Methodological challenges in systematic reviews of mHealth interventions: Survey and consensus-based recommendations

Jesus Lopez-Alcalde*, L Susan Wieland, Jürgen Barth, Rebecca Grainger, Nancy Baxter, Neil Heron, Andreas Triantafyllidis, Carme Carrion, Eleonora M C Trecca, Felix Holl, Ana Maria Wägner, Sarah Edney, Yuqian Yan, Concepción Campos-Asensio, Gemma Villanueva, Rachelle R Ramsey, Claudia M Witt

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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Abstract

Objective
Mobile Health (mHealth) refers to using mobile devices to support health. This study aimed to identify specific methodological challenges in systematic reviews (SRs) of mHealth interventions and to develop guidance for addressing selected challenges.

Study Design and Setting: Two-phase participatory research project. First, we sent an online survey to corresponding authors of SRs of mHealth interventions. On a five-category scale, survey respondents rated how challenging they found 24 methodological aspects in SRs of mHealth interventions compared to non-mHealth intervention SRs. Second, a subset of survey respondents participated in an online workshop to discuss recommendations to address the most challenging methodological aspects identified in the survey. Finally, consensus-based recommendations were developed based on the workshop discussion and subsequent interaction via email with the workshop participants and two external mHealth SR authors.

Results
We contacted 953 corresponding authors of mHealth intervention SRs, of whom 50 (5 %) completed the survey. All the respondents identified at least one methodological aspect as more or much more challenging in mHealth intervention SRs than in non-mHealth SRs. A median of 11 (IQR 7.25–15) out of 24 aspects (46 %) were rated as more or much more challenging. Those most frequently reported were: defining intervention intensity and components (85 %), extracting mHealth intervention details (71 %), dealing with dynamic research with evolving interventions (70 %), assessing intervention integrity (69 %), defining the intervention (66 %) and maintaining an updated review (65 %). Eleven survey respondents participated in the workshop (five had authored more than three mHealth SRs). Eighteen consensus-based recommendations were developed to address issues related to mHealth intervention integrity and to keep mHealth SRs up to date.

Conclusion
mHealth SRs present specific methodological challenges compared to non-mHealth interventions, particularly related to intervention integrity and keeping SRs current. Our recommendations for addressing these challenges can improve mHealth SRs.
Original languageEnglish
Article number105345
Number of pages9
JournalInternational Journal of Medical Informatics
Volume184
Early online date02 Feb 2024
DOIs
Publication statusPublished - Apr 2024

Bibliographical note

Funding Information:
We thank the survey respondents for their contribution to this research. We involved the relevant stakeholders (systematic reviewers) in identifying issues and developing recommendations by incorporating input from a web-based survey and an online workshop. This work was supported by the National Institutes of Health (NIH 2R24AT001293, Subaward 020468D). This funding source played no role in the design of this review, its execution, analysis, interpretation of the data, or the decision to submit results. We submitted the study synopsis to the Ethics Committee of Zurich, Switzerland and, after review, they stated that the study does not fall under the regulation of the Human Research Act of Switzerland (BASEC-Nr. Req-2022-00839). The survey and meeting participants gave their consent to participate. During the preparation of this work the authors used Copilot and Grammarly in order to improve language and readability. After using this tool, the authors reviewed and edited the content as needed and take full responsibility for the content of the publication.

Funding Information:
This work was supported by the National Institutes of Health (NIH 2R24AT001293, Subaward 020468D). This funding source played no role in the design of this review, its execution, analysis, interpretation of the data, or the decision to submit results.

Publisher Copyright:
© 2024 The Authors

Keywords

  • Digital health
  • eHealth
  • Systematic reviews
  • Meta-analysis
  • Survey

ASJC Scopus subject areas

  • Health Informatics

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