Improving a Web-Based Tool to Support Older Adults to Stay Independent at Home: Qualitative Study

Garvelink, Mirjam M.; Agbadjé, Titilayo Tatiana; Freitas, Adriana; Bergeron, Lysa; Petitjean, Thomas; Dugas, Michèle; Blair, Louisa; Archambault, Patrick; Roy, Noémie; Jones, Allyson

doi:10.2196/16979

Cited by 10 publications

(36 citation statements)

References 33 publications

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“…Among the 28 included studies, 14 (50%) were quantitative [ 37 - 48 , 63 , 64 ], 7 (25%) were qualitative [ 49 - 55 ], and 7 (25%) used mixed methods [ 56 - 62 ]. Studies were most frequently conducted in the United States [ 38 , 41 , 45 - 48 , 50 , 53 , 58 , 60 ], the Netherlands [ 37 , 55 , 57 , 59 ], the United Kingdom [ 54 , 62 ], and Australia [ 52 , 56 ].…”

Section: Resultsmentioning

confidence: 99%

mHealth Interventions to Support Caregivers of Older Adults: Equity-Focused Systematic Review

Garnett¹,

Northwood²,

Ting³

et al. 2022

JMIR Aging

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Background Informal caregivers, hereafter referred to as caregivers, provide support to older adults so that they can age safely at home. The decision to become a caregiver can be influenced by individual factors, such as personal choice, or societal factors such as social determinants of health, including household income, employment status, and culture-specific gender roles. Over time, caregivers’ health can be negatively affected by their caregiving roles. Although programs exist to support caregivers, the availability and appropriateness of services do not match caregivers’ expressed needs. Research suggests that supportive interventions offered through mobile health (mHealth) technologies have the potential to increase caregivers’ access to supportive services. However, a knowledge gap remains regarding the extent to which social determinants of health are considered in the design, implementation, and evaluation of mHealth interventions intended to support the caregivers of older adults. Objective This study aimed to conduct a systematic review to determine how health equity is considered in the design, implementation, and evaluation of mHealth interventions for caregivers of older adults using Cochrane Equity’s PROGRESS-Plus (place of residence, race, ethnicity, culture, language, occupation, gender, religion, education, social capital, socioeconomic status–plus age, disability, and sexual orientation) framework and synthesize evidence of the impacts of the identified caregiver-focused mHealth interventions. Methods A systematic review was conducted using 5 databases. Articles published between January 2010 and June 2021 were included if they evaluated or explored the impact of mHealth interventions on the health and well-being of informal caregivers of older adults. mHealth interventions were defined as supportive services, for example, education, that caregivers of older adults accessed via mobile or wireless devices. Results In total, 28 articles met the inclusion criteria and were included in the review. The interventions evaluated sought to connect caregivers with services, facilitate caregiving, and promote caregivers’ health and well-being. The PROGRESS-Plus framework factors were mainly considered in the results, discussion, and limitations sections of the included studies. Some PROGRESS-Plus factors such as sexual orientation, religion, and occupation, received little to no consideration across any phase of the intervention design, implementation, or evaluation. Overall, the findings of this review suggest that mHealth interventions were positively received by study participants. Such interventions have the potential to reduce caregiver burden and positively affect caregivers’ physical and mental health while supporting them as caregivers. The study findings highlight the importance of making support available to help facilitate caregivers’ use of mHealth interventions, as well as in the use of appropriate language and text. Conclusions The successful uptake and spread of mHealth interventions to support caregivers of older adults will depend on creating opportunities for the inclusive involvement of a broad range of stakeholders at all stages of design, implementation, and evaluation.

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Section: Resultsmentioning

confidence: 99%

mHealth Interventions to Support Caregivers of Older Adults: Equity-Focused Systematic Review

Garnett¹,

Northwood²,

Ting³

et al. 2022

JMIR Aging

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show abstract

“…Television was also found to be used to a somewhat lesser extent, but we included it in this paper due to ease-of-use and high accessibility across patient groups. Within the representative studies assessed in this study, apps/web-based technology had disease-specific targets, while the other technologies were primarily used in elderly patients, where the desire for individualized and tailored care is high [ 60 ]. Through analyzing the studies, we identified usability, scaling, and data management as important research areas regardless of eHealth implementation.…”

