Journal of Pediatric Psychology最新文献

{"title":"The Visible Difference Parenting Toolkit: development of an ACT-based intervention to improve the well-being of parents and caregivers of children with appearance-affecting conditions and injuries.","authors":"Maia Thornton, Heidi Williamson, Toity Deave, James Kiff, Diana Harcourt","doi":"10.1093/jpepsy/jsaf054","DOIUrl":"https://doi.org/10.1093/jpepsy/jsaf054","url":null,"abstract":"<p><strong>Objectives: </strong>Caregivers of children with appearance-affecting conditions or injuries can experience common psychosocial challenges, regardless of the cause or nature of their child's visible difference. Despite these common challenges, there is a lack of evidence-based cross-condition support for caregivers of children with visible differences.</p><p><strong>Methods: </strong>A self-guided acceptance and commitment therapy-based e-book intervention was developed utilizing a Participatory Action Research approach. Twenty-two caregivers of children with a range of visible differences reviewed the full pilot e-book intervention and responded to an online acceptability survey.</p><p><strong>Results: </strong>While several changes aimed at increasing the accessibility of the intervention materials were discussed, overall the feedback suggested that The Visible Difference Parenting Toolkit addressed an unmet support need. Both the content and the format of the intervention were found to be acceptable by parents, with ehealth Impact Questionnaire scores of >80. Participants recommended specific changes related to accessibility including adding features such as hyperlinks and a search bar to enable users to navigate the e-book.</p><p><strong>Conclusions: </strong>Caregivers reported that the content of The Visible Difference Parenting Toolkit was relevant to their lived experiences of caring for a child with a visible difference. Parents also reported that the presentation and format of The Visible Difference Parenting Toolkit was clear and accessible. The intervention addresses a previously unmet support need and is an acceptable intervention for caregivers of children with a visible difference.</p>","PeriodicalId":48372,"journal":{"name":"Journal of Pediatric Psychology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144650949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic review and meta analysis of psychological interventions to prevent or treat pediatric chronic disease in rural communities.","authors":"Brittany D Lancaster, Tristen Hefner, Calissa J Leslie-Miller, Kody Sexton, Dana M Bakula, Jason Van Allen, Christopher C Cushing, Crystal S Lim, David M Janicke, Elissa Jelalian, Katie Dayani, Ann M Davis","doi":"10.1093/jpepsy/jsae054","DOIUrl":"10.1093/jpepsy/jsae054","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this systematic review and meta-analysis was to examine the effectiveness of psychological interventions at improving physical or mental health outcomes for youth living in rural communities who have, or are at-risk for, any chronic medical condition in comparison to control interventions conducted in rural communities.</p><p><strong>Methods: </strong>Following prospective registration (OSF.IO/7TDQJ), 7 databases were searched through July 1, 2023. Studies were included if they were a randomized control trial of a psychological intervention conducted with youth living in a rural area who had, or were at-risk for, a chronic medical condition. Risk of bias was assessed with the Cochrane risk of bias version 2 tool. A qualitative synthesis and meta-analysis were conducted.</p><p><strong>Results: </strong>15 studies met inclusion criteria. Obesity studies (n = 13) primarily focused on body mass index metrics, with limited significant findings across studies. Asthma treatment interventions (n = 2) showed no impact on hospitalizations. 3 studies evaluated mental health outcomes with no significant group differences observed. We meta-analytically analyzed 9 studies that evaluated body mass index z-scores and identified an overall null effect (Hedge's g = 0.01, 95% CI [-0.07, 0.09], p = .85).</p><p><strong>Conclusions: </strong>Most included studies focused on pediatric obesity, and there was a limited range of health outcomes reported. Compared to controls, minimal significant improvements in health outcomes were identified for psychological interventions for youth living in rural communities. Future efforts may benefit from situating this work more systematically within a health disparities framework with a focus on understanding mechanisms of disparities and translating this work into interventions and policy changes.