{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T10:28:49Z","timestamp":1787048929380,"version":"build-2736575974"},"reference-count":58,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pediatric pulmonary hypertension (PH) requires complex, specialized home care. Digital health interventions offer scalable solutions to address healthcare disparities, improve educational access, and reduce health system burdens while empowering caregivers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This mini-review evaluates internet-based home care education for pediatric PH, focusing on public health implications, implementation strategies, and population-level outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a comprehensive narrative review of recent literature on internet-based education platforms and telehealth solutions for pediatric pulmonary hypertension, evaluating them through public health frameworks of accessibility, equity, and scalability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key findings<\/jats:title>\n                    <jats:p>Internet-based programs significantly improve medication adherence, complex skill acquisition (e.g., central line care), early symptom recognition, and caregiver self-efficacy. Effective platforms leverage multimodal learning, adaptive technologies, and interactive features. From a public health perspective, these interventions reduce preventable emergency department visits, lower long-term healthcare costs, and enhance quality of life. However, major barriers persist, including the digital divide, variable digital health literacy, and a lack of standardized content validation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Internet-based home care education is vital for pediatric PH management. Future efforts must prioritize standardized, evidence-based curricula, health equity across socioeconomic strata, digital health reimbursement policies, and integration into existing public health infrastructure to maximize population-level benefits.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1759723","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T10:01:10Z","timestamp":1787047270000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Internet-Based home care education for children with pulmonary hypertension: a public health perspective"],"prefix":"10.3389","volume":"14","author":[{"given":"Yan","family":"Li","sequence":"first","affiliation":[{"name":"Department of Cardiology, The Affiliated Children\u2019s Hospital of Xiangya School of Medicine, Central South University (Hunan Children\u2019s Hospital)","place":["Changsha, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Affiliated Children\u2019s Hospital of Xiangya School of Medicine, Central South University (Hunan Children\u2019s Hospital)","place":["Changsha, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Affiliated Children\u2019s Hospital of Xiangya School of Medicine, Central South University (Hunan Children\u2019s Hospital)","place":["Changsha, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanhong","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Affiliated Children\u2019s Hospital of Xiangya School of Medicine, Central South University (Hunan Children\u2019s Hospital)","place":["Changsha, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingqing","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Affiliated Children\u2019s Hospital of Xiangya School of Medicine, Central South University (Hunan Children\u2019s Hospital)","place":["Changsha, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,18]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"580","DOI":"10.1183\/09031936.00065713","article-title":"Registries for paediatric pulmonary hypertension","volume":"42","author":"Hansmann","year":"2013","journal-title":"Eur Respir J"},{"key":"B2","doi-asserted-by":"publisher","first-page":"901","DOI":"10.1016\/j.clinthera.2023.07.001","article-title":"Recent advances in pediatric pulmonary hypertension: implications for diagnosis and treatment","volume":"45","author":"Sullivan","year":"2023","journal-title":"Clin Ther"},{"key":"B3","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1097\/HCO.0000000000000822","article-title":"Update on pediatric pulmonary arterial hypertension","volume":"36","author":"Ivy","year":"2021","journal-title":"Curr