Use Of Digital Health Research Articles

Older Adults' Perspectives and Experiences With Digital Health in Singapore: Qualitative Study.

Technology use among older adults is increasingly common. Even though there is potential in leveraging technology to help them manage their health, only a small fraction of them use it for health-related purposes. This study seeks to understand the perspectives of and experiences with digital health (DH) among older adults in Singapore. A total of 16 participants (age range 60-80 years; n=11, 69% female) were interviewed for approximately an hour (range 27-64 minutes) about their health, DH use, and DH experiences. The interviews were recorded, transcribed verbatim, and thematically analyzed. Five main themes emerged from the interview: support in developing DH literacy, credibility, cost and benefit considerations, intrinsic drive to be healthy, and telehealth. Older adults need support in familiarizing themselves with DH. When considering DH options, older adults often relied on credible sources and preferred DH to be free. Monetary incentives were brought up as motivators. The intrinsic drive to live longer and healthily was expressed to be a huge encouragement to use DH to help obtain health-related knowledge and achieve healthy living goals. The idea of telehealth was also appealing among older adults but was seen to be more suited for individuals who have issues accessing a physical clinic. Our findings offer insights into the various aspects that matter to older adults in the adoption of DH, which in turn can help reshape their health-seeking behavior and lifestyle. As such, policy makers and DH implementors are encouraged to take these into consideration and align their strategies accordingly.

Digital Health Utilization in Spinal Cord Injury: A Descriptive Study of a Population-Based Prospective Cohort.

The objective of this study was to describe the use of digital health tools by people with spinal cord injury and associated factors. Cross-sectional data from the 2022 Swiss Spinal Cord Injury Cohort Study (SwiSCI) were analyzed. Descriptive statistics summarized data regarding sociodemographic characteristics, self-management, health, and digital health usage. Multiple logistic regression analysis examined the association of digital health use with reasons of use, concerns, confidence, sociodemographic characteristics, self-management, and comorbidities. Among 961 participants, 69% used digital health tools. Females were 1.79 times more likely to adopt them. People aged 60-70 had 3.84 times higher usage rates than 18-30 yrs old. Longer spinal cord injury duration increased usage by 0.98 times/year. Confidence using digital tools and positive health attitudes predicted usage. Comorbidities were positively correlated with usage. Concerns about digital health utilization had no significant impact. Our study provides one of the first comprehensive descriptions of digital health utilization in spinal cord injury. Its findings shed light on the intricate factors influencing digital health utilization, contribute to a deeper understanding of this patient population, and pave the way for more targeted and effective digital tools and strategies for their uptake.

Utilization Digital Health: Opportunities and Challenges in Enhancing Tuberculosis Treatment

Digital health interventions hold promise for patient-centered care, as they enable remote monitoring of patients and can be used to easily remind patients to take their medications. This study used a literature review technique with research collecting 30 research publications related to the use, opportunities and challenges of digital health in the treatment of tuberculosis. The literature review technique aims to evaluate and analyze previous research to provide context, show gaps in research, and support arguments for the research to be conducted. Several conclusions from this literature review research include: (1) Digital health has a significant role as an intervention in the management of tuberculosis patients. (2) Digital health offers great opportunities to improve the management and treatment of tuberculosis patients. The opportunity for digital health as an intervention for tuberculosis patients is very promising and can have a significant impact on various aspects of managing this disease. (3) Although digital health offers many opportunities for managing tuberculosis, there are also various challenges that must be faced in its implementation, including: challenges of technology access, patient compliance and engagement, data security and privacy, integration with traditional health systems, costs and funding, quality content and information as well as cultural and language barriers.

2.B. Scientific session: Learning from intercountry comparisons in digital healthcare transition monitoring

