e-Health interventions for healthy aging: a systematic review

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Abstract

Background

Healthy aging (HA) is a contemporary challenge for population health worldwide. Electronic health (e-Health) interventions have the potential to support empowerment and education of adults aged 50 and over.

Objectives

To summarize evidence on the effectiveness of e-Health interventions on HA and explore how specific e-Health interventions and their characteristics effectively impact HA.

Methods

A systematic review was conducted based on the Cochrane Collaboration methods including any experimental study design published in French, Dutch, Spanish, and English from 2000 to 2018.

Results

Fourteen studies comparing various e-Health interventions to multiple components controls were included. The target population, type of interventions, and outcomes measured were very heterogeneous across studies; thus, a meta-analysis was not possible. However, effect estimates indicate that e-Health interventions could improve physical activity. Positive effects were also found for other healthy behaviors (e.g., healthy eating), psychological outcomes (e.g., memory), and clinical parameters (e.g., blood pressure). Given the low certainty of the evidence related to most outcomes, these results should be interpreted cautiously.

Conclusions

This systematic review found limited evidence supporting the effectiveness of e-Health interventions, although the majority of studies show positive effects of these interventions for improving physical activity in older adults. Thus, better quality evidence is needed regarding the effects of e-Health on the physiological, psychological, and social dimensions of HA.

Systematic review registration

The review protocol was registered in PROSPERO (registration number: CRD42016033163)

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Most cited references 57

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Understanding the barriers to setting up a healthcare quality improvement process in resource-limited settings: a situational analysis at the Medical Department of Kamuzu Central Hospital in Lilongwe, Malawi

Josephine Agyeman-Duah, Antje Theurer, Charles Munthali … (2014)

Background Knowledge regarding the best approaches to improving the quality of healthcare and their implementation is lacking in many resource-limited settings. The Medical Department of Kamuzu Central Hospital in Malawi set out to improve the quality of care provided to its patients and establish itself as a recognized centre in teaching, operations research and supervision of district hospitals. Efforts in the past to achieve these objectives were short-lived, and largely unsuccessful. Against this background, a situational analysis was performed to aid the Medical Department to define and prioritize its quality improvement activities. Methods A mix of quantitative and qualitative methods was applied using checklists for observed practice, review of registers, key informant interviews and structured patient interviews. The mixed methods comprised triangulation by including the perspectives of the clients, healthcare providers from within and outside the department, and the field researcher’s perspectives by means of document review and participatory observation. Results Human resource shortages, staff attitudes and shortage of equipment were identified as major constraints to patient care, and the running of the Medical Department. Processes, including documentation in registers and files and communication within and across cadres of staff were also found to be insufficient and thus undermining the effort of staff and management in establishing a sustained high quality culture. Depending on their past experience and knowledge, the stakeholder interviewees revealed different perspectives and expectations of quality healthcare and the intended quality improvement process. Conclusions Establishing a quality improvement process in resource-limited settings is an enormous task, considering the host of challenges that these facilities face. The steps towards changing the status quo for improved quality care require critical self-assessment, the willingness to change as well as determined commitment and contributions from clients, staff and management.

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A mediation approach to understanding socio-economic inequalities in maternal health-seeking behaviours in Egypt

Lenka Benova, Oona Campbell, George Ploubidis (2015)

