Impact Of Digital Interventions Research Articles

The impact of digital interventions on health insurance coverage for reproductive, maternal, newborn and child health services in Kakamega, Kenya: a cluster randomized controlled trial.

The National Hospital Insurance Fund (NHIF) of Kenya was upgraded to improve access to healthcare for impoverished households, expand universal health coverage (UHC), and boost the uptake of essential reproductive, maternal, newborn and child health (RMNCH) services. However, premiums may be unaffordable for the poorest households. The Innovative Partnership for Universal Sustainable Healthcare (i-PUSH) program targets low-income women and their households to improve their access to and utilization of quality healthcare, including RMNCH services, by providing subsidized, mobile phone-based NHIF coverage in combination with enhanced, digital training of community health volunteers (CHVs) and upgrading of health facilities. This study evaluated whether expanded NHIF coverage increased the accessibility and utilization of quality basic RMNCH services in areas where i-PUSH was implemented using a longitudinal cluster randomized controlled trial in Kakamega, Kenya. A total of 24 pair-matched villages were randomly assigned either to the treatment or the control group. Within each village, 10 eligible households (i.e., with a woman aged 15-49 years who was either pregnant or with a child below 4 years) were randomly selected. The study applied a Difference-in-Difference methodology based on a pooled cross-sectional analysis of baseline, midline and endline data, with robustness checks based on balanced panels and ANCOVA methods. The analysis sample included 346 women, of whom 248 had had a live birth in the 3 years prior to any of the surveys, and 424 children aged 0-59 months. Improved NHIF coverage did not have a statistically significant impact on any of the RMNCH outcome indicators at midline nor endline. Uptake of RMNCH services, however, improved substantially in both control and treatment areas at endline compared to baseline. For instance, significant increases were observed in the number of antenatal care visits from baseline to midline (mean = 2.62 to 2.92) p < 0.01) and delivery with a skilled birth attendant from baseline to midline (mean = 0.91 to 0.97 (p < 0.01). Expanded NHIF coverage, providing enhanced access to RMNCH services of unlimited duration at both public and private facilities, did not result in an increased uptake of care, in a context where access to basic public RMNCH services was already widespread. However, the positive overall trend in RMNCH utilization indicators, in a period of constrained access due to the COVID-19 pandemic, suggests that the other components of the i-PUSH program may have been beneficial. Further research is needed to better understand how the provision of insurance, enhanced CHV training and improved healthcare quality interact to ensure pregnant women and young children can make full use of the continuum of care.

Digital health interventions for suicide prevention among LGBTQ: A narrative review.

Suicidal thoughts and behaviors (STBs) are prevalent within the Lesbian, Gay, Bisexual, Transgender, and Queers (LGBTQ) community, often exacerbated by challenges in accessing care and the perceived stigma and discrimination tied to disclosing one's identity. Digital health interventions that offer psychosocial self-help present a promising platform to reach individuals at risk of STBs, especially those who may not engage with conventional health services. This review aimed to assess the role of digital-based intervention in reducing STBs among LGBTQ individuals. We conducted a systematic literature search from three databases, PsycINFO, PubMed, and CINHAL, from 1st Jan 1990 to 31st December 2023. The review encompassed studies investigating the feasibility, acceptability, and impact of digital interventions on STBs, employing randomized control trials (RCTs), pseudo-RCTs, observational pre-posttest designs, and qualitative studies. Potential bias was evaluated using the McGill Mixed Methods Appraisal Tool (MMAT). Five non-overlapping studies were included, reporting data from 777 participants. The studies featured diverse types of digital interventions, including videos, online writing, and mobile applications. The studies included three RCTs, and two qualitative studies. Across most of these studies, notable enhancements or reductions in the proportion of participants reporting STBs were observed post-intervention, alongside improvements in help-seeking intentions. The findings underscored that the applications used in the studies were engaging, acceptable, and deemed feasible in effectively addressing suicide prevention among the LGBTQ community. Overall, digital interventions were found to be feasible and acceptable in suicide prevention among LGBTQ communities, demonstrating preliminary efficacy in increasing help-seeking behavior when experiencing suicidal thoughts and in reducing STBs. Therefore, advocating for widespread promotion and dissemination of digital health interventions is crucial, particularly in low- and middle-income countries (LMICs) with limited access to health services and heightened barriers to obtaining such services. Further research using fully powered RCT is imperative to assess the efficacy of these interventions.

