Virtual Counselling and Teletherapy Platforms for Students and Educators

The COVID-19 pandemic has added to the pre-existing challenges of diabetes management in many countries. It has accelerated the wider use of digital health solutions which have tremendous potential to improve health outcomes for people with diabetes. However, little is known about the attributes and the implementation of these solutions. To identify and describe digital health solutions for community-based diabetes management and to highlight their key implementation outcomes. We searched Ovid Medline, CINAHL, Embase, PsycINFO, and Web of Science for relevant articles. A purposive search was also used to identify grey literature. Articles that described digital health solutions that aimed to improve community-based diabetes management were included in this review. We applied a thematic synthesis of evidence to describe the characteristics of digital health solutions, and to summarize their key implementation outcomes. We included 15 articles that reported digital health solutions that primarily focused on community-based diabetes management. Nine of the 15 innovations involved were mobile applications and/or web-based platforms, and five were based on social media platforms. The majority of the digital health solutions were used for diabetes education and support. High engagement, utilization, and satisfaction rates with digital health solutions were observed. The use of digital health solutions was also associated with improvement in self-management, taking medication, and reduction in glycated hemoglobin (HbA1c) levels. COVID-19 triggered digital health solutions have tremendous potential to improve health outcomes for people with diabetes. Further studies are needed to evaluate the sustainability and scale-up of these solutions.

Despite Ghana's commitment to universal health coverage and the provision of mental health care in public institutions at no direct cost, the mental health system faces an overwhelming demand and logistical challenges, including a critical shortfall of mental health care professionals, geographic limitations, and stigma. n This commentary explores the challenges and opportunities within Ghana's mental health care system, emphasizing the critical role of mobile health (mHealth) and digital innovations in transforming mental health care delivery. n We highlight the role of mHealth interventions, including initiatives like the M-Healer smartphone toolkit that equips traditional healers with mental health management techniques, and collaborations with digital communities, such as the West African Digital Mental Health Alliance, in improving mental health services and developing culturally relevant digital mental health solutions. n Strategic actions that are essential for further advancing Ghana's mHealth landscape include establishing dedicated training programs for clinicians to build capacity in digital technologies and integrating digital health solutions into hospital systems.

Aim: This study examines the paradigm shift in India's healthcare sector due to the COVID-19 epidemic, explicitly focusing on adopting digital healthcare. The study explores the innovative initiatives undertaken by both the government and commercial sectors in virtual health and analyzes the long-term benefits of this transition.
 Methodology: The study utilizes a secondary research approach to investigate the development of India's digital healthcare system. Various sources such as reports, surveys, and official documents are reviewed to gather information on implementing digital health solutions. The study examines intelligent devices, telemedicine websites, and platforms like Arogya Setu that have played a crucial role in the digital healthcare revolution. Government programs such as the National Digital Health Mission (NDHM) and the establishment of e-hospitals are also analyzed to understand their impact. The study emphasizes the significance of data mining, the development of digital health records, and the necessary infrastructure to support digital healthcare.
 Results: The results indicate that the COVID-19 pandemic has accelerated the digitization of India's healthcare sector. Adopting digital health solutions, including telemedicine, wearable technology, and artificial intelligence, has gained significant momentum. Initiatives like the NDHM and the establishment of e-hospitals have contributed to the successful implementation of digital healthcare. The study highlights the benefits of digital healthcare, such as improved accessibility, cost-effectiveness, and accuracy of services. The importance of data mining and the development of digital health records are underscored as critical drivers of this transformation.
 Conclusion: To conclude, the COVID-19 pandemic has served as a driving force for the digital transformation of India's healthcare industry. The adoption of digital health solutions and the initiatives taken by the government lay the foundation for a more accessible and patient-centred healthcare future. The study emphasizes the significant implications of digital innovations in healthcare for healthcare organizations, medical device manufacturers, and remote care providers. While acknowledging that in-person treatment is still necessary and that comprehensive digitalization takes time, the study highlights the transformative potential of digitizing healthcare to improve access to care and enhance delivery methods. This digital revolution can potentially revolutionize the healthcare industry and improve healthcare outcomes.

