scholarly journals Design Features for Improving Mobile Health Intervention User Engagement: Systematic Review and Thematic Analysis

10.2196/21687 ◽  
2020 ◽  
Vol 22 (12) ◽  
pp. e21687
Author(s):  
Yanxia Wei ◽  
Pinpin Zheng ◽  
Hui Deng ◽  
Xihui Wang ◽  
Xiaomei Li ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mixed Methods ◽  
Mobile Health ◽  
Thematic Analysis ◽  
High Rate ◽  
Cochrane Library ◽  
User Engagement ◽  
Design Features ◽  
Unhealthy Lifestyle ◽  
Mhealth Intervention

Background Well-designed mobile health (mHealth) interventions support a positive user experience; however, a high rate of disengagement has been reported as a common concern regarding mHealth interventions. To address this issue, it is necessary to summarize the design features that improve user engagement based on research over the past 10 years, during which time the popularity of mHealth interventions has rapidly increased due to the use of smartphones. Objective The aim of this review was to answer the question “Which design features improve user engagement with mHealth interventions?” by summarizing published literature with the purpose of guiding the design of future mHealth interventions. Methods This review followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist. Databases, namely, PubMed, Web of Science, Cochrane Library, Ovid EMBASE, and Ovid PsycINFO, were searched for English and Chinese language papers published from January 2009 to June 2019. Thematic analysis was undertaken to assess the design features in eligible studies. The Mixed Methods Appraisal Tool was used to assess study quality. Results A total of 35 articles were included. The investigated mHealth interventions were mainly used in unhealthy lifestyle (n=17) and chronic disease (n=10) prevention programs. Mobile phone apps (n=24) were the most common delivery method. Qualitative (n=22) and mixed methods (n=9) designs were widely represented. We identified the following 7 themes that influenced user engagement: personalization (n=29), reinforcement (n=23), communication (n=20), navigation (n=17), credibility (n=16), message presentation (n=16), and interface aesthetics (n=7). A checklist was developed that contained these 7 design features and 29 corresponding specific implementations derived from the studies. Conclusions This systematic review and thematic synthesis identified useful design features that make an mHealth intervention more user friendly. We generated a checklist with evidence-based items to enable developers to use our findings easily. Future evaluations should use more robust quantitative approaches to elucidate the relationships between design features and user engagement.

scholarly journals Design Features for Improving Mobile Health Intervention User Engagement: Systematic Review and Thematic Analysis (Preprint)

2020 ◽  
Author(s):  
Yanxia Wei ◽  
Pinpin Zheng ◽  
Hui Deng ◽  
Xihui Wang ◽  
Xiaomei Li ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mixed Methods ◽  
Mobile Health ◽  
Thematic Analysis ◽  
High Rate ◽  
Cochrane Library ◽  
User Engagement ◽  
Design Features ◽  
Unhealthy Lifestyle ◽  
Mhealth Intervention

BACKGROUND Well-designed mobile health (mHealth) interventions support a positive user experience; however, a high rate of disengagement has been reported as a common concern regarding mHealth interventions. To address this issue, it is necessary to summarize the design features that improve user engagement based on research over the past 10 years, during which time the popularity of mHealth interventions has rapidly increased due to the use of smartphones. OBJECTIVE The aim of this review was to answer the question “Which design features improve user engagement with mHealth interventions?” by summarizing published literature with the purpose of guiding the design of future mHealth interventions. METHODS This review followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist. Databases, namely, PubMed, Web of Science, Cochrane Library, Ovid EMBASE, and Ovid PsycINFO, were searched for English and Chinese language papers published from January 2009 to June 2019. Thematic analysis was undertaken to assess the design features in eligible studies. The Mixed Methods Appraisal Tool was used to assess study quality. RESULTS A total of 35 articles were included. The investigated mHealth interventions were mainly used in unhealthy lifestyle (n=17) and chronic disease (n=10) prevention programs. Mobile phone apps (n=24) were the most common delivery method. Qualitative (n=22) and mixed methods (n=9) designs were widely represented. We identified the following 7 themes that influenced user engagement: personalization (n=29), reinforcement (n=23), communication (n=20), navigation (n=17), credibility (n=16), message presentation (n=16), and interface aesthetics (n=7). A checklist was developed that contained these 7 design features and 29 corresponding specific implementations derived from the studies. CONCLUSIONS This systematic review and thematic synthesis identified useful design features that make an mHealth intervention more user friendly. We generated a checklist with evidence-based items to enable developers to use our findings easily. Future evaluations should use more robust quantitative approaches to elucidate the relationships between design features and user engagement.

