Canter Kimberly S, Christofferson Jennifer, Scialla Michele A, Kazak Anne E
Nemours Center for Healthcare Delivery Science, Nemours Children's Health System, Wilmington, DE, USA.
Department of Pediatrics, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA, USA.
J Clin Psychol Med Settings. 2019 Mar;26(1):68-87. doi: 10.1007/s10880-018-9565-8.
This systematic review provides a synthesis of randomized-controlled trials of technology-focused family interventions for children with chronic illnesses and their families, focused on describing the current state of the literature and generating recommendations for future family systems work in the field of eHealth/mHealth. Twenty-three studies met inclusion criteria and were included in the systematic review. No identified studies featured an mHealth delivery modality. Relevant data were extracted and studies were assessed for quality. There was great variability with regard to intervention factors (e.g., format) and family-centered intervention targets. There is some evidence that eHealth interventions may lead to improvements in particular domains of family functioning (e.g., family conflict) for some groups of participants. However, mixed results and selection of numerous different intervention targets by investigators make it challenging to draw summative conclusions about the overall effectiveness of family systems eHealth interventions. Future research should move beyond feasibility/acceptability studies and examine family-centered processes as primary outcomes. Future research should also consider novel intervention formats to determine whether intervention effects are more robust for certain groups (e.g., individuals who prefer electronic intervention delivery to in-person intervention).
本系统评价综合了针对慢性病患儿及其家庭的以技术为重点的家庭干预随机对照试验，旨在描述当前文献状况，并为电子健康/移动健康领域未来的家庭系统工作提出建议。23项研究符合纳入标准并被纳入该系统评价。未发现有采用移动健康交付模式的研究。提取了相关数据并对研究进行了质量评估。在干预因素（如形式）和以家庭为中心的干预目标方面存在很大差异。有证据表明，电子健康干预可能会使某些参与者群体在家庭功能的特定领域（如家庭冲突）有所改善。然而，研究结果不一，且研究者选择了众多不同的干预目标，这使得就家庭系统电子健康干预的总体效果得出总结性结论具有挑战性。未来的研究应超越可行性/可接受性研究，将以家庭为中心的过程作为主要结果进行考察。未来的研究还应考虑新颖的干预形式，以确定某些群体（如更喜欢电子干预方式而非面对面干预的个体）的干预效果是否更强。
