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Paradis S, Roussel J, Bosson JL, Kern JB. Use of Smartphone Health Apps Among Patients Aged 18 to 69 Years in Primary Care: Population-Based Cross-sectional Survey. JMIR Form Res 2022; 6:e34882. [PMID: 35708744 PMCID: PMC9247815 DOI: 10.2196/34882] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 03/09/2022] [Accepted: 04/04/2022] [Indexed: 11/15/2022] Open
Abstract
Background The World Health Organization has defined mobile health (mHealth) as the “use of mobile and wireless technologies to support the achievement of health objectives.” Smartphones currently represent one of the main media forms for mHealth democratization. Health apps can be an interesting tool for changing health behaviors. However, their use in France is still poorly documented. Objective The main aim of this study was to evaluate the frequency of use of health apps among patients consulting in the primary care setting in France. The secondary aims were to evaluate the use of health apps according to the sociodemographic and medical characteristics of patients and to determine their use. Methods A population-based cross-sectional survey was carried out between November 2017 and January 2018 in the Grenoble area of France among patients aged between 18 and 69 years who were consulting at 13 primary care physician offices. Patients were provided with anonymous paper self-questionnaires. The main criterion for participation was the use of a smartphone health app, defined for the purpose of this study as any app supporting patients in efforts to be healthy. Results The participation rate was 49.27% (739/1500; 95% CI 46.7%-51.8%). The smartphone use was estimated at 82.6% (597/723; 95% CI 79.6%-85.2%). Of 597 smartphone owners, 47.7% (283/595; CI 43.6%-51.6%) used at least one smartphone health app. Health apps identified in this study were mainly related to wellness, prevention, and fitness (66.1%), as well as medication, treatments, and follow-up care (50.0%). The main factors associated with health app use were: use of social networks (odds ratio [OR] 3.4, 95% CI 2.1-5.3), age under 30 years (OR 2.7, CI 1.4-4.9), city size between 5001 and 10,000 inhabitants (OR 1.8, CI 1.1-2.8), and city size more than 10,000 inhabitants (OR 2.1, CI 1.4-3.2). Conclusions In this survey, nearly one out of two patients reported the use of smartphone health apps, which are currently focused on wellness, prevention, and fitness, and are largely used by the younger population. Trial Registration ClinicalTrials.gov NCT03351491; https://clinicaltrials.gov/ct2/show/NCT03351491
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Affiliation(s)
- Sabrina Paradis
- Department of General Practice, University Grenoble Alpes, Grenoble, France
- Translational Innovation in Medicine and Complexity, National Institute of Health and Medical Research, La Tronche, France
| | - Jeremy Roussel
- Department of General Practice, University Grenoble Alpes, Grenoble, France
| | - Jean-Luc Bosson
- Translational Innovation in Medicine and Complexity, National Institute of Health and Medical Research, La Tronche, France
- Department of Public Health, University Grenoble Alpes, Grenoble, France
| | - Jean-Baptiste Kern
- Department of General Practice, University Grenoble Alpes, Grenoble, France
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Jacob C, Sezgin E, Sanchez-Vazquez A, Ivory C. Sociotechnical Factors Affecting Patients' Adoption of Mobile Health Tools: Systematic Literature Review and Narrative Synthesis. JMIR Mhealth Uhealth 2022; 10:e36284. [PMID: 35318189 PMCID: PMC9121221 DOI: 10.2196/36284] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 03/16/2022] [Accepted: 03/22/2022] [Indexed: 12/23/2022] Open
Abstract
Background Mobile health (mHealth) tools have emerged as a promising health care technology that may contribute to cost savings, better access to care, and enhanced clinical outcomes; however, it is important to ensure their acceptance and adoption to harness this potential. Patient adoption has been recognized as a key challenge that requires further exploration. Objective The aim of this review was to systematically investigate the literature to understand the factors affecting patients’ adoption of mHealth tools by considering sociotechnical factors (from technical, social, and health perspectives). Methods A structured search was completed following the participants, intervention, comparators, and outcomes framework. We searched the MEDLINE, PubMed, Cochrane Library, and SAGE databases for studies published between January 2011 and July 2021 in the English language, yielding 5873 results, of which 147 studies met the inclusion criteria. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and the Cochrane Handbook were followed to ensure a systematic process. Extracted data were analyzed using NVivo (QSR International), with thematic analysis and narrative synthesis of emergent themes. Results The technical factors affecting patients’ adoption of mHealth tools were categorized into six key themes, which in turn were divided into 20 subthemes: usefulness, ease of use, data-related, monetary factors, technical issues, and user experience. Health-related factors were categorized into six key themes: the disease or health condition, the care team’s role, health consciousness and literacy, health behavior, relation to other therapies, integration into patient journey, and the patients’ insurance status. Social and personal factors were divided into three key clusters: demographic factors, personal characteristics, and social and cultural aspects; these were divided into 19 subthemes, highlighting the importance of considering these factors when addressing potential barriers to mHealth adoption and how to overcome them. Conclusions This review builds on the growing body of research that investigates patients’ adoption of mHealth services and highlights the complexity of the factors affecting adoption, including personal, social, technical, organizational, and health care aspects. We recommend a more patient-centered approach by ensuring the tools’ fit into the overall patient journey and treatment plan, emphasizing inclusive design, and warranting comprehensive patient education and support. Moreover, empowering and mobilizing clinicians and care teams, addressing ethical data management issues, and focusing on health care policies may facilitate adoption.
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Affiliation(s)
- Christine Jacob
- University of Applied Sciences Northwestern Switzerland, Olten, Switzerland
| | - Emre Sezgin
- The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, United States.,NORC at the University of Chicago, Chicago, IL, United States
| | - Antonio Sanchez-Vazquez
- Innovative Management Practice Research Centre, Anglia Ruskin University, Cambridge, United Kingdom
| | - Chris Ivory
- Innovative Management Practice Research Centre, Anglia Ruskin University, Cambridge, United Kingdom
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Bostrøm K, Varsi C, Eide H, Børøsund E, Kristjansdottir ÓB, Schreurs KMG, Waxenberg LB, Weiss KE, Morrison EJ, Nordang EF, Stubhaug A, Nes LS. Engaging with EPIO, a digital pain self-management program: a qualitative study. BMC Health Serv Res 2022; 22:577. [PMID: 35488295 PMCID: PMC9052507 DOI: 10.1186/s12913-022-07963-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 04/05/2022] [Indexed: 12/23/2022] Open
Abstract
Background Chronic pain conditions entail significant personal and societal burdens and improved outreach of evidence-based pain self-management programs are needed. Digital cognitive-behavioral self-management interventions have shown promise. However, evidence is still scarce and several challenges with such interventions for chronic pain exist. Exploring patients' experiences and engagement with digital interventions may be an essential step towards developing meaningful digital self-management interventions for those living with chronic pain. Objectives This study aimed to gain insight into the experiences of people with chronic pain when engaging with EPIO, an application (app)-based cognitive-behavioral pain self-management intervention program. Methods Participants (N = 50) living with chronic pain received access to the EPIO intervention in a feasibility pilot-study for 3 months. During this time, all participants received a follow-up phone call at 2–3 weeks, and a subsample (n = 15) also participated in individual semi-structured interviews after 3 months. A qualitative design was used and thematic analysis was employed aiming to capture participants’ experiences when engaging with the EPIO intervention program. Results Findings identifying program-related experiences and engagement were organized into three main topics, each with three sub-themes: (1) Engaging with EPIO; motivation to learn, fostering joy and enthusiasm, and helpful reminders and personalization, (2) Coping with pain in everyday life; awareness, practice and using EPIO in everyday life, and (3) The value of engaging with the EPIO program; EPIO – a friend, making peace with the presence of pain, and fostering communication and social support. Conclusions This qualitative study explored participants’ experiences and engagement with EPIO, a digital self-management intervention program for people living with chronic pain. Findings identified valued aspects related to motivation for engagement, and showed how such a program may be incorporated into daily life, and encourage a sense of acceptance, social support and relatedness. The findings highlight vital components for facilitating digital program engagement and use in support of self-management for people living with chronic pain. Trial registration ClinicalTrials.gov NCT03705104. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07963-x.
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Affiliation(s)
- Katrine Bostrøm
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Cecilie Varsi
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway.,Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
| | - Hilde Eide
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway.,Faculty of Health and Social Sciences, Centre for Health and Technology, University of South-Eastern Norway, Drammen, Norway
| | - Elin Børøsund
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway
| | - Ólöf B Kristjansdottir
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway.,Norwegian National Advisory Unit On Learning and Mastery in Health, Oslo University Hospital, Oslo, Norway
| | - Karlein M G Schreurs
- Department of Psychology, Health & Technology, University of Twente, Enschede, Netherlands
| | - Lori B Waxenberg
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Karen E Weiss
- Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Eleshia J Morrison
- Department of Psychiatry and Psychology, College of Medicine and Science, Mayo Clinic, Rochester, MN, USA
| | - Elise Flakk Nordang
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway
| | - Audun Stubhaug
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway.,Regional Advisory Unit On Pain, Oslo University Hospital, Oslo, Norway
| | - Lise Solberg Nes
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway. .,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway. .,Department of Psychiatry and Psychology, College of Medicine and Science, Mayo Clinic, Rochester, MN, USA.
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Smyth S, Curtin E, Tully E, Molphy Z, Breathnach F. Smartphone applications for surveillance of Gestational Diabetes: A Scoping Review (Preprint). JMIR Diabetes 2022; 7:e38910. [DOI: 10.2196/38910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 08/28/2022] [Accepted: 08/30/2022] [Indexed: 11/13/2022] Open
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Pestana-Santos M, Pestana-Santos A, Cabral IE, Santos MR, Lomba L. Nurses’ Views on How to Best Design a Program to Prevent Adolescents’ Anxiety in the Perioperative Period. A Qualitative Study. J Perianesth Nurs 2022; 37:458-466. [DOI: 10.1016/j.jopan.2021.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 08/08/2021] [Accepted: 10/03/2021] [Indexed: 11/29/2022]
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Postel-Vinay N, Shao JD, Pinton A, Servais A, Gebara N, Amar L. Home Blood Pressure Measurement and Self-Interpretation of Blood Pressure Readings During Pregnancy: Hy-Result e-Health Prospective Study. Vasc Health Risk Manag 2022; 18:277-287. [PMID: 35449534 PMCID: PMC9017708 DOI: 10.2147/vhrm.s350478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 04/05/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction Hy-Result is a rule management system designed to help patients to be compliant with the home blood pressure measurement (HBPM) monitoring schedule and to understand their BP readings. The aim of the Hy-Result e-Health prospective study is to evaluate the practice and experience of women using the Hy-Result coaching app for self-interpretation of BP readings during and after pregnancy. Methods Participants were asked to: i) measure their BP at home; ii) use the Hy-Result app and send their PDF report to the researcher; iii) answer anonymously to 3 online independent questionnaires (Q). Results A total of 107 women accepted to measure their BP and use the app. Among them 82 (77%) performed HBPM and used successfully the system and 72 (88%) shared to the investigator their PDF report by email. Of these, 95% declared the software was “easy” or “very easy” to use; 93% believe the software helps them to monitor their BP more effectively (74% agree, 18% somewhat agree); 94% that the color code classification was “clear”; 76 (93%) affirmed that the app helped them when consulting their physician for their BP evaluation. Majority (87%) perceived the software to be reliable. Furthermore, 71 (87%) said they trust the system and 51 (62%) declared that performing HBPM and self-interpret their readings was “reassuring” whereas 6 (7%) felt that it was “a concern”. Conclusion This study shows that the majority (88%) of pregnant women performed HBPM and successfully used the Hy-Result software for self-interpretation of the BP readings. The use of the validated Hy-Result system by pregnant women may thus be recommended in common practice by healthcare professionals and patient associations.
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Affiliation(s)
- Nicolas Postel-Vinay
- Hypertension Unit, ESH Excellence Center, Hôpital Européen Georges Pompidou, APHP, Paris, France
- Hospital at Home, Fondation Santé Service, Levallois, France
- Correspondence: Nicolas Postel-Vinay, Email
| | - Jiali-Delphine Shao
- Faculté de médecine de l’Université Paris Saclay, Le Kremlin Bicêtre, France
| | - Anne Pinton
- Department of Obstetrics and Gynecology, Trousseau Hospital, APHP, Sorbonne University, Paris, France
| | - Aude Servais
- Nephrology and Transplantation Department, Necker Hospital, APHP, Paris, France
| | - Nicole Gebara
- Hypertension Unit, ESH Excellence Center, Hôpital Européen Georges Pompidou, APHP, Paris, France
| | - Laurence Amar
- Hypertension Unit, ESH Excellence Center, Hôpital Européen Georges Pompidou, APHP, Paris, France
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Alharbi NS, AlGhanmi AS, Fahlevi M. Adoption of Health Mobile Apps during the COVID-19 Lockdown: A Health Belief Model Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074179. [PMID: 35409862 PMCID: PMC8998638 DOI: 10.3390/ijerph19074179] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 03/22/2022] [Accepted: 03/29/2022] [Indexed: 01/21/2023]
Abstract
This study aimed to investigate the adoption of the Sehha, Mawid, and Tetamman mobile health applications during the COVID-19 pandemic in Saudi Arabia. The present study investigated factors influencing app use intention based on the Health Belief Model (HBM) approach. This study was conducted using a sample of 176 participants from the Riyadh and Makkah regions during the lockdown in May 2020. This study uses structural equation modeling for data collected using SmartPLS 3.3.9 (GmbH, Oststeinbek, Germany) to examine the effect of constructs on the model. The most important predictor was the perceived benefits of the mobile health apps, followed by self-efficacy. The perceived barriers and cues to action have no significant effect on behavioral intention. The perceived benefits and self-efficacy as keys can provide an overview to the government and to health organizations for taking into account the most important factors of the adoption of mobile health apps, meaning that the developer must adjust to the characteristics of the community of people that need applications that provide many benefits and have an impact.
