bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patients’ suitability for digital health - what should be evaluated by health care professionals?
Authors: Kaihlanen A-M , Virtanen L , Kainiemi E , Heponiemi T 
Published: October 2023

Abstract

Background
The need to optimize health care services by utilizing digital technologies has been recognized worldwide to respond to the population's growing care needs. However, not everyone can benefit from digital solutions. Health care professionals have a crucial role in evaluating whether their patients could utilize digital health. This requires identifying the key factors to be evaluated. We carried out a scoping literature review to identify factors that professionals should consider when evaluating the patient's suitability for utilizing digital health.

Methods
Searches were conducted in four databases to identify studies that addressed instruments suitable for professionals to assess patient suitability for utilizing digital health. Two reviewers performed the abstract and full-text screening. The individual domains of the instruments were extracted and synthesized qualitatively.

Results
The review included 19 articles with 12 instruments. A total of 59 domains were found, which embodied multiple perspectives for evaluating patient suitability. Their main unifying factor was a focus on skills, such as the ability to apply digital health information and communicate online, and technical skills. Many domains also contained the ability to take care of own health, such as self-care activity, social support, and knowledge of the health system. There were fewer domains that covered attitudes and experiences with digital services, including comfort, motivation, and trust. Only a few domains considered the technology and facilities required to use digital health.

Conclusions
Based on the variety of instruments and the domains they measure, there is a lack of a systematic and comprehensive way of evaluating patient's potential for utilizing digital health. Professionals need quick and easy-to-use evaluation tools that cover multiple aspects of suitability, as well as instructions on how to use the information obtained when promoting the patients’ use of digital health.

Key messages
• Healthcare professionals need to consider the required skills, attitudes, health behavior and available technology of their patients to increase the utilization of digital health.
• Professionals need evaluation tools suitable for busy clinical work, as well as instructions on how to use the information obtained in the planning and implementation of the patient's individual care.
Digital health literacy – an evolving concept
Authors: Juvalta S , Feer S , Dratva J 
Published: October 2023

Abstract
Digital technologies are changing our health system, health information and health communication, and digital health literacy is becoming increasingly important to ensure equitable access to health. Digital health literacy applies to all contexts of health and healthcare, such as health information seeking behavior, navigation of healthcare systems, and healthcare access. However, the concept of digital health literacy is constantly evolving due to continuous technological developments and their adoption in society and health system. One of the first to define ehealth were Norman and Skinner. Their concept is based on the concept of health literacy, to seek, understand, critically evaluate, and apply information. The talk will outline the development of the digital health literacy concept since Norman and Skinners’ definition in 2006 to the current understanding of digital health literacy in 2023. The technological changes and the increasingly digitalized societies have led not only to an expansion, but also higher specificity of the literacies embedded in the digital health literacy concept. Aim of the talk is to raise the understanding for the complexity and the relevance of digital health literacy in children and adolescents by exemplifying digital health literacy in the context of child and adolescent lives and health needs. The concept, however, is not without critique, which will be addressed and discussed with the audience.
The increasing use of digital therapeutics of insomnia and other sleep disorders: a systematic review
Authors: Madeo G , Sanna A , Golinelli D , Foggi A , Cocchi F , Nante N 
Published: October 2023

Abstract

Background
Chronic insomnia is a significant public health problem affecting 15% of the adult population worldwide. There have been few research trials on digital therapeutics (Dtx) for insomnia and other sleep initiation and maintenance disorders (ISMD), and even less real world evaluations of their efficacy. The aim of this review is to describe the digital therapeutic (Dtx) solutions that have been reported in the scientific literature to mitigate the impact of ISMD on individuals.

Methods
We conducted a systematic review of Dtx and insomnia-related literature (with no time limits) by searching MEDLINE/Pubmed and Scopus with appropriate terms to find relevant articles. We included only primary studies and exluded those on patients with diseases other than ISMD. We extracted study characteristics such as the paper title, journal, and publication year, and we categorized them by setting of the study, type of technology/device, type of treatment provided, primary outcome, and clinical results of the Dtx use for ISMD.

Results
The search identified 129 articles, of which 15 full-text articles were assessed and included in the review after duplicate removal and screening. Most of the selected articles were randomized controlled trials (RTCs 60%) and real-world studies (40%) published between 2016 and 2023, and using the following types of digital technologies: mobile apps (66%), web-based programs (7%), and mixed solutions (27%). We report that these digital solutions provide digital-Cognitive Behavioural Therapy (d-CBT 67%), mindfullness (13%) and other treatments (20%). Many scientific contributions use the Insomnia Severity Index (47%) and sleep latency (20%) as primary outcomes, and all the included studies report significant improvements in ISMD control.

