Health Informatics: Three key themes and the academic-professional context

In this article we discuss a conceptual approach to Health Informatics. We then review the status, trends, and main challenges in relation to three themes in the development of this field: patient empowerment, equity in health, and data science application to health. We conclude with a brief review of the academic context and professional associations, both in Spain and at the international level

IMPLEMENTATION OF HEALTH-RELATED SMARTPHONE APPLICATIONS IN LOW- AND MIDDLE- INCOME COUNTRIES: SCOPING REVIEW AND LEARNINGS FROM THE CHILDSAFE APPLICATION IN MALAYSIA

While digital technologies such as smartphone apps have become an increasingly popular way to deliver health interventions, implementation and scale up remains a recognized challenge. Recently, the Johns Hopkins International Injury Research Unit and the Institute for Public Health in Malaysia collaborated in the development of a smartphone app for child injury prevention called ChildSafe that was piloted in Malaysia. The aim of this dissertation was to better understand the implementation of health apps in low- and middle-income countries to identify opportunities and gaps for future research, as well as to strengthen the design, implementation, and dissemination of the ChildSafe app. We had three objectives: 1) to better understand the current state of the peer-reviewed literature on the use and implementation of health apps in low- and middle-income countries; 2) to assess the adoption, fidelity, acceptability, and process of user engagement through the ChildSafe app; and 3) to examine the facilitators and barriers to implementation of the ChildSafe app from the perspective of caregivers of children under five. This dissertation comprises of three manuscript-oriented chapters, each presenting the results from one of these objectives. The first manuscript, “Use and Implementation of Health-Related Smartphone Apps in Low- and Middle-Income Countries” presents the results of a scoping review that identified gaps in the literature on the implementation of health apps in low- and middle-income countries. Building on these learnings, the second manuscript, “Adoption, Fidelity, and Acceptability of a Smartphone App for Child Injury Prevention” assessed the implementation of the ChildSafe app from multiple dimensions to generate insight to strengthen its design, implementation, and dissemination that may be relevant to other similar health apps. Finally, the third manuscript, “Facilitators and Barriers to Use and Implementation of a Smartphone App for Child Injury Prevention in Malaysia” applied an established implementation framework to identify facilitators and barriers to use and implementation of the ChildSafe app to contribute to a broader conceptual understanding of the implementation of health apps. Together, these manuscripts make the case for and demonstrate the value of considering implementation from the early stages of digital development through implementation and scale up

Assessing the quality of mobile apps for oral health: content analysis and usability

AIM: To review and characterize dental mobile apps in the peer-reviewed literature and two popular mobile app stores, and assess their quality. METHODS: A scoping review methodology was used to identify different types of mobile dental apps in seven medical and technical databases. The data of the identified research studies on dental apps were extracted (coded) by two researchers in a systematic process and the results were analyzed. Dental apps’ characteristics, publication pattern, development methodology, efficacy, and usability were reported. Then, a systematic review was conducted in Google Play and iOS app stores to identify patient-facing dental apps. Popular keywords were identified from multiple sources such as using Google Trends. Two researchers extracted the information of the identified dental apps and descriptive, and correlation analyses were conducted. Apps were evaluated for the presence of behavior change techniques (BCTs), evidence-based guidelines, technological features, privacy and security, credibility and health literacy. Lastly, a quality assessment using MARS scale was conducted for a selected sample of dental patient-facing apps from the published literature and the popular app stores. RESULTS: The search resulted in 38 studies on dental apps. The identified dental apps (37) targeted multiple users and the common topic was oral pathology such as dental caries. The majority of dental apps was developed for diagnostics and screening purposes (40.5%). Apps included varied features and educational strategies. Only two papers used theories for developing dental apps, and five studies followed user-centered design principles. Fourteen papers only reported the use of clinical guidelines for developing dental apps (36.8%). Mobile app search resulted in 52 patient-facing dental apps (37 Android apps, and 15 iOS apps). The majority of apps focused on Oral Hygiene Behavior (31%). Apps targeted multiple users and contained varied features and BCTs including instructions (80.8%) and credible source (67.3%). Eleven apps were identified for the third project and the highest total MARS score was Philips Sonicare. The app contained the largest number of features compared to other apps (24). CONCLUSION: The dissertation will warrant the selection and prescription of high-quality dental apps, and will advance the research work in mobile apps in dentistry