Health promotion and disease prevention with digital technologies for older people: Scoping review

Abstract Background In the aging world digital technologies are needed to target the health needs of older people. This study aimed to identify digital technologies for health promotion and disease prevention for older people by performing a scoping review. Methods A search of MEDLINE, PsycINFO, CINAHL and SCOPUS on 09.03.2022 identified 2150 studies. The inclusion criteria were: 1) Population: older people, 2) Concept: any digital health technology, 3) Context: health promotion and disease prevention in home or community settings. Preliminary study selection was performed automatically using the smart groups function in EndNote. Studies were clustered by digital technology type, health target, study design and study focus. Final study selection and data coding will be performed manually by two authors. Results Of the 2150 studies, 1874 studies were excluded, 159 studies met the inclusion criteria 1) and 2), but addressed different contexts (digital competence, digital technology development, disease management) or setting (care) and 117 studies were included. Digital technology types were: 1) any technologies (digital, virtual, video, eHealth or telehealth), 2) internet websites accessed via computer, 3) SMS or mobile phones, 4) exergaming or 5) smartphones or wearables. Health targets were: 1) physical activity, 2) mental health and wellness, 3) nutrition or 4) cognitive functioning. Study designs included primary studies (randomized-controlled trials) or reviews (systematic or scoping). Study focus was on effectiveness, feasibility or evaluation of digital technologies. Conclusions The health needs of older people are addressed by older technologies. Newer studies use heterogeneous terminology when referring to digital technologies. Future studies should focus on multiple aspects of healthy aging beyond mobility. More work is also needed to understand if and how a shift towards newer technologies occurs and if that is associated with health benefits in older people. Key messages • Older digital technologies (computers and mobile phones) address the health needs of older people. • Mobility is the main health target of digital technologies for older people in the context of health promotion and disease prevention.

The terms health app and medical app are often used interchangeably but do not necessarily mean the same.Medical apps can be regulated as mobile medical devices and therefore need to meet general safety and performance requirements.On the contrary, health apps are not part of this legal framework and do not need proof of their efficacy or guaranteeing data security.We need distinct definitions of health and medical apps to understand these terms better and regulate such technologies more effectively.We will provide an overview of health and medical apps definitions and a differentiation flowchart from public health and legal perspectives.A search in 6 databases identified 22 publications that defined health apps and 11 reports that described medical apps.The core elements of these definitions were identified through qualitative analysis.Health and medical apps share the same devices, technical functions and collect health data.While it can be highly challenging to decide which legal requirements have to be fulfilled by an app, we deem it unfit as a distinction criterion.It requires legal knowledge, which is neither suitable nor practical for users.However, medical device law is closely linked to the app's intended medical or health purpose criteria, which allows a clear differentiation.Additionally, the difference in the user group can be used for separation.Our suggestion for the definition would be that health apps are software programs on mobile devices that process health-related data on/for their user.They can be used by every health-conscious person to maintain, improve or manage the health of an individual or the community.As an umbrella term, health apps include medical apps.They share the same technological functions and devices as health apps.Health professionals, patients, and family caregivers are the main user groups of medical apps.Due to the intended use for clinical purposes, medical apps can be regulated as mobile medical devices.

Key messages:
Separating apps based on legal regulation is impractical & can't be expected from all stakeholders.Differencing between health and medical apps requires the user group and the health aim of the app.Health apps include medical apps.Since 2019, medical apps in Germany contain digital health applications (DiGA).Since 2022, medical apps partly include digital care applications (DiPA).

Background:
In the aging world digital technologies are needed to target the health needs of older people.This study aimed to identify digital technologies for health promotion and disease prevention for older people by performing a scoping review.

Background:
Mobile apps such as WhatsApp have become significant resources for information and social support in times of crisis.
Little is known about the role WhatsApp groups play in the context of living in conflict-affected regions.Living in such areas is associated with myriad mental health impacts, and recent studies have identified parents of young children as highly vulnerable in this regard.The study's aim was to examine parents' digital coping with political violence in southern Israel.

