JMIR Pediatrics and Parenting最新文献

{"title":"Codevelopment of a Digital Screening and Intervention Tool to Improve Lifestyle Habits in Children: Focus Group Study With Parents and Clinicians.","authors":"Alice Moyne, Tamara Perez, Trevor van Mierlo, Maryam Kebbe, Olivier Drouin","doi":"10.2196/84304","DOIUrl":"10.2196/84304","url":null,"abstract":"<p><strong>Background: </strong>Chronic preventable diseases represent a major burden in Canada, often rooted in unhealthy behaviors established during childhood. Despite recommendations for routine screening, most children are not assessed due to clinical barriers. This paper presents the early development of Project DISCO, a self-administered, digital preappointment tool to screen for and support healthy lifestyle behaviors, including physical activity, sleep, nutrition, and screen time, in children aged 2 to 12 years.</p><p><strong>Objective: </strong>This study aimed to explore clinicians' and parents' needs and past experiences with health technology; integrate their insights into the development of a digital tool for promoting health behaviors; and evaluate the usability, relevance, and acceptability of this tool.</p><p><strong>Methods: </strong>Three semistructured focus group and interview sessions were conducted with primary care clinicians and parents. Participants were recruited at the Groupe de Médecine de Famille Universitaire Saint-Hubert using purposive and convenience sampling: clinicians were recruited internally, whereas parents of children aged 2 to 12 years were invited via emails sent by clinic staff. Data were analyzed using a combination of inductive and deductive approaches. Findings informed iterative refinements throughout the codevelopment of the digital tool for promoting healthy lifestyle behaviors in children.</p><p><strong>Results: </strong>A total of 8 participants took part in 6 discussions, including 5 parents of children aged 3 to 12 years and 3 primary care clinicians. Hybrid thematic analysis identified six themes: (1) the potential of a digital tool to promote healthy habits in pediatrics; (2) implementation challenges and opportunities, including integration of the tool into clinical workflow; (3) adherence to and engagement with the tool, with suggestions for reminders and involvement of nurses; (4) perceived limitations and improvement of the screening tool, particularly the nutrition and sleep questionnaires; (5) feedback on the screening report and intervention emphasizing clarity and actionable guidance; and (6) perceived clinical value and opportunity costs. Insights from these discussions guided refinements of the digital tool.</p><p><strong>Conclusions: </strong>The findings support the tool's relevance and inform its ongoing development. A feasibility study is planned prior to a randomized controlled trial.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"9 ","pages":"e84304"},"PeriodicalIF":2.3,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13354948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148340193","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 Adolescents' Experiences of Cyberbullying in Jordan: Evidence From a Narrative Perspective.","authors":"Anwar M Eyadat, Maha M Albdour, Hanan A Abusbaitan, Vipavee Thongpriwan, Young Ik Cho, Amani Mobarki, Jovan Gwon","doi":"10.2196/92120","DOIUrl":"10.2196/92120","url":null,"abstract":"<p><strong>Background: </strong>Based on its nature, cyberbullying is expected to be frequent and prevalent because of the continuity of technological advancement over time. This change results in more victims and is challenging to detect, negatively affecting their health. Given that adolescents in Jordan face a high rate of cyberbullying, it is essential to understand how this experience affects them.</p><p><strong>Objective: </strong>This study aims to explore individual experiences and perspectives on cyberbullying victimization among adolescents to intervene and reduce future incidences of cyberbullying.</p><p><strong>Methods: </strong>We based our analysis on a cross-sectional study investigating cyberbullying and its mental health consequences among 400 students aged 14-17 years from public schools in central and northern Jordan. These respondents were asked to answer 3 open-ended questions describing their experiences with cyberbullying if they experienced cybervictimization as either victims or bully-victims, resulting in 240 responses. Thematic analysis was then used to interpret patterns of shared meaning across participants' narratives related to cyberbullying experiences in cyberspace.</p><p><strong>Results: </strong>A total of 3 key themes and several subthemes emerged from this study: (1) effects of cyberbullying, (2) challenges in overcoming its consequences, and (3) elements influencing the severity of cyberbullying experiences.</p><p><strong>Conclusions: </strong>The findings offer valuable insights for creating safer online environments and reducing cyberbullying's psychological and social harms through appropriate interventions.