Abstract
BackgroundChronic noncommunicable diseases (NCDs) such as asthma, diabetes, cancer, and persistent musculoskeletal pain impose an escalating and unsustainable burden on young people, their families, and society. Exploring how mobile health (mHealth) technologies can support management for young people with NCDs is imperative.ObjectiveThe aim of this study was to identify, appraise, and synthesize available qualitative evidence on users’ experiences of mHealth technologies for NCD management in young people. We explored the perspectives of both end users (young people) and implementers (health policy makers, clinicians, and researchers).MethodsA systematic review and meta-synthesis of qualitative studies. Eligibility criteria included full reports published in peer-reviewed journals from January 2007 to December 2016, searched across databases including EMBASE, MEDLINE (PubMed), Scopus, and PsycINFO. All qualitative studies that evaluated the use of mHealth technologies to support young people (in the age range of 15-24 years) in managing their chronic NCDs were considered. Two independent reviewers identified eligible reports and conducted critical appraisal (based on the Joanna Briggs Institute Qualitative Assessment and Review Instrument: JBI-QARI). Three reviewers independently, then collaboratively, synthesized and interpreted data through an inductive and iterative process to derive emergent themes across the included data. External validity checking was undertaken by an expert clinical researcher and for relevant content, a health policy expert. Themes were subsequently subjected to a meta-synthesis, with findings compared and contrasted between user groups and policy and practice recommendations derived.ResultsTwelve studies met our inclusion criteria. Among studies of end users (N=7), mHealth technologies supported the management of young people with diabetes, cancer, and asthma. Implementer studies (N=5) covered the management of cognitive and communicative disabilities, asthma, chronic self-harm, and attention deficit hyperactivity disorder. Quality ratings were higher for implementer compared with end user studies. Both complementary and unique user themes emerged. Themes derived for end users of mHealth included (1) Experiences of functionality that supported self-management, (2) Acceptance (technical usability and feasibility), (3) Importance of codesign, and (4) Perceptions of benefit (self-efficacy and empowerment). For implementers, derived themes included (1) Characteristics that supported self-management (functional, technical, and behavior change); (2) Implementation challenges (systems level, service delivery level, and clinical level); (3) Adoption considerations for specific populations (training end users; specific design requirements); and (4) Codesign and tailoring to facilitate uptake and person-centered care.ConclusionsSynthesizing available data revealed both complementary and unique user perspectives on enablers and barriers to designing, developing, and implementing mHealth technologies to support young people’s management of their chronic NCDs.Trial RegistrationPROSPERO CRD42017056317; http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD 42017056317 (Archived by WebCite at http://www.webcitation.org/6vZ5UkKLp)
Highlights
Young people are digital natives, and the portability and capabilities of digital technologies can act as a lever to connect them to health systems
Among studies of end users (N=7), mobile health (mHealth) technologies supported the management of young people with diabetes, cancer, and asthma
Themes derived for end users of mHealth included (1) Experiences of functionality that supported self-management, (2) Acceptance, (3) Importance of codesign, and (4) Perceptions of benefit
Summary
Young people are digital natives, and the portability and capabilities of digital technologies can act as a lever to connect them to health systems. This capability to connect is especially important for young people with chronic noncommunicable diseases (NCDs) during the critical transition from childhood to young adulthood [1,2]. Young People’s Use of Mobile Technologies to Support Self-Management of Chronic NCDs. We have previously identified how mobile health (mHealth) technologies could support self-management of young people with persistent musculoskeletal pain who are making this transition [2,3] and how to address their self-management needs by improving access to disease information, strategies to manage symptoms, and social support [4]. Exploring how mobile health (mHealth) technologies can support management for young people with NCDs is imperative
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