JMIR Pediatrics and Parenting最新文献

{"title":"Simulation of Contraceptive Access for Adolescents and Young Adults Using a Pharmacist-Staffed e-Platform: Development, Usability, and Pilot Testing Study.","authors":"Kayla Knowles, Susan Lee, Sophia Yapalater, Maria Taylor, Aletha Y Akers, Sarah Wood, Nadia Dowshen","doi":"10.2196/60315","DOIUrl":"10.2196/60315","url":null,"abstract":"<p><strong>Background: </strong>Offering contraceptive methods at pharmacies without a prescription is an innovative solution to reduce the incidence of unintended pregnancies among adolescents and young adults (AYA). Pharmacy-prescribed contraception may increase the convenience, simplicity, and affordability of contraceptives.</p><p><strong>Objective: </strong>The aim of this study was to develop, pilot test, and evaluate the acceptability and feasibility of a telemedicine electronic platform app simulating pharmacist prescribing of contraceptives to AYA as well as assess agreement between pharmacist-simulated contraceptive approvals and contraception as prescribed in routine clinic visits.</p><p><strong>Methods: </strong>This study was conducted in two phases: (1) development and usability testing of a prototype app to simulate pharmacists prescribing contraceptives to AYA and (2) pilot testing the app in a simulation for AYA requesting contraception from a pharmacist with pharmacist review and request approval or rejection. Eligibility criteria in both phases included the following: assigned female sex at birth, age 15-21 years, seeking contraceptive services at an academic adolescent medicine clinic, prior history of or intention to have penile-vaginal intercourse in the next 12 months, smartphone ownership, and English language proficiency. Phase 1 (usability) involved a video-recorded \"think aloud\" interview to share feedback and technical issues while using the app prototype on a smartphone and the completion of sociodemographic, sexual history, and perception of the prototype surveys to further develop the app. Phase 2 (pilot) participants completed phase 1 surveys, tested the updated app in a simulation, and shared their experiences in an audio-recorded interview. Descriptive analyses were conducted for quantitative survey data, and thematic analyses were used for interview transcripts.</p><p><strong>Results: </strong>Of the 22 participants, 10 completed usability testing, with a mean age of 16.9 (SD 1.97) years, and 12 completed pilot testing, with a mean age of 18.25 (SD 1.48) years. Three issues with the prototype were identified during \"think aloud\" interviews: challenges in comprehension of medical language, prototype glitches, and graphic design suggestions for engagement. Usability testing guided the frontend and backend creation of the platform. Overall, participants agreed or strongly agreed that using an app to receive contraceptives would make it easier for teens to access (n=19, 86%) and make contraceptive use less stigmatizing (n=19, 86%). In addition, participants agreed that receiving contraception prescriptions from a pharmacist without a clinic visit would be safe (n=18, 82%), convenient (n=19, 86%), acceptable (n=18, 82%), and easy (n=18, 82%). Pharmacists and medical providers had 100% agreement on the prescribed contraceptive method for pilot participants.</p><p><strong>Conclusions: </strong>AYA found contraceptive p","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"8 ","pages":"e60315"},"PeriodicalIF":2.1,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11888086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459943","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":"Usability and Acceptability of a Pregnancy App for Substance Use Screening and Education: A Mixed Methods Exploratory Pilot Study.","authors":"Haley Fitzgerald, Madison Frank, Katelyn Kasula, Elizabeth E Krans, Tamar Krishnamurti","doi":"10.2196/60038","DOIUrl":"10.2196/60038","url":null,"abstract":"<p><strong>Background: </strong>Increasing opioid and other substance use has led to a crisis of epidemic proportions, with substance use now recognized as a leading cause of maternal morbidity and mortality in the United States. Interventions will only be effective if those who would benefit are identified early and connected to care. Apps are a ubiquitous source of pregnancy information, but their utility as a platform for evaluating substance use during pregnancy is unknown.</p><p><strong>Objective: </strong>This study aims to explore the usability and acceptability of a pregnancy app for opioid and other substance use screening and education.</p><p><strong>Methods: </strong>This mixed methods, exploratory pilot study examined adult pregnant people with a history of substance use who were recruited from outpatient and inpatient settings at a tertiary care obstetric hospital. After completing a baseline survey collecting demographics, substance use, and technology use, participants accessed an existing pregnancy support app for 4 weeks. Qualitative methods were used to measure the acceptability of embedding substance use screening, education, and information within the tool. App use frequency and access to substance use educational content and treatment referral information were evaluated.