JMIR Pediatrics and Parenting最新文献

{"title":"Quality of First Prenatal Consultations in Malemba Nkulu, Democratic Republic of Congo: Challenges and Opportunities in a Cross-Sectional Study.","authors":"Fiston Ilunga Mbayo, Pascal Geri Madragule, Pacifique Kanku Wa Ilunga, Ignace Bwana Kangulu, Dalau Nkamba Mukadi","doi":"10.2196/78511","DOIUrl":"https://doi.org/10.2196/78511","url":null,"abstract":"<p><strong>Background: </strong>Maternal mortality remains alarmingly high in the Democratic Republic of Congo (DRC), particularly in rural areas where access to quality prenatal care is limited. Despite global efforts to improve maternal health, systemic gaps persist in the delivery of antenatal services.</p><p><strong>Objective: </strong>The objective of this study is to assess the quality of first antenatal consultations in the Malemba Nkulu health zone and identify structural and procedural factors contributing to substandard care.</p><p><strong>Methods: </strong>A cross-sectional descriptive study was conducted in November 2023 across 8 health facilities selected through simple random sampling. Data were collected from 248 pregnant women attending their first prenatal visit and from 14 health care providers. Quality indicators were assessed using a structured checklist based on World Health Organization (WHO) standards. Variables included provider qualifications, availability of diagnostic tools, and completeness of clinical assessments.</p><p><strong>Results: </strong>Only 2% (5/248) of first antenatal consultations met the minimum quality standards. Major deficiencies included lack of physical examinations 78% (193/248), absence of essential laboratory tests 92% (228/248), and inadequate counseling 85% (212/248). Facilities lacked basic equipment such as blood pressure monitors and hemoglobin tests. Provider training was inconsistent, and community awareness of prenatal care remained low.</p><p><strong>Conclusions: </strong>The quality of first antenatal consultations in Malemba Nkulu is critically poor, reflecting broader systemic challenges in rural maternal health care. Strengthening provider training, improving infrastructure, and enhancing community engagement are essential to reduce maternal mortality and improve outcomes in resource-limited settings.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"8 ","pages":"e78511"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Sex Differences in the Joint Trajectories of Depressive Symptoms and Body Mass Index From Adolescence to Early Adulthood: Longitudinal Observational Study.","authors":"Jing Chen, Rui Shan, Wen Yuan, Qiong Wu, Yang Yang, Yi-Hang Yang, Jing-Yao Liu, Wu-Cai Xiao, Shanghang Zhang, Li-Ming Wen, Xiao-Rui Zhang, Zheng Liu, Yi Song","doi":"10.2196/84632","DOIUrl":"10.2196/84632","url":null,"abstract":"","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"8 ","pages":"e84632"},"PeriodicalIF":2.3,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12483333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Promoting Family Engagement With Early Childhood Developmental Screening via the Baby Steps Text Messaging and Web Portal System: Longitudinal Randomized Controlled Trial.","authors":"Hyewon Suh, Julie A Kientz","doi":"10.2196/73443","DOIUrl":"10.2196/73443","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Approximately 1 in 6 US children has a developmental disability. Early detection is crucial but often delayed, especially in families with limited access to resources. Current paper-based screening methods, such as the Ages and Stages Questionnaire, face challenges such as cultural barriers and timing issues. Digital tools can improve parent engagement and screening accuracy. This research explores new technologies to enhance long-term parent involvement in developmental screening.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The study aims to understand whether features of a digital intervention specifically designed to engage parents in developmental screening are effective over a long-term period.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Parents of children between 7 and 12 months old were recruited through flyers at clinics and libraries, mailing lists, and social media, and then they self-enrolled after eligibility screening. We conducted a randomized controlled trial with 139 families over 20 months, along with follow-up interviews and surveys. The intervention consisted of an interactive web portal that combined developmental and sentimental record-keeping, family-friendly visualizations, and the ability to answer screening questions via multiple modalities (eg, text messaging and web), without involvement of health care providers. The control condition consisted of a web-based portal with no specific engagement features, modeled after standard web-based developmental screening tools.