Ethical considerations for developing pediatric mhealth interventions for teens with socially complex needs

Area of Science:

• Digital Health
• Adolescent Medicine
• Bioethics

Background:

• Mobile Health (mHealth) offers potential for reaching teens with complex needs, including medical illness and adverse childhood experiences (ACEs).
• Ethical considerations are often overlooked in mHealth development, despite thousands of interventions existing.
• Clinicians face ethical dilemmas when designing mHealth tools for this vulnerable population.

Approach:

• Adapted the Four Box Model (medical indications, patient preferences, quality of life, contextual features) to guide mHealth developers.
• Reviewed language, inclusive features, data sharing, and usability within the ethical framework.
• Utilized potential scenarios to illustrate ethical considerations for each aspect.

Key Points:

• The Four Box Model provides a structured approach to ethical mHealth design for teens with medical diagnoses and ACEs.
• Specific attention is given to language, inclusivity, data privacy, and user-friendliness.
• The framework aids in evaluating mHealth applications for ethical alignment and clinical suitability.

Conclusions:

• A novel framework is presented to support ethical design of mHealth interventions for underserved pediatric patients.
• This approach facilitates the safe transition of mHealth tools from research to clinical practice.
• The adapted Four Box Model ensures that ethical standards are integrated early in the mHealth design phase.