scholarly journals Applying the eHealth literacy lens: A systematic review of eHealth interventions targeted at socially disadvantaged groups (Preprint)

2020 ◽  
Author(s):  
Christina Cheng ◽  
Alison Beauchamp ◽  
Gerald R Elsworth ◽  
Richard H Osborne
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Rural Communities ◽  
Low Income ◽  
User Involvement ◽  
Low Literacy ◽  
Ehealth Literacy ◽  
Disadvantaged Groups ◽  
Socially Disadvantaged ◽  
Improve Health

BACKGROUND eHealth holds the potential to improve health outcomes. However, eHealth systems need to match the eHealth literacy needs of users in order to be equitably adopted. Socially disadvantaged groups have lower access and skills to use technologies and are at risk of being digitally marginalised, leading to potential widening of health disparities. OBJECTIVE This systematic review aimed to explore the role of eHealth literacy and user involvement in developing eHealth interventions targeted at socially disadvantaged groups. METHODS A systematic search was conducted across ten databases for eHealth interventions targeted at older adults, ethnic minority groups, low-income groups, low-literacy groups, and rural communities. The eHealth Literacy Framework was used to examine eHealth literacy components of reviewed interventions. Results were analysed using narrative synthesis. RESULTS Fifty-one studies reporting on the results of 48 interventions were evaluated. Most studies were targeted at older adults and ethnic minorities with only two studies focused on low-literacy groups. eHealth literacy was not considered in the development of any of the studies and no eHealth literacy assessment was conducted. User involvement in designing interventions was limited and eHealth intervention developmental frameworks were rarely used. Strategies to assist users to engage with technical systems were seldom included in the interventions, and accessibility features were limited. The results of the included studies also provided inconclusive evidence on the effectiveness of eHealth interventions. CONCLUSIONS The findings highlight that eHealth literacy is generally overlooked in developing eHealth interventions targeted at socially disadvantaged groups while evidence about the effectiveness of such interventions is limited. To ensure equal access and inclusiveness in the age of eHealth, eHealth literacy of disadvantaged groups needs to be addressed to help avoid a digital divide. This will assist the realization of recent technological advancements and, importantly, improve health equity. CLINICALTRIAL

scholarly journals Applying the Electronic Health Literacy Lens: Systematic Review of Electronic Health Interventions Targeted at Socially Disadvantaged Groups

10.2196/18476 ◽  
2020 ◽  
Vol 22 (8) ◽  
pp. e18476 ◽  
Author(s):  
Christina Cheng ◽  
Alison Beauchamp ◽  
Gerald R Elsworth ◽  
Richard H Osborne
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Low Income ◽  
User Involvement ◽  
Low Literacy ◽  
Ehealth Literacy ◽  
Disadvantaged Groups ◽  
Socially Disadvantaged ◽  
Electronic Health ◽  
Improve Health

Background Electronic health (eHealth) has the potential to improve health outcomes. However, eHealth systems need to match the eHealth literacy needs of users to be equitably adopted. Socially disadvantaged groups have lower access and skills to use technologies and are at risk of being digitally marginalized, leading to the potential widening of health disparities. Objective This systematic review aims to explore the role of eHealth literacy and user involvement in developing eHealth interventions targeted at socially disadvantaged groups. Methods A systematic search was conducted across 10 databases for eHealth interventions targeted at older adults, ethnic minority groups, low-income groups, low-literacy groups, and rural communities. The eHealth Literacy Framework was used to examine the eHealth literacy components of reviewed interventions. The results were analyzed using narrative synthesis. Results A total of 51 studies reporting on the results of 48 interventions were evaluated. Most studies were targeted at older adults and ethnic minorities, with only 2 studies focusing on low-literacy groups. eHealth literacy was not considered in the development of any of the studies, and no eHealth literacy assessment was conducted. User involvement in designing interventions was limited, and eHealth intervention developmental frameworks were rarely used. Strategies to assist users in engaging with technical systems were seldom included in the interventions, and accessibility features were limited. The results of the included studies also provided inconclusive evidence on the effectiveness of eHealth interventions. Conclusions The findings highlight that eHealth literacy is generally overlooked in developing eHealth interventions targeted at socially disadvantaged groups, whereas evidence about the effectiveness of such interventions is limited. To ensure equal access and inclusiveness in the age of eHealth, eHealth literacy of disadvantaged groups needs to be addressed to help avoid a digital divide. This will assist the realization of recent technological advancements and, importantly, improve health equity.

