May 10, 2023
Version 1
Mobile technologies as an implementation strategy in Primary Health Care: a scoping review V.1
- Rafael Aiello Bomfim1,
- Jean Ribeiro Leite1,
- Giovana Soares Buzinaro1,
- Hazelelponi Cerqueira Leite1,
- Jhenyffer Andrade Viana Cabral1
- 1UFMS
Protocol Citation: Rafael Aiello Bomfim, Jean Ribeiro Leite, Giovana Soares Buzinaro, Hazelelponi Cerqueira Leite, Jhenyffer Andrade Viana Cabral 2023. Mobile technologies as an implementation strategy in Primary Health Care: a scoping review. protocols.io https://dx.doi.org/10.17504/protocols.io.ewov1op1plr2/v1Version created by Rafael Aiello Bomfim
License: This is an open access protocol distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
Protocol status: Working
We use this protocol and it's working
Created: May 10, 2023
Last Modified: May 10, 2023
Protocol Integer ID: 81702
Abstract
Mobile health or m-health is defined as delivering health using a device or software oriented towards health purposes. Indeed, it is a technology that supports clinical and preventive health services or a way that improves access to health services. Understanding more broadly the possibilities of using m-health to improve health and implementation outcomes is necessary. This protocol will go through a scoping review of the applicability of mobile health as a strategy for implementing health interventions in contexts similar to Primary Health Care. Methods. This study will map the use of mobile health in randomized clinical trials as a strategy for implementing health interventions. This is a scoping review, following guidelines from the Joanna Briggs Institute(JBI). A search will be carried out in Medline, Web of Science, Scopus, Scielo and grey literature databases from 2016 to 2023 (April).
Guidelines
This study will be a scope review on the use of m-health in the implementation of health innovations and interventions. The Joanna Briggs Institute (JBI) methodology was used as a guide for the scope review.
search strategy
The search strategy aimed to look for randomized clinical trials that tested implementation, type II or III, as they test implementation strategies by relating them to health outcomes/outcomes, service and/or implementation. Type I hybrid studies were not included as they aim to assess the effects of an evidence-based intervention and better describe the context for implementation, but do not test an implementation strategy.
The search strategy used the three essential steps recommended by JBI, using four databases, initially analyzing title, abstract and keywords. The second step will be carried out by linking the keywords and indexed terms found to the search in the databases. The references of the articles found were also analyzed when information was not complete, as recommended in the third step by the JBI. The selection will be made by reading the titles and abstracts, and a filter according to the exclusion and inclusion criteria will be applied. Discrepancies were discussed and only if the researchers reached 75% agreement on the articles were they selected.
For this, a search will be carried out in PubMed, Web of Science (Clarivate), Scopus and Scielo databases with the following keywords: (((( telemedicine or m-health or mobile-health) and (implementation science or implementation or implementation outcomes or hybrid designs) and (health or health services research or chronic health or health services use or services use) and ( primary health care or Family health strategy) and ( randomized clinical trials))
The filters used with the acronym PCC (population, concept and context) were from articles published in the last 8 years and related to Health Services in Primary Care.
The acronym PCC used refers to the (P)population of children, adults or elderly people, (C)oncept in health using mobile-health as an implementation strategy, and (C)ontext in the context of primary health care (PHC).
After the search, all the records that will be identified in the databases will be transferred to the Microsoft Word 2010 software (Microsoft Corporation, USA) and with the help of endnote the duplicates will be excluded. Two independent reviewers will evaluate the title and abstracts according to the inclusion criteria to identify and select articles for review.
Eligibility Criteria
Only articles published in the period 2016-2023 and that had been research of randomized clinical trials of type II or III hybrid implementation and that had described at least one implementation outcome and that had applicability to the context of Primary Health Care will be included. , reporting health outcomes or service usage regarding the use of m-health for primary health care users.
