scholarly journals The experiences, needs and barriers of people with impairments related to usability and accessibility of digital health solutions, levels of involvement in the design process and strategies for participatory and universal design: a scoping review

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Silje Havrevold Henni ◽  
Sigurd Maurud ◽  
Kristin Skeide Fuglerud ◽  
Anne Moen

Abstract Objective Globally, the number of digital health solutions is increasing, but they are not always designed with access and utilisation for people with impairments in mind. Development efforts have often not included the voice and requirements of people with impairments, who make up 15% of the world’s population, despite the fact that this can help ensure broad access and utilisation. Little attention to and limited inclusion of people with impairments in the development of digital health solutions results in continued and reinforced inequalities in health services provision for people with impairments. This review investigates the needs and barriers of people with impairments related to use of digital health solutions and strategies to foster user participation, access and utilisation of digital health solutions. Methods This scoping review, based on the Joanna Briggs Institute Manual, had five phases: 1) identification of aim and research questions, 2) literature search in five databases (April/May 2020), 3) literature screening based on predetermined inclusion and exclusion criteria, 4) data extraction, and (5) reporting results. Results The literature search resulted in 5968 sources, of which 25 met our inclusion criteria. People with impairments appreciate digital health solutions that are designed to meet their specific impairment-related challenges. The reported needs and barriers related to technological design varied depending on the individuals’ challenges. The literature reported different types of participatory co-design strategies to foster access and utilisation of digital health solutions. Conclusion This scoping review support needs for increased awareness among developers to design solutions that meet people’s needs, contexts and states of health. By applying universal design as a strategy and including people with different types of impairments, starting in the idea creation phase of digital health solutions and throughout the development, developers can design solutions with better accessibility. Digital health solutions that are accessible and usable have a tremendous opportunity to foster health equity and achieve health promotion, prevention and self-care. This in turn can contribute to closing the gap between different population groups, reduce disparities and get the most from available healthcare services.

2021 ◽  
Author(s):  
Maria Brenner ◽  
Arielle Weir ◽  
Margaret McCann ◽  
Carmel Doyle ◽  
Mary Hughes ◽  
...  

BACKGROUND Development of the Key Performance Indicators for Digital Health Interventions: A Scoping Review OBJECTIVE Digital health interventions (DHIs) offer new methods for delivering healthcare, with the potential to innovate healthcare services. Key performance indicators (KPIs) play a role in evaluation, measurement, and improvement in healthcare quality and service performance. The scoping review question was developed following an initial search to identify literature to assist in the development of KPIs for an ongoing DHI initiative. During the initial search, it became clear that there was limited literature on how to develop specific and measurable KPIs that evaluate DHIs. The aim of this scoping review was to identify current knowledge and evidence surrounding the development of KPIs for DHIs. METHODS A rigorous literature search was conducted across ten key databases: AMED - The Allied and Complementary Medicine Database, CINAHL Complete, Health Source: Nursing/Academic Edition, MEDLINE, APA PsycINFO, EMBASE, EBM Reviews - Cochrane Database of Systematic Reviews, EBM Reviews - Database of Abstracts of Reviews of Effects, EBM Reviews - Health Technology Assessment, and IEEE Xplore. A descriptive summary of the literature was performed, and thematic analysis identified important or reoccurring themes. RESULTS Five references (representing four unique publications) were eligible for the review. Of the four included publications, two were articles on original research studies of a specific DHI, and two were overviews of methods for developing DHIs (not specific to a single DHI). All the included reports discussed the involvement of stakeholders in developing KPIs for DHIs. The step of identifying and defining the KPIs was completed using various methodologies, but all centered on a form of stakeholder involvement. Potential options for stakeholder involvement for KPI identification include the use of an elicitation framework, a factorial survey approach, or a Delphi study. Most of the included articles recognised the lack of literature relating to KPI development for DHIs, compared to the breath of literature available on the development of KPIs in other fields like health or informatics CONCLUSIONS Few articles were identified, highlighting a significant gap in the evidence-based knowledge in this domain. All the included articles discussed the involvement of stakeholders in developing KPIs for DHIs, which was performed using various methodologies. The articles acknowledged a lack of literature related to KPI development for DHIs. To allow comparability between KPI initiatives and facilitate work in the field, further research would be beneficial to develop a common methodology for KPI development for DHIs.