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Affiliation(s)
- Nouf Sahal Alharbi
- Department of Health Administration, College of Business Administration, King Saud University, Riyadh 11451, Saudi Arabia;
| | - Amany Shlyan AlGhanmi
- Department of Health Informatics, College of Health Sciences, Saudi Electronic University, Jeddah 93499, Saudi Arabia;
| | - Mochammad Fahlevi
- Management Department, BINUS Online Learning, Bina Nusantara University, Jakarta 11480, Indonesia
- Correspondence:
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Feasibility and Usability of Kegel Exercise Pregnancy Training App (KEPT App) among Pregnant Women with Urinary Incontinence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063574. [PMID: 35329262 PMCID: PMC8955097 DOI: 10.3390/ijerph19063574] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/08/2022] [Accepted: 03/15/2022] [Indexed: 12/14/2022]
Abstract
Pelvic floor muscle training (PFMT) is crucial to improving urinary incontinence (UI). This study aimed to assess the Kegel Exercise Pregnancy Training (KEPT) app’s feasibility and usability. This is a subgroup analysis from a researcher-blinded, randomised controlled pilot feasibility study among pregnant women with UI. The Malay version of the mHealth App Usability Questionnaire (Interactive) evaluated the app’s usability. Ten pregnant women completed the study, with mean age (SD) of 28.9 years (3.1). The app’s feasibility was rated above average. The app was reported with usable in all domains, (1) system information arrangement (4.98/7.0), (2) usefulness (4.89/7.0) and (3) ease-of-use and satisfaction (5.03/7.0). Education level was negatively correlated with the app’s feasibility (r = −0.81, p < 0.001) and all domains of usability such as ease-of-use (r = −0.66, p = 0.01), system information (r = −0.81, p = 0.001) and usefulness (r = −0.81, p = 0.001). PFMT video was among the app features chosen to be helpful. This study demonstrates that the newly developed user-centred design KEPT app is feasible and usable. However, the future app should provide direct feedback about their exercise techniques to motivate PFMT adherence.
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Rochat J, Ehrler F, Siebert JN, Ricci A, Garretas Ruiz V, Lovis C. Usability Testing of a Patient-Centered Mobile Health App for Supporting and Guiding the Pediatric Emergency Department Patient Journey: Mixed Methods Study. JMIR Pediatr Parent 2022; 5:e25540. [PMID: 35289754 PMCID: PMC8965675 DOI: 10.2196/25540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 03/18/2021] [Accepted: 12/21/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Patient experience in emergency departments (EDs) remains often suboptimal and can be a source of stress, particularly in pediatric settings. In an attempt to support patients and their families before, during, and after their visit to a pediatric ED, a mobile health (mHealth) app was developed by a multidisciplinary team based on patient-centered care principles. OBJECTIVE This study aims to evaluate the usability (effectiveness, efficiency, and satisfaction) of a new mHealth app, InfoKids, by potential end users through usability testing. METHODS The app was assessed through an in-laboratory, video-recorded evaluation in which participants had to execute 9 goal-oriented tasks, ranging from account creation to the reception of a diagnostic sheet at the end of the emergency care episode. Effectiveness was measured based on the task completion rate, efficiency on time on task, and user satisfaction according to answers to the System Usability Scale questionnaire. Think-aloud usability sessions were also transcribed and analyzed. Usability problems were rated for their severity and categorized according to ergonomic criteria. RESULTS A total of 17 parents participated in the study. The overall completion rate was 97.4% (149/153). Overall, they reported good effectiveness, with the task successfully completed in 88.2% (135/153) of cases (95% CI 83%-93%). Each task, with the exception of the first, created difficulties for some participants but did not prevent their completion by most participants. Users reported an overall good to excellent perceived usability of the app. However, ergonomic evaluation identified 14 usability problems occurring 81 time. Among these, 50% (7/14) were serious as their severity was rated as either major or catastrophic and indicated areas of improvements for the app. Following the suggested usability improvements by participants, mitigation measures were listed to further improve the app and avoid barriers to its adoption. CONCLUSIONS Usability of the InfoKids app was evaluated as good to excellent by users. Areas of improvement were identified, and mitigation measures were proposed to inform its development toward a universal app for all ED patients visiting a digitalized institution. Its contribution could also be useful in paving the way for further research on mobile apps aimed at supporting and accompanying patients in their care episodes, as research in this area is scarce.
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Affiliation(s)
- Jessica Rochat
- Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Division of Medical Information Sciences, University Hospitals of Geneva, Geneva, Switzerland
| | - Frédéric Ehrler
- Division of Medical Information Sciences, University Hospitals of Geneva, Geneva, Switzerland
| | - Johan N Siebert
- Department of Pediatric Emergency Medicine, Geneva Children's Hospital, University Hospitals of Geneva, Geneva, Switzerland
| | - Arnaud Ricci
- Division of Medical Information Sciences, University Hospitals of Geneva, Geneva, Switzerland
| | - Victor Garretas Ruiz
- Division of Medical Information Sciences, University Hospitals of Geneva, Geneva, Switzerland
| | - Christian Lovis
- Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Division of Medical Information Sciences, University Hospitals of Geneva, Geneva, Switzerland
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Aboumatar H, Pitts S, Sharma R, Das A, Smith BM, Day J, Holzhauer K, Yang S, Bass EB, Bennett WL. Patient engagement strategies for adults with chronic conditions: an evidence map. Syst Rev 2022; 11:39. [PMID: 35248149 PMCID: PMC8898416 DOI: 10.1186/s13643-021-01873-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 12/17/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Patient and family engagement (PFE) has been defined as a partnership between patients, families, and health care providers to achieve positive health care outcomes. There is evidence that PFE is critical to improving outcomes. We sought to systematically identify and map the evidence on PFE strategies for adults with chronic conditions and identify areas needing more research. METHODS We searched PubMed, CINAHL, EMBASE, and Cochrane, January 2015 to September 2021 for systematic reviews on strategies for engaging patients with chronic conditions and their caregivers. From each review, we abstracted search dates, number and type of studies, populations, interventions, and outcomes. PFE strategies were categorized into direct patient care, health system, and community-policy level strategies. We found few systematic reviews on strategies at the health system, and none at the community-policy level. In view of this, we also searched for original studies that focused on PFE strategies at those two levels and reviewed the PFE strategies used and study findings. RESULTS We found 131 reviews of direct patient care strategies, 5 reviews of health system strategies, and no reviews of community-policy strategies. Four original studies addressed PFE at the health system or community-policy levels. Most direct patient care reviews focused on self-management support (SMS) (n = 85) and shared decision-making (SDM) (n = 43). Forty-nine reviews reported positive effects, 35 reported potential benefits, 37 reported unclear benefits, and 4 reported no benefits. Health system level strategies mainly involved patients and caregivers serving on advisory councils. PFE strategies with the strongest evidence focused on SMS particularly for patients with diabetes. Many SDM reviews reported potential benefits especially for patients with cancer. DISCUSSION Much more evidence exists on the effects of direct patient care strategies on PFE than on the effects of health system or community-policy strategies. Most reviews indicated that direct patient care strategies had positive effects or potential benefits. A limitation of this evidence map is that due to its focus on reviews, which were plentiful, it did not capture details of individual interventions. Nevertheless, this evidence map should help to focus attention on gaps that require more research in efforts to improve PFE.
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Affiliation(s)
- Hanan Aboumatar
- Department of Medicine, Division of General Internal Medicine, Johns Hopkins University School of Medicine, 750 East Pratt Street 15th Floor, Baltimore, MD, 21202, USA.
| | - Samantha Pitts
- Department of Medicine, Division of General Internal Medicine, Johns Hopkins University School of Medicine, 750 East Pratt Street 15th Floor, Baltimore, MD, 21202, USA
| | - Ritu Sharma
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Asar Das
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Brandon M Smith
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jeff Day
- Department of Art as Applied to Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Katherine Holzhauer
- Department of Medicine, Division of General Internal Medicine, Johns Hopkins University School of Medicine, 750 East Pratt Street 15th Floor, Baltimore, MD, 21202, USA
| | - Sejean Yang
- Department of Medicine, Division of General Internal Medicine, Johns Hopkins University School of Medicine, 750 East Pratt Street 15th Floor, Baltimore, MD, 21202, USA
| | - Eric B Bass
- Department of Medicine, Division of General Internal Medicine, Johns Hopkins University School of Medicine, 750 East Pratt Street 15th Floor, Baltimore, MD, 21202, USA.,Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Wendy L Bennett
- Department of Medicine, Division of General Internal Medicine, Johns Hopkins University School of Medicine, 750 East Pratt Street 15th Floor, Baltimore, MD, 21202, USA
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Kela N, Eytam E, Katz A. Supporting Management of Noncommunicable Diseases With Mobile Health (mHealth) Apps: Experimental Study. JMIR Hum Factors 2022; 9:e28697. [PMID: 35234653 PMCID: PMC8928053 DOI: 10.2196/28697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 08/02/2021] [Accepted: 10/02/2021] [Indexed: 11/21/2022] Open
Abstract
Background Noncommunicable diseases (NCDs) are the leading global health problem in this century and are the principal causes of death and health care spending worldwide. Mobile health (mHealth) apps can help manage and prevent NCDs if people are willing to use them as supportive tools. Still, many people are reluctant to adopt these technologies. Implementing new apps could result in earlier intervention for many health conditions, preventing more serious complications. Objective This research project aimed to test the factors that facilitate the adoption of mHealth apps by users with NCDs. We focused on determining, first, what user interface (UI) qualities and complexity levels appeal to users in evaluating mHealth apps. We also wanted to determine whether people prefer that the data collected by an mHealth app be analyzed using a physician or an artificial intelligence (AI) algorithm. The contribution of this work is both theoretical and practical. We examined users’ considerations when adopting mHealth apps that promote healthy lifestyles and helped them manage their NCDs. Our results can also help direct mHealth app UI designers to focus on the most appealing aspects of our findings. Methods A total of 347 respondents volunteered to rate 3 models of mHealth apps based on 16 items that measured instrumentality, aesthetics, and symbolism. Respondents rated each model after reading 1 of 2 different scenarios. In one scenario, a physician analyzed the data, whereas, in the other, the data were analyzed by an AI algorithm. These scenarios tested the degree of trust people placed in AI algorithms versus the “human touch” of a human physician regarding analyzing data collected by an mHealth app. Results As shown by the responses, the involvement of a human physician in the application had a significant effect (P<.001) on the perceived instrumentality of the simple model. The complex model with more controls was rated significantly more aesthetic when associated with a physician performing data analysis rather than an AI algorithm (P=.03). Conclusions Generally, when participants found a human touch in the mHealth app (connection to a human physician who they assumed would analyze their data), they judged the app more favorably. Simple models were evaluated more positively than complex ones, and aesthetics and symbolism were salient predictors of preference. These trends suggest that designers and developers of mHealth apps should keep the designs simple and pay special attention to aesthetics and symbolic value.
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Affiliation(s)
- Neta Kela
- Shamoon College of Engineering, Ashdod, Israel
| | | | - Adi Katz
- Shamoon College of Engineering, Ashdod, Israel
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Schomakers EM, Lidynia C, Vervier LS, Calero Valdez A, Ziefle M. Applying an Extended UTAUT2 Model to Explain User Acceptance of Lifestyle and Therapy Mobile Health Apps: Survey Study. JMIR Mhealth Uhealth 2022; 10:e27095. [PMID: 35040801 PMCID: PMC8808343 DOI: 10.2196/27095] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 04/09/2021] [Accepted: 09/24/2021] [Indexed: 02/07/2023] Open
Abstract
Background Mobile health (mHealth) care apps are a promising technology to monitor and control health individually and cost-effectively with a technology that is widely used, affordable, and ubiquitous in many people’s lives. Download statistics show that lifestyle apps are widely used by young and healthy users to improve fitness, nutrition, and more. While this is an important aspect for the prevention of future chronic diseases, the burdened health care systems worldwide may directly profit from the use of therapy apps by those patients already in need of medical treatment and monitoring. Objective We aimed to compare the factors influencing the acceptance of lifestyle and therapy apps to better understand what drives and hinders the use of mHealth apps. Methods We applied the established unified theory of acceptance and use of technology 2 (UTAUT2) technology acceptance model to evaluate mHealth apps via an online questionnaire with 707 German participants. Moreover, trust and privacy concerns were added to the model and, in a between-subject study design, the influence of these predictors on behavioral intention to use apps was compared between lifestyle and therapy apps. Results The results show that the model only weakly predicted the intention to use mHealth apps (R2=0.019). Only hedonic motivation was a significant predictor of behavioral intentions regarding both app types, as determined by path coefficients of the model (lifestyle: 0.196, P=.004; therapy: 0.344, P<.001). Habit influenced the behavioral intention to use lifestyle apps (0.272, P<.001), while social influence (0.185, P<.001) and trust (0.273, P<.001) predicted the intention to use therapy apps. A further exploratory correlation analysis of the relationship between user factors on behavioral intention was calculated. Health app familiarity showed the strongest correlation to the intention to use (r=0.469, P<.001), stressing the importance of experience. Also, age (r=–0.15, P=.004), gender (r=–0.075, P=.048), education level (r=0.088, P=.02), app familiarity (r=0.142, P=.007), digital health literacy (r=0.215, P<.001), privacy disposition (r=–0.194, P>.001), and the propensity to trust apps (r=0.191, P>.001) correlated weakly with behavioral intention to use mHealth apps. Conclusions The results indicate that, rather than by utilitarian factors like usefulness, mHealth app acceptance is influenced by emotional factors like hedonic motivation and partly by habit, social influence, and trust. Overall, the findings give evidence that for the health care context, new and extended acceptance models need to be developed with an integration of user diversity, especially individuals’ prior experience with apps and mHealth.
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Affiliation(s)
| | - Chantal Lidynia
- Human-Computer Interaction Center, RWTH Aachen University, Aachen, Germany
| | | | | | - Martina Ziefle
- Human-Computer Interaction Center, RWTH Aachen University, Aachen, Germany
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Sanchez Antelo V, Szwarc L, Paolino M, Saimovici D, Massaccesi S, Viswanath K, Arrossi S. A Counseling Mobile App to Reduce the Psychosocial Impact of Human Papillomavirus Testing: Formative Research Using a User-Centered Design Approach in a Low-Middle-Income Setting in Argentina. JMIR Form Res 2022; 6:e32610. [PMID: 35023843 PMCID: PMC8796044 DOI: 10.2196/32610] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 11/01/2021] [Accepted: 11/17/2021] [Indexed: 01/16/2023] Open
Abstract
Background Human papillomavirus (HPV) testing detects sexually transmitted infections with oncogenic types of HPV. For many HPV-positive women, this result has negative connotations. It produces anxiety, fear of cancer or death, and disease denial. Face-to-face counseling could present many difficulties in its implementation, but a counseling mobile app could be practical and may help HPV-positive women reduce the psychosocial impact of the result, improve their knowledge of HPV and cervical cancer, and increase adherence to follow-up. Objective This study aims to understand HPV-tested women’s perceptions about an app as a tool to receive information and support to reduce the emotional impact of HPV-positive results. We investigated their preferences regarding app design, content, and framing. Methods We conducted formative research based on a user-centered design approach. We carried out 29 individual online interviews with HPV-positive women aged 30 years and over and 4 focus groups (FGs) with women through a virtual platform (n=19). We shared a draft of the app's potential screens with a provisional label of the possible content, options menus, draft illustrations, and wording. This allowed us to give women understandable triggers to debate the concepts involved on each screen. The draft content and labels were developed drawing from the health belief model (HBM) and integrative behavioral model (IBM) variables and findings of mobile health literature. We used an FG guide to generate data for the information architecture (ie, how to organize contents into features). We carried out thematic analysis using constructs from the HBM and IBM to identify content preferences and turn them into app features. We used the RQDA package of R software for data processing. Results We found that participants required more information regarding the procedures they had received, what HPV-positive means, what the causes of HPV are, and its consequences on their sexuality. The women mentioned fear of the disease and stated they had concerns and misconceptions, such as believing that an HPV-positive result is a synonym for cancer. They accepted the app as a tool to obtain information and to reduce fears related to HPV-positive results. They would use a mobile app under doctor or health authority recommendation. The women did not agree with the draft organization of screens and contents. They believed the app should first offer information about HPV and then provide customized content according to the users’ needs. The app should provide information via videos with experts and testimonies of other HPV-positive women, and they suggested a medical appointment reminder feature. The app should also offer information through illustrations, or infographics, but not pictures or solely text. Conclusions Providing information that meets women’s needs and counseling could be a method to reduce fears. A mobile app seems to be an acceptable and suitable tool to help HPV-positive women.