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Overall, we enrolled 67 parents in the control group and 72 parents in the experimental group, for a total of 139 enrolled participants. Several parent engagement strategies we deployed in the experimental group were effective in increasing milestone questionnaire completion, with text messaging standing out as the most impactful and efficient, offering the highest return relative to the effort required for its development and implementation. Overall, the experimental group demonstrated a 44% higher average response rate compared to controls (t125=-3.32, P&lt;.01). Participants in the experimental group submitted significantly more timely and valid responses, after text messaging was introduced (phase 2: 95% vs phase 1: 71%; t107=-4.44, P&lt;.01), which is a critical factor for effective and timely tracking of child development. The experimental group participants responded to more questions on average (mean 127.60, SD 49.01) than those in the control group (t70=-7.23, P&lt;.01) in phase 2 as well. In addition, study completion rates were significantly higher in the experimental group (83% vs 30%; t119=-8.40, P&lt;.01), indicating greater long-term engagement. Sentimental record-keeping features showed promise but limited use, suggesting the need for integration with tools parents already use.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This study demonstrates that a human-centered design approach for technology-based interventions can","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"8 ","pages":"e73443"},"PeriodicalIF":2.3,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immediate Kangaroo Mother Care for Sick Newborns: Quality Improvement Implementation and Feasibility Study.","authors":"Belén Fernández-Monteaguado, Ana Peña-Moreno, Inés Ramírez-de Andrés, Patricia Barbero-Casado, Eduardo Zarzuela-NÚñez, Beatriz Bellón-Vaquerizo, Cristina Martin Arriscado-Arroba, María Teresa Moral-Pumarega, Salvador Piris-Borregas, Carmen Rosa Pallás-Alonso","doi":"10.2196/78207","DOIUrl":"10.2196/78207","url":null,"abstract":"<p><strong>Background: </strong>A systematic separation of late preterm and/or sick newborns from their mothers and families continues to occur in most neonatal units around the world.</p><p><strong>Objective: </strong>The aim of this study was to implement immediate kangaroo mother care for sick newborns from birth.</p><p><strong>Methods: </strong>This study comprised preterm newborns at ≥34 weeks of gestational age and weighing ≥1800 g, term newborns with noninvasive ventilation, and newborns at ≥34 weeks of gestational age and weighing ≥1800 g with congenital anomalies that did not require urgent medical or surgical attention. Newborns were excluded in cases of advanced resuscitation or at medical discretion. The newborns in this study were maintained skin-to-skin for 120 minutes, preferably with the mother, and then transferred skin-to-skin to their destination unit.</p><p><strong>Results: </strong>In this study, 60 newborns were included. The median time for immediate kangaroo mother care was 120 minutes for all newborns; 100% of the time was spent with the mother, even when respiratory support was required. Immediate kangaroo mother care was interrupted for 13 of the 60 newborns, and this was more frequent in newborns with heart disease (9/13, 69%), with the main cause being the neonatologist's concern. No causes of separation were related to maternal issues, hypoglycemia, or temperature instability, and no incidents such as hypothermia were observed during kangaroo mother care, either at birth or during transport.</p><p><strong>Conclusions: </strong>Kangaroo mother care during the first 120 minutes of life in late premature or sick newborns is a safe and feasible practice.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"8 ","pages":"e78207"},"PeriodicalIF":2.3,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145150577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Association Between Behavioral Determinants and Intention to Use a Chatbot-Led Parenting Intervention by Caregivers of Adolescent Girls in South Africa: Cross-Sectional Study.","authors":"Maria Da Graca Ambrosio, Seema Vyas, Juliet Stromin, Shallen Lusinga, Paula Zinzer, Kanyisile Brukwe, Zamakhanya Makhanya, Hlengiwe Gwebu, Anne Schley, Laurie Markle, David Stern, Chiara Facciolà, G J Melendez-Torres, Frances Gardner, Jamie M Lachman","doi":"10.2196/76992","DOIUrl":"10.2196/76992","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;While