JMIR Pediatrics and Parenting最新文献

{"title":"Perceived Acceptability of Technology Modalities for the Provision of Universal Child and Family Health Nursing Support in the First 6-8 Months After Birth: Cross-Sectional Study.","authors":"Tessa Delaney, Jacklyn K Jackson, Alison L Brown, Christophe Lecathelinais, Luke Wolfenden, Nayerra Hudson, Sarah Young, Daniel Groombridge, Jessica Pinfold, Paul David Craven, Sinead Redman, John Wiggers, Melanie Kingsland, Margaret Hayes, Rachel Sutherland","doi":"10.2196/59191","DOIUrl":"10.2196/59191","url":null,"abstract":"<p><strong>Background: </strong>Child and Family Health Nursing (CFHN) services provide universal care to families during the first 2000 days (conception: 5 years) to support optimal health and developmental outcomes of children in New South Wales, Australia. The use of technology represents a promising means to encourage family engagement with CFHN services and enable universal access to evidenced-based age and stage information. Currently, there is little evidence exploring the acceptability of various models of technology-based support provided during the first 2000 days, as well as the maternal characteristics that may influence this.</p><p><strong>Objective: </strong>This study aims to describe (1) the acceptability of technology-based models of CFHN support to families in the first 6 months, and (2) the association between the acceptability of technology-based support and maternal characteristics.</p><p><strong>Methods: </strong>A cross-sectional survey was undertaken between September and November 2021 with women who were 6-8 months post partum within the Hunter New England Local Health District of New South Wales, Australia. Survey questions collected information on maternal demographics and pregnancy characteristics, perceived stress, access to CFHN services, as well as preferences and acceptability of technology-based support. Descriptive statistics were used to describe the characteristics of the sample, the proportion of women accessing CFHN services, maternal acceptability of technology-based support from CFHN services, and the appropriateness of timing of support. Multivariable logistic regression models were conducted to assess the association between maternal characteristics and the acceptability of technology-based CFHN support.</p><p><strong>Results: </strong>A total of 365 women participated in the study, most were 25 to 34 years old (n=242, 68%), had completed tertiary level education or higher (n=250, 71%), and were employed or on maternity leave (n=280, 78%). Almost all (n=305, 89%) women reported accessing CFHN services in the first 6 months following their child's birth. The majority of women (n=282-315, 82%-92%) \"strongly agreed or agreed\" that receiving information from CFHN via technology would be acceptable, and most (n=308) women \"strongly agreed or agreed\" with being provided information on a variety of relevant health topics. Acceptability of receiving information via websites was significantly associated with maternal employment status (P=.01). The acceptability of receiving support via telephone and email was significantly associated with maternal education level (adjusted odds ratio 2.64, 95% CI 1.07-6.51; P=.03 and adjusted odds ratio 2.90, 95% CI 1.20-7.00; P=.02, respectively). Maternal age was also associated with the acceptability of email support (P=.04).</p><p><strong>Conclusions: </strong>Technology-based CFHN support is generally acceptable to mothers. Maternal characteristics, including employment statu","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11462103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308690","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":"Effect of a Web-Based Nutritional and Physical Activity Intervention With Email Support (the EDDY Program) on Primary School Children's BMI Z-Score During the COVID-19 Pandemic: Intervention Study.","authors":"Alina Gansterer, Paula Moliterno, Rhoia Neidenbach, Caroline Ollerieth, Sarah Czernin, Juergen Scharhag, Kurt Widhalm","doi":"10.2196/50289","DOIUrl":"10.2196/50289","url":null,"abstract":"<p><strong>Background: </strong>COVID-19 mitigation measures enhanced increases in children's weight and BMI due to decreased physical activity and increased energy intake. Overweight and obesity were major worldwide problems before the pandemic, and COVID-19 increased their severity even more. High BMI directly correlates with health disadvantages including cardiovascular diseases, musculoskeletal disorders, and mental health diseases. Therefore, it is vitally important to develop counteracting interventions to maintain children's health during exceptional situations like pandemics. However, worldwide data from such interventions are limited, and to our knowledge, no suitable study has been carried out during the pandemic in Austria.</p><p><strong>Objective: </strong>This study was conducted to examine a 15-week web-based intervention with email support, the EDDY (Effect of Sports and Diet Trainings to Prevent Obesity and Secondary Diseases and to Influence Young Children's Lifestyle) program and the effect of nutritional education and physical activity on children's BMI z-score during the COVID-19 pandemic in Vienna, Austria.