Inequities in Healthcare Services caused by the Adoption of Digital Health Technologies: A Systematic Review (Preprint)

2021 ◽  
Author(s):  
Rui Yao ◽  
Wenli Zhang ◽  
Richard Evans ◽  
Guang Cao ◽  
Lining Shen
Keyword(s):  
Systematic Review ◽  
Influencing Factors ◽  
Digital Health ◽  
Health Inequities ◽  
Healthcare Services ◽  
The United States ◽  
Future Research ◽  
Unequal Distribution ◽  
Health Technologies ◽  
Starting Point

BACKGROUND Digital health technologies are rapidly adapting to healthcare contexts to provide improved medical services to citizens. However, contrary to expectations, their rapid adoption appears to have led to health inequities. OBJECTIVE The aim of this study is to systematically review the inequities of healthcare services brought about by the adoption of digital health technologies. The influencing factors of inequities, as well as corresponding countermeasures to ensure the health equity between different groups of citizens, is also studied. METHODS A systematic review of literature published from 1990 to 2020 was completed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) review process, and the electronic databases of Web of Science Core Collection, PubMed, and Scopus. Search, sorting, and data extraction processes were completed by two authors of the paper using Thomson Endnote. RESULTS In total, 1,895 studies were collected during the search process, of which 40 were identified for analysis. The earliest literature identified was published in 1993, with the number remaining below 2 for a long period of time. The number started to increase until 2016, with a peak thereafter being reached in 2020. The United States, the United Kingdom, and Norway ranked as the top three in terms of publication output. Health inequities caused by digital health technologies were mainly reflected by access and availability of digital technologies and the differences in healthcare outcomes. The factors that influenced inequities included: demographic factors (i.e., gender, age, race, region, economy, and education level), health conditions, and eHealth literacy. Finally, government agencies and medical institutions, digital health technology providers, and healthcare service receivers can all take actions to alleviate inequities, in future. CONCLUSIONS Findings provide a comprehensive starting point for future research allowing for further investigation into how digital health technologies may influence the unequal distribution of healthcare services. The interaction between individual subjective factors, as well as social support, and influencing factors should be included in future studies. In particular, access and availability to digital health technologies by vulnerable groups should be of paramount importance.

Digital health technologies for long term self-management of osteoporosis: a systematic review and meta-analysis (Preprint)

2021 ◽  
Author(s):  
Ghada Alhussein ◽  
Leontios Hadjileontiadis
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Digital Health ◽  
Meta Analysis ◽  
Self Management ◽  
Current Status ◽  
Future Research ◽  
Common Chronic Disease ◽  
Health Technologies ◽  
Management Interventions

