JMIR Pediatrics and Parenting最新文献

{"title":"Perceptions of Dietary mHealth Apps Among Adolescents: Scoping Review.","authors":"Maria B Magro, Alysha L Deslippe, Trisha C Baluyot, Angela S Alberga, Tamara R Cohen","doi":"10.2196/91650","DOIUrl":"https://doi.org/10.2196/91650","url":null,"abstract":"<p><strong>Background: </strong>Adolescents' high engagement with smartphones creates opportunities for mobile health (mHealth) apps targeting dietary behaviors. However, despite the availability of diverse dietary mHealth apps, user engagement remains low. Existing quantitative literature has identified barriers and facilitators to app effectiveness in youth (aged 10-19 years) but has not fully captured the nuanced perceptions of adolescents (aged 12-19 years), who represent a unique life stage. Synthesizing similarities and differences in adolescents' perceptions of what they value in dietary mHealth apps from qualitative studies may provide a more comprehensive understanding of app engagement and future app design.</p><p><strong>Objective: </strong>We aimed to synthesize adolescents' perceptions of using diverse dietary mHealth apps.</p><p><strong>Methods: </strong>A scoping review was conducted according to the 5-stage framework by Arksey and O'Malley. Eligible studies were published in English and reported on adolescents (aged 12-19 years) with perceptions of dietary mHealth apps using qualitative methods. Apps that were not specific to diet, relied only on SMS text messaging, were delivered as part of a school-based intervention or telemedicine service, or were housed on a website or social media platform were excluded. Five evidence sources (PsycINFO, Embase, Medline, Web of Science, and CINAHL) were searched. Extracted data were charted by 1 researcher following a pilot test. Similarities and differences in adolescents' perceptions were synthesized across studies using thematic analysis.</p><p><strong>Results: </strong>Of the 1195 search results, 1.2% (n=14) met the eligibility criteria. We identified six themes that represented adolescents' perceptions of using dietary mHealth apps: (1) functionality and design, (2) content and depth, (3) social connection and support, (4) entertainment and gamification, (5) goal setting and motivation, and (6) perceived effectiveness. Overall, adolescents favorably perceived apps that were easy to navigate, fostered social connections, were personalizable, and were gamified. Apps that were felt to increase awareness of personal eating habits, often through tracking calories and foods consumed, and foster awareness of personal well-being were especially discussed in relation to perceived app effectiveness.</p><p><strong>Conclusions: </strong>The findings of this review provide an innovative synthesis of adolescents' perceptions of diverse dietary mHealth apps, using qualitative data. Notably, dietary mHealth apps that were perceived as easy to navigate, tailored (eg, in terms of content), and gamified and those that included social engagement were perceived favorably, regardless of their dietary target and features. Apps that were perceived to improve adolescents' current dietary awareness were particularly valued. Inclusion of these elements in dietary mHealth apps may promote greater engagement. App de","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"9 ","pages":"e91650"},"PeriodicalIF":2.3,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231262","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 Perspectives and Barriers in Implementing Home Monitoring for Pediatric Pulmonary Diseases: Mixed Methods Study.","authors":"Mees Hp Stoop, Romy Krul, Badies Han Manai, Iris Groothuis, Arwen J Sprij, Marianne Nuijsink, Hettie M Janssens, Matthijs D Kruizinga","doi":"10.2196/101452","DOIUrl":"https://doi.org/10.2196/101452","url":null,"abstract":"<p><strong>Background: </strong>Home monitoring has the potential to enable early detection of disease progression in pediatric lung diseases such as asthma and cystic fibrosis (CF). There is minimal evidence regarding the opinions of caregivers and children on home monitoring.</p><p><strong>Objective: </strong>This study aimed to explore children's and caregivers' perspectives on home monitoring.</p><p><strong>Methods: </strong>This multicenter, mixed methods study included children aged 6 to 18 years with asthma or CF and their caregivers. Participants were recruited from Juliana Children's Hospital and Erasmus MC Sophia Children's Hospital between September 2023 and June 2025. Participants completed a structured questionnaire assessing experiences, attitudes, and potential barriers and facilitators to home monitoring. Fourteen children and their caregivers took part in in-depth interviews. Conventional content analysis was applied to both open-text and interview data.