Digital Health Education Research Articles

Awareness, Views, Perceptions, and Beliefs of Pharmacy Interns Regarding Digital Health in Saudi Arabia: Cross-sectional Study

BackgroundDigital health technologies and apps are rapidly advancing in recent years. It is expected to have more roles in transforming the health care system in this era of digital services. However, limited research is available regarding delivering digital health education in pharmacy and the pharmacy students’ perspectives on digital health. ObjectiveThis study aims to assess pharmacy interns’ awareness of digital health apps in Saudi Arabia and their views regarding the coverage of digital health in the education of pharmacists. In addition, we assessed the interns’ perceptions and beliefs about the concepts, benefits, and implementation of digital health in practice settings. MethodsA cross-sectional study using a web-based survey was conducted among pharmacy interns at Unaizah College of Pharmacy, Qassim University, Saudi Arabia. An invitation with a link to the web-based survey was sent to all interns registered at the college between January and March 2021. ResultsA total of 68 out of 77 interns registered in the internship year participated in this study, giving a response rate of 88%. The mean total score for pharmacy interns’ awareness of digital health apps in Saudi Arabia was 5.66 (SD 1.74; maximum attainable score=7). The awareness with different apps ranged from 97% (66/68) for the Tawakkalna app to 65% (44/68) for the Ministry of Health 937 call center. The mean total score for attitude and beliefs toward concepts and benefits of telehealth and telemedicine apps was 58.25 (SD 10.44; maximum attainable score=75). In this regard, 84% (57/68) of the interns believed that telehealth could enhance the quality of care, 71% (48/68) believed that it could help effectively provide patient counseling, and 69% (47/68) believed it could improve patients’ adherence to therapy. In this study, 41% (28/68) believed that the current coverage of digital health in the curriculum was average, whereas only 18% (12/68) believed it was high or very high coverage. Moreover, only 38% (26/68) attended additional educational activities related to digital health. Consequently, the majority (43/68, 63%) were of the opinion that there is a high or very high need to educate and train pharmacists in the field of digital health. ConclusionsOverall, the interns showed good awareness of common digital health apps in Saudi Arabia. Moreover, the majority of the interns had positive perceptions and beliefs about the concepts, benefits, and implementation of digital health. However, the findings showed that there is still scope for improvement in some areas. Moreover, most interns indicated that there is a need for more education and training in the field of digital health. Consequently, early exposure to content related to digital health and pharmacy informatics is an important step to help in the wide use of these technologies in the graduates’ future careers.

Digital Health Training Programs for Medical Students: Scoping Review.

BackgroundMedical schools worldwide are accelerating the introduction of digital health courses into their curricula. The COVID-19 pandemic has contributed to this swift and widespread transition to digital health and education. However, the need for digital health competencies goes beyond the COVID-19 pandemic because they are becoming essential for the delivery of effective, efficient, and safe care.ObjectiveThis review aims to collate and analyze studies evaluating digital health education for medical students to inform the development of future courses and identify areas where curricula may need to be strengthened.MethodsWe carried out a scoping review by following the guidance of the Joanna Briggs Institute, and the results were reported in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. We searched 6 major bibliographic databases and gray literature sources for articles published between January 2000 and November 2019. Two authors independently screened the retrieved citations and extracted the data from the included studies. Discrepancies were resolved by consensus discussions between the authors. The findings were analyzed using thematic analysis and presented narratively.ResultsA total of 34 studies focusing on different digital courses were included in this review. Most of the studies (22/34, 65%) were published between 2010 and 2019 and originated in the United States (20/34, 59%). The reported digital health courses were mostly elective (20/34, 59%), were integrated into the existing curriculum (24/34, 71%), and focused mainly on medical informatics (17/34, 50%). Most of the courses targeted medical students from the first to third year (17/34, 50%), and the duration of the courses ranged from 1 hour to 3 academic years. Most of the studies (22/34, 65%) reported the use of blended education. A few of the studies (6/34, 18%) delivered courses entirely digitally by using online modules, offline learning, massive open online courses, and virtual patient simulations. The reported courses used various assessment approaches such as paper-based assessments, in-person observations, and online assessments. Most of the studies (30/34, 88%) evaluated courses mostly by using an uncontrolled before-and-after design and generally reported improvements in students’ learning outcomes.ConclusionsDigital health courses reported in literature are mostly elective, focus on a single area of digital health, and lack robust evaluation. They have diverse delivery, development, and assessment approaches. There is an urgent need for high-quality studies that evaluate digital health education.

