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User-centered models for the development of digital health interventions are not consistently applied in healthcare settings. This study used a five-phase, user-centered approach to develop HEARTPrep©, a psychosocial intervention delivered via mobile app and telehealth to mothers expecting a baby with congenital heart disease (CHD) to promote maternal, family, and child well-being. Phases of intervention development were: (I) establishing partnerships; (II) creating content; (III) developing prototype and testable intervention; (IV) conducting think-aloud testing; and (V) completing beta testing. Partnerships with parents, clinicians, and design/technology experts were integral throughout the development of HEARTPrep©. Parents of children with CHD also served as participants in Phases II-V, contributing to the creation of content and providing feedback to inform the iterative refinement of HEARTPrep©. These five phases produced a refined digital health intervention with promising feasibility, usability, and acceptability results. This user-centered approach can be used to develop digital health interventions targeting various health outcomes. [ABSTRACT FROM AUTHOR]

Background Providing high-quality psychosocial care to parents and other primary caregivers of children with cancer (henceforth referred to as caregivers) is important, given the numerous challenges associated with a pediatric cancer diagnosis and the increased risk for negative psychosocial sequelae among caregivers. The Electronic Surviving Cancer Competently Intervention Program (eSCCIP) is a psychosocial eHealth intervention for caregivers, developed using an iterative, user-centered process. Method eSCCIP was tested in a single-arm pilot trial at Nemours Children's Hospital, Delaware (NCT05333601). The primary outcomes were intervention acceptability and feasibility, assessed via enrollment and retention targets, and item-level acceptability ratings. Enrollment and retention targets of 45% were set based on previous work, and an item-level acceptability threshold of 80% was set. A secondary exploratory analysis was conducted examining acute distress, anxiety, symptoms of post-traumatic stress, and family functioning. Results 44 caregivers enrolled in the study and 31 completed. The intervention was rated favorably by completers, with over 80% of the sample selecting "mostly true" or "very true" for all items of the eSCCIP Evaluation Questionnaire, which was used to assess acceptability and feasibility. Enrollment and retention rates were 54% and 70%, respectively. Exploratory psychosocial outcomes showed statistically significant decreases from pre-intervention to post-intervention for overall symptoms of post-traumatic stress disorder (PTSD), cluster D symptoms of PTSD (negative mood and cognitions), and anxiety. Small-moderate effect sizes were observed for all psychosocial outcomes of interest. Conclusions eSCCIP is an acceptable and feasible intervention for caregivers. Results are promising regarding reductions in symptoms of post-traumatic stress and anxiety. [ABSTRACT FROM AUTHOR]

Objective The COVID-19 Exposure and Family Impact Scales (CEFIS) were developed in Spring 2020 to assess effects of the COVID-19 pandemic on families and caregivers. Initial psychometric properties were promising. The current study examined the factor structure and evaluated convergent and criterion validity of the CEFIS in a new sample. Methods In October and November 2020, caregivers (N  = 2,531) of youth (0–21 years) scheduled for an ambulatory care visit at Nemours Children's Hospital, Delaware completed the CEFIS and measures of convergent (PROMIS Global Mental Health Scale, Family Assessment Device) and criterion validity (PTSD Checklist—Civilian). Confirmatory factor analysis was used to examine the factor structure of the CEFIS. Bivariate correlations and logistic regression were used to examine convergent and criterion validity. Results Factor analysis supported the original six- and three-factor structures for the Exposure and Impact scales, respectively. Second-order factor analyses supported the use of Exposure, Impact, and Distress total scores. Higher scores on the CEFIS Exposure, Impact, and Distress scales were associated with increased mental health concerns and poorer family functioning. Higher scores on all CEFIS scales were also associated with greater odds of having clinically significant posttraumatic stress symptoms. Conclusions The CEFIS is a psychometrically sound measure of the impact of the COVID-19 pandemic on family and caregiver functioning and may also be useful in identifying families who would benefit from psychological supports. [ABSTRACT FROM AUTHOR]

Objective: To provide a historical analysis through the examination of trends in type of articles, content areas, and population groups across all issues of the Journal of Pediatric Psychology (JPP).Method: All articles published in JPP between the years 1976-2015 were coded based on article type (e.g., original research, meta-analysis), content code (e.g., adherence, primary care), and population code (e.g., oncology, chronic and recurrent pain). Descriptive statistics were calculated.Results: The overall top article types, content codes, and population codes are described as well as top codes for each decade. Overall, the majority of articles were classified as original research. Although some population and content codes varied over time, there were some areas that were consistently present throughout issues, including family systems, cognitive/intellectual functioning, pediatric oncology, and type 1 diabetes. Many topics selected for special issues and topics were consistent with top population and content codes.Conclusions: Findings indicate that most top areas have consistently been present in JPP over the 39-year period. The current historical analysis highlights these patterns as well as serves as a historical record for JPP. [ABSTRACT FROM AUTHOR]

Research supports the importance of adequate fruit and vegetable intake during childhood. The current study examines relationships between physical activity, sedentary behavior, sleep, food insecurity, and fruit and vegetable intake in a sample of low-income, elementary-aged children. 148 participants were recruited from several agencies serving low-income families in a large midwestern metropolitan area. A measurement model was specified to ensure good fit between the data and predictive model. A structural model was run and several significant findings emerged. Food insecurity significantly predicted vegetable intake (latent regression coefficient = −0.18,p < 0.05), such that children with higher food insecurity consumed fewer servings of vegetables. Physical activity also significantly predicted fruit intake (latent regression coefficient = 0.32,p < 0.01) and vegetable intake (latent regression coefficient = 0.26,p < 0.01), such that children who were more physically active consumed more servings of fruits and vegetables. Data indicate that children with high food insecurity consumed fewer vegetables, and that physical activity is significantly related to fruit and vegetable intake. Possible implications for public policy are discussed. [ABSTRACT FROM PUBLISHER]

Pediatric obesity remains a prevalent health issue in the United States and around the world. Treatments are challenged by a lack of meaningful improvements in child healthy weight. The current commentary describes an intervention study with a unique approach: engaging fathers. The commentary describes why this approach is unique and promising in terms of future directions for the field to consider. [ABSTRACT FROM AUTHOR]