Pediatric eMental healthcare technologies: a systematic review of implementation foci in research studies, and government and organizational documents

Gehring, Nicole D; McGrath, Patrick J.; Wozney, Lori; Soleimani, Amir; Bennett, Kathryn; Hartling, Lisa; Huguet, Anna; Dyson, Michele P; Newton, Amanda S

doi:10.1186/s13012-017-0608-6

Cited by 22 publications

(17 citation statements)

References 64 publications

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“…It would also allow for development of frameworks or standards to facilitate the benchmarking of services for ongoing quality improvement 103 . Further consideration needs to be given to the nature of evaluation that is undertaken in these services, to ensure that the outcomes are those that are important to stakeholders — considering not just clinicians and young people, but also decision makers and funders, who may be more interested in feasibility, cost, penetration and sustainability 104 …”

Section: Discussionmentioning

confidence: 99%

Integrated (one‐stop shop) youth health care: best available evidence and future directions

Hetrick

Bailey

Smith³

et al. 2017

Medical Journal of Australia

198

280

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Although mental health problems represent the largest burden of disease in young people, access to mental health care has been poor for this group. Integrated youth health care services have been proposed as an innovative solution. Integrated care joins up physical health, mental health and social care services, ideally in one location, so that a young person receives holistic care in a coordinated way. It can be implemented in a range of ways. A review of the available literature identified a range of studies reporting the results of evaluation research into integrated care services. The best available data indicate that many young people who may not otherwise have sought help are accessing these mental health services, and there are promising outcomes for most in terms of symptomatic and functional recovery. Where evaluated, young people report having benefited from and being highly satisfied with these services. Some young people, such as those with more severe presenting symptoms and those who received fewer treatment sessions, have failed to benefit, indicating a need for further integration with more specialist care. Efforts are underway to articulate the standards and core features to which integrated care services should adhere, as well as to further evaluate outcomes. This will guide the ongoing development of best practice models of service delivery.

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Section: Discussionmentioning

confidence: 99%

Integrated (one‐stop shop) youth health care: best available evidence and future directions

Hetrick

Bailey

Smith³

et al. 2017

Medical Journal of Australia

198

280

View full text Add to dashboard Cite

show abstract

“…Beyond implementation, ongoing evaluation and monitoring of mobile and other digital health interventions is deemed critical to inform health policy and practice [ 80 , 81 ]. The World Health Organization provides guidance in this regard from the collective learning of 5 years of engagement with various international lead agencies working to strengthen their digital health deployments, develop robust evaluations, and scale up their activities nationally and regionally [ 68 ].…”

Section: Discussionmentioning

confidence: 99%

End User and Implementer Experiences of mHealth Technologies for Noncommunicable Chronic Disease Management in Young Adults: Systematic Review

Slater¹,

Campbell²,

Stinson³

et al. 2017

J Med Internet Res

137

122

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BackgroundChronic noncommunicable diseases (NCDs) such as asthma, diabetes, cancer, and persistent musculoskeletal pain impose an escalating and unsustainable burden on young people, their families, and society. Exploring how mobile health (mHealth) technologies can support management for young people with NCDs is imperative.ObjectiveThe aim of this study was to identify, appraise, and synthesize available qualitative evidence on users’ experiences of mHealth technologies for NCD management in young people. We explored the perspectives of both end users (young people) and implementers (health policy makers, clinicians, and researchers).MethodsA systematic review and meta-synthesis of qualitative studies. Eligibility criteria included full reports published in peer-reviewed journals from January 2007 to December 2016, searched across databases including EMBASE, MEDLINE (PubMed), Scopus, and PsycINFO. All qualitative studies that evaluated the use of mHealth technologies to support young people (in the age range of 15-24 years) in managing their chronic NCDs were considered. Two independent reviewers identified eligible reports and conducted critical appraisal (based on the Joanna Briggs Institute Qualitative Assessment and Review Instrument: JBI-QARI). Three reviewers independently, then collaboratively, synthesized and interpreted data through an inductive and iterative process to derive emergent themes across the included data. External validity checking was undertaken by an expert clinical researcher and for relevant content, a health policy expert. Themes were subsequently subjected to a meta-synthesis, with findings compared and contrasted between user groups and policy and practice recommendations derived.ResultsTwelve studies met our inclusion criteria. Among studies of end users (N=7), mHealth technologies supported the management of young people with diabetes, cancer, and asthma. Implementer studies (N=5) covered the management of cognitive and communicative disabilities, asthma, chronic self-harm, and attention deficit hyperactivity disorder. Quality ratings were higher for implementer compared with end user studies. Both complementary and unique user themes emerged. Themes derived for end users of mHealth included (1) Experiences of functionality that supported self-management, (2) Acceptance (technical usability and feasibility), (3) Importance of codesign, and (4) Perceptions of benefit (self-efficacy and empowerment). For implementers, derived themes included (1) Characteristics that supported self-management (functional, technical, and behavior change); (2) Implementation challenges (systems level, service delivery level, and clinical level); (3) Adoption considerations for specific populations (training end users; specific design requirements); and (4) Codesign and tailoring to facilitate uptake and person-centered care.ConclusionsSynthesizing available data revealed both complementary and unique user perspectives on enablers and barriers to designing, developing, and implementing mHealth technolog...