Extended-Reality Technologies: An Overview of Emerging Applications in Medical Education and Clinical Care.

Extended-Reality Technologies: An Overview of Emerging Applications in Medical Education and Clinical Care.

Digital Health in Pharmacy Education: Preparedness and Responsiveness of Pharmacy Programmes

To ensure the sustainability of pharmacy practice and provide health for all, pharmacy as a profession must embrace the digital transformation that has been changing healthcare at a rapid pace. The International Pharmaceutical Federation (FIP) has conducted a global study on digital health in pharmacy education to describe the readiness, adaptability, and responsiveness of pharmacy education programmes to train the current and future pharmaceutical workforce on digital health and to identify the knowledge and skill gaps of the existing pharmaceutical workforce with regard to digital health. An online survey was distributed to collect feedback from academics, pharmacy schools, pharmacists, and pharmacy students. The findings showed that a large proportion of pharmacy schools do not offer any digital health education, and the skillsets and knowledge of how to apply digital health technologies to solve existing clinical problems and improve care have been identified as a gap. The future of pharmacy and pharmaceutical sciences is digital and exciting. A digitally enabled and agile pharmaceutical workforce will capitalise on the benefits of digital health to serve the higher purpose of providing good health and wellbeing for all, leaving no one behind. Therefore, pharmacy and pharmaceutical sciences education should act now.

Digital Health Intervention to Increase Health Knowledge Related to Diseases of High Public Health Concern in Iringa, Tanzania: Protocol for a Mixed Methods Study.

BackgroundTraditionally, health promotion and health education have been provided to communities in the global south in the form of leaflets or orally by health care workers. Digital health interventions (DHIs) such as digital health messages accessed by smartphones have the potential to reach more people at a lower cost and to contribute to strengthening of health care systems. The DHI in this study focuses on disseminating digital health education regarding 3 disease complexes of high public health concern: HIV/AIDS, tuberculosis, and Taenia solium (neuro)cysticercosis or taeniasis, a parasitic zoonotic disease that requires a One Health approach. The DHI presents the participants with animated health videos (animations) and provides access to information spots (InfoSpots) with a free-of-charge digital health platform containing messages about health to rural Tanzanian communities.ObjectiveThe objective of this study is to measure the effect of the DHI on health knowledge uptake and retention over time in the rural communities.MethodsThis is a mixed methods study including a nonrandomized controlled trial and qualitative interviews conducted in rural Tanzania. A health platform containing digital health messages for the communities was developed prior to the study. The health messages consist of text, pictures, quizzes, and animations of everyday stories, aimed at disease prevention and early treatment. The baseline and immediate postintervention assessments were completed in Iringa, Tanzania in May 2019. The participants were interviewed by enumerators and completed questionnaires regarding health knowledge. Participants in the intervention group were exposed to 3 different health animations once on a tablet device. The participants’ health knowledge was assessed again immediately after the exposure. The first follow-up survey was undertaken in August 2019. The InfoSpots with the digital health platform were thereafter launched in the intervention villages in November 2019. Qualitative interviews were undertaken in February 2020. The second follow-up was completed in June 2020.ResultsA total of 600 participants have been enrolled in the trial. We will assess (1) the difference in knowledge scores between baseline and the immediate postintervention assessments in the intervention group and (2) the difference in knowledge scores between the intervention and control groups at baseline, 3 and 6 months post-DHI rollout. Since a randomized design did not prove feasible, potential confounders (eg, age, gender, education, and time of exposure) may be introduced, and results will be adjusted. Data analysis for the 35 qualitative interviews is currently ongoing, and perspectives and experiences related to use and nonuse of the InfoSpots are being explored.ConclusionsThe data have been collected, and the analysis is ongoing in this digital health study, aimed at evaluating the effects of a DHI based on relevant health messages. The publications of results can be expected this year.Trial RegistrationClinicalTrials.gov NCT03808597; https://clinicaltrials.gov/ct2/show/NCT03808597International Registered Report Identifier (IRRID)RR1-10.2196/25128

