The role of digital health for post-surgery care of older patients with hip fracture: a scoping review (Preprint)

2021 ◽  
Author(s):  
Jing Zhang ◽  
Yufeng Ge ◽  
Minghui Yang ◽  
Rebecca Ivers ◽  
Ruth Webster ◽  
...  

BACKGROUND Digital health interventions have the potential to improve the integration of health care at all system levels. Hip fracture is a serious injury for older people and integrated post-surgery care for hip fracture is vital for good recovery. OBJECTIVE The aim of this study was to understand and characterise digital health interventions used for hip fracture post-surgery care, and further to examine the extent to which of these digital health interventions address the six domains of the World Health Organisation (WHO) integrated care for older people framework. METHODS A scoping review was conducted, by searching the literature from English and Chinese electronic databases and trial registries, including Medline, EMBASE, ProQuest, PsycINFO, The Cochrane library, CINAHL, Open Science Framework, Clinicaltrials.gov, VIP, China National Knowledge of Infrastructure (CNKI) and Wanfang. Keywords used in the English database included hip fracture, post-surgery care and digital health interventions, while Chinese keywords included “Kuan Bu Gu Zhe (hip fracture)”, “Shu Hou Kang Fu (post-surgery care)” and “Shu Zi Jian Kang (digital health)”. Interventional, observational, qualitative studies as well as case reports and study reports were included in this study. We used a combined framework, the WHO integrated care for older people and WHO digital health intervention classifications, to support data synthesis. RESULTS A total of 4,542 articles were identified, of which 39 studies were included in the analysis. We identified only six randomised controlled trials. Digital health interventions were mainly used to help doctors provide clinical care and facilitate service delivery between the patients, caregivers and health providers. No studies focused on health workforce, financial policy or the development of infrastructure. The primary users of digital health interventions were limited to healthcare providers and patients, with no studies involving healthcare managers or the use of data services to support the data collection, management, use and exchange. From the post-surgery care perspective, most digital health interventions focused on physical therapy, bone protection and falls prevention. The functionalities of digital health interventions were mainly limited to health education or promotion and providing remote services. There were limited interventions implemented in low-and middle-income countries. CONCLUSIONS There are opportunities to expand the use of digital health for post-surgery care of hip fracture patients, but this requires a stronger evidence base, including high-quality larger-scale studies, more focus on application in resource-constrained settings, expanding to more users and capabilities of interventions, and exploring the role of digital health for the integrated care model to mitigate health system challenges.

2019 ◽  
Author(s):  
Brian Lo ◽  
Jenny Shi ◽  
Elisa Hollenberg ◽  
Alexxa Abi-Jaoudé ◽  
Andrew Johnson ◽  
...  

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.


10.2196/15942 ◽  
2020 ◽  
Vol 7 (6) ◽  
pp. e15942
Author(s):  
Brian Lo ◽  
Jenny Shi ◽  
Elisa Hollenberg ◽  
Alexxa Abi-Jaoudé ◽  
Andrew Johnson ◽  
...  

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.


2020 ◽  
Author(s):  
Mariam El Benny ◽  
Tamar Kabakian-Khasholian ◽  
Fadi El-Jardali ◽  
Marco Bardus

BACKGROUND Digital health interventions (DHIs) are increasingly being adopted globally to address various public health issues. DHIs can be categorized according to four main types of technology: mobile based, web based, telehealth, and electronic health records. In 2006, Norman and Skinner introduced the <i>eHealth literacy model</i>, encompassing six domains of skills and abilities (basic, health, information, scientific, media, and computer) needed to effectively understand, process, and act on health-related information. Little is known about whether these domains are assessed or accounted for in DHIs. OBJECTIVE This study aims to explore how DHIs assess and evaluate the eHealth literacy model, describe which health conditions are addressed, and which technologies are used. METHODS We conducted a scoping review of the literature on DHIs, based on randomized controlled trial design and reporting the assessment of any domain of the eHealth literacy model. MEDLINE, CINAHL, Embase, and Cochrane Library were searched. A duplicate selection and data extraction process was performed; we charted the results according to the country of origin, health condition, technology used, and eHealth literacy domain. RESULTS We identified 131 unique DHIs conducted in 26 different countries between 2001 and 2020. Most DHIs were conducted in English-speaking countries (n=81, 61.8%), delivered via the web (n=68, 51.9%), and addressed issues related to noncommunicable diseases (n=57, 43.5%) or mental health (n=26, 19.8%). None of the interventions assessed all six domains of the eHealth literacy model. Most studies focused on the domain of health literacy (n=96, 73.2%), followed by digital (n=19, 14.5%), basic and media (n=4, 3%), and information and scientific literacy (n=1, 0.7%). Of the 131 studies, 7 (5.3%) studies covered both health and digital literacy. CONCLUSIONS Although many selected DHIs assessed health or digital literacy, no studies comprehensively evaluated all domains of the eHealth literacy model; this evidence might be overlooking important factors that can mediate or moderate the effects of these interventions. Future DHIs should comprehensively assess the eHealth literacy model while developing or evaluating interventions to understand how and why interventions can be effective.


