JMIR Publications

ABSTRACT

Background:

The ongoing engagement of adolescents and young adults (AYAs) with chronic disease is vital during the transition process from paediatric to adult health care. To assist them in making a smooth transition, technology-based interventions can be an innovative way to build their skills to become independent adults.

Objective:

To evaluate the current evidence on technology-based interventions accessible via an internet-enabled device.

Methods:

This review was registered with PROSPERO 2018: CRD42018096487. A systematic search of MEDLINE Complete via EBSCOhost, EMBASE and CINAHL Complete via EBSCOhost was conducted on 1 May 2018, for studies that examined the perspectives of transition-age patients about technology-based interventions, the process involved in the development of a technology-based intervention or the evaluation of the effectiveness of a technology-based intervention. For each study, the comprehensiveness of reporting was appraised. The Downs and Black checklist was used for intervention efficacy trials, the Standards for Reporting Qualitative Research (SRQR) checklist was used for qualitative work and a 16-item tool developed by Tong et al. was used for questionnaire research.

Results:

: Twenty-eight studies were included comprising 15 qualitative studies, nine intervention efficacy studies and six questionnaire studies. The reporting comprehensiveness score of questionnaires was rated considerably lower (n=6, 12.5% to 57.1%) than the scores of intervention efficacy trials (n=9, 48.1% to 85.2%) and qualitative research (n=15, 40.5% to 92.9%). However, design flaws leading to biases were common across studies. AYAs were very receptive to obtaining information electronically. An intervention was more likely to be perceived as useful by the AYAs when there was a concerted effort to involve AYAs and subject matter experts together in the process of intervention design as opposed to relying solely on the AYAs or experts alone. The preferred medium used to convey messages varied greatly for AYAs, ranging from static text to audio-visual materials. However, being concise was the most important aspect to keeping AYAs engaged. AYAs showed an interest in receiving information on diverse topics, such as anxiety and stress management, dealing with insurance, and having a social relationship. Evidence indicates that a web-based intervention was promising in improving self-efficacy (standardized mean difference 0.28, 95% confidence interval 0.07 to 0.48; P = .01) and self-management (standardized mean difference 0.38, 95% confidence interval -0.14 to 2.38; P = .03) whilst no difference was found in quality of life and disease-specific knowledge. No intervention efficacy trial was conducted in any of the studies to evaluate the use of a mobile application.

Conclusions:

Through this systematic review, it is confirmed that AYAs were receptive to receive information through a website or mobile application. However, due to the lack of intervention efficacy trial, no conclusion can be drawn if intervention delivered via a mobile app is better than a website.