Among the implementation outcomes sought, those described by Proctor et al., 2013 were considered. (1)Acceptability: Perception among implementation stakeholders that a given treatment, service, practice or innovation is satisfactory. (2) Adoption: Action to try or use an evidence-based innovation or practice. It may be referred to as "acceptance" and measured from a provider or organization perspective. (3) Suitability: Relevance or suitability of the evidence-based innovation or practice for a given practice environment. It may capture some resistance to implementation efforts. (4) Feasibility: is the extent to which it can be used or performed successfully, as reflected in insufficient triage, retention, or participation rates. (5) Reliability: degree to which an intervention was implemented, comparing the original intervention with the one disseminated/implemented. (6) Cost of implementation: cost of an implementation effort, depends on the costs of a specific intervention, the implementation strategy used and the location of service delivery. (7) Penetration: integration of a practice into a service environment and its subsystems. (8) Sustainability: extent to which a newly implemented treatment is maintained or institutionalized within the stable and ongoing operations of a service environment.
Exclusion Criteria
Exclusion criteria will be the absence of an implementation outcome with a similar or close definition to that conceptualized by PROCTOR et al., 2013, in addition to implementation only with health professionals without considering users, and pilot studies.
Differences that occur between reviewers at each stage of the article selection process will be broken by a third reviewer. The form of selection and the results of the research were presented in the PRISMA-SCR flowchart.
Data Search and Extraction
The data will be organized in a Microsoft Excel 2010 table (Microsoft Corporation, USA) to record the main information of the selected studies according to the guidance of the JBI methodology for scoping reviews. The data will be entered into a spreadsheet in the software with the key information recommended by the JBI: year of publication, title, place of publication, theme, objective, type of study, keywords, the outcome of service, the outcome in health, the outcome of implementation and observations that bring key information about the study and its relationship with the scoping review (Table 1).
Analysis and interpretation of findings
Data will be synthesized and presented in a narrative and tabular format, investigating the occurrence of concepts, characteristics and populations addressed, choosing to map the results in a descriptive and non-analytical way, as recommended by the JBI methodology for scoping reviews. The survey results will also be reported in full and presented in the PRISMA-Scr flowchart.
Mobile technologies as an implementation strategy in Primary Health Care: a scoping review
Protocol references
1. Yin AL, Hachuel D, Pollock JP, Scheral ES, Estrin D. Digital health apps in clinical
care of inflammatory bowel disease: scoping review. J Med Internet Res [internet]
2019 [citado 28 out 2022];21(8):el4630. Disponível em doi: 10.2196/14630. PMID:
31429410;
2. Kim HJ, Kim HH, Ku H, Yoo KD, Lee S, Park JI, Kim HJ, Kim K, Chung MK, Lee
KH, Kim JH. Smart Decentralization of Personal Health Records with Physician Apps
and Helper Agents on Blockchain: Platform Design and Implementation Study. JMIR
Med Inform [internet]. 2021 Jun 7 [citado 28 out 2022];9(6):e26230. Disponível em
doi: 10.2196/26230. PMID: 34096877
3. Kampmeijer R, Pavlova M, Tambor M, Golinowska S, Groot W. The use of e-health
and m-health tools in health promotion and primary prevention among older adults: a
systematic literature review. BMC Health Serv Res. 2016;16 Suppl 5:290.
4. World Health Organization. Atlas of eHealth country profiles 2015: The use of
eHealth in support of universal health coverage. Available
2018.
5. Nau T, Owen A, Mazza D, Smith BJ. Engaging primary care providers in a m-health
strategy to support lifestyle change and blood pressure management. Digital Health
[internet]. 2021 Dec 15 [citado 28 out 2022];7:20552076211066746. Disponível em
doi:10.1177/20552076211066746
6. Lewkowitz AK, Cahill AG. Mobile Health Approaches to Breastfeeding. Clin Obstet
Gynecol. 2021 Jun 1;64(2):384-391. doi: 10.1097/GRF.0000000000000606. PMID:
33813523. Disponível em https://pubmed.ncbi.nlm.nih.gov/33813523/
7. Baman JR, Mathew DT, Jiang M, Passman RS. Mobile Health for Arrhythmia
Diagnosis and Management. J Gen Intern Med. 2022 Jan;37(1):188-197. doi:
10.1007/s11606-021-07007-w. Epub 2021 Jul 19. PMID: 34282532; PMCID:
PMC8288067.
