ABSTRACT
Background
Cyberbullying is a new risk factor for the well‐being of pediatric populations. Consequences of cyberbullying include both physical and mental health concerns such as depression, ...anxiety, and somatic concerns. Adolescents who have been victims of cyberbullying and developed secondary symptoms are often recommended to visit a healthcare provider to obtain effective, evidence‐based treatment. To date, no interventions exist in the healthcare setting for adolescents who are victims of cyberbullying.
Aims
The purpose of this project is to review interventional studies on cyberbullying that have components for adolescents who have been involved with cyberbullying and their parents and to provide recommendations on effective intervention components with the goal of guiding clinical practice.
Methods
A systematic review was conducted using the Institute of Medicine guidelines. A comprehensive electronic literature search was completed targeting interventions of cyberbullying in any setting. No date limits were used. Literature was searched in MEDLINE, Cumulative Index of Nursing and Allied Health Literature (CINAHL), PubMed, Communication and Mass Media Complete, Education Information Resource Center (ERIC), and PsycINFO databases. The following search terms were applied “cyberbullying” + “intervention” or “treatment” or “therapy” or “program.” Only articles with a pediatric population were selected for review.
Results
Seventeen cyberbullying intervention programs in 23 articles were found to meet the search criteria. The most frequently used intervention components included education on cyberbullying for the adolescent, coping skills, empathy training, communication and social skills, and digital citizenship. Parent education on cyberbullying was also found to be important and was included in programs with significant outcomes.
Linking Evidence to Action
As youth present to healthcare providers with symptoms related to cyberbullying, effective interventions are needed to guide evidence‐based practice. This review supports educating the individual youth and parent on cyberbullying and teaching the youth skills in communication and social, empathy, coping with cyberbullying, and digital citizenship.
Implementing lifestyle behavior programs in real-world settings challenges researchers. The Special Supplemental Nutrition Program for Women, Infants, and Children (
has implemented and sustained
(
...)'s client videos for clients to promote healthy lifestyle behaviors, and train-the-trainer videos, for personnel to enhance motivational interviewing techniques since 2015 and 2016, respectively. This paper describes the implementation processes and the results of client video implementation acceptability by WIC personnel.
To document the implementation process, we applied the Framework for Adaptation and Modifications to Evidence-Based Implementation Strategies (FRAME-IS). To evaluate implementation acceptability, we conducted semi-structured interviews with 15 WIC personnel. A qualitative analysis was conducted to identify the common themes.
The facilitators for client video implementation were the inclusion of the target audience and family members addressing daily challenges, easy implementation, and compatibility with daily practice. While videos online facilitated implementation, videos in DVD format could challenge implementation.
Future lifestyle intervention programs aimed for future implementation in community settings may consider the inclusion of the target audience and their family members and take into consideration easy implementation and compatibility.
Abstract
Engaging in positive healthy lifestyle behaviors continues to be a public health challenge, requiring innovative solutions. As the market for voice assistants (Amazon Alexa, Google ...Assistant, and Apple Siri) grows and people increasingly use them to assist their daily tasks, there is a pressing need to explore how voice assistant (VA) technology may be used in behavioral health interventions. A scoping review of literature was conducted to address a PICO (Population, Intervention, Comparison, and Outcome) question: across populations, how does the use of voice assistants in behavioral health research/interventions influence healthy lifestyle behaviors versus control or comparison interventions? To inform the science, a secondary aim of this review was to explore characteristics of VAs used in behavioral health research. The review was conducted following Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines with scoping review extension (PRISMA-ScR). Ten studies satisfied the inclusion criteria, representing research published through February 2019. Studies spanned pediatric to elderly populations, covering a vast array of self-management and healthy lifestyle behaviors. The majority of interventions were multicomponent, involving more than one of the following behavior change techniques grouped by cluster: shaping knowledge, self-belief, repetition and substitution, feedback and monitoring, goals and planning, antecedents, natural consequences, comparison of behavior, and identification. However, most studies were in early stages of development, with limited efficacy trials. VA technology continues to evolve and support behavioral interventions using various platforms (e.g., Interactive Voice Response IVR systems, smartphones, and smart speakers) which are used alone or in conjunction with other platforms. Feasibility, usability, preliminary efficacy, along with high user satisfaction of research adapted VAs, in contrast to standalone commercially available VAs, suggest a role for VAs in behavioral health intervention research.
The use of voice assistants in behavioral health to support self-management and healthy lifestyle behaviors is acceptable across diverse sets of participants, yet logistical and design challenges must be addressed prior to uptake in clinical practice.
Pokémon GO illuminated the potential for mobile phone gaming apps to engage users and promote health. However, much work is needed to fully understand the mechanisms through which digitally supported ...behavior change interventions operate, particularly for children and families.
The aims of this study were (1) to explore the Pokémon GO user experience from a family perspective and (2) to investigate Pokémon GO within the context of family health.
