Ana Carolina Pereira de Godoy, Reinaldo Bulgarelli Bestetti
{"title":"Hospitalization and Mortality in Brazilian Children and Adolescents Due to COVID-19: Retrospective Study.","authors":"Ana Carolina Pereira de Godoy, Reinaldo Bulgarelli Bestetti","doi":"10.2196/67546","DOIUrl":"https://doi.org/10.2196/67546","url":null,"abstract":"<p><strong>Background: </strong>COVID-19 is currently one of the most important medical challenges as it affects the entire population, with children and adolescents being infected as easily as adults.</p><p><strong>Objective: </strong>The objective of this study was to evaluate the prevalence of mortality in children and adolescents aged <19 years, compared to that of adults.</p><p><strong>Methods: </strong>This retrospective, observational study analyzed the medical records of all patients diagnosed with COVID-19 by real-time reverse transcription-quantitative polymerase chain reaction who were hospitalized at Hospital de Base and the Infant and Maternal Hospital of São José do Rio Preto, São Paulo, Brazil. Out of a total of 8986 hospitalized patients who were COVID-19 positive, 383 (4.26%) were children and adolescents aged <19 years (group 1), and 8603 (95.74%) were adults (group 2).</p><p><strong>Results: </strong>Overall, mortality was significantly higher (P<.001) in group 2 (2185/8603, 25.4%) compared to group 1 (12/383, 3.1%). A total of 11 (92%) of the 12 patients in group 1 that died had associated diseases. The mortality rates by age group were as follows: infants aged <1 year, 1.6% (2/123); children aged 1-4 years, 4% (4/95); children aged 5-9 years, 2% (1/47); adolescents aged 10-14 years, 2% (1/40); and adolescents aged 15-19 years, 5% (4/78).</p><p><strong>Conclusions: </strong>Mortality from COVID-19 in children and adolescents was significantly lower than that in adults and was associated with other comorbidities.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"8 ","pages":"e67546"},"PeriodicalIF":2.1,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112098","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}
Aurora Madrid-Rodríguez, María José Peláez-Cantero, Alfonso Lendínez-Jurado, Ana Suárez-Carrasco, Elena Godoy-Molina, Antonia Gámez-Ruiz, Ana Corripio-Mancera, Yolanda Ramón-Telo, Ana García-Ruiz, Isabel Leiva-Gea
{"title":"Assessing the Impact of a Telemedicine Program on Caregivers of Children With Complex Chronic Conditions: Pre-Post Intervention Study.","authors":"Aurora Madrid-Rodríguez, María José Peláez-Cantero, Alfonso Lendínez-Jurado, Ana Suárez-Carrasco, Elena Godoy-Molina, Antonia Gámez-Ruiz, Ana Corripio-Mancera, Yolanda Ramón-Telo, Ana García-Ruiz, Isabel Leiva-Gea","doi":"10.2196/62953","DOIUrl":"https://doi.org/10.2196/62953","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic was a paradigm shift in global health care. This situation highlighted the role of telemedicine in adapting to the care requirements of pediatric patients and their families by facilitating remote consultations and ensuring continuity of care.</p><p><strong>Objective: </strong>We aimed to establish the usefulness of a telemedicine program for caregivers of children with complex chronic conditions.</p><p><strong>Methods: </strong>We performed a quasi-experimental pre-post intervention study of a telemedicine program, regarding health care system use and caregiver quality of life while comparing two periods: before and during the COVID-19 pandemic. This study included caregivers of children with complex chronic conditions followed-up in a specialized unit.</p><p><strong>Results: </strong>A total of 34 families were included. The mean number of visits per year was higher in the preintervention period for both primary care consultations (P=.03) and hospital-specialized medical consultations (P=.03). The number of emergency room visits per year was lower in the pandemic period compared to the prepandemic period (P=.01). In both groups, an improvement in caregiver quality of life was detected at 12 months (P=.03). However, the Rosenberg self-esteem scale score for the primary caregiver was significantly lower at 3 months compared to the baseline (P=.03).</p><p><strong>Conclusions: </strong>Our study demonstrates that the use of a telemedicine program resulted in decreased scheduled face-to-face care visits and a reduction in the number of emergency department visits. Regarding the caregiver quality of life, outcomes were poorer among families whose children were affected by neurological conditions or were diagnosed at an older age.