JMIR Pediatrics and Parenting最新文献

{"title":"Disclosure Patterns of Opioid Use Disorders in Perinatal Care During the Opioid Epidemic on X From 2019 to 2021: Thematic Analysis.","authors":"Dezhi Wu, Minnie Ng, Saborny Sen Gupta, Phyllis Raynor, Youyou Tao, Yang Ren, Peiyin Hung, Shan Qiao, Jiajia Zhang, Jennifer Fillo, Xiaoming Li, Constance Guille, Kacey Eichelberger, Bankole Olatosi","doi":"10.2196/52735","DOIUrl":"10.2196/52735","url":null,"abstract":"<p><strong>Background: </strong>In 2021, the United States experienced a 14% rise in fatal drug overdoses totaling 106,699 deaths, driven by harmful opioid use, particularly among individuals in the perinatal period who face increased risks associated with opioid use disorders (OUDs). Increased concerns about the impacts of escalating harmful opioid use among pregnant and postpartum persons are rising. Most of the current limited perinatal OUD studies were conducted using traditional methods, such as interviews and randomized controlled trials to understand OUD treatment, risk factors, and associated adverse effects. However, little is known about how social media data, such as X, formerly known as Twitter, can be leveraged to explore and identify broad perinatal OUD trends, disclosure and communication patterns, and public health surveillance about OUD in the perinatal period.</p><p><strong>Objective: </strong>The objective is 3-fold: first, we aim to identify key themes and trends in perinatal OUD discussions on platform X. Second, we explore user engagement patterns, including replying and retweeting behaviors. Third, we investigate computational methods that could potentially streamline and scale the labor-intensive manual annotation effort.</p><p><strong>Methods: </strong>We extracted 6 million raw perinatal-themed tweets posted by global X users during the opioid epidemic from May 2019 to October 2021. After data cleaning and sampling, we used 500 tweets related to OUD in the perinatal period by US X users for a thematic analysis using NVivo (Lumivero) software.</p><p><strong>Results: </strong>Seven major themes emerged from our thematic analysis: (1) political views related to harmful opioid and other substance use, (2) perceptions of others' substance use, (3) lived experiences of opioid and other substance use, (4) news reports or papers related to opioid and other substance use, (5) health care initiatives, (6) adverse effects on children's health due to parental substance use, and (7) topics related to nonopioid substance use. Among these 7 themes, our user engagement analysis revealed that themes 4 and 5 received the highest average retweet counts, and theme 3 received the highest average tweet reply count. We further found that different computational methods excel in analyzing different themes.</p><p><strong>Conclusions: </strong>Social media platforms such as X can serve as a valuable tool for analyzing real-time discourse and exploring public perceptions, opinions, and behaviors related to maternal substance use, particularly, harmful opioid use in the perinatal period. More health promotion strategies can be carried out on social media platforms to provide educational support for the OUD perinatal population.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"7 ","pages":"e52735"},"PeriodicalIF":2.1,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11494255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381842","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 and Acceptability of Using a Digital Conversational Agent (Chatbot) for Delivering Parenting Interventions: Systematic Review.","authors":"Max C Klapow, Andrew Rosenblatt, Jamie Lachman, Frances Gardner","doi":"10.2196/55726","DOIUrl":"10.2196/55726","url":null,"abstract":"<p><strong>Background: </strong>Parenting interventions are crucial for promoting family well-being, reducing violence against children, and improving child development outcomes; however, scaling these programs remains a challenge. Prior reviews have characterized the feasibility, acceptability, and effectiveness of other more robust forms of digital parenting interventions (eg, via the web, mobile apps, and videoconferencing). Recently, chatbot technology has emerged as a possible mode for adapting and delivering parenting programs to larger populations (eg, Parenting for Lifelong Health, Incredible Years, and Triple P Parenting).</p><p><strong>Objective: </strong>This study aims to review the evidence of using chatbots to deliver parenting interventions and assess the feasibility of implementation, acceptability of these interventions, and preliminary outcomes.</p><p><strong>Methods: </strong>This review conducted a comprehensive search of databases, including Web of Science, MEDLINE, Scopus, ProQuest, and Cochrane Central Register of Controlled Trials. Cochrane Handbook for Systematic Review of Interventions and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were used to conduct the search. Eligible studies targeted parents of children aged 0 to 18 years; used chatbots via digital platforms, such as the internet, mobile apps, or SMS text messaging; and targeted improving family well-being through parenting. Implementation measures, acceptability, and any reported preliminary measures of effectiveness were included.