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Whitehead L, Robinson S, Arabiat D, Jenkins M, Morelius E. The Report of Access and Engagement With Digital Health Interventions Among Children and Young People: Systematic Review. JMIR Pediatr Parent 2024; 7:e44199. [PMID: 38231560 PMCID: PMC10831666 DOI: 10.2196/44199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 06/06/2023] [Accepted: 11/29/2023] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND Digital health interventions are increasingly used to deliver health-related interventions for children and young people to change health behaviors and improve health outcomes. Digital health interventions have the potential to enhance access to and engagement with children and young people; however, they may also increase the divide between those who can access technology and are supported to engage and those who are not. This review included studies that reported on the access to or engagement with digital health interventions among children and young people. OBJECTIVE This review aims to identify and report on access and engagement in studies involving digital health interventions among children and young people. METHODS A systematic review following the Joanna Briggs Institute methods for conducting systematic reviews was conducted. An electronic literature search was conducted for all studies published between January 1, 2010, and August 2022, across sources, including MEDLINE, CINAHL, and PsycINFO. Studies were included if they examined any aspect of access or engagement in relation to interventions among children and young people. The quality of the included papers was assessed, and data were extracted. Data were considered for meta-analysis, where possible. RESULTS A total of 3292 references were identified using search terms. Following the exclusion of duplicates and review by inclusion criteria, 40 studies were independently appraised for their methodological quality. A total of 16 studies were excluded owing to their low assessed quality and flawed critical elements in the study design. The studies focused on a variety of health conditions; type 1 diabetes, weight management and obesity, mental health issues, and sexual health were the predominant conditions. Most studies were conducted in developed countries, with most of them being conducted in the United States. Two studies reported data related to access and considered ethnicity and social determinants. No studies used strategies to enhance or increase access. All studies included in the review reported on at least 1 aspect of engagement. Engagement with interventions was measured in relation to frequency of engagement, with no reference to the concept of effective engagement. CONCLUSIONS Most digital health interventions do not consider the factors that can affect access and engagement. Of those studies that measured either access or engagement or both, few sought to implement strategies to improve access or engagement to address potential disparities between groups. Although the literature to date provides some insight into access and engagement and how these are addressed in digital health interventions, there are major limitations in understanding how both can be enhanced to promote equity. Consideration of both access and engagement is vital to ensure that children and young people have the ability to participate in studies. TRIAL REGISTRATION PROSPERO CRD42020170874; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=170874.
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Affiliation(s)
- Lisa Whitehead
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, Australia
- Centre for Postgraduate Nursing Studies, University of Otago, Christchurch, New Zealand
- The Centre for Evidence Informed Nursing, Midwifery and Healthcare Practice, Joondalup, Australia
- Australian Research Council Centre of Excellence for the Digital Child, Joondalup, Australia
- Maternal and Child Nursing Department, Faculty of Nursing, The University of Jordan, Amman, Jordan
| | - Suzanne Robinson
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, Australia
- The Centre for Evidence Informed Nursing, Midwifery and Healthcare Practice, Joondalup, Australia
| | - Diana Arabiat
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, Australia
- Australian Research Council Centre of Excellence for the Digital Child, Joondalup, Australia
- Maternal and Child Nursing Department, Faculty of Nursing, The University of Jordan, Amman, Jordan
| | - Mark Jenkins
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, Australia
| | - Evalotte Morelius
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, Australia
- Australian Research Council Centre of Excellence for the Digital Child, Joondalup, Australia
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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de Wit M, Gajewska KA, Goethals ER, McDarby V, Zhao X, Hapunda G, Delamater AM, DiMeglio LA. ISPAD Clinical Practice Consensus Guidelines 2022: Psychological care of children, adolescents and young adults with diabetes. Pediatr Diabetes 2022; 23:1373-1389. [PMID: 36464988 PMCID: PMC10107478 DOI: 10.1111/pedi.13428] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 09/30/2022] [Indexed: 12/12/2022] Open
Affiliation(s)
- Maartje de Wit
- Amsterdam UMC, Vrije Universiteit Amsterdam, Medical Psychology, Amsterdam Public Health, Amsterdam, Netherlands
| | - Katarzyna A Gajewska
- Diabetes Ireland, Dublin, Ireland.,School of Public Health, University College Cork, Cork, Ireland
| | | | | | - Xiaolei Zhao
- The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Given Hapunda
- Department of Psychology, University of Zambia, Lusaka, Zambia
| | - Alan M Delamater
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Linda A DiMeglio
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida, USA.,Department of Pediatrics, Division of Pediatric Endocrinology and Diabetology, Indiana University School of Medicine, Riley Hospital for Children, Indianapolis, Indiana, USA
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Jenkins BN, Moskowitz J, Halterman JS, Kain ZN. Applying theoretical models of positive emotion to improve pediatric asthma: A positive psychology approach. Pediatr Pulmonol 2021; 56:3142-3147. [PMID: 34379892 DOI: 10.1002/ppul.25600] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 06/15/2021] [Accepted: 06/22/2021] [Indexed: 02/05/2023]
Abstract
Positive emotion, encompassing feelings such as joy and happiness, has been shown to predict a multitude of health outcomes. However, the role of positive emotion in pediatric asthma is not understood. No work to date has examined how positive emotion may offer benefits to children and adolescents with asthma. Based on theory and models of positive emotion and health, we hypothesize that positive emotion may improve asthma outcomes through mediators such as health behaviors and health-relevant physiological functioning. Moreover, boosting positive emotion during times of stress may be particularly relevant in mitigating asthma symptoms. In the present commentary, we elaborate on the hypothesized mechanisms behind such associations grounded within positive emotion theoretical frameworks. Additionally, we summarize the methodologically rigorous work of positive emotion interventions in other clinical settings to propose that positive emotion could be a useful tool in the management of pediatric asthma.