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"8 ","pages":"e62953"},"PeriodicalIF":2.1,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112078","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":"Covid-19 vaccine uptake, sources of information and side effects reported by pregnant women in Western Australia: A cross-sectional cohort survey.","authors":"Nicole Catalano, Shailender Mehta","doi":"10.2196/66645","DOIUrl":"https://doi.org/10.2196/66645","url":null,"abstract":"<p><strong>Background: </strong>Pregnant women are a priority group for COVID-19 vaccination due to their vulnerability as a high-risk cohort. However, the current pregnancy uptake rate for the COVID-19 vaccination in Western Australia remains largely unknown.</p><p><strong>Objective: </strong>This study aimed to explore pregnant women's uptake rates, information sources and experience of vaccination against COVID-19 during pregnancy. We hypothesise that uptake of vaccination among pregnant women is higher than indicated in previous studies given different disease burden and different public health restrictions at time when data was collected.</p><p><strong>Methods: </strong>A cross-sectional survey was administered electronically to maternity patients at a single tertiary metropolitan hospital in Perth, Western Australia.</p><p><strong>Results: </strong>Five hundred and two women participated in the study. Overall, antenatal COVID-19 vaccination rate was 79% [n=398]. One half [51%, n=256] of all the women felt well informed, and information was sourced primarily from their General Practitioner [GP] [60%, n=301], midwives [35%, n=174] and obstetric doctors [13%, n=64]. Women with non-Caucasian ethnicity [34%, n=170 vs. 66%, n=332, p=0.073] and 'country of birth outside Australia' [47%, n=235] reported lower rates of vaccine information provision by hospital staff [34%, n=22 vs 66%, n=42, P = 0.04].</p><p><strong>Conclusions: </strong>The COVID-19 vaccine uptake was encouragingly high in our study with favourable attitudes and acceptance for the vaccine from majority of pregnant women. This self-reported study also identified opportunities for enhanced cultural competence and further education and training for hospital staff on COVID-19 vaccine information provision to ethnically diverse women. Further studies examining such interventions are warranted.</p><p><strong>Clinicaltrial: </strong></p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121011","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}
Dewi Nur Aisyah, Chyntia Aryanti Mayadewi, Astri Utami, Fauziah Mauly Rahman, Nathasya Humaira Adriani, Erlangga Al Farozi, Meldi Hafizh Sayoko, Aulia Chairunisa, Liza Restiana, Logan Manikam, Zisis Kozlakidis
{"title":"Using WhatsApp for Nutrition Surveillance Among Children Under 5 Years in West Java, Indonesia: Cross-Sectional Survey and Feasibility Study.","authors":"Dewi Nur Aisyah, Chyntia Aryanti Mayadewi, Astri Utami, Fauziah Mauly Rahman, Nathasya Humaira Adriani, Erlangga Al Farozi, Meldi Hafizh Sayoko, Aulia Chairunisa, Liza Restiana, Logan Manikam, Zisis Kozlakidis","doi":"10.2196/58752","DOIUrl":"10.2196/58752","url":null,"abstract":"<p><strong>Background: </strong>Large-scale programs involving nutrition-specific interventions have been carried out in Indonesia as a community-based approach at the primary care level across cities and districts, throughout the age-specific target population (ie, children under 5 years).</p><p><strong>Objective: </strong>The aim of this paper is to describe the potential use of WhatsApp as a tool for recording and monitoring the growth of children under 5 years by Posyandu (Pos Pelayanan Terpadu or community-based health service post), investigating its potential in enhancing health programs and services.</p><p><strong>Methods: </strong>Data were collected from Posyandu cadres in Bogor District, West Java, from March to June 2022. The anthropometric measurement data were reported in real time through a WhatsApp chatbot, automatically analyzed by the system, and presented in a structured dashboard. A qualitative assessment was carried out using a cross-sectional survey conducted from March to July 2022.