JMIR Publications

ABSTRACT

Background:

eHealth tools that assess and track health outcomes in children/young people are an emerging type of technology that have the potential to reform health service delivery and facilitate integrated, interdisciplinary care.

Objective:

The aim of this review was to summarise eHealth tools that have assessed and/or tracked health in children/young people to provide greater clarity around the: populations and settings in which they have been used; characteristics of digital devices (e.g. health domains, respondent, presence of tracking, connection to care); primary outcomes; and risks and challenges of implementation.

Methods:

A search was conducted in PsycINFO, PubMed/MEDLINE and EMBASE in April 2020. Studies were included if they evaluated a digital device of which the primary purpose was to assess and/or track health, focused on children/young people (birth-24 years), reported original research and were published in peer reviewed journals in English.

Results:

Thirty-nine papers were included in the review. Sample sizes ranged from 7 to 149,329 participants (median=163, mean=5,155). More studies were conducted in urban (46.2%, 18/39) than rural (7.7%, 3/39) regions or a combination of urban and rural areas (20.5%, 8/39); devices were implemented in 3 main settings: outpatient health clinics (30.8%, 12/39), hospitals (35.9%, 14/39), community outreach (25.6%, 10/39), or a combination of these settings (7.7%, 3/39). Mental and general health were the most common health domains assessed, with a single study assessing multiple health domains. Just under half of devices tracked children’s health over time (41.0%, 16/39) and two-thirds (64.1%, 25/39) connected children/young people to clinical care. It was more common for information to be collected from a single informant (i.e. the child/young person, trained health worker, clinician, parent/caregiver) than from multiple informants. The health of children/young people was assessed as a primary or secondary outcome in 14/39 studies (35.9%); however, only 1 study assessed whether using the digital tool improved the health of users. Most papers reported early phase research (formative or process evaluations), with fewer outcome evaluations and just 3 randomised controlled trials. Challenges/risks identified related to accessibility, clinical utility and safety, uptake, data quality, user interface/design aspects of the device, language/literacy, socio-cultural barriers and privacy/confidentiality concerns; ways to address these barriers were not thoroughly explored.

Conclusions:

eHealth tools that assess and/or track health in children/young people have the potential to enhance health service delivery; however, a strong evidence base validating the clinical utility, efficacy and safety of tools is lacking and more thorough investigation is needed to address risks and challenges of using these emerging technologies in clinical care. At present, there is greater potential for the tools to facilitate multi-informant, multi-domain assessments and longitudinally track health over time and room for further implementation in rural/remote regions and community settings around the world.