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Caiani EG, Kemps H, Hoogendoorn P, Asteggiano R, Böhm A, Borregaard B, Boriani G, Brunner La Rocca HP, Casado-Arroyo R, Castelletti S, Christodorescu RM, Cowie MR, Dendale P, Dunn F, Fraser AG, Lane DA, Locati ET, Małaczyńska-Rajpold K, Merșa CO, Neubeck L, Parati G, Plummer C, Rosano G, Scherrenberg M, Smirthwaite A, Szymanski P. Standardized assessment of evidence supporting the adoption of mobile health solutions: A Clinical Consensus Statement of the ESC Regulatory Affairs Committee: Developed in collaboration with the European Heart Rhythm Association (EHRA), the Association of Cardiovascular Nursing & Allied Professions (ACNAP) of the ESC, the Heart Failure Association (HFA) of the ESC, the ESC Young Community, the ESC Working Group on e-Cardiology, the ESC Council for Cardiology Practice, the ESC Council of Cardio-Oncology, the ESC Council on Hypertension, the ESC Patient Forum, the ESC Digital Health Committee, and the European Association of Preventive Cardiology (EAPC). EUROPEAN HEART JOURNAL. DIGITAL HEALTH 2024; 5:509-523. [PMID: 39318699 PMCID: PMC11417493 DOI: 10.1093/ehjdh/ztae042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 05/10/2024] [Accepted: 05/14/2024] [Indexed: 09/26/2024]
Abstract
Mobile health (mHealth) solutions have the potential to improve self-management and clinical care. For successful integration into routine clinical practice, healthcare professionals (HCPs) need accepted criteria helping the mHealth solutions' selection, while patients require transparency to trust their use. Information about their evidence, safety and security may be hard to obtain and consensus is lacking on the level of required evidence. The new Medical Device Regulation is more stringent than its predecessor, yet its scope does not span all intended uses and several difficulties remain. The European Society of Cardiology Regulatory Affairs Committee set up a Task Force to explore existing assessment frameworks and clinical and cost-effectiveness evidence. This knowledge was used to propose criteria with which HCPs could evaluate mHealth solutions spanning diagnostic support, therapeutics, remote follow-up and education, specifically for cardiac rhythm management, heart failure and preventive cardiology. While curated national libraries of health apps may be helpful, their requirements and rigour in initial and follow-up assessments may vary significantly. The recently developed CEN-ISO/TS 82304-2 health app quality assessment framework has the potential to address this issue and to become a widely used and efficient tool to help drive decision-making internationally. The Task Force would like to stress the importance of co-development of solutions with relevant stakeholders, and maintenance of health information in apps to ensure these remain evidence-based and consistent with best practice. Several general and domain-specific criteria are advised to assist HCPs in their assessment of clinical evidence to provide informed advice to patients about mHealth utilization.
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Affiliation(s)
- Enrico G Caiani
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, P.zza L. da Vinci 32, 20133 Milan, Italy
- IRCCS Istituto Auxiologico Italiano, San Luca Hospital, Piazzale Brescia 20, 20149 Milan, Italy
| | - Hareld Kemps
- Department of Cardiology, Maxima Medical Centre, Veldhoven, The Netherlands
- Department of Industrial Design, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Petra Hoogendoorn
- National eHealth Living Lab, Leiden University Medical Center, Leiden, The Netherlands
| | - Riccardo Asteggiano
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
- Poliambulatori Gruppo LARC—Laboratorio Analisi e Ricerca Clinica, Cardiology, Turin, Italy
| | - Allan Böhm
- Premedix Academy NGO, Bratislava, Slovakia
- 3rd Department of Internal Medicine, Comenius University in Bratislava, Bratislava, Slovakia
| | - Britt Borregaard
- Department of Cardiology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Cardiac, Thoracic and Vascular Surgery, Odense University Hospital, Odense, Denmark
| | - Giuseppe Boriani
