BackgroundThe number of commercial apps to improve health behaviours in children is growing rapidly. While this provides opportunities for promoting health, the content and quality of apps targeting children and adolescents is largely unexplored. This review systematically evaluated the content and quality of apps to improve diet, physical activity and sedentary behaviour in children and adolescents, and examined relationships of app quality ratings with number of app features and behaviour change techniques (BCTs) used.MethodsSystematic literature searches were conducted in iTunes and Google Play stores between May–November 2016. Apps were included if they targeted children or adolescents, focused on improving diet, physical activity and/or sedentary behaviour, had a user rating of at least 4+ based on at least 20 ratings, and were available in English. App inclusion, downloading and user-testing for quality assessment and content analysis were conducted independently by two reviewers. Spearman correlations were used to examine relationships between app quality, and number of technical app features and BCTs included.ResultsTwenty-five apps were included targeting diet (n = 12), physical activity (n = 18) and sedentary behaviour (n = 7). On a 5-point Mobile App Rating Scale (MARS), overall app quality was moderate (total MARS score: 3.6). Functionality was the highest scoring domain (mean: 4.1, SD: 0.6), followed by aesthetics (mean: 3.8, SD: 0.8), and lower scoring for engagement (mean: 3.6, SD: 0.7) and information quality (mean: 2.8, SD: 0.8). On average, 6 BCTs were identified per app (range: 1–14); the most frequently used BCTs were providing ‘instructions’ (n = 19), ‘general encouragement’ (n = 18), ‘contingent rewards’ (n = 17), and ‘feedback on performance’ (n = 13). App quality ratings correlated positively with numbers of technical app features (rho = 0.42, p < 0.05) and BCTs included (rho = 0.54, p < 0.01).ConclusionsPopular commercial apps to improve diet, physical activity and sedentary behaviour in children and adolescents had moderate quality overall, scored higher in terms of functionality. Most apps incorporated some BCTs and higher quality apps included more app features and BCTs. Future app development should identify factors that promote users’ app engagement, be tailored to specific population groups, and be informed by health behaviour theories.Electronic supplementary materialThe online version of this article (doi:10.1186/s12966-017-0538-3) contains supplementary material, which is available to authorized users.

BackgroundWeb-based interventions that provide personalized physical activity advice have demonstrated good effectiveness but rely on self-reported measures of physical activity, which are prone to overreporting, potentially reducing the accuracy and effectiveness of the advice provided.ObjectiveThis study aimed to examine whether the effectiveness of a Web-based computer-tailored intervention could be improved by integrating Fitbit activity trackers.MethodsParticipants received the 3-month TaylorActive intervention, which included 8 modules of theory-based, personally tailored physical activity advice and action planning. Participants were randomized to receive the same intervention either with or without Fitbit tracker integration. All intervention materials were delivered on the Web, and there was no face-to-face contact at any time point. Changes in physical activity (Active Australia Survey), sitting time (Workforce Sitting Questionnaire), and body mass index (BMI) were assessed 1 and 3 months post baseline. Advice acceptability, website usability, and module completion were also assessed.ResultsA total of 243 Australian adults participated. Linear mixed model analyses showed a significant increase in total weekly physical activity (adjusted mean increase=163.2; 95% CI 52.0-274.5; P=.004) and moderate-to-vigorous physical activity (adjusted mean increase=78.6; 95% CI 24.4-131.9; P=.004) in the Fitbit group compared with the non-Fitbit group at the 3-month follow-up. The sitting time and BMI decreased more in the Fitbit group, but no significant group × time interaction effects were found. The physical activity advice acceptability and the website usability were consistently rated higher by participants in the Fitbit group. Non-Fitbit group participants completed 2.9 (SD 2.5) modules, and Fitbit group participants completed 4.4 (SD 3.1) modules.ConclusionsIntegrating physical activity trackers into a Web-based computer-tailored intervention significantly increased intervention effectiveness.Trial RegistrationAustralian New Zealand Clinical Trials Registry ACTRN12616001555448; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=371793 (Archived by WebCite at http://www.webcitation.org/73ioTxQX2)

The purpose of this article is to determine if telehealth-delivered speech-language pathology interventions are as effective as traditional in-person delivery for primary school-age children with speech and/or language difficulties. A systematic review was conducted (in accordance with PRISMA guidelines) using five databases, two journals and reference lists. Titles and abstracts were screened for inclusion, with relevant studies reviewed in full-text. Initial searches identified 132 articles. Following exclusion of non-relevant studies, seven articles remained for inclusion. Results revealed both telehealth and in-person participants made significant and similar improvements when treatment effects were measured through five of the six outcome measures. Findings showed there is limited but promising evidence to support telehealth for delivering speech-language pathology intervention services to school-age children. Whilst this is encouraging, particularly for rural children where in-person services are limited, more rigorous study designs are required to support the efficacy of telehealth for this population.

Question: For children with community-acquired pneumonia discharged from an emergency department, observational unit, or inpatient ward (within 48 hours), is subsequent outpatient treatment with oral amoxicillin at a dose of 35-50 mg/kg/day noninferior to 70-90 mg/kg/day, and for 3 days noninferior to 7 days, with regard to the need for antibiotic retreatment? Findings: In this 2x2 factorial randomized clinical trial of 814 children requiring amoxicillin for community-acquired pneumonia at hospital discharge, antibiotic retreatment within 28 days occurred in 12.6% vs 12.4% of those randomized to lower vs higher doses, respectively, and in 12.5% vs 12.5% of those randomized to 3-day vs 7-day amoxicillin duration. Both comparisons met the prespecified 8% noninferiority margin.Meaning: Among children with community-acquired pneumonia discharged from an emergency department, observational unit, or inpatient ward, further outpatient treatment with oral amoxicillin at a dose of 35-50 mg/kg/day was noninferior to a dose of 70-90 mg/kg/day and for 3 days was noninferior to 7 days with regard to the need for later antibiotic retreatment.

Objective: To identify subgroups of Australian adults likely to receive physical activity advice from their general practitioner and to evaluate the content of the advice provided.Methods: Participants (n=1,799), recruited from the Australian Health and Social Science panel, completed an online survey. Signal Detection Analysis was used to identify subgroups that were more/less likely to have received physical activity recommendations.Results: Overall, 18% of participants received a physical activity recommendation from their general practitioner in the past 12 months and eight unique subgroups were identified. The subgroup with the highest proportion (54%) of participants reporting that they received a physical activity recommendation was those with poor physical and mental health-related quality of life and an average daily sitting time of <11 hours. Other subgroups with high proportions of individuals receiving recommendations were characterised by higher weight and/or the presence of co-morbidities. The most commonly prescribed physical activity type was aerobic activity. Few participants received specific physical activity advice. Conclusions:General practitioners are incorporating physical activity promotion into their practice, but primarily as a disease management tool and with limited specificity.Implications: Strategies to assist Australian general practitioners to effectively promote physical activity are needed.