Abstract

BackgroundMobile and smartphones are owned and accessed by many, making them a potentially optimal delivery mechanism to reach pediatric patients with socially complex needs (ie, pediatric populations who face overlapping adversities).ObjectiveTo address the specialized needs of youth from such groups, this review synthesized the literature exploring the use of phone-based delivery to access pediatric populations with socially complex needs, targeting mental and behavioral health outcomes. The purpose of this synthesis was to provide recommendations for future research developing phone-based interventions for youth with socially complex needs.MethodsA trained medical librarian conducted the search strategy in the following databases: PubMed, Scopus, CINAHL, PsycINFO, Cochrane CENTRAL Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Google Scholar. Studies targeting youth with socially complex needs were defined by recruiting samples that were primarily from traditionally underserved populations (ie, sex/gender minorities, racial/ethnic background, low socioeconomic status, rural/remote location, and sexual orientation). A systematic narrative framework was utilized and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed (registration number CRD42020141212).ResultsA total of 14 studies met the inclusion criteria, with 3 depicting the use of phones to complete assessment and tracking goals and 11 to intervene on mental and behavioral health targets.ConclusionsThe literature indicates important directions for future research, including (1) involving diverse and representative teens (ie, the likely users of the interventions), stakeholders, and clinical/research staff; (2) integrating evidence-based therapies with minority-focused theories; (3) harnessing mobile device capabilities; and (4) considering and assessing for potential costs in phones as delivery mechanisms.Trial RegistrationPROSPERO CRD42020141212; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=141212

Highlights

  • BackgroundPediatric populations with socially complex needs are likely to have their behavioral health negatively impacted—from having a lower health status than peers to being less likely to receive appropriate physical and mental health diagnoses [1]

  • If not appropriately evaluating tools with socially complex populations and adapting designs to fit their user and access needs [20], researchers and clinicians are missing the opportunity to reach pediatric populations through a medium that young people are already using for other purposes

  • This study synthesized the literature on the use of phones as a mental and behavioral health delivery mechanism for pediatric populations with socially complex needs

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Summary

Introduction

BackgroundPediatric populations with socially complex needs are likely to have their behavioral health negatively impacted—from having a lower health status than peers to being less likely to receive appropriate physical and mental health diagnoses [1]. The behavioral health disparities associated with having socially complex needs have lasting detrimental effects, including a higher likelihood of chronic illness in adulthood [4]. For these reasons, repeated calls to promote the behavioral health needs of such pediatric populations have been made [5,6,7,8,9,10]. Mobile and smartphones are owned and accessed by many, making them a potentially optimal delivery mechanism to reach pediatric patients with socially complex needs (ie, pediatric populations who face overlapping adversities)

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