2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Dinesh Visva Gunasekeran ◽  
Rachel Marjorie Wei Wen Tseng ◽  
Yih-Chung Tham ◽  
Tien Yin Wong

AbstractThe coronavirus disease 2019 (COVID-19) pandemic has overwhelmed healthcare services, faced with the twin challenges in acutely meeting the medical needs of patients with COVID-19 while continuing essential services for non-COVID-19 illnesses. The need to re-invent, re-organize and transform healthcare and co-ordinate clinical services at a population level is urgent as countries that controlled initial outbreaks start to experience resurgences. A wide range of digital health solutions have been proposed, although the extent of successful real-world applications of these technologies is unclear. This study aims to review applications of artificial intelligence (AI), telehealth, and other relevant digital health solutions for public health responses in the healthcare operating environment amidst the COVID-19 pandemic. A systematic scoping review was performed to identify potentially relevant reports. Key findings include a large body of evidence for various clinical and operational applications of telehealth (40.1%, n = 99/247). Although a large quantity of reports investigated applications of artificial intelligence (AI) (44.9%, n = 111/247) and big data analytics (36.0%, n = 89/247), weaknesses in study design limit generalizability and translation, highlighting the need for more pragmatic real-world investigations. There were also few descriptions of applications for the internet of things (IoT) (2.0%, n = 5/247), digital platforms for communication (DC) (10.9%, 27/247), digital solutions for data management (DM) (1.6%, n = 4/247), and digital structural screening (DS) (8.9%, n = 22/247); representing gaps and opportunities for digital public health. Finally, the performance of digital health technology for operational applications related to population surveillance and points of entry have not been adequately evaluated.


BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e053871
Author(s):  
Anam Shahil Feroz ◽  
Komal Valliani ◽  
Hajra Khwaja ◽  
Sehrish Karim

IntroductionCOVID-19 has significantly affected community health workers’ (CHWs) performance as they are expected to perform pandemic-related tasks along with routine essential healthcare services. A plausible way to optimise CHWs’ functioning during this pandemic is to couple the efforts of CHWs with digital tools. So far, no systematic evidence is available on the use of digital health interventions to support CHWs in low-middle-income countries (LMICs) amid the COVID-19 pandemic. The article describes a protocol for a scoping review of primary research studies that aim to map evidence on the use of unique digital health interventions to support CHWs during COVID-19 in LMICs.Methods and analysisOur methodology has been adapted from scoping review guidelines provided by Arksey and O’Malley, Levac et al. and the Joanna Briggs Institute. Our search strategy has been developed for the following four main electronic databases: Excerpta Medica Database, Medical Literature Analysis and Retrieval System Online, Cochrane Central Register of Controlled Trials and Cumulated Index to Nursing and Allied Health Literature. Google Scholar and reference tracking will be used for supplementary searches. Each article will be screened against eligibility criteria by two independent researchers at the title and abstract and full-text level. The review will include studies that targeted digital health interventions at CHWs’ level to provide support in delivering COVID-19-related and other essential healthcare services. A date limit of 31 December 2019 to the present date will be placed on the search and English language articles will be included.Ethics and disseminationFormal ethical approval is not required, as primary data will not be collected in this study. The results from our scoping review will provide valuable insight into the use of digital health interventions to optimise CHWs’ functioning and will reveal current knowledge gaps in research. The results will be disseminated through journal publications and conference presentations.


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Nora Bakaa ◽  
Lu Hsi Chen ◽  
Lisa Carlesso ◽  
Julie Richardson ◽  
Luciana Macedo

