The inclusion of implementation outcomes in digital health interventions for young adults: A scoping review

Abstract

Objective: Implementation outcomes are important in intervention research as a necessary precursor to achieving desired health outcomes. Considering the critical role of implementation outcomes, this study involved a comprehensive review of implementation outcome measures used in digital health interventions specifically targeting young adults.

Methods: This scoping review was reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews, and the search incorporated the elements of population, concept, and content framework in three electronic databases (PubMed, Embase, and CINAHL). A matrix was used for data extraction and integrative thematic synthesis for analysis. Implementation outcomes were reported based on the indicators in each study, totaling eight outcomes: acceptability, adoption, appropriateness, cost, feasibility, fidelity, penetration, and sustainability.

Results: The search yielded 2441 articles, and 17 were finally identified. The intervention implementation techniques that were adopted were telephone calls (n = 1); social media (n = 2); web-based programs (n = 4); short message service (n = 5); wearable devices (n = 1); mobile applications (n = 3); and a combination of phone calls, emails, and text messaging (n = 1). The highest number of implementation outcomes that were assessed in all the studies were acceptability (n = 10), feasibility (n = 10), and fidelity (n = 8). Short message service (n = 14), web-based programs (n = 11), and mobile applications (n = 7) had the highest number of implementation outcomes.

Conclusions: Researchers have largely assessed the acceptability and feasibility outcomes. The need to integrate the implementation outcomes framework in intervention research design is underscored.