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Affiliation(s)
- Victoria Sanchez Antelo
- Centro de Estudios de Estado y Sociedad, Consejo Nacional de Investigaciones Científicas y Técnicas, Ciudad Autónoma de Buenos Aires, Argentina
| | - Lucila Szwarc
- Centro de Estudios de Estado y Sociedad, Consejo Nacional de Investigaciones Científicas y Técnicas, Ciudad Autónoma de Buenos Aires, Argentina
| | - Melisa Paolino
- Centro de Estudios de Estado y Sociedad, Consejo Nacional de Investigaciones Científicas y Técnicas, Ciudad Autónoma de Buenos Aires, Argentina
| | - Diana Saimovici
- Centro de Estudios de Estado y Sociedad, Ciudad Autónoma de Buenos Aires, Argentina
| | - Silvia Massaccesi
- Secretaria de Salud de Ituzaingó, Instituto Provincial del Cáncer, Ministerio de Salud de la Provincia de Buenos Aires, Ituzaingo, Argentina
| | - Kasisomayajula Viswanath
- McGraw-Patterson Center for Population Sciences, Dana-Farber Cancer Institute, Boston, MA, United States.,Department of Social and Behavioral Sciences, Harvard T H Chan School of Public Health, Harvard University, Boston, MA, United States
| | - Silvina Arrossi
- Centro de Estudios de Estado y Sociedad, Consejo Nacional de Investigaciones Científicas y Técnicas, Ciudad Autónoma de Buenos Aires, Argentina
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64
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Breil B, Salewski C, Apolinário-Hagen J. Comparing the Acceptance of Mobile Hypertension Apps for Disease Management Among Patients Versus Clinical Use Among Physicians: Cross-sectional Survey. JMIR Cardio 2022; 6:e31617. [PMID: 34989683 PMCID: PMC8778565 DOI: 10.2196/31617] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 09/11/2021] [Accepted: 11/27/2021] [Indexed: 02/06/2023] Open
Abstract
Background High blood pressure or hypertension is a vastly prevalent chronic condition among adults that can, if not appropriately treated, contribute to several life-threatening secondary diseases and events, such as stroke. In addition to first-line medication, self-management in daily life is crucial for tertiary prevention and can be supported by mobile health apps, including medication reminders. However, the prescription of medical apps is a relatively novel approach. There is limited information regarding the determinants of acceptance of such mobile health (mHealth) apps among patients as potential users and physicians as impending prescribers in direct comparison. Objective The present study aims to investigate the determinants of the acceptance of health apps (in terms of intention to use) among patients for personal use and physicians for clinical use in German-speaking countries. Moreover, we assessed patients’ preferences regarding different delivery modes for self-care service (face-to-face services, apps, etc). Methods Based on an extended model of the unified theory of acceptance and use of technology (UTAUT2), we performed a web-based cross-sectional survey to explore the acceptance of mHealth apps for self-management of hypertension among patients and physicians in Germany. In addition to UTAUT2 variables, we measured self-reported self-efficacy, eHealth literacy, previous experiences with health apps, perceived threat to privacy, and protection motivation as additional determinants of mHealth acceptance. Data from 163 patients and 46 physicians were analyzed using hierarchical regression and mediation analyses. Results As expected, a significant influence of the unified theory of acceptance and use of technology (UTAUT) predictors on intentions to use hypertension apps was confirmed, especially for performance expectancy. Intention to use was moderate in patients (mean 3.5; SD 1.1; range 1-5) and physicians (mean 3.4, SD 0.9), and did not differ between both groups. Among patients, a higher degree of self-reported self-efficacy and protection motivation contributed to an increased explained variance in acceptance with R2=0.09, whereas eHealth literacy was identified as exerting a positive influence on physicians (increased R2=0.10). Furthermore, our findings indicated mediating effects of performance expectancy on the acceptance among patients but not among physicians. Conclusions In summary, this study has identified performance expectancy as the most important determinant of the acceptance of mHealth apps for self-management of hypertension among patients and physicians. Concerning patients, we also identified mediating effects of performance expectancy on the relationships between effort expectancy and social influence and the acceptance of apps. Self-efficacy and protection motivation also contributed to an increase in the explained variance in app acceptance among patients, whereas eHealth literacy was a predictor in physicians. Our findings on additional determinants of the acceptance of health apps may help tailor educational material and self-management interventions to the needs and preferences of prospective users of hypertension apps in future research.
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Affiliation(s)
- Bernhard Breil
- Faculty of Health Care, Hochschule Niederrhein, University of Applied Sciences, Krefeld, Germany
| | - Christel Salewski
- Department of Health Psychology, Faculty of Psychology, University of Hagen, Hagen, Germany
| | - Jennifer Apolinário-Hagen
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
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65
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Bryan CJ, Wastler H, Allan N, Khazem LR, Rudd MD. Just-in-Time Adaptive Interventions (JITAIs) for Suicide Prevention: Tempering Expectations. Psychiatry 2022; 85:341-346. [PMID: 36344469 DOI: 10.1080/00332747.2022.2132775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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66
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Jezrawi R, Balakumar S, Masud R, Gabizon I, Bhagirath V, Varughese J, Brown M, Trottier D, Schwalm JD, McGillion M, Alvarez E, Lokker C. Patient and physician perspectives on the use and outcome measures of mHealth apps: Exploratory survey and focus group study. Digit Health 2022; 8:20552076221102773. [PMID: 35646382 PMCID: PMC9136450 DOI: 10.1177/20552076221102773] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 05/05/2022] [Indexed: 11/16/2022] Open
Abstract
Objective Factors that physicians and patients consider when making decisions about
using or recommending health apps are not well understood. We explored these
factors to better assess how to support such decision making. Methods We conducted an exploratory cross-sectional study in Ontario using
qualitative focus groups and quantitative surveys. 133 physicians and 94
community dwelling adults completed online surveys and we held two focus
groups of nine community dwelling participants who had cardiovascular risk
factors and an interest in using mHealth apps. Quantitative survey data was
analyzed descriptively. Focus groups were audio-recorded and transcribed
verbatim prior to inductive thematic content analysis. We integrated the
results from the surveys and focus groups to understand factors that
influence physicians' and patients' selection and use of such apps. Results Physicians recommend apps to patients but the level of evidence they prefer
to use to guide selection did not align with what they were currently using.
Patients trusted recommendations and reviews from medical organizations and
healthcare professionals when selecting apps and were motivated to continue
using apps when they supported goal setting and tracking, data sharing,
decision making, and empowerment. Conclusions The findings highlight the significance of evaluating mHealth apps based on
metrics that patients and physicians value beyond usage and clinical outcome
data. Patients engage with apps that support them in confidently managing
their health. Increased training and awareness of apps and creating a more
rigorous evidence base showing the value of apps to supporting health goals
will support greater adoption and acceptance of mHealth apps.
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Affiliation(s)
- Rita Jezrawi
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Sarmini Balakumar
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Canada
| | - Rafia Masud
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Itzhak Gabizon
- Department of Cardiology, Soroka University Medical Center, University of the Negev, Beer-Sheva, Israel
| | - Vinai Bhagirath
- Department of Medicine, McMaster University, Hamilton, Canada
| | - Jobin Varughese
- Department of Family Medicine, McMaster University, Hamilton, Canada.,Queen Square Family Health Team, Brampton, Canada
| | - Michael Brown
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Dan Trottier
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Canada
| | - J D Schwalm
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Canada
| | | | - Elizabeth Alvarez
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Cynthia Lokker
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
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Goodday SM, Karlin E, Alfarano A, Brooks A, Chapman C, Desille R, Karlin DR, Emami H, Woods NF, Boch A, Foschini L, Wildman M, Cormack F, Taptiklis N, Pratap A, Ghassemi M, Goldenberg A, Nagaraj S, Walsh E, Friend S. An Alternative to the Light Touch Digital Health Remote Study: The Stress and Recovery in Frontline COVID-19 Health Care Workers Study. JMIR Form Res 2021; 5:e32165. [PMID: 34726607 PMCID: PMC8668021 DOI: 10.2196/32165] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 10/12/2021] [Accepted: 10/27/2021] [Indexed: 01/22/2023] Open
Abstract
Background Several app-based studies share similar characteristics of a light touch approach that recruit, enroll, and onboard via a smartphone app and attempt to minimize burden through low-friction active study tasks while emphasizing the collection of passive data with minimal human contact. However, engagement is a common challenge across these studies, reporting low retention and adherence. Objective This study aims to describe an alternative to a light touch digital health study that involved a participant-centric design including high friction app-based assessments, semicontinuous passive data from wearable sensors, and a digital engagement strategy centered on providing knowledge and support to participants. Methods The Stress and Recovery in Frontline COVID-19 Health Care Workers Study included US frontline health care workers followed between May and November 2020. The study comprised 3 main components: (1) active and passive assessments of stress and symptoms from a smartphone app, (2) objective measured assessments of acute stress from wearable sensors, and (3) a participant codriven engagement strategy that centered on providing knowledge and support to participants. The daily participant time commitment was an average of 10 to 15 minutes. Retention and adherence are described both quantitatively and qualitatively. Results A total of 365 participants enrolled and started the study, and 81.0% (n=297) of them completed the study for a total study duration of 4 months. Average wearable sensor use was 90.6% days of total study duration. App-based daily, weekly, and every other week surveys were completed on average 69.18%, 68.37%, and 72.86% of the time, respectively. Conclusions This study found evidence for the feasibility and acceptability of a participant-centric digital health study approach that involved building trust with participants and providing support through regular phone check-ins. In addition to high retention and adherence, the collection of large volumes of objective measured data alongside contextual self-reported subjective data was able to be collected, which is often missing from light touch digital health studies. Trial Registration ClinicalTrials.gov NCT04713111; https://clinicaltrials.gov/ct2/show/NCT04713111
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Affiliation(s)
- Sarah M Goodday
- 4YouandMe, Seattle, WA, United States.,Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | | | | | | | | | | | - Daniel R Karlin
- 4YouandMe, Seattle, WA, United States.,MindMed, New York, NY, United States.,Tufts University School of Medicine, Boston, MA, United States
| | - Hoora Emami
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | | | - Adrien Boch
- Evidation Health Inc, San Mateo, CA, United States
| | | | | | - Francesca Cormack
- Cambridge Cognition, Cambridge, United Kingdom.,Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | | | - Abhishek Pratap
- Krembil Center for Neuroinformatics, Center for Addiction and Mental Health, Toronto, ON, Canada.,Vector Institute, Toronto, ON, Canada.,University of Washington, Seattle, WA, United States.,King's College London, London, United Kingdom
| | - Marzyeh Ghassemi
- Vector Institute, Toronto, ON, Canada.,Institute for Medical Engineering and Science, MIT, Cambridge, MA, United States.,Department of Electrical Engineering and Computer Science, MIT, Cambridge, MA, United States
| | - Anna Goldenberg
- Vector Institute, Toronto, ON, Canada.,The Hospital for Sick Children, Toronto, ON, Canada.,Department of Computer Science, University of Toronto, Toronto, ON, Canada.,Canadian Institute for Advanced Research, Toronto, ON, Canada
| | - Sujay Nagaraj
- Vector Institute, Toronto, ON, Canada.,The Hospital for Sick Children, Toronto, ON, Canada
| | - Elaine Walsh
- School of Nursing, University of Washington, Seattle, WA, United States
| | -
- 4YouandMe, Seattle, WA, United States
| | - Stephen Friend
- 4YouandMe, Seattle, WA, United States.,Department of Psychiatry, University of Oxford, Oxford, United Kingdom
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Thomas S, Pulman A, Dogan H, Jiang N, Passmore D, Pretty K, Fairbanks B, Davies Smith A, Thomas PW. Creating a Digital Toolkit to Reduce Fatigue and Promote Quality of Life in Multiple Sclerosis: Participatory Design and Usability Study. JMIR Form Res 2021; 5:e19230. [PMID: 34889744 PMCID: PMC8704114 DOI: 10.2196/19230] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 10/29/2020] [Accepted: 09/06/2021] [Indexed: 11/21/2022] Open
Abstract
Background Fatigue is one of the most common and debilitating symptoms of multiple sclerosis (MS), experienced by more than 80% of people with MS. FACETS (Fatigue: Applying Cognitive Behavioral and Energy Effectiveness Techniques to Lifestyle) is an evidence-based, face-to-face, 6-session group fatigue management program for people with MS. Homework tasks are an integral part of FACETS and are currently undertaken in a paper-based form. Feedback from a consultation undertaken with FACETS attendees and health care professionals with experience in delivering the FACETS program suggested that being able to complete the homework tasks digitally would be desirable, potentially enhancing engagement and adherence and enabling on-the-go access to fit into busy lifestyles. Relative to other long-term conditions, there are few apps specifically for MS and, of those available, many have been developed with little or no input from people with MS. Objective The purpose of this mixed methods study was to create a digital toolkit comprising the homework tasks (eg, activity diary, goal planner, thought diary) of the FACETS program for people with MS, considering end users’ unique requirements throughout the design, build, prototyping, and testing stages. Methods Phase 1 involved the elicitation of detailed user requirements for the toolkit via 2 focus groups with previous attendees of FACETS (n=3 and n=6) and wireframing. Phase 2 involved supervised usability testing with people with MS (n=11) with iterative prototyping. The usability sessions involved going through test scenarios using the FACETS toolkit on an Android test phone with video capture and concurrent think-aloud followed by completion of the System Usability Scale (SUS) and a semistructured interview collecting feedback about design, content, and functionality. Results The mean SUS score for the digital toolkit was 74.3 (SD 16.8, 95% CI 63.2-85.6; range 37.5-95), which equates to an adjective rating of good and a B grade (70th-79th percentile range) on the Sauro-Lewis curved grading scale. A number of usability and design issues (such as simplifying overall screen flow to better meet users’ needs) and suggestions for improvements (such as using location-based services and displaying personalized information and progress via a central dashboard) were addressed and implemented during the usability testing cycle. Conclusions This work highlights the importance of the participation of people with MS across the entire development cycle, working to a human-centered design methodology to enable a considered and MS-centered solution to be developed. Continued horizon scanning for emergent technological enhancements will enable us to identify opportunities for further improvements to the FACETS toolkit prior to launch. The toolkit supports self-monitoring and management of fatigue and has potential applicability to other long-term conditions where fatigue is a significant issue.