8. Hussain-Shamsy N, Shah A, Vigod SN, Zaheer J, Seto E. Mobile Health for Perinatal
Depression and Anxiety: Scoping Review. J Med Internet Res. 2020 Apr
13;22(4):e17011. doi: 10.2196/17011. PMID: 32281939; PMCID: PMC7186872.
9. Proctor, E. K., Powell, B. J., & McMillen, J. C. (2013). Implementation strategies:
recommendations for specifying and reporting. Implementation science, 8(1), 1-11.
10. Peters MDJ, Godfrey C, McInerney P, Munn Z, Tricco AC, Khalil, H. Chapter 11:
Scoping Reviews (2020 version). In: Aromataris E, Munn Z (Editors). JBI Manual for
Evidence Synthesis. JBI [internet] 2020 [citado 28 out 2022]. Disponível em
doi:10.46658/JBIMES-20-12.
11. Curran, G. M., Bauer, M., Mittman, B., Pyne, J. M., & Stetler, C. (2012).
Effectiveness-implementation hybrid designs: combining elements of clinical
effectiveness and implementation research to enhance public health impact. Medical
care, 50(3), 217.
12. Peters MDJ, Godfrey C, McInerney P, Munn Z, Tricco AC, Khalil, H. Chapter 11:
Scoping Reviews (2020 version). In: Aromataris E, Munn Z (Editors). JBI Manual for
Evidence Synthesis. JBI [internet] 2020 [citado 28 out 2022]. Disponível em
doi:10.46658/JBIMES-20-12.
13. Ashburner JM, Lee PR, Rivet CM, Barr Vermilya H, Lubitz SA, Zai AH. The
Implementation and Acceptability of a Mobile Application for Screening for Atrial
Fibrillation at Home. Telemed J E Health [internet]. 2021 Nov [citado 28 out
2022];27(11):1305-1310. Disponível em doi: 10.1089/tmj.2020.0427. PMID:
33606553.
14. Angell B, Lung T, Praveen D, Maharani A, Sujarwoto S, Palagyi A, et al. Cost-
effectiveness of a mobile technology-enabled primary care intervention for
cardiovascular disease risk management in rural Indonesia. Health Policy Plan
[internet]. 2021 May 17 [citado 28 out 2022];36(4):435-443. Disponível em doi:
10.1093/heapol/czab025. PMID: 33712844.
15. Scherrenberg, M., Zeymer, U., Schneider, S., Van der Velde, A. E., Wilhelm, M.,
Van’t Hof, A. W. J., Dendale, P. (2021). EU-CaRE study: could exercise-based
cardiac telerehabilitation also be cost-effective in elderly?. International journal of
cardiology, 340, 1-6.
16. Modi, D., Saha, S., Vaghela, P., Dave, K., Anand, A., Desai, S., & Shah, P. (2020).
Costing and cost-effectiveness of a mobile health intervention (ImTeCHO) in
improving infant mortality in tribal areas of Gujarat, India: cluster randomized
controlled trial. JMIR mHealth and uHealth, 8(10), e17066.
17. Guo, P., Qiao, W., Sun, Y., Liu, F., & Wang, C. (2020). Telemedicine technologies
and tuberculosis management: a randomized controlled trial. Telemedicine and e-
Health, 26(9), 1150-1156.
18. Erkkola-Anttinen, N., Irjala, H., Laine, M. K., Tähtinen, P. A., Löyttyniemi, E., &
Ruohola, A. (2019). Smartphone otoscopy performed by parents. Telemedicine and e-
Health, 25(6), 477-484.