scholarly journals Barriers and facilitators to implementing clinical imaging guidelines by healthcare professionals using theoretical domains framework: a mixed-methods systematic review protocol

BJR|Open ◽  
2021 ◽  
Vol 3 (1) ◽  
pp. 20210004
Author(s):  
Harriet Nalubega Kisembo ◽  
Ritah Nassanga ◽  
Faith Ameda Ameda ◽  
Moses Ocan ◽  
Alison A Kinengyere ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mixed Methods ◽  
Systematic Reviews ◽  
Financial Incentives ◽  
Healthcare Professionals ◽  
Information Source ◽  
Theoretical Domains Framework ◽  
Barriers And Facilitators ◽  
Cochrane Library ◽  
Clinical Imaging

Objectives: To identify, categorize, and develop an aggregated synthesis of evidence using the theoretical domains framework (TDF) on barriers and facilitators that influence implementation of clinical imaging guidelines (CIGs) by healthcare professionals (HCPs) in diagnostic imaging Methods: The protocol will be guided by the Joanna Briggs Institute Reviewers’ Manual 2014. Methodology for JBI Mixed Methods Systematic Reviews and will adhere to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA-P). Information source will include databases (MEDLINE, EMBASE and The Cochrane Library), internet search (https://www.google.com/scholar), experts’ opinion, professional societies/organizations websites and government bodies strategies/recommendations, and reference lists of included studies. Articles of any study design published in English from 1990 to date, having investigated factors operating as barriers and/or facilitators to the implementation CIGs by HCPs will be eligible. Selecting, appraising, and extracting data from the included studies will be independently performed by at least two reviewers using validated tools and Rayyan – Systematic Review web application. Disagreements will be resolved by consensus and a third reviewer as a tie breaker. The aggregated studies will be synthesized using thematic analysis guided by TDF. Results: Identified barriers will be defined a priori and mapped into 7 TDF domains including knowledge, awareness, effectiveness, time, litigationand financial incentives Conclusion: The results will provide an insight into a theory-based approach to predict behavior-related determinants for implementing CIGs and develop strategies/interventions to target the elicited behaviors. Recommendations will be made if the level of evidence is sufficient Advances in knowledge: Resource-constrained settings that are in the process of adopting CIGs may opt for this strategy to predict in advance likely impediments to achieving the goal of CIG implementation and develop tailored interventions during the planning phase. Systematic review Registration: PROSPERO ID = CRD42020136372 (https://www.crd.york.ac.uk/PROSPERO).

scholarly journals The Effectiveness of Self-Management of Hypertension in Adults Using Mobile Health: Systematic Review and Meta-Analysis

10.2196/17776 ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. e17776 ◽  
Author(s):  
Ran Li ◽  
Ning Liang ◽  
Fanlong Bu ◽  
Therese Hesketh
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Health Care ◽  
Medication Adherence ◽  
Mobile Health ◽  
Meta Analysis ◽  
Self Management ◽  
Narrative Synthesis ◽  
Management Behavior ◽  
Mhealth Intervention

