Peer-reviewed article
Mapping Randomized Controlled Trials of Family- and Community-Centered Healthcare Interventions for Pediatric Asthma, Type 1 Diabetes, or Juvenile Idiopathic Arthritis-A Scoping Review.
Solgaard Nielsen S, Bricca A, Orologas S, Malby Schoos AM, Bohr AH et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This scoping review mapped 76 randomized controlled trials of family- and community-centered interventions for children with three chronic diseases: asthma, type 1 diabetes, and juvenile idiopathic arthritis. Most interventions were short-term programs led by healthcare professionals that combined education, psychosocial support, and care coordination. The review found that interventions primarily targeted symptom management and disease control, and identified important gaps in the evidence base, particularly for juvenile idiopathic arthritis, peer support models, and non-professional delivery.
Key points
- 76 publications describing 71 interventions involving 16,342 children (median age 9 years) with asthma, type 1 diabetes, or juvenile idiopathic arthritis
- Most interventions (63%) lasted 6 months or less and were delivered in person (83%) by healthcare professionals (62%)
- Primary outcomes focused on symptom burden (44%), coping (24%), and disease control (20%), with mixed results compared
- Asthma dominated the evidence base (68% of interventions), while juvenile idiopathic arthritis represented only 3%
- Gaps identified include limited evidence on mixed diagnoses, peer support, family activities, and interventions delivered by non-professionals
Limitations
This is a scoping review mapping characteristics and study designs rather than synthesizing intervention effectiveness. The review does not provide definitive conclusions about which interventions work best, and the heterogeneity of interventions, outcomes, and study quality limits the ability to draw meta-analytical conclusions.
Abstract
Background Family and community are key support sources for children and adolescents with chronic illnesses. This study aimed to map the characteristics of family- and community-centered interventions for pediatric chronic somatic disease. Methods This scoping review followed the Arksey and O'Malley guidance. Through a systematic search in Medline (PubMed), EMBASE, PsycINFO, Cochrane, and CINAHL, free web sources, the gray literature, and citations, we identified publications of randomized controlled trials evaluating family- and community-centered interventions for children aged 0-17 years with asthma, type 1 diabetes, or juvenile idiopathic arthritis. Two or more reviewers independently conducted screening, verification of machine-assisted data extraction, risk-of-bias assessment, and narrative synthesis. Results Of 7285 items identified, we included 76 publications on 71 interventions comprising 16,342 participants (median n = 157; IQR 81-303; range 12-1316) with a median age of 9 (range 0-19) years. Interventions incorporating educational, psychosocial, and care-coordination elements targeted asthma (68%), type 1 diabetes (29%), and juvenile idiopathic arthritis (3%) that had lasted ≤6 months (63%) and were delivered in person (83%) by healthcare professionals (62%). Primary outcomes included symptom burden (44%), coping with the disease (24%), disease control (20%), activity participation, child psychosocial functioning, medication or healthcare use (18% each), or child quality of life (17%). Usual care (59%) and other treatment (31%) were frequent comparators. Conclusions Most interventions were short-term, healthcare professional-led multicomponent programs compared with usual care. Primary outcomes targeted symptom management and disease control. Mixed diagnoses, peer support, family activities, and non-professional delivery were uncommon. This study identified gaps in diagnosis coverage and the need for additional high-quality studies.