Opin Cardiol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1186\/s12887-023-03860-2","article-title":"Quantifying side effects and caregiver burdens of pediatric pulmonary hypertension therapies","volume":"23","author":"Nelson","year":"2023","journal-title":"BMC Pediatr"},{"key":"B5","doi-asserted-by":"publisher","first-page":"2037","DOI":"10.1161\/CIR.0000000000000329","article-title":"Pediatric pulmonary hypertension: guidelines from the American Heart Association and American thoracic society","volume":"132","author":"Abman","year":"2015","journal-title":"Circulation"},{"key":"B6","doi-asserted-by":"publisher","first-page":"100045","DOI":"10.1016\/j.ympdx.2020.100045","article-title":"In pursuit of health equity in pediatrics","volume":"5","author":"Montoya-Williams","year":"2020","journal-title":"J Pediatr X"},{"key":"B7","doi-asserted-by":"publisher","first-page":"e20049","DOI":"10.2196\/20049","article-title":"Digital approaches to remote pediatric health care delivery during the COVID-19 pandemic: existing evidence and a call for further research","volume":"3","author":"Badawy","year":"2020","journal-title":"JMIR Pediatr Parent"},{"key":"B8","doi-asserted-by":"publisher","first-page":"3415","DOI":"10.2147\/JMDH.S440082","article-title":"The efficacy of internet-based interventions in family-centered empowerment among children with chronic diseases: a mixed-methods systematic review","volume":"16","author":"Mulyana","year":"2023","journal-title":"J Multidiscip Healthc"},{"key":"B9","first-page":"01","article-title":"Revolutionizing pediatric medicine: the transformative influence of artificial intelligence","volume":"12","author":"Sanchez Salguero","year":"2023","journal-title":"EC Paediatrics"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1527281","DOI":"10.3389\/fped.2025.1527281","article-title":"Burden of pulmonary arterial hypertension in children globally, regionally, and nationally (1990\u20132021): results from the global burden of disease study","volume":"13","author":"Deng","year":"2025","journal-title":"Front Pediatr"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1251","DOI":"10.2217\/cer-2021-0128","article-title":"Healthcare resource utilization and costs in pediatric pulmonary arterial hypertension in a third-level hospital in Mexico","volume":"10","author":"Garc\u00eda-Aguilar","year":"2021","journal-title":"J Comp Eff Res"},{"key":"B12","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1542\/peds.2014-3834","article-title":"Trends in hospitalization for pediatric pulmonary hypertension","volume":"136","author":"Maxwell","year":"2015","journal-title":"Pediatrics"},{"key":"B13","doi-asserted-by":"publisher","first-page":"1312","DOI":"10.1093\/eurheartj\/ehad005","article-title":"Corrigendum to: 2022 ESC\/ERS guidelines for the diagnosis and treatment of pulmonary hypertension: developed by the task force for the diagnosis and treatment of pulmonary hypertension of the European Society of Cardiology (ESC) and the European respiratory society (ERS). endorsed by the international society for heart and lung transplantation (ISHLT) and the European reference network on rare respiratory diseases (ERN-LUNG)","volume":"44","year":"2023","journal-title":"Eur Heart J"},{"key":"B14","doi-asserted-by":"publisher","first-page":"101623","DOI":"10.1016\/j.cpcardiol.2023.101623","article-title":"Urban-Rural disparities in pulmonary hypertension-related mortality between 2004 and 2019: a call to improve access to specialty care centers for rural residents in the United States","volume":"48","author":"Issa","year":"2023","journal-title":"Curr Probl Cardiol"},{"key":"B15","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1186\/s12887-015-0412-x","article-title":"Parent\/caregiver health literacy among children with special health care needs: a systematic review of the literature","volume":"15","author":"Keim-Malpass","year":"2015","journal-title":"BMC Pediatr"},{"key":"B16","doi-asserted-by":"publisher","first-page":"386","DOI":"10.12965\/jer.1632708.354","article-title":"Caregiver\u2019s burden in pulmonary arterial hypertension: a clinical review","volume":"12","author":"Verma","year":"2016","journal-title":"J Exerc Rehabil"},{"key":"B17","doi-asserted-by":"publisher","first-page":"e145","DOI":"10.1542\/peds.2010-2105","article-title":"Low-dose, high-frequency