Background: Managing chronic diseases remains a critical challenge in primary health care (PHC) across the Organization for Economic Co-operation and Development countries. Electronic patient-reported outcome measures (ePROMs) are emerging as valuable tools for enhancing patient engagement, facilitating clinical decision-making, and improving health outcomes. However, their implementation in PHC remains limited, with significant variability in effectiveness and adoption. Objective: This systematic review aimed to assess the implementation and effectiveness of ePROMs in chronic disease management within PHC settings and to identify key barriers and facilitators influencing their integration. Methods: A mixed methods systematic review was conducted following the Cochrane Methods and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. We included studies that implemented ePROMs among adults for chronic disease management in PHC. The extracted data included patient health outcomes, provider workflow implications, implementation factors, and cost considerations. The reach, effectiveness, adoption, implementation, and maintenance framework was used. Results: Our search yielded 12,525 references, from which 22 (0.18%) studies were included after screening and exclusions. These studies, primarily conducted in the United States (n=9, 41%) and Canada (n=8, 36%), covered various chronic diseases and used diverse ePROM tools, predominantly mobile apps (n=9, 41%). While some studies (n=10, 45%) reported improvements in patient health outcomes and self-management, others (n=12, 55%) indicated no significant change. Key barriers included digital literacy gaps, integration challenges within clinical workflows, and increased provider workload. Facilitators included strong patient-provider relationships, personalized interventions, and technical support for users. While some studies (n=10, 45%) demonstrated improved patient engagement and self-management, long-term cost-effectiveness and sustainability remain uncertain. Conclusions: Success in implementing ePROMs in PHC appears to hinge on addressing digital literacy, ensuring personalization and meaningful patient-provider interactions, carefully integrating technology into clinical workflows, and conducting thorough research on their long-term impacts and cost-effectiveness. Future efforts should focus on these areas to fully realize the benefits of digital health technologies for patients, providers, and health care systems. Trial Registration: PROSPERO CRD42022333513; https://www.crd.york.ac.uk/PROSPERO/view/CRD42022333513 International Registered Report Identifier (IRRID): RR2-10.2196/48155

Background: Interactive conversational agents (chatbots) simulate human conversation using natural language processing and artificial intelligence. They enable dynamic interactions and are used in various fields, including education and healthcare. Objective: This systematic review aims to identify and synthesize studies on chatbots for women and expectant parents in the preconception, pregnancy, and postnatal period through 12 months postpartum. Methods: We searched in six electronic bibliographic databases (MEDLINE (Ovid), CINAHL (EBSCO), Embase, Web of Science, Inspec, and IEEE Xplore) using a pre-defined search strategy. We included sources if they focused on women in the preconception period, pregnant women and their partners, mothers, and fathers/coparents of babies up to 12 months old. Two reviewers independently screened studies and all disagreements were resolved by a third reviewer. Two reviewers independently extracted and validated data from the included studies into a standardized form and conducted quality appraisal. Results: Twelve studies met the inclusion criteria. Seven were from the USA, with others from Brazil, South Korea, Singapore, and Japan. The studies reported high user satisfaction, improved health intentions and behaviors, increased knowledge, and better prevention of preconception risks. Chatbots also facilitated access to health information and interactions with health professionals. Conclusion: We provide an overview of interactive conversational agents used in the perinatal period and their applications. Digital interventions using interactive conversational agents have a positive impact on knowledge, behaviors, attitudes, and the use of health services. Interventions using interactive conversational agents may be more effective than those using methods such as individual or group face-to-face delivery.

Background: Digital health literacy (DHL), recognized as a key determinant of health, can influence health and well-being, improve health equity, and reduce health disparities. However, DHL is often limited among forced migrant populations, who usually lack the skills to understand and evaluate health information or to access and use digital health resources appropriately. Objective: We aimed to (1) identify effective interventions designed to improve DHL among forced migrant populations and (2) categorize and describe the characteristics of interventions that aim to improve the abilities of forced migrants or adapt digital health services to meet the needs and expectations of forced migrant populations limited by low levels of DHL. Methods: We conducted a mixed methods systematic review according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 guidelines, involving an iterative process among the authors. A medical information specialist assisted in developing a search strategy for the 6 most relevant databases (MEDLINE, Embase, CINAHL, Web of Science, Academic Search Premier, and PsycINFO) and the Google Scholar search engine, covering studies published between 2000 and 2022. Pairs of reviewers selected, individually and independently, titles, abstracts, and then full texts. Data extraction and quality assessment were performed by 2 reviewers and validated by a senior researcher. We used narrative synthesis to provide a comprehensive overview of effective DHL interventions for forced migrant populations, highlighting their success factors. Results: We identified 1845 studies, of which only 6 (0.33%) were finally selected for narrative synthesis. Studies were excluded due to irrelevance, lack of primary data, or low methodological quality. The analysis revealed a diverse methodological landscape with a predominance of qualitative approaches aimed at understanding the challenges and needs of forced migrants concerning DHL. The main challenges were associated with cultural, linguistic, and practical contexts. Interventions targeted various groups, including older adults, individuals with low literacy or education, and those with limited digital experience. We identified 4 effective educational intervention categories to enhance DHL among forced migrants: education and training; education and social support; enabling and education; and social, educational, technological, and infrastructural support. Overall, most of the studies (5/6, 83%) reported positive results in terms of improving DHL among forced migrants. Conclusions: This systematic review highlights the importance of improving DHL among forced migrant populations to promote their health and well-being. In addition, it provides comprehensive knowledge about effective interventions conducted with these groups. These findings can inform stakeholders, particularly policy makers, of the need to address low DHL among forced migrant populations. Going forward, these stakeholders need to develop innovative initiatives that rely on holistic approaches and are based on the specific needs of forced migrants to improve equity and health outcomes. Trial Registration: PROSPERO CRD42022373448; https://www.crd.york.ac.uk/PROSPERO/view/CRD42022373448 International Registered Report Identifier (IRRID): RR2-10.2196/50798

