groups: Mixed Methods Study %A Skelton,Kara %A Evans,Retta %A LaChenaye,Jenna %+ Department of Health, Behavior and Society, Johns Hopkins University, 624 N Broadway, Baltimore, MD, 21205, United States, 1 2055633412, kara.skelton@jhu.edu %K online social support %K breastfeeding %K social media %K social support system %D 2020 %7 24.3.2020 %9 Original Paper %J JMIR Pediatr Parent %G English %X Background: Although most US mothers initiate breastfeeding, suboptimal breastfeeding rates still exist. Although breastfeeding is a complex process, social support has been linked with increases in positive breastfeeding outcomes. Recent technological advances, including the development of social networking sites, provide mothers with convenient access to a unique array of audiences from which to seek advice about parenting, including breastfeeding. However, little is known about how the use of the sites—specifically groups centered around breastfeeding—influences breastfeeding knowledge, attitudes, or behaviors. Objective: This mixed methods study aimed to explore utilization of an existing probreastfeeding Facebook group and how utilization influences breastfeeding-related knowledge, attitudes, and behaviors. Methods: Participants were recruited online through Facebook wall posts from within the existing group. Mothers aged between 18 and 50 years who were pregnant and intended to breastfeed, were currently breastfeeding, or had recently weaned their infant in the past 3 years were eligible to participate. Participants engaged in online focus group discussions (n=21) and individual interviews (n=12). Inductive content analysis of qualitative data led to the conceptualization and contextualization of a breastfeeding community of practice (COP). Using qualitative results, a quantitative survey was then developed to assess the prevalence of qualities of a COP as well as how COP usage influenced breastfeeding-related attitudes and knowledge. A total of 314 mothers completed the online survey. Results: Qualitative findings showed an overall sense of community, with subthemes of group trust, interaction, and the promotion of breastfeeding. A majority (287/314, 91.5%) of mothers initiated breastfeeding, with 69.0% (216/314) of mothers reporting exclusive breastfeeding their infant at 6 months. Approximately 98.5% (309/314) of mothers reported that the Facebook group captured and stored knowledge; therefore, information could be easily accessed and applied. In addition, 96.2% (302/317) of mothers reported that the Facebook group motivated them to share breastfeeding-related knowledge. Conclusions: The results suggest that this existing probreastfeeding Facebook group exhibits characteristics of an online COP, which was organically formed. Utilization of the Facebook group, in the context of an online COP, could be beneficial in impacting breastfeeding-related knowledge, attitudes, and behaviors. However, further examination and exploration of breastfeeding COPs, including using this type of model as a method of lactation support or as a telemedicine framework, is a clear need. %M 32207693 %R 10.2196/14355 %U http://pediatrics.jmir.org/2020/1/e14355/ %U https://doi.org/10.2196/14355 %U http://www.ncbi.nlm.nih.gov/pubmed/32207693 %0 Journal Article %@ 2561-6722 %I JMIR Publications %V 3 %N 1 %P e15093 %T Web-Based Technology to Improve Disease Knowledge Among Adolescents With Sickle Cell Disease: Pilot Study %A Saulsberry,Anjelica C %A Hodges,Jason R %A Cole,Audrey %A Porter,Jerlym S %A Hankins,Jane %+ Department of Hematology, St Jude Children's Research Hospital, 262 Danny Thomas Pl, Memphis, TN, , United States, 1 9015954153, jane.hankins@stjude.org %K sickle cell anemia %K eHealth %K transition to adult care %D 2020 %7 7.1.2020 %9 Original Paper %J JMIR Pediatr Parent %G English %X Background: Advancements in treatment have contributed to increased survivorship among children with sickle cell disease (SCD). Increased transition readiness, encompassing disease knowledge and self-management skills before transfer to adult care, is necessary to ensure optimal health outcomes. The Sickle Cell Transition E-Learning Program (STEP) is a public, Web-based, 6-module tool designed to increase transition readiness for youth with SCD. Objective: The objective of our study was to investigate the participation rate of youth with SCD in STEP and its association with transition readiness. Methods: This was a single-center, Institution Review Board–approved, retrospective cohort review. A total of 183 youths with SCD, aged between 12 and 15 years, were offered STEP as an adjunct to in-clinic disease education sessions. Participation rate (number of patients who used at least one STEP module divided by those approached) was calculated. The association among the number of STEP modules completed, disease knowledge, and self-management was explored. Results: Overall, 53 of the 183 approached adolescents completed at least one STEP module, yielding a participation rate in STEP of 29.0%. Of the 53 participants, 37 and 39 