151
|
Chao SM, Pan CK, Wang ML, Fang YW, Chen SF. Functionality and Usability of mHealth Apps in Patients with Peritoneal Dialysis: A Systematic Review. Healthcare (Basel) 2024; 12:593. [PMID: 38470704 PMCID: PMC10930967 DOI: 10.3390/healthcare12050593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 02/29/2024] [Accepted: 02/29/2024] [Indexed: 03/14/2024] Open
Abstract
mHealth has been utilized in the care of patients with chronic kidney disease, allowing the collection of patient health-related data, offering disease-related information, enabling the tracking and recording of biochemical parameters, and enabling communication with healthcare providers in real time through applications. mHealth may improve the health outcomes in patients with peritoneal dialysis. This systematic review aimed to summarize evidence regarding the functionality and usability of mHealth apps in patients with peritoneal dialysis. We conducted a comprehensive literature review, searching in five databases, including CINAHL, Cochrane, PsycINFO, PubMed, and Web of Science, to retrieve titles and abstracts related to peritoneal dialysis and mHealth applications for PRISMA recommendations from January 2013 to December 2023. Overall, 11 studies met all the inclusion criteria. The functionality of mHealth apps included inform, instruct, record, display, guide, remind/alert, and communicate. Most of the apps have multifunctionality. The usability was categorized into three aspects: efficiency (self-efficacy and usability), satisfaction, and effectiveness (underwent kidney transplantation and switched to hemodialysis, rehospitalization, peritonitis rate, infection rates at exit sites, mortality, fluid overload, inadequate solute clearance, biochemical values, quality of life, consumer quality index, and technology readiness). Generally, outcomes in the intervention group had better effects compared to those in the control group. Multifunctional mHealth apps show a good potential in improving the efficiency, satisfaction, and effectiveness for patients compared to traditional care. Future research should include more studies and participants to explore and verify the long-term effectiveness of mHealth apps.
Collapse
Affiliation(s)
- Shu-Mei Chao
- Department of Nursing, Tzu Chi University of Science and Technology, Hualien 970302, Taiwan; (S.-M.C.); (C.-K.P.)
| | - Chao-Kuei Pan
- Department of Nursing, Tzu Chi University of Science and Technology, Hualien 970302, Taiwan; (S.-M.C.); (C.-K.P.)
| | - Ming-Ling Wang
- School of Nursing, International Ph. D Program in Gerontology and Long-Term Care, Taipei Medical University, Taipei 110301, Taiwan;
| | - Yu-Wen Fang
- Department of Health Administration, Tzu Chi University of Science and Technology, Hualien 970302, Taiwan
| | - Shu-Fen Chen
- Department of Nursing, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan
| |
Collapse
|
152
|
McCartney H, Main A, Ibrar M, Rai HK, Weir NM, Maguire R. Professional-Facing Digital Health Solutions for the Care of Patients With Chronic Pain: Protocol for a Systematic Scoping Review. JMIR Res Protoc 2024; 13:e51311. [PMID: 38441946 PMCID: PMC10951835 DOI: 10.2196/51311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 12/22/2023] [Accepted: 02/13/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Chronic pain is a highly prevalent condition and one of the most common reasons why people seek health care. As a result, chronic pain has a significant personal and economic burden. The COVID-19 pandemic has aggravated the situation for patients with chronic pain through increased risk factors (eg, anxiety or depression) as well as decreased access to health care. Digital health solutions to support people with chronic pain are becoming increasingly popular. Most of the research has focused on patient-facing digital health solutions, although it is clear that the involvement of health and care professionals is crucial in chronic pain care. Certainly, digital health solutions intended for the use of health and care professionals in the care of patients with chronic pain (ie, professional facing) exist, for example, for clinical decision support; however, no review has investigated the studies reporting these interventions. OBJECTIVE The overall aim of this scoping review is to identify the available professional-facing digital health solutions for the purpose of chronic pain management. The objectives of this review are to investigate the components, target populations, and user settings of the available professional-facing digital solutions; health and care professionals' perspectives on using digital health solutions (if reported); the methods in which the digital health solutions are developed; and the outcomes of using professional-facing digital health solutions. METHODS Databases including MEDLINE, Embase, CINAHL, PsycInfo, and Inspec will be searched for studies reporting professional-facing digital health solutions for chronic pain care, using a comprehensive search strategy developed for each of the specific databases. A total of 2 independent reviewers will screen the titles and abstracts for review inclusion and then conduct full-text screening. Any conflicts in study inclusion will be resolved by a third reviewer at each stage of the screening process. Following data extraction and quality assessment, a qualitative content analysis of the results will be conducted. This review will identify the available professional-facing digital health solutions for chronic pain management. The results of this review are likely to be heterogeneous in terms of content (ie, the digital solutions will serve a variety of purposes, settings, target populations, etc) and methods (ie, experimental and nonexperimental designs). RESULTS The review is expected to finish in March 2024 and published in the summer of 2024. CONCLUSIONS This protocol outlines the need for a scoping review to identify professional-facing digital health solutions for the management of chronic pain. Results from this review will contribute to the growing field of research into the utility of digital health for chronic pain management. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/51311.
Collapse
Affiliation(s)
- Haruno McCartney
- Department of Computer and Information Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Ashleigh Main
- Department of Computer and Information Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Maryam Ibrar
- Department of Computer and Information Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Harleen Kaur Rai
- Department of Computer and Information Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Natalie McFayden Weir
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Roma Maguire
- Department of Computer and Information Sciences, University of Strathclyde, Glasgow, United Kingdom
| |
Collapse
|
153
|
Larsen E, Murton O, Song X, Joachim D, Watts D, Kapczinski F, Venesky L, Hurowitz G. Validating the efficacy and value proposition of mental fitness vocal biomarkers in a psychiatric population: prospective cohort study. Front Psychiatry 2024; 15:1342835. [PMID: 38505797 PMCID: PMC10948552 DOI: 10.3389/fpsyt.2024.1342835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 02/14/2024] [Indexed: 03/21/2024] Open
Abstract
Background The utility of vocal biomarkers for mental health assessment has gained increasing attention. This study aims to further this line of research by introducing a novel vocal scoring system designed to provide mental fitness tracking insights to users in real-world settings. Methods A prospective cohort study with 104 outpatient psychiatric participants was conducted to validate the "Mental Fitness Vocal Biomarker" (MFVB) score. The MFVB score was derived from eight vocal features, selected based on literature review. Participants' mental health symptom severity was assessed using the M3 Checklist, which serves as a transdiagnostic tool for measuring depression, anxiety, post-traumatic stress disorder, and bipolar symptoms. Results The MFVB demonstrated an ability to stratify individuals by their risk of elevated mental health symptom severity. Continuous observation enhanced the MFVB's efficacy, with risk ratios improving from 1.53 (1.09-2.14, p=0.0138) for single 30-second voice samples to 2.00 (1.21-3.30, p=0.0068) for data aggregated over two weeks. A higher risk ratio of 8.50 (2.31-31.25, p=0.0013) was observed in participants who used the MFVB 5-6 times per week, underscoring the utility of frequent and continuous observation. Participant feedback confirmed the user-friendliness of the application and its perceived benefits. Conclusions The MFVB is a promising tool for objective mental health tracking in real-world conditions, with potential to be a cost-effective, scalable, and privacy-preserving adjunct to traditional psychiatric assessments. User feedback suggests that vocal biomarkers can offer personalized insights and support clinical therapy and other beneficial activities that are associated with improved mental health risks and outcomes.
Collapse
Affiliation(s)
| | | | | | | | - Devon Watts
- Neuroscience Graduate Program, Department of Health Sciences, McMaster University, Hamilton, ON, Canada
- St. Joseph’s Healthcare Hamilton, Hamilton, ON, Canada
| | - Flavio Kapczinski
- Neuroscience Graduate Program, Department of Health Sciences, McMaster University, Hamilton, ON, Canada
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | | |
Collapse
|
154
|
Anders C, Moorthy P, Svensson L, Müller J, Heinze O, Knaup P, Wallwiener M, Deutsch TM, Le TV, Weinert L. Usability and User Experience of an mHealth App for Therapy Support of Patients With Breast Cancer: Mixed Methods Study Using Eye Tracking. JMIR Hum Factors 2024; 11:e50926. [PMID: 38441959 PMCID: PMC10951836 DOI: 10.2196/50926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 11/30/2023] [Accepted: 12/17/2023] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Early identification of quality of life (QoL) loss and side effects is a key challenge in breast cancer therapy. Digital tools can be helpful components of therapeutic support. Enable, a smartphone app, was used in a multicenter, prospective randomized controlled trial in 3 breast cancer centers. The app simultaneously serves as a therapy companion (eg, by displaying appointments), a tool for documenting QoL (eg, by enabling data collection for QoL questionnaires), and documentation of patient-reported side effects. The need for digital tools is continually rising. However, evidence of the effects of long-term use of mobile health (mHealth) apps in aftercare for patients with breast cancer is limited. Therefore, evaluating the usability and understanding the user experience of this mHealth app could potentially contribute valuable insights in this field. OBJECTIVE A usability study was conducted to explore how patients with breast cancer receiving neoadjuvant, adjuvant, or palliative outpatient treatment rated their engagement with the app , the user experience, and the benefits of using the app. METHODS A mixed methods approach was chosen to combine subjective and objective measures, including an eye-tracking procedure, a standardized usability questionnaire (mHealth App Usability Questionnaire), and semistructured interviews. Participants were surveyed twice during the study period. Interviews were transcribed verbatim and analyzed using thematic analysis. Analysis of the eye-tracking data was carried out using the tracker-integrated software. Descriptive analysis was conducted for the quantitative data. RESULTS The mHealth App Usability Questionnaire results (n=105) indicated good overall usability for 2 different time points (4 wk: mean 89.15, SD 9.65; 20 wk: mean 85.57, SD 12.88). The qualitative analysis of the eye-tracking recordings (n=10) and interviews (n=16) showed that users found the Enable app easy to use. The design of the app, information about therapies and side effects, and usefulness of the app as a therapy companion were rated positively. Additionally, participants contributed requests for additional app features and suggestions for improving the content and usability of the app. Relevant themes included optimization of the appointment feature, updating the app's content regularly, and self-administration. In contrast to the app's current passive method of operation, participants expressed a desire for more active engagement through messaging, alarms, or emails. CONCLUSIONS The results of this study demonstrate the good usability of the Enable app as well as the potential for further development. We concluded from patients' feedback and requests that mHealth apps could benefit from giving patients a more active role (eg, being able to actively document side effects as they occur). Additionally, regular updates of app content could further contribute to encouraging continued use of mHealth apps. Our findings may also assist other researchers in tailoring their mHealth apps to the actual needs of patients undergoing breast cancer therapy.
Collapse
Affiliation(s)
- Carolin Anders
- Institute of Medical Informatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Preetha Moorthy
- Department of Biomedical Informatics at the Center for Preventive Medicine and Digital Health (CPD), Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Laura Svensson
- Institute of Medical Informatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Julia Müller
- Institute of Medical Informatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Oliver Heinze
- Institute of Medical Informatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Petra Knaup
- Institute of Medical Informatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Markus Wallwiener
- Department of Obstetrics and Gynecology, Heidelberg University Hospital, Heidelberg, Germany
| | - Thomas M Deutsch
- Department of Obstetrics and Gynecology, Heidelberg University Hospital, Heidelberg, Germany
| | - Thao-Vy Le
- Department of Obstetrics and Gynecology, Heidelberg University Hospital, Heidelberg, Germany
| | - Lina Weinert
- Institute of Medical Informatics, Heidelberg University Hospital, Heidelberg, Germany
- Section for Oral Health, Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
| |
Collapse
|
155
|
Merolli M, Francis JJ, Vallance P, Bennell KL, Malliaras P, Hinman RS. Evaluation of Patient-Facing Mobile Apps to Support Physiotherapy Care: Systematic Review. JMIR Mhealth Uhealth 2024; 12:e55003. [PMID: 38437018 PMCID: PMC10949126 DOI: 10.2196/55003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/08/2024] [Accepted: 01/23/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND Mobile health interventions delivered through mobile apps are increasingly used in physiotherapy care. This may be because of the potential of apps to facilitate changes in behavior, which is central to the aims of care delivered by physiotherapists. A benefit of using apps is their ability to incorporate behavior change techniques (BCTs) that can optimize the effectiveness of physiotherapeutic interventions. Research continues to suggest that despite their importance, behavior change strategies are often missing in patient management. Evaluating mobile apps that physiotherapists can use to drive behavior change may inform clinical practice and potentially improve patient outcomes. Examining the quality of apps and exploring their key features that can support behavior change and physiotherapy care are important aspects of such an evaluation. OBJECTIVE The primary aim of this study was to describe the range of mobile apps in app stores that are intended for use by patients to support physiotherapy care. The secondary aims were to assess app quality, BCTs, and their behavior change potential. METHODS A systematic review of mobile apps in app stores was undertaken. The Apple App Store and Google Play were searched using a 2-step search strategy, using terms relevant to the physiotherapy discipline. Strict inclusion and exclusion criteria were applied: apps had to be intended for use by patients and be self-contained (or stand-alone) without the requirement to be used in conjunction with a partner wearable device or another plugin. Included apps were coded for BCTs using the Behavior Change Technique Taxonomy version 1. App quality was assessed using the Mobile App Rating Scale, and the App Behavior Change Scale was used to assess the app's potential to change behavior. RESULTS In total, 1240 apps were screened, and 35 were included. Of these 35 apps, 22 (63%) were available on both the Apple App Store and Google Play platforms. In total, 24 (69%) were general in their focus (eg, not condition-specific), with the remaining 11 (31%) being more specific (eg, knee rehabilitation and pelvic floor training). The mean app quality score (Mobile App Rating Scale) was 3.7 (SD 0.4) of 5 (range 2.8-4.5). The mean number of BCTs identified per app was 8.5 (SD 3.6). BCTs most frequently included in the apps were instruction on how to perform a behavior (n=32), action planning (n=30), and self-monitoring of behavior (n=28). The mean behavior change potential score (App Behavior Change Scale) was 8.5 (SD 3.1) of 21 (range 3-15). CONCLUSIONS Mobile apps available to support patient care received from a physiotherapist are of variable quality. Although they contain some BCTs, the potential for behavior change varied widely across apps. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/29047.
Collapse
Affiliation(s)
- Mark Merolli
- Centre for Health, Exercise & Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, Australia
- Centre for Digital Transformation of Health, The University of Melbourne, Melbourne, Australia
| | - Jill J Francis
- School of Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Patrick Vallance
- School of Health Sciences, The University of Melbourne, Melbourne, Australia
- Department of Physiotherapy, Podiatry, Prosthetics and Orthotics, School of Allied Health, Human Service and Sport, La Trobe University, Melbourne, Australia
| | - Kim L Bennell
- Centre for Health, Exercise & Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Peter Malliaras
- Department of Physiotherapy, Podiatry, Prosthetics and Orthotics, School of Allied Health, Human Service and Sport, La Trobe University, Melbourne, Australia
| | - Rana S Hinman
- Centre for Health, Exercise & Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, Australia
| |
Collapse
|
156
|
Materia FT, Smyth JM. Acceptability and concerns about innovative wearable health sensors in persons with and without chronic disease diagnosis. Internet Interv 2024; 35:100702. [PMID: 38221944 PMCID: PMC10787257 DOI: 10.1016/j.invent.2023.100702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 11/19/2023] [Accepted: 12/17/2023] [Indexed: 01/16/2024] Open
Abstract
Advances in biomedical engineering continue to produce innovative wearable health sensors capable of real-time ambulatory assessments (e.g., of physiology, the environment), holding great potential for advancing precision monitoring and interventions through the integration of such devices and data into eHealth systems. As with any novel device, however, user views on acceptability and concerns about the technology must be evaluated to facilitate widespread implementation and user adoption of such devices. One factor that may strongly influence user views is the potential relevance to, and need for, self-care for chronic disease management. We examined if acceptability and concerns regarding innovative wearable devices differed between individuals living with or without chronic disease. A U.S. adult sample (N = 448; 20-70 yrs.; 34 % Female; 60 % White, 35 % Hispanic) completed a web-based survey regarding their thoughts/opinions related to innovative wearable sensors. Two-thirds (67 %, N = 298) reported at least one chronic disease; one-third (33 %, N = 150) reported no chronic health conditions. Participants viewed learning modules about two innovative devices: a watch to detect environmental gases for respiratory health, and a chest-patch monitoring real-time ECG. For each device, participants rated acceptability across multiple dimensions, and then rated potential concerns (including general concerns and specific worries about negative health impacts). Respondents with and without chronic disease differed in education, race, and ethnicity. Controlling for these differences, individuals with chronic disease reported significantly higher acceptability for the watch and for the chest-patch. Healthy participants reported significantly higher general concerns about technology. However, when concern questions were asked specifically about the potential negative impacts of the two study devices on physical health and well-being, participants with chronic disease reported significantly higher concerns. Overall, results show that living with chronic disease influences acceptability and concerns associated with adoption of innovative sensors. These findings suggest it is essential to take potential users' health status into account when studying the design and implementation of innovative wearable sensors. Dissemination strategies may benefit from emphasizing the beneficial features of these devices, addressing hesitations, and customizing implementation approaches by user group.
