A realist review of mobile phone-based health interventions for non-communicable disease management in sub-Saharan Africa.
A realist review of mobile phone-based health interventions for non-communicable disease management in sub-Saharan Africa.
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DOI：
10.1186/s12916-017-0782-z
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发表时间：
2017-02-06
期刊：
影响因子：
9.3
通讯作者：
Quentin W
中科院分区：
文献类型：
--
作者：
Opoku D;Stephani V;Quentin W
在撒哈拉以南非洲，非传染性疾病的流行率正在上升。与此同时，移动的电话的使用正在增加，扩大了实施基于移动的电话的保健干预措施的机会。本综述旨在了解针对非传染性疾病的移动健康干预措施如何、为何、为谁以及在何种情况下改善了撒哈拉以南非洲的治疗和护理。检索了四个主要数据库（PubMed、科克伦图书馆、Web of Science和Google Scholar）和纳入文章的参考文献，以寻找报告移动医疗干预措施对撒哈拉以南非洲非传染性疾病患者影响的研究。截至2015年5月发表的所有研究均纳入综述。在采取现实主义审查方法之后，确定了中等范围的理论，并将其纳入了"了解移动保健干预措施对改善撒哈拉以南非洲非传染性疾病患者获得护理的贡献的框架“。该框架的主要指标包括诱发特征、需求、有利资源、感知有用性和感知易用性。对研究进行了深入分析，以充实框架。检索确定了6137个标题进行筛选，其中20个保留用于现实主义综合。移动保健干预措施对改善治疗和护理的贡献在于，它们促进了（远程）获得以前无法获得的（专门）服务。三个背景因素（易感特征，需求和使能资源）影响患者和提供者是否认为移动医疗干预措施有用且易于使用。只有当他们相信移动医疗是有用的和易于使用的，移动医疗最终将有助于改善获得医疗服务的机会。对纳入研究的分析表明，最重要的诱发特征是积极的态度和共同的沟通语言。最相关的需求是高疾病负担和缺乏第一次接触提供者的能力。重要的支持资源是稳定的通信网络、可访问的维护服务和监管政策。政策制定者和项目管理者应在引入移动医疗干预措施之前考虑患者和提供者的易感特征和需求以及必要的支持资源。研究人员将受益于更多地关注移动健康干预措施正在实施的背景，而不是（过于强烈地）关注这些干预措施的技术方面。本文的在线版本（doi：10.1186/s12916-017-0782-z）包含补充材料，可供授权用户使用。
The prevalence of non-communicable diseases (NCDs) is increasing in sub-Saharan Africa. At the same time, the use of mobile phones is rising, expanding the opportunities for the implementation of mobile phone-based health (mHealth) interventions. This review aims to understand how, why, for whom, and in what circumstances mHealth interventions against NCDs improve treatment and care in sub-Saharan Africa. Four main databases (PubMed, Cochrane Library, Web of Science, and Google Scholar) and references of included articles were searched for studies reporting effects of mHealth interventions on patients with NCDs in sub-Saharan Africa. All studies published up until May 2015 were included in the review. Following a realist review approach, middle-range theories were identified and integrated into a Framework for Understanding the Contribution of mHealth Interventions to Improved Access to Care for patients with NCDs in sub-Saharan Africa. The main indicators of the framework consist of predisposing characteristics, needs, enabling resources, perceived usefulness, and perceived ease of use. Studies were analyzed in depth to populate the framework. The search identified 6137 titles for screening, of which 20 were retained for the realist synthesis. The contribution of mHealth interventions to improved treatment and care is that they facilitate (remote) access to previously unavailable (specialized) services. Three contextual factors (predisposing characteristics, needs, and enabling resources) influence if patients and providers believe that mHealth interventions are useful and easy to use. Only if they believe mHealth to be useful and easy to use, will mHealth ultimately contribute to improved access to care. The analysis of included studies showed that the most important predisposing characteristics are a positive attitude and a common language of communication. The most relevant needs are a high burden of disease and a lack of capacity of first-contact providers. Essential enabling resources are the availability of a stable communications network, accessible maintenance services, and regulatory policies. Policy makers and program managers should consider predisposing characteristics and needs of patients and providers as well as the necessary enabling resources prior to the introduction of an mHealth intervention. Researchers would benefit from placing greater attention on the context in which mHealth interventions are being implemented instead of focusing (too strongly) on the technical aspects of these interventions. The online version of this article (doi:10.1186/s12916-017-0782-z) contains supplementary material, which is available to authorized users.