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van Kessel R, Roman-Urrestarazu A, Anderson M, Kyriopoulos I, Field S, Monti G, Reed SD, Pavlova M, Wharton G, Mossialos E. Mapping Factors That Affect the Uptake of Digital Therapeutics Within Health Systems: Scoping Review. J Med Internet Res 2023; 25:e48000. [PMID: 37490322 PMCID: PMC10410406 DOI: 10.2196/48000] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 05/31/2023] [Accepted: 06/16/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND Digital therapeutics are patient-facing digital health interventions that can significantly alter the health care landscape. Despite digital therapeutics being used to successfully treat a range of conditions, their uptake in health systems remains limited. Understanding the full spectrum of uptake factors is essential to identify ways in which policy makers and providers can facilitate the adoption of effective digital therapeutics within a health system, as well as the steps developers can take to assist in the deployment of products. OBJECTIVE In this review, we aimed to map the most frequently discussed factors that determine the integration of digital therapeutics into health systems and practical use of digital therapeutics by patients and professionals. METHODS A scoping review was conducted in MEDLINE, Web of Science, Cochrane Database of Systematic Reviews, and Google Scholar. Relevant data were extracted and synthesized using a thematic analysis. RESULTS We identified 35,541 academic and 221 gray literature reports, with 244 (0.69%) included in the review, covering 35 countries. Overall, 85 factors that can impact the uptake of digital therapeutics were extracted and pooled into 5 categories: policy and system, patient characteristics, properties of digital therapeutics, characteristics of health professionals, and outcomes. The need for a regulatory framework for digital therapeutics was the most stated factor at the policy level. Demographic characteristics formed the most iterated patient-related factor, whereas digital literacy was considered the most important factor for health professionals. Among the properties of digital therapeutics, their interoperability across the broader health system was most emphasized. Finally, the ability to expand access to health care was the most frequently stated outcome measure. CONCLUSIONS The map of factors developed in this review offers a multistakeholder approach to recognizing the uptake factors of digital therapeutics in the health care pathway and provides an analytical tool for policy makers to assess their health system's readiness for digital therapeutics.
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Affiliation(s)
- Robin van Kessel
- LSE Health, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
- Department of International Health, Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | - Andres Roman-Urrestarazu
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
| | - Michael Anderson
- LSE Health, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
| | - Ilias Kyriopoulos
- LSE Health, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
| | - Samantha Field
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Giovanni Monti
- LSE Health, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
| | - Shelby D Reed
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, United States
| | - Milena Pavlova
- Department of Health Services Research, Care and Public Health Research Institute, Faculty of Health Medicine and Life Science, Maastricht University, Maastricht, Netherlands
| | - George Wharton
- LSE Health, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
| | - Elias Mossialos
- LSE Health, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
- Institute of Global Health Innovation, Imperial College London, London, United Kingdom
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Richardson KA, McKibbin CL, Dabrowski BS, Punke ELA, Hartung CM. Parent Intention to Enroll in an Online Intervention to Enhance Health Behavior Change among Youth Treated with Psychotropic Medication Who Are Overweight or Obese: An Elicitation Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138057. [PMID: 35805722 PMCID: PMC9266077 DOI: 10.3390/ijerph19138057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/23/2022] [Accepted: 06/28/2022] [Indexed: 02/04/2023]
Abstract
Youth who are prescribed psychotropic medication are disproportionally affected by overweight/obesity (OW/OB), yet few interventions have been tailored to their needs. To develop new interventions, it is important to address the needs, preferences, and intentions of target users. Qualitative methods within the theory of planned behavior (TPB) framework were used in this study to identify salient beliefs which may influence attitudes associated with parents’ intentions to participate in a future online intervention designed to develop behavioral health coaching skills among parents and guardians. Twenty parents and guardians of youth with OW/OB who were taking psychotropic medications, and were eligible for the study, were recruited through TurkPrime. Parents and guardians identified key salient beliefs consistent with the theory of planned behavior including behavioral beliefs (e.g., access and convenience), normative beliefs (e.g., family), and control beliefs (e.g., cost) that may influence their decision to enroll in a future, parent-oriented intervention. The results of this study suggest important salient beliefs which may be included in future research, as well as specific preferences which may be used to guide the development of a future intervention. Future work should focus on the creation of a salient belief quantitative measure and assess the relationships of these beliefs to attitudinal constructs and behaviors.
