A total of 2277 records were retrieved. After identifying and deleting 1340 duplicates, 909 records remained for the review of titles, abstracts, and keywords. From screening the title and abstract, it was found that 769 articles were not related to the research topic. Afterward, 140 documents were selected for full-text review. Of these, 23 articles were excluded due to lack of access to the full text, and 117 full-text documents and 26 items of snowball searching were reviewed for the final study. A total of 93 articles were excluded due to their content that was not related to research topic. Finally, relevant data were extracted from 50 documents (Additional file 4). The process of selecting documents is shown in Fig. 1. The extracted themes for social innovation in the prevention and control of epidemic diseases are reported in the following (Fig. 2 and Table 1).
New products
The first theme of social innovation in the field of health is related to new products, which is divided into the following three sub-themes: technological products for control and management of epidemics, preventive products, diagnostic and therapeutic products. Technological products that have been used for control and management of epidemics include digital health tools for emergencies, touchless healthcare [13], innovative medical and protective equipment for dealing with COVID-19 [14, 15], new medical facilities [16], digital or remote service [17]. Digital health technologies were widely used during the COVID-19 crisis, including telecommunication technologies, mobile health apps, wearables, and online health services. Digital health is provided through virtual health care, telehealth, television interactions between health care providers and citizens, and access to online health information through mobile health apps [18]. Digital tools such as Internet of Things (IOT), biosensors, and artificial intelligence were also utilized to meet the dual goals of social distancing and healthcare in a “touchless” emergency situation [13]. Patient monitoring dashboard [19], ultraviolet light disinfection [10], mobile health programs [18], remote primary clinical care [20], remote case identification, personal protective equipment [21], and new product design in the fields of disinfection and prevention [3, 10, 15], mechanical hand washing systems [22] have all been used to manage health care during infectious disease outbreaks.
Diagnostic and therapeutic products include rapid and decentralized diagnostic tests [20, 23], mobile laboratories [23], respiratory devices for intensive care units [14], web-based triage tools [19, 24], pharmaceutical innovations in health [25], and virtual health care [18]. This innovation has been used through new and emerging technologies from simple software systems to robots and artificial intelligence, which are mostly used for diagnosis of COVID-19 as well as for logistics, transportation or auto-cleaning facilities [14, 26]. In addition, point-of-care decentralized test model [20], the Innovation Accelerator for diagnosis of COVID-19 [4], telemedicine digital platform for remote monitoring of long-term patient care [19] are innovations used for equipment in hospitals such as new types of ventilators for intensive care units that have been developed by various companies or startups [14].
New processes and policies
New processes and policies based on social innovations have been discussed in various studies, including the reorganization of care methods to set up video interactions between patients and health workers [18], virtual care services [16], intermediary and digital services [16], the creation of medical corps [27], novel organizational forms [22], health care delivery at home [19], the provision of care services by mobile units [19], digitization of services [5], hybrid communities (virtual and face-to-face) [28], process and product improvement [22, 29], home production of health products [30], and innovative health facilities [17, 31]. Health systems around the world have generally utilized three common procedures to quickly improve their structure: creation of novel treatment facilities, changes in users of public locations, and reconfiguration of current medical services to accommodate patients with COVID-19 [17].
Changes in emergency control and surveillance policies for monitoring infectious diseases address issues such as social distancing [3, 13, 16, 32,33,34,35], quarantine [28], tracking contacts and movement of people in the community [33, 36, 37], integrated command in epidemic control [29, 38], enforcement of control rules [22] and human–machine cooperation [15]. Manual control of contact tracking is impossible due to COVID-19 pandemic as well as high levels of transmission among asymptomatic persons. Use of a contact-tracking app that reminds people of their close contacts and immediately notifies them of positive cases is more effective in reducing the spread of an epidemic, especially when combined with social distancing.[33]
In addition, creative participatory policies have been developed in the context of epidemics in relation to a variety of topics, including democratization of innovative policies [13], interdisciplinary and innovation approaches [3], collective decision-making [13], creative strategies in the fight against epidemics [38], targeted national initiatives for control of epidemics [22], strategic protocols [19], forming temporary advisory groups for dealing with an epidemic [17], establishment of information and communications technology (ICT)-based cooperation [39], cross-sectoral cooperation and interdisciplinary measures [9], community participation in accordance with guidelines [8, 40], adjustment of economic and social conditions during an epidemic [3] and the formation of temporary COVID-19 consultative teams to guide government decisions [17].
