JMIR Pediatrics and Parenting最新文献

{"title":"mHealth-Enabled Stroke Screening for Pediatric Sickle Cell Disease in Low-Resource Settings: Systematic Literature Review of Critical Barriers, Emerging Technologies, and AI-Driven Solutions.","authors":"Nursat Jahan, Seung Yup Lee, Nafisa Anjum, Monica Swahn, Sangsun Choi, Andrew Peachey, Sweta Sneha, Chitalu Kabwe, Nazmus Sakib","doi":"10.2196/76937","DOIUrl":"10.2196/76937","url":null,"abstract":"<p><strong>Background: </strong>Sickle cell disease (SCD) is a genetic blood disorder affecting millions globally, with life-threatening complications, and most patients live in sub-Saharan Africa. Particularly, children with SCD have a high risk of stroke. Although early screening for stroke could help prevent many cases, access to effective stroke screening remains limited in low-resource settings (LRS). Existing traditional approaches are highly operator-dependent, costly, resource-intensive, or difficult to deploy at scale in pediatric care. These limitations highlight the urgent need for accessible, scalable, and child-appropriate stroke screening and assessment tools suitable for low-resource health care contexts.</p><p><strong>Objective: </strong>The aims of this systematic literature review are to (1) uncover system-level barriers affecting stroke screening accessibility for patients with pediatric sickle cell disease (PSCD) in LRS, including underserved contexts within high-income countries; (2) identify existing and emerging stroke screening and assessment technologies and their implementation characteristics, such as feasibility, scalability, portability, and training requirements; and (3) propose a user-centered mobile health (mHealth) framework for stroke screening that improves accessibility and feasibility in resource-constrained health care settings.</p><p><strong>Methods: </strong>PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed to organize the search process. A systematic search was conducted using an advanced query and defined eligibility criteria in the academic databases of PubMed, IEEE Xplore, Wiley Online Library, and Google Scholar. Studies published in English between January 1, 2021, and October 31, 2025, were selected. Collected data were arranged in a preformatted Microsoft Excel spreadsheet for analysis. Risk-of-bias assessment was performed using various risk-of-bias assessment tools because of the heterogeneity of the included studies. Narrative synthesis was used for data synthesis.</p><p><strong>Results: </strong>The literature search initially identified 1465 studies, of which 28 (2%) were selected for analysis. Among the 28 studies, 10 (36%) focused on stroke screening accessibility for patients with PSCD in either low- and middle-income countries or other income-level countries for LRS, and 18 (64%) outlined key features and the feasibility of stroke screening technologies. Identified barriers were organized into 4 major categories (workforce and training constraints, health care system and infrastructure barriers, sociocultural and awareness factors, and economic and logistical constraints), emphasizing difficulties in accessing stroke screening in LRS. Additionally, existing and emerging stroke screening technologies were classified into 5 groups: nonimaging, imaging, light-based optical spectroscopy, biomarker-based, and artificial intelligence- and machine","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"9 ","pages":"e76937"},"PeriodicalIF":2.3,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13053000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screen Time, Child Depression, and Anxiety During the COVID-19 Pandemic: Systematic Review and Meta-Analysis.","authors":"Marissa Yoshizawa, Jennifer Rafeedie, Jasmyn J Tang, Bryan T Lei, Ramon Durazo-Arvizu, Danny Azucar, Sharon Hudson, Sheela Rao, Karen Kay Imagawa, Alexis Deavenport-Saman","doi":"10.2196/83228","DOIUrl":"10.2196/83228","url":null,"abstract":"<p><strong>Background: </strong>In response to the COVID-19 pandemic, governments around the world enforced stay-at-home orders and social distancing guidelines that amplified the use of screen time among pediatric populations. Excessive screen time may negatively impact mental health by increasing depression and anxiety.</p><p><strong>Objective: </strong>The first aim was to conduct a systematic review of articles examining screen time and mental health outcomes among children and adolescents during the COVID-19 pandemic from 2020 to 2023. The second aim was to determine the combined effect sizes for the associations of screen time and depression and/or anxiety among children and adolescents during the COVID-19 pandemic from 2020 to 2023 and whether gender or age influenced outcomes.</p><p><strong>Methods: </strong>Bibliographic databases were searched including MEDLINE (Ovid), Embase (Elsevier), Cochrane Library (Wiley), CINAHL Complete (EBSCO), and PsycINFO (EBSCO). There were a total of 6462 nonduplicate studies that were screened. Study inclusion criteria included children ages 0 to <18 years, the effects of screen time on children during the COVID-19 pandemic, screen time and depression and/or anxiety, articles written in English, and articles, including quantitative and qualitative studies, published between 2020 and 2023. A total of 452 articles underwent full-text review with 23 articles meeting criteria for final article extraction.