Abstract In many countries, healthcare is facing several challenges, including increasing healthcare demand, healthcare workforce shortages, rising healthcare costs, and keeping healthcare accessible. It is thought that the use of digital health might help to tackle these challenges. However, digital health programs and interventions are often not (systematically) monitored or evaluated. Monitoring of the digital healthcare transition in countries over time helps policymakers and healthcare professionals to investigate which digital services work well, and which do not, to (partly) solve the experienced challenges. In Europe, several countries monitor the digital healthcare transition within the primary and secondary care in their country. Comparing and sharing the monitoring methodologies between countries and describing the current state of the digital healthcare transition in primary and secondary care, will help to learn from other countries about how digital health could help to tackle the frequently experienced healthcare challenges. During this workshop, three countries throughout Europe (the Netherlands, Italy and Denmark) will briefly share their methodologies used for monitoring the digital healthcare transition in their country and will provide an up-to-date overview of the current state of the digital healthcare transition in primary and secondary care in their country. Challenges, achievements and future plans for the monitoring of this transition will also be shortly discussed in 10-minute presentations. Further, there will be 25 minutes for audience interaction which will be moderated by the chairperson. During this discussion, there is time to hear experiences from other countries and explore best practices in monitoring the digital healthcare transition. Key messages • The digital healthcare transition can be monitored in different ways. Experiences from three European countries may inspire others to organize national monitoring programs. • The speed and nature of the digital healthcare transition differs between European countries. Experiences from three European countries provide insight into state of the art of national transitions.

EHealth profile and care coordination of primary care physicians

Abstract Background Digital health or eHealth is a vast field encompassing mobile health (mHealth), health information technology, wearable devices, telehealth, and telemedicine, and is changing the practice of medicine. While it holds promise for enhancing care coordination, its adoption is hindered by various barriers, including at the healthcare professional level. We assessed the eHealth profile of primary care physicians and its relationship with care coordination. Methods As part of the Commonwealth Fund 2022 IHP survey of primary care physicians, 1114 physicians in Switzerland completed a questionnaire on their digital health use, and care coordination practices. Based on their responses, we built a digital health score, summarizing physicians’ use of digital health tools, and a care coordination score. Associations between both scores were assessed using stratified analyses and multiple linear regression. Results Among 1114 participants (46% women, mean age 52), 83% used electronic patient records, 96% used teleconsultations for less than 5% of consultations, and 63% never used connected health tools for the monitoring of patients with chronic diseases. A total of 16% allowed for online appointments, 20% for online medical prescriptions, 52% for communicating electronically lists of medications with other healthcare professionals, and 89% the possibility of e-mail or web communications with the patient. The eHealth score was positively associated with the number of weekly working hours, being an internal medicine specialist or practicing physician, the number of full-time equivalents in the practice, and with being in a group practice setting. The higher the eHealth profile score, the higher was the care coordination score. Conclusions Physicians’ use of digital health tools was positively associated with care coordination. This could underscore the potential benefits of digital health in enhancing collaborative and interprofessional care practices. Key messages • In a large survey of primary care physicians, the use of digital health tools and care coordination were correlated. • Digital health could enhance collaborative and interprofessional care practices.

Digital health literacy of adults with low reading and writing skills: A mixed-methods study

Abstract Background Around 12% of the adult population living in Germany have low reading and writing skills. Little is known about their digital health literacy and use of digital health technologies. The objectives of the Liter@te study were to assess the digital health literacy of adults with low reading and writing skills and to explore which digital tools they used in everyday life. Methods A cross-sectional survey (n = 96) and five focus groups (n = 39) were conducted with adults aged 18-64 years with low reading and writing skills. Digital health literacy was measured using the eHEALS scale and compared with results from a nationwide sample. Focus group participants completed a task course on digital health information and then discussed their experiences. Survey data were analyzed using descriptive statistics and logistic regression. Qualitative content analysis was applied to analyze the focus group data. Results Survey participants were on average 44 years old, 72% were female and 92% were not born in Germany. Compared to the nationwide survey, use of digital health technologies and digital health literacy were lower. In addition, use of digital health technologies was associated with higher digital health literacy. Lack of technical skills, language problems, and searching and finding health information online were most challenging for focus group participants (mean age 43 years, 87% female). Focus group participants reported that they prefer videos when searching for health information online and seek support from family members or local organizations if they cannot find a solution to their health issue. Conclusions Adults with low reading and writing skills search for health information online, but have difficulties to find the appropriate information. Interventions to promote digital health literacy are needed to ensure that persons with low reading and writing skills are not further left behind. Key messages • Adults with low language skills have a low digital health literacy. • Reading and writing requirements and lack of technical skills make it difficult for them to search health information online.

Primary care physician eHealth profile and care coordination: a cross-sectional study.

