Telehealth Interventions Aimed at Parents and Caregivers of Children Living in Rural Settings: A Systematic Review

Figures & data

Figure 1. Flow diagram PRISMA.

Figure 2. Quality evaluation.

Table 1. General characteristics and population of the studies.

REFERENCE	Country and geographic location	Population details
Kelso et al. (2009)	United States of America. Four families from a remote area of a large western state were selected through responses to a flyer announcing the field test of VHVs	Each family had at least 1 child younger than 3 years who currently received services through part C early intervention services. Two families received speech and language therapy via VHVs. Another participated in occupational therapy and the fourth in physical therapy
Heitzman-Powell et al. (2014)	United States of America. Seven Families were recruited through existing service	Parents from four families participated in this evaluation of the OASIS Training Program
Ingersoll and Berger (2015)	United States of America. 27 parents. Recruitment focused on underserved communities by residence in a rural area	Parents of a child with autism spectrum disorders (ASD) between the ages of 27 and 73 months
Ashburner et al. (2016)	Australia. Queensland. Four parents of children with autism spectrum disorders (ASD) from rural and remote locations	Four mothers who had participated in a week-long face-to-face early intervention program delivered by an ASD-specialist in their local area in the past 18 months were invited to participate in a week-long follow-up program delivered via remote technologies
Guðmundsdóttir et al. (2017)	Iceland. Family criteria included living in a rural location 35–165 km distance from the trainer’s location. Three caregivers of children with autism. Two families and one special education teacher	The families were selected in collaboration with the State Diagnostic and Counseling Center in Iceland according to predetermined selection criteria
Guðmundsdóttir et al. (2019)	Iceland. Three families. Criteria also included living in a rural location at 35–165 km and 259–311 km from the trainer’s location	The families were selected in collaboration with the State Diagnostic and Counseling Center according to predetermined selection criteria regarding age (3–6 years), diagnosis, and geographic location of the family
Hines et al. (2019)	Australia. Four mothers and one teacher. Rural and remote	Participants were four children aged between 5 and 8 years, their mothers, and one child’s teacher. Participants lived in inner regional, remote or very remote Australia
Kohlhoff et al. (2019)	Australia. Two families living in a rural context	Two case studies are reported of families living in rural Australia. Each family has a child aged 2–3 years with disruptive behaviors
Kohlhoff et al. (2020)	Australia. Ten parents lived in a regional, rural or remote area of the Australian state of New South Wales (NSW)	Parents (n = 10) with a child aged 2–4 years referred to a community-based child behavior treatment clinic located in south-western Sydney

Table 2. Main interventions, means and results.