BACKGROUND Osteoporosis is the fourth most common chronic disease in the world. Adopting preventative measures and effective self-management interventions help in improving bone health. Mobile health (mHealth) technologies can play a key role in osteoporosis patient care and self- management. OBJECTIVE This study presents a systematic review and meta-analysis of the currently available mHealth applications targeting osteoporosis self-management, aiming to determine the current status, gaps and challenges the future research could address, proposing appropriate recommendations. METHODS In this systematic review and meta-analysis, we searched PubMed, Scopus, EBSCO, Web of Science, and IEEExplore databases between Jan 1, 2010 and May 31, 2021, for all English publications that describe apps dedicated to or being useful for osteoporosis, targeting self-management, nutrition, physical activity, risk assessment, delivered on smartphone devices for young and older adults. In addition, a survey of all osteoporosis-related apps available in iOS and Android app stores as of May 31, 2021 was also conducted. Primary outcomes of interest were the prevention or reduction of unhealthy behaviours or improvement in healthy behaviours of the six behaviours. Outcomes were summarised in a narrative synthesis and combined using random-effects meta-analysis. RESULTS In total, 3906 unique articles were identified. Of these, 32 articles met the inclusion criteria and were reviewed in depth. The 32 studies were comprising 14 235 participants, of whom on average 69.5% were female, with a mean age of 49.8 years (SD 17.8). The app search identified 23 relevant apps for osteoporosis self-management. The meta-analysis revealed that mHealth supported interventions resulted in a significant reduction in pain (Hedge’s g -1.09, 95%CI -1.68 to -0.45) and disability (Hedge’s g -0.77, 95%CI -1.59 to 0.05). The post-treatment effect of the digital intervention was significant for physical function (Hedge’s g 2.54, 95%CI -4.08 to 4.08); yet nonsignificant for wellbeing (Hedge’s g 0.17, 95% CI -1.84 to 2.17), physical activity (Hedges’ g 0.09, 95%CI -0.59 to 0.50), anxiety (Hedge’s g -0.29, 95%CI -6.11 to 5.53), fatigue (Hedge’s g -0.34, 95%CI -5.84 to 5.16), calcium (Hedge’s g -0.05, 95%CI -0.59 to 0.50) and vitamin D (Hedge’s g 0.10, 95% CI -4.05 to 4.26) intake, and trabecular score (Hedge’s g 0.06, 95%CI -1.00 to 1.12). CONCLUSIONS Osteoporosis apps have the potential to support and improve the management of the disease and its symptoms; they also appear to be a valuable tool for patients and health professionals. However, the majority of the apps that are currently available lack clinically validated evidence of their efficacy and they most focus on a limited number of symptoms. A more holistic and personalized approach, within a co-creation design ecosystem, is needed.

scholarly journals Digital mental health in China: a systematic review

2021 ◽  
pp. 1-19
Author(s):  
Xiaolong Zhang ◽  
Shôn Lewis ◽  
Joseph Firth ◽  
Xu Chen ◽  
Sandra Bucci
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Mental Health Problems ◽  
Digital Health ◽  
Meta Analysis ◽  
Chinese Language ◽  
Health Problems ◽  
Future Research ◽  
The West ◽  
Health Technologies

Abstract Mental health problems are highly prevalent in China; however, China's mental health services lack resources to deliver high-quality care to people in need. Digital mental health is a promising solution to this short-fall in view of the population's digital literacy. In this review, we aim to: (i) investigate the effectiveness, acceptability, usability, and safety of digital health technologies (DHTs) for people with mental health problems in China; (ii) critically appraise the literature; and (iii) make recommendations for future research directions. The databases MEDLINE, PsycINFO, EMBASE, Web of Science, CNKI, WANFANG, and VIP were systemically searched for English and Chinese language articles evaluating DHTs for people with mental health problems in mainland China. Eligible studies were systematically reviewed. The heterogeneity of studies included precluded a meta-analysis. In total, 39 articles were retrieved, reporting on 32 DHTs for various mental health problems. Compared with the digital mental health field in the West, the Chinese studies targeted schizophrenia and substance use disorder more often and investigated social anxiety mediated by shame and culturally specific variants, DHTs were rarely developed in a co-production approach, and methodology quality was less rigorous. To our knowledge, this is the first systematic review focused on digital mental health in the Chinese context including studies published in both English and the Chinese language. DHTs were acceptable and usable among Chinese people with mental health problems in general, similar to findings from the West. Due to heterogeneity across studies and a paucity of robust control trial research, conclusions about the efficacy of DHTs are lacking.

Keeping Black Girls in School: A Systematic Review of Opportunities to Address Exclusionary Discipline Disparity

2021 ◽  
pp. 215336872098889
Author(s):  
Lynn A. Addington
Keyword(s):  
Systematic Review ◽  
Policy Development ◽  
The United States ◽  
Black Girls ◽  
Research Note ◽  
Future Research ◽  
Exclusionary Discipline ◽  
Girls Of Color ◽  
Single Location ◽  
Trauma Informed

