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Aim: Health literacy is the ability to understand and interpret health information and navigate the health‐care system. Low health literacy is associated with poorer health knowledge and disease management, increased chronic illness, underutilisation of preventative health services and increased hospitalisations. The aim of the study is to review the available literature on the relationship between parental health literacy and health outcomes for children with chronic disease in high‐income countries (HIC) and low‐ and middle‐income countries (LMIC). Methods: We systematically searched Medline, EMBASE and Web of Science, and assessed study quality using the Newcastle Ottawa Scale. We reviewed all relevant studies, and identified themes using thematic analysis. Results: Of 1167 studies assessed, 49 were included in the review. All studies were of adequate quality. Twenty‐two were from LMIC and 27 from HIC. Six themes were identified: Parental health literacy, parental education, socio‐economic conditions, identity and culture, family factors, and health behaviours. In both HIC and LMIC, lower parental health literacy was associated with poorer child health outcomes. Disease‐specific knowledge was found in a number of papers to directly impact parent health behaviour and child health outcomes, and may mitigate the effects of low parental health literacy. Conclusion: There is a clear link between parental health literacy, health behaviour and health outcomes for children with chronic disease. Disease‐specific knowledge as a target for health‐care interventions holds promise for application in low‐resourced settings with parents (particularly mothers) who have lower health literacy, where disease‐specific education may improve child health outcomes, although more research is required to determine how we can best facilitate these programmes. [ABSTRACT FROM AUTHOR]

Aim: The internet has rapidly developed to become a default information source for parents when searching for information about their child's medical condition. This study aims to understand how parents use, search for and appraise the relevance and credibility of online information relating to children's health. Methods: This research involved a practical task with parents of in‐patients with subacute health conditions at The Children's Hospital at Westmead. Each was presented with a scenario detailing symptoms of a paediatric health condition and asked to search for online health information on their mobile device. Participants' search was video‐recorded. A semi‐structured interview was then conducted to explore participants' use, search and appraisal of online health information. Interview audio recordings were transcribed verbatim and analysed using inductive thematic analysis. Videos of practical tasks were analysed using an observation checklist. Results: Twenty‐two parents participated. Four themes were identified: Wide spectrum of online health information utilisation, techniques in searching for online health information, appraising relevance and appraising credibility. Most parents used online health information flexibly in conjunction with consultations with health professionals, depending on assumptions about the severity of their child's condition, availability of health professionals and relationship with their child's doctor. Most focused on website titles and descriptions more than website sources when selecting a website. Conclusion: Most parents exhibited a wide use of online health information utilisation, from minimal to extensive. There are disparities between parents' perceived knowledge and performance during search and appraisal, emphasising the need for education to improve parents' eHealth literacy. [ABSTRACT FROM AUTHOR]

Aim: To explore associations between weight and type/frequency of urinary incontinence (UI) in children presenting to a tertiary hospital incontinence clinic.Methods: We retrospectively reviewed medical records of children who first attended the incontinence clinic at The Children's Hospital at Westmead between January 2004 and December 2014. A random sample of 1000 children was selected from 2022 patient records, and data were collected on weight, height, age, gender, UI parameters, bowel habits and medical history. Associations between predictors (weight categories, gender, snoring, constipation, faecal incontinence) and outcomes (daytime urinary incontinence (DUI) and nocturnal enuresis (NE)) were examined using χ2 tests and logistic regression analysis.Results: A total of 862 children were included in the study; 54% were male, and 28% were overweight/obese. No evidence of difference was found between the underweight/normal and overweight/obese weight children with NE (34 vs. 39%), DUI (7 vs. 9%) or combined NE and DUI (58 vs. 52.1%), P = 0.23. The frequency of NE (83 vs. 82%, P = 0.56) and DUI (52 vs. 58%, P = 0.20) was similar between the weight groups.Conclusion: In a large cohort of children presenting to a tertiary incontinence clinic, weight was not associated with the type or frequency of UI. [ABSTRACT FROM AUTHOR]