Background The levels and origins of socio-economic inequalities in health-seeking behaviours in Egypt are poorly understood. This paper assesses the levels of health-seeking behaviours related to maternal care (antenatal care [ANC] and facility delivery) and their accumulation during pregnancy and childbirth. Secondly, it explores the mechanisms underlying the association between socio-economic position (SEP) and maternal health-seeking behaviours. Thirdly, it examines the effectiveness of targeting of free public ANC and delivery care. Methods Data from the 2008 Demographic and Health Survey were used to capture two latent constructs of SEP: individual socio-cultural capital and household-level economic capital. These variables were entered into an adjusted mediation model, predicting twelve dimensions of maternal health-seeking; including any ANC, private ANC, first ANC visit in first trimester, regular ANC (four or more visits during pregnancy), facility delivery, and private delivery. ANC and delivery care costs were examined separately by provider type (public or private). Results While 74.2% of women with a birth in the 5-year recall period obtained any ANC and 72.4% delivered in a facility, only 48.8% obtained the complete maternal care package (timely and regular facility-based ANC as well as facility delivery) for their most recent live birth. Both socio-cultural capital and economic capital were independently positively associated with receiving any ANC and delivering in a facility. The strongest direct effect of socio-cultural capital was seen in models predicting private provider use of both ANC and delivery. Despite substantial proportions of women using public providers reporting receipt of free care (ANC: 38%, delivery: 24%), this free-of-charge public care was not effectively targeted to women with lowest economic resources. Conclusions Socio-cultural capital is the primary mechanism leading to inequalities in maternal health-seeking in Egypt. Future studies should therefore examine the objective and perceived quality of care from different types of providers. Improvements in the targeting of free public care could help reduce the existing SEP-based inequalities in maternal care coverage in the short term. Electronic supplementary material The online version of this article (doi:10.1186/s12913-014-0652-8) contains supplementary material, which is available to authorized users.

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Older Adults Perceptions of Technology and Barriers to Interacting with Tablet Computers: A Focus Group Study

Eleftheria Vaportzis, Maria Clausen, Alan J. Gow (2017)

Background New technologies provide opportunities for the delivery of broad, flexible interventions with older adults. Focus groups were conducted to: (1) understand older adults’ familiarity with, and barriers to, interacting with new technologies and tablets; and (2) utilize user-engagement in refining an intervention protocol. Methods Eighteen older adults (65–76 years old; 83.3% female) who were novice tablet users participated in discussions about their perceptions of and barriers to interacting with tablets. We conducted three separate focus groups and used a generic qualitative design applying thematic analysis to analyse the data. The focus groups explored attitudes toward tablets and technology in general. We also explored the perceived advantages and disadvantages of using tablets, familiarity with, and barriers to interacting with tablets. In two of the focus groups, participants had previous computing experience (e.g., desktop), while in the other, participants had no previous computing experience. None of the participants had any previous experience with tablet computers. Results The themes that emerged were related to barriers (i.e., lack of instructions and guidance, lack of knowledge and confidence, health-related barriers, cost); disadvantages and concerns (i.e., too much and too complex technology, feelings of inadequacy, and comparison with younger generations, lack of social interaction and communication, negative features of tablets); advantages (i.e., positive features of tablets, accessing information, willingness to adopt technology); and skepticism about using tablets and technology in general. After brief exposure to tablets, participants emphasized the likelihood of using a tablet in the future. Conclusions Our findings suggest that most of our participants were eager to adopt new technology and willing to learn using a tablet. However, they voiced apprehension about lack of, or lack of clarity in, instructions and support. Understanding older adults’ perceptions of technology is important to assist with introducing it to this population and maximize the potential of technology to facilitate independent living.

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Author and article information

Contributors

Ronald Buyl:

ORCID: http://orcid.org/0000-0002-6598-9505

ronald.buyl@vub.be

Idrissa Beogo: idyqc3000@gmail.com

Maaike Fobelets: maaike.fobelets@vub.be

Carole Deletroz: carole.deletroz@hesav.ch

Philip Van Landuyt: Philip.Fritz.Van.Landuyt@vub.be

Samantha Dequanter: samantha.dequanter@vub.be

Ellen Gorus: ellen.gorus@vub.be

Anne Bourbonnais: anne.bourbonnais@umontreal.ca

Anik Giguère: anik.giguere@fmed.ulaval.ca

Kathleen Lechasseur: kathleen.lechasseur@fsi.ulaval.ca

Marie-Pierre Gagnon: marie-pierre.gagnon@fsi.ulaval.ca

Journal

Journal ID (nlm-ta): Syst Rev

Journal ID (iso-abbrev): Syst Rev

Title: Systematic Reviews

Publisher: BioMed Central (London )