14. Feasibility of A Digital Video Health Education Program at an Outpatient Hemodialysis Center During A Pandemic

14. Feasibility of A Digital Video Health Education Program at an Outpatient Hemodialysis Center During A Pandemic

Willingness to Use Digital Health Tools in Patient Care Among Health Care Professionals and Students at a University Hospital in Saudi Arabia: Quantitative Cross-sectional Survey.

BackgroundThe adoption rate of digital health in the health care sector is low in many countries. A facilitating factor for successful implementation and adoption of digital health is acceptance by current and future health care professionals.ObjectiveThis study was conducted to identify factors associated with willingness to use digital health tools in patient care among health care professionals and students.MethodsThis was a quantitative cross-sectional survey study conducted among health care professionals and students at a university hospital in Riyadh, Saudi Arabia. A nonprobability convenience sampling procedure was used to recruit participants. Data were collected using a self-completed e-questionnaire that was distributed by email. Chi-square tests, t tests, and logistic regression were used to analyze the data.ResultsWe found that 181 out of 218 health care professionals (83.0%; 75.6% [59/78] physicians; 87.1% [122/140] nurses) and 115 out of 154 students (74.7%; 80.0% [76/95] medical students and 66.1% [39/59] nursing students) were willing to use digital tools in patient care. Willingness to use digital tools was significantly associated with attitude (Adjusted Odds Ratios [AOR] 1.96; 95% CI 1.14-3.36) and self-efficacy (AOR 1.64; 95% CI 1.17-2.30) among health care professionals, and with current year of study (AOR 2.08; 95% CI 1.18-3.68) and self-efficacy (AOR 1.77; 95% CI 1.17-2.69) among students. No significant difference in willingness to use digital tools was found between physicians and nurses (P=.113), and between medical and nursing students (P=.079).ConclusionsThe findings of this study should encourage policy makers and hospital managers to implement relevant eHealth interventions within routine health care systems in Saudi Arabia. For successful implementation, digital health education programs should be implemented simultaneously, so that current and future health care professionals are able to develop required positive attitudes as well as practical skills and competencies.

Possible Ethical Issues of Digital Mental Health Education During and After the COVID-19 Pandemic and How to Prevent Them.

Possible Ethical Issues of Digital Mental Health Education During and After the COVID-19 Pandemic and How to Prevent Them.

Integrated Digital Patient Education at the Bedside for Patients with Chronic Conditions: Observational Study.