19. Setiakarnawijaya, Y., Safadilla, E., Rahmadani, E. A., Robianto, A., & Fachrezzy, F.
(2021). Android-based physical fitness software guidance. Journal of Physical
Education and Sport, 21, 2313-2319.
20. Yen, H. Y. (2021). Smart wearable devices as a psychological intervention for healthy
lifestyle and quality of life: a randomized controlled trial. Quality of Life Research,
30, 791-802.
Gilmer, T., Burgos, J. L., Anzaldo-Campos, M. C., & Vargas-Ojeda, A. (2019). Cost-
Effectiveness of a Technology-Enhanced diabetes care management program in
Mexico. Value in health regional issues, 20, 41-46.
21. Pearson, N., Finch, M., Sutherland, R., Kingsland, M., Wolfenden, L., Wedesweiler,
T., Yoong, S. L. (2022). An mHealth Intervention to Reduce the Packing of
Discretionary Foods in Children’s Lunch Boxes in Early Childhood Education and
Care Services: Cluster Randomized Controlled Trial. Journal of Medical Internet
Research, 24(3), e27760.
22. Colomina, J., Drudis, R., Torra, M., Pallisó, F., Massip, M., Vargiu, E. (2021).
Implementing mHealth-enabled integrated care for complex chronic patients with
osteoarthritis undergoing primary hip or knee arthroplasty: prospective, two-arm,
parallel trial. Journal of Medical Internet Research, 23(9), e28320.
23. Patomella AH, Farias L, Eriksson C, Guidetti S, Asaba E. Engagement in Everyday
Activities for Prevention of Stroke: Feasibility of an mHealth-Supported Program for
People with TIA. Healthcare [internet]. 2021 Jul 30 [citado 28 out 2022];9(8):968.
Disponível em doi: 10.3390/healthcare9080968. PMID: 34442105;
24. Bomfim, RA; De-Carlo, AD; Cascaes, AM; Buccini, G; Probst, LF; Frazão, P.
Introdução à ciência de implementação para profissionais de saúde [internet]. Campo
Grande: UFMS; 2021 [citado 28 out 2022] 1. ed. Disponível em:
25. Jayasinghe I, Wickramasinghe Y, Kurera DM, Samarakoon N, Rupasinghe I,
Ponmalay P, et al. Feasibility of using telephone interviews and internet-based
message services during the COVID-19 pandemic in rural Sri Lanka: experiences
ofthe Rajarata Pregnancy Cohort. Rural and Remote Health. 2022 May 12 [citado 28
out 2022] 22(2), 7442. Disponível em doi: 10.22605/RRH7442. PMID: 35546146
26. Li S, Yin Z, Lesser J, Li C, Choi BY, Parra-Medina D, et al. Community Health
Worker-Led mHealth-Enabled Diabetes Self-management Education and Support
Intervention in Rural Latino Adults: Single-Arm Feasibility Trial. JMIR Diabetes
[internet]. 2022 May 30 [citado 28 out 2022];7(2):e37534. Dísponivel em: doi:
10.2196/37534. PMID: 35635752
27. Dorje T, Zhao G, Tso K, Wang J, Chen Y, Tsokey L, et al. Smartphone and social
media-based cardiac rehabilitation and secondary prevention in China (SMART-
CR/SP): a parallel-group, single-blind, randomised controlled trial. The Lancet Digital
Health [internet]. 2019 [citado 28 out 2022];1(7), e363-e374. Disponível em:
10.1016/S2589-7500(19)30151-7.
28. Vieira EM, Vieira CS, Bonifácio LP, de Oliveira Ciabati LM, Franzon AC, et al.
PRENACEL: Development and Evaluation of an M-health Strategy to Improve
Prenatal Care in Brazil. Open Aire [internet]. 2016 Aug [citado 28 out 2022] 15:16 .