</p><p><strong>Methods: </strong>The intervention consisted of 3 weekly videos-2 physical activity and 1 nutritional education video, respectively-and a biweekly email newsletter for the parents. This study was conducted in a Viennese primary school from February to June 2021 by a team of physicians, nutritionists, and sports scientists, including both professionals and students. The study population included an intervention group (who received web-based nutritional and physical activity training) and a control group (who received no intervention), comprising in total 125 children aged 8 to 11 years. Due to COVID-19 mitigation measures, the control group was a comparative group observed during the prior school year (2019-2020). Anthropometric measurements were obtained before and after the intervention in both groups.</p><p><strong>Results: </strong>Due to a high dropout rate (n=57, 45.6%) because of the mitigation measures, there were 41 children in the intervention group and 27 in the control group. At baseline, the BMI z-score was 1.0 (SD 1.1) in the intervention group and 0.6 (SD 1.2) in the control group (P=.17). After the study period, the BMI z-score decreased by 0.06 (SD 0.21) in the intervention group, whereas it increased by 0.17 (SD 0.34) in the control group (P<.001). Comparing the change in BMI z-scores within BMI categories in the intervention group and control group revealed a statistically significant difference in the normal-weight children (P=.006). Further results showed that the decrease in BMI z-score was significant in the intervention group among both boys (P=.004) and girls (P=.01).</p><p><strong>Conclusions: </strong>A web-based intervention with combined nutritional education and physical activity training might be an adequate tool to lessen the enhanced increase in body weight during a pandemic. T","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11426922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297388","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":"Red Blood Cell Transfusion for Incidence of Retinopathy of Prematurity: Prospective Multicenter Cohort Study.","authors":"Xiaoling Wang, Rui Rao, Hua Li, Xiaoping Lei, Wenbin Dong","doi":"10.2196/60330","DOIUrl":"10.2196/60330","url":null,"abstract":"<p><strong>Background: </strong>Retinopathy of prematurity (ROP) is a leading cause of visual impairment and blindness in preterm infants.</p><p><strong>Objective: </strong>This study sought to investigate the association between red blood cell (RBC) transfusion and ROP in very preterm infants (VPIs) to inform clinical strategies for ROP prevention and treatment.</p><p><strong>Methods: </strong>We designed a prospective multicenter cohort study that included VPIs and follow-up data from January 2017 to December 2022 at 3 neonatal clinical medicine centers. They were categorized into a transfusion group (infants who received an RBC transfusion within 4 wk) and a nontransfusion group. The relationship between RBC transfusion and ROP incidence was assessed using binary logistic regression, with subgroup analyses based on gestational age, birth weight, sex, and sepsis status. Inverse probability of treatment weighting and propensity score matching were applied to account for all potential confounding factors that could affect ROP development, followed by sensitivity analysis.</p><p><strong>Results: </strong>The study included 832 VPIs, including 327 in the nontransfusion group and 505 in the transfusion group. The transfusion group had a lower average birth weight and gestational age and a greater incidence of ROP, ≥stage 2 ROP, and severe ROP. Logistic regression analysis revealed that the transfusion group had a significantly greater risk of ROP (adjusted odds ratio [aOR] 1.70, 95% CI 1.14-2.53, P=.009) and ≥stage 2 ROP (aOR 1.68, 95% CI 1.02-2.78, P=.04) but not severe ROP (aOR 1.75, 95% CI 0.61-5.02, P=.30). The trend analysis also revealed an increased risk of ROP with an increasing number of transfusions and a larger volume of blood transfused (P for trend<.001). Subgroup analyses confirmed a consistent trend, with the transfusion group at a higher risk for ROP across all subgroups. Inverse probability of treatment weighting and propensity score matching analyses supported the initial findings.</p><p><strong>Conclusions: </strong>For VPIs, RBC transfusion significantly increases the risk of ROP, and the risk increases with an increasing number of transfusions and volume of blood transfused.