Mapping the Gaps: A Scoping Review of Virtual Care Solutions for Caregivers of Children with Chronic Illnesses

Nicole Pope^{1

2

3

4}, Kathyrn A Birnie^{4

5

6

7}, Melanie Noel^{7

8}, Justine Dol⁹, Danyu Li^{10

11}, Megan Macneil^{12

13}, Darrel Zientek¹⁴, Victoria Surry¹⁵, Jennifer N Stinson^{1

16}

Affiliations

¹ Child Health Evaluative Services, Research Institute, The Hospital for Sick Children, Toronto, ON M5G 1E8, Canada.
² Department of Nursing, Melbourne School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC 3052, Australia.
³ Murdoch Children's Research Institute, Melbourne, VIC 3052, Australia.
⁴ Department of Psychology and Neuroscience, Faculty of Science, Dalhousie University, Halifax, NS B3H 4R2, Canada.
⁵ Department of Anesthesiology, Perioperative and Pain Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada.
⁶ Department of Community Health Sciences, University of Calgary, Calgary, AB T2N 1N4, Canada.
⁷ Department of Psychology, University of Calgary, Calgary, AB T2N 1N4, Canada.
⁸ Alberta Children's Hospital Research Institute, Hotchkiss Brain Institute, Calgary, AB T2N 4N1, Canada.
⁹ Centre for Pediatric Pain Research, IWK Health, Halifax, NS B3K 6R8, Canada.
¹⁰ Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai 200433, China.
¹¹ School of Nursing, Fudan University, Shanghai 200433, China.
¹² Chronic Pain Network, McMaster University, Hamilton, ON L8S 4L8, Canada.
¹³ School of Public Health, University of Alberta, Edmonton, AB T6G 2R3, Canada.
¹⁴ Independent Researcher, Ottawa, ON K2J 4W5, Canada.
¹⁵ Faculty of Human and Social Development, School of Public Administration, University of Victoria, Victoria, BC V8P 5C2, Canada.
¹⁶ Lawrence S. Bloomberg Faculty of Nursing and IHPME, University of Toronto, Toronto, ON M5S 1A1, Canada.

PMID: 39857908
PMCID: PMC11763621
DOI: 10.3390/children12010077

Review

Mapping the Gaps: A Scoping Review of Virtual Care Solutions for Caregivers of Children with Chronic Illnesses

Nicole Pope et al. Children (Basel). 2025.

. 2025 Jan 10;12(1):77.

doi: 10.3390/children12010077.

Authors

Affiliations

¹ Child Health Evaluative Services, Research Institute, The Hospital for Sick Children, Toronto, ON M5G 1E8, Canada.
² Department of Nursing, Melbourne School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC 3052, Australia.
³ Murdoch Children's Research Institute, Melbourne, VIC 3052, Australia.
⁴ Department of Psychology and Neuroscience, Faculty of Science, Dalhousie University, Halifax, NS B3H 4R2, Canada.
⁵ Department of Anesthesiology, Perioperative and Pain Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada.
⁶ Department of Community Health Sciences, University of Calgary, Calgary, AB T2N 1N4, Canada.
⁷ Department of Psychology, University of Calgary, Calgary, AB T2N 1N4, Canada.
⁸ Alberta Children's Hospital Research Institute, Hotchkiss Brain Institute, Calgary, AB T2N 4N1, Canada.
⁹ Centre for Pediatric Pain Research, IWK Health, Halifax, NS B3K 6R8, Canada.
¹⁰ Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai 200433, China.
¹¹ School of Nursing, Fudan University, Shanghai 200433, China.
¹² Chronic Pain Network, McMaster University, Hamilton, ON L8S 4L8, Canada.
¹³ School of Public Health, University of Alberta, Edmonton, AB T6G 2R3, Canada.
¹⁴ Independent Researcher, Ottawa, ON K2J 4W5, Canada.
¹⁵ Faculty of Human and Social Development, School of Public Administration, University of Victoria, Victoria, BC V8P 5C2, Canada.
¹⁶ Lawrence S. Bloomberg Faculty of Nursing and IHPME, University of Toronto, Toronto, ON M5S 1A1, Canada.

