Marcia Nissen
30 results
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Item type:Publication, Deep phenotyping of suicidal ideation after discharge from psychiatric inpatient care: study protocol for an interdisciplinary, multicentre prospective observational study in Psychiatric University Hospitals(BMJ, 2026-02) - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Health equity readiness index for digital health organizationsBackground As healthcare becomes increasingly digitalized, new challenges and opportunities arise for advancing health equity. In response, a broad range of frameworks and recommendations have emerged to guide equitable innovation. Yet despite this momentum, real world progress remains limited and many digital health organizations (DHOs) struggle to translate health equity principles into concrete, actionable strategies. One promising avenue for closing this implementation gap lies in the use of organizational readiness assessments that not only diagnose current capacity but also help to define a roadmap for improvement. In response, this study introduces the Health Equity Readiness Index and a supporting novel self-assessment tool designed to support DHOs in evaluating and advancing their readiness to act on health equity. Methods Drawing on established frameworks from health equity, responsible AI, digital innovation, and organizational change, we created a five-dimensional Health Equity Readiness Index, encompassing strategy, governance, culture, data, and community collaboration. Each dimension was operationalized into 15 readiness indicators across four levels. A corresponding digital self-assessment tool was developed and evaluated for usability, acceptability, and perceived utility through user testing and a structured online survey targeting DHOs. Results The resulting tool provides a structured, low-barrier mechanism for DHOs to assess their current equity capacity and identify priority areas for improvement. Survey results (N = 124) showed broad applicability across diverse organizational contexts, with respondents spanning regions, service types, and roles. Participants rated the tool highly across all constructs (M ≥ 4.39/5). Qualitative feedback highlighted five overarching strengths (clarity, diagnostic value, actionability, usability, awareness) and three areas for future improvement (examples, customization, additional features). Overall, respondents perceived the tool as both relevant and actionable for guiding equity-oriented strategy. Conclusion This study contributes a novel framework and diagnostic tool for advancing organizational readiness for health equity in digital health, supporting DHOs in moving from intention to implementation. It also offers potential utility for funders, regulators, and health systems seeking to institutionalize equity through incentives or benchmarking.Type:journal articleJournal:International Journal for Equity in Health - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Advancing health equity and the role of digital health technologies: a scoping reviewBackground Health disparities persist, posing significant health, social and economic challenges. Digital health technologies (DHTs) present a promising opportunity to address these inequities and advance health equity. Despite this potential, a comprehensive and structured overview of existing frameworks and guidelines on advancing health equity and a clear understanding of the potential of DHTs in their implementation to systematically close the healthcare gap is yet to be done. Objective To this end, our objectives are twofold: first, to identify frameworks and guidelines that promote health equity and second, to pinpoint the role of DHTs as an avenue for their implementation. We conducted a scoping review informed by Arksey and O'Malley’s five-stage framework, methodological guidelines by the Joanna Briggs Institute and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. Sources of evidence A comprehensive search was conducted across seven databases on 6 December 2023: PubMed, EMBASE, Cochrane, PsycINFO, Scopus, Web of Science and WISO. Eligibility criteria We included primary and secondary studies published in English between 2010 and 2023 focusing on advancing health equity for priority populations. Charting methods For the analysis, we applied multistaged coding approaches to answer our twofold objective. Results The search identified 6419 studies, of which 38 met our final inclusion criteria and were included in this review. We extracted 559 recommendations on advancing health equity and synthesised these into 82 distinct recommendations across five levels of initiative and 19 areas of initiative. Thereby, 24% of the included studies explicitly mentioned the use of (digital) technology with 10 impact opportunities on advancing health equity. Conclusion Our synthesis offers key insights into the advancement of health equity across different levels of initiative and the role of DHTs in their implementation. This offers practitioners and researchers alike a comprehensive overview to make health equity advancement more tangible and actionable. Registration details https://osf.io/94phtType:journal articleJournal:BMJ OpenVolume:15Issue:6Scopus© Citations 13 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Toward a Smartphone-Based and Conversational Agent–Delivered Just-in-Time Adaptive Holistic Lifestyle Intervention for Older Adults Affected by Cognitive Decline: Two-Week Proof-of-Concept Study(JMIR Publications Inc., 2025-07-28); Scopus© Citations 4 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Leveraging Influencers to Reach and Engage Vulnerable Individuals With a Digital Health Intervention: Quasi-Experimental Field Study(JMIR Publications Inc., 2025-09-05); ; Theresa SchachnerBackground: Noncommunicable diseases are the leading cause of death, present economic challenges to health care systems worldwide, and disproportionally affect vulnerable individuals with low socioeconomic status (SES). While digital health interventions (DHIs) offer scalable and cost-effective solutions to promote health literacy and encourage behavior change, key challenges concern how to effectively reach and engage vulnerable individuals. To this end, social media influencers provide a unique opportunity to reach millions, and lasting engagement can be ensured through the design of DHIs in a manner that specifically appeals to low-SES individuals through alignment with their social background. Objective: The objectives of this study were 2-fold: to assess the effectiveness of leveraging influencers to reach vulnerable individuals (as measured via app downloads per stream viewers) and evaluate how the design of a DHI can improve engagement among this group (as measured via completion of the intervention). Methods: This study used a cross-sectional, quasi-experimental field design to assess both (1) the effectiveness of influencers in reaching vulnerable individuals and (2) the impact of specific design elements—such as gamification and storytelling—on user engagement using a stress