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Lancet Public Health
npj Digital Medicine
In 2019, the World Health Organization (WHO) released the first-ever evidence-based guidelines for digital health. The guideline provides nine recommendations on select digital health interventions that involve the use of a mobile phone or device. It also provides information on implementation considerations, quality and certainty of extant evidence, factors related to acceptability and feasibility of the intervention, and gaps in the evidence that can inform future research. Given the pivotaldoi:10.1038/s41746-020-00330-2 pmid:33015373 pmcid:PMC7501250 fatcat:fngod3gphramva5yqukrtluygu
more »... ole digital health can play in supporting health systems, seen especially in light of the COVID-19 pandemic, these guidelines can help provide a roadmap for governments and policymakers in introducing and scaling up digital health interventions to support population health outcomes.
Objective-Efforts in the domain of mobile health, or mHealth, have been criticized for the unfettered proliferation of pilots and a lack of a rigorous evidence base to support these strategies. In this letter, we present the response of a group of researchers in the mHealth community to the recent calls for evidence issued by global health and funding agencies. We support our conclusions through a summary of the numerous ongoing mHealth studies listed in the US federal clinical trial registry.doi:10.1016/j.ijmedinf.2012.11.016 pmid:23279850 pmcid:PMC3849805 fatcat:7pjw325blrd5zbbzkfjfl2dtuu
more »... ethods-We conducted a search on the US federal clinicaltrials.gov database using the keywords "mHealth", "mobile" or "cell AND phone" to obtain 1678 results of studies. We manually inspected each result to check if it fit the purview of an mHealth study. Studies that were terminated or withdrawn prior to submission were excluded. Results-We identified 215 unique mHealth studies that were registered in the clinicaltrials.gov database, of which 8.4% (n = 18) were observational in nature while the remaining 91.6% (n = 197) were interventional. Of the 215 studies, 81.8% (n = 176) studies used a classical randomized trial design and 40 new studies were added to the database between May and November 2012 alone. Based on these results, we posit that the field is entering a new 'era' where a body of rigorous evaluation of mHealth strategies is rapidly accumulating. Conclusions- The transition into an era of evidence-based mHealth supports our position that innovation in this domain can be evaluated with the same rigor as other public health strategies, attenuating some of the hype previously associated with mHealth.
As many low-to middle-income countries strive to achieve targets of reduced maternal, neonatal and infant mortality set by the Millennium Development Goals, health system innovations which can accelerate progress are being carefully examined. Among these are technologies and systems which aim to strengthen frontline health workers and the health systems within which they work, by enabling the registration of pregnancies, births and outcomes. Accurate, population-based numerators anddoi:10.1016/s0968-8080(12)39631-6 pmid:22789088 fatcat:w3aivzgrarbohafomvgqbubhpm
more »... can help to improve accountability of the health system to provide expected routine antenatal and post-natal care, as well as emergency support and referral, as needed. The enumeration of women of reproductive age, followed by prospective, voluntary registration of pregnancies has the potential to support governments, health agencies, and the populations they serve, to ensure public health service delivery and to guide informed policies.
This new framework lays out 12 common mHealth applications used as health systems strengthening innovations across the reproductive health continuum. Abbreviations: CHW, community health worker; ICT, information and communications technology; RMNCH, reproductive, maternal, newborn, and child health. The fictional "Project Vaccinate" is an mHealth system that integrates 6 of the 12 common mHealth applications to identify newborns and support families and community health workers in ensuringdoi:10.9745/ghsp-d-13-00031 pmid:25276529 pmcid:PMC4168567 fatcat:2kahpgixujftffl7htvgisaz7q
more »... y and complete vaccination. 12 common applications and a visual framework for mHealth
The Cochrane library
2018) Mobilebased technologies to support healthcare provider to healthcare provider communication and management of care. Cochrane Database of Systematic Reviews, 2018 (1). Mobile-based technologies to support healthcare provider to healthcare provider communication and management of care (Protocol) Mobile-based technologies to support healthcare provider to healthcare provider communication and management of care (Protocol)doi:10.1002/14651858.cd012927 fatcat:huav5v6burh63aevbfvz37d7vi
While the importance of mHealth scale-up has been broadly emphasized in the mHealth community, it is necessary to guide scale up efforts and investment in ways to help achieve the mortality reduction targets set by global calls to action such as the Millennium Development Goals, not merely to expand programs. We used the Lives Saved Tool (LiST)-an evidencebased modeling software-to identify priority areas for maternal and neonatal health services, by formulating six individual and combineddoi:10.1371/journal.pone.0102224 pmid:25014008 pmcid:PMC4094557 fatcat:oavvpgxxonakddus5omawu7wiy
more »... ventions scenarios for two countries, Bangladesh and Uganda. Our findings show that skilled birth attendance and increased facility delivery as targets for mHealth strategies are likely to provide the biggest mortality impact relative to other intervention scenarios. Although further validation of this model is desirable, tools such as LiST can help us leverage the benefit of mHealth by articulating the most appropriate delivery points in the continuum of care to save lives.