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"9 ","pages":"e92120"},"PeriodicalIF":2.3,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13351643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148333389","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 Technologically Mediated Motherhood Constellation: Smartphone and AI as Novel Actors in Maternal Psychic Organization.","authors":"Luca Cerniglia, Silvia Cimino","doi":"10.2196/91292","DOIUrl":"10.2196/91292","url":null,"abstract":"<p><strong>Unlabelled: </strong>The Daniel Stern concept of the motherhood constellation describes a distinctive psychic organization that emerges in the transition to motherhood, structured by 3 relational discourses and 4 thematic concerns: safeguarding infant life and growth, establishing primary relatedness, securing a matrix of support, and reorganizing maternal identity. Formulated in the mid-1990s, this framework preceded the pervasive integration of smartphones, social media, and artificial intelligence (AI) into everyday life. Contemporary mothers now care for infants in environments saturated by online information, connectivity, and AI-mediated support, raising questions about how these factors participate in and reshape the Stern architecture. This theoretical paper argues that smartphones and AI function not as neutral tools but as systemic actors within the motherhood constellation. Drawing on the Stern model, attachment theory, mentalization research, ecological perspectives, sociotechnical theory, and empirical work on technoference, maternal smartphone use, digital parenting, online maternal communities, and AI-based mental health interventions, we conceptualize digital technologies as entities whose affordances co-structure maternal psychic life. Available findings indicate that they simultaneously expand access to information and support, introduce interactional disruptions, and create new, partially algorithmic matrices of support, with effects moderated by patterns of use, maternal reflective functioning, child characteristics, platform design, and socio-structural conditions. We propose a technologically mediated motherhood constellation, in which smartphones and AI enter all 3 discourses (mother-own-mother, mother-self-as-mother, and mother-infant) and all 4 themes. Rather than asking whether technology is \"good\" or \"bad\" for motherhood, we outline a spectrum from technology-enhanced to technology-disrupted constellations and derive implications for clinical practice, research, technology design, and social policy.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"9 ","pages":"e91292"},"PeriodicalIF":2.3,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13291807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148309695","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 Search Trends on Child Abuse During the COVID-19 Pandemic Using the Most Widely Used Search Engine: Retrospective Observational Study.","authors":"Naoko Takada, Kosuke Ishizuka, Taiju Miyagami, Mizue Saita, Akihiko Kusakabe, Mitsuyasu Ohta, Toshio Naito","doi":"10.2196/93215","DOIUrl":"10.2196/93215","url":null,"abstract":"<p><strong>Background: </strong>Child abuse is an important issue that threatens child development. The COVID-19 pandemic had psychological, social, and economic effects, and concerns were raised about a possible increase in child maltreatment.</p><p><strong>Objective: </strong>This study aimed to describe online search trends on child abuse in Japan during the COVID-19 pandemic.</p><p><strong>Methods: </strong>We conducted a retrospective observational study on the online search volume of terms related to abuse, such as \"abuse,\" \"psychological abuse,\" \"physical abuse,\" \"neglect,\" \"sexual abuse,\" \"I might become abusive,\" \"I am scared I might become abusive,\" and \"I cannot stop abusing,\" in Yahoo! Japan. Search volumes were compared with trends in the number of reported cases of COVID-19.</p><p><strong>Results: </strong>The number of searches for \"neglect\" increased during periods of social change caused by the COVID-19 pandemic and when waves of the pandemic coincided with the summer vacation period. Searches for terms suggesting abuse, such as \"I might become abusive\" and \"I am scared I might become abusive,\" increased in 2020 followed by a decrease from 2021 onward. Most of the searches were conducted by women aged 20 to 49 years.</p><p><strong>Conclusions: </strong>Online searches related to \"neglect\" increased during periods of major social change during the COVID-19 pandemic. Searches suggestive of concern about perpetrating abuse were conducted predominantly by women aged 20 to 49 years. Online search data may serve as a useful tool for identifying trends in child abuse-related search interest.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"9 ","pages":"e93215"},"PeriodicalIF":2.3,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13342812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148309632","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":"Family-Focused Digital Mental Health Care for Pediatric Oppositional Symptoms and Caregiver Outcomes: Retrospective Analysis.","authors":"Darian Lawrence-Sidebottom, Kelsey McAlister, Donna McCutchen, Monika Roots, Jennifer Huberty","doi":"10.2196/82039","DOIUrl":"10.2196/82039","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Oppositional symptoms in youth are characterized by an angry or irritable mood and excessive defiance (eg, arguing), negatively impacting the mental well-being of children, adolescents, and their caregivers. Pediatric digital mental health interventions (DMHIs) that approach care from a whole-family perspective may effectively address mental health (MH) symptoms in both pediatric participants and their caregivers, though this has not been explored in the context of oppositional symptoms.