Background Effective treatment of hypertension requires careful self-management. With the ongoing development of mobile technologies and the scarcity of health care resources, mobile health (mHealth)–based self-management has become a useful treatment for hypertension, and its effectiveness has been assessed in many trials. However, there is a paucity of comprehensive summaries of the studies using both qualitative and quantitative methods. Objective This systematic review aimed to measure the effectiveness of mHealth in improving the self-management of hypertension for adults. The outcome measures were blood pressure (BP), BP control, medication adherence, self-management behavior, and costs. Methods A systematic search was conducted using 5 electronic databases. The snowballing method was used to scan the reference lists of relevant studies. Only peer-reviewed randomized controlled trials (RCTs) published between January 2010 and September 2019 were included. Data extraction and quality assessment were performed by 3 researchers independently, adhering to the validation guideline and checklist. Both a meta-analysis and a narrative synthesis were carried out. Results A total of 24 studies with 8933 participants were included. Of these, 23 studies reported the clinical outcome of BP, 12 of these provided systolic blood pressure (SBP) and diastolic blood pressure (DBP) data, and 16 articles focused on change in self-management behavior and medication adherence. All 24 studies were included in the narrative synthesis. According to the meta-analysis, a greater reduction in both SBP and DBP was observed in the mHealth intervention groups compared with control groups, −3.78 mm Hg (P<.001; 95% CI −4.67 to −2.89) and −1.57 mm Hg (P<.001; 95% CI −2.28 to −0.86), respectively. Subgroup analyses showed consistent reductions in SBP and DBP across different frequencies of reminders, interactive patterns, intervention functions, and study duration subgroups. A total of 16 studies reported better medication adherence and behavioral change in the intervention groups, while 8 showed no significant change. Six studies included an economic evaluation, which drew inconsistent conclusions. However, potentially long-term financial benefits were mentioned in all economic evaluations. All studies were assessed to be at high risk of bias. Conclusions This review found that mHealth self-management interventions were effective in BP control. The outcomes of this review showed improvements in self-management behavior and medication adherence. The most successful mHealth intervention combined the feature of tailored messages, interactive communication, and multifaceted functions. Further research with longer duration and cultural adaptation is necessary. With increasing disease burden from hypertension globally, mHealth offers a potentially effective method for self-management and control of BP. mHealth can be easily integrated into existing health care systems. Trial Registration PROSPERO CRD42019152062; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=152062

Factors affecting patient and physician engagement in remote healthcare for heart failure: a systematic review (Preprint)

2021 ◽  
Author(s):  
Ahmed Al-Naher ◽  
Jennifer Downing ◽  
Kathryn A Scott ◽  
Munir Pirmohamed
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
Health Outcomes ◽  
Healthcare Professionals ◽  
Clinical Care ◽  
Disease Process ◽  
Ease Of Use ◽  
Cochrane Library ◽  
User Engagement ◽  
Remote Care

BACKGROUND Adult chronic heart failure mainly affects an elderly population with multiple co-morbidities that often require frequent medical visits to prevent poor health outcomes. However the heart failure disease process reduces their independence by reducing mobility, exercise tolerance and cognitive decline. Remote care technologies can bridge the gap in care for these patients by allowing them to be followed up within the comfort of their home and encourage their self-care. However, patients, carers and healthcare professionals need to engage with the technology for it to be useful. OBJECTIVE This systematic review explored qualitative primary studies of remote care technologies used in heart failure, to determine the factors that affect user engagement with the technology. This is explored from the perspective of patients, carers, and healthcare professionals. METHODS Relevant studies published between 1/1/1990 – 19/9/2020 were identified from EMBASE, Ovid MEDLINE, Pubmed, Cochrane library and Scopus. These studies were then synthesized using thematic analysis. Relevant user experiences with remote care were extracted using line-by-line coding. These codes were summarised into secondary codes and core concepts, which were further merged into overarching themes that encapsulate user experience with remote care. RESULTS The review included 47 studies, which led to the generation of 5 overarching themes which affect engagement: (a) ‘Convenience’ relates to time saved by the intervention; (b) ‘Clinical Care’ relates to perceived quality of care and health outcomes; (c) ‘Communication’ involves feedback and interaction between patients, staff and carers; (d) ‘Education’ concerns the tailored information provided; and (e) ‘Ease of Use’ relates to accessibility and technical barriers to engagement. Each theme was applied to each user base of patient, carer and healthcare professional in a different manner. CONCLUSIONS The 5 themes identified highlight aspects of remote care that facilitate engagement, and should be considered in both future design and trials evaluating these technologies.