Collapse
Affiliation(s)
- Frank T. Materia
- Departments of Otolaryngology and Population Health, University of Kansas Medical Center, Kansas City, KS, United States of America
| | - Joshua M. Smyth
- Department of Psychology, The Ohio State University, Columbus, OH, United States of America
| |
Collapse
|
157
|
O'Connor C, Leyritana K, Doyle AM, Lewis JJ, Salvaña EM. Changes in Adherence and Viral Load Suppression Among People with HIV in Manila: Outcomes of the Philippines Connect for Life Study. AIDS Behav 2024; 28:837-853. [PMID: 37794284 DOI: 10.1007/s10461-023-04190-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2023] [Indexed: 10/06/2023]
Abstract
The Philippines HIV epidemic is among the fastest growing globally. Infections among men who have sex with men are rising at an alarming rate, necessitating targeted evidence-based interventions to retain people living with HIV in care, support adherence, and reach viral suppression. We conducted a 48-week prospective cohort study of 462 participants in which we provided a mobile health (mHealth) adherence support intervention using the Connect for Life platform. We observed an improvement in adherence, with the proportion of participants taking more than 95% of their antiretroviral therapy (ART) doses increasing from 78.6% at baseline to 90.3% at 48 weeks. Among treatment experienced participants, adherence improved significantly (McNemar's test = 21.88, P < 0.001). Viral load suppression did not change, with 92.6% suppression at baseline and 92.0% at 48 weeks. Illicit drug use was associated with reduced adherence (aOR = 0.56, 95%CI 0.31-1.00, P = 0.05) and being on second-line therapy was associated with poor viral load suppression (aOR = 0.33, 95%CI 0.14-0.78, P = 0.01). Quality of life improved following ART initiation, from a mean of 84.6 points (of a possible 120) at baseline to 91.01 at 48 weeks. Due to technical issues, fidelity to the intended intervention was low, with 22.1% (102/462) of participants receiving any voice calls and most others receiving a scaled-back SMS intervention. The mHealth intervention did not have any observed effect on adherence or on viral load suppression. While evidence of effectiveness of mHealth adherence interventions is mixed, these platforms should continue to be explored as part of differentiated treatment support services.
Collapse
Affiliation(s)
- Cara O'Connor
- Sustained Health Initiatives of the Philippines (SHIP), Mandaluyong, Philippines.
- The London School of Hygiene and Tropical Medicine, London, UK.
- Anova Health Institute, 12 Sherborne Ave. Parktown, Johannesburg, South Africa.
| | - Katerina Leyritana
- Sustained Health Initiatives of the Philippines (SHIP), Mandaluyong, Philippines
| | - Aoife M Doyle
- MRC International Statistics & Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK
| | - James J Lewis
- Y Lab, the Public Services Innovation Lab for Wales, School of Social Sciences, Cardiff University, Cardiff, UK
| | - Edsel Maurice Salvaña
- Institute of Molecular Biology and Biotechnology, National Institutes of Health, University of the Philippines Manila, Ermita, Manila, Philippines
- Section of Infectious Disease, Department of Medicine, University of the Philippines College of Medicine, University of the Philippines Manila, Ermita, Manila, Philippines
| |
Collapse
|
158
|
Rainbow C, Tatnell R, Blashki G, Fuller-Tyszkiewicz M, Melvin GA. Digital safety plan effectiveness and use: Findings from a three-month longitudinal study. Psychiatry Res 2024; 333:115748. [PMID: 38277811 DOI: 10.1016/j.psychres.2024.115748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 01/19/2024] [Accepted: 01/20/2024] [Indexed: 01/28/2024]
Abstract
Few studies have examined the effectiveness of self-guided smartphone apps for suicide safety planning, despite their increasing use. Participants (n = 610) were self-selected users of the Beyond Now suicide prevention safety planning app with a history of suicidal thoughts and behaviours. Surveys were completed (baseline, one and three months), safety plan content and app usage data was shared. Repeated-measures ANOVAs examined changes in suicidal ideation and suicide-related coping over three months. Multiple regression models were used to predict suicidal ideation and suicide-related coping at one- and three-month follow-ups with plan-related variables: perceived usefulness, personalised content, app use time and co-authoring of the plan with a third party. Significant reductions in suicidal ideation and increases in suicide-related coping were found over three months. Higher suicide-related coping at three months predicted lower suicidal ideation. Higher perceived usefulness and personalised content at three months were associated with higher suicide-related coping, but not suicidal ideation. App use time and co-authoring were not significantly related to suicidal ideation or suicide-related coping. Practitioners should empower clients to create safety plans with personalised (not generic) strategies that a client perceives to be useful. Such plans may strengthen beliefs about coping with suicidal ideation, which in turn reduces suicidal ideation over time.
Collapse
Affiliation(s)
- Christopher Rainbow
- Centre for Social and Early Emotional Development (SEED), School of Psychology, Deakin University, 1 Gheringhap St, Geelong, VIC 3220, Australia.
| | - Ruth Tatnell
- Centre for Social and Early Emotional Development (SEED), School of Psychology, Deakin University, 1 Gheringhap St, Geelong, VIC 3220, Australia
| | - Grant Blashki
- Nossal Institute for Global Health, University of Melbourne, Melbourne, Level 5, 333 Exhibition Street, VIC 3000, Australia; Beyond Blue, Melbourne, GPO Box 1883, Melbourne VIC 3001, Australia
| | - Matthew Fuller-Tyszkiewicz
- Centre for Social and Early Emotional Development (SEED), School of Psychology, Deakin University, 1 Gheringhap St, Geelong, VIC 3220, Australia
| | - Glenn A Melvin
- Centre for Social and Early Emotional Development (SEED), School of Psychology, Deakin University, 1 Gheringhap St, Geelong, VIC 3220, Australia
| |
Collapse
|
159
|
Vassallo M. The need for evidence-based mobile health technology. Age Ageing 2024; 53:afae034. [PMID: 38476103 DOI: 10.1093/ageing/afae034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Indexed: 03/14/2024] Open
Affiliation(s)
- Michael Vassallo
- University Hospitals Dorset NHS Foundation Trust -Older Person Medicine, Bournemouth BH7 7DW, UK
- Bournemouth University Faculty of Health and Social Sciences Royal London House, Bournemouth BH8 8GP, UK
| |
Collapse
|
160
|
Eklund R, Eisma MC, Boelen PA, Arnberg FK, Sveen J. The self-help app My Grief: Bereaved parents' experiences of helpfulness, satisfaction and usability. Internet Interv 2024; 35:100712. [PMID: 38298472 PMCID: PMC10828051 DOI: 10.1016/j.invent.2024.100712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 12/14/2023] [Accepted: 01/15/2024] [Indexed: 02/02/2024] Open
Abstract
Mobile health (mHealth) apps have been shown to be useful to monitor and reduce mental health problems across a variety of stress-related and affective disorders, yet research on the value of apps for prolonged grief is scarce. Therefore, the main aim of this study was to elucidate bereaved parents' experiences of using the self-help app My Grief with a focus on helpfulness, satisfaction, and usability. Data were derived from closed-ended and open-ended questions administered at the 3-month post-assessment of the intervention group (n = 67) within a randomized controlled trial testing the effects of access to the My Grief app. The sample consisted of 88 % women, with a mean age of 47 years, who predominantly lost their child to cancer (41 %), on average 4.8 years ago. Participating parents indicated that the My Grief app helped them increase their knowledge about prolonged grief and track their grief over time. The app was experienced as easy to navigate and around half of the parents used the app more than one day a week. Almost all parents were satisfied with the app and would recommend it to other parents in similar situations. The findings add to the knowledge base justifying mHealth within support systems for bereaved adults.
Collapse
Affiliation(s)
- Rakel Eklund
- Department of Women's and Children's Health, Uppsala University, Uppsala University Hospital, 751 85 Uppsala, Sweden
| | - Maarten C. Eisma
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, the Netherlands
| | - Paul A. Boelen
- Department of Clinical Psychology, Utrecht University, Utrecht, the Netherlands
- ARQ National Psychotrauma Centre, Diemen, the Netherlands
| | - Filip K. Arnberg
- National Centre for Disaster Psychiatry, Department of Medical Sciences, Uppsala University, Uppsala University Hospital, 751 85 Uppsala, Sweden
| | - Josefin Sveen
- Department of Women's and Children's Health, Uppsala University, Uppsala University Hospital, 751 85 Uppsala, Sweden
- Centre for Crisis Psychology, University of Bergen, Postbox 7800, 5020 Bergen, Norway
| |
Collapse
|
161
|
Lee JA, Wachira BW, Kennedy J, Asselin N, Mould-Millman NK. Utilisation of WhatsApp for Emergency Medical Services in Garissa, Kenya. Afr J Emerg Med 2024; 14:38-44. [PMID: 38304579 PMCID: PMC10830521 DOI: 10.1016/j.afjem.2024.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 12/27/2023] [Accepted: 01/08/2024] [Indexed: 02/03/2024] Open
Abstract
Garissa county, Kenya is a geographically large county with a mobile pastoralist population that has developed a method for emergency medical services (EMS) coordination using the WhatsApp communication platform. This work was based on a site visit, to better understand and describe the current operations, strengths, and weaknesses of the EMS communication system in Garissa. The use of WhatsApp in Garissa county seems to work well in the local context and has the potential to serve as a cost-effective solution for other EMS systems in Kenya, Africa, and other LMICs.
Collapse
Affiliation(s)
- J. Austin Lee
- Department of Emergency Medicine, Indiana University School of Medicine, Bloomington, Indiana, United States
| | | | | | | | | |
Collapse
|
162
|
Chen Z, Siegel LN, Prutzman YM, Wiseman KP. Characterizing perceived usability and its correlation with smoking cessation: An analysis of user assessments of the smoking cessation app quitSTART. Internet Interv 2024; 35:100714. [PMID: 38313141 PMCID: PMC10835281 DOI: 10.1016/j.invent.2024.100714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 11/09/2023] [Accepted: 01/15/2024] [Indexed: 02/06/2024] Open
Abstract
Background As smartphone ownership has become common in all demographic groups in the United States, smartphone applications (apps) for smoking cessation have grown in popularity due to their potential for supporting the diverse populations in the United States who are attempting to quit smoking. Usability is commonly assessed in mobile health (mHealth) technology as an important aspect of the user experience that could influence users' adherence to a health app and health outcomes. However, the variation of perceived usability across demographic groups, and the implications of that variation for app success, have not been well studied. Objective The aims of this study were to characterize variation in the perceived usability of the National Cancer Institute Smokefree.gov Initiative smoking cessation app quitSTART across demographic groups, and to assess the correlation between perceived usability and short-term smoking cessation. Methods We conducted a secondary analysis of data from a randomized controlled trial conducted from 2020 to 2021, which used a 16-item modified version of the mHealth App Usability Questionnaire (MAUQ) to quantify perceived usability four weeks after app download among 131 smokers attempting to quit. Responses were coded on a 5-point Likert-type scale ranging from strongly disagree (1) to strongly agree (5) and total perceived usability was calculated as the sum of all 16 items (range: 16-80). Associations between participant demographic characteristics (gender, race, education level, age, etc.) and total usability were determined using an ANCOVA model. A multivariable logistic regression model was used to assess the association between usability and smoking cessation, also assessed 4 weeks after app download. Results The ANCOVA model demonstrated that race was associated with perceived usability, with participants from a racial minority group reporting higher total usability than White participants (p < 0.001). White participants had an adjusted mean total usability of 55.8 (95 % CI: 52.8, 58.8) while racial minority group participants had an adjusted mean total usability of 66.5 (95 % CI: 61.2, 71.6). Other participant demographic characteristics, such as gender and sexual minority status, were not associated with mean total usability. Total usability was positively associated with smoking cessation (OR: 1.04, 95 % CI: 1.00, 1.08, p = 0.031). Conclusions Total perceived usability of quitSTART was higher among adults from a racial minority group compared to White adults, and perceived usability was positively associated with cessation success. These findings emphasize the importance of ensuring high usability of mHealth smoking cessation apps for diverse populations.
Collapse
Affiliation(s)
- Ziyan Chen
- University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Leeann N Siegel
- National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Yvonne M Prutzman
- National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Kara P Wiseman
- University of Virginia School of Medicine, Charlottesville, VA, USA
| |
Collapse
|
163
|
Han CY, Lim SL, Ong KW, Johal J, Gulyani A. Behavioral Lifestyle Intervention Program Using Mobile Application Improves Diet Quality in Adults With Prediabetes (D'LITE Study): A Randomized Controlled Trial. J Acad Nutr Diet 2024; 124:358-371. [PMID: 37820787 DOI: 10.1016/j.jand.2023.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 09/29/2023] [Accepted: 10/04/2023] [Indexed: 10/13/2023]
Abstract
BACKGROUND Mobile health applications (mHealth apps) are increasingly being used in weight loss interventions. However, evidence on the effects of such interventions on diet quality and their correlation with weight loss is lacking. OBJECTIVE The objective of this study was to examine whether changes in the diet quality of adults with prediabetes followed the use of an mHealth-enabled lifestyle intervention, compared with those who did not, and whether these changes correlated with weight loss. DESIGN A secondary analysis of a 6-month randomized controlled trial Diabetes Lifestyle Intervention using Technology Empowerment (D'LITE) was conducted, with participants recruited from October 2017 to September 2019. PARTICIPANTS/SETTING Community-dwelling adults (n = 148) in Singapore diagnosed with prediabetes and body mass index (BMI) ≥23 were included in this study. INTERVENTION Participants were randomized to receive either a 6-month mHealth-enabled lifestyle intervention program (diet and physical activity) or standard care dietary advice. MAIN OUTCOME MEASURES Dietary data were collected in the form of 2-day food records at baseline, 3, and 6 months. Changes in Alternate Healthy Eating Index-2010 (AHEI-2010) scores and food groups (servings/day), calculated from the dietary data, and correlation between changes in AHEI-2010 and weight loss at 3 and 6 months, were examined. STATISTICAL ANALYSES Between-group comparisons of continuous variables and within-participants variation were performed using longitudinal mixed-effect models, intention-to-treat principles. The models included treatment groups, time (baseline, 3 months, and 6 months), and covariates (age, sex, and BMI), as well as the group × time interactions, as fixed variables and within-participant variation in outcome values as random variable. The random intercept for participants accounted for the dependence of repeated measures. A likelihood ratio test was also conducted to test random effect variance. Spearman correlation test was used to examine correlation between changes in AHEI-2010 scores and weight loss. RESULTS There was a significant improvement in overall diet quality as ascertained by the AHEI-2010, by 6.2 points (95% confidence interval [CI], 3.8-8.7; P < 0.001) in the intervention group as compared with the control. The participants in the intervention group had a significantly greater reduction in intake of sugar-sweetened beverages (SSB) by 0.5 servings/day (95% CI, -0.8, -0.2; P < 0.001) and sodium by 726 mg/day (95% CI, -983, -468; P < .001), compared with those receiving standard care. At 3 and 6 months, a significant decrease in SSB (0.8 servings/day; 0.7 servings/day, respectively) and sodium (297 mg/day; 296 mg/day, respectively) intakes were reported compared with baseline intakes. Small positive correlations (r = 0.2; P < 0.05) were observed between changes in AHEI-2010 scores from baseline and percentage weight loss at 3 and 6 months. CONCLUSION For adults with prediabetes in Singapore, diet quality can be improved with an mHealth-enabled lifestyle intervention program. A small positive correlation exists between AHEI-2010 scores and weight loss.
Collapse
Affiliation(s)
- Chad Yixian Han
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Australia; NOVI Health, Singapore.
| | - Su Lin Lim
- Dietetics Department, National University Hospital, National University Health System, Singapore
| | - Kai Wen Ong
- Dietetics Department, National University Hospital, National University Health System, Singapore
| | - Jolyn Johal
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Australia
| | - Aarti Gulyani
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Australia
| |
Collapse
|
164
|
McCarthy MJ, Wicker A, Roddy J, Remiker M, Roy I, McCoy M, Cerino ES, Baldwin J. Feasibility and utility of mobile health interventions for depression and anxiety in rural populations: A scoping review. Internet Interv 2024; 35:100724. [PMID: 38352194 PMCID: PMC10863305 DOI: 10.1016/j.invent.2024.100724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 01/12/2024] [Accepted: 02/02/2024] [Indexed: 02/16/2024] Open
Abstract
Despite the potential of mobile health (mHealth) to address high rates of depression and anxiety in underserved rural communities, most mHealth interventions do not explicitly consider the realities of rural life. The aim of this scoping review is to identify and examine the available literature on mHealth interventions that consider the needs of rural populations in order to gauge their feasibility and utility for addressing depression and anxiety. Additionally, we provide an overview of rural users' perceptions about and preferences for mHealth-delivered mental health screening and intervention systems. Out of 169 articles identified, 16 met inclusion criteria. Studies were conducted across a wide range of countries, age groups, and rural subpopulations including individuals with bipolar disorder, anxiety, perinatal depression, PTSD, and chronic pain, as well as refugees, veterans, and transgender and LGBTQ+ individuals. All interventions were in the feasibility/acceptability testing stage for rural users. Identified strengths included their simplicity, accessibility, convenience, availability of support between sessions with providers, and remote access to a care team. Weaknesses included problems with charging phone batteries and exceeding data limits, privacy concerns, and general lack of comfort with app-based support. Based upon this review, we provide recommendations for future mHealth intervention development including the value of developer-user coproduction methods, the need to consider user variation in access to and comfort with smartphones, and potential data or connectivity limitations, mental health stigma, and confidentiality concerns in rural communities.