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11425406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Delivery of an Integrated Digital Health Care Approach for Children With Juvenile Idiopathic Arthritis: Usability Study.","authors":"Sonia Butler, Dean Sculley, Derek Santos, Xavier Gironès, Davinder Singh-Grewal, Andrea Coda","doi":"10.2196/56816","DOIUrl":"10.2196/56816","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Juvenile idiopathic arthritis (JIA) is a chronic inflammatory disorder with no cure. Most children are prescribed several medications aimed at controlling disease activity, managing symptoms, and reducing pain. Physical activity is also encouraged to retain musculoskeletal function. The primary determinants of treatment success are maintaining long-term adherence, ongoing monitoring by a pediatric rheumatologist, and involvement of an interdisciplinary team. To support these goals, a new digital intervention was developed, InteractiveClinics, which aimed to prompt children to take their medications, report pain levels, and increase their physical activity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to evaluate the usability of InteractiveClinics among children with JIA.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;As part of this pediatric cross-sectional study, 12 children were asked to wear a smartwatch for 2 weeks, which was synchronized to the InteractiveClinics phone app and web-based platform. Personalized notifications were sent daily to the watch and phone, to prompt and record medication adherence and pain level assessment. Physical activity was automatically recorded by the watch. At the end of the study, all children and parents completed a postintervention survey. Written comments were also encouraged to gain further feedback. Descriptive statistics were used to summarize the survey results, and all qualitative data underwent thematic analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Twelve children aged 10 to 18 years (mean 14.2, SD 3.1 years; female: n=8, 66.7%) and 1 parent for each child (n=12; female: n=8, 66.7%) were enrolled in the study. Based on the highest and lowest agreement areas of the survey, most children and parents liked the smartwatch and web-based platform; they found it easy to learn and simple to use. They were also satisfied with the pain and physical activity module. However, usability and acceptability barriers that hindered uptake were identified in the phone app and medication module. Children required a unique in-app experience, and their suggestive improvements included more personalization within the app; simplification by removing all links not relevant to antirheumatic medications; flexibility in response times; improved conferment through gamification; additional comment fields for the input of more data, such as medication side effects or pain-related symptoms; more detailed graphical illustrations of the physical activity module, including a breakdown of metrics; and importantly, interconnections between modules, because medication adherence, pain levels, and physical activity can each influence the other. They were, overall, improving usefulness for children and parents.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The usability of InteractiveClinics was positive. Children and parents liked the watch and web-based platform and were satisfied with the pain and physical activity module. Howev","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11421306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297387","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":"Psychological Interventions and Those With Elements of Positive Psychology for Child and Youth Mental Health During the COVID-19 Pandemic: Literature Review, Lessons Learned, and Areas for Future Knowledge Dissemination.","authors":"Lynnette Lyzwinski, Jennifer D Zwicker, Sheila Mcdonald, Suzanne Tough","doi":"10.2196/59171","DOIUrl":"10.2196/59171","url":null,"abstract":"<p><strong>Background: </strong>There was a marked decline in child and teenage mental health worldwide during the pandemic, with increasing prevalence of depression, anxiety, and suicide. Research indicates that positive psychological interventions may be beneficial for mental health.</p><p><strong>Objective: </strong>The aims of this review were to evaluate positive psychological interventions for child and youth mental health implemented during the COVID-19 pandemic and assess overall effectiveness for mental health and knowledge.</p><p><strong>Methods: </strong>We undertook a literature search of PubMed, MEDLINE, and Google Scholar for all eligible studies on digital and hybrid in-person psychological interventions for youth mental health during the COVID-19 pandemic. A particular emphasis was placed on positive psychological interventions or interventions that had components of positive psychology, including gratitude, acceptance, positive emotions, or resilience building.</p><p><strong>Results: </strong>A total of 41 interventions were included in this review. Most of the interventions were digital. Overall, most of the interventions assisted with one or more mental health or psychological indicators, such as depression, anxiety, posttraumatic stress disorder, stress, and resilience. However, findings were mixed when it came to targeting both depression and anxiety together. The interventions that promoted youth mental health most often had a range of diverse positive psychology components and were evidence based. Not all studies measured changes in mindfulness. Few studies examined knowledge acquired on mental health self-care, managing mental health problems, knowledge of positive psychological techniques, mindfulness knowledge, or mental health self-efficacy.