Section: Discussionmentioning

confidence: 99%

Enabling Guidelines for the Adoption of eHealth Solutions: Scoping Review

Støme¹,

Wilhelmsen²,

Kværner³

2021

JMIR Form Res

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Background Globally, public health care is under increasing pressure, an economic burden currently amplified by the COVID-19 outbreak. With the recognition that universal health coverage improves the health of a population and reduces health inequalities, universal health coverage has been acknowledged as a priority goal. To meet the global needs in a population with increased chronic illness and longer life expectancy, the health care system is in dire need of new, emerging technologies. eHealth solutions as a method of delivery may have an impact on quality of care and health care costs. As such, it is important to study methods previously used to avoid suboptimal implementation and promote general guidelines to further develop eHealth solutions. Objective This study aims to explore and thematically categorize a selected representation of early phase studies on eHealth technologies, focusing on papers that are under development or undergoing testing. Further, we want to assess enablers and barriers in terms of usability, scaling, and data management of eHealth implementation. The aim of this study to explore early development phase and feasibility studies was an intentional effort to provide applicable guidelines for evaluation at different stages of implementation. Methods A structured search was performed in PubMed, MEDLINE, and Cochrane to identify and provide insight in current eHealth technology and methodology under development and gain insight in the future potential of eHealth technologies. Results In total, 27 articles were included in this review. The clinical studies were categorized thematically by illness comparing 4 technology types deemed relevant: apps/web-based technology, sensor technology, virtual reality, and television. All eHealth assessment and implementation studies were categorized by their focus point: usability, scaling, or data management. Studies assessing the effect of eHealth were divided into feasibility studies, qualitative studies, and heuristic assessments. Studies focusing on usability (16/27) mainly addressed user involvement and learning curve in the adoption of eHealth, while the majority of scaling studies (6/27) focused on strategic and organizational aspects of upscaling eHealth solutions. Studies focusing on data management (5/27) addressed data processing and data sensitivity in adoption and diffusion of eHealth. Efficient processing of data in a secure manner, as well as user involvement and feedback, both throughout small studies and during upscaling, were the important enablers considered for successful implementation of eHealth. Conclusions eHealth interventions have considerable potential to improve lifestyle changes and adherence to treatment recommendations. To promote efficient implementation and scaling, user involvement to promote user-friendliness, secure and adaptable data management, and strategical considerations needs to b...

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“…From March– April 2020 medical students from the University of Queensland Ochsner Clinical School (UQ-OCS) attempted to train MVC patients to perform telehealth visits with the Epic MyChart platform. MyChart is a self-service web portal offered by most Epic healthcare organizations that allows patients to access their medical records and perform telehealth and eHealth services [ 17 ]. UQ-OHS students spent on average 5 hours per patient performing one-on-one training and coaching over the phone on telehealth visit navigation.…”

Section: Methodsmentioning

confidence: 99%

“…These were all manually reviewed in full, and 85 articles were further excluded based on inclusion criteria, and the final 22 articles were included in the meta-synthetic review. After the exclusion of many tools based on our search and exclusion parameters the following 'toolkits' were selected because of their focus on multidomain literacies of interest: READHY, eHEALS, eHLF, eHLA, and eHLQ [12, [16][17][18][19]. We identified key components of each tool that addressed the telehealth navigation trouble points identified in our outreach, while being mindful of selecting components that would be practical for use with older adult and low literate populations.…”

mentioning

confidence: 99%

Telehealth Literacy as a Social Determinant of Health: A Novel Screening Tool to Support Vulnerable Patient Equity

Gillie

Али

Vadlamuri

et al. 2022

ADR

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Background: Telehealth has evolved as a solution to COVID-19 isolation precautions and remote care with well-established health, socioeconomic, and practical benefits. However, there are many gaps in the current literature regarding telehealth use among older, low health literate, and resource-limited populations. There are ethical considerations that warrant understanding this digital divide. Objective: The objective of this review is to propose the Telehealth Literacy Screening Tool (TLST) for use in older adults and support the future inclusion of telehealth literacy as an important social determinant of health (SDOH). Methods: Initially a four-week outreach was performed that targeted older adults and low-health literate patients at the MedVantage Clinic (MVC) within Ochsner Health (OH) to identify common barriers to patient engagement with the OH Epic MyChart telehealth platform. Themes from those barriers directed a meta-synthetic review of the methods and ethical considerations of current, validated technological and telehealth literacy screening tools. Those findings were reported based on the standards of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. Results: Based on the barriers identified during our MVC patient outreach, PRISMA-reported review of telehealth literacy screening research, and evaluation of the MyChart platform and the technological resources required for its use; we developed a multidimensional questionnaire for telehealth literacy screening of older adults. Conclusion: The TLST is designed to identify patients in need of additional interventions for successful connection to telehealth services. This is an important step towards addressing the ethical obligation to decrease disparities in telehealth literacy for vulnerable populations and identifying telehealth literacy as a SDOH.

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Improving a Web-Based Tool to Support Older Adults to Stay Independent at Home: Qualitative Study

Cited by 10 publications

References 33 publications

mHealth Interventions to Support Caregivers of Older Adults: Equity-Focused Systematic Review

mHealth Interventions to Support Caregivers of Older Adults: Equity-Focused Systematic Review

Enabling Guidelines for the Adoption of eHealth Solutions: Scoping Review

Telehealth Literacy as a Social Determinant of Health: A Novel Screening Tool to Support Vulnerable Patient Equity

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