scholarly journals Associations between Digital Health Intervention Engagement and Dietary Intake: A Systematic Review

Nutrients ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 3281
Author(s):  
Tessa Delaney ◽  
Matthew Mclaughlin ◽  
Alix Hall ◽  
Sze Lin Yoong ◽  
Alison Brown ◽  
...  
Keyword(s):  
Dietary Intake ◽  
Subjective Experience ◽  
Digital Health ◽  
Grey Literature ◽  
Health Interventions ◽  
User Engagement ◽  
Narrative Synthesis ◽  
Subjective Experiences ◽  
Early Evidence ◽  
The Relationship

There has been a proliferation of digital health interventions (DHIs) targeting dietary intake. Despite their potential, the effectiveness of DHIs are thought to be dependent, in part, on user engagement. However, the relationship between engagement and the effectiveness of dietary DHIs is not well understood. The aim of this review is to describe the association between DHI engagement and dietary intake. A systematic search of four electronic databases and grey literature for records published before December 2019 was conducted. Studies were eligible if they examined a quantitative association between objective measures of engagement with a DHI (subjective experience or usage) and measures of dietary intake in adults (aged ≥18 years). From 10,653 citations, seven studies were included. Five studies included usage measures of engagement and two examined subjective experiences. Narrative synthesis, using vote counting, found mixed evidence of an association with usage measures (5 of 12 associations indicated a positive relationship, 7 were inconclusive) and no evidence regarding an association with subjective experience (both studies were inconclusive). The findings provide early evidence supporting an association between measures of usage and dietary intake; however, this was inconsistent. Further research examining the association between DHI engagement and dietary intake is warranted.

scholarly journals Associations Between Digital Health Intervention Engagement, Physical Activity, and Sedentary Behavior: Systematic Review and Meta-analysis

10.2196/23180 ◽  
2021 ◽  
Vol 23 (2) ◽  
pp. e23180
Author(s):  
Matthew Mclaughlin ◽  
Tessa Delaney ◽  
Alix Hall ◽  
Judith Byaruhanga ◽  
Paul Mackie ◽  
...  
Keyword(s):  
Physical Activity ◽  
Sedentary Behavior ◽  
Subjective Experience ◽  
Digital Health ◽  
Meta Analysis ◽  
Grey Literature ◽  
Positive Association ◽  
Health Intervention ◽  
Health Interventions ◽  
Vote Counting

Background The effectiveness of digital health interventions is commonly assumed to be related to the level of user engagement with the digital health intervention, including measures of both digital health intervention use and users’ subjective experience. However, little is known about the relationships between the measures of digital health intervention engagement and physical activity or sedentary behavior. Objective This study aims to describe the direction and strength of the association between engagement with digital health interventions and physical activity or sedentary behavior in adults and explore whether the direction of association of digital health intervention engagement with physical activity or sedentary behavior varies with the type of engagement with the digital health intervention (ie, subjective experience, activities completed, time, and logins). Methods Four databases were searched from inception to December 2019. Grey literature and reference lists of key systematic reviews and journals were also searched. Studies were eligible for inclusion if they examined a quantitative association between a measure of engagement with a digital health intervention targeting physical activity and a measure of physical activity or sedentary behavior in adults (aged ≥18 years). Studies that purposely sampled or recruited individuals on the basis of pre-existing health-related conditions were excluded. In addition, studies were excluded if the individual engaging with the digital health intervention was not the target of the physical activity intervention, the study had a non–digital health intervention component, or the digital health interventions targeted multiple health behaviors. A random effects meta-analysis and direction of association vote counting (for studies not included in meta-analysis) were used to address objective 1. Objective 2 used vote counting on the direction of the association. Results Overall, 10,653 unique citations were identified and 375 full texts were reviewed. Of these, 19 studies (26 associations) were included in the review, with no studies reporting a measure of sedentary behavior. A meta-analysis of 11 studies indicated a small statistically significant positive association between digital health engagement (based on all usage measures) and physical activity (0.08, 95% CI 0.01-0.14, SD 0.11). Heterogeneity was high, with 77% of the variation in the point estimates explained by the between-study heterogeneity. Vote counting indicated that the relationship between physical activity and digital health intervention engagement was consistently positive for three measures: subjective experience measures (2 of 3 associations), activities completed (5 of 8 associations), and logins (6 of 10 associations). However, the direction of associations between physical activity and time-based measures of usage (time spent using the intervention) were mixed (2 of 5 associations supported the hypothesis, 2 were inconclusive, and 1 rejected the hypothesis). Conclusions The findings indicate a weak but consistent positive association between engagement with a physical activity digital health intervention and physical activity outcomes. No studies have targeted sedentary behavior outcomes. The findings were consistent across most constructs of engagement; however, the associations were weak.