</p><p><strong>Results: </strong>The 28 female participants had a mean (SD) age of 31 (0.46) years; most were White (21/28, 75%) and Medicaid insured (26/28, 93%), with an annual household income of <US $30,000 (16/28, 57%). The mean gestational age at enrollment was 22 weeks. Almost half (13/28, 46%) were taking medication for opioid use disorder (methadone or buprenorphine). Other substances used included tobacco (22/28, 79%), marijuana (20/28, 71%), illicit opioids (9/28, 32%), alcohol (6/28, 21%), and stimulants (4/28, 14%), including cocaine, amphetamines, and benzodiazepines (2/28, 7%). Most (19/28, 68%) reported previously using one or more prenatal apps and 11% (3/28) cited prenatal apps as their most frequently used source of pregnancy information. After approximately 4 weeks of app exposure, 71% (20/28) logged in at least weekly, 89% (25/28) were satisfied with the app, and 96% (27/28) reported that the app was a helpful source of support. In cognitive interviews, participants reported that app-based disclosure of substance use could be easier than disclosing in person due to reduced stigma. However, participants expressed concerns about not knowing who would have access to this information.</p><p><strong>Conclusions: </strong>Incorporating substance use supports into a pregnancy app was found to be acceptable among those using substances. Participants reported frequent baseline use of prenatal apps, showed a high level of engagement with the pregnancy app during the study, and demonstrated interest in expanding the substance use support elements of this app. Embedding substance use screening, information, and connection to care into a tool with wide","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"8 ","pages":"e60038"},"PeriodicalIF":2.1,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11841748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415136","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":"Changes in Internet Activities and Influencing Factors for Problematic Internet Use During the COVID-19 Pandemic in Korean Adolescents: Repeated Cross-Sectional Study.","authors":"Sol I Kim, Jae-Chan Jin, Seo-Koo Yoo, Doug Hyun Han","doi":"10.2196/66448","DOIUrl":"10.2196/66448","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;As adolescents increasingly engage with digital experiences, the internet serves as a platform for social interaction, entertainment, and learning. The COVID-19 pandemic accelerated this trend, with remote learning and restricted physical interactions driving changes in internet behavior. Adolescents spent more time on gaming and social media, reflecting a notable shift in use patterns.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;We hypothesized that the COVID-19 pandemic changed internet use patterns among Korean adolescents, including content types, time spent on web-based activities, and pathological use prevalence. Additionally, we anticipated that these changes would correlate with shifts in adolescents' psychological status during the pandemic.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Data from 827 adolescents aged 12 to 15 years (n=144 in 2018, n=142 in 2019, n=126 in 2020, n=130 in 2021, n=143 in 2022, and n=142 in 2023) were gathered over 6 years from 43 middle schools across 16 regions and 1 hospital in South Korea. The demographic data collected included age, sex, and school year. Participants also provided information on their internet use patterns and levels of internet addiction. Additionally, psychological status, including mood, anxiety, attention, and self-esteem, was assessed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;There were significant differences in the depression scale (Patient Health Questionnaire 9). The Patient Health Questionnaire 9 scores for 2018, 2019, and 2023 decreased compared to those in 2020, 2021, and 2022 (F&lt;sub&gt;5&lt;/sub&gt;=3.07; P=.007). Regarding changes in internet use behavior, game playing among adolescents decreased after the pandemic compared to before, while watching videos increased. Additionally, the rate of problematic internet use was highest for games before COVID-19, but after COVID-19, it was highest for videos, and this trend continued until 2023 (χ&lt;sup&gt;2&lt;/sup&gt;&lt;sub&gt;3&lt;/sub&gt;=8.16, P=.04). Furthermore, this study showed that the Young's Internet Addiction Scale (YIAS) score was highest in the game group in 2018 compared to other groups before COVID-19 (F&lt;sub&gt;5&lt;/sub&gt;=14.63; P&lt;.001). In 2019, both the game and video groups had higher YIAS scores than other groups (F&lt;sub&gt;5&lt;/sub&gt;=9.37; P&lt;.001), and by 2022, the YIAS scores among the game, video, and Social Network Service groups did not differ significantly. The degree of influence on the severity of internet addiction was also greatest for games before COVID-19, but after COVID-19, the effect was greater for videos than for games.