Collapse
Affiliation(s)
- Michael J. McCarthy
- Department of Social Work, Northern Arizona University, 19 W McConnell Dr., Flagstaff, AZ 86011, United States of America
| | - Alexandra Wicker
- Department of Psychological Sciences, Northern Arizona University, 1100 S Beaver St., Flagstaff, AZ 86011, United States of America
| | - Juliette Roddy
- Department of Criminology & Criminal Justice, Northern Arizona University, 5 E McConnell Dr., Flagstaff, AZ 86011, United States of America
| | - Mark Remiker
- Center for Health Equity Research, Northern Arizona University, 1395 Knoles Drive, Flagstaff, AZ 86011, United States of America
| | - Indrakshi Roy
- Center for Health Equity Research, Northern Arizona University, 1395 Knoles Drive, Flagstaff, AZ 86011, United States of America
| | - Megan McCoy
- Department of Social Work, Northern Arizona University, 19 W McConnell Dr., Flagstaff, AZ 86011, United States of America
| | - Eric S. Cerino
- Department of Psychological Sciences, Northern Arizona University, 1100 S Beaver St., Flagstaff, AZ 86011, United States of America
| | - Julie Baldwin
- Center for Health Equity Research, Northern Arizona University, 1395 Knoles Drive, Flagstaff, AZ 86011, United States of America
| |
Collapse
|
165
|
Chhatwal K, Deighton A, Dhir A, Kumar VV, Titus-Glover S, Shah D, Holt L. Digital tools in cardiac reperfusion pathways: A systematic review. Future Healthc J 2024; 11:100128. [PMID: 38689702 PMCID: PMC11059274 DOI: 10.7861/fhj.2023-0033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
With health and surgery increasingly aided by digital technologies, there exists a growing impetus to understand how such tools must integrate into existing clinical pathways to ensure a positive impact on patient and organisational outcomes. Consequently, this study sought to collate evidence on the use of digital technology in cardiac reperfusion surgeries. We systematically searched three scientific databases for relevant articles. In total, 1,092 articles were retrieved, with 126 screened using inclusion/exclusion criteria, and 21 selected for analysis. Articles reported on the use of virtual reality, mHealth and telehealth in cardiovascular reperfusion procedures, ranging from surgical training regimens to postoperative rehabilitation. Here, despite clinical advantages, limitations were highlighted, including cost, ineffective interfaces and extensive training needed to operate novel digital tools. Nevertheless with further development and input from patient stakeholders, many limitations look set to dematerialise and provide tangible improvements to the benefit of patients and hard-pressed health institutions.
Collapse
Affiliation(s)
| | - Alexander Deighton
- Foundation year 1 doctor, Homerton Healthcare NHS Foundation Trust, London, UK
| | - Abhay Dhir
- Foundation year 1 doctor, North Devon Healthcare NHS Foundation Trust, Exeter, UK
| | - Varun Vijay Kumar
- Medical student, Barts and the London School of Medicine and Dentistry, London, UK
| | - Sean Titus-Glover
- Medical student, Barts and the London School of Medicine and Dentistry, London, UK
| | - Darsh Shah
- Medical student, Barts and the London School of Medicine and Dentistry, London, UK
| | - Luke Holt
- Medical student, Barts and the London School of Medicine and Dentistry, London, UK
| |
Collapse
|
166
|
Jonassaint CR, Parchuri E, O'Brien JA, Lalama CM, Lin J, Badawy SM, Hamm ME, Stinson J, Lalloo C, Carroll CP, Saraf SL, Gordeuk VR, Cronin R, Shah N, Lanzkron SM, Liles D, Trimnell C, Bailey L, Lawrence RH, Abebe KZ. Mental health, pain and likelihood of opioid misuse among adults with sickle cell disease. Br J Haematol 2024; 204:1029-1038. [PMID: 38171495 PMCID: PMC10939903 DOI: 10.1111/bjh.19243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 10/30/2023] [Accepted: 11/23/2023] [Indexed: 01/05/2024]
Abstract
Depressive symptoms are prevalent in individuals living with sickle cell disease (SCD) and may exacerbate pain. This study examines whether higher depressive symptoms are associated with pain outcomes, pain catastrophizing, interference and potential opioid misuse in a large cohort of adults with SCD. The study utilized baseline data from the 'CaRISMA' trial, which involved 357 SCD adults with chronic pain. Baseline assessments included pain intensity, daily mood, the Patient Health Questionnaire (PHQ), the Generalized Anxiety Disorders scale, PROMIS Pain Interference, Pain Catastrophizing Scale, the Adult Sickle Cell Quality of Life Measurement Information System and the Current Opioid Misuse Measure. Participants were categorized into 'high' or 'low' depression groups based on PHQ scores. Higher depressive symptoms were significantly associated with increased daily pain intensity, negative daily mood, higher pain interference and catastrophizing, poorer quality of life and a higher likelihood of opioid misuse (all p < 0.01). SCD patients with more severe depressive symptoms experienced poorer pain outcomes, lower quality of life and increased risk of opioid misuse. Longitudinal data from this trial will determine whether addressing depressive symptoms may potentially reduce pain frequency and severity in SCD.
Collapse
Affiliation(s)
| | - Ektha Parchuri
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Julia A O'Brien
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Christina M Lalama
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Jonathan Lin
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Sherif M Badawy
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Division of Hematology, Oncology and Stem Cell Transplant, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Megan E Hamm
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Jennifer Stinson
- Child Health Evaluative Sciences in Research Institute, Hospital for Sick Children and Lawrence S. Bloomberg, Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Chitra Lalloo
- Child Health Evaluation Sciences, Hospital for Sick Children, Toronto, Ontario, Canada
- Institute for Health Policy, Management & Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - C Patrick Carroll
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins Sickle Cell Center for Adults, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Santosh L Saraf
- Department of Medicine, Sickle Cell Center, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Victor R Gordeuk
- Department of Medicine, Sickle Cell Center, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Robert Cronin
- Department of Internal Medicine, Ohio State University, Columbus, Ohio, USA
| | - Nirmish Shah
- Division of Hematology, Division of Pediatric Hematology/Oncology, Sickle Cell Transition Program, Duke University, Durham, North Carolina, USA
| | - Sophie M Lanzkron
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins Sickle Cell Center for Adults, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Darla Liles
- Department of Internal Medicine, East Carolina University, Greenville, North Carolina, USA
| | | | - Lakiea Bailey
- Sickle Cell Community Consortium, Atlanta, Georgia, USA
| | - Raymona H Lawrence
- The Jiann-Ping Hsu College of Public Health, Georgia Southern University in Statesboro, Statesboro, Georgia, USA
| | - Kaleab Z Abebe
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| |
Collapse
|
167
|
Kowalski L, Finnes A, Koch S, Bujacz A. User engagement with organizational mHealth stress management intervention - A mixed methods study. Internet Interv 2024; 35:100704. [PMID: 38268709 PMCID: PMC10806331 DOI: 10.1016/j.invent.2023.100704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 12/22/2023] [Accepted: 12/30/2023] [Indexed: 01/26/2024] Open
Abstract
Mobile health (mHealth) demonstrates great promise for providing effective and accessible interventions within an organizational context. Compared with traditional workplace interventions, mHealth solutions may be significantly more scalable and easier to standardize. However, inadequate user engagement is a major challenge with mHealth solutions that can negatively impact the potential benefits of an intervention. More research is needed to better understand how to ensure sufficient engagement, which is essential for designing and implementing effective interventions. To address this issue, this study employed a mixed methods approach to investigate what factors influence user engagement with an organizational mHealth intervention. Quantitative data were collected using surveys (n = 1267), and semi-structured interviews were conducted with a subset of participants (n = 17). Primary findings indicate that short and consistent interactions as well as user intention are key drivers of engagement. These results may inform future development of interventions to increase engagement and effectiveness.
Collapse
Affiliation(s)
- Leo Kowalski
- Department of Learning, Informatics, Management and Ethics, Health Informatics Centre, Karolinska Institutet, Tomtebodavägen 18a, 171 65 Solna, Stockholm, Sweden
| | - Anna Finnes
- Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Nobels Väg 9, 171 65 Solna, Stockholm, Sweden
- Academic Primary Healthcare Centre, Region Stockholm, Solnavägen 1E, 113 65, Stockholm, Sweden
| | - Sabine Koch
- Department of Learning, Informatics, Management and Ethics, Health Informatics Centre, Karolinska Institutet, Tomtebodavägen 18a, 171 65 Solna, Stockholm, Sweden
| | - Aleksandra Bujacz
- Department of Learning, Informatics, Management and Ethics, Health Informatics Centre, Karolinska Institutet, Tomtebodavägen 18a, 171 65 Solna, Stockholm, Sweden
| |
Collapse
|
168
|
Keogh A, Brennan C, Johnston W, Dickson J, Leslie SJ, Burke D, Megyesi P, Caulfield B. Six-Month Pilot Testing of a Digital Health Tool to Support Effective Self-Care in People With Heart Failure: Mixed Methods Study. JMIR Form Res 2024; 8:e52442. [PMID: 38427410 PMCID: PMC10959238 DOI: 10.2196/52442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 10/26/2023] [Accepted: 11/22/2023] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Digital tools may support people to self-manage their heart failure (HF). Having previously outlined the human-centered design development of a digital tool to support self-care of HF, the next step was to pilot the tool over a period of time to establish people's acceptance of it in practice. OBJECTIVE This study aims to conduct an observational pilot study to examine the usability, adherence, and feasibility of a digital health tool for HF within the Irish health care system. METHODS A total of 19 participants with HF were provided with a digital tool comprising a mobile app and the Fitbit Charge 4 and Aria Air smart scales for a period of 6 months. Changes to their self-care were assessed before and after the study with the 9-item European HF Self-care Behavior Scale (EHFScBS) and the Minnesota Living with HF Questionnaire (MLwHFQ) using a Wilcoxon signed rank test. After the study, 3 usability questionnaires were implemented and descriptively analyzed: the System Usability Scale (SUS), Wearable Technology Motivation Scale (WTMS), and Comfort Rating Scale (CRS). Participants also undertook a semistructured interview regarding their experiences with the digital tool. Interviews were analyzed deductively using the Theoretical Domains Framework. RESULTS Participants wore their devices for an average of 86.2% of the days in the 6-month testing period ranging from 40.6% to 98%. Although improvements in the EHFScBS and MLwHFQ were seen, these changes were not significant (P=.10 and P=.70, respectively, where P>.03, after a Bonferroni correction). SUS results suggest that the usability of this system was not acceptable with a median score of 58.8 (IQR 55.0-60.0; range 45.0-67.5). Participants demonstrated a strong motivation to use the system according to the WTMS (median 6.0, IQR 5.0-7.0; range 1.0-7.0), whereas the Fitbit was considered very comfortable as demonstrated by the low CRS results (median 0.0, IQR 0.0-0.0; range 0.0-2.0). According to participant interviews, the digital tool supported self-management through increased knowledge, improved awareness, decision-making, and confidence in their own data, and improving their social support through a feeling of comfort in being watched. CONCLUSIONS The digital health tool demonstrated high levels of adherence and acceptance among participants. Although the SUS results suggest low usability, this may be explained by participants uncertainty that they were using it fully, rather than it being unusable, especially given the experiences documented in their interviews. The digital tool targeted key self-management behaviors and feelings of social support. However, a number of changes to the tool, and the health service, are required before it can be implemented at scale. A full-scale feasibility trial conducted at a wider level is required to fully determine its potential effectiveness and wider implementation needs.
Collapse
Affiliation(s)
- Alison Keogh
- Insight Centre Data Analytics, University College Dublin, Dublin, Ireland
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Carol Brennan
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - William Johnston
- Insight Centre Data Analytics, University College Dublin, Dublin, Ireland
| | - Jane Dickson
- Physiotherapy Department, Beacon Hospital, Dublin, Ireland
- Cardiology, Beacon Hospital, Dublin, Ireland
| | | | - David Burke
- Cardiology, Beacon Hospital, Dublin, Ireland
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Peter Megyesi
- Insight Centre Data Analytics, University College Dublin, Dublin, Ireland
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Brian Caulfield
- Insight Centre Data Analytics, University College Dublin, Dublin, Ireland
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| |
Collapse
|
169
|
Zheng A, Bergh M, Patel Murali K, Sadarangani T. Using mHealth to Improve Communication in Adult Day Services Around the Needs of People With Dementia: Mixed Methods Assessment of Acceptability and Feasibility. JMIR Form Res 2024; 8:e49492. [PMID: 38427418 PMCID: PMC10943430 DOI: 10.2196/49492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 11/27/2023] [Accepted: 12/15/2023] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Adult day services (ADS) provide community-based health care for older adults with complex chronic conditions but rely on outdated methods for communicating users' health information with providers. CareMOBI, a novel mobile health (mHealth) app, was developed to address the need for a technological platform to improve bidirectional information exchange and communication between the ADS setting and providers. OBJECTIVE This study aims to examine the feasibility and acceptability of CareMOBI in the ADS setting. METHODS A concurrent-triangulation mixed methods design was used, and participants were client-facing ADS staff members, including direct care workers (paid caregivers), nurses, and social workers. Interviews were conducted to describe barriers and facilitators to the adoption of the CareMOBI app. The acceptability of the app was measured using an adapted version of the Technology Acceptance Model questionnaire. Data were integrated into 4 themes as anchors of an informational matrix: ease of use, clinical value, fit within workflow, and likelihood of adoption. RESULTS A mix of ADS staff (N=22) participated in the study. Participants reported high levels of acceptability across the 4 domains. Qualitative findings corroborated the questionnaire results; participants viewed the app as useful and were likely to implement CareMOBI in their practice. However, participants expressed a need for proper training and technical support throughout the implementation process. CONCLUSIONS The CareMOBI app has the potential to improve care management in the ADS setting by promoting effective communication through an easy-to-use and portable method. While the integration of CareMOBI is acceptable and feasible, developing role-specific training modules and technical assistance programs is imperative for successful implementation within the ADS setting.
Collapse
Affiliation(s)
- Amy Zheng
- New York University Rory Meyers College of Nursing, New York, NY, United States
| | - Marissa Bergh
- New York University Rory Meyers College of Nursing, New York, NY, United States
| | - Komal Patel Murali
- New York University Rory Meyers College of Nursing, New York, NY, United States
- Hartford Institute for Geriatric Nursing, New York University Rory Meyers College of Nursing, New York, NY, United States
| | - Tina Sadarangani
- New York University Rory Meyers College of Nursing, New York, NY, United States
- Hartford Institute for Geriatric Nursing, New York University Rory Meyers College of Nursing, New York, NY, United States
- New York University Grossman School of Medicine, New York, NY, United States
| |
Collapse
|
170
|
Davis A, Lancaster B, Fleming K, Swinburne Romine R, Forseth B, Nelson EL, Dreyer Gillette M, Faith M, Sullivan DK, Pettee Gabriel K, Dean K, Olalde M. Effectiveness of a paediatric weight management intervention for rural youth (iA mHealthy): Primary outcomes of a cluster randomised control trial. Pediatr Obes 2024; 19:e13094. [PMID: 38173133 PMCID: PMC10922440 DOI: 10.1111/ijpo.13094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 12/05/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Youth in rural areas are disproportionally affected by obesity. Given the unique barriers rural populations face, tailoring and increasing access to obesity interventions is necessary. OBJECTIVE This paper evaluates the effectiveness of iAmHealthy, a family-based paediatric obesity intervention delivered to rural children, compared to a Newsletter Control. METHODS Participating schools (n = 18) were randomly assigned to iAmHealthy or Newsletter Control. iAmHealthy consists of individual health coaching and group sessions delivered via televideo to a participant's home. The child and parent's body mass index (BMI), child physical activity and child dietary intake were assessed at baseline, post-treatment (8 months) and follow-up (20 months). Multilevel modeling estimated the effect of treatment at both time points. RESULTS Parent and child dyads were recruited (n = 148) and randomised to iAmHealthy (n = 64) or the Control group (n = 84). The Control group had significant increases in child BMIz from baseline to follow-up. iAmHealthy youth had no significant changes in BMIz from baseline to post or follow-up. Child dietary intake, physical activity and parent BMI results are also discussed. CONCLUSIONS This trial extends previous paediatric obesity work by simultaneously increasing convenience and dose of treatment. Results suggest iAmHealthy resulted in a change in BMIz trajectories and long-term health behaviour for youth.
Collapse
Affiliation(s)
- Ann Davis
- Center for Children's Healthy Lifestyles & Nutrition, Kansas City, Missouri, USA
- Department of Pediatrics, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Brittany Lancaster
- Center for Children's Healthy Lifestyles & Nutrition, Kansas City, Missouri, USA
- Department of Pediatrics, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Kandace Fleming
- Lifespan Institute, University of Kansas, Lawrence, Kansas, USA
| | | | - Bethany Forseth
- Center for Children's Healthy Lifestyles & Nutrition, Kansas City, Missouri, USA
- Department of Physical Therapy, Rehabilitation Science, & Athletic Training, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Eve-Lynn Nelson
- Center for Children's Healthy Lifestyles & Nutrition, Kansas City, Missouri, USA
- Department of Pediatrics, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Meredith Dreyer Gillette
- Center for Children's Healthy Lifestyles & Nutrition, Kansas City, Missouri, USA
- Department of Pediatrics, Developmental and Behavioral Sciences, Children's Mercy Kansas City, Kansas City, Missouri, USA
| | - Myles Faith
- Department of Counseling, School, and Educational Psychology, Graduate School of Education, University at Buffalo - SUNY, Buffalo, New York, USA
| | - Debra K Sullivan
- Center for Children's Healthy Lifestyles & Nutrition, Kansas City, Missouri, USA
- Department of Dietetics & Nutrition, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Kelley Pettee Gabriel
- Department of Epidemiology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Kelsey Dean
- Center for Children's Healthy Lifestyles & Nutrition, Kansas City, Missouri, USA
- Department of Pediatrics, Developmental and Behavioral Sciences, Children's Mercy Kansas City, Kansas City, Missouri, USA
| | - Megan Olalde
- Center for Children's Healthy Lifestyles & Nutrition, Kansas City, Missouri, USA
- Department of Pediatrics, University of Kansas Medical Center, Kansas City, Kansas, USA
| |
Collapse
|
171
|
Farzandipour M, Heidarzadeh Arani M, Sharif R, Nabovati E, Akbari H, Anvari S. Improving asthma control and quality of life via a smartphone self-management app: A randomized controlled trial. Respir Med 2024; 223:107539. [PMID: 38325663 DOI: 10.1016/j.rmed.2024.107539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 01/21/2024] [Accepted: 01/25/2024] [Indexed: 02/09/2024]
Abstract
BACKGROUND Mobile phone applications (apps) show promise for enhancing asthma self-management, but their effectiveness varies. This study examined the effect of a smartphone asthma app on asthma control and quality of life. METHODS Using block randomization, 60 patients with asthma were allocated to an intervention group (n = 30) or control group (n = 30) for this single-blind randomized controlled trial. At baseline, both groups completed the Asthma Control Test (ACT) and Asthma Quality of Life Questionnaire-Marks (AQLQ-M). The intervention group used a smartphone-based asthma self-management app plus their regular treatment, while the control group received only usual care. Follow-up ACT and AQLQ-M assessments occurred at 3 and 6 months. SPSS version 26 was used for analysis, including descriptive statistics, non-parametric tests (Wilcoxon and Mann-Whitney U), and analysis of variance with repeated measurements. RESULTS Both groups showed improved asthma control and quality of life at 3 and 6 months compared to baseline. However, after 6 months the intervention group had significantly greater improvement than controls (p < 0.05). Repeated measures ANOVA revealed divergent changes in ACT and AQLQ-M scores over time, with the intervention group demonstrating greater enhancement of asthma control and quality of life (p < 0.001). CONCLUSION This study demonstrated that use of a smartphone-based asthma self-management app improved asthma control and quality of life after 6 months compared to usual care alone. These findings indicate that guideline-based asthma apps can positively impact outcomes.