Disponível em doi: 10.5281/zenodo.1126866.
29. Burchert S, Alkneme MS, Bird M, Carswell K, Cuijpers P, Hansen P, et al. User-
Centered App Adaptation of a Low-Intensity E-Mental Health Intervention for Syrian
Refugees. Frontiers in Psychiatry [internet]. 2019 Jan [citado 28 out 2022] 25;9.
Disponível em: doi: 10.3389/fpsyt.2018.00663. PMID: 30740065
30. Atallah N, Khalifa M, El Metwally A, Househ M. The prevalence and usage of m-
health applications among mental health patients in Saudi Arabia. Computer Methods
and Programs in Biomedicine [internet] . 2018 Mar [citado 28 out
2022];156:163–8.Disponível em: doi: 10.1016/j.cmpb.2017.12.002. PMID: 29428068
31. Morina N, Ewers SM, Passardi S, Schnyder U, Knaevelsrud C, Müller J, et al. Mental
health assessments in refugees and asylum seekers: evaluation of a tablet-assisted
screening software. Conflict and Health [internet]. 2017 Oct 2 [citado 28 out
2022];11(1). Disponível em: doi: 10.1186/s13031-017-0120-2. PMID: 29026438;
PMCID: PMC5623980.
32. Knaevelsrud C, Brand J, Lange A, Ruwaard J, Wagner B. Web-Based Psychotherapy
for Posttraumatic Stress Disorder in War-Traumatized Arab Patients: Randomized
Controlled Trial. Journal of Medical Internet Research [internet]. 2015 Mar [citado 28
out 2022] 20;17(3):e71. Disponível em: doi: 10.2196/jmir.3582. PMID: 25799024;
PMCID: PMC4385175
33. Mash R, Schouw D, Fischer AE. Evaluating the Implementation of the
GREAT4Diabetes WhatsApp Chatbot to Educate People With Type 2 Diabetes
During the COVID-19 Pandemic: Convergent Mixed Methods Study. JMIR Diabetes
[internet]. 2022 Jun 24 [citado 28 out 2022];7(2):e37882. Disponível em doi
10.2196/37882. PMID: 35537057
34. Bhardwaj V, Spaulding EM, Marvel FA, LaFave S, Yu J, Mota D, et al. Cost-
effectiveness of a Digital Health Intervention for Acute Myocardial Infarction
Recovery. Med Care [internet]. 2021 Nov 1[citado 28 out 2022];59(11):1023-1030.
Disponível em doi: 10.1097/MLR.0000000000001636. PMID: 34534188;
35. Figueiredo AEB, Ceccon RF, Figueiredo JHC. Doenças crônicas não transmissíveis e
suas implicações na vida de idosos dependentes. Ciência & Saúde Coletiva [Internet].
2021 Jan [citado 28 out 2022];26(1):77–88. Disponível em doi: 10.1590/1413-
81232020261.33882020
36. Kruse C, Betancourt J, Ortiz S, Valdes Luna SM, Bamrah IK, Segovia N. Barriers to
the Use of M-health in Improving Health Outcomes in Developing Countries:
Systematic Review. J Med Internet Res. [internet] 2019 Oct 9 [citado 28 out
2022];21(10):e13263. Disponível em doi: 10.2196/13263. PMID: 31593543;
37. Cucciniello MCG, Greta N, Ongaro E . Coordination Mechanisms for Implementing
Complex Innovations in the Health Care Sector. Public Management Review
[internet]. 2015 [citado 28 out 2022];17(7):1040-60. Disponível em:
10.1080/14719037.2015.1029348
38. Patomella AH, Farias L, Eriksson C, Guidetti S, Asaba E. Engagement in Everyday
Activities for Prevention of Stroke: Feasibility of an mHealth-Supported Program for
People with TIA. Healthcare [internet]. 2021 Jul 30 [citado 28 out 2022];9(8):968.
