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Weirauch V, Soehnchen C, Burmann A, Meister S. Methods, Indicators, and End-User Involvement in the Evaluation of Digital Health Interventions for the Public: Scoping Review. J Med Internet Res 2024; 26:e55714. [PMID: 38819891 PMCID: PMC11179021 DOI: 10.2196/55714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 03/28/2024] [Accepted: 04/24/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND Digital health interventions (DHIs) have the potential to enable public end users, such as citizens and patients, to manage and improve their health. Although the number of available DHIs is increasing, examples of successfully established DHIs in public health systems are limited. To counteract the nonuse of DHIs, they should be comprehensively evaluated while integrating end users. Unfortunately, there is a wide variability and heterogeneity according to the approaches of evaluation, which creates a methodological challenge. OBJECTIVE This scoping review aims to provide an overview of the current established processes for evaluating DHIs, including methods, indicators, and end-user involvement. The review is not limited to a specific medical field or type of DHI but offers a holistic overview. METHODS This scoping review was conducted following the JBI methodology for scoping reviews based on the framework by Arksey & O'Malley and complies with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. Three scientific databases (PubMed, Scopus, and Science Direct) were searched in April 2023. English and German studies between 2008 and 2023 were considered when evaluating DHIs that explicitly address public end users. The process of study selection was carried out by several researchers to avoid reviewer bias. RESULTS The search strategy identified 9618 publications, of which 160 were included. Among these included articles, 200 evaluations were derived and analyzed. The results showed that there is neither a consensus on the methods to evaluate DHIs nor a commonly agreed definition or usage of the evaluated indicators, which results in a broad variety of evaluation practices. This aligns with observations of the existing literature. It was found that there is a lack of references to existing frameworks for the evaluation of DHIs. The majority of the included studies referred to user-centered approaches and involved end users in the evaluation process. As assistance for people developing and evaluating DHIs and as a basis for thinking about appropriate ways to evaluate DHIs, a results matrix was created where the findings were combined per DHI cluster. Additionally, general recommendations for the evaluators of DHIs were formulated. CONCLUSIONS The findings of this scoping review offer a holistic overview of the variety and heterogeneity according to the approaches of evaluation of DHIs for public end users. Evaluators of these DHIs should be encouraged to reference established frameworks or measurements for justification. This would ease the transferability of the results among similar evaluation studies within the digital health sector, thereby enhancing the coherence and comparability of research in this area.
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Affiliation(s)
- Vera Weirauch
- Health Informatics, Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany
- Fraunhofer Institute for Software and Systems Engineering, Dortmund, Germany
| | - Clarissa Soehnchen
- Health Informatics, Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany
| | - Anja Burmann
- Fraunhofer Institute for Software and Systems Engineering, Dortmund, Germany
| | - Sven Meister
- Health Informatics, Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany
- Fraunhofer Institute for Software and Systems Engineering, Dortmund, Germany
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Maaß L, Zeeb H, Rothgang H. International perspectives on measuring national digital public health system maturity through a multidisciplinary Delphi study. NPJ Digit Med 2024; 7:92. [PMID: 38609458 PMCID: PMC11014962 DOI: 10.1038/s41746-024-01078-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 03/14/2024] [Indexed: 04/14/2024] Open
Abstract
Unlocking the full potential of digital public health (DiPH) systems requires a comprehensive tool to assess their maturity. While the World Health Organization and the International Telecommunication Union released a toolkit in 2012 covering various aspects of digitalizing national healthcare systems, a holistic maturity assessment tool has been lacking ever since. To bridge this gap, we conducted a pioneering Delphi study, to which 54 experts from diverse continents and academic fields actively contributed to at least one of three rounds. 54 experts participated in developing and rating multidisciplinary quality indicators to measure the maturity of national digital public health systems. Participants established consensus on these indicators with a threshold of 70% agreement on indicator importance. Eventually, 96 indicators were identified and agreed upon by experts. Notably, 48% of these indicators were found to align with existing validated tools, highlighting their relevance and reliability. However, further investigation is required to assess the suitability and applicability of all the suggestions put forward by our participants. Nevertheless, this Delphi study is an essential initial stride toward a comprehensive measurement tool for DiPH system maturity. By working towards a standardized assessment of DiPH system maturity, we aim to empower decision-makers to make informed choices, optimize resource allocation, and drive innovation in healthcare delivery. The results of this study mark a significant milestone in advancing DiPH on a global scale.