The role of technology in controlling and managing epidemics is the last subtheme identified in this category, which involves video interactions between patients and health workers [18], consideration of tools to control and manage the mobility of community members [36], tracking apps for locations and contacts [37, 41], creation of social maps for participation [42], implementation of digital alert systems [43], as well as digital and contactless assistance for protection [44], digital infrastructure for the provision of services [34], digital interactions [16], and health innovation technology [4, 25]. Also, there are mobile apps that assess and record the vicinity between people via Bluetooth, QR code checkpoints, Global Positioning System, and other devices [41].
Empowerment
The purpose of health empowerment is to promote community development for changing living conditions and engagement activities [45]. Empowerment is a key element of social innovation in response to epidemics, which has been characterized by building social capital and sustaining connections for communities [45]. Empowering different groups of society for responding to COVID-19 and other pandemics can lead to effective control conditions [29]. This component of social innovation is designed in three subcategories. First, the empowerment of health workers can be examined by the following measures: reducing the limitations of crisis through technology [16], health systems resilience [17, 46], health education approaches in crisis [25], decentralization of tasks to local level [29] and key determinants of health system resilience including governance, as well as finance, intersectoral cooperation, community participation for the provision of health facilities, health workers, medical technologies, products and the institution of public health practices [17].
The empowerment of community leaders involves the training of community leaders by medical staff [40], joint discussions between community leaders and health workers on management of epidemics [40], resilience leadership [19, 46], training in crisis participation methods [25], presentation of guidelines for religious communities [40], and leaders’ ability to identify and track epidemics [9]. Critical events such as COVID-19 pandemic require specific and novel health communication and education strategies, through which public health officials must meet public data requirements [47]. Centers for Disease Control and Prevention (CDC) provide guidance and advice for faith-based organizations on how to educate, prepare, and respond to COVID-19 epidemic [40].
The third category is empowering people in the community, which is perhaps the most effective type of empowerment ensuring the preparedness of society in the face of infectious diseases and epidemics through social resilience [22], participatory methods for empowerment [25], promotion of specialized and health-related knowledge through technology [16], and social awareness [33]. Most infectious diseases, including COVID-19, have a greater potential to spread and cause mortality in vulnerable and poor communities that are in need of empowering.[48] In some countries, multilingual hotlines have been established to ensure widespread availability of COVID-19 data. Knowledge sharing platforms are based on the idea of care as an ethical relationship. These platforms emphasize the relationship between attitudes and moral values, emotional relationships, the responsibility of individuals to participate in society and demonstrate understanding and respect for vulnerable individuals and communities, which provides a basis for community integration[49].
New practices and behaviors
Responding to an epidemic requires behavioral change, and social innovation can pave the way for the emergence of new behaviors at the time of crisis. This theme of social innovation can be divided into two-subthemes: technology-based participation and support mechanisms. Technology-based participation is related to the role of media in disseminating health information and encouraging solidarity between different groups, which includes the use of social media to publish health information and educate people on health matters [9, 29, 32, 49], application of knowledge-sharing platforms [49], sharing of information under supervision of health leaders [49], updating and dissemination of health information by health workers through the media [48], connecting communities through social media [50], and the dissemination of health information via new technological tools [21, 40]. Due to the spread of COVID-19 through close human contact, digital media, particularly social media, have been the main channels for data distribution [51]. The public page MNResearch Link on Facebook is a credible source of health research information utilized to disseminate research on the spread of infectious diseases and to improve community trust and engagement in health research [50]. OpenStreetPay allows users to make digital donations for facilitating non-contact assistance to homeless neighbors [44].
