Introduction

Child health has shown significant improvements over the last two decades^.1 However, we still face new challenges with the increasing prevalence of non-communicable diseases among children and more recently, with the social isolation imposed by the pandemic.

Mobile Health (mHealth) has played an important role in meeting the population's continuing health needs and has a clear potential to significantly increase the quality and efficiency of healthcare in the digital age, considering that more than four billion people worldwide the world have access to the Internet.^2-3

In this context, the WHO understands that e-Health is an important tool to achieve Universal Health Coverage and mHealth as a complementary strategy for the achievement of the Sustainable Development Goals, especially in low and middle-income countries.⁴ Hence the growing interest in expanding the use of these technologies in care practices and child health care.

Since the 1990s, there has been an increase in the use of e-Health in parallel with the advent of the Internet but with important regional differences that reveal the health needs of the population according to different economic and social contexts³. Furthermore, in times of pandemic and social isolation caused by COVID-19, e-Health has become an indispensable tool for health professionals and services.^5-6

Several studies have provided early evidence of the potential of mobile and wireless technologies for child health, such as interventions in chronic health conditions,^7-8treatment and improvement of clinical diagnosis⁹, treatment adherence,^10-11promotion of breastfeeding,¹² community interventions,¹³ experiences of using mHealth by health professionals,^14-15among others.

The existing systematic reviews on the use of mHealth in child health care mainly focused on the effectiveness of interventions in pregnancy and postpartum such as those by Lee et al.¹⁶and Chen et al.,¹⁷ but they did not include any Brazilian study. It appears that no study has yet described how mHealth interventions are being applied to improve childhood health outcomes comprehensively.

A preliminary survey on PROSPERO, MEDLINE, the Cochrane Database of Systematic Reviews and the Joanna Briggs Institute Database did not identify any current or ongoing scope reviews on the topic.

Thus, considering that knowledge about the use of the internet and the integration of online tools facilitates the implementation of health interventions⁴ and that further research on the use of the internet in child health care is still needed, this study aims is to map the mHealth interventions used to improve childhood health outcomes.

Methods

The proposed scoping review will be conducted in accordance with the JBI methodology for scoping reviews consisting of the following steps review question; eligibility criteria; literature search strategy; extract, analyze, and discuss the findings; conclusions and discuss the implications for practice and further research.¹⁸

Review question

How are mHealth interventions being applied to improve childhood health outcomes (disease prevention, monitoring, or diagnosis)?

Eligibility criteria

Eligible articles that will be included in this scope review include studies published in peer-reviewed journals, based on the Population Context, Concept (PCC) strategy criteria for a scoping review. ¹⁸

P-Participants

The review will consider studies that include children from 0 to 12 years of age. Studies involving both children and adolescents together will be excluded.

C-Concept

The concept of interest for the proposed scoping review is 'mobile health’ or 'mHealth’. There will be detailed studies on how mHealth is applied for disease prevention, monitoring, or diagnosis. Mobile health or mHealth is a subdivision of e-health and refers to the medical and public health tools and practices supported by mobile devices, such as smartphones, patient monitoring devices, personal digital assistants (PDAs) and others wireless devices.¹⁹

C-Context

This review will consider studies that assess mHealth interventions for improving health outcomes in childhood in the context of primary health care services, hospitals and home. There will be no geographical limitation applied in relation to this scoping review.

Literature search strategy

This scoping review will consider the following: books and documents, case reports, classical articles, clinical conference, clinical studies, clinical trials, clinical trial protocols, clinical trials phase I, introductory journal articles, journal articles, letters, meta-analyses, multicenter studies, news, newspaper articles, observational studies, randomized controlled trials, reviews, systematic reviews. This review will also consider qualitative studies that evaluated the experience of participants utilizing mHealth for childcare. This review will only encompass studies published in English, Spanish and Portuguese. The review will include studies published in the last 10 years considering the rapid update of the technological area.

The search strategy will follow a JBI three-phase process to identify the original published and unpublished studies. In the first phase, a draft of research will be conducted in PubMed to identify relevant articles on this topic. The text words in the title and abstracts used in the retrieved articles as well as the index terms used to describe the articles were used to develop a full search strategy ( Figure 1 ). In the second research phase, a final research strategy will be adopted for each source of information. The reference lists of all selected studies will be screened for studies during the third phase of the research.

The databases to be searched include PubMed (MEDLINE), CINAHL (via EBSCO), Embase, PsycINFO (via EBSCO), Scielo, Web of Science, LILACS, Health System Evidence. The search for unpublished studies and gray literature will include Scopus and the ProQuest Dissertations and Theses Global database. The authors will also review reference lists for all included studies.

Study selection

Following the search, all identified records will be compiled and uploaded into EndNote (Clarivate Analytics, PA, USA); the duplicates will be removed. Titles and abstracts will then be screened by two independent reviewers for assessment against the inclusion criteria for the review. Potentially relevant papers will be retrieved in full, and their citation details imported into the Joanna Briggs Institute’s System for the Unified Management, Assessment and Review of Information (JBI SUMARI) (The Joanna Briggs Institute, Adelaide, Australia).

The full text of selected citations will be assessed in detail against the inclusion criteria by two independent reviewers. Reasons for exclusion of full

text papers that do not meet the inclusion criteria will be recorded and reported in the scoping review.

Any disagreements that arise between the reviewers at each stage of the selection process will be resolved through discussion or a third reviewer. The results of the search will be reported in full in the final scoping review and presented in a Preferred Reporting Items for Systematic Reviews and Meta-analyses flow diagram for scoping reviews (PRISMA-ScR).²⁰

Data extraction

Data will be extracted from the papers included in the scoping review by two independent reviewers using a data extraction instrument; this instrument will be adapted from the standardized JBI data extraction tool in JBI System for the Unified Management, Assessment and Review of Information (JBI SUMARI) (JBI, Adelaide, Australia) to answer the research question.

The data extracted will include specific details about the population, concept, context, study methods and key findings relevant to the review question. Figure 2 displays a draft data extraction tool. The draft data extraction tool will be modified and revised as necessary during the each included paper's data extraction process. Modifications will be detailed in the full scoping review.

Any disagreements that arise between the reviewers will be resolved through discussion or a third reviewer. The authors of papers will be contacted to request missing or additional data where required.

Data presentation

The extracted data will be presented in diagrammatic or tabular form so that it aligns with the objective of this scoping review. The charting table will report on: the distribution of papers by year of publication, country of origin, study design, number/age/sex of participants, concept (smartphones, patient monitoring devices, personal digital assistants (PDAs) and others wireless devices), purpose of using the concept (prevention, monitoring or diagnosis), outcomes (diseases, child nutrition, development child, vaccine and others), context (primary health care services, hospitals and the home environment) and the key findings relevant. There will be a narrative summary with the tabulated and/or charted results, and it will describe how the results relate to the review's objective and question.

Results

The selected studies will be presented descriptively, according to PRISMA-ScR guideline. The extracted data will be presented in tables, along with a narrative summary of the findings.

Conclusions

Considering the exponential use of Internet in healthcare, this study will provide evidence on the development and implementation of online tools that are being used to promote children's health.

FUNDING

The authors declare no funding.

CONFLICTS OF INTEREST

The authors declare no conflict of interest.

ACKNOWLEDGMENTS

Valdinéia Barreto Ferreira at the Federal University of Bahia Library for her assistance with the development of the search strategy.

References

Datas de Publicação

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