</p><p><strong>Results: </strong>A total of 23 studies totaling 29,581 children and adolescents were included in the study. Results showed that most studies reported a positive association between screen time and depression and/or anxiety (r=0.175, 95% CI 0.124-0.226, P<.001 and r=0.157, 95% CI 0.0994-0.214, P<.001, respectively) during COVID-19. Meta-regression revealed that screen time measured in problematic use of electronic devices had a 0.15 higher correlation with anxiety compared to screen time measured in duration of electronic device use.</p><p><strong>Conclusions: </strong>During the COVID-19 pandemic, children and adolescents with higher levels of screen time had increased depression and/or anxiety. Findings suggest the need for ongoing parent, professional, and self-monitoring of youth screen behaviors and habits as well as activities that promote social connectedness during global or national health emergencies.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"9 ","pages":"e83228"},"PeriodicalIF":2.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13041624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Explanatory Factors of Vaccination Dropout Among Children Aged 12 to 23 Months in the Kikula Health Zone, Democratic Republic of Congo: Cross-Sectional Analytical Study.","authors":"Blaise Musoya Mumba, Fiston Ilunga Mbayo, Pacifique Kanku Wa Ilunga, Hermann Tamubango Kitoko, Pascal Geri Madragule, Jean Nyandwe Kyloka","doi":"10.2196/88879","DOIUrl":"10.2196/88879","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Vaccination is among the most effective public health interventions to reduce childhood morbidity and mortality. Despite World Health Organization recommendations, global immunization coverage has declined in recent years, with the COVID-19 pandemic causing the largest sustained backslide in routine immunization in 3 decades. In the Democratic Republic of Congo (DRC), full immunization coverage remains below 50%, hindered by inequities, supply shortages, and financing delays. In the Kikula Health Zone, administrative reports suggest coverage exceeding 100%, yet independent surveys consistently reveal low completion and high dropout rates between Bacillus Calmette-Guérin (BCG) and measles vaccines. No previous study has specifically examined determinants of dropping out in this setting.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study assessed the prevalence and determinants of vaccination dropout between BCG and measles vaccines among children aged 12 to 23 months in the Kikula Health Zone, Likasi, DRC.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;An analytical cross-sectional survey was conducted from April 22 to May 22, 2025, using 3-stage cluster sampling to recruit 300 mother-child pairs. Vaccination status was verified using cards; for children without documentation, caregiver recall and health facility registers were used to minimize misclassification. Structured questionnaires captured sociodemographic data, child characteristics, maternal knowledge, perceptions of services, and health system access. Dropout was defined as receipt of BCG but not the measles vaccine. Bivariate associations were tested using chi-square tests, and multivariate logistic regression identified independent predictors, with robust SEs to account for clustering. Ethics approval was obtained from the University of Kinshasa School of Public Health.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among 300 children, 115 (38.3%) had dropped out between BCG and measles vaccination, while 185 (61.7%) completed the schedule. Possession of a vaccination card was the strongest predictor: children without a card had 30-fold higher odds of dropout (adjusted odds ratio 30.9, 95% CI 11.6 82.0; P&lt;.001). Other factors associated with dropout in bivariate analysis included shorter residence duration (≤5 y), lower maternal education, and nonuse of child health services, although these lost significance in multivariate models. Maternal knowledge gaps were notable: 169 (56.3%) did not know their child's vaccination status and 148 (49.3%) expressed fear of side effects. Service perceptions were generally positive (participants reporting good reception: n=294, 98%), but 108 (36%) experienced waiting times of 1 to 2 hours. The exclusion of undocumented children likely led to underestimation of dropout prevalence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Vaccination dropout between BCG and measles remains high in the Kikula Health Zone, driven primarily by lack of vaccination cards and materna","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"9 ","pages":"e88879"},"PeriodicalIF":2.3,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13037574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship Among Internet Use, eHealth Literacy, Internet Addiction, and Physical Activity Among Adolescents: Cross-Sectional Study.","authors":"Xavier C C Fung, Joyce S C Cheung, Fay F Wang, Benson W M Lau, Shirley P C Ngai","doi":"10.2196/83936","DOIUrl":"10.2196/83936","url":null,"abstract":"<p><strong>Background: </strong>The internet is highly convenient and has become an indispensable part of daily life. However, its widespread use also has notable disadvantages, such as the risk of internet addiction. Still, increased internet use may enhance eHealth literacy, and online health information seeking may contribute to health promotion. In Hong Kong, internet addiction and low physical activity among adolescents are growing concerns, underscoring the need to address internet use to better support the health and well-being of youth.