scholarly journals Digital Health Interventions to Enhance Prevention in Primary Care: A Scoping Review (Preprint)

10.2196/33518 ◽  
2021 ◽  
Author(s):  
Van C Willis ◽  
Kelly Jean Thomas Craig ◽  
Yalda Yabbarpour ◽  
Elisabeth L Scheufele ◽  
Yull E Arriaga ◽  
...  
Keyword(s):  
Primary Care ◽  
Scoping Review ◽  
Digital Health ◽  
Health Interventions

Digital Health Interventions to Enhance Prevention in Primary Care: A Scoping Review (Preprint)

2021 ◽  
Author(s):  
Van C Willis ◽  
Kelly Jean Thomas Craig ◽  
Yalda Yabbarpour ◽  
Elisabeth L Scheufele ◽  
Yull E Arriaga ◽  
...  
Keyword(s):  
Primary Care ◽  
Electronic Health Record ◽  
Scoping Review ◽  
Subgroup Analysis ◽  
Care Management ◽  
Digital Health ◽  
Health Interventions ◽  
Health Record ◽  
Primary Care Settings ◽  
Electronic Health

BACKGROUND Digital transformation of primary care practices, including the use digital health interventions (DHIs), has yet to be systematically evaluated. OBJECTIVE To identify and describe the scope and use of current DHIs for preventive care in primary care settings. METHODS A scoping review to identify literature published from 2014 to 2020 was conducted across multiple databases using keywords and MeSH terms covering primary care professionals AND prevention and care management AND digital health. A subgroup analysis identified relevant studies conducted in US primary care settings excluding DHIs that use the electronic health record (EHR) as a retrospective data capture tool. Technology descriptions, outcomes (e.g., healthcare performance and implementation science), and study quality as per Oxford Levels of Evidence were abstracted. RESULTS The search yielded 5,274 citations of which 1,060 full-texts were identified. Following a subgroup analysis, 241 articles met inclusion criteria. Studies primarily examined DHIs among health information technology including EHRs (69%), clinical decision support (41%), telehealth (37%), or multiple technologies (61%). DHIs were predominantly used for tertiary prevention (55%). Of the core primary care functions, comprehensiveness was addressed most frequently (87%). DHI users were providers (85%), patients (46%), or multiples (37%). Reported outcomes were primarily clinical (70%) and statistically significant improvements were common (69%). Results were summarized across five topics for the most novel/distinct DHIs: population-centered, patient-centered, care access expansion, panel-centered (dashboarding), and application-driven DHIs. Quality of the included studies was moderate-to-low. CONCLUSIONS Preventive DHIs used in primary care settings demonstrated meaningful improvements in both clinical and non-clinical outcomes across user types; however, adoption and implementation in the US was limited to primarily electronic health record-centric platforms and users were mainly clinicians receiving alerts regarding care management for their patients. Evaluation of negative results, effects on health disparities, and many other gaps remain to be explored.

Development of the Key Performance Indicators for Digital Health Interventions: A Scoping Review (Preprint)

2021 ◽  
Author(s):  
Maria Brenner ◽  
Arielle Weir ◽  
Margaret McCann ◽  
Carmel Doyle ◽  
Mary Hughes ◽  
...  
Keyword(s):  
Scoping Review ◽  
Performance Indicators ◽  
Delphi Study ◽  
Current Knowledge ◽  
Digital Health ◽  
Stakeholder Involvement ◽  
Key Performance Indicators ◽  
Healthcare Services ◽  
Health Interventions ◽  
Original Research