adolescents had disease knowledge and self-management confidence rating available, respectively. A positive correlation (r=0.47) was found between the number of STEP modules completed and disease knowledge scores (P=.003). No association was found between the number of modules completed and self-management confidence ratings. Disease knowledge scores were significantly higher among participants who completed ≥3 STEP modules compared with those who completed <3 STEP modules (U=149.00; P=.007). Conclusions: Improvement in disease knowledge in adolescence is critical to ensure the youth’s ability to self-care during the period of transition to adult care. Despite low participation, the cumulative exposure to the STEP program suggested greater promotion of disease knowledge among adolescents with SCD before transfer to adult care. %M 31909718 %R 10.2196/15093 %U https://pediatrics.jmir.org/2020/1/e15093 %U https://doi.org/10.2196/15093 %U http://www.ncbi.nlm.nih.gov/pubmed/31909718 %0 Journal Article %@ 2561-6722 %I JMIR Publications %V 3 %N 1 %P e14109 %T Quality of Pregnancy Dating and Obstetric Interventions During Labor: Retrospective Database Analysis %A Reis,Zilma Silveira Nogueira %A Gaspar,Juliano De Souza %A Vitral,Gabriela Luiza Nogueira %A Abrantes,Vitor Barbosa %A de-Souza,Ingrid Michelle Fonseca %A Moreira,Maria Tereza Silveira %A Lopes Pessoa Aguiar,Regina Amélia %+ Center of Health Informatics, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena, 190, sala 601, Belo Horizonte, 30130100, Brazil, 55 31 3409 9467, zilma.medicina@gmail.com %K gestational age %K parturition %K ultrasound %K pregnancy dating %K information systems %D 2020 %7 15.4.2020 %9 Original Paper %J JMIR Pediatr Parent %G English %X Background: The correct dating of pregnancy is critical to support timely decisions and provide obstetric care during birth. The early obstetric ultrasound assessment before 14 weeks is considered the best reference to assist in determining gestational age (GA), with an accuracy of ±5 to 7 days. However, this information is limited in many settings worldwide. Objective: The aim of this study is to analyze the association between the obstetric interventions during childbirth and the quality of GA determination, according to the first antenatal ultrasound assessment, which assisted the calculation. Methods: This is a hospital-based cohort study using medical record data of 2113 births at a perinatal referral center. The database was separated into groups and subgroups of analyses based on the reference used by obstetricians to obtain GA at birth. Maternal and neonatal characteristics, mode of delivery, oxytocin augmentation, and forceps delivery were compared between groups of pregnancies with GA determination at different reference points: obstetric ultrasound assessment 14 weeks, 20 weeks, and ≥20 weeks or without antenatal ultrasound (suboptimal dating). Ultrasound-based GA information was associated with outcomes between the interest groups using chi-square tests, odds ratios (OR) with 95% CI, or the Mann-Whitney statistical analysis. Results: The chance of nonspontaneous delivery was higher in pregnancies with 14 weeks ultrasound-based GA (OR 1.64, 95% CI 1.35-1.98) and 20 weeks ultrasound-based GA (OR 1.58, 95% CI 1.31-1.90) when compared to the pregnancies with ≥20 weeks ultrasound-based GA or without any antenatal ultrasound. The use of oxytocin for labor augmentation was higher for 14 weeks and 20 weeks ultrasound-based GA, OR 1.41 (95% CI 1.09-1.82) and OR 1.34 (95% CI 1.04-1.72), respectively, when compared to those suboptimally dated. Moreover, maternal blood transfusion after birth was more frequent in births with suboptimal ultrasound-based GA determination (20/657, 3.04%) than in the other groups (14 weeks ultrasound-based GA: 17/1163, 1.46%, P=.02; 20 weeks ultrasound-based GA: 25/1456, 1.71%, P=.048). Cesarean section rates between the suboptimal dating group (244/657, 37.13%) and the other groups (14 weeks: 475/1163, 40.84%, P=.12; 20 weeks: 584/1456, 40.10%, P=.20) were similar. In addition, forceps delivery rates between the suboptimal dating group (17/657, 2.6%) and the other groups (14 weeks: 42/1163, 3.61%, P=.24; 20 weeks: 46/1456, 3.16%, P=.47) were similar. Neonatal intensive care unit admission was more frequent in newborns with suboptimal dating (103/570, 18.07%) when compared with the other groups (14 weeks: 133/1004, 13.25%, P=.01; 20 weeks: 168/1263, 13.30%, P=.01), excluding stillbirths and major fetal malformations. Conclusions: The present analysis highlighted relevant points of health care to improve obstetric assistance, confirming the importance of early access to technologies for pregnancy dating as an essential component of quality antenatal care. %M 32293572 %R 10.2196/14109 %U http://pediatrics.jmir.org/2020/1/e14109/ %U https://doi.org/10.2196/14109 %U http://www.ncbi.nlm.nih.gov/pubmed/32293572 %0 Journal Article %@ 2561-6722 %I JMIR Publications %V 3 %N 1 %P e15813 %T A Web-Based Intervention for Youth With Physical Disabilities: Comparing