Poor sleep is closely linked to mental health challenges and workplace burnout. Mental health and workplace stressors can impair sleep, while good sleep quality supports cognitive and emotional resources to cope with daily challenges. Despite positive outcomes of maintaining good sleep, many people struggle to get enough restorative sleep at night. Given the bidirectional relationship between sleep and mental health, evidence-based digital mental health solutions may offer an accessible and scalable approach to improving sleep quality. This study examines whether engagement with an employer-sponsored, multimodal digital mental health platform is associated with improvements in sleep quality over time, and whether changes in sleep quality are associated with concurrent changes in mental health and burnout outcomes. This 12-month prospective, observational study followed working adults who were newly registered to an employer-sponsored digital mental health platform (Modern Health). The platform leveraged technology (mobile and web) to connect employees with comprehensive provider-led and self-guided care through therapy, coaching, on-demand digital resources, and group psychoeducational sessions. Participants [N=578; 61.1% (n=353) women; mean age 33.88, SD 8.73 years; 40.3% (n=233) people of color] completed measures of self-rated sleep quality, depression, anxiety, and burnout (exhaustion, cynicism, and professional efficacy) at baseline and after 3 and 12 months of accessing the platform. Upon registering for the platform, participants were given an initial care recommendation, but could flexibly engage in any combination of services. Participants in this study engaged with at least one care modality, including therapy, coaching, psychoeducation sessions, and self-guided mental health resources. We examined perceived sleep quality and associations with other study variables at baseline, changes in perceived sleep quality over time, and whether changes in sleep quality correlated with concurrent changes in mental health and burnout. At baseline, 42% (243/578) reported poor sleep quality and were more likely to have higher levels of depression, anxiety, and burnout. A generalized linear mixed-effects model showed that each additional month of platform access was related to an increased odds of having good sleep quality by 3.7% (P=.02). Linear mixed-effects models found that higher sleep quality over time was associated with lower depression, anxiety, exhaustion, cynicism, and efficacy (all P<.001). Among participants reporting poor sleep quality at baseline, 44% (62/141) reported good sleep quality at 12 months. Within this subgroup, paired sample t tests showed significant reductions in depression (-48.3%) and anxiety (-38.3%), and increased cynicism, burnout, though cynicism levels remained below the cutoff for high burnout (23.9%; all P <.01). Use of an employer-sponsored digital mental health platform was associated with meaningful improvements in self-reported sleep quality over 12 months. These gains were associated with significant reductions in depression, anxiety, and burnout symptoms, highlighting broader well-being benefits of comprehensive mental health care.

Fatigue is the most common symptom in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and long COVID, impacting patients' quality of life; however, there is currently a lack of evidence-based context-aware tools for fatigue self-management in these populations. This study aimed to (1) address fatigue in ME/CFS and long COVID through the development of digital mobile health solutions for self-management, (2) predict perceived fatigue severity using real-time data, and (3) assess the feasibility and potential benefits of personalized digital mobile health solutions. The MyFatigue project adopts a patient-centered approach within the participatory health informatics domain. Patient representatives will be actively involved in decision-making processes. This study combines inductive and deductive research approaches, using qualitative studies to generate new knowledge and quantitative methods to test hypotheses regarding the relationship between factors like physical activity, sleep behaviors, and perceived fatigue in ME/CFS and long COVID. Co-design methods will be used to develop a personalized digital solution for fatigue self-management based on the generated knowledge. Finally, a pilot study will evaluate the feasibility, acceptance, and potential benefits of the digital health solution. The MyFatigue project opened to enrollment in November 2023. Initial results are expected to be published by the end of 2024. This study protocol holds the potential to expand understanding, create personalized self-management approaches, engage stakeholders, and ultimately improve the well-being of individuals with ME/CFS and long COVID. PRR1-10.2196/50157.

