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Technology-Focused Family Interventions in Pediatric Chronic Illness: A Systematic Review

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Abstract

This systematic review provides a synthesis of randomized-controlled trials of technology-focused family interventions for children with chronic illnesses and their families, focused on describing the current state of the literature and generating recommendations for future family systems work in the field of eHealth/mHealth. Twenty-three studies met inclusion criteria and were included in the systematic review. No identified studies featured an mHealth delivery modality. Relevant data were extracted and studies were assessed for quality. There was great variability with regard to intervention factors (e.g., format) and family-centered intervention targets. There is some evidence that eHealth interventions may lead to improvements in particular domains of family functioning (e.g., family conflict) for some groups of participants. However, mixed results and selection of numerous different intervention targets by investigators make it challenging to draw summative conclusions about the overall effectiveness of family systems eHealth interventions. Future research should move beyond feasibility/acceptability studies and examine family-centered processes as primary outcomes. Future research should also consider novel intervention formats to determine whether intervention effects are more robust for certain groups (e.g., individuals who prefer electronic intervention delivery to in-person intervention).

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Fig. 1

Reproduced with permission from Moher et al. (2009). http://www.prisma-statement.org

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Notes

  1. Intervention conditions included the following: I-InTERACT (TBI), unnamed online program (burns), Triple P ‘Positive Parenting Programme’ (Asthma), telemedicine (obesity), videoconferencing (epilepsy), TeenCope (T1DM), Web-MAP (chronic pain, headache), telehealth behavioral therapy (T1DM), CAPS (TBI), OPIS (CKD), online FPS (TBI), TOPS (TBI), Cascade (cancer survivors), HIP-Teens (obesity), STARBRIGHT World (SCD).

  2. White et al. (2004) featured a 2-year intervention; however, outcomes from the first 6 months only are reported in the included manuscript.

References

References marked with a * were included in the systematic review

  • Alderfer, M. A., Kazak, A. E., & Canter, K. S. (in press). Families and the healthcare system. In B. Fiese (Ed.), APA handbook of contemporary psychology. Washington, DC: American Psychological Association

  • *Antonini, T. N., Raj, S. P., Oberjohn, K. S., Cassedy, A., Makoroff, K. L., Fouladi, M., & Wade, S. L. (2014). A pilot randomized trial of an online parenting skills program for pediatric traumatic brain injury: Improvements in parenting and child behavior. Behavior Therapy, 45, 455–468.

    Article  PubMed  Google Scholar 

  • Borrelli, B., & Ritterband, R. (2015). Special issue on eHealth and mHealth: Challenges and future directions for assessment, treatment, and dissemination. Health Psychology, 34, 1205–1208.

    Article  Google Scholar 

  • Boutron, I., Altman, D. G., Moher, D., Schulz, K. F., Ravaud, P., & CONSORT NPT Group (2017). CONSORT statement for randomized trials of nonpharmacologic treatments: A 2017 update and a CONSORT extension for nonpharmacologic trial abstracts. Annals of Internal Medicine, 167, 40–47.

    Article  PubMed  Google Scholar 

  • Brannon, E. E., & Cushing, C. C. (2015). A systematic review: Is there an app for that? Translational science of pediatric behavior change for physical activity and dietary interventions. Journal of Pediatric Psychology, 40, 373–384.

    Article  PubMed  Google Scholar 

  • *Clarke, S. A., Calam, R., Morawska, A., & Sanders, M. (2014). Developing web-based Triple P ’ Positive Parenting Programme’ for families of children with asthma. Child: Care, Health & Development, 40, 492–497.

    Google Scholar 

  • Collins, S., Collins, L. M., Murphy, S. A., & Strecher, V. (2007). The multiphase optimization strategy (MOST) and the sequential multiple assignment randomized trial (SMART): New methods for more potent eHealth interventions. American Journal of Preventive Medicine, 32, S112–S118.

    Article  PubMed  PubMed Central  Google Scholar 

  • Cushing, C. C., & Steele, R. G. (2010). A meta-analytic review of eHealth interventions for pediatric health promoting and maintaining behaviors. Journal of Pediatric Psychology, 35, 937–949.

