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Fulltext Data Sharing and Global Public Health: Defining What We Mean by Data

Schwalbe N, Wahl B, Song J, Lehtimaki S

Front Digit Health, 2020;2:612339.
PMID: 34713073 DOI: 10.3389/fdgth.2020.612339
Fulltext Evidence on Digital Mental Health Interventions for Adolescents and Young People: Systematic Overview

Lehtimaki S, Martic J, Wahl B, Foster KT, Schwalbe N

JMIR Ment Health, 2021 Apr 29;8(4):e25847.
PMID: 33913817 DOI: 10.2196/25847

BACKGROUND: An estimated 1 in 5 adolescents experience a mental health disorder each year; yet because of barriers to accessing and seeking care, most remain undiagnosed and untreated. Furthermore, the early emergence of psychopathology contributes to a lifelong course of challenges across a broad set of functional domains, so addressing this early in the life course is essential. With increasing digital connectivity, including in low- and middle-income countries, digital health technologies are considered promising for addressing mental health among adolescents and young people. In recent years, a growing number of digital health interventions, including more than 2 million web-based mental health apps, have been developed to address a range of mental health issues.
OBJECTIVE: This review aims to synthesize the current evidence on digital health interventions targeting adolescents and young people with mental health conditions, aged between 10-24 years, with a focus on effectiveness, cost-effectiveness, and generalizability to low-resource settings (eg, low- and middle-income countries).
METHODS: We searched MEDLINE, PubMed, PsycINFO, and Cochrane databases between January 2010 and June 2020 for systematic reviews and meta-analyses on digital mental health interventions targeting adolescents and young people aged between 10-24 years. Two authors independently screened the studies, extracted data, and assessed the quality of the reviews.
RESULTS: In this systematic overview, we included 18 systematic reviews and meta-analyses. We found evidence on the effectiveness of computerized cognitive behavioral therapy on anxiety and depression, whereas the effectiveness of other digital mental health interventions remains inconclusive. Interventions with an in-person element with a professional, peer, or parent were associated with greater effectiveness, adherence, and lower dropout than fully automatized or self-administered interventions. Despite the proposed utility of digital interventions for increasing accessibility of treatment across settings, no study has reported sample-specific metrics of social context (eg, socioeconomic background) or focused on low-resource settings.
CONCLUSIONS: Although digital interventions for mental health can be effective for both supplementing and supplanting traditional mental health treatment, only a small proportion of existing digital platforms are evidence based. Furthermore, their cost-effectiveness and effectiveness, including in low- and middle-income countries, have been understudied. Widespread adoption and scale-up of digital mental health interventions, especially in settings with limited resources for health, will require more rigorous and consistent demonstrations of effectiveness and cost-effectiveness vis-à-vis the type of service provided, target population, and the current standard of care.
Beyond "business as usual": lessons from FIFA for fair benefit-sharing in global health

Wahl B, Butin G, Gombe S, Demiray A, Schwalbe N

Health Aff Sch, 2024 Jul;2(7):qxae068.
PMID: 39050554 DOI: 10.1093/haschl/qxae068

While researchers and agencies from low- and middle-income countries often contribute significantly to public health surveillance data, which is crucial for effective pandemic prevention, preparedness, and response activities, they often do not receive adequate compensation for their contributions. Incentivizing data sharing is important for informing public health responses to pathogens with pandemic potential. However, existing data-sharing legal frameworks have limitations. In this context, we looked beyond "business as usual" candidates to explore the applicability of a benefit-sharing model developed and implemented by the Fédération Internationale de Football Association (International Federation of Association Football; FIFA) in international association football. This model rewards grassroots contributions and redistributes benefits, promoting a fair balance of interests across diverse economic contexts. We discuss adapting FIFA's mechanisms, including training compensation and solidarity payments, to create a novel benefit-sharing framework in global health. Given the complexity of global health, we note ways in which components of the FIFA model would need to be adapted for global health. Challenges such as integrating into existing legal frameworks, ensuring broad international buy-in, and accommodating different pandemic periods are examined. While adapting the FIFA model presents challenges, it offers a promising approach to achieving more equitable data sharing and benefit distribution in global health.

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