</p><p><strong>Results: </strong>A total of 113 caregiver-child dyads (62 [54.9%] asthma and 51 [45.1%] CF) participated in this study. Willingness to use home monitoring was high among both children (asthma: n=47, 83.9%; CF: n=30, 62.5%) and caregivers (asthma: n=54, 87.1%; CF: n=44, 86.3%). Children with asthma and their caregivers showed significantly greater willingness to use the proposed types of home monitoring than children with CF and their caregivers. Caregivers who expressed difficulty with symptom interpretation were significantly more motivated to use home monitoring. Key barriers included time demands, usability, device size, and concerns about maintaining personal contact with health care providers. Facilitators included compact, user-friendly devices, clear instructions, and improved disease understanding.</p><p><strong>Conclusions: </strong>High willingness to adopt home monitoring was observed among children with asthma and children with CF, but preferences and perceived barriers differ. Tailoring device choice and implementation strategies to patient needs, minimizing burden, and integrating medical oversight are important for successful uptake.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"9 ","pages":"e101452"},"PeriodicalIF":2.3,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149228936","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":"Timely Initiation of Breastfeeding and Associated Factors in 20 Sub-Saharan African Countries: Cross-Sectional Multilevel Analysis of Recent Demographic and Health Surveys.","authors":"Tadele Derbew Kassie, Getnet Gedif, Mequanent Dessie Bitewa, Atsede Alle Ewunetie, Tewodros Shibabaw, Menberu Gete, Melkamu Siferih, Mikias Getahun Molla, Tirusew Wondie Wodie, Daniel Mulat Eshetu, Abebaw Abeje Muluneh, Aysheshim Asnake Abneh","doi":"10.2196/103827","DOIUrl":"10.2196/103827","url":null,"abstract":"<p><strong>Background: </strong>An important strategy to decrease infant morbidity and mortality is timely initiation of breastfeeding (TIBF), which is defined as putting the newborn to the breast within 1 hour of delivery. Delayed initiation of breastfeeding may contribute to high neonatal and infant mortality in sub-Saharan Africa.</p><p><strong>Objective: </strong>This study assessed the prevalence of TIBF and associated factors using recent Demographic and Health Survey data from 20 sub-Saharan African countries.</p><p><strong>Methods: </strong>Using recent Demographic and Health Survey data from sub-Saharan African countries, a cross-sectional study was conducted. Data were accessed on January 27, 2026. The analysis included 177,988 children after application of sampling weights. The hierarchical structure of the data was taken into consideration by conducting a multilevel logistic regression analysis. Results were presented using adjusted odds ratios (AORs) with 95% CIs. To evaluate cluster-level variance, random-effects measures such as the median odds ratio and intraclass correlation coefficient were reported.</p><p><strong>Results: </strong>Among 177,988 weighted samples, 59.05% (95% CI 58.82%-59.28%) initiated breastfeeding within 1 hour of birth. TIBF was more likely among rural residents (AOR 1.25, 95% CI 1.21-1.28), mothers with primary (AOR 1.48, 95% CI 1.45-1.52), secondary (AOR 1.22, 95% CI 1.19-1.26), and higher education (AOR 1.22, 95% CI 1.15-1.28), institutional delivery (AOR 1.40, 95% CI 1.36-1.43), multiparous (AOR 1.19, 95% CI 1.15-1.23), and grand multiparous mothers (AOR 1.10, 95% CI 1.05-1.14). Lower odds were observed among cesarean births (AOR 0.31, 95% CI 0.30-0.33), twin births (AOR 0.87, 95% CI 0.82-0.92), delayed antenatal care initiation (AOR 0.84, 95% CI 0.82-0.85), female children (AOR 0.90, 95% CI 0.88-0.91), and mothers with a history of child death (AOR 0.90, 95% CI 0.86-0.94).</p><p><strong>Conclusions: </strong>TIBF remains suboptimal in sub-Saharan Africa and is influenced by maternal, obstetric, and health care factors. Enhancing antenatal counseling and postnatal breastfeeding support, particularly after cesarean delivery and among vulnerable groups, may improve timely initiation practices.