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
| | - Hans-Peter Brunner La Rocca
- Department of Cardiology, Maastricht University Medical Centre, Maastricht, The Netherlands
- Cardiovascular Research Institute, University of Maastricht, Maastricht, The Netherlands
| | - Ruben Casado-Arroyo
- Department of Cardiology, Hopital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Silvia Castelletti
- IRCCS Istituto Auxiologico Italiano, San Luca Hospital, Piazzale Brescia 20, 20149 Milan, Italy
| | - Ruxandra Maria Christodorescu
- Department V-Internal Medicine, University of Medicine and Pharmacy V.Babes Timisoara, Timisoara, Romania
- Research Center, Institute of Cardiovascular Diseases, Timisoara, Romania
| | - Martin R Cowie
- Late CVRM, Biopharmaceuticals R&D, Astrazeneca, Boston MA, USA
| | - Paul Dendale
- Department of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
- Department of Cardiology, Hartcentrum Hasselt, Hasselt, Belgium
| | - Fiona Dunn
- Active Medical Devices, BSI, Milton Keynes, UK
- TEAM-NB, The European Association Medical devices of Notified Bodies, Sprimont, Belgium
| | - Alan G Fraser
- School of Medicine, Cardiff University, Heath Park, Cardiff, UK
| | - Deirdre A Lane
- Department of Cardiovascular Medicine and Liverpool Centre for Cardiovascular Sciences, University of Liverpool, Liverpool, UK
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Emanuela T Locati
- Department of Arrhythmology & Electrophysiology, IRCCS Policlinico San Donato, San Donato Milanese, Milano, Italy
| | - Katarzyna Małaczyńska-Rajpold
- Department of Cardiology, Lister Hospital, East and North Hertfordshire NHS Trust, London, UK
- Heart Division, Arrhythmia Section, Royal Brompton Hospital, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | - Caius O Merșa
- Rhea, Research Center for Heritage and Anthropology, West University of Timișoara, Timișoara, Romania
| | - Lis Neubeck
- Centre for Cardiovascular Health, Edinburgh Napier University, Edinburgh, UK
| | - Gianfranco Parati
- IRCCS Istituto Auxiologico Italiano, San Luca Hospital, Piazzale Brescia 20, 20149 Milan, Italy
- Department of Medicine and Surgery, University of Milano-Bicocca, Milano, Italy
| | - Chris Plummer
- Department of Cardiology, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Giuseppe Rosano
- CAG Cardiovascular, St George’s University Hospital, London, UK
- Cardiology, San Raffaele Cassino Hospital, Cassino, Italy
| | - Martijn Scherrenberg
- Department of Cardiology, Hartcentrum Hasselt, Hasselt, Belgium
- Faculty of Medicine, University of Antwerp, Antwerp, Belgium
| | | | - Piotr Szymanski
- Center for Postgraduate Medical Education, Marymoncka, Warsaw, Poland
- Clinical Cardiology Center, National Institute of Medicine MSWiA, Wołoska, Warsaw, Poland
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Hayotte M, Roubaud P, Bersia B, Nègre V, d'Arripe-Longueville F. Associations Between ADHD Symptomatology, Motivation for Physical Activity, and Technology Acceptability in Young Adult Women With Obesity. J Atten Disord 2024; 28:1406-1411. [PMID: 38742744 DOI: 10.1177/10870547241253157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
OBJECTIVE This study examined the relationships between ADHD symptomatology, the motivations for physical activity (PA) according to self-determination theory, and the acceptability of three PA promotion technologies (active video game, mobile application, and telehealth) according to the dimensions of the unified theory of acceptance and use of technology-2 (UTAUT2). METHOD A total of 312 women, aged 30.7 ± 7.1 years, followed for obesity with an average body mass index of 34.5 ± 7.8 kg/m², were included in this sub-analysis. RESULTS Fifty-seven individuals (18.3%) were identified with positive screening symptoms of ADHD. No differences emerged regarding acceptability of technology-based PA. However, individuals with positive screening for ADHD tended to have higher scores for acceptability of active video game on the UTAUT2 dimensions of effort expectancy and hedonic motivation. CONCLUSION This study suggests that active video game may be more appropriate than other technologies for individuals with obesity and ADHD symptoms.
