JMIR Pediatrics and Parenting最新文献

{"title":"Motivational Drivers for Teachers as Informal Health Educators to Initiate In-Class Discussions With Adolescents About Smoking: Moderated Mediation Study Using Attribution Theory.","authors":"Anna Joy Russ, Anna Bullo, Peter J Schulz","doi":"10.2196/81959","DOIUrl":"10.2196/81959","url":null,"abstract":"<p><strong>Background: </strong>Teachers have the potential to be influential figures in school-based health promotion as informal caregivers; yet little is known about what motivates them to initiate preventive conversations with students. Attribution theory offers a useful framework to explore how perceptions of responsibility shape communicative behavior, but it has rarely been applied in the context of teacher-student interactions around health risks such as smoking.</p><p><strong>Objective: </strong>This study applies the attribution theory to explore the motivational drivers that lead teachers to initiate discussions with adolescents about smoking.</p><p><strong>Methods: </strong>Data were collected from 101 middle schools in the Canton of Ticino, Switzerland, as part of a larger longitudinal study. The analysis focuses on 67 teachers who participated in the first wave. Responsibility attribution, concern, and previous classroom sanctions were examined in association with teachers' communication.</p><p><strong>Results: </strong>Results from a moderated mediation model showed that teachers who attributed greater responsibility to the school (internal attribution) reported higher levels of concern (β=-0.41; P=.002) and engaged in more frequent in-class discussions on smoking (β=-0.26; P=.02). Although concern alone was not directly related to communication (β=-0.14; P=.22), its effect was significantly moderated by contextual sanctions (β=1.01; P<.001).</p><p><strong>Conclusions: </strong>These findings highlight the motivational and contextual factors that shape teachers' communication with students on smoking behavior. By applying attribution theory in the novel context of health communication, this research contributes to understanding how perceived responsibility influences preventive communication in schools.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"9 ","pages":"e81959"},"PeriodicalIF":2.3,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718060","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":"Questionnaires used to explore the perspectives of parents and health professionals on young children's use of technology: A systematic review.","authors":"Charlotte Lund Rasmussen, Ivan Pui Hung Au, Danica Hendry, Amber Beynon, Sarah Stearne, George Thomas, Kate Mannell, Lisa Kervin, Susan Edwards, Courtenay Harris, Leon Straker, Juliana Zabatiero","doi":"10.2196/84712","DOIUrl":"https://doi.org/10.2196/84712","url":null,"abstract":"<p><strong>Background: </strong>Technology is integrated into many children's daily lives, with parents' and health professionals' perspectives shaping children's technology use. Measuring and understanding these perspectives is essential for developing strategies for supporting adults in decision-making that help children thrive in a digital world.</p><p><strong>Objective: </strong>This systematic review aimed to investigate the psychometric properties of questionnaires used to assess parents' and health professionals' perspectives on young children's use of technology related to health, wellbeing, and development. The secondary aim was to synthesize findings on these perspectives.</p><p><strong>Methods: </strong>Peer-reviewed articles published between January 2010 and September 2024 were identified through searches in seven electronic databases. Studies were included if they examined parental or healthcare professionals' perspectives on technology use among children aged birth-5 years. Two reviewers independently conducted the data extraction and study quality assessment. Reported psychometric properties of the questionnaires were synthesised. Deductive thematic analysis was utilised to explore the content focus of the questionnaire used in the included studies and synthesise the reported perspectives.</p><p><strong>Results: </strong>Eighty-five studies were included, all involving parents. No study investigated health professionals' perspectives. The methodological quality of the studies was generally low with 62 studies scoring below the threshold for acceptable quality. Fifty-two studies reported psychometric properties of the questionnaires used of which only 15 studies reported more than one measure of validity or reliability. Seventy-five studies reported participants' perspectives on children's technology use. Findings revealed that parents generally supported the role of digital devices in enhancing learning but expressed concerns about potential negative impacts on children's physical health, emotions, and behaviours.