Mobile-Health based physical activities co-production policies towards cardiovascular diseases prevention: findings from a mixed-method systematic review

Abstract

Background Cardiovascular disease (CVD) is the first cause of death globally, with huge costs worldwide. Most cases of CVD could be prevented by addressing behavioural risk factors. Among these factors, there is physical and amateur sports activity (PASA), which has a linear negative correlation with the risk of CVD. Nevertheless, attempts to encourage PASA, as exercise prescription programmes, achieved little impact at the community-wide level. A new frontier to promote PASA is represented by mobile health tools, such as exergaming, mobile device apps, health wearables, GPS/GIS and virtual reality. Nevertheless, there has not yet been any evident turnabout in patient active involvement towards CVD prevention, and inactivity rates are even increasing. This study aims at framing the state of the art of the literature about the use of m-health in supporting PASA, as a user-centric innovation strategy, to promote co-production health policies aiming at CVD prevention. Methods A mixed-method systematic literature review was conducted in the fields of health and healthcare management to highlight the intersections between PASA promotion and m-health tools in fostering co-produced services focused on CVD prevention. The literature has been extracted by the PRISMA logic application. The resulting sample has been first statistically described by a bibliometric approach and then further investigated with a conceptual analysis of the most relevant contributions, which have been qualitatively analysed. Results We identified 2,295 studies, on which we ran the bibliometric analysis. After narrowing the research around the co-production field, we found 10 papers relevant for the concept analysis of contents. The interest about the theme has increased in the last two decades, with a high prevalence of contributions from higher income countries and those with higher CVD incidence. The field of research is highly multi-disciplinary; most of documents belong to the medical field, with only a few interconnections with the technology and health policy spheres. Although the involvement of patients is recognized as fundamental for CVD prevention through PASA, co-design schemes are still lacking at the public management level. Conclusions While the link between the subjects of motor activity, medicine and technology is clear, the involvement of citizens in the service delivery process is still underinvestigated, especially the issue concerning how “value co-creation” could effectively be applied by public agencies. In synthesis, the analysis of the role of co-production as a system coordination method, which is so important in designing and implementing preventive care, is still lacking.

Multi-country collaborative citizen science projects to co-design cardiovascular disease prevention strategies and advocacy: findings from Ethiopia, Malawi, Rwanda, and South Africa

“…Another recent review reported on patient active involvement and the use of m-health in supporting physical activity and co-production of health policies aiming at CVD prevention. Findings from that review indicated that patients (and beneficiaries) participations in interventions co-design process, though recognized as fundamental for CVD prevention, were lacking [ 20 ]. Our study had employed citizen science and co-design approaches to facilitate multi-level stakeholders’ engagement, participatory learning, adaptation of tools, and support co-creation of knowledge, and advocacy for social action.…”

“…Recent systematic and scoping reviews have indicated the appropriateness of using a codesign or co-production approach to designing health-related programmes [ 17 , 19 ], and to promote health policies focusing on CVD prevention [ 20 ]. Citizen science and co-design approaches have been used to facilitate stakeholders’ engagement, participatory learning, adaptation of tools/processes, co-creation of knowledge, and advocacy for social action [ 21 , 22 ].…”

A Bibliometric Analysis of eHealth Scholarship (2000-2024): Multidisciplinary Contributions and Research Trends (Preprint)

“…Most bibliometric reviewers summarized literature subsets defined by eHealth user needs: promoting physical activity, healthy eating, and weight loss [9][10][11][12], preventing substance use [13], and providing e-mental health during the Covid-19 pandemic [14]. In addition, researchers reviewed digital technologies for health behavior change [15] and eHealth tools for anticoagulation management after cardiac valve replacement [16].…”

“…Technology-focused bibliometric reviews assessed literatures on technology adoption [23], telehealth [24], the internet of things [25], telemedicine in rural areas for cost-effective and sustainable healthcare [26], mobile health as a means of involving citizens and public agencies in cardiovascular diseases prevention [27], and artificial intelligence adoption by healthcare organizations [28].…”