JMIR Pediatrics and Parenting最新文献

{"title":"Evaluating the Preliminary Efficacy of the TRUST Intervention on Alone-Time and Communication During Well-Adolescent Visits: Quasi-Experimental Study.","authors":"Jyu-Lin Chen, Marissa Raymond-Flesch, Thomas J Hoffmann, Chen-Xi Lin, Ling Xu, Kimberly A Koester","doi":"10.2196/71433","DOIUrl":"10.2196/71433","url":null,"abstract":"<p><strong>Background: </strong>Alone time with health care providers is critical for adolescents, and several professional organizations recommend it. Alone time with providers promotes better utilization of health services, empowers adolescents to manage their health, and facilitates discussions on sensitive issues. However, only 40% of adolescents have private conversations with clinicians during visits. The advancement of mobile health technology provides an excellent opportunity to deliver effective interventions to promote adolescent-provider alone time with adolescents, parents, and providers.</p><p><strong>Objective: </strong>This pilot study aims to explore the preliminary efficacy of a technology-based intervention designed to increase alone time with providers during well-adolescent visits and its impact on trustworthiness, parent-adolescent communication, sexual risk communication, parental monitoring, and parental support before and after the intervention.</p><p><strong>Methods: </strong>A pre- and postintervention design was used. Participants were recruited through local clinics. After obtaining consent, participants accessed a study website to complete a baseline survey, independently interact with 4 educational modules on a website or cellphone, and complete a post-test survey 1 month after their well-adolescent visits. The surveys assessed alone time with providers, trustworthiness, parent-adolescent communication, sexual risk communication, parental monitoring, and parental support. Mixed model analysis and effect sizes were used to evaluate changes in these outcomes from pre- to postintervention.</p><p><strong>Results: </strong>Thirty-two dyads (38 adolescents and 32 mothers) participated in this pilot study. About 86% (n=33) of adolescents and 87% (n=28) of mothers completed the pre- and post-test assessments and the intervention. This study found a trend toward an increase in alone time from 81.6% to 84.4%, albeit not statistically significant. Adolescents initiating alone time with providers rose from 6.45% (n=2) to 18.5% (n=5). Over 90% (n=26) of adolescents reported feeling comfortable in one-on-one interactions with providers postintervention. Mixed model analysis revealed significant improvements among adolescents in parental monitoring (z=2.93, P<.001), sexual risk communication (z=3.11, P<.001), parent-adolescent communication (z=3.11, P<.001), open family communication (z=2.00, P=.04), and parental support (z=2.87, P<.001). For mothers, significant improvements were found in parental monitoring (z=2.45, P<.001) and problem family communication (z=2.24, P=.03).</p><p><strong>Conclusions: </strong>This pilot study demonstrates promising results regarding the preliminary efficacy of a technology-based intervention to increase alone time with providers during well-adolescent visits and to enhance communication and parenting practices. Improving access to alone time and strengthening communication between parents and adol","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"8 ","pages":"e71433"},"PeriodicalIF":2.3,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024376","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":"Evaluating Telepsychiatric Assessment Satisfaction in Children and Adolescents With Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder and Their Caregivers: Randomized Controlled Trial.","authors":"Shunya Kurokawa, Yuko Kawade, Kensuke Nomura, Nana Hosogane, Takashi Nagasawa, Yu Matsumoto, Shuichi Morinaga, Yuriko Kaise, Ayana Higuchi, Akiko Goto, Naoko Inada, Masaki Kodaira, Taishiro Kishimoto","doi":"10.2196/69791","DOIUrl":"10.2196/69791","url":null,"abstract":"<p><strong>Background: </strong>Children and adolescents with attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) often face structural and psychological barriers in accessing medical care, including economic costs, long wait times, and stress of attending new medical environments. The COVID-19 pandemic accelerated the adoption of telehealth services to overcome these challenges. However, few studies have assessed the satisfaction levels of children and adolescents diagnosed with neurodevelopmental disorders and their caregivers when they use telepsychiatry, particularly in Japan.</p><p><strong>Objective: </strong>This study aimed to evaluate satisfaction by conducting telepsychiatric assessments in children and adolescents diagnosed with ADHD or ASD and their caregivers and to identify factors associated with higher satisfaction levels.