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Affiliation(s)
- Sarah Thomas
- Bournemouth University Clinical Research Unit, Department of Medical Science & Public Health, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth, United Kingdom
| | - Andy Pulman
- Bournemouth University Clinical Research Unit, Department of Medical Science & Public Health, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth, United Kingdom
| | - Huseyin Dogan
- Department of Computing & Informatics, Faculty of Science & Technology, Bournemouth University, Bournemouth, United Kingdom
| | - Nan Jiang
- Department of Computing & Informatics, Faculty of Science & Technology, Bournemouth University, Bournemouth, United Kingdom
| | - David Passmore
- Department of Computing & Informatics, Faculty of Science & Technology, Bournemouth University, Bournemouth, United Kingdom
| | - Keith Pretty
- Department of Computing & Informatics, Faculty of Science & Technology, Bournemouth University, Bournemouth, United Kingdom
| | - Beth Fairbanks
- Department of Computing & Informatics, Faculty of Science & Technology, Bournemouth University, Bournemouth, United Kingdom
| | - Angela Davies Smith
- Bristol & Avon Multiple Sclerosis Centre, Southmead Hospital, North Bristol National Health Service Trust, Bristol, United Kingdom
| | - Peter W Thomas
- Bournemouth University Clinical Research Unit, Department of Medical Science & Public Health, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth, United Kingdom
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Li J, Silvera-Tawil D, Varnfield M, Hussain MS, Math V. Users' Perceptions Toward mHealth Technologies for Health and Well-being Monitoring in Pregnancy Care: Qualitative Interview Study. JMIR Form Res 2021; 5:e28628. [PMID: 34860665 PMCID: PMC8686472 DOI: 10.2196/28628] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 09/23/2021] [Accepted: 10/15/2021] [Indexed: 12/02/2022] Open
Abstract
Background Mobile health (mHealth) technologies, such as wearable sensors, smart health devices, and mobile apps, that are capable of supporting pregnancy care are emerging. Although mHealth could be used to facilitate the tracking of health changes during pregnancy, challenges remain in data collection compliance and technology engagement among pregnant women. Understanding the interests, preferences, and requirements of pregnant women and those of clinicians is needed when designing and introducing mHealth solutions for supporting pregnant women’s monitoring of health and risk factors throughout their pregnancy journey. Objective This study aims to understand clinicians’ and pregnant women’s perceptions on the potential use of mHealth, including factors that may influence their engagement with mHealth technologies and the implications for technology design and implementation. Methods A qualitative study using semistructured interviews was conducted with 4 pregnant women, 4 postnatal women, and 13 clinicians working in perinatal care. Results Clinicians perceived the potential benefit of mHealth in supporting different levels of health and well-being monitoring, risk assessment, and care provision in pregnancy care. Most pregnant and postnatal female participants were open to the use of wearables and health monitoring devices and were more likely to use these technologies if they knew that clinicians were monitoring their data. Although it was acknowledged that some pregnancy-related medical conditions are suitable for an mHealth model of remote monitoring, the clinical and technical challenges in the introduction of mHealth for pregnancy care were also identified. Incorporating appropriate health and well-being measures, intelligently detecting any abnormalities, and providing tailored information for pregnant women were the critical aspects, whereas usability and data privacy were among the main concerns of the participants. Moreover, this study highlighted the challenges of engaging pregnant women in longitudinal mHealth monitoring, the additional work required for clinicians to monitor the data, and the need for an evidence-based technical solution. Conclusions Clinical, technical, and practical factors associated with the use of mHealth to monitor health and well-being in pregnant women need to be considered during the design and feasibility evaluation stages. Technical solutions and appropriate strategies for motivating pregnant women are critical to supporting their long-term data collection compliance and engagement with mHealth technology during pregnancy.
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Affiliation(s)
- Jane Li
- Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Marsfield, Australia
| | - David Silvera-Tawil
- Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Marsfield, Australia
| | - Marlien Varnfield
- Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Herston, Australia
| | - M Sazzad Hussain
- Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Marsfield, Australia
| | - Vanitha Math
- Department of Obstetrics and Gynaecology, Gold Coast University Hospital, Gold Coast, Australia
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Cruz-Martínez RR, Wentzel J, Bente BE, Sanderman R, van Gemert-Pijnen JE. Toward the Value Sensitive Design of eHealth Technologies to Support Self-management of Cardiovascular Diseases: Content Analysis. JMIR Cardio 2021; 5:e31985. [PMID: 34855608 PMCID: PMC8686487 DOI: 10.2196/31985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/16/2021] [Accepted: 10/03/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND eHealth can revolutionize the way self-management support is offered to chronically ill individuals such as those with a cardiovascular disease (CVD). However, patients' fluctuating motivation to actually perform self-management is an important factor for which to account. Tailoring and personalizing eHealth to fit with the values of individuals promises to be an effective motivational strategy. Nevertheless, how specific eHealth technologies and design features could potentially contribute to values of individuals with a CVD has not been explicitly studied before. OBJECTIVE This study sought to connect a set of empirically validated, health-related values of individuals with a CVD with existing eHealth technologies and their design features. The study searched for potential connections between design features and values with the goal to advance knowledge about how eHealth technologies can actually be more meaningful and motivating for end users. METHODS Undertaking a technical investigation that fits with the value sensitive design framework, a content analysis of existing eHealth technologies was conducted. We matched 11 empirically validated values of CVD patients with 70 design features from 10 eHealth technologies that were previously identified in a systematic review. The analysis consisted mainly of a deductive coding stage performed independently by 3 members of the study team. In addition, researchers and developers of 6 of the 10 reviewed technologies provided input about potential feature-value connections. RESULTS In total, 98 connections were made between eHealth design features and patient values. This meant that some design features could contribute to multiple values. Importantly, some values were more often addressed than others. CVD patients' values most often addressed were related to (1) having or maintaining a healthy lifestyle, (2) having an overview of personal health data, (3) having reliable information and advice, (4) having extrinsic motivators to accomplish goals or health-related activities, and (5) receiving personalized care. In contrast, values less often addressed concerned (6) perceiving low thresholds to access health care, (7) receiving social support, (8) preserving a sense of autonomy over life, and (9) not feeling fear, anxiety, or insecurity about health. Last, 2 largely unaddressed values were related to (10) having confidence and self-efficacy in the treatment or ability to achieve goals and (11) desiring to be seen as a person rather than a patient. CONCLUSIONS Positively, existing eHealth technologies could be connected with CVD patients' values, largely through design features that relate to educational support, self-monitoring support, behavior change support, feedback, and motivational incentives. Other design features such as reminders, prompts or cues, peer-based or expert-based human support, and general system personalization were also connected with values but in narrower ways. In future studies, the inferred feature-value connections must be validated with empirical data from individuals with a CVD or similar chronic conditions.
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Affiliation(s)
- Roberto Rafael Cruz-Martínez
- Department of Psychology, Health and Technology, Faculty of Behavioural, Management and Social Sciences, Technical Medical Centre, University of Twente, Enschede, Netherlands
| | - Jobke Wentzel
- Department of Psychology, Health and Technology, Faculty of Behavioural, Management and Social Sciences, Technical Medical Centre, University of Twente, Enschede, Netherlands.,Department of Health and Social Studies, Windesheim University of Applied Sciences, Zwolle, Netherlands
| | - Britt Elise Bente
- Department of Psychology, Health and Technology, Faculty of Behavioural, Management and Social Sciences, Technical Medical Centre, University of Twente, Enschede, Netherlands
| | - Robbert Sanderman
- Department of Psychology, Health and Technology, Faculty of Behavioural, Management and Social Sciences, Technical Medical Centre, University of Twente, Enschede, Netherlands.,General Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Julia Ewc van Gemert-Pijnen
- Department of Psychology, Health and Technology, Faculty of Behavioural, Management and Social Sciences, Technical Medical Centre, University of Twente, Enschede, Netherlands
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Chute C, French T, Raman S, Bradley J. User Requirements for Co-Managed Digital Health & Care (Preprint). J Med Internet Res 2021; 24:e35337. [PMID: 35687379 PMCID: PMC9233266 DOI: 10.2196/35337] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 03/02/2022] [Accepted: 05/08/2022] [Indexed: 11/20/2022] Open
Abstract
Background The sustainability of health and social care has led to an imperative to shift the balance of care to communities and support person-centered, integrated, preventive, comanaged, and sustainable care. The digital tool set can support this shift; however, it must extend beyond a clinical focus to include broader personal, social, and environmental needs, experiences, and outcomes. The existing digital health and care design and user requirements literature focuses mainly on specific digital products or design methods. There is little whole-system or whole-of-life consideration, which is crucial to enacting more significant transformations that span different groups and domains. Objective This study aimed to present a set of recurring user requirements and themes for comanaged digital health and care services derived from the body of co-design projects within a digital health and care program. This study aimed to enable people and organizations looking to reorient their approach to health and care research and delivery from a system-led and condition-specific approach to a more person-centric, whole-of-life model. Methods Participatory design formed the core methodological approach in underlying the design research, from which user requirements were derived. The process of surfacing requirements involved a selection framework for the identification of eligible projects and a structured review process to consolidate user requirements. Results This paper presents a set of 14 common user requirements that resulted from a review of co-design projects. The findings demonstrate overlapping and reinforcing sets of needs from citizens and care professionals related to how data are comanaged to improve care and outcomes. This paper discusses the alignment, contrasts, and gaps with broader, comparable literature. It highlights consensus around requirements for personal health storytelling, sharing data on care experiences and how this can support personalized guidance, visualize trends to support decision-making, and generally improve dialog between a citizen and care professionals. These findings identify gaps around how groups and networks of people engage, posing difficult questions for people designing support services as some of the user requirements are not easily met by organizations operating in silos. Conclusions This study proposes future recommendations for citizens as active, informed, and consenting partners using new forms of privacy-preserving digital infrastructure that puts the citizen in firm control. It is also recommended that these findings be used by people developing new digital services to ensure that they can start with knowledge of the broader user requirement context. This should inform domain-specific research and development questions and processes. Further work is needed to extend these common requirements to more explicitly consider the trust framework required when citizens comanage their data and care across a broad range of formal and informal actors. Consideration of how authority, delegation, and trust function between members of the public will be critical.
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Affiliation(s)
- Chaloner Chute
- The Digital Health & Care Innovation Centre, University of Strathclyde, Glasgow, United Kingdom
| | - Tara French
- The Glasgow School of Art, Forres, United Kingdom
| | - Sneha Raman
- The Glasgow School of Art, Forres, United Kingdom
| | - Jay Bradley
- The Glasgow School of Art, Forres, United Kingdom
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72
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Areli E, Godfrey HK, Perry MA, Hempel D, Saipe B, Grainger R, Hale L, Devan H. 'I think there is nothing . . . that is really comprehensive': healthcare professionals' views on recommending online resources for pain self-management. Br J Pain 2021; 15:429-440. [PMID: 34840791 DOI: 10.1177/2049463720978264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objectives To explore healthcare professionals' views on, and attitudes, towards recommending online resources for persistent pain self-management. Methods This study was the qualitative phase of a two-phase mixed method study. Thirty-one New Zealand health professionals involved in the management of persistent pain were interviewed via focus groups and individual interviews. Data were analysed using the general inductive approach. Results The major themes were as follows: (1) risks and limits of online information outweigh benefits, (2) a blended model, of online resources with healthcare professional support, could work, (3) only trustworthy resources can be recommended, (4) need for personalisation and (5) perceived barriers to adoption. Conclusion Online resources were perceived as a useful adjunct to support pain self-management; however, due to potential risks of misinterpretation and misinformation, healthcare professionals proposed a 'blended model' where curated online resources introduced during face-to-face consultations could be used to support self-management. Participants needed 'trustworthy online resources' that provide evidence-based, updated information that is personalised to clients' health literacy and cultural beliefs. Practice implications Training for healthcare professionals on critical appraisal of online resources or curation of evidence-based online resources could increase recommendation of online resources to support pain self-management as an adjunct to in-person care.
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Affiliation(s)
- E Areli
- School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - H K Godfrey
- Centre for Health, Activity and Rehabilitation Research (CHARR), University of Otago, Wellington, New Zealand.,Centre for Science in Society, Victoria University of Wellington, Wellington, New Zealand
| | - M A Perry
- School of Physiotherapy, Centre for Health, Activity and Rehabilitation Research (CHARR), University of Otago, Wellington, New Zealand
| | - D Hempel
- Pain Management Service, Capital and Coast District Health Board, Wellington, New Zealand
| | - B Saipe
- Pain Management Service, Capital and Coast District Health Board, Wellington, New Zealand
| | - R Grainger
- Department of Medicine, University of Otago, Wellington, New Zealand
| | - L Hale
- School of Physiotherapy, Centre for Health, Activity and Rehabilitation Research (CHARR), University of Otago, Dunedin, New Zealand
| | - H Devan
- School of Physiotherapy, Centre for Health, Activity and Rehabilitation Research (CHARR), University of Otago, Wellington, New Zealand
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73
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Alessa T, Hawley M, de Witte L. Identification of the Most Suitable App to Support the Self-Management of Hypertension: Systematic Selection Approach and Qualitative Study. JMIR Mhealth Uhealth 2021; 9:e29207. [PMID: 34787586 PMCID: PMC8663499 DOI: 10.2196/29207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 04/23/2021] [Accepted: 08/01/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Smartphone apps are increasingly being used to aid in hypertension self-management, and a large and ever-growing number of self-management apps have been commercially released. However, very few of these are potentially effective and secure, and researchers have yet to establish the suitability of specific hypertension apps to particular contexts. OBJECTIVE The aim of this study is to identify the most suitable hypertension app in the context of Saudi Arabia and its health system. METHODS This study used a 2-stage approach to selecting the most suitable app for hypertension self-management. First, a systematic selection approach was followed to identify a shortlist of the most suitable apps according to the criteria of potential effectiveness, theoretical underpinning, and privacy and security. Second, an exploratory qualitative study was conducted to select the most suitable from the shortlist: 12 doctors were interviewed, and 22 patients participated in 4 focus groups. These explored participants' attitudes towards self-management apps in general, and their views towards the apps identified via the systematic selection process. The qualitative data were analyzed using framework analysis. RESULTS In the first stage, only 5 apps were found to be potentially effective while also having a theoretical underpinning and protecting users' data. In the second stage, both doctors and patients were generally interested in using hypertension apps, but most had no experience with these apps due to a lack of awareness of their availability and suitability. Patients and doctors liked apps that combine intuitive interfaces with a pleasant and clear visual design, in-depth features (eg, color-coded feedback accompanied with textual explanations), activity-specific reminders, and educational content regarding hypertension and potential complications. When the pros and cons of the 5 apps were discussed, 3 apps were identified as being more suitable, with Cora Health rated the highest by the participants. CONCLUSIONS Only 5 apps were deemed potentially effective and secure. Patients' and doctors' discussions of the pros and cons of these 5 apps revealed that 3 out of the 5 are clearly more suitable, with the Cora Health app being judged most suitable overall.
