scholarly journals Understanding Self-Guided Web-Based Educational Interventions for Patients With Chronic Health Conditions: Systematic Review of Intervention Features and Adherence

10.2196/18355 ◽  
2020 ◽  
Vol 22 (8) ◽  
pp. e18355
Author(s):  
Li Feng Xie ◽  
Alexandra Itzkovitz ◽  
Amelie Roy-Fleming ◽  
Deborah Da Costa ◽  
Anne-Sophie Brazeau
Keyword(s):  
Systematic Review ◽  
Clinical Outcomes ◽  
Goal Setting ◽  
Educational Interventions ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
Cochrane Library ◽  
Self Monitoring ◽  
Web Based ◽  
Chronic Health

Background Chronic diseases contribute to 71% of deaths worldwide every year, and an estimated 15 million people between the ages of 30 and 69 years die mainly because of cardiovascular disease, cancer, chronic respiratory diseases, or diabetes. Web-based educational interventions may facilitate disease management. These are also considered to be a flexible and low-cost method to deliver tailored information to patients. Previous studies concluded that the implementation of different features and the degree of adherence to the intervention are key factors in determining the success of the intervention. However, limited research has been conducted to understand the acceptability of specific features and user adherence to self-guided web interventions. Objective This systematic review aims to understand how web-based intervention features are evaluated, to investigate their acceptability, and to describe how adherence to web-based self-guided interventions is defined and measured. Methods Studies published on self-guided web-based educational interventions for people (≥14 years old) with chronic health conditions published between January 2005 and June 2020 were reviewed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) Statement protocol. The search was performed using the PubMed, Cochrane Library, and EMBASE (Excerpta Medica dataBASE) databases; the reference lists of the selected articles were also reviewed. The comparison of the interventions and analysis of the features were based on the published content from the selected articles. Results A total of 20 studies were included. Seven principal features were identified, with goal setting, self-monitoring, and feedback being the most frequently used. The acceptability of the features was measured based on the comments collected from users, their association with clinical outcomes, or device adherence. The use of quizzes was positively reported by participants. Self-monitoring, goal setting, feedback, and discussion forums yielded mixed results. The negative acceptability was related to the choice of the discussion topic, lack of face-to-face contact, and technical issues. This review shows that the evaluation of adherence to educational interventions was inconsistent among the studies, limiting comparisons. A clear definition of adherence to an intervention is lacking. Conclusions Although limited information was available, it appears that features related to interaction and personalization are important for improving clinical outcomes and users’ experience. When designing web-based interventions, the selection of features should be based on the targeted population’s needs, the balance between positive and negative impacts of having human involvement in the intervention, and the reduction of technical barriers. There is a lack of consensus on the method of evaluating adherence to an intervention. Both investigations of the acceptability features and adherence should be considered when designing and evaluating web-based interventions. A proof-of-concept or pilot study would be useful for establishing the required level of engagement needed to define adherence.

scholarly journals Understanding self-guided online educational platforms for patients with chronic health conditions: A systematic review of platforms’ features and adherence (Preprint)

2020 ◽  
Author(s):  
Li Feng Xie ◽  
Alexandra Itzkovitz ◽  
Amelie Roy-Fleming ◽  
Deborah Da Costa ◽  
Anne-Sophie Brazeau
Keyword(s):  
Systematic Review ◽  
Online Education ◽  
Clinical Outcomes ◽  
Chronic Diseases ◽  
Goal Setting ◽  
Cochrane Library ◽  
Self Monitoring ◽  
Chronic Respiratory Diseases ◽  
Online Platforms ◽  
Cochrane Reviews