Impact of digital interventions on the development of TPACK: Interviews, reports, and video simulation among pre-service teachers

Impact of digital interventions on the development of TPACK: Interviews, reports, and video simulation among pre-service teachers

Impact of digital intervention on antenatal paper records: results from audit of antenatal records

Abstract Background Good recordkeeping is important in antenatal care (ANC). The mIRA study aimed to improve ANC quality through tablet-based electronic decision support systems (EDSS). Electronic data entry was implemented alongside existing paper-based ANC records, adding an additional record-keeping requirement for health care providers. This study assesses the impacts of the EDSS on paper-based ANC records. Methods The audit was conducted in 19 primary healthcare facilities in Nepal. We examined pregnant women's records before (n = 136) and after (n = 138) EDSS implementation. For eight selected indicators in the ANC card and ANC register, we estimated the percentage completeness (any value recorded) and agreement (whether values matched), comparing results before and after intervention, additionally examining EDSS records. Results Completeness of paper ANC records was high before intervention (&amp;gt;90% for all indicators, except for tetanus toxoid vaccination). There was general trend towards variables being more complete after implementation of the EDSS for both the ANC card and the ANC register. There was &amp;gt;15% improvement in completeness and in agreement of tetanus toxoid vaccination date records in ANC cards and ANC registers after the intervention. Completeness of variables in the EDSS was low, suggesting recordkeeping in ANC cards and ANC registers was prioritized. Percentage agreement increased slightly in all eight indicators after intervention. Amongst the selected eight indicators, only women's age records showed &amp;gt;90% agreement both before and after the intervention. Conclusions EDSS did not have a negative impact on paper-based ANC records. Digital records are widely being used in high-income countries and the increasing implementation of electronic health records in low-resource settings increases the demand for evidence to understand the feasibility and impacts of digital health interventions in real-world settings. Key messages • The additional recordkeeping required by the EDSS resulted in general improvements in the completeness and agreement of ANC paper records. • Large-scale EDSS implementation should consider how to integrate digital and paper-based records to decrease burden on healthcare providers, and improve the standard of records.

Effects of digital cognitive behavioral therapy for depression on suicidal thoughts and behavior: Protocol for a systematic review and meta-analysis of individual participant data.

Digital cognitive behavioral therapy (i-CBT) interventions for the treatment of depression have been extensively studied and shown to be effective in the reduction of depressive symptoms. However, little is known about their effects on suicidal thoughts and behaviors (STB). Information on the impact of digital interventions on STB are essential for patients' safety because most digital interventions are self-help interventions without direct support options in case of a suicidal crisis. Therefore, we aim to conduct a meta-analysis of individual participant data (IPDMA) to investigate the effects of i-CBT interventions for depression on STB and to explore potential effect moderators. Data will be retrieved from an established and annually updated IPD database of randomized controlled trials investigating the effectiveness of i-CBT interventions for depression in adults and adolescents. We will conduct a one-stage and a two-stage IPDMA on the effects of these interventions on STB. All types of control conditions are eligible. STB can be measured using specific scales (e.g., Beck scale suicide, BSS) or single items from depression scales (e.g., item 9 of the PHQ-9) or standardized clinical interviews. Multilevel linear regression will be used for specific scales, and multilevel logistic regression will be used for treatment response or deterioration, operationalized as a change in score by at least one quartile from baseline. Exploratory moderator analyses will be conducted at participant, study, and intervention level. Two independent reviewers will assess the risk of bias using the Cochrane Risk of Bias Tool 2. This IPDMA will harness the available data to assess the effects (response and deterioration) of i-CBT interventions for depression interventions on STB. Information about changes in STB is essential to estimate patients' safety when engaging in digital treatment formats. We will pre-register this study with the open science framework after article acceptance to ensure consistency between online registration and the published trial protocol.