Abstract Objective The aim of this study was to evaluate the completeness of reporting of exercise adherence and exercise interventions delivered as part of clinical trials of post-operative total knee replacement (TKA) rehabilitation. Design: Scoping review Literature search A literature search was conducted in PubMed, EMBASE, AMED, CINAHL, SPORTDiscus and Cochrane Library. Study selection criteria All randomized controlled trials (RCT) that examined post-operative exercise-based interventions for total knee arthroplasty were eligible for inclusion. Studies that were multifactorial or contained exercise interventions for both hip and knee arthroplasty were also included. Data synthesis The definition, type of measurement used and outcome for exercise adherence were collected and analyzed descreptively. Quality of reporting of exercise interventions were assessed using the Consensus for Exercise Reporting Tool (CERT) and the Cochrane Risk of Bias Tool. Results There were a total of 112 RCTs included in this review. The majority of RCTs (63%, n = 71) did not report exercise adherence. Only 23% (n = 15) of studies provided a definition of adherence. RCTs were of poor quality, with 85% (n = 95) of studies having high or unclear risk of bias. Reporting of exercise interventions was poor, with only 4 items (of 19) (21%) of the CERT adequately reported (88–99%), with other items not fulfilled on at least 60% of the RCTs. There were no RCTs that had fulfilled all the criteria for the CERT. Conclusion The RCTs included in this study poorly reported exercise adherence, as well as description of the post-operative TKA rehabilitation intervention. Future RCTs should use valid and reliable measures of adherence and a proper tool for reporting of exercise interventions (e.g., CERT, TiDER). Pre-registration OSF:https://osf.io/9ku8a/


2020 ◽  
Author(s):  
Matthew Vaughan ◽  
Troy McGowan ◽  
Greg Mahoney

ABSTRACT Introduction The occurrence of dental emergencies, now termed as dental disease nonbattle injuries (D-DNBIs), has long been an impacting factor on militaries’ operational effectiveness. Owing to D-DNBIs contributing to low morale, the removal of personnel from duty, causing logistical hardships, and requiring deployable dental teams to operate in theater, there remains a significant benefit in the reduction in the occurrence of D-DNBIs. No study to date has reviewed D-DNBI rates specific to a modern military, and insight into whether militaries are seeing improvements in their dental preparedness remains to be gained. Materials and Methods A scoping review was conducted in accordance with the guidelines set out by Joanna Briggs Institute. Databases searched included SCOPUS, PubMed, OVID, and DOSS. Six hundred and one articles were initially screened, and six articles were included in the final review. Results A D-DNBI rate of 172 per 1,000 members per year was reported across the coalition, with the U.S., UK, and French militaries reporting on their dental experience. Both the French data and one UK study reported significantly higher D-DNBIs than their U.S. counterparts, who described 124 D-DNBIs per 1,000 members per year. A significant proportion of these D-DNBIs were reported to be “preventable,” which raises questions on the efficacy of garrison healthcare services. Dental disease nonbattle injury rates appear to be largely consistent with what was first reported decades ago, and there remains ongoing and significant value in expeditionary dental services providing supportive healthcare for any deployed military personnel. Conclusion Rates of D-DNBIs appear to be stable with what was historically reported when an international coalition is considered, with national variation. There remains a significant number of D- DNBIs which require dental treatment within the operational theater, and further efficiencies can be gained from predeployment treatment of “preventable” D-DNBIs.


Author(s):  
Endurance Uzobo ◽  
Aboluwaji D Ayinmoro

Background As it is common with the most devastating events in the world, women always seem to be at the most disadvantage position. This situation manifested during the period of COVID-19 lockdown throughout the world and Africa in particular. The purpose of this study is to explore Domestic Violence (DV) cases in African during the COVID-19 lockdown. Methods Data for this study were gleaned from an electronic literature search using various databases PubMed and BioMed Central, Web of Science, etc. Key search words were gender DV during and after COVID-19. A total of 68 records were identified during the search. However, only 46 of these sources met the inclusion criteria. Results From the review done in selected African countries which include Egypt, South Africa, Kenya, Nigeria, Ghana and Zimbabwe; it was discovered that COVID-19 lockdown across these countries worsens the already existing cases of DV. The study also noted that generally, the response of the government has been very poor in terms of dealing with DV cases in the period of COVID-19 lockdown. Conclusion The study concluded that despite the failures of government in tackling the DV pandemics, NGOs have been very active in championing the cause of those violated while also trying to provide succour to victims. Thus, the study recommended that countries in Africa need to join international initiatives in prioritising DV cases while trying to deal with the virus itself. Thus, one disease should not be traded for another.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Fernando Santos-Beneit ◽  
Vytautas Raškevičius ◽  
Vytenis A. Skeberdis ◽  
Sergio Bordel