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"9 ","pages":"e103827"},"PeriodicalIF":2.3,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13679858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149225060","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":"Use of WhatsApp in Children's Oral Health Education Among Mothers in a Maternal and Child Cohort: Qualitative Content Analysis.","authors":"Natália Gardin Varano, Ruann Oswaldo Carvalho da Silva, Julia Schlichting Azevedo, Juliana Schaia Rocha, Luciana Reis Azevedo Alanis, Deborah Carvalho, Renata Iani Werneck","doi":"10.2196/89204","DOIUrl":"10.2196/89204","url":null,"abstract":"<p><strong>Background: </strong>Research indicates that social media platforms play an important role in disseminating health information. Mothers, in particular, frequently seek guidance on child health through digital resources. Given the growing demand for health-related content, it is necessary to understand how these tools contribute to maternal health education, especially regarding the ability to interpret and apply health information.</p><p><strong>Objective: </strong>This study aims to investigate how WhatsApp influences the health education processes of mothers, as well as to identify the interests and competencies related to infant oral health among mothers participating in a maternal and child cohort.</p><p><strong>Methods: </strong>This was a qualitative, exploratory study grounded in the Bardin content analysis framework. Text messages exchanged between mothers and health professionals in a WhatsApp group linked to the Curitiba Maternal and Child Health Cohort (COOSMIC) were analyzed, referring to the years 2020 and 2021.</p><p><strong>Results: </strong>The corpus was composed of 36 dialogues: 28 concerning infant oral health and 8 regarding the group's impact. The recording units were categorized by themes and interpreted according to emerging core meanings. We identified 2 main themes: eruption of primary teeth (mentioned 12 times) and bruxism in children (mentioned 5 times). Furthermore, in the topic related to the group's impact, we observed a pattern among participants in recognizing the group as a source of support, guidance, and mutual help, highlighting the role of professionals and peer-to-peer exchanges in overcoming doubts and insecurities. Mothers demonstrated an active search for information and collaborative interaction with health professionals, establishing WhatsApp as a support and education network. Competencies linked to oral health literacy ranged from autonomy, empowerment, and security to insecurity, misinformation, and knowledge limitations regarding infant oral health information.</p><p><strong>Conclusions: </strong>WhatsApp proved to be a relevant tool for accessing information and guidance on infant oral health, favoring mutual support and communication among peers and professionals. The competencies and limitations identified in the mothers' oral health literacy highlight the importance of professionally mediated educational strategies aimed at improving the quality of information and promoting autonomy in infant care.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"9 ","pages":"e89204"},"PeriodicalIF":2.3,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149196784","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":"Weekend Texting Screen Time and Incident Nicotine Use in Early Adolescents: Longitudinal Analysis of the Adolescent Brain Cognitive Development Study.","authors":"Gabriel Zamora, Michael L Thomas, Alejandro D Meruelo","doi":"10.2196/100303","DOIUrl":"10.2196/100303","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Adolescent nicotine use initiation remains a significant public health concern. While screen-based behaviors have been linked to substance use, few prospective studies have examined specific forms of interactive screen engagement or tested potential psychological mechanisms underlying this association.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to examine whether weekend texting screen time was prospectively associated with subsequent nicotine use initiation among early adolescents and evaluate whether negative urgency statistically accounted for part of this association.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We analyzed longitudinal data from a large cohort of adolescents who were nicotine naive at baseline. Weekend texting screen time (hours) was assessed via self-report. Negative urgency, reflecting impulsive action during negative affect, was measured using the UPPS (Urgency, Premeditation, Perseverance, and Sensation Seeking) impulsivity scale. Incident nicotine use initiation was modeled using Cox proportional hazards regression, adjusting for sex, age, race, ethnicity, and household income. We evaluated whether adjustment for negative urgency attenuated the texting-initiation association and conducted a sensitivity analysis restricted to participants for whom texting assessment, negative urgency assessment, and nicotine use initiation were temporally ordered.