scholarly journals Associations Between Digital Health Intervention Engagement, Physical Activity, and Sedentary Behavior: Systematic Review and Meta-analysis (Preprint)

2020 ◽  
Author(s):  
Matthew Mclaughlin ◽  
Tessa Delaney ◽  
Alix Hall ◽  
Judith Byaruhanga ◽  
Paul Mackie ◽  
...  
Keyword(s):  
Physical Activity ◽  
Sedentary Behavior ◽  
Subjective Experience ◽  
Digital Health ◽  
Meta Analysis ◽  
Grey Literature ◽  
Positive Association ◽  
Health Intervention ◽  
Health Interventions ◽  
Vote Counting

BACKGROUND The effectiveness of digital health interventions is commonly assumed to be related to the level of user engagement with the digital health intervention, including measures of both digital health intervention use and users’ subjective experience. However, little is known about the relationships between the measures of digital health intervention engagement and physical activity or sedentary behavior. OBJECTIVE This study aims to describe the direction and strength of the association between engagement with digital health interventions and physical activity or sedentary behavior in adults and explore whether the direction of association of digital health intervention engagement with physical activity or sedentary behavior varies with the type of engagement with the digital health intervention (ie, subjective experience, activities completed, time, and logins). METHODS Four databases were searched from inception to December 2019. Grey literature and reference lists of key systematic reviews and journals were also searched. Studies were eligible for inclusion if they examined a quantitative association between a measure of engagement with a digital health intervention targeting physical activity and a measure of physical activity or sedentary behavior in adults (aged ≥18 years). Studies that purposely sampled or recruited individuals on the basis of pre-existing health-related conditions were excluded. In addition, studies were excluded if the individual engaging with the digital health intervention was not the target of the physical activity intervention, the study had a non–digital health intervention component, or the digital health interventions targeted multiple health behaviors. A random effects meta-analysis and direction of association vote counting (for studies not included in meta-analysis) were used to address objective 1. Objective 2 used vote counting on the direction of the association. RESULTS Overall, 10,653 unique citations were identified and 375 full texts were reviewed. Of these, 19 studies (26 associations) were included in the review, with no studies reporting a measure of sedentary behavior. A meta-analysis of 11 studies indicated a small statistically significant positive association between digital health engagement (based on all usage measures) and physical activity (0.08, 95% CI 0.01-0.14, SD 0.11). Heterogeneity was high, with 77% of the variation in the point estimates explained by the between-study heterogeneity. Vote counting indicated that the relationship between physical activity and digital health intervention engagement was consistently positive for three measures: subjective experience measures (2 of 3 associations), activities completed (5 of 8 associations), and logins (6 of 10 associations). However, the direction of associations between physical activity and time-based measures of usage (time spent using the intervention) were mixed (2 of 5 associations supported the hypothesis, 2 were inconclusive, and 1 rejected the hypothesis). CONCLUSIONS The findings indicate a weak but consistent positive association between engagement with a physical activity digital health intervention and physical activity outcomes. No studies have targeted sedentary behavior outcomes. The findings were consistent across most constructs of engagement; however, the associations were weak.

scholarly journals THE NEED FOR INFORMATION AND THE ATTITUDE TOWARDS DIGITAL TECHNOLOGIES AS FACTORS OF CRITICAL AND UNCRITICAL DISSEMINATION OF PANDEMIC NEWS

