MICA: BIOS - Assessing the potential of wearable digital biosensors for health system strengthening in LMICs.

非传染性疾病，包括心脏病、癌症、慢性呼吸道疾病和糖尿病，在许多发展中国家日益成为重要的健康问题。例如，2012年的一项全球调查发现，在全世界5280万死亡人数中，有3450万人死于非传染性疾病，其中近75%发生在发展中国家。这些疾病导致的大多数过早死亡是可以通过改变生活方式来预防的，例如增加体育活动、戒烟、减少饮酒和吃更健康的食物。然而，在世界范围内，公共卫生当局促进更健康的习惯从而改善生活的能力仍然不足。此外，在资源匮乏的国家，由于缺乏资源和信息系统薄弱，往往无法准确了解非传染性疾病的负担和相关风险因素的流行情况。例如，最近对全球健康调查趋势的审查发现，100个国家没有关于胆固醇的人口数据，64个国家没有关于血压的数据。因此，卫生当局缺乏必要的信息来制定应对这些挑战的政策和规划。开发用于健康监测的新的可穿戴技术，如智能手表和智能手环，是一项很有前途的技术创新，具有支持预防和控制非传染性疾病方案的巨大潜力。在高收入国家，无线医疗设备的商业成功和健身追踪器的快速普及推动了这一领域的进步，导致越来越复杂的硬件和软件可以捕获广泛的生物识别数据，包括呼吸、氧饱和度、心率、血压、皮肤温度等。与此同时，发展中国家的无线网络得到了极大的扩展，它可以提供必要的基础设施，使数据能够从用户传输到卫生信息系统。因此，可穿戴卫生系统可以用于对可预防疾病的风险因素及其在人群中的分布进行定期调查，为制定政策以尽量减少这些风险的卫生当局提供重要信息。可穿戴健康系统还可用于根据个人进展向用户发送信息，帮助他们实现健康目标并降低风险。然而，尽管有这些承诺，可穿戴健康监测仪的公共卫生潜力仍未得到开发，因为迄今为止还没有研究探索这种设备如何支持卫生政策和规划。本项目旨在对这一潜力进行初步评价，为更全面的多国研究奠定基础。研究活动将在柬埔寨进行，在那里将部署一个原型装置进行实地评价。这是一个典型的国家，迄今为止，大多数研究和预防都集中在传染病上，而非传染性疾病尽管日益重要，但得到的关注和支持却少得多。在这方面，采用可穿戴设备可能有助于加强预防方案和监测人口健康。认识到引进一项新技术是一个复杂的过程，我们将探索可能或多或少有利于采用拟议创新的各种体制、社会经济和技术因素，并特别注意个人用户的反应。

Non-communicable diseases, including heart diseases, cancers, chronic respiratory diseases, and diabetes, are increasingly important health concerns in many developing countries. In 2012, for example, a global survey found that non-communicable diseases accounted for 34.5 million deaths of the 52.8 million deaths worldwide, and nearly 75% of those occurred in developing countries. Most premature deaths from these diseases are preventable through changes in lifestyle, such as increasing physical activity, quitting smoking, reducing the consumption of alcohol, and eating healthier food. However, capacities of public health authorities to promote healthier habits and thus improve lives are still inadequate worldwide. In poor-resourced countries, moreover, the burden of non-communicable diseases and the prevalence of associated risk factors is often not known with precision due to the lack of resources and weak information systems. For example, recent reviews of global trends in health surveys found that population data on cholesterol were not available in 100 countries, and no data on blood pressure were obtained for 64 countries. As a result, health authorities lack essential information to develop policy and programmes to address these challenges.The development of new wearable technologies for health monitoring, such as smartwatches and smartbands, is a promising technological innovation with great potential to support programmes for the prevention and control of non-communicable diseases. Boosted by commercial success of wireless medical devices and the rapid uptake of fitness trackers in high-income countries, advances in this sector have led to increasingly sophisticated hardware and software which can capture a wide range of biometric data, including respiration, oxygen saturation, heart rate, blood pressure, skin temperature, and more. In parallel, there has been a great expansion of wireless networks in developing countries, which can provide the necessary infrastructure to enable data transfer from users to health information systems. Thus, wearable health systems could be introduced to conduct regular surveys on risk factors for preventable diseases and their distribution across population groups, providing important information to health authorities who develop policy to minimise these risks. Wearable health systems can also be used to deliver messages to the users based on individual progress, helping them to achieve health targets and reduce risks. Despite these promises, however, the public health potential of wearable health monitors remains untapped, as no studies to date have explored ways in which such devices could support health policy and programmes. This project aims to conduct a preliminary evaluation of this potential, laying the foundation of a more comprehensive multi-country study. Research activities will be conducted in Cambodia, where a prototype device will be deployed for field evaluation. This is an exemplary case country in which most research and prevention to date have focused on infectious diseases, while non-communicable diseases have received much less attention and support despite their increasing importance. In this context, the introduction of wearable devices could be useful for strengthening preventive programmes and monitoring of population health. Aware that the introduction of a novel technology is a complex process, we will explore the full range of institutional, socio-economic and technical factors that may be more or less conducive to the uptake of the proposed innovation, with particular attention to the response of individual users.