BACKGROUND Development of the Key Performance Indicators for Digital Health Interventions: A Scoping Review OBJECTIVE Digital health interventions (DHIs) offer new methods for delivering healthcare, with the potential to innovate healthcare services. Key performance indicators (KPIs) play a role in evaluation, measurement, and improvement in healthcare quality and service performance. The scoping review question was developed following an initial search to identify literature to assist in the development of KPIs for an ongoing DHI initiative. During the initial search, it became clear that there was limited literature on how to develop specific and measurable KPIs that evaluate DHIs. The aim of this scoping review was to identify current knowledge and evidence surrounding the development of KPIs for DHIs. METHODS A rigorous literature search was conducted across ten key databases: AMED - The Allied and Complementary Medicine Database, CINAHL Complete, Health Source: Nursing/Academic Edition, MEDLINE, APA PsycINFO, EMBASE, EBM Reviews - Cochrane Database of Systematic Reviews, EBM Reviews - Database of Abstracts of Reviews of Effects, EBM Reviews - Health Technology Assessment, and IEEE Xplore. A descriptive summary of the literature was performed, and thematic analysis identified important or reoccurring themes. RESULTS Five references (representing four unique publications) were eligible for the review. Of the four included publications, two were articles on original research studies of a specific DHI, and two were overviews of methods for developing DHIs (not specific to a single DHI). All the included reports discussed the involvement of stakeholders in developing KPIs for DHIs. The step of identifying and defining the KPIs was completed using various methodologies, but all centered on a form of stakeholder involvement. Potential options for stakeholder involvement for KPI identification include the use of an elicitation framework, a factorial survey approach, or a Delphi study. Most of the included articles recognised the lack of literature relating to KPI development for DHIs, compared to the breath of literature available on the development of KPIs in other fields like health or informatics CONCLUSIONS Few articles were identified, highlighting a significant gap in the evidence-based knowledge in this domain. All the included articles discussed the involvement of stakeholders in developing KPIs for DHIs, which was performed using various methodologies. The articles acknowledged a lack of literature related to KPI development for DHIs. To allow comparability between KPI initiatives and facilitate work in the field, further research would be beneficial to develop a common methodology for KPI development for DHIs.

scholarly journals Social Cognitive Theories and Electronic Health Design: Scoping Review (Preprint)

2018 ◽  
Author(s):  
Patricia Grace-Farfaglia
Keyword(s):  
Scoping Review ◽  
Social Cognitive ◽  
Digital Health ◽  
Health Intervention ◽  
Health Interventions ◽  
Design Features ◽  
Social Design ◽  
Web Based ◽  
Cognitive Theories ◽  
Social Cognitive Theories

BACKGROUND There are several social cognitive theories (SCTs) and models that support platform design in electronic health (eHealth) promotion trials. The rationale for this scoping review was to determine how social design features (informational aid, expressive support, gaming, and tailored content) are used to promote self-efficacy, engagement, knowledge, and behavior change. OBJECTIVE This study aimed to review a broad spectrum of digital health interventions in the literature seeking trials that use SCTs for the design of eHealth applications. METHODS The author conducted a systematic scoping review of 161 Web-based health interventions from published randomized clinical trials using 1 or more tools to address the social cognitive determinants in their website design from January 2006 to April 2016. An iterative approach was used in the selection of studies and data extraction. The studies were analyzed for quality and coded for type of social design features employed. RESULTS Expressive interaction tools were found in 48.6% (54/111) of studies categorized as a strong recommendation by the Joanna Briggs Institute criteria. Overall, less than half of the studies addressed participant social support and motivational needs (43.8%). The vast majority of studies (100%) relied on the use of the Web for delivery of informational aid and tailored content for the individual participant (75.9%). CONCLUSIONS This review fills a research gap by linking social theory to Web strategy to improve the impact and sustainability of eHealth interventions. A Digital Health Intervention Model was developed to provide a framework to enhance future Web-based health intervention design and execution.

scholarly journals Surveying the Role of Analytics in Evaluating Digital Mental Health Interventions for Transition-Aged Youth: Scoping Review (Preprint)

2019 ◽  
Author(s):  
Brian Lo ◽  
Jenny Shi ◽  
Elisa Hollenberg ◽  
Alexxa Abi-Jaoudé ◽  
Andrew Johnson ◽  
...  
Keyword(s):  
Mental Health ◽  
Scoping Review ◽  
Care Delivery ◽  
Digital Health ◽  
Controlled Trial ◽  
Health Interventions ◽  
Health Apps ◽  
Mental Health Interventions ◽  
Usage Data

