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A Scoping Review of Sensors, Wearables, and Remote Monitoring For Behavioral Health: Uses, Outcomes, Clinical Competencies, and Research Directions

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Abstract

Sensors and wearables measure physiological and behavioral data in real time for behavioral health, using a variety of methods, interventions, and outcomes. A six-stage scoping review of 10 literature databases focused on keywords in four concept areas: (1) mobile technologies; (2) sensors, wearables, and remote monitoring; (3) mood and anxiety disorders, as well as stress; and (4) behavioral health care. Two authors independently screened results based on titles and abstracts, reviewed the full-text articles, and used inclusion/exclusion criteria to find research that studied self-report or management of symptoms and interventions. Out of a total of 5468 potential references, 76 papers were selected and an additional 16 studies were discovered in references. Of the 92 studies, 54 (58.7%) focused on mood (depressive, N = 28; bipolar, N = 26), 18 (19.6%) on anxiety disorders, and 20 (21.7%) on psychological stress/stress disorders. There were 7 (7.6%) randomized controlled trials, and 31 (33.7%) comparison studies. Research is shifting toward standardized methods, interventions, and evaluation measures, with longitudinal correlation, prediction, and/or biomarking/digital phenotyping of patients’ outcomes. These technologies pose several challenges for users, clinicians (e.g., selection, training, skills), healthcare systems (e.g., technology, integration into workflow, privacy), and organizations (e.g., training, creating a professional e-culture, change). Future research is needed on clinical health outcomes; human–computer interaction; medico-legal, professional, and privacy policy issues; models of service delivery; and effectiveness at a population level, across cultures, and related to economic costs. Clinician and institutional competencies could ensure quality of care, integration of missions, and institutional change.

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Acknowledgements

American Telemedicine Association and the Telemental Health Interest Group. Department of Pschiatry and Behavioral Sciences, University of California, Davis School of Medicine. Veteran Affairs Northern California Health Care System and Mental Health Service. Office of Connected Care, Department of Veterans Affairs.

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Authors and Affiliations

  1. Department of Psychiatry & Behavioral Sciences, University of California Davis, Sacramento, CA, USA

    Donald M. Hilty

  2. Office of Connected Care, Office of Health Informatics, US Department of Veterans Affairs, Washington, D.C, USA

    Christina M. Armstrong

  3. Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, USA

    David D. Luxton

  4. Department of Psychiatry and Psychology Mayo Clinic, Rochester, MN, USA

    Melanie T. Gentry

  5. Department of Radiology & Imaging Sciences, Emory University, Atlanta, Georgia

    Elizabeth A. Krupinski

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Hilty, D.M., Armstrong, C.M., Luxton, D.D. et al. A Scoping Review of Sensors, Wearables, and Remote Monitoring For Behavioral Health: Uses, Outcomes, Clinical Competencies, and Research Directions. J. technol. behav. sci. 6, 278–313 (2021). https://doi.org/10.1007/s41347-021-00199-2

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