2021 ◽  
pp. 170-195
Author(s):  
Elena I. Rasskazova ◽  
Galina V. Soldatova ◽  
Yulia Y. Neyaskina ◽  
Olga S. Shiriaeva
Keyword(s):  
Subjective Experience ◽  
New Technologies ◽  
Modern Society ◽  
Sociodemographic Factors ◽  
Subjective Experiences ◽  
Individual Level ◽  
Related Information ◽  
Digital World ◽  
The Individual ◽  
The Relationship

Relevance. The modern society creates the image of a successful person as actively interacting with different information flows, including an impressive stream of news content. This paper assumes that there is a personal need for tracking and spreading news that develops in the interaction between person and digital world. The individual level of this need could explain the interaction with information (its critical and uncritical dissemination) and the subjective experience of its redundancy and inaccuracy, including those experiences and actions in a pandemic situation. The aim of the study was to reveal the relationship of the subjective need for news with personal values, beliefs about technologies (“technophilia”) and the dissemination of news about the pandemic. Method. 270 people (aged 18 to 61) filled out The short (Schwartz) Portrait Values Questionnaire (PVQ), Beliefs about New Technologies Questionnaire, Monitoring of Information about Coronavirus Scale as well as items on the subjective need for receiving and disseminating news, readiness for critical and non-critical dissemination of news about pandemics, subjective experiences of redundancy and distrust of pandemic-related information. Results. According to the results, the Need for News Scale allows assessing the subjective importance of receiving news and discussing them with other people and is characterized by sufficient consistency and factor validity. The need for regular news is more pronounced among men, older people, people with higher education, married people, people who have children, while the need to discuss news is not related to sociodemographic factors. For people, who are more prone to technophilia, it is more important to regularly receive and discuss news information with others, which, in turn, mediates the relationship between technophilia and monitoring news about coronavirus. The need for news dissemination mediates the relationship between technophilia and readiness for critical and non-critical dissemination of information about the pandemic.

scholarly journals Digital Interventions to Support Adolescents and Young Adults With Cancer: Systematic Review

JMIR Cancer ◽  
10.2196/12071 ◽  
2019 ◽  
Vol 5 (2) ◽  
pp. e12071 ◽  
Author(s):  
Lisa McCann ◽  
Kathryn Anne McMillan ◽  
Gemma Pugh
Keyword(s):  
Young Adults ◽  
Cancer Diagnosis ◽  
Subjective Experience ◽  
Emotional Health ◽  
Digital Health ◽  
Health Interventions ◽  
Adolescents And Young Adults ◽  
Research Papers ◽  
Digital Interventions ◽  
Diagnosis Of Cancer

Background The last decade has seen an increase in the number of digital health interventions designed to support adolescents and young adults (AYAs) with cancer. Objective The objective of this review was to identify, characterize, and fully assess the quality, feasibility, and efficacy of existing digital health interventions developed specifically for AYAs, aged between 13 and 39 years, living with or beyond a cancer diagnosis. Methods Searches were performed in PubMed, EMBASE, and Web of Science to identify digital health interventions designed specifically for AYA living with or beyond a cancer diagnosis. Data on the characteristics and outcomes of each intervention were synthesized. Results A total of 4731 intervention studies were identified through the searches; 38 interventions (43 research papers) met the inclusion criteria. Most (20/38, 53%) were website-based interventions. Most studies focused on symptom management and medication adherence (15, 39%), behavior change (15, 39%), self-care (8, 21%), and emotional health (7, 18%). Most digital health interventions included multiple automated and communicative functions such as enriched information environments, automated follow-up messages, and access to peer support. Where reported (20, 53% of studies), AYAs’ subjective experience of using the digital platform was typically positive. The overall quality of the studies was found to be good (mean Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields scores >68%). Some studies reported feasibility outcomes (uptake, acceptability, and attrition) but were not sufficiently powered to comment on intervention effects. Conclusions Numerous digital interventions have been developed and designed to support young people living with and beyond a diagnosis of cancer. However, many of these interventions have yet to be deployed, implemented, and evaluated at scale.