BMJ Global Health
Downloaded from Mehl GL, et al. ...doi:10.1136/bmjgh-2017-000626 pmid:29713512 pmcid:PMC5922498 fatcat:jiofxf55sfej5prfnym2r4gdqy
Despite advances in digital technology to generate demand for health services, considerable gaps remain in our understanding of which interventions are effective, which characteristics mediate their benefit for different target populations and health domains, and what is necessary to ensure effective deployment. Future research should examine the long-term effects of, equity in access to, and cost-effectiveness and efficiency of digital demand generation interventions. ABSTRACT The recentdoi:10.9745/ghsp-d-18-00165 pmid:30305339 pmcid:PMC6203418 fatcat:accdna2axncdxjagx3pthg4yny
more »... uction of digital health into generating demand for health commodities and services has provided practitioners with an expanded universe of potential tools to strengthen demand and ensure service delivery receipt. However, considerable gaps remain in our understanding of which interventions are effective, which characteristics mediate their benefit for different target populations and health domains, and what is necessary to ensure effective deployment. This paper first provides an overview of the types of digital health interventions for demand generation, including untargeted client communication, client-to-client communication, on-demand information services, personal health tracking, client financial transactions, and targeted client communication. It then provides a general overview of 118 studies published between January 1, 2010, and October 3, 2017, that used digital interventions to generate demand for health interventions. The majority (61%) of these studies used targeted client communication to provide health education or reminders to improve treatment adherence, and the most frequently (27%) studied health condition was HIV/AIDS. Intervention characteristics that have been found to have some effect on gains in demand generation include modality, directionality, tailoring, phrasing, and schedule. The paper also explores new emergent digital approaches that expand the potential effect of traditional demand generation in terms of personalization of content and services, continuity of care, and accountability tracking. Applying existing frameworks for monitoring and evaluation and reporting, research on emerging approaches will need to consider not only their feasibility but also their effectiveness in achieving demand generation outcomes. We propose a research agenda to help guide the field of digital demand generation studies and programs within a broader health systems strengthening agenda, including establishing and documenting the influence of intervention characteristics within different populations and health domains and examining the long-term effects and cost-effectiveness of digital demand generation interventions, as well as equity in access to such interventions.
The Cochrane library
Study flow diagram (SRH: sexual and reproductive health; MNCH: maternal, neonatal, and child health) Free C, Tamrat T, Henschke N, Glenton C, Lewin L, Fønhus M, Mehl G, Villanueva G, Maayan N, Bergman ...doi:10.1002/14651858.cd013680 fatcat:y3ksvomtnrfr5pqh3f6edr5fhi
health interventions using mobile phones: mobile health (mHealth) evidence reporting and assessment (mERA) checklist Smisha Agarwal, 1,2,3 Amnesty E LeFevre, 1,2 Jaime Lee, 1,2 Kelly L'Engle, 4, 5 Garrett ... Mehl, 6 Chaitali Sinha, 7 Alain Labrique 1,2 for the WHO mHealth Technical Evidence Review Group To improve the completeness of reporting of mobile health (mHealth) interventions, the WHO mHealth ...doi:10.1136/bmj.i1174 pmid:26988021 fatcat:6pwndnit7nefveykv3oyz7qwz4
The Cochrane library
Additional references Agarwal 2016 Agarwal S, LeFevre AE, Lee J, L'Engle K, Mehl G, Sinha C, et al. ... Free C, Tamrat T, Henschke N, Glenton C, Lewin L, Fønhus M, Mehl G, Villanueva G, Maayan N, Bergman H. ...doi:10.1002/14651858.cd013679 fatcat:3y75hnp76nd7tbk52xrt7waab4
Despite the growing use of technology in the health sector, little evidence is available on the technological performance of mobile health programs nor on the willingness of target users to utilize these technologies as intended (behavioral performance). In this case study of the Mobile Technology for Health (MOTECH) program in Ghana, we assess the platform's effectiveness in delivering messages, along with user response across sites in five districts from 2011 to 2014. Methods: MOTECH isdoi:10.1186/s12911-017-0421-9 pmid:28292288 pmcid:PMC5351254 fatcat:tieq3vxpcbdejfw3elbmarelju
more »... sed of "Client Data Application" (CDA) which allows providers to digitize and track service delivery information for women and infants and "Mobile Midwife" (MM) which sends automated educational voice messages to the mobile phones of pregnant and postpartum women. Using a naturalist study design, we draw upon system generated data to evaluate message delivery, client engagement, and provider responsiveness to MOTECH over time and by level of facility. Results: A total of 7,370 women were enrolled in MM during pregnancy and 14,867 women were enrolled postpa1rtum. While providers were able to register and upload patient-level health information using CDA, the majority of these uploads occurred in Community-based facilities versus Health Centers. For MM, 25% or less of expected messages were received by pregnant women, despite the majority (>77%) owning a private mobile phone. While over 80% of messages received by pregnant women were listened to, postpartum rates of listening declined over time. Only 25% of pregnant women received and listened to at least 1 first trimester message. By 6-12 months postpartum, less than 6% of enrolled women were exposed to at least one message. Conclusions: Caution should be exercised in assuming that digital health programs perform as intended. Evaluations should measure the technological, behavioral, health systems, and/or community factors which may lead to breaks in the impact pathway and influence findings on effectiveness. The MOTECH platform's technological limitations in 'pushing' out voice messages highlights the need for more timely use of data to mitigate delivery challenges and improve exposure to health information. Alternative message delivery channels (USSD or SMS) could improve the platform's ability to deliver messages but may not be appropriate for illiterate users. Trial registration: Not applicable.
BMJ Global Health
See: http:// creativecommons. org/ licenses/ by-nc/ 4. 0/. orCId id Garrett Livingston Mehl http:// orcid. org/ 0000-0001-9946-2202 ...doi:10.1136/bmjgh-2019-002067 pmid:32181003 pmcid:PMC7050342 fatcat:rbxjsvr43bgcdizbmzfveorf7e
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