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Better Health Services and Preventive Interventions: eHealth

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Guest Editor
Institute for Health and Nursing Science, Charité - Universitätsmedizin Berlin, Oudenarder Strasse 16, 13347 Berlin, Germany
Interests: prevention of risk behavior; health promotion; eHealth; mHealth; digital public health; youth; university students; implementation; innovative interventions

Special Issue Information

Dear colleagues,

In recent years, eHealth has been proposed as a crucial tool in promoting better health care and prevention and the importance of eHealth has become increasingly evident. The COVID-19 pandemic additionally highlights the relevance of the availability of such services. Services and technologies such as mobile health apps, virtual reality, video consultation services, and social media have the potential to increase the quality of services and interventions, save costs, allow access from a distance and reduce barriers. Moreover, eHealth interventions are uniquely suited for personalization and tailoring of services and information to the individual needs of users. At the same time, they can be overly complex, time-consuming, and exclusive. Therefore, it is essential to learn more about eHealth services and preventive interventions, their effectiveness and implementation. Development of eHealth services and interventions not only requires a feasibility assessment and multi-disciplinary expertise, they further rely on user needs and acceptability. Diverse evaluation approaches, frameworks and tools co-exist to examine the effectiveness of eHealth that also take into account the complexity of technology. So far, little attention has been paid to the implementation of eHealth services and interventions in the real world. The implementation of eHealth needs to be analyzed in depth, since it may result in a loss of impact, harm for users, unnecessary costs, as well as the frustration or rejection of health care.

In this Special Issue, we aim to cover the full spectrum of eHealth-related research that includes theoretical, methodological, original qualitative and quantitative research, as well as review articles.

Dr. Stefanie Maria Helmer
Guest Editor

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Keywords

  • eHealth
  • mHealth
  • prevention
  • health services
  • implementation
  • acceptability
  • evaluation
  • evidence-based

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Published Papers (8 papers)

