Barriers to and Facilitators of Engagement With Remote Measurement Technology for Managing Health: Systematic Review and Content Analysis of Findings.

Sara Simblett,Peter Gamble,Ashley Polhemus,Hannah Curtis,Til Wykes,Til Wykes,Ben Greer,Faith Matcham,José Ferrão

doi:10.2196/10480

Abstract

BackgroundRemote measurement technology refers to the use of mobile health technology to track and measure change in health status in real time as part of a person’s everyday life. With accurate measurement, remote measurement technology offers the opportunity to augment health care by providing personalized, precise, and preemptive interventions that support insight into patterns of health-related behavior and self-management. However, for successful implementation, users need to be engaged in its use.ObjectiveOur objective was to systematically review the literature to update and extend the understanding of the key barriers to and facilitators of engagement with and use of remote measurement technology, to guide the development of future remote measurement technology resources.MethodsWe conducted a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines involving original studies dating back to the last systematic review published in 2014. We included studies if they met the following entry criteria: population (people using remote measurement technology approaches to aid management of health), intervention (remote measurement technology system), comparison group (no comparison group specified), outcomes (qualitative or quantitative evaluation of the barriers to and facilitators of engagement with this system), and study design (randomized controlled trials, feasibility studies, and observational studies). We searched 5 databases (MEDLINE, IEEE Xplore, EMBASE, Web of Science, and the Cochrane Library) for articles published from January 2014 to May 2017. Articles were independently screened by 2 researchers. We extracted study characteristics and conducted a content analysis to define emerging themes to synthesize findings. Formal quality assessments were performed to address risk of bias.ResultsA total of 33 studies met inclusion criteria, employing quantitative, qualitative, or mixed-methods designs. Studies were conducted in 10 countries, included male and female participants, with ages ranging from 8 to 95 years, and included both active and passive remote monitoring systems for a diverse range of physical and mental health conditions. However, they were relatively short and had small sample sizes, and reporting of usage statistics was inconsistent. Acceptability of remote measurement technology according to the average percentage of time used (64%-86.5%) and dropout rates (0%-44%) was variable. The barriers and facilitators from the content analysis related to health status, perceived utility and value, motivation, convenience and accessibility, and usability.ConclusionsThe results of this review highlight gaps in the design of studies trialing remote measurement technology, including the use of quantitative assessment of usage and acceptability. Several processes that could facilitate engagement with this technology have been identified and may drive the development of more person-focused remote measurement technology. However, these factors need further testing through carefully designed experimental studies.Trial RegistrationInternational Prospective Register of Systematic Reviews (PROSPERO) CRD42017060644; https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=60644 (Archived by WebCite at http://www.webcitation.org/70K4mThTr)

Highlights

Global smartphone ownership has increased, which provides ready access to the internet, and a means of actively logging information and passively gathering big data [1]
Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a systematic review of studies to answer the question “What are the barriers to and facilitators of engagement with remote measurement technology?” We registered the trial with the International Prospective Register of Systematic Reviews (PROSPERO registration number CRD42017060644)
We included studies if they met the following criteria: (1) were published in English; (2) included health care remote measurement technology (RMT), defined as any mobile technology that enables monitoring of a person’s health status through a remote interface, with the data either transmitted to a health care provider for review or to be used as a means of education for the user themselves [4]; and (3) were original studies published from January 2014 reporting the results of questionnaires, interviews, focus groups, and other indicators, providing information about barriers to and facilitators of engagement with RMT systems using mHealth tools

Summary

Introduction

Global smartphone ownership has increased, which provides ready access to the internet, and a means of actively logging information and passively gathering big data [1]. A surge in the availability of wearable devices (eg, smart watches and fitness trackers) has enabled continuous and real-time collection of biosignatures and accelerometry [2]. These mobile tools, and platform infrastructures surrounding them, could provide intelligent remote measurement technology (RMT) to support health management. Feedback to health care professionals could facilitate efficient and timely decisions about treatment. These tools have the capacity to augment and extend health care opportunities, they come with challenges associated with acceptability. For successful implementation, users need to be engaged in its use

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