Digital health interventions for all? Examining inclusivity across all stages of the digital health intervention research process

Trials, Год журнала: 2024, Номер 25(1)

Опубликована: Янв. 30, 2024

Abstract Digital interventions offer many possibilities for improving health, as remote can enhance reach and access to underserved groups of society. However, research evaluating digital health demonstrates that such technologies do not equally benefit all some in fact seem reinforce a “digital divide.” By better understanding these potential pitfalls, we may contribute narrowing the divide promotion. The aim this article is highlight reflect upon study design decisions might unintentionally inequities across key stages—recruitment, enrollment, engagement, efficacy/effectiveness, retention. To address concerns highlighted, propose strategies including (1) standard definition “effectiveness” should be revised include measure inclusivity; (2) studies report broad range inequity indicators participants recruited, randomized, retained conduct sensitivity analyses examining sociodemographic differences both effect engagement interventions; (3) from historically marginalized involved procedures, those related recruitment, consent, intervention implementation assessment, retention; (4) eligibility criteria minimized carefully selected screening process streamlined; (5) preregistration trials recruitment benchmarks sample diversity comprehensive lists characteristics assessed; (6) within embedded systematically test retention improve inclusivity. would ability recruit, randomize, engage, retain broader more representative population trials, ultimately minimizing broadly health.

Язык: Английский

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Mobile health (m-health) smartphone interventions for adolescents and adults with overweight or obesity

Cochrane library, Год журнала: 2024, Номер 2024(2)

Опубликована: Фев. 20, 2024

Язык: Английский

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Impact of feedback generation and presentation on self-monitoring behaviors, dietary intake, physical activity, and weight: a systematic review and meta-analysis

International Journal of Behavioral Nutrition and Physical Activity, Год журнала: 2024, Номер 21(1)

Опубликована: Янв. 4, 2024

Abstract Self-monitoring of dietary intake, physical activity, and weight is a key strategy in behavioral interventions, some interventions provide self-monitoring feedback to facilitate goal setting promote engagement. This systematic review aimed evaluate whether increases intervention effectiveness, which forms presentation (e.g., personalized vs. not personalized) generation (i.e., human algorithm-generated) are most effective. To achieve this aim, 5 electronic databases (PubMed/MEDLINE, Web Science, CINAHL, PsycINFO, Google Scholar) were searched April 2022 yielded 694 unique records, out 24 articles reporting on 19 studies included (with total 3261 participants). Two reviewers independently screened titles abstracts then full texts categorized as eligible or excluded according the pre-registered criteria availability text, peer reviewed manuscript English; adult participants randomized controlled trial that both feedback; comparisons different no primary outcomes diet, behavior, and/or weight). All assessed for methodological quality by two using revised Cochrane risk-of-bias tool (version 2). Ten compared feedback, human- algorithm-generated remaining 4 formats frequency, richness). A random effects meta-analysis indicated activity with provision more effective than without (d=0.29, 95% CI [0.16;0.43]). No could be conducted other due heterogeneity study designs outcomes. There mixed results regarding form superior. Limitations evidence were: lack details about provided, brevity exclusion did isolate when testing packages, high risk bias many studies. underlines importance including interventions; however, research needed identify maximize effectiveness. Trial registration (PROSPERO) CRD42022316206.

Язык: Английский

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Efficacy of an app-based multimodal lifestyle intervention on body weight in persons with obesity: results from a randomized controlled trial

International Journal of Obesity, Год журнала: 2023, Номер 48(1), С. 118 - 126

Опубликована: Ноя. 28, 2023

Abstract Background Despite an increasing number of smartphone applications (apps) addressing weight management, data on the effect app-based multimodal obesity treatment approaches loss is limited. This study aimed to examine a digital intervention program delivered by app body in persons with obesity. Methods For this single-centre randomized controlled study, 168 adults mass index (BMI) between 30.0 and 40.0 kg/m 2 without severe comorbidities were recruited region Munich into two groups. The ADHOC group received from baseline for 12 weeks plus follow-up. EXPECT after “waiting” (no intervention). Anthropometric data, quality life ( EuroQol , EQ-5D-5L), usage collected. Results 64.3% participants women, mean age was 46.8 ± 11.0 years, BMI 34.2 2.8 . completers analysis resulted 3.2 kg (3.2 3.0%) 0.4 2.6 (0.3 2.6%) weeks, significant difference groups (β [95% CI] = −2.9 [−3.8; −1.9], p < 0.001). Completers showed maintenance 24 weeks. time spent associated reduction −0.10 [−0.18; −0.01], 0.03). Conclusions Application results moderate Trial registration registered German Clinical Trials Register (Registration number: DRKS00025291).

Язык: Английский

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Ten Years of TeleHealth and Digital Healthcare: Where Are We?

Healthcare, Год журнала: 2023, Номер 11(6), С. 875 - 875

Опубликована: Март 17, 2023

Due to the development of technological innovation devices, availability increasingly performing networks, improvement digitization processes, and push greater diffusion determined by COVID-19 pandemic, Digital Healthcare (DH), also referred as Health [...].