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;During the COVID-19 pandemic, internet use for academic and commercial purposes, including remote classes and videoconferences, increased rapidly worldwide, leading to a significant rise in overall internet use time. The demand for and dependence on digital platforms is expected to grow even further in the coming era. Until now, concerns have primarily focused on the use of games, but it","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"8 ","pages":"e66448"},"PeriodicalIF":2.1,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11862775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400079","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":"Efficacy, Feasibility, and Acceptability of an Emotional Competence Tele-Intervention for Mandarin-Speaking Children Aged 5 to 7 Years With Developmental Language Disorder: Pilot Study With an Interrupted Time-Series Design.","authors":"Hsin-Hui Lu, Shih-Yuan Liang, Yi-Chia Huang","doi":"10.2196/60333","DOIUrl":"10.2196/60333","url":null,"abstract":"<p><strong>Background: </strong>Children with developmental language disorder (DLD) often experience language difficulties that hinder their ability to acquire emotional competence. Poor emotional competence is associated with emotional and behavioral problems in young children.</p><p><strong>Objective: </strong>This research involved two studies focusing on (1) the emotional competence of Mandarin-speaking children aged 5 to 7 years with DLD and (2) the efficacy, feasibility, and acceptability of a tele-intervention designed to enhance their emotional competence in Taiwan.</p><p><strong>Methods: </strong>Five children with DLD from study 1 declined to participate in study 2, the emotional competence tele-intervention, and were excluded from the analysis. We compared the emotional competence of 20 Mandarin-speaking children with DLD to that of 24 children with typical language development (TLD). The children with DLD were, on average, aged 5.79 (SD 0.47) years, whereas the children with TLD were, on average, aged 5.93 (SD 0.31) years. We assessed the children's emotional competence, nonverbal ability, verbal comprehension, vocabulary acquisition, and expressive language skills. In study 2, all children with DLD included in study 1 engaged in an emotional competence tele-intervention. An interrupted time-series design was used to examine their emotional competence. In total, 20 children with DLD provided data on emotional competence evaluated using the Emotional Lexicon Test. These data were individually collected at 3 time points after study 1 (time 1). These phases included baseline (time 1 to time 2), during the tele-intervention (time 2 to time 3), and follow-up (time 3 to time 4), spanning approximately 18 to 20 weeks from time 1 to time 4. Recruitment, retention, and attendance rates were calculated to evaluate the intervention's feasibility, and participant mood was evaluated after each session to calculate the intervention's acceptability.</p><p><strong>Results: </strong>No significant changes in the children's ability to understand basic or complex emotional terms were observed during the baseline period. However, changes were observed during the tele-intervention period, and these changes remained throughout the follow-up period. With a recruitment rate of 80% (20/25), all participants completed 4 intervention sessions, with retention and attendance rates exceeding 95% (19/20). A total of 90% (18/20) of the participants deemed each session to be acceptable.</p><p><strong>Conclusions: </strong>Mandarin-speaking children aged 5 to 7 years with DLD exhibited lower emotional competence compared with their counterparts with TLD. Tele-interventions are effective in enhancing the emotional competence of children with DLD, demonstrating feasibility and acceptability for these children and their parents in Taiwan.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"8 ","pages":"e60333"},"PeriodicalIF":2.1,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11862772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400138","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":"Community Caregivers' Perspectives on Health IT Use for Children With Medical Complexity: Qualitative Interview Study.","authors":"Farah Elkourdi, Onur Asan","doi":"10.2196/67289","DOIUrl":"10.2196/67289","url":null,"abstract":"<p><strong>Background: </strong>Children with medical complexity represent a unique pediatric population requiring extensive health care needs and care coordination. Children with medical complexities have multiple significant chronic health problems that affect multiple organ systems and result in functional limitations and high health care needs or use. Often, there is a need for medical technology and total care for activities of daily living, much of which is provided at home by family and caregivers. Health IT (HIT) is a broad term that includes various technologies, such as patient portals, telemedicine, and mobile health apps. These tools can improve the care of children with medical complexity by enhancing communication, information exchange, medical safety, care coordination, and shared decision-making. In this study, we identified children with medical complexity as children aged <21 years who have >3 chronic health conditions. Community caregivers contribute to the care management of children with medical complexity, serving as advocates and coordinators, primary sources of information about children's needs, and facilitators of access to care. They are often the first point of contact for the families of children with medical complexity, particularly in vulnerable communities, including families in rural areas, low-income households, and non-English-speaking immigrant populations.