    Article  PubMed  Google Scholar 

  • *Davis, A. M., Sampilo, M., Steiger Gallagher, K., Dean, K., Baby Saroja, M., Yu, Q., & Sporn, N. (2016). Treating rural paediatric obesity through telemedicine vs. telephone: Outcomes from a cluster randomized controlled trial. Journal of Telemedicine and Telecare, 22, 86–95.

    Article  PubMed  Google Scholar 

  • *Davis, A. M., Sampilo, M., Steiger Gallagher, K., Landrum, Y., & Malone, B. (2013). Treating rural pediatric obesity through telemedicine: Outcomes from a small randomized controlled trial. Journal of Pediatric Psychology, 38, 932–943.

    Article  PubMed  PubMed Central  Google Scholar 

  • Devine, K. A., Manne, S. L., Lee, L., Bartell, A. S., Sands, S. A., Myers-Virtue, S., & Ohman-Strickland, P. (2016). Barriers to psychological care among primary caregivers of children undergoing hematopoietic stem cell transplantation. Supportive Care in Cancer, 24, 2235–2242.

    Article  PubMed  Google Scholar 

  • Doss, B. D., Feinberg, L. K., Rothman, K., Roddy, M. K., & Comer, J. S. (2017). Using technology to enhance and expand interventions for couples and families: Conceptual and methodological considerations. Journal of Family Psychology, 31, 983–993.

    Article  PubMed  PubMed Central  Google Scholar 

  • Eccleston, C., Fisher, E., Law, E., Bartlett, J., & Palermo, T. M. (2015). Psychological interventions for parents of children and adolescents with chronic illness (review). The Cochrane Database of Systematic Reviews, 4, CD009660.

    PubMed Central  Google Scholar 

  • Fedele, D., Cushing, C., Fritz, A., Amaro, C., & Ortiga, A. (2017). Mobile health interventions for improving health outcomes in youth. JAMA Pediatrics, 171, 461–469.

    Article  PubMed  PubMed Central  Google Scholar 

  • File, T., & Camille, R. (2014). Computer and internet use in the United States: 2013. American Community Survey Reports. Washington, DC: U.S. Census Bureau. Retrieved February 3, 2018 from http://www.census.gov/content/dam/Census/library/publications/2014/acs/acs-28.pdf.

  • *Glueckauf, R. L., Fritz, S. P., Ecklund-Johnson, E. P., Liss, H. J., Dages, P., & Carney, P. (2002). Videoconferencing-based family counseling for rural teenagers with epilepsy: Phase 1 findings. Rehabilitation Psychology, 47, 49–72.

    Article  Google Scholar 

  • *Grey, M., Whittermore, R., Jeon, S., Murphy, K., Faulkner, M. S., Delamater, A., & the TeenCope Study Group (2013). Internet psycho-education programs improve outcomes in youth with type 1 diabetes. Diabetes Care, 36, 2475–2482.

    Article  PubMed  PubMed Central  Google Scholar 

  • Gutiérrez-Colina, A. M., Lee, J. L., VanDellen, M., Mertens, A., & Marchak, G., J (2017). Family functioning and depressive symptoms in adolescent and young adult cancer survivors and their families: A dyadic analytic approach. Journal of Pediatric Psychology, 42, 19–27.

    PubMed  Google Scholar 

  • Kazak, A. E., Simms, S., & Rourke, M. T. (2002). Family systems practice in pediatric psychology. Journal of Pediatric Psychology, 27, 133–143.

    Article  PubMed  Google Scholar 

  • *Ketchen, B., Hazzard, A., Lassiter, S., Barber, N., Armistead, L., Mentz, R., & Hsu, L. (2006). STARBRIGHT world: A pilot study of a home-based sickle cell psychoeducational intervention. Children’s Health Care, 35, 321–338.

    Article  Google Scholar 

  • *Law, E. F., Beals-Erickson, S. E., Noel, M., Claar, R., & Palermo, T. M. (2015). Pilot randomized controlled trial of internet-delivered cognitive-behavioral treatment for pediatric headache. Headache, 55, 1410–1425.

    Article  PubMed  PubMed Central  Google Scholar 

  • *Lehmkuhl, H. D., Storch, E. A., Cammarata, C., Meyer, K., Rahman, O., Silverstein, J., …, Geffken, G. (2010). Telehealth behavior therapy for the management of type 1 diabetes in adolescents. Journal of Diabetes Science and Technology, 4, 199–208.