</p><p><strong>Objective: </strong>This study aimed to investigate the effects of internet use, eHealth literacy, and internet addiction on adolescents' physical activity in Hong Kong.</p><p><strong>Methods: </strong>An online cross-sectional study was conducted in Hong Kong between June 2023 and August 2023. Secondary school students aged 12 to 18 years were recruited. Data were collected using the eHealth Literacy Scale, the International Physical Activity Questionnaire, the Chen Internet Addiction Scale, and a questionnaire assessing demographic characteristics and the use of eHealth technologies. Spearman ρ correlation and mediation analyses were performed to examine the relationships among variables.</p><p><strong>Results: </strong>A total of 117 participants were included. Participants reported an average internet use of 5.28 (SD 3.50) hours per day, and the mean eHealth literacy score was 31.15 (SD 4.04). Correlation analyses revealed that internet use was positively correlated with internet addiction (r=0.33; P<.001) but negatively correlated with physical activity (r=-0.21; P=.02), and internet addiction was negatively correlated with physical activity (r=-0.26; P=.005). In addition, the mediation analysis demonstrated that both internet use and eHealth literacy had a direct effect on internet addiction (B=1.53, P<.001 and B=-0.91, P=.002, respectively). Internet addiction had a direct effect on physical activity (B=-43.94, P=.02). In contrast, eHealth literacy had no significant direct effect on physical activity and did not mediate the relationship between internet use and physical activity.</p><p><strong>Conclusions: </strong>The findings highlight the importance of eHealth literacy in reducing internet addiction. However, future research should further examine factors that mediate the relationship between eHealth literacy and physical activity or other health-related behaviors. This study sheds light on the benefits of promoting eHealth literacy among adolescents to prevent internet addiction and offers practical insights for teachers and parents.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"9 ","pages":"e83936"},"PeriodicalIF":2.3,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13035029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthy Lifestyle Practices, Online Health Information-Seeking Behaviors, and Internet Usage Among Pregnant Women: Multigroup Structural Equation Modeling Approach.","authors":"Ying Lau, Yueyang Yi, Zebulon To, Sai Ho Wong, Thomas Yuen Tung Lam","doi":"10.2196/80637","DOIUrl":"10.2196/80637","url":null,"abstract":"<p><strong>Background: </strong>Singapore is a multicultural society characterized by a diverse array of ethnic groups, including Chinese, Malay, Indians, and others. A considerable percentage of Singaporeans are active users of the internet. The internet has become a significant resource for health education, particularly for women who wish to learn about a healthy lifestyle during pregnancy. However, it is still unclear how pregnant women search for information online, particularly within specific groups.</p><p><strong>Objective: </strong>This study aimed to explore the relationship between healthy lifestyle practices, online health information-seeking behaviors, and internet usage (IU) among 1905 pregnant women.</p><p><strong>Methods: </strong>Structural equation modeling (SEM) was used to evaluate the relationships between the appropriate intake of food groups, healthy diet practices (HD), internet for dietary advice (ID), internet for physical activity advice (IP), and IU, based on 5 hypotheses rooted in theoretical concepts. We used a multigroup SEM approach to examine these hypotheses across various ages, ethnicities, BMI, and categories of pregnant groups.</p><p><strong>Results: </strong>Our results confirmed 5 hypotheses, indicating significant relationships among the variables: appropriate intake of food groups was positively linked to HD (β=0.262; P<.001); HD was positively linked to ID (β=.168; P<.001); ID was positively linked to IP (β=0.185; P<.001); IP was positively linked to IU (β=0.190; P<.001); and HD was negatively linked to IU (β=-0.208; P<.001). The multigroup SEM analyses yielded significant differences in Hypotheses 2 and 3 when comparing different age groups (P=.009), BMI categories (P=.03), and number of pregnancies (P=.003).</p><p><strong>Conclusions: </strong>Our findings offer valuable insights into developing customized online interventions aimed at encouraging a healthy lifestyle during pregnancy.