Conclusions
Both evidence resulting from controlled trials and real-world data suggest that digital therapeutics can result in relatively high levels of engagement and clinically meaningful sleep improvements.

Key messages
• This review demonstrate that both RCTs and real-world evidence support the efficacy of digitally-provided treatments for mitigating the impact and improve outcomes of patients with insomnia.
• In a ever evolving scenario, where new digital solutions and therapeutics continuously enter the market, it is mandatory to constantly monitor the efficacy and safety of such innovations.
Measuring digital health literacy in children and adolescents
Authors: Feer S , Juvalta S , Dratva J 
Published: October 2023

Abstract
The talk will address the different digital health literacy instruments currently existing and present their advantages and limitations. The rapid growth in access and use of digital (health) information resources in our society can also be observed among adolescents and children. However, to date no instrument exists that was specifically designed to measure how children and adolescents find, understand, appraise, and use such digital health information and services. The aim of the talk is to provide an overview of digital literacy instruments and present strengths and limitations of existing instruments. One limitation, the self-reported nature of digital health literacy, will be addressed and potential solutions discussed with the audience. The talk will demonstrate the current lack of instruments to measure digital health literacy in children and adolescents, and what this means for child and adolescent public health and the promotion of digital health literacy.
eHealth profile of patients with diabetes
Authors: Jendly M , Santschi V , Tancredi S , Konzelmann I , Raboud L , Chiolero Arnaud 
Published: October 2023

Abstract

Background
Digital health technology can be useful to improve the health of patients with diabetes, to support patient-centered care, and self-management. In this cross-sectional study, we described the eHealth profile of patients with diabetes, based on their use of digital health technology, and its association with sociodemographic characteristics.

Methods
We used data from the “Qualité Diabète Valais” cohort study, conducted in one region of Switzerland (Canton Valais) since 2020. Participants with type 1 or type 2 diabetes completed questionnaires on sociodemographic characteristics and on the use of digital health technology. We defined eHealth profiles based on three features, i.e., ownership or use of 1) internet-connected devices (smartphone, tablet, or computer), 2) mHealth applications, and 3) connected health tools (activity sensor, smart weight scale, or connected blood glucose meter). We assessed the association between sociodemographic characteristics and participants’ eHealth profiles using stratified analyses and logistic regression models.

Results
398 participants (38% women) with a mean age of 65 years were included. The vast majority (94%) were Swiss citizens or bi-national; 14% had a primary level education, 51% a secondary level, and 32% a tertiary level. Some 75% of participants had type 2 diabetes. Some 90% of the participants owned internet-connected devices, 43% used mHealth applications, and 44% owned a connected health tool. Older age and a lower educational level were associated with lower odds of all features of the eHealth profile.

Conclusions
While most participants owned internet-connected devices, only about half of them used mHealth applications or owned connected health tools. Older participants and those with a lower educational level were less likely to use digital health technology. eHealth implementation strategies need to consider these sociodemographic patterns among patients with diabetes.

Key messages
• eHealth use among patients with diabetes was associated with younger age and higher education.
• eHealth strategies need to consider that patients at higher risk of complications are those who use eHealth the least.
Digital health literacy in schools: new tools, empirical findings and implications for interventions
Authors: Okan O , Stauch L , Rangnow P , Renninger D , Hartmann A , Fischer L , Dadaczynski K 
Published: October 2023

Abstract
Children and youth are important populations to receive education and training on digital health literacy, while digital health literacy has recently increased attention as an important determinant of child and adolescent health. Albeit schools are the best equipped settings to enhance health-related competencies and digital literacy capacities of children and adolescents, the uptake of digital health literacy by European schools is still in its infancy and progresses somewhat slowly. Reasons are that digital health literacy is a relatively new topic in education, an overcrowded curriculum, lacking training opportunities for teachers on the subject, economic constraints and poor digital health policies for the education sector, and limited knowledge about the digital health literacy needs of schoolchildren, teachers, and schools, as well as missing evidence needed to inform these issues. A new project on digital health literacy in schools in Germany seeks out to close some of these gaps by conducting two large-scale surveys among secondary schoolchildren and teachers. New measurement tools have been developed and used to generate first time data on digital health literacy in schools, not only assessing personal capacities of schoolchildren and teachers but of learning opportunities and instructions concerning digital health literacy teaching and learning provided in schools. These findings will inform future tailored educational programs, public health interventions, and health and education policies in order to enable the uptake of digital health literacy in education, schools, and teacher training.
Innovative online portal to support persons with obesity: STOP Project RCT
Authors: Moorhead A , Zheng H , Engel F , Vu B , Hemmje M , Lynch L , Bond R , Wang H , McTear M 
Published: October 2023

Abstract

Background
This research is part of the STOP project, a H2020 RISE project funded by European Commission (GA No 823978) to address the challenge of preventing obesity in Europe. The interdisciplinary European STOP project aims to establish a data and knowledge ecosystem as a basis for the STOP Portal to enable healthcare professionals in decision support, and persons with obesity in analysis and feedback of health information to optimise healthy nutrition. The aim of this current randomised controlled trial (RCT) was to determine the effectiveness of the newly developed system for adults with overweight and obesity to lose weight.