    Article  PubMed  PubMed Central  Google Scholar 

  • Long, A. C., & Palermo, T. M. (2009). Brief report: Web-based management of adolescent chronic pain: Development and usability testing on an online family cognitive behavioral therapy program. Journal of Pediatric Psychology, 34, 511–516.

    Article  PubMed  Google Scholar 

  • Lutz Stehl, M., Kazak, A. E., Alderfer, M. A., Rodriguez, A., Hwang, W. T., Pai, A. L. H., …, GreyReilly, A. (2009). Conducting a randomized clinical trial of an psychological intervention for parents/caregivers of children with cancer shortly after diagnosis. Journal of Pediatric Psychology, 34, 803–816.

    Article  Google Scholar 

  • Marsac, M. L., Hildenbrand, A. K., Kohser, K. L., Winston, F. K., Li, Y., & Kassam-Adams, N. (2013). Preventing posttraumatic stress following pediatric injury: A randomized controlled trial of a web-based psycho-educational intervention for parents. Journal of Pediatric Psychology, 38, 1101–1111.

    Article  PubMed  PubMed Central  Google Scholar 

  • Mayer, D. K., Ratichek, S., Berhe, H., Stewart, S., McTavish, F., Gustafson, D., & Parsons, S. K. (2010). Development of a health-related website for parents of children receiving hematopoetic stem cell transplant: HSCT-CHESS. Journal of Cancer Survivorship, 4, 67–73.

    Article  PubMed  Google Scholar 

  • McGrady, M. E. (2014). Commentary: Demonstrating cost-effectiveness in pediatric psychology. Journal of Pediatric Psychology, 6, 602–611.

    Article  Google Scholar 

  • Miller, G. F., Coffield, E., Leroy, Z., & Wallin, R. (2016). Prevalence and costs of five chronic conditions in children. The Journal of School Nursing, 32, 357–364.

    Article  PubMed  PubMed Central  Google Scholar 

  • Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & The PRISMA Group (2009). Preferred reporting items for systematic reviews and meta- analyses: The PRISMA statement. PLoS Medicine, 6, e1000097. https://doi.org/10.1371/journal.pmed1000097.

    Article  PubMed  PubMed Central  Google Scholar 

  • Mullins, L. L., Gillapsy, S. R., Molzon, E. S., & Chaney, J. M. (2014). Parent and family interventions in pediatric psychology: Clinical applications. Clinical Practice in Pediatric Psychology, 2, 281–293.

    Article  Google Scholar 

  • *Narad, M., Minich, N., Taylor, H. G., Korkwood, M., Brown, T. M., Stancin, T., & Wade, S. L. (2015). Effects of a web-based intervention on family-functioning following pediatric traumatic brain injury. Journal of Developmental and Behavioral Pediatrics, 36, 700–707.

    Article  PubMed  PubMed Central  Google Scholar 

  • Noser, A. E., Cushing, C. C., McGrady, M. E., Amaro, C. M., & Huffhines, L. P. (2017). Adaptive intervention designs in pediatric psychology: The promise of sequential multiple assignment randomized trials of pediatric interventions. Clinical Practice in Pediatric Psychology, 5, 170–179.

    Article  Google Scholar 

  • Orszag, P. R., & Emanuel, E. J. (2010). Health care reform and cost control. The New England Journal of Medicine, 363, 601–603.

    Article  CAS  PubMed  Google Scholar 

  • Pai, A. L., Greenley, R. N., Lewandowski, A., Drotar, D., Youngstrom, E., & Peterson, C. C. (2007). A meta-analytic review of the influence of pediatric cancer on parent and family functioning. Journal of Family Psychology, 21, 407–415.

    Article  PubMed  Google Scholar 

  • Palermo, T. M. (2008). Editorial: Section on innovations in technology in measurement, assessment, and intervention. Journal of Pediatric Psychology, 33, 35–38.

    Article  PubMed  Google Scholar 

  • *Palermo, T. M., Law, E. F., Fales, J., Bromberg, M. H., Jessen-Fiddick, T., & Tai, G. (2016). Internet-delivered cognitive-behavioral treatment for adolescents with chronic pain and their parents: A randomized controlled multicenter trial. Pain, 157, 174–185.