</p><p><strong>Methods: </strong>A total of 68 patients aged 6-17 years with a confirmed diagnosis of ADHD or ASD and their caregivers participated in this study. The participants were recruited from Keio University Hospital and four collaborating institutions in Japan. Each patient and their caregiver underwent two assessment sessions, one face-to-face and the other via telepsychiatric assessment (a remote video tool), in a randomized order. Upon completing both assessments, the participants completed a satisfaction questionnaire using a 5-point Likert scale that covered aspects such as audio and video quality, seamless communication, perceived warmth, reduced burden, and the ability to behave naturally. Spearman rank correlation coefficients and multiple regression analyses were performed to identify factors associated with overall satisfaction.</p><p><strong>Results: </strong>Among the patients, 70% (47/67) reported being \"satisfied\" or \"very satisfied\" with the telepsychiatric assessment, and 88% (60/68) of caregivers reported similar satisfaction levels. Multiple regression analysis showed that in children, high satisfaction was associated with seamless viewing of the screen, reduced burden of hospital visits, and the ability to speak naturally during the assessment. For caregivers, visual clarity and the child's natural behavior were crucial factors.</p><p><strong>Conclusions: </strong>Telepsychiatric assessments are an effective and practical option to provide care for children and adolescents diagnosed with ADHD or ASD and their caregivers, offering high levels of satisfaction. Technical reliability and reduced travel burden significantly contributed to positive experiences. However, ensuring that children and adolescents behave naturally and feel a sense of warmth during remote assessment is crucial to maximizing their satisfaction. Telepsychiatric services can enhance the quality of health care, making them valuable supplementary tools for clinical practice.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"8 ","pages":"e69791"},"PeriodicalIF":2.3,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12413181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016349","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":"A Mobile Phone App to Support Self-Management and Transition to Adult Health Services in Young People With a Chronic Illness: Single-Arm Pilot Intervention Study.","authors":"Shehani C Samarasinghe, Riham Al Na'abi, Hoi Lun Cheng, Jeffrey Yeung, Katharine S Steinbeck","doi":"10.2196/67061","DOIUrl":"10.2196/67061","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Pediatric to adult health service (AHS) transition is a challenging time for many adolescents and young adults with chronic illness. As the responsibility of illness management shifts from parents to the young person themselves, many young people fail to transition in a timely manner, which has important health consequences. Mobile apps show potential in assisting young people to self-manage their condition during this vulnerable time, but empirical data on app uptake as well as efficacy with respect to transition outcomes and illness control are lacking.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to evaluate the usage of a mobile app called \"TransitionMate\" (TMApp) by adolescents and young adults, which was purpose-built to support chronic illness self-management for youth undergoing transition. Secondary aims were to assess AHS attendance and changes in illness control over the first 12 months post transition. Upon demonstration of TMApp feasibility (49/70, ≥70% of participants using TMApp at least once a month), a randomized controlled trial was planned to test app efficacy in relation to transition and illness control outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Young people aged 16-19 years who were transitioning out of 2 major pediatric hospitals in Sydney, New South Wales, Australia, were recruited. Just before transition, participants' demographic and clinical details were collected, and TMApp was installed on their mobile devices. Participants were contacted by telephone at 6 and 12 months for information on self-reported usage, app usefulness, and other feedback. Quantitative cohort-level usage data, including the number of times specific app features were accessed, were tracked via mobile analytics. At 12 months, electronic medical records from participants' designated AHS were accessed for data on AHS attendances, measures of illness control, and unplanned hospitalizations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In total, 73 adolescents and young adults (30 male; median age 18, IQR 17-18 y) were recruited, with 1 withdrawing participation in the first month. Participants were primarily from 3 chronic illness subgroups-diabetes mellitus (n=23), inflammatory bowel disease (n=19), and cystic fibrosis (n=9). Of the total, 50% (36/72) of participants reported using TMApp at 1 month post transition. Self-reported usage rates fell to 25% and 11% at 6 and 12 months, respectively. Mobile analytics data broadly corroborated self-reported usage. Furthermore, 8 participants who continued to use TMApp for 12 months gave a median usefulness rating of 8/10. Over two-thirds (48/72, 68%) of participants successfully transitioned to their designated AHS by 12 months. Among the successful transitioners who had illness control data available on electronic medical records, over 80% (24/30) maintained a stable or improved illness status at 12 months.