Between January and February 2017, congruent with one of the largest anticipated Pokémon GO updates Gen 2, participants were recruited from parks, word of mouth, and social media to complete a Web-based survey. Participants were surveyed about family characteristics, interest, and experiences playing Pokémon GO and healthy lifestyle beliefs. Using a revised Godin Leisure-Time Exercise Questionnaire, a retrospective pre-post design assessed changes in parent physical activity (PA) before and after playing Pokémon GO.
Self-reported data from 160 parents and 31 children were included in the final analyses (representing 129 parents and 31 parent-child dyads). Gameplay most often occurred between sons aged 10 years or younger and mothers. "Spending time together" was the most cited reason for gameplay by both parents (122/160, 76.3%) and children (24/31, 77%), followed by "it helped me go outdoors" for parents (113/160, 70.1%) and "I am a Pokémon fan" by children (21/31, 68%). Interestingly, open-ended responses indicated that gameplay could trigger both positive and negative emotional parent response. The most cited reason for app disengagement was boredom; conversely, the most cited reason for app re-engagement was in-app events. For parents, there were significant increases in minutes spent in mild (mean 23.36 SD 66.02; t
=3.50, P<.001) and moderate (mean 21.76 SD 53.04; t
=4.70, P<.001) PA per week after playing Pokémon GO. However, child perceptions of parental influence on PA most significantly associated with parents who reported weekly strenuous PA both before (r
=.514, P=.003) and after (r
=.536, P=.003) Pokémon GO uptake.
Pokémon GO transcended traditional understanding of digital health and uniquely reached across generations to engage users. Findings from this study highlight that, for a period of time, Pokémon GO fostered social and physical well-being for children and families through a multifaceted approach.
Abstract Sugar‐sweetened beverage (SSB) consumption is strongly associated with obesity. Autonomous motivation and self‐efficacy, key concepts of self‐determination theory, may influence SSB ...consumption. Low‐income mothers of young children experience disproportionate rates of obesity. Whether autonomous motivation and self‐efficacy are associated with SSB consumption in low‐income mothers of young children is unknown. This exploratory secondary data analysis explored whether autonomous motivation or self‐efficacy were associated with SBB consumption using data from a lifestyle intervention for low‐income, overweight or obese mothers with young children. Participants ( N = 311) completed surveys assessing autonomous motivation, self‐efficacy, and SSB consumption at baseline, after the 16‐week intervention, and at 3‐month follow‐up. Using baseline data, we performed linear regression models to explore associations of self‐efficacy and autonomous motivation with SSB consumption. We also performed mixed effects models to explore whether autonomous motivation or self‐efficacy were associated with SSB consumption over time. At baseline, a one‐point increase in autonomous motivation and self‐efficacy were associated with 4.36 ( p < 0.001) and 6.43 ( p = 0.025) fewer ounces of SSB consumption per day, respectively. In longitudinal models, SSB consumption decreased over time. Change in SSB consumption was associated with self‐efficacy ( B = −4.88; p = 0.015) and autonomous motivation ( B = −2.29; p = 0.008). Our findings suggest self‐efficacy and autonomous motivation may influence SSB consumption among mothers of young children with overweight and obesity. Further investigation should explore if self‐efficacy and autonomous motivation have long‐term effects on SSB consumption.
Adolescent obesity is a powerful predictor of morbidity and mortality, yet amenable to modifiable behaviors. To accurately summarize the effects of behavioral interventions on changes in adolescent ...body mass index and/or weight status, we assessed existing systematic reviews for reporting transparency and methodological quality.
Five databases were searched through September 2017 to identify relevant systematic reviews. Reviews were evaluated for reporting transparency and methodological quality using PRISMA Reporting Checklist and Assessment of Multiple Systematic Reviews Instrument. Evidence was synthesized across high-quality reviews.
Four of twelve systematic reviews were of high methodological quality. All four focused on the treatment of overweight/obesity in adolescent populations, representing 97 international studies. Findings indicate intervention compared with no intervention/wait list showed larger effects for improving BMI/BMI z-scores. Small improvements (averaging a 3.7-kg decrease) in weight/weight percentile were observed following a supervised exercise plus dietary and/or behavior support intervention. Health-related quality of life may improve following interventions, but overall attention to associated psychological variables (depression, self-esteem/perception) is limited.
Adherence to objective checklists and protocols for rigorous conduct and reporting of systematic reviews is warranted. Consensus evidence is urgently needed to define and report behavior change interventions related to obesity prevention and treatment.
ABSTRACT
Background: Unhealthy lifestyle behaviors are major public health problems. Promoting positive behavior change is an ongoing challenge that warrants innovative solutions. Mobile phone use is ...becoming widespread across populations and merits further exploration as a strategy to promote wellness and reduce health disparities.
