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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: 31 July 2025 | Viewed by 11164

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Special Issue Editor

Prof. Dr. Holly Blake

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Guest Editor

School of Health Sciences, University of Nottingham, Nottingham NG7 2HA, UK
Interests: digital health; health promotion; public health; workforce
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Health promotion and the prevention of disease are global priorities. With the rising prevalence of non-communicable disease and mental health illnesses, there is an urgent need to focus on enabling individuals, families, populations, and communities to adopt lifestyles that promote and improve their health. Health promotion approaches include primary prevention (preventing the onset of illness and disease), secondary prevention (preventing the progression of illness and disease) and tertiary prevention (mitigating further illness and suffering in those who are already ill). Digital technologies are becoming increasingly important as a mechanism for the delivery of health promotion interventions in healthcare or community settings. In recent years, there has been a proliferation of innovations and emerging technologies in e-health, m-health, telehealth, gamification, virtual reality, and the Internet of Things. Their application includes, but are not limited to, health education (e.g., to enhance health literacy and/or competencies), health monitoring, health communications (e.g., mass messaging, the Internet, and social media health campaigns), psychosocial and behavioural interventions for health promotion, health protection and disease prevention (e.g., alcohol and substance use, smoking cessation, diet, physical activity, health screening and vaccination uptake). Of further value is exploring users’ engagement with digital interventions, and how health professionals, health educators, or other health champions integrate digital health promotion innovations into their everyday practice. We invite submissions based on empirical research, or high-quality evidence reviews, such as systematic or scoping review.

Prof. Dr. Holly Blake
Guest Editor

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

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Keywords

digital Health
e-health
m-health
health promotion
health education
prevention
public health

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Published Papers (7 papers)

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Research

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14 pages, 582 KiB

Open AccessArticle

Paediatric Preparedness: Document Analysis of the Challenges Experienced Using Smartwatch Technologies to Support Children Living with a Chronic Health Condition

by Sonia Butler, Dean Sculley, Derek Santos, Xavier Gironès, Davinder Singh-Grewal and Andrea Coda

Int. J. Environ. Res. Public Health 2025, 22(2), 133; https://doi.org/10.3390/ijerph22020133 - 21 Jan 2025

Viewed by 933

Abstract

Smartwatch technology is increasingly being used to support the management of chronic health conditions. Yet, many new digital health innovations fail because the correct foundations are not well established. This exploratory study aims to uncover the challenges experienced during the setup phase of a smartwatch intervention, to support the prototype development of a digital health intervention for children. Five children with a chronic health condition were asked to wear a smartwatch for 14 days that collects health data (pain levels, medication adherence, and physical activity performance). To explore the experiences of these children, their parents and the research team, all written records were analysed using READ’s four steps of document analysis and reported using the Standards for Reporting Qualitative Research checklist. The following three themes emerged: 1.) Infrastructure limitations: inexpensive smartphones prevented connection, and outpatient clinics’ internet black spots constrained setup and training; 2.) Personal phone restrictions: limited setup, training, and engagement; 3.) Elimination of the parent’s phone: provided children with digital support (a smartphone, pre-installed apps, cellular data) to allow active participation. Overall, we identified barriers hindering the use of smartwatch technology in clinical practice. More resources are needed to ensure paediatric preparedness for digital health support. Full article

(This article belongs to the Special Issue Digital Innovations for Health Promotion)

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24 pages, 4878 KiB

Open AccessArticle

Digital Educational Escape Rooms for Providing Knowledge on Stress Management and Health Promotion for Students—A Rapid Review and Pilot Study

by Joanna Albrecht, Anna Lea Stark-Blomeier, Pascal Schütz, Nina Lenhard, Christoph Dockweiler and Pinar Tokgöz

Int. J. Environ. Res. Public Health 2025, 22(1), 93; https://doi.org/10.3390/ijerph22010093 - 11 Jan 2025

Cited by 1 | Viewed by 994

Abstract

The impact of stress on students’ well-being and academic success is tremendous. This paper addresses the issue of balancing stress with the realm of a digital educational escape room (deER). This article demonstrates how a deER can serve as a means of providing knowledge on stress management and health promotion for university students. The objective was twofold—to explore the state of research regarding deERs in stress management and health promotion for students and to investigate the user experience and acceptance of a deER prototype. The methodology combines a rapid literature review and the conceptual as well as technical development of the deER prototype. Additionally, pilot testing was conducted in alignment with relevant theory. The rapid review included four publications meeting the inclusion criteria. Data for deER prototype testing were collected from students at the University of Siegen (first Bachelor’s and Master’s degree). The pilot study results (n = 4 participants) indicated that deER education on coping strategies, which incorporates mindfulness exercises, increases productivity and is considered helpful for stress management. This suggests that deERs can provide enjoyable and effective support for students in acquiring personal stress management strategies, potentially enhancing health promotion at universities. However, larger, more diverse studies are needed to fully assess their feasibility and integration into university structures. Full article