</p><p><strong>Conclusions: </strong>Diverse multicomponent interventions appear to assist with youth mental health overall, although their effects on both depression and anxiety are less clear. There is also a need for more research on knowledge gains to determine whether the interventions improved knowledge on mental health-supportive behaviors, which may be sustained beyond the intervention. Finally, more studies need to evaluate whether the interventions assisted with increasing self-efficacy for practicing positive psychological techniques as well as changes in mindfulness levels. Future studies should not only assess effectiveness for mental health outcomes but also assess knowledge translation, with valid measures of knowledge and self-efficacy for mental health-supportive behaviors and positive psychological skills acquired (eg, the ability to practice mindfulness).</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11437230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Web-Based Surveys to Collect Long-Term Pediatric Outcomes in Patients With Twin-Twin Transfusion Syndrome Treated With Fetoscopic Laser Photocoagulation: Observational Study.","authors":"Eric Bergh, Kimberly Rennie, Jimmy Espinoza, Anthony Johnson, Ramesha Papanna","doi":"10.2196/60039","DOIUrl":"10.2196/60039","url":null,"abstract":"<p><strong>Background: </strong>In the United States, patients with monochorionic diamniotic twins who undergo in utero fetoscopic laser photocoagulation (FLP) for twin-twin transfusion syndrome (TTTS) may travel great distances for care. After delivery, many parents cannot return to study sites for formal pediatric evaluation due to geographic location and cost.</p><p><strong>Objective: </strong>The aim of this study was to collect long-term pediatric outcomes in patients who underwent FLP for TTTS.</p><p><strong>Methods: </strong>We assessed the feasibility of using a web-based survey designed in REDCap (Research Electronic Data Capture; Vanderbilt University) to collect parent-reported outcomes in children treated for TTTS at a single center during 2011-2019. Patients with ≥1 neonatal survivor were invited via email to complete 5 possible questionnaires: the child status questionnaire (CSQ); fetal center questionnaire (FCQ); Ages & Stages Questionnaires, Third Edition (ASQ-3); Modified Checklist for Autism in Toddlers, Revised With Follow-Up (M-CHAT-R/F); and thank you questionnaire (TYQ). The R programming language (R Foundation for Statistical Computing) was used to automate survey distribution, scoring, and creation of customized reports. The survey was performed in 2019 and repeated after 12 months in the same study population in 2020.</p><p><strong>Results: </strong>A total of 389 patients in 26 different states and 2 international locations had an email address on file and received an invitation in 2019 to complete the survey (median pediatric age 48.9, IQR 1.0-93.6 months). Among surveyed mothers in 2019, the overall response rate was 37.3% (145/389), and the questionnaire completion rate was 98% (145/148), 87.8% (130/148), 71.1% (81/100), 86.4% (19/22), and 74.3% (110/148) for the CSQ, FCQ, ASQ-3, M-CHAT-R/F, and TYQ, respectively. In 2020, the overall response rate was 57.8% (56/97), and the questionnaire completion rate was 96.4% (54/56), 91.1% (51/56), 86.1% (31/36), 91.7% (11/12), and 80.4% (45/56) for the CSQ, FCQ, ASQ-3, M-CHAT-R/F, and TYQ, respectively.</p><p><strong>Conclusions: </strong>This is the first study to use both REDCap and computer automation to aid in the dissemination, collection, and reporting of surveys to collect long-term pediatric outcomes in the field of fetal medicine.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11441452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297391","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 Mobile App Supporting Evidence-Based Parenting Skills: Thematic Analysis of Parent Experience.","authors":"Nathan Hodson, Peter Woods, Juan Luque Solano, Charlotte Talbot, Domenico Giacco","doi":"10.2196/53907","DOIUrl":"10.2196/53907","url":null,"abstract":"<p><strong>Background: </strong>Disruptive behavior disorders are among the most common disorders of childhood, and evidence-based parenting programs are the first-line treatment. Digital microinterventions have been proposed as one possible means of supporting parenting style change by giving parents in-the-moment advice about how to respond to challenging behavior. Until now, no digital microintervention supporting evidence-based parenting skills programs has been evaluated.</p><p><strong>Objective: </strong>The aim of this study is to evaluate the subjective experience of parents using a digital microintervention to support evidence-based parenting skills, with particular attention to acceptability, usability, family relationships, and parents' values.