Digital health holds promise for enhancing care coordination and supporting patient self-management. However, various barriers, including at the healthcare professional level, hinder its adoption. This cross-sectional study explored the eHealth profile of primary care physicians and its relationship with care coordination. As part of "The Commonwealth Fund's 2022 International Health Policy Survey of Primary Care Physicians in 10 Countries", 1114 physicians in Switzerland completed a questionnaire on their sociodemographic and workplace characteristics, digital health use and care coordination practices. Based on their responses concerning the modality, frequency and application of digital health tools, we created a digital health score. Based on responses describing the collaboration with specialists and paramedical health professionals, we created a care coordination score. The associations between both scores were assessed using stratified analyses and multiple linear regression. Among the 1114 participants (46% women, mean age 52 years), 83% used electronic patient records, 96% used teleconsultations for less than 5% of consultations, and 63% never used connected health tools to monitor patients with chronic diseases. Further, 16% allowed online appointments, 20% online medical prescriptions, 52% the possibility of electronically communicating lists of medications with other healthcare professionals, and 89% the possibility of email or web communications with the patient. The eHealth score was positively associated with the number of weekly working hours, being an internal medicine specialist or practising physician, the number of full-time equivalents in the practice and being in a group practice setting. The higher the eHealth profile score, the higher the care coordination score. Digital health and care coordination were positively associated. This could underscore the potential benefits of digital health in enhancing collaborative and interprofessional care practices.

Digital Health as a Mechanism to Reduce Neonatal Intensive Care Unit Admissions: Retrospective Cohort Study.

Admission to the neonatal intensive care unit (NICU) is costly and has been associated with financial and emotional stress among families. Digital health may be well equipped to impact modifiable health factors that contribute to NICU admission rates. The aim of the study is to investigate how the use of a comprehensive prenatal digital health platform is associated with gestational age at birth and mechanisms to reduce the risk of admission to the NICU. Data were extracted from 3326 users who enrolled in a comprehensive digital health platform between January 2020 and May 2022. Multivariable linear and logistic regression models were used to estimate the associations between hours of digital health use and (1) gestational age at birth and (2) mechanisms to reduce the risk of a NICU admission. Multivariable logistic regression models estimated the associations between (1) gestational age at birth and (2) mechanisms to reduce the risk of a NICU admission and the likelihood of a NICU admission. All analyses were stratified by the presence of any gestational conditions during pregnancy. For users both with and without gestational conditions, hours of digital health use were positively associated with gestational age at birth (in weeks; with gestational conditions: β=.01; 95% CI 0.0006-0.02; P=.04 and without gestational conditions: β=.01; 95% CI 0.0006-0.02; P=.04) and mechanisms that have the potential to reduce risk of a NICU admission, including learning medically accurate information (with gestational conditions: adjusted odds ratio [AOR] 1.05, 95% CI 1.03-1.07; P<.001 and without gestational conditions: AOR 1.04, 95% CI 1.02-1.06; P<.001), mental health management (with gestational conditions: AOR 1.06, 95% CI 1.04-1.08; P<.001 and without gestational conditions: AOR 1.03, 95% CI 1.02-1.05; P<.001), and understanding warning signs during pregnancy (with gestational conditions: AOR 1.08, 95% CI 1.06-1.11; P<.001 and without gestational conditions: AOR 1.09, 95% CI 1.07-1.11; P<.001). For users with and without gestational conditions, an increase in gestational age at birth was associated with a decreased likelihood of NICU admission (with gestational conditions: AOR 0.62, 95% CI 0.55-0.69; P<.001 and without gestational conditions: AOR 0.59, 95% CI 0.53-0.65; P<.001). Among users who developed gestational conditions, those who reported that the platform helped them understand warning signs during pregnancy had lower odds of a NICU admission (AOR 0.63, 95% CI 0.45-0.89; P=.01). Digital health use may aid in extending gestational age at birth and reduce the risk of NICU admission.

Exploring Physicians' Perceptions of Digital Health's Impact on the Patient-Physician Relationship in the Primary Health Care Setting: Qualitative Descriptive Study.