Digital interventions to improve adherence to maintenance medication in asthma.

Digital interventions to improve adherence to maintenance medication in asthma.

Digital implementation of originally school-based stroke educational programme in Greece due to the COVID-19 pandemic

ABSTRACT This paper describes the digitalization process of an originally school-based educational programme to an online version and confirms its efficacy on teaching young children as well as their parents about stroke symptoms and the necessary actions needed to be taken in the event of a stroke. Forty children (20 children with neurodevelopmental disorders (NDDs) and 20 without NDDs), aged 4–9 years, as well as 35 of these children’s parents (30–50 years old) participated in the study in Greece. All individuals watched 5 educational videos, designed and produced by the Super Grand League Team. Each video had a mean duration of 15 minutes. Most children had no prior knowledge neither in stroke symptoms nor to the appropriate actions after a stroke. Children’s knowledge of stroke symptoms (except the symptom of speech disturbance) and the appropriate actions following stroke improved significantly immediately post training (p < 0.05). Children with NDDs demonstrated no significant differences when compared to their peers without NDDs in regards to the knowledge gains. In the same line, parents showed a significant increase in their knowledge as regards the stroke symptoms (p < 0.001). Only 2 parents (5.7%) knew the correct emergency number before participating in the online programme, while all of them (100%) responded correctly after the programme. The current work using multimodal remote education demonstrates significant improvement in learning about stroke symptomatology and the necessary steps that need to follow. Future work should evaluate the impact of digital interventions in respect of onset-to-door times and stroke outcomes.

The impact of digital interventions on antimicrobial stewardship in hospitals: a qualitative synthesis of systematic reviews.

BackgroundAntimicrobial stewardship (AMS) programmes in hospitals support optimal antimicrobial use by utilizing strategies such as restriction policies and education. Several systematic reviews on digital interventions supporting AMS have been conducted but they have focused on specific interventions and outcomes.ObjectivesTo provide a systematic overview and synthesis of evidence on the effectiveness of digital interventions to improve antimicrobial prescribing and monitoring in hospitals.MethodsMultiple databases were searched from 2010 onwards. Review papers were eligible if they included studies that examined the effectiveness of AMS digital interventions in an inpatient hospital setting. Papers were excluded if they were not systematic reviews, were limited to a paediatric setting, or were not in English.ResultsEight systematic reviews were included for data extraction. A large number of digital interventions were evaluated, with a strong focus on clinical decision support. Due to the heterogeneity of the interventions and outcome measures, a meta-analysis could not be performed. The majority of reviews reported that digital interventions reduced antimicrobial use and improved antimicrobial appropriateness. The impact of digital interventions on clinical outcomes was inconsistent.ConclusionsDigital interventions reduce antimicrobial use and improve antimicrobial appropriateness in hospitals, but no firm conclusions can be drawn about the degree to which different types of digital interventions achieve these outcomes. Evaluation of sociotechnical aspects of digital intervention implementation is limited, despite the critical role that user acceptance, uptake and feasibility play in ensuring improvements in AMS are achieved with digital health.

The impact of digital interventions on help-seeking behaviour for mental health problems: a systematic literature review.

