Objective The aim of this systematic review was to synthesize current knowledge of the factors influencing healthcare professional adoption of mobile health (m-health) applications. Methods Covering a period from 2000 to 2014, we conducted a systematic literature search on four electronic databases (PubMed, EMBASE, CINAHL, PsychInfo). We also consulted references from included studies. We included studies if they reported the perceptions of healthcare professionals regarding barriers and facilitators to m-health utilization, if they were published in English, Spanish, or French and if they presented an empirical study design (qualitative, quantitative, or mixed methods). Two authors independently assessed study quality and performed content analysis using a validated extraction grid with pre-established categorization of barriers and facilitators. Results The search strategy led to a total of 4223 potentially relevant papers, of which 33 met the inclusion criteria. Main perceived adoption factors to m-health at the individual, organizational, and contextual levels were the following: perceived usefulness and ease of use, design and technical concerns, cost, time, privacy and security issues, familiarity with the technology, risk-benefit assessment, and interaction with others (colleagues, patients, and management). Conclusion This systematic review provides a set of key elements making it possible to understand the challenges and opportunities for m-health utilization by healthcare providers.

Introduction: One Health is a concept that establishes the link between humans, animals and the environment in a collaborative approach. Since One Health’s inception, several interventions have been developed in many regions and countries worldwide to tackle complex health problems, including epidemics and pandemics. In the developed world, many collaborative platforms have been created with an international strategy to address issues specific or not to their environment. Unfortunately, there is a lack of synthesis on the challenges and opportunities Low and Middle-Income Countries (LMICs) face.Methods: Following The Preferred Reporting Elements for PRISMA Systematic Reviews and Meta-Analyses (PRISMA), we conducted a systematic review. We applied a search strategy to electronic bibliographic databases (PubMed, Embase, Global Health, Web of Science and CINAHL). We assessed the included articles’ quality using the Mixed Methods Appraisal tool (MMAT).Results and discussion: A total of 424 articles were initially identified through the electronic database search. After removing duplicates (n = 68), 356 articles were screened for title and abstract, and 16 were retained for full-text screening. The identified barriers were the lack of political will, weak governance and lack of human, financial and logistics resources. Concerning the enablers, we listed the existence of a reference framework document for One Health activities, good coordination between the different sectors at the various levels, the importance of joint and multisectoral meetings that advocated the One Health approach and the Availability of funds and adequate resources coupled with the support of Technical and Financial partners.Conclusion: One Health strategy and interventions must be implemented widely to address the rising burden of emerging infectious diseases, zoonotic diseases, and antimicrobial resistance. Addressing those challenges and reinforcing the enablers to promote managing global health challenges is necessary.Systematic Review Registration: https://www.crd.york.ac.uk/prospero/record_email.php, Unique Identifier: CRD42023393693.

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet

We conducted a mixed-methods knowledge synthesis to assess the effectiveness of interventions to improve caregivers’ involvement in decision making with seniors, and to describe caregivers’ experiences of decision making in the absence of interventions. We analyzed forty-nine qualitative, fourteen quantitative, and three mixed-methods studies. The qualitative studies indicated that caregivers had unmet needs for information, discussions of values and needs, and decision support, which led to negative sentiments after decision making. Our results indicate that there have been insufficient quantitative evaluations of interventions to involve caregivers in decision making with seniors and that the evaluations that do exist found few clinically significant effects. Elements of usual care that received positive evaluations were the availability of a decision coach and a supportive decision-making environment. Additional rigorously evaluated interventions are needed to help caregivers be more involved in decision making with seniors.

Background: Social aspects play an important role in individual health and should be taken into consideration in the long-term care for people with multimorbidity. Purposes: To describe social vulnerability, to examine its correlation with the number of chronic conditions, and to investigate which chronic conditions were significantly associated with the most socially vulnerable state in patients with multimorbidity. Methods: Cross-sectional analysis from the baseline data of the Patient-Centred Innovations for Persons with Multimorbidity (PACEinMM) Study. Participants were patients attending primary healthcare settings in Quebec, Canada. A social vulnerability index was applied to identify social vulnerability level. The index value ranges from 0 to 1 (1 as the most vulnerable). Spearman’s rank correlation coefficient was calculated for the correlation between the social vulnerability index and the number of chronic conditions. Logistic regression was applied to investigate which chronic conditions were independently associated with the most socially vulnerable state. Results: There were 301 participants, mean age 61.0 ± 10.5, 53.2% female. The mean number of chronic health conditions was 5.01 ± 1.82, with the most common being hyperlipidemia (78.1%), hypertension (69.4%), and obesity (54.2%). The social vulnerability index had a median value of 0.13 (range 0.00–0.78). There was a positive correlation between the social vulnerability index and the number of chronic conditions (r = 0.24, p < 0.001). Obesity, depression/anxiety, and cardiovascular diseases were significantly associated with the most socially vulnerable patients with multimorbidity. Conclusions: There was a significant correlation between social vulnerability and the total number of chronic conditions, with depression/anxiety, obesity, and cardiovascular diseases being the most related to social vulnerability.

Polypharmacy carries the risk of adverse events, especially in people with multimorbidity. To investigate the prevalence of polypharmacy in community-dwelling adults, the association of multimorbidity with polypharmacy and the use of medications for primary prevention. Cross-sectional analysis of the follow-up data from the Program of Research on the Evolution of a Cohort Investigating Health System Effects (PRECISE) in Quebec, Canada. Multimorbidity was defined as the presence of three or more chronic diseases and polypharmacy as self-reported concurrent use of five or more medications. Primary prevention was conceptualized as the use of statin or low-dose antiplatelets without a reported diagnostic of cardiovascular disease. Mean age 56.7 ± 11.6, 62.5% female, 30.3% had multimorbidity, 31.9% had polypharmacy (n = 971). The most common drugs used were statins, renin–angiotensin system inhibitors and psychotropics. Compared to participants without any chronic disease, the adjusted odds ratios (ORs) for having polypharmacy were 2.78 [95% confidence interval (CI): 1.23–6.28] in those with one chronic disease, 8.88 (95% CI: 4.06–19.20) in those with two chronic diseases and 25.31 (95% CI: 11.77–54.41) in those with three or more chronic diseases, P < 0.001. In participants without history of cardiovascular diseases, 16.2% were using antiplatelets and 28.5% were using statins. Multimorbidity was associated with increased likelihood of using antiplatelets (adjusted OR: 2.98, 95% CI: 1.98–4.48, P < 0.001) and statins (adjusted OR: 3.76, 95% CI: 2.63–5.37, P < 0.001) for primary prevention. There was a high prevalence of polypharmacy in community-dwelling adults in Quebec and a strong association with multimorbidity. The use of medications for primary prevention may contribute to polypharmacy and raise questions about safety.