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Table 3 Synthesis table

From: Interactive media for parental education on managing children chronic condition: a systematic review of the literature

Study authors Population, design, intervention (tools) and Outcome Findings Literacy level of tools (Flesch-Kincaid Grade Level) Assessment of Quality
Fall AJ et al. 1998 [5] Population: 20 parents of children with asthma.
Design: intervention (pre and post assessment)
Intervention: Interactive, computer-based program; Outcome: Newcastle Asthma Knowledge Questionnaire
10 parents showed improved performance;
3 parents showed no change;
4 parents showed declined performance
3 dropped out
Test scores improved from 21.8 at baseline to 23.5 after the intervention (95 % CI of 22.71 to 24.29) p = 0.06
Intervention tool: n/a
Outcome measure: Newcastle Asthma Knowledge Questionnaire ranged from 2.2 to 11.9 grade level
Mixed results study;
Fair quality study
Sullivan-Bolyai et al. 2012 [21] Populations: Parents: (10 in pilot, 13 in focus groups and 16 in intervention)
Design: Intervention (pre and post assessment)
Intervention: Interactive human patient simulators
Outcome: Change in Diabetes Awareness and Reasoning Test
For Diabetes Awareness and reasoning: 16 point increase in intervention vs 16 point increase in control, (p = 0.94, F = 3.15)
Self-efficacy diabetes scores in intervention group increased by 8 points vs 6 point increase for control (p = 0.68, F = 0.17)
Hypoglycemia fear-survey showed a 5 point decrease in scores for the intervention group vs 7 decrease in controls (p = 0.87, F = 0.03), lower scores showed less fear of hypoglycemia
n/a The internal validity of the study was good; randomization occurred in the pilot arm to limit potential confounders but small cohort that was randomized
Thompson et al.[22] Population: Inner city population at a library, a Department of Motor Vehicles office, and a fast food chain location. 20–25 % of the population in the area was under the age of 14, 49–65 % had a high school education or less for adults, and 26–32 % of the parents were single.
Intervention: Use of an information kiosk Outcome: Interest in using the information provided from the sessions 1846 sessions of informational kiosk use
1447 session of the interactive kiosk (47 % at the fast food chain location; 35 % at the public library; 18 % at the DMV)
165 of the 250 respondents who completed the exit survey found the information from the kiosk useful; 113 respondents said they plan to talk with their physicians about the information from the sessions
  Fair quality observational study; Skew of results from one site but large sample population. Lack of statistical analyses results for associations is concerning.
Wenninger et al. 2000 [23] Population: 129 families of children with Atopic Dermatitis
Intervention: Combination of psychological counseling in addition to clinic visits
Outcome: Disease severity, Quality of Life of the parents, and coping skills of parents and patients
Severity of Atopic Dermatitis (SCORE-AD scores) decreased by 20.5 points in intervention vs 16.2 points in control (t = 1.27, p = 0.21)
Confidence in medical treatment in the intervention arm (F = 7.96 of MANOVA, P < 0.01)
Coping skills surveyed showed decreased rumination in the intervention group (t =2.44, p < 0.05)
  Good internal validity of the study, but concerned about the lack of tables comparing the baseline characteristics of the intervention and control groups within the study
Huss et al. 2003 [24] Population: children with asthma
Intervention: Computer based asthma education program
Outcome: Disease severity, Patient quality of life, Disease knowledge
No difference in asthma knowledge between the intervention and control group. Intervent group had a 0.4 point improvement on Air Control testing vs control groups 0.3 points improvement (95 % CI, −0.3 to 1.1) p >0.05)
No significant changes found in pulmonary function tests.
No significant change in responses to Asthma Knowledge Questionnaire
N/A Fair internal validity for the study, but analysis did not mention controlling for asthma severity. Lack of actual statistical values for some analyses is concerning.
Guendelman et al. 2002 [25] Population: 134 children with Asthma
Intervention: An interactive health learning device
Outcome: Limitation in physical activity, use of health services, peak flow readings
19/62 intervention and 26/60 control children had peak flow readings in yellow or red zone (OR = 0.43, (0.23,0.82) p = 0.01); 20/62 intervention and 28/60 control children reported limitations in physical activity (OR = 0.52 (0.29,0.94) p = 0.03); 4/62 intervention and 1/60 control children had a hospitalization during study period (OR = 0.99 (0.25,3.88) p = 0.96); 6/62 intervention and 11/60 control children had an ED visit (OR 0.59 (0.25, 1.35) P = 0.21) N/A Good internal validity with allocation concealment and randomization
Shegog et al. 2001 [26] Population: 71 urban, minority children with asthma
Intervention: Computer-based asthma education program
Outcome: Disease knowledge, self-efficacy
Intervention group had an improvement in their knowledge scores (21.1, 95 % CI [19.38 to 22.82] p <0.01)
Self-efficacy showed an improvement in the intervention group (mean 56.5, 95 % CI [53.38, 59.62] p = 0.04)
N/A Fair study, analysis did not try to control for disease severity or child’s performance in school
Horan et al. 1990 [27] Population: 20 adolescents with Diabetes
Intervention: Computer based program to educate and monitor diabetes
Outcome: Hemglobin A1c percentages, bloodglucose levels, disease knowledge
Disease knowledge improved in 60 % of intervention and 50 % of control children
Improvement in blood glucose in the intervention group prior to lunch (F = 10.922, p < 0.02) and prior to dinner (F = 7.221, p < 0.025)
N/A Poor internal validity, selection bias introduced through matching without controlling being performed in the analysis
Dragone et al. 2002 [28] Population: 31 children with leukemia
Intervention: CD-ROM based education program for cancer
Outcome: Sense of control through health locus of control survey
Intervention group had an improvement in their survey results (r2 = 0.33, F = 6.38, p = 0.004) CD-ROM program reading level 5.5. Good internal validity study, analysis did not try to control for parental education level
Krishna et al. 2003 [29] Population: 228 children with asthma
Intervention: Internet-enabled interactive media asthma education program.
Outcome: Disease knowledge, caregiver Quality of Life
Intervention groups showed improved disease knowledge (2.52, 95 CI [−0.38, 5.42], p = 0.029)
Quality of Life scores showed no difference between the groups.
  Fair internal validity, quality of life had a small recall interval and no attempts to control for caregiver education through analysis
Homer et al. 2002 [30] Population: 106 high risk urban children with asthma
Intervention: Multimedia software for asthma education
Outcome: Number of ED visits and acute office visits, parent knowledge of disease, child knowledge of disease
Intervention and control groups had reduction in ED visits (2.14 to 0.86 in intervention group, 2.24 to 0.73 in control) with no statistical difference between the groups
Parent knowledge (score of 80 in intervention and 78 in control) was no statistically different between the groups
Child knowledge improved both groups (F =18.78, p < 0.001)
N/A Good internal validity, randomization protocol was well explained and data analysis tried to adjust for possible confounders
Swallow et al. 2014 [31] Population: 41 parents of children with CKD stage 3–5, 30 children with CKD stage 3–5 Intervention: Online parent information and support program
Outcome: Parent management of disease, parent empowerment, father’s level of support
Parents in the intervention showed improvement in perceived competence in managing their child’s condition vs control (2.6, 95 CI (−1.6,6.7) P = 0.213)
Intervention parents had a slight decrease in empowerment (−0.2, 95 % CI (−0.5, 0.2) P = 0.404)
Father support level showed an decrease in score (−4.3, 95 % CI (−24.7, 16.2) P =0.667) among the intervention group
Online intervention Reading level 11.6 Fair internal validity, lack of adjustment for potential confounders in analysis. Possible selection bias.