Methods:
In-depth interviews were conducted with 21 parents of young children (<17) residing in communities near the Israel-Gaza border and who are members of local online parents' groups on WhatsApp.Data were analyzed to answer questions regarding the benefits and disadvantages that parents assign to online groups; and regarding the role of digital communication in maintaining health and well-being.

Results:
The findings reveal that online groups are often discussed as a shared and ubiquitous coping resource that supports mental health and well-being.Parents report they use the group to share ways to deal with the situation effectively and exchange social support, and as a space that facilitates community cohesion.Furthermore, during escalations, members perceived the group as the most trustworthy source of information.The groups' continuous availability had drawbacks as well.Some participants pointed to digital stress caused by the fear of missing out on information, or by information overload.

Conclusions:
Our results demonstrate the effectiveness of digital environments in helping parents cope with a collective stressor: a particularly worthy goal given that social media apps now constitute the primary online connection for most individuals.This has broad impacts on health promotion efforts for mental health issues related to political violence as well as other largescale health crises such as the COVID-19 pandemic.

Key messages:
Digital environments can serve as a platform for successful coping with collective stressors.Health practitioners should consider drawbacks when planning digital support efforts.
Abstract citation ID: ckac131.168Digital phenotyping for monitoring and prediction of physical activity level during pregnancy

Background:
Gestational diabetes mellitus (GDM) is one of the most common complications in pregnancy.Physical activity (PA) during pregnancy may reduce the adverse pregnancy outcomes.Digital phenotyping can develop interactive risk profiles to better reflect a person's daily mobility than traditional retrospective self-assessment questionnaires.Therefore, the aims of the proposed research are to 1) test the acceptability and applicability of the BEIWE app during pregnancy, 2) characterize daily physical mobility during pregnancy, and 3) describe differences in physical mobility in women with and without diabetes.

Methods:
This prospective cohort study will include 20 pregnant women with GDM and 20 without GDM from the Diabetes Center of the Medical Clinic or outpatient clinics of the Tu ¨bingen Women's Clinic, Tuebingen, Germany.The study was approved by the Ethics Committee of the University Hospital Tuebingen (004/2022BO1).At baseline (22 weeks gestation), participants will be instructed to download the app.Passive data (phenotypic information) is collected automatically during the observation period.The follow-up assessment will be conducted three weeks after delivery.The acceptance of the app and comparison of the groups with and without diabetes will be conducted through Statistical analysis.

Results:
Recruitment of participants has started and follow-up assessment is estimated to be finalized in fall 2022.Study design and results will be presented at the conference.

Conclusions:
PA during pregnancy has been associated with minimum risk of a pregnancy, and self-monitoring of PA via an app may play a role in improving pregnancy outcomes.However, the success of Apps depends on their validity and reliability, which lack evidence.

Key messages:
The result of the study will develop a qualification measure for PA with no intervention.
It also provides information for planning and conducting subsequent intervention studies.
European Public Health Conference 2022 groups function in EndNote.Studies were clustered by digital technology type, health target, study design and study focus.Final study selection and data coding will be performed manually by two authors.The health needs of older people are addressed by older technologies.Newer studies use heterogeneous terminology when referring to digital technologies.Future studies should focus on multiple aspects of healthy aging beyond mobility.More work is also needed to understand if and how a shift towards newer technologies occurs and if that is associated with health benefits in older people.Key messages: Older digital technologies (computers and mobile phones) address the health needs of older people.Mobility is the main health target of digital technologies for older people in the context of health promotion and disease prevention.
Methods:A search of MEDLINE, PsycINFO, CINAHL and SCOPUS on 09.03.2022 identified 2150 studies.The inclusion criteria were: 1) Population: older people, 2) Concept: any digital health technology, 3) Context: health promotion and disease prevention in home or community settings.Preliminary study selection was performed automatically using the smart 15th