scholarly journals A retrospective analysis of digital health intervention addressing COVID-19 in China

2021 ◽  
Author(s):  
Mengji Chen ◽  
Shan Xu ◽  
Lewis Husain ◽  
Gauden Galea
Keyword(s):  
Retrospective Analysis ◽  
Digital Health ◽  
Health Intervention

scholarly journals mCARE, a digital health intervention package on pregnancy surveillance and care-seeking reminders from 2018 to 2027 in Bangladesh: a model-based cost-effectiveness analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e042553
Author(s):  
Youngji Jo ◽  
Amnesty Elizabeth LeFevre ◽  
Hasmot Ali ◽  
Sucheta Mehra ◽  
Kelsey Alland ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Home Visit ◽  
Digital Health ◽  
Status Quo ◽  
Health Intervention ◽  
Text Messages ◽  
Care Seeking ◽  
Intervention Package ◽  
The Status ◽  
The Cost

ObjectiveWe estimated the cost-effectiveness of a digital health intervention package (mCARE) for community health workers, on pregnancy surveillance and care-seeking reminders compared with the existing paper-based status quo, from 2018 to 2027, in Bangladesh.InterventionsThe mCARE programme involved digitally enhanced pregnancy surveillance, individually targeted text messages and in-person home-visit to pregnant women for care-seeking reminders for antenatal care, child delivery and postnatal care.Study designWe developed a model to project population and service coverage increases with annual geographical expansion (from 1 million to 10 million population over 10 years) of the mCARE programme and the status quo.Major outcomesFor this modelling study, we used Lives Saved Tool to estimate the number of deaths and disability-adjusted life years (DALYs) that would be averted by 2027, if the coverage of health interventions was increased in mCARE programme and the status quo, respectively. Economic costs were captured from a societal perspective using an ingredients approach and expressed in 2018 US dollars. Probabilistic sensitivity analysis was undertaken to account for parameter uncertainties.ResultsWe estimated the mCARE programme to avert 3076 deaths by 2027 at an incremental cost of $43 million relative to the status quo, which is translated to $462 per DALY averted. The societal costs were estimated to be $115 million for mCARE programme (48% of which are programme costs, 35% user costs and 17% provider costs). With the continued implementation and geographical scaling-up, the mCARE programme improved its cost-effectiveness from $1152 to $462 per DALY averted from 5 to 10 years.ConclusionMobile phone-based pregnancy surveillance systems with individually scheduled text messages and home-visit reminder strategies can be highly cost-effective in Bangladesh. The cost-effectiveness may improve as it promotes facility-based child delivery and achieves greater programme cost efficiency with programme scale and sustainability.

scholarly journals What is an appropriate level of evidence for a digital health intervention?

The Lancet ◽  
2018 ◽  
Vol 392 (10165) ◽  
pp. 2665-2667 ◽  
Author(s):  
Felix Greaves ◽  
Indra Joshi ◽  
Mark Campbell ◽  
Samantha Roberts ◽  
Neelam Patel ◽  
...  
Keyword(s):  
Digital Health ◽  
Health Intervention ◽  
Level Of Evidence

scholarly journals Development and Evaluation of a Digital Health Intervention for Substance Use Reduction in Young Refugees With Problematic Use of Alcohol and/or Cannabis—Study Protocol for a Single-Armed Feasibility Trial

2021 ◽  
Vol 9 ◽  
Author(s):  
Laura Charlotte Fischer ◽  
Vera Kölligan ◽  
Nuri Wieland ◽  
Michael Klein
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Digital Health ◽  
Health Intervention ◽  
Target Group ◽  
Feasibility Trial ◽  
Secondary Outcome ◽  
Post Intervention ◽  
Problematic Use ◽  
Digital Interventions

Background: Refugee populations are at substantial risk of developing substance use disorder (SUD) and other mental health disorders. At the same time, refugee populations face numerous barriers to accessing mental health services. Digital interventions can address some of these issues, as emerging evidence indicates that digital interventions offer an effective, low-cost alternative with high accessibility and similar efficacy as standard SUD prevention programs. As an add-on to traditional services, they further present a viable approach to the lack of personnel available for foreign language communication in preventive and therapeutic settings. In the present study, we thus aim to develop and evaluate a digital health intervention (DHI) for the reduction of substance use for young refugees with problematic use of alcohol and/or cannabis. The intervention will be implemented in a smartphone app, translated into Arabic, English, Farsi, German, and Pashto, and is to be used stand-alone. It is based on methods from cognitive behavioral therapy, contains culturally adapted elements, provides practical information on how to deal safely with alcohol and cannabis, and motivates behavior change through increased self-reflection and behavioral, cognitive, and emotional skills-training in interactive exercises.Methods: We conduct a single-armed feasibility trial among 150 young refugees with problematic use of alcohol and/or cannabis. Participants will receive a digital screening and digital health intervention (DHI) for the reduction of problematic substance use, carried out over a 4-week time frame. The primary outcomes are the intervention's feasibility and the target population's acceptance of the intervention. The secondary outcome is a change in substance use post-intervention from baseline. Measurements are taken pre-intervention (baseline), post-intervention (after 4 weeks), and at 3- and 6-month follow-ups. We expect the intervention to be feasible and accepted by the target group.Discussion: The present study will establish to what degree the digital intervention (the “BePrepared App”) is feasible and accepted by the target group. The evaluation of an easily accessible, feasible, and accepted intervention may impact refugees' mental health and health-related consequences. It aims at overcoming barriers to preventive health care in the substance use field for underserved refugee populations as a tool within a larger set of urgently needed interventions.Trial Registration: DRKS00021095 at the “German Clinical Trials Register” (30.03.2020).