Digital health has become essential for effective clinical practice. However, the successful adoption of digital health is dependent on the strength of the patient-physician relationship. The patient-physician relationship shapes the quality of care and impacts health care outcomes, especially in primary care. However, the impact of the increasing use of digital health on the patient-physician relationship is uncertain. This study aims to explore the types of digital health primary care physicians use and understand their impact on the patient-physician relationship from their perspective. This exploratory qualitative descriptive study used individual in-depth interviews guided by a semistructured topic guide. We purposively sampled physicians from 6 general primary care clinics in Singapore and used thematic analysis to identify emergent themes. We conducted 12 interviews. We found that primary care physicians in Singapore had minimal exposure to digital health beyond the scope of institutional implementation. The three key themes that emerged were as follows: (1) evolving roles of both physicians and patients; (2) impact on trust, knowledge acquisition, and longitudinal care; and (3) adoption and use factors of digital health impacting patient-physician relationships. The adoption and use factors comprised "social and personal," "technical and material," and "organization and policy" factors. The study identified that, while primary care physicians held mostly positive views on adopting digital health in improving the patient-physician relationship, they were concerned that digital health might erode trust, hinder proper knowledge acquisition, and reduce humanistic interaction. These concerns called for a nuanced approach to ensure that digital health would not compromise the patient-physician relationship. This could be achieved by ensuring that physicians possess the necessary skills, knowledge, and positive attitude, while health care organizations would provide robust IT capabilities and support. We recommend that education be refined and government policies on digital health adoption and use be revised to align with the goal of strengthening the patient-physician relationship.

Digital Health Readiness: Making Digital Health Care More Inclusive.

This paper proposes an approach to assess digital health readiness in clinical settings to understand how prepared, experienced, and equipped individual people are to participate in digital health activities. Existing digital health literacy and telehealth prediction tools exist but do not assess technological aptitude for particular tasks or incorporate available electronic health record data to improve efficiency and efficacy. As such, we propose a multidomain digital health readiness assessment that incorporates a person's stated goals and motivations for use of digital health, a focused digital health literacy assessment, passively collected data from the electronic health record, and a focused aptitude assessment for critical skills needed to achieve a person's goals. This combination of elements should allow for easy integration into clinical workflows and make the assessment as actionable as possible for health care providers and in-clinic digital health navigators. Digital health readiness profiles could be used to match individuals with support interventions to promote the use of digital tools like telehealth, mobile apps, and remote monitoring, especially for those who are motivated but do not have adequate experience. Moreover, while effective and holistic digital health readiness assessments could contribute to increased use and greater equity in digital health engagement, they must also be designed with inclusivity in mind to avoid worsening known disparities in digital health care.

Older adults’ preferences in the utilization of digital health and social services: a qualitative analysis of responses to open-ended questions

BackgroundWhile digital health and social services offer promising solutions, they often overlook the perspectives and needs of older adults. This study aims to comprehensively investigate the preferences of older adults regarding the use and development of digital health and social services.MethodsThe survey spanned from 19 March to 31 March 2023. The study population comprised 1100 Finnish individuals aged 75 and over from across Finland. The study used qualitative inductive content analysis to examine the open-ended responses obtained in the survey.ResultsWe identified eight main categories for the older adults’ preferences: usability, service design, and security; training, support, instructions, and information; flexibility of compatible devices; understandable language and interpretation of laboratory results; available and accessible services; desired functionalities; delivery of information for viewing, and personalization.ConclusionsOlder adults’ involvement in digital services’ strategy development is crucial, emphasizing value co-creation and segmentation while avoiding value co-destruction. Segmenting users and understanding their needs aids in customizing services, improving healthcare provision. Further research should assess the impact of segmentation-based training and digital device provision on older adults’ adoption of digital health and social services.

Digital Health Technology Use Across Socioeconomic Groups Prior to and During the COVID-19 Pandemic: Panel Study.

