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Berhanu T, Abera M, Girma S, Tesfaye Y. Elimination disorders and associated factors among children and adolescents age 5-14 year-old attending paediatric outpatient clinic at Wolaita Sodo University comprehensive specialized hospital, South Ethiopia. Child Adolesc Psychiatry Ment Health 2024; 18:52. [PMID: 38702758 PMCID: PMC11069281 DOI: 10.1186/s13034-024-00739-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 04/03/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND Elimination disorder occurs in children over the age of normal toileting who continue to have an inability to control urination or feces, either during the day, at night, or both. Paediatric elimination disorders are not well understood by parents, teachers, medical professionals, mental health practitioners, and researchers. Hence, this study aimed to assess the magnitude of elimination disorder and associated factors among children and Adolescents aged 5-14 years old at Wolaita Sodo University Comprehensive Specialized Hospital, South Ethiopia, in 2022. METHOD A hospital-based cross-sectional study was conducted from September 22 to November 22, 2022, at Wolaita Sodo University Comprehensive Specialized Hospital. A systematic random sampling technique was employed to select 423 study subjects. The data were gathered using a structured, face-to-face interviewer-administered questionnaire. The development of the symptom score for dysfunctional elimination syndrome of Vancouver questionnaires was used to screen for elimination disorders. Logistic regression model was used to determine the association between the outcome and independent variables. A 95% CI and Odds ratio with corresponding p-value < 0.05 were used to determine the predictors of the outcome variable. RESULT The overall magnitude of elimination disorder among children and Adolescents age 5-14 in this study was (n 70, 16.8%); in boys (n 47, 17.3%) and girls (n 23, 15.75%). The prevalence of enuresis was (n 64, 15.3%), encopresis (n 15, 3.6%), both enuresis and encopresis, or combined elimination disorder (n 9, 2.2%). Age 9-11 years (AOR = 3.2, 95%CI:1.09, 9.43), family size four and above (AOR = 3.4, 95%CI:1.78, 6.56), family history of elimination disorder (AOR = 3.9, 95%CI:2.12, 7.45), emotional problem (AOR = 2.2, 95%CI:1.18, 4.05), hyperactive problem (AOR = 3.8, 95%CI:1.83, 7.83), low toilet training skills (AOR = 5.9, 95%CI:2.61, 13.33), bad parenting practices, were poor supervision (AOR = 4.4, 95%CI 1.29, 14.69) were significantly associated with elimination disorder. CONCLUSION AND RECOMMENDATION In this study, approximately one in five children and adolescents had an elimination disorder. Younger age, family size four and above, positive family history of elimination disorder, presence of emotional and hyperactive problems, bad parenting practices, and low toilet training skills were factors associated with elimination disorders. Therefore, preventative, etiological, and therapeutic measure, early toilet training, supportive parenting practices, screening for children's and adolescents' behavioral problems, and elimination disorders need attention to reduce the effect of the problem.
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Affiliation(s)
- Tamene Berhanu
- Wolaita Sodo University College of Health Science and Medicine, Wolaita Sodo, Ethiopia.
| | - Mubarek Abera
- Department of Psychiatry, Faculty of Medical Sciences, Jimma University, Jimma, Ethiopia
| | - Shimelis Girma
- Department of Psychiatry, Faculty of Medical Sciences, Jimma University, Jimma, Ethiopia
| | - Yonas Tesfaye
- Department of Psychiatry, Faculty of Medical Sciences, Jimma University, Jimma, Ethiopia
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Canter KS, Vega G, Perez Ramirez A, Munoz Osorio A, Thomas C, Lewis AM, Arasteh K, Kazak A. Acceptability and Feasibility of eSCCIP: Results From a Pilot Study of the Electronic Surviving Cancer Competently Intervention Program. J Pediatr Psychol 2023; 48:216-227. [PMID: 36303445 PMCID: PMC10027060 DOI: 10.1093/jpepsy/jsac082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 10/04/2022] [Accepted: 10/05/2022] [Indexed: 11/14/2022] Open
Abstract
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.
