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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Digital Health".

Deadline for manuscript submissions: closed (10 April 2021) | Viewed by 39158

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Special Issue Editor

Prof. Dr. Sharon Lawn

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Guest Editor

College of Medicine and Public Health, Flinders University, Adelaide, SA 5001, Australia
Interests: chronic condition self-management; self-care; mental health and physical health comorbidity; multimorbidity; person’s perspective
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Special Issue Information

Dear Colleagues,

This Special Issue of the International Journal of Environmental Research and Public Health will be devoted to digital interventions that support self-management by individuals across the continuum of prevention, early intervention, and management of long-term physical or mental health conditions.

In an ever-changing world in which digital technology is becoming part of our everyday lives, a more nuanced understanding of how digital interventions can impact on our physical, psychological, and social health is of critical importance if we are to make the most of the opportunities they afford to address our most pressing health issues. This Special Issue will add to the knowledge base and advance our international understanding of digital interventions and self-management within research and practice across the globe.

We encourage you to submit original, empirical studies as well as systematic reviews or meta-analyses. Short reports and methodological papers will also be considered. Especially, we encourage the submission of interdisciplinary work and multicountry collaborative research, and manuscripts that address (but are not limited to) digital interventions and self-management applied to the following fields:

‘Hard to reach’ populations;
Rural and remote contexts;
Co-morbidity and multimorbidity;
Consumer perspectives;
Peer support;
Descriptions of development, implementation, validation, or the evaluation of interventions;
Empirical studies (quantitative, qualitative and mixed methods) applied to any subject related to digital interventions (broadly defined) in high- and/or low-resource environments.

If you have an idea but are not certain whether this falls into the scope of this Special Issue, you may contact the Guest Editor: Professor Sharon Lawn.

Prof. Sharon Lawn
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

Digital health
Self-management
Self-care
Chronic disease
Health service interventions
Peer support
E-health

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Related Special Issue

Digital Intervention and Self-Management: 2nd Edition in International Journal of Environmental Research and Public Health

Published Papers (8 papers)

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Research

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12 pages, 354 KiB

Open AccessArticle

Physical Therapists’ Opinion of E-Health Treatment of Chronic Low Back Pain

by Jesús Martínez de la Cal, Manuel Fernández-Sánchez, Guillermo Adolfo Matarán-Peñarrocha, Deirdre A. Hurley, Adelaida María Castro-Sánchez and Inmaculada Carmen Lara-Palomo

Int. J. Environ. Res. Public Health 2021, 18(4), 1889; https://doi.org/10.3390/ijerph18041889 - 16 Feb 2021

Cited by 21 | Viewed by 4388

Abstract

(1) Background: Using new technologies to manage home exercise programmes is an approach that allows more patients to benefit from therapy. The objective of this study is to explore physical therapists’ opinions of the efficacy and disadvantages of implementing a web-based telerehabilitation programme for treating chronic low back pain (CLBP). (2) Methods: Nineteen physical therapists from academic and healthcare fields in both the public and private sector participated in the qualitative study. Texts extracted from a transcript of semi-structured, individual, in-depth interviews with each consenting participant were analysed to obtain the participants’ prevailing opinions. The interviews lasted approximately 40 min each. The participants’ responses were recorded. (3) Results: The results suggest that telerehabilitation can only be successful if patients become actively involved in their own treatment. However, exercise programmes for LBP are not always adapted to patient preferences. New technologies allow physical therapists to provide their patients with the follow-up and remote contact they demand, but long-term adherence to treatment stems from knowledge of the exercises and the correct techniques employed by the patients themselves. (4) Conclusions: Physical therapists treating patients with chronic non-specific low back pain believe that new technologies can provide highly effective means of reaching a greater number of patients and achieving significant savings in healthcare costs, despite the limitations of a telerehabilitation approach in developing an appropriate and effective patient-based physiotherapy programme. Full article

(This article belongs to the Special Issue Digital Intervention and Self-Management)

17 pages, 381 KiB

Open AccessArticle

Psychosocial Characteristics by Weight Loss and Engagement in a Digital Intervention Supporting Self-Management of Weight

by Ellen S. Mitchell, Qiuchen Yang, Heather Behr, Annabell Ho, Laura DeLuca, Christine N. May and Andreas Michaelides

