Effectiveness of information and communications technology interventions for stroke survivors and their support people: a systematic review

Freund, Megan; Carey, Mariko; Dilworth, Sophie; Waller, Amy; Mansfield, Elise; Rose, Anna; Thienel, Renate; Hyde, Lisa

doi:10.1080/09638288.2021.1913245

Cited by 11 publications

(23 citation statements)

References 44 publications

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“…Web-based interventions require an internet connection delivered via an internet-enabled device and include the receipt of e-mail or access to web pages [ 47 , 49 , 51 , 53 – 62 ]. While all mobile applications require an internet connection, the distinction for a web-based intervention is that the user is expected to access a web page or resource online.…”

Section: Resultsmentioning

confidence: 99%

Do digital health interventions hold promise for stroke prevention and care in Black and Latinx populations in the United States? A scoping review

Rivera,

Nurse,

Shah

et al. 2023

BMC Public Health

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Background Black and Latinx populations are disproportionately affected by stroke and are likely to experience gaps in health care. Within fragmented care systems, remote digital solutions hold promise in reversing this pattern. However, there is a digital divide that follows historical disparities in health. Without deliberate attempts to address this digital divide, rapid advances in digital health will only perpetuate systemic biases. This study aimed to characterize the range of digital health interventions for stroke care, summarize their efficacy, and examine the inclusion of Black and Latinx populations in the evidence base. Methods We searched PubMed, the Web of Science, and EMBASE for publications between 2015 and 2021. Inclusion criteria include peer-reviewed systematic reviews or meta-analyses of experimental studies focusing on the impact of digital health interventions on stroke risk factors and outcomes in adults. Detailed information was extracted on intervention modality and functionality, clinical/behavioral outcome, study location, sample demographics, and intervention results. Results Thirty-eight systematic reviews met inclusion criteria and yielded 519 individual studies. We identified six functional categories and eight digital health modalities. Case management (63%) and health monitoring (50%) were the most common intervention functionalities. Mobile apps and web-based interventions were the two most commonly studied modalities. Evidence of efficacy was strongest for web-based, text-messaging, and phone-based approaches. Although mobile applications have been widely studied, the evidence on efficacy is mixed. Blood pressure and medication adherence were the most commonly studied outcomes. However, evidence on the efficacy of the various intervention modalities on these outcomes was variable. Among all individual studies, only 38.0% were conducted in the United States (n = 197). Of these U.S. studies, 54.8% adequately reported racial or ethnic group distribution. On average, samples were 27.0% Black, 17.1% Latinx, and 63.4% White. Conclusion While evidence of the efficacy of selected digital health interventions, particularly those designed to improve blood pressure management and medication adherence, show promise, evidence of how these interventions can be generalized to historically underrepresented groups is insufficient. Including these underrepresented populations in both digital health experimental and feasibility studies is critical to advancing digital health science and achieving health equity.

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Section: Resultsmentioning

confidence: 99%

Do digital health interventions hold promise for stroke prevention and care in Black and Latinx populations in the United States? A scoping review

Rivera,

Nurse,

Shah

et al. 2023

BMC Public Health

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“…Existing interventions to improve transitional care following stroke mainly focus on the medical aspects of management and functional rehabilitation. 22 – 25 The use of online resources has widened access to post-stroke functional rehabilitation while maintaining its efficacy. 26 However, few data are available on online resources to improve psychological burden among stroke survivors, and/or informal caregivers.…”

Section: Introductionmentioning

confidence: 99%

What are the available online resources targeting psychosocial burden among stroke survivors and their informal caregivers: A scoping review

Delvallée,

Garreau,

Termoz

et al. 2024

DIGITAL HEALTH

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Background After discharge home, stroke survivors and their informal caregivers face a significant lack of support and information which accentuates their psychosocial burden. Online resources might provide this support and address psychosocial needs, but existing online stroke programmes mainly target functional rehabilitation. We aimed to map the existing literature on online resources that have been evaluated in stroke rehabilitation and aimed at reducing psychosocial impact in stroke survivors and informal caregivers. Methods MEDLINE was searched (2010–2024) to identify studies investigating online resources targeting psychosocial health. Studies were selected and extracted independently by two reviewers. We described the content, use, and psychosocial impact of these interventions using a narrative approach. Results Eleven studies were included in the review, reporting 10 online resources (two studies relating to the same resource). Online resources were heterogeneous: eight information/resources websites, one mobile app, and one forum. Five online resources were dedicated to stroke survivors, four to stroke survivors and their informal caregivers, and one to informal caregivers. Two randomized controlled trials reported a significant decrease in depressive symptoms associated with the use of online resources. Stroke survivors and informal caregivers find online resources useful and acceptable to address their psychosocial needs. Conclusions Few online stroke resources have been designed and evaluated to support post-stroke psychosocial rehabilitation. Further larger-scale research needs to study the impact of these interventions on psychosocial recovery over time.