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Affiliation(s)
- Kimberly S Canter
- Nemours Center for Healthcare Delivery Science, Nemours Children’s Health, Wilmington, DE, USA
- Department of Pediatrics, Thomas Jefferson University, Philadelphia, PA, USA
| | - Gabriela Vega
- Nemours Center for Healthcare Delivery Science, Nemours Children’s Health, Wilmington, DE, USA
| | - Alejandra Perez Ramirez
- Nemours Center for Healthcare Delivery Science, Nemours Children’s Health, Wilmington, DE, USA
| | - Angel Munoz Osorio
- Nemours Center for Healthcare Delivery Science, Nemours Children’s Health, Wilmington, DE, USA
| | - Courtney Thomas
- Nemours Center for Healthcare Delivery Science, Nemours Children’s Health, Wilmington, DE, USA
| | - Amanda M Lewis
- Nemours Center for Healthcare Delivery Science, Nemours Children’s Health, Wilmington, DE, USA
| | - Kamyar Arasteh
- Nemours Center for Healthcare Delivery Science, Nemours Children’s Health, Wilmington, DE, USA
| | - Anne Kazak
- Nemours Center for Healthcare Delivery Science, Nemours Children’s Health, Wilmington, DE, USA
- Department of Pediatrics, Thomas Jefferson University, Philadelphia, PA, USA
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Canter KS, Strang A, Wilks S, Okonak K, Chidekel A. Acceptability and feasibility of a brief behavioral sleep intervention for youth with CF. J Cyst Fibros 2023; 22:179-182. [PMID: 35871972 DOI: 10.1016/j.jcf.2022.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 07/14/2022] [Accepted: 07/14/2022] [Indexed: 11/19/2022]
Abstract
Youth with CF are at increased risk for physiological and behavioral sleep difficulties due to disease-specific symptoms and more general pediatric sleep challenges. Despite evidence suggesting that behavioral sleep interventions are effective for improving common sleep difficulties, no interventions exist for youth with CF. SLEEP-CF was designed to fill this gap by providing tailored, flexible behavioral sleep support to youth with CF. Results suggest that SLEEP-CF is an acceptable and feasible behavioral sleep intervention, even in a population with normative sleep habits. There may be benefit in terms of improving sleep knowledge and sleep hygiene. Technology use during and after bedtime is prevalent. CF care team members are encouraged to assess sleep as part of routine CF care, and to provide support as indicated.
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Affiliation(s)
- Kimberly S Canter
- Nemours Center for Healthcare Delivery Science, Nemours Children's Health, 1600 Rockland Road, Wilmington, DE 19803, United States; Division of Behavioral Health, Nemours Children's Health, Delaware, 1600 Rockland Road, Wilmington, DE 19803, United States; Department of Pediatrics, Thomas Jefferson University, 1025 Walnut Street, Philadelphia, PA 19107, United States.
| | - Abigail Strang
- Department of Pediatrics, Thomas Jefferson University, 1025 Walnut Street, Philadelphia, PA 19107, United States; Division of Pulmonology, Nemours Children's Health, Delaware, 1600 Rockland Road, Wilmington, DE 19803, United States
| | - Sophie Wilks
- Division of Pulmonology, Nemours Children's Health, Delaware, 1600 Rockland Road, Wilmington, DE 19803, United States
| | - Katherine Okonak
- Nemours Center for Healthcare Delivery Science, Nemours Children's Health, 1600 Rockland Road, Wilmington, DE 19803, United States
| | - Aaron Chidekel
- Department of Pediatrics, Thomas Jefferson University, 1025 Walnut Street, Philadelphia, PA 19107, United States; Division of Pulmonology, Nemours Children's Health, Delaware, 1600 Rockland Road, Wilmington, DE 19803, United States
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Canter KS, McIntyre R, Babb R, Ramirez AP, Vega G, Lewis A, Bottrell C, Lawlor C, Kazak AE. A community-based trial of a psychosocial eHealth intervention for parents of children with cancer. Pediatr Blood Cancer 2022; 69:e29352. [PMID: 34532970 DOI: 10.1002/pbc.29352] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 08/12/2021] [Accepted: 08/31/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND The Electronic Surviving Cancer Competently Intervention Program (eSCCIP), a psychosocial eHealth intervention for parents and caregivers of children with cancer (parents), was delivered in a community-based psychosocial oncology center. Primary endpoints were intervention acceptability, feasibility, and accessibility, with a secondary exploratory focus on psychosocial outcomes. PROCEDURE Oncology therapists in a psychosocial oncology center were trained in eSCCIP delivery. Participants were eligible for participation if they were the primary caregiver of a child with cancer between the ages 0 and 17, could read and write in English, and had reliable internet access to complete eSCCIP. Surveys were administered electronically at baseline and post intervention to evaluate study endpoints. Effect sizes (Cohen's d) were computed for exploratory psychosocial outcomes. Nineteen parents completed the intervention. RESULTS Parents rated eSCCIP as highly acceptable, feasible, and accessible. A large clinical effect was detected for acute distress (d = 0.79). Moderate clinical effects were reported for overall posttraumatic stress disorder (PTSD) symptoms (d = 0.37), negative mood/cognitions (d = 0.59), and symptoms of anxiety (d = 0.48). CONCLUSIONS Results indicate that eSCCIP is an acceptable, feasible, and accessible psychosocial intervention for parents. Exploratory analyses suggest that participation in eSCCIP may contribute to decreases in acute distress, symptoms of anxiety, and symptoms of PTSD.