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The purpose of this study was to assess oppositional symptoms in children and adolescents (aged 6 to 17 years) participating in care within the real-world conditions of a family-centered DMHI. We aimed to (1) examine baseline oppositional severity and its associations with child demographic and clinical characteristics (eg, co-occurring MH symptoms), and caregiver symptoms; (2) evaluate demographic, clinical, and engagement factors associated with oppositional symptoms during care with the DMHI; and (3) determine whether changes in oppositional symptoms during care are associated with improvements in caregivers' stress, burnout, and sleep.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Retrospective analyses included 3781 child-caregiver pairs who participated in coaching and therapy with Bend Health Inc, a family-centered, pediatric DMHI. Assessments at baseline and monthly during care measured pediatric and caregiver symptoms. Children and adolescents were grouped by oppositional severity at baseline: not significant, subclinical, and clinical. Pediatric characteristics, care type, and caregiver symptoms were compared between groups. Linear mixed-effects models assessed oppositional symptoms over months and then tested whether oppositional severity and rate of symptom improvement were associated with caregiver outcomes over time.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Baseline oppositional symptoms were not significant for 51.55% (1949/3781), subclinical for 26.47% (1001/3781), and clinical for 21.98% (831/3781). More severe oppositional symptoms were associated with younger age (P&lt;.001), nonfemale sex (P&lt;.001), White race or ethnicity (P&lt;.001), higher rates of MH diagnoses (all P&lt;.001), and higher rates of co-occurring inattention, hyperactivity, depression, and sleep problems (all P&lt;.001). Odds of elevated caregiver symptoms increased with more severe oppositional symptoms (all P&lt;.001). At the end of care (final follow-up), oppositional symptoms improved for 73.93% (740/1001) with subclinical symptoms and 82.43% (685/831) with clinical symptoms. Symptom trajectories followed a logarithmic curve, with the greatest improvements in the first several months (P&lt;.001). While more severe oppositional symptoms were associated with more severe caregiver stress, burnout, and sleep problems (all P&lt;.001), monthly improvements in caregiver symptoms were significantly larger for those whose child improved more quickly (all P&lt;.001","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"9 ","pages":"e82039"},"PeriodicalIF":2.3,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13286078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148302979","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":"Impact of a Real-Time Virtual Rounding Queue on Neonatal Intensive Care Unit Rounding Practices: Survey Study of Clinicians' Perceptions.","authors":"Elizabeth S Jarrett, Alexis Quade, Johannah M Scheurer, Michael B Pitt, John Sartori, Scott Lunos, Tamara Kasal, Rubina F Rizvi","doi":"10.2196/78547","DOIUrl":"10.2196/78547","url":null,"abstract":"<p><strong>Background: </strong>While family-centered rounds are considered the standard of care, coordinating the presence of all stakeholders without knowing when the medical team will arrive can make their implementation challenging. To address this barrier, we created novel software, Q-rounds, that is integrated into the electronic health record and creates a real-time rounding queue that updates nurses and family members on medical team rounding time and allows families to join in person or remotely via phone. A previous observational study showed that the implementation of Q-rounds in a neonatal intensive care unit (NICU) led to increased nurse and family presence.</p><p><strong>Objective: </strong>This study aimed to understand clinicians' perceptions of the use of Q-rounds on NICU rounding practices, such as the impact on rounding efficiency and clinician satisfaction, as well as facilitators and barriers in its implementation.</p><p><strong>Methods: </strong>Q-rounds was implemented in the NICU at M Health Fairview Masonic Children's Hospital in May 2023. In this survey study, surveys were distributed to physicians, advanced practice providers, and nurses 6 weeks before implementation and 6 weeks afterward to collect data on the impact of Q-rounds on family-centered rounds. Data were analyzed both quantitatively and qualitatively.</p><p><strong>Results: </strong>There were 118 respondents in the preimplementation phase and 110 in the postimplementation phase. After implementation of Q-rounds, clinicians perceived an increase in nurse presence (\"most\" or \"almost all of the time\" n/N= 48/105, 46% to n/N=24/36, 75%; P<.001) and family presence (at least \"sometimes\" n/N=45/106, 46% to n/N=35/36, 97%; P<.001) on rounds. Respondents perceived rounds as more efficient (n/N=56/105, 53% to n/N=27/36, 75%; P=.006), and more respondents indicated being satisfied with rounds (n/N=59/105, 46% to n/N=62/84, 74%; P=.003). There was no perceived difference in rounding duration. These findings were supported by thematic analysis of open-ended responses.