JMIR Publications

ABSTRACT

Background:

Children’s participation in healthcare is one of the most important components in the management of their disease. eHealth services that are adapted to the needs of children have the potential for restructuring how children and professionals work together. We have developed the digital interactive assessment and communication tool, Sisom, to give children between 6-12 years “a voice" in their own healthcare. However, the implementation of eHealth services such as Sisom in daily practice in pediatric healthcare is rarely investigated.

Objective:

The purpose of this study was to explore the process of implementing Sisom for children in pediatric care in Sweden. More specifically, to (1) evaluate whether the implementation strategy was conducted as planned; (2) understand the barriers and facilitators of the implementation strategy in pediatric care settings; (3) gain insight into how professionals work with the specific intervention; and (4) gain insight into the usefulness and effects of the intervention from the professionals’ perspectives.

Methods:

A process evaluation design was used to study the implementation of Sisom at four pediatric care centers in Sweden. An extensive amount of qualitative and quantitative data was collected before, during and after the intervention through self-report checklists, memos and interviews with professionals. In total, 46 children, age 6- 13 years, participated. The children used Sisom at two occasions during 6 months. When they have used Sisom, a printed report forms the basis for a forthcoming dialogue between professionals, children and their parents.

Results:

To our knowledge, this is the first implementation study of an eHealth communication tool aimed at strengthening children’s participation in pediatric healthcare. Key factors for successful implementation were alignment of the solution with the values and goals of the organization, healthcare professionals’ beliefs in the usefulness and usability of the solution and healthcare professionals’ willingness to change their professional roles guided by the solution.

Conclusions:

The results from the study shows that it is possible to restructure healthcare delivery towards a child-centered approach if there is a willingness and preparedness in the organization to implement an eHealth solution with the aim of restructuring the way of working with children’s participation.