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Affiliation(s)
- Kimberly S Canter
- Nemours Center for Healthcare Delivery Science, Wilmington, Delaware, USA.,Department of Pediatrics, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Rebecca McIntyre
- Inova Schar Cancer Institute, Life with Cancer, Fairfax, Virginia, USA
| | - Rebecca Babb
- Inova Schar Cancer Institute, Life with Cancer, Fairfax, Virginia, USA.,Department of Pediatric Hematology/Oncology, Inova Children's Hospital, Fairfax, Virginia, USA
| | | | - Gabriela Vega
- Nemours Center for Healthcare Delivery Science, Wilmington, Delaware, USA
| | - Amanda Lewis
- Nemours Center for Healthcare Delivery Science, Wilmington, Delaware, USA
| | - Cathy Bottrell
- Inova Schar Cancer Institute, Life with Cancer, Fairfax, Virginia, USA.,Center for Cancer and Blood Disorders, Pediatric Specialists of Virginia, Fairfax, Virginia, USA
| | - Christopher Lawlor
- Center for Cancer and Blood Disorders, Pediatric Specialists of Virginia, Fairfax, Virginia, USA.,Department of Pediatrics, George Washington University, Washington, District of Columbia, USA.,Department of Oncology, Children's National Medical Center, Washington, District of Columbia, USA
| | - Anne E Kazak
- Nemours Center for Healthcare Delivery Science, Wilmington, Delaware, USA.,Department of Pediatrics, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
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Newton AS, March S, Gehring ND, Rowe AK, Radomski AD. Establishing a Working Definition of User Experience for eHealth Interventions of Self-reported User Experience Measures With eHealth Researchers and Adolescents: Scoping Review. J Med Internet Res 2021; 23:e25012. [PMID: 34860671 PMCID: PMC8686463 DOI: 10.2196/25012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 03/27/2021] [Accepted: 09/23/2021] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Across eHealth intervention studies involving children, adolescents, and their parents, researchers have measured user experience to assist with intervention development, refinement, and evaluation. To date, no widely accepted definitions or measures of user experience exist to support a standardized approach for evaluation and comparison within or across interventions. OBJECTIVE We conduct a scoping review with subsequent Delphi consultation to identify how user experience is defined and measured in eHealth research studies, characterize the measurement tools used, and establish working definitions for domains of user experience that could be used in future eHealth evaluations. METHODS We systematically searched electronic databases for published and gray literature available from January 1, 2005, to April 11, 2019. We included studies assessing an eHealth intervention that targeted any health condition and was designed for use by children, adolescents, and their parents. eHealth interventions needed to be web-, computer-, or mobile-based, mediated by the internet with some degree of interactivity. We required studies to report the measurement of user experience as first-person experiences, involving cognitive and behavioral factors reported by intervention users. We appraised the quality of user experience measures in included studies using published criteria: well-established, approaching well-established, promising, or not yet established. We conducted a descriptive analysis of how user experience was defined and measured in each study. Review findings subsequently informed the survey questions used in the Delphi consultations with eHealth researchers and adolescent users for how user experience should be defined and measured. RESULTS Of the 8634 articles screened for eligibility, 129 articles and 1 erratum were included in the review. A total of 30 eHealth researchers and 27 adolescents participated in the Delphi consultations. On the basis of the literature and consultations, we proposed working definitions for 6 main user experience domains: acceptability, satisfaction, credibility, usability, user-reported adherence, and perceived impact. Although most studies incorporated a study-specific measure, we identified 10 well-established measures to quantify 5 of the 6 domains of user experience (all except for self-reported adherence). Our adolescent and researcher participants ranked perceived impact as one of the most important domains of user experience and usability as one of the least important domains. Rankings between adolescents and researchers diverged for other domains. CONCLUSIONS Findings highlight the various ways in which user experience has been defined and measured across studies and what aspects are most valued by researchers and adolescent users. We propose incorporating the working definitions and available measures of user experience to support consistent evaluation and reporting of outcomes across studies. Future studies can refine the definitions and measurement of user experience, explore how user experience relates to other eHealth outcomes, and inform the design and use of human-centered eHealth interventions.
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Affiliation(s)
- Amanda S Newton
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Sonja March
- School of Psychology and Counselling, Centre for Health Research, University of Southern Queensland, Springfield Central, Australia
| | - Nicole D Gehring
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Arlen K Rowe
- School of Psychology and Counselling, Centre for Health Research, University of Southern Queensland, Springfield Central, Australia
| | - Ashley D Radomski
- Knowledge Institute for Child and Youth Mental Health and Addictions, Ottawa, ON, Canada
- CHEO (Children's Hospital of Eastern Ontario) Research Institute, Ottawa, ON, Canada
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Matching Psychosocial Support Needs of Parents of a Child with a Chronic Illness to a Feasible Intervention. Matern Child Health J 2020; 24:1238-1247. [PMID: 32613332 PMCID: PMC7476963 DOI: 10.1007/s10995-020-02925-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Objectives Parents of children with a chronic illness (CI) are at risk for psychosocial problems. The aim of this study was to refine an existing face-to-face intervention into an online psychosocial group intervention for parents by (1) exploring which themes are important, (2) determine what type of intervention parents would like and (3) assess parents’ practical preferences. Methods Parents of children with a CI (0–18 years) were invited to complete an online questionnaire. To acquire more in-depth information, focus groups and telephone interviews were conducted. Descriptive statistics were used. Results 272 parents (mean age = 43.1 years, 85% female) participated. Three focus groups (15 parents) and seven telephone interviews were conducted. Most important themes were: the CI of the child, family functioning, taking care of yourself, relationships with others and practical support. Parents preferred a group with parents of children in the same age category. At first, parents preferred face-to-face contact. After an explanation and demonstration of an online intervention, parents became more positive about online support, mostly because they could participate from home. Conclusions for Practice Parents have a need for psychosocial support focusing on different themes. Professionals should explain and demonstrate an online intervention to parents. Based on these results, Op Koers Online for parents was developed. An RCT to assess feasibility and effectiveness of the intervention is currently running.