BACKGROUND Chronic diseases contribute to 71% of deaths worldwide every year and an estimated 15 million people between the ages of 30 to 69 years die mainly due to cardiovascular disease, cancer, chronic respiratory diseases, or diabetes. Online education platforms may offer numerous health benefits on disease management and on related health consequences. It is also considered to be a flexible, lower cost method to deliver tailored information to patients. Previous studies concluded that the implementation of different features and degree of adherence to the platform are key factors in determining the success of the intervention. However, limited research has been done to understand the level of acceptability of the specific features and user adherence to self-guided online platforms. OBJECTIVE The aims of this systematic review are to understand how online platforms features are evaluated, to investigate which features have the greatest and lowest level of acceptability and to describe how adherence to online self-guided platforms is defined and measured. METHODS Studies published on self-guided online education platforms for people (≥14 years old) with chronic diseases published between January 2005 to June 2019 were reviewed following the PRISMA Statement protocol. The search was done using the databases of PubMed and Cochrane Library: Cochrane Reviews. The comparison of the interventions and analysis of the features were based on the published content from the selected articles. RESULTS A total of fifteen studies were included. Seven principal features were identified with goal setting, self-monitoring, and feedback being the most frequently used. The level of acceptability of the different features was measured based on the comments collected from users, their association with clinical outcomes and/or device adherence. The use of quizzes was positively reported by participants. Self-monitoring, goal setting, feedback, and discussion forums had mixed results. The negative acceptability was mainly related to the choice of the discussion topic, lack of face-to-face contact, and technical issues. This review also showed that evaluation of adherence to educational platform was inconsistent among the studies therefore limiting comparison. A clear definition of adherence to the platform is lacking. CONCLUSIONS This review suggests that features related to interaction and personalization provide better clinical outcomes and positive users’ experience. The negatively reported features were mainly related to not targeting the population’s needs, low human involvement within the platform, and technical barriers. Only six studies reported the level of acceptability of their features on users’ experience, clinical outcomes or device adherence, which highlights the needs for further studies. There is a lack of consensus on the method used for measuring the level of adherence to the platform, therefore we suggest to use a standardized framework to measure adherence.

scholarly journals Completeness and timeliness of diphtheria-tetanus-pertussis, measles-mumps-rubella, and polio vaccines in young children with chronic health conditions: A systematic review

Vaccine ◽  
2019 ◽  
Vol 37 (13) ◽  
pp. 1725-1735 ◽  
Author(s):  
Emma J. Walker ◽  
Noni E. MacDonald ◽  
Nehal Islam ◽  
Nicole Le Saux ◽  
Karina A. Top ◽  
...  
Keyword(s):  
Systematic Review ◽  
Young Children ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
Chronic Health

Fatigue in Child Chronic Health Conditions: A Systematic Review of Assessment Instruments

PEDIATRICS ◽  
2015 ◽  
Vol 135 (4) ◽  
pp. e1015-e1031 ◽  
Author(s):  
A. Crichton ◽  
S. Knight ◽  
E. Oakley ◽  
F. E. Babl ◽  
V. Anderson
Keyword(s):  
Systematic Review ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
Assessment Instruments ◽  
Chronic Health

scholarly journals The Health and Retirement Study: Analysis of Associations Between Use of the Internet for Health Information and Use of Health Services at Multiple Time Points (Preprint)

2017 ◽  
Author(s):  
Hyunju Shim ◽  
Jennifer Ailshire ◽  
Elizabeth Zelinski ◽  
Eileen Crimmins
Keyword(s):  
Health Service ◽  
Health Information ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
The Internet ◽  
Web Based ◽  
Chronic Health ◽  
Time Points ◽  
Doctor Visits ◽  
Use Of The Internet