Patient confidentiality has remained a central issue in the current “big data” era of healthcare. Protections such as the Health Insurance Portability and Accountability Act of 1996 (HIPAA) exist to ensure that digital personal health information (PHI) are legally secure from threats and breaches that would threaten confidentiality. To be compliant with HIPAA regulations, steps must be taken by health care providers and digital health platforms, and these fall under the Privacy Rule, which outlines appropriate uses and disclosures of PHI, and the Security Rule, which lays out with granularity the steps that must be taken to adhere to the HIPAA regulations. Through deliberate design of secure digital health platforms, we can use technological advances in the collection, measurement, and delivery of health care to advance care and improve patient safety. Renewed efforts to optimize and standardize health care delivery has facilitated the implementation of electronic and digital health solutions that benefit medical and surgical training and efficiency while minimizing harm to patients. Cross-industry innovations such as the OR Black Box® will allow us to accomplish these lofty goals. Finally, we must strive to include patients in this digital health movement, as now more than ever we can create knowledge translation solutions that ensure that patients understand their health in a meaningful way.

Digital health solutions are often used to support caregivers in managing acute pain in their children. The aim of this scoping review was to identify, characterize, and synthesize the literature on caregiver-targeted digital health solutions for acute pain management in children as it relates to caregiver, child, and implementation outcomes. Studies must have described a caregiver-targeted digital health solution for acute pain management in children that provides information or support to caregivers of children experiencing acute pain (eg, needle-related procedure, injury, medical procedure). Studies that included caregivers of children 0 to 19 years were eligible. Following the Joanna Briggs Institute scoping review methodology, MEDLINE, Embase, CINAHL, and PsycINFO databases were searched from January 1, 2010 to May 20, 2025. Two reviewers completed screening and data extraction, and a third reviewer resolved disagreements. From 8949 records screened, 33 studies were eligible. From these, there were 15 individual digital health solutions identified. Of the 7,125 caregivers, 95.2% were mothers. More than half of digital health solutions targeted caregivers of newborns (0-1 years, 60.6%), and all except 2 focused on acute pain during needle-related procedures (eg, vaccinations). Overall, 21 studies reported on caregiver outcomes (primarily knowledge), 11 reported on child outcomes (primarily pain and distress), and 28 reported on implementation outcomes (primarily adoption and acceptability). There is a need for (1) standardization in the evaluation of digital health solutions for caregivers, (2) digital health solutions that target acute pain other than needle-related procedures, and (3) increased diversity of caregivers (eg, non-White, non-mothers) and solutions (eg, culturally diverse).

Background: The prevalence of mental disorders, particularly anxiety and depression, has been increasing and is becoming a major public health concern in Portugal. Digital mental health solutions offer scalable and accessible tools for monitoring and managing mental health. 'P5 Mental Health' has been created as a platform to assess and monitor symptoms of anxiety and depression in the Portuguese population, and to offer strategies to promote well-being to support users. Objective: This study aims to (1) describe the P5 Mental Health platform, (2) evaluate its feasibility as a digital mental health monitoring tool, and (3) analyze trends in the prevalence and severity of anxiety and depression symptoms over a four-year period, particularly in response to major societal stressors. Methods: Between September 2020 and September 2024, 46,032 responses were collected from platform users. Anxiety and depression symptoms were assessed using the Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) scales. Longitudinal trends were analyzed across four time periods. Welch's ANOVA and Games-Howell post hoc tests were conducted to compare symptom severity across time, and ordinal logistic regression was used to examine the impact of time on symptom progression. Results: Anxiety and depression symptoms increased between 2020 and 2022, stabilized thereafter, and showed a slight decline in 2024. The proportion of users reporting moderate to severe anxiety (GAD-7 ≥ 10) rose from 30.87% in September 2020 to 66.30% in June 2022. Similarly, the prevalence of moderate to severe depressive symptoms (PHQ-9 ≥ 10) rose from 3.62% in March 2021 to 51.54% in August 2021. Despite a small decrease in 2024, symptom levels remained significantly higher than baseline levels recorded at the beginning (p < 0.001). A strong positive correlation was found between anxiety and depression symptoms (r = 0.739, p < 0.001), underscoring their high comorbidity. Conclusions: This study demonstrates the feasibility of the P5 Mental Health platform as a real-time mental health monitoring tool, particularly during periods of heightened social and economic stress. The findings highlight the need for sustained digital mental health interventions beyond crisis periods to ensure long-term engagement; however, future improvements should focus on increasing user engagement and adding personalized features to ensure long-term mental health management.

