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Meta-Review of mHealth Applications in Children Endorses Viability


The review included nearly 30,000 young patients and found a "small, but significant" effect of mHealth as a viable modality in their treatment.

As ubiquitous mobile technology integrates itself more and more seamlessly into the lives of subsequent generations, there have naturally been concerns regarding what that may entail for the eyes, minds, and social lives of the young.

In terms of mobile technology designed to help manage diseases, however, that predisposition may be beneficial.

According to a large meta-review of 37 studies, health interventions delivered to children and teens through mobile apps have a significant potential to boost healthy behaviors and improve disease outcomes.

After rapid growth in the number of health interventions delivered through an application on patients’ mobile devices, numerous research studies have assessed their effectiveness. However, the apps evaluated in studies and meta-analyses are largely targeted at adults, with goals like improving diabetes management or educating cancer patients. The literature on the apps’ efficacy among children and teens is comparatively scant, with only one systematic review existing, which focused solely on obesity.

A group of researchers aiming to fill this gap in the literature conducted a meta-analysis of 36 articles on 37 different studies encompassing a nearly 30,000 participants aged 18 or younger. They calculated study-level and aggregate effect sizes by analyzing disease outcomes reported in the research. Their findings were published in JAMA Pediatrics.

At the individual study level, effect size varied widely among the different interventions, but the aggregate effect size was “small, but significant.” The researchers found significantly larger effect sizes among studies that included the children’s caregivers as participants in the intervention. However, some other variables that were predicted to impact the effect sizes did not in fact moderate these outcomes, such as the use of text messaging within the intervention, the age group of the participants, or the intervention’s development being guided by stakeholder involvement or the use of a theoretical framework.

The researchers noted that the aggregate effect size was similar to that found in other meta-analyses of mobile health, or mHealth, interventions, indicating that these apps “may be a viable modality for health care professionals to effect health-related changes in pediatric populations.”

Effectiveness of the app-based interventions did not vary based on the participants’ demographic characteristics, the targeted health outcomes, or the length of the study, which the study authors wrote “may suggest that mHealth interventions can be effective for a wide range of youth and for a variety of pediatric health outcomes.”

They called for further research into the mechanisms by which caregiver involvement improves outcomes, as well as whether adding domains like communities or schools to the interventions would result in better health.

While the body of research on the topic is still small, the review’s findings provide cause for optimism that mobile app interventions can be a practical tool for improving measures of health among children and teens.

“Given the ubiquity of mobile phone use and the willingness of youth to use their mobile devices for health-related activities, mHealth interventions appear poised to be a viable health behavior change intervention modality,” the study authors concluded.

A version of this story originally appears in the American Journal of Managed Care.

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