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Affiliation(s)
- Laura Maaß
- University of Bremen, SOCIUM Research Center on Inequality and Social Policy, Department Health, Long-Term Care and Pensions, Bremen, Germany.
- Leibniz ScienceCampus Digital Public Health Bremen, Bremen, Germany.
| | - Hajo Zeeb
- Leibniz ScienceCampus Digital Public Health Bremen, Bremen, Germany
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Department Prevention and Evaluation, Bremen, Germany
| | - Heinz Rothgang
- University of Bremen, SOCIUM Research Center on Inequality and Social Policy, Department Health, Long-Term Care and Pensions, Bremen, Germany
- Leibniz ScienceCampus Digital Public Health Bremen, Bremen, Germany
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Albrecht J, Maaß L, Tokgöz P, Hrynyschyn R, Wrona KJ, Stark AL, Dunsche C, Fischer F, Schmidt A, Schulz H, Hidding S, Dockweiler C. [How much digital public health is in public health degree programs? A systematic analysis of module handbooks in German full-time study programs at public colleges and universities]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2024; 67:339-350. [PMID: 38436689 DOI: 10.1007/s00103-024-03844-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 01/29/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND Professionals, especially in the field of digital public health (DiPH), are crucial for a successful digital transformation in social and health care. However, it is still unclear to what extent academic professionals are taught DiPH-related content in their public health (PH) studies. METHODS This study used a systematic module handbook analysis to analyze accredited full-time PH-oriented degree programs at public colleges and universities in Germany for DiPH-related module content. Through the "Hochschulkompass" platform and the member programs of the German Public Health Association (DGPH), 422 programs were identified. Included module handbooks were evaluated by content analysis using MAXQDA. RESULTS Only 10 bachelor and 6 master programs contain DiPH. They are heterogeneous in their focus and belong to different subfields of public health ("methods, definition, history, and social medicine" = 5; "health management" = 5; "digital health" = 3; "health services research" = 2; "health communication" = 1). Differences were found between the common understanding of DiPH in academia and the content in the module handbooks. The content identified in the analysis focuses mainly on technical areas. Social and health science content is only marginally present. DISCUSSION The heterogeneous study programs with a connection to DiPH allow academic PH specialists to develop specific profiles. To achieve comprehensive competencies in DiPH, there is a need for further development of modules with relevance to the respective degree program. The results could be used for the (further) development of relevant modules and a core curriculum in DiPH.
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Affiliation(s)
- Joanna Albrecht
- Universität Siegen, Lebenswissenschaftliche Fakultät, Department Digitale Gesundheitswissenschaften und Biomedizin, Professur für Digital Public Health, Siegen, Deutschland
- Deutsche Gesellschaft für Public Health e.V., Fachbereich Digital Public Health, Berlin, Deutschland
| | - Laura Maaß
- Leibniz WissenschaftsCampus Digital Public Health Bremen, Bremen, Deutschland.
- Universität Bremen, Forschungszentrum Ungleichheit und Sozialpolitik (SOCIUM), Mary-Somerville-Straße 3, 28359, Bremen, Deutschland.