</p><p><strong>Results: </strong>Of the 1766 initial results, 10 studies met the inclusion criteria. The included studies, primarily conducted in high-income countries (8/10, 80%), demonstrated a high mean retention rate (72.8%) and reported high acceptability (10/10, 100%). However, significant heterogeneity in interventions, measurement methods, and study quality necessitate cautious interpretation. Reporting bias, lack of clarity in the operationalization of engagement measures, and platform limitations were identified as limiting factors in interpreting findings.</p><p><strong>Conclusions: </strong>This is the first study to review the implementation feasibility and acceptability of chatbots for delivering parenting programs. While preliminary evidence suggests that chatbots can be used to deliver parenting programs, further research, standardization of reporting, and scaling up of effectiveness testing are critical to harness the full benefits of chatbots for promoting family well-being.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"7 ","pages":"e55726"},"PeriodicalIF":2.1,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11494261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393969","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":"Videoconference-Delivered Cognitive Behavioral Therapy for Parents of Adolescents With Internet Addiction: Pilot Randomized Controlled Trial.","authors":"Hideki Horita, Yoichi Seki, Takumi Yamaguchi, Yuki Shiko, Yohei Kawasaki, Eiji Shimizu","doi":"10.2196/60604","DOIUrl":"10.2196/60604","url":null,"abstract":"<p><strong>Background: </strong>The rise in internet addiction, including web-based gaming and social networking services, is a serious concern. Even with access to medical institutions and counseling services, individuals with internet addiction, particularly adolescents, often refuse medical treatment or counseling. Parent-focused psychological intervention may lead to positive outcomes by improving the parent-adolescent relationship and helping parents identify and modify their adolescent's problematic behaviors, including internet addiction.</p><p><strong>Objective: </strong>This study was a pilot randomized controlled trial to test the feasibility of remote cognitive behavioral therapy via videoconferencing for parents of adolescents with internet addiction.</p><p><strong>Methods: </strong>A total of 13 parents of adolescents aged 12-20 years with internet addiction were recruited and randomly assigned to either 12 sessions of the videoconference-delivered cognitive behavioral therapy (vCBT) group (n=6, 46%) or the waitlist control group (n=7, 54%). The study period was from March 1, 2018, to March 31, 2022. The primary outcome was the scores of the Young Internet Addiction Test reported by the adolescents. The secondary outcomes were adolescents' hours of internet use per day (Internet Addiction Test), reported by the adolescents and by their parents; the Young Diagnostic Questionnaire, completed by the parents; and the quality of life of the adolescents and the parents, measured by the EQ-5D-5L. These were evaluated at weeks 0 and 13.</p><p><strong>Results: </strong>As the primary outcome, the mean total Internet Addiction Test score decreased from 67.7 (SD 18.3; 6/13, 46%) at week 0 to 56.2 (SD 25.1; 5/9, 56%) at week 13 in the vCBT group, compared to an increase from 66.9 (SD 21.9; 7/13, 54%) to 68.0 (SD 18.7; 4/9, 44%) in the control group. For all outcomes, no significant differences were found between the 2 groups (all P>.05).</p><p><strong>Conclusions: </strong>This study suggested the practical feasibility of vCBT for parents of adolescents with internet addiction. Further large-scale, multicenter randomized controlled trials are necessary to examine the effectiveness.</p><p><strong>Trial registration: </strong>UMIN Clinical Trials Registry UMIN000032483; https://tinyurl.com/yuhen6c9.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"7 ","pages":"e60604"},"PeriodicalIF":2.1,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11487207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366792","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":"Predictors of Participation in a Perinatal Text Message Screening Protocol for Maternal Depression and Anxiety: Prospective Cohort Study.","authors":"Julia Barnwell, Cindy Hénault Robert, Tuong-Vi Nguyen, Kelsey P Davis, Chloé Gratton, Guillaume Elgbeili, Hung Pham, Michael J Meaney, Tina C Montreuil, Kieran J O'Donnell","doi":"10.2196/53786","DOIUrl":"10.2196/53786","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Universal screening for depression and anxiety in pregnancy has been recommended by several leading medical organizations, but the implementation of such screening protocols may overburden health care systems lacking relevant resources. Text message screening may provide a low-cost, accessible alternative to in-person screening assessments. However, it is critical to understand who is likely to participate in text message-based screening protocols before such approaches can be implemented at the population level.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to examine sources of selection bias in a texting-based screening protocol that assessed symptoms of depression and anxiety across pregnancy and into the postpartum period.