CPR training improves skill retention of in-hospital pediatric providers","volume":"128","author":"Sutton","year":"2011","journal-title":"Pediatrics"},{"key":"B18","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1016\/j.jpeds.2019.04.046","article-title":"Racial and ethnic differences in pediatric pulmonary hypertension: an analysis of the pediatric pulmonary hypertension network registry","volume":"211","author":"Ong","year":"2019","journal-title":"J Pediatr"},{"key":"B19","doi-asserted-by":"publisher","first-page":"418","DOI":"10.1177\/003335490512000409","article-title":"Limited English proficiency, primary language at home, and disparities in children\u2019s health care: how language barriers are measured matters","volume":"120","author":"Flores","year":"2005","journal-title":"Public Health Rep"},{"key":"B20","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1089\/15305620260353171","article-title":"Cost effectiveness of telemedicine for the delivery of outpatient pulmonary care to a rural population","volume":"8","author":"Agha","year":"2002","journal-title":"Telemed J E Health"},{"key":"B21","first-page":"10","article-title":"Cultural sensitivity in public health: defined and demystified","volume":"9","author":"Resnicow","year":"1999","journal-title":"Ethn Dis"},{"key":"B22","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1542\/peds.113.1.1","article-title":"Using telemedicine to provide pediatric subspecialty care to children with special health care needs in an underserved rural community","volume":"113","author":"Marcin","year":"2004","journal-title":"Pediatrics"},{"key":"B23","doi-asserted-by":"publisher","first-page":"e0212163","DOI":"10.1371\/journal.pone.0212163","article-title":"Patterns of internet and smartphone use by parents of children with chronic kidney disease","volume":"14","author":"Garrido","year":"2019","journal-title":"PLoS One"},{"key":"B24","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1089\/tmj.2020.0562","article-title":"Rapid rise of pediatric telehealth during COVID-19 in a large multispecialty health system","volume":"28","author":"Howie","year":"2021","journal-title":"Telemed J E Health"},{"key":"B25","doi-asserted-by":"publisher","first-page":"e12814","DOI":"10.1002\/emp2.12814","article-title":"Pediatric health care use during the COVID-19 pandemic: lessons learned from the initial 2020 wave","volume":"3","author":"Wagh","year":"2022","journal-title":"J Am Coll Emerg Physicians Open"},{"key":"B26","doi-asserted-by":"publisher","first-page":"1273","DOI":"10.1542\/peds.2004-0335","article-title":"Telemedicine reduces absence resulting from illness in urban child care: evaluation of an innovation","volume":"115","author":"McConnochie","year":"2005","journal-title":"Pediatrics"},{"key":"B27","doi-asserted-by":"publisher","first-page":"e093798","DOI":"10.1136\/bmjopen-2024-093798","article-title":"Effect of a structured educational intervention delivered through a mobile application on glycated haemoglobin and self-efficacy in adolescents with type 1 diabetes mellitus: a systematic review and meta-analysis","volume":"15","author":"Rubab","year":"2025","journal-title":"BMJ Open"},{"key":"B28","doi-asserted-by":"publisher","first-page":"212","DOI":"10.1111\/cea.13793","article-title":"Digital health interventions in children with asthma","volume":"51","author":"Ferrante","year":"2020","journal-title":"Clin Exp Allergy"},{"key":"B29","doi-asserted-by":"publisher","first-page":"e27999","DOI":"10.2196\/27999","article-title":"Digital technologies for monitoring and improving treatment adherence in children and adolescents with asthma: scoping review of randomized controlled trials","volume":"4","author":"Milne-Ives","year":"2021","journal-title":"JMIR Pediatr Parent"},{"key":"B30","doi-asserted-by":"publisher","first-page":"1203","DOI":"10.3390\/children8121203","article-title":"Digital technologies for children and parents sharing self-management in childhood chronic or long-term conditions: a scoping review","volume":"8","author":"Edwards","year":"2021","journal-title":"Children (Basel)"},{"key":"B31","doi-asserted-by":"publisher","first-page":"1906","DOI":"10.1186\/s12889-024-19333-9","article-title":"Public health education using social learning theory: a systematic scoping