Digital healthcare interventions to support parents with acutely ill children at home: A systematic review.

Short lived acute illness in children is common, yet their parents often feel uncertain about recognising signs symptoms of acute illness and knowing when to seek medical intervention. This has led to seeking unscheduled or delayed support. Digital and mobile technologies are being used to support individuals with healthcare needs, known as digital health interventions. Parents have access to digital health interventions that provide information regarding children's health, yet there is limited exploration of how these are used to support decision-making when caring for acutely ill children. This systematic review was undertaken to explore digital interventions to support parents with acutely ill children at home. Studies were identified by following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. A search of five databases (MEDLINE, CINAHL, Embase, PsycNET, and Web of Knowledge) was conducted using search terms (Medical Subject Headings and keywords) relating to digital interventions, children, acute illness, and health information. Forty-eight papers were screened; seven were included in the review and critically appraised using the Mixed Method Appraisal Tool. In total, 3,558 parents were included. Meta-analysis was not possible due to heterogeneity of papers; thus, narrative synthesis was used to synthesize results and explore relationships between studies. The following aspects were documented: types and characteristics of interventions; how interventions were developed; accessibility, usability and acceptability; measures of impact upon parental knowledge, confidence; and satisfaction with the intervention and usefulness. Limited evidence exists on the availability, impact and efficacy of digital interventions supporting parents caring for acutely ill children at home. Barriers exist regarding accessibility, health literacy and there is limited representation of the diverse needs of parents from different countries, cultures and populations beyond mothers. Further research is needed to co-design and evaluate digital interventions designed with, and for, these parents.