Disponível em doi: 10.3390/healthcare9080968. PMID: 34442105;
39. Seto E, Morita PP, Tomkun J, Lee TM, Ross H, Reid-Haughian C, Kaboff A,
Mulholland D, Cafazzo JA. Implementation of a Heart Failure Telemonitoring System
in Home Care Nursing: Feasibility Study. JMIR Med Inform [internet]. 2019 Jul 26
[citado 28 out 2022];7(3):e11722. Disponível em doi: 10.2196/11722. PMID:
31350841;
40. Chapman Smith SN, Brown PC, Waits KH, Wong JS, Bhatti MS, Toqeer Q, Ricks
JV, Stockner ML, Habtamu T, Seelam J, Britt RC, Giovia JM, Blankson BK, Bennam
P, Gormley MA, Lu J, Ornato JP. Development and Evaluation of a User-Centered
Mobile Telestroke Platform. Telemed J E Health. 2019 Jul [citado 28 out
2022];25(7):638-648. Disponível em doi: 10.1089/tmj.2018.0044. PMID: 30207927;
41. Rudin RS, Fanta CH, Qureshi N, Duffy E, Edelen MO, Dalal AK, Bates DW. A
Clinically Integrated mHealth App and Practice Model for Collecting Patient-
Reported Outcomes between Visits for Asthma Patients: Implementation and
Feasibility. Appl Clin Inform [internet]. 2019 Oct [citado 28 out 2022];10(5):783-793.
Disponível em doi: 10.1055/s-0039-1697597. PMID: 31618782;
42. Hearn J, Wali S, Birungi P, Cafazzo JA, Ssinabulya I, Akiteng AR, Ross HJ, Seto E,
Schwartz JI. A digital self-care intervention for Ugandan patients with heart failure
and their clinicians: User-centred design and usability study. Digit Health [internet].
2022 Sep 27 [citado 28 out 2022];8:20552076221129064. Disponível em doi:
10.1177/20552076221129064. PMID: 36185389;
43. Sop DM, Crouch T, Zhang Y, Lipato T, Wilson J, Smith WR. Feasibility and Quality
Validation of a Mobile Application for Enhancing Adherence to Opioids in Sickle
Cell Disease. Healthcare [internet]. 2022 Aug 10 [citado 28 out 2022];10(8):1506.
Disponível em doi: 10.3390/healthcare10081506. PMID: 36011162;
44. Li S, Yin Z, Lesser J, Li C, Choi BY, Parra-Medina D, et al. Community Health
Worker-Led mHealth-Enabled Diabetes Self-management Education and Support
Intervention in Rural Latino Adults: Single-Arm Feasibility Trial. JMIR Diabetes
[internet]. 2022 May 30 [citado 28 out 2022];7(2):e37534. Dísponivel em: doi:
10.2196/37534. PMID: 35635752
45. Adrian H. Zai, Molly Caffrey, Conor S. O'Brien, Dawei Jiang, Remona Kanyat, and
Sara Silacci.The Implementation and Acceptability of a Combined Mobile
Application with a COVID-19 at-Home Test Kit. Telemedicine and e-Health
[internet].Jul 2022 [citado 28 out 2022];1064-1069. Disponível em doi:
10.1089/tmj.2021.0487
46. Smith-Turchyn J, Adams S, Sabiston C. Testing of a Self-administered 6-Minute
Walk Test Using Technology: Usability, Reliability and Validity Study. JMIR
Rehabil Assist Technol [intenert]. 2021[citado 28 out 2022];8(3):e22818. Disponível
em doi: 10.2196/22818
47. Kawajiri M, Nakamura Y, Yoshida M, Takeishi Y, Masaki A, Iwasaki Y, et al.
Acceptability and Feasibility of a Sedentary Behavior Reduction Program during
Pregnancy: A Semi-Experimental Study. Healthcare [internet]. 2020 Oct 29 [citado 28
out 2022];8(4):439. Disponível em doi: 10.3390/healthcare8040439. PMID:
33137900
48. Vieira EM, Vieira CS, Bonifácio LP, de Oliveira Ciabati LM, Franzon AC, et al.
PRENACEL: Development and Evaluation of an M-health Strategy to Improve
Prenatal Care in Brazil. Open Aire [internet]. 2016 Aug [citado 28 out 2022] 15:16 .
