Scaling Up mHealth: Where Is the Evidence?

Centre for Public Mental Health, Department of Psychology, Stellenbosch University, Stellenbosch, South Africa.
PLoS Medicine (Impact Factor: 14.43). 02/2013; 10(2):e1001382. DOI: 10.1371/journal.pmed.1001382
Source: PubMed


Mark Tomlinson and colleagues question whether there is sufficient evidence on implementation and effectiveness to match the wide enthusiasm for mHealth interventions, and propose a global strategy to determine needed evidence to support mHealth scale-up.

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    • "This research concluded Smartphone applications for pregnant women will be an effective educational tool compared to other existing mediators even though frequency or scope of using it would be varied according to the user's age. Frequently mentioned challenges of research on APE using Smartphone are methodological issues and lack of strong evidence for the use of mHealth [26], [27]. Accordingly, Educational use of Smartphones in the real world has to be studied closely to seek advanced ways of antenatal parent education using ICTs. "

    01/2016; 6(5):404-409. DOI:10.7763/IJIET.2016.V6.722
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    • "i - sions about whether , or how , to do so ( ExpandNet , 2009 ) . Our findings are supported by other studies that also identify that the rigor of mHealth evaluations must be improved to increase both the scientific value and program - matic utility of evaluation results ( Bloomfield et al . , 2014 ; Kumar et al . , 2013 ; Nilsen et al . , 2012 ; Tomlinson et al . , 2013 ; WHO , 2011 ) . Such evidence would be critical to balance expectations with potential , to avoid wasteful"
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    ABSTRACT: mHealth-the use of mobile technologies for health-is a growing element of health system activity globally, but evaluation of those activities remains quite scant, and remains an important knowledge gap for advancing mHealth activities. In 2010, the World Health Organization and Columbia University implemented a small-scale survey to generate preliminary data on evaluation activities used by mHealth initiatives. The authors describe self-reported data from 69 projects in 29 countries. The majority (74%) reported some sort of evaluation activity, primarily nonexperimental in design (62%). The authors developed a 6-point scale of evaluation rigor comprising information on use of comparison groups, sample size calculation, data collection timing, and randomization. The mean score was low (2.4); half (47%) were conducting evaluations with a minimum threshold (4 + ) of rigor, indicating use of a comparison group, while less than 20% had randomized the mHealth intervention. The authors were unable to assess whether the rigor score was appropriate for the type of mHealth activity being evaluated. What was clear was that although most data came from mHealth projects pilots aimed for scale-up, few had designed evaluations that would support crucial decisions on whether to scale up and how. Whether the mHealth activity is a strategy to improve health or a tool for achieving intermediate outcomes that should lead to better health, mHealth evaluations must be improved to generate robust evidence for cost-effectiveness assessment and to allow for accurate identification of the contribution of mHealth initiatives to health systems strengthening and the impact on actual health outcomes.
    Journal of Health Communication 06/2015; 20(10):1-6. DOI:10.1080/10810730.2015.1018624 · 1.61 Impact Factor
    • "Currently over 50,000 health apps are available worldwide [1] compared to the number 17,000 in 2010 [2], meanwhile, there are increased concerns about the quality of health apps. For instance, a certain amount of health apps are released without clinical trials and lack evidence-based content [3] [4], mechanisms for protection of patients' health data, and regulations [5] [6] [7]. Previous research on the dissemination of health apps has shown that physicians are considered as a potential channel for introducing health apps to patients [8]. "
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    ABSTRACT: Currently over 50, 000 mobile health apps are available worldwide. In general, they are considered as innovations potentially delivering benefits to patients. Physicians are considered as potential channels to disseminate these innovations to patients. However, physicians' behavior in this regard has not been studied. To capture physicians' attitudes towards recommending health apps to patients and to describe factors influencing physicians' behavior, taking the specifics of an early adopter country, Sweden, into account. Diffusion of Innovation theory, the Health App Maturity Model and the Six Hurdles Model were used to construct a web-based survey that was answered by 44 Swedish physicians. Survey results were followed up with 2 individual interviews. Descriptive statistics were used for quantitative data analysis and recursive abstraction for qualitative data analysis. Only a small group of physicians currently recommend mobile health apps to their patients. However, most physicians have a positive attitude and perceive improvement of patients' self-management ability as main benefit of health apps. Main perceived weaknesses include the lack of evidence-based content and lack of multi-language support. Regulation of health apps under the Medical Device Directive is asked for to assure quality and patient safety. Innovators and early adopters play an important role in the diffusion of mobile health apps. Interpersonal communication is seen as the most effective way for physicians gaining information and also motivates them to recommend mobile health apps to their patients. Physicians' knowledge about certified websites to ensure quality is however low.
    Studies in health technology and informatics 05/2015; 210:793-7. DOI:10.3233/978-1-61499-512-8-793
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