BackgroundPatient education delivered by a health care provider increases patients’ understanding and adherence to medical instructions, which helps to improve patient health. Multiple challenges exist to delivering effective patient education to patients with multiple chronic conditions, including giving the necessary time, range, and types of learning materials, and assessing the level of understanding. To help overcome these challenges, it is important to study new electronic means to assist in patient education, such as the use of mobile devices, interactive media, 3-dimensional images, and multimedia educational content at the bedside.ObjectiveThe goal of this study was to address the need for blended learning strategies combining technical and workflow integration of digital patient education systems for patients with chronic conditions within and across the regular process of care. Studies are needed to evaluate the utility and benefits of these technologies for providers and patients alike.MethodsA mixed-methods approach was employed including survey administration to 178 patients after they received digital patient education in person with a health care provider, and qualitative interviews with 16 nurse educators who used the mobile digital health education technology to deliver instruction to patients. Patient survey data were analyzed using chi-square statistical tests. Qualitative interviews were analyzed for user acceptance and perceived value themes.ResultsPatients who were counseled using a blended digital health education approach reported improved understanding of educational content (P=.034) and chronic health conditions (P<.001), were more motivated to care for themselves at home (P<.001), were more likely to say that they felt capable of making health care decisions with their doctors (P<.001) and on their own (P=.001), and were more likely to report their intention to follow their doctor’s instructions (P<.001) than were patients whose education was not computer-based. Nurse educators felt that the digital education system and content enhanced their education efforts and could be easily integrated into the outpatient clinical workflow.ConclusionsPatient education for individuals with chronic conditions may be more effective than traditional formats when provided in blended digital formats supervised by a health care provider.

Mitigating COVID-19 Impact on the Portuguese Population Mental Health: The Opportunity That Lies in Digital Mental Health.

COVID-19 mitigation measures present unprecedented challenges in mental healthcare delivery, posing high risk to the mental health of at-risk populations, namely patients diagnosed with COVID-19, frontline healthcare providers, and those submitted to quarantine or isolation measures, as well as the general population. Ensuring safe and equitable access to mental healthcare by these groups entails resorting to innovative psychosocial intervention strategies, such as digital mental health. In this perspective piece, we describe the impact of COVID-19 on the Portuguese population's mental health, present an overview on initiatives developed to address the challenges currently faced by the Portuguese mental healthcare system, and discuss how the timely implementation of a comprehensive digital mental health strategy, coupling research, education, implementation, and quality assessment initiatives, might buffer COVID-19's impact on the Portuguese society.

Undergraduate Medical Competencies in Digital Health and Curricular Module Development: Mixed Methods Study.

BackgroundOwing to an increase in digital technologies in health care, recently leveraged by the COVID-19 pandemic, physicians are required to use these technologies appropriately and to be familiar with their implications on patient care, the health system, and society. Therefore, medical students should be confronted with digital health during their medical education. However, corresponding teaching formats and concepts are still largely lacking in the medical curricula.ObjectiveThis study aims to introduce digital health as a curricular module at a German medical school and to identify undergraduate medical competencies in digital health and their suitable teaching methods.MethodsWe developed a 3-week curricular module on digital health for third-year medical students at a large German medical school, taking place for the first time in January 2020. Semistructured interviews with 5 digital health experts were recorded, transcribed, and analyzed using an abductive approach. We obtained feedback from the participating students and lecturers of the module through a 17-item survey questionnaire.ResultsThe module received overall positive feedback from both students and lecturers who expressed the need for further digital health education and stated that the field is very important for clinical care and is underrepresented in the current medical curriculum. We extracted a detailed overview of digital health competencies, skills, and knowledge to teach the students from the expert interviews. They also contained suggestions for teaching methods and statements supporting the urgency of the implementation of digital health education in the mandatory curriculum.ConclusionsAn elective class seems to be a suitable format for the timely introduction of digital health education. However, a longitudinal implementation in the mandatory curriculum should be the goal. Beyond training future physicians in digital skills and teaching them digital health’s ethical, legal, and social implications, the experience-based development of a critical digital health mindset with openness to innovation and the ability to assess ever-changing health technologies through a broad transdisciplinary approach to translate research into clinical routine seem more important. Therefore, the teaching of digital health should be as practice-based as possible and involve the educational cooperation of different institutions and academic disciplines.