10.2196/23473 ◽  
2021 ◽  
Vol 23 (6) ◽  
pp. e23473
Author(s):  
Mariam El Benny ◽  
Tamar Kabakian-Khasholian ◽  
Fadi El-Jardali ◽  
Marco Bardus

Background Digital health interventions (DHIs) are increasingly being adopted globally to address various public health issues. DHIs can be categorized according to four main types of technology: mobile based, web based, telehealth, and electronic health records. In 2006, Norman and Skinner introduced the eHealth literacy model, encompassing six domains of skills and abilities (basic, health, information, scientific, media, and computer) needed to effectively understand, process, and act on health-related information. Little is known about whether these domains are assessed or accounted for in DHIs. Objective This study aims to explore how DHIs assess and evaluate the eHealth literacy model, describe which health conditions are addressed, and which technologies are used. Methods We conducted a scoping review of the literature on DHIs, based on randomized controlled trial design and reporting the assessment of any domain of the eHealth literacy model. MEDLINE, CINAHL, Embase, and Cochrane Library were searched. A duplicate selection and data extraction process was performed; we charted the results according to the country of origin, health condition, technology used, and eHealth literacy domain. Results We identified 131 unique DHIs conducted in 26 different countries between 2001 and 2020. Most DHIs were conducted in English-speaking countries (n=81, 61.8%), delivered via the web (n=68, 51.9%), and addressed issues related to noncommunicable diseases (n=57, 43.5%) or mental health (n=26, 19.8%). None of the interventions assessed all six domains of the eHealth literacy model. Most studies focused on the domain of health literacy (n=96, 73.2%), followed by digital (n=19, 14.5%), basic and media (n=4, 3%), and information and scientific literacy (n=1, 0.7%). Of the 131 studies, 7 (5.3%) studies covered both health and digital literacy. Conclusions Although many selected DHIs assessed health or digital literacy, no studies comprehensively evaluated all domains of the eHealth literacy model; this evidence might be overlooking important factors that can mediate or moderate the effects of these interventions. Future DHIs should comprehensively assess the eHealth literacy model while developing or evaluating interventions to understand how and why interventions can be effective.


2021 ◽  
pp. 030573562110194
Author(s):  
Amy Visser ◽  
Megan Lee ◽  
Timothy Barringham ◽  
Nasim Salehi

Professional popular musicians are at increased risk of psychological distress, substance use problems, and suicide, yet little evidence is available on effective psychotherapeutic practices to address these issues. This scoping review aims to understand how professional popular musicians perceive, engage with, and respond to mental health interventions. Four databases were searched, garnering a total of 310 articles. Of these, six met inclusion criteria. Four thematic categories were explored: (1) amenability of professional popular musicians to particular therapeutic approaches; (2) attribution of treatment outcomes to tailored approaches; (3) professional popular musicians’ perceived barriers to treatment; and (4) recommendations for treatment approaches. The scoping review supports the importance of considering the characteristics of professional popular musicians as a distinct group with unique well-being needs, challenges, and strengths. There is a clear preference for tailored, affordable, and accessible approaches that consider the uniquities of musicianship and the need to explore the role of nonclinical support, such as friends, family, and industry peers.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Julie MacInnes ◽  
Jenny Billings ◽  
Alexandra Lelia Dima ◽  
Chris Farmer ◽  
Giel Nijpels

PurposeThe purpose of this paper is to identify the range, type and outcomes of technological innovations aimed at supporting older people to maintain their independence within the context of integrated care at home. We also discuss key emergent themes relevant to the use of person-centred technology for older people in integrated care and propose recommendations for policy and practice.Design/methodology/approachAn integrative review methodology was used to identify and describe recent scientific publications in four stages: problem identification, literature search, data evaluation and data analysis.FindingsTwelve studies were included in the review. Three studies described remote consultations, particularly telemedicine; five studies described tools to support self-management; three studies described the use of healthcare management tools, and one study described both remote consultation and self-care management. Emergent themes were: acceptability, accessibility and use of digital technologies; co-ordination and integration of services; the implementation of digital technologies; and safety and governance. Several recommendations are proposed relevant to integrated care teams, technology developers and researchers.Originality/valueThis review uniquely considers the extent to which novel digital technologies used in integrated care for older people are person-centred.


2021 ◽  
Author(s):  
Maria Brenner ◽  
Arielle Weir ◽  
Margaret McCann ◽  
Carmel Doyle ◽  
Mary Hughes ◽  
...  

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.


Author(s):  
Islène Araujo de Carvalho ◽  
Joanne Epping-Jordan ◽  
John R. Beard

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