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Research

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18 pages, 714 KiB  
Article
Sustaining Our Relationship: Dyadic Interactions Supported by Technology for People with Dementia and Their Informal Caregivers
by Viktoria Hoel, Eliva Atieno Ambugo and Karin Wolf-Ostermann
Int. J. Environ. Res. Public Health 2022, 19(17), 10956; https://doi.org/10.3390/ijerph191710956 - 2 Sep 2022
Cited by 10 | Viewed by 2929
Abstract
Impaired memory function and challenges in communication affect the ability of people living with dementia to interact with family caregivers socially. The onset of dementia in a family member and the communication challenges that follow can lead to conflict, isolation and loss of [...] Read more.
Impaired memory function and challenges in communication affect the ability of people living with dementia to interact with family caregivers socially. The onset of dementia in a family member and the communication challenges that follow can lead to conflict, isolation and loss of closeness in the relationship. I-CARE is a tablet-based technology providing leisure activities specifically designed for people living with dementia to do in tandem with caregivers. The intention is that caregiving dyads engage with I-CARE together, using the activities contained in the system as the basis for positive social interactions. This paper reports on a mixed-methods feasibility study of I-CARE, evaluating the system’s usability and assessing the impact on caregiving dyads. We also explored barriers and facilitators to independent use of the technology among community-dwelling people living with dementia and their family caregiver. Results suggest that I-CARE is a feasible tool to facilitate positive experiences in dementia caregiving dyads. Important relationship outcomes for the participating dyads were enrichment in social interactions, facilitated communication, having a shared activity and relationship sustenance. Successful uptake requires continuous proactive support tailored to the needs and preconditions of users over an extended time until they feel confident using the system independently. Full article
(This article belongs to the Special Issue Better Health Services and Preventive Interventions: eHealth)
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19 pages, 21619 KiB  
Article
Hosting an Online World Café to Develop an Understanding of Digital Health Promoting Settings from a Citizen’s Perspective—Methodological Potentials and Challenges
by Joanna Albrecht, Anna Lea Stark, Eleana Dongas, Kamil J. Wrona and Christoph Dockweiler
Int. J. Environ. Res. Public Health 2022, 19(16), 9969; https://doi.org/10.3390/ijerph19169969 - 12 Aug 2022
Cited by 4 | Viewed by 3299
Abstract
Brown and Isaacs’ World Café is a participatory research method to make connections to the ideas of others. During the SARS-CoV-2 pandemic and the corresponding contact restrictions, only digital hostings of World Cafés were possible. This article aims to present and reflect on [...] Read more.
Brown and Isaacs’ World Café is a participatory research method to make connections to the ideas of others. During the SARS-CoV-2 pandemic and the corresponding contact restrictions, only digital hostings of World Cafés were possible. This article aims to present and reflect on the potentials and challenges of hosting online World Cafés and to derive recommendations for other researchers. Via Zoom and Conceptboard, three online World Cafés were conducted in August 2021. In the World Cafés, the main focus was on the increasing digitization in settings in the context of health promotion and prevention from the perspective of setting members of educational institutions, leisure clubs, and communities. Between 9 and 13 participants participated in three World Cafés. Hosting comprises the phases of design and preparation, realisation, and evaluation. Generally, hosting an online World Café is a suitable method for participatory engagement, but particular challenges have to be overcome. Overall café hosts must create an equal participation environment by ensuring the availability of digital devices and stable internet access. The event schedule must react flexibly to technical disruptions and varying participation numbers. Further, compensatory measures such as support in the form of technical training must be implemented before the event. Finally, due to the higher complexity of digitalisation, roles of participants and staff need to be distributed and coordinated. Full article
(This article belongs to the Special Issue Better Health Services and Preventive Interventions: eHealth)
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19 pages, 833 KiB  
Article
Needs of Lung Cancer Patients Receiving Immunotherapy and Acceptance of Digital and Sensor-Based Scenarios for Monitoring Symptoms at Home—A Qualitative-Explorative Study
by Milena von Kutzleben, Jan Christoph Galuska, Andreas Hein, Frank Griesinger and Lena Ansmann
Int. J. Environ. Res. Public Health 2022, 19(15), 9265; https://doi.org/10.3390/ijerph19159265 - 28 Jul 2022
Cited by 1 | Viewed by 2199
Abstract
Background: The development of immunotherapy in the treatment for lung cancer has changed the outlook for both patients and health care practitioners. However, reporting and management of side effects are crucial to ensure effectiveness and safety of treatment. The aim of this study [...] Read more.
Background: The development of immunotherapy in the treatment for lung cancer has changed the outlook for both patients and health care practitioners. However, reporting and management of side effects are crucial to ensure effectiveness and safety of treatment. The aim of this study was to learn about the subjective experiences of patients with lung cancer receiving immunotherapy and to explore their potential acceptance of digital and sensor-based systems for monitoring treatment-related symptoms at home. Methods: A qualitative-explorative interview study with patients with lung cancer (n = 21) applying qualitative content analysis. Results: Participants had trouble to classify and differentiate between symptoms they experienced and it seemed challenging to assess whether symptoms are serious enough to be reported and to figure out the right time to report symptoms to health care practitioners. We identified four basic needs: (1) the need to be informed, (2) the need for a trustful relationship, (3) the need to be taken seriously, and (4) the need for needs-oriented treatment concepts. The idea of digital and sensor-based monitoring initially provoked rejection, but participants expressed more differentiated attitudes during the interviews, which could be integrated into a preliminary model to explain the acceptance of digital and sensor-based monitoring scenarios. Conclusions: Supporting lung cancer patients and their health care providers in communicating about treatment-related symptoms is important. Technology-based monitoring systems are considered to be potentially beneficial. However, in view of the many unfulfilled information needs and the unsatisfactory reporting of symptoms, it must be critically questioned what these systems can and should compensate for, and where the limits of such monitoring lie. Full article