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"9 ","pages":"e80637"},"PeriodicalIF":2.3,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13035086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Feasibility of Supporting Caregivers of Young Children With Disruptive Behaviors Through Nurse-Delivered Phone Coaching: Quality Improvement Study.","authors":"Hannah Mulholland, Jasmine Berry, Tammy Schmit, Barbara McIlrath, Jocelyn Lebow","doi":"10.2196/65244","DOIUrl":"10.2196/65244","url":null,"abstract":"<p><strong>Background: </strong>Although childhood behavior problems are common, and strong evidence-based interventions exist to address these challenges, many families struggle to access care and remain in treatment long enough to see results. The Support and Advocacy through Providing Parents Helpful Interventions, Resources, and Education (SAPPHIRE) program was developed to address barriers to accessing care for disruptive behaviors in young children.</p><p><strong>Objective: </strong>This quality improvement program assessed the feasibility of SAPPHIRE, a primary care-based intervention delivered via telephone by trained nurses to caregivers of young children (n=36, ages 1-6 y) who exhibit disruptive behaviors.</p><p><strong>Methods: </strong>The feasibility and acceptability of the SAPPHIRE program were assessed during a 3-month quality improvement study.</p><p><strong>Results: </strong>Of 36 participants, 25 (69%) completed the SAPPHIRE program. Over the course of 3 months, the number of nurse calls with completers ranged from 1 to 15, with a mean of 5.3 (SD 3.4) calls. Overall, nurses spent an average of 120.9 (SD 99.2, range 15-380) minutes on the phone with each caregiver across the 3-month pilot period. Caregivers and nurses rated the program as acceptable across all metrics. For nurses, strengths of SAPPHIRE included the continuity of care with one family, while barriers included time constraints. Comparison of preintervention and postintervention caregiver ratings on measures of disruptive behaviors showed a moderate to negligible effect on reported behavior problems depending on the age of the child (children <4 y: d=0.55 and children 4-6 y: d=0.18). Caregiver-rated parenting self-competence increased over the course of the SAPPHIRE intervention, approaching a large effect (d=0.75).</p><p><strong>Conclusions: </strong>Findings suggest that SAPPHIRE is a feasible and acceptable treatment for caregivers of young children with disruptive behaviors and shows promise for increasing parenting self-competence, which is a hypothesized moderator of future behavior problems. These preliminary data support the need for more rigorous empirical evaluation of the SAPPHIRE program.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"9 ","pages":"e65244"},"PeriodicalIF":2.3,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13027681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147533390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Pattern and Characteristics of Childhood Unintentional Injuries in Abha Maternity and Children Hospital, KSA: Prospective Descriptive Study.","authors":"Ihab Mohammed Ibrahim Elsorogy, Niemat Mohammed Tahir Ali, Alam Eldin Musa Mustafa, Ibrahim Alhelali, Ibrahim Al-Benhassan, Ahmed Alhijab A Alhazmi, Safa Ahmed Ali Fadoul, Emad Mohammed Mosaad Mohammed, Mohammed Mahmoud Mohammed Almusdi","doi":"10.2196/83867","DOIUrl":"10.2196/83867","url":null,"abstract":"<p><strong>Background: </strong>In Saudi Arabia, unintentional injuries among children represent a prevalent and significant public health issue and severe injuries are of the leading indications for hospitalization and impairments.</p><p><strong>Objective: </strong>This study aimed to describe the pattern of unintentional trauma in children admitted to Abha Maternal and Children Hospital, South region of Saudi Arabia.</p><p><strong>Methods: </strong>This study was a prospective descriptive, cross-sectional, hospital-based study, which was conducted in the Pediatric Intensive Care Unit, Maternity and Children's Hospital, Abha, Aseer region, Saudi Arabia. This is the central and main hospital in the region but not the only hospital receiving childhood injuries. The study period was from January 2023 to January 2024. Children's age groups were from 0 to 12 years old. All children in the study were admitted with a diagnosis of unintentional injuries, like RTAs (road traffic accidents), falls, and other home accidents. The study included 104 children and the data collected were analyzed using SPSS (version 27; IBM Corp). Appropriate statistical tests were used for the analysis and all tests were two tailed and probability P≤.05 is considered significant.</p><p><strong>Results: </strong>The sample size of the study was 104 children. The gender distribution was 35 females (33.7 %) and 69 males (66.3 %). The patients were recruited from 18 cities in the Aseer region. About half of the patients (49%) were aged 6-12 years. Road traffic accidents (RTA) represent the highest percentage of accidents, with 66 (63.5%) children, followed by falls from height with 38 (36.5%) patients. The most significant types of injuries were head and brain injuries 37 (35.6%), followed by chest and lung injuries 12 (11.5%). Most patients (n=62, 59.6%) remained admitted to the pediatric intensive care unit (PICU) for one to three days. Followed by three to seven days (27), then eight to 14 days (14). Head/brain axonal injury is also the most common injury associated with complications, followed by polytrauma.