- mHealth adoption and tool development has seen a surge as patients seek convenient and cost-effective methods to manage their own health and wellness. With that, testing for new mHealth tools and interventions for chronic disease management has also increased as researchers look to introduce new products onto the market.
In order for mHealth adoption research to be useful and effective, certain benchmarks must be met to communicate the success of the trial. The World Health Organization (WHO) has developed a set of standards – the mHealth evidence reporting and assessment (mERA) checklist – that all mHealth intervention studies should adhere to in order to properly show the results of research.
“The guiding principle for the development of these criteria was to identify a minimum set of information needed to define what the mHealth intervention is (content), where it is being implemented (context), and how it was implemented (technical features), to support replication of the intervention,” say researchers from WHO.
Developing this kind of criteria is critical due to the high volume of mHealth research that has emerged in recent years. According to the WHO, much of this research lacks quality insights. By developing a set of research standards, the organization hopes to facilitate better and more useful data about mHealth interventions.
“Over the past decade, global enthusiasm and the interest of development agencies, researchers, and policy makers have led to the rapid proliferation of mHealth solutions throughout developed and developing countries,” the WHO notes. “Despite the emergence of hundreds of mHealth studies and initiatives, there remains a lack of rigorous, high quality evidence on the efficacy and effectiveness of such interventions.”
The reason for this lacking quality of research evidence is likely due to the fact that mHealth development combines two disparate industries – technology and public health, WHO claims.
Technology innovations are typically discussed rapidly and in media such as white papers, conference papers, and technology blogs. Public health research takes a longer trajectory, culminating a formal journal publication.
WHO created a group of industry experts, the mHealth Technical Evidence Review Group (mTERG), which saw that they needed to combine the research processes for technology and public health in order to create a better overall result for mHealth intervention studies.
“mTERG identified the need for a tool that provides guidelines for the reporting of evidence on the effectiveness of mHealth interventions,” WHO reported. “The group recognised that the evaluation and reporting of mHealth and [information and communication technologies] interventions requires a unique lens, blending a combination of study designs and methods, as well as reporting that incorporates the description of the intervention and the context in which the intervention is implemented.”
Overall, mERA developed sixteen core values to mHealth intervention research:
- Description of infrastructure
- Description of technology platform
- Level of technology interoperability
- Method for intervention delivery
- Intervention content
- Usability testing
- User feedback
- Summary of barriers and facilitators for intervention and adoption
- Cost assessment
- Adoption inputs/program entry
- Limitations for large-scale adoption
- Description of appropriateness of intervention in certain contexts
- Level of health data security
- Compliance with federal guidelines
- Level of user adherence to intervention guidelines
According to WHO researchers, the mERA checklist aims to be generally applicable regardless of intervention study design.
“The mERA checklist aims to be agnostic to study design, and applied in conjunction with the existing tools that support transparent reporting of the study designs used,” WHO explained.
“Adoption of the mERA checklist by journal editors and authors in a standardised manner is anticipated to improve the transparency and rigour in reporting, while highlighting issues of bias and generalisability, and ultimately temper criticisms of overenthusiastic reporting in mHealth.”
While the checklist is not a required element for mHealth intervention reporting, WHO maintains that it will share the checklist at various mHealth conferences and events. Ideally, the checklist will be ubiquitously adopted, helping to enhance the quality and transparency of mHealth intervention research.