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Gentile M, Messineo L, La Guardia D, Arrigo M, Città G, Ayala A, Cusimano G, Martines P, Mendolia G, Allegra M. A Parent-Mediated Telehealth Program for Children with Autism Spectrum Disorder : Promoting Parents' Ability to Stimulate the Children's Learning, Reduce Parenting Stress, and Boost Their Sense of Parenting Empowerment. J Autism Dev Disord 2022; 52:5285-5300. [PMID: 35235129 DOI: 10.1007/s10803-022-05482-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2022] [Indexed: 01/05/2023]
Abstract
This study investigates the effectiveness of a 6-month parent-mediated early intervention telehealth program for children with an autism spectrum disorder. The participants comprised a total of 27 parents. The findings showed that participation in the program promotes parents' empowerment and reduce parental stress and a general improvement in the parents' ability to stimulate children's learning. Moreover, the study reveals an effect of parents' age in mediating the relationship among the parents' ability, stress, and empowerment levels. These results suggest that an early intervention telehealth program may help parents become aware of how to benefit from interactions with their children, promote their empowerment, and reduce parenting stress.
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Affiliation(s)
- Manuel Gentile
- Istituto per le Tecnologie Didattiche, Consiglio Nazionale delle Ricerche, via Ugo la Malfa, 153, 90146, Palermo, Italy
| | - Linda Messineo
- Istituto per le Tecnologie Didattiche, Consiglio Nazionale delle Ricerche, via Ugo la Malfa, 153, 90146, Palermo, Italy.
| | - Dario La Guardia
- Istituto per le Tecnologie Didattiche, Consiglio Nazionale delle Ricerche, via Ugo la Malfa, 153, 90146, Palermo, Italy
| | - Marco Arrigo
- Istituto per le Tecnologie Didattiche, Consiglio Nazionale delle Ricerche, via Ugo la Malfa, 153, 90146, Palermo, Italy
| | - Giuseppe Città
- Istituto per le Tecnologie Didattiche, Consiglio Nazionale delle Ricerche, via Ugo la Malfa, 153, 90146, Palermo, Italy
| | - Antonia Ayala
- Istituto per le Tecnologie Didattiche, Consiglio Nazionale delle Ricerche, via Ugo la Malfa, 153, 90146, Palermo, Italy
| | - Gaspare Cusimano
- Istituto per le Tecnologie Didattiche, Consiglio Nazionale delle Ricerche, via Ugo la Malfa, 153, 90146, Palermo, Italy
| | - Pio Martines
- Azienda Sanitaria Provinciale di Trapani, Cittadella della Salute, viale della Provincia, 2, 91016, Erice Casa-Santa, Trapani, Italy
| | - Giovanna Mendolia
- Azienda Sanitaria Provinciale di Trapani, Cittadella della Salute, viale della Provincia, 2, 91016, Erice Casa-Santa, Trapani, Italy
| | - Mario Allegra
- Istituto per le Tecnologie Didattiche, Consiglio Nazionale delle Ricerche, via Ugo la Malfa, 153, 90146, Palermo, Italy
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Lee V, Albaum C, Tablon Modica P, Ahmad F, Gorter JW, Khanlou N, McMorris C, Lai J, Harrison C, Hedley T, Johnston P, Putterman C, Spoelstra M, Weiss JA. The impact of COVID-19 on the mental health and wellbeing of caregivers of autistic children and youth: A scoping review. Autism Res 2021; 14:2477-2494. [PMID: 34591373 PMCID: PMC8646541 DOI: 10.1002/aur.2616] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 08/25/2021] [Accepted: 09/10/2021] [Indexed: 12/30/2022]
Abstract
Caregivers and families of autistic people have experienced stress and increase in demands due to the COVID‐19 pandemic that may have long‐term negative consequences for both their own and their children's mental health. A scoping review was conducted to identify pandemic related demands experienced by caregivers and families of autistic children and youth. The review also consolidated information on coping strategies and parenting‐related guidelines that have emerged to help parents meet these demands. Search strategies were approved by a research librarian and were conducted in peer‐reviewed and gray literature databases between May 2020 and February 2021. Additional resources were solicited through author networks and social media. All articles were published between December 2019 and February 2021. Article summaries were charted, and a thematic analysis was conducted with confirmation of findings with our knowledge users. Twenty‐three published articles and 14 pieces of gray literature were included in the review. The majority of articles characterized and highlighted the increase in demands on caregivers of autistic children and youth during the pandemic globally. Both quantitative and qualitative studies suggest that parents have experienced an increase in stress and mental health‐related symptoms during lockdown measures. Findings suggest that families are employing coping strategies, but there no evidence‐based supports were identified. The review highlighted the potential long‐term impact of prolonged exposure to increasing demands on the mental health and wellbeing of caregivers and families of autistic people, and pointed to a need for the rapid development and evaluation of flexible and timely support programs.
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Affiliation(s)
- Vivian Lee
- Department of Psychology, Carleton University, Ottawa, Canada
| | - Carly Albaum
- Department of Psychology, York University, Toronto, Canada
| | | | - Farah Ahmad
- School of Health Policy and Management, York University, Toronto, Canada
| | | | | | - Carly McMorris
- Werklund School of Education, University of Calgary, Calgary, Canada
| | - Jonathan Lai
- Canadian Autism Spectrum Disorder Alliance, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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