Int. J. Environ. Res. Public Health 2021, 18(4), 1712; https://doi.org/10.3390/ijerph18041712 - 10 Feb 2021

Cited by 7 | Viewed by 7592

Abstract

There is substantial variability in weight loss outcomes. Psychosocial characteristics underlying outcomes require better understanding, particularly on self-managed digital programs. This cross-sectional study examines differences in psychosocial characteristics by weight loss and engagement outcome, and which characteristics are most associated with weight loss, on a self-managed digital weight loss program. Some underexplored psychosocial characteristics are included, such as flourishing, or a sense of meaning and purpose in life. A questionnaire was emailed to a random sample of 10,000 current users at week 5 in the program and 10,000 current users at week 17. The questionnaire was completed by 2225 users, and their self-reported weight and recorded program engagement data were extracted from the program’s database. Multiple comparison tests indicated that mental health quality of life, depression, anxiety, work-life balance, and flourishing differed by weight loss outcome at program end (week 17; ≥5%, 2–5%, below 2%) and by engagement tertile at program beginning and end (weeks 5 and 17). Only anxiety was associated with weight loss in a backward stepwise regression controlling for engagement and sociodemographic characteristics. Flourishing did not predict weight loss overall but predicted the weight loss outcome group. Our findings have implications for creating more effective interventions for individuals based on psychosocial characteristics and highlight the potential importance of anxiety in underexplored self-managed digital programs. Full article

(This article belongs to the Special Issue Digital Intervention and Self-Management)

12 pages, 2968 KiB

Open AccessArticle

Self-Management Mobile Virtual Reality Program for Women with Gestational Diabetes

by Sung-Hoon Kim, Hye Jin Kim and Gisoo Shin

Int. J. Environ. Res. Public Health 2021, 18(4), 1539; https://doi.org/10.3390/ijerph18041539 - 5 Feb 2021

Cited by 14 | Viewed by 3815

Abstract

The incidence of type 2 diabetes and gestational diabetes shows an increasing trend worldwide, and women diagnosed with gestational diabetes are more likely to develop type 2 diabetes within 5 years of delivery. This is closely related to lifestyle habits such as dietary intake and physical activity; hence, self-management should be continuously practiced. However, after childbirth, women find it challenging to practice self-management due to physical discomfort and child rearing. Therefore, it is necessary to develop an intervention program that is tailored to the characteristics of each participant and allows them to practice self-health management efficiently without time and space restrictions. This study aimed to develop a self-management mobile virtual reality program and investigate its efficacy in preventing type 2 diabetes after childbirth among women diagnosed with gestational diabetes. Intervention with the self-management mobile virtual reality program was performed for 12 weeks. The data of 57 participants in the experimental group and 62 participants in the control group were analyzed. After 12 weeks, the body weight, body fat, hemoglobin A1c, and fasting glucose were decreased in the experimental group compared with the control group. In addition, the dietary habits and health-promoting lifestyle profile were improved in the experimental group compared with the control group. These findings demonstrated that a self-managed mobile virtual reality program could be used as an intervention method for health promotion. To verify the effectiveness of intervention with the self-management mobile virtual reality program, a follow-up study with a larger number of research subjects should be conducted in the future. Full article

(This article belongs to the Special Issue Digital Intervention and Self-Management)

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16 pages, 323 KiB

Open AccessArticle

Social and Demographic Patterns of Health-Related Internet Use Among Adults in the United States: A Secondary Data Analysis of the Health Information National Trends Survey

by Rose Calixte, Argelis Rivera, Olutobi Oridota, William Beauchamp and Marlene Camacho-Rivera

Int. J. Environ. Res. Public Health 2020, 17(18), 6856; https://doi.org/10.3390/ijerph17186856 - 19 Sep 2020