digital innovation, including chatbots, offers a potentially cost-effective means to scale public health programs in low-income settings, user engagement rates remain low. Barriers to participant engagement (eg, perceived difficulty of use, busyness, low levels of digital literacy) may exacerbate inequality when adopting digital-only interventions as alternatives to in-person programs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This cross-sectional study nested within a 2×2 clustered factorial trial that followed the Multiphase Optimization Strategy principles investigated the relationship between behavioral determinants (ie, human and socioeconomic characteristics that facilitate the use of digital health interventions [DHIs]) and caregiver intention to use a digital public health intervention, ParentText, an open-source, rule-based parenting chatbot designed to promote positive parenting, improve adolescent health, and reduce risky behaviors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Caregivers of adolescent girls (10-17 years; N=1034 caregivers) were recruited by implementation partners from a community-wide project aimed at HIV prevention in two districts of Mpumalanga, South Africa. A Digital Health Engagement Model was adapted from the technology acceptance model, the PEN-3 model theoretical frameworks, and the Theory of Planned Behavior to investigate the relationship between behavioral determinants and the intentions of caregivers to engage in ParentText. Community facilitators administered baseline surveys to caregivers during intervention onboarding. Regression models tested associations between behavioral determinants (ie, perceived ease of use, perceived usefulness, attitude, hedonic motivation, habit, price value, and social influence) and intentions of caregivers to use the parenting chatbot. Interaction effects were explored to examine whether individual-level sociodemographic and psychosocial characteristics moderate associations between overall behavioral determinants and intentions to use the chatbot.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Caregivers reported a mean of 2.85 (SD 0.79) and 2.90 (SD 0.72) out of a maximum score of 4 regarding their intention to use their mobile data and to continue using ParentText in the future, respectively. Overall behavioral determinants predicted by 76% (odds ratio 1.76, 95% CI 1.72-1.81) the intentions of caregivers to spend mobile data and by 85% (odds ratio 1.85, 95% CI 1.81-1.90) their intentions to use ParentText in the future. Moderator analysis suggested the interaction effects of age, paternal absence, financial efficacy, and stress on the relationship between overall behavioral determinants and intention outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This is the first known study to investigate the associations between overall behavioral determinants and participant intentions to use a parenting chatbot in a low-income setting. This study identifies behavioral determinants ","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"8 ","pages":"e76992"},"PeriodicalIF":2.3,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12453451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145125863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Virtual Reality-Based Cognitive Control Training Game for Children With Attention-Deficit/Hyperactivity Disorder Symptoms: Preliminary Effectiveness Study.","authors":"Hyunjoo Song, Yunhye Oh, JongIn Choi, Seong-Yong Ohm","doi":"10.2196/66617","DOIUrl":"10.2196/66617","url":null,"abstract":"<p><strong>Background: </strong>Recent advancements in digital technologies hold promise for psychological interventions. Virtual reality (VR) has emerged as a particularly innovative tool, and its application expanded during the COVID-19 pandemic period. A recent study combining material and psychological rewards within a VR platform showed that this approach effectively improves attention-deficit behaviors in children with attention-deficit/hyperactivity disorder (ADHD), enhancing their inhibitory control abilities.</p><p><strong>Objective: </strong>This study aimed to evaluate the effectiveness of a newly developed VR-based cognitive control training game for children with ADHD symptoms. Specifically, it examined the sustainability of the training effects through a 3-month follow-up assessment. In addition, the study analyzed training response patterns and influential factors using a clustering method.