(This article belongs to the Special Issue Better Health Services and Preventive Interventions: eHealth)
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17 pages, 545 KiB  
Article
Adolescents’ Perceptions of Gender Aspects in a Virtual-Reality-Based Alcohol-Prevention Tool: A Focus Group Study
by Christina Prediger, Robert Hrynyschyn, Iasmina Iepan and Christiane Stock
Int. J. Environ. Res. Public Health 2022, 19(9), 5265; https://doi.org/10.3390/ijerph19095265 - 26 Apr 2022
Cited by 3 | Viewed by 1991
Abstract
Virtual reality (VR) is an innovative tool for alcohol prevention among adolescents. However, many aspects of virtual simulations for alcohol prevention remained unstudied, and research on opportunities for tailoring such tools to users’ gender using avatar-based pathways is lacking. The present study, therefore, [...] Read more.
Virtual reality (VR) is an innovative tool for alcohol prevention among adolescents. However, many aspects of virtual simulations for alcohol prevention remained unstudied, and research on opportunities for tailoring such tools to users’ gender using avatar-based pathways is lacking. The present study, therefore, explores adolescents’ perceptions of gender portrayal and gender tailoring using Virtual LimitLab—a VR simulation for building refusal skills for dealing with peer pressure to consume alcohol. Focus groups were conducted after individual simulation testing with 13 adolescents in four groups, whose statements and discussion underwent thematic analysis. Three main themes were identified: the relevance of gender, opinions on different tailoring options for gender, and opinions on flirt orientation. Divergent arguments for different tailoring options and representations of gender in the simulation were proposed. Some participants changed opinions during discussions. Sexual harassment was consensually deemed an important issue that is linked to both partying and alcohol and was concluded to require being addressed along with alcohol prevention. A consensus also formed around open flirting possibilities (regardless of gender), and awareness of non-binary peers was raised. Based on the observed sensitivity of the adolescents to gender diversity, it is necessary to include LGBTQIA+ adolescents when developing gender-sensitive simulations. Full article
(This article belongs to the Special Issue Better Health Services and Preventive Interventions: eHealth)
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16 pages, 8429 KiB  
Article
Designing an eHealth Well-Being Program: A Participatory Design Approach
by Yannick van Hierden, Timo Dietrich and Sharyn Rundle-Thiele
Int. J. Environ. Res. Public Health 2021, 18(14), 7250; https://doi.org/10.3390/ijerph18147250 - 6 Jul 2021
Cited by 4 | Viewed by 3801
Abstract
In recent years, the relevance of eHealth interventions has become increasingly evident. However, a sequential procedural application to cocreating eHealth interventions is currently lacking. This paper demonstrates the implementation of a participatory design (PD) process to inform the design of an eHealth intervention [...] Read more.
In recent years, the relevance of eHealth interventions has become increasingly evident. However, a sequential procedural application to cocreating eHealth interventions is currently lacking. This paper demonstrates the implementation of a participatory design (PD) process to inform the design of an eHealth intervention aiming to enhance well-being. PD sessions were conducted with 57 people across four sessions. Within PD sessions participants experienced prototype activities, provided feedback and designed program interventions. A 5-week eHealth well-being intervention focusing on lifestyle, habits, physical activity, and meditation was proposed. The program is suggested to be delivered through online workshops and online community interaction. A five-step PD process emerged; namely, (1) collecting best practices, (2) participatory discovery, (3) initial proof-of-concept, (4) participatory prototyping, and (5) pilot intervention proof-of-concept finalisation. Health professionals, behaviour change practitioners and program planners can adopt this process to ensure end-user cocreation using the five-step process. The five-step PD process may help to create user-friendly programs. Full article
(This article belongs to the Special Issue Better Health Services and Preventive Interventions: eHealth)
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17 pages, 658 KiB  
Article
Examining Protection Motivation and Network Externality Perspective Regarding the Continued Intention to Use M-Health Apps
by Yumei Luo, Guiping Wang, Yuwei Li and Qiongwei Ye
Int. J. Environ. Res. Public Health 2021, 18(11), 5684; https://doi.org/10.3390/ijerph18115684 - 26 May 2021
Cited by 27 | Viewed by 4439
Abstract
M-health apps have developed rapidly and are widely accepted, but users’ continued intention to use m-health apps has not been fully explored. This study was designed to obtain a better understanding of users’ continued intention to use m-health apps. We developed a theoretical [...] Read more.
M-health apps have developed rapidly and are widely accepted, but users’ continued intention to use m-health apps has not been fully explored. This study was designed to obtain a better understanding of users’ continued intention to use m-health apps. We developed a theoretical model by incorporating the protection motivation theory and network externalities and conducted an empirical study of a 368-respondent sample. The results showed that: (1) perceived vulnerability has a direct impact on users’ self-efficacy and response efficacy; (2) self-efficacy and response efficacy have a direct impact on users’ attitudes and continued intention; (3) network externalities affect users’ attitudes and continued intention, among which direct network externalities have an indirect impact on users’ continued intention through attitude; and (4) the impacts of self-efficacy, response efficacy, and indirect network externalities on continued intention are partially meditated by attitudes. Full article
(This article belongs to the Special Issue Better Health Services and Preventive Interventions: eHealth)
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Review