A punitive legacy of the responses to school shootings in the United States is the expansion of exclusionary discipline. Black girls have disproportionately experienced this form of punishment as compared to white girls and non-Black girls of color. A small, but growing, body of research has examined the patterns and causes of this disparity. Current studies have made suggestions for possible solutions to address this disparity, but these recommendations are not readily accessible in a single location. A catalogue of these ideas could provide a useful foundation for policy development and evaluation. The present research note seeks to generate this resource by conducting a systematic review to identify and categorize recommendations aimed at reducing the discipline disparity experienced by Black girls. Based on this review, four categories emerged that center around: (1) culturally competent school programs, (2) enhanced teacher training, (3) spaces at school for empowering Black girls, and (4) trauma-informed student policies. This research note discusses these categories of recommendations using an intersectional framework and concludes with a summary of next steps to guide future research and policy work to address the disproportionate use of exclusionary discipline against Black girls.

scholarly journals A Bibliometric Analysis of the Global Trend of Using Alginate, Gelatine, and Hydroxyapatite for Bone Tissue Regeneration Applications

Polymers ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 647
Author(s):  
Mohamed Saiful Firdaus Hussin ◽  
Aludin Mohd Serah ◽  
Khairul Azri Azlan ◽  
Hasan Zuhudi Abdullah ◽  
Maizlinda Izwana Idris ◽  
...  
Keyword(s):  
Tissue Engineering ◽  
Bone Tissue Engineering ◽  
Bone Tissue ◽  
Bibliometric Analysis ◽  
Research Work ◽  
The United States ◽  
Research Area ◽  
Bone Tissue Regeneration ◽  
Future Research ◽  
Starting Point

Collecting information from previous investigations and expressing it in a scientometrics study can be a priceless guide to getting a complete overview of a specific research area. The aim of this study is to explore the interrelated connection between alginate, gelatine, and hydroxyapatite within the scope of bone tissue and scaffold. A review of traditional literature with data mining procedures using bibliometric analyses was considered to identify the evolution of the selected research area between 2009 and 2019. Bibliometric methods and knowledge visualization technologies were implemented to investigate diverse publications based on the following indicators: year of publication, document type, language, country, institution, author, journal, keyword, and number of citations. An analysis using a bibliometric study found that 7446 papers were located with the keywords “bone tissue” and “scaffold”, and 1767 (alginate), 185 (gelatine), 5658 (hydroxyapatite) papers with those specific sub keywords. The number of publications that relate to “tissue engineering” and bone more than doubled between 2009 (1352) and 2019 (2839). China, the United States and India are the most productive countries, while Sichuan University and the Chinese Academy of Science from China are the most important institutions related to bone tissue scaffold. Materials Science and Engineering C is the most productive journal, followed by the Journal of Biomedical Materials Research Part A. This paper is a starting point, providing the first bibliometric analysis study of bone tissue and scaffold considering alginate, gelatine and hydroxyapatite. A bibliometric analysis would greatly assist in giving a scientific insight to support desired future research work, not only associated with bone tissue engineering applications. It is expected that the analysis of alginate, gelatine and hydroxyapatite in terms of 3D bioprinting, clinical outcomes, scaffold architecture, and the regenerative medicine approach will enhance the research into bone tissue engineering in the near future. Continued studies into these research fields are highly recommended.

scholarly journals The Role of Value Stream Mapping in Healthcare Services: A Scoping Review

2021 ◽  
Vol 18 (3) ◽  
pp. 951
Author(s):  
Juan A. Marin-Garcia ◽  
Pilar I. Vidal-Carreras ◽  
Julio J. Garcia-Sabater
Keyword(s):  
Scoping Review ◽  
Healthcare Services ◽  
The United States ◽  
Environmental Indicators ◽  
Sustainability Indicators ◽  
Healthcare Sector ◽  
Value Stream Mapping ◽  
Value Stream ◽  
Starting Point