Digital technologies have become more important in the health care sector in the past decades. This transition from conventional to digital health care has been accelerated by the impact of the COVID-19 pandemic, which poses the risk of creating a "digital divide," inadvertently placing those who are older, economically disadvantaged, and have a lower level of education at a disadvantage. This study focuses on the influence of socioeconomic factors on the adoption of digital health technology in the Frisian population and how this relation is affected by the COVID-19 pandemic. In 2019 and 2020, a panel study was conducted on digital health in the Frisian population in the Netherlands. In the survey, the use of digital health technology was operationalized in a broad sense, going beyond the care context by also including preventative health-promoting solutions generally available on the consumer market, such as wearables and lifestyle apps. First, to assess the influence of socioeconomic factors on the total use of digital health apps, a generalized linear model was fitted with use of digital health app as the dependent variable and socioeconomic factors as between-subject factors on the 2019 data. Second, to analyze whether the use of separate health apps increased from 2019 to 2020, we conducted chi-square tests on different digital health app types. Third, to examine the influence of COVID-19 on the use of digital health apps, a generalized linear mixed model was fitted with the use of digital health apps as the dependent variable, COVID-19 as the within-subject variable, and socioeconomic factors as between-subject factors. The results indicated that prior to the COVID-19 pandemic, digital health technology use was higher in women, younger people, and those who are well educated and economically more privileged. Moreover, the percentage of people who reported using digital health technology rose from 70% (1580/2258) to 82.5% (1812/2197) due to the COVID-19 pandemic. This increase was significant for all separate types of digital health technology (all P<.001). In addition, we found the interaction effects of COVID-19 with age and education attainment, indicating that the lower total use among older people and people with lower education attainment became slightly less apparent from 2019 to 2020. These findings on the influence of the COVID-19 pandemic on the digital divide indicated that the use of all types of digital health apps increased and that older individuals and people with a lower level of education caught up a little during COVID-19. Future research should gain more insight into this effect and examine whether it persists beyond the COVID-19 pandemic. Additionally, future endeavors should focus on vulnerable groups, ensuring they receive adequate attention to guarantee access to health care, preventative health-promoting solutions, and social services.

“Addressing barriers to digital health readiness among a Latino population”

ObjectiveThere are many potential barriers to an individual's readiness and ability to use telehealth, including technology access, trust and knowledge. This qualitative study was a partnership between Jefferson and Esperanza Health Center (EHC), focused on addressing barriers to digital readiness among the Latino population served by EHC. MethodsWe conducted semi-structured interviews with Latino patients to assess their experiences with technology and willingness to learn more about technology for healthcare. Interviews were transcribed, coded, and analyzed using a content analysis approach. ResultsWe completed 28 interviews. Most interviews (n = 23, 82 %) were conducted in Spanish. Barriers to using health technology included forgetting passwords, platforms not being available in multiple languages, and lacking digital skills. ConclusionParticipants identified a need and interest in receiving support to develop technological skills needed to access health information and engage in digital health services. Future work is needed to develop patient-centered interventions to support the digital health readiness needs of underserved populations. InnovationHealthcare systems and community health organizations can partner to build the capacity of community members to identify barriers in digital health use. These partnerships have the potential to empower communities to create culturally sensitive interventions that aim to increase digital health literacy.

Clinical training and practice of using digital health solutions among healthcare workers in clinical settings during Hajj season.

Digital health solutions are widely used in Saudi Arabia, but training, clinical practice and challenges related to using digital health applications have not been evaluated from the perspective of healthcare workers during the Haj season in Makkah. The current study was planned to explore clinical training, practices and challenges related to the use of digital health among healthcare workers during the Haj season from June to August 2023. Of the 470 subjects, 347(73.8%) were males and 123(26.2%) were females. The overall median age was 40 years (interquartile range: 27-56 years). In the clinical practice of using digital health, 185(39.4%) of the subjects strongly agreed that digital health was useful and beneficial during transportation difficulties, and 167(35.5%) strongly agreed that digital health applications had changed their working routine during the Haj season. Negative outcome expectations were the challenge least reported by 72(15.3%) respondents.

Implementation of a population mental health and wellness text-message service: a mixed-methods study

BackgroundDespite the growing adoption of digital health tools as a means to support mental health, many individuals remain unaware of the variety of mental health resources available to them through this format. To address this knowledge gap, this study advanced the design, development, and implementation of a text-based service called SaskWell to raise awareness of evidence based mental health resources and create more immediate connections to these tools. The two primary objectives of the study were to assess and evaluate the adoption of SaskWell by focusing on user acceptance, satisfaction, and perceived benefit, and to identify factors which contributed to user engagement with the SaskWell text-based service. Both quantitative and qualitative data contributed to the final study results.ResultsThis study utilized a co-designed text-messaging service to provide residents of Saskatchewan an important connection to digital mental health and wellness resources during the height of the COVID-19 pandemic. Using the RE-AIM framework as an implementation guide, four distinct cycles of SaskWell were delivered with modifications to the service in each subsequent cycle based on user engagement, feedback, and the direction of a community advisory group. Quantitative data was collected through user engagement text message response data, along with enrollment and exit surveys, while semi-structured interviews served as the primary means of qualitative data collection. In addition to the quantitative user data, these user interviews resulted in themes exploring motivation to sign-up for the service, perceptions of texting as a mechanism to deliver mental health resources, the impact of SaskWell on mental health and well-being, and beliefs on the future potential of text-based mental health supports.ConclusionsBoth the user engagement survey and the qualitative data supported the worth of ongoing efforts to refine and extend the use of text messaging as a means to engage citizens around the awareness and use of digital mental health and wellness resources. As the pandemic has receded into the background in many peoples’ daily lives, for healthcare providers, and others who continue to be impacted more heavily by the persistent challenges of this global event, this type of service may continue to be timely.