scholarly journals Digital Predictors of Morbidity, Hospitalization, and Mortality Among Older Adults: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 2 ◽  
Author(s):  
Sofia Daniolou ◽  
Andreas Rapp ◽  
Celina Haase ◽  
Alfred Ruppert ◽  
Marlene Wittwer ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Health Outcomes ◽  
Digital Health ◽  
Meta Analysis ◽  
Design Development ◽  
Clinical Implementation ◽  
Care Needs ◽  
Health Technologies ◽  
Improve Health

The widespread adoption of digital health technologies such as smartphone-based mobile applications, wearable activity trackers and Internet of Things systems has rapidly enabled new opportunities for predictive health monitoring. Leveraging digital health tools to track parameters relevant to human health is particularly important for the older segments of the population as old age is associated with multimorbidity and higher care needs. In order to assess the potential of these digital health technologies to improve health outcomes, it is paramount to investigate which digitally measurable parameters can effectively improve health outcomes among the elderly population. Currently, there is a lack of systematic evidence on this topic due to the inherent heterogeneity of the digital health domain and the lack of clinical validation of both novel prototypes and marketed devices. For this reason, the aim of the current study is to synthesize and systematically analyse which digitally measurable data may be effectively collected through digital health devices to improve health outcomes for older people. Using a modified PICO process and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) framework, we provide the results of a systematic review and subsequent meta-analysis of digitally measurable predictors of morbidity, hospitalization, and mortality among older adults aged 65 or older. These findings can inform both technology developers and clinicians involved in the design, development and clinical implementation of digital health technologies for elderly citizens.

scholarly journals The Association of Frailty with Poverty in Older Adults: A Systematic Review

2021 ◽  
pp. 1-7
Author(s):  
Audai A. Hayajneh ◽  
Mohammad Rababa
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Low Income ◽  
Social Life ◽  
Negative Consequences ◽  
Cross Sectional ◽  
Search Terms ◽  
The Social ◽  
The Relationship ◽  
Financial Issues

<b><i>Introduction:</i></b> Suffering from both frailty and poverty may have significant negative consequences on older adults’ lives. This study aimed to conduct a systematic review to investigate the relationship between frailty and low income among older adults. <b><i>Methods:</i></b> This systematic review was guided by the PRISMA guidelines and was aimed at exploring the frailty in older adults with low income and evaluating the robustness of the synthesis. Cross-sectional and longitudinal studies published in English between 2008 and 2020 were identified using search terms entered into the following databases: CINAHL, Medline, Google Scholar, and PubMed. <b><i>Results:</i></b> Nine articles met the inclusion criteria. This review revealed a positive relationship between frailty and poverty. Such a relationship could be explained through 3 dimensions of the relationship between frailty and poverty among older adults identified based on the findings of the reviewed studies. <b><i>Discussion/Conclusion:</i></b> The social life, environmental conditions, and financial issues were positively correlated and coexisted with both frailty and poverty. Frailty should be treated on a holistic basis, considering financial issues. Among these financial issues is poverty, which disrupts older adults’ social activities, hinders them from building successful social relationships, and reduces their quality of life.

scholarly journals Green Space and Health Equity: A Systematic Review on the Potential of Green Space to Reduce Health Disparities

2021 ◽  
Vol 18 (5) ◽  
pp. 2563
Author(s):  
Alessandro Rigolon ◽  
Matthew H. E. M. Browning ◽  
Olivia McAnirlin ◽  
Hyunseo (Violet) Yoon
Keyword(s):  
Public Health ◽  
Systematic Review ◽  
Health Disparities ◽  
Health Equity ◽  
Low Income ◽  
Green Space ◽  
Public Health Issue ◽  
Protective Effects ◽  
Beneficial Effects ◽  
Disadvantaged Groups

Disadvantaged groups worldwide, such as low-income and racially/ethnically minoritized people, experience worse health outcomes than more privileged groups, including wealthier and white people. Such health disparities are a major public health issue in several countries around the world. In this systematic review, we examine whether green space shows stronger associations with physical health for disadvantaged groups than for privileged groups. We hypothesize that disadvantaged groups have stronger protective effects from green space because of their greater dependency on proximate green space, as they tend to lack access to other health-promoting resources. We use the preferred reporting items for systematic reviews and meta-analyses (PRISMA) method and search five databases (CINAHL, Cochrane, PubMed, Scopus, and Web of Science) to look for articles that examine whether socioeconomic status (SES) or race/ethnicity modify the green space-health associations. Based on this search, we identify 90 articles meeting our inclusion criteria. We find lower-SES people show more beneficial effects than affluent people, particularly when concerning public green spaces/parks rather than green land covers/greenness. Studies in Europe show stronger protective effects for lower-SES people versus higher-SES people than do studies in North America. We find no notable differences in the protective effects of green space between racial/ethnic groups. Collectively, these results suggest green space might be a tool to advance health equity and provide ways forward for urban planners, parks managers, and public health professionals to address health disparities.