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;TMApp was not used regularly enough by ou","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"8 ","pages":"e67061"},"PeriodicalIF":2.3,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12408094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993857","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":"Feasibility, Barriers, and Facilitators of Long-Term Physical Activity Tracking During Treatment: Interview Study Among Childhood Cancer Patients.","authors":"Emma den Hartog, Wim J E Tissing, Sebastian B B Bon, Patrick van der Torre, Emma J Verwaaijen","doi":"10.2196/75322","DOIUrl":"10.2196/75322","url":null,"abstract":"<p><strong>Background: </strong>Children with cancer are at risk of reduced physical activity. Gaining insight into physical activity using smartwatches could improve understanding of individual potential during treatment, support early recognition of aberrant physical activity, and enable tailored support.</p><p><strong>Objective: </strong>This study aimed to explore the feasibility, barriers, facilitators, and considerations of long-term physical activity tracking using a smartwatch during childhood cancer treatment.</p><p><strong>Methods: </strong>In this prospective study, 30 children (age 8-18 years) under active cancer treatment were included in 2 phases. During phase 1, 15 children wore a smartwatch daily for 12 consecutive weeks, and in-depth interviews were conducted to identify principal considerations used to optimize wearability and the methods for phase 2. In phase 2, another 15 children wore the smartwatch, and semistructured interviews were conducted at weeks 1, 3, 6, and 12. These interviews were thematically analyzed to identify barriers and facilitators. An iterative process of alternating data collection and analysis allowed for ongoing method refinement and deepening thematic analysis during the study period.</p><p><strong>Results: </strong>Key considerations for improvement identified in phase 1 led to refinements in phase 2, including enhanced engagement, regular prompts, customized plans, personalized setup, and improved aesthetics and comfort. The interviews conducted during phase 2 identified barriers and facilitators. The 4 most prominent themes were burden and resilience, motivational drivers and perception, insight and evaluation, and user experience and functionality. Feasibility was influenced by the child's physical state and perceived burden. Motivation, perceived value, and expectations played crucial roles in sustaining adherence, while also the balance between positive reinforcement and potential confrontation affected long-term use. User experience, including attractiveness, comfort, and usability, impacted acceptance.</p><p><strong>Conclusions: </strong>Real-time and long-term physical activity tracking using a smartwatch in children during cancer treatment was not feasible in our cohort. A personalized approach, incorporating individual preferences and physical condition, is essential to support adherence.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"8 ","pages":"e75322"},"PeriodicalIF":2.3,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12408935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972153","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":"Content Development for a Multilevel Intervention to Operationalize Behavior Change Theory and Improve Parenting Behaviors for Physical Activity: Descriptive Study.","authors":"Breanne C Wilhite, Erin Hennessy, Christina Economos, Jennifer Sacheck, Rachel Zive, Christine Odalen, Stephanie Herrick, Daniel P Hatfield","doi":"10.2196/73510","DOIUrl":"10.2196/73510","url":null,"abstract":"<p><strong>Background: </strong>Theory-informed strategies for engaging parents in children's physical activity (PA) promotion show promise. However, behavior-change interventions must become more rigorous in both their application of theory and the reporting of its use to continue to advance the field.</p><p><strong>Objective: </strong>This study aims to elucidate how 2 behavior change theories were used to develop parent communication materials in a 20-week communications campaign, nested within a multilevel (school-home) intervention to promote children's PA. The innovation described in this study is derived from the Supporting Physical Literacy at School and Home (SPLASH) feasibility study (2021-2022).</p><p><strong>Methods: </strong>A team of 7 experts, including graduate students, researchers, faculty, and child PA specialists, collaboratively designed the process used to develop the intervention content. With experience in theory-informed interventions and health-related communication campaigns, they held recurring meetings to refine the approach.</p><p><strong>Results: </strong>A four-step process was used to develop the theory-informed parent communication materials: (1) establish a theoretical foundation for communication materials (ie, social cognitive theory and self-determination theory) and conduct focus groups with the priority population; (2) identify and select PA parenting behaviors aligned with evidence and behavioral theories to form PA parenting objectives that advance children's PA; (3) identify theoretical determinants of parent behavior change and outline methods for applying determinants to address PA parenting objectives; (4) operationalize theory-informed strategy and draft, review, and finalize materials. Parent communications were delivered through print materials and electronic channels, including email, text messages, Facebook (Meta Platforms, Inc), and activity videos.