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Participants from the Montreal Antenatal Well-Being Study (n=1130) provided detailed sociodemographic information and completed questionnaires assessing symptoms of depression (Edinburgh Postnatal Depression Scale [EPDS]) and anxiety (State component of the State-Trait Anxiety Inventory [STAI-S]) at baseline between 8 and 20 weeks of gestation (mean 14.5, SD 3.8 weeks of gestation). Brief screening questionnaires, more suitable for delivery via text message, assessing depression (Whooley Questions) and anxiety symptoms (Generalized Anxiety Disorder 2-Item questionnaire) were also collected at baseline and then via text message at 14-day intervals. Two-tailed t tests and Fisher tests were used to identify maternal characteristics that differed between participants who responded to the text message screening questions and those who did not. Hurdle regression models were used to test if individuals with a greater burden of depression and anxiety at baseline responded to fewer text messages across the study period.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Participants who responded to the text messages (n=933) were more likely than nonrespondents (n=114) to self-identify as White (587/907, 64.7% vs 39/96, 40.6%; P&lt;.001), report higher educational attainment (postgraduate: 268/909, 29.5% vs 15/94, 16%; P=.005), and report higher income levels (CAD $150,000 [a currency exchange rate of CAD $1=US $0.76 is applicable] or more: 176/832, 21.2% vs 10/84, 11.9%; P&lt;.001). There were no significant differences in symptoms of depression and anxiety between the 2 groups at baseline or postpartum. However, baseline depression (EPDS) or anxiety (STAI-S) symptoms did predict the total number of text message time points answered by participants, corresponding to a decrease of 1% (e&lt;sup&gt;β&lt;/sup&gt;=0.99; P&lt;.001) and 0.3% (e&lt;sup&gt;β&lt;/sup&gt;=0.997; P&lt;.001) in the number of text message time points answered per point increase in EPDS or STAI-S score, respectively.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Findings from this study highlight the feasibility of text message-based screening protocols with high participation rates. However, our findings also highlight how screening and service delivery via","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"7 ","pages":"e53786"},"PeriodicalIF":2.1,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11487212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366791","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 of MyREADY Transition BBD Mobile App, a Health Intervention Technology Platform, to Improve Care Transition for Youth With Brain-Based Disabilities: User-Centered Design Approach.","authors":"Ariane Marelli, Ronen Rozenblum, Clara Bolster-Foucault, Alicia Via-Dufresne Ley, Noemie Maynard, Khush Amaria, Barb Galuppi, Sonya Strohm, Linda Nguyen, Claire Dawe-McCord, Connie Putterman, Adrienne H Kovacs, Jan Willem Gorter","doi":"10.2196/51606","DOIUrl":"10.2196/51606","url":null,"abstract":"<p><strong>Background: </strong>Transition from pediatric to adult health care varies and is resource intensive. Patient-centered health information technology (HIT) interventions are increasingly being developed in partnership with patients.</p><p><strong>Objective: </strong>This study aims to develop an internet-based mobile app intervention for patients with brain-based disabilities to improve transition in care readiness.</p><p><strong>Methods: </strong>The app was designed for patients aged 15 to 17 years with brain-based disabilities having the ability to use a mobile app. A multidisciplinary team, an industry partner, and a patient and family advisory council was assembled. We hypothesized that existing tools could be migrated into the app to address education, empowerment, and navigation. We used cognitive learning theory to support chapters targeting transition in care skill sets. We used the agile iterative methodology to engage stakeholders.</p><p><strong>Results: </strong>We developed a novel MyREADY Transition HIT platform. An electronic mentor supported cognitive learning with messaging, quizzes, rewards, and videos. We used gaming to guide navigation through a fictitious health care city. Adapting existing tools was achieved by the patient and family advisory council requesting personalization. Our iterative design required time-consuming back-end technology management. Developing the platform took 24 months instead of our grant-approved 12 months, impacting the onset of the planned trial within the allotted budget.</p><p><strong>Conclusions: </strong>A novel patient-centered HIT platform to improve health care transition was successfully developed in partnership with patients and industry. Careful resource management was needed to achieve timely delivery of the end product, flagging the cautious planning required to deliver HIT tools in time for the much-needed trials informing their clinical application.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT03852550; https://clinicaltrials.gov/study/NCT03852550.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"7 ","pages":"e51606"},"PeriodicalIF":2.