The characteristics and acceptance of Technology-Enabled diabetes prevention programs (t-DPP) amongst individuals with prediabetes: A scoping review.

AIM AND OBJECTIVE: As rising global prevalence of diabetes burdens an overstrained healthcare system, it would be prudent to employ primary prevention strategies. This review aims to detail characteristics of technology-enabled diabetes prevention programs (t-DPP) and the technology acceptance amongst prediabetic individuals. DESIGN: A scoping review. REVIEW METHODS: Summative and direct content analysis. DATA SOURCES: Seven electronic databases-PubMed, Cochrane, Embase, CINAHL, Scopus, PsycINFO and Web of Science-were searched from inception till 9 June 2022 for primary studies conducted on t-DPP. Initial search identified 2412 unique articles. Removal of duplicates and irrelevant articles resulted in 58 full text articles screened and 17 articles meeting the eligibility criteria. There was no limitation to study type or year of publication, but language was limited to English. RESULTS: Common t-DPP characteristics include physical activity (n = 17), diet control (n = 16), coaching (n = 12), social support (n = 9) and skills acquisition (n = 12). Technological acceptance of t-DPPs were generally positive as participants found them useful (n = 5) and easy to use (n = 4), with majority of the participants interested (n = 5) and engaging well with it (n = 13). However, personal-, design- and technological-level factors were found to negatively influence t-DPPs acceptance. CONCLUSION: This review reported a generally positive technological acceptance. The result encourages remote delivery of diabetes prevention programs, offering researchers a guide to t-DPP development. However, it also highlights the need for integration of behavioural change theories and socio-cultural considerations, with gaps in knowledge amongst men and young adults. IMPLICATIONS FOR NURSING: The success of t-DPP can reinforce clinical advice and sustain health behaviours advocated by nurses. Involvement of diabetes-trained nurses would enable continual risk assessment, monitoring and timely intervention to prevent diabetes and potential complications. REPORTING METHOD: PRISMA-ScR checklist.

Barriers and facilitators to the adoption of digital health interventions for COPD management: A scoping review.

BACKGROUND: Knowledge of the barriers and facilitators in the adoption of digital health interventions (DHI) is sparse yet crucial to facilitate chronic obstructive pulmonary disease (COPD) management. OBJECTIVES: This scoping review aimed to summarize patient- and healthcare provider-level barriers and facilitators in the adoption of DHIs for COPD management. METHODS: Nine electronic databases were searched from inception up till October 2022 for English language evidence. Inductive content analysis was used. RESULTS: This review included 27 papers. Frequent patient-level barriers were poor digital literacy (n = 6), impersonal care delivery (n = 4), and fear of being controlled by telemonitoring data (n = 4). Frequent patient-level facilitators were improved disease understanding and management (n = 17), bi-directional communication and contact with healthcare providers (n = 15), and remote monitoring and feedback (n = 14). Frequent healthcare provider-level barriers were increased workload (n = 5), lack of technology interoperability with existing health systems (n = 4), lack of funding (n = 4), and lack of dedicated and trained manpower (n = 4). Frequent healthcare provider-level facilitators were improved efficiency of care delivery (n = 6) and DHI training programmes (n = 5). CONCLUSION: DHIs have the potential to facilitate COPD self-management and improve efficiency of care delivery. However, several barriers challenge its successful adoption. Attaining organizational support in developing user centric DHIs that can be integrated and are interoperable with existing health systems is crucial if we are to witness tangible return on investments at the patient-, healthcare provider- and healthcare system-level.

Effectiveness of caregiver-mediated exercise interventions on activities of daily living, anxiety and depression post-stroke rehabilitation: A systematic review and meta-analysis.

AIMS: This review aims to examine updated evidence to evaluate the effectiveness of caregiver-mediated exercise interventions on basic and extended activities of daily living (ADL), anxiety and depression of post-stroke rehabilitation individuals. DESIGN: A systematic review and meta-analysis. DATA SOURCES: Six electronic databases, including CINAHL, CENTRAL, Embase, PubMed, PsycINFO and Scopus, grey literature and trial registry were searched from inception until February 2021. METHODS: Only randomized controlled trials written in English were included. Meta-analyses were conducted for basic and extended ADL, anxiety and depression outcomes using RevMan software. Overall quality of evidence was assessed using Grading of Recommendations, Assessment, Development and Evaluation framework. RESULTS: A total of 11 randomized controlled trials comprising 2120 participants were identified, with 10 trials meta-analysed. Meta-analyses indicated statistically significant effects favouring caregiver-mediated exercise interventions for basic ADL. Subgroup analyses revealed significant effects for exercise-only interventions mediated by caregivers for basic ADL. No significant effects were found for extended ADL, anxiety and depression for stroke survivors. CONCLUSION: Caregiver-mediated exercise interventions appear to have beneficial impacts on basic ADL for stroke survivors, suggesting caregiver-mediated exercise interventions as a potentially feasible way to improve functional independence. IMPACT: Caregiver-mediated intervention with exercises as a major component could be a promising approach to augment stroke rehabilitation. Future research should include high-quality studies with focus on specific intervention components or to explore caregiver outcomes.

Effectiveness of eHealth-based cognitive behavioural therapy on depression: A systematic review and meta-analysis.

AIMS AND OBJECTIVES: To systematically appraise the effects of eHealth cognitive behavioural therapy on depression and anxiety severity, quality of life, adherence and attrition rates observed in adults with clinically diagnosed depression. BACKGROUND: eHealth-based cognitive behavioural therapy is an increasingly popular intervention on depression, but current reviews investigating the effects of eHealth interventions on depression are not exclusive to the clinically depressed. DESIGN: A systematic review and meta-analysis. METHODS: Following the PRISMA guidelines, a systematic search of randomised controlled trials related to eHealth cognitive behavioural therapy published from inception from six databases and three trial registries was undertaken. RESULTS: A total of 15 studies were included in this systematic review. The meta-analysis revealed that, when compared to passive comparators, eHealth cognitive behavioural therapy had a statistically significant effect on depression (d = -0.62, 95% CI: -0.96 to -0.28, p = .0003) and anxiety severity (d = -0.65, 95% CI: -1.10 to -0.21, p = .004) but not for quality of life (d = 0.30, 95% CI: -0.09 to 0.07, p = .13). When compared to active comparators, a statistically significant effect on depression (d = -0.31, 95% CI: -0.55 to -0.07, p = .01) and anxiety severity (d = -0.50, 95% CI: -0.81 to -0.19, p = .002) was observed, but not for quality of life (d = 0.22, 95% CI: -0.04 to 0.48, p = .10). Weighted averages for adherence and attrition rates were low. CONCLUSION: eHealth cognitive behavioural therapy showed effectiveness in reducing depression and anxiety severity, but not quality of life. Further research is required to culturally adapt CBT interventions and explore the long-term benefits of eHealth cognitive behavioural therapy. RELEVANCE TO CLINICAL PRACTICE: The use of eHealth-based cognitive behavioural therapy could potentially bridge treatment gaps and serve as an adjunct to active treatment plans or an alternative for those without access to treatment.