Язык: Английский

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Umbrella review of social inequality in digital interventions targeting dietary and physical activity behaviors

npj Digital Medicine, Год журнала: 2025, Номер 8(1)

Опубликована: Янв. 6, 2025

Digital interventions are increasingly utilized as a lever to promote population health, yet not everyone may equally benefit from them. This umbrella review pooled the insights available systematic and scoping reviews regarding potential social inequalities in digital intervention uptake, engagement effectiveness, focusing on promotion of weight-related behaviors (diet, physical activity, sedentary behavior) weight loss (maintenance) adults. Six databases were searched 1970 October 2023. Forty-six included, which most focused activity effectiveness. Age gender/ sex differences frequently studied. Most found be effective irrespective age, while men benefitted more than women. Other inequality indicators (e.g., income, education) rarely studied, despite them being causes divide. A thorough exploration health is required for all.

Язык: Английский

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Perspective: A Conceptual Framework for Adaptive Personalized Nutrition Advice Systems (APNASs)

Advances in Nutrition, Год журнала: 2023, Номер 14(5), С. 983 - 994

Опубликована: Июль 5, 2023

Nearly all approaches to personalized nutrition (PN) use information such as the gene variants of individuals deliver advice that is more beneficial than a generic "1-size-fits-all" recommendation. Despite great enthusiasm and increased availability commercial services, thus far, scientific studies have only revealed small negligible effects on efficacy effectiveness dietary recommendations, even when using genetic or other individual information. In addition, from public health perspective, scholars are critical PN because it primarily targets socially privileged groups rather general population, thereby potentially widening inequality. Therefore, in this we propose extend current by creating adaptive systems (APNASs) tailored type timing for needs, capacities, receptivity real-life food environments. These encompass broadening goals (i.e., what should be achieved) incorporate "individual goal preferences" beyond currently advocated biomedical (e.g., making sustainable choices). Moreover, they cover "personalization processes behavior change" providing situ, "just-in-time" environments (how change), which accounts capacities constraints economic resources). Finally, concerned with "participatory dialog between experts" actual virtual dieticians, nutritionists, advisors) setting deriving measures adaption. Within framework, emerging digital ecosystems enable continuous, real-time monitoring, advice, support exposure consumption. We present vision novel framework along scenarios arguments describe its potential efficiently address population needs target would benefit most implementation.

Язык: Английский

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Reducing intervention- and research-induced inequalities to tackle the digital divide in health promotion

International Journal for Equity in Health, Год журнала: 2023, Номер 22(1)

Опубликована: Дек. 4, 2023

Abstract Social inequalities are an important contributor to the global burden of disease within and between countries. Using digital technology in health promotion healthcare is seen by some as a potential lever reduce these inequalities; however, research suggests that risks re-enacting or evening widening disparities. Most on this divide focuses small number social inequality indicators stems from Western, educated, industrialized, rich, democratic (WEIRD) There need for systematic, international, interdisciplinary contextualized impact well underlying mechanisms across globe In June 2023, eighteen multi-disciplinary researchers representing thirteen countries six continents came together discuss current issues field contributing divide. Ways practices contribute were explored, including intervention development, testing, implementation. Based dialogue, we provide suggestions overcoming barriers improving disciplines, countries, sectors. The community must actively advocate system-level changes regarding policy so improve all.

Язык: Английский

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Health behavior interventions among people with lower socio-economic position: a scoping review of behavior change techniques and effectiveness

Health Psychology and Behavioral Medicine, Год журнала: 2024, Номер 12(1)

Опубликована: Июнь 18, 2024

Background Behavior change interventions can unintendedly widen existing socio-economic health inequalities. Understanding why are (in)effective among people with lower position (SEP) is essential. Therefore, this scoping review aims to describe what reported about the behavior techniques (BCTs) applied within and their effectiveness in encouraging physical activity healthy eating, reducing smoking alcohol consumption according SEP.

Язык: Английский

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Unintended Consequences of Digital Behavior Change Interventions

European Journal of Health Psychology, Год журнала: 2024, Номер 31(3), С. 141 - 149

Опубликована: Июль 2, 2024

Abstract: Background: Digital Behavior Change Interventions (DBCIs) offer substantial potential to widely disseminate prevention and health promotion content. One key issue remains the absence of high-quality evidence effects DBCIs for long-term outcomes unintended consequences. Here, we argue that in addition better-quality on health, a more consideration consequences multiple levels is warranted. Objectives: We suggest multilevel perspective building socio-ecological understanding prevention. Methods: Narrative literature review. Results: Unintended can be located level individual engaging with DBCIs, social interactions, services, domains from health-related, behavior modification, affective aspects data privacy financial implications. Implications: Our proposed social–ecological improves classification DBCIs. This could facilitate cumulative base support development effective inclusive

Язык: Английский

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