</p>","PeriodicalId":48372,"journal":{"name":"Journal of Pediatric Psychology","volume":" ","pages":"579-595"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141564845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic review and meta-analysis of the effect of psychological interventions on anxiety in children and youth with chronic medical conditions.","authors":"Susan T Tran, Keely Bieniak, Helen Bedree, Michelle Adler, Suliat Ogunmona, Iris Kovar-Gough, Wenjuan Ma, Hiran Thabrew, Natoshia R Cunningham","doi":"10.1093/jpepsy/jsae097","DOIUrl":"10.1093/jpepsy/jsae097","url":null,"abstract":"<p><strong>Objectives: </strong>Anxiety disorders affect 20%-50% of youth with chronic medical conditions (CMCs) and can interfere with medical care and treatment outcomes. Psychological therapies are typically designed for youth without CMCs; thus, this systematic review (Open Science Framework preregistration osf.io/a52nd/) assesses the effect of psychological therapies on anxiety, functional impairment and health-related quality of life (HRQOL) in this unique population.</p><p><strong>Methods: </strong>We included randomized controlled trials of psychological therapies vs. any comparator for youth (ages 24 and younger) with CMCs that assessed child anxiety. We excluded studies of adults and those not in English. Medline, Embase, PsycInfo, and CENTRAL databases were searched, studies were screened using COVIDENCE software, and meta-analysis was undertaken in R. Study quality was assessed using the Cochrane Risk of Bias tool, version 2. Quality of evidence was assessed using the GRADE system.</p><p><strong>Results: </strong>Thirty-three studies with 2676 participants (ages 5-21 years) were included in the meta-analysis. Nearly all had at least some risk of bias. Overall, psychological interventions resulted in lower anxiety (Hedges' g = -0.48 [-0.71; -0.25]), but did not have a significant effect on functional impairment or HRQOL. Based on the GRADE criteria, we have moderate confidence in these results. Treatments with higher risk of bias and those with live therapist components had greater effects on anxiety.</p><p><strong>Conclusions: </strong>Psychological interventions may be effective for improving anxiety for children and youth with CMCs, particularly those with a live therapist. More high-quality studies are needed to understand what components produce the best outcomes for patients.</p>","PeriodicalId":48372,"journal":{"name":"Journal of Pediatric Psychology","volume":" ","pages":"658-675"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12392405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary: Considering the Clinical Implications of \"A Systematic Review and Meta-Analysis of Adherence Interventions for Youth and Young Adults\".","authors":"Cecily N Conour, Christina L Duncan","doi":"10.1093/jpepsy/jsae083","DOIUrl":"10.1093/jpepsy/jsae083","url":null,"abstract":"","PeriodicalId":48372,"journal":{"name":"Journal of Pediatric Psychology","volume":" ","pages":"550-551"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142337166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic review of interventions for dietary adherence in pediatric disease management.","authors":"Elizabeth K Towner, Heather D Gibbs, Ella Hu, Susana R Patton","doi":"10.1093/jpepsy/jsae109","DOIUrl":"10.1093/jpepsy/jsae109","url":null,"abstract":"<p><strong>Objective: </strong>Though diet is important in the management of many pediatric chronic medical conditions, the last comprehensive review of interventions targeting dietary adherence was published over 20 years ago. This systematic review provides an update on efficacy and existing gaps for dietary adherence interventions in pediatric disease management.</p><p><strong>Method: </strong>We searched PubMed, MEDLINE, Embase, CENTRAL, PsychINFO, Web of Science, and Scopus up to July 1, 2023 for randomized controlled or clinical trials of interventions that targeted dietary adherence in youth 0-18 years old with a chronic medical condition (not obesity), included nutrition education and behavioral/psychological support, and reported dietary adherence outcomes. We identified manuscripts (N = 15) that spanned four broad diet types (healthy, carbohydrate-modified, elimination, single-nutrient modified), 10 pediatric chronic medical conditions, and 1,110 participants. Primary (dietary adherence) and secondary (disease metrics) outcome findings are organized by diet type; other descriptive information is collapsed across trials.