scholarly journals Development, Feasibility, Acceptability, and Utility of an Expressive Speech-Enabled Digital Health Agent to Deliver Online, Brief Motivational Interviewing for Alcohol Misuse: Descriptive Study

10.2196/25837 ◽  
2021 ◽  
Vol 23 (9) ◽  
pp. e25837
Author(s):  
Maya Boustani ◽  
Stephanie Lunn ◽  
Ubbo Visser ◽  
Christine Lisetti
Keyword(s):  
Alcohol Use ◽  
Behavioral Health ◽  
Digital Health ◽  
Health Intervention ◽  
The Internet ◽  
Conversational Agents ◽  
Promising Alternative ◽  
Expressive Speech ◽  
3 Dimensional ◽  
Behavioral Health Intervention

Background Digital health agents — embodied conversational agents designed specifically for health interventions — provide a promising alternative or supplement to behavioral health services by reducing barriers to access to care. Objective Our goals were to (1) develop an expressive, speech-enabled digital health agent operating in a 3-dimensional virtual environment to deliver a brief behavioral health intervention over the internet to reduce alcohol use and to (2) understand its acceptability, feasibility, and utility with its end users. Methods We developed an expressive, speech-enabled digital health agent with facial expressions and body gestures operating in a 3-dimensional virtual office and able to deliver a brief behavioral health intervention over the internet to reduce alcohol use. We then asked 51 alcohol users to report on the digital health agent acceptability, feasibility, and utility. Results The developed digital health agent uses speech recognition and a model of empathetic verbal and nonverbal behaviors to engage the user, and its performance enabled it to successfully deliver a brief behavioral health intervention over the internet to reduce alcohol use. Descriptive statistics indicated that participants had overwhelmingly positive experiences with the digital health agent, including engagement with the technology, acceptance, perceived utility, and intent to use the technology. Illustrative qualitative quotes provided further insight about the potential reach and impact of digital health agents in behavioral health care. Conclusions Web-delivered interventions delivered by expressive, speech-enabled digital health agents may provide an exciting complement or alternative to traditional one-on-one treatment. They may be especially helpful for hard-to-reach communities with behavioral workforce shortages.

A Review of Digital Health Design Approaches: Challenges Towards Real World Implementation (Preprint)

2021 ◽  
Author(s):  
Anthony Duffy ◽  
Sylvain Moreno ◽  
Greg Christie
Keyword(s):  
Real World ◽  
User Satisfaction ◽  
Digital Health ◽  
Healthcare Delivery ◽  
Health Intervention ◽  
Rapid Expansion ◽  
Stakeholder Group ◽  
Design Approach ◽  
Intervention Design ◽  
Growing Pains

BACKGROUND Digital health represents an important strategy in the future of healthcare delivery. Over the past decade, mHealth has accelerated the agency of healthcare users. Despite prevailing excitement about the potential of digital health, questions remain on efficacy, uptake, usability and patience outcome. This challenge is confounded by two industries, DIGITAL and HEALTH, that have vastly different approaches to research, design, testing and implementation. In this regard, there is a need to examine prevailing design approaches, to weigh their benefits and challenges towards implementation, and to recommend a path forward that synthesises the needs of this complex stakeholder group. OBJECTIVE This review studies prominent digital health intervention (DHI) design approaches mediating the digital health space. In doing so, we seek to examine each methodology’s: origins, perceived benefits, contrasting nuances, challenges, and typical use-case scenarios. METHODS A narrative synthesis approach to literature review was employed to review existing evidence. We searched indexed scientific literature using keywords relative to different digital health intervention designs. Papers selected after screening were those that discussed the design and implementation of digital health design approaches. RESULTS 120 papers on intervention design were selected for full-text review. We selected the 20 most prominent papers on each design approach, synthesizing findings under the categories of origins, advantages, disadvantages, challenges and cases. CONCLUSIONS Digital health is experiencing the growing pains of rapid expansion. Currently, numerous design approaches are being implemented in order to harmonise the needs of a complex stakeholder group. Whether the primary stakeholder is positioned as the end-user/person/human/patient, the challenge to synthesise the constraints and affordances of both digital design and healthcare, built equally around user satisfaction and clinically efficacy remains paramount. Further research that works towards a transdisciplinarity in digital health may help to break down friction in this field. Until digital health is viewed as a hybridised industry with unique requirements rather than competing interests, the nuances that each design approach posits will be difficult to realise in a real world context. We encourage the collaboration of digital and health experts within hybrid design teams, through all stages of intervention design, in order to create a better digital health culture and design ethos.

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