- Deutsche Gesellschaft für Public Health e.V., Fachbereich Digital Public Health, Berlin, Deutschland.
| | - Pinar Tokgöz
- Universität Siegen, Lebenswissenschaftliche Fakultät, Department Digitale Gesundheitswissenschaften und Biomedizin, Professur für Digital Public Health, Siegen, Deutschland
| | - Robert Hrynyschyn
- Leibniz WissenschaftsCampus Digital Public Health Bremen, Bremen, Deutschland
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institut für Gesundheits- und Pflegewissenschaft, Berlin, Deutschland
- Deutsche Gesellschaft für Public Health e.V., Fachbereich Digital Public Health, Berlin, Deutschland
| | - Kamil J Wrona
- Hochschule Bielefeld, Fachbereich Ingenieurwissenschaften und Mathematik, Bielefeld, Deutschland
- Hochschule Bielefeld, Fachbereich Gesundheit, Bielefeld, Deutschland
| | - Anna Lea Stark
- Universität Siegen, Lebenswissenschaftliche Fakultät, Department Digitale Gesundheitswissenschaften und Biomedizin, Professur für Digital Public Health, Siegen, Deutschland
| | - Celina Dunsche
- Universität Siegen, Lebenswissenschaftliche Fakultät, Department Digitale Gesundheitswissenschaften und Biomedizin, Professur für Digital Public Health, Siegen, Deutschland
| | - Florian Fischer
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institut für Public Health, Berlin, Deutschland
- Hochschule Kempten, Bayerisches Zentrum Pflege Digital, Kempten, Deutschland
- Deutsche Gesellschaft für Public Health e.V., Fachbereich Digital Public Health, Berlin, Deutschland
| | - Annalena Schmidt
- Universität Bremen, Fachbereich Human- und Gesundheitswissenschaften, Bremen, Deutschland
- Deutsche Gesellschaft für Public Health e.V., Fachbereich Digital Public Health, Berlin, Deutschland
| | - Henriette Schulz
- Universität Siegen, Lebenswissenschaftliche Fakultät, Department Digitale Gesundheitswissenschaften und Biomedizin, Professur für Digital Public Health, Siegen, Deutschland
- Deutsche Gesellschaft für Public Health e.V., Fachbereich Digital Public Health, Berlin, Deutschland
| | - Sarah Hidding
- Universität Siegen, Lebenswissenschaftliche Fakultät, Department Digitale Gesundheitswissenschaften und Biomedizin, Professur für Digital Public Health, Siegen, Deutschland
- Deutsche Gesellschaft für Public Health e.V., Fachbereich Digital Public Health, Berlin, Deutschland
| | - Christoph Dockweiler
- Universität Siegen, Lebenswissenschaftliche Fakultät, Department Digitale Gesundheitswissenschaften und Biomedizin, Professur für Digital Public Health, Siegen, Deutschland
- Deutsche Gesellschaft für Public Health e.V., Fachbereich Digital Public Health, Berlin, Deutschland
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Evans L, Evans J, Fletcher M, Abdullah A, Ahmed Z. Mapping Respiratory Health Digital Interventions in South and Southeast Asia: Protocol for a Scoping Review. JMIR Res Protoc 2024; 13:e52517. [PMID: 38214954 PMCID: PMC10818234 DOI: 10.2196/52517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 09/19/2023] [Accepted: 09/21/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND The last 2 decades have been a time of exponential growth and maturation for digital health, while the global burden of respiratory disease continues to grow worldwide. Leveraging digital health interventions (DHIs) to manage and mitigate respiratory disease and its adverse health effects presents itself as an obvious path forward. OBJECTIVE We aimed to understand the current digital landscape and enabling environment around respiratory health to reduce costs, avoid duplication, and understand the comprehensiveness of DHIs. METHODS This study will follow a scoping review methodology as outlined by Arksey and O'Malley, the Joanna Briggs Institute, and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist. MEDLINE, Embase, CINAHL, PsycINFO, Cochrane Library, Web of Science, PakiMedNet, and MyMedR databases will be searched along with key websites, repositories, and gray literature databases. The terms "respiratory health," "digital health," "South Asia," and "Southeast Asia," as well as related terms will be searched. The results will be screened for duplicates and then against the inclusion and exclusion criteria. For the studies included, data will be extracted, collated, and analyzed. RESULTS The scoping review was started in July 2023 and will be finalized by February 2024. Results will be presented following the World Health Organization's classification of DHIs to categorize interventions in a standardized format and the mobile health evidence reporting and assessment checklist to report on the effectiveness of interventions. Further exposition of the evidence extracted will be presented through narrative synthesis. CONCLUSIONS As DHIs continue to proliferate, the need to understand the current landscape becomes more pertinent. In this scoping review, we will seek to more clearly understand what digital health tools and technologies are being used in the current landscape of digital health in South and Southeast Asia for respiratory health and to what extent they are addressing the respiratory health needs of the region. The results will inform recommendations on digital health tools for respiratory health in South and Southeast Asia will help funders and implementers of DHIs leverage existing technologies and accelerate innovations that address documented gaps in the studied countries. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/52517.
