Effectiveness of Integrated Digital Solutions to Empower Older Adults in Aspects Related to Their Health: Systematic Review and Meta-Analysis
BackgroundDigital solutions, such as mobile apps or telemonitoring devices, are frequently considered facilitators in the process of empowering older adults, but they can also act as a source of digital exclusion or disempowerment if they are not adequate for older adults’ ne...
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JMIR Publications
2025-01-01
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| Series: | Journal of Medical Internet Research |
| Online Access: | https://www.jmir.org/2025/1/e54466 |
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| author | Ana Isabel Martins Óscar Ribeiro Gonçalo Santinha Telmo Silva Nelson P Rocha Anabela G Silva |
| author_facet | Ana Isabel Martins Óscar Ribeiro Gonçalo Santinha Telmo Silva Nelson P Rocha Anabela G Silva |
| author_sort | Ana Isabel Martins |
| collection | DOAJ |
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BackgroundDigital solutions, such as mobile apps or telemonitoring devices, are frequently considered facilitators in the process of empowering older adults, but they can also act as a source of digital exclusion or disempowerment if they are not adequate for older adults’ needs and characteristics.
ObjectiveThis study aimed to synthesize and critically evaluate existing evidence on the effectiveness of integrated digital solutions that enable interaction for empowering older adults in aspects related to their health and to explore potential factors (eg, type of technology, participants’ characteristics) impacting effectiveness.
MethodsA systematic search was carried out in PubMed, ScienceDirect, SCOPUS, EBSCO, and SciELO using a combination of terms informed by previous reviews on empowerment. Screening of references was performed against predefined inclusion criteria. Data extraction and the methodological quality of included studies using the PEDro (Physiotherapy Evidence Database) scale were performed by 2 authors. The certainty of evidence was graded for the main comparisons and outcomes of the review using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) framework. When at least 3 studies were available within the same domain of empowerment (knowledge, support by others, capacities, and behaviors) and comparison group, a meta-analysis was performed.
ResultsA total of 30 manuscripts were included in the review. Regarding knowledge, there was very low certainty of evidence of a medium effect size (ES) favoring the digital intervention group (k=5, ES=0.40, 95% CI 0.07-0.73, I2=79%). Regarding capacities, there was low certainty of evidence of no between-group differences (k=5, d=0.13, 95% CI –0.02 to 0.29, I2=0%) when comparing digital solutions against no intervention, low certainty of evidence of a medium ES favoring the digital intervention group (k=13, d=0.29, 95% CI 0.07-0.52, I2=79%) when comparing digital solutions against usual care, and very low certainty of evidence of no between-group differences (k=4, d=0.97, 95% CI –0.62 to 2.56, I2=97%) when comparing digital interventions to face-to-face interventions. Regarding social support and behaviors, no meta-analysis was possible, and existing evidence is conflicting.
ConclusionsThere is very-low-to-low certainty of evidence that using integrated digital solutions results in increased knowledge and increased capacities (mainly self-efficacy) when compared to usual care and impacts capacities to an extent similar to face-to-face interventions at postintervention. Interestingly, results also suggest, with low certainty of evidence, that there are no differences between using digital solutions and no intervention for improving capacities. Included studies and technologies were diverse, and meta-analysis showed high heterogeneity, which limits the confidence in the results and suggests that further research might affect the conclusions of this review.
