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利用移动电话改善中低收入国家年轻人的性健康和生殖健康:系统评价以确定障碍、促进因素和各种移动健康解决方案。

Using mobile phones to improve young people sexual and reproductive health in low and middle-income countries: a systematic review to identify barriers, facilitators, and range of mHealth solutions.

机构信息

Department of Community Health Sciences, The Aga Khan University, Stadium Road, PO Box 3500, Karachi, 74800, Pakistan.

Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada.

出版信息

Reprod Health. 2021 Jan 16;18(1):9. doi: 10.1186/s12978-020-01059-7.


DOI:10.1186/s12978-020-01059-7
PMID:33453723
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7811742/
Abstract

BACKGROUND: Globally, reproductive health programs have used mHealth to provide sexual and reproductive health (SRH) education and services to young people, through diverse communication channels. However, few attempts have been made to systematically review the mHealth programs targeted to improve young people SRH in low-and-middle-income countries (LMICs). This review aims to identify a range of different mHealth solutions that can be used for improving young people SRH in LMICs and highlight facilitators and barriers for adopting mHealth interventions designed to target SRH of young people. METHODS: Databases including PubMed, CINAHL Plus, Science Direct, Cochrane Central, and grey literature were searched between January 01, 2005 and March 31, 2020 to identify various types of mHealth interventions that are used to improve SRH services for young people in LMICs. Of 2948 titles screened after duplication, 374 potentially relevant abstracts were obtained. Out of 374 abstracts, 75 abstracts were shortlisted. Full text of 75 studies were reviewed using a pre-defined data extraction sheet. A total of 15 full-text studies were included in the final analysis. RESULTS: The final 15 studies were categorized into three main mHealth applications including client education and behavior change communication, data collection and reporting, and financial transactions and incentives. The most reported use of mHealth was for client education and behavior change communication [n = 14, 93%] followed by financial transactions and incentives, and data collection and reporting Little evidence exists on other types of mHealth applications described in Labrique et al. framework. Included studies evaluated the impact of mHealth interventions on access to SRH services (n = 9) and SRH outcomes (n = 6). mHealth interventions in included studies addressed barriers of provider prejudice, stigmatization, discrimination, fear of refusal, lack of privacy, and confidentiality. The studies also identified barriers to uptake of mHealth interventions for SRH including decreased technological literacy, inferior network coverage, and lower linguistic competency. CONCLUSION: The review provides detailed information about the implementation of mobile phones at different levels of the healthcare system for improving young people SRH outcomes. This systematic review recommends that barriers to uptake mHealth interventions be adequately addressed to increase the potential use of mobile phones for improving access to SRH awareness and services. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42018087585 (Feb 5, 2018).

摘要

背景:在全球范围内,生殖健康计划利用移动医疗通过各种沟通渠道向年轻人提供性健康和生殖健康教育和服务。然而,很少有尝试对针对中低收入国家年轻人生殖健康的移动医疗计划进行系统审查。本综述旨在确定一系列不同的移动医疗解决方案,可用于改善中低收入国家年轻人的生殖健康,并强调采用旨在针对年轻人生殖健康的移动医疗干预措施的促进因素和障碍。

方法:在 2005 年 1 月 1 日至 2020 年 3 月 31 日期间,检索了 PubMed、CINAHL Plus、Science Direct、Cochrane Central 和灰色文献数据库,以确定各种类型的移动医疗干预措施,用于改善中低收入国家年轻人的生殖健康服务。在重复后筛选出的 2948 个标题中,获得了 374 个潜在相关的摘要。从 374 个摘要中,筛选出 75 个摘要。使用预先定义的数据提取表对 75 篇研究的全文进行了审查。共有 15 篇全文研究被纳入最终分析。

结果:最终的 15 项研究分为三个主要的移动医疗应用领域,包括客户教育和行为改变沟通、数据收集和报告以及金融交易和激励措施。使用移动医疗进行客户教育和行为改变沟通的报道最多[ n=14,93%],其次是金融交易和激励措施以及数据收集和报告。Labrique 等人框架中描述的其他类型的移动医疗应用证据很少。纳入的研究评估了移动医疗干预措施对获得生殖健康服务的影响( n=9)和生殖健康结果的影响( n=6)。纳入研究中的移动医疗干预措施解决了提供者偏见、污名化、歧视、拒绝恐惧、缺乏隐私和保密性等障碍。研究还确定了接受生殖健康移动医疗干预措施的障碍,包括技术素养降低、网络覆盖不足和语言能力较低。

结论:本综述提供了有关在医疗保健系统的不同层面实施手机以改善年轻人生殖健康结果的详细信息。本系统评价建议充分解决移动医疗干预措施的采用障碍,以增加手机在提高生殖健康意识和服务获取方面的潜在用途。

系统评价注册:PROSPERO CRD42018087585(2018 年 2 月 5 日)。

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本文引用的文献

[1]
A quasi-experimental text messaging trial to improve adolescent sexual and reproductive health and smoking knowledge in Indonesia.

Sex Health. 2020-4

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Using mobile phones to improve young people's sexual and reproductive health in low- and middle-income countries: a systematic review protocol to identify barriers, facilitators and reported interventions.

Syst Rev. 2019-5-18

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Reprod Health. 2017-1-17

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