scholarly journals Methods to Evaluate the Effects of Internet-Based Digital Health Interventions for Citizens: Systematic Review of Reviews

10.2196/10202 ◽  
2018 ◽  
Vol 20 (6) ◽  
pp. e10202 ◽  
Author(s):  
Paolo Zanaboni ◽  
Patrice Ngangue ◽  
Gisele Irène Claudine Mbemba ◽  
Thomas Roger Schopf ◽  
Trine Strand Bergmo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Digital Health ◽  
Health Interventions ◽  
Review Of Reviews

scholarly journals Methods to Evaluate the Effects of Internet-Based Digital Health Interventions for Citizens: Systematic Review of Reviews (Preprint)

2018 ◽  
Author(s):  
Paolo Zanaboni ◽  
Patrice Ngangue ◽  
Gisele Irène Claudine Mbemba ◽  
Thomas Roger Schopf ◽  
Trine Strand Bergmo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Randomized Controlled Trials ◽  
Digital Health ◽  
Behavioral Outcomes ◽  
Health Interventions ◽  
Care Utilization ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Review Of Reviews

BACKGROUND Digital health can empower citizens to manage their health and address health care system problems including poor access, uncoordinated care and increasing costs. Digital health interventions are typically complex interventions. Therefore, evaluations present methodological challenges. OBJECTIVE The objective of this study was to provide a systematic overview of the methods used to evaluate the effects of internet-based digital health interventions for citizens. Three research questions were addressed to explore methods regarding approaches (study design), effects and indicators. METHODS We conducted a systematic review of reviews of the methods used to measure the effects of internet-based digital health interventions for citizens. The protocol was developed a priori according to Preferred Reporting Items for Systematic review and Meta-Analysis Protocols and the Cochrane Collaboration methodology for overviews of reviews. Qualitative, mixed-method, and quantitative reviews published in English or French from January 2010 to October 2016 were included. We searched for published reviews in PubMed, EMBASE, The Cochrane Database of Systematic Reviews, CINHAL and Epistemonikos. We categorized the findings based on a thematic analysis of the reviews structured around study designs, indicators, types of interventions, effects and perspectives. RESULTS A total of 20 unique reviews were included. The most common digital health interventions for citizens were patient portals and patients' access to electronic health records, covered by 10/20 (50%) and 6/20 (30%) reviews, respectively. Quantitative approaches to study design included observational study (15/20 reviews, 75%), randomized controlled trial (13/20 reviews, 65%), quasi-experimental design (9/20 reviews, 45%), and pre-post studies (6/20 reviews, 30%). Qualitative studies or mixed methods were reported in 13/20 (65%) reviews. Five main categories of effects were identified: (1) health and clinical outcomes, (2) psychological and behavioral outcomes, (3) health care utilization, (4) system adoption and use, and (5) system attributes. Health and clinical outcomes were measured with both general indicators and disease-specific indicators and reported in 11/20 (55%) reviews. Patient-provider communication and patient satisfaction were the most investigated psychological and behavioral outcomes, reported in 13/20 (65%) and 12/20 (60%) reviews, respectively. Evaluation of health care utilization was included in 8/20 (40%) reviews, most of which focused on the economic effects on the health care system. CONCLUSIONS Although observational studies and surveys have provided evidence of benefits and satisfaction for patients, there is still little reliable evidence from randomized controlled trials of improved health outcomes. Future evaluations of digital health interventions for citizens should focus on specific populations or chronic conditions which are more likely to achieve clinically meaningful benefits and use high-quality approaches such as randomized controlled trials. Implementation research methods should also be considered. We identified a wide range of effects and indicators, most of which focused on patients as main end users. Implications for providers and the health system should also be included in evaluations or monitoring of digital health interventions.

scholarly journals The Acceptability and Usability of Digital Health Interventions for Adults With Depression, Anxiety, and Somatoform Disorders: Qualitative Systematic Review and Meta-Synthesis

10.2196/16228 ◽  
2020 ◽  
Vol 22 (7) ◽  
pp. e16228 ◽  
Author(s):  
Shireen Patel ◽  
Athfah Akhtar ◽  
Sam Malins ◽  
Nicola Wright ◽  
Emma Rowley ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Somatoform Disorders ◽  
Digital Health ◽  
Health Interventions ◽  
Health Conditions ◽  
Future Research ◽  
World Population ◽  
Personal Support ◽  
The Individual