the Role of Mentors in 12- and 4-Week Formats %A Lindsay,Sally %A Cagliostro,Elaine %+ Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Road, Toronto, ON, M4G 1R8, Canada, 1 416 525 6220 ext 3654, slindsay@hollandbloorview.ca %K social support %K mentor %K youth %K adolescent %K employment %D 2020 %7 8.1.2020 %9 Original Paper %J JMIR Pediatr Parent %G English %X Background: Youths with physical disabilities face many barriers in society, including social exclusion, stigma, and difficulties finding employment. Electronic mentoring (e-mentoring) offers a promising opportunity for youths with disabilities and has the potential to improve their inclusion while enhancing career outcomes. However, little is known about the role of mentors in a Web-based e-mentoring format to improve employment outcomes. Objective: This study aimed to explore the role of mentors in engaging youths in an e-mentoring intervention and to compare and contrast mentors’ engagement strategies within a 12- and 4-week format. Methods: This paper drew on a pilot feasibility study, which is a group, Web-based employment readiness intervention involving a discussion forum for youths with physical disabilities. Our intervention involved having trained youth mentors (ie, near-peers who also had a disability) lead Web-based discussion forums while offering peer support and resources, which involved 12 modules completed over both a 12- or 4-week format. We used a mixed method approach including qualitative data (mentor interviews and discussion forum data) and quantitative data (pre-post survey data) comparison. Results: A total of 24 youths participated across 3 e-mentoring intervention groups: 9 in the 12-week format (mean age 17.7 years [SD 1.7]) and 15 in the 4-week format (mean age 19.5 years [SD 2.6]), led by 3 trained youth mentors with disabilities, 2 males and 1 female (mean age 22 years [SD 2.64]). Our findings revealed that mentors engaged youths in the e-mentoring program by providing informational, emotional, and tangible support. We noted more instances of mentors providing advice, empathy, and encouragement in the 12-week format compared with the 4-week format. We also found fewer examples of providing advice, developing a rapport, and social support from mentors in the 4-week format. Our findings revealed no significant differences between the 2 groups regarding time spent in the forum, number of logins, number of posts, and self-rated engagement. Conclusions: Mentors in the 12-week and 4-week format engaged participants differently in providing informational and emotional support, although there were no differences in tangible support provided. Mentors reported that the 12-week format was too long and lacked interaction between participants, whereas the 4-week format felt rushed and had fewer detailed responses from mentees. International Registered Report Identifier (IRRID): RR2-10.2196/resprot.8034 %M 31913132 %R 10.2196/15813 %U https://pediatrics.jmir.org/2020/1/e15813 %U https://doi.org/10.2196/15813 %U http://www.ncbi.nlm.nih.gov/pubmed/31913132 %0 Journal Article %@ 2561-6722 %I JMIR Publications %V 3 %N 1 %P e17165 %T College Student Problematic Internet Use and Digital Communication Medium Used With Parents: Cross-Sectional Study %A Kerr,Bradley %A D'Angelo,Jon D %A Diaz-Caballero,Ali %A Moreno,Megan A %+ University of Wisconsin-Madison, 2870 University Ave, Suite 200, Madison, WI, , United States, 1 608 262 4440, bkerr@wisc.edu %K parents %K young adults %K social media %D 2020 %7 23.4.2020 %9 Original Paper %J JMIR Pediatr Parent %G English %X Background: Problematic internet use (PIU) is associated with mental health concerns such as depression and affects more than 12% of young adults. Few studies have explored potential influences of parent–college student digital communication on college students’ risk of PIU. Objective: This study sought to understand the relationship between parent–college student digital communication frequency via phone calls, text messages, and Facebook contacts and PIU among college students. Methods: Incoming first-year students were randomly selected from registrar lists of a midwestern and northwestern university for a 5-year longitudinal study. Data from interviews conducted in summer 2014 were used. Measures included participants’ daily Facebook visits, communication frequency with parents via phone call and text message, and 3 variables related to Facebook connection status and communication: (1) parent–college student Facebook friendship status, (2) college student blocking personal Facebook content from parent, and (3) Facebook communication frequency. PIU risk was assessed using the Problematic and Risky Internet Use Screening Scale. Analysis included participants who reported visiting Facebook at least once per day. Multiple linear regression was used, followed by a post hoc mediation with Hayes process macro to further investigate predictive relationships among significant variables. Results: A total of 151 participants reported daily Facebook use and