Situation
Since 2022, our work within Rochdale place has been primarily focused on direct to population activities supporting long term conditions, and mental health support across the primary care health system. The direct to population approaches have been delivered through a combination of E-comms via text batching from GP surgeries, and use of carefully curated ‘landing pages’ to target specific cohorts within Rochdale place.
Within the long-term condition focus, diabetes and diabetes prevention have been a specific target group for Rochdale place, given the prevalence of 8.8% within the local adult population against a national average of 7.3% (based on NHS Quality Outcome Framework 2021/22).
Solution
To cater to the needs of the population, we curated a collection of digital health apps designed to address various health and wellness requirements associated with diabetes. The apps underwent a thorough selection process with guidance from our clinical team, who pinpointed those most beneficial for empowering individuals to self-manage aspects of their condition.
After finalising the app selection, we generated text content with direct links to the chosen apps. Collaborating with Primary Care Networks throughout Rochdale, we subsequently distributed these texts directly to individuals identified as having diabetes.
Results
Over the period May 2023 to October 2023, utilising the text-batch campaign, we saw over 2,400 downloads achieved, equivalent to 400 apps per month. This equates to 11% of the targeted population. If this was extrapolated across a full-year effect (circa.4,800 Downloads), we would reach 23% of those adults identified in the prevalence data (circa 21,000 adults) who either have been diagnosed with diabetes or are at a pre-diabetic stage.
Of note, is the evidence-based impact and benefit of use of the range of Apps deployed during these campaigns for diabetic and pre-diabetic patients. Over a period of five months, the three most downloaded diabetes apps were identified. Among them, the Low Carb Programme, which has been proven to improve diabetes management. Studies have shown that the app helps reduce HBA1c levels to less than 6.5% across the research group. After using the Low Carb Programme for a year, the number of participants reporting an HBA1c level of less than 6.5% increased from 25.7% to 50.3%.
Links to Research
In research that ORCHA has previously conducted it was found that blood glucose levels amongst those with Type 2 Diabetes can be reduced by up to 1.1% when patients use digital health tools alongside their standard medication.
Patients with Type 1 Diabetes can reduce their blood sugar (HbA1c), on average, by 0.5%. In 21 out of the 25 trials, patients using digital health tools to supplement their care achieved better HbA1c results. In 20 out of the 25 trials, there were additional reported reductions in cholesterol levels, blood pressure and Body Mass Index. Amongst those with Type 2 Diabetes, the improvements in blood sugar levels were similar to the benefits patients receive when using Metformin, a commonly used medicine to lower blood sugar levels which is often the first line of treatment for the condition.
Although researchers expect a drop-out rate of 40% when patients trial digital tools, there were lower drop-out rates when the people with diabetes used them, at 20%. In the trials, the average duration of diabetes for those using digital health was 12.49 years and the average age was 52.
If you would like to read more information about this study, click the link: www.frontiersin.org/articles/10.3389/fcdhc.2022.936752/full
If you would like to visit the campaign page or browse our library of health apps please visit: ourrochdale.orchahealth.com/en-GB
Situation
As per the Mental Health of Children and Young People in England 2023 report, from NHS England, it was found that 1 in 5 children and young people aged 8 to 25 residing in England likely had a mental health disorder in 2023. Despite a previous increase in rates from 2017 to 2020, the prevalence remained steady across all age groups from 2022 to 2023. The NHS is currently extending support to a record number of children and young people, having already assisted over 700,000 individuals with their mental health needs. NHS staff are exerting extraordinary efforts to meet the heightened demand for services.
Solution
In Dorset, it was acknowledged that there is a need to assist children and young people in addressing their mental health and well-being concerns when it comes to early help and prevention, especially considering the increasing demand for access and longer waiting times across services.
To address this, Public Health Dorset were involved in the selection of 10 free apps that would make up a targeted Children and Young People’s campaign with a specific landing page on the ORCHA public facing library.
The apps identified targeted particular areas around mental health and well-being including anxiety, depression, stress, sleep, self-harm and bereavement as well as apps to support friends and family members of young people who are struggling with their mental health.
