Using Health Information Systems to Support Behavioral Interventions in Local Contexts: Scoping Review

Individual-level behavioral interventions are designed to improve health behaviors and manage noncommunicable diseases. Neighborhood geo-referenced contexts (NGRCs) significantly impact the success of these interventions. Integrating NGRC data into health information systems (HISs), including electronic medical records (EMRs), electronic health records (EHRs), and personal health records (PHRs), can enhance personalized NGRC-focused behavioral interventions and improve health outcomes. Despite the potential benefits, there is a notable gap in the literature about NGRC-focused behavioral interventions using HISs.

This scoping review aims to review the current status and stakeholder insights of NGRC-focused behavioral interventions using HISs.

Two reviewers examined publications indexed by MEDLINE (Ovid) and Scopus. Publications reporting on NGRC-focused behavioral interventions using HISs were included. We extracted data on study characteristics, population attributes, diseases, health setting characteristics, HISs, NGRCs, behavioral interventions, outcomes, and conclusions, with suggestions for future research.

The literature search identified 24 studies for inclusion. Of these, EHRs or EMRs were mostly used in 20 studies, with limited focus on PHRs. HISs were not used in the entire process of NGRC-focused behavioral interventions in 23 studies. Behavioral interventions in 21 studies focused exclusively on social needs interventions, with comparatively limited attention given to lifestyle change interventions. NGRCs mainly focused on built environments (n=24), with less attention to natural (n=1) and social (n=4) environments. The spatiotemporal characteristics of NGRCs were described in limited detail. "Destination accessibility" was the main focus within built environments. Other characteristics ("density," "design," "diversity," and "distance") were less studied. Stakeholders' perspectives highlighted the value, convenience, patient autonomy, and privacy of integrating content (NGRCs) and/or technology (HISs) into behavioral interventions, despite the persistence of certain social concerns. We summarized 15 recommendations in terms of NGRC-focused behavioral interventions using HISs.

PHRs have the potential to actively integrate more diverse, dynamic, and/or high-resolution NGRCs. Additionally, PHRs can participate in the entire process of NGRC-focused behavioral interventions, particularly in outpatient lifestyle change interventions. Health care providers can support these interventions to help achieve public health goals and advance health equity.