were included in analyses. Among these participants, 59.6% (90/151) were female, 62.3% (94/151) were from the midwestern university, and 78.8% (119/151) were white. Mean Facebook visits per day was 4.3 (SD 3.34). There was a collective significant effect between participant daily Facebook visits, college student–parent phone calls, texts, and all 3 Facebook connection variables (F6,144=2.60, P=.02, R2=.10). Phone calls, text messages, and Facebook contacts were not associated with PIU risk. However, two individual items were significant predictors for PIU: participant daily Facebook visits were positively associated with increased PIU risk (b=0.04, P=.006) and being friends with a parent on Facebook was negatively associated with PIU risk (b=–0.66, P=.008). Participant daily Facebook visits were not a significant mediator of the relationship between college student–parent Facebook friendship and PIU risk (b=–0.04; 95% CI –0.11 to 0.04). Conclusions: This study did not find support for a relationship between parent–college student digital communication frequency and PIU among college students. Instead, results suggested Facebook friendship may be a protective factor. Future studies should examine how a parent-child Facebook friendship might protect against PIU among children at varying developmental stages. %M 32324140 %R 10.2196/17165 %U http://pediatrics.jmir.org/2020/1/e17165/ %U https://doi.org/10.2196/17165 %U http://www.ncbi.nlm.nih.gov/pubmed/32324140 %0 Journal Article %@ 2561-6722 %I JMIR Publications %V 3 %N 1 %P e18043 %T Association of Social Media Use and High-Risk Behaviors in Adolescents: Cross-Sectional Study %A Vente,Teresa %A Daley,Mary %A Killmeyer,Elizabeth %A Grubb,Laura K %+ Ann & Robert H Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, 225 East Chicago Avenue, Box 16, Chicago, IL, United States, 1 518 339 5440, tvente@luriechildrens.org %K self-harm %K social media %K nonsuicidal self-injury %K sexting %D 2020 %7 26.5.2020 %9 Original Paper %J JMIR Pediatr Parent %G English %X Background: Previous studies have demonstrated the prevalence of social media use and identified the presence of high-risk behaviors among adolescents, including self-harm and sharing of sexually explicit messages. Objective: This study aimed to identify patterns in the amount of time spent on social media by adolescents who engage in high-risk behavior and the extent to which they use social media as a platform for sharing such behaviors. Methods: This was a descriptive cross-sectional study of 179 adolescents seen in a pediatric clinic at an urban medical center. We used an anonymous self-report survey to obtain demographic characteristics, rates of self-harm thoughts and behaviors, sharing of sexually explicit messages, and social media use as determined by total hours spent on social media per day and the number of applications used. Results: Most adolescents reported spending 3 to 5 hours on social media each day and using 3 or more social media applications. Almost 1 in 8 (22/179, 12.3%) adolescents self-reported having ever engaged in self-injury with a mean age of onset of 11.8 years. Over a quarter (49/179, 27.4%) of adolescents reported sharing sexually explicit messages. Relative risk of engaging in self-injury and or sharing sexually explicit messages increased with the use of 4 or more social media applications (1.66; CI 1.11-2.48). Conclusions: Results show a relationship between the number of social media applications used and increased rates of high-risk behaviors. We identified relevant risk factors that clinicians can use to screen for high-risk behavior and parents can monitor to encourage education about healthy online practices. %M 32452820 %R 10.2196/18043 %U http://pediatrics.jmir.org/2020/1/e18043/ %U https://doi.org/10.2196/18043 %U http://www.ncbi.nlm.nih.gov/pubmed/32452820 %0 Journal Article %@ 2561-6722 %I JMIR Publications %V 3 %N 1 %P e16545 %T Perspectives of Nurses and Doulas on the Use of Information and Communication Technology in Intercultural Pediatric Care: Qualitative Pilot Study %A Berbyuk Lindström,Nataliya %A Rodríguez Pozo,Rocío %+ Department of Applied IT, University of Gothenburg, Box 100, Gothenburg, 405 30, Sweden, 46 733268716, nataliya.berbyuk.lindstrom@ait.gu.se %K child care %K migrant mother %K nurse %K doula %K smartphone %K mobile phone %K Google Translate %K internet, mHealth %K digital health %K intercultural communication %D 2020 %7 17.3.2020 %9 Original Paper %J JMIR Pediatr Parent %G English %X Background: Sweden is rapidly becoming an increasingly multicultural and digitalized society. Encounters between pediatric nurses and migrant mothers, who are often primary caregivers, are impeded by language problems and cultural differences. To support mothers, doulas, who are women having the same linguistic and cultural backgrounds, serve as cultural bridges in interactions with health care professionals. In addition, information and communication technology (ICT) can potentially be used to manage interactions owing to its