</p><p><strong>Objective: </strong>This study aims to introduce the HIT needs and preferences for children with medical complexity from the perspective of community caregivers. By including their perspective on HIT development, we can better appreciate the challenges they face, the insights they offer, and the ways in which they bridge gaps in care, support, and resources.</p><p><strong>Methods: </strong>We conducted semistructured interviews (n=12) with formal community caregivers of children with medical complexity populations from a parent advocacy network on the US East Coast. Interviews were audio recorded via Zoom and then transcribed. An inductive thematic analysis was conducted to reveal HIT challenges and preferences for improving the care of children with medical complexity.</p><p><strong>Results: </strong>We categorized the interview results into themes and subthemes. There are four main themes: (1) telehealth transforming care for children with medical complexity during the COVID-19 pandemic, (2) suggested tools and technologies for care for children with medical complexity, (3) HIT feature preferences, and (4) transition to adult care. Each theme had multiple subthemes capturing all details related to design features of needed technologies.</p><p><strong>Conclusions: </strong>The study emphasizes the need to develop and enhance HIT for the care of children with medical complexity. The identified themes can serve as design guidelines for designers by establishing a foundation for user-centered HIT tools to effectively support children with medical","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"8 ","pages":"e67289"},"PeriodicalIF":2.1,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11851040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392138","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":"A Primary Care Group Resilience Intervention Promotes Child and Caregiver Behavioral Health.","authors":"Joan Jeung, Andrew Nguyen, Jennifer Martinez, Li Zhang","doi":"10.2196/67638","DOIUrl":"10.2196/67638","url":null,"abstract":"<p><strong>Unlabelled: </strong>This pilot study of the redesigned Resilience Clinic, a group-based psychoeducational intervention designed to promote relational health and child and family resilience provides preliminary evidence that participation in this intervention is associated with decreased caregiver stress, anxiety, and child behavioral concerns.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"8 ","pages":"e67638"},"PeriodicalIF":2.3,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11833186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392137","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":"Implementing Diabetes Distress Screening in a Pediatric Endocrinology Clinic Using a Digital Health Platform: Quantitative Secondary Data Analysis.","authors":"Nicole A Kahhan, Larry A Fox, Matthew Benson, Susana R Patton","doi":"10.2196/65107","DOIUrl":"10.2196/65107","url":null,"abstract":"<p><strong>Background: </strong>Type 1 diabetes (T1D) management requires following a complex and constant regimen relying on child or caregiver behaviors, skills, and knowledge. Psychological factors such as diabetes distress (DD), depression, and burnout are pertinent considerations in the treatment of pediatric T1D. Approximately 40% of youth and 61% of caregivers experience DD. Implementation of DD screening as part of clinical best practice is recommended and may facilitate treatment referral, perhaps leading to improved health or well-being for youth with T1D and their caregivers. By building on existing institutional infrastructure when available, screening via digital health platforms (applications, or \"apps\") may allow for timely screening of, and response to, DD.</p><p><strong>Objective: </strong>This work details the creation, implementation, and refinement of a process to screen for DD in youth and their caregivers in the context of routine T1D care using a digital health platform.</p><p><strong>Methods: </strong>DD screening was implemented in an outpatient endocrinology clinic over 1 year as part of a larger screen-to-treat trial for children aged 8-12.99 years and their caregivers. Validated measures were sent via digital health platform to be completed prior to the clinic visit. Results were initially reviewed manually, but a digital best practice alert (BPA) was later built to notify staff of elevated scores. Families experiencing DD received resources sent via the digital health platform. For this secondary analysis, child demographics and glycated hemoglobin A1c (HbA1c) were collected.</p><p><strong>Results: </strong>During the screening period, absolute completion rates were 36.78% and 38.83%, with adjusted screening rates at 52.02% and 54.48%, for children and caregivers, respectively. A total of 21 children (mean HbA1c 8.04%, SD 1.39%) and 26 caregivers (child mean HbA1c 8.04%, SD 1.72%) reported elevated DD. Prior to BPA development, resources were sent to all but 1 family. After BPA implementation, all families were sent resources.