Evidence-based reporting, methods and content of allergy-specific digital training programs

Abstract Background The World Allergy Organization frames allergies as a “major global public health issue”, due to the consistently high prevalence of, e.g., allergic rhinitis (up to 30%). Digital training programs (DTPs) may help fostering self-management and provide allergy-specific information, given, for instance, their good accessibility. We aimed to assess an exploratory sample of allergy-specific, interactive and feedback-oriented DTPs towards the extent to which these tools meet established criteria for the reporting, methods, and content of evidence-based (digital) health information. Methods We searched for DTPs via scientific databases and online sources and developed a checklist from established scientific guidelines for digital health information. The checklist contained 44 items covering 11 domains related to content (e.g. evidence-base), structure (e.g. trainer qualification) and impact (e.g. user perspective). Results 15 DTPs covered an average of 37% of the items (score 33/88). Items relating to intervention (58%), content (49%), and data safety (60%) were frequently considered, as opposed to user safety (10%), qualification of staff (10%), effectiveness (16%), and user perspective (45%). In 13 of 15 DTPs, a minimum of 3 domains were not covered at all. Regarding evidence-based content, 46% scored on use of scientific research, 53% on regular information update, and 33% on provision of references. Conclusions Allergy-specific DTPs conform only partly to established criteria for evidence-based (digital) health information and education. The named methodological and content-wise shortcomings pose considerable obstacles for users. While there have been related, general criticisms earlier, this study provides empirical evidence via the example of allergy-specific DTPs. Key messages For DTPs to add value, service providers and health information experts need to cooperate much closer to reduce the 'reporting vs. requirements' gap. Cooperation is also needed to agree essential methodological and content-wise features of DTPs and similar services.

Digital module of a complex school-based health education program tries to maintain equality

Abstract Issue Health education of adolescents requires digital communication channels besides the traditional interpersonal setting. Use of e-learnings can be beneficial in multiple aspects when targeting positive health behavior change. Description A complex, school-based health education program is operated by Semmelweis University in a North-Hungarian town, Balassagyarmat, given, that the vast majority of students have proper internet access. Ongoing peer education is completed by e-learning modules in order to improve the continuity of the program, repeat key statements, deliver more information and create a private channel to discuss intimate issues. The online system was built on novel educational techniques in gamification and rewarding to enhance motivation and engagement of participants. The same e-learning modules are available for all students from different type of education and sociocultural background. We try to assess if this concept provides equality. Results 41 multimedia e-learning modules consisting of 12 types of interactive game-like activities has been developed in 10 topics. Each of them are used by around 60-70% of the participants of the program (about 240 students per year). High school students showed slight difference from vocational school students in activity and in performance. According to their feedback, pupils welcome this channel regardless to their type of education. Lessons While developing the digital health education program based on new pedagogical methods, the concept was not modified for students of different school types, but all of them participated in the same educational and rewarding system. We believe, that the project trends to maintain equality. Key messages Multimedia digital modules are favorable in health education for adolescents. Health education statements can be the same for students of different educational settings.

Engaging parents in digital sexual and reproductive health education: evidence from the JACK trial

BackgroundResearch evidence and international policy highlight the central role that parents play in promoting positive sexual behaviour and outcomes in their children, however they can be difficult to engage in sexual and reproductive health (SRH) education programmes. Digital health promotion that uses online and mobile technologies (OMTs) to promote parent-child communication may offer an innovative solution to reach parents, however, few programmes have used OMTs to involve parents in SRH, and none have reported lessons learned in relation to optimising engagement. This study addresses this gap in the literature by reporting acceptability and feasibility of using OMTs to engage parents in SRH education. Findings will be relevant for those wishing to develop and implement digital SRH programmes with parents internationally.MethodsThe Jack Trial is a UK-wide cluster randomised controlled trial recruiting over 8000 adolescents from 66 socially and religiously diverse post-primary schools. An embedded mixed-methods process evaluation explored user engagement with parent components of the If I Were Jack SRH education programme, which include online animated films and a parent-teen homework exercise.ResultsA total of 109 adolescents, teachers, parents and SRH policy experts took part in semi-structured interviews and focus groups, 134 parents responded to an online survey, and 3179 adolescents completed a programme engagement and satisfaction questionnaire. Parents who accessed the materials were positive about them; 87% rated them as ‘good or excellent’ and 67% said they helped them have conversations with their child about SRH. Web analytics revealed that 27% of contacted parents accessed the digital materials, with 9% viewing the animated films. Only 38% of teachers implemented the homework exercise, mainly because they assumed that students would not complete it or it might result in backlash from parents.ConclusionsWhile digital parental materials show promise for engaging parents in SRH education, this study suggests that in order to optimise engagement, parental components that give parents the necessary skills to have conversations with their children about sex should be coupled with efforts to increase school and teacher confidence to communicate with parents on sensitive topics.Trial registrationISRCTN99459996.