Associations between digital health intervention engagement and dietary intake: A Systematic Review (Preprint)

2020 ◽  
Author(s):  
Tessa Delaney ◽  
Matthew Mclaughlin ◽  
Alix Hall ◽  
Sze Lin Yoong ◽  
Alison Brown ◽  
...  
Keyword(s):  
Systematic Review ◽  
Dietary Intake ◽  
Subjective Experience ◽  
Vegetable Intake ◽  
Digital Health ◽  
Poor Quality ◽  
Fruit And Vegetable Intake ◽  
Fruit And Vegetable ◽  
Vote Counting

BACKGROUND There has been a proliferation of digital health interventions (DHIs) targeting dietary intake. Despite their potential, the effectiveness of such interventions are thought to be dependent, in part, on user engagement. However, the relationship between engagement and the effectiveness of dietary DHIs is not well understood. OBJECTIVE As such, the aim of this systematic review is to describe the association between DHI engagement (both usage and subjective experience) and dietary intake. METHODS A comprehensive search for peer-reviewed literature was undertaken in four electronic databases (EMBASE, MEDLINE, PsychINFO, Scopus) from inception to December 2019. A hand search of targeted journals, grey literature searches and a search of relevant references of similar reviews was also conducted. Studies were eligible if they examined a quantitative association between objective measures of engagement with a DHI (subjective experience or usage) and measures of dietary intake in adults (aged ≥18 years). Authors single screened studies, with a pair of review authors assessing quality of studies and extracting relevant data. Narrative syntheses using vote counting was undertaken to explore to relationship between measures of engagement and dietary intake. RESULTS The search resulted in 10,653 citations, of which seven studies (from nine articles) were included in the review. The majority of studies (n=5) included usage measures of engagement rather than subjective experience (n=2). Logins were the most commonly reported usage measure (n=5 studies), and fruit and vegetable intake was the most common measure of dietary intake (n=4 studies). The heterogeneity of engagement and dietary intake measures limited the use of meta-analytic techniques, however narrative review (vote counting) found mixed evidence of an association with usage measures (5 of 12 associations indicating a positive relationship, 7 were inconclusive). No evidence regarding an association with subjective experience was found (0 of 2 associations were inconclusive). The majority of included studies (n=5) were rated poor quality according to the Newcastle Ottawa Scale. CONCLUSIONS The findings provide some evidence supporting an association between measures of usage and fruit and vegetable intake, however this was inconsistent. No evidence was found regarding an association with subjective experience. Given the limited number of studies included in the review and poor quality of available evidence further research examining the association between DHI engagement and dietary intake using consistent measures, with an additional focus on subjective experience is warranted. CLINICALTRIAL CRD42018112189

scholarly journals Intensity of affective experience is modulated by magnitude of intracranial electrical stimulation in human orbitofrontal, cingulate, and insular cortex

2019 ◽  
Author(s):  
Jennifer Yih ◽  
Danielle E. Beam ◽  
Kieran Fox ◽  
Josef Parvizi
Keyword(s):  
Electrical Stimulation ◽  
Electric Current ◽  
Subjective Experience ◽  
Insular Cortex ◽  
Affective States ◽  
Subjective Experiences ◽  
Anterior Portion ◽  
Neurosurgical Patients ◽  
Intracranial Electrodes ◽  
The Relationship

The subjective and behavioral effects of intracranial electrical stimulation (iES) have been studied for decades, but there is a knowledge gap regarding the relationship between the magnitude of electric current and the type, intensity, and valence of evoked subjective experiences. We report on rare iES data from 18 neurosurgical patients with implanted intracranial electrodes in the orbitofrontal cortex (OFC), the insula (INS), and the anterior portion of cingulate cortex (ACC). ACC stimulation elicited somatic and visceral sensations, whereas OFC stimulation predominantly elicited olfactory and gustatory responses, and INS stimulation elicited a mix of effects involving somatic and visceral sensations, olfaction, and gustation. Further, we found striking evidence that the magnitude of electric current delivered intracranially correlated positively with the perceived intensity of subjective experience and the evoked emotional state, a relationship observed across all three regions. Finally, we observed that the majority of reported experiences were negatively-valenced and unpleasant, especially those elicited by ACC stimulation. The present study provides novel case studies from the human brain confirming that these structures contribute causally to the creation of affective states, and demonstrates a direct relationship between the magnitude of electrical stimulation of these structures and the qualia of elicited subjective experience.