Patient satisfaction and digital health in primary health care: a scoping review protocol.

Using digital health in primary health care (PHC) contributes to reducing costs and travel time, achieving global development goals, improving access, quality and longitudinality of care, and managing health crises. Its evaluation must go beyond the technical-operational aspects to include patient satisfaction, a key element in assessing the quality of care. To identify and map patient satisfaction (expectations, desires, cultural values) about the adoption of digital health strategies and assess their impact on the quality of care in PHC. The review will follow the recommendations proposed by the Joanna's Briggs Institute (JBI) manual, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) and the methodology proposed by Arksey and O'Malley and Levac et al. and will be conducted in nine stages. The search will be conducted in health studies databases (MEDLINE via PubMed, EMBASE, CINAHL, Web of Science, and BVS), gray literature, and preprint repositories (Google Scholar and MedRxiv). Two reviewers will select the studies, and the third will analyze possible conflicts. The inclusion criteria comprise studies that have been made available in their entirety, whether they are primary studies or short communications, as well as the following materials extracted from the gray literature: preprints, manuals, government documents, books, guidelines, theses and dissertations. Exclusion criteria include literature reviews, abstracts, books, conference archives, letters to the editor, duplicates and opinion articles. Data will be analyzed by content analysis and inferential statistics. This protocol is registered on the Open Science Framework (OSF) under DOI 10.17605/OSF.IO/PUJDB. The study aims to understand aspects related to the expectations, desires, and cultural values of patients from different countries, as well as the strengths and critical nodes of the use of digital health on the quality of care in PHC.

Online digital health and informatics education for undergraduate nursing students in China: impacts and recommendations

BackgroundDigital health plays a vital role in healthcare services. Governments in many countries, including China, are increasingly advocating for the appropriate use of digital technologies to address significant health system challenges. It is crucial to incorporate digital health education into the curriculum for future nurses to adapt to the changes in the digital medical system. This study aimed to evaluate the impact of an online Digital Health and Informatics Course in China on the knowledge and comprehension of key digital health and informatics topics, self-assessment of nursing informatics competencies, and satisfaction among undergraduate nursing students. The findings of this study provide recommendations for the design and implementation of future digital health education.MethodsThis study employed a one-group, quasi-experimental mixed-methods design with pre- and post-assessments. The participants received digital health and informatics education through six three-hour online sessions in six interactive days, with online self-learning materials in between. An online quiz and focus group discussions pre- and post the course were designed to evaluate the knowledge and comprehension of key digital health and informatics topics. Also, a validated Chinese version of the Self-assessment of Nursing Informatics Competencies Scale was conducted pre- and post-course to assess self-assessment of nursing informatics competencies. Additionally, all students were invited to participate in an online survey with a performance-focused course evaluation form as well as focus group discussions to gather their feedback on the learning experience and their evaluations of the course.ResultsA total of 24 undergraduate nursing students were enrolled in the course. All students completed all sessions of this course, resulting in an attendance rate of 100%. Additionally, all students completed both pre- and post-assessments. In terms of the knowledge and comprehension of key digital health and informatics topics, scores of the quiz on knowledge assessment improved from the pre-test [mean pretest score: 78.33 (SD 6.005)] to the post-test [mean post-test score: 83.17 (SD 4.86)] upon completion of the course (P < 0.001). Also, students acknowledged that the course enhanced their knowledge and comprehension of informatics and digital health, the benefits of (nursing) informatics in clinical practice, and the role of health care professionals in informatics and digital health. In terms of self-assessment of nursing informatics competencies, scores on nursing informatics attitudes demonstrated significant improvement (P < 0.001). Furthermore, students reported high satisfaction with various aspects of this course, including the opportunity to explore broad horizons in informatics for future careers, engaging in group discussions, and analyzing case studies on the use of informatics and digital health in clinical practice.ConclusionsThis Online Digital Health and Informatics education effectively improved undergraduate nursing students’ knowledge and comprehension of the key digital health and informatics topics, nursing informatics attitudes in the self-assessment of nursing informatics competency with high levels of satisfaction. In order to ensure that future education in digital health and informatics for nursing students is in line with the technological advancements in clinical settings, it is necessary to foster collaboration between medical school training and clinical practice. This collaboration should involve the use of clinical examples to illustrate advanced digital health applications and the inclusion of practical exercises on the use of digital health technology in clinical settings.