    Article  PubMed  PubMed Central  Google Scholar 

  • *Palermo, T. M., Wilson, A. C., Peters, M., Lewandowski, A., & Somhegyi, H. (2009). Randomized controlled trial of an internet delivered family cognitive behavioral therapy intervention for children and adolescents with chronic pain. Pain, 146, 205–213.

    Article  PubMed  PubMed Central  Google Scholar 

  • Park, E., Kim, H., & Steinhoff, A. (2016). Health-related internet use by informal caregivers of children and adolescents: An integrative literature review. Journal of Medical Internet Research, 18, e57.

    Article  PubMed  PubMed Central  Google Scholar 

  • *Petranovich, C. L., Wade, S. L., Taylor, H. G., Cassedy, A., Stancin, T., Kirkwood, M. W., & Maines Brown, T. (2015). Long-term caregiver mental health outcomes following a predominately online intervention for adolescents with complicated mild to severe traumatic brain injury. Journal of Pediatric Psychology, 40, 680–688.

    Article  PubMed  PubMed Central  Google Scholar 

  • Pew Research Center. (2017). Mobile Fact Sheet [Fact Sheet]. Retrieved February 3, 2018 from http://www.pewinternet.org/fact-sheet/mobile/.

  • *Raj, S. P., Antonini, T. N., Oberjohn, K. S., Cassedy, A., Makoroff, K. L., & Wade, S. L. (2015). Web-based parenting skills program for pediatric traumatic brain injury reduces psychological distress among lower-income parents. The Journal of Head Trauma Rehabilitation, 30, 347–356.

    Article  PubMed  Google Scholar 

  • Ritterband, L. M., Ardalan, K., Thorndike, F. P., Magee, J. C., Saylor, D. K., Cox, D. J., …, Borowitz, S. M. (2008). Real world use of an internet intervention for pediatric encopresis. Journal of Medical Internet Research, 10, e16.

    Article  PubMed  PubMed Central  Google Scholar 

  • Roddy, M. K., Nowlan, K. M., & Doss, B. D. (2017). A randomized controlled trial of coach contact during a brief online intervention for distressed couples. Family Process, 56, 835–851.

    Article  PubMed  Google Scholar 

  • Sahler, O. J., Dolgin, M., Phipps, S., Fairclough, D. L., Askins, M., Katz, E., …, Butler, R. W. (2013). Specificity of problem-solving skills training in mothers of children with newly diagnosed cancer: Report of a multi-site randomized trial. Journal of Clinical Oncology, 31, 1329–1335.

    Article  PubMed  PubMed Central  Google Scholar 

  • Sahler, O. J., Fairclough, D. L., Phipps, S., Mulhern, R. K., Dolgin, M. J., Noll, R. B., …, Butler, R. W. (2005). Using problem-solving skills training to reduce negative affectivity in mothers of children with newly diagnosed cancer: Report of a multi-site randomized trial. Journal of Consulting and Clinical Psychology, 73, 273–283.

    Article  Google Scholar 

  • Stark, L. J., Opipari-Arrigan, L., Filigno, S. S., Simon, S. L., Leonard, A., Mogayzel, P. J., …, Powers, S. W. (2016). Web-based intervention for nutritional management in cystic fibrosis. Journal of Pediatric Psychology, 41, 510–521.

    Article  PubMed  Google Scholar 

  • Stinson, J., Wilson, R., Gill, N., Yamada, J., & Holt, J. (2009). A systematic review of internet-based self-management interventions for youth with health conditions. Journal of Pediatric Psychology, 34, 495–510.

    Article  PubMed  Google Scholar 

  • *Sveen, J., Andersson, G., Buhrman, B., Sjöberg, F., & Willebrand, M. (2017). Internet-based information and support program for parents of children with burns: A randomized controlled trial. Burns, 43, 583–591.

    Article  PubMed  Google Scholar 

  • *Swallow, V. M., Knafl, K., Santacroce, S., Campbell, M., Hall, A. G., Smith, T., & Carolan, I. (2014). An interactive health communication application for supporting parents managing childhood long-term conditions: Outcomes of a randomized controlled feasibility trial. JMIR Research Protocols, 3, e69.

    Article  PubMed  PubMed Central  Google Scholar 

  • Tercyak, K. P., Donze, J. R., Prahlad, S., Mosher, R. B., & Shad, A. T. (2006). Identifying, recruiting, and enrolling adolescent survivors of childhood cancer into a randomized controlled trial of health promotion: Preliminary experiences in the survivor health and resilience education (SHARE) program. Journal of Pediatric Psychology, 31, 252–261.