ObjectiveDigital health has been gaining widespread attention but has not been fully integrated into the existing healthcare system. However, it remains unclear whether the new digital health solutions align with users’ needs and wants. This study examines how citizens perceive the functionalities of digital health and how different health risks influence their perception.MethodsUsing an online survey, data are collected from over 4000 Danish citizens. The data are analysed using linear regression models.ResultsThe results show how users’ perceptions of digital health differ significantly. Users are highly interested in data sharing across different healthcare stakeholders but less interested in online health communities. The results also show that the support for digital health is correlated with various health risks, including age, smoking and social network. However, health risks do not have uniform relationship with the perceived value of digital health.ConclusionsWhile developing and implementing new digital health solutions, it is important to consider the perceptions of people who are expected to benefit from such solutions. This study contributes to the literature by deepening the knowledge of how citizens with different risk profiles perceive the multitude of digital health tools being introduced in the healthcare sector.

Digital health education develops an understanding of the pragmatic use of digital technologies, including health apps, artificial intelligence and wearables, in the National Health Service (NHS). Staff should feel confident...

BackgroundAboriginal and Torres Strait Islander (Indigenous) peoples living in remote Australia experience a heavy burden of ill health and multiple barriers to accessing health care. Digital health technologies (DHTs) have the potential to help overcome some of these challenges and increase access to comprehensive primary health care (CPHC), thereby improving equity of health outcomes. However, little is known about the community and provider preferences for the use of digital technologies for improving health and wellness.ObjectiveThe study aims to co-design, implement, and evaluate how DHTs can improve access to CPHC in remote Indigenous communities in the Northern Territory (NT), Australia.MethodsThis multiphased project will take a participatory action research approach to co-design and optimize digital health solutions with local community members and health service staff in 2 communities. Our mixed methods approach will include pre- and postimplementation focus group discussions, interviews, quantitative analysis of CPHC utilization administrative data, and surveys administered by Indigenous community-based researchers to understand the use of digital devices and connectivity, eHealth literacy, preferences for different attributes of DHTs using best-worst scaling, and consumer satisfaction and experiences with DHT interventions. Priority DHTs will be selected for implementation based on consumer and health staff preferences. Focus group discussions and interview data will explore community and health service staff preferences, experiences, and satisfaction with implemented DHTs. A realist approach will be taken to identify how DHT interventions work, for whom, and in what circumstances, so that the understanding of why some interventions work while others do not is expanded. Economic analyses will be conducted to calculate the incremental costs and benefits of implemented DHT interventions. The scalability of digital health solutions will be tested in two additional communities. Project partners include key funding, service, and support agencies in the NT and nationally.ResultsAs of November 2024, we have selected two implementation sites. Digital health initiatives are underway at the implementation sites, and evaluation activities are progressing. The initial findings from these sites have informed our scalability assessment in an additional two sites.ConclusionsKnowledge translation is integral to the study design, which involves partnering with consumers, CPHC service providers, and a range of key stakeholders to inform health service providers and policy makers about which DHTs work for which groups of consumers, and under what circumstances, to improve access to CPHC. This unique study will accommodate consumer and provider preferences regarding the use of DHTs to improve CPHC access and address the lack of knowledge about how to deploy digital solutions to best support CPHC in remote Indigenous Australia.International Registered Report Identifier (IRRID)DERR1-10.2196/68892

Purpose: This review aimed to investigate the effectiveness of digital school-based mental health interventions for adolescents in Sub-Saharan Africa. Method: The authors conducted a comprehensive search of digital school-based mental health interventions to identify studies conducted in Sub-Saharan Africa targeting adolescents between the ages of (10–19) years. Peer-reviewed studies published in English between 2009 and May 2023 were obtained through electronic bibliographic databases. Result: Only one study met the full inclusion criteria for this review. The included study tested a digital mental health intervention (“Shamiri Digital”) for treating depression, anxiety, and well-being in adolescents. The “Shamiri Digital” intervention demonstrated positive outcomes on depressive symptoms within the full sample. Discussion: The dearth of studies investigating digital mental health solutions for adolescents in low-income countries demonstrates a critical gap in intervention and research for adolescent mental health in resource constrictive settings