</p><p><strong>Results: </strong>The study involved 42 Posyandu in 3 villages, engaging 282 staff, and the WhatsApp chatbot recorded anthropometric data for 4571 children under 5 years. The qualitative assessment indicated widespread system utilization, with 50% (45/90) affirming comprehensive data input. Additionally, 66.4% (83/129) found the system easy to use, and 66.7% (82/123) expressed clarity in comprehending variables. Moreover, 75.6% (93/123) found the data input flow easily understood, and 74% (91/123) suggested that the system contributed to enhancing Posyandu activities and the quality of data reporting. Regarding staff proficiency, 63.5% (80/126) affirmed their adeptness in using the system, and 71% (88/124) asserted their high capability in providing training to colleagues.</p><p><strong>Conclusions: </strong>The potential use of WhatsApp as a surveillance tool for recording children's nutritional status is promising, suggesting broader applications within health programs. Nonetheless, this expansion requires additional improvements, including human resource preparation, Posyandu infrastructure development, and strong regulatory support.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"8 ","pages":"e58752"},"PeriodicalIF":2.1,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081043","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}
Zhao Ni, Intan Maharani Sulistyawati Batubara, Jackson Jr Nforbewing Ndenkeh, Georges Bediang, Habakkuk Yumo, Xuehong Zhang, Sunyong Oh, Yuchen Zhao, LaRon E Nelson
{"title":"Likelihood of Leveraging Augmented Reality Technology to Promote HIV Prevention and Treatment Among Adolescent Girls and Young Women in Cameroon: Cross-Sectional Survey.","authors":"Zhao Ni, Intan Maharani Sulistyawati Batubara, Jackson Jr Nforbewing Ndenkeh, Georges Bediang, Habakkuk Yumo, Xuehong Zhang, Sunyong Oh, Yuchen Zhao, LaRon E Nelson","doi":"10.2196/69471","DOIUrl":"10.2196/69471","url":null,"abstract":"<p><strong>Intro: </strong>Adolescent girls and young women in sub-Saharan Africa (SSA) represent 4 out of every 5 newly diagnosed HIV cases among adolescent girls and young women globally. Leveraging augmented reality (AR) technology for HIV prevention and treatment holds significant potential among young people. However, there is a knowledge gap regarding the acceptance of AR by adolescent girls and young women in SSA.</p><p><strong>Objective: </strong>This study aimed to assess the likelihood of adolescent girls and young women in Cameroon using AR for HIV testing, prevention, and treatment. The study findings will lay the groundwork for developing AR-based interventions to prevent and treat HIV in Cameroon and beyond.</p><p><strong>Methods: </strong>This was a cross-sectional survey conducted in Yaounde, Cameroon, in which 637 adolescent girls and young women were recruited using a combination of multistage cluster and snowball sampling techniques. We used an electronic survey to collect data on participants' knowledge, prior use of AR technology, and likelihood of using AR technology for HIV prevention and treatment, and associated factors. Multivariate ordinal regressions were used to analyze the factors associated with the likelihood of adolescent girls and young women using AR to prevent HIV.</p><p><strong>Results: </strong>The study showed that 84% (536/637) of adolescent girls and young women had never heard of AR before this study, and only 8% (49/637) had prior experience using AR. Participants' median age was 22 (IQR 21-24) years, with the majority (362/637, 56.8%) aged between 21 and 25 years. Despite the low usage rate of AR among participants, there was a high likelihood of using AR to promote HIV prevention and treatment. Specifically, 72% (459/637) of participants reported that they were likely to use AR to visualize the HIV transmission process, while 73% (465/637) and 74% (471/637) reported the likelihood of using AR to learn about pre-exposure prophylaxis (PrEP) and how HIV medication lowers HIV viral load, respectively. More importantly, 54% (342/637) and 50% (319/637) of participants reported that they were extremely likely to use AR to learn the correct way of using condom and self-testing for HIV, respectively. The high likelihood of using AR to prevent and treat HIV was associated with a higher education level (P=.01), having ever tested for HIV (P=.03), and a history of previously using health apps or searching for health information on their phones (P<.001).</p><p><strong>Conclusions: </strong>The likelihood of using AR technology to promote HIV prevention and treatment is high among adolescent girls and young women in Cameroon. Future research should focus on exploring the preferred features of AR-based digital health interventions and consider methods of implementing them in the context of Cameroon or SSA.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"8 ","pages":"e69471"},"PeriodicalIF":2.1,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12088605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046570","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}