The biological and Mechanical Behavior of the Standard Implant under Removable Partial Dentures: Systematic Review

2021 ◽  
Vol 8 ◽  
Author(s):  
Ghita Kadri ◽  
Loubna Bahije ◽  
Saloua Berrada
Keyword(s):  
Systematic Review ◽  
Stress Distribution ◽  
Mechanical Behavior ◽  
High Rate ◽  
Cochrane Library ◽  
Implant Survival ◽  
Removable Partial Denture ◽  
Support Surfaces ◽  
Prosthetic Complications

Background: The implant-supported removable partial denture appears to be an interesting alternative for cases where the implant-supported fixed prosthesis is contraindicated whether it is for medical, local, or financial reasons. The objective of this systematic review is to evaluate the biological and mechanical behavior of the implant under a removable partial denture.Methods: A literature search was conducted on the following databases: Pubmed [Medline], Science Direct, and Cochrane Library. Research was limited to publications in English and French during the period from 01/1/2007 to 27/03/2020.Results: Of the 334 citations initially identified, 22 articles met our inclusion criteria, assessing the implant survival rate, patient satisfaction, and the occurrence of implant and prosthetic complications. As well as the evaluation of the stress distribution on the three support surfaces of this prosthesis. Finally, the evaluation of implant localization. The results showed a high rate of implant survival, the occurrence of some prosthetic complications. Stable and acceptable bone resorption over the long term. Better stress distribution at the implant and the bone.Conclusion: The biological and mechanical behavior of the implant under this type of prosthesis appears to be viable in the short, medium, and long term. Although this association between implantology and partial prosthesis seems promising, additional studies are needed to spread this practice still reserved for some specific cases.

scholarly journals Using Mobile Applications to Increase Physical Activity: A Systematic Review

2020 ◽  
Vol 17 (21) ◽  
pp. 8238
Author(s):  
Laura Pradal-Cano ◽  
Carolina Lozano-Ruiz ◽  
José Juan Pereyra-Rodríguez ◽  
Francesc Saigí-Rubió ◽  
Anna Bach-Faig ◽  
...  
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Mobile Health ◽  
Mobile Applications ◽  
Dietary Behaviour ◽  
Cochrane Library ◽  
Full Text Review ◽  
Mobile Health Applications ◽  
Bibliographic Search ◽  
Health Applications

Unhealthy diet and physical inactivity—major risk factors for the main non-communicable diseases—can be addressed by mobile health applications. Using an evidence-based systematic review design, we analysed studies on mobile applications to foster physical activity to determine whether they met the objective of increasing adults’ physical activity. A bibliographic search was conducted in October 2020 using PubMed, Cochrane Library Plus, Biomed Central, Psychology Database, and SpringerLink, retrieving 191 articles. After titles and abstracts were reviewed, 149 articles were excluded, leaving 42 articles for a full-text review, of which 14 met the inclusion criteria. Despite differences in study duration, design, and variables, 13 of the 14 studies reported that applications were effective in increasing physical activity and healthy habits as dietary behaviour. However, further longer-term studies with larger samples are needed to confirm the effectiveness of mobile health applications in increasing physical activity.

scholarly journals Mobile health interventions to promote physical activity and reduce sedentary behaviour in the workplace: A systematic review

2019 ◽  
Vol 5 ◽  
pp. 205520761983988 ◽  
Author(s):  
Sarah Ann Buckingham ◽  
Andrew James Williams ◽  
Karyn Morrissey ◽  
Lisa Price ◽  
John Harrison
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Sedentary Behaviour ◽  
Mobile Health ◽  
Technology Use ◽  
Methodological Quality ◽  
Experimental Studies ◽  
Cochrane Library ◽  
Behaviour Change Techniques ◽  
The Impact