Cited by 59 | Viewed by 6661

Abstract

National surveys of U.S. adults have observed significant increases in health-related internet use (HRIU), but there are documented disparities. The study aims to identify social and demographic patterns of health-related internet use among U.S. adults. Using data from the Health Information National Trends Survey (HINTS) 4 cycle 3 and HINTS 5 cycle 1, we examined HRIU across healthcare, health information seeking, and participation on social media. Primary predictors were gender, race/ethnicity, age, education, income, and nativity with adjustments for smoking and survey year. We used multivariable logistic regression with survey weights to identify independent predictors of HRIU. Of the 4817 respondents, 43% had used the internet to find a doctor; 80% had looked online for health information. Only 20% had used social media for a health issue; 7% participated in an online health support group. In multivariable models, older and low SES participants were significantly less likely to use the internet to look for a provider, use the internet to look for health information for themselves or someone else, and less likely to use social media for health issues. Use of the internet for health-related purposes is vast but varies significantly by demographics and intended use. Full article

(This article belongs to the Special Issue Digital Intervention and Self-Management)

11 pages, 1899 KiB

Open AccessArticle

Digital Diabetes Care System Observations from a Pilot Evaluation Study in Vietnam

by Tran Quang Khanh, Pham Nhu Hao, Eytan Roitman, Itamar Raz, Baruch Marganitt and Avivit Cahn

Int. J. Environ. Res. Public Health 2020, 17(3), 937; https://doi.org/10.3390/ijerph17030937 - 3 Feb 2020

Cited by 4 | Viewed by 3816

Abstract

Digital technologies are gaining an important role in the management of patients with diabetes. We assessed clinical outcomes and user satisfaction of incorporating a digital diabetes care system in diabetes clinics of a developing country. The system integrated a wireless blood glucose monitor that communicates data to any smartphone utilizing a patented acoustic data transfer method, a mobile-app, and cloud-based software that stores, analyzes, and presents data. Five hospital endocrinology clinics in Vietnam sequentially recruited all patients willing to join the study, providing they had a smartphone and access to internet connectivity. Face-to-face visits were conducted at baseline and at 12 weeks, with monthly digital visits scheduled in the interim and additional digital visits performed as needed. HbA1c levels were measured at baseline and at 12 weeks (±20 days). The study included 300 patients of whom 279 completed the evaluation. Average glucose levels declined from 170.4 ± 64.6 mg/dL in the first 2 weeks to 150.8 ± 53.2 mg/dL in the last 2 weeks (n = 221; p < 0.001). HbA1c levels at baseline and 12 weeks declined from 8.3% ± 1.9% to 7.6% ± 1.3% (n = 126; p < 0.001). The digital solution was broadly accepted by both patients and healthcare professionals and improved glycemic outcomes. The durability, scalability, and cost-effectiveness of this approach merits further study. Full article

(This article belongs to the Special Issue Digital Intervention and Self-Management)

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13 pages, 1188 KiB

Open AccessArticle

Home Blood Pressure Monitoring by a Mobile-Based Model in Chongqing, China: A Feasibility Study

by Meng Xiao, Xun Lei, Fan Zhang, Zhenxing Sun, Vanessa Catherine Harris, Xiaojun Tang and Lijing Yan

Int. J. Environ. Res. Public Health 2019, 16(18), 3325; https://doi.org/10.3390/ijerph16183325 - 10 Sep 2019

Cited by 10 | Viewed by 3516

Abstract

Purpose: Increasing attention is being paid to the role of the intelligent self-management of hypertension under the context of increasing prevalence but limited medical resources. However, heterogeneity in interventions and outcome measures has hindered the interpretation of research evaluating mobile health technologies for hypertension control, and little study of such technology has been performed in China. Objective: This was a feasibility study aimed to understand patient and medical practitioners’ acceptance and experience of a mobile-phone based platform for the management of hypertensive patients. Methods: The model used behavioral incentives for daily blood pressure measurement and physician-facing prioritization of patients based on level of blood-pressure control. Patients were enrolled by purposive sampling. The platform was used for two-week blood pressure monitoring through WeChat, which simulated our future app. Qualitative interviews with patients and providers were conducted in time. Results: Twenty hypertensive patients and two providers were enrolled and used the platform throughout the two weeks. Patients reported daily home blood pressure monitoring to be simple, feasible and increased their health awareness. Specifically, patients self-reported that reminders, the daily frequency and time of monitoring, and positive reinforcement were important for maintaining adherence. Providers reported that they could manage patients more quickly and accurately, but reasonable feedback information was needed to avoid excessive increases in workload. Conclusion: The adoption of mobile-based technology to monitor patient’s blood pressure may provide a practical solution for managing patients in Chongqing, China. Patient health education and enhanced app functionality could improve patient compliance and satisfaction while reducing provider workload. Full article

