Use of Synchronous Digital Health Technologies for the Care of Children With Special Health Care Needs and Their Families: Scoping Review
asthma; children with special health care needs; co-design; congenital heart disease; digital health; palliative care; pediatrics; scoping review
BACKGROUND: Use of synchronous digital health technologies for care delivery to children with special health care needs (having a chronic physical, behavioral, developmental, or emotional condition in combination with high resource use) and their families at home has shown promise for improving outcomes and increasing access to care for this medically fragile and resource-intensive population. However, a comprehensive description of the various models of synchronous home digital health interventions does not exist, nor has the impact of such interventions been summarized to date. OBJECTIVE: We aim to describe the various models of synchronous home digital health that have been used in pediatric populations with special health care needs, their outcomes, and implementation barriers. METHODS: A systematic scoping review of the literature was conducted, guided by the Arksey and O'Malley Scoping Review Framework. MEDLINE, CINAHL, and EMBASE databases were searched from inception to June 2018, and the reference lists of the included systematic reviews and high-impact journals were hand-searched. RESULTS: A total of 38 articles were included in this review. Interventional articles are described as feasibility studies, studies that aim to provide direct care to children with special health care needs, and studies that aim to support family members to deliver care to children with special health care needs. End-user involvement in the design and implementation of studies is evaluated using a human-centered design framework, and factors affecting the implementation of digital health programs are discussed in relation to technological, human, and systems factors. CONCLUSIONS: The use of digital health to care for children with special health care needs presents an opportunity to leverage the capacity of technology to connect patients and their families to much-needed care from expert health care providers while avoiding the expenses and potential harms of the hospital-based care system. Strategies to scale and spread pilot studies, such as involving end users in the co-design techniques, are needed to optimize digital health programs for children with special health care needs.
Bird M; Li L; Ouellette C; Hopkins K; McGillion M H; Carter N
JMIR Pediatrics and Parenting
2019
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.2196/15106" target="_blank" rel="noreferrer noopener">10.2196/15106</a>
eHealth and mHealth psychosocial interventions for youths with chronic illnesses: A systematic review
chronic illness; eHealth; mental health; mHealth; pediatrics; psychosocial interventions
BACKGROUND: An estimated 12.8% of children and adolescents experience chronic health conditions which lead to poor quality of life, adjustment and coping issues, and concurrent mental health problems. Digital health deployment of psychosocial interventions to support youth with chronic illness has become increasingly popular with the advent of the technological advances in the Digital Age. OBJECTIVE: To (1) systematically review published efficacy studies of eHealth (internet-based) and mHealth (mobile health) psychosocial interventions for youths with chronic illnesses; and, (2) review intervention theory and treatment components. METHODS: PubMed, Embase, Web of Science, PsychInfo, and Cochrane Database of Systematic reviews were searched for studies published from 2008-2019 of eHealth and mHealth psychosocial interventions designed for children and adolescents with chronic illnesses in which efficacy outcomes were reported. We excluded studies of interventions for caregivers, healthy youth, disease and medication management, and telehealth interventions that function solely as a platform to connect patients to providers via phone, text, or videoconference. RESULTS: We screened 2,551 articles, and 133 relevant full-text articles. Sixteen efficacy studies with psychosocial and health outcomes met inclusion criteria, which represented 12 unique interventions. Of the included studies, 12 were randomized controlled trials and four were prospective cohort studies with no comparison group. Most interventions were based in cognitive-behavioral theory and designed as eHealth interventions; only 2 were designed as an mHealth intervention. All but two interventions provided access to support staff via text, phone, email, or discussion forums. The significant heterogeneity in intervention content, intervention structure, medical diagnoses, and outcomes precluded meta-analysis. For example, measurement timepoints ranged from immediately post-completion of the mHealth program to 18-months later, and we identified 39 unique outcomes of interest. The majority of included studies (11/16, 68.75%) reported significant changes in measured health and/or psychosocial post-treatment outcomes, with small to large effect sizes. CONCLUSIONS: Although the available literature on the efficacy of eHealth and mHealth psychosocial interventions for youth with chronic illnesses is limited, preliminary research suggests some evidence of positive treatment responses. Future studies should continue to evaluate whether digital health platforms may be a viable alternative model of delivery to traditional face-to-face approaches.
Lau N; Waldbaum S; Parigoris R; O'Daffer A; Walsh C; Colt SF; Yi-Frazier JP; Palermo TM; McCauley E; Rosenberg AR
JMIR Pediatrics and Parenting
2020
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.2196/22329" target="_blank" rel="noreferrer noopener">10.2196/22329</a>