JMIR Publications

ABSTRACT

Background:

Individual-level behavioral interventions are designed to improve health behaviors and manage noncommunicable diseases (NCDs). Geo-referenced contexts at the neighborhood level (NGRCs) significantly impact the success of these interventions. Integrating NGRC data into health information systems (HISs)—including electronic medical records (EMRs), electronic health records (EHRs), and personal health records (PHRs)—can enhance personalized behavioral interventions, known as NGRC-focused behavioral interventions, and improve health outcomes. Despite the potential benefits, there is a notable gap in the literature regarding the use of HISs to support NGRC-focused behavioral interventions.

Objective:

This scoping review aims to review the current status and stakeholders’ insights about using HISs to support NGRC-focused behavioral interventions.

Methods:

Two reviewers examined publications indexed by Medline (Ovid) and Scopus. Publications reporting on using HISs to support individual level NGRC-focused behavioral interventions were included. Study attributes, population attributes, disease, and health setting characteristics, HISs, NGRCs, behavioral interventions, results, and conclusions and future studies were extracted.

Results:

The literature search identified twenty-four studies for inclusion. Of these, twenty studies utilized EHRs or EMRs, with limited focus on PHRs. Twenty-three studies did not apply Health Information Systems (HISs) throughout the entire process of NGRC-focused behavioral interventions. Regarding behavioral interventions, twenty-two studies concentrated exclusively on social needs interventions, with limited focus on lifestyle change interventions. Research on NGRCs mainly focused on built environments (n=24), with less attention to natural (n=1) and social (n=4) environments, and little details on spatiotemporal characteristics. Within built environments, 'Destination Accessibility' was the main focus, while 'Density,' 'Design,' and 'Distance' were less studied, and 'Diversity' was not considered at all. Insights from ten studies on stakeholders' perspectives highlighted the importance of integrating NGRCs and HISs into behavioral interventions, despite some persisting social or technological concerns. A list of fourteen recommendations regarding NGRC-focused behavioral interventions using HISs was developed.

Conclusions:

PHRs can actively integrate more diverse NGRCs and participate in the whole process of NGRC-focused behavioral interventions, especially in outpatient lifestyle change interventions, with the help of healthcare providers, thus achieving public health goals and promoting health equity.