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Affiliation(s)
- Tourkiah Alessa
- Biomedical Technology Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.,Centre for Assistive Technology and Connected Healthcare, School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
| | - Mark Hawley
- Centre for Assistive Technology and Connected Healthcare, School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
| | - Luc de Witte
- Centre for Assistive Technology and Connected Healthcare, School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
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Ang SM, Chen J, Liew JH, Johal J, Dan YY, Allman-Farinelli M, Lim SL. Efficacy of Interventions That Incorporate Mobile Apps in Facilitating Weight Loss and Health Behavior Change in the Asian Population: Systematic Review and Meta-analysis. J Med Internet Res 2021; 23:e28185. [PMID: 34783674 PMCID: PMC8663646 DOI: 10.2196/28185] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 06/10/2021] [Accepted: 09/23/2021] [Indexed: 12/20/2022] Open
Abstract
Background Smartphone apps have shown potential in enhancing weight management in Western populations in the short to medium term. With a rapidly growing obesity burden in Asian populations, researchers are turning to apps as a service delivery platform to reach a larger target audience to efficiently address the problem. Objective This systematic review and meta-analysis aims to determine the efficacy of interventions that incorporate apps in facilitating weight loss and health behavior change in the Asian population. Methods A total of 6 databases were searched in June 2020. The eligible studies included controlled trials in which an app was used in the intervention. The participants were aged 18 years or older and were of Asian ethnicity. A meta-analysis to test intervention efficacy, subgroup analyses, and post hoc analyses was conducted to determine the effects of adding an app to usual care and study duration. The primary outcome was absolute or percentage weight change, whereas the secondary outcomes were changes to lifestyle behaviors. Results A total of 21 studies were included in this review, and 17 (81%) were selected for the meta-analysis. The pooled effect size across 82% (14/17) of the randomized controlled trials for weight change was small to moderate (Hedges g=–0.26; 95% CI –0.41 to –0.11), indicating slightly greater weight loss achieved in the intervention group; however, this may not be representative of long-term studies (lasting for more than a year). Supplementing multicomponent usual care with an app led to greater weight loss (Hedges g=–0.28; 95% CI –0.47 to –0.09). Asian apps were largely culturally adapted and multifunctional, with the most common app features being communication with health professionals and self-monitoring of behaviors and outcomes. Conclusions More evidence is required to determine the efficacy of apps in the long term and address the low uptake of apps to maximize the potential of the intervention. Future research should determine the efficacy of each component of the multicomponent intervention to facilitate the designing of studies that are most effective and cost-efficient for weight management. Trial Registration PROSPERO CRD42020165240; https://tinyurl.com/2db4tvn6
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Affiliation(s)
- Siew Min Ang
- Department of Dietetics, National University Hospital, Singapore, Singapore
| | - Juliana Chen
- School of Life and Environmental Sciences, Charles Perkins Centre, The University of Sydney, Sydney, Australia
| | - Jia Huan Liew
- Science Unit, Lingnan University, Hong Kong, Hong Kong
| | - Jolyn Johal
- Joanna Briggs Institute, University of Adelaide, Adelaide, Australia
| | - Yock Young Dan
- Department of Medicine, National University Hospital, Singapore, Singapore
| | - Margaret Allman-Farinelli
- School of Life and Environmental Sciences, Charles Perkins Centre, The University of Sydney, Sydney, Australia
| | - Su Lin Lim
- Department of Dietetics, National University Hospital, Singapore, Singapore
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Hansen ST, Ehrari H, Kristiansen S, Olsen LS, Jensen RS, Kjær TW, Beck M. User perspectives and preferences regarding a mobile health cough application: A qualitative study during the coronavirus disease pandemic in Denmark. Digit Health 2021; 7:20552076211045590. [PMID: 34676102 PMCID: PMC8524649 DOI: 10.1177/20552076211045590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 08/24/2021] [Indexed: 11/16/2022] Open
Abstract
Introduction Health care systems worldwide are currently facing major challenges because of the coronavirus disease pandemic. When individuals experience coronavirus disease symptoms, they often have to decide whether to seek health care services and render themselves vulnerable to infection or stay home and monitor their condition. Coronavirus disease management strategies should aim to reduce transmission, promote disease control, and facilitate self-monitoring within the population. In this regard, mobile health technologies serve as supportive tools, and acquiring knowledge about user perspectives will facilitate the development and integration of coronavirus disease-related applications. Accordingly, this study aimed to examine user perspectives on applications that monitor coronavirus disease-related physical signs and identify discrepancies between user expectations and developer design perspectives within the Danish context. Materials and methods A qualitative research design was adopted. Semi-structured telephone interviews were conducted to examine user expectations during the first wave of the coronavirus disease pandemic in April 2020. The theoretical framework, which was inspired by the concept of health literacy, was developed using a six-step thematic analytic approach. Results The analysis yielded two major themes that captured user experiences: (1) coronavirus disease-related applications may serve as digital tools that foster safety when physical signs are monitored and (2) the acceptability of coronavirus disease-related applications depends on the adoption of a personalised and user-friendly design.
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Affiliation(s)
- Stine Thestrup Hansen
- Department of Breast Surgery and Plastic Surgery, Zealand University Hospital, Denmark.,Department of Regional Health Research, University of Southern Denmark, Denmark
| | - Humira Ehrari
- Department of Neurology, Zealand University Hospital, Denmark
| | | | - Lotte Schelde Olsen
- Department of Neurology, Zealand University Hospital, Denmark.,Department of Clinical Medicine, University of Copenhagen, Denmark
| | | | - Troels Wesenberg Kjær
- Department of Neurology, Zealand University Hospital, Denmark.,Department of Clinical Medicine, University of Copenhagen, Denmark
| | - Malene Beck
- Department of Neurology, Zealand University Hospital, Denmark.,Department of Regional Health Research, University of Southern Denmark, Denmark
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Tobias G, Sgan-Cohen H, Spanier AB, Mann J. Perceptions and Attitudes Toward the Use of a Mobile Health App for Remote Monitoring of Gingivitis and Willingness to Pay for Mobile Health Apps (Part 3): Mixed Methods Study. JMIR Form Res 2021; 5:e26125. [PMID: 34609320 PMCID: PMC8527382 DOI: 10.2196/26125] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 12/13/2020] [Accepted: 08/07/2021] [Indexed: 01/19/2023] Open
Abstract
Background Gum infection, known as gingivitis, is a global issue. Gingivitis does not cause pain; however, if left untreated, it can worsen, leading to bad breath, bleeding gums, and even tooth loss, as the problem spreads to the underlying structures anchoring the teeth in the jaws. The asymptomatic nature of gingivitis leads people to postpone dental appointments until clinical signs are obvious or pain is evident. The COVID-19 pandemic has necessitated social distancing, which has caused many people to postpone dental visits and neglect gingival health. iGAM is a dental mobile health (mHealth) app that remotely monitors gum health, and an observational study demonstrated the ability of iGAM to reduce gingivitis. We found that a weekly dental selfie using the iGAM app reduced the signs of gingivitis and promoted oral health in a home-based setting. Objective The aim of this mixed methods study is to assess perceptions, attitudes, willingness to pay, and willingness to use an mHealth app. Methods The first qualitative phase of the study included eight semistructured interviews, and the second quantitative phase included data collected from responses to 121 questionnaires. Results There was a consensus among all interviewees that apps dealing with health-related issues (mHealth apps) can improve health. Three themes emerged from the interviews: the iGAM app is capable of improving health, the lack of use of medical apps, and a contradiction between the objective state of health and the self-definition of being healthy. Participants were grouped according to how they responded to the question about whether they believed that mHealth apps could improve their health. Participants who believed that mHealth apps can enhance health (mean 1.96, SD 1.01) had a higher willingness to pay for the service (depending on price) than those who did not believe in app efficacy (mean 1.31, SD 0.87; t119=−2417; P=.02). A significant positive correlation was found between the amount a participant was willing to pay and the benefits offered by the app (rs=0.185; P=.04). Conclusions Potential mHealth users will be willing to pay for app use depending on their perception of the app’s ability to help them personally, provided they define themselves as currently unhealthy.
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Affiliation(s)
- Guy Tobias
- Department of Community Dentistry, Faculty of Dental Medicine, The Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
| | - Harold Sgan-Cohen
- Department of Community Dentistry, Faculty of Dental Medicine, The Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
| | - Assaf B Spanier
- Department of Software Engineering, Azrieli College of Engineering, Jerusalem, Israel
| | - Jonathan Mann
- Department of Community Dentistry, Faculty of Dental Medicine, The Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
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Bombana M, Wittek M, Müller G, Heinzel-Gutenbrunner M, Wensing M. Women's Media Use and Preferences of Media-Based Interventions on Lifestyle-Related Risk Factors in Gynecological and Obstetric Care: A Cross-Sectional Multi-Center Study in Germany. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189840. [PMID: 34574762 PMCID: PMC8466324 DOI: 10.3390/ijerph18189840] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 09/14/2021] [Accepted: 09/15/2021] [Indexed: 11/16/2022]
Abstract
This study aimed to investigate factors affecting (1) women’s media use regarding health-related behaviors during pregnancy and lactation, (2) women’s preferences for media format, and (3) the content of media-based interventions on lifestyle-related risk factors during pregnancy and lactation. A cross-sectional observational multi-center study of pregnant and lactating women and women of childbearing age was carried out in 14 randomly selected obstetric and gynecologic care settings in the 12 most populated cities in Baden-Wuerttemberg, South-West Germany. Data from 219 surveyed women showed that older women, pregnant women, and lactating women have a higher probability of using media during pregnancy and lactation, respectively. The majority of women preferred a combination of analog and digital media-based interventions in gynecological (46.9%) and obstetric (47.1%) care settings and at home (73.0%). Women would like to see information brochures and flyers on health-related behaviors during pregnancy and lactation for use in gynecological and obstetric care settings, and for media use at home, they would like to have books. The probability of preferring the favored media formats in gynecological and obstetric care settings and at home were associated with pregnancy status, relationship status, socioeconomic status (SES), ethnicity, and health insurance status. About 80% of the surveyed women preferred media content regarding recommendations for a healthy lifestyle and healthy behavior during pregnancy and lactation. All of the independent variables were associated with the probability of preferring a specific media content. The SES was found to play a major role in the probability of preferring a specific media content, followed by pregnancy status, ethnicity, and health insurance status. The results from our study provide a basis for tailored preventive interventions in gynecological and obstetric care settings and for use at home. The results imply that a woman can be reached before conception, during pregnancy, or during lactation with preventive measures tailored to their requirements; however, acceptance may vary across personal attributes, such as SES, ethnicity, and others.
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Affiliation(s)
- Manuela Bombana
- Department of General Practice and Health Service Research, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany; (M.W.); (M.W.)
- Department of Health Promotion, AOK Baden-Württemberg, Presselstrasse 19, 70191 Stuttgart, Germany;
- Correspondence: ; Tel.: +49-711-2593-7945
| | - Maren Wittek
- Department of General Practice and Health Service Research, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany; (M.W.); (M.W.)
| | - Gerhard Müller
- Department of Health Promotion, AOK Baden-Württemberg, Presselstrasse 19, 70191 Stuttgart, Germany;
| | | | - Michel Wensing
- Department of General Practice and Health Service Research, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany; (M.W.); (M.W.)
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Menon R, Meyer J, Nippak P, Begum H. Smartphone Alcohol Use Disorder Recovery Apps: a Survey of Behavioral Intention to Use (Preprint). JMIR Hum Factors 2021; 9:e33493. [PMID: 35363145 PMCID: PMC9015776 DOI: 10.2196/33493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 12/22/2021] [Accepted: 02/14/2022] [Indexed: 11/24/2022] Open
Abstract
Background Alcohol use disorder (AUD) carries a huge health and economic cost to society. Effective interventions exist but numerous challenges limit their adoption, especially in a pandemic context. AUD recovery apps (AUDRA) have emerged as a potential complement to in-person interventions. They are easy to access and show promising results in terms of efficacy. However, they rely on individual adoption decisions and remain underused. Objective The aim of this survey study is to explore the beliefs that determine the intention to use AUDRA. Methods We conducted a cross-sectional survey study of people with AUD. We used the Unified Theory of Acceptance and Use of Technology, which predicts use and behavioral intention to use based on performance expectancy, effort expectancy, social influence, and facilitating conditions. Participants were recruited directly from 2 sources; first, respondents at addiction treatment facilities in Ontario, Canada, were contacted in person, and they filled a paper form; second, members from AUD recovery support groups on social media were contacted and invited to fill an internet-based survey. The survey was conducted between October 2019 and June 2020. Results The final sample comprised 159 participants (124 involved in the web-based survey and 35 in the paper-based survey) self-identifying somewhat or very much with AUD. Most participants (n=136, 85.5%) were aware of AUDRA and those participants scored higher on performance expectancy, effort expectancy, and social influence. Overall, the model explains 35.4% of the variance in the behavioral intention to use AUDRA and 11.1% of the variance in use. Social influence (P=.31), especially for women (P=.23), and effort expectancy (P=.25) were key antecedents of behavioral intention. Facilitating conditions were not significant overall but were moderated by age (P=.23), suggesting that it matters for older participants. Performance expectancy did not predict behavioral intention, which is unlike many other technologies but confirms other findings associated with mobile health (mHealth). Open-ended questions suggest that privacy concerns may significantly influence the use of AUDRA. Conclusions This study suggests that unlike many other technologies, the adoption of AUDRA is not mainly determined by utilitarian factors such as performance expectancy. Rather, effort expectancy and social influence play a key role in determining the intention to use AUDRA.
