Commentary: Pediatric eHealth Interventions: Common Challenges During Development, Implementation, and Dissemination

Over the past two decades, eHealth interventions have rapidly grown in popularity (Fatehi & Wootton, 2012). eHealth has been defined in numerous ways ranging from “using the Internet and other electronic channels for the access and delivery of health and lifestyle information and services” to “health promotion delivered and managed over the Internet” (see Table 3 in Oh, Rizo, Enkin, & Jadad, 2005). For the purposes of this Commentary and to be consistent with prior literature within health psychology, eHealth is defined as the use of technology to “function as an active ingredient in treatments” such as health behavior interventions (Cushing & Steele, 2010, p. 937). This includes using technology to gather information from patients and to provide support and guidance to patients and their families to promote improved health outcomes (Cushing & Steele, 2010; Palermo, 2008). Examples of eHealth technologies include Internet Web sites, mobile phone-enabled capabilities (e.g., text messaging, software applications), computer games, CD-ROMs, tablets, and computers. Among pediatric populations, a growing number of eHealth interventions has been tested and made available (Cushing & Steele, 2010; Gustafson et al., 2012; Palermo, Wilson, Peters, Lewandowski, & Somhegyi, 2009; Ritterband et al., 2013; Stinson, Wilson, Gill, Tamda, & Holt, 2009). Children and adolescents appear particularly amenable to using eHealth programs because they may have greater facility and comfort with and spend more time using technologies such as the Internet and mobile phones (Bennett, Maton, & Kervin, 2008). Although there is a growing literature on the effectiveness of eHealth interventions among pediatric populations, considerably less attention has been paid to the logistical issues associated with developing, testing, and disseminating these interventions. Although there has been some discussion of these topics in the adult literature (Ahern, Patrick, Phalen, & Neiley, 2006; Danaher & Seeley, 2009; Eng, 2002; Pagliari, 2007), eHealth interventions being delivered to children and families have their own distinct challenges and considerations. Further, although eHealth interventions can be unique in their design and purpose, there are common issues that arise when developing and implementing these interventions in the pediatric population. These design, planning, ethical, and logistical issues are particularly important to examine because they have the potential to significantly hinder or facilitate the eHealth research. Thus, the goals of this commentary are to review key challenges that pediatric eHealth researchers may encounter when planning, developing, testing, and disseminating new eHealth interventions and to propose possible solutions for addressing these challenges based on the literature and the authors’ experiences conducting pediatric eHealth research. An overview of key issues related to eHealth intervention development, testing, and dissemination can be found in Table I. Table I. Checklist of Tasks and Considerations for eHealth Program Projectsa