Exploring the Use of the Behavior Change Technique Taxonomy and the Persuasive System Design Model in Defining Parent-Focused eHealth Interventions: Scoping Review.

BACKGROUND: Taxonomies and models are useful tools for defining eHealth content and intervention features, enabling comparison and analysis of research across studies and disciplines. The Behavior Change Technique Taxonomy version 1 (BCTTv1) was developed to decrease ambiguity in defining specific characteristics inherent in health interventions, but it was developed outside the context of digital technology. In contrast, the Persuasive System Design Model (PSDM) was developed to define and evaluate the persuasive content in software solutions but did not have a specific focus on health. Both the BCTTv1 and PSDM have been used to define eHealth interventions in the literature, with some researchers combining or reducing the taxonomies to simplify their application. It is unclear how well the taxonomies accurately define eHealth and whether they should be used alone or in combination. OBJECTIVE: This scoping review explored how the BCTTv1 and PSDM capture the content and intervention features of parent-focused eHealth as part of a program of studies investigating the use of technology to support parents with therapy home programs for children with special health care needs. It explored the active ingredients and persuasive technology features commonly found in parent-focused eHealth interventions for children with special health care needs and how the descriptions overlap and interact with respect to the BCTTv1 and PSDM taxonomies. METHODS: A scoping review was used to clarify concepts in the literature related to these taxonomies. Keywords related to parent-focused eHealth were defined and used to systematically search several electronic databases for parent-focused eHealth publications. Publications referencing the same intervention were combined to provide comprehensive intervention details. The data set was coded using codebooks developed from the taxonomies in NVivo (version 12; QSR International) and qualitatively analyzed using matrix queries. RESULTS: The systematic search found 23 parent-focused eHealth interventions described in 42 articles from various countries; delivered to parents with children aged 1 to 18 years; and covering medical, behavioral, and developmental issues. The predominant active ingredients and intervention features in parent-focused eHealth were concerned with teaching parents behavioral skills, encouraging them to practice and monitor the new skills, and tracking the outcomes of performing the new skills. No category had a complete set of active ingredients or intervention features coded. The two taxonomies conceptually captured different constructs even when their labels appeared to overlap in meaning. In addition, coding by category missed important active ingredients and intervention features. CONCLUSIONS: The taxonomies were found to code different constructs related to behavior change and persuasive technology, discouraging the merging or reduction of the taxonomies. This scoping review highlighted the benefit of using both taxonomies in their entirety to capture active ingredients and intervention features important for comparing and analyzing eHealth across different studies and disciplines. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-doi.org/10.15619/nzjp/47.1.05.

Let's not go back to 'normal'! lessons from COVID-19 for professionals working in childhood disability.

PURPOSE: The worldwide COVID-19 pandemic has changed almost all aspects of our lives, and the field of childhood disability is no exception. METHODS: This article is based on an invited lecture by the first author at a conference-the eHealth Summit ("Pediatric Rehabilitation in a Digital Space")-organized by the other authors and their colleagues in May 2020. RESULTS: The first author offers his own experiences and perspectives, supplemented by comments and observations contributed by many of the 9000+ attendees at this talk, as curated by the second and third authors. The basic messages are that while life for families of children with developmental disabilities, and for service providers who work with them, is significantly altered, many important lessons are being learned. CONCLUSIONS: The comments from participants support the currency of the ideas that were presented, and encourage childhood disability professionals to reflect on what we are learning, so that we can seize the opportunities they afford to do things differently-and we believe better-moving forward.IMPLICATIONS FOR REHABILITATIONIdeas generated by colleagues and parents suggest that there may be alternatives to "business as usual" in childhood disability services after the COVID pandemic is over.People are recognizing opportunities, and benefits, to offering services virtually, including being able to see children in their natural environments, saving parents time, money and hassles to attend clinics in person, and perhaps increasing the availability of services.Many issues remain to be investigated systematically, including, among others, what services (assessments and interventions) require hands-on connections, what payment structures can accommodate new models of services, how professionals can work together in a virtual world, and what families will want.Regardless of the final answers to these issues, we believe that we should not simply "go back to normal"; rather, we should expand the range, nature and locations of our services for children with developmental disabilities and their families.

Pediatric Teleheath: Opportunities Created by the COVID-19 and Suggestions to Sustain Its Use to Support Families of Children with Disabilities.

AIMS: Telehealth is being rapidly adopted by physical and occupational therapists in pediatrics as a strategy to maintain services during the COVID-19 crisis. This perspective presents a mix of theoretical and practice perspectives to support the implementation of telehealth. Although research evidence is just emerging, there is sufficient indication to believe telehealth is effective. However, which telehealth strategies are best for which children and families, and which intervention goals, are not yet clear. METHODS: We discuss how different telehealth strategies (e.g. videoconferencing, emails, phone calls, online programs) are being used to address specific intervention goals. Comments from therapists using telehealth and examples of practices in different context and with different populations are provided. We discuss how newly adopted telehealth practices could be included in future hybrid service delivery models and programs, as well as factors influencing the decision to offer face-to-face or online interventions. CONCLUSION: Although telehealth has been implemented quickly as a response to a health care crisis, and is not a one-size-fits-all intervention, we believe it offers great opportunities to increase the accessibility, cost-effectiveness and family-centredness of our services, to best support families of children with disabilities.