</p><p><strong>Methods: </strong>We conducted serial interviews with 11 parents of 33 children before and after spending 3 weeks using an app including 3 digital microinterventions. Parents were recruited via local authorities in the Midlands region of the United Kingdom. Previous participation in a parenting program was an inclusion criterion. Interviews explored family composition; child behavior problems; and experience of using the mobile app, including barriers to use. Thematic analysis was conducted from a user-centered design perspective, and illustrative case vignettes were produced.</p><p><strong>Results: </strong>Many parents used the app in ways that helped them rather than strictly following the instructions they were given. Parents described a range of barriers to using the app including practical problems and failure to change child behavior. Parents and children responded in a variety of ways to the use of the phone, with many wholeheartedly embracing the convenience of technology. Case vignettes illustrate the uniqueness of each family's experience.</p><p><strong>Conclusions: </strong>Parents' use of a mobile app supporting evidence-based parenting skills is difficult to predict due to the unique challenges each family encounters. Many parents found it an acceptable and helpful addition to family life, but increased personalization is likely to be key to supporting parents. Future digital microintervention developers should keep in mind that parents are likely to use the app pragmatically rather than following instructions, may struggle to use a complex app under pressure, and are likely to hold complex feelings about parenting with an app.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11391659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134100","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 Relationship Between Symptom Change and Use of a Web-Based Self-Help Intervention for Parents of Children With Externalizing Behavior Disorders: Exploratory Study.","authors":"Laura Wähnke, Christina Dose, Marie-Theres Klemp, Judith Mühlenmeister, Julia Plück, Manfred Döpfner","doi":"10.2196/54051","DOIUrl":"10.2196/54051","url":null,"abstract":"<p><strong>Background: </strong>Web-based self-help (WASH) has been found to be effective in the treatment of child externalizing behavior disorders. However, research on the associations of caregivers' use of WASH and symptom changes of child externalizing behaviors is lacking.</p><p><strong>Objective: </strong>This study examined the longitudinal and reciprocal associations between the use of WASH by caregivers of children with externalizing behavior disorders and their children's externalizing behavior symptoms.</p><p><strong>Methods: </strong>Longitudinal data of 276 families from 2 intervention conditions of a randomized controlled trial (either unguided or supported by a therapist over the phone) were analyzed. Caregiver- and clinician-rated child externalizing behavior symptoms were assessed before (T1), in the middle (T2), and after the 6-month WASH intervention (T3). Additionally, 2 indicators of the caregivers' use of the WASH intervention were considered: number of log-ins (frequency) and the percentage of completed material (intensity). Associations of caregivers' use during early (T1-T2) and late (T2-T3) treatment with child externalizing behavior symptoms were analyzed using path analyses (structural equation modeling).</p><p><strong>Results: </strong>Frequency and intensity of use were higher during the first 3 months than during the next 3 months of the intervention period. The number of log-ins at early treatment was significantly but weakly associated with caregiver-reported child externalizing behavior symptoms in the long term (T3). Moreover, caregiver-reported child externalizing severity at T2 predicted the number of log-ins in the late treatment. The results were not replicated when considering the percentage of completed material as a measure of use or when considering clinician ratings of child externalizing behavior symptoms.</p><p><strong>Conclusions: </strong>The findings provide the first, albeit weak, evidence for longitudinal associations between caregivers' use of WASH and improvements in caregiver-rated child externalizing behavior symptoms. However, as the associations were rather weak and could not be replicated across different rater perspectives and operationalizations of use, further research is needed to better understand these relations and their interplay with other putative influence factors (eg, quality of the implementation of the interventions, changes in parenting behaviors).</p><p><strong>Trial registration: </strong>German Clinical Trials Register DRKS00013456; https://www.drks.de/DRKS00013456.</p><p><strong>International registered report identifier (irrid): </strong>RR2-10.1186/s12888-020-2481-0.