scholarly journals Awareness, treatment, and control of hypertension in adults aged 45 years and over and their spouses in India: A nationally representative cross-sectional study

PLoS Medicine ◽  
2021 ◽  
Vol 18 (8) ◽  
pp. e1003740
Author(s):  
Sanjay K. Mohanty ◽  
Sarang P. Pedgaonkar ◽  
Ashish Kumar Upadhyay ◽  
Fabrice Kämpfen ◽  
Prashant Shekhar ◽  
...  
Keyword(s):  
Older Adults ◽  
Living Arrangement ◽  
Diet Restriction ◽  
Indian States ◽  
Salt Diet ◽  
Hypertension Prevalence ◽  
Disadvantaged Groups ◽  
Socially Disadvantaged ◽  
Nationally Representative ◽  
And Control

Background Lack of nationwide evidence on awareness, treatment, and control (ATC) of hypertension among older adults in India impeded targeted management of this condition. We aimed to estimate rates of hypertension ATC in the older population and to assess differences in these rates across sociodemographic groups and states in India. Methods and findings We used a nationally representative survey of individuals aged 45 years and over and their spouses in all Indian states (except one) in 2017 to 2018. We identified hypertension by blood pressure (BP) measurement ≥140/90 mm Hg or self-reported diagnosis if also taking medication or observing salt/diet restriction to control BP. We distinguished those who (i) reported diagnosis (“aware”); (ii) reported taking medication or being under salt/diet restriction to control BP (“treated”); and (iii) had measured systolic BP <140 and diastolic BP <90 (“controlled”). We estimated age–sex adjusted hypertension prevalence and rates of ATC by consumption quintile, education, age, sex, urban–rural, caste, religion, marital status, living arrangement, employment status, health insurance, and state. We used concentration indices to measure socioeconomic inequalities and multivariable logistic regression to estimate fully adjusted differences in these outcomes. Study limitations included reliance on BP measurement on a single occasion, missing measurements of BP for some participants, and lack of data on nonadherence to medication. The 64,427 participants in the analysis sample had a median age of 57 years: 58% were female, and 70% were rural dwellers. We estimated hypertension prevalence to be 41.9% (95% CI 41.0 to 42.9). Among those with hypertension, we estimated that 54.4% (95% CI 53.1 to 55.7), 50.8% (95% CI 49.5 to 52.0), and 28.8% (95% CI 27.4 to 30.1) were aware, treated, and controlled, respectively. Across states, adjusted rates of ATC ranged from 27.5% (95% CI 22.2 to 32.8) to 75.9% (95% CI 70.8 to 81.1), from 23.8% (95% CI 17.6 to 30.1) to 74.9% (95% CI 69.8 to 79.9), and from 4.6% (95% CI 1.1 to 8.1) to 41.9% (95% CI 36.8 to 46.9), respectively. Age–sex adjusted rates were lower (p < 0.001) in poorer, less educated, and socially disadvantaged groups, as well as for males, rural residents, and the employed. Among individuals with hypertension, the richest fifth were 8.5 percentage points (pp) (95% CI 5.3 to 11.7; p < 0.001), 8.9 pp (95% CI 5.7 to 12.0; p < 0.001), and 7.1 pp (95% CI 4.2 to 10.1; p < 0.001) more likely to be aware, treated, and controlled, respectively, than the poorest fifth. Conclusions Hypertension prevalence was high, and ATC of the condition were low among older adults in India. Inequalities in these indicators pointed to opportunities to target hypertension management more effectively and equitably on socially disadvantaged groups.

scholarly journals Pre-Frailty and Frailty in Dialysis and Pre-Dialysis Patients: A Systematic Review of Clinical and Biochemical Markers

2021 ◽  
Vol 18 (18) ◽  
pp. 9579
Author(s):  
Ana Pereira ◽  
Luís Midão ◽  
Marta Almada ◽  
Elísio Costa
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Older Adults ◽  
Biochemical Markers ◽  
Web Of Science ◽  
Routine Care ◽  
Geriatric Syndrome ◽  
Dialysis Patients ◽  
Improve Health