Objective This systematic review aimed to assess the effectiveness, feasibility and acceptability of mobile health (mHealth) technology (including wearable activity monitors and smartphone applications) for promoting physical activity (PA) and reducing sedentary behaviour (SB) in workplace settings. Methods Systematic searches were conducted in seven electronic databases (MEDLINE, SPORTDiscus, Scopus, EMBASE, PsycINFO, Web of Science and the Cochrane library). Studies were included if mHealth was a major intervention component, PA/SB was a primary outcome, and participants were recruited and/or the intervention was delivered in the workplace. Study quality was assessed using the Effective Public Health Practice Project (EPHPP) tool. Interventions were coded for behaviour change techniques (BCTs) using the Coventry, Aberdeen and London – Refined (CALO-RE) taxonomy. Results Twenty-five experimental and quasi-experimental studies were included. Studies were highly heterogeneous and only one was rated as ‘strong’ methodological quality. Common BCTs included self-monitoring, feedback, goal-setting and social comparison. A total of 14/25 (56%) studies reported a significant increase in PA, and 4/10 (40%) reported a significant reduction in sedentary time; 11/16 (69%) studies reported a significant impact on secondary outcomes including reductions in weight, systolic blood pressure and total cholesterol. While overall acceptability was high, a large decline in technology use and engagement was observed over time. Conclusions While methodological quality was generally weak, there is reasonable evidence for mHealth in a workplace context as a feasible, acceptable and effective tool to promote PA. The impact in the longer term and on SB is less clear. Higher quality, mixed methods studies are needed to explore the reasons for decline in engagement with time and the longer-term potential of mHealth in workplace interventions. Protocol registration: The review protocol was registered with PROSPERO: CRD42017058856

scholarly journals Mobile Health Technology Interventions for Suicide Prevention: Systematic Review (Preprint)

2018 ◽  
Author(s):  
Ruth Melia ◽  
Kady Francis ◽  
Emma Hickey ◽  
John Bogue ◽  
Jim Duggan ◽  
...  
Keyword(s):  
Suicidal Ideation ◽  
Suicide Prevention ◽  
Mobile Health ◽  
Cochrane Library ◽  
Outcome Variable ◽  
Controlled Trials ◽  
Safe Practice ◽  
Mhealth Intervention ◽  
Self Harm ◽  
Mhealth Technology

BACKGROUND Digital interventions are proposed as one way by which effective treatments for self-harm and suicidal ideation may be improved and their scalability enhanced. Mobile devices offer a potentially powerful medium to deliver evidence-based interventions with greater specificity to the individual when the intervention is needed. The recent proliferation of publicly available mobile apps designed for suicide prevention underlines the need for robust evidence to promote safe practice. OBJECTIVE This review aimed to examine the effectiveness of currently available mobile health (mHealth) technology tools in reducing suicide-specific outcomes. METHODS The following databases were searched: Cochrane Central Register of Controlled Trials (The Cochrane Library), MEDLINE, EMBASE, PsycINFO, and relevant sources of gray literature. All published and unpublished randomized controlled trials (RCTs), pseudo-RCTs, and pre-post observational studies that evaluated the effectiveness of mHealth technology in suicide prevention delivered via mobile computing and communication technology were included. Studies were included if they measured at least one suicide outcome variable (ie, suicidal ideation, suicidal intent, nonsuicidal self-injurious behavior, and suicidal behavior). A total of 2 review authors independently extracted data and assessed study suitability, in accordance with the Cochrane Collaboration Risk of Bias Tool, on July 31, 2018. Owing to the heterogeneity of outcomes found across studies, results were not amenable for pooled synthesis, and a meta-analysis was not performed. A narrative synthesis of the available research is presented here. RESULTS A total of 7 studies met criteria for inclusion . Four published articles that reported on the effectiveness of the following mobile phone apps were included: iBobbly, Virtual Hope Box, BlueIce, and Therapeutic Evaluative Conditioning. Results demonstrated some positive impacts for individuals at elevated risk of suicide or self-harm, including reductions in depression, psychological distress, and self-harm and increases in coping self-efficacy. None of the apps evaluated demonstrated the ability to significantly decrease suicidal ideation compared with a control condition. In addition, 3 unpublished and recently completed trials also met criteria for inclusion in the review. CONCLUSIONS Further research is needed to evaluate the efficacy of stand-alone mHealth technology–based interventions in suicide prevention. The small number of studies reported in this review tentatively indicate that such tools may have a positive impact on suicide-specific outcomes. Future mHealth intervention evaluations would benefit from addressing the following 3 main methodological limitations : (1) heterogeneity of outcomes: a lack of standardized measurement of suicide outcomes across studies; (2) ecological validity: the tendency to exclude potential participants because of the elevated suicide risk may reduce generalizability within clinical settings; and (3) app regulation and definition: the lack of a standardized classification system for mHealth intervention type points to the need for better definition of the scope of such technologies to promote safe practice.

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