Optimizing Training Programs and Opportunities for Professional Development in the Era of Digital Pain Interventions: A Unique Opportunity for Collaboration (Preprint)

2020 ◽  
Author(s):  
Amara Nasir ◽  
Syed Hazique Mahmood
Keyword(s):  
Digital Health ◽  
Grey Literature ◽  
Health Interventions ◽  
Optimal Care ◽  
Medical Specialties ◽  
Health Technologies ◽  
Learning Techniques ◽  
Pain Intervention ◽  
Pain Patients ◽  
Patient Centric

UNSTRUCTURED Introduction: New digital health technologies provide accessible adjuncts to alleviating pain in the general population. The advent novel digital pain interventions have resulted in a rapidly evolving learning environment. Improving knowledge and understanding of these digital patient-centric approaches to treating pain is vital for our current practitioners and new cadre of trainees. The objective of this manuscript is to initiate a discussion about digital pain intervention educational needs of residents as well as attendings in PM&R, anesthesia and neurology. Methodology: After reviewing Accreditation Council Graduate Medical Education (ACGME) and relevant American Board of Medical Specialties policies and best available evidence, including grey literature, we interviewed a group of practicing physicians in physiatry, anesthesiology and neurology, including program directors, to provide expert opinion, guidance and formulate recommendations on educational requirements, research endeavors, and learning techniques and opportunities in utilizing digital health interventions for management of pain. IRB approval was not required. Conclusions: We hope that this manuscript will serve as the basis of designing a comprehensive educational program and outlining opportunities for research that prioritizes optimal care for pain patients and leverages the unique and complementary knowledge base within our fields.

scholarly journals Exploring Socioeconomic Inequities in Access to Palliative and End-of-life Care in the Uk: A Mixed Methods Narrative Synthesis

2021 ◽  
Author(s):  
Maddy French ◽  
Thomas Keegan ◽  
Eleftherios Anestis ◽  
Nancy Preston
Keyword(s):  
Mixed Methods ◽  
End Of Life ◽  
Socioeconomic Position ◽  
End Of Life Care ◽  
Grey Literature ◽  
Narrative Synthesis ◽  
Life Care ◽  
Local Conditions ◽  
The Uk ◽  
The Relationship

Abstract Background: Efforts to understand and tackle socioeconomic inequities in access to palliative and end-of-life care require comprehensive understanding about the extent of and reasons for inequities. Most research on this topic examines differences in receipt of care. There is a need for theoretically driven research that considers both receipt of care and the wider factors influencing the relationship between socioeconomic position and access to palliative and end-of-life care. Methods: A mixed-methods narrative synthesis on socioeconomic position and access to palliative and end-of-life care in the UK. Study searches were conducted in databases AMED, Medline, Embase, CINAHL, SocIndex, and Academic Literature Search along with grey literature sources in July 2020. The candidacy model of access, which describes access as a seven-stage negotiation between patients and providers, guided study searches and provided a theoretical lens through which data were synthesised.Results: Searches retrieved 5303 studies (after de-duplication), 29 of which were included. The synthesis generated four overarching themes, within which concepts of candidacy were evident: identifying needs; taking action; local conditions; and receiving care.Conclusion: Socioeconomic position does not have a consistent association with receipt of palliative and end-of-life care in the UK. The use of the candidacy model of access helped to identify key gaps in the UK evidence, including those concerning the relationship between socioeconomic position, organisational context, and assessing need for palliative care.

scholarly journals Identifying optimal frameworks to implement or evaluate digital health interventions: a scoping review protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e037643
Author(s):  
Charlene Soobiah ◽  
Madeline Cooper ◽  
Vanessa Kishimoto ◽  
R Sacha Bhatia ◽  
Ted Scott ◽  
...  
Keyword(s):  
Scoping Review ◽  
Health Knowledge ◽  
Digital Health ◽  
Grey Literature ◽  
Health Interventions ◽  
Qualitative Description ◽  
Ethical Review ◽  
Advisory Panel ◽  
Healthcare Team ◽  
Scoping Reviews