Methods
This was a pilot two-arm RCT: 1. intervention (n = 15) and 2. control (n = 15). All the participants were adults with overweight or obesity. The intervention group used the STOP Portal, while the control group did not use this system, no intervention. Participants were randomised into one of the two groups using a computer randomised programme. The primary outcome was percentage reported weight loss, by three months. Four data collection points for both the intervention and control groups at 1. baseline (month 0); 2. month 1; 3. month 2; and 4. month 3. The STOP Portal collects the following data: physiological data, knowledge resources, biomedical data, self-reporting activity and food data. Ethical approval was obtained.

Results
A total of 30 adults registered for this pilot RCT and participated up to three months. The results clearly indicated that adults (18 years+) who were overweight or obese and were in the intervention group and using the STOP Portal significantly (P &lt; 0.001) lost body weight (kg; % weight loss; BMI). Thus the STOP Portal was significantly effective for participants losing body weight.

Conclusions
Overall, the STOP Portal is easy to use, fit for purpose and is significantly effective for adults with overweight and obesity to lose weight.

Key messages
• Innovative online portal, STOP Portal, is significantly effective for adults with overweight and obesity to lose weight.
• This project addresses obesity management and prevention through the foundation of an innovative platform to support persons with obesity with a better nutrition.
Investigating the gendered nature of new parents’ digital technology use for health information
Authors: Hiebert B , Donelle L , Hall J , Facca D 
Published: October 2023

Abstract

Background
Parenting is marked by intense emotional and health information needs for individuals and families. Understanding how digital technologies are used by new parents may allow public health organizations to tailor digital health information resources and delivery methods to better meet needs.

Methods
A qualitative descriptive study was conducted to understand new parents’ experiences with digital technology during their transition to parenting. Individuals in Ontario, Canada who had become a parent in the past 24 months were recruited to participate in a focus group. Participants were asked to describe the technologies used to support their parenting and how they were used to support self and family health. Focus group data were subjected to thematic analysis using inductive coding.

Results
Focus groups were conducted with 26 heterosexual female participants. Participants primarily used digital technologies (smartphone, social media) to seek information on maternal, foetal, and infant health and establish social and emotional supports. Parental health information work was gendered and categorized by 2 dominant themes. First, “‘Let me know when I'm needed'” typifies fathers’ limited health information seeking and reinforces mothers as lay information mediaries. Second, “Information Curation” captures participants’ belief that gender biases built-in to digital parenting resources reified the gendered nature of health information work for new parents.

Conclusions
While parents regularly use digital resources for health information seeking, the gendered nature of such digital resources reinforces gendered divisions of health work.

Key messages
• Digital technologies tailored to new parents actively reinforces gender norms.
• Public health organizations have an opportunity to engage with new parents to identify how digital information resources can be created that support equitable division of health information work.
Association between sleep duration and high blood pressure in Lithuanian adolescents
Authors: Stankute I , Kuciene R , Dulskiene V , Medzioniene J 
Published: October 2023

Abstract

Background
Sufficient sleep duration in children plays an essential role in physical, mental, and emotional development. High blood pressure (HBP) is growing public health problem in youth. The aim of this study was to evaluate the association between short sleep duration (SSD) and HBP in Lithuanian adolescents aged 11-18 years.

Methods
The cross-sectional study was conducted from 2019 to 2020 in Kaunas district, Lithuania. HBP was defined according to the 2017 AAP guidelines. Sleep duration was calculated from the time of going to bed to the time of waking up. SSD was defined as sleeping &lt;8 h/day. Multivariate logistic regression was used to calculate aORs and 95% CI.

Results
The present analysis included 1368 subjects (723 boys and 645 girls) with a mean age of 13.96±1.76 years. Overall, the prevalence of HBP was 43.6% (51.3% for boys and 34.9% for girls). Overall, 21.7% of the subjects reported sleep duration of 7- &lt; 8 h/day, and 11.3% - &lt;7 h/day. In the total sample, after adjustment for sex, BMI, breakfast consumption, and parental smoking, significant associations were found between SSDs and HBP (7-&lt;8 h/day: aOR=1.47; 95% CI, 1.12-1.95; P = 0.006, and &lt;7 h/day: aOR=1.52; 95% CI, 1.05-2.20; P = 0.025), compared to subjects who were sleeping ≥8 h/day. In boys, after adjustment for potential confounders, SSDs were associated with higher odds of HBP (7-&lt;8 h/day: aOR=1.94; 95% CI, 1.30-2.89; P = 0.001, and &lt;7 h/day: aOR=2.35; 95% CI, 1.35-4.12; P = 0.003). There was no significant association between SSD and HBP among girls.

