JMIR Publications

ABSTRACT

Background:

Digital technologies are increasingly integrating into peoples’ daily living environments like schools, sport clubs, health care facilities or the local community. These living environments or settings play a crucial role for health promotion and prevention purposes since they affect the health of its members, as the World Health Organization (WHO) declares. Implementing digital health promotion and prevention interventions in settings offers the opportunity to reach specific target groups, to lower the costs of implementation and to improve the health of the population. Until now it lacks scientific evidence that reviews and maps the research field of digital health promotion and prevention in settings.

Objective:

The overall objective of this scoping review is to provide an overview of research targeting digital health promotion and primary prevention in settings. It focusses on assessing the range of the scientific literature regarding various outcomes like applied technology, targeted setting and area of health promotion or prevention and on identifying research gaps that result from these findings.

Methods:

The scoping review was conducted following the framework by Levac et al. [1]. We searched in eight scientific databases (MEDLINE, CINAHL, SocINDEX, PsycINFO, PSYNDEX, IEEE Xplore, BASE and Web of Science), grey literature sources and reference lists for literature on digital setting-based health promotion and prevention published between 2010 and January 2020. The screening of articles was based on a priori defined eligibility criteria. Thus, we included empirical and non-empirical publications published in English or German and excluded articles on secondary or tertiary prevention and on health promotion at the workplace

Results:

From an initial number of 8,888 records, the literature search led to 200 included publications. Overall, we identified a huge diversity and breadth of literature regarding digital setting-based health promotion and prevention. The variety of technology types extents from computer programs to smartphone applications up to sensor devices. We found various analogue, digital or blended settings in which digital health promotion and prevention takes place. The most frequent analogue settings are schools (19.5%) and neighborhoods or communities (12%). Social media applications are also included because in some studies social media is defined as a (digital) setting. Social media applications account for 31.5% of the identified settings. The most commonly focused area of health promotion and prevention are physical activity (40.5%), nutrition (22.5%) and sexual health (17%). The majority of interventions combine several health promotion or prevention methods including environmental change, providing information, social support, training, incentives and monitoring. Finally, we found that articles mostly report on behavioral rather than structural health promotion and prevention in settings.

Conclusions:

The research field of digital health promotion and prevention in settings is very broad and heterogeneous. At the same time we identified research gaps regarding the absence of valid definitions of relevant terms (e.g. digital settings) and the lack of literature on structural health promotion and prevention. Therefore, it remains unclear how digital technologies can contribute to structural (or organizational) changes in settings. More research is needed to successfully implement digital technologies in order to reach health promotion and prevention in settings.