Reference	Intervention	Main results
Kelso et al. (2009)	Therapy sessions were scheduled by the interventionists and were conducted over the desktop Web conferencing system. Each interventionist was in an office at the central early intervention program location	Parents liked that sessions were recorded and could be watched again later and that visits could occur even when traditional visits were not possible, such as when the child was ill, or weather prevented travel
Heitzman-Powell et al. (2014)	The OASIS modules covered general information about autism, basic ABA principles and procedures, how to use ABA procedures to teach new skills, reduce challenging behavior, generalize skills to other settings, how to collect and analyze data for data-based intervention decision making, and how to work with treatment teams and other providers	The Parents Improve Their Implementation of ABA Procedures: across all parents, the mean pretest performance was 30.6% (range = 14%–46%), and the mean posttest performance was 71.8% (range = 51%–83%). The mean pre- to posttest skill gain across all parents was 41.23 percentage points (range = 28%–59%)
Ingersoll and Berger (2015)	Self-Directed Group: Access to the secure, password-protected ImPACT Online website for up to 6 months. Therapist-Assisted Group: Access to the ImPACT Online website and were encouraged to work through the program at the same pace as the self-directed group	Participants in the therapist-assisted group were more likely to engage with the website than those in the self-directed group: F 2,24 = 17.65, P < .001. In total, 85% of participants completed the program, with a significantly greater completion rate in the therapist-assisted group (N = 27): χ^2 1 = 5.06, P = .03
Ashburner et al. (2016)	Programs (a) similar structure with five daily sessions of 1.5 h duration (Four working with the families only, and one for a team discussion); (b) the same number and discipline of local service providers; and (c) similar interventions targeting the same skill areas for each child	The qualitative content analysis revealed five themes: (a) upskilling of parents and local service providers; (b) reducing cost, time and travel; (c) flexible, regular, ongoing support; (d) enabling families to access support from home, and (e) enhancing connections between team members
Guðmundsdóttir et al. (2017)	The intervention involved teaching caregivers methods to increase children’s socio communicative behavior. Training consisted of a package of behavior intervention procedures based on the Sunny Starts program	The results from the two families show that teaching caregivers via telecommunication, following in situ training, was effective in increasing their skills
Guðmundsdóttir et al. (2019)	The methods taught to the parent in Sunny Starts and in this study are represented by the acronym and mnemonic Teaching “DANCE” (D—decide, A—arrange, N—now, C—count and contemplate, E—enjoy) which describes teaching strategies based on naturalistic behavioral intervention procedures	The results from the three families show that teaching parents via brief in situ training and ongoing telecommunication training increased their skills and had a positive effect on the children's skills, especially social attending
Hines et al. (2019)	Relationship-based, person-centered approaches employing collaborative coaching techniques that developed parents’ and teachers’ capacities to meet children’s learning and support needs (Early Childhood Intervention Australia 2016)	Parents and teachers were unanimous that effective therapeutic relationships with children had developed. Two parents noted that their children were more readily engaged because they were in a comfortable, familiar environment
Kohlhoff et al. (2019)	The first phase of the PCIT program, CDI, aims to improve the quality of the parent–child relationship and provide the parent with skills to manage non-dangerous but undesirable child behaviors. PDI program, which aims to improve child compliance	Case 1 and Case 2 over the course of the IPCIT program improved child behavior, increased parenting confidence and a closer, warmer parent–child relationship
Kohlhoff et al. (2020)	The recommended standard of care for childhood with disruptive behavior disorders is parent-training based behavior therapy, of which parent–child interaction therapy (PCIT) has been identified as one of the most effective programs	Pre-treatment results suggested that parents’ primary motivations for seeking treatment were behavior of the target child and the negative impacts on other members of the family. Post-treatment results indicated that parents experienced positive outcomes and numerous benefits from the I-PCIT program

Table

Electronic search report No. 1
Database	Ovid MEDLINE(R) and Epub Ahead of Print, In-Process & Other Non-Indexed Citations, Daily and Versions(R)
Platform	Ovid
Search date	10-01-2020
Search date range	January 2000—December 2020
Language restrictions	English
Search strategy	1. exp Parents/ (116162) 2. exp Fathers/ (9331) 3. exp Mothers/ (45042) 4. exp Caregivers/ (38219) 5. Carers.mp. (13062) 6. Family Caregivers.mp. (7192) 7. 1 or 2 or 3 or 4 or 5 or 6 (161345) 8. exp Child/ (1937985) 9. Children.mp. (1068978) 10. exp Child, Preschool/ (930486) 11. 8 or 9 or 10 (2245719) 12. 7 and 11 (78512) 13. exp Telemedicine/ (31832) 14. Telehealth.mp. (6403) 15. eHealth.mp. (4433) 16. exp Telerehabilitation/ (451) 17. Telecare.mp. (781) 18. Teletherapy.mp. (5751) 19. Telepractice.mp. (140) 20. Remote consultation.mp. (5033) 21. 13 or 14 or 15 or 16 or 17 or 18 or 19 or 20 (43109) 22. exp Rural Population/ (61004) 23. Rural Spatial Distribution.mp. (125) 24. Rural Communit*.mp. (12172) 25. exp Rural Health Services/ (13087) 26. exp Rural Health/ (23512) 27. rural.mp. (172488) 28. 22 or 23 or 24 or 25 or 26 or 27 (172488) 29. 21 and 28 (3354) 30. 12 and 29 (51) 33. limit 30 to yr="2000 – 2020” (50)
Results	50