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among 5,965 nicotine-naïve adolescents followed prospectively, 239 (4%) initiated nicotine use. Greater weekend texting was associated with increased hazard of nicotine use initiation (per hour: hazard ratio [HR]=1.07, 95% CI 1.04-1.11). A 5-hour increase corresponded to an approximately 30% to 40% higher hazard of initiation. Weekend texting was positively associated with negative urgency (β=0.079; &lt;i&gt;P&lt;/i&gt;&lt;.001), and negative urgency independently predicted nicotine use initiation (per point: HR=1.19, 95% CI 1.13-1.25). Inclusion of negative urgency slightly attenuated the texting association (per hour: HR=1.06, 95% CI 1.02-1.09), although attenuation was modest. In standardized models, a 1-SD increase in weekend texting was associated with a 21% higher hazard of initiation (HR=1.21, 95% CI 1.10-1.31). In a sensitivity analysis restricted to participants with temporally ordered assessments and nicotine use initiation, weekend texting remained associated with nicotine use initiation (HR=1.11, 95% CI 1.06-1.16), and negative urgency remained independently associated with use initiation (HR=1.11, 95% CI 1.02-1.21). Adjustment for negative urgency attenuated the texting log-hazard coefficient by 6.8%.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Greater weekend texting screen time was prospectively associated with subsequent nicotine use initiation among early adolescents. Negative urgency was independently associated with nicotine use initiation and modestly attenuated the texting-initiation association. These findings are consis","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"9 ","pages":"e100303"},"PeriodicalIF":2.3,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184636","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":"Agreement and Screening Performance of an App-Based Cranial Shape Assessment Tool Compared With a 3D Scanner in Municipal Child Health Checkups in Japan: Instrument Validation Study.","authors":"Yui Honda, Mai Takeshita, Hiroki Kajita, Yoriko Kotoku, Kayo Ueda, Shigeharu Hosono, Hiromi Eto","doi":"10.2196/105473","DOIUrl":"10.2196/105473","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Positional cranial deformities are common in infancy. Smartphone-based apps are increasingly used to assess infant head shape, but evidence comparing these tools with 3D scanners across age groups in community-based settings remains limited.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study evaluated age-stratified agreement and screening performance of a mobile app for estimating Cranial Vault Asymmetry Index (CVAI) and Cephalic Index, compared with a 3D scanner, when used by a trained examiner during routine municipal health checkups in Japan.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a cross-sectional study in Goto City, Japan, between May 2023 and March 2025. Independent, age-specific cohorts of children attending municipal health checkups at 4, 18, and 42 months were included. Paired cranial measurements were obtained by a trained examiner using a VECTRA H2 3D scanner (Canfield Scientific Inc) and the mobile app. Agreement was assessed using mean differences, 95% limits of agreement (LoA), and intraclass correlation coefficients (ICCs), with device-stratified sensitivity analyses. Screening performance was evaluated using sensitivity and specificity based on prespecified clinical thresholds. Receiver operating characteristic (ROC) analyses were secondary exploratory analyses. The primary outcome was app-based CVAI for detecting scanner-defined moderate-or-worse plagiocephaly (CVAI≥7%). Secondary outcomes were app-based Cephalic Index for detecting brachycephaly (Cephalic Index&gt;94%) and dolichocephaly (Cephalic Index&lt;79%).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The final analytic samples comprised 262 children at 4 months, 171 at 18 months, and 216 at 42 months. Agreement for continuous CVAI was highest at 4 months (mean difference 0.14, 95% LoA -4.18 to 4.46; ICC 0.76, 95% CI 0.71-0.81) and lower at 18 months (ICC 0.42, 95% CI 0.29-0.54) and 42 months (ICC 0.49, 95% CI 0.38-0.59). For Cephalic Index, the app consistently overestimated values relative to the scanner, with mean differences of 3.83 SD 3.42, 3.24 SD 3.07, and 2.61 SD 3.33 points at 4, 18, and 42 months, respectively. For detecting scanner-defined moderate-or-worse plagiocephaly, app sensitivity and specificity were 84.8% and 88.0% at 4 months, 50.0% and 88.4% at 18 months, and 53.3% and 89.6% at 42 months, respectively. Device-stratified analyses showed some variation in measurement agreement and screening performance across devices.