</p><p><strong>Conclusions: </strong>Parents' perspectives on children's technology use were frequently assessed through questionnaires, though the validity of these questionnaires was often poor, with limited psychometric testing. Parental perspectives were mixed with educational benefits being recognised, while countered with concerns about the impact on children's physical health and development. High-quality questionnaires are needed to generate stronger evidence informing strategies to support families in technology use decision-making with and for children.</p><p><strong>Clinicaltrial: </strong></p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730258","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":"Family Engagement in a Digital Intervention Targeting Risk for Anxiety in Parent-Child Dyads: Mixed Methods Study.","authors":"Isaac A Mirzadegan, Ericka M Lewis, Sally L Cole, Alexandria M Meyer","doi":"10.2196/79898","DOIUrl":"10.2196/79898","url":null,"abstract":"<p><strong>Background: </strong>Digital health programs are increasingly important in the treatment and prevention of mental health problems in young children. However, suboptimal family engagement with a program may hamper its effectiveness. Family engagement in digital mental health programs is multifaceted and poorly understood, with ill-defined relationships among aspects of participation and program outcomes (ie, what constitutes effective engagement). Moreover, little is known about the barriers and facilitators to effectively engaging families at risk for anxiety, who may not be actively seeking treatment.</p><p><strong>Objective: </strong>Making Mistakes is a novel, internet-based, cognitive behavioral preventive program for caregivers and their 5- to 7-year-old children, which aims to reduce the risk of anxiety by targeting family transmission of perfectionism or error sensitivity-that is, negative overreactivity to mistakes. This mixed methods study examined multiple facets of parent-and-child engagement in Making Mistakes, including adherence, cognitive and affective engagement, barriers, facilitators, and perceived outcomes associated with involvement.</p><p><strong>Methods: </strong>A total of 87 dyads were included in a quantitative analysis of adherence to the program, including overall adherence and sustained engagement. Eighteen dyads completed qualitative interviews, which were subjected to a qualitative thematic analysis. Finally, a sample of Making Mistakes activity journals was qualitatively reviewed and synthesized.</p><p><strong>Results: </strong>Parent and child adherence were strongly positively correlated (r85=0.95). Dyads had low adherence to the weekly modules, which did not differ by intervention condition. Completion rates averaged 20%, with adherence declining over time. In contrast, qualitative data indicated high levels of investment in program content and topics, elucidated barriers and facilitators to program engagement, and highlighted numerous psychosocial benefits.</p><p><strong>Conclusions: </strong>Engagement, operationalized as rote adherence to an intervention developer's criteria, may insufficiently capture the aspects of participation that are most meaningfully related to positive outcomes. Researchers and intervention developers should prioritize cognitive and affective aspects of engagement with program content, along with promoting and assessing behavioral engagement beyond adherence to program components. Making Mistakes shows promise as a low-cost, disseminable strategy to reduce intergenerational risk for anxiety. These findings have particular relevance for digital health programs focused on prevention, parent-child dyads, and anxiety and perfectionism.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"9 ","pages":"e79898"},"PeriodicalIF":2.3,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13064961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646922","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":"Brazilian Immigrant Parents' Perspectives on Oral Health in Early Childhood and Suggested Strategies for Education, Access, and Care: Qualitative Study.","authors":"Ana Cristina Lindsay, Denise Lima Nogueira, Steven A Cohen, Mary L Greaney","doi":"10.2196/78835","DOIUrl":"10.2196/78835","url":null,"abstract":"<p><strong>Background: </strong>Oral health in early childhood is vital for long-term well-being, yet dental caries is highly prevalent among young children in the United States, especially in low-income and immigrant families. Brazilian immigrants, a rapidly growing Latin American population in the United States, face distinct barriers to oral health care, such as language differences, limited access to care, and a lack of culturally tailored resources. Despite this, Brazilian immigrants are understudied in public health research. Understanding Brazilian immigrant parents' perspectives is essential to advancing oral health equity through culturally responsive strategies.</p><p><strong>Objective: </strong>This study aims to understand (1) parents' views on the best ways to support their children's oral health, (2) perceived barriers to oral health care, and (3) preferred methods and strategies for addressing barriers and receiving oral health education and care.</p><p><strong>Methods: </strong>This qualitative study usedin-depth, semistructured interviews with Brazilian immigrant parents. Guided by the social ecological model, the data were thematically analyzed to identify multilevel influences on oral health behaviors as well as intervention preferences.