</p><p><strong>Results: </strong>Overall, interventions yielded moderate-high adherence for most diet types. Interventions used similar approaches for nutrition education (e.g., meal plans) and behavioral support (e.g., goal setting, monitoring, feedback). Risk of bias was assessed using the Quality Criteria Checklist for Primary Research (Academy of Nutrition and Dietetics Evidence Analysis Process) revealing bias may be present in five trials.</p><p><strong>Conclusions: </strong>Interventions targeting dietary adherence remain sparse. Research is needed to examine adherence in all pediatric chronic conditions where diet is a component of disease management and to identify factors impacting dietary adherence and best practices for intervening on dietary adherence. This protocol is registered on April 5, 2024 at the Open Source Framework: https://doi.org/10.17605/OSF.IO/46YNF.</p>","PeriodicalId":48372,"journal":{"name":"Journal of Pediatric Psychology","volume":" ","pages":"676-698"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic review of culturally targeted behavioral and psychosocial interventions among children from racially and ethnically minoritized backgrounds with chronic health conditions in the United States.","authors":"Samantha A Carreon, Caryn R R Rodgers, Aurelia Minuti, Ana M Gutierrez-Colina, Marissa N Baudino, LaTerrica Williams, Ashley M Butler","doi":"10.1093/jpepsy/jsaf035","DOIUrl":"10.1093/jpepsy/jsaf035","url":null,"abstract":"<p><strong>Objective: </strong>Few reviews have evaluated culturally targeted interventions for youth who have chronic health conditions. This systematic review aimed to describe health, psychosocial, behavioral, and sociocultural outcomes of culturally targeted interventions among children from racially and ethnically minoritized backgrounds who have a chronic condition in the United States.</p><p><strong>Methods: </strong>A systematic literature review was conducted (January 1, 2013 through July 1, 2023). We reviewed randomized and non-randomized controlled clinical trials investigating culturally targeted, psychologist-involved interventions among children (ages 0-18 years) from racially/ethnically minoritized backgrounds in the United States with obesity, asthma, diabetes, sickle cell disease, cancer, cystic fibrosis, epilepsy, lupus, arthritis, and human immunodeficiency virus. Studies were included that compared culturally targeted interventions to non-targeted interventions or no intervention. Searches were conducted in PubMed, Embase, Central, and PsycINFO. Covidence was used for data screening, assessment, and extraction. Risk of bias was assessed with the Cochrane risk of bias version 2 tool. Extracted outcome variables included child health and healthcare utilization, and child and parent psychosocial, behavioral, and sociocultural outcomes.</p><p><strong>Results: </strong>The review included one study evaluating the effectiveness of the Physician Asthma Care Education (PACE) intervention compared to PACE Plus, a culturally enhanced version, among African American and Latino youth with asthma. Participants included 112 primary care providers and 867 pediatric patients.</p><p><strong>Conclusions: </strong>Health, psychosocial/behavioral, and sociocultural outcomes of culturally targeted interventions for racially and ethnically minoritized youth with chronic health conditions in the United States are unknown. Future research should prioritize the development and evaluation of culturally targeted interventions for these populations.</p>","PeriodicalId":48372,"journal":{"name":"Journal of Pediatric Psychology","volume":" ","pages":"552-560"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review and meta-analysis of pediatric integrated primary care for the prevention and treatment of physical and behavioral health conditions.","authors":"Cody A Hostutler, Jeffrey D Shahidullah, Jennifer A Mautone, Tiffany M Rybak, Chimereodo Okoroji, Teryn Bruni, Kevin G Stephenson, Leah Vance Utset, Kurt A Freeman, Leah LaLonde, Andrew R Riley","doi":"10.1093/jpepsy/jsae038","DOIUrl":"10.1093/jpepsy/jsae038","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effects of behavioral health interventions delivered within pediatric integrated primary care models on clinical outcomes.