accessibility. Objective: The objective of this study was to investigate the role of ICT in managing communicative challenges related to language problems and cultural differences in encounters with migrant mothers from the perspectives of Swedish pediatric nurses and doulas. Methods: Deep semistructured interviews with five pediatric nurses and four doulas from a migrant-dense urban area in western Sweden were audio recorded, transcribed, and analyzed using thematic content analysis. Results: The results showed that ICT contributes to mitigating communicative challenges in interactions by providing opportunities for nurses and migrant mothers to receive distance interpreting via telephones and to themselves interpret using language translation apps. Using images and films from the internet is especially beneficial while discussing complex and culturally sensitive issues to complement or substitute verbal messages. These findings suggest that ICT helps enable migrant mothers to play a more active role in interactions with health care professionals. This has important implications for their involvement in other areas, such as child care, language learning, and integration in Sweden. Conclusions: The findings of this study suggest that ICT can be a bridging tool between health care professionals and migrants. The advantages and disadvantages of translation tools should be discussed to ensure that quality communication occurs in health care interactions and that health information is accessible. This study also suggests the development of targeted multimodal digital support, including pictorial and video resources, for pediatric care services. %M 32181748 %R 10.2196/16545 %U http://pediatrics.jmir.org/2020/1/e16545/ %U https://doi.org/10.2196/16545 %U http://www.ncbi.nlm.nih.gov/pubmed/32181748 %0 Journal Article %@ 2561-6722 %I JMIR Publications %V 3 %N 1 %P e17517 %T Families’ Degree of Satisfaction With Pediatric Telehomecare: Interventional Prospective Pilot Study in Catalonia %A López Seguí,Francesc %A Batlle Boada,Astrid %A García García,Juan José %A López Ulldemolins,Ana %A Achotegui del Arco,Ane %A Adroher Mas,Cristina %A García Cuyàs,Francesc %+ Sant Joan de Déu Hospital, Catalan Ministry of Health, Passeig de Sant Joan de Déu, 2, Barcelona, 08950, Spain, 34 932 53 21 00, fgarciac@sjdhospitalbarcelona.org %K home health monitoring %K pediatrics %K telehomecare %K videoconferencing %K satisfaction with care %K remote sensing technology %K telemedicine %K telehealth %D 2020 %7 26.3.2020 %9 Original Paper %J JMIR Pediatr Parent %G English %X Background: Pediatric home hospitalization improves the quality of life of children and their families, involving them in their children’s care, while favoring the work-life balance of the family. In this context, technology guarantees accessibility to assistance, which provides security to users. From the perspective of the health care system, this could lower the demand for hospital services and reduce hospitalization costs. Objective: This study aimed to assess families’ degree of satisfaction and acceptability of pediatric telehomecare and explore the clinical characteristics of children benefiting from the program. Methods: A total of 95 children and their families participated in the home-hospitalization pilot program operated by Sant Joan de Déu Hospital in Barcelona, Spain. Families were visited once a day and patients were monitored using a kit consisting of a scale, a thermometer, a pulse oximeter, and a blood pressure monitor. Data on parental experience, satisfaction, safety, and preference for care was collected by means of a questionnaire. Data about the children’s characteristics were collected from medical records. Descriptive and comparative statistics were used to analyze the data. Results: A total of 65 survey respondents expressed very high levels of satisfaction. Families reported their experiences as being very positive, preferring home hospitalization in 94% (61/65) of cases, and gave high scores regarding the use of telemonitoring devices. The program did not record any readmissions after 72 hours and reported a very low number of adverse incidents. The user profile was very heterogeneous, highlighting a large number of respiratory patients and patients with infections that required endovenous antibiotic therapy. Conclusions: Pediatric home hospitalization through telemonitoring is a feasible and desirable alternative to traditional hospitalization, both from the perspective of families and the hospital. The results of this analysis showed a very high degree of satisfaction with the care received and that the home-based telemonitoring system resulted in few adverse incidents. %M 32213471 %R 10.2196/17517 %U http://pediatrics.jmir.org/2020/1/e17517/ %U https://doi.org/10.2196/17517 %U http://www.ncbi.nlm.nih.gov/pubmed/32213471 %0 Journal Article %@ 2561-6722 %I JMIR Publications %V 3 %N 1 %P e13031 %T Using Digital Media to Empower Adolescents in Smoking Prevention: Mixed Methods Study %A Park,Eunhee %A Chang,Yu-Ping %+ University at