{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,5]],"date-time":"2026-07-05T15:15:14Z","timestamp":1783264514870,"version":"3.54.6"},"reference-count":46,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Expectations"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Parents of children with chronic diseases in rural Iran experience profound challenges, including limited access to pediatric specialists, social isolation, and severe financial strain. Concurrently, healthcare providers face workforce shortages, administrative burdens, and fragmented referral systems. This study aimed to explore unmet care needs and comparative perspectives of parents and providers regarding the integration of artificial intelligence to strengthen chronic disease management in resource\u2010limited rural settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using a qualitative descriptive design, we conducted semi\u2010structured interviews with 20 parents of children with chronic illnesses and 15 healthcare providers (physicians, nurses, and community health workers) from rural health centres in Iran. Participants were selected through purposive sampling based on direct experience with pediatric chronic disease management in villages (&lt;\u200920,000 population). Data were analysed using conventional content analysis with iterative coding to derive emergent themes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Five key themes emerged: (1) Unmet daily care needs including geographic barriers to specialists, maternal emotional isolation, and catastrophic out\u2010of\u2010pocket expenses; (2) Systemic constraints faced by providers, notably administrative overload (\u201cpajama time\u201d), critical workforce shortages, and inefficient referral pathways; (3) AI as a potential bridge through symptom prediction models for early intervention, chatbots for emergency guidance, and AI\u2010enabled teleconsultations to reduce unnecessary travel; (4) Divergent trust narratives parents expressed skepticism about autonomous AI decision\u2010making while providers raised concerns about data privacy, workload implications, and erosion of clinical authority; and (5) Integration pathways emphasising AI embedded within the existing Behvarz (community health worker) network, mandatory digital literacy training, and co\u2010designed platforms incorporating local cultural beliefs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>AI technologies show promise for augmenting, though not replacing, human\u2010centred care in rural pediatric chronic disease management. Successful implementation requires culturally resonant, transparent tools developed through participatory design with families and providers, robust data governance, and strategic alignment with Iran's primary healthcare infrastructure. This context\u2010sensitive framework prioritises equity, trust\u2010building, and caregiver empowerment while acknowledging the irreplaceable role of human empathy in chronic care delivery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient or Public Contribution<\/jats:title>\n                    <jats:p>\n                      Parents of children with chronic illnesses and healthcare providers were central to this research as knowledge partners rather than passive subjects. Twenty parents with lived experience of caring for a child with chronic disease in rural settings, alongside 15 frontline healthcare providers, actively shaped the study through in\u2010depth sharing of their experiences during semi\u2010structured interviews. Their narratives directly informed all emergent themes and the resulting conceptual framework. To ensure interpretive validity, we conducted member checking with a purposive subset of participants (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20098 parents and\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20096 providers) who reviewed preliminary findings and provided feedback on whether the themes accurately reflected their realities and concerns. This iterative validation process strengthened the trustworthiness of our analysis and ensured that the final framework resonated with the everyday challenges and aspirations of rural families and providers. While participants were not involved in the initial study design or manuscript drafting due to the exploratory nature of this qualitative investigation, their experiential expertise fundamentally shaped the research outcomes and recommendations for culturally grounded AI integration. Their contributions transformed abstract technological possibilities into contextually meaningful pathways for supporting rural pediatric chronic disease management.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hex.70705","type":"journal-article","created":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T08:24:50Z","timestamp":1780475090000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Between Hope and Skepticism: Parent and Provider Expectations of Artificial Intelligence as a Bridge to Human\u2010Centered Care for Children With Chronic Illness"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4204-5480","authenticated-orcid":false,"given":"Atefeh","family":"Shamsi","sequence":"first","affiliation":[{"name":"Nursing Care Research Center, Clinical Sciences Institute, Faculty of Nursing, Baqiyatallah University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahboobeh","family":"Namnabati","sequence":"additional","affiliation":[{"name":"Nursing and Midwifery Care Research Center, Isfahan University of Medical Sciences Isfahan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asghar","family":"Ehteshami","sequence":"additional","affiliation":[{"name":"Health Information Technology Research Center, Isfahan University of Medical Sciences Isfahan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamed","family":"Zandi Esfahani","sequence":"additional","affiliation":[{"name":"Department of Pediatrics School of Medicine, Emam Hossein Hospital Research Center, Isfahan University of Medical Sciences Isfahan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,3]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1814259"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/svn-2017-000101"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.7861\/futurehosp.6-2-94"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.2196\/49788"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41746-022-00700-y"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.techsoc.2023.102443"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/1460458219874641"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2589-7500(21)00132-1"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.2307\/249008"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.2307\/30036540"},{"key":"e_1_2_14_12_1","volume-title":"Diffusion of Innovations","author":"Rogers E. 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