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Under municipal health checkup conditions with a trained examiner, app-based CVAI showed the strongest performance at 4 months and may be useful for early screening. However, performance was weaker at 18 and 42 months. App-based Cephalic Index was systematically higher than scanner-based Cephalic Index, potentially increasing false-positive classifications for brachycephaly when identical thresholds are applied. Performance varied somewhat between devices, although device effects could not b","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"9 ","pages":"e105473"},"PeriodicalIF":2.3,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13662245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184625","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":"Woebot for Postpartum Mood and Anxiety: Randomized Controlled Trial Evaluating Feasibility, Acceptability, and Preliminary Efficacy of a Mobile Cognitive Behavioral Therapy Intervention.","authors":"Toluwalase Ajayi, Jacqueline Kueper, Jill Waalen, Lauren Ariniello, Edward Ramos, Giulia Milan, Katie Baca-Motes, Andre Williams, Lauren Bullard, Athena Robinson","doi":"10.2196/74083","DOIUrl":"10.2196/74083","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Postpartum psychological distress, ranging from transient mood and anxiety disturbances to full-syndrome postpartum depression, is prevalent. Many postpartum individuals lack access to evidence-based interventions due to stigma and insufficient provider availability. The treatment gap is particularly pronounced among historically marginalized groups, including Black, Hispanic/Latina, and low-income mothers. Digital health interventions offer support to address this.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;We aimed to evaluate the feasibility, acceptability, and preliminary efficacy of Woebot for Postpartum Mood and Anxiety (W-PPMA), a smartphone-based relational agent delivering cognitive behavioral therapy-informed psychoeducation to postpartum individuals.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This randomized controlled trial recruited participants from the PowerMom study, a digital platform for maternal health research. Eligible individuals (≥16 y, &lt;3 mo post partum) were randomized to W-PPMA or a waitlist control condition. W-PPMA, an investigational digital mental health intervention, features a relational agent delivering cognitive behavioral therapy-based psychoeducation via text-based conversations. Primary outcomes included feasibility (Usage Rating Profile-Intervention Revised, Feasibility Subscale), acceptability (Usage Rating Profile-Intervention Revised, Acceptability Subscale), and satisfaction (Client Satisfaction Questionnaire-8) assessed at the 8-week end of intervention (EOI). The secondary outcome was change in depressive symptoms (Patient Health Questionnaire-8) among those with elevated baseline symptoms. Exploratory outcomes included anxiety (Generalized Anxiety Disorder-7 items), stress (Perceived Stress Scale), perinatal depression (Edinburgh Postnatal Depression Scale), Mother-to-Infant Bonding Scale, and therapeutic alliance (Working Alliance Inventory-Short Revised). This study followed CONSORT (Consolidated Standards of Reporting Trials) guidelines and received Institutional Review Board approval.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of 267 participants (W-PPMA=144, waitlist=123), mean age was 32.2 (SD 5.1) years; 12.7% (n=34) identified as Hispanic/Latina, 8.6% (n=23) as Black, and 68.5% (n=183) as White. W-PPMA users engaged with the app a median of 9 (IQR 5-24) days across 4 active weeks (IQR 2-7). At EOI, W-PPMA participants reported high feasibility (Usage Rating Profile-Intervention Revised, Feasibility Subscale median 31, IQR 28-34), acceptability (Usage Rating Profile-Intervention Revised, Acceptability Subscale median 30, IQR 28-34), and satisfaction (Client Satisfaction Questionnaire-8 median 26, IQR 24-29). Among those with baseline depressive symptoms (n=97), Patient Health Questionnaire-8 scores improved modestly in the W-PPMA group compared to waitlist (mean change -0.7, SD 3.4, vs 0.0, SD 4.8; Cohen &lt;i&gt;d&lt;/i&gt;=-0.16). Exploratory analyses showed a statistically significant between-group diff","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"9 ","pages":"e74083"},"PeriodicalIF":2.3,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13662244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184729","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":"Development and Internal Validation of an Interpretable Machine Learning Model for Identifying Past-Year Nonsuicidal Self-Injury Among Adolescents With Depression: Retrospective Study.","authors":"Gaoyang Liu, Chenxi Yang, Wendan Chen, Ningning Ding, Wenwen Tian, Xinwu Ye, Mengdan Luo, Xinnan Mao, Guohua Zhang, Ke Zheng","doi":"10.2196/95340","DOIUrl":"https://doi.org/10.2196/95340","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Nonsuicidal self-injury (NSSI) is common among adolescents with depressive disorders and is associated with substantial clinical burden. Machine learning may assist in identifying multidimensional patterns associated with NSSI, although its incremental value beyond direct clinical assessment remains uncertain.