Table

Electronic search report No. 2
Database	EMBASE
Platform	EMBASE
Search date	10-01-2020
Search date range	January 2000—December 2020
Language restrictions	English
Search strategy	1. ‘parent’/exp (251239) 2. ‘father’/exp (29778) 3. ‘mother’/exp (148024) 4. ‘caregiver’/exp (85586) 5. #1 OR #2 OR #3 OR #4 (329934) 6. ‘child’/exp (2965692) 7. ‘preschool child’/exp (635927) 8. #6 OR #7 (2965692) 9. #5 AND #8 (161217) 10. ‘telemedicine’/exp (45566) 11. ‘telehealth’/exp (52783) 12. ‘ehealth’/exp (52783) 13. ‘telerehabilitation’/exp (1049) 14. ‘telecare’/exp (33) 15. ‘teletherapy’/exp (701) 16. ‘telepractice’/exp (11) 17. ‘remote consultation’/exp (10663) 18. #10 OR #11 OR #12 OR #13 OR #14 OR #15 OR #16 OR #17 (52800) 19. ‘rural population’/exp (49266) 20. ‘rural spatial distribution’/exp (88) 21. ‘rural community’/exp (49266) 22. ‘rural health care’/exp (13777) 23. ‘rural health’/exp (1313) 24. ‘rural area’/exp (55857) 25. #19 OR #20 OR #21 OR #22 OR #23 OR #24 (114485) 26. #18 AND #25 (2530) 27. #9 AND #26 (38) 28. #9 AND #26 AND [2000-2020]/py (38)
Results	38

Table

Electronic search report No. 3
Database	SCOPUS
Platform	SCOPUS
Search date	10-01-2020
Search date range	January 2000—December 2020
Language restrictions	English
Search strategy	(((“Parent*” OR “Father*” OR “Mother*” OR “Caregiver*” OR “carer*” OR “Family Caregiver*”) AND (“Child*” OR “Children” OR “Child, Preschool”)) AND ((“Telemedicine” OR “Telehealth” OR “eHealth” OR “Telerehabilitation” OR “Remote Consultation” OR “Telecare” OR “Teletherapy” OR “Telepractice”) AND (“Rural Population” OR “Rural Spatial Distribution” OR “Rural Community” OR “Rural Health Services” OR “Rural Health” OR “rural”))) AND(PUBYEAR >2000 AND PUBYEAR <2020)
Results	155

Table

Electronic search report No. 4
Database	APA—PSYCNET
Platform	APA—PSYCNET
Search date	10-01-2020
Search date range	January 2000—December 2020
Language restrictions	English
Search strategy	Any Field: (((“Parent*” OR “Father*” OR “Mother*” OR “Caregiver*” OR “carer*” OR “Family Caregiver*”) AND (“Child*” OR “Children” OR “Child, Preschool”)) AND ((“Telemedicine” OR “Telehealth” OR “eHealth” OR “Telerehabilitation” OR “Remote Consultation” OR “Telecare” OR “Teletherapy” OR “Telepractice”) AND (“Rural Population” OR “Rural Spatial Distribution” OR “Rural Community” OR “Rural Health Services” OR “Rural Health” OR “rural”))) AND Year: 2000–2020
Results	86

Table

Electronic search report No. 5
Database	LILACS
Platform	LILACS advanced platform (iAH)
Search date	10-01-2020
Search date range	January 2000—December 2020
Language restrictions	English
Search strategy	(tw:((tw:((tw:((“Parent*” OR “Father*” OR “Mother*” OR “carer*” OR “caregiver*” OR “Family Caregiver*”))))) AND (tw:((tw:((“Child*” OR “Children” OR “Child, Preschool”))))))) AND (tw:((tw:((tw:((“Telemedicine” OR “Telehealth” OR “eHealth” OR “Telerehabilitation” OR “Remote Consultation” OR “Telecare” OR “Teletherapy” OR “Telepractice”))))) AND (tw:((tw:((“Rural Population” OR “Rural Spatial Distribution” OR “Rural Community” OR “Rural Health Services” OR “Rural Health Center” OR “Rural Health” OR “rural”))))))) AND (year_cluster:[2000–2020])
Results	88

