scholarly journals Digital health intervention design and deployment for engaging demographic groups likely to be affected by the digital divide: protocol for a systematic scoping review (Preprint)

10.2196/32538 ◽  
2021 ◽  
Author(s):  
Catherine L. Jenkins ◽  
Sumayyah Imran ◽  
Aamina Mahmood ◽  
Katherine Bradbury ◽  
Elizabeth Murray ◽  
...  
Keyword(s):  
Digital Divide ◽  
Scoping Review ◽  
Digital Health ◽  
Health Intervention ◽  
Intervention Design ◽  
Demographic Groups

What features of DHI design and deployment enable or hinder engagement with DHIs by demographic groups likely to be affected by the digital divide? Protocol for a systematic scoping review (Preprint)

2021 ◽  
Author(s):  
Catherine L. Jenkins ◽  
Sumayyah Imran ◽  
Aamina Mahmood ◽  
Katherine Bradbury ◽  
Elizabeth Murray ◽  
...  
Keyword(s):  
Digital Divide ◽  
Health Inequalities ◽  
Scoping Review ◽  
Digital Health ◽  
Health Improvement ◽  
Policy Makers ◽  
Healthcare Facilities ◽  
Demographic Groups ◽  
Health Related ◽  
Translation Services

UNSTRUCTURED Digital health interventions (DHIs) refer to interventions designed to support health-related knowledge transfer and deployed via digital technologies, such as mobile applications (apps) (Soobiah et al., 2020). DHIs are a double-edged sword: they have the potential to reduce health inequalities, for example by making treatments available remotely to rural populations underserved by healthcare facilities or by helping to overcome language barriers via in-app translation services. However, if not designed and deployed with care, DHIs also have the potential to increase health inequalities and exacerbate effects of the digital divide. Patient-level and public health measures delivered digitally therefore need to consider ways to mitigate the digital divide through DHI design, deployment and engagement mechanisms sensitive to the needs of digitally-excluded populations. This protocol outlines the procedure for a systematic scoping review focussing on features of DHI design and deployment that facilitate (or not) access to and engagement with DHIs by people from demographic groups likely to be affected by the digital divide. The results will have wider implications for researchers and policy makers using DHIs for health improvement peri-pandemic and post-pandemic and will inform best practices in the design and deployment of DHIs.

A Review of Digital Health Design Approaches: Challenges Towards Real World Implementation (Preprint)

2021 ◽  
Author(s):  
Anthony Duffy ◽  
Sylvain Moreno ◽  
Greg Christie
Keyword(s):  
Real World ◽  
User Satisfaction ◽  
Digital Health ◽  
Healthcare Delivery ◽  
Health Intervention ◽  
Rapid Expansion ◽  
Stakeholder Group ◽  
Design Approach ◽  
Intervention Design ◽  
Growing Pains

BACKGROUND Digital health represents an important strategy in the future of healthcare delivery. Over the past decade, mHealth has accelerated the agency of healthcare users. Despite prevailing excitement about the potential of digital health, questions remain on efficacy, uptake, usability and patience outcome. This challenge is confounded by two industries, DIGITAL and HEALTH, that have vastly different approaches to research, design, testing and implementation. In this regard, there is a need to examine prevailing design approaches, to weigh their benefits and challenges towards implementation, and to recommend a path forward that synthesises the needs of this complex stakeholder group. OBJECTIVE This review studies prominent digital health intervention (DHI) design approaches mediating the digital health space. In doing so, we seek to examine each methodology’s: origins, perceived benefits, contrasting nuances, challenges, and typical use-case scenarios. METHODS A narrative synthesis approach to literature review was employed to review existing evidence. We searched indexed scientific literature using keywords relative to different digital health intervention designs. Papers selected after screening were those that discussed the design and implementation of digital health design approaches. RESULTS 120 papers on intervention design were selected for full-text review. We selected the 20 most prominent papers on each design approach, synthesizing findings under the categories of origins, advantages, disadvantages, challenges and cases. CONCLUSIONS Digital health is experiencing the growing pains of rapid expansion. Currently, numerous design approaches are being implemented in order to harmonise the needs of a complex stakeholder group. Whether the primary stakeholder is positioned as the end-user/person/human/patient, the challenge to synthesise the constraints and affordances of both digital design and healthcare, built equally around user satisfaction and clinically efficacy remains paramount. Further research that works towards a transdisciplinarity in digital health may help to break down friction in this field. Until digital health is viewed as a hybridised industry with unique requirements rather than competing interests, the nuances that each design approach posits will be difficult to realise in a real world context. We encourage the collaboration of digital and health experts within hybrid design teams, through all stages of intervention design, in order to create a better digital health culture and design ethos.