</p><p><strong>Methods: </strong>A total of 29 children and adolescents (21 males and 8 females) aged 10-14 years participated in the study, with a mean IQ of 94 (SD 16.53). For 20 consecutive days, participants self-administered the training on a daily basis using the VR app. The following assessments were administered face-to-face: the Korean Wechsler Intelligence Scale for Children, Fourth Edition; the Stroop test; the Color Trails test; and the Flanker test from the National Institutes of Health toolbox. In addition, the parent-completed Korean Child Behavior Checklist was used to identify behavioral problems in the children. Participants engaged in at least 20 minutes of daily training for 20 consecutive days, with assessments conducted at baseline, posttraining, and follow-up.</p><p><strong>Results: </strong>Repeated measures ANOVA revealed significant main effects in the Stroop Color-Word test (F2,56=4.97; P=.001; ηp2=0.151), Child Behavior Checklist (CBCL) Total Problems (F2,56=21.0; P<.001; ηp2=0.429), CBCL Attention Problems (F2,56=11.7; P<.001; ηp2=0.294), and CBCL ADHD (F2,56=3.46; P=.004; ηp2=0.110). K-means clustering identified 2 distinct clusters that did not differ significantly in IQ variables but showed significant differences in game-related behavioral variables, including mean correct response time (t27=-2.56; P=.02) and the correct response ratio (t27=2.60; P=.02).</p><p><strong>Conclusions: </strong>The findings indicate that the VR-based training effectively improved cognitive control on the Stroop test and ADHD-related symptoms as measured by the CBCL. However, no significant training effects were observed on other attentional measures, namely the Color Trails test and the Flanker test from the National Institutes of Health toolbox. This VR-based approach shows promise as a potential therapeutic intervention for children with ADHD symptoms.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"8 ","pages":"e66617"},"PeriodicalIF":2.3,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Internet-Based Cognitive Behavioral Therapy for Children and Adolescents With Dental or Injection Phobia: 1-year Follow-Up Assessment.","authors":"Robert Schibbye, Erik Hedman-Lagerlöf, Viktor Kaldo, Göran Dahllöf, Shervin Shahnavaz","doi":"10.2196/80376","DOIUrl":"10.2196/80376","url":null,"abstract":"<p><strong>Background: </strong>Dental phobia (DP) and injection phobia (IP) are common in pediatric populations, resulting in inability to receive dental care. Internet-based cognitive behavioral therapy (ICBT) has demonstrated efficacy, but its long-term effects are unexplored.</p><p><strong>Objective: </strong>This study aimed to evaluate the long-term effects of ICBT on DP and IP in children and adolescents.</p><p><strong>Methods: </strong>In total, 49 participants (mean age 11.1 years, SD 2.1) with DP, IP, or both underwent a 12-week, parent-guided, exposure-based ICBT, supplemented by visits at local dental clinics and weekly psychologist correspondence. Assessments occurred at baseline, posttreatment, and 1-year follow-up. Primary outcomes included diagnostic status (clinical interview) and ability to receive dental procedures. Secondary outcomes included measures of dental anxiety, injection anxiety, negative cognitions, and self-efficacy. The study was conducted in Sweden.</p><p><strong>Results: </strong>Of the 49 participants, 42 (86%) completed the 1-year follow-up. At 1-year follow-up, 19 (53%) of 36 (86%) participants who initially met the criteria for DP no longer did (P<.001), and 17 (46%) of 37 (88%) participants who initially met the criteria for IP did not fulfill the IP diagnosis (P<.001). Repeated-measures ANOVA showed significant improvements, with large effect sizes for self-reported ability to undergo dental procedures (d=1.1, P<.001), dental fear (d=1.0, P<.001), negative cognitions (d=0.9, P<.001), injection fear (d=0.7, P<.001), and self-efficacy (d=1.1, P<.001). Predictor analysis showed greater improvements in older participants and males.</p><p><strong>Conclusions: </strong>This study discussed the clinical implications of and approaches to ICBT implementation. ICBT for children and adolescents with DP and IP maintains its effects over a 1-year follow-up period, facilitating improved self-reported willingness to undergo dental treatment. Given its accessibility and sustained efficacy, ICBT should be considered for managing severe dental fear in pediatric dentistry.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT02588079; https://clinicaltrials.gov/study/NCT02588079.