Summary of Issues and Challenges in the Use of New Technologies in Clinical Care and With Children and Adolescents With Chronic Illness

Assessment and Management of Pain in Juvenile Idiopathic Arthritis

“…With emerging interactive and communication technologies (e-health), especially the Internet, new media for the delivery of psychological interventions are now available (82). The Internet has emerged as one of the top health information resources and modes of social communication for young people and continues to be increasingly integrated into the provision of health care services (83).…”

A Critical Review of the Use of Technology to Provide Psychosocial Support for Children and Young People with Long-Term Conditions

“…Developing supportive technology in isolation from the intended 'users' increases the likelihood that it will not be acceptable to children and young people, resulting in them not using it or its use not being sustained (Drotar, Greenley, Hoff, et al, 2006). User involvement has become a central tenet to service development, policy and research in the UK (Staniszewska & Ahmed, 2000) but user involvement should not be limited solely to adult perceptions.…”

“…It has become increasingly recognized that development of a complex intervention requires the same degree of development as a drug evaluation in order to understand how it works, its acceptability to users and to inform methods of evaluation (Campbell et al, 2007;Craig et al, 2008). This has been noted to be particularly relevant when developing supportive technology as the "lack of theory development and explicit testing of theories has limited the scientific impact and generalizability of research and practice…" (Drotar et al, 2006). If there is limited understanding of how supportive technology works, it is not possible to identify the most appropriate outcomes, hence making it impossible to accurately determine whether technology is of benefit.…”

Reply

“…In addition, given the paucity of research in this area, we still do not know the best way to present selfmanagement or transitional care programs on the Internet, although some basic standards are developing (12). For example, most of the programs use a self-help format, in which the treatment protocol is presented in modular fashion on the Internet and the patient works through it more or less independently.…”

“…Clearly, this is a burgeoning area that extends beyond the Internet to include gaming (13), CD-ROMs, personal digital assistants, mobile phones (short-message service and/or text-messaging), and synchronous videoconferencing (12). For example, McDonagh and Hackett cited the use of Sweet Talk, which is a motivational push support network using daily automated text-messaging through a mobile phone to reinforce clinic-based self-management goals in teens with diabetes (14).…”