mHealth learning strategies to support behaviour change in individuals using wheelchairs and/or scooters: a systematic review

The purpose of this systematic review of the literature is to build understanding of the key elements and recommendations for the design of mHealth technology for individuals using wheelchairs and/or scooters and identify key features associated with the use of mHealth to support healthy behaviour changes for this population. Eight major electronic databases were systematically searched to identify mobile health (mHealth) interventions, which targeted adult WC/S users. Independent reviewers used Endnote and Covidence to manage articles meeting review criteria and to exclude duplicates. A quality assessment was conducted on each included article. Nine articles describing studies with diverse study designs met criteria to be included in this review. Several interactive application intervention features, such as participant collaboration and goal setting, and key technical features to support mHealth app development and utilisation were identified. Results found intuitive and simple designs of mHealth apps, with the ability to customise to support learning styles and preferences, support usability and acceptability by participants. More research is needed to evaluate best practices to support initial training of end-users, mHealth apps’ ability to support long-term behaviour change and maintenance, and the understanding of active ingredients in complex interventions that include mHealth apps. Both interactive mHealth application intervention and technical features support healthy behaviour change among individuals using wheelchairs and scooters. Utilizing evidence to develop mHealth applications (apps) support best practices, participant satisfaction, and usability.mHealth apps are feasible to support health behavior change for wheelchair and/or scooter users, with considerations for customization to support diverse learning preferences and needs.Active learning strategies (e.g., goal setting, self-assessment, collaborative learning), within or in conjunction with the app, support behavior change. Utilizing evidence to develop mHealth applications (apps) support best practices, participant satisfaction, and usability. mHealth apps are feasible to support health behavior change for wheelchair and/or scooter users, with considerations for customization to support diverse learning preferences and needs. Active learning strategies (e.g., goal setting, self-assessment, collaborative learning), within or in conjunction with the app, support behavior change.

本系统文献综述旨在明确针对轮椅及/或电动代步车使用者的移动健康（mHealth）技术设计核心要素与相关建议，并识别该人群使用移动健康技术支持健康行为改变的关键关联特征。研究系统检索了8个主要电子数据库，以筛选面向成年轮椅/代步车使用者的移动健康干预研究。由独立评审人员使用Endnote与Covidence管理符合综述标准的文献，并剔除重复条目。对每一篇纳入文献均开展了质量评价。最终共有9篇涵盖多样研究设计的文献符合纳入标准，被纳入本次综述。
研究识别出多项交互式应用干预特征（如参与者协作与目标设定），以及支撑移动健康应用开发与使用的关键技术特征。结果表明，移动健康应用需具备直观简洁的设计，并支持个性化定制以适配不同学习风格与偏好，以此提升使用者的易用性与接受度。
目前仍需开展更多研究，以评估支持终端用户初始培训的最佳实践、移动健康应用支撑长期行为改变与维持的能力，以及理解包含移动健康应用的复杂干预中的活性成分。交互式移动健康应用干预与技术特征均可助力轮椅及电动代步车使用者实现健康行为改变。基于证据开发移动健康应用，有助于践行最佳实践、提升参与者满意度与易用性。移动健康应用在轮椅及/或代步车使用者的健康行为改变支持中具备可行性，需考虑个性化定制以适配多样化的学习偏好与需求。应用内或结合应用开展的主动学习策略（如目标设定、自我评估、协作学习）可有效支持行为改变。基于证据开发移动健康应用，有助于践行最佳实践、提升参与者满意度与易用性。移动健康应用在轮椅及/或代步车使用者的健康行为改变支持中具备可行性，需考虑个性化定制以适配多样化的学习偏好与需求。应用内或结合应用开展的主动学习策略（如目标设定、自我评估、协作学习）可有效支持行为改变。