Objectives: The primary objectives were to (a) identify current published research in electronic health (eHealth) and mobile health (mHealth) interventions for youth undergoing cancer treatment and child, adolescent, and young adult survivors of childhood cancer and (b) critically appraise the current scientific evidence on their effectiveness and efficacy. As an exploratory aim, we identified pediatric cancer patients' and survivors' perceptions, attitudes, and concerns related to eHealth and mHealth interventions. Methods: A comprehensive search of the literature was performed to identify peerreviewed journal articles that included the use of mHealth and eHealth interventions among youth receiving active cancer treatment and survivors of childhood cancer through the age range of childhood to young adulthood (mean age 21 years or younger at the time of diagnosis; mean age 39 years or younger at the time of intervention). The search was conducted via six electronic databases: PubMed, CINAHL, EMBASE, PsycINFO, IEEEXplore and the Cochrane Library.Results: Of the 1879 potential records examined, 21 met criteria for inclusion for a total of 1506 participants. Of the investigations included, 13 were randomized controlled trials, and eight were nonrandomized studies. Findings demonstrated feasibility as well as acceptability with these approaches. Evidence of efficacy for interventions targeting emotional distress, health behaviors, health outcomes, and neurocognitive functioning was mixed. Conclusions:Given the growing evidence of efficacy, coupled with increasing access to digital technologies, eHealth and mHealth may serve an important role in improving mental and physical health outcomes of youth undergoing cancer treatment and child, adolescent, and young adult survivors of childhood cancer. K E Y W O R D Sadolescent, cancer, childhood, eHealth, emotional distress, mHealth, neurocognitive functioning, oncology, patient-reported outcomes, young adult
Background The Benefits and Barriers Model proposes both benefits and barriers associated with nonsuicidal self‐injury (NSSI) and that a negative association with the self plays a key role in the initial selection of and acute motivation for NSSI. The current investigation builds upon previous findings by assessing the added benefit of targeting self‐criticism in the treatment of NSSI. Methods Sample included 40 participants (30 females; Mage = 14.92) enrolled in dialectical behavior therapy for adolescents within a partial hospitalization program. All study participants received dialectical behavior therapy for adolescents, and those randomized to the experimental condition received an additional brief cognitive intervention developed to decrease self‐criticism. Results There was no evidence of an indirect effect of targeting self‐criticism upon NSSI at post‐treatment via post‐treatment self‐criticism (b = −0.98, p = .543); however, there was evidence of a significant interaction between treatment condition and self‐criticism at pretreatment in the prediction of NSSI at post‐treatment (b = 0.33, p = .030). Analyses of simple slopes indicated the conditional direct effect of targeting self‐criticism varied as a function of patient’s level of self‐criticism at the onset of treatment, such that individuals −1 SD below the mean (b = −5.76, p = .037) and at average pretreatment levels of self‐criticism (b = −4.09, p = .042), but not + 1 SD above the mean (b = −2.42, p = .056), experienced fewer incidents of NSSI at post‐treatment. Conclusions The results of this investigation support the added benefit of targeting self‐criticism in the treatment of NSSI for adolescents.
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