Background

With the introduction of privacy regulations such as the California Consumer Privacy Act and the European Union General Data Protection Regulation (GDPR), effective data protection in mobile health (mHealth) is rapidly becoming a concern. However, we have a limited understanding of the contexts and mechanisms that affect the likelihood of failures and successes in mHealth data protection, and their subsequent impacts. In this review and theory development paper, we aim to address this critical knowledge gap.

Method

We conducted a systematic literature search using PubMed, Embase, and Scopus databases. To synthesize the evidence, we adopted a realist review approach and compiled the extracted information based on context-mechanism-outcome (CMO) configurations. Out of an initial set of 611 records, 19 articles met the eligibility criteria and were included.

Results

Our findings indicate that the failures and successes in data protection and their impacts (effective mHealth interventions, data protection awareness, and adoption/use of mHealth systems) depend contingently upon a number of contextual factors (systems, users, tasks, services, geographic elements) and causal mechanisms (unauthorized access, device theft, loss, and sharing, lack of cyber-hygiene, and data protection concerns for failures, and trust building activity, secure and law compliant platforms, and perceived data protection, for successes). We conceptualized the CMO configurations to provide explanations for the reported failures and successes in data protection.

Conclusion

For effective mHealth interventions, the dark side of system use (data breaches) must be mitigated and remediated. Our study offers a theoretical model that contextually explains how the mechanisms of success and failures work in mHealth.

中文翻译：

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迈向移动健康数据保护（MHDP）的背景理论：现实主义观点。

背景

随着诸如加州消费者隐私法案和欧盟通用数据保护法规（GDPR）之类的隐私法规的出台，移动医疗（mHealth）中有效的数据保护正迅速成为人们关注的问题。但是，我们对影响mHealth数据保护失败和成功的可能性及其后续影响的背景和机制了解有限。在这篇综述和理论发展论文中，我们旨在解决这一关键的知识鸿沟。

方法

我们使用PubMed，Embase和Scopus数据库进行了系统的文献检索。为了综合证据，我们采用了现实主义者的审查方法，并根据情境-机制-结果（CMO）配置对提取的信息进行了汇编。在最初的611条记录中，有19条符合资格条件的文章被包括在内。

结果

我们的发现表明，数据保护的失败和成功及其影响（有效的mHealth干预措施，数据保护意识以及对mHealth系统的采用/使用）取决于许多上下文因素（系统，用户，任务，服务，地理元素） ）和因果机制（未经授权的访问，设备失窃，丢失和共享，缺乏网络卫生以及对故障的数据保护问题，以及对信任建立活动，安全和法规遵从的平台以及可感知的数据保护，以取得成功）。我们将CMO配置概念化，以对所报告的数据保护失败和成功进行解释。

结论

对于有效的mHealth干预措施，必须减轻和纠正系统使用的阴暗面（数据泄露）。我们的研究提供了一个理论模型，可以在上下文中解释成功和失败的机制如何在mHealth中发挥作用。