</p><p><strong>Conclusions: </strong>A novel virtual rounding queue software that notifies families and nurses of when to expect the rounding team was associated with increased clinician perceptions of efficiency, participation in rounds by nurses and families, and satisfaction with rounds.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"9 ","pages":"e78547"},"PeriodicalIF":2.3,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13278618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148278699","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":"Engagement, Acceptability, and Impact of a Parenting App to Support Infant Sleep and Parent Well-Being: Quasi-Experimental Study.","authors":"Jessica Appleton, Anne-Marie Maxwell, Heilok Cheng, Sarah Taki, Deborah Stockton, Judith Fethney, Ann Debelin, Elizabeth Denney-Wilson, Nicole Reilly","doi":"10.2196/88948","DOIUrl":"10.2196/88948","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Many parents today use digital or mobile health (mHealth) resources for parenting information and support. Thus, interventions or programs to support parenting delivered in this way are a rapidly growing area of innovation and research. Evidence indicates that face-to-face interventions that provide education and support for parents about infant sleep can have positive impacts on both infant sleep and maternal mood. However, there is limited research on the delivery of such interventions via digital or mHealth platforms. SleepWellBaby is an infant sleep mobile app for parents with infants and young children. The app provides parents with a 7-day program that may be repeated according to individual user demand, with information and interactive features aimed at supporting parents to understand infant sleep, and providing advice about strategies to support sleep in a responsive way.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The study objectives were (1) to determine engagement with, and acceptability of, an mHealth-delivered parenting program to support infant sleep and (2) to investigate the impact of the program on parental fatigue, emotional health, and parenting competence, confidence, and self-efficacy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A multimethod quasi-experimental pre-post study design was used. Participants were parents of infants aged under 6 months, recruited through online advertising. Participants completed baseline questionnaires, then 2 further follow-up questionnaires at 7 days and 30 days post baseline. These questionnaires captured participant demographics (baseline) and perceptions of the program (follow-up), in addition to measuring parental fatigue (Fatigue Severity Scale), parent sense of competence, confidence, and self-efficacy (Me as a Parent Scale), and symptoms of anxiety (Generalized Anxiety Disorder 7-item scale) and depression (Edinburgh Postnatal Depression Scale) at all time points. Open-ended text responses were also collected at the 2 follow-up surveys. Questionnaire data were linked with participants' engagement with the program (Engagement Index), measured using app analytics.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Participants' (baseline: n=700; 7-d follow-up: n=339; and 30-d follow-up: n=220) engagement with the program varied; however, the majority reported cessation of app use by 1 month. Most participants were broadly satisfied with the program, finding the app easy to use and understand, and reported they could trust the information on the app. Those participants who had higher engagement or found the program most helpful for their sleep and their infant's sleep showed the greatest improvement in their fatigue. Qualitative feedback from participants noted that while many found the app a lifeline with helpful information and features, others noted unintended negative impacts, such as spending too much time on their phone.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Delivery of an infant sleep progra","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"9 ","pages":"e88948"},"PeriodicalIF":2.3,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13256176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148228553","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: 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":"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 are 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, well-being, and development. The secondary aim was to synthesize findings on these perspectives.</p><p><strong>Methods: </strong>Peer-reviewed papers published between January 2010 and September 2024 were identified through searches in 7 electronic databases. Studies were included if they examined parental or health care professionals' perspectives on technology use among children aged birth to 5 years. Two reviewers (CLR and IPHA) independently conducted the data extraction and study quality assessment. Reported psychometric properties of the questionnaires were synthesized. Deductive thematic analysis was used to explore the content focus of the questionnaire used in the included studies and synthesize the reported perspectives.</p><p><strong>Results: </strong>In total, 85 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. In total, 52 studies reported psychometric properties of the questionnaires used, of which, only 15 studies reported more than 1 measure of validity or reliability. A total of 75 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 behaviors.