</p><p><strong>Methods: </strong>We searched Medline, EMBASE, CENTRAL, PsycINFO, and SCOPUS for studies published from January 1, 1998, to September 20, 2023. We included studies that evaluated onsite behavioral health integration in pediatric primary care using a comparator condition (usual, enhanced usual care, or waitlist). Outcome data on symptom change, impairment/quality of life, health indicator, and behavior change were extracted using Covidence software. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guideline was followed Risk of bias analysis was conducted using the Cochrane Risk of Bias tool. We used multilevel meta-analysis to synthesize multiple outcomes nested within studies. Open Science Foundation pre-registration: #10.17605/OSF.IO/WV7XP.</p><p><strong>Results: </strong>In total, 33 papers representing 27 studies involving 6,879 children and caregivers were included. Twenty-four studies were randomized controlled trials and three were quasi-experimental designs. Seventeen papers reported on treatment trials and 16 reported on prevention trials. We found a small overall effect size (SMD = 0.19, 95% confidence interval [0.11, 0.27]) supporting the superiority of integrated primary care to usual or enhanced usual care. Moderator analyses suggested similar effectiveness between co-located and integrated models and no statistically significant differences were found between treatment and prevention trials.</p><p><strong>Conclusions: </strong>Results suggest that integrated primary care is superior to usual and enhanced usual care at improving behavior, quality of life, and symptoms. Integrated primary care research needs improved standards for reporting to promote better synthesis and understanding of the literature.</p>","PeriodicalId":48372,"journal":{"name":"Journal of Pediatric Psychology","volume":" ","pages":"561-578"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141312037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic review and meta-analysis of interventions to promote medication adherence among children, adolescents, and young adults with medical conditions.","authors":"Meghan E McGrady, Mary E Keenan-Pfeiffer, Amy C Lang, Amy E Noser, Anshul P Tyagi, Julia K Herriott, Rachelle R Ramsey","doi":"10.1093/jpepsy/jsae036","DOIUrl":"10.1093/jpepsy/jsae036","url":null,"abstract":"<p><strong>Objective: </strong>This meta-analysis examined the efficacy of adherence-promotion interventions for children, adolescents, and young adults prescribed a medication for > 90 days as part of a treatment regimen for a medical condition.</p><p><strong>Methods: </strong>A systematic literature review was conducted to identify randomized controlled trials of adherence-promotion interventions published between 2013 and 2023 and including children, adolescents, and/or young adults with a medical condition. A total of 38 articles representing 39 trials met inclusion criteria. A narrative synthesis was conducted to summarize included trials and a random-effects model was used to compute an overall intervention effect. Effect sizes by adherence outcome assessment methodology, participant age, and technology use were also computed.</p><p><strong>Results: </strong>Pediatric adherence-promotion interventions demonstrate a medium effect with those randomized to an intervention displaying greater improvements in medication adherence than those randomized to a comparator condition (SMD = 0.46, 95% CI: 0.31, 0.60, n = 37; 95% Prediction Interval: -0.32, 1.23).</p><p><strong>Conclusions: </strong>Adherence interventions for children, adolescents, and young adults with medical conditions increase adherence.</p>","PeriodicalId":48372,"journal":{"name":"Journal of Pediatric Psychology","volume":" ","pages":"531-549"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12392408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141437680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic review and meta-analysis of psychological interventions for depression symptoms in young people with long-term physical health conditions.","authors":"Sarah E D Perzow, Junxiao Hu, Madison Bristol, Elizabeth B Ruzicka, Michelle A Clementi, Elizabeth P Handing, Elizabeth Vargas, Ana M Gutierrez-Colina, Lauren D Gulley, Lauren B Shomaker","doi":"10.1093/jpepsy/jsaf049","DOIUrl":"10.1093/jpepsy/jsaf049","url":null,"abstract":"<p><strong>Objectives: </strong>Depression is prevalent, impairing, and detrimental to health. The objective of this systematic review and meta-analysis was to assess the efficacy of psychological interventions for decreasing symptoms of depression among young people with long-term physical health conditions.