Aim: Studies of published clinical trials involving children have shown frequent omissions in key aspects of design and conduct, but these problems may be artefactual and due to editorial processes and space limitations. To determine actual design and conduct, we analysed the completeness of key domains in trial protocols involving children submitted to Human Research Ethics Committees.Methods: The ethics committees of all eight children's hospitals in Australia were invited to participate. De-identified trial protocols submitted for review in 2012 were evaluated using a checklist derived from Consolidated Standards of Reporting Trials, the Cochrane Risk of Bias Tool and Good Clinical Practice guidelines.Results: Four ethics committees agreed to participate, and 69 protocols were analysed. The domains almost always reported were clustered around the background and trial plan (planned interventions for each group (99%), specific objectives (97%) and scientific background (96%)). Risk-of-bias domains such as random sequence generation and blinding of participants were often reported (75-90%). Domains least reported were clustered around the statistical analysis plan (66%), specified intention-to-treat analysis (54%), the justification for the proposed trial based upon a systematic review (48%) and age-specific outcomes (48%).Conclusions: Protocols of trials involving children assessed by ethics committees generally include details on background and basic design, but many key domains in trial design and conduct are not covered. Despite widespread recognition of how problems in the design and conduct of trials may lead to unreliable results, investigators still appear to be omitting key elements in trial protocols. [ABSTRACT FROM AUTHOR]

Aim: The internet has enabled parents to become informed medical consumers and take an active role in their child's treatment. We aimed to determine parents' online medical information-seeking behaviour about their child's health. This included sources of information, reasons for searching, use and assessment of information and whether parents wanted assistance with searching and assessing information.Methods: A questionnaire was distributed to 331 parents and carers of inpatients and outpatients at Children's Hospital at Westmead in 2015. Most questions involved tick-box responses and a few free-text responses. Responses were tabulated and described by frequencies and percentages. Associations between participant demographics and responses were examined using chi-square tests.Results: In all, 308 (93%) questionnaires were returned. Most participants (90%) reported searching for medical information about their child's health. Of these, 96% searched the internet, and of these, 63% used a smartphone. The most common reason for searching before seeing the doctor was to prepare questions. The most common reasons for searching after seeing the doctor were to know more and because participants had more questions. Only half (57%) ascertained whether an information source was reliable. Most wanted guidance on searching (69%) and assessing reliability (77%).Conclusions: Almost all parents search for online information about their child's health, but most are unsure whether the information they find is trustworthy and are hesitant to act on or present it to their child's doctor. Health professionals could discuss this with parents during consultations to dispel potential misunderstandings and provide guidance on searching and assessing. [ABSTRACT FROM AUTHOR]

Background: Adolescence is a key developmental period that affects lifelong health and is impacted by adolescents regularly engaging with digital health information. Adolescents need digital health literacy (DHL) to effectively evaluate the quality and credibility of such information, and to navigate an increasingly complex digital health environment. Few educational resources exist to improve DHL, and few have involved adolescents during design. The co-design approach may hold utility through developing interventions with participants as design partners., Objective: This project aimed to explore the co-design approach in developing an educational resource to improve adolescents' DHL., Methods: Adolescents (12-17 years old) attended 4 interactive co-design workshops (June 2021-April 2022). Participant perspectives were gathered on DHL and the design of educational resources to improve it. Data generated were analyzed through content analysis to inform educational resource development., Results: In total, 27 participants from diverse backgrounds attended the workshops. Insight was gained into participants' relationship with digital health information, including acceptance of its benefits and relevance, coupled with awareness of misinformation issues, revealing areas of DHL need. Participants provided suggestions for educational resource development that incorporated the most useful aspects of digital formats to develop skills across these domains. The following 4 themes were derived from participant perspectives: ease of access to digital health information, personal and social factors that impacted use, impacts of the plethora of digital information, and anonymity offered by digital sources. Initial participant evaluation of the developed educational resource was largely positive, including useful suggestions for improvement., Conclusions: Co-design elicited and translated authentic adolescent perspectives and design ideas into a functional educational resource. Insight into adolescents' DHL needs generated targeted educational resource content, with engaging formats, designs, and storylines. Co-design holds promise as an important and empowering tool for developing interventions to improve adolescents' DHL., (©Callum C Lewis, Melody Taba, Tiffany B Allen, Patrina HY Caldwell, S Rachel Skinner, Melissa Kang, Hamish Henderson, Liam Bray, Madeleine Borthwick, Philippa Collin, Kirsten McCaffery, Karen M Scott. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 07.08.2024.)