PMID: 39857908
PMCID: PMC11763621
DOI: 10.3390/children12010077

Abstract

Background/Objectives: Caregivers of children with chronic illnesses, including chronic pain, experience high levels of distress, which impacts their own mental and physical health as well as child outcomes. Virtual care solutions offer opportunities to provide accessible support, yet most overlook caregivers' needs. We conducted a scoping review to create an interactive Evidence and Gap Map (EGM) of virtual care solutions across a stepped care continuum (i.e., from self-directed to specialized care) for caregivers of youth with chronic illnesses. Methods: The review methodology was co-designed with four caregivers. Data sources were the peer-reviewed scientific literature and a call for innovations. Records were independently coded and assessed for quality. Results: Overall, 73 studies were included. Most virtual care solutions targeted caregivers of children with cancer, neurological disorders, and complex chronic illnesses. Over half were noted at lower levels of stepped care (i.e., self-guided apps and websites), with psychological strategies being predominant (84%). However, very few addressed caregivers' physical health (15%) or provided family counseling (19%) or practical support (1%). Significant gaps were noted in interventions for managing caregiver chronic pain, despite its high prevalence and impact on child outcomes. Conclusions: Evidence and Gap Maps are innovative visual tools for knowledge synthesis, facilitating rapid, evidence-informed decision-making for patients, families, health professionals, and policymakers. This EGM highlighted high-quality virtual care solutions ready for immediate scaling and identified critical evidence gaps requiring prioritization. To address the complexities of pediatric chronic illnesses, including chronic pain, virtual care initiatives must prioritize family-centered, accessible, and equitable approaches. Engaging caregivers as partners is critical to ensure interventions align with their needs and priorities.

Keywords: adolescents; children; chronic illnesses; chronic pain; evidence and gap map; primary caregivers; stepped care; virtual care.

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Conflict of interest statement

Jennifer Stinson, the senior author of this manuscript, serves as a Section Board Member of Children. This role did not influence the representation or interpretation of the research results presented in this manuscript. All other authors declare no conflicts of interest.

Figures

**Figure 1**
Levels of stepped care. Model adapted from Mental Health Commission of Canada, *Newfoundland and Labrador Stepped Care 2.0 e-Mental Health Demonstration Project*: Health Canada: 2019 [38].

**Figure 3**
Virtual care solutions by stepped care levels.

**Figure 4**
Static version of the Evidence and Gap Map (EGM) showing the number and quality of included studies across the stepped care continuum and virtual care components. The rows represent the five levels of the stepped care continuum (Figure 1), and the columns depict the higher-order components of virtual care solutions. Each cell indicates the intersection of these two dimensions, with study counts and quality ratings displayed. A small legend is included below to clarify the structure of the figure. For a more comprehensive and interactive exploration, the EGM is available online at https://lab.research.sickkids.ca/iouch/caregivers/, accessed on 18 December 2024, where users can apply filters and sort data to suit their needs.

See this image and copyright information in PMC

Cited by

Balancing Care and Sacrifice: Lived Experiences and Support Needs of Primary Caregivers in Pediatric Chronic Pain Across Canada and Australia.
Pope N, Drumm N, Birnie KA, Noel M, Berryman C, Ferencz N, Killackey T, Macneil M, Zientek D, Surry V, Stinson JN. Pope N, et al. Children (Basel). 2025 Jul 10;12(7):911. doi: 10.3390/children12070911. Children (Basel). 2025. PMID: 40723104 Free PMC article.

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Mapping the Gaps: A Scoping Review of Virtual Care Solutions for Caregivers of Children with Chronic Illnesses

Affiliations

Mapping the Gaps: A Scoping Review of Virtual Care Solutions for Caregivers of Children with Chronic Illnesses

Authors

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Abstract

Conflict of interest statement

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