Table

Electronic search report No. 6
Database	Web of Science
Platform	Web of Science [V.5.35] (SCI-EXPANDED, SSCI, A & HCI, ESCI)
Search date	10-01-2020
Search date range	January 2000—December 2020
Language restrictions	English
Search strategy	ALL = (((“Parent*” OR “Father*” OR “Mother*” OR “Caregiver*” OR “carer*” OR “Family Caregiver*”) AND (“Child*” OR “Children” OR “Child, Preschool”)) AND ((“Telemedicine” OR “Telehealth” OR “eHealth” OR “Telerehabilitation” OR “Remote Consultation” OR “Telecare” OR “Teletherapy” OR “Telepractice”) AND (“Rural Population” OR “Rural Spatial Distribution” OR “Rural Community” OR “Rural Health Services” OR “Rural Health” OR “rural”))) T= 2000-2020.
Results	122

Table

	Reference	Reason
1	Hilty, D. M., Sison, J. I., Nesbitt, T. S., & Hales, R. E. (2000). Telepsychiatric consultation for ADHD in the primary care setting. Journal of the American Academy of Child and Adolescent Psychiatry, 39(1), 15-16.	It is not a primary study
2	Elford, D. R., White, H., St John, K., Maddigan, B., Ghandi, M., & Bowering, R. (2001). A prospective satisfaction study and cost analysis of a pilot child telepsychiatry service in Newfoundland. Journal of Telemedicine and Telecare, 7(2), 73-81.	The context is not rural
3	Kopel, H., Nunn, K., & Dossetor, D. (2001). Evaluating satisfaction with a child and adolescent psychological telemedicine outreach service. Journal of Telemedicine and Telecare, 7(2_suppl), 35-40.	Not focused on parents and / or caregivers
4	Savard, L., Borstad, A., Tkachuck, J., Lauderdale, D., & Conroy, B. (2003). Telerehabilitation consultations for clients with neurologic diagnoses: cases from rural Minnesota and American Samoa. NeuroRehabilitation, 18(2), 93-102.	Not focused on children
5	Young, T. L., & Ireson, C. (2003). Effectiveness of school-based telehealth care in urban and rural elementary schools. Pediatrics, 112(5), 1088-1094.	Not focused on parents and / or caregivers
6	Goodenough, B., & Cohn, R. J. (2004). Parent attitudes to audio/visual telecommunications in childhood cancer: an Australian study. Telemedicine Journal & e-Health, 10(Supplement 2), S-15.	Not focused on parents and / or caregivers
7	Marcin, J. P., Ellis, J., Mawis, R., Nagrampa, E., Nesbitt, T. S., & Dimand, R. J. (2004). Using telemedicine to provide pediatric subspecialty care to children with special health care needs in an underserved rural community. Pediatrics, 113(1), 1-6.	The context is not rural
8	Ozuah, P. O., & Reznik, M. (2004). The role of telemedicine in the care of children in under-served communities. Journal of telemedicine and telecare, 10(1_suppl), 78-80.	It is not a primary study
9	Greenberg, N., Boydell, K. M., & Volpe, T. (2006). Pediatric telepsychiatry in Ontario: Caregiver and service provider perspectives. The journal of behavioral health services & research, 33(1), 105-111.	Not focused on parents and / or caregivers
10	Harper, D. C. (2006). Telemedicine for children with disabilities. Children's Health Care, 35(1), 11-27.	Face-to-face intervention in a local center
11	Savin, D., Garry, M. T., Zuccaro, P., & Novins, D. (2006). Telepsychiatry for treating rural American Indian youth. Journal of the American Academy of Child & Adolescent Psychiatry.	Not focused on parents and / or caregivers
12	Sulzbacher, S., Vallin, T., & Waetzig, E. Z. (2006). Telepsychiatry improves paediatric behavioural health care in rural communities. Journal of telemedicine and telecare, 12(6), 285-288.	It is not a primary study
13	Bensink, M., Wootton, R., Irving, H., Hallahan, A., Theodoros, D., Russell, T., … & Barnett, A. G. (2007). Investigating the cost-effectiveness of videotelephone based support for newly diagnosed paediatric oncology patients and their families: design of a randomised controlled trial. BMC health services research, 7(1), 1-8.	It is not a primary study