Nathan Hodson, Peter Ivor Woods, Stephanie Donohoe, Juan Luque Solano, James Gardner, Manuel Giardino, Michael Sobolev, Domenico Giacco
{"title":"Augmenting Parenting Programs With the Pause Mobile App: Mixed Methods Evaluation.","authors":"Nathan Hodson, Peter Ivor Woods, Stephanie Donohoe, Juan Luque Solano, James Gardner, Manuel Giardino, Michael Sobolev, Domenico Giacco","doi":"10.2196/68807","DOIUrl":"10.2196/68807","url":null,"abstract":"<p><strong>Background: </strong>Parenting programs are the recommended treatment for common mental health problems of childhood such as conduct disorder. In the United Kingdom, local authorities have responsibility for providing or commissioning these programs through face-to-face and video call weekly groups and e-learning style asynchronous offerings. However, there has been a shortage of research into the potential of digital resources to augment and enhance parenting groups.</p><p><strong>Objective: </strong>This pilot study aimed to explore whether providing digital microinterventions in a mobile app (Pause) to augment parenting programs is a feasible strategy. Pause fits into parenting programs and prompts and supports parents to use each week's new parenting skill at home. Specifically, we want to understand (1) whether parents use Pause, (2) what type of features or tools in Pause are most frequently used for support, and (3) what are the perceived strengths and weaknesses of Pause.</p><p><strong>Methods: </strong>Pause was provided to parents attending 3 of the most common parenting programs delivered across 3 local authorities in the United Kingdom. During weekly sessions, parents were supported to add \"tools\" in the app, which mapped onto the training in their session, for example, distracting their child, setting age-appropriate consequences, and using praise. Preprogram surveys were obtained at the first session. After programs were completed, postprogram surveys were administered to measure app use, gather which tools parents used, and explore the strengths and weaknesses of the app. Participants and practitioners were invited for interviews, where the strengths and weaknesses of augmenting parenting programs with Pause were discussed in more detail.</p><p><strong>Results: </strong>In total, 53 parents were recruited from groups. A total of 25 of 53 (47%) parents completed postsurveys distributed at their final parenting group session, in keeping with typical rates of attrition in parenting programs. In addition, 7 parents and 3 practitioners agreed to interviews after the program. Most of the parents (23/25, 92%) had used Pause. Other than the journal, used by 17 parents, the most popular tools were the relax tool and praise tool, each used by 10 parents. Survey data revealed specific strengths and weaknesses of the tools in Pause, particularly highlighting that parents wanted Pause to provide more ideas for distraction or relaxation activities. Interviews revealed the challenges parents attending programs face, the range of family members using Pause, and the diverse settings where it was used. Interviews also revealed specific opportunities for improving the user interface and for addressing challenges in the journaling function.</p><p><strong>Conclusions: </strong>This pilot study found good acceptability and engagement with Pause. Interviews revealed promising evidence, suggesting that Pause may improve family life and aid chil","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"8 ","pages":"e68807"},"PeriodicalIF":2.1,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12079061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001397","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":"Evidence of Interventions for the Prevention of Unintentional Injuries: Scoping Review.","authors":"Sheela Shetty, Baby S Nayak, Anice George, Avinash Shetty, Vasudeva Guddattu","doi":"10.2196/67877","DOIUrl":"https://doi.org/10.2196/67877","url":null,"abstract":"<p><strong>Background: </strong>Unintentional injuries are the leading cause of death and disability among young children. Preventive strategies for unintentional injuries are mainly based on surveillance data and identifying risk factors.