JMIR Publications

ABSTRACT

Background:

Chronic diseases contribute to 71% of deaths worldwide every year and an estimated 15 million people between the ages of 30 to 69 years die mainly due to cardiovascular disease, cancer, chronic respiratory diseases, or diabetes. Online education platforms may offer numerous health benefits on disease management and on related health consequences. It is also considered to be a flexible, lower cost method to deliver tailored information to patients. Previous studies concluded that the implementation of different features and degree of adherence to the platform are key factors in determining the success of the intervention. However, limited research has been done to understand the level of acceptability of the specific features and user adherence to self-guided online platforms.

Objective:

The aims of this systematic review are to understand how online platforms features are evaluated, to investigate which features have the greatest and lowest level of acceptability and to describe how adherence to online self-guided platforms is defined and measured.

Methods:

Studies published on self-guided online education platforms for people (≥14 years old) with chronic diseases published between January 2005 to June 2019 were reviewed following the PRISMA Statement protocol. The search was done using the databases of PubMed and Cochrane Library: Cochrane Reviews. The comparison of the interventions and analysis of the features were based on the published content from the selected articles.

Results:

A total of fifteen studies were included. Seven principal features were identified with goal setting, self-monitoring, and feedback being the most frequently used. The level of acceptability of the different features was measured based on the comments collected from users, their association with clinical outcomes and/or device adherence. The use of quizzes was positively reported by participants. Self-monitoring, goal setting, feedback, and discussion forums had mixed results. The negative acceptability was mainly related to the choice of the discussion topic, lack of face-to-face contact, and technical issues. This review also showed that evaluation of adherence to educational platform was inconsistent among the studies therefore limiting comparison. A clear definition of adherence to the platform is lacking.

Conclusions:

This review suggests that features related to interaction and personalization provide better clinical outcomes and positive users’ experience. The negatively reported features were mainly related to not targeting the population’s needs, low human involvement within the platform, and technical barriers. Only six studies reported the level of acceptability of their features on users’ experience, clinical outcomes or device adherence, which highlights the needs for further studies. There is a lack of consensus on the method used for measuring the level of adherence to the platform, therefore we suggest to use a standardized framework to measure adherence.