Aims: The purpose of this paper is to review the evidence using text messaging as a tool to deliver healthy lifestyle behavior intervention programs in pediatric and adolescent populations. The following question was used to guide the systematic review, “In pediatric and adolescent populations, how does the use of text‐message–based interventions versus control or comparison interventions affect healthy lifestyle behaviors?”
Methods: A systematic search for relevant literature was conducted in the following databases: MEDLINE, PubMed, Google Scholar, Cochrane Library, and PsycINFO, and by hand‐searching bibliographies. Evidence was compiled from experimental studies in peer‐reviewed journals published from 2004 to May 15, 2011. Data were extracted using guidelines set forth by the Centre for Reviews and Dissemination.
Results: Thirty‐seven articles were identified from the comprehensive search. Eight articles representing seven studies (two articles were published describing different aspects of the outcomes from one study) met inclusion for this review. Mean age of participants in the study ranged from 8.7 to 17.9 years of age. Differences between groups on healthy lifestyle behaviors were significant in five studies.
Conclusions: This review supports previous literature suggesting that mobile phones are uniquely positioned to bridge gaps in health disparities and reach across demographics. Interventions using short messaging service may be most effective as a reminder system to support disease management behaviors. Existing recommendations for tailored, interactive, and family‐centered care are supported with mobile technology recommended to augment clinical practice and health behavior change efforts. However, more rigorous, theory‐based intervention research using mobile technology is warranted in pediatric and adolescent populations.
Lebanon has the highest per-capita concentration of refugees worldwide. There is an urgent need to offer psychosocial interventions to vulnerable groups such as Syrian refugee adolescents. To assess ...the feasibility, acceptability, and preliminary effects of a cognitive–behavioral intervention (Creating Opportunities for Patient Empowerment COPE) on depression, anxiety, and quality of life (QOL) in a sample of adolescent refugees (13-17 years) living in Lebanon. A preexperimental study design was used. COPE 7-Session was delivered to 31 adolescent Syrian refugees. Participants were assessed for depression (Personal Health Questionnaire–9), anxiety (General Anxiety Disorders Scale), and QOL (Pediatric Quality of Life Inventory). Feasibility and acceptability findings indicated that the COPE program was a positive experience for teens. Significant decreases in depression and anxiety, and increases in QOL were also reported. COPE is an effective cognitive–behavioral intervention that can be delivered in an Arabic/Middle-Eastern setting for teen refugees to improve mental health and QOL.
BACKGROUNDDiabetes devices, like insulin pumps and continuous glucose monitors (CGMs), capture and store patient adherence and utilization data that can be retrieved or downloaded providing objective ...information on self-management behaviors; yet, diabetes device data remain underutilized in research.
OBJECTIVEThe aim of the study was to examine the usability and feasibility of personal diabetes device data collected using a clinical download platform retooled for research purposes.
METHODSInvestigators evaluated the feasibility of raw diabetes device data collection. One hundred eight preteens and adolescents with Type 1 diabetes and their parents provided consent/assent.
RESULTSData were successfully collected from the diabetes devices (insulin pumps and CGM) of 97 youth using a clinical download software adapted for research, including data from all three commercially available CGM systems and insulin pumps brands, which contained all current and previous models of each insulin pump brand. The time required to download, mode of connection, and process varied significantly between brands. Despite the use of an agnostic download software, some outdated device brands and cloud-based CGM data were unsupported during data collection. Within the download software, dummy clinical accounts were created for each study participant, which were then linked back to a master study account for data retrieval. Raw device data were extracted into seven to eight Excel files per participant, which were then used to develop aggregate daily measures.
DISCUSSIONOur analysis is the first of its kind to examine the feasibility of raw diabetes device data using a clinical download software. The investigators highlight issues encountered throughout the research process, along with mitigating strategies to inform future inquiry.
CONCLUSIONThis study demonstrates the feasibility of raw data collection, from a wide variety of insulin pump and CGM brands, through the retooling of a clinical download software. Data from these personal devices provide a unique opportunity to study self-management behavior and the glycemic response of individuals in their everyday environments.
Little is known about how sex as a biological variable may contribute to differences in quality of life (QOL) and mental health outcomes following a brief intervention among adolescent Syrian ...refugees. This paper explores the results of a secondary data analysis to investigate differences by sex on self-reported QOL and mental health outcomes among Syrian refugees who participated in a 7-session cognitive behavioral skills building intervention. A one group pretest–posttest design was used to deliver the intervention to 31 adolescent refugees (13–17 years; 15 male, and 16 female). At baseline, there were no significant differences between males and females on mean scores of depression, anxiety, or QOL. Post-intervention, self-reported scores for QOL and mental health were significantly different between sexes. Males demonstrated a significant decrease in anxiety scores compared to females. Among males only, significant decreases in depression and anxiety scores were observed with significant improvement in total QOL.
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