Precision health in behaviour change interventions: A scoping review.

Precision health seeks to optimise behavioural interventions by delivering personalised support to those in need, when and where they need it. Conceptualised a decade ago, progress toward this vision of personally relevant and effective population-wide interventions continues to evolve. This scoping review aimed to map the state of precision health behaviour change intervention research. This review included studies from a broader precision health review. Six databases were searched for studies published between January 2010 and June 2020, using the terms 'precision health' or its synonyms, and including an intervention targeting modifiable health behaviour(s) that was evaluated experimentally. Thirty-one studies were included, 12 being RCTs (39%), and 17 with weak study design (55%). Most interventions targeted physical activity (27/31, 87%) and/or diet (24/31, 77%), with 74% (23/31) targeting two to four health behaviours. Interventions were personalised via human interaction in 55% (17/31) and digitally in 35% (11/31). Data used for personalising interventions was largely self-reported, by survey or diary (14/31, 45%), or digitally (14/31, 45%). Data was mostly behavioural or lifestyle (20/31, 65%), and physiologic, biochemical or clinical (15/31, 48%), with no studies utilising genetic/genomic data. This review demonstrated that precision health behaviour change interventions remain dependent on human-led, low-tech personalisation, and have not fully considered the interaction between behaviour and the social and environmental contexts of individuals. Further research is needed to understand the relationship between personalisation and intervention effectiveness, working toward the development of sophisticated and scalable behaviour change interventions that have tangible public health impact.

Trends and gaps in precision health research: a scoping review.

OBJECTIVE: To determine progress and gaps in global precision health research, examining whether precision health studies integrate multiple types of information for health promotion or restoration. DESIGN: Scoping review. DATA SOURCES: Searches in Medline (OVID), PsycINFO (OVID), Embase, Scopus, Web of Science and grey literature (Google Scholar) were carried out in June 2020. ELIGIBILITY CRITERIA: Studies should describe original precision health research; involve human participants, datasets or samples; and collect health-related information. Reviews, editorial articles, conference abstracts or posters, dissertations and articles not published in English were excluded. DATA EXTRACTION AND SYNTHESIS: The following data were extracted in independent duplicate: author details, study objectives, technology developed, study design, health conditions addressed, precision health focus, data collected for personalisation, participant characteristics and sentence defining 'precision health'. Quantitative and qualitative data were summarised narratively in text and presented in tables and graphs. RESULTS: After screening 8053 articles, 225 studies were reviewed. Almost half (105/225, 46.7%) of the studies focused on developing an intervention, primarily digital health promotion tools (80/225, 35.6%). Only 28.9% (65/225) of the studies used at least four types of participant data for tailoring, with personalisation usually based on behavioural (108/225, 48%), sociodemographic (100/225, 44.4%) and/or clinical (98/225, 43.6%) information. Participant median age was 48 years old (IQR 28-61), and the top three health conditions addressed were metabolic disorders (35/225, 15.6%), cardiovascular disease (29/225, 12.9%) and cancer (26/225, 11.6%). Only 68% of the studies (153/225) reported participants' gender, 38.7% (87/225) provided participants' race/ethnicity, and 20.4% (46/225) included people from socioeconomically disadvantaged backgrounds. More than 57% of the articles (130/225) have authors from only one discipline. CONCLUSIONS: Although there is a growing number of precision health studies that test or develop interventions, there is a significant gap in the integration of multiple data types, systematic intervention assessment using randomised controlled trials and reporting of participant gender and ethnicity. Greater interdisciplinary collaboration is needed to gather multiple data types; collectively analyse big and complex data; and provide interventions that restore, maintain and/or promote good health for all, from birth to old age.

The Psychosocial Impacts of COVID-19 on a Sample of Australian Adults: Cross-sectional Survey and Sentiment Analysis.

BACKGROUND: The COVID-19 pandemic has had enormous impacts on people's lives, including disruptions to their normal ways of behaving, working, and interacting with others. Understanding and documenting these experiences is important to inform the ongoing response to COVID-19 and disaster preparedness efforts. OBJECTIVE: The aim of this study was to examine the psychosocial impacts of COVID-19 on a sample of Australian adults. METHODS: The data analyzed were derived from a larger cross-sectional survey of Australian adults that was administered during the month of May 2020. Participants (N=3483) were asked in which ways COVID-19 had most greatly impacted them; the responses produced a text data set containing 1 COVID-19 impact story for each participant, totaling 86,642 words. Participants also completed assessments of their sociodemographic characteristics (sex, age, financial stress), level of concern related to COVID-19, personality trait profile, and satisfaction with life. Impact stories were analyzed using sentiment analysis and compared against the Theoretical Domains Framework to determine the most frequently impacted life domains. Finally, a multinomial regression analysis, stratified by participant sex, was conducted to identify the associations of psychological and demographic socializations with sentiment toward COVID-19. RESULTS: In total, 3483 participants completed the survey, the majority of whom were female (n=2793, 80.2%). Participants' impact stories were most commonly categorized as neutral (1544/3483, 44.3%), followed by negative (1136/3483, 32.6%) and positive (802/3483, 23.1%). The most frequently impacted life domains included behavioral regulation, environmental context and resources, social influences, and emotions, suggesting that the COVID-19 pandemic was impacting these areas of participants' lives the most. Finally, the regression results suggested that for women, lower satisfaction with life and higher financial stress were associated with increased likelihood of negative, rather than positive, sentiment (P<.001); however, the proportion of variance in the sentiment that was explained was very small (<5%). CONCLUSIONS: Participant sentiment toward COVID-19 varied. High rates of neutral and negative sentiment were identified. Positive sentiment was identified but was not as common. Impacts to different areas of people's lives were identified, with a major emphasis on behavioral regulation and related domains such as social influences, environmental context and resources, and emotions. Findings may inform the development of mental health and social support resources and interventions to help alleviate the psychosocial consequences of disaster response measures.

Defining precision health: a scoping review protocol.

INTRODUCTION: Precision health is a nascent field of research that would benefit from clearer operationalisation and distinction from adjacent fields like precision medicine. This clarification is necessary to enable precision health science to tackle some of the most complex and significant health problems that are faced globally. There is a pressing need to examine the progress in human precision health research in the past 10 years and analyse this data to first, find similarities and determine discordances in how precision health is operationalised in the literature and second, identify gaps and future directions for precision health research. METHODS AND ANALYSIS: To define precision health and map research in this field, a scoping review will be undertaken and reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses - Scoping Review Extension guidelines. Systematic searches of scientific databases (Medline, Embase, Scopus, Web of Science and PsycINFO) and grey literature sources (Google Scholar, Google Patents) identified 8053 potentially eligible articles published from 1 January 2010 to 30 June 2020. Following removal of duplicates, a total of 3190 articles were imported for screening. Article data will be extracted using a customised extraction template on Covidence and analysed descriptively using narrative synthesis. ETHICS AND DISSEMINATION: Ethics approval is not required. Findings will be disseminated through professional networks, conference presentations and publication in a scientific journal.

Towards Intelligent, Multidimensional Context-Aware Personalised Healthcare and Wellness Support Services.

Healthcare and wellness support that consider context within different dimensions can lead to intelligent, personalised recommendations that will more likely be accepted and acted upon by consumers. In this paper, we look at the main components of traditional personalised healthcare and wellness support services, and identify some of the challenges that should be addressed in creating a more intelligent and efficient solution. Our contribution lies in defining away forward in terms of designing such a solution.