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Social media has evolved from connection to compulsion, disproportionately harming children and adolescents. Addictive designs together with developmental vulnerability fuel mental health risks and highlight the urgent need for stricter age limits and stronger protections.
Kosola S
Introduction The adoption and acceptance of parental control apps (PCAs) are threatened by many factors, even though mobile applications are at the forefront of mobile computing technologies. Existing studies indicate that PCA adoption can be improved by understanding users' behavioral intention and mindsets. Several adoption studies show that task features are among the most influential factors influencing users' perceptions of mobile applications. The role of PCA features, such as digital etiquette, cyberbullying, child tracking, and family values, remains largely unexamined in current research. Methods Thus, by using task-technology fit (TTF) theory, this study examines how task-technology features and characteristics affect the behavioral intention of parents toward PCA adoption within the context of Saudi Arabia. To empirically test the proposed theoretical model, data were collected from 388 parents in Saudi Arabia. A multistage analysis, which consists of partial least squares structural equation modeling (PLS-SEM), partial least squares prediction algorithms (PLS-predict), and artificial neural networks (ANN), was employed to examine the outcome of PCA behavioral adoption. Results The results demonstrate that digital etiquette, cyberbullying, family values, and parental mediation significantly and positively influence TTF, whereas mobility, child tracking, and inappropriate online content do not have a significant impact. Furthermore, TTF was found to be a significant predictor of parents' behavioral intention toward PCA adoption. These findings can be utilized to enhance the design of PCAs and thus the user experience for both parents and children. Moreover, this study extends and contributes to the understanding of task features in the context of PCAs through the TTF model.
Alkhalifah A, Bukar UA
Introduction Children discharged after in-hospital treatment for severe anaemia or severe malaria in sub-Saharan Africa remain at high risk of readmission and death, particularly in malaria-endemic settings where recurrent infections are common. Post-discharge malaria chemoprevention (PDMC) has demonstrated substantial reductions in mortality and hospital readmissions and is now recommended by the WHO. However, optimal PDMC delivery strategies, via existing health systems, that optimise adherence remain unclear, particularly in West Africa where implementation and evidence of impact on clinical outcomes are limited. This trial aims to determine the effectiveness of different PDMC delivery strategies and adherence support mechanisms in optimising completion of PDMC courses. Secondary objectives include assessing clinical outcomes (readmissions, outpatient visits, mortality), evaluating health system linkage mechanisms and examining the acceptability and feasibility of the different delivery approaches. Methods and analysis A cluster-randomised implementation trial will be conducted in central and southern Benin across urban and rural settings. Clusters, defined as villages within the catchment areas of two referral hospitals, will be randomly allocated (1:1:1) to one of three arms: (A) facility-based drug distribution (all courses) at discharge with community health worker (CHW) home visit reminders; (B) monthly community-based drug delivery by CHWs combined with phone reminders; and (C) dispensing all courses to caregivers at discharge without adherence support (control). Eligible participants are children under 10 years hospitalised with severe anaemia or severe malaria and clinically stable at discharge. All participants should receive three courses of dihydroartemisinin-piperaquine at weeks 2, 6 and 10 post-discharge and will be followed for 14 weeks. The primary endpoint is incomplete adherence to the full PDMC regimen (3 courses/9 doses). Secondary endpoints include all-cause and malaria-specific readmissions, outpatient visits and mortality. Quantitative outcomes will be analysed using mixed-effects regression models under an intention-to-treat approach. Qualitative methods will assess acceptability and feasibility among caregivers, providers and policymakers. Ethics and dissemination Ethical approval was received from the institutional review boards of the Benin Institute of Applied Biomedical Sciences and Liverpool School of Tropical Medicine. Trial findings will be disseminated to national and international stakeholders through meetings, peer-reviewed publications and major conferences to inform PDMC policy, implementation guidelines and global malaria scale-up efforts, particularly through engagement with the World Health Organization and major malaria funding partners TRIAL REGISTRATION NUMBER: ClinicalTrials.gov, NCT06601712, registered on 14 September 2024 (https://clinicaltrials.gov/study/NCT06601712); and Pan African Clinical Trials Registry, PACTR202411682724094, registered on 5 November 2024 (https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=31962).
Accrombessi M, Assongba L, Khairallah C et al.