</p><p><strong>Conclusions: </strong>Road traffic accidents are a significant cause of death and disability in Saudi Arabia for all age groups. A strong association existed between the PICU admission duration and the outcome (P=.02). Health and community institutes and governments should increase community education about the risks and consequences of RTA, strengthen traffic rules and laws, and punish violators.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"9 ","pages":"e83867"},"PeriodicalIF":2.3,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13028911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147533449","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":"Technology Access and Preferences for Smartphone App Interventions to Optimize Iron Chelation Therapy Adherence Among Adolescents, Young Adults, and Parents of Children Receiving Chronic Transfusions: Cross-Sectional Survey Study.","authors":"Paavani Reddy, Margaret Locke, Sherif Badawy","doi":"10.2196/69584","DOIUrl":"10.2196/69584","url":null,"abstract":"<p><strong>Background: </strong>Iron chelation therapy (ICT) is essential for people with hematological disorders requiring chronic transfusions to minimize the risk of iron overload, yet suboptimal adherence is prevalent. Widespread use of personal technology makes mobile health (mHealth) an attractive platform to promote adherence.</p><p><strong>Objective: </strong>This study aimed to examine access to mobile technology and preferences for an mHealth intervention to improve adherence to ICT.</p><p><strong>Methods: </strong>A cross-sectional survey that included 63 items assessing technology access, mHealth preferences, and demographics was administered through REDCap (Research Electronic Data Capture), a digital research data tool, during packed red blood cell transfusion visits. Parents of children receiving chronic transfusions, as well as adolescents and young adults receiving chronic transfusions, were enrolled between August 2018 and June 2019. Patients had to have a hematologic diagnosis requiring chronic transfusions, be receiving ICT, and be aged 12 years or older to complete the survey. Parents were required to have a child aged 24 months who met these criteria.</p><p><strong>Results: </strong>A total of 60 participants were included (median age 31.5, IQR 20-39 years; n=40, 67% female), with 29 (48%) being parents and 31 (52%) being patients. All parents and patients owned an electronic tablet, a smartphone, or both. The most endorsed mHealth app features among all participants included laboratory test monitoring (55/60, 92%), reminders to take iron chelation medication (50/60, 83%), and education about ICT (49/60, 82%). Parents' most endorsed features included laboratory test monitoring (27/29, 93%) and education about ICT (25/29, 86%). Patients' most endorsed features included laboratory test monitoring (28/31, 90%) and reminders to take iron chelation medication (28/31, 90%). There were no substantial differences between parents and patients in their preferences.</p><p><strong>Conclusions: </strong>Both parents and adolescents and young adults reported a strong interest in multiple mHealth app features. Participants provided valuable insights into optimal strategies and preferred app features for developing a multifunctional technology-based behavioral intervention to promote ICT adherence.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"9 ","pages":"e69584"},"PeriodicalIF":2.3,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13011995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515430","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 Usability Testing of the Mobile Childhood Asthma Management Program (mCHAMP) App: Sequential Mixed Methods Study.","authors":"Robert J Lucero, Kristen Shear, Andrea Fidler, David Fedele, Yunpeng Xia, David Janicke","doi":"10.2196/71681","DOIUrl":"10.2196/71681","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;More than 6 million children in the United States have asthma, and more than 20% are clinically obese. Youth with asthma and obesity are susceptible to poor health outcomes, including greater asthma symptom severity and hospitalizations, reduced physical activity, and poorer quality of life. Mobile health technologies can increase access to chronic disease self-management interventions, and family members can be powerful influencers given their substantial control over a child's behavior and home environment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The Mobile Childhood Asthma Management Program (mCHAMP) app is based on the in-person Childhood Asthma Management Program (CHAMP) behavioral family intervention pilot trial of school-aged children with asthma and obesity. In this study, we translated the CHAMP content into digital content and conducted summative testing to measure the usability, learnability, and efficiency of the mCHAMP app.