IMPORTANCE Mobile health interventions are increasingly popular in pediatrics; however, it is unclear how effective these interventions are in changing health outcomes.OBJECTIVE To determine the effectiveness of mobile health interventions for improving health outcomes in youth 18 years or younger.DATA SOURCES Studies published through November 30, 2016, were collected through PubMed, Cumulative Index to Nursing and Allied Health Literature, Educational Resources Information Center, and PsychINFO. Backward and forward literature searches were conducted on articles meeting study inclusion criteria. Search terms included telemedicine, eHealth, mobile health, mHealth, app, and mobile application.STUDY SELECTION Search results were limited to infants, children, adolescents, or young adults when possible. Studies were included if quantitative methods were used to evaluate an application of mobile intervention technology in a primary or secondary capacity to promote or modify health behavior in youth 18 years or younger. Studies were excluded if the article was an unpublished dissertation or thesis, the mean age of participants was older than 18 years, the study did not assess a health behavior and disease outcome, or the article did not include sufficient statistics. Inclusion and exclusion criteria were applied by 2 independent coders with 20% overlap. Of 9773 unique articles, 36 articles (containing 37 unique studies with a total of 29 822 participants) met the inclusion criteria. DATA EXTRACTION AND SYNTHESISOf 9773 unique articles, 36 articles (containing 37 unique studies) with a total of 29 822 participants met the inclusion criteria. Effect sizes were calculated from statistical tests that could be converted to standardized mean differences. All aggregate effect sizes and moderator variables were tested using random-effects models. MAIN OUTCOMES AND MEASURES Change in health behavior or disease control.RESULTS A total of 29 822 participants were included in the studies. In studies that reported sex, the total number of females was 11 226 (53.2%). Of those reporting age, the average was 11.35 years. The random effects aggregate effect size of mobile health interventions was significant (n = 37; Cohen d = 0.22; 95% CI, 0.14-0.29). The random effects model indicated that providing mobile health intervention to a caregiver increased the strength of the intervention effect. Studies that involved caregivers in the intervention produced effect sizes (n = 16; Cohen d = 0.28; 95% CI, 0.18-0.39) larger than those that did not include caregivers (n = 21; Cohen d = 0.13; 95% CI, 0.02-0.25). Other coded variables did not moderate study effect size.CONCLUSIONS AND RELEVANCE Mobile health interventions appear to be a viable health behavior change intervention modality for youth. Given the ubiquity of mobile phones, mobile health interventions offer promise in improving public health.

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Introduction: Oronasal fistulae following palatoplasty may affect patients’ quality of life by impacting their ability to eat, speak, and maintain oral hygiene. We aimed to quantify the impact of previous oronasal fistula repair on patients’ quality of life using patient-reported outcome psychometric tools. Methods: A cross-sectional study of 8- to 9-year-old patients with cleft palate and/or lip was completed. Patients who had a cleft team clinic between September 2018 and August 2019 were recruited. Participants were divided into 2 groups (no fistula, prior fistula repair). Differences in the individual CLEFT-Q and Child Oral Health Impact Profile-Short Form 19 (COHIP-SF 19) Oral Health scores between the 2 groups were evaluated using a multivariate analysis controlling for Veau classification and syndromic diagnosis. Results: Sixty patients with a history of cleft palate were included. Forty-two (70%) patients had an associated cleft lip. Thirty-two (53.3%) patients had no history of fistula and 28 (46.7%) patients had undergone a fistula repair. CLEFT-Q Dental, Jaw, and Speech Function were all higher in patients without a history of a fistula repair; however, none of these differences were statistically significant. The COHIP-SF 19 Oral Health score demonstrated a significantly lower score in the fistula group, indicating poorer oral health ( P = .05). Conclusions: One would expect that successful repair of a fistula would result in improved function and patient satisfaction, but the consistent trend toward lower CLEFT-Q scores and significantly increased COHIP-SF 19 Oral Health scores in our study group suggests that residual effects linger and that the morbidity of a fistula may not be completely treated with a secondary correction.

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Purpose: This study described the COVID-19 risk mitigation actions of people with a total laryngectomy (TL) during the pandemic. Method: An online survey was completed by 215 people with a TL who lived in the United States. The survey was open from December 1, 2021, to January 15, 2022. Results: There was a significant increase in frequency of heat and moisture exchange (HME) device use during the pandemic compared with pre–COVID-19. Frequency of HME use was significantly greater for those who were vaccinated and those who had at least one clinical visit with their speech-language pathologist (SLP). The use of virtual visits increased from 9% pre–COVID-19 to 37% during the pandemic. Seventy percent of respondents were “satisfied” or “very satisfied” with virtual visits and 51% judged them “as good as in-person.” Eighty percent were vaccinated for COVID-19 and 75% received a booster. One third reported that they did not wear mask over the face or over the tracheostoma. Twenty percent had tested positive for COVID-19 with 70% of these people requiring hospitalization. Conclusions: HME use and virtual SLP visits increased during the pandemic and the vaccination rate was high among this group of respondents. Overall, there were still large percentages of people with a TL who were not using an HME, not vaccinated, and did not wear a mask. SLPs should consider reaching out directly to their TL caseload, particularly those not yet seen during the pandemic, to support uptake of COVID-19 mitigation activities specific to people with a TL as the pandemic persists.

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