Evaluating Digital Health Interventions: Key Questions and Approaches.

The advancement of mobile technology had positively influenced healthcare services An emerging subfield of mobile technology is mobile health (m-Health) in which mobile applications are used for health purposes The aim of this study was to analyze and assess literature published in the field of m-Health SciVerse Scopus was used to retrieve literature in m-Health The study period was set from 2006 to 2016 ArcGIS 101 was used to present geographical distribution of publications while VOSviewer was used for data visualization Growth of publications, citation analysis, and research productivity were presented using standard bibliometric indicators During the study period, a total of 5465 documents were published, giving an average of 4968 documents per year The h-index of retrieved documents was 81 Core keywords used in literature pertaining to m-Health included diabetes mellitus, adherence, and obesity among others Relative growth rate and doubling time of retrieved literature were stable from 2009 to 2015 indicating exponential growth of literature in this field A total of 4638 (849%) documents were multi-authored with a mean collaboration index of 41 authors per article The United States of America ranked first in productivity with 1926 (352%) published documents India ranked sixth with 183 (33%) documents while China ranked seventh with 155(28%) documents VA Medical Center was the most prolific organization/institution while Journal of Medical Internet Research was the preferred journal for publications in the field of m-Health Top cited articles in the field of m-Health included the use of mobile technology in improving adherence in HIV patients, weight loss, and improving glycemic control in diabetic patients The size of literature in m-Health showed a noticeable increase in the past decade Given the large volume of citations received in this field, it is expected that applications of m-Health will be seen into various health aspects and health services Research in m-Health needs to be encouraged, particularly in the fight against AIDS, poor medication adherence, glycemic control in Africa and other low income world regions where technology can improve health services and decrease disease burden

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Bibliometric analysis of worldwide scientific literature in mobile - health: 2006–2016

This is the protocol for a review and there is no abstract. The objectives are as follows:

The review has the following two objectives.


To identify, appraise and synthesise qualitative research evidence on healthcare workers’ perceptions and experiences regarding their use of mHealth technologies to provide and support the delivery of primary healthcare services.


To identify hypotheses, for subsequent consideration and assessment in effectiveness reviews, about why some technologies are more effective than others.

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Health workers’ perceptions and experiences of using mHealth technologies to deliver primary healthcare services: a qualitative evidence synthesis

Autism spectrum disorder (ASD) is recognized as a global public health concern, yet almost everything we know about ASD comes from high-income countries. Here we performed a scoping review of all research on ASD ever published in sub-Saharan Africa (SSA) in order to identify ASD knowledge gaps in this part of the world. Fifty-three publications met inclusion criteria. Themes included the phenotype, genetics and risk factors for ASD in SSA, screening and diagnosis, professional knowledge, interventions for ASD, parental perceptions, and social-cognitive neuroscience. No epidemiological, early intervention, school-based or adult studies were identified. For each identified theme, we aimed to summarize results and make recommendations to fill the knowledge gaps. The quality of study methodologies was generally not high. Few studies used standardized diagnostic instruments, and intervention studies were typically small-scale. Overall, findings suggest a substantial need for large-scale clinical, training, and research programmes to improve the lives of people who live with ASD in SSA. However, SSA also has the potential to make unique and globally-significant contributions to the etiology and treatments of ASD through implementation, interventional, and comparative genomic science. Autism Res 2017, 10: 723-749. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.

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Autism spectrum disorder in sub-saharan africa: A comprehensive scoping review.

Background: In a bid to deliver quality health services in resource-poor settings, mobile health (mHealth) is increasingly being adopted. The role of mHealth in facilitating evidence-based clinical decision-making through data collection, decision algorithms, and evidence-based guidelines, for example, is established in resource-rich settings. However, the extent to which mobile clinical decision support systems (mCDSS) have been adopted specifically in resource-poor settings such as Africa and the lessons learned about their use in such settings are yet to be established. Objective: The aim of this study was to synthesize evidence on the use of mHealth for point-of-care decision support and improved quality of care by health care workers in Africa. Methods: A scoping review of 4 peer-reviewed and 1 grey literature databases was conducted. No date limits were applied, but only articles in English language were selected. Using pre-established criteria, 2 reviewers screened articles and extracted data. Articles were analyzed using Microsoft Excel and MAXQDA. Results: We retained 22 articles representing 11 different studies in 7 sub-Saharan African countries. Interventions were mainly in the domain of maternal health and ranged from simple text messaging (short message service, SMS) to complex multicomponent interventions. Although health workers are generally supportive of mCDSS and perceive them as useful, concerns about increased workload and altered workflow hinder sustainability. Facilitators and barriers to use of mCDSS include technical and infrastructural support, ownership, health system challenges, and training. Conclusions: The use of mCDSS in sub-Saharan Africa is an indication of progress in mHealth, although their effect on quality of service delivery is yet to be fully explored. Lessons learned are useful for informing future research, policy, and practice for technologically supported health care delivery, especially in resource-poor settings. [JMIR Mhealth Uhealth 2017;5(3):e38]

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mHealth for Clinical Decision-Making in Sub-Saharan Africa: A Scoping Review.

Mobile phone penetration rates have reached 63% in sub-Saharan Africa (SSA) and are projected to pass 70% by 2013. In SSA, millions of people who never used traditional landlines now use mobile phones on a regular basis. Mobile health, or mHealth, is the utilization of short messaging service (SMS), wireless data transmission, voice calling, and smartphone applications to transmit health-related information or direct care. This systematic review analyzes and summarizes key articles from the current body of peer-reviewed literature on PubMed on the topic of mHealth in SSA. Studies included in the review demonstrate that mHealth can improve and reduce the cost of patient monitoring, medication adherence, and healthcare worker communication, especially in rural areas. mHealth has also shown initial promise in emergency and disaster response, helping standardize, store, analyze, and share patient information. Challenges for mHealth implementation in SSA include operating costs, knowledge, infrastructure, and policy amongmany others. Further studies of the effectiveness of mHealth interventions are being hindered by similar factors aswell as a lack of standardization in study design. Overall, the current evidence is not strong enough to warrant large-scale implementation of existing mHealth interventions in SSA, but rapid progress of both infrastructure and mHealth-related research in the region could justify scale-up of the most promising programs in the near future.

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Thomas J. Betjeman

Papers

mHealth in sub-Saharan Africa