BACKGROUND The use of the internet for health information among older people is receiving increasing attention, but how it is associated with chronic health conditions and health service use at concurrent and subsequent time points using nationally representative data is less known. OBJECTIVE This study aimed to determine whether the use of the internet for health information is associated with health service utilization and whether the association is affected by specific health conditions. METHODS The study used data collected in a technology module from a nationally representative sample of community-dwelling older Americans aged 52 years and above from the 2012 Health and Retirement Study (HRS; N=991). Negative binomial regressions were used to examine the association between use of Web-based health information and the reported health service uses in 2012 and 2014. Analyses included additional covariates adjusting for predisposing, enabling, and need factors. Interactions between the use of the internet for health information and chronic health conditions were also tested. RESULTS A total of 48.0% (476/991) of Americans aged 52 years and above reported using Web-based health information. The use of Web-based health information was positively associated with the concurrent reports of doctor visits, but not over 2 years. However, an interaction of using Web-based health information with diabetes showed that users had significantly fewer doctor visits compared with nonusers with diabetes at both times. CONCLUSIONS The use of the internet for health information was associated with higher health service use at the concurrent time, but not at the subsequent time. The interaction between the use of the internet for health information and diabetes was significant at both time points, which suggests that health-related internet use may be associated with fewer doctor visits for certain chronic health conditions. Results provide some insight into how Web-based health information may provide an alternative health care resource for managing chronic conditions.

Effects of Patient- and Family-Centered Care for Young Adults With Chronic Health Conditions and Their Family Members: A Systematic Review

2019 ◽  
pp. 216769681988345
Author(s):  
David Allen ◽  
Nerina Scarinci ◽  
Louise Hickson
Keyword(s):  
Systematic Review ◽  
Young Adults ◽  
Meta Analysis ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
Family Centered Care ◽  
Chronic Health ◽  
Centered Care ◽  
The Impact ◽  
Family Centered

Patient- and family-centered care has been shown to improve outcomes across a range of health conditions. The purpose of this study was to determine the impact of interventions to improve the patient- and family-centeredness of care (PFCIs) on the effectiveness of care of young adults (16–25) with chronic health conditions. A segregated design mixed-methods systematic review with meta-analysis and meta-synthesis of the literature was conducted. Thirteen quantitative papers and three qualitative papers were identified for inclusion. Random-effects meta-analysis was performed on quantitative findings, and a meta-synthesis was performed on qualitative findings. Preliminary evidence suggests that PFCIs were associated with improvements in the self-efficacy of young people with chronic health conditions. However, there were very few identified studies, and those that were identified were primarily in the field of mental health, requiring ongoing further research.

scholarly journals Web-Based Patient Education in Orthopedics: Systematic Review (Preprint)

2017 ◽  
Author(s):  
Tessa Dekkers ◽  
Marijke Melles ◽  
Bob Sander Groeneveld ◽  
Huib de Ridder
Keyword(s):  
Systematic Review ◽  
Patient Education ◽  
Health Information ◽  
Cost Effective ◽  
Educational Interventions ◽  
Effective Alternative ◽  
Cochrane Library ◽  
The Internet ◽  
Web Based ◽  
Cost Effective Alternative

BACKGROUND Patients with orthopedic conditions frequently use the internet to find health information. Patient education that is distributed online may form an easily accessible, time- and cost-effective alternative to education delivered through traditional channels such as one-on-one consultations or booklets. However, no systematic evidence for the comparative effectiveness of Web-based educational interventions exists. OBJECTIVE The objective of this systematic review was to examine the effects of Web-based patient education interventions for adult orthopedic patients and to compare its effectiveness with generic health information websites and traditional forms of patient education. METHODS CINAHL, the Cochrane Library, EMBASE, MEDLINE, PsycINFO, PUBMED, ScienceDirect, Scopus, and Web of Science were searched covering the period from 1995 to 2016. Peer-reviewed English and Dutch studies were included if they delivered patient education via the internet to the adult orthopedic population and assessed its effects in a controlled or observational trial. RESULTS A total of 10 trials reported in 14 studies involving 4172 patients were identified. Nine trials provided evidence for increased patients’ knowledge after Web-based patient education. Seven trials reported increased satisfaction and good evaluations of Web-based patient education. No compelling evidence exists for an effect of Web-based patient education on anxiety, health attitudes and behavior, or clinical outcomes. CONCLUSIONS Web-based patient education may be offered as a time- and cost-effective alternative to current educational interventions when the objective is to improve patients’ knowledge and satisfaction. However, these findings may not be representative for the whole orthopedic patient population as most trials included considerably younger, higher-educated, and internet-savvy participants only.

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