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Affiliation(s)
- Rijuta Menon
- School of Health Services Management, Ted Rogers School of Management, Ryerson University, Toronto, ON, Canada
| | - Julien Meyer
- School of Health Services Management, Ted Rogers School of Management, Ryerson University, Toronto, ON, Canada
| | - Pria Nippak
- School of Health Services Management, Ted Rogers School of Management, Ryerson University, Toronto, ON, Canada
| | - Housne Begum
- School of Health Services Management, Ted Rogers School of Management, Ryerson University, Toronto, ON, Canada
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Saunders R, Seaman K, Emery L, Crompton D, Lynch C, Penjor D, Sagar S. My hip journey: A qualitative study of patients' experiences of an eHealth program for patient preparation and recovery from hip replacement surgery. J Clin Nurs 2021; 31:1580-1587. [PMID: 34427362 DOI: 10.1111/jocn.16011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 07/01/2021] [Accepted: 07/05/2021] [Indexed: 11/26/2022]
Abstract
AIM AND OBJECTIVE To explore patient experiences, perceived benefits and suggestions of an eHealth program for pre- and post-operative education for total hip arthroplasty. BACKGROUND eHealth programs for surgical patients can facilitate the delivery of information, provide individualised rehabilitation plans and enable communication with health professionals to promote overall patient recovery. DESIGN A qualitative descriptive study was conducted following the COREQ guidelines. A convenience sample of nine patients who had total hip arthroplasty and used the My Hip Journey eHealth program were recruited and participated in individual semi-structured telephone interviews. Interviews were audio recorded, transcribed verbatim and analysed using inductive thematic analysis. RESULTS The participant group were aged between 53 and 70 years. The results are described in three overarching themes and sub-themes: (1) Supported surgical journey-how the My Hip Journey eHealth program supported them in their preparation and recovery from their surgery, and how the program provided information and encouraged engagement; (2) Motivated recovery-how patients found the program motivational, facilitated their self-management and enabled communication with the healthcare team if they had any concern; and (3) Functionality-how the program related to ease of use, its interactivity with the patient and suggestions for future use. CONCLUSIONS The patients reported that using the eHealth program for pre- and post-operative education was helpful to their overall surgical experience and recovery. It was found to engage patients in their care, enabled self-management, encouraged communication with health professionals and motivated them with their recovery. These findings identify the potential for eHealth programs to support patients in the preparation and post-operative stages, and in their post-discharge self-care for other surgical and orthopaedic journeys. RELEVANCE TO CLINICAL PRACTICE Patient experiences of eHealth education can inform nurses of the benefits of eHealth and the development of future eHealth education programs.
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Affiliation(s)
- Rosemary Saunders
- Centre for Research in Aged Care, School of Nursing & Midwifery, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Karla Seaman
- Centre for Research in Aged Care, School of Nursing & Midwifery, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Laura Emery
- School of Nursing & Midwifery, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Debra Crompton
- School of Nursing & Midwifery, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Chantelle Lynch
- School of Nursing & Midwifery, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Dorji Penjor
- School of Nursing & Midwifery, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Sonali Sagar
- School of Nursing & Midwifery, Edith Cowan University, Joondalup, Western Australia, Australia
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Schmaderer M, Miller JN, Mollard E. Experiences of Using a Self-management Mobile App Among Individuals With Heart Failure: Qualitative Study. JMIR Nurs 2021; 4:e28139. [PMID: 34406966 PMCID: PMC8386366 DOI: 10.2196/28139] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 06/17/2021] [Accepted: 07/04/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Interventions that focus on the self-management of heart failure are vital to promoting health in patients with heart failure. Mobile health (mHealth) apps are becoming more integrated into practice to promote self-management strategies for chronic diseases, optimize care delivery, and reduce health disparities. OBJECTIVE The purpose of this study was to explore the experience of using a self-management mHealth intervention in individuals with heart failure to inform a future mHealth intervention study. METHODS This study used a qualitative descriptive design. Participants were enrolled in the intervention groups of a larger parent study using a mobile app related to self-management of heart failure. The purposive, convenient, criterion-based sample for this qualitative analysis comprised 10 patients who responded to phone calls and were willing to be interviewed. Inclusion criteria for the parent study were adults who were hospitalized at Nebraska Medical Center with a primary diagnosis and an episode of acute decompensated heart failure; discharged to home without services such as home health care; had access to a mobile phone; and were able to speak, hear, and understand English. RESULTS Study participants were middle-aged (mean age 55.8, SD 12 years; range 36-73 years). They had completed a mean of 13.5 (SD 2.2) years (range 11-17 years) of education. Of the 10 participants, 6 (60%) were male. Half of them (5/10, 50%) were New York Heart Association Classification Class III patients and the other half were Class IV patients. The intervention revealed four self-management themes, including (1) I didn't realize, and now I know; (2) It feels good to focus on my health; (3) I am the leader of my health care team; and (4) My health is improving. CONCLUSIONS Participants who used a self-management mHealth app intervention for heart failure reported an overall positive experience. Their statements were organized into four major themes. The education provided during the study increased self-awareness and promoted self-management of their heart failure. The mHealth app supported patient empowerment, resulting in better heart failure management and improved quality of life. Participants advocated for themselves by becoming the leader of their health, especially when communicating with their health care team. Finally, the mHealth app was used by the participants as a self-management tool to assist in symptom management and improve their overall health. Future research should study symptom evaluation, medication tracking, and possibly serve as a health provider communication platform to empower individuals to be leaders in their chronic disease management.
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Affiliation(s)
- Myra Schmaderer
- College of Nursing, University of Nebraska Medical Center, Lincoln, NE, United States
| | - Jennifer N Miller
- College of Nursing, University of Nebraska Medical Center, Lincoln, NE, United States
| | - Elizabeth Mollard
- College of Nursing, University of Nebraska Medical Center, Lincoln, NE, United States
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81
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Hutton JS, Huang G, Wiley C, DeWitt T, Ittenbach RF. Randomized Trial of a Mobile App Introduced During Well-Visits to Enhance Guidance for Reading With Young Children. Acad Pediatr 2021; 21:977-987. [PMID: 34020099 DOI: 10.1016/j.acap.2021.05.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 04/28/2021] [Accepted: 05/12/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To estimate feasibility, usability and efficacy of a mobile parenting app (Rx for Success; RxS) to enhance reading guidance provided to parents of young children during well-visits. METHODS This trial was conducted at a clinic serving primarily families of Hispanic ethnicity and low-socioeconomic status (SES) where Reach Out and Read (ROR) is standard practice. It involved 252 parent-child dyads in 2 age groups (~6-months old, ~18-months old) randomized during well-visits to receive RxS or a children's book modeling alternatives to screen time (Control) by research coordinators. RxS involves videos, activities and "push" messages. Follow-up assessments were conducted approximately 6 months later, including impression and use, shared reading behaviors, child language and screen time. RESULTS A total of 217 dyads completed both visits (110 RxS, 107 Control). Time to introduce RxS was under 3 minutes and 32% of parents experienced largely minor performance issues. Parent impression of RxS was favorable for both age groups at baseline and follow-up, though use was infrequent, attributable to a desire for more relevant and updated content. Significant findings favoring RxS included shared reading as a favorite activity, more frequent shared reading reported at 12 months and higher language scores at 24 months. Screen time was equivalent between cohorts, exceeding American Academy of Pediatrics guidelines. CONCLUSIONS A mobile app introduced to parents of young children from low-SES backgrounds was feasible during well-visits, rated as helpful, and effective to enhance shared reading at younger and language at older ages. While a potentially impactful enhancement to ROR, features needing improvement were identified.
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Affiliation(s)
- John S Hutton
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center (JS Hutton and T DeWitt), Cincinnati, Ohio; Reading and Literacy Discovery Center, Cincinnati Children's Hospital Medical Center (JS Hutton and T DeWitt), Cincinnati, Ohio.
| | - Guixia Huang
- Division of Biostatistics and Epidemiology, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center (G Huang and RF Ittenbach), Cincinnati, Ohio
| | - Catherine Wiley
- Community Health Center at Connecticut Children's Hospital (C Wiley), Hartford, Conn
| | - Thomas DeWitt
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center (JS Hutton and T DeWitt), Cincinnati, Ohio; Reading and Literacy Discovery Center, Cincinnati Children's Hospital Medical Center (JS Hutton and T DeWitt), Cincinnati, Ohio
| | - Richard F Ittenbach
- Division of Biostatistics and Epidemiology, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center (G Huang and RF Ittenbach), Cincinnati, Ohio
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Martinengo L, Stona AC, Griva K, Dazzan P, Pariante CM, von Wangenheim F, Car J. Self-guided Cognitive Behavioral Therapy Apps for Depression: Systematic Assessment of Features, Functionality, and Congruence With Evidence. J Med Internet Res 2021; 23:e27619. [PMID: 34328431 PMCID: PMC8367167 DOI: 10.2196/27619] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 04/13/2021] [Accepted: 04/23/2021] [Indexed: 12/16/2022] Open
Abstract
Background Mental health disorders affect 1 in 10 people globally, of whom approximately 300 million are affected by depression. At least half of the people affected by depression remain untreated. Although cognitive behavioral therapy (CBT) is an effective treatment, access to mental health specialists, habitually challenging, has worsened because of the COVID-19 pandemic. Internet-based CBT is an effective and feasible strategy to increase access to treatment for people with depression. Mental health apps may further assist in facilitating self-management for people affected by depression; however, accessing the correct app may be cumbersome given the large number and wide variety of apps offered by public app marketplaces. Objective This study aims to systematically assess the features, functionality, data security, and congruence with evidence of self-guided CBT-based apps targeting users affected by depression that are available in major app stores. Methods We conducted a systematic assessment of self-guided CBT-based apps available in Google Play and the Apple App Store. Apps launched or updated since August 2018 were identified through a systematic search in the 42matters database using CBT-related terms. Apps meeting the inclusion criteria were downloaded and assessed using a Samsung Galaxy J7 Pro (Android 9) and iPhone 7 (iOS 13.3.1). Apps were appraised using a 182-question checklist developed by the research team, assessing their general characteristics, technical aspects and quality assurance, and CBT-related features, including 6 evidence-based CBT techniques (ie, psychoeducation, behavioral activation, cognitive restructuring, problem solving, relaxation, and exposure for comorbid anxiety) as informed by a CBT manual, CBT competence framework, and a literature review of internet-based CBT clinical trial protocols. The results were reported as a narrative review using descriptive statistics. Results The initial search yielded 3006 apps, of which 98 met the inclusion criteria and were systematically assessed. There were 20 well-being apps; 65 mental health apps, targeting two or more common mental health disorders, including depression; and 13 depression apps. A total of 28 apps offered at least four evidence-based CBT techniques, particularly depression apps. Cognitive restructuring was the most common technique, offered by 79% (77/98) of the apps. Only one-third of the apps offered suicide risk management resources, whereas 17% (17/98) of the apps offered COVID-19–related information. Although most apps included a privacy policy, only a third of the apps presented it before account creation. In total, 82% (74/90) of privacy policies stated sharing data with third-party service providers. Half of the app development teams included academic institutions or health care providers. Conclusions Only a few self-guided CBT-based apps offer comprehensive CBT programs or suicide risk management resources. Sharing of users’ data is widespread, highlighting shortcomings in health app market governance. To fulfill their potential, self-guided CBT-based apps should follow evidence-based clinical guidelines, be patient centered, and enhance users’ data security.
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Affiliation(s)
- Laura Martinengo
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
| | - Anne-Claire Stona
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
| | - Konstadina Griva
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
| | - Paola Dazzan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.,National Institute for Health Research Biomedical Research Centre at South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Carmine Maria Pariante
- Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, London, United Kingdom
| | - Florian von Wangenheim
- Professor of Technology Marketing, Department of Management, Technology & Economics, ETH Zurich, Zurich, Switzerland
| | - Josip Car
- Centre for Population Health Sciences, 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
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83
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Inglis-Jassiem G, Grimmer K, Conradie T, Louw Q. Descriptive Review of Online Information Resources for People With Stroke: Protocol for a Scoping Review. JMIR Res Protoc 2021; 10:e23174. [PMID: 34255721 PMCID: PMC8317032 DOI: 10.2196/23174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 03/03/2021] [Accepted: 04/12/2021] [Indexed: 11/18/2022] Open
Abstract
Background People with stroke and their caregivers experience numerous information needs; internet-based resources may offer cost-effective ways to improve access to information about this condition and its management, including the availability of resources and support. The quality of online health information is, therefore, an important consideration for both developers and consumers of these online resources. Objective This study aims to map and evaluate the content, readability, understandability, design, and quality characteristics of freely available online information resources (ie, websites) that empower people with stroke and their caregivers with information and self-help strategies poststroke. Methods This descriptive review will follow the five systematic and rigorous methodological steps that are recommended for scoping reviews, which include the following: (1) identifying the research question, (2) identifying relevant studies, (3) selecting the studies, (4) charting the data, and (5) collating, summarizing, and reporting the results. Data will then be synthesized and analyzed thematically. Results As of February 2021, the scoping review is in the data extraction stage. Data will be synthesized, and the first results are expected to be submitted for publication in an open-access peer-reviewed journal in August 2021. In addition, we will develop an accessible summary of the results for stakeholder meetings. Ethical approval is not required for this review, as it will only include publicly available information. Conclusions This study is novel and will evaluate the typology, content, and design-related criteria, including accessibility, aesthetics, navigability, interactivity, privacy, and data protection, of online information resources for stroke. The review will be limited to online resources published in English. International Registered Report Identifier (IRRID) DERR1-10.2196/23174
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Affiliation(s)
- Gakeemah Inglis-Jassiem
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Karen Grimmer
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Thandi Conradie
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Quinette Louw
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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Mushquash AR, Pearson ES, Waddington K, MacIsaac A, Mohammed S, Grassia E, Smith S, Wekerle C. User Perspectives on a Resilience-Building App (JoyPop): Qualitative Study. JMIR Mhealth Uhealth 2021; 9:e28677. [PMID: 34255696 PMCID: PMC8299348 DOI: 10.2196/28677] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 05/31/2021] [Accepted: 05/31/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Resilience is the capability, resources, and processes that are available to a person or system to adapt successfully in the face of stress or adversity. Given that resilience can be enhanced, using advances in technology to deliver and evaluate the impact of resilience interventions is warranted. Evidence supports the effectiveness of the resilience-building JoyPop app in improving resilience-related outcomes after use; however, experiential data from users is also needed to provide a more comprehensive account of its utility. OBJECTIVE The aim of this study was to explore users' experiences with the JoyPop app and their perspectives on its utility. METHODS This qualitative description study involved a combination of group and one-on-one semistructured interviews with a subset of first-year undergraduate students who participated in a larger evaluation of the JoyPop app. Participants used the app for a 4-week period and were subsequently asked about their frequency of app use, most and least used features (and associated reasons), most and least helpful features (and associated reasons), barriers to use, facilitators of use and continuation, and recommendations for improvement. Data were coded and categorized through inductive content analysis. RESULTS The sample of 30 participants included 24 females and 6 males, with a mean age of 18.77 years (SD 2.30). App use ranged from 1 to 5 times daily (mean 2.11, SD 0.74), with the majority indicating that they used the app at least twice daily. The Rate My Mood, Journal, and SquareMoves features were reported to be used most often, while the Rate My Mood, Journal, and Breathing Exercises features were identified as the most helpful. A number of themes and subthemes pertaining to facilitators of app use (prompts, creating routine, self-monitoring opportunities, expressive opportunities), barriers to app use (editing, lack of variety, student lifestyle), outcomes of app use (increased awareness, checking in with oneself, helpful distraction, emotional control), and recommendations for app improvement (adding more features, enhancing existing features, enhancing tracking abilities, providing personalization) were identified. CONCLUSIONS This study provides insight into the aspects of the JoyPop app that motivated and benefitted users, as well as measures that can be taken to improve user experiences and promote longer-term uptake. Users were willing to engage with the app and incorporate it into their routine, and they valued the ability to self-monitor, express emotion, and engage in distraction.