</p><p><strong>Results: </strong>Forty-eight Brazilian immigrant parents (29 mothers and 19 fathers) participated. Most had low acculturation levels and lived in primarily Portuguese-speaking households. Parents stressed the need for early, community-based oral health education in schools and daycares. They preferred visual and digital materials, such as videos, apps, and cartoons in Portuguese to overcome language barriers. Parents spoke of language and cultural challenges, limiting access and reducing confidence in navigating care. Access to affordable dental services was a major concern. Parents supported expanded school-based services and culturally welcoming care. Notably, mothers often focused on home routines and navigating systems, while fathers emphasized community outreach and structural barriers.</p><p><strong>Conclusions: </strong>Brazilian immigrant parents called for linguistically and culturally tailored oral health programs to be offered in trusted community settings, along with improved dental care access through policy changes and expanded insurance coverage. Multilevel strategies addressing both behavioral and systemic barriers show promise in reducing disparities. Future efforts should prioritize the development and evaluation of scalable, culturally responsive models that meet the needs of Brazilian immigrant families.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"9 ","pages":"e78835"},"PeriodicalIF":2.3,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13055948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634591","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":"mHealth-Enabled Stroke Screening for Pediatric Sickle Cell Disease in Low-Resource Settings: Systematic Literature Review of Critical Barriers, Emerging Technologies, and AI-Driven Solutions.","authors":"Nursat Jahan, Seung Yup Lee, Nafisa Anjum, Monica Swahn, Sangsun Choi, Andrew Peachey, Sweta Sneha, Chitalu Kabwe, Nazmus Sakib","doi":"10.2196/76937","DOIUrl":"10.2196/76937","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Sickle cell disease (SCD) is a genetic blood disorder affecting millions globally, with life-threatening complications, and most patients live in sub-Saharan Africa. Particularly, children with SCD have a high risk of stroke. Although early screening for stroke could help prevent many cases, access to effective stroke screening remains limited in low-resource settings (LRS). Existing traditional approaches are highly operator-dependent, costly, resource-intensive, or difficult to deploy at scale in pediatric care. These limitations highlight the urgent need for accessible, scalable, and child-appropriate stroke screening and assessment tools suitable for low-resource health care contexts.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The aims of this systematic literature review are to (1) uncover system-level barriers affecting stroke screening accessibility for patients with pediatric sickle cell disease (PSCD) in LRS, including underserved contexts within high-income countries; (2) identify existing and emerging stroke screening and assessment technologies and their implementation characteristics, such as feasibility, scalability, portability, and training requirements; and (3) propose a user-centered mobile health (mHealth) framework for stroke screening that improves accessibility and feasibility in resource-constrained health care settings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed to organize the search process. A systematic search was conducted using an advanced query and defined eligibility criteria in the academic databases of PubMed, IEEE Xplore, Wiley Online Library, and Google Scholar. Studies published in English between January 1, 2021, and October 31, 2025, were selected. Collected data were arranged in a preformatted Microsoft Excel spreadsheet for analysis. Risk-of-bias assessment was performed using various risk-of-bias assessment tools because of the heterogeneity of the included studies. Narrative synthesis was used for data synthesis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The literature search initially identified 1465 studies, of which 28 (2%) were selected for analysis. Among the 28 studies, 10 (36%) focused on stroke screening accessibility for patients with PSCD in either low- and middle-income countries or other income-level countries for LRS, and 18 (64%) outlined key features and the feasibility of stroke screening technologies. Identified barriers were organized into 4 major categories (workforce and training constraints, health care system and infrastructure barriers, sociocultural and awareness factors, and economic and logistical constraints), emphasizing difficulties in accessing stroke screening in LRS. Additionally, existing and emerging stroke screening technologies were classified into 5 groups: nonimaging, imaging, light-based optical spectroscopy, biomarker-based, and artificial intelligence- and machine","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"9 ","pages":"e76937"},"PeriodicalIF":2.3,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13053000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628737","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":"Screen Time, Child Depression, and Anxiety During the COVID-19 Pandemic: Systematic Review and Meta-Analysis.","authors":"Marissa Yoshizawa, Jennifer Rafeedie, Jasmyn J Tang, Bryan T Lei, Ramon Durazo-Arvizu, Danny Azucar, Sharon Hudson, Sheela Rao, Karen Kay Imagawa, Alexis Deavenport-Saman","doi":"10.2196/83228","DOIUrl":"10.2196/83228","url":null,"abstract":"<p><strong>Background: </strong>In response to the COVID-19 pandemic, governments around the world enforced stay-at-home orders and social distancing guidelines that amplified the use of screen time among pediatric populations. Excessive screen time may negatively impact mental health by increasing depression and anxiety.</p><p><strong>Objective: </strong>The first aim was to conduct a systematic review of articles examining screen time and mental health outcomes among children and adolescents during the COVID-19 pandemic from 2020 to 2023. The second aim was to determine the combined effect sizes for the associations of screen time and depression and/or anxiety among children and adolescents during the COVID-19 pandemic from 2020 to 2023 and whether gender or age influenced outcomes.</p><p><strong>Methods: </strong>Bibliographic databases were searched including MEDLINE (Ovid), Embase (Elsevier), Cochrane Library (Wiley), CINAHL Complete (EBSCO), and PsycINFO (EBSCO). There were a total of 6462 nonduplicate studies that were screened. Study inclusion criteria included children ages 0 to <18 years, the effects of screen time on children during the COVID-19 pandemic, screen time and depression and/or anxiety, articles written in English, and articles, including quantitative and qualitative studies, published between 2020 and 2023. A total of 452 articles underwent full-text review with 23 articles meeting criteria for final article extraction.</p><p><strong>Results: </strong>A total of 23 studies totaling 29,581 children and adolescents were included in the study. Results showed that most studies reported a positive association between screen time and depression and/or anxiety (r=0.175, 95% CI 0.124-0.226, P<.001 and r=0.157, 95% CI 0.0994-0.214, P<.001, respectively) during COVID-19. Meta-regression revealed that screen time measured in problematic use of electronic devices had a 0.15 higher correlation with anxiety compared to screen time measured in duration of electronic device use.</p><p><strong>Conclusions: </strong>During the COVID-19 pandemic, children and adolescents with higher levels of screen time had increased depression and/or anxiety. Findings suggest the need for ongoing parent, professional, and self-monitoring of youth screen behaviors and habits as well as activities that promote social connectedness during global or national health emergencies.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"9 ","pages":"e83228"},"PeriodicalIF":2.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13041624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595023","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":"Explanatory Factors of Vaccination Dropout Among Children Aged 12 to 23 Months in the Kikula Health Zone, Democratic Republic of Congo: Cross-Sectional Analytical Study.","authors":"Blaise Musoya Mumba, Fiston Ilunga Mbayo, Pacifique Kanku Wa Ilunga, Hermann Tamubango Kitoko, Pascal Geri Madragule, Jean Nyandwe Kyloka","doi":"10.2196/88879","DOIUrl":"10.2196/88879","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Vaccination is among the most effective public health interventions to reduce childhood morbidity and mortality. Despite World Health Organization recommendations, global immunization coverage has declined in recent years, with the COVID-19 pandemic causing the largest sustained backslide in routine immunization in 3 decades. In the Democratic Republic of Congo (DRC), full immunization coverage remains below 50%, hindered by inequities, supply shortages, and financing delays. In the Kikula Health Zone, administrative reports suggest coverage exceeding 100%, yet independent surveys consistently reveal low completion and high dropout rates between Bacillus Calmette-Guérin (BCG) and measles vaccines. No previous study has specifically examined determinants of dropping out in this setting.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study assessed the prevalence and determinants of vaccination dropout between BCG and measles vaccines among children aged 12 to 23 months in the Kikula Health Zone, Likasi, DRC.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;An analytical cross-sectional survey was conducted from April 22 to May 22, 2025, using 3-stage cluster sampling to recruit 300 mother-child pairs. Vaccination status was verified using cards; for children without documentation, caregiver recall and health facility registers were used to minimize misclassification. Structured questionnaires captured sociodemographic data, child characteristics, maternal knowledge, perceptions of services, and health system access. Dropout was defined as receipt of BCG but not the measles vaccine. Bivariate associations were tested using chi-square tests, and multivariate logistic regression identified independent predictors, with robust SEs to account for clustering. Ethics approval was obtained from the University of Kinshasa School of Public Health.