Literature Collection

BACKGROUND: Digital health interventions are emerging as an approach to support obesity management through self-management and remote care. However, utilization, impact, and practicality remain unclear. This study aims to map research on digital health interventions for obesity management among adults, describing their characteristics, uses, and outcomes, and identifying gaps. METHODS: A comprehensive scoping review following Arksey and O'Malley's methodological framework, in accordance with the Joanna Briggs Institute's guidelines and reported in line with the PRISMA-ScR guidelines, examined studies published between 2015 and 2025 across four databases: PubMed, Google Scholar, Scopus, and APA PsycNet. RESULTS: A total of 43 studies met the eligibility criteria. Digital health interventions for obesity encompassed consultations and education on healthy lifestyle, behavioral change strategies, physical activity, dietary management, weight goal setting, intermittent fasting, gamification, and psychological support. Digital health interventions were delivered through telehealth, mobile apps, web-based programs, multicomponent digital approaches integrating several digital tools, and hybrid models combining digital delivery with face-to-face communication. These interventions often supported by devices such as digital scales, wearable trackers, and telemonitoring units to enhance self-monitoring, adherence, and engagement. The interventions were implemented across clinical, workplace, and community settings, including adaptations developed during the COVID-19 pandemic. The included studies showed varying and inconsistently reported outcomes, with some showing significant weight loss, improvements in metabolic markers and behavioral outcomes, including dietary adherence, physical activity, and self-monitoring, as well as favorable feasibility outcomes and the potential to maintain continuity of service delivery during the COVID-19 outbreak. CONCLUSIONS: Digital health interventions used telehealth, mobile applications, web-based, multicomponent, and hybrid models across different settings, including healthcare settings (e.g., clinical and primary care) and community settings. Digital devices, such as scales, wearables, and activity trackers, were often incorporated to support self-tracking, adherence, and engagement. Reported outcomes included weight loss, improved self-monitoring, and behavioral changes such as enhanced dietary adherence and increased physical activity, and a favorable feasibility outcome; however, these outcomes were not consistently reported across all studies. Key gaps included short follow-up periods and limited evidence from LMICs. Future research should prioritize sustainable, equitable, scalable, culturally adapted, and cost-effective digital interventions.

BACKGROUND: There is a high prevalence of health problems among single people who are homeless. Specialist primary health care services for this population have been developed in several locations across England; however, there have been very few evaluations of these services. OBJECTIVES: This study evaluated the work of different models of primary health care provision in England to determine their effectiveness in engaging people who are homeless in health care and in providing continuity of care for long-term conditions. It concerned single people (not families or couples with dependent children) staying in hostels, other temporary accommodation or on the streets. The influence on outcomes of contextual factors and mechanisms (service delivery factors), including integration with other services, were examined. Data from medical records were collated on participants' use of health care and social care services over 12 months, and costs were calculated. DESIGN AND SETTING: The evaluation involved four existing Health Service Models: (1) health centres primarily for people who are homeless (Dedicated Centres), (2) Mobile Teams providing health care in hostels and day centres, (3) Specialist GPs providing some services exclusively for patients who are homeless and (4) Usual Care GPs providing no special services for people who are homeless (as a comparison). Two Case Study Sites were recruited for each of the specialist models, and four for the Usual Care GP model. PARTICIPANTS: People who had been homeless during the previous 12 months were recruited as 'case study participants'; they were interviewed at baseline and at 4 and 8 months, and information was collected about their circumstances and their health and service use in the preceding 4 months. Overall, 363 participants were recruited; medical records were obtained for 349 participants. Interviews were conducted with 65 Case Study Site staff and sessional workers, and 81 service providers and stakeholders. RESULTS: The primary outcome was the extent of health screening for body mass index, mental health, alcohol use, tuberculosis, smoking and hepatitis A among participants, and evidence of an intervention if a problem was identified. There were no overall differences in screening between the models apart from Mobile Teams, which scored considerably lower. Dedicated Centres and Specialist GPs were more successful in providing continuity of care for participants with depression and alcohol and drug problems. Service use and costs were significantly higher for Dedicated Centre participants and lower for Usual Care GP participants. Participants and staff welcomed flexible and tailored approaches to care, and related services being available in the same building. Across all models, dental needs were unaddressed and staff reported poor availability of mental health services. LIMITATIONS: There were difficulties recruiting mainstream general practices for the Usual Care GP model. Medical records could not be accessed for 14 participants of this model. CONCLUSIONS: Participant characteristics, contextual factors and mechanisms were influential in determining outcomes. Overall, outcomes for Dedicated Centres and for one of the Specialist GP sites were relatively favourable. They had dedicated staff for patients who were homeless, 'drop-in' services, on-site mental health and substance misuse services, and worked closely with hospitals and homelessness sector services. FUNDING: This project was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (HSDR 13/156/03) and will be published in full in Health and Social Care Delivery Research; Vol. 11, No. 16. See the NIHR Journals Library website for further project information.; Health problems are common among single people who are homeless, but there is little evidence of the best ways to deliver primary health care to them. This study evaluated four types of services (models) that are in existence: (1) health centres primarily for people who are homeless (Dedicated Centres); (2) Mobile Teams that provide health care in hostels and day centres; (3) Specialist GPs that have some services exclusively for patients who are homeless; and (4) Usual Care GPs providing health care to all patients, with no special services for people who are homeless. The study concentrated on single people (not homeless families or couples with dependent children) staying in hostels, other temporary accommodation and on the streets. Overall, 363 patients at these practices who had been homeless in the previous 12 months participated, and information was collected from them over a 12-month period. We examined the extent to which screening for different health conditions was undertaken, and to which treatment and follow-up care were provided for participants with chronic respiratory problems, depression, alcohol problems and drug problems. Information was gathered from their medical records about use of health and social care services over 12 months. Overall, outcomes for Dedicated Centres and for one of the Specialist GP sites were more favourable. They had staff working specifically with patients who were homeless; provided flexible ‘drop-in’ services instead of requiring patients to book appointments; and worked closely with mental health, alcohol and drug services, and with hostels, day centres and street outreach teams. Participants were also more satisfied with the health care they received from the specialist models, and were more likely to say that they had confidence and trust in doctors and nurses at these sites. Across all models, dental needs were unaddressed and staff reported poor availability of mental health services.; eng

The incidence of mental illness continues to increase since the start of the COVID-19 pandemic (Mental Health America, 2022). Demand for mental health services has grown, and providers report being "unable to meet the demand" or having an increase in wait times for access to care (American Psychological Association, 2022, para. 1). Due to this increase in demand, more patients are seeking mental health care from their primary care providers. Over the past decade, integrative models of care have been expanding into mental health care (Lake, 2017). Integrative Nursing is a strategy for improving the quality of care provided to patients seeking care for mental health diagnoses, as well as those with a goal of increasing mental health and wellbeing. This article proposes that Integrative Nursing can serve as a framework for providing whole-person mental health care.