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Affiliation(s)
| | | | | | - Véronique Nègre
- Université Côte d'Azur, CHU Nice, Centre Spécialisé Obésité PACA Est, France
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Yudkin JS, Messiah SE, Allicock MA, Barlow SE. Integration of e-Health Strategies for Post-COVID-19 Pandemic Pediatric Weight Management Programs. Telemed J E Health 2024; 30:321-330. [PMID: 37552819 DOI: 10.1089/tmj.2023.0068] [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] [Indexed: 08/10/2023] Open
Abstract
Background: The COVID-19 pandemic catalyzed a renewed urgency to address the obesity pandemic and accelerated the use of technology to treat pediatric obesity. Yet, there are significant incongruities between the existing literature on technology for obesity management and the current health care system that may lead to suboptimal outcomes and increased costs. This study reviewed the types of e-health strategies currently in use, highlighted inconsistencies and overlap in terminology, and identified future research directions in e-health for childhood obesity, including gaps in implementation science. Methods: This narrative literature review synthesized seminal articles from the literature, as well as recent articles, using PubMed and Google Scholar that focused on the use of technology in treating pediatric obesity. This inclusive strategy was intended to elucidate the heterogeneity in how different disciplines are using digital health terminology in pediatric obesity research. Results: Both the prevalence of e-health interventions and its associated terminology are increasing in the peer-reviewed literature, especially since the beginning of the COVID-19 pandemic. Yet, their definitions and usage are unstandardized, leading to a lack of cohesion in the research and between disciplines. There is a gap in implementation science outcomes, including reimbursement, that may significantly impact external validity and uptake. Conclusion: A more systematic and precise approach to researching e-health that can assess specific technologies and combinations of technologies, their short-term and long-term effect sizes, and feasibility can produce the necessary data that may lead to reimbursement policies and, ultimately, improved pediatric weight management outcomes.
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Affiliation(s)
- Joshua S Yudkin
- School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Dallas, Texas, USA
| | - Sarah E Messiah
- School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Dallas, Texas, USA
- Center for Pediatric Population Health, School of Public Health, The University of Texas Health Science Center at Houston, Dallas, Texas, USA
- Department of Pediatrics, McGovern Medical School, Houston, Texas, USA
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Marlyn A Allicock
- School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Dallas, Texas, USA
- Center for Pediatric Population Health, School of Public Health, The University of Texas Health Science Center at Houston, Dallas, Texas, USA
| | - Sarah E Barlow
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Division of Pediatric Gastroenterology, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Children's Health, Children's Medical Center Dallas, Dallas, Texas, USA
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Li L, Zhao X, Abdugheni R, Yu F, Zhao Y, Ma BF, Yang Z, Li R, Li Y, Maimaitiyiming Y, Maimaiti M. Gut microbiota changes associated with low-carbohydrate diet intervention for obesity. Open Life Sci 2024; 19:20220803. [PMID: 38299011 PMCID: PMC10828666 DOI: 10.1515/biol-2022-0803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 10/20/2023] [Accepted: 11/14/2023] [Indexed: 02/02/2024] Open
Abstract
Low-carbohydrate diets (LCDs) are frequently recommended for alleviating obesity, and the gut microbiota plays key roles in energy metabolism and weight loss. However, there is limited in-human research on how LCD changes gut microbiota. In this before-after study, 43 participants were assigned to the LCD intervention for 4 weeks. The main objective was to investigate the specific changes that occur in the participants' microbiome in response to the LCD. Changes in gut microbiota were analyzed using 16s rRNA sequencing. Body composition was measured using InBody 770. Remarkably, 35 participants (79.07%) lost more than 5% of their body weight; levels of BMI, body fat, and total cholesterol were significantly decreased, indicating the effectiveness of the LCD intervention. The richness of microbiota significantly increased after the intervention. By taking the intersection of ANOVA and linear discriminant analysis effect size (LEfSe) analysis results, we identified three phyla, three classes, four orders, five families, and six genera that were differentially enriched between baseline and week-4 time points. Among the three phyla, relative abundances of Firmicutes and Actinobacteriota decreased significantly, while Bacteroidetes increased significantly. At the genus level, Ruminococcus, Agathobacter, Streptococcus, and Bifidobacterium showed a significant reduction in relative abundances, whereas Parabacteroides and Bacteroides increased steadily. Our results demonstrate that LCD can effectively alleviate obesity and modify certain taxa of gut microbiota, providing potential insights for personalized dietary interventions against obesity.