14	Bensink, M., Armfield, N., Irving, H., Hallahan, A., Theodoros, D., Russell, T., … & Wootton, R. (2008). A pilot study of videotelephone-based support for newly diagnosed paediatric oncology patients and their families. Journal of telemedicine and telecare, 14(6), 315-321.	The context is not rural
15	Witmans, M. B., Dick, B., Good, J., Schoepp, G., Dosman, C., Hawkins, M. E., … & Witol, A. (2008). Delivery of pediatric sleep services via telehealth: the Alberta experience and lessons learned. Behavioral sleep medicine, 6(4), 207-219.	Not focused on parents and / or caregivers
16	Atkinson, N. L., Saperstein, S. L., Desmond, S. M., Gold, R. S., Billing, A. S., & Tian, J. (2009). Rural eHealth nutrition education for limited-income families: an iterative and user-centered design approach. Journal of medical Internet research, 11(2), e21.	Intervention carried out by other electronic systems
17	Bensink, M. E., Armfield, N. R., Pinkerton, R., Irving, H., Hallahan, A. R., Theodoros, D. G., … & Wootton, R. (2009). Using videotelephony to support paediatric oncology-related palliative care in the home: from abandoned RCT to acceptability study. Palliative medicine, 23(3), 228-237.	The context is not rural
18	Scharer, K., Colon, E., Moneyham, L., Hussey, J., Tavakoli, A., & Shugart, M. (2009). A comparison of two types of social support for mothers of mentally ill children. Journal of Child and Adolescent Psychiatric Nursing, 22(2), 86-98.	Intervention carried out by other electronic systems
19	Davis, A. M., James, R. L., Boles, R. E., Goetz, J. R., Belmont, J., & Malone, B. (2011). The use of TeleMedicine in the treatment of paediatric obesity: feasibility and acceptability. Maternal & child nutrition, 7(1), 71-79.	Face-to-face intervention in a local center
20	Gallagher, K. S., Davis, A. M., Malone, B., Landrum, Y., & Black, W. (2011). Treating rural pediatric obesity through telemedicine: Baseline data from a randomized controlled trial. Journal of pediatric psychology, 36(6), 687-695.	Face-to-face intervention in a local center
21	Hopper, B., Buckman, M., & Edwards, M. (2011). Evaluation of satisfaction of parents with the use of videoconferencing for a pediatric genetic consultation. Twin Research and Human Genetics, 14(4), 343-346.	The context is not rural
22	Mulgrew, K. W., Shaikh, U., & Nettiksimmons, J. (2011). Comparison of parent satisfaction with care for childhood obesity delivered face-to-face and by telemedicine. Telemedicine and e-Health, 17(5), 383-387.	Face-to-face intervention in a local center
23	Pepler, A., Boydell, K. M., Teshima, J., Volpe, T., Braunberger, P. G., & Minden, D. (2011). Transforming Child and Youth Mental Health Care via Innovative Technological Solutions. Healthcare quarterly (Toronto, Ont.), 14, 92-102.	The context is not rural
24	Bradford, N., Young, J., Armfield, N. R., Bensink, M. E., Pedersen, L. A., Herbert, A., & Smith, A. C. (2012). A pilot study of the effectiveness of home teleconsultations in paediatric palliative care. Journal of Telemedicine and Telecare, 18(8), 438-442.	The context is not rural
25	Constantinescu, G. (2012). Satisfaction with telemedicine for teaching listening and spoken language to children with hearing loss. Journal of telemedicine and telecare, 18(5), 267-272.	The context is not rural
26	Houston, K. T., & Stredler-Brown, A. (2012). A Model of Early Intervention for Children with Hearing Loss Provided through Telepractice. Volta Review, 112(3).	It is not a primary study
27	Jacob, M. K., Larson, J. C., & Craighead, W. E. (2012). Establishing a telepsychiatry consultation practice in rural Georgia for primary care physicians: A feasibility report. Clinical pediatrics, 51(11), 1041-1047.	Face-to-face intervention in a local center