(This article belongs to the Special Issue Digital Innovations for Health Promotion)

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15 pages, 1749 KiB

Open AccessArticle

Understanding Multi-Level Factors Impacting Digital Health Literacy in the Deep South of the United States

by Tanvi V. Padalkar, Keyonsis Hildreth, Gabrielle B. Rocque, Stacey A. Ingram, Omari Whitlow, Dan Chu, Connie C. Shao, Courtney P. Williams, Claudia M. Hardy, Chao-Hui Sylvia Huang and Nicole L. Henderson

Int. J. Environ. Res. Public Health 2025, 22(1), 41; https://doi.org/10.3390/ijerph22010041 - 31 Dec 2024

Cited by 1 | Viewed by 1346

Abstract

As healthcare and health services become increasingly digitized, individuals with low digital health literacy (DHL) may experience inequitable care and outcomes. We explored factors impacting DHL and recommendations for improvement from community health coordinators and advisors (CHAs) in Alabama and Mississippi in United States. Semi-structured interviews were conducted with CHAs to gather insights on their perspectives on and experiences with DHL. Interviews were transcribed and analyzed using a grounded coding schema, with key barriers and recommendations mapped onto the Taplin Multi-Level Intervention model to help identify influences across various levels. Thirty-two CHAs participated, predominantly female (94%) and Black or African American (94%). At the individual level, factors involved demographic characteristics, increased patient workload, and attitudes towards technology. Social support was captured at the relationships level. At the provider level, provider–patient communication and injustices were involved, compounded by health system infrastructure and culture at the practice-setting level. Resource landscape and shared knowledge and beliefs were significant at the community level. The COVID-19 pandemic further highlighted these challenges at the societal level. CHAs provided targeted recommendations for addressing barriers at each level. CHAs identified multi-level factors contributing to DHL and emphasized levels based on comprehensive interventions. Full article

(This article belongs to the Special Issue Digital Innovations for Health Promotion)

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13 pages, 2400 KiB

Open AccessArticle

Development of an eHealth Intervention Prototype to Prevent Health Risk Behaviors Among Hispanic Adolescents: A User-Centered Formative Study

by Yannine Estrada, Alyssa Lozano, Padideh Lovan, Devina J. Boga, Lara Martinuzzi, Jennifer Chavez, Maria I. Tapia, Guillermo Prado and Victoria Behar-Zusman

Int. J. Environ. Res. Public Health 2024, 21(12), 1613; https://doi.org/10.3390/ijerph21121613 - 1 Dec 2024

Viewed by 1465

Abstract

Health risk behaviors continue to disproportionately affect Hispanic youth. Despite the existence of successful family and school-based interventions, there is a need for developing and testing individually-based preventive interventions that are easily accessed and widely disseminated. Therefore, this study aimed to develop a prototype (proof of concept) for an individual-level mobile application (app), informed by Hispanic parents and adolescents, to prevent/reduce drug use and sexual risk behaviors among Hispanic youth. An iterative user-centered approach was used to inform the development of the app prototype via focus groups with 66 participants (n = 46 adolescents, n = 20 parents). A coding team analyzed data from the focus groups and identified major themes. The coding team summarized interview data into sub-categories that yielded five intervention modules for Hispanic adolescents, three more than originally proposed (i.e., drug use and sexual risk behaviors): (1) effective communication, (2) depression, (3) sexual health, (4) drug use, and (5) mindfulness. A mobile application for health risk behaviors can be used as an additional preventive tool to decrease the existing behavioral health disparities among Hispanic youth. Incorporating a user-centered approach to inform development is important for including the needs and voices of this population. Full article

(This article belongs to the Special Issue Digital Innovations for Health Promotion)

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24 pages, 2399 KiB

Open AccessArticle

Alcohol Prevention in Urgent and Emergency Care (APUEC): Development and Evaluation of Workforce Digital Training on Screening, Brief Intervention, and Referral for Treatment

by Holly Blake, Emma J. Adams, Wendy J. Chaplin, Lucy Morris, Ikra Mahmood, Michael G. Taylor, Gillian Langmack, Lydia Jones, Philip Miller and Frank Coffey

Int. J. Environ. Res. Public Health 2023, 20(22), 7028; https://doi.org/10.3390/ijerph20227028 - 7 Nov 2023