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Affiliation(s)
- Li Li
- Clinical Nutrition Department of the First Affiliated Hospital of Xinjiang Medical University, Urumqi830011, Xinjiang, China
| | - Xiaoguo Zhao
- School of Public Health, Xinjiang Medical University, Urumqi830011, Xinjiang, China
| | - Rashidin Abdugheni
- State Key Laboratory of Desert and Oasis Ecology, Xinjiang Institute of Ecology and Geography, Chinese Academy of Sciences,
Urumqi, China
| | - Feng Yu
- School of Public Health, Xinjiang Medical University, Urumqi830011, Xinjiang, China
| | - Yunyun Zhao
- School of Public Health, Xinjiang Medical University, Urumqi830011, Xinjiang, China
| | - Ba-Fang Ma
- Department of Immunology, School of Basic Medical Sciences, Xinjiang Medical University, Urumqi830011, Xinjiang, China
| | - Zhifang Yang
- Clinical Nutrition Department of the First Affiliated Hospital of Xinjiang Medical University, Urumqi830011, Xinjiang, China
| | - Rongrong Li
- Clinical Nutrition Department of the First Affiliated Hospital of Xinjiang Medical University, Urumqi830011, Xinjiang, China
| | - Yue Li
- Clinical Nutrition Department of the First Affiliated Hospital of Xinjiang Medical University, Urumqi830011, Xinjiang, China
| | - Yasen Maimaitiyiming
- Department of Immunology, School of Basic Medical Sciences, Xinjiang Medical University, Urumqi830011, Xinjiang, China
- Department of Public Health, and Department of Hematology of First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou310058, Zhejiang, China
| | - Mayila Maimaiti
- Clinical Nutrition Department of the First Affiliated Hospital of Xinjiang Medical University, Urumqi830011, Xinjiang, China
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Coelho C, Dobbie LJ, Crane J, Douiri A, Learoyd AE, Okolo O, Panagiotopoulos S, Pournaras DJ, Ramar S, Rubino F, Singhal R, le Roux CW, Taheri S, McGowan B. Laparoscopic adjustable gastric banding with liraglutide in adults with obesity and type 2 diabetes (GLIDE): a pilot randomised placebo controlled trial. Int J Obes (Lond) 2023; 47:1132-1142. [PMID: 37696925 PMCID: PMC10599987 DOI: 10.1038/s41366-023-01368-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 08/05/2023] [Accepted: 08/16/2023] [Indexed: 09/13/2023]
Abstract
INTRODUCTION Obesity drives type 2 diabetes (T2DM) development. Laparoscopic adjustable gastric banding (LAGB) has lower weight reduction than other bariatric procedures. Liraglutide, a GLP-1 receptor agonist, improves weight and glycaemic control in patients with T2DM. This study aimed to determine the efficacy and safety of liraglutide 1.8 mg in participants undergoing LAGB. METHODS GLIDE, a pilot randomised, double-blind, placebo-controlled trial, evaluated LAGB with either liraglutide 1.8 mg or placebo in participants with T2DM and obesity. Participants were randomised (1:1) to 6-months therapy post-LAGB, with further 6 months off-treatment follow-up. The primary outcome was change in HbA1c from randomisation to the end of treatment, secondary outcomes included body weight change. A sample size of 58 (29 per group) had 80% power to detect a 0.6% difference in HbA1c between groups. RESULTS Twenty-seven participants were randomised to liraglutide (n = 13) or placebo (n = 14). Multivariate analysis showed no difference between placebo and liraglutide arms in HbA1c at 6 months (HbA1c:0.2 mmol/mol, -11.3, 11.6, p = 0.98) however, at 12 months HbA1c was significantly higher in the liraglutide arm (HbA1c:10.9 mmol/mol, 1.1, 20.6, p = 0.032). There was no difference between arms in weight at 6 months (BW:2.0 kg, -4.2, 8.1, p = 0.50), however, at 12 months weight was significantly higher in the liraglutide arm (BW:8.2 kg, 1.6, 14.9, p = 0.02). There were no significant differences in adverse events between groups. CONCLUSIONS Our pilot data suggest no additional improvement in glycaemic control or BW with LAGB and liraglutide therapy. However, this trial was significantly underpowered to detect a significant change in the primary or secondary outcomes. Further trials are needed to investigate whether GLP-1 agonists, and particularly with more effective weekly agents (i.e. semaglutide or tirzepatide), are of benefit following metabolic surgery. CLINICAL TRIAL REGISTRATION EudraCT number 2015-005402-11.