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“…As part of that beginning, it is critical to note that most applied games and digital interventions that are developed and tested in a research setting stay in the scientific community, belying the main purpose of their development in the first place: large, scalable impact at low cost (Hollis et al 2017 ). One of the reasons for the lack of implementation success might be absence of a systematic strategy for effective dissemination of evidence-based applied games (Gehring et al 2017 ). Our Games for Emotional and Mental Health (GEMH) lab is at the early stages of building this strategic framework which includes (a) a replicable methodology by which games for mental health can be co-developed with partners in diverse disciplines including design, engineering and art; (b) an index of resources essential for not only successful development, but also dissemination and/or commercialization and the digital infrastructure required to maintain these interventions; and (c) a set of rationale for applying diverse research approaches (e.g., playtesting, user research, RCTs, experimental designs, qualitative interviews) that test not just for game design elements, outcomes and mechanisms, but also track the success of commercial uptake and other dissemination markers ( www.gemhlab.com ).…”

Section: Discussionmentioning

confidence: 99%

Preventing Childhood Anxiety Disorders: Is an Applied Game as Effective as a Cognitive Behavioral Therapy-Based Program?

2017

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A large proportion of children experience subclinical levels of anxiety and cognitive-behavioral therapy (CBT) aimed at preventing anxiety disorders is moderately effective. However, most at-risk children do not seek help or drop out of programs prematurely because of stigma, lack of motivation, and accessibility barriers. Applied games have received increased attention as viable alternatives and have shown promising results, but direct comparisons between applied games and the gold-standard CBT are lacking. Our aim was to investigate whether the applied game MindLight is as effective as CBT (i.e., Coping Cat) within an indicated prevention context. We conducted a randomized controlled non-inferiority trial with a sample of 174 children (7- to 12-year olds) with elevated levels of anxiety, comparing MindLight to CBT. Anxiety was assessed with self- and parent-reports at pre- and post-program, and at 3- and 6-month follow-ups. Intention-to-treat and completers-only confidence interval approach and latent growth curve modeling showed an overall significant quadratic decrease in child- and parent-reported anxiety symptoms over time and, as predicted, the magnitude of improvement was the same for MindLight and CBT. The within-group effect sizes were small to medium at post-test (− 0.32 to − 0.63), and medium to large (− 0.60 to − 1.07) at 3- and 6-month follow-ups. Furthermore, MindLight and CBT were rated equally anxiety inducing, difficult, and appealing; CBT was rated as more relevant to daily life than MindLight. The current study adds to the growing research on applied games for mental health and shows that these games hold potential as alternative delivery models for evidence-based therapeutic techniques.Electronic supplementary materialThe online version of this article (10.1007/s11121-017-0843-8) contains supplementary material, which is available to authorized users.

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Pediatric eMental healthcare technologies: a systematic review of implementation foci in research studies, and government and organizational documents

Cited by 22 publications

References 64 publications

Integrated (one‐stop shop) youth health care: best available evidence and future directions

Integrated (one‐stop shop) youth health care: best available evidence and future directions

End User and Implementer Experiences of mHealth Technologies for Noncommunicable Chronic Disease Management in Young Adults: Systematic Review

Preventing Childhood Anxiety Disorders: Is an Applied Game as Effective as a Cognitive Behavioral Therapy-Based Program?

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