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Floryan MR, Ritterband LM, Chow PI. Principles of gamification for Internet interventions. Transl Behav Med 2020; 9:1131-1138. [PMID: 30944933 DOI: 10.1093/tbm/ibz041] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Gamification is a popular method used to add entertaining and appealing dimensions to nongaming activities. Researchers of technology-based behavioral and mental-health-focused interventions have shown considerable interest in gamification to enhance engagement and adherence. There have been a number of gamification frameworks proposed, each with differences in focus but with overlapping similarities. A review of these frameworks highlight critical issues in gamification-lack of clear definitions, standards, and a need for an overarching model for applying gamification, rather than simply describing gamification. These issues leave researchers challenged to apply gamification to its full potential. This paper explores gamification as a construct and endeavors to define its core features. A useful way of evaluating the potential utility of gamification features in the context of an intervention is by distinguishing between exogenous applications of gamification (layering game mechanics externally upon a system) and endogenous application of gamification (developing mechanics intrinsic to the given experience). By then comparing and contrasting six gamification frameworks, components are identified that lay at the intersection and a theoretical model is proposed. A theory-driven set of gamification principles, organized into four categories, is developed and presented. Of particular interest is the utilization of this model as it relates to behavioral and mental-health-focused Internet-based interventions. To demonstrate the potential of this gamification framework, the generated principles are overlaid onto the established Model for Internet Interventions, extending it, and providing a more concrete foundation for researchers of Internet interventions. The presented model will assist researchers and developers who are interested in applying gamification to Internet interventions.
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Affiliation(s)
- Mark R Floryan
- Department of Computer Science, University of Virginia School of Engineering and Applied Science, Charlottesville, VA, USA
| | - Lee M Ritterband
- Center for Behavioral Health and Technology, Department of Psychiatry and Neurobehavioral Sciences, School of Medicine, University of Virginia, Charlottesville, VA, USA
| | - Philip I Chow
- Center for Behavioral Health and Technology, Department of Psychiatry and Neurobehavioral Sciences, School of Medicine, University of Virginia, Charlottesville, VA, USA
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Shaffer KM, Tigershtrom A, Badr H, Benvengo S, Hernandez M, Ritterband LM. Dyadic Psychosocial eHealth Interventions: Systematic Scoping Review. J Med Internet Res 2020; 22:e15509. [PMID: 32130143 PMCID: PMC7081137 DOI: 10.2196/15509] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 11/08/2019] [Accepted: 12/19/2019] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Dyadic psychosocial interventions have been found beneficial both for people coping with mental or physical health conditions as well as their family members and friends who provide them with support. Delivering these interventions via electronic health (eHealth) may help increase their scalability. OBJECTIVE This scoping review aimed to provide the first comprehensive overview of dyadic eHealth interventions for individuals of all ages affected by mental or physical illness and their family members or friends who support them. The goal was to understand how dyadic eHealth interventions have been used and to highlight areas of research needed to advance dyadic eHealth intervention development and dissemination. METHODS A comprehensive electronic literature search of PubMed, EMBASE, Cochrane, Cumulative Index to Nursing and Allied Health Literature, and PsycINFO was conducted for articles published in the English language through March 2019. Eligible records described a psychosocial eHealth intervention that intervened with both care recipients and their support person. RESULTS A total of 7113 records were reviewed of which 101 met eligibility criteria. There were 52 unique dyadic eHealth interventions identified, which were tested across 73 different trials. Of the unique interventions, 33 were conducted among dyads of children and their supporting parent, 1 was conducted with an adolescent-young adult care recipient population, and the remaining 18 were conducted among adult dyads. Interventions targeting pediatric dyads most commonly addressed a mental health condition (n=10); interventions targeting adult dyads most commonly addressed cancer (n=9). More than three-fourths of interventions (n=40) required some human support from research staff or clinicians. Most studies (n=64) specified one or more primary outcomes for care recipients, whereas less than one-fourth (n=22) specified primary outcomes for support persons. Where specified, primary outcomes were most commonly self-reported psychosocial or health factors for both care recipients (n=43) and support persons (n=18). Results of the dyadic eHealth intervention tended to be positive for care recipients, but evidence of effects for support persons was limited because of few studies specifying primary outcomes for supporters. Trials of dyadic eHealth interventions were most commonly randomized controlled trials (RCTs; n=44), and RCTs most commonly compared the dyadic eHealth intervention to usual care alone (n=22). CONCLUSIONS This first comprehensive review of dyadic eHealth interventions demonstrates that there is substantial, diverse, and growing literature supporting this interventional approach. However, several significant gaps were identified. Few studies were designed to evaluate the unique effects of dyadic interventions relative to individual interventions. There was also limited assessment and reporting of outcomes for support persons, and there were no interventions meeting our eligibility criteria specifically targeting the needs of older adult dyads. Findings highlight areas of research opportunities for developing dyadic eHealth interventions for novel populations and for increasing access to dyadic care.
