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Journal of General Internal Medicine

, Volume 33, Issue 12, pp 2191–2200 | Cite as

Telehealth Interventions Designed for Women: an Evidence Map

  • Karen M. GoldsteinEmail author
  • Leah L. Zullig
  • Eric A. Dedert
  • Amir Alishahi Tabriz
  • Timothy W. Brearly
  • Giselle Raitz
  • Suchita Shah Sata
  • John D. Whited
  • Hayden B. Bosworth
  • Adelaide M. Gordon
  • Avishek Nagi
  • John W. WilliamsJr
  • Jennifer M. Gierisch
Review Paper

Abstract

Background

Telehealth employs technology to connect patients to the right healthcare resources at the right time. Women are high utilizers of healthcare with gender-specific health issues that may benefit from the convenience and personalization of telehealth. Thus, we produced an evidence map describing the quantity, distribution, and characteristics of evidence assessing the effectiveness of telehealth services designed for women.

Methods

We searched MEDLINE® (via PubMed®) and Embase® from inception through March 20, 2018. We screened systematic reviews (SRs), randomized trials, and quasi-experimental studies using predetermined eligibility criteria. Articles meeting inclusion criteria were identified for data abstraction. To assess emerging trends, we also conducted a targeted search of ClinicalTrials.gov.

Results

Two hundred thirty-four primary studies and three SRs were eligible for abstraction. We grouped studies into focused areas of research: maternal health (n = 96), prevention (n = 46), disease management (n = 63), family planning (n = 9), high-risk breast cancer assessment (n = 10), intimate partner violence (n = 7), and mental health (n = 3). Most interventions focused on phone as the primary telehealth modality and featured healthcare team-to-patient communication and were limited in duration (e.g., < 12 weeks). Few interventions were conducted with older women (≥ 60 years) or in racially/ethnically diverse populations. There are few SRs in this area and limited evidence regarding newer telehealth modalities such as mobile-based applications or short message service/texting. Targeted search of clinical.trials.gov yielded 73 ongoing studies that show a shift in the use of non-telephone modalities.

Discussion

Our systematic evidence map highlights gaps in the existing literature, such as a lack of studies in key women’s health areas (intimate partner violence, mental health), and a dearth of relevant SRs. With few existing SRs in this literature, there is an opportunity for examining effects, efficiency, and acceptability across studies to inform efforts at implementing telehealth for women.

Notes

Acknowledgements

We would like to thank Megan Von Isenburg for the assistance with the literature search and retrieval, Jennifer McDuffie for the support in conducting this project during all phases, Angela Zoss for the data visualization assistance, and Liz Wing for the editorial assistance. We also thank the study participants who volunteered to be a part of the research described here. Additionally, we would like to thank the following key stakeholders and technical expert panel members for their feedback during the development and execution of this project: Lori Bastian, Alicia Christy, Kathy Frisbee, Sally Haskell, Jan Lindsay, Nancy Maher, Carolyn Turvey, and Alan West.

Funding

Drs. Zullig and Goldstein are supported by Veterans Affairs (VA) Health Services Research and Development (HSR&D) Career Development Awards (CDA) (CDA 13-025 and CDA 13-263, respectively). Dr. Dedert is supported by a CSR&D Service of the VA Office of Research and Development Career Development Award (Number 1IK2CX000718). Dr. Bosworth is supported by a VA HSR&D Research Career Scientist (RCS) Award (RCS 08-027). Dr. Whited is supported by a VA HSR&D Award (SD 16-192). This work was supported by the Center of Innovation for Health Services Research in Primary Care (CIN 13-410) at the Durham VA and the VA Evidence-based Synthesis Program (ESP 09-010). The primary source of funding for this work was the VA Evidence-based Synthesis Program (ESP 09-010). This work was also supported by the Center of Innovation for Health Services Research in Primary Care (CIN 13-410).

Compliance with Ethical Standards

Conflict of Interest

Dr. Whited is a co-editor of Teledermatology: A User’s Guide published by Cambridge University Press and receives royalties based on sales. All other authors declare no conflicts of interest.

Disclaimer

The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs, the United States government, or Duke University.

Supplementary material

11606_2018_4655_MOESM1_ESM.docx (414 kb)
ESM 1 (DOCX 413 kb)

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Copyright information

© Society of General Internal Medicine (This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply) 2018

Authors and Affiliations

  • Karen M. Goldstein
    • 1
    • 2
    Email author
  • Leah L. Zullig
    • 1
    • 3
  • Eric A. Dedert
    • 4
    • 5
    • 6
  • Amir Alishahi Tabriz
    • 7
  • Timothy W. Brearly
    • 8
    • 9
  • Giselle Raitz
    • 2
  • Suchita Shah Sata
    • 2
  • John D. Whited
    • 1
    • 2
  • Hayden B. Bosworth
    • 1
    • 2
    • 3
    • 6
    • 10
  • Adelaide M. Gordon
    • 1
  • Avishek Nagi
    • 1
  • John W. WilliamsJr
    • 1
    • 2
  • Jennifer M. Gierisch
    • 1
    • 2
    • 3
  1. 1.Center for Health Services Research in Primary Care Durham Veterans Affairs Health Care SystemDurhamUSA
  2. 2.Department of MedicineDuke UniversityDurhamUSA
  3. 3.Department of Population Health SciencesDuke UniversityDurhamUSA
  4. 4.Durham Veterans Affairs Health Care SystemDurhamUSA
  5. 5.VA Mid-Atlantic Mental Illness Research, Education and Clinical Center (MIRECC)DurhamUSA
  6. 6.Department of Psychiatry and Behavioral SciencesDuke University Medical CenterDurhamUSA
  7. 7.Department of Health Policy and Management, Gillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillUSA
  8. 8.Salisbury Veterans Affairs Health Care SystemSalisburyUSA
  9. 9.Neuropsychology Assessment ServiceWalter Reed National Military Medical CenterBethesdaUSA
  10. 10.School of NursingDuke UniversityDurhamUSA

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