Sun-Young Yang

Objectives: This study aimed to develop core contents and strategies for digital healthcare services across the life span. Methods: Documents on government and public health organizations in Korea, England, and United States were reviewed to determine life stages. Secondary data analysis was conducted to identify major health problems, and these were prioritized depending on the size and seriousness of the problems. A survey was conducted to identify the needs for digital healthcare service. Results: This study identified life stages as pregnancy, infancy and early years, childhood and adolescence, early adulthood, middle age and older adulthood. Obesity, stress, and depression were prioritized health problems across the life span. The need for app-based digital healthcare was based on self-efficacy, attitudes. digital health literacy and skills. Health problems could be prevented with managed healthcare services with behavior change techniques (BCTs). The phases of intervention included collecting data, clustering clients, curating services, and monitoring and evaluation. Lifestyle score, ecological momentary assessment (EMA), chatbot service and gamification were recommended to increase effectiveness and efficiency of the intervention. Conclusion: Digital healthcare services should be developed through collaboration with offline health promotion services and prospective studies to produce evidence for effectiveness and efficiency.

BACKGROUND Following the confirmation of the effect of the pilot of the Korea Mobile Healthcare National Program in 2016, the program has been conducted annually since 2018 to improve the risk factors for metabolic syndrome. However, since this implementation began, the program has not been evaluated. OBJECTIVE The purpose of this study was to retrospectively investigate the results of the Korea Mobile Healthcare National Program in 2018 and 2019. METHODS Health behavior of participants with risk factors for metabolic syndrome were managed using a mobile app for 24 weeks and feedback was provided. Paired t-test and chi squared test were used for comparing results before and after 24 weeks. RESULTS Of the 8,712 participants enrolled in 2018, 7,619 completed the 24 weeks program while 10,990 of the 12,447 participants enrolled in 2019 completed the program. After the program, over 60% participants had improvement in one or more risk factors (63.09% in 2018, 65.85% in 2019). There was a statistically significant improvement in the proportion of participants who had each risk factor (blood pressure, fasting plasma glucose, triglyceride, high density lipoprotein cholesterol, and waist circumference) in both 2018 and 2019 (p < .001). The average value of each risk factor also improved in a positive direction. CONCLUSIONS This study showed that the Korea Mobile Healthcare National Program may contribute to improvement in the risk factors for metabolic syndrome.

This study evaluated whether a mobile health (mHealth) application can instigate healthy behavioral changes and improvements in metabolic disorders in individuals with metabolic abnormalities. Participants were divided into an mHealth intervention group (IG), which used a mobile app for 24 weeks, and a conventional IG. All mobile apps featured activity monitors, with blood pressure and glucose monitors, and body-composition measuring devices. The two groups were compared after 24 weeks in terms of health-behavior practice rate and changes in the proportion of people with health risks, and health behaviors performed by the IG that contributed to reductions in more than one health risk factor were analyzed using multiple logistic regression. Preference for low-sodium diet, reading nutritional facts, having breakfast, and performing moderate physical activity significantly increased in the mHealth IG. Furthermore, the mHealth IG showed a significant increase of eight items in the mini-dietary assessment; particularly, the items "I eat at least two types of vegetables of various colors at every meal" and "I consume dairies, such as milk, yogurt, and cheese, every day." The proportion of people with health risks, with the exception of fasting glucose, significantly decreased in the mHealth IG, while only the proportion of people with at-risk triglycerides and waist circumference of females significantly decreased in the control group. Finally, compared to those who did not show improvements of health risks, those who showed improvements of health risks in the mHealth IG had an odds ratio of 1.61 for moderate to vigorous physical activity, 1.65 for "I do not add more salt or soy sauce in my food," and 1.77 for "I remove fat in my meat before eating." The findings suggest that the additional use of a community-based mHealth service through a mobile application is effective for improving health behaviors and lowering metabolic risks in Koreans.