review","volume":"24","author":"Liu","year":"2024","journal-title":"BMC Public Health"},{"key":"B32","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1097\/PCC.0000000000000051","article-title":"The development of an internet-based knowledge exchange platform for pediatric critical care clinicians worldwide*","volume":"15","author":"Wolbrink","year":"2014","journal-title":"Pediatr Crit Care Med"},{"key":"B33","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1016\/j.ppedcard.2009.09.002","article-title":"Towards improving the care of children with pulmonary hypertension: the rationale for developing a pediatric pulmonary hypertension network","volume":"27","author":"Abman","year":"2009","journal-title":"Prog Pediatr Cardiol"},{"key":"B34","doi-asserted-by":"publisher","first-page":"240006","DOI":"10.1183\/16000617.0006-2024","article-title":"Medication adherence, related factors and outcomes among patients with pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension: a systematic review","volume":"33","author":"Le Bozec","year":"2024","journal-title":"Eur Respir Rev"},{"key":"B35","doi-asserted-by":"publisher","first-page":"e12402","DOI":"10.1002\/pul2.12402","article-title":"Creating a digital approach for promoting physical activity in pediatric pulmonary hypertension: a framework for future interventions","volume":"14","author":"Avitabile","year":"2024","journal-title":"Pulm Circ"},{"key":"B36","doi-asserted-by":"publisher","first-page":"627","DOI":"10.1055\/s-0033-1356461","article-title":"Current challenges in pediatric pulmonary hypertension","volume":"34","author":"Takatsuki","year":"2013","journal-title":"Semin Respir Crit Care Med"},{"key":"B37","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1016\/j.rec.2016.01.002","article-title":"2015 ESC\/ERS guidelines for the diagnosis and treatment of pulmonary hypertension","volume":"69","author":"Gali\u00e8","year":"2016","journal-title":"Rev Esp Cardiol (Engl Ed)"},{"key":"B38","doi-asserted-by":"publisher","first-page":"e12031","DOI":"10.1002\/pul2.12031","article-title":"Building a dedicated pediatric pulmonary hypertension program: a consensus statement from the pediatric pulmonary hypertension network","volume":"12","author":"Handler","year":"2022","journal-title":"Pulm Circ"},{"key":"B39","doi-asserted-by":"publisher","first-page":"497","DOI":"10.1177\/1203475417715208","article-title":"Using visual aids to enhance physician-patient discussions and increase health literacy","volume":"21","author":"Pratt","year":"2017","journal-title":"J Cutan Med Surg"},{"key":"B40","doi-asserted-by":"publisher","first-page":"e182","DOI":"10.1097\/PG9.0000000000000182","article-title":"Telehealth for pediatric gastroenterology care now: the transition to telehealth and the impact of webinar-based didactics","volume":"3","author":"Setty","year":"2022","journal-title":"JPGN Rep"},{"key":"B41","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1097\/01.NPR.0000681796.57869.a0","article-title":"Family-centered care for children with medical complexity: a goal-planning initiative","volume":"45","author":"Lindstrom","year":"2020","journal-title":"Nurse Pract"},{"key":"B42","doi-asserted-by":"publisher","first-page":"e64814","DOI":"10.2196\/64814","article-title":"Exploring health educational interventions for children with congenital heart disease: scoping review","volume":"8","author":"Barbazi","year":"2025","journal-title":"JMIR Pediatr Parent"},{"key":"B43","doi-asserted-by":"publisher","first-page":"1801","DOI":"10.1017\/S104795112100500X","article-title":"Condition notification assisted by virtual reality technology reduces the anxiety levels of parents of children with simple CHD: a prospective randomised controlled study","volume":"32","author":"Wang","year":"2022","journal-title":"Cardiol Young"},{"key":"B44","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1164\/rccm.201207-1290OC","article-title":"Lower socioeconomic status is associated with worse outcomes in pulmonary arterial hypertension","volume":"187","author":"Wu","year":"2012","journal-title":"Am J Respir Crit Care Med"},{"key":"B45","doi-asserted-by":"publisher","first-page":"e69304","DOI":"10.2196\/69304","article-title":"Measuring reliable internet connectivity among families with children: secondary analysis of a US national