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Affiliation(s)
| | - Erin S Pearson
- School of Kinesiology, Lakehead University, Thunder Bay, ON, Canada
| | - Kayla Waddington
- School of Kinesiology, Lakehead University, Thunder Bay, ON, Canada
| | - Angela MacIsaac
- Department of Psychology, Lakehead University, Thunder Bay, ON, Canada
| | - Shakira Mohammed
- Department of Psychology, Lakehead University, Thunder Bay, ON, Canada
| | - Elizabeth Grassia
- Department of Psychology, Lakehead University, Thunder Bay, ON, Canada
| | - Savanah Smith
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
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85
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Degroote L, De Paepe A, De Bourdeaudhuij I, Van Dyck D, Crombez G. Effectiveness of the mHealth intervention 'MyDayPlan' to increase physical activity: an aggregated single case approach. Int J Behav Nutr Phys Act 2021; 18:92. [PMID: 34233718 PMCID: PMC8265041 DOI: 10.1186/s12966-021-01163-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 06/25/2021] [Indexed: 11/17/2022] Open
Abstract
Background e- and mHealth interventions using self-regulation techniques like action and coping planning have the potential to tackle the worldwide problem of physical inactivity. However, they often use one-week self-regulation cycles, providing support toward an active lifestyle on a weekly basis. This may be too long to anticipate on certain contextual factors that may fluctuate from day to day and may influence physical activity. Consequently, the formulated action and coping plans often lack specificity and instrumentality, which may decrease effectiveness of the intervention. The aim of this study was to evaluate effectiveness of a self-regulation, app-based intervention called ‘MyDayPlan’. “MyDayPlan’ provides an innovative daily cycle in which users are guided towards more physical activity via self-regulation techniques such as goal setting, action planning, coping planning and self-monitoring of behaviour. Methods An ABAB single-case design was conducted in 35 inactive adults between 18 and 58 years (M = 40 years). The A phases (A1 and A2) were the control phases in which the ‘MyDayPlan’ intervention was not provided. The B phases (B1 and B2) were the intervention phases in which ‘MyDayPlan’ was used on a daily basis. The length of the four phases varied within and between the participants. Each phase lasted a minimum of 5 days and the total study lasted 32 days for each participant. Participants wore a Fitbit activity tracker during waking hours to assess number of daily steps as an outcome. Single cases were aggregated and data were analysed using multilevel models to test intervention effects and possible carry-over effects. Results Results showed an average intervention effect with a significant increase in number of daily steps from the control to intervention phases for each AB combination. From A1 to B1, an increase of 1424 steps (95% CI [775.42, 2072.32], t (1082) = 4.31,p < .001), and from A2 to B2, an increase of 1181 steps (95% CI [392.98, 1968.16], t (1082) = 2.94, p = .003) were found. Furthermore, the number of daily steps decreased significantly (1134 steps) when going from the first intervention phase (B1) to the second control phase (A2) (95% CI [− 1755.60, − 512.38], t (1082) = − 3.58, p < .001). We found no evidence for a difference in trend between the two control (95% CI [− 114.59, 197.99], t (1078) = .52, p = .60) and intervention phases (95% CI [− 128.79,284.22], t (1078) = .74, p = .46). This reveals, in contrast to what was hypothesized, no evidence for a carry-over effect after removing the ‘MyDayPlan’ app after the first intervention phase (B1). Conclusion This study adds evidence that the self-regulation mHealth intervention, ‘MyDayPlan’ has the capacity to positively influence physical activity levels in an inactive adult population. Furthermore, this study provides evidence for the potential of interventions adopting a daily self-regulation cycle in general. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-021-01163-2.
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Affiliation(s)
- L Degroote
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium. .,Research Foundation Flanders, Brussels, Belgium. .,Department of Clinical-Experimental and Health Psychology, Ghent University, Ghent, Belgium.
| | - A De Paepe
- Department of Clinical-Experimental and Health Psychology, Ghent University, Ghent, Belgium
| | - I De Bourdeaudhuij
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - D Van Dyck
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - G Crombez
- Department of Clinical-Experimental and Health Psychology, Ghent University, Ghent, Belgium
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86
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Chiang Y, Tsay P, Chen C, Hsu C, Yu H, Chang C, Lo F, Moons P. A Delphi Study on the Healthcare Needs of Patients with Type 1 Diabetes during the Transition from Adolescence to Adulthood: Consensus among Patients, Primary Caregivers, and Healthcare Providers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18137149. [PMID: 34281086 PMCID: PMC8296953 DOI: 10.3390/ijerph18137149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 06/29/2021] [Accepted: 07/02/2021] [Indexed: 11/16/2022]
Abstract
Patients with type 1 diabetes mellitus at the age of 16-25 face the challenges of the deterioration of disease control and accelerated exacerbation. Providing interventions that meet patient's healthcare needs can reduce the impact and improve health outcome. The purpose of this study was to identify the healthcare needs of patients with type 1 diabetes during the adolescence to adulthood transition period from the perspectives of patients, parents and healthcare providers. A two-round Delphi study was conducted among 48 participants, and included 17 patients, 16 primary caregivers, and 15 healthcare providers. The central tendency and dispersion were computed to establish a consensus. Seventy-one healthcare needs were identified across five dimensions-technology, external support, internal support, management, and healthcare-and 56 were considered as important healthcare needs and with a moderate to high level of agreement. Meanwhile, patients, primary caregivers, and healthcare providers were found to display significantly different opinions (p < 0.05) for 23 healthcare needs. This study concluded the consensus of the healthcare needs of patients with type 1 diabetes mellitus during the adolescence to adulthood transition period from a systematic investigation. The findings can serve as reference for developing transitional intervention strategies.
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Affiliation(s)
- Yuehtao Chiang
- School of Nursing, College of Medicine, Chang-Gung University, Taoyuan 33302, Taiwan; (H.Y.); (C.C.)
- Division of Pediatric Endocrinology & Genetics, Department of Pediatrics, Chang-Gung Memorial Hospital, Taoyuan 33305, Taiwan
- Correspondence: (Y.C.); (F.L.); Tel.: +886-3-2118800 (ext. 3866) (Y.C.); Tel.: +886-3-3281200 (ext. 8969) (F.L.)
| | - Peikwei Tsay
- Department of Public Health and Center of Biostatistics, College of Medicine, Chang-Gung University, Taoyuan 33302, Taiwan;
| | - Chiwen Chen
- College of Nursing, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan;
| | - Chienlung Hsu
- Department of Information Management, Chang-Gung University, Taoyuan 33302, Taiwan;
- Graduate Institute of Business and Management, Chang Gung University, Taoyuan 33302, Taiwan
- Healthy Aging Research Center, Chang Gung University, Taoyuan 33302, Taiwan
- Department of Visual Communication Design, Ming Chi University of Technology, New Taipei 24301, Taiwan
- Department of Nursing, Taoyuan Chang Gung Memorial Hospital, Taoyuan 33044, Taiwan
| | - Hsingyi Yu
- School of Nursing, College of Medicine, Chang-Gung University, Taoyuan 33302, Taiwan; (H.Y.); (C.C.)
- Department of Nursing, Chang-Gung Memorial Hospital, Taoyuan 33305, Taiwan
| | - Chiwen Chang
- School of Nursing, College of Medicine, Chang-Gung University, Taoyuan 33302, Taiwan; (H.Y.); (C.C.)
- Division of Pediatric Endocrinology & Genetics, Department of Pediatrics, Chang-Gung Memorial Hospital, Taoyuan 33305, Taiwan
| | - Fusung Lo
- Division of Pediatric Endocrinology & Genetics, Department of Pediatrics, Chang-Gung Memorial Hospital, Taoyuan 33305, Taiwan
- College of Medicine, Chung-Gung University, Taoyuan 33302, Taiwan
- Correspondence: (Y.C.); (F.L.); Tel.: +886-3-2118800 (ext. 3866) (Y.C.); Tel.: +886-3-3281200 (ext. 8969) (F.L.)
| | - Philip Moons
- Department of Public Health and Primary Care, KU Leuven-University of Leuven, 3000 Leuven, Belgium;
- Institute of Health and Care Sciences, University of Gothenburg, 40530 Gothenburg, Sweden
- Department of Paediatrics and Child Health, University of Cape Town, Cape Town 7701, South Africa
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Wyatt TH, Bayless AK, Krauskopf P, Gaylord N. Using mHealth Applications to Promote Self-Managed Health Behaviors Among Teens. J Pediatr Nurs 2021; 59:164-172. [PMID: 33932646 DOI: 10.1016/j.pedn.2021.04.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 04/21/2021] [Accepted: 04/21/2021] [Indexed: 11/30/2022]
Abstract
THEORETICAL PRINCIPLES As technology use increasingly expands, the opportunity to capitalize on it for healthcare education, monitoring, and assessment has grown rapidly, especially among adolescent patients. As apps are developed, consideration should be given to self-management theory concepts. PHENOMENA ADDRESSED The proliferation of mobile health (mHealth) applications allows adolescents to access healthcare information in new, innovative ways. Many health applications focus on health promotion, fitness, and nutrition and others help persons with chronic disease. This article offers a compelling case for incorporating mHealth into teen healthcare by reviewing current data on teens' technology use, showing how mHealth aligns with self-management theory concepts, and offering a case scenario on mHealth-enhanced self-management care. RESEARCH LINKAGES The ability to combine accurate and immediate healthcare information with continual social support could radically improve teen's self-management behaviors, especially when mHealth apps use connectivity, a feedback loop, and concepts known to enhance self-management behaviors.
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Affiliation(s)
- Tami H Wyatt
- University of Tennessee, Knoxville College of Nursing, Knoxville, TN, United States of America.
| | - Adaya Kirk Bayless
- University of Tennessee, Knoxville College of Nursing, Knoxville, TN, United States of America
| | - Patti Krauskopf
- Shenandoah University Health & Life Sciences, University Drive, Winchester, VA, United States of America.
| | - Nan Gaylord
- The University of Tennessee-Knoxville College of Nursing, Knoxville, TN, United States of America.
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Wouldes TA, Crawford A, Stevens S, Stasiak K. Evidence for the Effectiveness and Acceptability of e-SBI or e-SBIRT in the Management of Alcohol and Illicit Substance Use in Pregnant and Post-partum Women. Front Psychiatry 2021; 12:634805. [PMID: 34025470 PMCID: PMC8131659 DOI: 10.3389/fpsyt.2021.634805] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 03/17/2021] [Indexed: 12/12/2022] Open
Abstract
Alcohol and illicit psychoactive drug use during pregnancy have increased worldwide, putting women and their children's health and development at risk. Multiple drug use, comorbid psychiatric disorders, sexual and physical abuse are common in women who use alcohol and drugs during pregnancy. The effects on the mother include poor reproductive and life-long health, legal, family, and social problems. Additionally, the exposed child is at increased risk of long-term physical health, mental health, and developmental problems. The stigma associated with substance use during pregnancy and some clinicians' reticence to inquire about substance use means many women are not receiving adequate prenatal, substance abuse, and mental health care. Evidence for mHealth apps to provide health care for pregnant and post-partum women reveal the usability and effectiveness of these apps to reduce gestational weight gain, improve nutrition, promote smoking cessation and manage gestational diabetes mellitus, and treat depression and anxiety. Emerging evidence suggests mHealth technology using a public health approach of electronic screening, brief intervention, or referral to treatment (e-SBIRT) for substance use or abuse can overcome the typical barriers preventing women from receiving treatment for alcohol and drug use during pregnancy. This brief intervention delivered through a mobile device may be equally effective as SBIRT delivered by a health care professional in preventing maternal drug use, minimizing the effects to the exposed child, and providing a pathway to therapeutic options for a substance use disorder. However, larger studies in more diverse settings with women who have co-morbid mental illness and a constellation of social risk factors that are frequently associated with substance use disorders are needed.
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Affiliation(s)
- Trecia A Wouldes
- Department of Psychological Medicine, Faculty of Medical and Health Science, University of Auckland, Auckland, New Zealand
| | - Andi Crawford
- Department of Psychological Medicine, Faculty of Medical and Health Science, University of Auckland, Auckland, New Zealand
- Te Ara Manapou, Parenting and Pregnancy Service, Hawke's Bay District Health Board, Hastings, New Zealand
| | - Suzanne Stevens
- Department of Psychological Medicine, Faculty of Medical and Health Science, University of Auckland, Auckland, New Zealand
| | - Karolina Stasiak
- Department of Psychological Medicine, Faculty of Medical and Health Science, University of Auckland, Auckland, New Zealand
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Kassem LM, Alhabib B, Alzunaydi K, Farooqui M. Understanding Patient Needs Regarding Adverse Drug Reaction Reporting Smartphone Applications: A Qualitative Insight from Saudi Arabia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3862. [PMID: 33917014 PMCID: PMC8067764 DOI: 10.3390/ijerph18083862] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 03/28/2021] [Accepted: 03/31/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND A pragmatic shift in the healthcare sector characterized by moving from curative to preventive approaches highlights the role of pharmacovigilance in patient safety. There have been few published studies on patient reporting of adverse drug reactions (ADRs) in Saudi Arabia. This qualitative study aims to explore the community opinions and the need for patient-friendly smartphone applications (SPAs) to enhance their participation in ADR reporting. METHODS Purposeful sampling was followed to recruit study participants, a semi-structured interview guide was used to conduct interviews, and the saturation was reached after the 13th interviewer; no new information was obtained after two subsequent interviews. All the interviews were audio-recorded, transcribed verbatim, and analyzed by means of a standard content analysis framework. RESULTS As per the WHO guidelines, eleven participants were aware of the term "ADR". All the participants denied receiving any prior education and attending events about ADRs and were unaware of the Saudi FDA-ADR reporting systems. The use of technologies such as SPAs has been widely accepted with a high level of concern for data confidentiality and privacy. CONCLUSIONS These findings point out the need to build patient-oriented educational programs to increase their awareness of ADR reporting and to prioritize the use of artificial intelligence (AI) to be integrated in the Saudi healthcare system to develop future SPAs for improving both patient safety and signal detection of ADRs.
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Affiliation(s)
- Lamyaa M. Kassem
- Department of Pharmacy Practice, Unaizah College of Pharmacy, Qassim University, Unaizah 51911, Saudi Arabia; (B.A.); (K.A.); (M.F.)