Patterns of digital health access and use among US adults: a latent class analysis

BackgroundDigital technologies allow users to engage in health-related behaviors associated with positive outcomes. We aimed to identify classes of US adults with distinct digital technologies access and health use patterns and characterize class composition. Data came from Health Information National Trends Survey Wave 5 Cycles 1–4, a nationally representative cross-sectional survey of US adults (N = 13,993). We used latent class analysis to identify digital technologies access and health use patterns based on 32 ternary variables of behaviors and access to requisite technologies and platforms, including the internet, internet-enabled devices, health monitors, and electronic health records (EHRs). We ran a multinomial logistic regression to identify sociodemographic and health correlates of class membership (n = 10,734).ResultsTen classes captured patterns of digital technology access and health use among US adults. This included a digitally isolated, a mobile-dependent, and a super user class, which made up 8.9%, 7.8%, and 13.6% of US adults, respectively, and captured access patterns from only basic cellphones and health monitors to near complete access to web-, mobile-, and EHR-based platforms. Half of US adults belonged to classes that lacked access to EHRs and relied on alternative web-based tools typical of patient portals. The proportion of class members who used digital technologies for health purposes varied from small to large. Older and less educated adults had lower odds of belonging to classes characterized by access or engagement in health behaviors. Hispanic and Asian adults had higher odds of belonging to the mobile-dependent class. Individuals without a regular healthcare provider and those who had not visited a provider in the past year were more likely to belong to classes with limited digital technologies access or health use.DiscussionOnly one third of US adults belonged to classes that had near complete access to digital technologies and whose members engaged in almost all health behaviors examined. Sex, age, and education were associated with membership in classes that lacked access to 1 + digital technologies or exhibited none to limited health uses of such technologies. Results can guide efforts to improve access and health use of digital technologies to maximize associated health benefits and minimize disparities.

The Use of Digital Health by South Asian Communities: A Scoping Review.

South Asian individuals experience a higher burden of chronic diseases and limited access to health care services compared with their Caucasian peers. Digital health interventions can enhance the delivery of health care, minimize health inequities, and consequently improve health status among minority ethnic groups. However, it is unclear how South Asian people view and perceive the use of digital health technologies to support their health needs. Thus, the aim of this review is to identify South Asian individuals' experiences and attitudes of digital health and explore the barriers and facilitators affecting their use of digital health services.

The use of digital health interventions to deliver prehabilitation in solid organ transplant recipients: are we there yet?

Prehabilitation, defined as preparing the body physically and psychologically for upcoming surgery is of increasing prominence in presurgical care. The aim of this review is to discuss the evidence base around prehabilitation in solid organ transplantation, the use of digital health as a tool to deliver these interventions, and consider future directions. Prehabilitation is of increasing interest as an adjunct to pretransplant care for individuals working up for solid organ transplantation. To date, research has shown that prehabilitation is acceptable and feasible; however, the literature base remains small. The majority of research has been delivered using in-person rehabilitation programmes, and the evidence base utilizing digital health as a means to deliver prehabilitation is limited. To date, the research evidence base in prehabilitation for solid organ transplantation is limited. Evidence in other surgical populations has demonstrated promising results, particularly in aerobic capacity, physical function and postoperative complications. Further high-quality randomized controlled clinical trials are required to strengthen the evidence base, understand how digital health can be harnessed and utilized to deliver multimodal prehabilitation with an aim to see how this may form part of routine care in the solid organ transplantation pathway.