Designing a Screening Program for Prevention of Avoidable Blindness in Iran through a Participatory Action Approach

The role of mobile health in prevention, diagnosis, treatment and self-care of COVID-19 from the healthcare professionals' perspectives

Background

To facilitate disease management, understanding the attitude of healthcare professionals regarding the use of this tool can help mobile health (mHealth) program developers develop appropriate interventions.

Aims

To assess the perspective of healthcare professionals regarding the contribution of mobile-based interventions in the prevention, diagnosis, self-care, and treatment (PDST) of COVID-19.

Methods

This is a survey study conducted in 2020 in Iran with 81 questions. In this study mHealth functionalities were categorized into four dimensions including innovative, monitoring and screening, remote services, and education and decision-making. The data were analyzed using descriptive statistics, ANOVA, and the Kruskal-Wallis test to compare the attitudes of the different job groups.

Results

In total, 123 providers participated, and 87.4% of them reported that mHealth technology is moderate to most helpful for the management of COVID-19. Healthcare professionals believed that mHealth technology could be most helpful in self-care and least helpful in the diagnosis of COVID-19. Regarding the functionalities of the mobile application, the results showed that the use of patient decision aids can be most helpful in self-care and the use of computer games can be least helpful in treatment. The participants believed that mHealth is more effective in monitoring and screening dimensions and less effective in providing remote services.

Conclusions

This study showed that healthcare professionals believed that mHealth technology could have a better contribution to self-care for patients with COVID-19. Therefore, it is better to plan and invest more in the field of self-care to help patients to combat COVID-19. The results of this study revealed which mhealth functionalities work better in four domains of prevention, treatment, self-care, and diagnosis of COVID-19. This can help healthcare authorities to implement appropriate IT-based interventions to combat COVID-19.

Best Practices and Lessons Learned for Action Research in eHealth Design and Implementation: Literature Review

BACKGROUND

Action research (AR) is an established research framework to introduce change in a community following a cyclical approach and involving stakeholders as coresearchers in the process. In recent years, it has also been used for eHealth development. However, little is known about the best practices and lessons learned from using AR for eHealth development.

OBJECTIVE

This literature review aims to provide more knowledge on the best practices and lessons learned from eHealth AR studies. Additionally, an overview of the context in which AR eHealth studies take place is given.

METHODS

A semisystematic review of 44 papers reporting on 40 different AR projects was conducted to identify the best practices and lessons learned in the research studies while accounting for the particular contextual setting and used AR approach.

RESULTS

Recommendations include paying attention to the training of stakeholders' academic skills, as well as the various roles and tasks of action researchers. The studies also highlight the need for constant reflection and accessible dissemination suiting the target group.

CONCLUSIONS

This literature review identified room for improvements regarding communicating and specifying the particular AR definition and applied approach.

Eye Care Utilization in A Community-oriented Mobile Screening Programme for Improving Eye Health in Iran: A Cluster Randomized Trial

PURPOSE

To evaluate the effect of a mobile-based screening programme on eye care utilization in Iran.

METHOD

In this cluster randomized community trial, a representative sample of residents aged≥50 years from urban and rural areas in four districts in Tehran province were enrolled. The clusters were randomly assigned to one of the three parallel arms; the mHealth arm with digital data collection, vision screening test and retina evaluation using an integrated mobile application, the conventional arm with manual data collection and screening tests using Snellen chart and Fundus photography at the local primary healthcare facility, and the control arm with manual data collection without screening tests. The main outcome measure was eye care utilization which was defined as at least one visit to an optometrist or ophthalmologist.

RESULTS

Of 3312 eligible individuals, 2520 (76.1%) participated. In the first 3 months after the screening programme, eye care utilization was higher among those who were referred by the mHealth method (35.6% 95%CI: 31.1-40.4%) compared to those referred by the conventional method (32.7%, 95%CI: 27.5-38.2%) and to those observed in the control arm (4.5%, 95%CI: 3.2-6.0). Eye care utilization improved (OR = 1.5, 95%CI: 1.2-1.9) among the referred people after the screening programme compared to the utilization before this programme; however, this improvement was significantly higher in the mHealth method (OR: 1.7, 95%CI: 1.2-2.4) compared to the conventional method (OR: 1.2, 95%CI: 0.8-1.8).

CONCLUSION AND RELEVANCE

The mobile-based screening programme can significantly improve eye care utilization at the community level.