Background The prevalence of mental health disorders continues to rise, with almost 4% of the world population having an anxiety disorder and almost 3.5% having depression in 2017. Despite the high prevalence, only one-third of people with depression or anxiety receive treatment. Over the last decade, the use of digital health interventions (DHIs) has risen rapidly as a means of accessing mental health care and continues to increase. Although there is evidence supporting the effectiveness of DHIs for the treatment of mental health conditions, little is known about what aspects are valued by users and how they might be improved. Objective This systematic review aimed to identify, appraise, and synthesize the qualitative literature available on service users’ views and experiences regarding the acceptability and usability of DHIs for depression, anxiety, and somatoform disorders. Methods A systematic search strategy was developed, and searches were run in 7 electronic databases. Qualitative and mixed methods studies published in English were included. A meta-synthesis was used to interpret and synthesize the findings from the included studies. Results A total of 24 studies were included in the meta-synthesis, and 3 key themes emerged with descriptive subthemes. The 3 key themes were initial motivations and approaches to DHIs, personalization of treatment, and the value of receiving personal support in DHIs. The meta-synthesis suggests that participants’ initial beliefs about DHIs can have an important effect on their engagement with these types of interventions. Personal support was valued very highly as a major component of the success of DHIs. The main reason for this was the way it enabled individual personalization of care. Conclusions Findings from the systematic review have implications for the design of future DHIs to improve uptake, retention, and outcomes in DHIs for depression, anxiety, and somatoform disorders. DHIs need to be personalized to the specific needs of the individual. Future research should explore whether the findings could be generalized to other health conditions.

Systematic review and meta-analysis of attrition within digital health interventions for people with multiple sclerosis (Preprint)

2021 ◽  
Author(s):  
William Bevens
Keyword(s):  
Multiple Sclerosis ◽  
Systematic Review ◽  
Digital Health ◽  
Meta Analysis ◽  
Health Interventions ◽  
Attrition Rates ◽  
Participant Engagement ◽  
Randomised Controlled ◽  
And Control ◽  
Insight Into

BACKGROUND Digital health interventions (DHI) have revolutionised the management of multiple sclerosis (MS). It is now understood that the technological elements that comprise DHIs can influence participant engagement and that people with MS (PwMS) can experience significant barriers to remaining enrolled in DHIs related to the use of these elements. It is essential to explore the influence of technological elements in mitigating attrition after allocation. OBJECTIVE We examined the study design and technological elements of documented DHIs targeted at PwMS and how these correlated with attrition among participants of randomised-controlled trials (RCTs). METHODS We conducted a systematic review and meta-analysis of RCTs (n=17) describing digital technologies for health interventions for PwMS. We analysed attrition of included studies using a random-effects model and meta-regression to measure the association between potential moderators. RESULTS There were no measured differences in attrition between intervention and control arms; however, some of the heterogeneity observed was explained by the composite technological element score. The pooled attrition rates for the intervention and control arms were 10.6% and 11.2% respectively. CONCLUSIONS Ultimately, this paper provides insight into the technological composition of DHIs and will aid in the design of future studies in this area.

scholarly journals Digital health interventions to fight smoking habits in European countries: a systematic review

2017 ◽  
Vol 27 (suppl_3) ◽  
Author(s):  
F D'Aloisio ◽  
D Pezzato ◽  
G Gervasi ◽  
A Ubiali ◽  
NL Bragazzi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Digital Health ◽  
Health Interventions ◽  
European Countries ◽  
Smoking Habits

scholarly journals Mechanisms of Change in Digital Health Interventions for Mental Disorders in Youth: Systematic Review (Preprint)

2021 ◽  
Author(s):  
Matthias Domhardt ◽  
Sophie Engler ◽  
Hannah Nowak ◽  
Arne Lutsch ◽  
Amit Baumel ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mental Disorders ◽  
Digital Health ◽  
Quality Criteria ◽  
Process Research ◽  
Health Interventions ◽  
Mechanisms Of Change ◽  
Cochrane Central Register ◽  
Cognitive Mediators ◽  
Intervening Variables