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study compares 7 supervised machine learning model variants for classifying past-year NSSI status among adolescents with depressive disorders and conducts detailed analyses of interpretability, sensitivity, subgroup performance, and clinical utility using a random forest model as the focal exploratory model.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We retrospectively identified 437 adolescents aged 10-19 years who received inpatient or outpatient psychiatric care at 4 hospitals in Zhejiang Province, China, between January 2021 and December 2023. A total of 410 eligible participants were included, of whom 274 reported NSSI during the preceding year. The primary analysis included 67 assessment-time sociodemographic, physiological, biochemical, and clinical-behavioral features. The sample was divided into a training set (287/410, 70%) and an untouched held-out test set (123/410, 30%) using stratified random sampling. Hyperparameters were optimized using 5-fold cross-validation within the training set. Performance was evaluated using discrimination, classification metrics, calibration, and decision-curve analysis. Random forest model behavior was examined using Gini importance, permutation importance, and Shapley Additive Explanations (SHAP).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The radial basis function support vector machine achieved the highest mean cross-validated area under the receiver operating characteristic curve (AUROC) in the training set (0.720), whereas the random forest showed the highest observed AUROC and area under the precision-recall curve (AUPRC) and the lowest Brier score in the held-out test set. The random forest achieved an AUROC of 0.681 (95% CI 0.583-0.778), an AUPRC of 0.808 (95% CI 0.741-0.874), an accuracy of 0.667 (95% CI 0.585-0.748), a sensitivity of 0.720 (95% CI 0.622-0.817), a specificity of 0.561 (95% CI 0.415-0.707), and a Brier score of 0.212 (95% CI 0.188-0.236). Its calibration slope was 1.013. Pairwise AUROC differences between the random forest and alternative models were not statistically significant after Holm correction (Holm-adjusted P values ranged from .17 to .81). The full random forest model did not outperform a suicidal-ideation-only model (AUROC 0.701), whereas excluding suicidal ideation and previous suicide attempt reduced the AUROC to 0.540. A biochemical-only model showed near-chance discrimination (AUROC 0.513). Decision-curve analysis indicated that the random forest provided greater net benefit than the assess-all and assess-none strategies across threshold probabilities of approximately 0.51-0.80. Suicidal ideation showed the mos","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"9 ","pages":"e95340"},"PeriodicalIF":2.3,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138628","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":"Barriers to Reducing Children's Screen Time and Associated Factors Among Mothers of Under-Five Children in Woliso City Administration, Oromia Ethiopia: Community-Based Cross-Sectional Study.","authors":"Ababo Demeke, Wubishet Gezimu","doi":"10.2196/100021","DOIUrl":"10.2196/100021","url":null,"abstract":"<p><strong>Background: </strong>Screen time (ST) is the time spent using screen-based devices and has become a global health concern. Excessive ST negatively impacts children's health and development; however, it has been increasing dramatically among young children. Parents are the primary caregivers responsible for monitoring children's ST. Therefore, identifying potential barriers and their attributes is fundamental to taking early action.</p><p><strong>Objective: </strong>The study aimed to assess barriers to reducing excessive ST and the factors associated with these barriers among mothers of under-five children in Woliso City Administration, Central Ethiopia.