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11411226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134102","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":"Online Ambassador Visits for Hospitalized Children With Cancer: Qualitative Evaluation of Implementation.","authors":"Natasha Nybro Boensvang, Mette Weibel, Claire E Wakefield, Pernille Envold Bidstrup, Marianne Olsen, Karin Bækgaard Nissen, Vibeke Spager, Martin Kaj Fridh, Hanne Bækgaard Larsen","doi":"10.2196/53309","DOIUrl":"10.2196/53309","url":null,"abstract":"<p><strong>Background: </strong>Children with cancer or cancer-like disease risk treatment-related isolation, which can negatively impact their peer relationships and social competencies and exacerbate their loneliness. During the COVID-19 pandemic, increased online socialization became the new normal imposed by national isolation guidelines. To adhere to the treatment-related isolation guidelines, children with cancer were offered online classmate \"ambassador\" visits during hospitalization.</p><p><strong>Objective: </strong>This study aimed to identify facilitators and barriers to online classmate \"ambassador\" visits during children with cancer's hospitalization through a qualitative descriptive process evaluation using the Consolidated Framework for Implementation Research.</p><p><strong>Methods: </strong>From January to April 2022, we conducted 39 individual semistructured interviews with hospitalized children (n=16), their classmates (n=16), teachers from their schools (n=3), and study nurses (n=4) from involved hospitals. Most interviews (n=37, 95%) were conducted online using Microsoft Teams or Google Meet, while 2 (5%) interviews were conducted in person at the participants' residences. This approach allowed us to gain a broad understanding of the facilitators and barriers to online ambassador visits.</p><p><strong>Results: </strong>We identified four themes: (1) working together, (2) ensuring participation, (3) staying connected, and (4) together online. The themes are described in terms of facilitators and barriers to online ambassador visits with 3 Consolidated Framework for Implementation Research domains: innovation, individuals, and the implementation process.</p><p><strong>Conclusions: </strong>Addressing the social needs of hospitalized children through online visits with their classmates may be relevant when one-on-one meetings are problematic. The online visits are highly dependent on collaboration between study nurses and teachers and assessing the needs of the hospitalized children. While a high degree of adult engagement and a stable internet connection are pivotal, these online visits can promote much-needed social interaction between children across physical settings.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11411222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134101","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":"Parental Autonomy in the Care of Premature Newborns and the Experience of a Neonatal Team: Observational Prospective Study.","authors":"Salvador Piris-Borregas, Beatriz Bellón-Vaquerizo, Leticia Velasco-Echeburúa, Lidia Niño-Díaz, Susana Sánchez-Aparicio, María López-Maestro, Carmen Rosa Pallás-Alonso","doi":"10.2196/55411","DOIUrl":"10.2196/55411","url":null,"abstract":"<p><strong>Background: </strong>The European Foundation for the Care of Newborn Infants (EFCNI) has promoted the importance of parental involvement in the care of children.</p><p><strong>Objective: </strong>The study aimed to examine how the time required by parents to achieve autonomy in the care of their very low-birth weight newborn infants was modified during the implementation of a training program.</p><p><strong>Methods: </strong>This was an observational prospective study in the context of a quality improvement initiative. The Cuídame (meaning \"Take Care of Me\" in English) program was aimed at achieving parental autonomy. It was implemented over 2 periods: period 1, from September 1, 2020, to June 15, 2021; and period 2, from July 15, 2021, to May 31, 2022. The days required by parents to achieve autonomy in several areas of care were collected from the electronic health system.</p><p><strong>Results: </strong>A total of 54 and 43 families with newborn infants were recruited in periods 1 and 2, respectively. Less time was required to acheive autonomy in period 2 for participation in clinical rounds (median 10.5, IQR 5-20 vs 7, IQR 4-10.5 d; P<.001), feeding (median 53.5, IQR 34-68 vs 44.5, IQR 37-62 d; P=.049), and observation of neurobehavior (median 18, IQR 9-33 vs 11, IQR 7-16 d; P=.049). More time was required to achieve autonomy for kangaroo mother care (median 14, IQR 7-23 vs 21, IQR 10-31 d; P=.02), diaper change (median 9.5, IQR 4-20 vs 14.5, IQR 9-32 d; P=.04), and infection prevention (median 1, IQR 1-2 vs 6, IQR 3-12; P<.001).</p><p><strong>Conclusions: </strong>Parents required less time to achieve autonomy for participation in clinical rounds, feeding, and observation of neurobehavior during the implementation of the training program. Nevertheless, they required more time to achieve autonomy for kangaroo mother care, diaper change, and infection prevention.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11388622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126879","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}