Collapse
Affiliation(s)
- Mehrdad Farzandipour
- Health Information Management Research Center, Kashan University of Medical Sciences, Kashan, Iran; Department of Health Information Management and Technology, Allied Medical Sciences Faculty, Kashan University of Medical Sciences, Kashan, Iran
| | - Marzieh Heidarzadeh Arani
- Pediatric Department, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran; Asthma and Allergy Clinic, Kashan University of Medical Sciences, Kashan, Iran
| | - Reihane Sharif
- Health Information Management Research Center, Kashan University of Medical Sciences, Kashan, Iran; Department of Health Information Management and Technology, Allied Medical Sciences Faculty, Kashan University of Medical Sciences, Kashan, Iran.
| | - Ehsan Nabovati
- Health Information Management Research Center, Kashan University of Medical Sciences, Kashan, Iran; Department of Health Information Management and Technology, Allied Medical Sciences Faculty, Kashan University of Medical Sciences, Kashan, Iran
| | - Hossein Akbari
- Department of Biostatistics and Epidemiology, School of Health, Kashan University of Medical Sciences, Kashan, Iran
| | - Shima Anvari
- Health Information Management Research Center, Kashan University of Medical Sciences, Kashan, Iran; Department of Health Information Management and Technology, Allied Medical Sciences Faculty, Kashan University of Medical Sciences, Kashan, Iran
| |
Collapse
|
172
|
Lazaro MJ, Alvaran A, Yun MH, Kim S. Mobile Health Application for Seizure Management: A Human-Systems Integration Approach. Hum Factors 2024; 66:744-769. [PMID: 35337190 DOI: 10.1177/00187208221074427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE The study aims to develop a mHealth application for seizure management based on the human system integration (HSI) approach. BACKGROUND Unmet healthcare needs among people with epilepsy continue to exist despite the advancement in healthcare technology. Current seizure management methods are found to be ineffective. Therefore, a more efficient strategy such as mHealth technology is necessary to aid seizure management. METHOD The needs identification phase involved identifying the user requirements by interviewing 10 stakeholders and conducting thematic analysis and needs interpretation technique. In the solution identification phase, the system requirements were derived using various human-centered design and systems engineering approaches and were evaluated through quality function deployment to determine design targets. For the design and evaluation phase, the design targets were reflected in the app through the iterative prototyping process, and the interface and functional design were evaluated by seven human factors and ergonomics experts and four stakeholders, respectively. RESULTS Three primary needs and ten user requirements were derived from the needs identification phase. Ten out of fifteen system requirements were selected as design targets to be included in the final prototype. Results of the evaluation showed that the interface design of the proposed app showed superior usability compared to a competitor app and that the app functions were beneficial for the stakeholders. CONCLUSION The mHealth app designed through the HSI framework showed good potential in addressing the main issues in seizure management. APPLICATION The mHealth app design methodology based on the HSI approach can be applied to the design of small-scale systems in various domains.
Collapse
Affiliation(s)
- May Jorella Lazaro
- Interdisciplinary Program in Cognitive Science, Seoul National University, South Korea
| | | | - Myung Hwan Yun
- Department of Industrial Engineering & Institute for Industrial System Innovation, Seoul National University, Seoul, Korea
| | - Sungho Kim
- Department of Systems Engineering, Republic of Korea Air Force Academy, South Korea
| |
Collapse
|
173
|
Heyman RE, Daly KA, Slep AMS, Wolff MS. Leveraging technology to increase the disseminability of evidence-based treatment of dental fear: An uncontrolled pilot study. J Public Health Dent 2024; 84:36-42. [PMID: 38114444 DOI: 10.1111/jphd.12598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 08/14/2023] [Accepted: 11/17/2023] [Indexed: 12/21/2023]
Abstract
OBJECTIVES U.S. and global estimates indicate that over 30% of adults fear receiving dental care, including over 20% who have visited a dentist in the last year, leading to avoidance and degraded oral and systemic health. Although evidence-based cognitive-behavioral treatments for dental fear (CBT-DF) exist, they have little impact on the millions who seek dental care annually because they are not disseminable (6 h of in-chair time, delivered only in person at a few sites). We developed a disseminable CBT-DF stepped-care treatment comprising (Step 1) a mobile-health application and, for those who remain fearful, (Step 2) a 1-h, one-on-one psychological treatment session that allows practice during exposure to the patient's most-feared stimuli. We hypothesized that the treatment would (a) be rated highly on usability and credibility and (b) result in clinically consequential (i.e., lowering fear into the 0-3 "no/low fear" zone) and statistically significant changes in global dental fear. METHOD Racially/ethnically diverse patients (N = 48) with moderate to severe dental fear were recruited; all completed Step 1, and n = 16 completed Step 2. RESULTS As hypothesized, users found the stepped-care treatment highly usable, credible, and helpful. Critically, this stepped-care approach produced reductions in patients' dental fear that were both clinically consequential (with half no longer fearful) and statistically significant (d = 1.11). CONCLUSIONS This usable, credible, stepped-care approach to dental fear treatment holds promise for liberating evidence-based CBT-DF from specialty clinics, allowing broad dissemination.
Collapse
Affiliation(s)
- Richard E Heyman
- Family Translational Research Group, New York University College of Dentistry, New York, New York, USA
| | - Kelly A Daly
- Family Translational Research Group, New York University College of Dentistry, New York, New York, USA
| | - Amy M Smith Slep
- Family Translational Research Group, New York University College of Dentistry, New York, New York, USA
| | - Mark S Wolff
- University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania, USA
| |
Collapse
|
174
|
Düking P, Sperlich B, Voigt L, Van Hooren B, Zanini M, Zinner C. ChatGPT Generated Training Plans for Runners are not Rated Optimal by Coaching Experts, but Increase in Quality with Additional Input Information. J Sports Sci Med 2024; 23:56-72. [PMID: 38455449 PMCID: PMC10915606 DOI: 10.52082/jssm.2024.56] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 12/19/2023] [Indexed: 03/09/2024]
Abstract
ChatGPT may be used by runners to generate training plans to enhance performance or health aspects. However, the quality of ChatGPT generated training plans based on different input information is unknown. The objective of the study was to evaluate ChatGPT-generated six-week training plans for runners based on different input information granularity. Three training plans were generated by ChatGPT using different input information granularity. 22 quality criteria for training plans were drawn from the literature and used to evaluate training plans by coaching experts on a 1-5 Likert Scale. A Friedmann test assessed significant differences in quality between training plans. For training plans 1, 2 and 3, a median rating of <3 was given 19, 11, and 1 times, a median rating of 3 was given 3, 5, and 8 times and a median rating of >3 was given 0, 6, 13 times, respectively. Training plan 1 received significantly lower ratings compared to training plan 2 for 3 criteria, and 15 times significantly lower ratings compared to training plan 3 (p < 0.05). Training plan 2 received significantly lower ratings (p < 0.05) compared to plan 3 for 9 criteria. ChatGPT generated plans are ranked sub-optimally by coaching experts, although the quality increases when more input information are provided. An understanding of aspects relevant to programming distance running training is important, and we advise avoiding the use of ChatGPT generated training plans without an expert coach's feedback.
Collapse
Affiliation(s)
- Peter Düking
- Department of Sports Science and Movement Pedagogy, Technische Universität Braunschweig, Braunschweig, Germany
| | - Billy Sperlich
- Integrative and Experimental Exercise Science, Department of Sport Science, University of Würzburg, Würzburg, Germany
| | - Laura Voigt
- Institute of Psychology, German Sport University Cologne, Cologne, Germany
| | - Bas Van Hooren
- Department of Nutrition and Movement Sciences, School of Nutrition and Translational Research in Metabolism (NUTRIM), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Michele Zanini
- School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Christoph Zinner
- Department of Sport, University of Applied Sciences for Police and Administration of Hesse, Wiesbaden, Germany
| |
Collapse
|
175
|
Cha BS, Borghouts J, Eikey E, Mukamel DB, Schueller SM, Sorkin DH, Stadnick NA, Zhao X, Zheng K, Schneider ML. Variability in the Integration of Peers in a Multi-site Digital Mental Health Innovation Project. Adm Policy Ment Health 2024; 51:226-239. [PMID: 38246948 PMCID: PMC10850170 DOI: 10.1007/s10488-023-01331-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2023] [Indexed: 01/23/2024]
Abstract
Peer support specialists ("peers") who have the lived experience of, and are in recovery from, mental health challenges are increasingly being integrated into mental health care as a reimbursable service across the US. This study describes the ways peers were integrated into Help@Hand, a multi-site innovation project that engaged peers throughout efforts to develop and offer digital mental health interventions across counties/cities ("sites") in California. Using a mixed methods design, we collected quantitative data via quarterly online surveys, and qualitative data via semi-annual semi-structured phone interviews with key informants from Help@Hand sites. Quantitative data were summarized as descriptive findings and qualitative data from interviews were analyzed using rapid qualitative analysis methods. In the final analytic phase, interview quotes were used to illustrate the complex realities underlying quantitative responses. 117 quarterly surveys and 46 semi-annual interviews were completed by key informants from 14 sites between September 2020 and January 2023. Peers were integrated across diverse activities for support and implementation of digital mental health interventions, including development of training and educational materials (78.6% of sites), community outreach (64.3%), technology testing (85.7%), technology piloting (90.9%), digital literacy training (71.4%), device distribution (63.6%), technical assistance (72.7%), and cross-site collaboration (66.7%). Peer-engaged activities shifted over time, reflecting project phases. Peer-provided digital literacy training and technology-related support were key ingredients for project implementations. This study indicates the wide range of ways peers can be integrated into digital mental health intervention implementations. Considering contextual readiness for peer integration may enhance their engagement into programmatic activities.
Collapse
Affiliation(s)
- Biblia S Cha
- Department of General Internal Medicine, University of California, Irvine, Irvine, CA, USA.
- School of Medicine, University of California, Irvine, 100 Theory, Suite 120, Irvine, CA, 92697, USA.
| | - Judith Borghouts
- Department of General Internal Medicine, University of California, Irvine, Irvine, CA, USA
| | - Elizabeth Eikey
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, San Diego, CA, USA
- The Design Lab, University of California, San Diego, San Diego, CA, USA
| | - Dana B Mukamel
- Department of General Internal Medicine, University of California, Irvine, Irvine, CA, USA
| | - Stephen M Schueller
- Department of Informatics, University of California, Irvine, Irvine, CA, USA
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA
| | - Dara H Sorkin
- Department of General Internal Medicine, University of California, Irvine, Irvine, CA, USA
| | - Nicole A Stadnick
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
- Dissemination and Implementation Science Center, UC San Diego Altman Clinical and Translational Research Institute, La Jolla, CA, USA
- Child and Adolescent Services Research Center, San Diego, CA, USA
| | - Xin Zhao
- Department of General Internal Medicine, University of California, Irvine, Irvine, CA, USA
| | - Kai Zheng
- Department of Informatics, University of California, Irvine, Irvine, CA, USA
| | | |
Collapse
|
176
|
Willms A, Liu S. Exploring the Feasibility of Using ChatGPT to Create Just-in-Time Adaptive Physical Activity mHealth Intervention Content: Case Study. JMIR Med Educ 2024; 10:e51426. [PMID: 38421689 PMCID: PMC10940976 DOI: 10.2196/51426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 12/15/2023] [Accepted: 12/27/2023] [Indexed: 03/02/2024]
Abstract
BACKGROUND Achieving physical activity (PA) guidelines' recommendation of 150 minutes of moderate-to-vigorous PA per week has been shown to reduce the risk of many chronic conditions. Despite the overwhelming evidence in this field, PA levels remain low globally. By creating engaging mobile health (mHealth) interventions through strategies such as just-in-time adaptive interventions (JITAIs) that are tailored to an individual's dynamic state, there is potential to increase PA levels. However, generating personalized content can take a long time due to various versions of content required for the personalization algorithms. ChatGPT presents an incredible opportunity to rapidly produce tailored content; however, there is a lack of studies exploring its feasibility. OBJECTIVE This study aimed to (1) explore the feasibility of using ChatGPT to create content for a PA JITAI mobile app and (2) describe lessons learned and future recommendations for using ChatGPT in the development of mHealth JITAI content. METHODS During phase 1, we used Pathverse, a no-code app builder, and ChatGPT to develop a JITAI app to help parents support their child's PA levels. The intervention was developed based on the Multi-Process Action Control (M-PAC) framework, and the necessary behavior change techniques targeting the M-PAC constructs were implemented in the app design to help parents support their child's PA. The acceptability of using ChatGPT for this purpose was discussed to determine its feasibility. In phase 2, we summarized the lessons we learned during the JITAI content development process using ChatGPT and generated recommendations to inform future similar use cases. RESULTS In phase 1, by using specific prompts, we efficiently generated content for 13 lessons relating to increasing parental support for their child's PA following the M-PAC framework. It was determined that using ChatGPT for this case study to develop PA content for a JITAI was acceptable. In phase 2, we summarized our recommendations into the following six steps when using ChatGPT to create content for mHealth behavior interventions: (1) determine target behavior, (2) ground the intervention in behavior change theory, (3) design the intervention structure, (4) input intervention structure and behavior change constructs into ChatGPT, (5) revise the ChatGPT response, and (6) customize the response to be used in the intervention. CONCLUSIONS ChatGPT offers a remarkable opportunity for rapid content creation in the context of an mHealth JITAI. Although our case study demonstrated that ChatGPT was acceptable, it is essential to approach its use, along with other language models, with caution. Before delivering content to population groups, expert review is crucial to ensure accuracy and relevancy. Future research and application of these guidelines are imperative as we deepen our understanding of ChatGPT and its interactions with human input.
Collapse
Affiliation(s)
- Amanda Willms
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada
| | - Sam Liu
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada
| |
Collapse
|
177
|
Demirel S, Roke Y, Hoogendoorn AW, Hoefakker J, Hoeberichts K, van Harten PN. Assessing the Effectiveness of STAPP@Work, a Self-Management Mobile App, in Reducing Work Stress and Preventing Burnout: Single-Case Experimental Design Study. J Med Internet Res 2024; 26:e48883. [PMID: 38275128 PMCID: PMC10940977 DOI: 10.2196/48883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 12/06/2023] [Accepted: 01/17/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Work-related stress and burnout remain common problems among employees, leading to impaired health and higher absenteeism. The use of mobile health apps to promote well-being has grown substantially; however, the impact of such apps on reducing stress and preventing burnout is limited. OBJECTIVE This study aims to assess the effectiveness of STAPP@Work, a mobile-based stress management intervention, on perceived stress, coping self-efficacy, and the level of burnout among mental health employees. METHODS The study used a single-case experimental design to examine the use of STAPP@Work among mental health employees without a known diagnosis of burnout (N=63). Participants used the app for 1 week per month repeatedly for a period of 6 months. Using a reversal design, the participants used the app 6 times to assess replicated immediate (1 week after use) and lasting (3 weeks after use) effects. The Perceived Stress Scale, the Coping Self-Efficacy Scale, and the Burnout Assessment Tool were used to measure the outcomes. Linear mixed models were used to analyze the data. RESULTS After 6 months of app use for 1 week per month, the participants showed a statistically significant decrease in perceived stress (b=-0.38, 95% CI -0.67 to -0.09; P=.01; Cohen d=0.50) and burnout symptoms (b=-0.31, 95% CI -0.51 to -0.12; P=.002; Cohen d=0.63) as well as a statistically significant improvement in problem-focused coping self-efficacy (b=0.42, 95% CI 0-0.85; P=.049; Cohen d=0.42). Long-term use of the app provided consistent reductions in burnout symptoms over time, including in the level of exhaustion and emotional impairment. CONCLUSIONS The use of an app-based stress management intervention has been shown to reduce burnout symptoms and enhance coping self-efficacy among mental health workers. Prevention of burnout and minimization of work-related stress are of utmost importance to protect employee health and reduce absenteeism.
