Aims: Telehealth is being rapidly adopted by physical and occupational therapists in pediatrics as a strategy to maintain services during the COVID-19 crisis. This perspective presents a mix of theoretical and practice perspectives to support the implementation of telehealth. Although research evidence is just emerging, there is sufficient indication to believe telehealth is effective. However, which telehealth strategies are best for which children and families, and which intervention goals, are not yet clear. Methods: We discuss how different telehealth strategies (e.g. videoconferencing, emails, phone calls, online programs) are being used to address specific intervention goals. Comments from therapists using telehealth and examples of practices in different context and with different populations are provided. We discuss how newly adopted telehealth practices could be included in future hybrid service delivery models and programs, as well as factors influencing the decision to offer face-to-face or online interventions. Conclusion: Although telehealth has been implemented quickly as a response to a health care crisis, and is not a one-size-fits-all intervention, we believe it offers great opportunities to increase the accessibility, cost-effectiveness and family-centredness of our services, to best support families of children with disabilities.

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BACKGROUND Intervention effectiveness research is dependent on the ability to accurately identify the active ingredients of the intervention but is frequently sub-optimal. The active ingredients in parent-focused eHealth (PFeHealth) include the persuasive technology elements provided by the technology along with behaviour change techniques inherent in the intervention. Two taxonomies have been used to describe the active ingredients of eHealth interventions along with their associated behaviour models. The Fogg Behaviour Model (FBM) and Persuasive System Design Model (PSDM) relate to persuasive technology; whilst the Capability-Opportunity-Motivation:Behaviour Model (COM:B) and the Behaviour Change Techniques Taxonomy (BCTTv1) describe active relate to behaviour change. OBJECTIVE The objective of this scoping review was to explore how the active ingredients in parent-focused eHealth are used and reported in publications. Understanding similarities and differences in how the two taxonomies define the active ingredients was a second objective. METHODS A scoping review of parent-focused eHealth publications was undertaken. Publications needed to describe interaction between the parent and the computer interface to ensure Persuasive Technology was included in the intervention. Data from the included publications were charted and analysed using deductive content analysis based on the FBM, PSDM, COM:B and BCTTv1. RESULTS The scoping review mapped 23 PFeHealth interventions described in 42 articles published between 2012 and 2018. A range of chronic childhood health and behaviour concerns were represented including medical, behavioural, and developmental issues. The most popular features included in the interventions were interactive questionnaires or charts followed by instructional videos. Just over half the interventions mentioned a behaviour change theory. Only two interventions referenced PSDM and only one intervention referred to COM:B and BCTTv1. The most frequent behaviour change techniques included learning a behavioural skill, practising it, and self-monitoring the behaviour and its outcome(s). The most frequently used persuasive techniques were tailoring the intervention towards family needs and interests, simplifying tasks and individualising the intervention. The two taxonomies coded different constructs and could not be merged. Of the 125 combined BCTs and PSDs that could have potentially been used, over 40% were not represented in the included publications. Supplementary material listing BCTs included in the intervention was only provided by one of the 42 included publications. Discrepancies between this list of BCTs and the scoping review analysis were noted. CONCLUSIONS Merging taxonomies related to behaviour change and persuasive technology may fail to capture the persuasive ingredients inherent in technology. This scoping review highlighted the need for supplementary material describing the active ingredients within a PFeHealth publication, and the benefit of using two taxonomies to capture both the behaviour change and persuasive technology ingredients that influence the experience and behaviours of parents using the technology. CLINICALTRIAL not applicable

Background Taxonomies and models are useful tools for defining eHealth content and intervention features, enabling comparison and analysis of research across studies and disciplines. The Behavior Change Technique Taxonomy version 1 (BCTTv1) was developed to decrease ambiguity in defining specific characteristics inherent in health interventions, but it was developed outside the context of digital technology. In contrast, the Persuasive System Design Model (PSDM) was developed to define and evaluate the persuasive content in software solutions but did not have a specific focus on health. Both the BCTTv1 and PSDM have been used to define eHealth interventions in the literature, with some researchers combining or reducing the taxonomies to simplify their application. It is unclear how well the taxonomies accurately define eHealth and whether they should be used alone or in combination. Objective This scoping review explored how the BCTTv1 and PSDM capture the content and intervention features of parent-focused eHealth as part of a program of studies investigating the use of technology to support parents with therapy home programs for children with special health care needs. It explored the active ingredients and persuasive technology features commonly found in parent-focused eHealth interventions for children with special health care needs and how the descriptions overlap and interact with respect to the BCTTv1 and PSDM taxonomies. Methods A scoping review was used to clarify concepts in the literature related to these taxonomies. Keywords related to parent-focused eHealth were defined and used to systematically search several electronic databases for parent-focused eHealth publications. Publications referencing the same intervention were combined to provide comprehensive intervention details. The data set was coded using codebooks developed from the taxonomies in NVivo (version 12; QSR International) and qualitatively analyzed using matrix queries. Results The systematic search found 23 parent-focused eHealth interventions described in 42 articles from various countries; delivered to parents with children aged 1 to 18 years; and covering medical, behavioral, and developmental issues. The predominant active ingredients and intervention features in parent-focused eHealth were concerned with teaching parents behavioral skills, encouraging them to practice and monitor the new skills, and tracking the outcomes of performing the new skills. No category had a complete set of active ingredients or intervention features coded. The two taxonomies conceptually captured different constructs even when their labels appeared to overlap in meaning. In addition, coding by category missed important active ingredients and intervention features. Conclusions The taxonomies were found to code different constructs related to behavior change and persuasive technology, discouraging the merging or reduction of the taxonomies. This scoping review highlighted the benefit of using both taxonomies in their entirety to capture active ingredients and intervention features important for comparing and analyzing eHealth across different studies and disciplines. International Registered Report Identifier (IRRID) RR2-doi.org/10.15619/nzjp/47.1.05