Nursing Department, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
J Med Internet Res. 2024 Nov 26;26:e56556. doi: 10.2196/56556.
With advances in medical technologies, more children with chronic diseases are now living on into adulthood. The development of proficient self-management skills is essential for adolescents and young adults to transition from pediatric to adult health care services. An innovative way to improve the current care model and foster self-management skills could be through eHealth or mHealth (mobile health) interventions, in particular, when considering the rising ownership of digital technology by adolescents and young adults.
This systematic review aimed to evaluate the features, acceptability, usability, engagement, and intervention efficacy of eHealth and mHealth interventions that support self-management and health care transition in adolescents and young adults with chronic disease.
This review followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) reporting guidelines (registration number CRD42023378355). We systematically searched the MEDLINE complete, Embase, Cochrane Library, CINAHL complete, and ProQuest Health & Medical complete. We considered only articles published in or since 2019, as we aimed to extend the data collected by 2 previous systematic reviews.
A total of 16,752 studies were screened. After removing duplicates, 14,507 studies were excluded based on the title and abstract. Ultimately, 22 studies were included. The interventions ranged from simple text messages to complex interventions involving web-based games and engagement of health care providers, which were summarized into 6 themes: medication monitoring and reminders, symptom tracking and monitoring, management goal setting, knowledge education and self-management skills training, incentives and reinforcement, and communication. Most adolescents and young adults felt the eHealth and mHealth interventions were feasible, as they were convenient, easy to use, and accessible in the context of helping manage their health. However, user engagement was variable and presented a gradual decline in youth engagement with these apps over time. Barriers that prevent user engagement are diverse, such as time-consuming video uploads, noncontinuous access to a phone, reading literacy levels, language, and false impressions. Moreover, adolescents and young adults had different preferred styles of message delivery and functions, especially the engaging elements, disease-specific information, and opportunities to communicate with peers, health care providers, and app teams.
There remains limited data about the effectiveness of eHealth and mHealth interventions facilitating the self-management and health care transition of adolescents and young adults with chronic diseases. Based on the available evidence, they were receptive to and interested in receiving information and managing their health using mobile apps or websites. Considering adolescents and young adults had different preferred styles of message delivery and features, to improve user engagement and provide focused interventions, it would be better to involve them early in the design process to identify their specific needs, as well as collaborate with health care providers and app teams to obtain suggestions.
随着医疗技术的进步，现在有更多患有慢性疾病的儿童能够进入成年期。青少年和年轻人要从儿科医疗服务过渡到成人医疗服务，熟练掌握自我管理技能至关重要。通过电子健康（eHealth）或移动健康（mHealth）干预措施，特别是考虑到青少年和年轻人对数字技术的拥有率不断上升，这可能是改善当前护理模式和培养自我管理技能的一种创新方法。
本系统评价旨在评估支持慢性病青少年和年轻人自我管理和医疗过渡的 eHealth 和 mHealth 干预措施的特征、可接受性、可用性、参与度和干预效果。
本研究遵循 PRISMA（系统评价和荟萃分析的首选报告项目）报告指南（注册号 CRD42023378355）。我们系统地检索了 MEDLINE 完整、Embase、Cochrane 图书馆、CINAHL 完整和 ProQuest 健康与医学完整数据库。我们只考虑了自 2019 年或之后发表的文章，因为我们旨在扩展之前 2 项系统评价所收集的数据。
共筛选出 16752 项研究。剔除重复项后，根据标题和摘要排除了 14507 项研究。最终纳入 22 项研究。这些干预措施范围从简单的短信到涉及基于网络的游戏和医疗保健提供者参与的复杂干预措施，可总结为 6 个主题：药物监测和提醒、症状跟踪和监测、管理目标设定、知识教育和自我管理技能培训、激励和强化以及沟通。大多数青少年和年轻人认为 eHealth 和 mHealth 干预措施是可行的，因为它们在帮助管理健康方面方便、易用且可及。然而，用户参与度各不相同，并且随着时间的推移，青少年对这些应用程序的参与度逐渐下降。阻碍用户参与的因素多种多样，例如上传视频耗时、手机无法连续使用、阅读读写水平、语言以及错误印象等。此外，青少年和年轻人对消息传递和功能的偏好风格不同，特别是他们喜欢的互动元素、特定疾病的信息以及与同龄人、医疗保健提供者和应用程序团队沟通的机会。
目前关于促进慢性病青少年和年轻人自我管理和医疗过渡的 eHealth 和 mHealth 干预措施的有效性数据有限。根据现有证据，他们愿意并有兴趣通过移动应用程序或网站接收信息并管理自己的健康。考虑到青少年和年轻人对消息传递和功能的偏好风格不同，为了提高用户参与度并提供针对性的干预措施，最好在设计过程早期让他们参与进来，以确定他们的特定需求，并与医疗保健提供者和应用程序团队合作，以获得建议。
