Applying technology to promote sexual and reproductive health and prevent gender based violence for adolescents in low and middle-income countries: digital health strategies synthesis from an umbrella review
Aim
Adolescents in low-and-middle-income countries (LMICs) are facing numerous developmental, sexual and reproductive health (SRH) challenges including exposure to multidimensional violence. Gender-based violence (GBV) specifically intimate partner violence (IPV) are both highly prevalent in LMICs and are strongly linked with poor SRH outcomes. However, GBV and IPV interventions have not yet been adequately integrated in SRH due to individual, social, cultural, service, and resource barriers. To promote long-term SRH, a more holistic approach that integrates GBV and IPV, and adolescent development needs is imperative. Digital health has the potential to address multiple service setup, provision, and addressing access barriers through designing and providing integrated SRH care. However, there are no guidelines for an integrated digital SRH and development promotion for adolescents in LMICs.
Methods
An umbrella review was conducted to synthesize evidence in three inter-related areas of digital health intervention literature: (i) SRH, (ii) GBV specifically IPV as a subset, and (iii) adolescent development and health promotion. We first synthesize findings for each area of research, then further analyze the implications and opportunities to inform approaches to develop an integrated intervention that can holistically address multiple SRH needs of adolescents in LMICs. Articles published in English, between 2010 and 2020, and from PubMed were included.
Results
Seventeen review articles met our review inclusion criterion. Our primary finding is that application of digital health strategies for adolescent SRH promotion is highly feasible and acceptable. Although effectiveness evidence is insufficient to make strong recommendations for interventions and best practices suggestions, some user-centered design guidelines have been proposed for web-based health information and health application design for adolescent use. Additionally, several digital health strategies have also been identified that can be used to further develop integrated GBV-IPV-SRH-informed services to improve adolescent health outcomes. We generated several recommendations and strategies to guide future digital based SRH promotion research from our review.
Conclusions
Rigorous research that focuses on intervention effectiveness testing using a combination of digital health strategies and standardized albeit contextualized outcome measures would be important. Methodological improvement such as adoption of longitudinal experimental design will be crucial in generating evidence-based intervention and practice guidelines for adolescents in LMICs.
Top-30
Journals
|
1
2
3
|
|
|
Sexual and Reproductive Health Matters
3 publications, 7.89%
|
|
|
Journal of Medical Internet Research
3 publications, 7.89%
|
|
|
International Journal of Environmental Research and Public Health
2 publications, 5.26%
|
|
|
JMIR Formative Research
2 publications, 5.26%
|
|
|
Archives of Sexual Behavior
2 publications, 5.26%
|
|
|
Current Sexual Health Reports
1 publication, 2.63%
|
|
|
BMC Digital Health
1 publication, 2.63%
|
|
|
Journal of Adolescent Health
1 publication, 2.63%
|
|
|
Social Sciences
1 publication, 2.63%
|
|
|
European Journal of Psychotraumatology
1 publication, 2.63%
|
|
|
PLoS ONE
1 publication, 2.63%
|
|
|
Postgraduate Medical Journal
1 publication, 2.63%
|
|
|
Integrated Science
1 publication, 2.63%
|
|
|
PLOS Digital Health
1 publication, 2.63%
|
|
|
Health Science Reports
1 publication, 2.63%
|
|
|
Public Health Challenges
1 publication, 2.63%
|
|
|
Clinical Nursing Research
1 publication, 2.63%
|
|
|
Therapeutic Advances in Reproductive Health
1 publication, 2.63%
|
|
|
Youth
1 publication, 2.63%
|
|
|
Healthcare
1 publication, 2.63%
|
|
|
Global Health Action
1 publication, 2.63%
|
|
|
Advances in Human Biology
1 publication, 2.63%
|
|
|
Open Public Health Journal
1 publication, 2.63%
|
|
|
BMJ Open
1 publication, 2.63%
|
|
|
JMIR Research Protocols
1 publication, 2.63%
|
|
|
Social Science and Medicine
1 publication, 2.63%
|
|
|
Sexes
1 publication, 2.63%
|
|
|
The Lancet Global Health
1 publication, 2.63%
|
|
|
Health Promotion International
1 publication, 2.63%
|
|
|
1
2
3
|
Publishers
|
1
2
3
4
5
6
|
|
|
MDPI
6 publications, 15.79%
|
|
|
JMIR Publications
6 publications, 15.79%
|
|
|
Springer Nature
5 publications, 13.16%
|
|
|
Taylor & Francis
5 publications, 13.16%
|
|
|
Elsevier
3 publications, 7.89%
|
|
|
Public Library of Science (PLoS)
2 publications, 5.26%
|
|
|
Oxford University Press
2 publications, 5.26%
|
|
|
Wiley
2 publications, 5.26%
|
|
|
SAGE
2 publications, 5.26%
|
|
|
Research Square Platform LLC
1 publication, 2.63%
|
|
|
Ovid Technologies (Wolters Kluwer Health)
1 publication, 2.63%
|
|
|
Bentham Science Publishers Ltd.
1 publication, 2.63%
|
|
|
IGI Global
1 publication, 2.63%
|
|
|
BMJ
1 publication, 2.63%
|
|
|
1
2
3
4
5
6
|
- We do not take into account publications without a DOI.
- Statistics recalculated weekly.