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Affiliation(s)
- Claudia Coelho
- Department of Diabetes and Endocrinology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Laurence J Dobbie
- Department of Diabetes and Endocrinology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - James Crane
- Department of Endocrinology, King's College Hospital NHS Foundation Trust, London, UK
| | - Abdel Douiri
- School of Life Course and Population Sciences, Faculty of Life Sciences & Medicine, King College London, London, UK
| | - Annastazia E Learoyd
- School of Life Course and Population Sciences, Faculty of Life Sciences & Medicine, King College London, London, UK
| | - Olanike Okolo
- Department of Diabetes and Endocrinology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Spyros Panagiotopoulos
- Department of Minimal Access Surgery, King's College Hospital NHS Foundation Trust, London, UK
| | - Dimitri J Pournaras
- Department of Upper GI and Bariatric/Metabolic Surgery, North Bristol NHS Trust, Southmead Hospital, Bristol, UK
| | - Sasindran Ramar
- Department of Minimal Access Surgery, King's College Hospital NHS Foundation Trust, London, UK
| | - Francesco Rubino
- Department of Diabetes, School of Life Course Sciences, King's College London, London, UK
| | - Rishi Singhal
- Upper GI Unit at Heart of England, NHS Foundation Trust, Birmingham, UK
| | - Carel W le Roux
- Diabetes Complications Research Centre, University College Dublin, Dublin, Ireland, UK
| | - Shahrad Taheri
- Department of Medicine, Weill Cornell Medicine Qatar, Doha, Qatar
| | - Barbara McGowan
- Department of Diabetes and Endocrinology, Guy's and St Thomas' NHS Foundation Trust, London, UK.
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Dobbie LJ, Coelho C, Crane J, McGowan B. Clinical evaluation of patients living with obesity. Intern Emerg Med 2023; 18:1273-1285. [PMID: 37119384 PMCID: PMC10412477 DOI: 10.1007/s11739-023-03263-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 03/11/2023] [Indexed: 05/01/2023]
Abstract
Obesity is a significant public health concern which is implicated in cardiometabolic disease, mechanical complications and psychiatric sequelae. BMI is currently used for diagnosis; however, it has limited sensitivity for adiposity in certain circumstances. This has led to the development of risk stratification tools like the Edmonton Staging criteria and the Kings Obesity Staging Criteria: these facilitate and guide comprehensive obesity-related complication assessment. Healthcare professionals working within obesity clinics should adopt evidence-based communication strategies, including shared decision-making, motivational interviewing, and realistic goal setting. It is also vital to avoid weight-stigmatising terminology in all aspects of care, as this can negatively impact patients. Primary care plays an essential part in obesity care and should work to promptly identify cases, initiate treatment and forward on to specialist services where appropriate. Clinical evaluation of the patient living with obesity should take a holistic approach and involve input from bariatric physicians, dietitians, psychologists, and bariatric surgeons, wider members of the multi-disciplinary team should be involved where needed. Clinicians should take a detailed history, examination and order laboratory tests to investigate for complications. Overall, with appropriate evaluation, these assessments can guide patient management and facilitate long-term improvement in health.