Collapse
Affiliation(s)
- Sevda Demirel
- Expertise Center for Autism Spectrum Disorder, GGz Centraal, Almere, Netherlands
| | - Yvette Roke
- Expertise Center for Autism Spectrum Disorder, GGz Centraal, Almere, Netherlands
| | - Adriaan W Hoogendoorn
- Department of Psychiatry, Amsterdam Universitair Medische Centra, Amsterdam, Netherlands
- Mental Health Program, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | | | - Kirsten Hoeberichts
- Expertise Center for Autism Spectrum Disorder, GGz Centraal, Almere, Netherlands
| | - Peter N van Harten
- Department of Psychiatry, GGz Centraal, Amersfoort, Netherlands
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands
| |
Collapse
|
178
|
Lee ASY, Datu JAD, Chung KKH, Fung WK, Cheung RYM. Can a multicomponent positive psychological intervention promote well-being in parents of young children? A randomized controlled trial study in Hong Kong. Fam Process 2024. [PMID: 38417912 DOI: 10.1111/famp.12979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 01/28/2024] [Accepted: 01/30/2024] [Indexed: 03/01/2024]
Abstract
The present research examined the effects of an Early Advancement in Social-Emotional Health and Positivity (EASP) multicomponent positive psychological intervention on parents' well-being in Hong Kong. Participants were parents of young children (N = 120; Mage = 37.19 years, SD = 4.71, range = 24-53; female = 95.00%) who participated in the one-month randomized control trial. Participants were randomly assigned into the intervention (n = 50) and waitlist control groups (n = 70). Parents in the intervention group received two online workshops and an evidence-based smartphone application that targeted four positive psychological skills: (1) mindful parenting, (2) hope, (3) positive reappraisal, and (4) growth mindset. The results of the multivariate regression analysis revealed that the intervention significantly improved various dimensions of participants' positive psychological skills, subjective well-being, and psychological well-being immediately at the conclusion of the program. The findings of this study underscore the importance of the well-being payoffs linked to cultivating positive psychological skills among parents of young children.
Collapse
Affiliation(s)
- Alfred S Y Lee
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
- Centre for Child and Family Science, The Education University of Hong Kong, Tai Po, Hong Kong
| | - Jesus Alfonso Daep Datu
- Academic Unit of Human Communication, Learning, and Development, The University of Hong Kong, Pokfulam, Hong Kong
- Centre for Advancement in Inclusive and Special Education, The University of Hong Kong, Pokfulam, Hong Kong
| | - Kevin Kien Hoa Chung
- Centre for Child and Family Science, The Education University of Hong Kong, Tai Po, Hong Kong
- Department of Early Childhood Education, The Education University of Hong Kong, Tai Po, Hong Kong
| | - Wing Kai Fung
- School of Education, Liverpool Hope University, Liverpool, United Kingdom
| | - Ryan Yat Ming Cheung
- Centre for Child and Family Science, The Education University of Hong Kong, Tai Po, Hong Kong
- Division of Educational Psychology, Hong Kong Psychological Society, Kowloon, Hong Kong
| |
Collapse
|
179
|
Oehm JB, Riepenhausen SL, Storck M, Dugas M, Pryss R, Varghese J. Integration of Patient-Reported Outcome Data Collected Via Web Applications and Mobile Apps Into a Nation-Wide COVID-19 Research Platform Using Fast Healthcare Interoperability Resources: Development Study. J Med Internet Res 2024; 26:e47846. [PMID: 38411999 PMCID: PMC10933715 DOI: 10.2196/47846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 07/30/2023] [Accepted: 12/12/2023] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND The Network University Medicine projects are an important part of the German COVID-19 research infrastructure. They comprise 2 subprojects: COVID-19 Data Exchange (CODEX) and Coordination on Mobile Pandemic Apps Best Practice and Solution Sharing (COMPASS). CODEX provides a centralized and secure data storage platform for research data, whereas in COMPASS, expert panels were gathered to develop a reference app framework for capturing patient-reported outcomes (PROs) that can be used by any researcher. OBJECTIVE Our study aims to integrate the data collected with the COMPASS reference app framework into the central CODEX platform, so that they can be used by secondary researchers. Although both projects used the Fast Healthcare Interoperability Resources (FHIR) standard, it was not used in a way that data could be shared directly. Given the short time frame and the parallel developments within the CODEX platform, a pragmatic and robust solution for an interface component was required. METHODS We have developed a means to facilitate and promote the use of the German Corona Consensus (GECCO) data set, a core data set for COVID-19 research in Germany. In this way, we ensured semantic interoperability for the app-collected PRO data with the COMPASS app. We also developed an interface component to sustain syntactic interoperability. RESULTS The use of different FHIR types by the COMPASS reference app framework (the general-purpose FHIR Questionnaire) and the CODEX platform (eg, Patient, Condition, and Observation) was found to be the most significant obstacle. Therefore, we developed an interface component that realigns the Questionnaire items with the corresponding items in the GECCO data set and provides the correct resources for the CODEX platform. We extended the existing COMPASS questionnaire editor with an import function for GECCO items, which also tags them for the interface component. This ensures syntactic interoperability and eases the reuse of the GECCO data set for researchers. CONCLUSIONS This paper shows how PRO data, which are collected across various studies conducted by different researchers, can be captured in a research-compatible way. This means that the data can be shared with a central research infrastructure and be reused by other researchers to gain more insights about COVID-19 and its sequelae.
Collapse
Affiliation(s)
| | | | - Michael Storck
- Institute of Medical Informatics, University of Münster, Münster, Germany
| | - Martin Dugas
- Institute of Medical Informatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Rüdiger Pryss
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - Julian Varghese
- Institute of Medical Informatics, University of Münster, Münster, Germany
| |
Collapse
|
180
|
Young SR, Dworak EM, Kaat AJ, Adam H, Novack MA, Slotkin J, Stoeger J, Nowinski CJ, Hosseinian Z, Amagai S, Pila S, Diaz MV, Correa AA, Alperin K, Omberg L, Kellen M, Camacho MR, Landavazo B, Nosheny RL, Weiner MW, Gershon RM. Development and Validation of a Vocabulary Measure in the Mobile Toolbox. Arch Clin Neuropsychol 2024:acae010. [PMID: 38414411 DOI: 10.1093/arclin/acae010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 01/24/2024] [Accepted: 01/27/2024] [Indexed: 02/29/2024] Open
Abstract
OBJECTIVE We describe the development of a new computer adaptive vocabulary test, Mobile Toolbox (MTB) Word Meaning, and validity evidence from 3 studies. METHOD Word Meaning was designed to be a multiple-choice synonym test optimized for self-administration on a personal smartphone. The items were first calibrated online in a sample of 7,525 participants to create the computer-adaptive test algorithm for the Word Meaning measure within the MTB app. In Study 1, 92 participants self-administered Word Meaning on study-provided smartphones in the lab and were administered external measures by trained examiners. In Study 2, 1,021 participants completed the external measures in the lab and Word Meaning was self-administered remotely on their personal smartphones. In Study 3, 141 participants self-administered Word Meaning remotely twice with a 2-week delay on personal iPhones. RESULTS The final bank included 1363 items. Internal consistency was adequate to good across samples (ρxx = 0.78 to 0.81, p < .001). Test-retest reliability was good (ICC = 0.65, p < .001), and the mean theta score was not significantly different upon the second administration. Correlations were moderate to large with measures of similar constructs (ρ = 0.67-0.75, p < .001) and non-significant with measures of dissimilar constructs. Scores demonstrated small to moderate correlations with age (ρ = 0.35 to 0.45, p < .001) and education (ρ = 0.26, p < .001). CONCLUSION The MTB Word Meaning measure demonstrated evidence of reliability and validity in three samples. Further validation studies in clinical samples are necessary.
Collapse
Affiliation(s)
- Stephanie Ruth Young
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Elizabeth M Dworak
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Aaron J Kaat
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Hubert Adam
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Miriam A Novack
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Jerry Slotkin
- Center for Health Assessment Research and Translation, University of Delaware, Newark, DE, USA
| | | | - Cindy J Nowinski
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Zahra Hosseinian
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Saki Amagai
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Sarah Pila
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Maria Varela Diaz
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Anyelo Almonte Correa
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | | | | | - Monica R Camacho
- University of California San Francisco, San Francisco CA, USA
- Northern California Institute for Research and Education, San Francisco Veteran's Administration Medical Center, San Francisco, CA, USA
| | - Bernard Landavazo
- University of California San Francisco, San Francisco CA, USA
- Northern California Institute for Research and Education, San Francisco Veteran's Administration Medical Center, San Francisco, CA, USA
| | - Rachel L Nosheny
- University of California San Francisco, San Francisco CA, USA
- Northern California Institute for Research and Education, San Francisco Veteran's Administration Medical Center, San Francisco, CA, USA
| | - Michael W Weiner
- University of California San Francisco, San Francisco CA, USA
- Northern California Institute for Research and Education, San Francisco Veteran's Administration Medical Center, San Francisco, CA, USA
| | - Richard M Gershon
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| |
Collapse
|
181
|
Jabir AI, Lin X, Martinengo L, Sharp G, Theng YL, Tudor Car L. Attrition in Conversational Agent-Delivered Mental Health Interventions: Systematic Review and Meta-Analysis. J Med Internet Res 2024; 26:e48168. [PMID: 38412023 PMCID: PMC10933752 DOI: 10.2196/48168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 09/21/2023] [Accepted: 12/04/2023] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND Conversational agents (CAs) or chatbots are computer programs that mimic human conversation. They have the potential to improve access to mental health interventions through automated, scalable, and personalized delivery of psychotherapeutic content. However, digital health interventions, including those delivered by CAs, often have high attrition rates. Identifying the factors associated with attrition is critical to improving future clinical trials. OBJECTIVE This review aims to estimate the overall and differential rates of attrition in CA-delivered mental health interventions (CA interventions), evaluate the impact of study design and intervention-related aspects on attrition, and describe study design features aimed at reducing or mitigating study attrition. METHODS We searched PubMed, Embase (Ovid), PsycINFO (Ovid), Cochrane Central Register of Controlled Trials, and Web of Science, and conducted a gray literature search on Google Scholar in June 2022. We included randomized controlled trials that compared CA interventions against control groups and excluded studies that lasted for 1 session only and used Wizard of Oz interventions. We also assessed the risk of bias in the included studies using the Cochrane Risk of Bias Tool 2.0. Random-effects proportional meta-analysis was applied to calculate the pooled dropout rates in the intervention groups. Random-effects meta-analysis was used to compare the attrition rate in the intervention groups with that in the control groups. We used a narrative review to summarize the findings. RESULTS The systematic search retrieved 4566 records from peer-reviewed databases and citation searches, of which 41 (0.90%) randomized controlled trials met the inclusion criteria. The meta-analytic overall attrition rate in the intervention group was 21.84% (95% CI 16.74%-27.36%; I2=94%). Short-term studies that lasted ≤8 weeks showed a lower attrition rate (18.05%, 95% CI 9.91%- 27.76%; I2=94.6%) than long-term studies that lasted >8 weeks (26.59%, 95% CI 20.09%-33.63%; I2=93.89%). Intervention group participants were more likely to attrit than control group participants for short-term (log odds ratio 1.22, 95% CI 0.99-1.50; I2=21.89%) and long-term studies (log odds ratio 1.33, 95% CI 1.08-1.65; I2=49.43%). Intervention-related characteristics associated with higher attrition include stand-alone CA interventions without human support, not having a symptom tracker feature, no visual representation of the CA, and comparing CA interventions with waitlist controls. No participant-level factor reliably predicted attrition. CONCLUSIONS Our results indicated that approximately one-fifth of the participants will drop out from CA interventions in short-term studies. High heterogeneities made it difficult to generalize the findings. Our results suggested that future CA interventions should adopt a blended design with human support, use symptom tracking, compare CA intervention groups against active controls rather than waitlist controls, and include a visual representation of the CA to reduce the attrition rate. TRIAL REGISTRATION PROSPERO International Prospective Register of Systematic Reviews CRD42022341415; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022341415.
Collapse
Affiliation(s)
- Ahmad Ishqi Jabir
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence And Technological Enterprise, Singapore, Singapore
| | - Xiaowen Lin
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
| | - Laura Martinengo
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
| | - Gemma Sharp
- Department of Neuroscience, Monash University, Melbourne, Australia
| | - Yin-Leng Theng
- Centre for Healthy and Sustainable Cities, Wee Kim Wee School of Communication and Information, Nanyang Technological University Singapore, Singapore, Singapore
| | - Lorainne Tudor Car
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom
| |
Collapse
|
182
|
Funnell EL, Spadaro B, Martin-Key NA, Benacek J, Bahn S. Perception of Apps for Mental Health Assessment With Recommendations for Future Design: United Kingdom Semistructured Interview Study. JMIR Form Res 2024; 8:e48881. [PMID: 38393760 PMCID: PMC10924263 DOI: 10.2196/48881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 09/07/2023] [Accepted: 01/29/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Mental health care provision in the United Kingdom is overwhelmed by a high demand for services. There are high rates of under-, over-, and misdiagnosis of common mental health disorders in primary care and delays in accessing secondary care. This negatively affects patient functioning and outcomes. Digital tools may offer a time-efficient avenue for the remote assessment and triage of mental health disorders that can be integrated directly into existing care pathways to support clinicians. However, despite the potential of digital tools in the field of mental health, there remain gaps in our understanding of how the intended user base, people with lived experiences of mental health concerns, perceive these technologies. OBJECTIVE This study explores the perspectives and attitudes of individuals with lived experiences of mental health concerns on mental health apps that are designed to support self-assessment and triage. METHODS A semistructured interview approach was used to explore the perspectives of the interviewees using 5 open-ended questions. Interviews were transcribed verbatim from audio data recordings. The average interview lasted 46 minutes (rounded to the nearest min; SD 12.93 min). A thematic analysis was conducted. RESULTS Overall, 16 individuals were interviewed in this study. The average age was 42.25 (SD 15.18) years, half of the interviewees identified as women (8/16, 50%), and all were White (16/16, 100%). The thematic analysis revealed six major themes: (1) availability and accessibility, (2) quality, (3) attitudes, (4) safety, (5) impact, and (6) functionality. CONCLUSIONS Engaging in clear communication regarding data security and privacy policies, adopting a consent-driven approach to data sharing, and identifying gaps in the app marketplace to foster the inclusion of a range of mental health conditions and avoid oversaturation of apps for common mental health disorders (eg, depression and anxiety) were identified as priorities from interviewees' comments. Furthermore, reputation was identified as a driver of uptake and engagement, with endorsement from a respected source (ie, health care provider, academic institution) or direct recommendation from a trusted health care professional associated with increased interest and trust. Furthermore, there was an interest in the role that co-designed digital self-assessments could play in existing care pathways, particularly in terms of facilitating informed discussions with health care professionals during appointments and by signposting individuals to the most appropriate services. In addition, interviewees discussed the potential of mental health apps to provide waiting list support to individuals awaiting treatment by providing personalized psychoeducation, self-help tips, and sources of help. However, concerns regarding the quality of care being affected because of digital delivery have been reported; therefore, frequent monitoring of patient acceptability and care outcomes is warranted. In addition, communicating the rationale and benefits of digitizing services will likely be important for securing interest and uptake from health care service users.
Collapse
Affiliation(s)
- Erin L Funnell
- Cambridge Centre for Neuropsychiatric Research, Department of Chemical Engineering, University of Cambridge, Cambridge, United Kingdom
- Psyomics Ltd, Cambridge, United Kingdom
| | - Benedetta Spadaro
- Cambridge Centre for Neuropsychiatric Research, Department of Chemical Engineering, University of Cambridge, Cambridge, United Kingdom
| | - Nayra A Martin-Key
- Cambridge Centre for Neuropsychiatric Research, Department of Chemical Engineering, University of Cambridge, Cambridge, United Kingdom
| | - Jiri Benacek
- Cambridge Centre for Neuropsychiatric Research, Department of Chemical Engineering, University of Cambridge, Cambridge, United Kingdom
| | - Sabine Bahn
- Cambridge Centre for Neuropsychiatric Research, Department of Chemical Engineering, University of Cambridge, Cambridge, United Kingdom
- Psyomics Ltd, Cambridge, United Kingdom
| |
Collapse
|
183
|
Schmitz B, Wirtz S, Sestayo-Fernández M, Schäfer H, Douma ER, Alonso Vazquez M, González-Salvado V, Habibovic M, Gatsios D, Kop WJ, Peña-Gil C, Mooren F. Living Lab Data of Patient Needs and Expectations for eHealth-Based Cardiac Rehabilitation in Germany and Spain From the TIMELY Study: Cross-Sectional Analysis. J Med Internet Res 2024; 26:e53991. [PMID: 38386376 PMCID: PMC10921324 DOI: 10.2196/53991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 12/28/2023] [Accepted: 01/30/2024] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND The use of eHealth technology in cardiac rehabilitation (CR) is a promising approach to enhance patient outcomes since adherence to healthy lifestyles and risk factor management during phase III CR maintenance is often poorly supported. However, patients' needs and expectations have not been extensively analyzed to inform the design of such eHealth solutions. OBJECTIVE The goal of this study was to provide a detailed patient perspective on the most important functionalities to include in an eHealth solution to assist them in phase III CR maintenance. METHODS A guided survey as part of a Living Lab approach was conducted in Germany (n=49) and Spain (n=30) involving women (16/79, 20%) and men (63/79, 80%) with coronary artery disease (mean age 57 years, SD 9 years) participating in a structured center-based CR program. The survey covered patients' perceived importance of different CR components in general, current usage of technology/technical devices, and helpfulness of the potential features of eHealth in CR. Questionnaires were used to identify personality traits (psychological flexibility, optimism/pessimism, positive/negative affect), potentially predisposing patients to acceptance of an app/monitoring devices. RESULTS All the patients in this study owned a smartphone, while 30%-40% used smartwatches and fitness trackers. Patients expressed the need for an eHealth platform that is user-friendly, personalized, and easily accessible, and 71% (56/79) of the patients believed that technology could help them to maintain health goals after CR. Among the offered components, support for regular physical exercise, including updated schedules and progress documentation, was rated the highest. In addition, patients rated the availability of information on diagnosis, current medication, test results, and risk scores as (very) useful. Of note, for each item, except smoking cessation, 35%-50% of the patients indicated a high need for support to achieve their long-term health goals, suggesting the need for individualized care. No major differences were detected between Spanish and German patients (all P>.05) and only younger age (P=.03) but not sex, education level, or personality traits (all P>.05) were associated with the acceptance of eHealth components. CONCLUSIONS The patient perspectives collected in this study indicate high acceptance of personalized user-friendly eHealth platforms with remote monitoring to improve adherence to healthy lifestyles among patients with coronary artery disease during phase III CR maintenance. The identified patient needs comprise support in physical exercise, including regular updates on personalized training recommendations. Availability of diagnoses, laboratory results, and medications, as part of a mobile electronic health record were also rated as very useful. TRIAL REGISTRATION ClinicalTrials.gov NCT05461729; https://clinicaltrials.gov/study/NCT05461729.