Interactive conversational agents, also known as chatbots, have the potential to increase the success rate of digital technology interventions to promote healthy behaviors. However, due to their newness and limited use, little is known about their integration, usefulness, and effectiveness in promoting smoking and vaping cessation. The aim of this mixed-methods systematic review was to assess the effectiveness and characteristics of current interactive conversational agents in promoting and supporting smoking and vaping cessation. A mixed-methods systematic review was conducted to identify studies published in the last 20 years in five relevant databases. Eight studies, including seven on smoking cessation and one on smoking and vaping cessation, were included. The results showed that, compared to other smoking cessation methods, chatbots can lead to better engagement in treatment, resulting in higher rates of sustained abstinence and improved quality of life. In addition, chatbots can be perceived as empathetic and establish a decent therapeutic alliance thanks to their communication skills. This knowledge could be useful for the development of interactive conversational agents to support smoking and/or vaping cessation. Alternative intervention tools targeting younger generations, such as chatbots, may offer an additional way for public health professionals to reach them.

The shift to a digitalized health system brings particular challenges for immigrant mothers who experience a triple adaptation: becoming a mother, navigating a new healthcare system and using technology. This study aims to explore digital health literacy barriers perceived by immigrant mothers and facilitators that could sustain their empowerment related to their health and that of their family. An ethnographic study based on the socioecological model was used to analyze data collected from three individual interviews and two focus groups. The results of the interviews and focus groups allowed us to understand the cultural impact of the lack of digital literacy in the context of healthcare for immigrant mothers in their host country, as well as the barriers and facilitators to access and use digital health information. This study identifies individual, organizational and global level barriers to accessing digital health services amongst immigrant mothers. It also highlighted potential strategies that could support their empowerment in accessing and using digital health resources for their health and that of their family. For instance, training and coaching to help immigrant mothers navigate the health care system are needed. It is also important to adapt public policies to better support the integration of immigrant families in their host country.

Background: Population aging is associated with a growing prevalence of neurocognitive disorders among adults aged 65 years and older. Digital health technologies offer promising opportunities to support cognitive health and well-being in this population. However, their effectiveness largely depends on users’ level of engagement. Despite the recognized importance of engagement in digital health, limited evidence exists on how engagement is conceptualized, measured, and related to intervention outcomes among older adults living with neurocognitive disorders. Objective: This scoping review aimed to describe how engagement with digital health technologies among older adults with neurocognitive disorders is conceptualized and measured, examine the relationship between engagement and the effectiveness of digital health interventions, and identify factors that facilitate or hinder engagement. Methods: A scoping review was conducted following the Joanna Briggs Institute methodological guidance and reported in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) checklist. A comprehensive search strategy, developed in collaboration with an information specialist, was applied to MEDLINE, Embase, CINAHL, Web of Science, and Google Scholar, without date restrictions. Empirical studies involving adults aged 65 years and older living with neurocognitive disorders and using digital health technologies were included. Study selection and data extraction were performed independently by at least 2 reviewers, and the results were synthesized narratively. Results: Of the 1665 records identified after duplicate removal, 2 studies met the inclusion criteria. One study examined computerized cognitive stimulation and cognitive engagement programs among community-dwelling older adults with mild neurocognitive disorders, whereas the other explored the use of a personalized digital reminiscence application in long-term care settings among individuals with major neurocognitive disorders. No study used a validated instrument to directly measure engagement. However, observable indicators and markers related to the behavioral, cognitive, and affective components of engagement were reported. Both studies also documented concurrent cognitive or psychosocial outcomes. Factors facilitating engagement included professional support, content personalization, and involvement of informal caregivers, whereas limiting factors included cognitive fluctuations, fatigue, technical complexity, and reliance on external support. Conclusions: This scoping review highlights a significant gap in the literature regarding the explicit conceptualization and standardized measurement of engagement with digital health technologies among older adults living with neurocognitive disorders. The findings underscore the need to develop and apply multidimensional, context-sensitive engagement measurement tools tailored to this population to better understand and optimize digital health interventions.