Patients under dialysis are known to be more vulnerable to frailty, a dynamic geriatric syndrome defined as a state of vulnerability to stressors, due to numerous metabolic changes. With rise of life expectancy globally, it is important to understand the complexity of the pathophysiology of frailty and identify possible markers that can help with the prognosis and diagnosis of frailty. The aim of this systematic review is to give an overview of the knowledge regarding clinical and biochemical markers associated with pre-frailty and frailty in dialysis and pre-dialysis patients. In November 2020, PubMed, Embase and Web of Science were searched. Studies regarding biomarkers associated with (pre-)frailty in (pre-)dialysis patients were included. This systematic review identified clinical and biochemical markers in pre-frail and frail patients under dialysis or pre-dialysis published in the literature. This study shows that more investigation is necessary to identify markers that can differentiate these processes to be used as a diagnostic and prognostic tool in routine care and management of geriatric needs. Interventions that can improve health outcomes in pre-frail and frail older adults under dialysis or pre-dialysis are essential to improve not only the individual’s quality of life but also to reduce the burden to the health systems.

scholarly journals A systematic review of randomized trials for engaging socially disadvantaged groups in health research: A distillation approach

2019 ◽  
Author(s):  
Michael C Mullarkey ◽  
Mallory Dobias ◽  
Alyssa Maron ◽  
Sarah Kate Bearman
Keyword(s):  
Systematic Review ◽  
Community Engagement ◽  
Health Research ◽  
Research Participation ◽  
Research Process ◽  
Targeted Interventions ◽  
Research Engagement ◽  
Disadvantaged Groups ◽  
Socially Disadvantaged ◽  
Engagement Interventions

Research that fails to include sufficient representation from socially disadvantaged groups cannot make strong inferences about those groups. This relative lack of knowledge poses theoretical and clinical problems for health research. More effective community engagement with socially disadvantaged groups is often proposed as a way to increase research engagement. However, community engagement is a heterogeneous construct, including everything from how participants are contacted to whether researchers work with an organization within the community. Further, community engagement efforts vary widely in their effectiveness in recruiting and retaining participants from socially disadvantaged groups. Therefore, some types of community engagement may be more effective than others. We conducted a systematic review of randomized controlled trials attempting to increase recruitment or retention of socially disadvantaged groups. We then applied systematic distillation procedures to examine which components of community engagement interventions were associated with successful recruitment or retention outcomes. Generally, we found research process related variables (e.g. having a systematic contact plan) most frequently differentiated effective vs. ineffective recruitment or retention outcomes. Partial associations between components in effective interventions, including negative associations, were descriptively stronger than partial associations in the ineffective interventions, indicating targeted interventions may be more effective than more generalized interventions. The literature was also relatively sparse and at unclear-to-high-risk for bias. Future pre-registered, research process-oriented, and targeted recruitment and retention interventions may increase the research participation of socially disadvantaged groups in health research.

scholarly journals Best Practices for Living Labs When Studying Older Adults Living in Rural Communities

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 1035-1035
Author(s):  
Ashley Nakagawa ◽  
Shannon Freeman ◽  
Alanna Koopmans ◽  
Chris Ross ◽  
Richard McAloney
Keyword(s):  
Older Adults ◽  
Rural Communities ◽  
Best Practices ◽  
Real World ◽  
Innovation Process ◽  
User Involvement ◽  
The United States ◽  
Scientific Validity ◽  
Living Lab ◽  
Living Labs

Abstract There are two core concepts that make living labs distinguishable: involvement of users as co-creators and evaluation in a real-world setting. Living labs increase the potential for product acceptance and adoption due to testing and tailoring with target users. Currently, there is a lack of a universally accepted guideline for best practices. The objective of this review is to identify the best practices of living labs that can be recognized by the scientific community and followed in future labs. A 5-stage scoping review, following Arksey and O’Malley’s (2005) framework, was used to map out the coverage of different aspects of living lab methodology. A systematic search for articles involving living lab framework and older adults published between 2016-2021, was conducted in seven databases. Nine articles were included after review, the majority of which were published in health journals and were from Italy and the United States. An overview of consistent user involvement in the innovation process, real-world testing vs. laboratory testing, and participant scope findings will be shared. Multiple rounds of user feedback, real-world testing, and a small but diverse participant group were the most successful in increasing positive sentiments about the products tested in a living lab environment. The lack of published articles on living lab frameworks studying older adults indicate a gap in the literature. Creating a universally accepted definition for living labs and guidelines for best practices will allow for scientific validity and comparisons of studies and may increase the use and popularity of living labs.

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