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 mCARE, a digital health intervention package on pregnancy surveillance and care-seeking reminders from 2018 to 2027 in Bangladesh: a model-based cost-effectiveness analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e042553
Author(s):  
Youngji Jo ◽  
Amnesty Elizabeth LeFevre ◽  
Hasmot Ali ◽  
Sucheta Mehra ◽  
Kelsey Alland ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Home Visit ◽  
Digital Health ◽  
Status Quo ◽  
Health Intervention ◽  
Text Messages ◽  
Care Seeking ◽  
Intervention Package ◽  
The Status ◽  
The Cost

ObjectiveWe estimated the cost-effectiveness of a digital health intervention package (mCARE) for community health workers, on pregnancy surveillance and care-seeking reminders compared with the existing paper-based status quo, from 2018 to 2027, in Bangladesh.InterventionsThe mCARE programme involved digitally enhanced pregnancy surveillance, individually targeted text messages and in-person home-visit to pregnant women for care-seeking reminders for antenatal care, child delivery and postnatal care.Study designWe developed a model to project population and service coverage increases with annual geographical expansion (from 1 million to 10 million population over 10 years) of the mCARE programme and the status quo.Major outcomesFor this modelling study, we used Lives Saved Tool to estimate the number of deaths and disability-adjusted life years (DALYs) that would be averted by 2027, if the coverage of health interventions was increased in mCARE programme and the status quo, respectively. Economic costs were captured from a societal perspective using an ingredients approach and expressed in 2018 US dollars. Probabilistic sensitivity analysis was undertaken to account for parameter uncertainties.ResultsWe estimated the mCARE programme to avert 3076 deaths by 2027 at an incremental cost of $43 million relative to the status quo, which is translated to $462 per DALY averted. The societal costs were estimated to be $115 million for mCARE programme (48% of which are programme costs, 35% user costs and 17% provider costs). With the continued implementation and geographical scaling-up, the mCARE programme improved its cost-effectiveness from $1152 to $462 per DALY averted from 5 to 10 years.ConclusionMobile phone-based pregnancy surveillance systems with individually scheduled text messages and home-visit reminder strategies can be highly cost-effective in Bangladesh. The cost-effectiveness may improve as it promotes facility-based child delivery and achieves greater programme cost efficiency with programme scale and sustainability.

scholarly journals What is an appropriate level of evidence for a digital health intervention?

The Lancet ◽  
2018 ◽  
Vol 392 (10165) ◽  
pp. 2665-2667 ◽  
Author(s):  
Felix Greaves ◽  
Indra Joshi ◽  
Mark Campbell ◽  
Samantha Roberts ◽  
Neelam Patel ◽  
...  
Keyword(s):  
Digital Health ◽  
Health Intervention ◽  
Level Of Evidence

scholarly journals Use of Digital Technology to Enhance Tuberculosis Control: Scoping Review

10.2196/15727 ◽  
2020 ◽  
Vol 22 (2) ◽  
pp. e15727 ◽  
Author(s):  
Yejin Lee ◽  
Mario C Raviglione ◽  
Antoine Flahault
Keyword(s):  
United States ◽  
Resource Management ◽  
Treatment Adherence ◽  
Scoping Review ◽  
Digital Technology ◽  
Digital Health ◽  
The United States ◽  
Data Services ◽  
The World ◽  
And Control

Background Tuberculosis (TB) is the leading cause of death from a single infectious agent, with around 1.5 million deaths reported in 2018, and is a major contributor to suffering worldwide, with an estimated 10 million new cases every year. In the context of the World Health Organization’s End TB strategy and the quest for digital innovations, there is a need to understand what is happening around the world regarding research into the use of digital technology for better TB care and control. Objective The purpose of this scoping review was to summarize the state of research on the use of digital technology to enhance TB care and control. This study provides an overview of publications covering this subject and answers 3 main questions: (1) to what extent has the issue been addressed in the scientific literature between January 2016 and March 2019, (2) which countries have been investing in research in this field, and (3) what digital technologies were used? Methods A Web-based search was conducted on PubMed and Web of Science. Studies that describe the use of digital technology with specific reference to keywords such as TB, digital health, eHealth, and mHealth were included. Data from selected studies were synthesized into 4 functions using narrative and graphical methods. Such digital health interventions were categorized based on 2 classifications, one by function and the other by targeted user. Results A total of 145 relevant studies were identified out of the 1005 published between January 2016 and March 2019. Overall, 72.4% (105/145) of the research focused on patient care and 20.7% (30/145) on surveillance and monitoring. Other programmatic functions 4.8% (7/145) and electronic learning 2.1% (3/145) were less frequently studied. Most digital health technologies used for patient care included primarily diagnostic 59.4% (63/106) and treatment adherence tools 40.6% (43/106). On the basis of the second type of classification, 107 studies targeted health care providers (107/145, 73.8%), 20 studies targeted clients (20/145, 13.8%), 17 dealt with data services (17/145, 11.7%), and 1 study was on the health system or resource management. The first authors’ affiliations were mainly from 3 countries: the United States (30/145 studies, 20.7%), China (20/145 studies, 13.8%), and India (17/145 studies, 11.7%). The researchers from the United States conducted their research both domestically and abroad, whereas researchers from China and India conducted all studies domestically. Conclusions The majority of research conducted between January 2016 and March 2019 on digital interventions for TB focused on diagnostic tools and treatment adherence technologies, such as video-observed therapy and SMS. Only a few studies addressed interventions for data services and health system or resource management.

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