Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
Centre for Global eHealth Innovation, Techna Institute, University Health Network, Toronto, ON, Canada.
JMIR Mhealth Uhealth. 2019 Oct 7;7(10):e14275. doi: 10.2196/14275.
Cardiovascular disease (CVD) has grown to become one of the leading causes of mortality worldwide. The advancements of CVD-related treatments have led to a decline in CVD prevalence among individuals in high-income countries (HICs). However, these improvements do not reflect the state of individuals in low- and middle-income countries (LMICs) and vulnerable subgroup populations in HICs, such as the Indigenous. To help minimize the health disparities in these populations, technology-based interventions have been offered as a potential solution, but there is concern regarding if they will be effective, or even needed, as these tools have been designed for use in HICs.
The objective of this study was to explore how mobile health (mHealth) interventions currently assist individuals in Indigenous communities and LMICs with CVD management.
A scoping review guided by the methods outlined by Arksey and O'Malley was conducted. A comprehensive search was completed by 2 reviewers in 5 electronic databases using keywords related to mobile health, cardiovascular disease, self-care, Indigenous communities, and LMICs. Studies were screened over 2 rounds and critically reviewed using a descriptive-analytical narrative method. Descriptive data were categorized into thematic groups reflecting the major findings related to the study objective.
We identified a total of 11 original articles and 11 review papers that met the criteria for this scoping review. The majority of the studies included a telemonitoring- and text messaging (short message service, SMS)-related feature associated with the intervention. The use of SMS was the most common approach to effectively promote disease management among individuals in both LMICs and Indigenous communities. However, customizing for cultural considerations within the design of the intervention was highlighted as a pivotal component to encourage CVD management. Specifically, individuals emphasized that the inclusion of collaborative partnerships with community members would strengthen the effectiveness of the intervention by ensuring it was designed with the appropriate context.
Technology-based interventions used within Indigenous communities and LMICs have shown their potential to assist individuals with managing their condition. Although the literature available regarding this topic is limited, this review outlines key components to promote the effective use of these tools in the context of these vulnerable populations.
心血管疾病（CVD）已成为全球主要死亡原因之一。CVD 相关治疗的进步导致高收入国家（HIC）人群 CVD 患病率下降。然而，这些改善并未反映出中低收入国家（LMIC）和 HIC 中弱势群体（如原住民）的状况。为了帮助缩小这些人群的健康差距，已提出基于技术的干预措施作为一种潜在的解决方案，但有人担心这些干预措施是否有效，甚至是否需要，因为这些工具是专为 HIC 设计的。
本研究旨在探讨移动健康（mHealth）干预措施目前如何帮助原住民社区和 LMIC 人群管理 CVD。
采用 Arksey 和 O'Malley 方法学指南进行范围综述。两名审查员在 5 个电子数据库中使用与移动健康、心血管疾病、自我护理、原住民社区和 LMIC 相关的关键词完成了全面搜索。研究经过两轮筛选，并使用描述性分析叙述方法进行了批判性审查。描述性数据分为反映与研究目标相关的主要发现的主题组。
我们确定了 11 篇原始文章和 11 篇综述文章，这些文章符合本范围综述的标准。大多数研究包括与干预措施相关的远程监测和短信（短消息服务，SMS）功能。使用 SMS 是在 LMIC 和原住民社区中促进个体疾病管理的最常见方法。然而，突出强调了在干预措施设计中定制文化考虑因素作为鼓励 CVD 管理的关键组成部分。具体而言，个体强调，与社区成员建立合作伙伴关系将通过确保以适当的背景设计干预措施来增强干预措施的有效性。
在原住民社区和 LMIC 中使用的基于技术的干预措施已显示出帮助个体管理其病情的潜力。尽管关于这一主题的文献有限，但本综述概述了在这些弱势群体背景下促进有效使用这些工具的关键组成部分。