</p><p><strong>Conclusions: </strong>This descriptive study advances progress in the development of school-based PA promotion efforts seeking to incorporate parent engagement strategies by detailing how behavior-change theories can be operationalized to improve PA parenting behaviors. This methodology is valuable for others seeking to translate theoretical constructs into behavior-change communication messages.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"8 ","pages":"e73510"},"PeriodicalIF":2.3,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12379748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972582","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":"Understanding the Implications of mHealth Technology in Collaborative Care Programs and Its Role in Supporting Postpartum Care: Qualitative Interview Study of the Baby2Home Intervention Using the Parallel Journeys Framework.","authors":"Chryselle Rego, Joshua E Santiago, Emily S Miller, Craig F Garfield, Jacqueline Gollan, Kathleen O'Sullivan, Dinah Williams, Enid Montague, Young Seok Lee","doi":"10.2196/70936","DOIUrl":"10.2196/70936","url":null,"abstract":"<p><strong>Background: </strong>The postpartum period represents a critical period for both birthing and nonbirthing parents due to mental health concerns and new caregiving demands. Collaborative care models aim to address these needs, but postpartum care remains fragmented, lacking continuity and holistic support. Baby2Home (B2H) is a digital intervention rooted in the collaborative care model, specifically designed to support parents through their transition into parenthood by addressing their physical, emotional, and psychosocial needs. This intervention seeks to close the gaps left by traditional care models by providing continuous, organized, and accessible support throughout the postpartum period. In our qualitative study of the B2H intervention, we reference the parallel journeys framework and use it as a part of our analysis to evaluate whether mobile health (mHealth) technology addresses the holistic needs (postpartum and psychosocial) of new parents.</p><p><strong>Objective: </strong>We aimed to assess how the B2H app supports the holistic needs of new parents and addresses care gaps identified in traditional postpartum services.</p><p><strong>Methods: </strong>We conducted semistructured interviews with 20 birthing and nonbirthing parents selected through purposive sampling based on their app use. Data were analyzed using the postpartum parallel journeys framework and inductive coding.</p><p><strong>Results: </strong>Our findings demonstrate the comprehensive impact of the B2H intervention in addressing both the physical and psychosocial needs of new parents. B2H supported postpartum care by helping parents navigate uncertainties, enhancing health care provider-parent communication, promoting self-care, and increasing parental self-efficacy. Psychosocial support included symptom identification, timely care manager assessments, coordinated treatment, and transition resources. The app also addressed care gaps by promoting inclusivity for nonbirthing parents, bridging screening and treatment, supporting real-time treatment navigation, and ensuring continuity of care.</p><p><strong>Conclusions: </strong>We demonstrate that the use of mHealth technology such as the B2H app can effectively support the multifaceted needs of new parents during their postpartum care period. By applying the parallel journeys framework, the research also identifies gaps in care that are addressed by the B2H app, presenting unique opportunities for future development and research.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"8 ","pages":"e70936"},"PeriodicalIF":2.3,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12421202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972161","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 Cold and Vibration on Venipuncture Pain Management in Children Aged 2-7 Years Old: Randomized Controlled Trial.","authors":"Zi-Yun Zhou, Long-Yi Hu, Ming-Li Wang, Si-Qi Li, Le-Shan Zhou","doi":"10.2196/67918","DOIUrl":"10.2196/67918","url":null,"abstract":"<p><strong>Background: </strong>The pain resulting from venipuncture is one of the primary sources of stress during childhood and can have adverse effects on children. The Buzzy device can play an important role in alleviating the pain of venipuncture in children.</p><p><strong>Objective: </strong>The aim of this study is to investigate the independent and combined effects of cold and vibration in reducing venipuncture pain and resistance behavior in children aged 2-7 years.</p><p><strong>Methods: </strong>A total of 130 children who underwent venipuncture were randomly assigned to 4 groups: 32 in the control group, 30 in the external cold group, 37 in the vibration group, and 31 in the cold combined with vibration group. The cold, vibration, and cold combined with vibration interventions used the Buzzy device. Nurses used the Face, Legs, Activity, Cry, Consolability Pain Behavior Scale and the Children's Behavior Scale to assess pain and resistance behaviors before and during the venipuncture.