Collapse
Affiliation(s)
- Boris Schmitz
- Department of Rehabilitation Sciences, Faculty of Health, University of Witten/Herdecke, Witten, Germany
- Center for Medical Rehabilitation, DRV Clinic Königsfeld, Ennepetal, Germany
| | - Svenja Wirtz
- Department of Rehabilitation Sciences, Faculty of Health, University of Witten/Herdecke, Witten, Germany
- Center for Medical Rehabilitation, DRV Clinic Königsfeld, Ennepetal, Germany
| | | | - Hendrik Schäfer
- Department of Rehabilitation Sciences, Faculty of Health, University of Witten/Herdecke, Witten, Germany
- Center for Medical Rehabilitation, DRV Clinic Königsfeld, Ennepetal, Germany
| | - Emma R Douma
- Center of Research on Psychological Disorders and Somatic Diseases, Tilburg University, Tilburg, Netherlands
| | - Marta Alonso Vazquez
- Health Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
| | - Violeta González-Salvado
- Cardiology and Coronary Care Department, IDIS, CIBER CV, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - Mirela Habibovic
- Center of Research on Psychological Disorders and Somatic Diseases, Tilburg University, Tilburg, Netherlands
| | | | - Willem Johan Kop
- Center of Research on Psychological Disorders and Somatic Diseases, Tilburg University, Tilburg, Netherlands
| | - Carlos Peña-Gil
- Cardiology and Coronary Care Department, IDIS, CIBER CV, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - Frank Mooren
- Department of Rehabilitation Sciences, Faculty of Health, University of Witten/Herdecke, Witten, Germany
- Center for Medical Rehabilitation, DRV Clinic Königsfeld, Ennepetal, Germany
| |
Collapse
|
184
|
Wekerle C, Gilmore AK, Self-Brown S. Editorial: Technology innovations for violence prevention, mental wellness and resilience among youth. Front Digit Health 2024; 6:1365726. [PMID: 38440197 PMCID: PMC10910084 DOI: 10.3389/fdgth.2024.1365726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 01/15/2024] [Indexed: 03/06/2024] Open
Affiliation(s)
- Christine Wekerle
- Department of Pediatrics, Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada
- Department of Psychiatry & Behavioural Neuroscience, Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada
- Optentia Research Unit, South-West University, Vanderbijlpark, South Africa
| | - Amanda K. Gilmore
- Mark Chaffin Center for Healthy Development, School of Public Health, Georgia State University, Atlanta, GA, United States
| | - Shannon Self-Brown
- Mark Chaffin Center for Healthy Development, School of Public Health, Georgia State University, Atlanta, GA, United States
| |
Collapse
|
185
|
Hovadick ACDA, Cardoso MA. Family-Based WhatsApp Intervention to Promote Healthy Eating Behaviors Among Amazonian School Children: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2024; 13:e54446. [PMID: 38373039 PMCID: PMC10912988 DOI: 10.2196/54446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 01/10/2024] [Accepted: 01/11/2024] [Indexed: 02/20/2024] Open
Abstract
BACKGROUND Stunting and micronutrient deficiencies have persistently affected children in the Brazilian Amazon for decades. However, in recent years, a notable increase in childhood overweight prevalence has been observed, particularly in the context of heightened food insecurity exacerbated by the COVID-19 pandemic. Despite the limited number of effective solutions proposed to tackle this problem, digital interventions have shown great promise worldwide in preventing obesity and promoting healthy diets. OBJECTIVE This study aims to describe the protocol of a family-based WhatsApp intervention, specifically designed to investigate the efficacy of multimedia messaging in preventing excessive weight gain and improving healthy eating practices among school-aged children in the Amazon region. METHODS This study protocol outlines a theory-driven randomized controlled trial based on the cognitive theory of multimedia learning and the social cognitive theory. A total of 240 parents or caregivers of children enrolled in the Maternal and Child Health and Nutrition Cohort Study in Acre (MINA-Brazil) will be recruited by phone and social media. The intervention group will receive persuasive multimedia messages through WhatsApp over 19 weeks, while the waitlist control group will remain in the usual care. The primary outcome is a change in children's BMI in z score. Secondary outcomes are changes in dietary intake and biochemical indicators of the children. Outcome measures will be assessed at baseline and 5 months after randomization in comparison to usual care. The analysis will use an intent-to-treat approach and will be conducted using the statistical package Stata (version 18.0), with a significance level set at P<.05. Paired and unpaired 2-tailed t tests will be applied to compare mean changes in the outcomes. RESULTS Data collection started in June 2023, and final measurements are scheduled to be completed in December 2023. The results of the main analysis are expected to be available in 2024. CONCLUSIONS This innovative multimedia message intervention holds significant potential for fostering behavioral changes among Amazonian children. TRIAL REGISTRATION Brazilian Clinical Trials Registry RBR-5zdnw6t; https://ensaiosclinicos.gov.br/rg/RBR-5zdnw6t. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/54446.
Collapse
Affiliation(s)
| | - Marly Augusto Cardoso
- Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil
- Global Health and Tropical Medicine (GHTM), Associate Laboratory in Translation and Innovation Towards Global Health (LA-REAL), Instituto de Higiene e Medicina Tropical (IHMT), Universidade NOVA de Lisboa (UNL), Lisbon, Portugal
| |
Collapse
|
186
|
Cordova D, Bauermeister JA, Warner S, Wells P, MacLeod J, Neilands TB, Mendoza Lua F, Delva J, Fessler KB, Smith V, Khreizat S, Boyer C. Efficacy of a Digital Health Preventive Intervention for Adolescents With HIV or Sexually Transmitted Infections and Substance Use Disorder: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2024; 13:e47216. [PMID: 38373025 PMCID: PMC10912993 DOI: 10.2196/47216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 12/21/2023] [Accepted: 12/24/2023] [Indexed: 02/20/2024] Open
Abstract
BACKGROUND HIV or sexually transmitted infections remain a significant public health concern in the United States, with adolescents affected disproportionately. Adolescents engage in HIV/STI risk behaviors, including drug use and condomless sex, which increase the risk for HIV/STIs. At-risk adolescents, many of whom are racial minorities, experience HIV/STI disparities. Although at-risk adolescents are disproportionately affected by HIV/STI risk behaviors and infections and although the Centers for Disease Control and Prevention recommends routine HIV/STI testing for adolescents, relatively few adolescents report having ever been tested for HIV/STI. With expected increases in health clinic visits as a result of the Affordable Care Act combined with technological advances, health clinics and mobile health (mHealth), including apps, provide innovative contexts and tools to engage at-risk adolescents in HIV/STI prevention programs. Yet, there is a dearth of efficacious mHealth interventions in health clinics to prevent and reduce both condomless sex and drug use and increase HIV/STI testing for at-risk adolescents. OBJECTIVE To address this gap in knowledge, we developed a theory-driven, culturally congruent mHealth intervention (hereon referred to as S4E [Storytelling 4 Empowerment]) that has demonstrated feasibility and acceptability in a clinical setting. The next step is to examine the preliminary efficacy of S4E on adolescent HIV/STI testing and risk behaviors. This goal will be accomplished by 2 aims: the first aim is to develop a cross-platform and universal version of S4E. The cross-platform and universal version of S4E will be compatible with both iOS and Android operating systems and multiple mobile devices, aimed at providing adolescents with ongoing access to the intervention once they leave the clinic, and the second aim is to evaluate the preliminary efficacy of S4E, relative to usual care control condition, in preventing or reducing drug use and condomless sex and increasing HIV/STI testing in a clinical sample of at-risk adolescents aged 14-21 years living in Southeast Michigan. METHODS In this study, 100 adolescents recruited from a youth-centered community health clinic will be randomized via blocked randomization with random sequences of block sizes to one of the 2 conditions: S4E mHealth intervention or usual care. Theory-driven and culturally congruent, S4E is an mHealth adaptation of face-to-face storytelling for empowerment, which is registered with the Substance Abuse and Mental Health Services Administration's National Registry of Evidence-Based Programs and Practices. RESULTS This paper describes the protocol of our study. The recruitment began on May 1, 2018. This study was registered on December 11, 2017, in ClinicalTrials.gov. All participants have been recruited. Data analysis will be complete by the end of March 2024, with study findings available by December 2024. CONCLUSIONS This study has the potential to improve public health by preventing HIV/STI and substance use disorders. TRIAL REGISTRATION ClinicalTrials.gov NCT03368456; https://clinicaltrials.gov/study/NCT03368456. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/47216.
Collapse
Affiliation(s)
- David Cordova
- School of Social Work, University of Michigan, Ann Arbor, MI, United States
| | - José A Bauermeister
- School of Nursing, University of Pennsylvania, Philadelphia, PA, United States
| | - Sydni Warner
- School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | | | - Jennifer MacLeod
- Livingston Physician Organization, Livingston, MI, United States
| | - Torsten B Neilands
- School of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Frania Mendoza Lua
- Crown Family School of Social Work, Policy, and Practice, University of Chicago, Chicago, IL, United States
| | - Jorge Delva
- School of Social Work, Boston University, Boston, MA, United States
| | | | | | - Sarah Khreizat
- School of Social Work, University of Michigan, Ann Arbor, MI, United States
| | - Cherrie Boyer
- School of Medicine, University of California San Francisco, San Francisco, CA, United States
| |
Collapse
|
187
|
Haack LM, Armstrong CC, Travis K, Aguilera A, Darrow SM. HealthySMS Text Messaging System Adjunct to Adolescent Group Cognitive Behavioral Therapy in the Context of COVID-19 (Let's Text!): Pilot Feasibility and Acceptability Study. JMIR Ment Health 2024; 11:e49317. [PMID: 38373030 PMCID: PMC10912989 DOI: 10.2196/49317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 12/19/2023] [Accepted: 01/11/2024] [Indexed: 02/20/2024] Open
Abstract
BACKGROUND The widespread occurrence and devastating impact of adolescent depression warrant health service research focused on feasible and acceptable digital health tools to supplement evidence-based intervention (EBI) efforts, particularly in the context of shelter-in-place guidelines disrupting youth socialization and service use in the wake of the COVID-19 pandemic. Given the promise of SMS text message interventions to enhance EBI engagement, our team developed the HealthySMS system as an adjunct to one of the most empirically supported interventions for adolescent depression: cognitive behavioral therapy (CBT) group services. The system sends daily SMS text messages requesting responses assessing mood, thoughts, and activities; weekly attendance reminder messages; daily tips about adherence (eg, a prompt for activity completion); and personalized responses based on participants' texts. OBJECTIVE This study aims to evaluate the feasibility and acceptability of HealthySMS in a real-world setting and explore potential mechanisms of change in EBI engagement, before evaluating the system's impact on adolescents' group CBT engagement and, ultimately, depression outcomes. METHODS Over the course of 2020, we invited all 20 adolescents receiving CBT group services for depression at an outpatient psychiatry clinic to enroll in our HealthySMS study; ultimately, 17 (85%) adolescents agreed to participate. We tracked participant initiation and engagement with the HealthySMS system as well as the content of SMS text message responses to HealthySMS. We also invited each participant to engage in a semistructured interview to gather additional qualitative inputs on the system. RESULTS All (n=17, 100%) research participants invited agreed to receive HealthySMS messages, and 94% (16/17) of the participants maintained use during the first month without opting out. We uncovered meaningful qualitative themes regarding the feasibility and acceptability of HealthySMS, as well as its potential impact on EBI engagement. CONCLUSIONS Taken together, the results of this pilot study suggest that HealthySMS adjunct to adolescent CBT group depression services is feasible and acceptable, as evidenced by high rates of HealthySMS initiation and low rates of dropout, as well as meaningful themes uncovered from participants' qualitative feedback. In addition, the findings provide evidence regarding iterative improvements to the HealthySMS system and research protocol, as well as potential mechanisms of change for enhanced EBI engagement and, ultimately, adolescent depression outcomes, which can be used in future effectiveness research.
Collapse
Affiliation(s)
- Lauren M Haack
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, United States
| | - Courtney C Armstrong
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, United States
| | - Kate Travis
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, United States
| | - Adrian Aguilera
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, United States
- School of Social Welfare, University of California Berkeley, Berkeley, CA, United States
| | - Sabrina M Darrow
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, United States
| |
Collapse
|
188
|
Zsarnóczky-Dulházi F, Lelbach Á, Racz L, Trzaskoma L, Berkes I, Sümegi T, Kopper B. [Testing an innovative approach to smartphone sensor-based technology for verification of effectiveness of home exercise]. Orv Hetil 2024; 165:265-273. [PMID: 38368572 DOI: 10.1556/650.2024.32974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 12/12/2023] [Indexed: 02/19/2024]
Abstract
Bevezetés: A világjárvány ráébresztette a társadalmat arra, hogy
adódhatnak olyan különleges helyzetek, amikor a betegek nem tudnak személyesen
találkozni egészségügyi szakembereikkel, az ellátás folyamatossága mégsem
szakadhat meg. A gyógytornaellátás során eddig is általánosan alkalmazott
eljárás volt a személyes alkalmak közötti otthoni gyakorlásra ösztönzés a
terápia sikeressége érdekében. Ám a foglalkozásokon megtanult és begyakorolt
feladatok ismétlésszáma és pontossága kérdéses az otthoni környezetben, ami
csökkentheti az eredményességet, és növelheti a sérülésveszélyt.
Célkitűzés: Kutatásunkban olyan megoldást teszteltünk,
amely megfizethető és széles körben elérhető eszközöket, okostelefont és
laptopot használ képernyőmegosztási technológia alkalmazásával.
Módszer: A 3 hétig tartó vizsgálatunkban négy csoport
(vizsgálati: fiatal, n = 50, életkor 25,6 ± 3,1 év; idősebb felnőttek, n = 50,
életkor 74,8 ± 9,1 év; kontroll: fiatal, n = 20, életkor 26,25 ± 3,6 év; idősebb
felnőttek, n = 20, életkor 70,15 ± 5,2 év) vett részt. A résztvevők feladata
guggolási és térdemelési gyakorlatok végrehajtása volt egy előre meghatározott
végtagszöghelyzetig. A vizsgálati csoport tagjai a végtagmozgások és
szöghelyzetek nyomon követésére egy – goniométeres alkalmazással a combjukra
rögzített – okostelefont és egy aktivált képernyőmegosztási funkcióval
rendelkező laptopot használtak, amely valós idejű önellenőrzést tett lehetővé.
Eredmények: A célszögtől való eltérés szignifikánsan
csökkent (a guggolás esetében a fiataloknál 7,7°-ról 1,7°-ra, az idősebbeknél
16,4°-ról 7,3°-ra; térdemelés esetén a fiataloknál 10,8°-ról 3,2°-ra, az
idősebbeknél 14,8°-ról 6,4°-ra), vagyis a gyakorlatok végrehajtása
szignifikánsan pontosabb lett a vizsgálati csoportokban.
Következtetés: Eredményeink azt mutatják, hogy amikor a
résztvevők numerikus visszajelzést kaptak a laptop képernyőjén keresztül, akkor
a gyakorlat végrehajtásának pontossága jelentősen megnőtt. Összehasonlításaink
és statisztikai elemzéseink alapján összességében kijelenthetjük, hogy olyan,
könnyen hozzáférhető eszközök és módszerek is felhasználhatók az otthoni
mozgásszervi rehabilitáció eredményességének javításához, mint az okostelefon és
a laptop. Orv Hetil. 2024; 165(7): 265–273.