</p><p><strong>Methods: </strong>CENTRAL, MEDLINE, PsycINFO, PubMed, clinicaltrials.gov, and WHO ICTRIP were searched through July 1, 2023. Selection criteria were randomized controlled trials of psychological interventions targeting depression symptoms among people ≤29 years diagnosed with long-term physical health conditions. Risk of bias was assessed using the Cochrane RoB version 2 tool. Outcome data were analyzed using fixed-effects models. Pooled standardized mean difference (SMD) between experimental and control was calculated using an inverse variance approach with a linear model. Heterogeneity was assessed by χ2 test on Cochran's Q statistic and quantified with I2 statistic.</p><p><strong>Results: </strong>Results included six trials (N = 376) of 11- to 18-year-olds (Mfemale=80%), recruited from pediatric clinics in the United States. Two of six eligible studies had an inclusion criterion related to elevated depression symptoms; the remainder included youth with heterogeneous depression levels. Psychological interventions were more efficacious than controls for reducing depression symptoms and functional disability. Pooled SMD for depression symptoms was -.30 (-.51, -.10), with a significant overall effect (Z = 2.92, p = .004). Pooled SMD for functional disability was -.35 (-.66, -.05), with a significant overall effect (Z = 2.28, p = .02). Moderate study heterogeneity was noted in two study outcomes.</p><p><strong>Conclusions: </strong>Psychological interventions reduce depression symptoms and functional disability among youth with long-term physical health conditions. Research is needed to elucidate participant/trial characteristics contributing to outcomes.</p>","PeriodicalId":48372,"journal":{"name":"Journal of Pediatric Psychology","volume":" ","pages":"699-714"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12392407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144838294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic review and meta-analysis of combined cognitive-behavioral therapy and physical activity and exercise interventions for pediatric chronic disease.","authors":"William R Black, Lauren von Klinggraeff, David A White, Bethany Forseth, Jamie L Jackson, Carolyn R Bates, Christopher D Pfledderer, Sidney Dobbins, Kristen R Hoskinson, Alison Gehred, Ann M Davis","doi":"10.1093/jpepsy/jsae087","DOIUrl":"10.1093/jpepsy/jsae087","url":null,"abstract":"<p><strong>Objective: </strong>Cognitive-behavioral (CBT) interventions combined with either a physical activity (CBT+PA) or exercise intervention (CBT+Ex) are becoming more common in pediatric populations. Considering the independent effects of PA and exercise on health and psychological outcomes, it is unclear whether CBT alone differs from CBT+PA or CBT+Ex in efficacy. The main objective of this systematic review and meta-analysis of randomized clinical trials (RCTs) was to assess the efficacy of CBT+PA and CBT+Ex interventions in pediatric chronic disease.</p><p><strong>Method: </strong>This review included RCTs in children (≤18 years) with a chronic condition, a CBT+Ex or CBT+PA intervention, and an objective measure of PA&Ex. Seven databases were searched using MeSH terms and key terms and included studies published before July 1, 2023. Abstracts were reviewed for inclusion by two independent reviewers, data was extracted by three independent reviewers. Risk of bias (RoB 2) and study quality were coded. Random effect meta-analyses of differences in between-group change in PA&Ex were conducted.</p><p><strong>Results: </strong>Eligible studies (k = 5) reported outcomes for a combined 446 children. A small, nonsignificant overall effect was found (d = 0.10, 95% CI -0.16, 0.35) indicating intervention groups (CBT+PA or CBT+Ex) increased engagement in PA&Ex more than comparator groups (CBT). Additional analyses were inconclusive due to the small number of eligible studies.</p><p><strong>Discussion: </strong>Additional RCTs are needed with integrated PA&Ex interventions targeting pediatric chronic disease. Future trials should report more detailed PA&Ex data. The full protocol for this analysis was prospectively registered in Open Science Framework (project ID: osf.io/m4wtc).</p>","PeriodicalId":48372,"journal":{"name":"Journal of Pediatric Psychology","volume":" ","pages":"620-632"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}