</p><p><strong>Objective: </strong>This study aimed to review and synthesize published literature that determined the effectiveness of interventions for preventing unintentional injuries among children.</p><p><strong>Methods: </strong>The methodological framework was supported by The Joanna Briggs Institute Reviewer's Manual - Methodology for JBI Scoping Reviews as well as the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. The inclusion criteria to include the studies in the review were unintentional injuries in children, interventions to prevent injuries, a brief description of the intervention and the outcome of the intervention, and articles published in a peer-reviewed journal and written in the English language.</p><p><strong>Results: </strong>In total, 21 articles were included in the review following the systematic search of key databases such as Web of Science, PubMed/MEDLINE, Scopus, ScienceDirect, and gray literature for studies published between July 2013 and May 2023. Of the 21 articles, 16 were randomized controlled trials, 4 were nonrandomized controlled trials, and 1 was a mixed method study. The findings of the review showed that interventions, either as a single measure (video-based teaching, testimonial story-based teaching, health education, storybook reading) or in combination (knowledge quiz and simulation test, module-based teaching along with personal counseling, and teaching with the help of video and poster), have shown a considerable decline in the number and severity of injuries. The studies included various target populations, including children and adolescents between 0 and 19 years old.</p><p><strong>Conclusions: </strong>The review results indicate the need to plan, implement, and reinforce preventive measures and techniques to reduce unintentional injuries among children. They can also serve as a useful indicator for policymakers.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"8 ","pages":"e67877"},"PeriodicalIF":2.1,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12052295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002095","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}
Isobel Butorac, Roisin McNaney, Joshua Paolo Seguin, Patrick Olivier, Jaimie C Northam, Lucy A Tully, Talia Carl, Adrian Carter
{"title":"Developing Digital Mental Health Tools With Culturally Diverse Parents and Young People: Qualitative User-Centered Design Study.","authors":"Isobel Butorac, Roisin McNaney, Joshua Paolo Seguin, Patrick Olivier, Jaimie C Northam, Lucy A Tully, Talia Carl, Adrian Carter","doi":"10.2196/65163","DOIUrl":"https://doi.org/10.2196/65163","url":null,"abstract":"<p><strong>Background: </strong>Approximately 39% of young people (aged 16-24 y) experience mental ill health, but only 23% seek professional help. Early intervention is essential for reducing the impacts of mental illness, but young people, particularly those from culturally diverse communities, report experiencing shame and stigma, which can deter them from engaging with face-to-face services. Digital mental health (DMH) tools promise to increase access, but there is a lack of literature exploring the suitability of DMH tools for culturally diverse populations.</p><p><strong>Objective: </strong>The project was conducted in partnership with a large-scale national DMH organization that promotes evidence-based early intervention, treatment, and support of mental health in young people and their families. The organization wanted to develop a self-directed web-based platform for parents and young people that integrates psychological assessments and intervention pathways via a web-based \"check-in\" tool. Our project explored the views of culturally diverse parents and young people on the opportunities and barriers to engagement with a web-based DMH screening tool.