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Objective

The objective of this review is to identify enabling and inhibiting factors for mHealth adoption in low resource settings, by giving emphasis on the stakeholders representing the caregiving side. Another objective of this study is to support implementation agencies (governmental and non-governmental) in designing scalable mHealth interventions.

Methods

A PEO (Population, Exposure, Outcome) approach was used to formulate the review question. A pre-defined search strategy was implemented; Google Scholar, PubMed and gray literature were searched using alternate terms for “mHealth”, “adoption” and “developing countries”. CASP [7] tools were used to assess the quality of selected evidence. After applying inclusion and exclusion criteria on search results and critical appraisal of the selected evidence, twelve studies were selected for the review.

Results

Adoption factors operated at the levels of organization, facility-based service provider and frontline health worker. Engagement of end users during design phase, informed clinical decision making, utilization of mHealth evidence, employers’ tolerance of some personal use of devices, automation of tasks and user-friendliness of application are key enabling factors for mHealth adoption in developing countries. On the contrary, absence of national policy on mHealth, poor knowledge base on mHealth, using two systems in parallel, duplication of efforts, poor Internet connectivity and shortage of electricity are important inhibiting factors for mHealth adoption.

Conclusions

The review provides an insight about the challenges and opportunities related to mHealth adoption in developing countries. Implementation agencies should give careful consideration to these factors before designing and deploying any mHealth-enabled intervention. It is also important to understand the concept of incremental innovation so that resources spent on pilot interventions are optimized and full potential is achieved.  相似文献   
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Prevalence of obesity, an established risk factor for many cancers, has increased dramatically over the past 50 years in the United States and across the globe. Relative to normoweight cancer patients, obese cancer patients often have poorer prognoses, resistance to chemotherapies, and are more likely to develop distant metastases. Recent progress on elucidating the mechanisms underlying the obesity?cancer connection suggests that obesity exerts pleomorphic effects on pathways related to tumor development and progression and, thus, there are multiple opportunities for primary prevention and treatment of obesity-related cancers. Obesity-associated alterations, including systemic metabolism, adipose inflammation, growth factor signaling, and angiogenesis, are emerging as primary drivers of obesity-associated cancer development and progression. These obesity-associated host factors interact with the intrinsic molecular characteristics of cancer cells, facilitating several of the hallmarks of cancer. Each is considered in the context of potential preventive and therapeutic strategies to reduce the burden of obesity-related cancers. In addition, this review focuses on emerging mechanisms behind the obesity?cancer link, as well as relevant dietary interventions, including calorie restriction, intermittent fasting, low-fat diet, and ketogenic diet, that are being implemented in preclinical and clinical trials, with the ultimate goal of reducing incidence and progression of obesity-related cancers.  相似文献   
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