Objective Firearm injury is the leading cause of death among children. Evidence shows that counseling around firearm safety from trusted clinicians increases safe storage practices. The American Academy of Pediatrics (AAP) has recommended pediatricians provide counseling on the topic to patients and caregivers, yet gaps remain in understanding how counseling is delivered, especially in the Southeastern US. This study aimed to describe patterns of and barriers to firearm anticipatory guidance among pediatric clinicians in the Southeast. Methods A cross-sectional survey was developed to assess awareness of recommendations/provision of firearm safety counseling. The survey was distributed between July 30-December 10, 2025 across six Southern states through AAP chapters and direct emails from physician champions. Descriptive analyses were conducted to describe the sample and summarize responses to survey questions. Results Among respondents (n = 131), 92.0% report ever counseling on firearm safety. Counseling was driven mostly by perceived risk (50.4%) and age-specific well visits (61.7%) and delivered during well (83.3%) and behavioral health visits (45.6%). Time was the dominant barrier to delivering counseling (60.0%). Conclusions Delivery of firearm safety counseling is inconsistent and dependent on context and perceived risk. Structural barriers limit delivery of messaging. Opportunities exist to standardize safety counseling in pediatric care.
Brisendine AE, Hubbard D, Downs A et al.
Background Post-traumatic stress disorder (PTSD) in children and adolescents poses a significant public health challenge, particularly in settings with limited access to traditional mental health services. eHealth technologies are increasingly used to manage pediatric PTSD; however, evidence remains fragmented and unsynthesized. Aim To comprehensively map the application of eHealth technologies in the management of PTSD among children and adolescents, with a focus on technology modalities, target populations, implementation settings, content elements, outcomes, feasibility, and acceptability. This review also aimed to identify current evidence gaps and highlight priorities for future research. Study design Following the Arksey and O'Malley framework and PRISMA-ScR guidelines, seven databases were searched up to November 2025. Eligible studies involved eHealth tools targeting pediatric PTSD and included quantitative, qualitative, or mixed-methods designs. Study quality was appraised using the Mixed Methods Appraisal Tool (MMAT). Results A total of 26 studies published between 2010 and 2025 were included. eHealth modalities encompassed websites, mobile applications, digital games, telemedicine, virtual reality, and wearable sensors, covering the full management continuum from training, assessment, prediction, prevention, intervention, to monitoring. Most studies focused on school-aged children and adolescents, with limited attention to preschoolers or vulnerable populations. Non-randomized studies generally reported short-term PTSD symptom improvements, whereas randomized controlled trials yielded inconsistent results, with limited long-term follow-up data. Overall, feasibility and acceptability were high; however, challenges included distractions in home environments, technical issues, privacy concerns, and variable adherence. Conclusion eHealth demonstrates broad applicability and feasibility in pediatric PTSD management, yet evidence for clinical efficacy remains insufficient. The field is transitioning from "technology validation" toward "efficacy evaluation and system integration." Future research should prioritize rigorous randomized controlled trials, extended follow-ups, culturally and developmentally appropriate designs, cost-effectiveness analyses, and deeper integration of eHealth into clinical care pathways. Policy support is essential to ensure sustainable implementation, especially in resource-limited settings.
Ju L, Zhang D, Guan R et al.
Summary Background. Food allergy (FA) is a growing public health concern among school-aged children. Schools are high-risk settings for accidental exposures and anaphylaxis, yet staff frequently report insufficient preparedness to manage such emergencies. Educational programs are essential to improve knowledge, confidence, and preventive practices. This study aimed to develop and evaluate a nationwide web-based FA training program for school professionals, aimed at improving knowledge and perceived competence in FA management. Methods. A quasi-experimental interventional study was conducted among 639 Portuguese school professionals, of whom 477 completed FA questionnaires. Participants were in pre-test (n = 172), post-test (n=100), and pre-post groups (n = 205). The intervention was an online program based on guidelines from the European Academy of Allergy and Clinical Immunology, Portuguese education and health authorities, and a national FA manual. FA knowledge was assessed with a 26-item validated questionnaire covering general concepts, allergen avoidance, and school practices. Perceptions of competence were gauged using Likert scales. Statistical analysis used General Linear Model repeated measures. Results. Knowledge scores increased significantly from baseline (62.1%) to post-intervention (79.6%) (p < 0.001). The most significant gains were observed in anaphylaxis management (+35.6%), bullying awareness (+42.4%), and prevention of accidental exposures. Perceived competence in allergen identification, label reading, and exposure prevention also improved significantly (p < 0.001). Conclusions. This nationwide web-based program substantially enhanced school staff's FA knowledge and perceived competence, addressing critical gaps in emergency preparedness. Its scalability supports integration into national and international school health policies to improve safety and inclusion for children with FA.
Machado R, Pádua I, Lima R et al.