Conclusions
Our study showed that SSD was significantly associated with increased odds of HBP in Lithuanian adolescents, especially in boys. Public health strategies should focus more on prevention of modifiable cardiovascular disease risk factors.

Key messages
• Sufficient sleep duration is important for adolescents’ health and may contribute to reduce the risk of cardiovascular disease.
• Future prospective studies are needed to confirm these findings.
Changing inequalities in life-expectancy by income in Finland 1997-2020
Authors: Tarkiainen L , Martikainen P , Junna L , Remes H 
Published: October 2023

Abstract

Background
Previous studies show that in recent decades the changes in mortality disparities between income groups in Finland have been driven by alcohol- and smoking-related causes of death. The gap between the extreme income quintiles narrowed in 2008-14 particularly due to the declining alcohol-related mortality. We analysed the most recent changes in mortality disparities and the causes of deaths behind them.

Methods
We used register based individual level total population data for ages 30-95+ and yearly follow-up for mortality in 1996-2020 including information on disposable household income quintile in the previous year. Preston method was used for assessing the impact of smoking on mortality. We calculated trends in life expectancy (LE) at age 30 for three-year periods in 1997-2020 and then conducted an Arriaga cause of death decomposition of the gap between highest and lowest quintiles and changes in LE for each quintile from 2015-17 to 2018-20.

Results
We observed an increasing gap in LE by income due to stagnating LE in the lowest income quintile from 2015 onward among both men and women. Among men the stagnation was observed even after eliminating smoking- and alcohol-related mortality and among women the LE slightly increased after accounting for smoking and alcohol but the gap to the highest quintile increased clearly. Decomposing the change in LE from 2015-17 to 2018-2020 by causes of death showed no specific causes of death behind the stagnation and the widening gap. Among both men and women mortality due to circulatory diseases showed a substantial decline in the lowest quintile whereas in all other causes mortality increased or declined only slightly.

Conclusions
Inequalities in LE by income are widening again in Finland due to stagnation in the lowest income quintile. Contrary to the prior decades the increasing disparities are not attributable to smoking and alcohol-related deaths but occur in the majority of causes of death.

Key messages
• After nearly a decade of narrowing mortality inequalities we observed an increasing gap in life expectancy by income mainly due to stagnation in the lowest income quintile.
• Contrary to the prior decades the increasing disparities and stagnation of the lowest income quintile are not explained by smoking and alcohol-related deaths but occur in majority of causes of death.
A conceptual framework for early life determinants of future multimorbidity
Authors: Stannard S , Berrington A , Paranjothy S , Owen R , Fraser SDS , Hoyle R B , Batchelor S , Welch J , Alwan N A 
Published: October 2023

Abstract

Background
Social, biological and environmental factors in early life, defined as the period from preconception until age 18, play a role in shaping the risk of Multiple Long-Term Condition Multimorbidity (MLTC-M). There is a need for conceptual framing of these factors to inform and shape future research on aetiology and for modelling prevention scenarios of MLTC-M. We developed a conceptual framework to characterise early life determinants of future MLTC-M risk.

Methods
The conceptualisation of determinant domains was shaped by reviewing existing research evidence and policy, and co-produced with public contributors living in the UK via two workshops, one with 8 contributors age 18-30 regardless of MLTC-M status, and one with 12 contributors age 40-65 who all self-reported MLTC-M.

Results
Domains included: 1.Prenatal, antenatal, neonatal and birth; 2.Adverse childhood experiences; 3.Child health, check-ups and screening; 4.Developmental attributes; 5.Child education and health literacy; 6.Demographics; 7. Parent health and health behaviours; 8.Socioeconomics; 9.Parental family factors; 10.Neighbourhood, physical environment and health care systems; 11.Health behaviours and diet; 12.Religion, spirituality and culture. Some domains identified by the public contributors, such as religion, health screening, check-ups, and diet, were not well represented within the research evidence or policy documents.

Conclusions
This co-produced conceptualisation can inform research to investigate the early life characteristics of population groups at risk of future MLTC-M, as well as policy directions towards prevention of early-onset MLTC-M. Additionally, it can shape the direction of further data collection, particularly with respect to the understudied domains identified by our public contributors.

Key messages
• We developed a conceptual framework to characterise early life determinants of multimorbidity.
• This conceptualisation can inform future research and policy directions towards prevention of multimorbidity.