Mapping Theories, Models, and Frameworks to Evaluate Digital Health Interventions: Scoping Review
BackgroundDigital health interventions (DHIs) are a central focus of health care transformation efforts, yet their uptake in practice continues to fall short of their potential. In order to achieve their desired outcomes and impact, DHIs need to reach their target population...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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JMIR Publications
2024-02-01
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| Series: | Journal of Medical Internet Research |
| Online Access: | https://www.jmir.org/2024/1/e51098 |
| _version_ | 1797323971001057280 |
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| author | Geneviève Rouleau Kelly Wu Karishini Ramamoorthi Cherish Boxall Rebecca H Liu Shelagh Maloney Jennifer Zelmer Ted Scott Darren Larsen Harindra C Wijeysundera Daniela Ziegler Sacha Bhatia Vanessa Kishimoto Carolyn Steele Gray Laura Desveaux |
| author_facet | Geneviève Rouleau Kelly Wu Karishini Ramamoorthi Cherish Boxall Rebecca H Liu Shelagh Maloney Jennifer Zelmer Ted Scott Darren Larsen Harindra C Wijeysundera Daniela Ziegler Sacha Bhatia Vanessa Kishimoto Carolyn Steele Gray Laura Desveaux |
| author_sort | Geneviève Rouleau |
| collection | DOAJ |
| description |
BackgroundDigital health interventions (DHIs) are a central focus of health care transformation efforts, yet their uptake in practice continues to fall short of their potential. In order to achieve their desired outcomes and impact, DHIs need to reach their target population and need to be used. Many factors can rapidly intersect between this dynamic of users and interventions. The application of theories, models, and frameworks (TMFs) can facilitate the systematic understanding and explanation of the complex interactions between users, practices, technology, and health system factors that underpin research questions. There remains a gap in our understanding of how TMFs have been applied to guide the evaluation of DHIs with real-world health system operations.
ObjectiveThis study aims to map TMFs used in studies to guide the evaluation of DHIs. The objectives are to (1) describe the TMFs and the constructs they target, (2) identify how TMFs have been prospectively used (ie, their roles) in primary studies to evaluate DHIs, and (3) to reflect on the relevance and utility of our findings for knowledge users.
MethodsThis scoping review was conducted in partnership with knowledge users using an integrated knowledge translation approach. We included papers (eg, reports; empirical quantitative, qualitative, and mixed methods studies; conference proceedings; and dissertations) if primary insights resulting from the application of TMFs were presented. Any type of DHI was eligible. Papers published from 2000 and onward were mainly identified from the following databases: MEDLINE (Ovid), CINAHL Complete (EBSCOhost), PsycINFO (Ovid), EBM Reviews (Ovid), and Embase (Ovid).
ResultsA total of 156 studies published between 2000 and 2022 were included. A total of 68 distinct TMFs were identified across 85 individual studies. In more than half (85/156, 55%) of the included studies, 1 of following 6 prevailing TMFs were reported: Consolidated Framework for Implementation Research (n=39); the Reach, Effectiveness, Adoption, Implementation, and Maintenance Framework (n=17); the Technology of Acceptance Model (n=16); the Unified Theory on Acceptance and Use of Technology (n=12); the Diffusion of Innovation Theory (n=10); and Normalization Process Theory (n=9). The most common intended roles of the 6 TMFs were to inform data collection (n=86), to inform data analysis (n=69), and to identify key constructs that may serve as barriers and facilitators (n=52).
