Do digital health interventions hold promise for stroke prevention and care in Black and Latinx populations in the United States? A scoping review.
Do digital health interventions hold promise for stroke prevention and care in Black and Latinx populations in the United States? A scoping review.
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DOI：
10.1186/s12889-023-17255-6
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发表时间：
2023-12-21
影响因子：
4.5
通讯作者：
中科院分区：
文献类型：
--
作者：
黑人和拉丁裔人口受到中风的影响尤为严重，并且可能会遇到医疗保健方面的缺口。在分散的护理系统中，远程数字解决方案有望扭转这种模式。然而，历史上的健康差异导致了数字鸿沟。如果不刻意尝试解决这一数字鸿沟，数字健康的快速进步只会使系统性偏见长期存在。本研究旨在描述中风护理数字健康干预措施的范围，总结其功效，并检查证据库中黑人和拉丁裔人群的纳入情况。我们检索了 PubMed、Web of Science 和 EMBASE 2015 年至 2021 年间的出版物。纳入标准包括同行评审的系统评价或实验研究的荟萃分析，重点关注数字健康干预措施对成人中风危险因素和结果的影响。提取了有关干预方式和功能、临床/行为结果、研究地点、样本人口统计和干预结果的详细信息。 38 项系统评价符合纳入标准，并产生了 519 项单独研究。我们确定了六种功能类别和八种数字健康模式。病例管理（63%）和健康监测（50%）是最常见的干预功能。移动应用程序和基于网络的干预措施是两种最常研究的方式。基于网络、短信和电话的方法的有效性证据最为有力。尽管移动应用程序已被广泛研究，但其功效的证据却参差不齐。血压和药物依从性是最常研究的结果。然而，各种干预方式对这些结果的有效性的证据各不相同。在所有个别研究中，只有 38.0% 在美国进行（n = 197）。在这些美国研究中，54.8% 充分报告了种族或民族分布。平均而言，样本中黑人占 27.0%，拉丁裔占 17.1%，白人占 63.4%。虽然所选数字健康干预措施（尤其是那些旨在改善血压管理和药物依从性的干预措施）的有效性的证据显示出希望，但如何将这些干预措施推广到历史上代表性不足的群体的证据还不够。将这些代表性不足的人群纳入数字健康实验和可行性研究对于推进数字健康科学和实现健康公平至关重要。在线版本包含可在 10.1186/s12889-023-17255-6 获取的补充材料。
Black and Latinx populations are disproportionately affected by stroke and are likely to experience gaps in health care. Within fragmented care systems, remote digital solutions hold promise in reversing this pattern. However, there is a digital divide that follows historical disparities in health. Without deliberate attempts to address this digital divide, rapid advances in digital health will only perpetuate systemic biases. This study aimed to characterize the range of digital health interventions for stroke care, summarize their efficacy, and examine the inclusion of Black and Latinx populations in the evidence base. We searched PubMed, the Web of Science, and EMBASE for publications between 2015 and 2021. Inclusion criteria include peer-reviewed systematic reviews or meta-analyses of experimental studies focusing on the impact of digital health interventions on stroke risk factors and outcomes in adults. Detailed information was extracted on intervention modality and functionality, clinical/behavioral outcome, study location, sample demographics, and intervention results. Thirty-eight systematic reviews met inclusion criteria and yielded 519 individual studies. We identified six functional categories and eight digital health modalities. Case management (63%) and health monitoring (50%) were the most common intervention functionalities. Mobile apps and web-based interventions were the two most commonly studied modalities. Evidence of efficacy was strongest for web-based, text-messaging, and phone-based approaches. Although mobile applications have been widely studied, the evidence on efficacy is mixed. Blood pressure and medication adherence were the most commonly studied outcomes. However, evidence on the efficacy of the various intervention modalities on these outcomes was variable. Among all individual studies, only 38.0% were conducted in the United States (n = 197). Of these U.S. studies, 54.8% adequately reported racial or ethnic group distribution. On average, samples were 27.0% Black, 17.1% Latinx, and 63.4% White. While evidence of the efficacy of selected digital health interventions, particularly those designed to improve blood pressure management and medication adherence, show promise, evidence of how these interventions can be generalized to historically underrepresented groups is insufficient. Including these underrepresented populations in both digital health experimental and feasibility studies is critical to advancing digital health science and achieving health equity. The online version contains supplementary material available at 10.1186/s12889-023-17255-6.
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影响因子：
2.5
作者：
Spruill TM;Williams O;Teresi JA;Lehrer S;Pezzin L;Waddy SP;Lazar RM;Williams SK;Jean-Louis G;Ravenell J;Penesetti S;Favate A;Flores J;Henry KA;Kleiman A;Levine SR;Sinert R;Smith TY;Stern M;Valsamis H;Ogedegbe G
通讯作者：
Ogedegbe G
DOI：
10.12968/bjon.2020.29.5.266
发表时间：
2020-03-12
期刊：
British journal of nursing (Mark Allen Publishing)
影响因子：
--
作者：
Celik, Aycan;Forde, Rita;Sturt, Jackie
通讯作者：
Sturt, Jackie
影响因子：
4.1
作者：
Enricho Nkhoma D;Jenya Soko C;Joseph Banda K;Greenfield D;Li YJ;Iqbal U
通讯作者：
Iqbal U
DOI：
10.1097/xeb.0000000000000055
发表时间：
2015-09-01
影响因子：
--
作者：
Aromataris, Edoardo;Fernandez, Ritin;Tungpunkom, Patraporn
通讯作者：
Tungpunkom, Patraporn
影响因子：
5.1
作者：
Friedman, Nizan;Chan, Vicky;Reinkensmeyer, David J.
通讯作者：
Reinkensmeyer, David J.