Lean healthcare aims to manage and improve the processes in the healthcare sector by eliminating everything that adds no value by improving quality of services, ensuring patient safety and facilitating health professionals’ work to achieve a flexible and reliable organization. Value Stream Mapping (VSM) is considered the starting point of any lean implementation. Some papers report applications of VSM in healthcare services, but there has been less attention paid to their contribution on sustainability indicators. The purpose of this work is to analyze the role of VSM in this context. To do so, a scoping review of works from recent years (2015 to 2019) was done. The results show that most applications of VSM reported are in the tertiary level of care, and the United States of America (USA) is the country which leads most of the applications published. In relation with the development of VSM, a heterogeneity in the maps and the sustainability indicators is remarkable. Moreover, only operational and social sustainability indicators are commonly included. We can conclude that more standardization is required in the development of the VSM in the healthcare sector, also including the environmental indicators.

scholarly journals A Systematic Review of the Use of Telemedicine in the Military Forces Worldwide

2020 ◽  
Vol 21 (11) ◽  
Author(s):  
Reza Mohammadi ◽  
Zeinab Tabanejad ◽  
Shahabeddin Abhari ◽  
Behnam Honarvar ◽  
Mina Lazem ◽  
...  
Keyword(s):  
Systematic Review ◽  
Data Extraction ◽  
Healthcare Providers ◽  
Military Medicine ◽  
Healthcare Services ◽  
Developed Countries ◽  
The United States ◽  
Positive Effects ◽  
Military Forces ◽  
The Military

Context: Considering the pivotal role of telemedicine in providing healthcare services for remote areas, some of the military medical centers, especially in developed countries, use different types of telemedicine programs. Objectives: The present study aimed at identifying the implemented telemedicine projects in military medicine worldwide and introducing their features. Evidence Acquisition: The current systematic review was performed in 2018. PubMed, Scopus, Embase, and Web of Science databases were searched for articles published from 2014 to 2018 by a combination of related keywords, and the related original articles were then selected based on the inclusion and exclusion criteria. Data were collected by a data extraction form, and then the data were summarized and reported based on the study objectives. Results: Of the 173 articles retrieved from the first round of search, 12 were included in the study; five (41.66%) studies had used the synchronous (real-time telemedicine) method. The United States, with nine studies, had the highest number of projects in military telemedicine. Most studies (n = 7) were performed on tele-psychology and the application of telemedicine in psychology. All selected studies reported the positive effects of telemedicine on providing healthcare for military forces. Conclusions: The proper utilization of telemedicine equipment is effective in saving time for both patients and healthcare providers, reducing costs, supporting in natural disasters, and satisfying patients with military medicine. To achieve telemedicine program objectives, they should be set precisely. Considering the importance of timely healthcare services, it is suggested to utilize synchronous methods and tools such as video conferencing.

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.

scholarly journals An eHealth Capabilities Framework for Graduates and Health Professionals: Mixed-Methods Study (Preprint)

2018 ◽  
Author(s):  
Melissa Brunner ◽  
Deborah McGregor ◽  
Melanie Keep ◽  
Anna Janssen ◽  
Heiko Spallek ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Workforce Development ◽  
Curriculum Design ◽  
Health Care Professionals ◽  
Technology Implementation ◽  
Digital Health ◽  
Current Evidence ◽  
Future Research ◽  
University Graduates ◽  
Health Technologies

BACKGROUND The demand for an eHealth-ready and adaptable workforce is placing increasing pressure on universities to deliver eHealth education. At present, eHealth education is largely focused on components of eHealth rather than considering a curriculum-wide approach. OBJECTIVE This study aimed to develop a framework that could be used to guide health curriculum design based on current evidence, and stakeholder perceptions of eHealth capabilities expected of tertiary health graduates. METHODS A 3-phase, mixed-methods approach incorporated the results of a literature review, focus groups, and a Delphi process to develop a framework of eHealth capability statements. RESULTS Participants (N=39) with expertise or experience in eHealth education, practice, or policy provided feedback on the proposed framework, and following the fourth iteration of this process, consensus was achieved. The final framework consisted of 4 higher-level capability statements that describe the learning outcomes expected of university graduates across the domains of (1) digital health technologies, systems, and policies; (2) clinical practice; (3) data analysis and knowledge creation; and (4) technology implementation and codesign. Across the capability statements are 40 performance cues that provide examples of how these capabilities might be demonstrated. CONCLUSIONS The results of this study inform a cross-faculty eHealth curriculum that aligns with workforce expectations. There is a need for educational curriculum to reinforce existing eHealth capabilities, adapt existing capabilities to make them transferable to novel eHealth contexts, and introduce new learning opportunities for interactions with technologies within education and practice encounters. As such, the capability framework developed may assist in the application of eHealth by emerging and existing health care professionals. Future research needs to explore the potential for integration of findings into workforce development programs.