Buffalo, 3435 Main Street, Buffalo, NY, 14214, United States, 1 7168293701, eunheepa@buffalo.edu %K adolescent %K children %K digital media production %K technology %K empowerment %K smoking prevention %D 2020 %7 31.3.2020 %9 Original Paper %J JMIR Pediatr Parent %G English %X Background: There is a critical need for effective health education methods for adolescent smoking prevention. The coproduction of antismoking videos shows promising results for adolescent health education. Objective: This study explored the feasibility of a smoking prevention program using the coproduction of antismoking videos in order to empower adolescents in smoking prevention and tobacco control. A smoking prevention program based on coproduction of antismoking videos over eight sessions was implemented in a low-income neighborhood. Methods: A mixed methods design with a concurrent embedded approach was used. In total, 23 adolescents participated in the program. During the prevention program, small groups of participants used video cameras and laptops to produce video clips containing antismoking messages. Quantitative data were analyzed using the Wilcoxon signed-rank test to examine changes in participants’ psychological empowerment levels between pre- and postintervention; qualitative interview data were analyzed using content analysis. Results: Pre- and postcomparison data revealed that participants’ psychological empowerment levels were significantly enhanced for all three domains—intrapersonal, interactional, and behavioral—of psychological empowerment (P<.05). Interviews confirmed that the coproduction of antismoking videos is feasible in empowering participants, by supporting nonsmoking behaviors and providing them with an opportunity to help build a smoke-free community. Conclusions: Both quantitative and qualitative data supported the feasibility of the coproduction of antismoking videos in empowering adolescents in smoking prevention. Coproduction of antismoking videos with adolescents was a beneficial health education method. %M 32229463 %R 10.2196/13031 %U http://pediatrics.jmir.org/2020/1/e13031/ %U https://doi.org/10.2196/13031 %U http://www.ncbi.nlm.nih.gov/pubmed/32229463 %0 Journal Article %@ 2561-6722 %I JMIR Publications %V 3 %N 1 %P e20712 %T Using Social Media and Technology to Communicate in Pediatric HIV Research: Qualitative Study With Young Adults Living With or Exposed to Perinatal HIV %A Berman,Claire A %A Kacanek,Deborah %A Nichamin,Mindy %A Wilson,Dominique %A Davtyan,Mariam %A Salomon,Liz %A Patel,Kunjal %A Reznick,Megan %A Tassiopoulos,Katherine %A Lee,Sonia %A Bauermeister,Jose %A Paul,Mary %A Aldape,Theresa %A Seage III,George R %+ Department of Epidemiology, Harvard TH Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, United States, 1 6174321853, cberman@hsph.harvard.edu %K pediatric HIV %K perinatal HIV %K youth %K young adults %K social media %K study retention %K COVID-19 %D 2020 %7 23.6.2020 %9 Original Paper %J JMIR Pediatr Parent %G English %X Background: As young adults living with perinatal HIV (PHIV) or perinatal HIV exposure but uninfected (PHEU) grow older and manage the challenges and competing demands of young adulthood, new approaches are needed to facilitate their retention in longitudinal research and clinical care beyond in-person clinic visits. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the novel virus that causes coronavirus disease (COVID-19), emerged in the United States in January 2020 and has underscored this need; studies are adapting to remote communication with and data collection from participants. However, there are limited data on communication preferences among young adults who are living with PHIV or PHEU. Objective: The objectives of this qualitative study were to describe participants’ perceptions and use of social media and technology in their personal lives and in the context of participating in longitudinal pediatric HIV research and to describe the implications of the use of technology and social media for communication and retention purposes within a longitudinal pediatric study about HIV. Methods: We conducted 6 focus group discussions with 31 young adults living with PHIV and 13 in-depth interviews with 6 young adults living with PHIV and 7 living with PHEU. We asked about their preferences for the use of social media and digital technology in the Adolescent Master Protocol, a US-based longitudinal cohort study of youth affected by HIV. Results: Participants’ willingness to use social media platforms, telephone calls, SMS text messages, and video calls within the context of HIV research varied due to fears of HIV stigma and inadvertent disclosure. However, trusting relationships with clinical staff positively impacted their willingness to use these platforms. Conclusions: Our findings offer insight into how pediatric studies and clinics can communicate with participants as they age, even as new technologies and social media platforms emerge and replace old ones. For optimal retention, pediatric clinical staff should consider