Human papilloma virus (HPV) is one of the most frequent sexually transmitted viruses globally, with serious clinical consequences, such as cervical cancer. This study aims to evaluate knowledge and awareness of, and attitudes and beliefs towards, HPV and vaccines for it among women from several Saudi Arabian regions. A cross-sectional descriptive study was carried out among Saudi Arabian women. Data were collected from December 9, 2024, to May 9, 2025, via an online survey including women's demographics, knowledge, awareness, attitudes, and beliefs regarding HPV and vaccination against it. An overall of 627 women took part in the study. The majority of the population (32.1%) is aged from 36 to 45 years. In total, 47.4% of the participants have an adequate level of knowledge of HPV, 51.5% know that it is sexually transmitted, and 41.3% know that it can cause cervical cancer. The main information sources were the Ministry of Health and social media. Around 66.7% of the participants believed that the HPV vaccine is not safe. Marital status, religion, and educational status were demonstrably associated with overall knowledge and awareness of HPV and a vaccine for it. Age, marital status, children, region, education level, and occupation were significantly associated with beliefs concerning HPV. This study reported a gap in awareness and knowledge of cervical cancer and HPV; risk and HPV vaccination complications were found to be barriers to vaccine acceptance.
Kariri YA, Kuriry IA, Albargy HA et al.
Background/Objectives: Online health information (OHI) is used by adolescents and caregivers to manage pediatric rheumatic diseases (PRDs). Little is known about the lived experiences of this group as they navigate complex, evolving online healthcare information and services. This study aimed to explore the lived experiences and indicators of digital health literacy (DHL) among adolescents with PRD and caregivers of children and adolescents with PRD through their use of OHI to learn about and manage their disease. Methods: Qualitative interviews using Interpretive Description methodology was utilized. Adolescent and caregiver participants were recruited using purposeful sampling from one rheumatology clinic in Saskatchewan, Canada. After completing a pre-interview questionnaire, one-on-one semi-structured telephone interviews were completed, audio-recorded, transcribed verbatim, and analyzed using constant comparative analysis. Results: A total of 10 caregivers and 7 adolescents completed the interviews. Three key themes emerged: (1) OHI offers knowledge without imposing on PRD practitioners. Participants were motivated to use OHI for symptom management, reassurance, and medication administration. (2) Participants had difficulty finding OHI, resulting from their search strategies, desire for answers to complex problems, lack of information for novel biologic medications, the absence of adolescent-focused OHI, and confusion around pediatric to adult disease names. (3) Although aware of misinformation, participants discussed and demonstrated inadequate appraisal of OHI. Conclusions: Participants relied on inappropriate indicators of medical accuracy and misplaced trust in OHI sources, leading to exposure to misinformation. Proactively addressing these concerns, including OHI prescriptions, fostering independent OHI appraisal, and development of age-appropriate OHI, may improve DHL and aid PRD management.
Eling C, Stinson JN, Rosenberg AM et al.
Sharenting-the practice of parents sharing children's personal data and images on digital platforms-has become increasingly normalized, raising concerns about privacy, safety, and psychological well-being. While existing literature emphasizes the role of healthcare professionals in guiding families on digital risks, less attention has been paid to how clinicians themselves navigate these practices as parents. This paper introduces the concept of the "clinician-parent paradox in sharenting," describing situations in which professional guidance on children's digital safety coexists with personal online practices that may contribute to children's digital exposure. We further propose the notion of a "digital credibility shield," whereby professional identity may generate a perceived sense of control and attenuate risk perception in personal digital behaviour. Drawing on ethical considerations related to autonomy, professional responsibility, and the child's right to an open future, we argue that this paradox reflects a broader tension between expertise and everyday practice in digital environments. Conceptualizing this phenomenon may support ethical self-reflection among healthcare professionals and provide a foundation for future empirical and normative research on digital parenting in clinical contexts.
Aydin Ayva D, Uysal M
Introduction Several studies have individually suggested that somapacitan, a once-weekly growth hormone (GH) treatment, has similar efficacy and safety to once-daily GH in children with GH deficiency. Here, we assessed the efficacy and safety of somapacitan versus daily GH after 52 and 156 weeks of treatment using pooled data from the REAL 3, REAL 4, and REAL 6 trials. Methods Participants receiving somapacitan 0.16 mg/kg/week or daily GH 0.034 mg/kg/day were included. Some participants switched from daily GH to somapacitan after 52 weeks of treatment, so data beyond week 52 were analysed separately. Outcomes, including height velocity (HV) and adverse events (AEs), were analysed by treatment group. An additional analysis was conducted in relation to puberty onset and Tanner stage. Results At week 52, HV was similar in participants receiving somapacitan and those receiving daily GH. At week 156, mean (SD) HV (cm/year) was 7.5 (1.6) in participants who had always received somapacitan, 7.6 (2.0) in those who had always received daily GH, and 7.8 (1.4) in those who switched to somapacitan from daily GH. Most AEs were mild and unlikely to be treatment-related. HV remained stable for up to 130 weeks in pubertal children, and was similar across treatment groups and Tanner stages. Conclusions In this pooled analysis of clinical trial data, somapacitan demonstrated similar efficacy and safety to daily GH for up to 156 weeks of treatment. A dose of 0.16 mg/kg/week of somapacitan was able to maintain consistent growth in children and adolescents who reached puberty.
Sävendahl L, Maniatis AK, Pietropoli A et al.