BACKGROUND Consumer-facing digital health interventions provide a promising avenue to bridge gaps in mental health care delivery. To evaluate these interventions, understanding how the target population uses a solution is critical to the overall validity and reliability of the evaluation. As a result, usage data (analytics) can provide a proxy for evaluating the engagement of a solution. However, there is paucity of guidance on how usage data or analytics should be used to assess and evaluate digital mental health interventions. OBJECTIVE This review aimed to examine how usage data are collected and analyzed in evaluations of mental health mobile apps for transition-aged youth (15-29 years). METHODS A scoping review was conducted using the Arksey and O’Malley framework. A systematic search was conducted on 5 journal databases using keywords related to usage and engagement, mental health apps, and evaluation. A total of 1784 papers from 2008 to 2019 were identified and screened to ensure that they included analytics and evaluated a mental health app for transition-aged youth. After full-text screening, 49 papers were included in the analysis. RESULTS Of the 49 papers included in the analysis, 40 unique digital mental health innovations were evaluated, and about 80% (39/49) of the papers were published over the past 6 years. About 80% involved a randomized controlled trial and evaluated apps with information delivery features. There were heterogeneous findings in the concept that analytics was ascribed to, with the top 3 being engagement, adherence, and acceptability. There was also a significant spread in the number of metrics collected by each study, with 35% (17/49) of the papers collecting only 1 metric and 29% (14/49) collecting 4 or more analytic metrics. The number of modules completed, the session duration, and the number of log ins were the most common usage metrics collected. CONCLUSIONS This review of current literature identified significant variability and heterogeneity in using analytics to evaluate digital mental health interventions for transition-aged youth. The large proportion of publications from the last 6 years suggests that user analytics is increasingly being integrated into the evaluation of these apps. Numerous gaps related to selecting appropriate and relevant metrics and defining successful or high levels of engagement have been identified for future exploration. Although long-term use or adoption is an important precursor to realizing the expected benefits of an app, few studies have examined this issue. Researchers would benefit from clarification and guidance on how to measure and analyze app usage in terms of evaluating digital mental health interventions for transition-aged youth. Given the established role of adoption in the success of health information technologies, understanding how to abstract and analyze user adoption for consumer digital mental health apps is also an emerging priority.

Digital health interventions in prevention, relapse and therapy of mild and moderate depression – a scoping review (Preprint)

2020 ◽  
Author(s):  
Pinar Tokgöz ◽  
Robert Hrynyschyn ◽  
Jessica Hafner ◽  
Simone Schönfeld ◽  
Christoph Dockweiler
Keyword(s):  
Behavior Therapy ◽  
Cognitive Behavior Therapy ◽  
Scoping Review ◽  
Relapse Prevention ◽  
Digital Health ◽  
Health Interventions ◽  
Cognitive Behavior ◽  
Comprehensive Overview ◽  
Web Based ◽  
Treatment Of Depression

BACKGROUND Depression is a major cause for disability worldwide and digital health interventions are expected to be a more augmentative and effective treatment. According to the fast-growing field of information and communication technologies and its dissemination, there is a need of mapping the technological landscape, as well as its benefits and challenges for users. OBJECTIVE A scoping review was conducted to provide a comprehensive overview in the field of digital health interventions for the treatment of depression. The purpose of this scoping review was to give an overview of the used DHI for depression. The main goal of this review was then to provide a comprehensive review of the system landscape and its technological state and functions, as well as its evidence and benefits for users. METHODS A scoping review was conducted to provide a comprehensive overview in the field of digital health interventions for the treatment of depression. PubMed, Psyndex, and Cochrane were searched by two independent researchers between May 2019 and April 2019 to identify relevant publications and were examined due to inclusion and exclusion criteria. For conducting the systematic review, ‘Rayyan’, a free web-tool, was used. RESULTS In total, 51 studies were included in the qualitative synthesis. After categorizing the field of application in prevention, early detection, therapy and relapse prevention, the search showed dominant numbers of studies in the field therapy (N= 42). There was only one prevention study, three studies for early detection and five studies for relapse prevention. Dominant measures of depression severity were the PHQ-9 or the BDI-II scale. The most dominant therapy approaches were cognitive behavior therapy, acceptance and commitment therapy and problem-solving therapy. Most of the studies revealed significant effects of digital health intervention when cognitive behavior therapy applied. cognitive behavior therapy as the most dominant form was often provided by web-based systems. Combined approaches consisting of web-based and smartphone-based approaches are constantly rising. CONCLUSIONS Digital health interventions for treating depression are quite comprehensive. There are different interventions focusing on different fields of care. While most applications can be beneficial to achieving a better care for depression patients, it can be hindering in determining which approaches in the depression care are suitable. Computerized CBT has shown good effects in the treatment of depression, but treatment for depression still stays very individualistic.