Collapse
Affiliation(s)
- Fanni Zsarnóczky-Dulházi
- 1 Magyar Testnevelési és Sporttudományi Egyetem, Kineziológia Tanszék Budapest, Alkotás u. 42-48., 1123 Magyarország
| | - Ádám Lelbach
- 1 Magyar Testnevelési és Sporttudományi Egyetem, Kineziológia Tanszék Budapest, Alkotás u. 42-48., 1123 Magyarország
- 2 Semmelweis Egyetem, Általános Orvostudományi Kar, Belgyógyászati és Onkológiai Klinika, Tanszéki Csoport Budapest Magyarország
- 3 Dr. Rose Magánkórház Budapest Magyarország
| | - Levente Racz
- 1 Magyar Testnevelési és Sporttudományi Egyetem, Kineziológia Tanszék Budapest, Alkotás u. 42-48., 1123 Magyarország
| | - Lukasz Trzaskoma
- 4 Department of Theory of Sport, Faculty of Physical Education, Józef Piłsudski University of Physical Education in Warsaw Varsó Lengyelország
| | - István Berkes
- 5 Magyar Testnevelési és Sporttudományi Egyetem, Egészségtudományi és Sportorvosi Tanszék Budapest Magyarország
| | - Tekla Sümegi
- 6 Nemzeti Kézilabda Akadémia Balatonboglár Magyarország
| | - Bence Kopper
- 1 Magyar Testnevelési és Sporttudományi Egyetem, Kineziológia Tanszék Budapest, Alkotás u. 42-48., 1123 Magyarország
| |
Collapse
|
189
|
Mhando F, Nyankomo M, Hall C, Olughu K, Hlongwa M, Janson S, Idahosa LO, Conserve DF. Digital Intervention Services to Promote HIV Self-Testing and Linkage to Care Services: A Bibliometric and Content Analysis-Global Trends and Future Directions. Public Health Rev 2024; 45:1606354. [PMID: 38434540 PMCID: PMC10904570 DOI: 10.3389/phrs.2024.1606354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 01/30/2024] [Indexed: 03/05/2024] Open
Abstract
Objective: The global burden of HIV remains a critical public health challenge, particularly in sub-Saharan Africa, home to over two-thirds of individuals living with HIV. HIV self-testing (HIVST) has emerged as a promising strategy endorsed by the World Health Organization to achieve UNAIDS targets. Despite its potential, challenges persist in linking self-testers to care post a positive result. Digital health interventions, including chatbots and mobile applications, offer innovative solutions to address this gap. However, a comprehensive bibliometric analysis of the collaboration and growth in the literature at the intersection of HIVST and digital interventions is lacking. Methods: The study employs a bibliometric approach, leveraging data from the Web of Science, to analyze the characteristics, citation pattern and content of 289 articles spanning 1992-2023. The analysis involves performance assessment, scientific collaboration analysis, science mapping, and content analysis. Key bibliometric indicators, such as annual growth rate, citation impact, and authorship patterns, are explored. Collaboration patterns among countries, institutions, and authors are elucidated, and thematic mapping provides insight into the key research themes. Results: The analysis reveals a dynamic and expanding field, with an annual scientific growth rate of 12.25%. Notable contributions come from diverse sources, including North America, Europe, and Africa. High-impact journals such as JMIR mHealth and uHealth play a crucial role in disseminating research findings. African authors, including Lebelonyane R, Ford N, and Lockman S, feature prominently, reflecting a positive trend in diverse authorship. Co-citation analysis highlights influential manuscripts, with systematic reviews dominating the top-cited articles. Collaboration analysis underscores strategic partnerships globally, particularly involving the United States, Australia, South Africa, and the United Kingdom. Conclusion: This bibliometrics analysis provides a comprehensive overview of the digital health landscape in HIVST and linkage to care. It identifies key contributors, high-impact journals, and collaborative networks. The thematic map reveals nuanced research domains, including alcohol dependence, men's health, outcomes, and user acceptance. The findings offer insights for researchers, policymakers, and practitioners, guiding future directions in the evolving intersection of HIVST and digital health interventions.
Collapse
Affiliation(s)
- Frank Mhando
- Johannesburg Business School, University of Johannesburg, Johannesburg, South Africa
- Ifakara Health Institute, Bagamoyo Research and Training Centre, Bagamoyo, Tanzania
| | - Marwa Nyankomo
- Johannesburg Business School, University of Johannesburg, Johannesburg, South Africa
| | - Christa Hall
- Milken Institute School of Public Health, The George Washington University, Washington, DC, United States
| | - Kelia Olughu
- Milken Institute School of Public Health, The George Washington University, Washington, DC, United States
| | - Mbuzeleni Hlongwa
- School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
- Public Health, Societies and Belonging, Human Sciences Research Council, Pretoria, South Africa
| | - Samuel Janson
- Milken Institute School of Public Health, The George Washington University, Washington, DC, United States
| | - Love O. Idahosa
- Department of Economics, The University of Warwick, Coventry, United Kingdom
| | - Donaldson F. Conserve
- Johannesburg Business School, University of Johannesburg, Johannesburg, South Africa
- Milken Institute School of Public Health, The George Washington University, Washington, DC, United States
| |
Collapse
|
190
|
Müller R, Klemmt M, Koch R, Ehni HJ, Henking T, Langmann E, Wiesing U, Ranisch R. "That's just Future Medicine" - a qualitative study on users' experiences of symptom checker apps. BMC Med Ethics 2024; 25:17. [PMID: 38365749 PMCID: PMC10874001 DOI: 10.1186/s12910-024-01011-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 02/06/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND Symptom checker apps (SCAs) are mobile or online applications for lay people that usually have two main functions: symptom analysis and recommendations. SCAs ask users questions about their symptoms via a chatbot, give a list with possible causes, and provide a recommendation, such as seeing a physician. However, it is unclear whether the actual performance of a SCA corresponds to the users' experiences. This qualitative study investigates the subjective perspectives of SCA users to close the empirical gap identified in the literature and answers the following main research question: How do individuals (healthy users and patients) experience the usage of SCA, including their attitudes, expectations, motivations, and concerns regarding their SCA use? METHODS A qualitative interview study was chosen to clarify the relatively unknown experience of SCA use. Semi-structured qualitative interviews with SCA users were carried out by two researchers in tandem via video call. Qualitative content analysis was selected as methodology for the data analysis. RESULTS Fifteen interviews with SCA users were conducted and seven main categories identified: (1) Attitudes towards findings and recommendations, (2) Communication, (3) Contact with physicians, (4) Expectations (prior to use), (5) Motivations, (6) Risks, and (7) SCA-use for others. CONCLUSIONS The aspects identified in the analysis emphasise the specific perspective of SCA users and, at the same time, the immense scope of different experiences. Moreover, the study reveals ethical issues, such as relational aspects, that are often overlooked in debates on mHealth. Both empirical and ethical research is more needed, as the awareness of the subjective experience of those affected is an essential component in the responsible development and implementation of health apps such as SCA. TRIAL REGISTRATION German Clinical Trials Register (DRKS): DRKS00022465. 07/08/2020.
Collapse
Affiliation(s)
- Regina Müller
- Institute of Philosophy, University Bremen, Bremen, Germany.
| | - Malte Klemmt
- Institute of General Practice and Palliative Care, Hannover Medical School, Hannover, Germany
| | - Roland Koch
- Institute of General Practice and Interprofessional Care, University Hospital Tübingen, Tübingen, Germany
| | - Hans-Jörg Ehni
- Institute of Ethics and History of Medicine, University Tübingen, Tübingen, Germany
| | - Tanja Henking
- Institute of Applied Social Science, University of Applied Science Würzburg- Schweinfurt, Würzburg, Germany
| | - Elisabeth Langmann
- Institute of Ethics and History of Medicine, University Tübingen, Tübingen, Germany
| | - Urban Wiesing
- Institute of Ethics and History of Medicine, University Tübingen, Tübingen, Germany
| | - Robert Ranisch
- Faculty of Health Science Brandenburg, University of Potsdam, Potsdam, Germany
| |
Collapse
|
191
|
Williams H, Steinberg S, Leon K, Vingum R, Hu M, Berzin R, Hagg H, Hanaway P. Predictive Criterion Validity of the Parsley Symptom Index Against the Patient-Reported Outcomes Measurement Information System-10 in a Chronic Disease Cohort: Retrospective Cohort Study. JMIR Form Res 2024; 8:e53316. [PMID: 38363587 PMCID: PMC10907938 DOI: 10.2196/53316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 01/11/2024] [Accepted: 01/14/2024] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND Approximately 60% of US adults live with chronic disease, imposing a significant burden on patients and the health care system. With the rise of telehealth, patient-reported outcomes measures (PROMs) have emerged as pivotal tools for managing chronic disease. While numerous PROMs exist, few have been designed explicitly for telehealth settings. The Parsley Symptom Index (PSI) is an electronic patient-reported outcome measure (ePROM) developed specifically for telehealth environments. OBJECTIVE Our aim is to determine whether the PSI predicts changes in the established Patient-Reported Outcomes Measurement Information System-10 (PROMIS-10) Global Health, a 10-question short form. METHODS We conducted a retrospective cohort study using data from 367 unique patients, amassing 1170 observations between August 30, 2017, and January 30, 2023. Patients completed the PSI and the PROMIS-10 multiple times throughout the study period. Using univariate regression models, we assess the predictive criterion validity of the PSI against PROMIS-10 scores. RESULTS This study revealed significant relationships between the PSI and PROMIS-10 physical and mental health scores through comprehensive univariate analyses, thus establishing support for the criterion validity of the PSI. These analyses highlighted the PSI's potential as an insightful tool for understanding and predicting both mental and physical health dimensions. CONCLUSIONS Our findings emphasize the importance of the PSI in capturing the nuanced interactions between symptomatology and health outcomes. These insights reinforce the value of the PSI in clinical contexts and support its potential as a versatile tool in both research and practice.
Collapse
Affiliation(s)
- Hants Williams
- Applied Health Informatics, School of Health Professions, Stony Brook University, Stony Brook, NY, United States
| | | | | | - Ryan Vingum
- Untold Content, Cincinnati, OH, United States
| | - Mengyao Hu
- Applied Health Informatics, School of Health Professions, Stony Brook University, Stony Brook, NY, United States
| | | | | | | |
Collapse
|
192
|
Peterson NE, Thomas M, Hunsaker S, Stewart T, Collett CJ. mHealth Gratitude Exercise Mindfulness App for Resiliency Among Neonatal Intensive Care Unit Staff: Three-Arm Pretest-Posttest Interventional Study. JMIR Nurs 2024; 7:e54561. [PMID: 38363595 PMCID: PMC10907946 DOI: 10.2196/54561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 01/20/2024] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND Health care is highly complex and can be both emotionally and physically challenging. This can lead health care workers to develop compassion fatigue and burnout (BO), which can negatively affect their well-being and patient care. Higher levels of resilience can potentially prevent compassion fatigue and BO. Strategies that enhance resilience include gratitude, exercise, and mindfulness. OBJECTIVE The purpose of this study was to determine if a 3-week daily resiliency practice, prompted via a gratitude, exercise, and mindfulness smartphone app, impacted the professional quality of life, physical activity, and happiness level of health care workers in a newborn intensive care unit setting. METHODS In total, 65 participants from a level III newborn intensive care unit at a regional hospital in the western United States completed this study. The Professional Quality of Life Scale, Physical Activity Vital Sign, and Subjective Happiness Score instruments were used to evaluate the effects of the mobile health (mHealth) intervention. Further, 2-tailed dependent paired t tests were used to evaluate participant pre- and postintervention instrument scores. Multiple imputation was used to predict scores of participants who practiced an intervention but did not complete the 3 instruments post intervention. RESULTS Dependent t tests using the original data showed that participants, as a whole, significantly improved in BO (t35=2.30, P=.03), secondary trauma stress (STS; t35=2.11, P=.04), and happiness (t35=-3.72, P<.001) scores. Compassion satisfaction (CS; t35=-1.94, P=.06) and exercise (t35=-1.71, P=.10) were trending toward, but did not reach, significance. Using the original data, only the gratitude intervention group experienced significant improvements (CS, BO, and happiness), likely due to the higher number of participants in this group. Analysis using imputed data showed that participants, as a whole, had significant improvements in all areas: CS (t64=-4.08, P<.001), BO (t64=3.39, P=.001), STS (t64=4.08, P<.001), exercise (t64=-3.19, P=.002), and happiness (t64=-3.99, P<.001). Looking at the intervention groups separately using imputed data, the gratitude group had significant improvements in CS, BO, STS, and happiness; the exercise group had significant improvements in STS and exercise; and the mindfulness group had significant improvements in CS and happiness. CONCLUSIONS Phone app delivery of resilience-enhancing interventions is a potentially effective intervention model for health care workers. Potential barriers to mHealth strategies are the technical issues that can occur with this type of intervention. Additional longitudinal and experimental studies with larger sample sizes need to be completed to better evaluate this modality.
Collapse
Affiliation(s)
- Neil E Peterson
- College of Nursing, Brigham Young University, Provo, UT, United States
| | - Michael Thomas
- College of Nursing, Brigham Young University, Provo, UT, United States
| | - Stacie Hunsaker
- College of Nursing, Brigham Young University, Provo, UT, United States
| | | | - Claire J Collett
- College of Nursing, Brigham Young University, Provo, UT, United States
| |
Collapse
|
193
|
Lyzwinski L, Elgendi M, Menon C. Innovative Approaches to Menstruation and Fertility Tracking Using Wearable Reproductive Health Technology: Systematic Review. J Med Internet Res 2024; 26:e45139. [PMID: 38358798 PMCID: PMC10905339 DOI: 10.2196/45139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 08/02/2023] [Accepted: 10/27/2023] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Emerging digital health technology has moved into the reproductive health market for female individuals. In the past, mobile health apps have been used to monitor the menstrual cycle using manual entry. New technological trends involve the use of wearable devices to track fertility by assessing physiological changes such as temperature, heart rate, and respiratory rate. OBJECTIVE The primary aims of this study are to review the types of wearables that have been developed and evaluated for menstrual cycle tracking and to examine whether they may detect changes in the menstrual cycle in female individuals. Another aim is to review whether these devices are effective for tracking various stages in the menstrual cycle including ovulation and menstruation. Finally, the secondary aim is to assess whether the studies have validated their findings by reporting accuracy and sensitivity. METHODS A review of PubMed or MEDLINE was undertaken to evaluate wearable devices for their effectiveness in predicting fertility and differentiating between the different stages of the menstrual cycle. RESULTS Fertility cycle-tracking wearables include devices that can be worn on the wrists, on the fingers, intravaginally, and inside the ear. Wearable devices hold promise for predicting different stages of the menstrual cycle including the fertile window and may be used by female individuals as part of their reproductive health. Most devices had high accuracy for detecting fertility and were able to differentiate between the luteal phase (early and late), fertile window, and menstruation by assessing changes in heart rate, heart rate variability, temperature, and respiratory rate. CONCLUSIONS More research is needed to evaluate consumer perspectives on reproductive technology for monitoring fertility, and ethical issues around the privacy of digital data need to be addressed. Additionally, there is also a need for more studies to validate and confirm this research, given its scarcity, especially in relation to changes in respiratory rate as a proxy for reproductive cycle staging.
Collapse
Affiliation(s)
- Lynnette Lyzwinski
- Menrva Research Group, School of Mechatronics Systems Engineering and Engineering Science, Simon Fraser University, Vancouver, BC, Canada
| | - Mohamed Elgendi
- Biomedical and Mobile Health Technology Laboratory, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Carlo Menon
- Menrva Research Group, School of Mechatronics Systems Engineering and Engineering Science, Simon Fraser University, Vancouver, BC, Canada
- Biomedical and Mobile Health Technology Laboratory, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| |
Collapse
|
194
|
Jahan F, Parvez SM, Rahman M, Billah SM, Yeasmin F, Jahir T, Hasan R, Darmstadt GL, Arifeen SE, Hoque MM, Shahidullah M, Islam MS, Ashrafee S, Foote EM. Acceptability and operational feasibility of community health worker-led home phototherapy treatment for neonatal hyperbilirubinemia in rural Bangladesh. BMC Pediatr 2024; 24:123. [PMID: 38360716 PMCID: PMC10868082 DOI: 10.1186/s12887-024-04584-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 01/22/2024] [Indexed: 02/17/2024] Open
Abstract
There is an unmet need for phototherapy treatment in low- and middle-income countries (LMICs) to prevent disability and death of newborns with neonatal hyperbilirubinemia. Home phototherapy deployed by community health workers (CHWs) in LMICs may help increase access to essential newborn postnatal care in a more acceptable way for families and lead to an increase in indicated treatment rates for newborns with hyperbilirubinemia. We aimed to investigate the operational feasibility and acceptability of a CHW-led home phototherapy intervention in a rural sub-district of Bangladesh for families and CHWs where home delivery was common and a treatment facility for neonatal hyperbilirubinemia was often more than two hours from households. We enrolled 23 newborns who were ≥ 2 kg in weight and ≥ 35 weeks gestational age, without clinical danger signs, and met the American Academy of Pediatric treatment criteria for phototherapy for hyperbilirubinemia. We employed a mixed-method investigation to evaluate the feasibility and acceptability of home phototherapy through surveys, in-depth interviews and focus group discussions with CHWs, mothers, and grandparents. Mothers and family members found home phototherapy worked well, saved them money, and was convenient and easy to operate. CHWs found it feasible to deploy home phototherapy and identified hands-on training, mHealth job aids, a manageable workload, and prenatal education as facilitating factors for implementation. Feasibility and acceptability concerns were limited amongst parents and included: a lack of confidence in CHWs' skills, fear of putting newborn infants in a phototherapy device, and unreliable home power supply. CHW-led home phototherapy was acceptable to families and CHWs in rural Bangladesh. Further investigation should be done to determine the impact of home phototherapy on treatment rates and on preventing morbidity associated with neonatal hyperbilirubinemia. Clinical Trial (CT) registration ID: NCT03933423, full protocol can be accessed at https://doi.org/10.1186/s13102-024-00824-6 . Name of the trial registry: clinicaltrials.gov. Clinical Trial (CT) registration Date: 01/05/2019.
Collapse
Affiliation(s)
- Farjana Jahan
- Environmental Health and WASH, Health System and Population Studies Division, International Centre for Diarrhoeal Diseases Research, Bangladesh (icddr,b), Dhaka, 1212, Bangladesh.