Trial RegistrationPROSPERO CRD42022346823; https://tinyurl.com/39k29pzc |
| format | Article |
| id | doaj-art-98c645234e994046b87eedbf0e16a600 |
| institution | Kabale University |
| issn | 1438-8871 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | Journal of Medical Internet Research |
| spelling | doaj-art-98c645234e994046b87eedbf0e16a6002025-01-09T16:00:34ZengJMIR PublicationsJournal of Medical Internet Research1438-88712025-01-0127e5446610.2196/54466Effectiveness of Integrated Digital Solutions to Empower Older Adults in Aspects Related to Their Health: Systematic Review and Meta-AnalysisAna Isabel Martinshttps://orcid.org/0000-0002-5220-0528Óscar Ribeirohttps://orcid.org/0000-0003-4740-7951Gonçalo Santinhahttps://orcid.org/0000-0002-4732-5959Telmo Silvahttps://orcid.org/0000-0001-9383-7659Nelson P Rochahttps://orcid.org/0000-0003-3801-7249Anabela G Silvahttps://orcid.org/0000-0002-4386-5851 BackgroundDigital solutions, such as mobile apps or telemonitoring devices, are frequently considered facilitators in the process of empowering older adults, but they can also act as a source of digital exclusion or disempowerment if they are not adequate for older adults’ needs and characteristics. ObjectiveThis study aimed to synthesize and critically evaluate existing evidence on the effectiveness of integrated digital solutions that enable interaction for empowering older adults in aspects related to their health and to explore potential factors (eg, type of technology, participants’ characteristics) impacting effectiveness. MethodsA systematic search was carried out in PubMed, ScienceDirect, SCOPUS, EBSCO, and SciELO using a combination of terms informed by previous reviews on empowerment. Screening of references was performed against predefined inclusion criteria. Data extraction and the methodological quality of included studies using the PEDro (Physiotherapy Evidence Database) scale were performed by 2 authors. The certainty of evidence was graded for the main comparisons and outcomes of the review using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) framework. When at least 3 studies were available within the same domain of empowerment (knowledge, support by others, capacities, and behaviors) and comparison group, a meta-analysis was performed. ResultsA total of 30 manuscripts were included in the review. Regarding knowledge, there was very low certainty of evidence of a medium effect size (ES) favoring the digital intervention group (k=5, ES=0.40, 95% CI 0.07-0.73, I2=79%). Regarding capacities, there was low certainty of evidence of no between-group differences (k=5, d=0.13, 95% CI –0.02 to 0.29, I2=0%) when comparing digital solutions against no intervention, low certainty of evidence of a medium ES favoring the digital intervention group (k=13, d=0.29, 95% CI 0.07-0.52, I2=79%) when comparing digital solutions against usual care, and very low certainty of evidence of no between-group differences (k=4, d=0.97, 95% CI –0.62 to 2.56, I2=97%) when comparing digital interventions to face-to-face interventions. Regarding social support and behaviors, no meta-analysis was possible, and existing evidence is conflicting. ConclusionsThere is very-low-to-low certainty of evidence that using integrated digital solutions results in increased knowledge and increased capacities (mainly self-efficacy) when compared to usual care and impacts capacities to an extent similar to face-to-face interventions at postintervention. Interestingly, results also suggest, with low certainty of evidence, that there are no differences between using digital solutions and no intervention for improving capacities. Included studies and technologies were diverse, and meta-analysis showed high heterogeneity, which limits the confidence in the results and suggests that further research might affect the conclusions of this review. Trial RegistrationPROSPERO CRD42022346823; https://tinyurl.com/39k29pzchttps://www.jmir.org/2025/1/e54466 |
| spellingShingle | Ana Isabel Martins Óscar Ribeiro Gonçalo Santinha Telmo Silva Nelson P Rocha Anabela G Silva Effectiveness of Integrated Digital Solutions to Empower Older Adults in Aspects Related to Their Health: Systematic Review and Meta-Analysis Journal of Medical Internet Research |
| title | Effectiveness of Integrated Digital Solutions to Empower Older Adults in Aspects Related to Their Health: Systematic Review and Meta-Analysis |
| title_full | Effectiveness of Integrated Digital Solutions to Empower Older Adults in Aspects Related to Their Health: Systematic Review and Meta-Analysis |
| title_fullStr | Effectiveness of Integrated Digital Solutions to Empower Older Adults in Aspects Related to Their Health: Systematic Review and Meta-Analysis |
| title_full_unstemmed | Effectiveness of Integrated Digital Solutions to Empower Older Adults in Aspects Related to Their Health: Systematic Review and Meta-Analysis |
| title_short | Effectiveness of Integrated Digital Solutions to Empower Older Adults in Aspects Related to Their Health: Systematic Review and Meta-Analysis |
| title_sort | effectiveness of integrated digital solutions to empower older adults in aspects related to their health systematic review and meta analysis |
| url | https://www.jmir.org/2025/1/e54466 |
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