iMedicalApps and JMIR Publications have partnered to help disseminate interesting & innovative digital health research being done worldwide. Each article in this series will feature summaries of interesting studies to help you keep up to date on the latest in digital health research. We invite you to share your thoughts on the study in the comments section.
Designing, implementing and evaluating mobile health technologies for managing chronic conditions in older adults: A Scoping Review
1. What was the motivation behind your study?
This scoping review was conducted in advance of our design and build of a mobile health app to support an interprofessional nurse-led team approach in the delivery of community-based stroke rehabilitation in home care. The app, called MyST (short for My Stroke Team), was inspired by the end-users it was actually designed to serve (See: https://www.youtube.com/watch?v=W8u9w-ZywRg). MyST will be implemented within the context of an intervention that promotes optimal aging at home for older adults with multiple chronic conditions (MCC). Refer to: achru
2. Describe your study.
We systematically mapped the breadth of research related to three topic areas: mobile and electronic devices, technology based healthcare delivery, and aging populations and/or chronic conditions. From the research question “What are the current practices and recommendations for designing, implementing and evaluating mHealth solutions to support older adults living in their homes?” we identified 42 studies. Next, using a descriptive analytical method, we extracted and charted data. We then presented key lessons and recommendations, identified gaps and suggested directions for future work.
3. What were the results of the study?
To ensure success, a user-centered, collaborative, interdisciplinary and iterative approach is imperative to enhance feasibility, acceptability and usability of mHealth innovations. Implementation within systems or organizations requires a thorough understanding of culture, values and context readiness from researchers. Notably, the implementation science of mHealth technologies in home-based care for older adults and self-management of chronic conditions are important areas for further research.
4. What is the main point that readers should take away from this study?
Despite robust interest in mHealth innovations, more research is still required. With most of the recent studies being pilots or feasibility studies, there is only a limited ability to explore impact. To truly advance our understanding of these innovations, their role within healthcare, and to permit future framework development, we will require larger studies, perhaps employing a cohort design. As well, frameworks will be needed to guide the iterative process of development and to facilitate knowledge transfer between developers, healthcare experts and end users.
5. What was the most surprising finding from your study?
Most surprising was the lack of studies that addressed how mHealth innovations can support community-dwelling older adults with MCC, their family caregivers and their home care providers. Given the current size and projected growth of this demographic, this was startling. In a context where policy initiatives are targeted toward promoting aging in place, the potential for mHealth innovations are considerable. The combination of mobility and technology is powerful and it enables care supports, for both clients and providers, which are personal, efficient and available at any location.
6. What are the next steps? How do you envision this work ultimately translating into clinical practice or affecting R&D?
Our first priority is to implement MyST in a real world practice setting alongside an interprofessional intervention to support home-based stroke rehabilitation. As with all projects directed through the Aging, Community and Health Research Network (ACHRU), the goal is to accelerate the transition of research results into practice by conducting simultaneous implementation and evaluation of interventions and by partnering with users, stakeholders and decision-makers through all phases of research.
This Q&A was contributed by Dr. Jenny Ploeg, RN, PhD (Professor, School of Nursing at McMaster University) and Dr. Maureen Markle-Reid, RN, PhD (Associate Professor, School of Nursing, McMaster University). They are co-scientific directors of the Aging, Community and Health Research Unit (ACHRU), funded by the Canadian Institutes of Health Research Signature Initiative in Community Based Primary Healthcare and the Ontario Ministry of Health and Long Term Care Health System Research Fund. Follow the ACHRU on Twitter to learn more.