Perceptions of Digital Health Education Among European Medical Students: Mixed Methods Survey.

BackgroundDigital health technologies hold promise to enhance patient-related outcomes, to support health care staff by reducing their workload, and to improve the coordination of care. As key users of digital health technologies, health care workers are crucial to enable a meaningful digital transformation of health care. Digital health literacy and digital skills should become prerequisite competencies for health professionals to facilitate the implementation and leverage the potential of digital technologies to improve health.ObjectiveWe aimed to assess European medical students’ perceived knowledge and opinions toward digital health, the status of digital health implementation in medical education, and the students’ most pressing needs.MethodsThe explanatory design of our mixed methods study was based on an online, anonymous, self-administered survey targeted toward European medical students. A linear regression analysis was used to identify the influence of the year of medical studies on the responses. Additional analysis was performed by grouping the responses by the self-evaluated frequency of eHealth technology use. Written responses to four qualitative questions in the survey were analyzed using an inductive approach.ResultsThe survey received a total of 451 responses from 39 European countries, and there were respondents for every year of medical studies. The majority of respondents saw advantages in the use of digital health. While 40.6% (183/451) felt prepared to work in a digitized health care system, more than half (240/451, 53.2%) evaluated their eHealth skills as poor or very poor. Medical students considered lack of education to be the reason for this, with 84.9% (383/451) agreeing or strongly agreeing that more digital health education should be implemented in the medical curriculum. Students demanded introductory and specific eHealth courses covering data management, ethical aspects, legal frameworks, research and entrepreneurial opportunities, role in public health and health systems, communication skills, and practical training. The emphasis lay on tailoring learning to future job requirements and interprofessional education.ConclusionsThis study shows a lack of digital health-related formats in medical education and a perceived lack of digital health literacy among European medical students. Our findings indicate a gap between the willingness of medical students to take an active role by becoming key players in the digital transformation of health care and the education that they receive through their faculties.

Medical students’ perceptions and expectations regarding digital health education and training: A qualitative study

Introduction Digital health – the convergence of digital technologies within health and health care to enhance the efficiency of health-care delivery – is fast becoming an integral part of routine medical practice. The integration of digital health into traditional practice brings significant changes. Logic dictates that for medical practitioners to operate in this new digitally enabled environment, they require specific knowledge, skills and competencies relating to digital health. However, very few medical programmes in Australia and globally include digital health within their regular curriculum. This pilot study aimed to explore medical students’ perceptions and expectations of digital health education and training (ET). Methods An online survey and focus groups were used to collect information about medical students’ perceptions and expectations relating to digital health and ET relating to this field within the medical programme at the University of Queensland. Sixty-three students took part in the survey, and 17 students were involved in four focus groups. Results Most participants had no formal ET in digital health. Most participants (n = 43; 68%) expressed a willingness to learn about digital health as part of their medical programme. Discussion Primarily, knowledge- and practice-related factors have motivated students to learn about digital health. The analysis of focus group data identified two superordinate themes: (a) drivers of digital health ET and (b) expectations relating to digital health ET. Students agreed that digital health is a relevant field for their future practice that should be taught as part of their regular curriculum.