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Affiliation(s)
- Kelly M Shaffer
- Center for Behavioral Health and Technology, University of Virginia School of Medicine, Charlottesville, VA, United States
- Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | | | - Hoda Badr
- Baylor College of Medicine, Houston, TX, United States
| | | | - Marisol Hernandez
- Memorial Sloan Kettering Cancer Center, New York, NY, United States
- CUNY School of Medicine/City College of New York, New York, NY, United States
| | - Lee M Ritterband
- Center for Behavioral Health and Technology, University of Virginia School of Medicine, Charlottesville, VA, United States
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Parker A, Brine S, McGonnell M, Baert A, Corkum P. Usability Testing of the Teacher Help for Learning Disabilities Program: An eHealth Intervention for Teachers. CANADIAN JOURNAL OF SCHOOL PSYCHOLOGY 2020. [DOI: 10.1177/0829573518825425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Use of evidence-based interventions for learning disabilities (LDs) in the classroom is limited by several factors such as teachers’ knowledge of LDs and access to interventions. eHealth interventions (i.e., interventions delivered via the Internet) have the potential to be a powerful tool in overcoming barriers to implementing evidence-based strategies within the classroom. The current article describes the development and usability testing of Teacher Help for LD, an eHealth professional development program that assists classroom teachers in providing evidence-based interventions to students with LDs. Specialists in LDs ( n = 18), consisting of individuals within the educational and health systems, were asked to evaluate the usability of the Teacher Help for LD intervention and provide their feedback. Results from both quantitative and qualitative data suggest that participants were very satisfied with the program and found the program highly usable. Results will help to prepare and modify the program for use with regular classroom teachers in an upcoming cluster randomized controlled trial across Canada.
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Affiliation(s)
- Ashton Parker
- Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | - Sarah Brine
- Dalhousie University, Halifax, Nova Scotia, Canada
| | | | - Annie Baert
- Nova Scotia Department of Education and Early Childhood Development, Nova Scotia, Halifax, Canada
| | - Penny Corkum
- Dalhousie University, Halifax, Nova Scotia, Canada
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Canter KS, Deatrick JA, Hilgart MM, Myers J, Vega G, Ritterband LM, Kazak AE. eSCCIP: A Psychosocial eHealth Intervention for Parents of Children with Cancer. CLINICAL PRACTICE IN PEDIATRIC PSYCHOLOGY 2019; 7:44-56. [PMID: 38333421 PMCID: PMC10852099 DOI: 10.1037/cpp0000264] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
Objective eHealth interventions may facilitate the dissemination of evidence-based psychosocial interventions to families of children with chronic illnesses, including cancer. This article describes a four-phase, mixed-methods, user-centered approach to the design and evaluation of a novel psychosocial intervention for parents of children with cancer (Electronic Surviving Cancer Competently Intervention Program [eSCCIP]), adapted from an in-person intervention (Surviving Cancer Competently Intervention Program). Methods Development of eSCCIP involved a multidisciplinary design team of content and eHealth experts. Iterative Think Aloud testing and beta testing with parents of children with cancer was also completed. Results An intensive, user-centered development and evaluation process was utilized to develop an eHealth intervention for parents of children with cancer. Initial testers rated eSCCIP favorably on questionnaires evaluating user experience and perceptions, and provided positive feedback and suggestions for additional improvement through qualitative interviews. Conclusions Initial results suggest that eSCCIP may be an acceptable, feasible, and usable intervention for parents of children with cancer. eSCCIP is now ready for a larger pilot evaluation of usability, feasibility, and impact on target outcomes, including the reduction of anxiety and PTSS and improvements in family functioning.
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Affiliation(s)
- Kimberly S Canter
- Nemours Center for Healthcare Delivery Science, Nemours Children's Health System, Wilmington, Delaware; Department of Pediatrics, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Janet A Deatrick
- Department of Family and Community Nursing, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania
| | - Michelle M Hilgart
- Center for Behavioral Health and Technology, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Jeffrey Myers
- Nemours Biomedical Research, Nemours Children's Health System, Wilmington, Delaware
| | - Gabriela Vega
- Nemours Children's Health System, Wilmington, Delaware
| | - Lee M Ritterband
- Center for Behavioral Health and Technology, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Anne E Kazak
- Nemours Children's Health System, Wilmington, Delaware
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Wysocki T, Pierce J, Caldwell C, Aroian K, Miller L, Farless R, Hafezzadeh I, McAninch T, Lee JM. A Web-Based Coping Intervention by and for Parents of Very Young Children With Type 1 Diabetes: User-Centered Design. JMIR Diabetes 2018; 3:e16. [PMID: 30559089 PMCID: PMC6307695 DOI: 10.2196/diabetes.9926] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 05/08/2018] [Accepted: 06/15/2018] [Indexed: 12/13/2022] Open
Abstract
Background Management of type 1 diabetes (T1D) among children aged <6 years is exceptionally challenging for parents and caregivers. Metabolic and psychosocial outcomes among very young children with T1D (YC-T1D) are tightly associated with their parents’ ability to meet these challenges. There is scant research testing interventions targeting these issues and few resources to equip health care providers with feasible and effective coping strategies for these parents. User-centered design (UCD) of a continuously accessible Web-based resource could be a mechanism for helping parents of YC-T1D cope more effectively with the complex challenges they face by providing them with information, solutions, and emotional support. Objective The objectives of this paper are to (1) describe the application of UCD principles to the development of a Web-based coping intervention designed by and for parents of very young children (<6 years old) with T1D; (2) illustrate the use of crowdsourcing methods in obtaining the perspectives of parents, health care providers, and Web development professionals in designing and creating this resource; and (3) summarize the design of an ongoing randomized controlled trial (RCT) that is evaluating the effects of parental access to this resource on pertinent child and parent outcomes. Methods This paper illustrates the application of UCD principles to create a Web-based coping resource designed by and for parents of YC-T1D. A Web-based Parent Crowd, a Health Care Provider Crowd, and a Focus Group of minority parents provided input throughout the design process. A formal usability testing session and design webinars yielded additional stakeholder input to further refine the end product. Results This paper describes the completed website and the ongoing RCT to evaluate the effects of using this Web-based resource on pertinent parent and child outcomes. Conclusions UCD principles and the targeted application of crowdsourcing methods provided the foundation for the development, construction, and evaluation of a continuously accessible, archived, user-responsive coping resource designed by and for parents of YC-T1D. The process described here could be a template for the development of similar resources for other special populations that are enduring specific medical or psychosocial distress. The ongoing RCT is the final step in the UCD process and is designed to validate its merits.