</p><p><strong>Results: </strong>Compared with the control group, the cold group, vibration group, and cold combined with vibration group experienced milder pain and demonstrated weaker resistance behavior (P<.05). Pairwise comparison results showed that the combination group was superior to the vibration group (P<.05).</p><p><strong>Conclusions: </strong>External cold and vibration are effective in reducing procedural pain and improving compliance in children aged 2-7 years undergoing venipuncture. The cold combined with vibration has a synergistic effect, and the effect is better than vibration only.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"8 ","pages":"e67918"},"PeriodicalIF":2.3,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12377409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971642","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":"Evaluating a Digital Intervention to Reduce Aggression and Pro-Firearm Violence Attitudes Among Young Black Males: Pretest-Posttest Feasibility Study.","authors":"Chuka Emezue, Jessica Bishop-Royse, Andrew Froilan, Tara Wilkes, Niranjan S Karnik, Wrenetha A Julion","doi":"10.2196/70048","DOIUrl":"10.2196/70048","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Pediatric and adolescent firearm injuries and fatalities in the United States have surged to levels not seen since the mid-1990s, marking a critical public health inflection point. Young Black males (ages 15-24) experience firearm-related fatality rates 24 times higher than their White peers. Despite this disproportionate risk, they are less likely to participate in traditional firearm violence prevention programs. This disparity highlights the urgent need for innovative, culturally responsive approaches that address the emotional, behavioral, and social determinants of violence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This pilot study aims to evaluate the preliminary effects of BrotherlyACT, a culturally responsive, trauma-informed, multicomponent mobile and web-based intervention designed to support young Black males (ages 15-24) in navigating and preventing community violence, substance use, and mental health challenges. The intervention aims to increase access to precrisis support and mental health resources for youth living in low-resource, high-violence settings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Seventy young Black males with Serious Fighting, Friend Weapon Carrying, Community Environment, and Firearm Threats (SaFETy) scores between 1 and 5 (indicating low-to-moderate firearm violence risk) were enrolled in this prospective pretest-posttest study. Participants completed a psychoeducational component of the BrotherlyACT intervention, consisting of 7 video-based modules. Surveys were administered at baseline and again 4 weeks later to assess changes in attitudes toward guns and violence (Attitudes Toward Guns and Violence Questionnaire), reactive and proactive aggression (Reactive-Proactive Aggression Questionnaire), psychological distress (Kessler Psychological Distress Scale), and depressive symptoms (8-item Patient Health Questionnaire). Paired t tests were conducted to analyze pre-post differences.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 70 young Black males (mean age 20.97 years, SD 2.44 years) participated in the study. Nearly half reported recent physical fights (48/70, 69%), gun threats (39/70, 56%), or hearing gunshots in their neighborhood (63/70, 90%). More than 50% (39/70, 56%) reported illicit drug use, and 32 out of 70 (46%) reported substance-related violence. SaFETy scores revealed heterogeneous but elevated exposure to firearm risk factors, particularly in community violence and firearm threats. Postintervention, participants demonstrated a statistically significant reduction in attitudes toward guns and violence (Attitudes Toward Guns and Violence Questionnaire; mean 29.8-26.1, P&lt;.001, d=0.53), with the largest shift observed in \"Aggressive Response to Shame\" (28% reduction). Reactive aggression significantly declined (mean 10.48-8.67, P=.008, d=0.37), whereas proactive aggression remained stable. Psychological distress and depressive symptoms remained stable. Nearly all participants (68/70, 97%) ","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"8 ","pages":"e70048"},"PeriodicalIF":2.3,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972243","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":"Development and Implementation of a Birth Forecasting Tool to Optimize Resources in Obstetrical Care During the COVID-19 Pandemic: Mixed-Methods Study.","authors":"Huibert-Jan Joosse, Karin Jongsma, Marcel Moes, Kitty W Bloemenkamp, Wouter M Tiel Groenestege, Wouter W van Solinge, Saskia Haitjema, Maarten B Kok","doi":"10.2196/68284","DOIUrl":"10.2196/68284","url":null,"abstract":"<p><strong>Background: </strong>Medical resource allocation is important to ensure availability of care, especially in challenging circumstances like a pandemic. In fields of unpredictable care demand such as obstetrics, forecasting may help manage scarce resources.