A collaboration also took place with Dorset Youth Association who are part of the voluntary sector for them to reflect the same apps to ensure a consistent message at a time when young people are inundated with different messages online, including about apps and mental health.
By introducing a collection of digital health solutions helps children and young people autonomously tackle various mental health challenges or difficulties they may be facing or experiencing.
Further advantages of implementing a digital health campaign includes providing immediate access to support for those in need. Recognizing that the majority of young people are familiar with and comfortable using digital technologies, they are more inclined to engage with such initiatives.
Christian Telfer (NHS Dorset) said:
“Our population are actively searching for digital mental health and wellbeing support and clicking through to the Our Dorset App Library as a resource. Having a dedicated and trusted Youth Mental Health Apps page available is a much-needed section of that Library and reassures people that they are using apps which have met quality standards.”
Results
Since the campaign launched In August 2023 we have seen nearly 2000 individual visits to the landing page. The Dorset microsite has had 9,498 total visits in that time meaning that 19% of the sessions are from the campaign page.
There have been over 200 app downloads from the campaign, and this makes up 21% of Dorset’s downloads since the campaign was launched.
The app with the most downloads from the campaign is Move Mood with 58 downloads. Of the apps that are included in the campaign 84% of their all-time downloads on our public facing microsite have taken place since the campaign went live.
The data indicated that digital health solutions are pivotal in aiding children and young people who are struggling with their emotional health and well – being. In having a curated selection of apps available on a dedicated landing page enables them to explore and select independently, potentially influencing their emotional wellbeing positively whilst providing them immediate access to a range of different support tools.
If you would like to visit the campaign page or browse our library of health apps please visit: ourdorset.orchahealth.com/en-GB
In 2022, the UK government published the first ever Women’s Health Strategy for England to tackle the gender health gap. The 127-page strategy stated that “historically, the health and care system has been designed by men, for men”. However, this isn’t an England-specific problem. Already in 2024 the World Economic Forum has prioritised discussion on closing the gender health gap worldwide, citing “with only 1% of healthcare R&D invested in female-specific conditions, what key actions and commitments are needed to achieve gender health parity?”
Good health and improved economic power go hand in hand, particularly for women and girls. Being able to earn a living raises women, and by association their families too. A woman’s ability to do that is directly impacted by poorer health and poorer health outcomes, sometimes even premature death, when compared to men.
According to the Global Alliance for Women’s Health:
“Addressing the women’s health gap could potentially boost the global economy by at least $1 trillion annually by 2040. Investing in women’s health – which is more than just sexual or reproductive health – is therefore not only a matter of health equity, but a chance to help women have expanded workforce participation. Most importantly, it would help them live healthier lives.”
The Global Alliance for Women’s Health (weforum.org)
How is access to safe digital health helping?
ORCHA’s mission is to put the power of digital health safely into the hands of everyone who needs it.
However, when we look specifically at apps which have undergone the ORCHA Baseline Review (OBR) in the areas of women’s health and pregnancy, sadly the data only serves to highlight the World Economic Forum’s 1% statistic. ORCHA’s Data and Insights Manager, Lisa Gobin, has delved into the data and her findings are stark.
Only 9.6% of the total number of apps which have undergone the OBR are categorised to support women’s health.
And, in further concerning news, the standard of apps in this area is lower, with only 47% passing the OBR vs an overall figure (for all apps, all topics) of 51%.
In a final reflection of the lack of serious, continual, investment in apps covering women’s health only 30% of these apps meet their ESF Tier requirement vs an overall figure (for all apps, all topics) of 40%. Evidence standards framework (ESF) for digital health technologies | Our programmes | What we do | About | NICE.
There is some good news, Lisa reassures us.
The busiest year for app releases in this area was 2021 demonstrating, hopefully, an improvement in choices for women and digital health solutions offered to them. Unsurprisingly, it follows that the busiest year for app reviews undertaken by ORCHA in this area was 2022.
It is heartening to see growth and demand in this area increasing year on year. But is it enough, fast enough? And how are we ensuring that we’re meeting our mission by putting the power of digital health safely in the hands of everyone who needs it – in this case women and girls specifically?