scholarly journals Genomic Health Literacy Interventions in Pediatrics: Scoping Review

10.2196/26684 ◽  
2021 ◽  
Vol 23 (12) ◽  
pp. e26684
Author(s):  
Aarushi Gupta ◽  
Joseph A Cafazzo ◽  
Maarten J IJzerman ◽  
Joost F Swart ◽  
Sebastiaan Vastert ◽  
...  
Keyword(s):  
Decision Making ◽  
Health Literacy ◽  
Patient Education ◽  
Scoping Review ◽  
Pediatric Patients ◽  
Digital Health ◽  
Health Interventions ◽  
Care Providers ◽  
Genomic Information ◽  
Pediatric Illnesses

Background The emergence of genetic and genomic sequencing approaches for pediatric patients has raised questions about the genomic health literacy levels, attitudes toward receiving genomic information, and use of this information to inform treatment decisions by pediatric patients and their parents. However, the methods to educate pediatric patients and their parents about genomic concepts through digital health interventions have not been well-established. Objective The primary objective of this scoping review is to investigate the current levels of genomic health literacy and the attitudes toward receiving genomic information among pediatric patients and their parents. The secondary aim is to investigate patient education interventions that aim to measure and increase genomic health literacy among pediatric patients and their parents. The findings from this review will be used to inform future digital health interventions for patient education. Methods A scoping review using PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines and protocols was completed using the following databases: MEDLINE, Embase, CINAHL, and Scopus. Our search strategy included genomic information inclusive of all genetic and genomic terms, pediatrics, and patient education. Inclusion criteria included the following: the study included genetic, genomic, or a combination of genetic and genomic information; the study population was pediatric (children and adolescents <18 years) and parents of patients with pediatric illnesses or only parents of patients with pediatric illnesses; the study included an assessment of the knowledge, attitudes, and intervention regarding genomic information; the study was conducted in the last 12 years between 2008 and 2020; and the study was in the English language. Descriptive data regarding study design, methodology, disease population, and key findings were extracted. All the findings were collated, categorized, and reported thematically. Results Of the 4618 studies, 14 studies (n=6, 43% qualitative, n=6, 43% mixed methods, and n=2, 14% quantitative) were included. Key findings were based on the following 6 themes: knowledge of genomic concepts, use of the internet and social media for genomic information, use of genomic information for decision-making, hopes and attitudes toward receiving genomic information, experiences with genetic counseling, and interventions to improve genomic knowledge. Conclusions This review identified that older age is related to the capacity of understanding genomic concepts, increased genomic health literacy levels, and the perceived ability to participate in decision-making related to genomic information. In addition, internet-searching plays a major role in obtaining genomic information and filling gaps in communication with health care providers. However, little is known about the capacity of pediatric patients and their parents to understand genomic information and make informed decisions based on the genomic information obtained. More research is required to inform digital health interventions and to leverage the leading best practices to educate these genomic concepts.

scholarly journals Surveying the Role of Analytics in Evaluating Digital Mental Health Interventions for Transition-Aged Youth: Scoping Review

10.2196/15942 ◽  
2020 ◽  
Vol 7 (6) ◽  
pp. e15942
Author(s):  
Brian Lo ◽  
Jenny Shi ◽  
Elisa Hollenberg ◽  
Alexxa Abi-Jaoudé ◽  
Andrew Johnson ◽  
...  
Keyword(s):  
Mental Health ◽  
Scoping Review ◽  
Care Delivery ◽  
Digital Health ◽  
Controlled Trial ◽  
Health Interventions ◽  
Health Apps ◽  
Mental Health Interventions ◽  
Usage Data