BACKGROUND Digital health interventions (DHIs) are efficacious for several mental disorders in youth; however, integrated, evidence-based knowledge about the mechanisms of change in these interventions is lacking. OBJECTIVE This systematic review aims to comprehensively evaluate studies on mediators and mechanisms of change in different DHIs for common mental disorders in children and adolescents. METHODS A systematic literature search of the electronic databases Cochrane Central Register of Controlled Trials, Embase, MEDLINE, and PsycINFO was conducted, complemented by backward and forward searches. Two independent reviewers selected studies for inclusion, extracted the data, and rated the methodological quality of eligible studies (ie, risk of bias and 8 quality criteria for process research). RESULTS A total of 25 studies that have evaluated 39 potential mediators were included in this review. Cognitive mediators were the largest group of examined intervening variables, followed by a broad range of emotional and affective, interpersonal, parenting behavior, and other mediators. The mediator categories with the highest percentages of significant intervening variables were the groups of affective mediators (4/4, 100%) and combined cognitive mediators (13/19, 68%). Although more than three-quarters of the eligible studies met 5 or more quality criteria, causal conclusions have been widely precluded. CONCLUSIONS The findings of this review might guide the empirically informed advancement of DHIs, contributing to improved intervention outcomes, and the discussion of methodological recommendations for process research might facilitate mediation studies with more pertinent designs, allowing for conclusions with higher causal certainty in the future.

scholarly journals The Acceptability and Usability of Digital Health Interventions for Adults With Depression, Anxiety, and Somatoform Disorders: Qualitative Systematic Review and Meta-Synthesis (Preprint)

2019 ◽  
Author(s):  
Shireen Patel ◽  
Athfah Akhtar ◽  
Sam Malins ◽  
Nicola Wright ◽  
Emma Rowley ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Somatoform Disorders ◽  
Digital Health ◽  
Health Interventions ◽  
Health Conditions ◽  
Future Research ◽  
World Population ◽  
Personal Support ◽  
The Individual

BACKGROUND The prevalence of mental health disorders continues to rise, with almost 4% of the world population having an anxiety disorder and almost 3.5% having depression in 2017. Despite the high prevalence, only one-third of people with depression or anxiety receive treatment. Over the last decade, the use of digital health interventions (DHIs) has risen rapidly as a means of accessing mental health care and continues to increase. Although there is evidence supporting the effectiveness of DHIs for the treatment of mental health conditions, little is known about what aspects are valued by users and how they might be improved. OBJECTIVE This systematic review aimed to identify, appraise, and synthesize the qualitative literature available on service users’ views and experiences regarding the acceptability and usability of DHIs for depression, anxiety, and somatoform disorders. METHODS A systematic search strategy was developed, and searches were run in 7 electronic databases. Qualitative and mixed methods studies published in English were included. A meta-synthesis was used to interpret and synthesize the findings from the included studies. RESULTS A total of 24 studies were included in the meta-synthesis, and 3 key themes emerged with descriptive subthemes. The 3 key themes were initial motivations and approaches to DHIs, personalization of treatment, and the value of receiving personal support in DHIs. The meta-synthesis suggests that participants’ initial beliefs about DHIs can have an important effect on their engagement with these types of interventions. Personal support was valued very highly as a major component of the success of DHIs. The main reason for this was the way it enabled individual personalization of care. CONCLUSIONS Findings from the systematic review have implications for the design of future DHIs to improve uptake, retention, and outcomes in DHIs for depression, anxiety, and somatoform disorders. DHIs need to be personalized to the specific needs of the individual. Future research should explore whether the findings could be generalized to other health conditions.

scholarly journals Factors affecting implementation of digital health interventions for people with psychosis or bipolar disorder, and their family and friends: a systematic review

2019 ◽  
Vol 6 (3) ◽  
pp. 257-266 ◽  
Author(s):  
Golnar Aref-Adib ◽  
Tayla McCloud ◽  
Jamie Ross ◽  
Puffin O'Hanlon ◽  
Victoria Appleton ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bipolar Disorder ◽  
Digital Health ◽  
Health Interventions ◽  
Factors Affecting
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