Peer-reviewed article
Barriers and Enablers Affecting Successful Implementation of the Electronic Health Service Sisom: Multicenter Study of Child Participation in Pediatric Care
Petra Svedberg, Susann Arvidsson, Ingrid Larsson, Ing‐Marie Carlsson, Jens Nygren ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study evaluated how a digital tool called Sisom was implemented in four pediatric care centers in Sweden to help children aged 6-12 participate in their own health care. The tool allows children to communicate their needs and concerns, which professionals then use to guide conversations with children and parents. The research found that successful implementation requires organizational alignment with child-centered values, professional belief in the tool's usefulness, and willingness to change how professionals work with children.
Key points
- Sisom is a digital interactive assessment and communication tool designed to give children aged 6-12 a voice in their health care
- The study collected qualitative and quantitative data from 46 children across four Swedish pediatric care centers over 6 months
- Key success factors were organizational alignment with child-centered values, professional belief in the tool's usefulness and usability, and professionals' willingness to change their roles
- A printed report from Sisom formed the basis for dialogue between professionals, children, and parents
- The study demonstrates that restructuring health care toward child participation is possible with organizational willingness and preparedness to implement eHealth solutions
Limitations
The study was conducted only in Sweden with 46 children, so findings may not generalize to other countries or health systems. The study evaluates implementation processes and professional perspectives rather than measuring clinical outcomes or direct impacts on children's health or well-being.
Abstract
BACKGROUND: Children's participation in health care is one of the most important components in the management of their disease. Electronic health (eHealth) services that are adapted to the needs of children have the potential for restructuring how children and professionals work together. Therefore, a digital interactive assessment and communication tool, Sisom, was developed to give children aged between 6 and 12 years a voice in their own health care. However, the implementation of eHealth services such as Sisom in daily practice in pediatric health care is rarely investigated. OBJECTIVE: The aim of this study was to explore the process of implementing Sisom for children in pediatric care in Sweden. More specifically, the study aimed to (1) evaluate whether the implementation strategy was conducted as planned, (2) understand the barriers and facilitators of the implementation strategy in pediatric care settings, (3) gain insight into how professionals work with the specific intervention, and (4) gain insight into the usefulness and effects of the intervention from the professionals' perspectives. METHODS: A process evaluation design was used to study the implementation of Sisom at 4 pediatric care centers in Sweden. An extensive amount of qualitative and quantitative data was collected before, during, and after the intervention through self-report checklists, memos, and interviews with professionals. In total, 46 children, aged between 6 and 13 years, participated. The children used Sisom on two occasions during 6 months. When they used Sisom, a printed report formed the basis for a forthcoming dialogue between professionals, children, and their parents. RESULTS: To our knowledge, this is the first implementation study of an eHealth communication tool aimed at strengthening children's participation in pediatric health care. Key factors for successful implementation were alignment of the solution with the values and goals of the organization, health care professionals' beliefs in the usefulness and usability of the solution, and health care professionals' willingness to change their professional roles guided by the solution. CONCLUSIONS: The results from the study show that it is possible to restructure health care delivery toward a child-centered approach, if there is a willingness and preparedness in the organization to implement an eHealth solution with the aim of restructuring the way of working with children's participation.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Implementation of Sisom, a digital interactive assessment and communication tool that enables children aged 6-12 to express their needs and concerns, with results communicated via printed reports to guide professional-child-parent dialogue
- Population
- 46 children aged 6-13 years in pediatric care settings in Sweden
Key finding
Implementation was feasible and demonstrated that restructuring health care toward child-centered participation is possible