- Environmental Interventions Unit, Infectious Disease Division, icddr,b, 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh.
| | - Sarker Masud Parvez
- Environmental Health and WASH, Health System and Population Studies Division, International Centre for Diarrhoeal Diseases Research, Bangladesh (icddr,b), Dhaka, 1212, Bangladesh
- Children's Health and Environment Program, Child Health Research Centre, The University of Queensland, South Brisbane, QLD, Australia
| | - Mahbubur Rahman
- Environmental Health and WASH, Health System and Population Studies Division, International Centre for Diarrhoeal Diseases Research, Bangladesh (icddr,b), Dhaka, 1212, Bangladesh
| | - Sk Masum Billah
- Maternal and Child Health Division, International Centre for Diarrhoeal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh
- Faculty of Medicine and Health, School of Public Health, University of Sydney, Sydney, Australia
| | - Farzana Yeasmin
- Environmental Health and WASH, Health System and Population Studies Division, International Centre for Diarrhoeal Diseases Research, Bangladesh (icddr,b), Dhaka, 1212, Bangladesh
| | - Tania Jahir
- College of Medicine, Nursing & Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - Rezaul Hasan
- Environmental Health and WASH, Health System and Population Studies Division, International Centre for Diarrhoeal Diseases Research, Bangladesh (icddr,b), Dhaka, 1212, Bangladesh
| | - Gary L Darmstadt
- Prematurity Research Center, Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA
| | - Shams El Arifeen
- Maternal and Child Health Division, International Centre for Diarrhoeal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Md Mahbubul Hoque
- Department of Neonatology, Bangladesh, Children Hospital & Institute, Dhaka, Bangladesh
| | | | - Muhammad Shariful Islam
- National Newborn Health Program (NNHP) and Integrated Management of Childhood Illness (IMCI), Directorate General of Health Services, Dhaka, Bangladesh
| | - Sabina Ashrafee
- National Newborn Health Program (NNHP) and Integrated Management of Childhood Illness (IMCI), Directorate General of Health Services, Dhaka, Bangladesh
| | - Eric M Foote
- Prematurity Research Center, Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA
| |
Collapse
|
195
|
Lund-Jacobsen T, Schwarz P, Martino G, Pappot H, Piil K. Development of an App for Symptom Management in Women With Breast Cancer Receiving Maintenance Aromatase Inhibitors: Protocol for a Mixed Methods Feasibility Study. JMIR Res Protoc 2024; 13:e49549. [PMID: 38358787 PMCID: PMC10905362 DOI: 10.2196/49549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 12/06/2023] [Accepted: 12/11/2023] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Patients with postmenopausal nonmetastatic estrogen receptor-positive breast cancer often experience a reduced quality of life after primary treatment. The disease and treatment trajectory consists of surgery followed by chemotherapy or radiation therapy. Upon this, maintenance hormone therapy with an aromatase inhibitor can result in several physical and psychosocial symptoms. Optimal symptom control during maintenance therapy is central to maintaining the patient's quality of life. OBJECTIVE This study aims to (1) develop an electronic symptom management tool for patients with postmenopausal early breast cancer receiving maintenance aromatase inhibitors with an endocrine aspect and (2) assess the feasibility, acceptability, and usability of the pilot version of the Bone@BC app. Furthermore, longitudinally, symptom prevalence and quality of life for patients with postmenopausal nonmetastatic estrogen receptor-positive breast cancer will be explored. METHODS This study follows a multistage research plan. In stage 1, a systematic literature review to establish an overview of aromatase inhibitor-related symptoms reported by postmenopausal women with nonmetastatic estrogen receptor-positive breast cancer will be completed. In stage 2, a comprehensive overview of symptoms related to aromatase inhibitors (letrozole, exemestane, and anastrozole) will be performed (eg, by reviewing medical leaflets and guidelines). In stage 3, an electronic app with a user-friendly Patient Concern Inventory list to comprise symptoms and concerns will be developed. Last, in stage 4, a convergent mixed methods feasibility study of the pilot version of the Bone@BC app will be conducted. A total of 45 patients with postmenopausal nonmetastatic estrogen receptor-positive breast cancer will use the app daily for symptom identification and respond to 6 serial patient-reported outcome measurements for 12 weeks. Finally, semistructured interviews will be performed. The primary outcome includes consent rate, attrition rate, retention rates, technical issues, and adherence, assessed using preestablished criteria on feasibility and a mixed methods approach for exploring acceptability. A patient advisory board consisting of 5 women with breast cancer is recruited to include their perspectives and experiences in the planning, organization, implementation, and dissemination of the research throughout the project. RESULTS At the time of submitting this paper (January 2024), a total of 23 patients have been included in the stage 2 medical audit over the recruitment period of 3 months (November 2022 to February 2023), and 19 patients have been enrolled in stage 2, the semistructured patient interviews. CONCLUSIONS This protocol describes a study investigating the feasibility, acceptability, and usability of the symptom management tool Bone@BC developed for patients with breast cancer with an endocrine aspect. TRIAL REGISTRATION ClinicalTrails.gov NCT05367830; https://clinicaltrials.gov/ct2/show/NCT05367830. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/49549.
Collapse
Affiliation(s)
- Trine Lund-Jacobsen
- Department of Endocrinology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Peter Schwarz
- Department of Endocrinology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Gabriella Martino
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Helle Pappot
- Department of Oncology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Karin Piil
- Department of Oncology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| |
Collapse
|
196
|
Yordanov S, Akhter K, Quan Teh J, Naushahi J, Jalloh I. Measurement of Head Circumference Using a Smartphone: Feasibility Cohort Study. JMIR Form Res 2024; 8:e54194. [PMID: 38354022 PMCID: PMC10902771 DOI: 10.2196/54194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 12/23/2023] [Accepted: 01/14/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Accurate head circumference (HC) measurement is essential when assessing neonates and infants. Tape measure HC measurements are prone to errors, particularly when performed by parents/guardians, due to individual differences in head shape, hair style and texture, subject cooperation, and examiner techniques, including tape measure placement and tautness. There is, therefore, the need for a more reliable method. OBJECTIVE The primary objective of this study was to evaluate the validity, reliability, and consistency of HC app measurement compared to the current standard of practice, serving as a proof-of-concept for use by health care professionals. METHODS We recruited infants attending the neurosurgery clinic, and parents/guardians were approached and consented to participate in the study. Along with the standard head circumference measurement, measurements were taken with the head circumference app (HC app) developed in-house, and we also collected baseline medical history and characteristics. For the statistical analysis, we used RStudio (version 4.1.1). In summary, we analyzed covariance and intraclass correlation coefficient (ICC) to compare the measurement's within-rater and interrater reliability. The F test was used to analyze the variance between measurements and the Bland-Altman agreement, t test, and correlation coefficients were used to compare the tape measurement to the measures taken by the HC app. We also used nonvalidated questionnaires to explore parental or guardians' experiences, assess their views on app utility, and collect feedback. RESULTS The total number of recruited patients was 37. Comparison between the app measurements and the measurements with a tape measure showed poor reliability (ICC=0.177) and wide within-app variations (ICC=0.341). The agreement between the measurements done by parents/guardians and the tape measurements done by the researcher was good (ICC=0.901). Parental/guardian feedback was overall very positive, with most of the parents/guardians reporting that the app was easy to use (n=31, 84%) and that they are happy to use the app in an unsupervised setting, provided that they are assured of the measurement quality. CONCLUSIONS We developed this project as a proof-of-concept study, and as such, the app has shown great potential to be used both in a clinical setting and by parents/guardians in their own homes.
Collapse
Affiliation(s)
- Stefan Yordanov
- Academic Division of Neurosurgery, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, University of Cambridge, Cambridge, United Kingdom
| | - Kalsoom Akhter
- Academic Division of Neurosurgery, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, University of Cambridge, Cambridge, United Kingdom
| | - Jye Quan Teh
- Academic Division of Neurosurgery, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, University of Cambridge, Cambridge, United Kingdom
| | - Jawad Naushahi
- Academic Division of Neurosurgery, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, University of Cambridge, Cambridge, United Kingdom
| | - Ibrahim Jalloh
- Academic Division of Neurosurgery, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, University of Cambridge, Cambridge, United Kingdom
| |
Collapse
|
197
|
Bickmann P, Froböse I, Grieben C. An mHealth Application in German Health Care System: Importance of User Participation in the Development Process. J Med Syst 2024; 48:20. [PMID: 38353872 PMCID: PMC10866790 DOI: 10.1007/s10916-024-02042-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 02/05/2024] [Indexed: 02/16/2024]
Abstract
This paper addresses the challenges and solutions in developing a holistic prevention mobile health application (mHealth app) for Germany's healthcare sector. Despite Germany's lag in healthcare digitalization, the app aims to enhance primary prevention in physical activity, nutrition, and stress management. A significant focus is on user participation and usability to counter the prevalent issue of user attrition in mHealth applications, as described by Eysenbach's 'law of attrition'. The development process, conducted in a scientific and university context, faces constraints like limited budgets and external service providers. The study firstly presents the structure and functionality of the app for people with statutory health insurance in Germany and secondly the implementation of user participation through a usability study. User participation is executed via usability tests, particularly the think-aloud method, where users verbalize their thoughts while using the app. This approach has proven effective in identifying and resolving usability issues, although some user feedback could not be implemented due to cost-benefit considerations. The implementation of this study into the development process was able to show that user participation, facilitated by methods like think-aloud, is vital for developing mHealth apps. Especially in health prevention, where long-term engagement is a challenge. The findings highlight the importance of allocating time and resources for user participation in the development of mHealth applications.
Collapse
Affiliation(s)
- Peter Bickmann
- Institute of Movement Therapy, German Sport University Cologne, Cologne, Germany.
| | - Ingo Froböse
- Institute of Movement Therapy, German Sport University Cologne, Cologne, Germany
| | | |
Collapse
|
198
|
Wüllner S, Hermenau K, Krutkova M, Petras IK, Hecker T, Siniatchkin M. Mobile applications in adolescent psychotherapy during the COVID-19 pandemic: a systematic review. Front Public Health 2024; 12:1345808. [PMID: 38420028 PMCID: PMC10899334 DOI: 10.3389/fpubh.2024.1345808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 01/31/2024] [Indexed: 03/02/2024] Open
Abstract
Background To bridge the gap in adolescent psychotherapy created by the increasing need for mental health interventions and the limited possibilities of in-person treatment during the pandemic, many health care providers opted to offer online mental health care programs. As a result, the number of mental health apps available in app stores experienced a sharp increase during the COVID-19 pandemic. Objective The aim of the current review is to provide an overview of feasibility and effectiveness studies testing mobile applications in adolescent psychotherapy during the peak phase of the COVID-19 pandemic. Methods We conducted a literature search in Pubmed, PsychInfo, Google Scholar, OpenSIGLE and OpenGREY for papers published from June 2020 to June 2023. Studies were included if they evaluated app-based interventions intended for psychotherapeutic treatment and targeted adolescents between 12 and 27 years of age with symptoms of psychological disorders. The quality of each study was assessed using the Systematic Assessment of Quality in Observational Research (SAQOR). Effectiveness outcomes were analyzed by vote counting and calculating a binomial probability test. Results The search yielded 31 relevant studies that examined 27 different apps with a total of 1,578 adolescent participants. Nine articles were primary effectiveness studies and 22 focused on feasibility measures as primary outcome. There was evidence that mental health apps influenced adolescents' psychotherapy, with 83% of the studies with effectiveness outcomes favoring the intervention (p = 0.002). Sixty-one percent of the included studies were rated at low or very low quality. Conclusions The pandemic has given apps a firm and important role in healthcare that will probably continue to expand in the future. To ensure that mental health apps are truly effective and beneficial for adolescents' psychotherapy, we need a standardized measurement of quality features of mental health apps and higher quality app evaluation studies. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=406455, PROSPERO International Prospective Register of Systematic Reviews [CRD42023406455].
Collapse
Affiliation(s)
- Sarah Wüllner
- University Clinic of Child and Adolescent Psychiatry and Psychotherapy, Protestant Hospital Bethel, Bielefeld University, Medical School East Westphalia, Bielefeld, Germany
| | - Katharin Hermenau
- University Clinic of Child and Adolescent Psychiatry and Psychotherapy, Protestant Hospital Bethel, Bielefeld University, Medical School East Westphalia, Bielefeld, Germany
| | - Mariya Krutkova
- University Clinic of Child and Adolescent Psychiatry and Psychotherapy, Protestant Hospital Bethel, Bielefeld University, Medical School East Westphalia, Bielefeld, Germany
| | - Ira-Katharina Petras
- University Clinic of Child and Adolescent Psychiatry and Psychotherapy, Protestant Hospital Bethel, Bielefeld University, Medical School East Westphalia, Bielefeld, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics of Children and Adolescents, University Hospital Rheinisch-Westfälische Technische Hochschule Aachen, Aachen, Germany
| | - Tobias Hecker
- Institute for Interdisciplinary Conflict and Violence Research, Bielefeld University, Bielefeld, Germany
- Department of Psychology, Faculty of Psychology and Sports Science, Bielefeld University, Bielefeld, Germany
| | - Michael Siniatchkin
- University Clinic of Child and Adolescent Psychiatry and Psychotherapy, Protestant Hospital Bethel, Bielefeld University, Medical School East Westphalia, Bielefeld, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics of Children and Adolescents, University Hospital Rheinisch-Westfälische Technische Hochschule Aachen, Aachen, Germany
| |
Collapse
|
199
|
Locke S, Osborne J. Determining the Right Levels of Health Coaching and Heart Rate Variability Biofeedback in a Workplace Behavior Change Intervention: Multiphase Optimization Strategy Preparation Study. JMIR Form Res 2024; 8:e47181. [PMID: 38354036 PMCID: PMC10902773 DOI: 10.2196/47181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 12/16/2023] [Accepted: 01/04/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Work-related stress is associated with poor job performance and negative health outcomes. Changing health behaviors through corporate wellness programs can improve physical and mental health and help employees manage stress. This project sought to pilot the potential addition of brief coaching and biofeedback to an 8-week web-based self-help program to improve employee stress using the multiphase optimization strategy. OBJECTIVE This study aims to determine which candidate components will be tested in a later optimization phase and at what dose they will be tested, examine the feasibility and acceptability of delivering the different components, investigate whether the outcomes can be feasibly measured, and review evidence to build a conceptual model before the optimization phase. METHODS The study was positioned within the preparation phase of the multiphase optimization strategy. It is a 2×2×2×2 design with 4 components: 2 types of health coaching and 2 types of biofeedback. All components were tested by turning them on or off. A total of 16 adult office workers (mean age 40, SD 14.3 years; n=15 women) completed an 8-week self-paced web-based stress management and health behavior change program and were randomly assigned to 1 of the 16 conditions, created from a combination of the 4 candidate components. Assessments included web analytics, surveys, and interviews regarding program recommendations, likes, and dislikes. RESULTS Findings from the interviews provided suggestions to improve the intervention (eg, separating wellness from stress content) and trial conduct (eg, streamlining the onboarding process). On average, participants logged into the wellness program 83 times (range 36-291), with 75% (12/16) participant retention and 67% (8/12) survey completion. There were no reported problems with coaching or obtaining data from interviews or apps. The interview findings suggested potential mediators to include and assess in a future conceptual model. CONCLUSIONS The results provided areas to improve the intervention content and trial methods. Instead of progressing to the next scheduled large-scale optimization phase, our plan to iterate through a second preparation phase after making changes to the protocol, apps, and corporate coaching partner.
Collapse
Affiliation(s)
- Sean Locke
- Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, St Catharines, ON, Canada
| | - Jenna Osborne
- Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, St Catharines, ON, Canada
| |
Collapse
|
200
|
Gagnon J, Probst S, Chartrand J, Lalonde M. mHealth App Usability Questionnaire for Stand-Alone mHealth Apps Used by Health Care Providers: Canadian French Translation, Cross-Cultural Adaptation, and Validation (Part 1). JMIR Form Res 2024; 8:e50839. [PMID: 38349710 PMCID: PMC10900083 DOI: 10.2196/50839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 01/17/2024] [Accepted: 01/19/2024] [Indexed: 03/01/2024] Open
Abstract
BACKGROUND An increasing number of health care professionals are using mobile apps. The mHealth App Usability Questionnaire (MAUQ) was designed to evaluate the usability of mobile health apps by patients and providers. However, this questionnaire is not available in French. OBJECTIVE This study aims to translate (from English to Canadian French), cross-culturally adapt, and initiate the validation of the original version of MAUQ for stand-alone mobile health apps used by French-speaking health care providers. METHODS A cross-cultural research study using a well-established method was conducted to translate MAUQ to Canadian French by certified translators and subsequently review it with a translation committee. It was then back translated to English. The back translations were compared with the original by the members of the committee to reach consensus regarding the prefinal version. A pilot test of the prefinal version was conducted with a sample of 49 potential users and 10 experts for content validation. RESULTS The statements are considered clear, with interrater agreement of 99.14% among potential users and 90% among experts. Of 21 statements, 5 (24%) did not exceed the 80% interrater agreement of the experts regarding clarity. Following the revisions, interrater agreement exceeded 80%. The content validity index of the items varied from 0.90 to 1, and the overall content validity index was 0.981. Individual Fleiss multirater κ of each item was between 0.89 and 1, showing excellent agreement and increasing confidence in the questionnaire's content validity. CONCLUSIONS This process of translation and cultural adaptation produced a new version of MAUQ that was validated for later use among the Canadian French-speaking population. An upcoming separate study will investigate the psychometric properties of the adapted questionnaire.
Collapse
Affiliation(s)
- Julie Gagnon
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
- Département des sciences de la santé, Université du Québec à Rimouski, Rimouski, QC, Canada
| | - Sebastian Probst
- Haute École Spécialisée de Suisse occidentale, University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland
- Care Directorate, University Hospital Geneva, Geneva, Switzerland
- College of Medicine Nursing and Health Sciences, University of Galway, Galway, Ireland
| | - Julie Chartrand
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - Michelle Lalonde
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
- Institut du Savoir Montfort, Montfort Hospital, Ottawa, ON, Canada
| |
Collapse
|