Background Consumer-facing digital health interventions provide a promising avenue to bridge gaps in mental health care delivery. To evaluate these interventions, understanding how the target population uses a solution is critical to the overall validity and reliability of the evaluation. As a result, usage data (analytics) can provide a proxy for evaluating the engagement of a solution. However, there is paucity of guidance on how usage data or analytics should be used to assess and evaluate digital mental health interventions. Objective This review aimed to examine how usage data are collected and analyzed in evaluations of mental health mobile apps for transition-aged youth (15-29 years). Methods A scoping review was conducted using the Arksey and O’Malley framework. A systematic search was conducted on 5 journal databases using keywords related to usage and engagement, mental health apps, and evaluation. A total of 1784 papers from 2008 to 2019 were identified and screened to ensure that they included analytics and evaluated a mental health app for transition-aged youth. After full-text screening, 49 papers were included in the analysis. Results Of the 49 papers included in the analysis, 40 unique digital mental health innovations were evaluated, and about 80% (39/49) of the papers were published over the past 6 years. About 80% involved a randomized controlled trial and evaluated apps with information delivery features. There were heterogeneous findings in the concept that analytics was ascribed to, with the top 3 being engagement, adherence, and acceptability. There was also a significant spread in the number of metrics collected by each study, with 35% (17/49) of the papers collecting only 1 metric and 29% (14/49) collecting 4 or more analytic metrics. The number of modules completed, the session duration, and the number of log ins were the most common usage metrics collected. Conclusions This review of current literature identified significant variability and heterogeneity in using analytics to evaluate digital mental health interventions for transition-aged youth. The large proportion of publications from the last 6 years suggests that user analytics is increasingly being integrated into the evaluation of these apps. Numerous gaps related to selecting appropriate and relevant metrics and defining successful or high levels of engagement have been identified for future exploration. Although long-term use or adoption is an important precursor to realizing the expected benefits of an app, few studies have examined this issue. Researchers would benefit from clarification and guidance on how to measure and analyze app usage in terms of evaluating digital mental health interventions for transition-aged youth. Given the established role of adoption in the success of health information technologies, understanding how to abstract and analyze user adoption for consumer digital mental health apps is also an emerging priority.

scholarly journals Digital health interventions in prevention, relapse and therapy of mild and moderate depression: a scoping review (Preprint)

2020 ◽  
Author(s):  
Pinar Tokgöz ◽  
Robert Hrynyschyn ◽  
Jessica Hafner ◽  
Simone Schönfeld ◽  
Christoph Dockweiler
Keyword(s):  
Early Detection ◽  
Behavior Therapy ◽  
Cognitive Behavior Therapy ◽  
Scoping Review ◽  
Relapse Prevention ◽  
Digital Health ◽  
Health Interventions ◽  
Cognitive Behavior ◽  
Web Based ◽  
Treatment Of Depression

BACKGROUND Depression is a major cause for disability worldwide and digital health interventions are expected to be a more augmentative and effective treatment. According to the fast-growing field of information and communication technologies and its dissemination, there is a need of mapping the technological landscape, as well as its benefits for users. OBJECTIVE The purpose of this scoping review was to give an overview of the used DHI for depression. The main goal of this review was then to provide a comprehensive review of the system landscape and its technological state and functions, as well as its evidence and benefits for users. METHODS A scoping review was conducted to provide a comprehensive overview in the field of digital health interventions for the treatment of depression. PubMed, Psyndex and the Cochrane Library were searched by two independent researchers in October 2020 to identify relevant publications of the last ten years and were examined due to inclusion and exclusion criteria. For conducting the systematic review, ‘Rayyan’, a free web-tool, was used. RESULTS In total, 65 studies were included in the qualitative synthesis. After categorizing the field of application in prevention, early detection, therapy and relapse prevention, the search showed dominant numbers of studies in the field of therapy (N= 52). There was only one study for prevention, five studies for early detection and seven studies for relapse prevention. The most dominant therapy approaches were cognitive behavior therapy, acceptance and commitment therapy and problem-solving therapy. Most of the studies revealed significant effects of digital health interventions when cognitive behavior therapy applied. Cognitive behavior therapy as the most dominant form was often provided by web-based systems. Combined approaches consisting of web-based and smartphone-based approaches are constantly rising. CONCLUSIONS Digital health interventions for treating depression are quite comprehensive. There are different interventions focusing on different fields of care. While most interventions can be beneficial to achieve a better depression treatment, it can be hindering in determining which approaches are suitable. Cognitive behavior therapy that has been realized with digital health interventions has shown good effects in the treatment of depression, but treatment for depression still stays very individualistic.