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among 300 children, 115 (38.3%) had dropped out between BCG and measles vaccination, while 185 (61.7%) completed the schedule. Possession of a vaccination card was the strongest predictor: children without a card had 30-fold higher odds of dropout (adjusted odds ratio 30.9, 95% CI 11.6 82.0; P&lt;.001). Other factors associated with dropout in bivariate analysis included shorter residence duration (≤5 y), lower maternal education, and nonuse of child health services, although these lost significance in multivariate models. Maternal knowledge gaps were notable: 169 (56.3%) did not know their child's vaccination status and 148 (49.3%) expressed fear of side effects. Service perceptions were generally positive (participants reporting good reception: n=294, 98%), but 108 (36%) experienced waiting times of 1 to 2 hours. The exclusion of undocumented children likely led to underestimation of dropout prevalence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Vaccination dropout between BCG and measles remains high in the Kikula Health Zone, driven primarily by lack of vaccination cards and materna","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"9 ","pages":"e88879"},"PeriodicalIF":2.3,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13037574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595039","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":"Relationship Among Internet Use, eHealth Literacy, Internet Addiction, and Physical Activity Among Adolescents: Cross-Sectional Study.","authors":"Xavier C C Fung, Joyce S C Cheung, Fay F Wang, Benson W M Lau, Shirley P C Ngai","doi":"10.2196/83936","DOIUrl":"10.2196/83936","url":null,"abstract":"<p><strong>Background: </strong>The internet is highly convenient and has become an indispensable part of daily life. However, its widespread use also has notable disadvantages, such as the risk of internet addiction. Still, increased internet use may enhance eHealth literacy, and online health information seeking may contribute to health promotion. In Hong Kong, internet addiction and low physical activity among adolescents are growing concerns, underscoring the need to address internet use to better support the health and well-being of youth.</p><p><strong>Objective: </strong>This study aimed to investigate the effects of internet use, eHealth literacy, and internet addiction on adolescents' physical activity in Hong Kong.</p><p><strong>Methods: </strong>An online cross-sectional study was conducted in Hong Kong between June 2023 and August 2023. Secondary school students aged 12 to 18 years were recruited. Data were collected using the eHealth Literacy Scale, the International Physical Activity Questionnaire, the Chen Internet Addiction Scale, and a questionnaire assessing demographic characteristics and the use of eHealth technologies. Spearman ρ correlation and mediation analyses were performed to examine the relationships among variables.</p><p><strong>Results: </strong>A total of 117 participants were included. Participants reported an average internet use of 5.28 (SD 3.50) hours per day, and the mean eHealth literacy score was 31.15 (SD 4.04). Correlation analyses revealed that internet use was positively correlated with internet addiction (r=0.33; P<.001) but negatively correlated with physical activity (r=-0.21; P=.02), and internet addiction was negatively correlated with physical activity (r=-0.26; P=.005). In addition, the mediation analysis demonstrated that both internet use and eHealth literacy had a direct effect on internet addiction (B=1.53, P<.001 and B=-0.91, P=.002, respectively). Internet addiction had a direct effect on physical activity (B=-43.94, P=.02). In contrast, eHealth literacy had no significant direct effect on physical activity and did not mediate the relationship between internet use and physical activity.</p><p><strong>Conclusions: </strong>The findings highlight the importance of eHealth literacy in reducing internet addiction. However, future research should further examine factors that mediate the relationship between eHealth literacy and physical activity or other health-related behaviors. This study sheds light on the benefits of promoting eHealth literacy among adolescents to prevent internet addiction and offers practical insights for teachers and parents.