Getting safe digital health into women’s hands starts with us
If global smartphone usage data is considered as a representation of accessibility to digital health apps, it is reassuring to read that “the gender gap in smartphone ownership is usually in the mid-single digits, where gaps exist at all.” Smartphone Ownership Is Growing Rapidly Around the World, but Not Always Equally | Pew Research Center.
Infact, Pew Research goes further, to say “gender plays only a limited role in explaining differences in technological use in most countries. Whether in advanced or emerging economies, men and women generally use technology – including smartphones, the internet and social media – at similar rates.”
It is no coincidence then that we have noticed an increased need across clients to surface safe apps to women, with the majority now dedicating areas of their public facing Health App Libraries to apps aimed at women and girls.
ORCHA Senior Customer Success Manager, Stephanie Lord, has spoken with her Project Lead for ORCHA at Sussex Community Foundation Trust to further demonstrate that the right steps are being taken to support women and girls’ health outcomes.
Mel Briers, Digital Nurse Specialist (Innovation), RGN/SCPHN – Sussex Community NHS Foundation Trust:
“Having looked after women throughout my career as a nurse and midwife I am passionate about the way digital platforms can support women of all ages, backgrounds and experiences to access high quality health and wellbeing information that will enable them to make informed decisions about their own health. Creating a Women’s Health Carousel on our SCFT ORCHA Library created a safe space, where women could seek advice and support on sensitive issues and manage their own health, in ways that would not otherwise have been available to them, going some way to promoting equity in healthcare delivery.”
Lisa backs this strategy up with ORCHA insights, women are actively searching for – and downloading – apps related to their health.
Infact, in 2023, use of Women’s Health carousel topics was up by 35% compared to 2022.
Perhaps the most startling statistic Lisa has for us is in the growth of downloads for apps in this area, the year-on-year increase has been consistent since 2018. Unsurprisingly, during the COVID pandemic and lockdowns downloads in this area increased exponentially, seeing growth in 2020 of 920% compared to 2019.
But even without the effect of lockdowns, from 2021 to 2023 downloads increased again, by 223%, and given the increased searches this year so far, we are predicting further growth consistent with this trend.
Our next steps
ORCHA Senior Vice-President for UK Health Systems, Alison Johnson, knows exactly what our next steps need to be:
” As part of our activation strategies, and from the emergent data trends being seen, we have a great opportunity to create portfolios of safe Apps that support a wide range of support for Women. Our work with our clients in curating access to these products means we can support more women in improving their self-care, and more importantly, improve women’s health outcomes.”
And it’s true – women and girls have the technology they need in their hands, and when presented with safe digital solutions they’re engaged and open to accessing the support. There is a worldwide demand to serve them improved health outcomes. But, as we’ve noted, the growth of apps in this area peaked in 2021, and the quality of women’s health apps assessed by ORCHA isn’t as consistently high as the average health app. So whilst the work has most definitely started, there is a long way to go.
The future for the sector is clearer than ever, as ORCHA’s Founding CEO Liz Ashall-Payne tells us:
“Looking back on mine and the teams journey with ORCHA, I’ve seen a significant increase in awareness and support for women’s health. As we move forward into the digital era, let’s continue to advocate for innovation and accessibility in healthcare, empowering every woman with the resources she needs to lead a healthy life. Together, we’re not just shaping the future; we’re revolutionising it—one digital step at a time”.
There is evidence of a recent increase in self-harm among young people in England. Statistics suggest that nationally, 7.3% of girls, and 3.6% of boys, aged 11 to 16, had self-harmed or attempted suicide at some point. The figures for 17 to 19 year olds were 21.5% for girls and 9.7% for boys. Over the course of someone’s lifetime, 1 in 14 people self-harm.
Over the last week colleagues at ORCHA have been looking at the impact digital health solutions have had in this sadly growing area of need.
As Customer Success Manager Mike Pearce says,
“It shows that if people are struggling out there that there IS someone who will listen and there are digital health apps that can be used. So powerful the impact ORCHA is having with the Papyrus service“