ConclusionsAs TMFs are most often reported to be applied to support data collection and analysis, researchers should consider more clearly synthesizing key insights as practical use cases to both increase the relevance and digestibility of their findings. There is also a need to adapt or develop guidelines for better reporting DHIs and the use of TMFs to guide evaluation. Hence, it would contribute to ensuring ongoing technology transformation efforts are evidence and theory informed rather than anecdotally driven. |
| first_indexed | 2024-03-08T05:36:40Z |
| format | Article |
| id | doaj.art-390f7b94001c41b9ab7c6b4f2325d3bf |
| institution | Directory Open Access Journal |
| issn | 1438-8871 |
| language | English |
| last_indexed | 2024-03-08T05:36:40Z |
| publishDate | 2024-02-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | Journal of Medical Internet Research |
| spelling | doaj.art-390f7b94001c41b9ab7c6b4f2325d3bf2024-02-05T16:00:48ZengJMIR PublicationsJournal of Medical Internet Research1438-88712024-02-0126e5109810.2196/51098Mapping Theories, Models, and Frameworks to Evaluate Digital Health Interventions: Scoping ReviewGeneviève Rouleauhttps://orcid.org/0000-0003-1093-6577Kelly Wuhttps://orcid.org/0000-0002-9805-5514Karishini Ramamoorthihttps://orcid.org/0000-0002-7066-0560Cherish Boxallhttps://orcid.org/0000-0002-7850-233XRebecca H Liuhttps://orcid.org/0000-0002-3946-4035Shelagh Maloneyhttps://orcid.org/0009-0001-7298-6900Jennifer Zelmerhttps://orcid.org/0000-0002-1556-6686Ted Scotthttps://orcid.org/0000-0002-6190-050XDarren Larsenhttps://orcid.org/0000-0003-0614-4251Harindra C Wijeysunderahttps://orcid.org/0000-0001-8464-1080Daniela Zieglerhttps://orcid.org/0000-0002-7210-5296Sacha Bhatiahttps://orcid.org/0000-0001-6206-5318Vanessa Kishimotohttps://orcid.org/0000-0002-4516-1225Carolyn Steele Grayhttps://orcid.org/0000-0002-2146-0001Laura Desveauxhttps://orcid.org/0000-0003-3429-1865 BackgroundDigital health interventions (DHIs) are a central focus of health care transformation efforts, yet their uptake in practice continues to fall short of their potential. In order to achieve their desired outcomes and impact, DHIs need to reach their target population and need to be used. Many factors can rapidly intersect between this dynamic of users and interventions. The application of theories, models, and frameworks (TMFs) can facilitate the systematic understanding and explanation of the complex interactions between users, practices, technology, and health system factors that underpin research questions. There remains a gap in our understanding of how TMFs have been applied to guide the evaluation of DHIs with real-world health system operations. ObjectiveThis study aims to map TMFs used in studies to guide the evaluation of DHIs. The objectives are to (1) describe the TMFs and the constructs they target, (2) identify how TMFs have been prospectively used (ie, their roles) in primary studies to evaluate DHIs, and (3) to reflect on the relevance and utility of our findings for knowledge users. MethodsThis scoping review was conducted in partnership with knowledge users using an integrated knowledge translation approach. We included papers (eg, reports; empirical quantitative, qualitative, and mixed methods studies; conference proceedings; and dissertations) if primary insights resulting from the application of TMFs were presented. Any type of DHI was eligible. Papers published from 2000 and onward were mainly identified from the following databases: MEDLINE (Ovid), CINAHL Complete (EBSCOhost), PsycINFO (Ovid), EBM Reviews (Ovid), and Embase (Ovid). ResultsA total of 156 studies published between 2000 and 2022 were included. A total of 68 distinct TMFs were identified across 85 individual studies. In more than half (85/156, 55%) of the included studies, 1 of following 6 prevailing TMFs were reported: Consolidated Framework for Implementation Research (n=39); the Reach, Effectiveness, Adoption, Implementation, and Maintenance Framework (n=17); the Technology of Acceptance Model (n=16); the Unified Theory on Acceptance and Use of Technology (n=12); the Diffusion of Innovation Theory (n=10); and Normalization Process Theory (n=9). The most common intended roles of the 6 TMFs were to inform data collection (n=86), to inform data analysis (n=69), and to identify key constructs that may serve as barriers and facilitators (n=52). ConclusionsAs TMFs are most often reported to be applied to support data collection and analysis, researchers should consider more clearly synthesizing key insights as practical use cases to both increase the relevance and digestibility of their findings. There is also a need to adapt or develop guidelines for better reporting DHIs and the use of TMFs to guide evaluation. Hence, it would contribute to ensuring ongoing technology transformation efforts are evidence and theory informed rather than anecdotally driven.https://www.jmir.org/2024/1/e51098 |
| spellingShingle | Geneviève Rouleau Kelly Wu Karishini Ramamoorthi Cherish Boxall Rebecca H Liu Shelagh Maloney Jennifer Zelmer Ted Scott Darren Larsen Harindra C Wijeysundera Daniela Ziegler Sacha Bhatia Vanessa Kishimoto Carolyn Steele Gray Laura Desveaux Mapping Theories, Models, and Frameworks to Evaluate Digital Health Interventions: Scoping Review Journal of Medical Internet Research |
| title | Mapping Theories, Models, and Frameworks to Evaluate Digital Health Interventions: Scoping Review |
| title_full | Mapping Theories, Models, and Frameworks to Evaluate Digital Health Interventions: Scoping Review |
| title_fullStr | Mapping Theories, Models, and Frameworks to Evaluate Digital Health Interventions: Scoping Review |
| title_full_unstemmed | Mapping Theories, Models, and Frameworks to Evaluate Digital Health Interventions: Scoping Review |
| title_short | Mapping Theories, Models, and Frameworks to Evaluate Digital Health Interventions: Scoping Review |
| title_sort | mapping theories models and frameworks to evaluate digital health interventions scoping review |
| url | https://www.jmir.org/2024/1/e51098 |
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