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Affiliation(s)
- Tim Wysocki
- Nemours Children's Specialty Care, Center for Health Care Delivery Science, Nemours Children's Health System, Jacksonville, FL, United States
| | - Jessica Pierce
- Nemours Children's Hospital, Center for Health Care Delivery Science, Nemours Children's Health System, Orlando, FL, United States
| | - Cindy Caldwell
- Nemours Children's Specialty Care, Center for Health Care Delivery Science, Nemours Children's Health System, Jacksonville, FL, United States
| | - Karen Aroian
- College of Nursing, University of Central Florida, Orlando, FL, United States
| | - Louis Miller
- eCity Interactive, Inc, Philadelphia, PA, United States
| | | | | | - Terri McAninch
- Nemours Foundation, Department of Marketing and Communication, Nemours Children's Health System, Jacksonville, FL, United States
| | - Joyce M Lee
- Child Health Evaluation Research, Department of Pediatrics, University of Michigan, Ann Arbor, MI, United States
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Wright KD, Raazi M, Walker KL. Internet-delivered, preoperative, preparation program (I-PPP): Development and examination of effectiveness. J Clin Anesth 2017; 39:45-52. [DOI: 10.1016/j.jclinane.2017.03.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 02/18/2017] [Accepted: 03/04/2017] [Indexed: 11/28/2022]
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Schueller SM, Stiles-Shields C, Yarosh L. Online Treatment and Virtual Therapists in Child and Adolescent Psychiatry. Child Adolesc Psychiatr Clin N Am 2017; 26:1-12. [PMID: 27837935 PMCID: PMC5123797 DOI: 10.1016/j.chc.2016.07.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Online and virtual therapies are a well-studied and efficacious treatment option for various mental and behavioral health conditions among children and adolescents. However, many interventions have not considered the unique affordances offered by technologies that might align with the capacities and interests of youth users. In this article, the authors discuss learnings from child-computer interaction that can inform future generations of interventions and guide developers, practitioners, and researchers how to best use new technologies for youth populations. The article concludes with innovative examples illustrating future potentials of online and virtual therapies such as gaming and social networking.
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Affiliation(s)
- Stephen M. Schueller
- Northwestern University, Department of Preventive Medicine, Center for Behavioral Intervention Technologies (CBITs), 750 N. Lake Shore Drive, Chicago, IL 60611
| | - Colleen Stiles-Shields
- Northwestern University, Department of Preventive Medicine, Center for Behavioral Intervention Technologies (CBITs), 750 N. Lake Shore Drive, Chicago, IL 60611
| | - Lana Yarosh
- University of Minnesota, Department of Computer Science and Engineering, 200 Union Street, SE, Minneapolis, MN 55455-0159
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Shepard JA, Poler JE, Grabman JH. Evidence-Based Psychosocial Treatments for Pediatric Elimination Disorders. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2016; 46:767-797. [PMID: 27911597 DOI: 10.1080/15374416.2016.1247356] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Pediatric elimination disorders are common in childhood, yet psychosocial correlates are generally unclear. Given the physiological concomitants of both enuresis and encopresis, and the fact that many children with elimination disorders are initially brought to their primary care physician for treatment, medical evaluation and management are crucial and may serve as the first-line treatment approach. Scientific investigation on psychological and behavioral interventions has progressed over the past couple of decades, resulting in the identification of effective treatments for enuresis and encopresis. However, the body of literature has inherent challenges, particularly given the multicomponent nature of many of the treatment packages. This review identified 25 intervention studies-18 for nocturnal enuresis and 7 for encopresis-over the past 15 years and classified them according to the guidelines set forth by the Task Force on the Promotion and Dissemination of Psychological Procedures. For nocturnal enuresis, the urine alarm and dry-bed training were identified as well-established treatments, Full Spectrum Home Therapy was probably efficacious, lifting was possibly efficacious, and hypnotherapy and retention control training were classified as treatments of questionable efficacy. For encopresis, only two probably efficacious treatments were identified: biofeedback and enhanced toilet training (ETT). Best practice recommendations and suggestions for future research are provided to address existing limitations, including heterogeneity and the multicomponent nature of many of the interventions for pediatric elimination disorders.