The second subtheme discussed in the literature related to emergence of new behaviors in epidemic conditions is crisis support mechanisms, which includes social media campaigns regarding aid and economic solutions [3], interaction between members of different communities [16], online local support [14], modulation and preparation of stimulus messages [22], promotion of empathy [47], cooperation between social and health workers [10, 40, 52], public participation in funding [23], apps and websites for accessing health information [15, 18]. Social innovation in supplying innovative equipment and facilities to support consumers, employees, and the public health system often focuses on living and protection needs. One such supporting innovation that was implemented during COVID-19 crisis was the service of hotels to provide their own resources and rooms as separate offices for people who cannot work from home, including Amsterdam-based hotel Zoku that offered this service along with 24-h room delivery service [14]. Another type of crisis support mechanism is to evoke empathy from the community, elicit donations and recruit volunteers to address social needs. For example, in the wake of COVID-19 outbreak, Malaysians used hashtags to recruit volunteers supporting and providing food for the poor and the homeless [22, 23].
Community engagement
Community participation in epidemics has been examined in relation to four subthemes: awareness, control, care, and production support. The aim of participation is to empower local leaders, parents, families, groups, and the community as a whole. It involves scheduled activities to reach, affect, and engage all sections and units of the community in working toward a common goal. Community participation is a process in which individuals and families take responsibility for community’s health and well-being and also build up the capacity for contributing to the development of community [31]. Community engagement includes awareness-raising and counseling within local and religious communities [40, 45], holding religious meetings to mobilize communities for participating in the fight against COVID-19 [40], promoting individual participation [25, 53], and adapting measures to local contexts [43]. New approaches for contributing to combating infectious diseases involve using native abilities to build capacity for health innovations and ensure their appropriateness and sustainability [30]. The CDC provides guidelines for Healthy Community Partnership (HCP), Department of Spiritual Care and Chaplaincy (DSCC), and Medicine for the Greater Good (MGG) to bring faith-based organizations (like mosques and churches) together to participate in controlling COVID-19 [40].
Mobilization of population in the fight against the epidemic [48], participation of universities and other organizations in control of epidemics [3], participatory measures and systems [3], participation of social groups in control of epidemics [43], and stakeholder participation in epidemic control sessions [9, 54] have been considered actions of community participation. Besides, the participation of people is essential for the effectiveness of measures such as social distance and mask wearing [48]. Some of the countries mobilized networks of community health workers to promote community participation in responding to COVID-19. Their roles range from increasing consciousness via house-to-house visits, assisting with contact tracing, maintaining necessary and basic health facilities, offering essential drugs to patients without COVID-19, following or checking observance to quarantine processes, and evaluating the mental health [17]. NGOs enable the establishment of new institutions for solving problems such as COVID-19 crisis as the most important social innovations in times of crisis [39].
Participation in health care addresses issues such as the volunteer role of educators in the provision of care services [43], provision of health services under supervision of indigenous communities [32], mobilization of capacities of the community [10], and promotion of principles of self-care and contact tracing by community leaders [40, 55]. Interaction between local communities and health systems has been shown to be the key for informing service delivery, decision-making, governance, and meeting the needs of communities before, during, and after crises. Community participation strategies such as partnering with local and native leaders and working with community participants to organize messages and campaigns are critical during public health crises and pandemics [17]. Information and communication technology can play a role in changing the culture of health care and encouraging citizen participation in health. The concept of mobile health, or mHealth, is an example of this technology that effectively provides access to information and enables exchange of information[56].
Contribution to the production of care and protection products has been discussed in relation to human resources in the health industry during epidemics [7], partnerships between the private and public sectors [30], partnerships for mobilizing new resources in times of crisis [39], charitable financial assistance for management of epidemics [23], voluntary networks to combat the epidemic [23, 55], asset-based community development and participation [10], and participation in the production of health products [38].
Limitations
The main limitation of this review is the omission of a number of sources due to lack of access to full texts during the review process. However, the purpose of this study was to quickly review published literature in the field of social innovation in the control and prevention of infectious diseases. While we made efforts to address this issue by contacting the responsible authors to maximize access to resources, we may have missed some sources. We, however, believe that this limitation is relatively negligible due to the wide range of databases searched like Web of science, Scopus and PubMed.
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