</p><p><strong>Conclusions: </strong>Early findings indicate that DD education, screening, and response can be integrated via digital platforms in a freestanding outpatient endocrinology clinic, thereby facilitating timely treatment referral and provision of resources for those identified with distress. Notably, in the observed 1-year screening period, screening rates were low, and barriers to implementation were identified. While some implementation challenges were iteratively addressed, there is a need for future quality improvement initiatives to improve screening rates and the identification of, or response to, DD in our pediatric patients and their families.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"8 ","pages":"e65107"},"PeriodicalIF":2.1,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366183","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 Program to Support Family Caregivers of Children Undergoing Growth Hormone Therapy: Qualitative Feasibility Study.","authors":"Alba Jiménez-Díaz, Maitena Pierantonelli, Patricia Morte Coscolín, Amaia Salinas-Uhalte, Silvia Quer-Palomas, Octavio Rivera-Romero, Rocío Herrero, Luis Fernández-Luque, Rosa Baños, Ricardo C Berrios, Antonio de Arriba","doi":"10.2196/55023","DOIUrl":"10.2196/55023","url":null,"abstract":"<p><strong>Background: </strong>Caregivers of children with growth hormone deficiency often face emotional challenges (eg, stress) associated with their children's health conditions. This psychological burden might affect children's adherence to treatment and hinder their health-related quality of life (HrQoL). This assumption is leading to seriously considering multidimensional clinical approaches to pediatric health conditions where the emotional well-being of caregivers should be accounted for to optimize children's health outcomes. Novel mobile health (mHealth) solutions based on emotional and behavioral change techniques can play a promising role because they are increasingly used within different health areas to support adaptive psychological functioning. However, whether and how mHealth solutions of this type of emotional well-being support caregivers of children with growth-related problems is an issue that needs to be clarified.</p><p><strong>Objective: </strong>This study aimed to gather qualitative information to better understand individualized experiences of caregiving of children undergoing growth hormone therapy (GHt) and perceived barriers or facilitators for the adoption of an mHealth solution called Adhera Caring Digital Program (ACDP).</p><p><strong>Methods: </strong>A total of 10 family caregivers were recruited at Miguel Servet Children's Hospital, and they engaged with the ACDP for 1 month. The ACDP is a mobile-based digital intervention focused on promoting the overall well-being of family caregivers which provides access to personalized education, motivational mobile-based messages, and mental well-being exercises such as mindfulness or respiratory exercises. Subsequently, an individual semistructured interview was performed to gather qualitative user experience information.</p><p><strong>Results: </strong>The digital intervention was well-received. The ACDP was found to be useful, easy to use, and understandable, addressing all the difficulties expressed by caregivers. It was also noted to be particularly helpful at the beginning of the treatment and, for some families, became a natural tool that strengthened the parent-child relationship.</p><p><strong>Conclusions: </strong>The ACDP is a promising and well-accepted tool that enhances the experience of patients and caregivers. It improves the management of growth hormone deficiency and promotes the overall well-being of family caregivers.</p><p><strong>Trial registration: </strong>ClinicalTrials NCT04812665; https://clinicaltrials.gov/study/NCT04812665.</p><p><strong>International registered report identifier (irrid): </strong>RR2-10.1186/s12911-022-01935-1.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"8 ","pages":"e55023"},"PeriodicalIF":2.1,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11840389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190673","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":"Using a Consumer Wearable Activity Monitoring Device to Study Physical Activity and Sleep Among Adolescents in Project Viva: Cohort Study.","authors":"Yutong Zhang, Nicole Bornkamp, Marie-France Hivert, Emily Oken, Peter James","doi":"10.2196/59159","DOIUrl":"10.2196/59159","url":null,"abstract":"<p><strong>Background: </strong>The increasing prevalence of physical inactivity and insufficient sleep in adolescents likely contribute to worsening cardiometabolic and mental health. However, obtaining accurate behavioral measures is a challenge. Consumer wearable devices offer a user-friendly method to assess physical activity and sleep.</p><p><strong>Objective: </strong>This study aimed to describe the process and the preliminary results of physical activity and sleep collected using a consumer wearable Fitbit device in an adolescent cohort.</p><p><strong>Methods: </strong>We provided Fitbit Charge 2 or Charge 3 wrist-worn activity monitors to adolescent participants in Project Viva, a Boston, Massachusetts area cohort, from 2017 to 2022. We invited participants to wear the devices for ≥7 days for 24 hours a day to measure their physical activity, heart rate, and sleep, and allowed them to keep the device as a participation incentive.