(This article belongs to the Special Issue Digital Intervention and Self-Management)

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12 pages, 321 KiB

Open AccessArticle

Community-Driven Priorities in Smartphone Application Development: Leveraging Social Networks to Self-Manage Type 2 Diabetes in a Low-Income African American Neighborhood

by Pamela J. Surkan, Kathryne S. Mezzanotte, Laura M. Sena, Larry W. Chang, Joel Gittelsohn, Ylva Trolle Lagerros, Charlene C. Quinn and Wayne W. Zachary

Int. J. Environ. Res. Public Health 2019, 16(15), 2715; https://doi.org/10.3390/ijerph16152715 - 30 Jul 2019

Cited by 7 | Viewed by 4433

Abstract

Social networks have the potential to enhance Type 2 Diabetes Mellitus (T2DM) self-management. We used qualitative methods to study if and how mobile application (app) functions that mobilize social resources to improve T2DM management would be desired in a low-income African American community. Data were collected through community discussions and in-depth interviews with 78 participants in 2016–2018. Participants included individuals with self-reported pre-diabetes, T2DM, close family members or friends of a T2DM patient, and healthcare providers. Open-ended questions solicited information about challenges with T2DM management and gathered ideas on features of a mobile app that could address them. Data were transcribed and thematically coded by two coders using Atlas-ti. Regarding types of app functions, main themes included: (1) the importance of having support in diabetes self-care; (2) using informal networks to help to each other; and (3) monitoring one another through an app. Suggested app features included reminders for and transportation to medical visits, sharing information and exercise companionship, and providing opportunities for monitoring by friends/family members, especially in case of emergencies. Participants viewed an app as a potential vehicle for reinforcing accomplishments in T2DM self-management. Future research should implement and test an app with these features in this or similar communities. Full article

(This article belongs to the Special Issue Digital Intervention and Self-Management)

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21 pages, 2464 KiB

Open AccessReview

A Technology-Mediated Interventional Approach to the Prevention of Metabolic Syndrome: A Systematic Review and Meta-Analysis

by Gaeun Kim, Ji-Soo Lee and Soo-Kyoung Lee

Int. J. Environ. Res. Public Health 2021, 18(2), 512; https://doi.org/10.3390/ijerph18020512 - 10 Jan 2021

Cited by 12 | Viewed by 4032

Abstract

Background: Technology-mediated interventions help overcome barriers to program delivery and spread metabolic syndrome prevention programs on a large scale. A meta-analysis was performed to evaluate the impact of these technology-mediated interventions on metabolic syndrome prevention. Methods: In this meta-analysis, from 30 January 2018, three databases were searched to evaluate interventions using techniques to propagate diet and exercise lifestyle programs for adult patients with metabolic syndrome or metabolic risk. Results: Search results found 535 citations. Of these, 18 studies met the inclusion criteria analyzed in this article. The median duration of intervention was 4 months and the follow-up period ranged from 1.5 to 30 months. The standardized mean difference (SMD) between the two groups was waist circumference −0.35 (95% CI −0.54, −0.15), triglyceride −0.14 (95% CI −0.26, −0.03), fasting blood glucose −0.31 (95% CI −0.42, −0.19), body weight −1.34 (95% CI −2.04, −0.64), and body mass index −1.36 (95% CI −2.21, −0.51). There was no publication bias in this study. Conclusion: Technology-mediated intervention improved clinically important metabolic syndrome related indicators such as excess body fat around the waist, fasting glucose, and body mass index. These interventions will play an important role in the dissemination of metabolic syndrome prevention programs. Full article

(This article belongs to the Special Issue Digital Intervention and Self-Management)

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