eHealth and mHealth Interventions for Ethnic Minority and Historically Underserved Populations in Developed Countries: an Umbrella Review

Abstract

Health disparities among historically disadvantaged populations can undermine the effectiveness of eHealth and mHealth interventions and limit their acceptability among diverse community members. The twin aims of this umbrella review of systematic reviews (SRs) are to summarise the evidence on the characteristics and effectiveness of eHealth and mHealth interventions among underserved populations in developed counties and provide recommendations to community organizers, policy makers and researchers. Comprehensive searches were conducted in bibliographic databases, Google Scholar and references lists for SRs published in English between 2000 and 2019. SRs were selected following a protocol registered with PROSPERO. Two independent reviewers were involved in the selection appraisal process, quality assessment and data extraction process. Six SRs met the inclusion criteria for this umbrella review. The six SRs concerned interventions delivered by computer programmes, cell-phones or other electronic devices. The studies in the SRs reported improvements to physiological wellbeing, health knowledge and self-management, as well as improvements in psychosocial outcomes. This umbrella review concludes with recommendations for community organizers, policy makers and researches for the formation of guidelines, inclusion of target community members in the development of eHealth interventions and directions for future research.

A Cardiovascular Health and Wellness Mobile Health Intervention Among Church-Going African Americans: Formative Evaluation of the FAITH! App

“…A preliminary finding of our formative evaluation was the importance of considering unique cultural influences, as these can be facilitators/barriers to intervention engagement. Few mHealth interventions have adopted tailoring strategies to include content specifically optimized to the sociocharacteristics of AAs [ 30 ]. Our parent study is the first to document the development of an mHealth app with faith-based content for CV health promotion to the AA faith community [ 18 ].…”

Understanding mobile application development and implementation to monitor Posyandu data in Indonesia: a 3-year hybrid action research to build “a bridge” from the community to the national scale

“…Even though the elds are different, the idea of emphasizing the con dence and satisfaction of CHWs proposed by the study remains essential and relevant (43). In the future, it is suggested to improve the training by emphasizing such insight as well as considering different measures to reach a larger effect in 6 to 12 months (44). The good impact is that the CHWs will engage more in the intervention and bene t the society and the government (45) Although, in general, the cadres' knowledge and skills in the Posyandu mobile app implementation have reached expectations, the implementation of a new information system is not easy because there are many in uencing factors to be considered.…”

Detecting and Treating Psychosocial and Lifestyle-Related Difficulties in Chronic Disease: Development and Treatment Protocol of the E-GOAL eHealth Care Pathway

“…In addition to its opportunities for individual tailoring, another main advantage of eHealth interventions is the improved accessibility of self-management support for most patients, including under-served groups [ 55 ]. Evidence supports the effectiveness of eHealth interventions in improving health, self-management, and psychosocial outcomes of under-served populations [ 56 ]. At the same time, some vulnerable populations may be disadvantaged by eHealth: Patients do need access to digital devices as well as general skills on a computer and Internet use [ 45 ], and it has been found that, for instance, people who were unemployed or with low education benefited less from web-based interventions [ 55 ].…”

“…At the same time, some vulnerable populations may be disadvantaged by eHealth: Patients do need access to digital devices as well as general skills on a computer and Internet use [ 45 ], and it has been found that, for instance, people who were unemployed or with low education benefited less from web-based interventions [ 55 ]. To optimize eHealth interventions’ effectiveness and acceptability for individuals in under-served groups, it is recommended to incorporate specific tailoring strategies (e.g., to language, culture, and literacy) and technologies (e.g., simple features or no requirement for Internet access), and to include these populations in each stage of intervention development [ 56 ]. The latter is a limitation of the current study, as we did not pay special attention to sufficient involvement of members of under-served groups in the co-creation stages of the eHealth care pathway development.…”