scholarly journals Digital Health Platforms in Saudi Arabia: Determinants from the COVID-19 Pandemic Experience

Healthcare ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1517
Author(s):  
Saeed M. Alghamdi ◽  
Abdullah S. Alsulayyim ◽  
Jaber S. Alqahtani ◽  
Abdulelah M. Aldhahir
Keyword(s):  
Saudi Arabia ◽  
Digital Health ◽  
Digital Technologies ◽  
Vital Role ◽  
Future Research ◽  
Narrative Form ◽  
Published Data ◽  
Health Technologies ◽  
Significant Burden ◽  
Mobile Health Applications

COVID-19 poses a significant burden to healthcare systems. Healthcare organisations with better health innovation infrastructures have faced a reduced burden and achieved success in curbing COVID-19. In Saudi Arabia, digital technologies have played a vital role in fighting SARS-CoV-2 transmission. In this paper, we aimed to summarise the experience of optimising digital health technologies in Saudi Arabia as well as to discuss capabilities and opportunities during and beyond the COVID-19 pandemic. A literature search was conducted up to September 2021 to document the experience of using DHTPs in Saudi Arabia in response to the COVID-19 outbreak. We also considered any published data, press briefings, and announcements by the MOH in Saudi Arabia. The findings were synthesised in narrative form. Health officials succeeded in optimising and maintaining a strategy to mitigate the spread of the virus via different digital technologies, such as mobile health applications, artificial intelligence, and machine learning. The quick digital response in Saudi Arabia was facilitated by governmental support and by considering users and technology determinants. Future research must concentrate on establishing and updating the guidelines for using DHTPs.

Digital Health Literacy: A Bibliometric Analysis (Preprint)

2021 ◽  
Author(s):  
Keng Yang ◽  
Yekang Hu ◽  
Hanying Qi
Keyword(s):  
Health Literacy ◽  
Health Outcomes ◽  
Digital Divide ◽  
Bibliometric Analysis ◽  
Digital Health ◽  
The United States ◽  
Research Progress ◽  
Future Research ◽  
Scientific Publications ◽  
Number Of Publications

BACKGROUND Digital health is growing at a rapid pace, and digital health literacy has tremendous potential to promote health outcomes, bridge the digital divide, and improve health inequalities. OBJECTIVE The purposes of this study are to conduct a systematic bibliometric analysis on the field of dig-ital health literacy and to understand the research context and trends in this field. METHODS A total of 1,955 scientific publications were collected from the Web of Science (WoS) core col-lection. Institutional cooperation, journal co-citation, theme bursting, keyword co-occurrence, author cooperation, author co-citation, literature co-citation and references in the field of digi-tal health literacy were analyzed using the VOSviewer and CiteSpace knowledge mapping tools. RESULTS The results demonstrated that the United States was the leader in number of publications and citations in this field. The University of California System was first in terms of institutional contributions. The Journal of Medical Internet Research led in number of publications, cita-tions and co-citations. Research areas in the field of digital health literacy mainly include the definition and scale of health literacy, health literacy and health outcomes, health literacy and the digital divide, and the influencing factors of health literacy. CONCLUSIONS We summarize research progress in the field of digital health literacy and reveal the context, trends, and trending topics of digital health literacy research through statistical analysis and network visualization. Our work can serve as a fundamental reference and directional guide for future research in this field.

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