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"8 ","pages":"e80376"},"PeriodicalIF":2.3,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489423/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Exergames on Motor Skills, Psychological Well-Being, and Cognitive Abilities in Schoolchildren and Adolescents: Scoping Review.","authors":"Eleonora Rosi, Valentina Bianchi, Ilaria Baù, Rebecca Nuzzo, Stefania Valsecchi, Massimo Molteni, Paola Colombo","doi":"10.2196/71416","DOIUrl":"10.2196/71416","url":null,"abstract":"<p><strong>Background: </strong>In a world where children are increasingly sedentary, the need for innovative solutions to promote physical activity is felt more than ever. Exergames-interactive video games combining physical activity with gaming-are an attractive way to engage children in exercise while having fun. Although exergames have demonstrated several benefits for the health and physical activity of children and young people, the impact of these devices is poorly explored, especially in the school context.</p><p><strong>Objective: </strong>This scoping review was aimed at analyzing the effects of exergames on motor skills, psychological well-being, and cognitive abilities in children and adolescents during physical education hours and play-based activities. Our specific goal was to explore and describe the effects of exergames in school programs and their potential to improve physical and mental health in educational settings.</p><p><strong>Methods: </strong>We carried out our review in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. We searched 3 bibliographic databases from 2019 to June 2024 and included all scientific studies involving children and adolescents interacting with exergames during physical education lessons at school.</p><p><strong>Results: </strong>Our database search produced 1694 articles. After performing 3 levels of screening (title, abstract, and full text), 25 articles were left. The majority of the studies confirmed that the use of exergames during physical education and playful sport activities is associated with a number of improvements. More specifically, these devices can provide motor benefits as well as psychological or cognitive benefits, such as cognitive flexibility and attentional functions, overall well-being, and a greater sense of self-efficacy, self-confidence, and mood.</p><p><strong>Conclusions: </strong>These results may have significant implications for public health or education: exergames may become accessible and useful devices for promoting physical activity in young people, potentially benefiting motor skills but also psychological and cognitive functions, increasing children's participation in physical activities, and leading to a general improvement in their sense of self-efficacy and well-being. Exergames can improve children's physical and cognitive skills, thus becoming a complementary and additional device to traditional physical education exercises and helpful tools to increase physical movement in extracurricular activities.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"8 ","pages":"e71416"},"PeriodicalIF":2.3,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12443355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advice for Improving the Experience of Web-Based Patient Portals: Qualitative Interviews With Caregiver-Adolescent Dyads.","authors":"Rachel E Granberg, Jessica M Goldberg, Alison L Antes, Christine Bereitschaft, Fabienne Bourgeois, James DuBois, Bryan A Sisk","doi":"10.2196/72134","DOIUrl":"10.2196/72134","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Web-based patient portals can benefit adolescents and their caregivers by increasing access and providing greater understanding of one's health information, enhancing communication with clinicians, and supporting caregiver influence. Despite these benefits, adolescent uptake has been low with high attrition rates. Feedback from adolescents and caregivers is essential to improve the uptake and usability of the web-based patient portal.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The aim of the study is to identify advice for medical informatics administrators and clinicians directed at improving the adolescent and caregiver experience with the web-based patient portal.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Caregivers completed a demographic survey followed by separate qualitative, semistructured interviews with adolescent-caregiver dyads with and without chronic illnesses. Caregivers and adolescents were interviewed separately regarding advice for administrators and clinicians on several topics, including (1) providing adolescent and caregiver portal access, (2) how doctors should discuss the portal with families and the content of their notes, and (3) what general advice they had to improve portal access for families. We performed thematic analysis to develop a codebook, and team members applied these codes to the transcripts and analyzed for overlaps and contrasts.