survey","volume":"27","author":"Doan","year":"2025","journal-title":"J Med Internet Res"},{"key":"B46","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1038\/s41746-022-00663-0","article-title":"A framework for digital health equity","volume":"5","author":"Richardson","year":"2022","journal-title":"NPJ Digit Med"},{"key":"B47","doi-asserted-by":"publisher","first-page":"e032415","DOI":"10.1161\/JAHA.123.032415","article-title":"Addressing disparities in pediatric congenital heart disease: a call for equitable health care","volume":"13","author":"Chowdhury","year":"2024","journal-title":"J Am Heart Assoc"},{"key":"B48","doi-asserted-by":"publisher","first-page":"266","DOI":"10.1080\/23294515.2017.1403980","article-title":"Ethical and regulatory challenges of research using pervasive sensing and other emerging technologies: iRB perspectives","volume":"8","author":"Nebeker","year":"2017","journal-title":"AJOB Empir Bioeth"},{"key":"B49","doi-asserted-by":"publisher","first-page":"1679","DOI":"10.1056\/NEJMp2003539","article-title":"Virtually perfect? Telemedicine for COVID-19","volume":"382","author":"Hollander","year":"2020","journal-title":"N Engl J Med"},{"key":"B50","doi-asserted-by":"publisher","first-page":"e49003","DOI":"10.2196\/49003","article-title":"Digital health reimbursement strategies of 8 European countries and Israel: scoping review and policy mapping","volume":"11","author":"van Kessel","year":"2023","journal-title":"JMIR Mhealth Uhealth"},{"key":"B51","doi-asserted-by":"publisher","first-page":"e100176","DOI":"10.1136\/bmjhci-2020-100176","article-title":"Use of eHealth in the management of pulmonary arterial hypertension: review of the literature","volume":"27","author":"Gonzalez-Garcia","year":"2020","journal-title":"BMJ Health Care Inform"},{"key":"B52","doi-asserted-by":"publisher","first-page":"17","DOI":"10.33546\/bnj.2350","article-title":"Patient and family-centered care for children: a concept analysis","volume":"9","author":"Seniwati","year":"2023","journal-title":"Belitung Nurs J"},{"key":"B53","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1097\/JCN.0000000000000466","article-title":"Quality of life for parents of children with congenital heart defect: a systematic review","volume":"33","author":"Gregory","year":"2018","journal-title":"J Cardiovasc Nurs"},{"key":"B54","doi-asserted-by":"publisher","first-page":"e776","DOI":"10.1016\/j.jpainsymman.2024.02.443","article-title":"Effect of medication information delivery format on cognitive load and knowledge retention of informal caregivers (RP209)","volume":"67","author":"McPherson","year":"2024","journal-title":"J Pain Symptom Manage"},{"key":"B55","doi-asserted-by":"publisher","first-page":"e70072","DOI":"10.1002\/pul2.70072","article-title":"Hank the heart and animation-based education for pulmonary hypertension","volume":"15","author":"Cash","year":"2025","journal-title":"Pulm Circ"},{"key":"B56","doi-asserted-by":"publisher","first-page":"e648","DOI":"10.1161\/CIR.0000000000000478","article-title":"Telemedicine in pediatric cardiology: a scientific statement from the American Heart Association","volume":"135","author":"Satou","year":"2017","journal-title":"Circulation"},{"key":"B57","doi-asserted-by":"publisher","first-page":"e21726","DOI":"10.2196\/21726","article-title":"Addressing the digital inverse care law in the time of COVID-19: potential for digital technology to exacerbate or mitigate health inequalities","volume":"23","author":"Davies","year":"2021","journal-title":"J Med Internet Res"},{"key":"B58","doi-asserted-by":"publisher","first-page":"e56512","DOI":"10.7759\/cureus.56512","article-title":"The impact of integrated patient education on short-term revisit rates in healthcare settings: a quality improvement project","volume":"16","author":"Alqallaf","year":"2024","journal-title":"Cureus"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2026.1759723\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T10:01:11Z","timestamp":1787047271000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2026.1759723\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,18]]},"references-count":58,"alternative-id":["10.3389\/fped.2026.1759723"],"URL":"https:\/\/doi.org\/10.3389\/fped.2026.1759723","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,18]]},"article-number":"1759723"}}