management DHI featuring a slow-paced breathing exercise. In total, 3 differently designed versions of this DHI were developed following a fractional factorial design (StressLess, Breeze, and TragicKingdom). Reach was calculated as the number of downloads per viewers per stream and influencer. Engagement with the DHI was measured via number of conversational turns and milestone and intervention completion rates. Participants’ SES and technology acceptance were evaluated through a postintervention survey. Descriptive statistics, chi-square tests, and ANOVAs were used to examine the effects of the DHI design on reach and engagement metrics. Results: The recruitment via 8 influencers (total streams=25; total viewers=12,667) generated 220 downloads. The average reach ratio across streams amounted to 16.2% (SD 15.5%), with significant differences between conditions (ꭓ22=8.0, P=.02; StressLess: 8.1%, SD 9.3%; Breeze: 14%, SD 10.5%; TragicKingdom: 28.4%, SD 17.6%). The intervention completion rate across all DHI versions amounted to 7.7% (17/220), with no significant differences between conditions (P=.48). Conclusions: This work provides the first evidence that recruitment via influencers yields high reach ratios, moving far beyond the reach of traditional social media platforms. Nonetheless, based on the data collected, the ability to leverage such platforms to recruit vulnerable individuals remains unclear. In addition, while engagement with the promoted interventions was initially high, the completion rate of the full breathing exercise was comparably low, indicating that the influencer promotion strategy cannot fully overcome the well-documented adherence barriers in digital health.Type:journal articleJournal:Journal of Medical Internet ResearchVolume:27DOI:10.2196/67174Scopus© Citations 5 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Proactive behavior in voice assistants: A systematic review and conceptual model(2024); Scopus© Citations 25 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Impact of digital assistive technologies on the quality of life for people with dementia: a scoping review(2024); ; Rasita VinayBackground Digital assistive technologies (DATs) have emerged as promising tools to support the daily life of people with dementia (PWD). Current research tends to concentrate either on specific categories of DATs or provide a generic view. Therefore, it is of essence to provide a review of different kinds of DATs and how they contribute to improving quality of life (QOL) for PWD. Design Scoping review using the framework proposed by Arksey and O’Malley and recommendations from Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. Data sources Cochrane, Embase, PubMed, Scopus and Web of Science (January 2013 to May 2023). Eligibility criteria for selecting studies Completed scientific literature with a primary focus on DATs for PWD, perspectives of caregivers, family members or healthcare workers in relation to a PWD, people living in diverse settings and all severities of dementia. Data extraction and synthesis Screening and data extraction were conducted, followed by quantitative and qualitative analyses using thematic analysis principles and Digital Therapeutics Alliance categories for DAT grouping. Results The literature search identified 6083 records, with 1056 duplicates. After screening, 4560 full texts were excluded, yielding 122 studies of different designs. The DATs were categorised into digital therapeutics (n=109), patient monitoring (n=30), digital diagnostics (n=2), care support (n=2) and health system clinical software (n=1). These categories were identified to impact various aspects of QOL: preserving autonomy, engagement, and social interaction, health monitoring and promotion, improving activities of daily living, improving cognition, maintaining dignity, managing behavioural and psychological symptoms of dementia and safety/surveillance. Conclusions Various DATs offer extensive support, elevating the QOL of PWD. Digital therapeutics are predominantly used for ageing-in-place and independent living through assistance with daily tasks. Future research should focus on less-represented digital health technology categories, such as care support, health & wellness or software solutions. Observing ongoing DAT developments and their long-term effects on QOL remains essential.Type:journal articleJournal:BMJ OpenVolume:14 (2)Scopus© Citations 22 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Success Factors of Growth-Stage Digital Health Companies: Systematic Literature Review(JMIR Publications Inc., 2024-12-11); Scopus© Citations 13 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Advancing health equity and the role of digital health technologies: a scoping review protocolIntroduction Healthcare systems around the world exhibit inherent systemic inequities that disproportionately impact marginalised populations. Digital health technologies (DHTs) hold promising potential to address these inequities and to play a pivotal role in advancing health equity. However, there is a notable gap regarding a comprehensive and structured overview of existing frameworks and guidelines on advancing health equity and a clear understanding of the potential of DHTs in their implementation. To this end, our primary objectives are first to identify prevalent frameworks and guidelines that promote health equity and second to pinpoint the contemporary role of DHTs as an avenue for implementing these frameworks and guidelines. This synthesis will guide future DHTs, ensuring equitable accessibility and effectiveness and ultimately contributing to enhancing health equity among marginalised populations. Methods and analysis This work adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Scoping Reviews. To identify pertinent evidence, we will employ seven electronic databases (PubMed, EMBASE, Cochrane, PsycINFO, Scopus, Web of Science and WISO) encompassing the fields of medicine, healthcare and social sciences. Moreover, selected grey literature will be considered. We will include primary and secondary studies published in English between 2010 and 2023 that focus on (technology and non-technology-based) frameworks and guidelines for health equity improvement. Each article will undergo an independent assessment for eligibility, followed by the extraction of pertinent data from eligible sources. Subsequently, the extracted data will be subjected to qualitative and quantitative analyses, and findings will be presented using narrative and descriptive formats. Ethics and dissemination Ethical approval is deemed unnecessary for this scoping review, as it involves synthesising existing knowledge. The findings from this study will be disseminated through peer-reviewed publications.Type:journal articleJournal:BMJ OpenVolume:14Issue:10Scopus© Citations 18 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Top-funded digital health companies offering lifestyle interventions for dementia prevention: Company overview and evidence analysis(2024-05-05)
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