P-300: Family-centered, community-based healthcare for pediatric type1 diabetes, asthma and juvenile idiopathic arthritis - a scoping review
S S Nielsen, A Bricca, S Orologas, A -M M Schoos, A -H Bohr, K L Østergaard, J Mondahl, S Gram, D Grabowski, T P Rasmussen, F D Bilgin, C Simonÿ, A Luijk, L N Remmen, H Hallas, M T Mittet, L Jensen, J R ChristensenAbstract
Introduction
Family-centered, community-based interventions are key for supporting children and adolescents with chronic illness, yet these interventions have not been systematically mapped.
Objectives
To map the participants, interventions, comparators, and outcome characteristics of community-based, family-centered healthcare interventions for children and youth with asthma, type 1 diabetes, or juvenile idiopathic arthritis.
Methods
Following Arksey and O’Malley’s framework, we searched databases MEDLINE, EMBASE, PsycINFO, Cochrane Library, and CINAHL, supplemented by grey literature and citation tracking for eligible publications on randomized controlled trials (RCTs) of target interventions. Two reviewers independently screened studies, extracted data, assessed quality with the Cochrane risk-of-bias tools, and mapped the findings.
Results
Seventy-two RCTs (76 papers) from 1985–2025 involving 16,441 children, median age 9 (0-19) years, mostly addressed asthma (69%), followed by type 1 diabetes (28%) and juvenile idiopathic arthritis (3%). Interventions were primarily multicomponent (99 %), combining education in illness management (90%), psychotherapy or behavioral therapy (53%), and care coordination (53%); usually delivered by healthcare or other professionals in home or community settings; and lasted for six months or less. Comparators were usual care (50%), other interventions (36%), waiting list (13%) and within-subject controls (1%). Common outcomes included symptom days, clinical indicators, self-management, healthcare use, activity participation, and psychosocial functioning. The overall methodological quality was average-to-low.
Conclusions
Most RCTs targeted asthma, with notable gaps for type 1 diabetes and juvenile idiopathic arthritis. Activity participation outcomes were often measured but rarely were a primary intervention target. Evidence gaps identified were condition-diverse coverage, explicit focus on activity participation, and a greater involvement of non-medical providers, lay workers, or peers.