Cited by 2 | Viewed by 2910

Abstract

Excessive alcohol consumption carries a significant health, social and economic burden. Screening, brief intervention and referral to treatment (SBIRT) is one approach to identifying patients with excessive alcohol consumption and providing interventions to help them reduce their drinking. However, healthcare workers in urgent and emergency care settings do not routinely integrate SBIRT into clinical practice and raise a lack of training as a barrier to SBIRT delivery. Therefore, “Alcohol Prevention in Urgent and Emergency Care” (APUEC) training was developed, delivered, and evaluated. APUEC is a brief, stand-alone, multimedia, interactive digital training package for healthcare workers. The aim of APUEC is to increase positive attitudes, knowledge, confidence and skills related to SBIRT through the provision of (a) education on the impact of alcohol and the role of urgent and emergency care in alcohol prevention, and (b) practical guidance on patient assessment, delivery of brief advice and making referral decisions. Development involved collaborative–participatory design approaches and a rigorous six-step ASPIRE methodology (involving n = 28 contributors). APUEC was delivered to healthcare workers who completed an online survey (n = 18) and then participated in individual qualitative interviews (n = 15). Analysis of data was aligned with Levels 1–3 of the Kirkpatrick Model of Training Evaluation. Survey data showed that all participants (100%) found the training useful and would recommend it to others. Insights from the qualitative data showed that APUEC digital training increases healthcare workers’ perceived knowledge, confidence and skills related to alcohol prevention in urgent and emergency care settings. Participants viewed APUEC to be engaging and relevant to urgent and emergency care workers. This digital training was perceived to be useful for workforce skills development and supporting the implementation of SBIRT in clinical practice. While the impact of APUEC on clinician behaviour and patient outcomes is yet to be tested, APUEC digital training could easily be embedded within education and continuing professional development programmes for healthcare workers and healthcare trainees of any discipline. Ultimately, this may facilitate the integration of SBIRT into routine care and contribute to population health improvement. Full article

(This article belongs to the Special Issue Digital Innovations for Health Promotion)

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Review

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26 pages, 1764 KiB

Open AccessReview

A Horizon Scan of Neurotechnology Innovations

by Shona Haston, Sean Gill, Katie Twentyman, Elizabeth Green, Opeyemi Agbeleye, Claire Eastaugh, Dawn Craig, Sonia Garcia Gonzalez-Moral and Andrew Mkwashi

Int. J. Environ. Res. Public Health 2025, 22(5), 811; https://doi.org/10.3390/ijerph22050811 - 21 May 2025

Abstract

Neurotechnology is a rapidly emerging field with vast potential within healthcare, but also has inherent concerns. There is, therefore, a need to ensure the responsible and ethical development and regulation of these technologies. This horizon scan aimed to provide an overview of neurotechnologies in development and those approved by the FDA as of June 2024 for a range of conditions relating to mental health, healthy ageing, and physical disability. Searches of clinical trials, conferences, journals, and news were performed in March 2024. Relevant technologies were identified through a process of screening, data extraction and synthesis. A total of 81 unique neurotechnologies were identified, with 23 relating to mental health, 31 to healthy ageing, and 42 to physical disability. A total of 79% percent did not yet have FDA approval and 77.4% were at earlier stages of development (pilot/feasibility studies), with 22.6% at pivotal or post-market stages. Digital elements were common features of the technologies, including software, apps, and connectivity to other devices; however, there were only three technologies with an identifiable AI component. A complex regulatory landscape and unique ethical and safety concerns associated with neurotechnology could pose challenges to innovators, though the emerging nature of the field also provides an opportunity to pre-emptively address potential issues. Full article

(This article belongs to the Special Issue Digital Innovations for Health Promotion)

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11 pages, 646 KiB

Open AccessReview

Technology for Young Adults with Stroke: An Australian Environmental Scan

by Dinah Amoah, Sarah Prior, Matthew Schmidt, Carey Mather and Marie-Louise Bird

Int. J. Environ. Res. Public Health 2024, 21(9), 1254; https://doi.org/10.3390/ijerph21091254 - 21 Sep 2024

Viewed by 1648

Abstract

Technology has the potential to address the unique needs of young stroke survivors. Despite this, little is known about the technological resources available to support young adults with stroke. This study aimed to identify and compile available technological resources that cater to the specific needs of young adults (18–30 years) with stroke in Australia. An environmental scan was conducted from December 2023 to March 2024. Sources included websites, app stores, rehabilitation centres, hospitals, organisations, technology developers, and healthcare professionals. Of the 114 resources identified, 11% were for re-training limb movement, 40% for speech rehabilitation, 20% for medication reminders, and 29% were social media posts offering peer mentoring and support. Most limb movement (75%) and medication reminder (87%) apps were free. However, most speech therapy apps (78%) had associated costs. Social media posts were hosted on Facebook (64%), Instagram (21%), TikTok (9%), YouTube (3%), and other websites (3%). Forty-six percent of the social media posts targeting young stroke survivors did not specify the age group. These resources were identified as available to young people with stroke. Although the resources found focused on young stroke survivors, it was difficult to ascertain the specific age group that was being targeted. Full article

(This article belongs to the Special Issue Digital Innovations for Health Promotion)

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