Indian Dermatologists Wield Technology to Combat COVID-19!

Indian Dermatologists Wield Technology to Combat COVID-19!

Effects of the Digital Game “Fit, Food, Fun” on Nutritional Knowledge: A Pilot Study among German Children and Adolescents

AbstractIntroduction:Serious games are a novel and entertaining approach for digital health education in the younger population. Aim of this pilot study was to evaluate the short-term effectiveness of the serious game “Fit, Food, Fun” (FFF) among a subset of children and adolescents in Germany with regard to nutritional knowledge.Materials and Methods:Two Bavarian secondary schools were each allocated to one intervention arm. The gameplay intervention (gameplay group; GG) consisted of a 15-minute gameplay session for each of three days (Tuesday to Thursday), while the teaching intervention (teaching group; TG) was performed as a 15-minute classic lecture for the same number of days. Given nutritional information was based on the recommendations of the “German Nutrition Society e.V.” and was identical for both intervention groups. Nutritional knowledge was evaluated through a standardised questionnaire at baseline (Monday) and post-intervention (Friday). Lifestyle behaviour (diet; physical activity) and anthropometrics (height; weight) were assessed once at baseline. Inclusion criteria were sufficient German language skills and parental consent form. Statistical analyses were performed using the statistical software R (R Core Team, 2018).Results:In total, 47 students (62% male) were assigned to the GG and 47 students (72% male) to the TG. The mean age was 13.5 years in the GG and 12.8 years in the TG. The mean body mass index was in the normal range (GG: 24.4 kg/m2; TG: 22.0 kg/m2). Data at baseline and post-intervention are analysed for 36 participants in the GG and for 40 participants in the TG. Compared to baseline, results revealed significant improvements (p-value &lt; 0.001) in nutritional knowledge in both intervention groups. There was a between-group difference with significantly (p-value = 0.0139) higher increase of nutritional knowledge in the TG.Discussion:This pilot study provides evidence for the short-term efficacy of both game-based and traditional education approaches on the improvement of nutritional knowledge; however, further research in warranted to assess the potential effect of a digital gameplay intervention on nutritional behaviour. Finally, the FFF game might be considered as an appropriate educational tool for imparting nutritional knowledge in an entertaining and effective format among children and adolescents.

How Do Publicly Available Allergy-Specific Web-Based Training Programs Conform to the Established Criteria for the Reporting, Methods, and Content of Evidence-Based (Digital) Health Information and Education: Thematic Content Evaluation.

BackgroundAllergic diseases, such as allergic asthma, rhinitis, and atopic eczema, are widespread, and they are a considerable burden on the health care system. For patients and health care professionals, Web-based training programs may be helpful to foster self-management and provide allergy-specific information, given, for instance, their good accessibility.ObjectiveThis study aimed to assess an exploratory sample of publicly available allergy-specific Web-based training programs—that is, interactive, feedback-oriented Web-based training platforms promoting health behavior change and improvement of personal skills—with regard to (1) general characteristics, aims, and target groups and (2) the extent to which these tools meet established criteria for the reporting, methods, and content of evidence-based (digital) health information and education.MethodsWeb-based training programs were identified via an initial Google search and a search of English and German language websites of medical and public health services, such as the European Centre for Allergy Research Foundation (German), Asthma UK, and Anaphylaxis Canada. We developed a checklist from (1) established guidelines for Web-based health information (eg, the Journal of the American Medical Association benchmarks, DISCERN criteria, and Health On the Net code) and (2) a database search of related studies. The checklist contained 44 items covering 11 domains in 3 areas: (1) content (completeness, transparency, and evidence), (2) structure (data safety and qualification of trainers and authors), and (3) impact (effectiveness, user perspective, and integration into health care). We rated the Web-based training programs as completely, partly, or not satisfying each checklist item and calculated overall and domain-specific scores for each Web-based training program using SPSS 23.0 (SPSS Inc).ResultsThe 15 identified Web-based training programs covered an average of 37% of the items (score 33 out of 88). A total of 7 Web-based training programs covered more than 40% (35/88; maximum: 49%; 43/88). A total of 5 covered 30% (26/88) to 40% (35/88) of all rated items and the rest covered fewer (n=3; lowest score 24%; 21/88). Items relating to intervention (58%; 10/18), content (49%; 9/18), and data safety (60%; 1/2) were more often considered, as opposed to user safety (10%; 0.4/4), qualification of staff (10%; 0.8/8), effectiveness (16%; 0.4/2), and user perspective (45%; 5/12). In addition, in 13 of 15 Web-based training programs, a minimum of 3 domains were not covered at all. Regarding evidence-based content, 46% of all Web-based training programs (7/15) scored on use of scientific research, 53% on regular information update (8/15), and 33% on provision of references (5/15). None of 15 provided details on the quality of references or the strength of evidence.ConclusionsEnglish and German language allergy-specific Web-based training programs, addressing lay audiences and health care professionals, conform only partly to established criteria for the reporting, methods, and content of evidence-based (digital) health information and education. Particularly, well-conducted studies on their effectiveness are missing.