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11480690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355724","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 Apps in the Digital Marketplace for Pediatric Patients With Cancer: Systematic Search and Analysis.","authors":"Micah A Skeens, Daniel I Jackson, Malcolm S Sutherland-Foggio, Emre Sezgin","doi":"10.2196/58101","DOIUrl":"10.2196/58101","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The substantial increase in smartphone ownership has led to a rise in mobile health (mHealth) app use. Developing tailored features through mHealth apps creates a pathway to address the health care needs of pediatric patients with cancer and their families who have complex care needs. However, few apps are designed specifically to integrate with pediatric cancer care.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study reports a systematic search and analysis of mHealth apps available on the Apple App (iOS) and Google Play (Android) stores designed for pediatric cancer through a list of features that serve (1) patients, (2) caregivers, or (3) both audiences.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we reviewed apps for pediatric patients with cancer and caregivers available as of January 30, 2024. We searched the Apple App and Google Play stores with a list of keyword combinations focusing on pediatric cancer care. The inclusion criteria were (1) specifically apps targeted toward pediatric patients with cancer, their families, or both; (2) available in either app store; and (3) available in English. Apps were assessed using the Mobile Application Rating Scale (MARS). The MARS is a quality assessment for mHealth apps, including components of engagement, functionality, aesthetics, and informational quality (5-point Likert scale items-1: low and 5: high quality).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In total, 22 apps were identified and 17 of those apps were available on both platforms. The most popular features (n=12) were resource sharing, symptom tracking, reminders, care team connections, journaling, community support, medication tracking, data visualizations, and appointment tracking. Features and interfaces were designed for caregivers (n=9) more frequently than the patients (n=7) while a subset of apps created options for both users (n=6). A total of 16 apps received positive reviews (mean 4.4, SD 0.59; Min=3.1, Max=5.0). A small subset (n=3) achieved over 5000 downloads; however, the majority (n=15) had fewer than 500. More than half (n=12) of the apps were not available in English. Apps requested access to a range of device functionalities to operate (mean 2.72, SD 3.13; Min=0, Max=10). Out of 22, a total of 17 apps were publicly accessible. The mean MARS scores for the apps ranged from 1.71 (SD 0.75) to 4.33 (SD 0.82). Overall, apps scored high on functionality (mean 3.72, SD 0.54) but low on engagement (mean 3.02, SD 0.93).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Our review highlights the promising yet underdeveloped potential of mHealth apps in pediatric oncology care, underscoring the need for more inclusive, comprehensive, and integrative digital health solutions. Future developments should actively involve key stakeholders from the pediatric oncology community, including patients, families, and health care professionals, to ensure ","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"7 ","pages":"e58101"},"PeriodicalIF":2.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11460307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355725","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":"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":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;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.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;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.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;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.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;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).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Technology-based CFHN support is generally acceptable to mothers. Maternal characteristics, including employment statu","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"7 ","pages":"e59191"},"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":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;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.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;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.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;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.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;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&lt;.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).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;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":"7 ","pages":"e50289"},"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":"7 ","pages":"e60330"},"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":"7 ","pages":"e56816"},"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}