</p><p><strong>Objective: </strong>The development, validation, and implementation of a regional birth forecasting tool to support obstetrical staff planning in the Utrecht region during the COVID-19 pandemic.</p><p><strong>Methods: </strong>We combined predicted birth dates retrieved from Saltro, a large regional primary care laboratory, with data from the Dutch national perinatal registry (Perined) and Statistics Netherlands for model development. We created and implemented an HTML tool visualizing these forecasts, which were discussed during the regional acute obstetric health care network meetings. Six months after implementation, we assessed the impact of the tool using an evaluative stakeholder meeting.</p><p><strong>Results: </strong>We achieved a performance accuracy (R) of 0.45, 0.61, and 0.67 (all actual number of births within 95% CI) forecasting the number of births in the region, pooled in 1-, 2-, and 3-weekly bins, respectively. After presenting these findings to stakeholders, we implemented a forecasting tool using the 2-week bin model. The evaluative stakeholder meeting proved that the tool improved communication, awareness of health care need, and collaborations among health care providers in the Utrecht region. Additionally, stakeholders identified additional applications, such as communication with patients and training of obstetric health care providers.</p><p><strong>Conclusions: </strong>Implementation of a forecasting tool for the number of births based on available data across the health care system added value to obstetrical care by providing insight into care demand, and increasing communication, awareness, and collaboration between health care providers. Further research should aim at improving regional obstetric acute care by fostering data sharing in order to improve health care demand forecasts.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"8 ","pages":"e68284"},"PeriodicalIF":2.3,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12373259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972642","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":"Usability Testing of an Internet-Based Responsive Parenting Program for Caregivers of Young Survivors of Childhood Cancer Living in Rural and Appalachian Communities: Mixed Methods Study.","authors":"Emily L Moscato, Eva Darow, Jessica Quach, Adrien M Winning, Matthew Schmidt, Shari L Wade, Cynthia A Gerhardt, Emre Sezgin","doi":"10.2196/70055","DOIUrl":"https://doi.org/10.2196/70055","url":null,"abstract":"<p><strong>Background: </strong>Young survivors of childhood cancer diagnosed and treated before the age of 7 years are at heightened risk of developmental difficulties. As a result, their caregivers may experience stress as they navigate various educational and health care systems while advocating for their child's needs. To our knowledge, there are no tailored early interventions or support programs to address the unique and multifaceted needs of young survivors of childhood cancer and their caregivers. Digital platforms can provide anticipatory guidance and developmental resources, which may be especially impactful for families at increased risk for health and educational disparities, particularly in underserved rural and Appalachian areas.</p><p><strong>Objective: </strong>This mixed methods study describes the usability testing of an internet-based responsive parenting program for caregivers of young survivors of childhood cancer, called the Preparing for Life and Academics for Young Survivors (PLAY) program.</p><p><strong>Methods: </strong>Twelve caregivers of young survivors of childhood cancer (9 biological parents, 2 grandfathers, and 1 legal guardian; 33% rural, 33% Appalachian, and 83% White) participated in an online usability session with a task-based, think-aloud method. This session was followed by completion of the System Usability Scale (SUS), responses to reaction cards to describe their experiences with the platform, and a semistructured interview. Two trained coders used rapid analysis and consensus methods to identify themes.</p><p><strong>Results: </strong>Overall, caregivers found the platform easy to use (92% SUS >68; mean 82.2, SD 14.45). Most caregivers provided positive feedback in response to reaction cards (eg, useful, appealing, and valuable) to describe the platform. Qualitative findings highlighted that most caregivers perceived the platform as \"easy to use,\" and several participants described it as a helpful educational tool. Participants noted that potential platform improvements should include accessibility features (eg, closed captioning for videos), more tailored content, and usability on mobile devices.</p><p><strong>Conclusions: </strong>With further improvements, digital platforms such as PLAY may be a promising avenue to bridge access to care for high-need groups and ultimately improve child neurodevelopmental outcomes.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"8 ","pages":"e70055"},"PeriodicalIF":2.3,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144790228","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}