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Affiliation(s)
| | | | - James Crane
- Guy’s and St Thomas’ NHS Foundation Trust, London, UK
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Pedersen K, Schlichter BR. Improving Predictability and Effectiveness in Preventive Digital Health Interventions: Scoping Review. Interact J Med Res 2023; 12:e40205. [PMID: 37471129 PMCID: PMC10401197 DOI: 10.2196/40205] [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: 06/10/2022] [Revised: 11/01/2022] [Accepted: 06/09/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Lifestyle-related diseases caused by inadequate diet and physical activity cause premature death, loss of healthy life years, and increased health care costs. Randomized controlled trial (RCT) studies indicate that preventive digital health interventions (P-DHIs) can be effective in preventing these health problems, but the results of these studies are mixed. Adoption studies have identified multiple factors related to individuals and the context in which they live that complicate the transfer of positive results from RCT studies to practical use. Implementation studies have revealed barriers to the large-scale implementation of mobile health (mHealth) solutions in general. Consequently, there is no clear path to delivering predictable outcomes from P-DHIs and achieving effectiveness when scaling up interventions to reduce health problems in society. OBJECTIVE This research aimed to expand our understanding of how to increase the outcome predictability of P-DHIs by focusing on physical activity and diet behaviors and amplify our understanding of how to improve effectiveness in large-scale implementations. METHODS The research objective was pursued through a multidisciplinary scoping review. This scoping review used the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) as a guide. A comprehensive search of Web of Science and PubMed limited to English-language journal articles published before January 2022 was conducted. Google Scholar was used for hand searches. Information systems theory was used to identify key constructs influencing outcomes of IT in general. Public health and mHealth literature were used to identify factors influencing the adoption of, outcomes from, and implementation of P-DHIs. Finally, the P-DHI investment model was developed based on information systems constructs and factors from the public health and mHealth literature. RESULTS In total, 203 articles met the eligibility criteria. The included studies used a variety of methodologies, including literature reviews, interviews, surveys, and RCT studies. The P-DHI investment model suggests which constructs and related factors should be emphasized to increase the predictability of P-DHI outcomes and improve the effectiveness of large-scale implementations. CONCLUSIONS The research suggests that outcome predictability could be improved by including descriptions of the constructs and factors in the P-DHI investment model when reporting from empirical studies. Doing so would increase our understanding of when and why P-DHIs succeed or fail. The effectiveness of large-scale implementations may be improved by using the P-DHI investment model to evaluate potential difficulties and possibilities in implementing P-DHIs to create better environments for their use before investing in them and when designing and implementing them. The cost-effectiveness of large-scale implementations is unknown; implementations are far more complicated than just downloading and using apps, and there is uncertainty accompanying implementations given the lack of coordinated control over the constructs and factors that influence the outcome.
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Affiliation(s)
- Keld Pedersen
- Information Systems, Department of Management, Aarhus University, Aarhus C, Denmark
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8
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Tung JYL, Poon GWK, Du J, Wong KKY. Obesity in children and adolescents: Overview of the diagnosis and management. Chronic Dis Transl Med 2023; 9:122-133. [PMID: 37305109 PMCID: PMC10249183 DOI: 10.1002/cdt3.58] [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: 08/30/2022] [Revised: 01/04/2023] [Accepted: 01/13/2023] [Indexed: 03/09/2023] Open
Abstract
Childhood obesity is one of the biggest public health challenges globally. It is associated with various adverse health consequences throughout life. Prevention and early intervention represent the most reasonable and cost-effective approaches. Considerable progress has been achieved in the management of obesity in children and adolescents; yet, implementation in the real world remains a challenge. This article aimed to present an overview of the diagnosis and management of obesity in children and adolescents.
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Affiliation(s)
- Joanna Y. L. Tung
- Department of Paediatrics and Adolescent MedicineThe University of Hong KongPokfulamHong KongChina
- Department of Paediatrics and Adolescent MedicineHong Kong Children's HospitalHong KongChina
| | - Grace W. K. Poon
- Department of Paediatrics and Adolescent MedicineThe University of Hong KongPokfulamHong KongChina
| | - Juan Du
- Department of EndocrinologyJilin Province People's HospitalJilinChina
- The Paediatric Precision Medicine CentreChildren's Hospital of ChangchunJilinChina
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Alam S, Zhang M, Harris K, Fletcher LM, Reneker JC. The Impact of Consumer Wearable Devices on Physical Activity and Adherence to Physical Activity in Patients with Cardiovascular Disease: A Systematic Review of Systematic Reviews and Meta-Analyses. Telemed J E Health 2022. [DOI: 10.1089/tmj.2022.0280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Sabrina Alam
- Department of Population Health Science, John D. Bower School of Population Health; Jackson, Mississippi, USA
| | - Mengna Zhang
- Department of Population Health Science, John D. Bower School of Population Health; Jackson, Mississippi, USA
| | - Kisa Harris
- Department of Population Health Science, John D. Bower School of Population Health; Jackson, Mississippi, USA
| | - Lauren M. Fletcher
- Rowland Medical Library; University of Mississippi Medical Center, Jackson, Mississippi, USA
- John D. Rockefeller Library, Brown University, Providence, Rhode Island, USA
| | - Jennifer C. Reneker
- Department of Population Health Science, John D. Bower School of Population Health; Jackson, Mississippi, USA
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