</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 recognized, 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>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"9 ","pages":"e84712"},"PeriodicalIF":2.3,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13256481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148228540","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":"Fully Virtual, Focused Applied Behavior Analysis Services: Acceptability and Feasibility Study.","authors":"William H Edwards, Brittany C Wierzba","doi":"10.2196/90243","DOIUrl":"10.2196/90243","url":null,"abstract":"<p><strong>Background: </strong>Traditional models of applied behavior analysis (ABA) services for those diagnosed with autism spectrum disorder (ASD) involve time-intensive, labor-intensive, comprehensive, in-person services. The increasing prevalence of ASD in the United States has precipitated a need to identify effective, accessible, and innovative methods to address the needs of those with ASD.</p><p><strong>Objective: </strong>The present descriptive study examines the feasibility and acceptability of a fully virtual, targeted model of ABA service delivery.</p><p><strong>Methods: </strong>This retrospective analysis evaluated changes over time in adaptive behavior, maladaptive behavior, and caregiver satisfaction during focused, virtual ABA therapy delivered by a Board Certified Behavior Analyst.</p><p><strong>Results: </strong>Improvements in standard scores across Vineland-3 domains and improvements in quality of life (Child and Family Quality of Life, Second Edition), in addition to high levels of caregiver satisfaction, were observed over time.</p><p><strong>Conclusions: </strong>While causality cannot be determined for these improvements, results support the feasibility and acceptability of this novel ABA service delivery model.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"9 ","pages":"e90243"},"PeriodicalIF":2.3,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13251544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148212759","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":"Health Care Use and Recurrence Rate in Hemolytic Disease of the Fetus and Newborn: Retrospective Cohort Study.","authors":"Nehaa Khadka, Michael J Fassett, Carol Mao, Fagen Xie, Vicki Y Chiu, Jiaxiao M Shi, Theresa M Im, Sunhea Kim, Daniella Park, Darios Getahun","doi":"10.2196/88772","DOIUrl":"10.2196/88772","url":null,"abstract":"<p><strong>Background: </strong>Hemolytic disease of the fetus and newborn (HDFN) is a life-threatening condition resulting from maternal-fetal erythrocyte antigen incompatibility. Although anti-Rhesus D (RhD) prophylaxis has reduced RhD-associated cases, HDFN persists due to non-RhD antibodies and gaps in prevention. Population-based data on maternal and neonatal outcomes and recurrence patterns are limited.</p><p><strong>Objective: </strong>This study aimed to characterize maternal and neonatal outcomes, health care use patterns, and recurrence rates of HDFN across pregnancies.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of 464,711 pregnancies within the Kaiser Permanente Southern California system from January 1, 2008, to June 30, 2022. HDFN diagnoses were confirmed using validated natural language processing-assisted manual chart review and followed through 2023. Maternal characteristics, neonatal outcomes, and health care use were compared by HDFN status, and recurrence patterns were evaluated among individuals with ≥2 pregnancies. Chi-square tests and Wilcoxon rank-sum tests were used to compare characteristics between HDFN and non-HDFN pregnancies. Statistical significance was defined as P<.05.</p><p><strong>Results: </strong>Among all pregnancies, 139 of 464,711 (0.03%) were diagnosed with HDFN. Women with HDFN were more likely than those without HDFN to be older (aged ≥35 years; n=42, 30.2% vs n=97,146, 20.9%) and multiparous (n=121, 87.1% vs n=264,766, 57%). Infants affected by HDFN had higher rates of preterm birth (n=40, 28.4% vs n=42,240, 9.5%), low birth weight (<2500 g; n=22, 15.6% vs n=31,740, 7.1%), and neonatal jaundice (n=92, 65.2% vs n=162,465, 36.4%) than non-HDFN infants. Delivery hospitalizations (median 5.0, IQR 2.0-7.5 days vs median 2.0, IQR 1.0-2.0 days) and neonatal intensive care unit stays (median 4.0, IQR 0.0-7.0 days vs median 0.0, IQR 0.0-0.0 days) were longer, and maternal nondelivery hospitalizations were more frequent (n=27, 19.4% vs n=23,228, 5%) among pregnancies complicated by HDFN. Among women with a prior HDFN-affected pregnancy, 83.3% (n=25) experienced recurrence in a subsequent pregnancy. Of these recurrent cases, 32% (n=8) were severe, and 75% (n=6) involved fetal anemia requiring at least 1 intrauterine transfusion.</p><p><strong>Conclusions: </strong>HDFN was rare but was associated with substantial maternal and neonatal morbidity, including higher rates of preterm birth, increased neonatal intensive care unit admissions, and greater health care use. Recurrence was frequent and clinically significant, underscoring the importance of early surveillance and proactive management strategies.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"9 ","pages":"e88772"},"PeriodicalIF":2.3,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13282594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148176923","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}