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We performed 102 interviews with 51 dyads of caregivers and adolescents (26 with chronic illness and 25 without chronic illness). The majority of adolescents and their caregivers were White (adolescents: n=28, 55% and caregivers: n=28, 55%) or Black (adolescents: n=21, 41% and caregivers: n=21, 41%) and female (adolescents: n=30, 59% and caregivers: n=50, 98%). The majority of caregivers had accessed their child's portal (n=33, 65%), whereas the majority of adolescents had not (n=17, 33%). We identified three themes related to adolescent and caregiver advice: (1) encouraging and supporting portal use, (2) recognizing the emotional experience of portal use, and (3) improving portal usability, understandability, and individualization. Adolescents and their caregivers provided specific recommendations regarding initial access or enrollment including improving resources and clinician encouragement as well as improving the usability in terms of user-friendly design, understandable language, and clear expectations. Finally, caregivers and adolescents had varied opinions on confidentiality and access but emphasized the importance of understanding the emotional impact and providing guidance to caregivers and adolescents.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Adolescents and caregivers outlined critical advice to medical informatics administrators and clinicians to improve the patient portal uptake and usability. Further research is required to determine the best application for these recommendations, including the potential use for advance technol","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"8 ","pages":"e72134"},"PeriodicalIF":2.3,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12464496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex Differences in the Joint Trajectories of Depressive Symptoms and Body Mass Index From Adolescence to Early Adulthood: Longitudinal Observational Study.","authors":"Jing Chen, Rui Shan, Wen Yuan, Qiong Wu, Yang Yang, Yi-Hang Yang, Jing-Yao Liu, Wu-Cai Xiao, Shanghang Zhang, Li-Ming Wen, Xiao-Rui Zhang, Zheng Liu, Yi Song","doi":"10.2196/72722","DOIUrl":"10.2196/72722","url":null,"abstract":"<p><strong>Background: </strong>Adolescence is a critical transitional period between childhood and adulthood, marked by dramatic changes in physical and psychosocial health. Adolescents are vulnerable to both depression and adiposity, but how these conditions evolve over time from adolescence to early adulthood and whether sex differences exist remains unclear.</p><p><strong>Objective: </strong>This study aims to first identify the population heterogeneity in the joint trajectories of depressive symptoms and BMI from adolescence to early adulthood and then explore the sex differences in the joint trajectories.</p><p><strong>Methods: </strong>In this study, we adopt the latent class trajectory modeling to identify the combined trajectories of depressive symptoms and BMI from adolescence at baseline to early adulthood at follow-ups using a longitudinal study (2010-2020). We used the multinomial logistic regressions to examine the sex-specific associations with the trajectory classifications.</p><p><strong>Results: </strong>Our results found that individuals' depressive symptoms and BMI might not always change parallelly from adolescence to early adulthood. Instead, some individuals appeared to be prone to depressive symptoms or elevated BMI, while others were multimorbid with both of them. Moreover, our study identified a clear sex-specific pattern in the joint trajectories of depressive symptoms and BMI: the females were at a higher risk of developing depressive symptoms but remained relatively stable weight status over time (odds ratio [OR] 0.68, 95% CI 0.52-0.89), while the males were at a lower risk of developing depressive symptoms but with an increasing risk of developing adiposity over time (OR 1.83, 95% CI 1.35-2.49).</p><p><strong>Conclusions: </strong>Depressive symptoms and BMI might not always change in parallel from adolescence to early adulthood, and there is a clear sex-specific pattern in the joint trajectories of depressive symptoms and BMI. This will inform the design of future sex-specific interventions that match the distinguished profiles in male and female participants during the period of adolescence and early adulthood, respectively, thus maximizing the intervention effects in preventing both depression and adiposity in early life.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"8 ","pages":"e72722"},"PeriodicalIF":2.3,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12422740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}