scholarly journals A GDPR-compliant information system to improve community primary care in a middle income country

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
V A Oliveira ◽  
R B David ◽  
L G Mota ◽  
M Barral-Netto ◽  
R P Carreiro ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Information System ◽  
Primary Health Care ◽  
Health System ◽  
Community Health ◽  
Digital Health ◽  
Family Health ◽  
Health Interventions ◽  
Primary Health

Abstract Background A strong primary health care (PHC) is associated to better overall health system results. Brazil has good results in PHC in the last decades, integrating 260,000 community health workers (CHW) in 43,000 family health teams (FHT), assisting 90 million people and delivering 500 million health activities yearly, such as home visits, consultations, colposcopy, etc. We address the challenges of incorporating CHA-produced data to official electronic health records, automate its analysis and promote information use by FHT to plan activities & prioritize individuals considering social determinants of health, clinical data and treatment plans. Our study developed a general data protection regulation (GDPR) compliant information system to improve community health agents and family health teams coordination of care in order to address this challenge. Methods The intervention was developed using UX techniques and combines Apps and Web dashboards, issuing digital alerts to the FHT and municipal health manager, regarding individual health status and pending care for each covered individual. The research used the “Monitoring and Evaluating Digital Health Interventions” toolbox by World Health Organization (WHO), and GDPR compliance was attained by terms of use acceptance, pseudonymisation and anonymization procedures. Results Stage 1 and Stage 2 Maturity tests with doctors, nurses and CHA showed good feasibility, usability and user satisfaction of the solution. UX and Qualitative Assessment are reported separately. Conclusions Results so far point that the solution is viable and acknowledged as useful by health professionals. Stage 3 (Pilot) will run in September 2020 in two different cities to test efficacy and health system adherence in real world setting. Digital health interventions are powerful tool to improve health care system performance, particularly in Primary Health Care. Key messages Digital Health Intervention are viable in Primary Care as long as they reduce health profesisonal burden and increase service quality. Brazil is a promising environment for Digital Health. Careful planning, development and deployment are essential in the process.

scholarly journals Primary care professionals’ attitudes towards digital health interventions for common mental disorders: study protocol for a mixed methods systematic review

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e045657
Author(s):  
Maria Hanf ◽  
Julian Hirt ◽  
Marjan van den Akker
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Mixed Methods ◽  
Mental Disorders ◽  
Care Setting ◽  
Primary Care Setting ◽  
Digital Health ◽  
Health Interventions ◽  
Mental Health Interventions ◽  
Primary Care Professionals

IntroductionMental disorders such as depression are common, and an estimated 264 million people are affected by them throughout the world. In recent years, studies on digital health interventions to treat mental disorders have shown evidence of their efficacy, and interest in using them has increased as a result. In the primary care setting, depression and anxiety are the two most frequently diagnosed and treated mental disorders. When they do not refer them to specialists, primary care professionals such as general practitioners treat patients with mental disorders themselves but have insufficient time to treat them adequately. Furthermore, there is a shortage of psychotherapists and those that exist have long waiting lists for an appointment. The purpose of this mixed methods systematic review is to explore the attitudes of primary care professionals towards the use of digital health interventions in the treatment of patients with mental disorders. Their attitudes will provide an indication whether digital mental health interventions can effectively complement standard care in the primary care setting.Methods and analysisWe searched for qualitative, quantitative and mixed methods studies published in English, German, Spanish, Russian, French and Dutch after January 2010 for inclusion in the review. The included studies must involve digital mental health interventions conducted via computer and/or mobile devices in the primary care setting. The search was conducted in July 2020 in the following electronic bibliographic databases: MEDLINE, Embase, CINAHL, PsycINFO and Web of Science Core Collection. Two reviewers will independently screen titles, abstracts and full texts and extract data. We will use the ‘Integrated methodology’ framework to combine both quantitative and qualitative data.Ethics and disseminationEthical approval is not required. We will disseminate the results of the mixed methods systematic review in a peer-reviewed journal and scientific conferences.PROSPERO registration numberCRD42020188879.

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