Development of a Resource Guide to Support the Engagement of Mental Health Providers and Patients With Digital Health Tools: Multimethod Study

Methods for Co-designing Health Communication Initiatives with People with Disability: A Scoping Review

Co-design, a collaborative approach where end-users are actively involved in design processes, has gained traction in health communication. Its integration into health communication initiatives holds promise for amplifying the voices of people with disability. Despite this, its application remains inconsistent. This scoping literature review explores how people with disability are included, when and through what methods to co-design health communication interventions. Principles of importance are considered and identified. Thirty articles published between 2018 and 2023 were reviewed. The review identified a range of methods used in health communication initiatives, with people with disability engaging at different stages and in different ways. While co-design offers potential for improved health communication, challenges such as unpredictable outcomes, diversity of participant needs, and barriers to full engagement persist. Improved transparency and consistency in reporting co-design processes are recommended to enhance rigor and effectiveness of future initiatives.

Determinants of e-Mental Health Use During COVID-19: Cross-sectional Canadian Study

Background

Access to mental health treatment across Canada remains a challenge, with many reporting unmet care needs. National and provincial e-Mental health (eMH) programs have been developed over the past decade across Canada, with many more emerging during COVID-19 in an attempt to reduce barriers related to geography, isolation, transportation, physical disability, and availability.

Objective

The aim of this study was to identify factors associated with the utilization of eMH services across Canada during the COVID-19 pandemic using Andersen and Newman’s framework of health service utilization.

Methods

This study used data gathered from the 2021 Canadian Digital Health Survey, a cross-sectional, web-based survey of 12,052 Canadians aged 16 years and older with internet access. Bivariate associations between the use of eMH services and health service utilization factors (predisposing, enabling, illness level) of survey respondents were assessed using χ2 tests for categorical variables and t tests for the continuous variable. Logistic regression was used to predict the probability of using eMH services given the respondents’ predisposing, enabling, and illness-level factors while adjusting for respondents’ age and gender.

Results

The proportion of eMH service users among survey respondents was small (883/12,052, 7.33%). Results from the logistic regression suggest that users of eMH services were likely to be those with regular family physician access (odds ratio [OR] 1.57, P=.02), living in nonrural communities (OR 1.08, P<.001), having undergraduate (OR 1.40, P=.001) or postgraduate (OR 1.48, P=.003) education, and being eHealth literate (OR 1.05, P<.001). Those with lower eMH usage were less likely to speak English at home (OR 0.06, P<.001).

Conclusions

Our study provides empirical evidence on the impact of individual health utilization factors on the use of eMH among Canadians during the COVID-19 pandemic. Given the opportunities and promise of eMH services in increasing access to care, future digital interventions should both tailor themselves toward users of these services and consider awareness campaigns to reach nonusers. Future research should also focus on understanding the reasons behind the use and nonuse of eMH services.

Mapping the role of patient and public involvement during the different stages of healthcare innovation: A scoping review

BACKGROUND

Patient and public involvement (PPI) has become increasingly important in the development, delivery and improvement of healthcare. PPI is used in healthcare innovation; yet, how it is used has been under-reported. The aim of this scoping review is to identify and map the current available empirical evidence on the role of PPI during different stages of healthcare innovation.

METHODS

The scoping review was conducted in accordance with PRISMAScR and included any study published in a peer-reviewed journal between 2004 and 2021 that reported on PPI in healthcare innovation within any healthcare setting or context in any country. The following databases were searched: Medline, EMBASE, CINAHL, PsycInfo, HMIC and Google Scholar. We included any study type, including quantitative, qualitative and mixed-method studies. We excluded theoretical frameworks, conceptual, scientific or grey literature as well as discussion and opinion papers.

RESULTS

Of the 87 included studies, 81 (93%) focused on or were conducted by authors in developed countries. A wide range of conditions were considered, with more studies focusing on mental health (n = 18, 21%) and cancer care (n = 8, 9%). The vast majority of the studies focused on process and service innovations (n = 62, 71%). Seven studies focused on technological and clinical innovations (8%), while 12 looked at both technological and service innovations (14%). Only five studies examined systems innovation (5%) and one study looked across all types of innovations (1%). PPI is more common in the earlier stages of innovation, particularly problem identification and invention, in comparison to adoption and diffusion.

CONCLUSION

Healthcare innovation tends to be a lengthy process. Yet, our study highlights that PPI is more common across earlier stages of innovation and focuses mostly on service innovation. Stronger PPI in later stages could support the adoption and diffusion of innovation.

PATIENT OR PUBLIC CONTRIBUTION

One of the coauthors of the paper (S. S.) is a service user with extensive experience in PPI research. S. S. supported the analysis and writing up of the paper.