28	Chen, H. T., Tseng, M. H., Lu, L., Sie, J. Y., Chen, Y. J., Chung, Y., & Lai, F. (2014). Cloud computing-based smart home-based rehabilitation nursing system for early intervention. Advanced Science Letters, 20(1), 218-221.	Intervention carried out by other electronic systems
29	Hanlon-Dearman, A., Edwards, C., Schwab, D., Millar, M. C., & Longstaffe, S. (2014). “Giving voice”: evaluation of an integrated telehealth community care model by parents/guardians of children diagnosed with fetal alcohol spectrum disorder in Manitoba. Telemedicine and e-Health, 20(5), 478-484.	Face-to-face intervention in a local center
30	Guiberson, M., Rodríguez, B. L., & Zajacova, A. (2015). Accuracy of telehealth-administered measures to screen language in Spanish-speaking preschoolers. Telemedicine and e-Health, 21(9), 714-720.	Face-to-face intervention in a local center
31	Klitzman, P., Armstrong, B., & Janicke, D. M. (2015). Distance as a predictor of treatment attendance in a family based pediatric weight management program in rural areas. The Journal of Rural Health, 31(1), 19-26.	Face-to-face intervention in a local center
32	Langkamp, D. L., McManus, M. D., & Blakemore, S. D. (2015). Telemedicine for children with developmental disabilities: a more effective clinical process than office-based care. Telemedicine and e-Health, 21(2), 110-114.	Face-to-face intervention in a local center
33	Reese, R. J., Slone, N. C., Soares, N., & Sprang, R. (2015). Using telepsychology to provide a group parenting program: A preliminary evaluation of effectiveness. Psychological Services, 12(3), 274.	Face-to-face intervention in a local center
34	Davis, A. M., Sampilo, M., Gallagher, K. S., Dean, K., Saroja, M. B., Yu, Q., … & Sporn, N. (2016). Treating rural paediatric obesity through telemedicine vs. telephone: Outcomes from a cluster randomized controlled trial. Journal of telemedicine and telecare, 22(2), 86-95.	Face-to-face intervention in a local center
35	Gardner, K., Bundy, A., & Dew, A. (2016). Perspectives of rural carers on benefits and barriers of receiving occupational therapy via information and communication technologies. Australian occupational therapy journal, 63(2), 117-122.	Intervention carried out by other electronic systems
36	Guiberson, M. (2016). Telehealth measures screening for developmental language disorders in Spanish-speaking toddlers. Telemedicine and e-health, 22(9), 739-745.	Face-to-face intervention in a local center
37	Iacono, T., Dissanayake, C., Trembath, D., Hudry, K., Erickson, S., & Spong, J. (2016). Family and practitioner perspectives on telehealth for services to young children with autism. Stud Health Technol Inform, 231, 63-73.	Not focused on parents and / or caregivers
38	Ramkumar, V., Selvakumar, K., Vanaja, C. S., Hall, J. W., Nagarajan, R., & Neethi, J. (2016). Parents’ perceptions of tele-audiological testing in a rural hearing screening program in South India. International journal of pediatric otorhinolaryngology, 89, 60-66.	Not focused on parents and / or caregivers
39	Smith, N. M., & Satyshu, R. D. (2016). Pediatric diabetes telemedicine program improves access to care for rural families: role of APRNs. Pediatric nursing, 42(6), 294-300.	Face-to-face intervention in a local center
40	Wakefield, C. E., Sansom-Daly, U. M., McGill, B. C., Ellis, S. J., Doolan, E. L., Robertson, E. G., … & Cohn, R. J. (2016). Acceptability and feasibility of an e-mental health intervention for parents of childhood cancer survivors:“Cascade”. Supportive Care in Cancer, 24(6), 2685-2694.	The context is not rural
41	Bagayoko, C. O., Niang, M., Anne, A., Traoré, D., Sangho, H., Traoré, A. K., & Geissbuhler, A. (2017). The delegation of tasks in the era of e-health to support community interventions in maternal and child health: lessons learned from the PACT-Denbaya project. Medecine et sante tropicales, 27(4), 354-359.	Study in language not included