    Article  PubMed  Google Scholar 

  • Van Cleave, J., Gortmaker, S. L., & Perrin, J. M. (2010). Dynamics of obesity and chronic health conditions among children and youth. JAMA, 303, 623–630.

    Article  PubMed  Google Scholar 

  • Van Schoors, M., Caes, L., Knoble, N. B., Goubert, L., Verhofstadt, L. L., & Alderfer, M. A. (2017). Systematic review: Associations between family functioning and child adjustment after pediatric cancer diagnosis: A meta-analysis. Journal of Pediatric Psychology, 42, 6–18.

    PubMed  Google Scholar 

  • *Wade, S. L., Carey, J., & Wolfe, C. R. (2006). An online family intervention to reduce parental distress following pediatric brain injury. Journal of Consulting and Clinical Psychology, 74, 445–454.

    Article  PubMed  Google Scholar 

  • *Wade, S. L., Karver, C. L., Taylor, H. G., Cassedy, A., Stancin, T., Kirkwood, M. W., & Maines Brown, T. (2014). Counselor-assisted problem solving improves caregiver efficacy following adolescent brain injury. Rehabilitation Psychology, 59, 1–9.

    Article  PubMed  PubMed Central  Google Scholar 

  • *Wade, S. L., Walz, N. C., Carey, J., McMullen, K. M., Cass, J., Mark, E., & Yeates, K. O. (2011). Effect on behavior problems of teen online problem-solving for adolescent traumatic brain injury. Pediatrics, 128, e947–e953.

    Article  PubMed  PubMed Central  Google Scholar 

  • *Wade, S. L., Walz, N. C., Carey, J., McMullen, K. M., Cass, J., Mark, E., & Yeates, K. O. (2012). A randomized trial of teen online problem solving: Efficacy in improving caregiver outcomes after brain injury. Health Psychology, 31, 767–776.

    Article  PubMed  Google Scholar 

  • *Wakefield, C. E., Sansom-Daly, U. M., McGill, B. C., Ellis, S. J., Doolan, E. L., Robertson, E. G., …, Cohn, R. J. (2016). Acceptability and feasibility of an e-mental health intervention for parents of childhood cancer survivors: “Cascade”. Supportive Care in Cancer, 24, 2685–2694.

    Article  PubMed  Google Scholar 

  • Watson McDonell, K., & Prinz, R. J. (2017). A review of technology-based youth and family-focused interventions. Clinical Child and Family Psychology Review, 20, 185–200.

    Article  Google Scholar 

  • *White, M. A., Martin, P. D., Newton, R. L., Walden, H. M., York-Crowe, E. E., Gordon, S. T., …, Williamson, D. A. (2004). Mediators of weight loss in a family-based intervention presented over the internet. Obesity Research, 12, 1050–1059.

    Article  PubMed  Google Scholar 

  • *Whittemore, R., Jaser, S. S., Jeon, S., Liberti, L., Delamater, A., Murphy, K., …, Grey, M. (2012). An internet coping skills training program for youth with type 1 diabetes: Six-month outcomes. Nursing Research, 61, 395–404.

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

The authors would like to thank Melissa Alderfer, Ph.D., for her helpful comments on an earlier draft of this manuscript. The PRISMA Statement and the PRISMA Explanation and Elaboration document are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Authors and Affiliations

  1. Nemours Center for Healthcare Delivery Science, Nemours Children’s Health System, Wilmington, DE, USA

    Kimberly S. Canter, Jennifer Christofferson, Michele A. Scialla & Anne E. Kazak

  2. Department of Pediatrics, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA, USA

    Kimberly S. Canter & Anne E. Kazak

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  1. Kimberly S. Canter
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  2. Jennifer Christofferson
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Correspondence to Kimberly S. Canter.

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Kimberly S. Canter, Jennifer Christofferson, Michele A. Scialla, and Anne E. Kazak declare that they have no conflict of interest.

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Canter, K.S., Christofferson, J., Scialla, M.A. et al. Technology-Focused Family Interventions in Pediatric Chronic Illness: A Systematic Review. J Clin Psychol Med Settings 26, 68–87 (2019). https://doi.org/10.1007/s10880-018-9565-8

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