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We applied a sequential mixed methods approach. The mCHAMP app targeted adult caregivers of children living with asthma and obesity aged 6 to 12 years. A consumer-centered approach was used to guide the identification of user requirements and conduct of summative usability testing. While the mCHAMP app is primarily caregiver facing, it is intended to connect caregivers with registered nurse (RN) interventionists. Therefore, we sought feedback from RNs as key stakeholders.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Caregivers (n=10) were female (n=10, 100%) and mostly African American (n=8, 80%), and half (n=5, 50%) had an annual household income of &lt;US $25,000; most of their children (n=6, 60%) were in the 99th BMI percentile. Post-Study eHealth Usability Questionnaire scores indicated high overall satisfaction, usefulness, and quality of the mCHAMP app. Most caregivers (n=7, 70%) were able to complete all 15 tasks across the 6 modules with 2 or fewer hints. The average total time to complete all tasks was 17 (SD 3.9; range 11.4-24.1) minutes. Most caregivers (n=7, 70%) wanted information in static form but also preferred alternatives (eg, audio or video) to support flexibility with consuming the content. Caregivers expressed the need for more child-facing content as well as tailored decision support related to diet and exercise. RNs (n=5) strongly endorsed their role and use of the mCHAMP app to promote self-management among caregivers of children with obesity and asthma. They noted the importance of integrating the mCHAMP app into a local electronic health record and existing workflows.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Caregivers expressed a desire for an intervention that was easy to use and could integrate into their busy family lives. We met this expectation based on the usability, learnability, and efficiency results of our study. The mCHAMP app has the potential to increase self-management for parents and pediatric patients with asthma with multimorbidity, w","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"9 ","pages":"e71681"},"PeriodicalIF":2.3,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13049398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147487732","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":"Digital Health Interventions for Sexual Health Education Among Adolescents With Autism Spectrum Disorder: Scoping Review.","authors":"Elsi Rahmadani, Idris Adewale Ahmed","doi":"10.2196/79009","DOIUrl":"10.2196/79009","url":null,"abstract":"<p><strong>Background: </strong>Adolescents with autism spectrum disorder (ASD) experience persistent barriers to accessing comprehensive and developmentally appropriate sexual health education. Conventional curricula often fail to reflect their cognitive, social, and communication needs, increasing vulnerability to misinformation and sexual exploitation. Digital health interventions offer a promising avenue to deliver tailored, interactive, and accessible learning experiences for adolescents with ASD.</p><p><strong>Objective: </strong>This scoping review aimed to map and synthesize the evidence on digital health interventions designed to provide sexual health education to adolescents with ASD.</p><p><strong>Methods: </strong>A scoping review was conducted using Arksey and O'Malley's framework, refined with Joanna Briggs Institute guidance and reported following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) standards. In total, 6 databases (ie, PubMed, Scopus, CINAHL, ERIC, PsycINFO, and Web of Science) were searched from 2010 to June 2025. Eligible studies involved adolescents aged 10 to 19 years with ASD, used digital platforms to deliver sexual or reproductive health education, and were published in English. Two reviewers independently screened, extracted, and synthesized data using descriptive and thematic approaches.</p><p><strong>Results: </strong>A total of 16 studies met the inclusion criteria. Most studies were conducted in high-income countries and delivered content through video-based, web-based, or mobile modalities. Key features associated with positive learning outcomes included personalization, strong visual interactivity, and caregiver involvement. Reported improvements focused on sexual knowledge, behavioral understanding, and user acceptability. However, methodological limitations were common, including small and nonrepresentative samples, a lack of standardized outcome measures, and minimal gender-specific or culturally adapted content. Notably, co-design with autistic adolescents and implementation in low- and middle-income countries was scarce.</p><p><strong>Conclusions: </strong>Digital health interventions demonstrate promising early effectiveness for delivering inclusive, developmentally appropriate sexual health education to adolescents with ASD. To advance this field, future research must strengthen methodological rigor, include diverse and gender-balanced populations, use participatory design, and ensure cultural adaptability to support equitable access globally.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"9 ","pages":"e79009"},"PeriodicalIF":2.3,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13002158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147487233","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}