AbstractIn this study we have developed a method based on Flux Balance Analysis to identify human metabolic enzymes which can be targeted for therapeutic intervention against COVID-19. A literature search was carried out in order to identify suitable inhibitors of these enzymes, which were confirmed by docking calculations. In total, 10 targets and 12 bioactive molecules have been predicted. Among the most promising molecules we identified Triacsin C, which inhibits ACSL3, and which has been shown to be very effective against different viruses, including positive-sense single-stranded RNA viruses. Similarly, we also identified the drug Celgosivir, which has been successfully tested in cells infected with different types of viruses such as Dengue, Zika, Hepatitis C and Influenza. Finally, other drugs targeting enzymes of lipid metabolism, carbohydrate metabolism or protein palmitoylation (such as Propylthiouracil, 2-Bromopalmitate, Lipofermata, Tunicamycin, Benzyl Isothiocyanate, Tipifarnib and Lonafarnib) are also proposed.


2021 ◽  
Vol 12 (2) ◽  
pp. 169-187
Author(s):  
Christina J. Pickering ◽  
Maya Dancey ◽  
Karen Paik ◽  
Tracey O’Sullivan

AbstractInformal caregivers are a population currently in the shadows of disaster risk reduction (DRR), and yet essential to the provision of healthcare services. This scoping review explored the literature to understand issues related to informal caregiving and promising practices to support resilience for disasters. Following guidelines for scoping review as outlined by Tricco et al. (2016), relevant publications were identified from five major databases—Medline, Embase, PubMed, Web of Science, and Scopus. Relevant studies referenced informal caregiving and disasters for a variety of population groups including children, people with disabilities or chronic illnesses, and older adults. Studies were excluded if they discussed formal caregiving services (for example, nursing), lacked relevance to disasters, or had insufficient discussion of informal caregiving. Overall, 21 articles met the inclusion criteria and were fully analyzed. Five themes were identified: (1) the need for education and training in DRR; (2) stressors around medication and supply issues; (3) factors affecting the decision-making process in a disaster; (4) barriers leading to disaster-related problems; and (5) factors promoting resilience. Recommended areas of strategic action and knowledge gaps are discussed. Many informal caregivers do not feel adequately prepared for disasters. Given the important role of informal caregivers in healthcare provision, preparedness strategies are essential to support community resilience for those requiring personal care support. By understanding and mobilizing assets to support the resilience of informal caregivers, we also support the resilience of the greater healthcare system and the community, in disaster contexts.


2017 ◽  
Vol 21 (4) ◽  
pp. 308-320 ◽  
Author(s):  
Mark Rubin

Hypothesizing after the results are known, or HARKing, occurs when researchers check their research results and then add or remove hypotheses on the basis of those results without acknowledging this process in their research report ( Kerr, 1998 ). In the present article, I discuss 3 forms of HARKing: (a) using current results to construct post hoc hypotheses that are then reported as if they were a priori hypotheses; (b) retrieving hypotheses from a post hoc literature search and reporting them as a priori hypotheses; and (c) failing to report a priori hypotheses that are unsupported by the current results. These 3 types of HARKing are often characterized as being bad for science and a potential cause of the current replication crisis. In the present article, I use insights from the philosophy of science to present a more nuanced view. Specifically, I identify the conditions under which each of these 3 types of HARKing is most and least likely to be bad for science. I conclude with a brief discussion about the ethics of each type of HARKing.


2012 ◽  
Vol 134 (11) ◽  
Author(s):  
Seung Ki Moon ◽  
Daniel A. McAdams

Companies that generate a variety of products and services are creating, and increasing research on, mass-customized products in order to satisfy customers’ specific needs. Currently, the majority of effort is focused on consumers who are without disabilities. The research presented here is motivated by the need to provide a basis of product design methods for users with some disability—often called universal design (UD). Product family design is a way to achieve cost-effective mass customization by allowing highly differentiated products serving distinct market segments to be developed from a common platform. By extending concepts from product family design and mass customization to universal design, we propose a method for developing and evaluating a universal product family within uncertain market environments. We will model design strategies for a universal product family as a market economy where product family platform configurations are generated through market segments based on a product platform and customers’ preferences. A coalitional game is employed to evaluate which design strategies provide more benefit when included in the platform based on the marginal profit contribution of each strategy. To demonstrate an implementation of the proposed method, we use a case study involving a family of light-duty trucks.


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