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      Digital Technologies for Health Promotion and Disease Prevention in Older People: Scoping Review

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          Abstract

          Background

          Digital technologies have the potential to contribute to health promotion and disease prevention in the aging world.

          Objective

          This study aims to identify digital technologies for health promotion and disease prevention that could be used independently by older people in nonclinical settings using a scoping review.

          Methods

          Through database (MEDLINE, PsycINFO, CINAHL, and SCOPUS; to March 3, 2022) and manual searches (to June 14, 2022), 90 primary studies and 8 systematic reviews were included in this scoping review. The eligibility was based on the PCC (Population, Concept, and Context) criteria: (1) people aged 50 years or older (population), (2) any digital (health) technology (eg, smartphone apps, websites, virtual reality; concept), and (3) health promotion and disease prevention in daily life in nonclinical and noninstitutional settings (context). Data items included study characteristics, PCC criteria, opportunities versus challenges, and evidence gaps. Data were synthesized using descriptive statistics or narratively described by identifying common themes.

          Results

          The studies were published in 2005-2022 and originated predominantly from North America and Europe. Most primary studies were nonrandomized, reported quantitative data, and investigated effectiveness or feasibility (eg, acceptance or usability) of digital technologies in older people. The participants were aged 50 years to 99 years, predominantly female, affluent (ie, with high income, education, and digital competence), and intended to use or used digital technologies for a median of 3 months independently at home or in community settings. The digital technologies included mobile or nonmobile technologies or virtual reality. The studies used “modern devices” (eg, smartphones, wearables, or gaming consoles) or modern and “older devices” (eg, computers or mobile phones). The users interacted with digital technologies via websites, emails, text messages, apps, or virtual reality. Health targets of digital technologies were mobility, mental health, nutrition, or cognition. The opportunities versus challenges of digital technologies were (1) potential health benefits versus unclear or no benefits for some outcomes, (2) monitoring of health versus ethical issues with data collection and management, (3) implications for functioning in daily life (ie, potential to prolong independent living) versus unclear application for clinical management or care, (4) tailoring of technical properties and content toward older users versus general use, (5) importance of human support for feasibility versus other factors required to improve feasibility, (6) reduction of social isolation versus access to digital technologies, and (7) improvement in digital competence versus digital divide.

          Conclusions

          Various digital technologies were independently used by people aged 50 years or older for health promotion and disease prevention. Future studies should focus on (1) more diverse populations of older people, (2) new digital technologies, (3) other (clinical and care) settings, and (4) outcome evaluation to identify factors that could enhance any health benefits of digital technologies.

          International Registered Report Identifier (IRRID)

          RR2-10.2196/37729

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          Most cited references139

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          PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation

          Scoping reviews, a type of knowledge synthesis, follow a systematic approach to map evidence on a topic and identify main concepts, theories, sources, and knowledge gaps. Although more scoping reviews are being done, their methodological and reporting quality need improvement. This document presents the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) checklist and explanation. The checklist was developed by a 24-member expert panel and 2 research leads following published guidance from the EQUATOR (Enhancing the QUAlity and Transparency Of health Research) Network. The final checklist contains 20 essential reporting items and 2 optional items. The authors provide a rationale and an example of good reporting for each item. The intent of the PRISMA-ScR is to help readers (including researchers, publishers, commissioners, policymakers, health care providers, guideline developers, and patients or consumers) develop a greater understanding of relevant terminology, core concepts, and key items to report for scoping reviews.
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            Scoping studies: towards a methodological framework

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              AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both

              The number of published systematic reviews of studies of healthcare interventions has increased rapidly and these are used extensively for clinical and policy decisions. Systematic reviews are subject to a range of biases and increasingly include non-randomised studies of interventions. It is important that users can distinguish high quality reviews. Many instruments have been designed to evaluate different aspects of reviews, but there are few comprehensive critical appraisal instruments. AMSTAR was developed to evaluate systematic reviews of randomised trials. In this paper, we report on the updating of AMSTAR and its adaptation to enable more detailed assessment of systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. With moves to base more decisions on real world observational evidence we believe that AMSTAR 2 will assist decision makers in the identification of high quality systematic reviews, including those based on non-randomised studies of healthcare interventions.
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                Author and article information

                Contributors
                Journal
                J Med Internet Res
                J Med Internet Res
                JMIR
                Journal of Medical Internet Research
                JMIR Publications (Toronto, Canada )
                1439-4456
                1438-8871
                2023
                23 March 2023
                : 25
                : e43542
                Affiliations
                [1 ] Department of Prevention and Evaluation Leibniz Institute for Prevention Research and Epidemiology Bremen Germany
                [2 ] Leibniz-Science Campus Digital Public Health Bremen Bremen Germany
                [3 ] Department of Administration Leibniz Institute for Prevention Research and Epidemiology Bremen Germany
                [4 ] Department Q6- Adults, Seniors, Women’s and Men’s Health, Health Equity Federal Centre for Health Education Cologne Germany
                [5 ] Faculty 11 Human and Health Sciences University of Bremen Bremen Germany
                Author notes
                Corresponding Author: Karina Karolina De Santis desantis@ 123456leibniz-bips.de
                Author information
                https://orcid.org/0000-0001-7647-6767
                https://orcid.org/0000-0001-6860-3295
                https://orcid.org/0000-0002-7780-255X
                https://orcid.org/0000-0002-3393-9976
                https://orcid.org/0000-0002-7530-7707
                https://orcid.org/0000-0001-7509-242X
                Article
                v25i1e43542
                10.2196/43542
                10131689
                36951896
                1545410b-15d5-4318-84ba-91db9c7b4dbf
                ©Karina Karolina De Santis, Lea Mergenthal, Lara Christianson, Annalena Busskamp, Claudia Vonstein, Hajo Zeeb. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 23.03.2023.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on https://www.jmir.org/, as well as this copyright and license information must be included.

                History
                : 14 October 2022
                : 9 November 2022
                : 30 November 2022
                : 31 January 2023
                Categories
                Review
                Review

                Medicine
                digital technology,health technology,digital public health,health promotion,disease prevention,healthy aging,elderly population,older adult,older population,scoping review

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