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"9 ","pages":"e83936"},"PeriodicalIF":2.3,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13035029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582392","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":"Healthy Lifestyle Practices, Online Health Information-Seeking Behaviors, and Internet Usage Among Pregnant Women: Multigroup Structural Equation Modeling Approach.","authors":"Ying Lau, Yueyang Yi, Zebulon To, Sai Ho Wong, Thomas Yuen Tung Lam","doi":"10.2196/80637","DOIUrl":"10.2196/80637","url":null,"abstract":"<p><strong>Background: </strong>Singapore is a multicultural society characterized by a diverse array of ethnic groups, including Chinese, Malay, Indians, and others. A considerable percentage of Singaporeans are active users of the internet. The internet has become a significant resource for health education, particularly for women who wish to learn about a healthy lifestyle during pregnancy. However, it is still unclear how pregnant women search for information online, particularly within specific groups.</p><p><strong>Objective: </strong>This study aimed to explore the relationship between healthy lifestyle practices, online health information-seeking behaviors, and internet usage (IU) among 1905 pregnant women.</p><p><strong>Methods: </strong>Structural equation modeling (SEM) was used to evaluate the relationships between the appropriate intake of food groups, healthy diet practices (HD), internet for dietary advice (ID), internet for physical activity advice (IP), and IU, based on 5 hypotheses rooted in theoretical concepts. We used a multigroup SEM approach to examine these hypotheses across various ages, ethnicities, BMI, and categories of pregnant groups.</p><p><strong>Results: </strong>Our results confirmed 5 hypotheses, indicating significant relationships among the variables: appropriate intake of food groups was positively linked to HD (β=0.262; P<.001); HD was positively linked to ID (β=.168; P<.001); ID was positively linked to IP (β=0.185; P<.001); IP was positively linked to IU (β=0.190; P<.001); and HD was negatively linked to IU (β=-0.208; P<.001). The multigroup SEM analyses yielded significant differences in Hypotheses 2 and 3 when comparing different age groups (P=.009), BMI categories (P=.03), and number of pregnancies (P=.003).</p><p><strong>Conclusions: </strong>Our findings offer valuable insights into developing customized online interventions aimed at encouraging a healthy lifestyle during pregnancy.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"9 ","pages":"e80637"},"PeriodicalIF":2.3,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13035086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582316","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 Feasibility of Supporting Caregivers of Young Children With Disruptive Behaviors Through Nurse-Delivered Phone Coaching: Quality Improvement Study.","authors":"Hannah Mulholland, Jasmine Berry, Tammy Schmit, Barbara McIlrath, Jocelyn Lebow","doi":"10.2196/65244","DOIUrl":"10.2196/65244","url":null,"abstract":"<p><strong>Background: </strong>Although childhood behavior problems are common, and strong evidence-based interventions exist to address these challenges, many families struggle to access care and remain in treatment long enough to see results. The Support and Advocacy through Providing Parents Helpful Interventions, Resources, and Education (SAPPHIRE) program was developed to address barriers to accessing care for disruptive behaviors in young children.</p><p><strong>Objective: </strong>This quality improvement program assessed the feasibility of SAPPHIRE, a primary care-based intervention delivered via telephone by trained nurses to caregivers of young children (n=36, ages 1-6 y) who exhibit disruptive behaviors.</p><p><strong>Methods: </strong>The feasibility and acceptability of the SAPPHIRE program were assessed during a 3-month quality improvement study.</p><p><strong>Results: </strong>Of 36 participants, 25 (69%) completed the SAPPHIRE program. Over the course of 3 months, the number of nurse calls with completers ranged from 1 to 15, with a mean of 5.3 (SD 3.4) calls. Overall, nurses spent an average of 120.9 (SD 99.2, range 15-380) minutes on the phone with each caregiver across the 3-month pilot period. Caregivers and nurses rated the program as acceptable across all metrics. For nurses, strengths of SAPPHIRE included the continuity of care with one family, while barriers included time constraints. Comparison of preintervention and postintervention caregiver ratings on measures of disruptive behaviors showed a moderate to negligible effect on reported behavior problems depending on the age of the child (children <4 y: d=0.55 and children 4-6 y: d=0.18). Caregiver-rated parenting self-competence increased over the course of the SAPPHIRE intervention, approaching a large effect (d=0.75).</p><p><strong>Conclusions: </strong>Findings suggest that SAPPHIRE is a feasible and acceptable treatment for caregivers of young children with disruptive behaviors and shows promise for increasing parenting self-competence, which is a hypothesized moderator of future behavior problems. These preliminary data support the need for more rigorous empirical evaluation of the SAPPHIRE program.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"9 ","pages":"e65244"},"PeriodicalIF":2.3,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13027681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147533390","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}