</p><p><strong>Methods: </strong>We conducted a 2-phase qualitative study aiming to identify potential issues faced by culturally diverse communities when engaging with DMH tools designed for the Australian public. We worked with 18 culturally diverse participants (parents: n=8, 44%; young people: n=10, 56%) in a series of design-led workshops drawing on methods from speculative design and user experience to understand the opportunities and barriers that organizations might face when implementing population-level DMH tools with culturally diverse communities. NVivo was used to conduct thematic analyses of the audio-recorded and transcribed workshop data.</p><p><strong>Results: </strong>Five themes were constructed from the workshops: (1) trust in the use and application of a DMH tool, (2) data management and sharing, (3) sociocultural influences on mental health, (4) generational differences in mental health and digital literacy, and (5) stigma and culturally based discrimination in mental health support.</p><p><strong>Conclusions: </strong>The emergent themes have important considerations for researchers wishing to develop more inclusive DMH tools. The study found that healthy parent-child relationships will increase engagement in mental health support for young persons from culturally diverse backgrounds. Barriers to engagement with DMH tools included culturally based discrimination, the influence of culture on mental health support, and the potential impact of a diagnostic label on help seeking. The study's findings suggest a need for culturally safe psychoeducation for culturally diverse end users that fosters self-determination with tailored resources. They also highlight important key challenges when working with culturally diverse populations.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"8 ","pages":"e65163"},"PeriodicalIF":2.1,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12056437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002067","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}
Shimin Zhu, Yuxi Hu, Di Qi, Samson Tse, Ko Ling Chan, Jessica Sun, Paul Lee
{"title":"Effects of Web-Based Single-Session Growth Mindset Interventions for Reducing Adolescent Anxiety: Four-Armed Randomized Controlled Trial.","authors":"Shimin Zhu, Yuxi Hu, Di Qi, Samson Tse, Ko Ling Chan, Jessica Sun, Paul Lee","doi":"10.2196/63500","DOIUrl":"https://doi.org/10.2196/63500","url":null,"abstract":"<p><strong>Background: </strong>Anxiety disorders are the most common mental health conditions worldwide, yet 65% of those affected do not access services. The high prevalence of anxiety and the low rate of intervention uptake highlight the urgent need to develop timely, scalable, and effective interventions suitable for adolescents. This study adapted existing single-session interventions (SSIs) to further develop an SSI focused on a growth mindset regarding negative emotions for adolescent mental health.</p><p><strong>Objective: </strong>The study aims to compare the effectiveness of 4 SSIs, SSI of a growth mindset for anxiety (SIGMA), SIGMA with boosters (SIGMA-Booster), SSI of a growth mindset of personality (SSIGP), and an active control group (support therapy [ST]), in reducing adolescent anxiety.</p><p><strong>Methods: </strong>Classes from each secondary school were randomized to 1 of 4 intervention conditions: SIGMA, SIGMA-Booster, SSIGP, or ST. Each intervention took approximately 45 minutes online. Participants reported on anxiety symptoms (primary outcome), depressive symptoms, suicidal/self-harming thoughts, perceived control, hopelessness, attitude toward help-seeking, and psychological well-being (secondary outcomes) at preintervention, 2-week follow-up, and 8-week follow-up. Participants also completed a feedback scale postintervention. Generalized estimating equations were used to examine the effectiveness of the SSIs.</p><p><strong>Results: </strong>A total of 731 adolescents from 7 secondary schools were randomized. The intent-to-treat analysis found a significant decrease in anxiety symptoms. The mean and 95% CI at baseline were 6.8 (6.0-7.6) for SIGMA-Booster, 6.5 (5.8-7.3) for SIGMA, 7.0 (6.2-7.7) for SSIGP, and 6.9 (6.1-7.7) for ST. At the 2-week follow-up, the mean and 95% CI were 5.9 (5.1-6.7) for SIGMA-Booster, 5.7 (4.9-6.5) for SIGMA, 5.4 (4.6-6.2) for SSIGP, and 5.7 (4.9-6.4) for ST. At the 8-week follow-up, the mean and 95% CI were 5.9 (5.1-6.7) for SIGMA-Booster, 5.3 (4.5-6.0) for SIGMA, 5.6 (4.8-6.4) for SSIGP, and 5.8 (5.1-6.6) for ST. These reductions were observed across all 4 groups. Moderation analysis found that participants with higher motivation for change, higher baseline anxiety scores, and fixed mindsets showed greater improvements in anxiety symptoms. Most participants (459/731, 62.8%) viewed the feasibility and acceptability of the SSIs positively.