Interventions that facilitate help-seeking could help individuals to get care earlier on which could also help avert some mental health crises. Delivering interventions via a digital format could mitigate some key barriers to mental healthcare. We reviewed the literature for digital interventions which facilitate formal or informal help-seeking for mental health problems. We examined the impact of identified interventions on actual and intended help-seeking and attitudes towards help-seeking. We identified 35 interventions. About half (51%) of studies showed an improvement in at least one help-seeking outcome with the greatest number showing an improvement in help-seeking intentions and the fewest studies showing an improvement in actual behaviour (29%). Findings suggest that interventions that promote active participation and personal involvement through sharing one's own narrative seem to be promising practices to facilitate help-seeking. Our findings suggest digital interventions can improve help-seeking for mental health problems among a range of populations. Given speciality mental health resources are scarce, further research needs to consider how these interventions could best target the most vulnerable groups to link them with mental healthcare and how these interventions might facilitate earlier intervention in a way that might reduce need for crisis care and support.

Estimation of health impact from digitalizing last-mile Logistics Management Information Systems (LMIS) in Ethiopia, Tanzania, and Mozambique: A Lives Saved Tool (LiST) model analysis.

BackgroundDigital health has become a widely recognized approach to addressing a range of health needs, including advancing universal health coverage and achieving the Sustainable Development Goals. At present there is limited evidence on the impact of digital interventions on health outcomes. A growing body of peer-reviewed evidence on digitalizing last-mile electronic logistics management information systems (LMIS) presents an opportunity to estimate health impact.MethodsThe impact of LMIS on reductions in stockouts was estimated from primary data and peer-reviewed literature, with three scenarios of impact: 5% stockout reduction (conservative), 10% stockout reduction (base), and 15% stockout reduction (optimistic). Stockout reduction data was inverted to stock availability and improved coverage for vaccines and essential medicines using a 1:1 conversion factor. The Lives Saved Tool (LiST) model was used to estimate health impact from lives saved in newborns and children in Mozambique, Tanzania, and Ethiopia between 2022 and 2026 across the three scenarios.ResultsImproving coverage of vaccines with a digital LMIS intervention in the base scenario (conservative, optimistic) could prevent 4,924 (2,578–6,094), 3,998 (1,621–4,915), and 17,648 (12,656–22,776) deaths in Mozambique, Tanzania, and Ethiopia, respectively over the forecast timeframe. In addition, scaling up coverage of non-vaccine medications could prevent 17,044 (8,561–25,392), 21,772 (10,976–32,401), and 34,981 (17,543–52,194) deaths in Mozambique, Tanzania, and Ethiopia, respectively. In the base model scenario, the maximum percent reduction in deaths across all geographies was 1.6% for vaccines and 4.1% for non-vaccine medications.InterpretationThis study projects that digitalization of last-mile LMIS would reduce child mortality by improving coverage of lifesaving health commodities. This analysis helps to build the evidence base around the benefits of deploying digital solutions to address health challenges. Findings should be interpreted carefully as stockout reduction estimates are derived from a small number of studies.

Impact of a Digital Intervention on Perceived Stress, Resiliency, Social Support, and Intention to Leave Among Newly Licensed Graduate Nurses: A Randomized Controlled Trial.

The nursing shortage has been deemed a public health crisis as the turnover rate of newly licensed graduate nurses (NLGNs) continues to grow. One of five NLGNs are leaving the profession due to work dissatisfaction and feelings of inadequacy, risking patient safety. A prospective, randomized controlled trial evaluated the impact of a 6-week digital intervention (text messaging) on NLGNs' self-reported stress, resiliency, sense of support, and intention to leave their jobs, organization, and profession. Messages to the experimental group (n = 10) conveyed emotional, esteem, and networking support, and messages to the control group (n = 11) were medical facts. The digital intervention in the form of medical facts increased the control group's sense of social support. Stress, resilience, and intention to leave their jobs, organizations, or profession did not change for either the control or experimental group. A digital intervention, such as text messaging, potentially can increase NLGNs' sense of support during their first year of hire. [J Contin Educ Nurs. 2021;52(8):367-374.].