IntroductionDigital health interventions (DHIs) are defined as health services delivered electronically through formal or informal care. DHIs can range from electronic medical records used by providers to mobile health apps used by consumers. DHIs involve complex interactions between user, technology and the healthcare team, posing challenges for implementation and evaluation. Theoretical or interpretive frameworks are crucial in providing researchers guidance and clarity on implementation or evaluation approaches; however, there is a lack of standardisation on which frameworks to use in which contexts. Our goal is to conduct a scoping review to identify frameworks to guide the implementation or evaluation of DHIs.Methods and analysisA scoping review will be conducted using methods outlined by the Joanna Briggs Institute reviewers’ manual and will conform to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. Studies will be included if they report on frameworks (ie, theoretical, interpretive, developmental) that are used to guide either implementation or evaluation of DHIs. Electronic databases, including MEDLINE, EMBASE, CINAHL and PsychINFO will be searched in addition to grey literature and reference lists of included studies. Citations and full text articles will be screened independently in Covidence after a reliability check among reviewers. We will use qualitative description to summarise findings and focus on how research objectives and type of DHIs are aligned with the frameworks used.Ethics and disseminationWe engaged an advisory panel of digital health knowledge users to provide input at strategic stages of the scoping review to enhance the relevance of findings and inform dissemination activities. Specifically, they will provide feedback on the eligibility criteria, data abstraction elements, interpretation of findings and assist in developing key messages for dissemination. This study does not require ethical review. Findings from review will support decision making when selecting appropriate frameworks to guide the implementation or evaluation of DHIs.

scholarly journals Challenges of and Solutions for Developing Tailored Video Interventions That Integrate Multiple Digital Assets to Promote Engagement and Improve Health Outcomes: Tutorial

10.2196/21128 ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. e21128
Author(s):  
Camilla Harshbarger ◽  
Olivia Burrus ◽  
Sivakumar Rangarajan ◽  
John Bollenbacher ◽  
Brittany Zulkiewicz ◽  
...  
Keyword(s):  
Digital Health ◽  
Health Interventions ◽  
Multidisciplinary Teams ◽  
User Engagement ◽  
Design And Development ◽  
Counseling Intervention ◽  
Video Clips ◽  
Tailored Messages ◽  
Digital Interventions ◽  
Digital Assets

Background Video is a versatile and popular medium for digital health interventions. As mobile device and app technology advances, it is likely that video-based interventions will become increasingly common. Although clinic waiting rooms are complex and busy environments, they offer the opportunity to facilitate engagement with video-based digital interventions as patients wait to see their providers. However, to increase efficiency in public health, leverage the scalability and low cost of implementing digital interventions, and keep up with rapidly advancing technology and user needs, more design and development guidance is needed for video-based tailored interventions. Objective We provide a tutorial for digital intervention researchers and developers to efficiently design and develop video-based tailored digital health interventions. We describe the challenges and solutions encountered with Positive Health Check (PHC), a hybrid app used to deliver a brief, interactive, individually tailored video-based HIV behavioral counseling intervention. PHC uses video clips and multimedia digital assets to deliver intervention content, including interactive tailored messages and graphics, a repurposed animated video, and patient and provider handouts generated in real time by PHC. Methods We chronicle multiple challenges and solutions for the following: (1) using video as a medium to enhance user engagement, (2) navigating the complexity of linking a database of video clips with other digital assets, and (3) identifying the main steps involved in building an app that will seamlessly deliver to users individually tailored messages, graphics, and handouts. Results We leveraged video to enhance user engagement by featuring “video doctors,” full-screen video, storyboards, and streamlined scripts. We developed an approach to link the database of video clips with other digital assets through script coding and flow diagrams of algorithms to deliver a tailored user experience. We identified the steps to app development by using keyframes to design the integration of video and digital assets, using agile development methods to gather iterative feedback from multidisciplinary teams, and creating an intelligent data-driven back-end solution to tailor message delivery to individual users. Conclusions Video-based digital health interventions will continue to play an important role in the future of HIV prevention and treatment, as well as other clinical health practices. However, facilitating the adoption of an HIV video intervention in HIV clinical settings is a work in progress. Our experience in designing and developing PHC presented unique challenges due to the extensive use of a large database of videos tailored individually to each user. Although PHC focuses on promoting the health and well-being of persons with HIV, the challenges and solutions presented in this tutorial are transferable to the design and development of video-based digital health interventions focused on other areas of health.

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