Digital Health Professions Education in the Field of Pediatrics: Systematic Review and Meta-Analysis by the Digital Health Education Collaboration.

BackgroundReducing childhood morbidity and mortality is challenging, particularly in countries with a shortage of qualified health care workers. Lack of trainers makes it difficult to provide the necessary continuing education in pediatrics for postregistration health professionals. Digital education, teaching and learning by means of digital technologies, has the potential to deliver medical education to a large audience while limiting the number of trainers needed.ObjectiveThe goal of the research was to evaluate whether digital education can replace traditional learning to improve postregistration health professionals’ knowledge, skills, attitudes, and satisfaction and foster behavior change in the field of pediatrics.MethodsWe completed a systematic review of the literature by following the Cochrane methodology. We searched 7 major electronic databases for articles published from January 1990 to August 2017. No language restrictions were applied. We independently selected studies, extracted data, and assessed risk of bias, and pairs of authors compared information. We contacted authors of studies for additional information if necessary. All pooled analyses were based on random effects models. We included individually or cluster randomized controlled trials that compared digital education with traditional learning, no intervention, or other forms of digital education. We assessed the quality of evidence using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) criteria.ResultsTwenty studies (1382 participants) were included. Participants included pediatricians, physicians, nurses, and midwives. Digital education technologies were assessed including high-fidelity mannequins (6 studies), computer-based education (12 studies), mobile learning (1 study), and virtual reality (1 study). Most studies reported that digital education was either as effective as or more effective than the control intervention for outcomes including skill, knowledge, attitude, and satisfaction. High-fidelity mannequins were associated with higher postintervention skill scores compared with low-fidelity mannequins (standardized mean difference 0.62; 95% CI 0.17-1.06; moderate effect size, low-quality evidence). One study reported physician change in practicing behavior and found similar effects between offline plus online digital education and no intervention. The only study that assessed impact on patient outcome found no difference between intervention and control groups. None of the included studies reported adverse or untoward effects or economic outcomes of the digital education interventions. The risk of bias was mainly unclear or high. The quality of evidence was low due to study inconsistencies, limitations, or imprecision across the studies.ConclusionsDigital education for postregistration health professions education in pediatrics is at least as effective as traditional learning and more effective than no learning. High-fidelity mannequins were found to be more effective at improving skills than traditional learning with low-fidelity mannequins. Computer-based offline/online digital education was better than no intervention for knowledge and skill outcomes and as good as traditional face-to-face learning. This review highlights evidence gaps calling for more methodologically rigorous randomized controlled trials on the topic.Trial RegistrationPROSPERO CRD42017057793; https://tinyurl.com/y5q9q5o6