The Role of Digital Maturity Assessment in Technology Interventions with Industrial Internet Playground

The use of digital technologies such as Internet of Things and advanced data analytics are central in digitally transforming manufacturing companies towards Industry 4.0. Success cases are frequently reported, and there is clear evidence of technology interventions conducted by industry. However, measuring the impact and effect of such interventions on digital maturity and on the organizational adoption can be challenging. Therefore, the research aim of this paper is to explore how the combination of the different methods of Industrial Internet Playground (IIP) pilots, Shadow Infrastructure (SI) and digital maturity assessment can assist in conducting and documenting the technical, as well as organisational, impact of digital interventions. Through an elaborate literature review of existing digital maturity assessment tools and key dimensions in digital transformation, we have developed a digital maturity assessment tool (DMAT), which is presented and applied in the paper to identify digital development areas and to evaluate and document the effects of digital interventions. Thus, the paper contributes with new knowledge of how the IIP pilot and SI combined with digital maturity assessment can support effective, transparent and documented digital transformation throughout an organisation, as explored through theory and a practice case.

Construções Imaginadas: a estética da intervenção digital

Este estudo tem como objetivo analisar o impacto da intervenção digital, tendo como corpus imagens de três filmes com construções criativas, de persuasão e sedução, criando ilusões virtuais: SimOne (Andrew Niccol, 2002),The App (Elisa Fukasa, 2019) e Her (Spike Jonze, 2013). O protagonista de The App é induzido a acreditar que está falando com alguém intrigante; o de Her, apesar de aceitar a virtualidade, deve admitir o fim de sua experiência digital. Em SimOne, a invenção da imagem da atriz convence espectadores, mas por tempo limitado. Apresento como relevantes os conceitos de Peter Weibel (2005) de “post-media computer possibilities”, que Lev Manovich (2001) denomina de “post-media aesthetics”, mas sugiro outra possibilidade, ao aplicar o conceito de “estética da hipervenção”, “hiper” embasado na hiper-realidade de Baudrillard e “venção” como invenção/intervenção digital. A metodologia de base adotada para a análise é a dialética de Hans-Georg Gadamer.Palavras-chave:Estética da Hipervenção. Hiper-realidade. Imagens Virtuais. Pós-mídia. Tecnologias Digitais

22.C. Workshop: Digital interventions in public mental health: current impact and future directions

Abstract As digitalization is permeating all aspects of society, questions arise as to how it can be fruitfully employed to sustain the public health goals of quality, accessibility, efficiency and equity in healthcare and on how digital interventions can contribute to tackle global public health threats. With an estimated prevalence of around 450 million people currently suffering from mental disorders and 1 in 4 people in the world affected at some point in life, mental health care and prevention is recognized by the World Health Organization as a global public health priority. In this workshop we will specifically focus on the use and impact of digital interventions in public metal health. As evidence on the impact of digital preventive interventions are accumulating in the field of mental health, we believe there is urgent need and scope: i) to present a conceptual framework that identifies when and how the different features of digitalization can support the pursue of mental health and well-being at the population and clinical level: from risk factors' identification and control, to primary and secondary prevention, to diagnosis and access to care, to compliance to treatment, ii) to retrieve, pool and critically appraise the available evidence on the adoption, application and impact of digital solutions to the above, and iii) to collect and share best practices at the European and global level that can be replicated, adapted and scaled up in different socio-demographic and epidemiological settings, for different mental health disorders and target populations. The workshop's structure and content aims at accomplishing with the above by: 1) introducing the topic of digitalization in mental health from the perspective of public health, ii) providing three original contributions on three different innovative aspects of the digitalization of public mental health (see below), iii) engaging the audience in a fruitful discussion on the data presented, stimulating the debate around current gaps in knowledge, as well as system and policy barriers to the design, implementation and evaluation of digital Interventions in public mental health. As detailed in the presentations' abstracts below, the three original contributions will, respectively focus on: 1) the current use of telemedicine for mental health care and prevention, the digital features enabling its adoption and the assessment of its impact on clinical and public health outcomes, 2) the potential offered by digital biomarkers in defining digital phenotyping so as to inform personalized prevention and care in mental health that and 3) technology and mobile health for high-risk populations with the presentation of selected best practices. Key messages Digital interventions are supporting mental health care and prevention in different settings. The impact of digital interventions for mental health needs to be measured.