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“…eHealth interventions aimed at reducing cardiovascular risk factors have shown promising results in glycemic control, achieving smoking cessation, diet and weight management, and increasing physical activity, and are generally acceptable and feasible [ 11 - 14 ]. A recent systematic review found that information and communication technology interventions aimed at stroke survivors and their carers are likely to provide some benefit, although the heterogeneity in study design and outcomes measured makes it difficult to draw nuanced conclusions [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

“…A recent cross-sectional survey of stroke survivors (n=248) and carers (n=127) in the United States found that 81% of stroke survivors and 97% of carers had internet access and that smartphones were the most common device used to access the internet [ 25 ]. Beyond this, although information and communication technology interventions aimed at stroke survivors and their carers are likely to provide benefits, there is little information available about how stroke survivors use technology in their day-to-day lives [ 15 ]. A better understanding of this general use would assist in understanding how many people with lived experience of stroke have the potential to engage with eHealth programs or research.…”

Section: Introductionmentioning

confidence: 99%

Access to and Use of Internet and Social Media by Low-Morbidity Stroke Survivors Participating in a National Web-Based Secondary Stroke Prevention Trial: Cross-sectional Survey

Clancy¹,

Bonevski²,

English³

et al. 2022

J Med Internet Res

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Background eHealth applications for stroke are a growing area of research that has yielded promising results. However, little is known about how stroke survivors engage with the internet, social media, and other digital technologies on a day-to-day basis. Objective This study had three main objectives: to describe the type, frequency, and purpose of technology use among a cohort of low-morbidity stroke survivors; to investigate associations between social media use and participant factors, including sociodemographics, physical function, and independence in activities of daily living; and to investigate associations between stroke-related health risk factors and the use of the internet to search for health and medical information. Methods This study is a secondary analysis of data obtained during a national randomized controlled trial—Prevent 2nd Stroke. The participants were stroke survivors recruited from 2 Australian stroke registries who completed 2 telephone-administered surveys to collect data on demographics and stroke characteristics; health risk factors (diet quality, physical activity, blood pressure medication, alcohol intake, anxiety and depression, and smoking status); physical functioning; independence in activities of daily living; and questions about what technology they had access to, how often they used it, and for what purposes. Participants were eligible if they had no more than a moderate level of disability (modified Rankin score ≤3) and had access to the internet. Multivariable logistic regression was used to assess the associations between social media use and sociodemographics, physical function, and independence in activities of daily living as well as associations between stroke-related health risk factors and the use of the internet to search for health and medical information. Results Data from 354 participants were included in the analysis. Approximately 79.1% (280/354) of participants used the internet at least daily, 40.8% (118/289) accessed social media on their phone or tablet daily, and 46.4% (134/289) looked up health and medical information at least monthly. Women were 2.7 times more likely to use social media (adjusted odds ratio 2.65, 95% CI 1.51-4.72), and people aged >75 years were significantly less likely to use social media compared with those aged <55 years (adjusted odds ratio 0.17, 95% CI 0.07-0.44). Health risk factors were not found to be associated with searching for health- or medical-related information. Conclusions The internet appears to be a viable platform to engage with stroke survivors who may not be high-morbidity to conduct research and provide information and health interventions. This is important given that they are at high risk of recurrent stroke regardless of their level of disability. Exploring the technology use behaviors and the possibility of eHealth among survivors who experience higher levels of morbidity or disability because of their stroke is an area of research that warrants further study.

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Effectiveness of information and communications technology interventions for stroke survivors and their support people: a systematic review

Cited by 11 publications

References 44 publications

Do digital health interventions hold promise for stroke prevention and care in Black and Latinx populations in the United States? A scoping review

Do digital health interventions hold promise for stroke prevention and care in Black and Latinx populations in the United States? A scoping review

What are the available online resources targeting psychosocial burden among stroke survivors and their informal caregivers: A scoping review

Access to and Use of Internet and Social Media by Low-Morbidity Stroke Survivors Participating in a National Web-Based Secondary Stroke Prevention Trial: Cross-sectional Survey

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