</p><p><strong>Conclusions: </strong>The SSI for all 4 groups was effective in reducing anxiety and depression among adolescents over 8 weeks. Our data suggest the potential benefits of brief web-based interventions for adolescents, which could serve as scalable, destigmatized, and cost-effective alternatives to school-based programs. The intervention effects may have been underestimated, as this study did not exclude adolescents with minimal or no anxiety symptoms. Future studies should focus on the specific effects of interventions for adolescents with varyi","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"8 ","pages":"e63500"},"PeriodicalIF":2.1,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12048788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054286","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}
Radhwan Hussein Ibrahim, Marghoob Hussein Yaas, Mariwan Qadir Hamarash, Salwa Hazim Al-Mukhtar, Mohammed Faris Abdulghani, Osama Al Mushhadany
{"title":"Adapting Cognitive Behavioral Therapy for Adolescents in Iraq via Mobile Apps: Qualitative Study of Usability and Outcomes.","authors":"Radhwan Hussein Ibrahim, Marghoob Hussein Yaas, Mariwan Qadir Hamarash, Salwa Hazim Al-Mukhtar, Mohammed Faris Abdulghani, Osama Al Mushhadany","doi":"10.2196/67137","DOIUrl":"https://doi.org/10.2196/67137","url":null,"abstract":"<p><strong>Background: </strong>Mental health challenges, including anxiety and depression, are increasingly common among adolescents. Mobile health (mHealth) apps offer a promising way to deliver accessible cognitive behavioral therapy (CBT) interventions. However, research on the usability and effectiveness of apps explicitly tailored for adolescents is limited.</p><p><strong>Objective: </strong>This study aimed to explore the usability, engagement, and perceived effectiveness of a mobile CBT app designed for adolescents, focusing on user experiences and mental health outcomes.</p><p><strong>Methods: </strong>A qualitative study was conducted with 40 adolescents aged 13-19 years (mean age 15.8, SD 1.9 years; 18/40, 45% male; 22/40, 55% female) who engaged with a CBT app for 4 weeks. Mental health diagnoses included anxiety (20/40, 50%), depression (15/40, 38%), and both (5/40, 13%). Of these, 10 (25%) of the 40 participants had previous CBT experience. Feedback was gathered through focus groups and individual interviews, and thematic analysis identified key themes related to usability, engagement, and perceived effectiveness. Quantitative data on mood and anxiety scores were analyzed with paired t tests.</p><p><strong>Results: </strong>The mean usability score was 3.8 (SD 0.6), and the mean effectiveness score was 3.9 (SD 0.7). Older participants (aged 16-19 years) reported significantly higher usability (mean 4.1, SD 0.4) and effectiveness scores (mean 4.3, SD 0.5) compared to younger participants (aged 13-15 years) (P=.03). Females had higher usability (mean 4, SD 0.6) and effectiveness scores (mean 4.2, SD 0.7) than males (mean 3.6, SD 0.7, and mean 3.5, SD 0.8, respectively; P=.03). Participants with prior CBT experience had 2.8 times higher odds of reporting high usability scores (95% CI 1.6-5; P=.002) and 3.1 times higher odds of reporting high effectiveness scores (95% CI 1.7-5.6; P=.001). Usability challenges included complex navigation (20/40, 50%), interface design issues (12/40, 30%), and content overload (8/40, 20%). Factors positively influencing engagement were motivation driven by personal relevance (20/40, 50%) and gamification features (10/40, 25%), while lack of personalization (14/40, 35%) and external distractions (18/40, 45%) were significant barriers. Mood improvement (15/40, 38%) and learning new coping skills (12/40, 30%) were the most reported outcomes.</p><p><strong>Conclusions: </strong>The mobile CBT app shows potential for improving adolescent mental health, with initial improvements in mood and anxiety. Future app iterations should prioritize simplifying navigation, adding personalization features, and enhancing technical stability to support long-term engagement.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"8 ","pages":"e67137"},"PeriodicalIF":2.1,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031730","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}