</p><p><strong>Results: </strong>We collected over 7 million minutes of physical activity, heart rate, and sleep data from 677 participants, 53% (356/677) of whom were female. The mean (SD) age of participants was 17.7 (0.7) years. Among the 677 participants, 65% (n=439) were non-Hispanic White, 14% (n=947) were non-Hispanic Black, 10% (n=69) were Hispanic, 3.2% (n=22) were non-Hispanic Asian, and 7.8% (n=53) belonged to other races. Participants demonstrated a high adherence to the research protocol, with the mean (SD) wear duration of 7.5 (1.1) days, and 90% of participants (612/677) had 5 or more days wearing the device for >600 minutes/day. The mean (SD) number of steps was 8883 (3455) steps/day and the mean (SD) awake sedentary time was 564 (138) minutes/day. Male participants were more often engaged in very active (27 minutes/day) and moderately active physical activity (29 minutes/day) compared with female participants (15 and 17 minutes/day, respectively). Over 87% (588/677) of participants had sleep data available for 5 or more days, among whom the average nightly sleep duration was 7.9 (SD 0.9) hours.</p><p><strong>Conclusions: </strong>This study demonstrated the feasibility of using consumer wearable devices to measure physical activity and sleep in a cohort of US adolescents. The high compliance rates provide valuable insights into adolescent behavior patterns and their influence on chronic disease development and mental health outcomes.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"8 ","pages":"e59159"},"PeriodicalIF":2.1,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11813160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190747","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 Chatbot-Based Oral Health Care for Young Children and Evaluation of its Effectiveness, Usability, and Acceptability: Mixed Methods Study.","authors":"Kittiwara Pupong, Jaranya Hunsrisakhun, Samerchit Pithpornchaiyakul, Supawadee Naorungroj","doi":"10.2196/62738","DOIUrl":"10.2196/62738","url":null,"abstract":"<p><strong>Background: </strong>Chatbots are increasingly accepted in public health for their ability to replicate human-like communication and provide scalable, 24/7 services. The high prevalence of dental caries in children underscores the need for early and effective intervention.</p><p><strong>Objective: </strong>This study aimed to develop the 30-Day FunDee chatbot and evaluate its effectiveness, usability, and acceptability in delivering oral health education to caregivers of children aged 6 to 36 months.</p><p><strong>Methods: </strong>The chatbot was created using the artificial intelligence (AI) chatbot behavior change model, integrating behavioral change theories into content designed for 3-5 minutes of daily use over 30 days. A pre-post experimental study was conducted from December 2021 to February 2022 in Hat Yai District, Songkhla Province, and Maelan District, Pattani Province, Thailand. Fifty-eight caregivers completed a web-based structured questionnaire at baseline and 2 months post baseline to evaluate knowledge, protection motivation theory-based perceptions, and tooth-brushing practices. Usability was assessed via chatbot logfiles and a web-based questionnaire at 2 months post baseline. Acceptability was evaluated through three methods: (1) open-ended chatbot interactions on day 30, (2) a web-based structured questionnaire at 2 months post baseline, and (3) semistructured telephone interviews with 15 participants 2 weeks post intervention. Participants for interviews were stratified by adherence levels and randomly selected from Hatyai and Maelan districts. All self-reported variables were measured on a 5-point Likert scale (1=lowest, 5=highest).</p><p><strong>Results: </strong>The chatbot was successfully developed based on the 4 components of the AI chatbot behavior change model. Participants had a mean age of 34.5 (SD 8.6) years. The frequency of tooth brushing among caregivers significantly improved, increasing from 72.4% at baseline to 93.1% two months post baseline (P=.006). Protection motivation theory-based perceptions also showed significant improvement, with mean scores rising from 4.0 (SD 0.6) at baseline to 4.5 (SD 0.6) two months post baseline (P<.001). The chatbot received high ratings for satisfaction (4.7/5, SD 0.6) and usability (4.7/5, SD 0.5). Participants engaged with the chatbot for an average of 24.7 (SD 7.2) days out of 30. Caregivers praised the chatbot's content quality, empathetic communication, and multimedia design, but noted the intervention's lengthy duration and messaging system as limitations.</p><p><strong>Conclusions: </strong>The 30-Day FunDee chatbot effectively enhanced caregivers' perceptions of oral health care and improved tooth-brushing practices for children aged 6-36 months. High user satisfaction and engagement demonstrate its potential as an innovative tool for oral health education. These findings warrant further validation through large-scale, randomized controlled trials.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"8 ","pages":"e62738"},"PeriodicalIF":2.1,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123807","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}