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Affiliation(s)
- Brooke N Jenkins
- Department of Psychology, Chapman University, Orange, California, USA.,Center on Stress & Health, University of California, Irvine, California, USA.,Department of Anesthesiology and Perioperative Care, University of California, Irvine, California, USA
| | - Judith Moskowitz
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Jill S Halterman
- Department of Pediatrics, University of Rochester Medical Center, Rochester, New York, USA
| | - Zeev N Kain
- Center on Stress & Health, University of California, Irvine, California, USA.,Department of Anesthesiology and Perioperative Care, University of California, Irvine, California, USA
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Ray MK, McMichael A, Rivera-Santana M, Noel J, Hershey T. Technological Ecological Momentary Assessment Tools to Study Type 1 Diabetes in Youth: Viewpoint of Methodologies. JMIR Diabetes 2021; 6:e27027. [PMID: 34081017 PMCID: PMC8212634 DOI: 10.2196/27027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 03/26/2021] [Accepted: 04/03/2021] [Indexed: 11/13/2022] Open
Abstract
Type 1 diabetes (T1D) is one of the most common chronic childhood diseases, and its prevalence is rapidly increasing. The management of glucose in T1D is challenging, as youth must consider a myriad of factors when making diabetes care decisions. This task often leads to significant hyperglycemia, hypoglycemia, and glucose variability throughout the day, which have been associated with short- and long-term medical complications. At present, most of what is known about each of these complications and the health behaviors that may lead to them have been uncovered in the clinical setting or in laboratory-based research. However, the tools often used in these settings are limited in their ability to capture the dynamic behaviors, feelings, and physiological changes associated with T1D that fluctuate from moment to moment throughout the day. A better understanding of T1D in daily life could potentially aid in the development of interventions to improve diabetes care and mitigate the negative medical consequences associated with it. Therefore, there is a need to measure repeated, real-time, and real-world features of this disease in youth. This approach is known as ecological momentary assessment (EMA), and it has considerable advantages to in-lab research. Thus, this viewpoint aims to describe EMA tools that have been used to collect data in the daily lives of youth with T1D and discuss studies that explored the nuances of T1D in daily life using these methods. This viewpoint focuses on the following EMA methods: continuous glucose monitoring, actigraphy, ambulatory blood pressure monitoring, personal digital assistants, smartphones, and phone-based systems. The viewpoint also discusses the benefits of using EMA methods to collect important data that might not otherwise be collected in the laboratory and the limitations of each tool, future directions of the field, and possible clinical implications for their use.
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Affiliation(s)
- Mary Katherine Ray
- Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, United States
| | - Alana McMichael
- Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, United States
| | - Maria Rivera-Santana
- Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, United States
| | - Jacob Noel
- Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, United States
| | - Tamara Hershey
- Department of Psychiatry, Mallinckrodt Institute of Radiology, Washington University in St. Louis, St. Louis, MO, United States
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Jaser SS, Whittemore R, Choi L, Nwosu S, Russell WE. Randomized Trial of a Positive Psychology Intervention for Adolescents With Type 1 Diabetes. J Pediatr Psychol 2020; 44:620-629. [PMID: 30840084 DOI: 10.1093/jpepsy/jsz006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 01/21/2019] [Accepted: 01/21/2019] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To evaluate the effects of a positive psychology intervention for adolescents with type 1 diabetes (T1D) on adherence, glycemic control, and quality of life. METHODS Adolescents with T1D (n = 120) and their caregivers were randomized to either an Education (EDU) (n = 60) or Positive Affect (PA) intervention (n = 60). Adolescents in the PA group received the intervention reminders (gratitude, self-affirmation, parental affirmation, and small gifts) via text messages or phone calls over 8 weeks. Questionnaires were completed by adolescents and caregivers and clinical data (glucometer and HbA1c) were collected at baseline 3 and 6 months. Data were analyzed using generalized linear modeling. RESULTS After adjusting for covariates, adolescents in the PA group demonstrated significant improvement in quality of life at 3 months, compared to the EDU group, but this was not sustained at 6 months. Similarly, the PA group showed a significant decrease in disengagement coping at 3 months but not at 6 months. There was no significant intervention effect on blood glucose monitoring, but the odds of clinically significantly improvement (checking at least one more time/day) were about twice as high in the PA group as the EDU group. No significant effects were found for glycemic control. CONCLUSIONS A positive psychology intervention had initial significant, positive effects on coping and quality of life in adolescents with T1D. A more intensive or longer-lasting intervention may be needed to sustain these effects and to improve adherence and glycemic control.
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Affiliation(s)
- Sarah S Jaser
- Department of Pediatrics, Vanderbilt University Medical Center
| | | | - Leena Choi
- Department of Biostatistics, Vanderbilt University Medical Center
| | - Samuel Nwosu
- Department of Biostatistics, Vanderbilt University Medical Center
| | - William E Russell
- Department of Pediatrics, Vanderbilt University Medical Center.,Department of Biostatistics, Vanderbilt University Medical Center
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