Jump to: Research

14 pages, 718 KiB  
Review
Evaluation Methods Applied to Digital Health Interventions: What Is Being Used beyond Randomised Controlled Trials?—A Scoping Review
by Robert Hrynyschyn, Christina Prediger, Christiane Stock and Stefanie Maria Helmer
Int. J. Environ. Res. Public Health 2022, 19(9), 5221; https://doi.org/10.3390/ijerph19095221 - 25 Apr 2022
Cited by 13 | Viewed by 4104
Abstract
Despite the potential of digital health interventions (DHIs), evaluations of their effectiveness face challenges. DHIs are complex interventions and currently established evaluation methods, e.g., the randomised controlled trial (RCT), are limited in their application. This study aimed at identifying alternatives to RCTs as [...] Read more.
Despite the potential of digital health interventions (DHIs), evaluations of their effectiveness face challenges. DHIs are complex interventions and currently established evaluation methods, e.g., the randomised controlled trial (RCT), are limited in their application. This study aimed at identifying alternatives to RCTs as potentially more appropriate evaluation approaches. A scoping review was conducted to provide an overview of existing evaluation methods of DHIs beyond the RCT. Cochrane Central Register of Controlled Trials, MEDLINE, Web of Science, and EMBASE were screened in May 2021 to identify relevant publications, while using defined inclusion and exclusion criteria. Eight studies were extracted for a synthesis comprising four alternative evaluation designs. Factorial designs were mostly used to evaluate DHIs followed by stepped-wedge designs, sequential multiple assignment randomised trials (SMARTs), and micro randomised trials (MRTs). Some of these methods allow for the adaptation of interventions (e.g., SMART or MRT) and the evaluation of specific components of interventions (e.g., factorial designs). Thus, they are appropriate for addressing some specific needs in the evaluation of DHIs. However, it remains unsolved how to establish these alternative evaluation designs in research practice and how to deal with the limitations of the designs. Full article
(This article belongs to the Special Issue Better Health Services and Preventive Interventions: eHealth)
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14 pages, 652 KiB  
Review
Effectiveness of Social Media-Based Interventions for the Promotion of Physical Activity: Scoping Review
by Liane Günther, Sarah Schleberger and Claudia R. Pischke
Int. J. Environ. Res. Public Health 2021, 18(24), 13018; https://doi.org/10.3390/ijerph182413018 - 10 Dec 2021
Cited by 22 | Viewed by 5223
Abstract
A global target of the World Health Organization (WHO) is to reduce physical inactivity among all adults and adolescents by approximately fifteen percent by 2030. Social media could have an impact in this effort because of its enormous reach, potentially addressing underserved populations [...] Read more.
A global target of the World Health Organization (WHO) is to reduce physical inactivity among all adults and adolescents by approximately fifteen percent by 2030. Social media could have an impact in this effort because of its enormous reach, potentially addressing underserved populations in need for physical activity (PA) interventions. This scoping review provides a broad overview of social media-based interventions and systematically maps the evidence regarding their effectiveness for PA promotion and other health outcomes. Scopus and Medline were searched using the terms “physical activity” and “social media” and the names of key social media platforms. Following the PRISMA guidelines for scoping reviews, abstracts and full texts were screened for eligibility. In total, 12,321 publications were identified and 53 met the inclusion criteria. The use of Facebook was most prevalent in PA interventions, followed by study-specific platforms. More than one third of the studies revealed positive effects regarding the promotion of PA. Additionally, social media-based interventions positively affected other physical dimensions of health (e.g., weight or blood pressure). Results pertaining to feasibility were heterogeneous. Social media seems to be a promising tool for increasing PA at the population level. Future studies should take the abundance of platforms into account and select social media platforms consciously. Full article
(This article belongs to the Special Issue Better Health Services and Preventive Interventions: eHealth)
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