Virtual social enterprise: modeling sustainability of an enterprise by digital intervention

PurposeSocial enterprises (SEs) have emerged as a tool to sustainable development. SEs create a social value along with an economic value. However, the aspect of SEs still missing from literature is the process of virtualization. The purpose of this paper is to introduce international social entrepreneurship as an emerging form of social entrepreneurship that is using information and communication technology (ICT)-enabled innovation and networking with international partners as virtual enterprise network, to create social and economic values across the borders.Design/methodology/approachIn this paper, qualitative research paradigm is adopted to study the internationalization of SEs. To identify the drivers of internationalization, in-depth literature review was conducted. Articles from six databases and Google Scholar were searched to propose a comprehensive model for internationalization of SEs.FindingsThere is limited academic work on the use and impact of digital intervention (ICTs) on SEs and, especially, on the virtualization of SEs as there is no paper explaining virtualization of SEs. This paper proposes a model for the internationalization of SEs, named virtual social enterprise.Research limitations/implicationsThe conceptual models and discussions on the virtualization of SEs are very limited in the extant literature. Very few articles could be found that studied the process of internationalization of SEs. Thus, the paper would have far-reaching implications for social enterprise theory and practice.Originality/valueThis is first study of its kind proposing a comprehensive theoretical model for internationalization of SEs. This model could be used by SEs for networking across international boundaries to control the flow of information and to market their products.

Protocol of an open, three-arm, individually randomized trial assessing the effect of delivering sexual and reproductive health information to young people (aged 13\u201324) in Kenya and Peru via mobile phones: adolescent/youth reproductive mobile access and delivery initiative for love and life outcomes (ARMADILLO) study stage 2

BackgroundYoung people face special challenges to accessing needed sexual and reproductive health (SRH) information and support. With high penetration and access, mobile phones provide a new channel for reaching young people, but there is little evidence around the impact of digital interventions on improving health outcomes. The Adolescent/Youth Reproductive Mobile Access and Delivery Initiative for Love and Life Outcomes (ARMADILLO) study will assess the effect of an intervention providing SRH information to young people via text message on their mobile phones in Kenya and Peru. This protocol details an open, individually-randomized, three-arm trial lasting seven weeks to assess the effect of the ARMADILLO intervention on dispelling myths and misconceptions related to contraception. A secondary objective is to determine whether youth given access to SRH information via text message can accurately retain that information.MethodsFollowing a household enumeration, one eligible youth per household will be randomly selected for participation and randomized by computer into one of the three arms. Intervention arm participants will receive access to ARMADILLO content, control participants will receive no information, and ‘Arm 3’ participant interactions will vary by site: in Kenya, they will be alerted to various SRH domains and encouraged to learn on their own; in Peru, they will receive key content from each domain with the option to learn more if they wish. Participants will complete multiple-choice questionnaires administered by data collectors at baseline (prior to randomization), at intervention-period end (after week seven), and eight weeks after timing out of the intervention period.DiscussionPart of the Sustainable Development Goal commitment towards ensuring healthy lives and promoting well-being for all at all ages includes a commitment to ‘ensuring universal access to sexual health and reproductive health-care services, including for family planning, information and education’. If proven to be effective, interventions like ARMADILLO can bridge an important gap towards achieving universal access to SRH information and education for an otherwise difficult-to-reach group.Trial registrationThis trial was retrospectively registered with the ISRCTN Registry and assigned registration number ISRCTN85156148 on 29 May, 2018.