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Affiliation(s)
- Laura Evans
- Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Jay Evans
- Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Monica Fletcher
- Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Adina Abdullah
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Zakiuddin Ahmed
- Riphah Institute of Healthcare Improvement and Safety, Islamabad, Pakistan
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Schnall R, Sanabria G, Jia H, Cho H, Bushover B, Reynolds NR, Gradilla M, Mohr DC, Ganzhorn S, Olender S. Efficacy of an mHealth self-management intervention for persons living with HIV: the WiseApp randomized clinical trial. J Am Med Inform Assoc 2023; 30:418-426. [PMID: 36469808 PMCID: PMC9933073 DOI: 10.1093/jamia/ocac233] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 11/11/2022] [Accepted: 11/24/2022] [Indexed: 12/12/2022] Open
Abstract
IMPORTANCE Progression of HIV disease, the transmission of the disease, and premature deaths among persons living with HIV (PLWH) have been attributed foremost to poor adherence to HIV medications. mHealth tools can be used to improve antiretroviral therapy (ART) adherence in PLWH and have the potential to improve therapeutic success. OBJECTIVE To determine the efficacy of WiseApp, a user-centered design mHealth intervention to improve ART adherence and viral suppression in PLWH. DESIGN, SETTING, AND PARTICIPANTS A randomized (1:1) controlled efficacy trial of the WiseApp intervention arm (n = 99) versus an attention control intervention arm (n = 101) among persons living with HIV who reported poor adherence to their treatment regimen and living in New York City. INTERVENTIONS The WiseApp intervention includes the following components: testimonials of lived experiences, push-notification reminders, medication trackers, health surveys, chat rooms, and a "To-Do" list outlining tasks for the day. Both study arms also received the CleverCap pill bottle, with only the intervention group linking the pill bottle to WiseApp. RESULTS We found a significant improvement in ART adherence in the intervention arm compared to the attention control arm from day 1 (69.7% vs 48.3%, OR = 2.5, 95% CI 1.4-3.5, P = .002) to day 59 (51.2% vs 37.2%, OR = 1.77, 95% CI 1.0-1.6, P = .05) of the study period. From day 60 to 120, the intervention arm had higher adherence rates, but the difference was not significant. In the secondary analyses, no difference in change from baseline to 3 or 6 months between the 2 arms was observed for all secondary outcomes. CONCLUSIONS The WiseApp intervention initially improved ART adherence but did not have a sustained effect on outcomes.
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Affiliation(s)
- Rebecca Schnall
- School of Nursing, Columbia University, New York, New York, USA
- Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Gabriella Sanabria
- College of Public Health, University of South Florida, Tampa, Florida, USA
| | - Haomiao Jia
- School of Nursing, Columbia University, New York, New York, USA
| | - Hwayoung Cho
- Department of Family, Community, and Health System Science, College of Nursing, University of Florida, Gainesville, Florida, USA
| | - Brady Bushover
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Nancy R Reynolds
- Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
| | | | - David C Mohr
- Center for Behavioral Intervention Technologies, Department of Preventive Medicine, Northwestern University, Chicago, Illinois, USA
| | - Sarah Ganzhorn
- School of Nursing, Columbia University, New York, New York, USA
| | - Susan Olender
- Division of Infectious Disease, Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA
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