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Affiliation(s)
- Jaclyn A Shepard
- a Department of Psychiatry & Neurobehavioral Sciences , University of Virginia School of Medicine
| | - Joseph E Poler
- a Department of Psychiatry & Neurobehavioral Sciences , University of Virginia School of Medicine
| | - Jesse H Grabman
- a Department of Psychiatry & Neurobehavioral Sciences , University of Virginia School of Medicine
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Traynor A, Morrissey E, Egan J, McGuire BE. The effectiveness of information and communication technology-based psychological interventions for paediatric chronic pain: protocol for a systematic review, meta-analysis and intervention content analysis. Syst Rev 2016; 5:175. [PMID: 27756437 PMCID: PMC5069887 DOI: 10.1186/s13643-016-0350-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 09/23/2016] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Resource and geographic barriers are the commonly cited constraints preventing the uptake of psychological treatment for chronic pain management. For adults, there is some evidence to support the use of information and communication technology (ICT) as a mode of treatment delivery. However, mixed findings have been reported for the effectiveness and acceptability of psychological interventions delivered using information and communication technology for children and adolescents. This is a protocol for a review that aims to (i) evaluate the effectiveness of psychological interventions delivered using information and communication technology for children and adolescents with chronic pain and (ii) identify the intervention components and usability factors in technology-based treatments associated with behaviour change. METHODS/DESIGN We will conduct a systematic review to evaluate the effectiveness of psychological interventions for paediatric chronic pain delivered using ICT. We plan to directly compare ICT-based, psychological interventions with active control, treatment as usual or waiting list control conditions. This systematic review will be reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance. Published and unpublished randomised controlled trials will be included and the literature search will comprise Ovid MEDLINE, Ovid Embase, PsycINFO and the Cochrane Library on Wiley, including CENTRAL and Cochrane Database of Systematic Reviews. Grey literature including theses, dissertations, technical and research reports will also be examined. Two review authors will independently conduct study selection, relevant data extraction and assessment of methodological quality. Risk of bias in included studies will be assessed using the Cochrane Collaboration risk of bias tool criteria. Two qualified coders will independently code behaviour change techniques according to the behaviour change taxonomy (v1) of 93 hierarchically clustered techniques and a novel coding scheme for mode of delivery and usability factors. A quantitative synthesis will be conducted if appropriate. DISCUSSION The findings of this review may offer insight for healthcare professionals working in chronic pain services and to researchers involved in designing and evaluating information and communication technology-based interventions. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42016017657.
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Affiliation(s)
- Angeline Traynor
- School of Psychology, National University of Ireland, Galway, Ireland
| | - Eimear Morrissey
- School of Psychology, National University of Ireland, Galway, Ireland
| | - Jonathan Egan
- School of Psychology, National University of Ireland, Galway, Ireland
| | - Brian E. McGuire
- School of Psychology, National University of Ireland, Galway, Ireland
- Centre for Pain Research, National University of Ireland, Galway, Ireland
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Kassam-Adams N, Marsac ML, Kohser KL, Kenardy J, March S, Winston FK. Pilot Randomized Controlled Trial of a Novel Web-Based Intervention to Prevent Posttraumatic Stress in Children Following Medical Events. J Pediatr Psychol 2016; 41:138-48. [PMID: 26089554 PMCID: PMC4723670 DOI: 10.1093/jpepsy/jsv057] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 04/02/2015] [Accepted: 05/18/2015] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To assess feasibility and estimate effect size of a self-directed online intervention designed to prevent persistent posttraumatic stress after acute trauma. METHODS Children aged 8-12 years with a recent acute medical event were randomized to the intervention (N = 36) or a 12-week wait list (N = 36). Posttraumatic stress, health-related quality of life, appraisals, and coping were assessed at baseline, 6, 12, and 18 weeks. RESULTS Most children used the intervention; half completed it. Medium between-group effect sizes were observed for change in posttraumatic stress severity from baseline to 6 weeks (d = -.68) or 12 weeks (d = -.55). Exploratory analyses suggest greatest impact for at-risk children, and a small effect for intervention initiated after 12 weeks. Analysis of covariance did not indicate statistically significant group differences in 12-week outcomes. CONCLUSIONS This pilot randomized controlled trial provides preliminary evidence that a self-directed online preventive intervention is feasible to deliver, and could have an effect in preventing persistent posttraumatic stress.