communication approaches offering flexible and tailored options for young adults participating in HIV research. %M 32540839 %R 10.2196/20712 %U http://pediatrics.jmir.org/2020/1/e20712/ %U https://doi.org/10.2196/20712 %U http://www.ncbi.nlm.nih.gov/pubmed/32540839 %0 Journal Article %@ 2561-6722 %I JMIR Publications %V 3 %N 1 %P e20049 %T Digital Approaches to Remote Pediatric Health Care Delivery During the COVID-19 Pandemic: Existing Evidence and a Call for Further Research %A Badawy,Sherif M %A Radovic,Ana %+ Department of Pediatrics, Northwestern University Feinberg School of Medicine, 225 E Chicago Avenue, Box #30, Chicago, IL, 60654, United States, 1 312 227 4000 ext 74836, sbadawy@luriechildrens.org %K coronavirus %K COVID-19 %K SARS-CoV-2 %K pandemic %K outbreak %K public health %K pediatric %K children %K adolescents %K telehealth %K telemedicine %K digital %K interventions %K digital health %K digital medicine %K mobile health %K mHealth %K eHealth %K health care delivery %D 2020 %7 25.6.2020 %9 Viewpoint %J JMIR Pediatr Parent %G English %X The global spread of the coronavirus disease (COVID-19) outbreak poses a public health threat and has affected people worldwide in various unprecedented ways, both personally and professionally. There is no question that the current global COVID-19 crisis, now more than ever, is underscoring the importance of leveraging digital approaches to optimize pediatric health care delivery in the era of this pandemic. In this perspective piece, we highlight some of the available digital approaches that have been and can continue to be used to streamline remote pediatric patient care in the era of the COVID-19 pandemic, including but not limited to telemedicine. JMIR Pediatrics and Parenting is currently publishing a COVID-19 special theme issue in which investigators can share their interim and final research data related to digital approaches to remote pediatric health care delivery in different settings. The COVID-19 pandemic has rapidly transformed health care systems worldwide, with significant variations and innovations in adaptation. There has been rapid expansion of the leveraging and optimization of digital approaches to health care delivery, particularly integrated telemedicine and virtual health. Digital approaches have played and will play major roles as invaluable and reliable resources to overcome restrictions and challenges imposed during the COVID-19 pandemic and to increase access to effective, accessible, and consumer-friendly care for more patients and families. However, a number of challenges remain to be addressed, and further research is needed. Optimizing digital approaches to health care delivery and integrating them into the public health response will be an ongoing process during the current COVID-19 outbreak and during other possible future pandemics. Regulatory changes are essential to support the safe and wide adoption of these approaches. Involving all relevant stakeholders in addressing current and future challenges as well as logistical, technological, and financial barriers will be key for success. Future studies should consider evaluating the following research areas related to telemedicine and other digital approaches: cost-effectiveness and return on investment; impact on quality of care; balance in use and number of visits needed for the management of both acute illness and chronic health conditions; system readiness for further adoption in other settings, such as inpatient services, subspecialist consultations, and rural areas; ongoing user-centered evaluations, with feedback from patients, families, and health care providers; strategies to optimize health equity and address disparities in access to care related to race and ethnicity, socioeconomic status, immigration status, and rural communities; privacy and security concerns for protected health information with Health Insurance Portability and Accountability Act (HIPAA)–secured programs; confidentiality issues for some specific populations, especially adolescents and those in need of mental health services; early detection of exposure to violence and child neglect; and integration of training into undergraduate and graduate medical education and subspecialty fellowships. Addressing these research areas is essential to understanding the benefits, sustainability, safety, and optimization strategies of telemedicine and other digital approaches as key parts of modern health care delivery. These efforts will inform long-term adoption of these approaches with expanded dissemination and implementation efforts. %M 32540841 %R 10.2196/20049 %U http://pediatrics.jmir.org/2020/1/e20049/ %U https://doi.org/10.2196/20049 %U http://www.ncbi.nlm.nih.gov/pubmed/32540841 %0 Journal Article %@ 2561-6722 %I JMIR Publications %V 3 %N 1 %P e14632 %T An App for Identifying Children at Risk for Developmental Problems Using Multidimensional Computerized Adaptive Testing: Development and Usability Study %A Hsu,Chen-Fang %A Chien,Tsair-Wei %A Chow,Julie Chi %A Yeh,Yu-Tsen %A