The aging population requires cutting-edge approaches to geriatric care, with digital health technologies playing a crucial part in meeting the challenging demands of healthcare. Current approaches frequently fall short of the goal of providing comprehensive, real-time monitoring and merging contextually complex information for use in the treatment of patients. This paper addresses these limitations by integrating the innovative approaches within the RO-SmartAgeing system and the NeuroPredict platform to boost geriatric-care outcomes. It emphasizes the multifaceted design and development processes of these digital health solutions, emphasizing a multidisciplinary approach and a meticulous choice of decision-making tools. This paper presents the inclusion of decision-making tools, namely the Medical Blackbox and Gaitband, into the RO-SmartAgeing system and the NeuroPredict platform; these tools have been developed for the purpose of gathering complex physiological data and allow for in-depth evaluations of gait patterns and vital health parameters in elderly individuals. The present research emphasizes major breakthroughs in sensing technology and decision-making capabilities, illustrating the manner in which these tools enhance patient outcomes by providing timely, data-driven insights. The results demonstrate that these tailored decision-making tools significantly improve patient outcomes, underscoring the need for such ongoing improvements able to address digital health solutions tailored to the dynamic demands of an increasingly aging population.

Digital health solutions continue to grow in both number and capabilities. Despite these advances, the confidence of the various stakeholders — from patients and clinicians to payers, industry and regulators — in medicine remains quite low. As a result, there is a need for objective, transparent, and standards-based evaluation of digital health products that can bring greater clarity to the digital health marketplace. We believe an approach that is guided by end-user requirements and formal assessment across technical, clinical, usability, and cost domains is one possible solution. For digital health solutions to have greater impact, quality and value must be easier to distinguish. To that end, we review the existing landscape and gaps, highlight the evolving responses and approaches, and detail one pragmatic framework that addresses the current limitations in the marketplace with a path toward implementation.

BackgroundDigital health technologies have been proposed to support hospital-to-home transition for older adults. The COVID-19 pandemic and the associated physical distancing guidelines have propelled a shift toward digital health technologies. However, the characteristics of older adults who participated in digital health research interventions to support hospital-to-home transitions remain unclear. This information is needed to assess whether current digital health interventions are generalizable to the needs of the broader older adult population.ObjectiveThis rapid review of the existing literature aimed to identify the characteristics of the populations targeted by studies testing the implementation of digital health interventions designed to support hospital-to-home transitions, identify the characteristics of the samples included in studies testing digital health interventions used to support hospital-to-home transitions, and create recommendations for enhancing the diversity of samples within future hospital-to-home digital health interventions.MethodsA rapid review methodology based on scoping review guidelines by Arksey and O’Malley was developed. A search for peer-reviewed literature published between 2010 and 2021 on digital health solutions that support hospital-to-home transitions for older adults was conducted using MEDLINE, Embase, and CINAHL databases. The data were analyzed using descriptive statistics and qualitative content analysis. The Sex- and Gender-Based Analysis Plus lens theoretically guided the study design, analysis, and interpretation.ResultsA total of 34 studies met the inclusion criteria. Our findings indicate that many groups of older adults were excluded from these interventions and remain understudied. Specifically, the oldest old and those living with cognitive impairments were excluded from the studies included in this review. In addition, very few studies have described the characteristics related to gender diversity, education, race, ethnicity, and culture. None of the studies commented on the sexual orientation of the participants.ConclusionsThis is the first review, to our knowledge, that has mapped the literature focusing on the inclusion of older adults in digital hospital-to-home interventions. The findings suggest that the literature on digital health interventions tends to operationalize older adults as a homogenous group, ignoring the heterogeneity in older age definitions. Inconsistency in the literature surrounding the characteristics of the included participants suggests a need for further study to better understand how digital technologies to support hospital-to-home transitions can be inclusive.