Disponível em doi: 10.5281/zenodo.1126866.
49. Burchert S, Alkneme MS, Bird M, Carswell K, Cuijpers P, Hansen P, et al. User-
Centered App Adaptation of a Low-Intensity E-Mental Health Intervention for Syrian
Refugees. Frontiers in Psychiatry [internet]. 2019 Jan [citado 28 out 2022] 25;9.
Disponível em: doi: 10.3389/fpsyt.2018.00663. PMID: 30740065
50. Atallah N, Khalifa M, El Metwally A, Househ M. The prevalence and usage of m-
health applications among mental health patients in Saudi Arabia. Computer Methods
and Programs in Biomedicine [internet] . 2018 Mar [citado 28 out 2022];
156:163–8.Disponível em: doi: 10.1016/j.cmpb.2017.12.002. PMID: 29428068
51. Morina N, Ewers SM, Passardi S, Schnyder U, Knaevelsrud C, Müller J, et al. Mental
health assessments in refugees and asylum seekers: evaluation of a tablet-assisted
screening software. Conflict and Health [internet]. 2017 Oct 2 [citado 28 out
2022];11(1). Disponível em: doi: 10.1186/s13031-017-0120-2. PMID: 29026438;
PMCID: PMC5623980.
52. Knaevelsrud C, Brand J, Lange A, Ruwaard J, Wagner B. Web-Based Psychotherapy
for Posttraumatic Stress Disorder in War-Traumatized Arab Patients: Randomized
Controlled Trial. Journal of Medical Internet Research [internet]. 2015 Mar [citado 28
out 2022] 20;17(3):e71. Disponível em: doi: 10.2196/jmir.3582. PMID: 25799024;
PMCID: PMC4385175
53. Jefee-Bahloul H, Moustafa MK, Shebl FM, Barkil-Oteo A. Pilot Assessment and
Survey of Syrian Refugees’ Psychological Stress and Openness to Referral for
Telepsychiatry (PASSPORT Study). Telemedicine and e-Health [internet]. 2014 Oct
[citado 28 out 2022] 20(10):977–9. Disponível em: doi: 10.1089/tmj.2013.0373. Epub
2014 Sep 4. PMID: 25188281.
54. Smith-Ray RL, Nikzad N, Singh T, Jiang JZ, Taitel MS, Quer G, et al. A cross-
sectional study of physical activity participation among adults with chronic conditions
participating in a digital health program. Digital Health [internet]. 2019 Jan [citado
28 out 2022];5:205520761988098. Disponível em doi: 10.1177/2055207619880986.
PMID: 35173975
55. Tahsin F, Tracy S, Chau E, Harvey S, Loganathan M, McKinstry B, et al. Exploring
the relationship between the usability of a goal-oriented m-health application and non-
usage attrition in patients with multimorbidity: A blended data analysis approach.
Digit Health [internet]. 2021 Oct 5 [citado 28 out 2022];7:20552076211045579.
Disponível em: doi: 10.1177/20552076211045579. PMID: 34868614;
56. Dorje T, Zhao G, Tso K, Wang J, Chen Y, Tsokey L, et al. Smartphone and social
media-based cardiac rehabilitation and secondary prevention in China (SMART-
CR/SP): a parallel-group, single-blind, randomised controlled trial. The Lancet Digital
Health [internet]. 2019 [citado 28 out 2022];1(7), e363-e374. Disponível em:
10.1016/S2589-7500(19)30151-7.