ISSN (Electronic): 2046-4053

Publication date (Electronic): 3 June 2020

Publication date PMC-release: 3 June 2020

Publication date Collection: 2020

Volume: 9

Electronic Location Identifier: 128

Affiliations

[1 ]GRID grid.8767.e, ISNI 0000 0001 2290 8069, Faculty of Medicine and Pharmacy, Department of Public Health Sciences, Biostatistics and Medical Informatics(BISI) Research Group, , Vrije Universiteit Brussel (VUB), ; Brussels, Belgium

[2 ]GRID grid.440010.1, École des sciences infirmières et des études de la santé/School of Nursing and Health Studies, , Université de Saint-Boniface, ; Winnipeg, Manitoba Canada

[3 ]GRID grid.477307.0, School of Health Sciences (HESAV), , University of Applied Sciences and Arts Western Switzerland, ; Avenue de Beaumont 21, CH-1011 Lausanne, Switzerland

[4 ]GRID grid.8767.e, ISNI 0000 0001 2290 8069, Faculty of Medicine and Pharmacy, Department of Gerontology, Frailty in Ageing (FRIA) Research Group, , Vrije Universiteit Brussel (VUB), ; Brussels, Belgium

[5 ]GRID grid.14848.31, ISNI 0000 0001 2292 3357, Faculty of Nursing, , Université de Montréal, ; Montreal, Quebec Canada

[6 ]GRID grid.294071.9, Research Center of the Institut universitaire de gériatrie de Montréal (CRIUGM), ; Montreal, Quebec Canada

[7 ]GRID grid.23856.3a, ISNI 0000 0004 1936 8390, Faculty of Medicine, , Université Laval, ; Quebec, Canada

[8 ]GRID grid.23856.3a, ISNI 0000 0004 1936 8390, Centre de recherche sur les soins et services de première ligne de l’Université Laval (CERSSPL-UL), ; Quebec, Canada

[9 ]GRID grid.23856.3a, ISNI 0000 0004 1936 8390, Research Center of the Centre Hospitalier de Québec-Université Laval (CRCHUQ-UL), ; Quebec, Canada

[10 ]GRID grid.23856.3a, ISNI 0000 0004 1936 8390, Faculty of Nursing Sciences, , Université Laval, Québec, ; 1050 avenue de la Médecine, Quebec, Canada

Author information

Ronald Buyl http://orcid.org/0000-0002-6598-9505

Article

Publisher ID: 1385

DOI: 10.1186/s13643-020-01385-8

PMC ID: 7271471

PubMed ID: 32493515

SO-VID: b369ad66-650b-4c8e-95b3-3635db6fb8b2

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 27 January 2020

Date accepted : 11 May 2020

Funding

Funded by: Dissemination grant from the Canadian Institutes for Health Research

Custom metadata

ScienceOpen disciplines: Public health

Keywords: e-health intervention,healthy aging,e-health,information technology

Data availability:

ScienceOpen disciplines: Public health

Keywords: e-health intervention, healthy aging, e-health, information technology

e-Health interventions for healthy aging: a systematic review

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Abstract

Background

Objectives

Methods

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Conclusions

Systematic review registration

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REPO4EU WP2 Systematic Reviews

Most cited references 57

Understanding the barriers to setting up a healthcare quality improvement process in resource-limited settings: a situational analysis at the Medical Department of Kamuzu Central Hospital in Lilongwe, Malawi

A mediation approach to understanding socio-economic inequalities in maternal health-seeking behaviours in Egypt

Older Adults Perceptions of Technology and Barriers to Interacting with Tablet Computers: A Focus Group Study

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