42	Brinkel, J., Dako-Gyeke, P., Krämer, A., May, J., & Fobil, J. N. (2017). An investigation of users’ attitudes, requirements and willingness to use mobile phone-based interactive voice response systems for seeking healthcare in Ghana: a qualitative study. Public Health, 144, 125-133.	Intervention carried out by other electronic systems
43	Salomone, E., & Maurizio Arduino, G. (2017). Parental attitudes to a telehealth parent coaching intervention for autism spectrum disorder. Journal of telemedicine and telecare, 23(3), 416-420.	It is not a primary study
44	McLellan, L. F., Andrijic, V., Davies, S., Lyneham, H. J., & Rapee, R. M. (2017). Delivery of a therapist-facilitated telecare anxiety program to children in rural communities: a pilot study. Behaviour Change, 34(3), 156-167.	Face-to-face intervention in a local center
45	Modi, D., Desai, S., Dave, K., Shah, S., Desai, G., Dholakia, N., … & Shah, P. (2017). Cluster randomized trial of a mHealth intervention “ImTeCHO” to improve delivery of proven maternal, neonatal, and childcare interventions through community-based Accredited Social Health Activists (ASHAs) by enhancing their motivation and strengthening supervision in tribal areas of Gujarat, India: study protocol for a randomized controlled trial. Trials, 18(1), 1-14.	It is not a primary study
46	Stuckey, R., & Domingues-Montanari, S. (2017). Telemedicine is helping the parents of children with neurodevelopmental disorders living in remote and deprived areas.	It is not a primary study
47	Subramaniam, S., Brunson, L. Y., Cook, J. E., Larson, N. A., Poe, S. G., & Peter, C. C. S. (2017). Maintenance of parent-implemented discrete-trial instruction during videoconferencing. Journal of Behavioral Education, 26(1), 1-26.	Face-to-face intervention in a local center
48	Sutcliffe, C. G., Thuma, P. E., van Dijk, J. H., Sinywimaanzi, K., Mweetwa, S., Hamahuwa, M., & Moss, W. J. (2017). Use of mobile phones and text messaging to decrease the turnaround time for early infant HIV diagnosis and notification in rural Zambia: an observational study. BMC pediatrics, 17(1), 1-9.	Intervention carried out by other electronic systems
49	Bearss, K., Burrell, T. L., Challa, S. A., Postorino, V., Gillespie, S. E., Crooks, C., & Scahill, L. (2018). Feasibility of parent training via telehealth for children with autism spectrum disorder and disruptive behavior: A demonstration pilot. Journal of autism and developmental disorders, 48(4), 1020-1030.	Face-to-face intervention in a local center
50	Gielen, A. C., Bishai, D. M., Omaki, E., Shields, W. C., McDonald, E. M., Rizzutti, N. C., … & Aitken, M. E. (2018). Results of an RCT in two pediatric emergency departments to evaluate the efficacy of an m-health educational app on car seat use. American journal of preventive medicine, 54(6), 746-755.	The context is not rural
51	Hooshmand, M., & Foronda, C. (2018). Comparison of telemedicine to traditional face-to-face care for children with special needs: A quasiexperimental study. Telemedicine and e-Health, 24(6), 433-441.	The context is not rural
52	Kuravackel, G. M., Ruble, L. A., Reese, R. J., Ables, A. P., Rodgers, A. D., & Toland, M. D. (2018). Compass for hope: Evaluating the effectiveness of a parent training and support program for children with ASD. Journal of Autism and Developmental Disorders, 48(2), 404-416.	Face-to-face intervention in a local center
53	Lesher, A. P., & Shah, S. R. (2018, April). Telemedicine in the perioperative experience. In Seminars in pediatric surgery (Vol. 27, No. 2, pp. 102-106). WB Saunders.	It is not a primary study
54	Little, L. M., Wallisch, A., Pope, E., & Dunn, W. (2018). Acceptability and cost comparison of a telehealth intervention for families of children with autism. Infants & Young Children, 31(4), 275-286.	The context is not rural
55	Sharp, T. (2018). Improving equity in rural maternity care with technology. Women and Birth, 31, S44.	It is not a primary study
