Digital behaviour change interventions for younger children with chronic health conditions: A systematic review

Amberly Brigden*, Emma Anderson, Catherine Linney, Richard Morris, Roxanne Parslow, Teona Serafimova, Lucie Smith, Emily Briggs, Maria Loades, Esther Crawley

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)

Abstract

Background The prevalence of chronic health conditions in childhood is increasing, and behavioural interventions can support the management of these conditions. Compared to face-to-face treatment, the use of digital interventions may be more cost-effective, appealing and accessible, but there has been inadequate attention to their use with younger populations (children aged 5- 12 years).

Objective This systematic review aimed to: Aim 1) identify effective digital interventions, Aim 2) report the characteristics of promising interventions and Aim 3) describe the user’s experience of the digital intervention.

Methods Four databases were searched (EMBASE, PsycINFO, MEDLINE and the Cochrane Library) between January2014- January2019. The inclusion criteria for studies were: (1). Children aged 5-12-years of age, (2) interventions for behaviour change, (3) Randomised controlled trials, (4) digital interventions (5) chronic health conditions. Two researchers independently double-reviewed papers to assess eligibility, extract data and assess quality.

Results Databases searches identified 2643 papers. We identified 17 eligible interventions. The most promising interventions (having a beneficial effect and with low risk of bias) were: three targeting overweight/obesity, using exergaming or social media, and two for anxiety, using online cognitive behavioural therapy (CBT). Characteristics of promising interventions included: gaming features, therapist support and parental involvement. Most were purely behavioural interventions (rather than CBT or third-wave), typically using the Behaviour Change Techniques (BCTs) “feedback and monitoring”, “shaping knowledge”, “repetition and substitution” and “reward”. Three paper included qualitative data about the user’s experience. We developed the following themes: “parental involvement”, “Connection with a health professional is important for engagement”, “Technological affordances and barriers” and “Child-centred design”.

Conclusions Out of the 17 eligible interventions, digital interventions for anxiety and overweight/obesity had the greatest promise. Using qualitative methods during digital intervention development and evaluation may lead to more meaningful, usable, feasible and engaging interventions, especially for this underresearched younger population. The following characteristics could be considered when developing digital interventions for younger children: involvement of parents, gaming features, additional therapist support, behavioural (rather than cognitive) approaches, and particular BCTs (“feedback and monitoring”, “shaping knowledge”, “repetition and substitution” and “reward”). This review suggests a model for improving the conceptualisation and reporting of behavioural interventions involving children and parents.
Original languageEnglish
Article numbere16924
Number of pages22
JournalJMIR
Volume22
Issue number7
DOIs
Publication statusPublished - 31 Jul 2020

Keywords

  • behavioural interventions
  • digital interventions
  • child psychology
  • paediatric practice
  • chronic health conditions
  • systematic review

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