Enhancing Adherence and Mental Well-Being in Pediatric Growth Hormone Therapy: Feasibility Prospective Observational Study of a Family-Centered Digital Companion
Bibliographic record
Abstract
Background: Managing a child undergoing growth hormone treatment (GHt) can be burdensome for the families, which can lead to psychological problems and poor treatment adherence. The Adhera Caring Digital Program (ACDP) is a mobile-based digital health intervention designed to support the physical and mental well-being of families of individuals with chronic conditions. Objective: This study aimed to evaluate the clinical feasibility of a digital intervention to support families by focusing on caregivers of children undergoing GHt and its impact on treatment adherence. Methods: This is a prospective observational study. A total of 51 caregivers of children undergoing GHt with low adherence (below 85%) to treatment were recruited at the Pediatric Endocrinology Unit at the Miguel Servet Children's University Hospital and enrolled into the ACDP for 3 months. Results: A total of 51 parents participated in the digital intervention for 3 months. The use of ACDP was associated with a significant increase in adherence rate (P<.001). At baseline, all families had suboptimal adherence (below 85%), and after the intervention, 75% (n=38) of the families reached optimal levels of adherence. Also, the perceived pain of injection was reduced, as well as anxiety and stress. Initially, 21.56% (n=11) of caregivers reported depression symptoms, categorized as mild (11.76%, n=6), moderate (7.84%, n=4), and extremely severe (1.96%, n=1), while post intervention, only 1.96% (n=1) of caregivers reported depression as "severe." Anxiety levels at baseline were reported by a total of 23.53% (n=12) of caregivers (mild: 7.84%, n=4, moderate: 13.73%, n=7, and severe: 1.96%, n=1). After the intervention, only 11.76% (n=6) reported mild (5.88%, n=3) or moderate (5.88%, n=3) anxiety levels. Initially, 23.5% (n=12) of caregivers reported stress as mild (7.84%, n=4), moderate (13.72%, n=7), and severe (1.96%, n=1) stress, and following the intervention, these symptoms reduced to 7.84% (n=4) (mild: 5.88%, n=3, severe: 1.96%, n=1). Conclusions: The ACDP is a promising tool, and it has been demonstrated to significantly increase the adherence rate, adding value to the patient and caregiver journey, and improving the management of growth hormone deficiency while promoting the overall well-being of family caregivers. Our results show that the digital support provided by the solution significantly increased the quality of life of the caregivers by increasing their psychological, emotional, and social well-being and decreasing their depression, anxiety, and stress symptoms.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".