56	Thobias, J., & Kiwanuka, A. (2018). Design and implementation of an m-health data model for improving health information access for reproductive and child health services in low resource settings using a participatory action research approach. BMC medical informatics and decision making, 18(1), 1-10.	Intervention carried out by other electronic systems
57	Allegra, M., Arrigo, M., Ayala, A., Cusimano, G., Gentile, M., La Guardia, D., … & Messineo, L. (2019). Abilitazione e Tele-abilitazione Home-based per i Disturbi dello Spettro Autistico: il progetto ATHENA. RICERCHE DI PSICOLOGIA.	Study in language not included
58	Chai, L. K., Collins, C. E., May, C., Ashman, A., Holder, C., Brown, L. J., & Burrows, T. L. (2019). Feasibility and efficacy of a web-based family telehealth nutrition intervention to improve child weight status and dietary intake: a pilot randomised controlled trial. Journal of telemedicine and telecare, 1357633X19865855.	The context is not rural
59	Chai, L. K., Collins, C. E., May, C., Brown, L. J., Ashman, A., & Burrows, T. L. (2019). Fidelity and acceptability of a family-focused technology-based telehealth nutrition intervention for child weight management. Journal of telemedicine and telecare, 1357633X19864819.	The context is not rural
60	Dadds, M. R., Thai, C., Mendoza Diaz, A., Broderick, J., Moul, C., Tully, L. A., … & Cane, L. (2019). Therapist-assisted online treatment for child conduct problems in rural and urban families: Two randomized controlled trials. Journal of consulting and clinical psychology, 87(8), 706.	Face-to-face intervention in a local center
61	Hoffmann, A. N., Bogoev, B. K., & Sellers, T. P. (2019). Using telehealth and expert coaching to support early childhood special education parent-implemented assessment and intervention procedures. Rural Special Education Quarterly, 38(2), 95-106.	Face-to-face intervention in a local center
62	Kistler, J., Cristaldi, K. K., Queenan, C., Garber, K., Wells, E., & Mcelligott, J. T. (2019). Caregiver Perceptions of Telehealth School-based Health Centers. Health Behavior and Policy Review, 6(4), 344-352.	Face-to-face intervention in a local center
63	Marchand, G., & Healy, S. (2019). Implementation of Project CHASE (Children with Autism Supported to Exercise): A Facebook-Delivered, Parent-Mediated Physical Activity Intervention. Palaestra, 33(3).	Intervention carried out by other electronic systems
64	Modi, D., Dholakia, N., Gopalan, R., Venkatraman, S., Dave, K., Shah, S., … & Shah, P. (2019). mHealth intervention “ImTeCHO” to improve delivery of maternal, neonatal, and childcare services—A cluster-randomized trial in tribal areas of Gujarat, India. PLoS medicine, 16(10), e1002939.	Intervention carried out by other electronic systems
65	Tsami, L., Lerman, D., & Toper-Korkmaz, O. (2019). Effectiveness and acceptability of parent training via telehealth among families around the world. Journal of Applied Behavior Analysis, 52(4), 1113-1129.	The context is not rural
66	Fortini, S., Espeche, A., & Caraballo, R. (2020). Telemedicine and epilepsy: a patient satisfaction survey of a pediatric remote care program. Epilepsy Research, 165, 106370.	Face-to-face intervention in a local center
67	Mytsyk, A., & Pryshliak, M. (2020). Telepractice in the System of Providing Correctional and Developmental Services to Children with Speech Disorders: Interaction at a Distance. Journal of History Culture and Art Research, 9(3), 94-105.	It is not a primary study
68	Swanson, M., MacKay, M., Yu, S., Kagiliery, A., Bloom, K., & Schwebel, D. C. (2020). Supporting caregiver use of child restraints in rural communities via interactive virtual presence. Health Education & Behavior, 47(2), 264-271.	Intervention carried out by other electronic systems

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