</p><p><strong>Methods: </strong>A community-based cross-sectional study was conducted from January 10, 2024, through February 29, 2024. A systematic random sampling technique was used to select 423 mothers of under-five children. EpiData (version 3.1) was used for data entry, and SPSS (version 20) was used for analysis. Linear regression analysis was used to identify factors associated with barriers to reducing ST. The multiple linear regression assumptions were checked, and statistical significance was declared at <i>P</i><.05 with 95% CIs.</p><p><strong>Results: </strong>A total of 423 participants were involved in this study (a 100% response rate). The mean score of barriers among mothers was 4.28 (SD 1.04). Educational status of the mother (β=-0.130, 95% CI -0.255 to -0.004), child's ST (β=0.369, 95% CI 0.328-0.409), parental attitude (β=-0.382, 95% CI 0.264-0.499), parental perceptions of the effect of ST on cognitive well-being (β=0.021, 95% CI 0.009-0.034), parental restrictive practices regarding ST (β=-0.011, 95% CI -0.004 to -0.018), and availability of public facilities (β=0.849, 95% CI 0.759-0.940) were shown to have a significant association with parental barriers.</p><p><strong>Conclusions: </strong>Most mothers of under-five children experienced 4 barriers to reducing ST. The study also identified 6 factors associated with barriers to reducing ST, including level of education, attitudes toward ST, restrictive practices, perceptions of cognitive effects, children's ST, and lack of public facilities. Enhancing access to public spaces, implementing educational programs, and developing community initiatives are recommended to overcome these barriers and support healthy screen habits.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"9 ","pages":"e100021"},"PeriodicalIF":2.3,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13648946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138589","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":"The Arabic Canadian Occupational Performance Measure (Arabic-COPM) in Pediatric Rehabilitation: Quantitative Reliability Study.","authors":"Hikmat Hadoush, Rawan Sweileh, Nihad Almasri","doi":"10.2196/87822","DOIUrl":"https://doi.org/10.2196/87822","url":null,"abstract":"<p><strong>Background: </strong>The Canadian Occupational Performance Measure (COPM) has achieved global implementation across 35 countries in more than 20 language versions. However, its psychometric properties for children with physical disabilities remain unverified.</p><p><strong>Objective: </strong>This study aimed to evaluate the interrater and test-retest reliability of the Arabic version of the COPM (Arabic-COPM) in this pediatric population.</p><p><strong>Methods: </strong>A cross-sectional study was conducted using a convenience sample of parents of children with physical disabilities recruited from multi-rehabilitation centers. For the interrater reliability assessment, 100 parents completed the Arabic-COPM through independent interviews with 2 raters. A subsample of 30 (30%) parents repeated the assessment after a 14-day interval for the test-retest reliability analysis, in which they identified their children's 5 most significant daily activity problems and rated the performance and satisfaction levels for each problem using standardized 10-point scales.</p><p><strong>Results: </strong>Reliability analyses demonstrated excellent psychometric properties. Intraclass correlation coefficients (ICCs) for interrater reliability were 0.84 (performance) and 0.80 (satisfaction), while test-retest reliability coefficients were 0.83 and 0.91, respectively. Interrater agreement analysis revealed 73% concordance in problem prioritization between independent assessors. Bland-Altman plots indicated narrow limits of agreement for both performance (-1.69 to 1.60) and satisfaction scores (-1.03 to 0.98). Cohen κ analysis for problem categorization demonstrated slight-to-fair interrater agreement and slight-to-moderate test-retest agreement across COPM domains. Content analysis identified a predominant concern with daily activities (82%-85% of problems), particularly mobility functions, followed by dressing and eating subcategories.</p><p><strong>Conclusions: </strong>The Arabic-COPM demonstrated excellent reliability metrics for both interrater consistency and temporal stability when administered to parents of children with physical disabilities. These robust measurement properties support its application as a validated instrument for implementing family-centered rehabilitation approaches in Arabic-speaking clinical contexts.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"9 ","pages":"e87822"},"PeriodicalIF":2.3,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138574","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}