Chou,Willy %+ Department of Physical Medicine and Rehabilitation, Chi Mei Medical Center, Chi Mei Medical Groups, No. 901, Chung Hwa Road, Yung Kung District, Tainan, 710, Taiwan, 886 62812811, ufan0101@ms22.hinet.net %K computer adaptive testing %K developmental delay %K multidimensional %K mobile phone %K screening %D 2020 %7 16.4.2020 %9 Original Paper %J JMIR Pediatr Parent %G English %X Background: The use of multidomain developmental screening tools is a viable strategy for pediatric professionals to identify children at risk for developmental problems. However, a specialized multidimensional computer adaptive testing (MCAT) tool has not been developed to date. Objective: We developed an app using MCAT, combined with Multidimensional Screening in Child Development (MuSiC) for toddlers, to help patients and their family members or clinicians identify developmental problems at an earlier stage. Methods: We retrieved 75 item parameters from the MuSiC literature item bank for 1- to 3-year-old children, and simulated 1000 person measures from a normal standard distribution to compare the efficiency and precision of MCAT and nonadaptive testing (NAT) in five domains (ie, cognitive skills, language skills, gross motor skills, fine motor skills, and socioadaptive skills). The number of items saved and the cutoff points for the tool were determined and compared. We then developed an app for a Web-based assessment. Results: MCAT yielded significantly more precise measurements and was significantly more efficient than NAT, with 46.67% (=(75-40)/75) saving in item length when measurement differences less than 5% were allowed. Person-measure correlation coefficients were highly consistent among the five domains. Significantly fewer items were answered on MCAT than on NAT without compromising the precision of MCAT. Conclusions: Developing an app as a tool for parents that can be implemented with their own computers, tablets, or mobile phones for the online screening and prediction of developmental delays in toddlers is useful and not difficult. %M 32297867 %R 10.2196/14632 %U http://pediatrics.jmir.org/2020/1/e14632/ %U https://doi.org/10.2196/14632 %U http://www.ncbi.nlm.nih.gov/pubmed/32297867 %0 Journal Article %@ 2561-6722 %I JMIR Publications %V 3 %N 1 %P e15348 %T The Sign 4 Little Talkers Intervention to Improve Listening, Understanding, Speaking, and Behavior in Hearing Preschool Children: Outcome Evaluation %A Davidson,Rosemary %A Randhawa,Gurch %+ Institute for Health Research, University of Bedfordshire, University Square, Luton, LU1 3JU, United Kingdom, 44 1234 400 ext 400, rosemary.davidson@beds.ac.uk %K sign language %K early years %K intervention %K disadvantage %D 2020 %7 30.6.2020 %9 Original Paper %J JMIR Pediatr Parent %G English %X Background: Gaining age-appropriate proficiency in speech and language in the early years is crucial to later life chances; however, a significant proportion of children fail to meet the expected standards in these early years outcomes when they start school. Factors influencing the development of language and communication include low income, gender, and having English as an additional language (EAL). Objective: This study aimed to determine whether the Sign 4 Little Talkers (S4LT) program improves key developmental outcomes in hearing preschool children. S4LT was developed to address gaps in the attainment of vocabulary and communication skills in preschool children, identified through routine monitoring of outcomes in early years. Signs were adapted and incorporated into storybooks to improve vocabulary, communication, and behavior in hearing children. Methods: An evaluation of S4LT was conducted to measure key outcomes pre- and postintervention in 8 early years settings in Luton, United Kingdom. A total of 118 preschool children were tested in 4 early years outcomes domains—listening, speaking, understanding, and managing feelings and behavior—as well as Leuven well-being scales and the number of key words understood and spoken. Results: Statistically significant results were found for all measures tested: words spoken (P<.001) and understood (P<.001), speaking (P<.001), managing feelings and behavior (P<.001), understanding (P<.001), listening and attention (P<.001), and well-being (P<.001). Approximately two-thirds of the children made expected or good progress, often progressing multiple steps in educational attainment after being assessed as developmentally behind at baseline. Conclusions: The findings reported here suggest that S4LT may help children to catch up with their peers at a crucial stage in development and become school ready by improving their command of language and communication as well as learning social skills. Our analysis also highlights specific groups of children who are not responding as well as expected, namely boys with EAL, and who require additional, tailored support. %M 32452813 %R 10.2196/15348 %U https://pediatrics.jmir.org/2020/1/e15348 %U https://doi.org/10.2196/15348 %U http://www.ncbi.nlm.nih.gov/pubmed/32452813