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Affiliation(s)
| | - Meghan L Marsac
- Children's Hospital of Philadelphia, University of Pennsylvania
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17
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Grey M, Liberti L, Whittemore R. Costs of Development and Maintenance of an Internet Program for Teens with Type 1 Diabetes. HEALTH AND TECHNOLOGY 2015. [PMID: 26213677 DOI: 10.1007/s12553-015-0109-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Many adolescents with type 1 diabetes (T1D) have difficulty completing self-management tasks within the context of their social environments. Group-based approaches to psycho-educational support have been shown to prevent declines in glucose control, but are challenging to implement due to youths' many activities and costs. A novel solution is providing psycho-educational support via the internet. The purpose of this study is to describe the cost of developing and maintaining two internet psycho-educational programs, both of which have been shown to improve health outcomes in adolescents with T1D. We calculated actual costs of personnel and programming in the development of TEENCOPE™ and Managing Diabetes, two highly interactive programs that were evaluated in a multi-site clinical trial (n=320). Cost calculations were set at U.S. dollars and converted to value for 2013 as expenses were incurred over 6 years. Development costs over 1.5 years totaled $324,609, with the majority of costs being for personnel to develop and write content in a creative and engaging format, to get feedback from teens on content and a prototype, and IT programming. Maintenance of the program, including IT support, a part-time moderator to assure safety of the discussion board (0.5-1 hour/week), and yearly update of content was $43,845/year, or $137.00 per youth over 4.5 years. Overall, program and site development were relatively expensive, but the program reach was high, including non-white youth from 4 geographically distinct regions. Once developed, maintenance was minimal. With greater dissemination, cost-per-youth would decrease markedly, beginning to offset the high development expense.
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Affiliation(s)
- Margaret Grey
- Yale University School of Nursing, New Haven, Connecticut
| | - Lauren Liberti
- Yale University School of Nursing, New Haven, Connecticut
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18
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Freeman KA, Riley A, Duke DC, Fu R. Systematic Review and Meta-Analysis of Behavioral Interventions for Fecal Incontinence With Constipation. J Pediatr Psychol 2014; 39:887-902. [DOI: 10.1093/jpepsy/jsu039] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Wu YP, Steele RG, Connelly MA, Palermo TM, Ritterband LM. Commentary: pediatric eHealth interventions: common challenges during development, implementation, and dissemination. J Pediatr Psychol 2014; 39:612-23. [PMID: 24816766 DOI: 10.1093/jpepsy/jsu022] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVE To provide an overview of common challenges that pediatric eHealth researchers may encounter when planning, developing, testing, and disseminating eHealth interventions along with proposed solutions for addressing these challenges. METHODS The article draws on the existing eHealth literature and the authors' collective experience in pediatric eHealth research. RESULTS AND CONCLUSIONS The challenges associated with eHealth interventions and their proposed solutions are multifaceted and cut across a number of areas from eHealth program development through dissemination. Collaboration with a range of individuals (e.g., multidisciplinary colleagues, commercial entities, primary stakeholders) is the key to eHealth intervention success. To ensure adequate resources for design, development, and planning for sustainability, a number of public and private sources of funding are available. A study design that addresses ethical concerns and security issues is critical to ensure scientific integrity and intervention dissemination. Table I summarizes key issues to consider during eHealth intervention development, testing, and dissemination.
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Affiliation(s)
- Yelena P Wu
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah, Clinical Child Psychology Program, University of Kansas, University of Missouri-Kansas City School of Medicine and Children's Mercy Hospitals and Clinics, University of Washington, Seattle Children's Research Institute, and Behavioral Health and Technology, University of Virginia Health System
| | - Ric G Steele
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah, Clinical Child Psychology Program, University of Kansas, University of Missouri-Kansas City School of Medicine and Children's Mercy Hospitals and Clinics, University of Washington, Seattle Children's Research Institute, and Behavioral Health and Technology, University of Virginia Health System
| | - Mark A Connelly
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah, Clinical Child Psychology Program, University of Kansas, University of Missouri-Kansas City School of Medicine and Children's Mercy Hospitals and Clinics, University of Washington, Seattle Children's Research Institute, and Behavioral Health and Technology, University of Virginia Health System
| | - Tonya M Palermo
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah, Clinical Child Psychology Program, University of Kansas, University of Missouri-Kansas City School of Medicine and Children's Mercy Hospitals and Clinics, University of Washington, Seattle Children's Research Institute, and Behavioral Health and Technology, University of Virginia Health SystemDivision of Public Health, Department of Family and Preventive Medicine, University of Utah, Clinical Child Psychology Program, University of Kansas, University of Missouri-Kansas City School of Medicine and Children's Mercy Hospitals and Clinics, University of Washington, Seattle Children's Research Institute, and Behavioral Health and Technology, University of Virginia Health System
| | - Lee M Ritterband
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah, Clinical Child Psychology Program, University of Kansas, University of Missouri-Kansas City School of Medicine and Children's Mercy Hospitals and Clinics, University of Washington, Seattle Children's Research Institute, and Behavioral Health and Technology, University of Virginia Health System
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Abstract
Encopresis is a medical condition that can be seen in the school setting with children of all ages, though primarily at the early childhood and elementary level. This condition can cause a great amount of frustration with the student, family, and teachers due to the child's inability to control elimination patterns. The school nurse must be aware of the warning signs that a student may be experiencing encopresis in order to promote treatment. This article will assist the school nurse in understanding typical causes for functional encopresis, knowing how to help a student who soils, and developing an individualized healthcare plan that assists a student to become continent of stool again. Encopresis is not just an accident.
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