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90
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Vansimaeys C, Benamar L, Balagué C. Digital health and management of chronic disease: A multimodal technologies typology. Int J Health Plann Manage 2021; 36:1107-1125. [PMID: 33786849 DOI: 10.1002/hpm.3161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 02/19/2021] [Accepted: 03/13/2021] [Indexed: 11/08/2022] Open
Abstract
This cross-sectional descriptive study aims to (1) describe the current digital technology (DT) use of people with chronic diseases (CD) by identifying different user profiles and (2) determine whether those profiles have specific characteristics regarding health-related variables and patient-doctor relationship quality (RQ). An online questionnaire assessing the uses of multiple types of DT (the Internet, mobile applications and connected devices) and several dimensions related to health and patient-doctor RQ was completed by 954 individuals living with CD. DT user groups were obtained by k-means cluster analysis and then compared using Mann-Whitney tests. The results show three profiles of DT users: (1) hyperconnected (8.9%, regular users of all DTs), (2) biconnected (19.1%, regular users of the Internet and mobile apps) and (3) hypoconnected (72%, casual users of the Internet only). The hyperconnected and biconnected groups are more empowered, more knowledgeable about their treatment and more committed to their doctors than the hypoconnected group. Nonadherence to treatment, health motivations, self-efficacy for health management and the trust dimension of the patient-doctor RQ did not differ between groups. We conclude by discussing the low use of the most recent technologies in the CD population, although these technologies seem to provide access to health information that empowers patients and leads to a better relationship with their doctors.
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Affiliation(s)
- Camille Vansimaeys
- LITEM, Univ Evry, IMT-BS, Université Paris-Saclay, Evry, France.,Université de Paris, LPPS, Boulogne Billancourt, France
| | - Lamya Benamar
- LITEM, Univ Evry, IMT-BS, Université Paris-Saclay, Evry, France
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91
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Palfai TP, Kratzer MPL, Morone NE, Bernstein JA. Integrating patient perspectives in the development of a mobile health intervention to address chronic pain and heavy drinking in primary care: a qualitative study of patients in an urban, safety-net hospital setting. Addict Sci Clin Pract 2021; 16:20. [PMID: 33757584 PMCID: PMC7988929 DOI: 10.1186/s13722-021-00230-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 03/10/2021] [Indexed: 11/10/2022] Open
Abstract
Background Chronic pain and heavy drinking are conditions that commonly co-occur among primary care patients. Despite the availability of behavioral interventions that target these conditions individually, engagement and adherence to treatment remain a challenge, and there have been no interventions designed to address both of these conditions together for patients presenting to primary care. This study seeks to incorporate the perspectives of patients regarding symptoms, treatment experiences, views on behavior change, and technology use to develop a tailored, integrated mobile health intervention that addresses both pain and heavy drinking among patients in primary care. Methods Twelve participants with moderate or greater chronic pain intensity and heavy drinking were recruited from primary care clinics in a large urban safety-net hospital. One-on-one interviews were recorded and transcribed. Codes were developed from interview transcripts, followed by thematic analysis in which specific meanings were assigned to codes. Participants also completed a series of Likert-based rating scales to evaluate components of the proposed intervention to supplement qualitative interviews. Results A number of themes were identified that had implications for intervention tailoring including: ambivalence about changing drinking, low expectations about pain treatment success, desire for contact with a designated provider, common use of smartphones but lack of familiarity with functions as a potential barrier to use, and strategies to maintain engagement and adherence. Evaluative ratings indicated that the proposed intervention content was perceived as helpful and the proposed structure, layout and design of the mobile intervention was acceptable to patients. Conclusions Results supported the view that a mobile health intervention delivered via smartphone with electronic coaching is an acceptable method of addressing chronic pain and heavy drinking among patients in primary care. The interviews highlight the need to utilize an intervention approach that addresses motivation to change drinking, sets realistic expectations for change, provides careful attention to training/education of the use of technology components, and fosters engagement through the use of reminders, feedback, and personalized activities.
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Affiliation(s)
- Tibor P Palfai
- Department of Psychological and Brain Sciences, Boston University, 900 Commonwealth Ave., Boston, MA, 02215, USA.
| | - Maya P L Kratzer
- Department of Psychological and Brain Sciences, Boston University, 900 Commonwealth Ave., Boston, MA, 02215, USA
| | - Natalia E Morone
- Department of Medicine, Section of Internal Medicine, Boston University School of Medicine, 801 Massachusetts Ave, 2nd Floor, Boston, MA, 02118, USA
| | - Judith A Bernstein
- Department of Community Health Sciences, School of Public Health, Boston University, 801 Massachusetts Ave, 4th Floor, Boston, MA, 02118, USA
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92
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Shaygan M, Jaberi A. The effect of a smartphone-based pain management application on pain intensity and quality of life in adolescents with chronic pain. Sci Rep 2021; 11:6588. [PMID: 33758322 PMCID: PMC7988051 DOI: 10.1038/s41598-021-86156-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 03/11/2021] [Indexed: 11/09/2022] Open
Abstract
The development, implementation, and qualitative evaluation of smartphone-based pain management applications may provide an opportunity for more optimal management of pediatric pain in the homesetting. The present mixed-method study was conducted to assess a smartphone-based pain management application regarding the feasibility, adherence, participant satisfaction, and effectiveness on pain intensity and quality of life in adolescents with chronic pain. The study was carried out in the quantitative and qualitative stages using a mixed-method approach. The quantitative stage included 128 adolescents who met the ICD-11 criteria of chronic pain. After random allocation, adolescents allocated to the intervention group received a pain management program through a smartphone-based application. No education was given to the adolescents in the control group. The adolescents were assessed regarding pain intensity and different dimensions of quality of life at pre-intervention, post-intervention, and three-month follow-up. The findings in the quantitative stage were explained by qualitative interviews. The findings of the quantitative stage showed significant improvements in the pain intensity, emotional, social, and school functioning but not in the physical functioning of the adolescents. A high level of adherence (78.12%) and satisfaction (Mean = 26.45, SD = 6.45) with thes martphone-based pain management program was found. Based on the qualitative interviews, adolescents' pain management strategies can be classified in three main categories: physical management, psychological management, and interpersonal resources. The results confirm the positive effect of a smartphone-based pain management program on the pain intensity and different dimensions of quality of life of adolescents with chronic pain. Within the context of chronic pain management, a mobile application incorporating both the psychological and physical management of pain may help adolescents with chronic pain to reduce the negative impacts of pain on their life.
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Affiliation(s)
- Maryam Shaygan
- Community Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Azita Jaberi
- Community Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
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93
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Mekonnen ZA, Gelaye KA, Were MC, Tilahun B. Acceptability, Barriers and Facilitators of Mobile Text Message Reminder System Implementation in Improving Child Vaccination: A Qualitative Study in Northwest Ethiopia. J Multidiscip Healthc 2021; 14:605-616. [PMID: 33727823 PMCID: PMC7955748 DOI: 10.2147/jmdh.s298167] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 02/23/2021] [Indexed: 12/31/2022] Open
Abstract
Background Mobile phone text message-based mHealth interventions have shown promise in improving health service delivery. Despite the promising findings at a small scale and few contexts, implementing new technologies as part of changes to health care services is inherently challenging. Though there is a potential to introduce mHealth initiatives to health systems of developing countries, existing evidence on the barriers and facilitators of implementation in different contexts is not adequate. Therefore, this study aimed to explore the acceptability, barriers and facilitators of implementing mobile text message reminder system for child vaccination in Ethiopia. Methods This study applied a phenomenological study design. The study was conducted in north-west, Ethiopia between July 28 and August 19, 2020. A total of 23 participants were purposively selected for the in-depth and key informant interviews. We used an interview guide to collect data and audio-records of interviews were transcribed verbatim. Coding was done to identify patterns and thematic analysis was conducted using ATLAS ti7 software. Results The findings indicated that mothers were receptive to mobile text message reminders for their child’s vaccination. Low mobile phone ownership, access to mobile network, access to electricity and illiteracy among the target population were identified as barriers that would affect implementation. Confidentiality and security-related issues are not barriers to implementation of text message reminders for child vaccination service. Facilitators for implementation include stakeholder collaboration, providing orientation/training to users, and willingness to pay by clients. Conclusion In this study, using mobile phone text message reminders for child vaccination services are acceptable by clients. Barriers identified were related to inadequate ICT infrastructure and other technical issues. Addressing the potential barriers and leveraging the existing opportunities could optimize the implementation in resource-limited settings. Before actual implementation, program implementers should also consider providing orientation to users on the proposed mHealth program.
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Affiliation(s)
- Zeleke Abebaw Mekonnen
- Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.,Health System Directorate, Federal Ministry of Health, Addis Ababa, Ethiopia
| | - Kassahun Alemu Gelaye
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Martin C Were
- Department of Biomedical Informatics, Vanderbilt Medical Center, Nashville, TN, 37232, USA
| | - Binyam Tilahun
- Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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94
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Sarradon-Eck A, Bouchez T, Auroy L, Schuers M, Darmon D. Attitudes of General Practitioners Toward Prescription of Mobile Health Apps: Qualitative Study. JMIR Mhealth Uhealth 2021; 9:e21795. [PMID: 33661123 PMCID: PMC7974757 DOI: 10.2196/21795] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 11/10/2020] [Accepted: 01/08/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Mobile health (mHealth) apps are a potential means of empowering patients, especially in the case of multimorbidity, which complicates patients' care needs. Previous studies have shown that general practitioners (GPs) have both expectations and concerns regarding patients' use of mHealth apps that could impact their willingness to recommend the apps to patients. OBJECTIVE The aim of this qualitative study is to investigate French GPs' attitudes toward the prescription of mHealth apps or devices aimed toward patients by analyzing GPs' perceptions and expectations of mHealth technologies. METHODS A total of 36 GPs were interviewed individually (n=20) or in a discussion group (n=16). All participants were in private practice. A qualitative analysis of each interview and focus group was conducted using grounded theory analysis. RESULTS Considering the value assigned to mHealth apps by participants and their willingness or resistance to prescribe them, 3 groups were defined based on the attitudes or positions adopted by GPs: digital engagement (favorable attitude; mHealth apps are perceived as additional resources and complementary tools that facilitate the medical work, the follow-up care, and the monitoring of patients; and apps increase patients' compliance and empowerment); patient protection (related to the management of patient care and fear of risks for patients, concerns about patient data privacy and security, doubt about the usefulness for empowering patients, standardization of the medical decision process, overmedicalization, risks for individual freedom, and increasing social inequalities in health); doctor protection (fear of additional tasks and burden, doubt about the actionability of patient-gathered health data, risk for medical liability, dehumanization of the patient-doctor relationship, fear of increased drug prescription, and commodification of patient data). CONCLUSIONS A deep understanding of both the expectations and fears of GPs is essential to motivate them to recommend mHealth apps to their patients. The results of this study show the need to provide appropriate education and training to enhance GPs' digital skills. Certification of the apps by an independent authority should be encouraged to reassure physicians about ethical and data security issues. Our results highlight the need to overcome technical issues such as interoperability between data collection and medical records to limit the disruption of medical work because of data flow.
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Affiliation(s)
- Aline Sarradon-Eck
- Aix Marseille University, INSERM, IRD, SESSTIM, Marseille, France.,Institut Paoli-Calmettes, CanBios UMR1252, Marseille, France
| | | | - Lola Auroy
- Université Grenoble Alpes, Centre National de la Recherche Scientifique, Sciences Po Grenoble, Pacte, Grenoble, France
| | - Matthieu Schuers
- Department of General Medicine, Rouen University Hospital, Rouen, France.,Department of Biomedical Informatics, Rouen University Hospital, Rouen, France.,INSERM, U1142, Laboratoire d'Informatique Médicale et d'Ingénierie des Connaissances en e-Santé (LIMICS), Sorbonne Université, Paris, France
| | - David Darmon
- Aix Marseille University, INSERM, IRD, SESSTIM, Marseille, France.,Université Côte d'Azur, Rétines, Healthy, DERMG, Nice, France
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95
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Mobile device use among inpatients on a psychiatric unit: A preliminary study. Psychiatry Res 2021; 297:113720. [PMID: 33540205 DOI: 10.1016/j.psychres.2021.113720] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 01/11/2021] [Indexed: 11/22/2022]
Abstract
Few studies have investigated barriers to mobile phone use for health purposes among patients with serious mental illness. In an inpatient psychiatric adult sample, we examined: (a) patterns and perceptions of mobile phone use and (b) the role of psychiatric diagnoses on mobile phone use for mental health purposes. Participants completed questionnaires after using a psychometrically validated scale to determine capacity for consent. Descriptive analyses revealed that most participants owned a smartphone (94%), data plan (94%), and frequently accessed the internet (75%). Only 27% used their mobile phones daily for health purposes and 47% had used their mobile phone to access their electronic medical record (EMR). Participants with psychotic disorders were significantly less likely to have mobile access to their EMR and expressed difficulty in using a mobile app for mental health purposes; whereas participants with depressive disorders expressed low interest in using their mobile devices to monitor their mental health. Adult psychiatric inpatients may have access to and be willing to use mobile phones for purposes related to mental health. However, key barriers may include frequency of mobile phone use for health purposes and lack of mobile access to the EMR, particularly among those with psychotic disorders.
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96
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Manyati TK, Mutsau M. Exploring the effectiveness of telehealth interventions for diagnosis, contact tracing and care of Corona Virus Disease of 2019 (COVID19) patients in sub Saharan Africa: a rapid review. HEALTH AND TECHNOLOGY 2021; 11:341-348. [PMID: 33585154 PMCID: PMC7870280 DOI: 10.1007/s12553-020-00485-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 10/01/2020] [Indexed: 12/23/2022]
Abstract
The efficacy of leveraging telehealth services on clinical outcomes remains scarcely documented. We conducted a rapid review to explore the effectiveness of telehealth interventions for the diagnosis, contact tracing and care of the corona virus disease of 2019 in sub Saharan Africa. Using MEDLINE, Science Direct and Cochrane Library databases, a review was conducted during the month of July 2020 of peer reviewed articles reporting on the use of telehealth interventions in sub-Saharan Africa. All the studies were assessed against the inclusion criteria by two independent reviewers. The 7 studies included in the synthesis were conducted in 2 countries [Nigeria (× 1), Zimbabwe (× 1)], and commentaries covering the entire sub Saharan Africa in general (× 4) and to Uganda (× 1). All the included articles and commentaries were published in 2020. We established that mobile applications are effective in providing information for referrals of potential patients infected by COVID 19 and provides convenient access to routine care without the risk of exposure through close contact. In countries such as Nigeria, mobile positioning data significantly improved decision making, capacity and scope of contact tracing and surveillance of known contacts of confirmed cases. We noted that collaborations between the government, mobile network operators and technology companies were utilised for successful mobile positioning data tracing interventions for COVID patients. Mobile applications such as the Vula platform in South Africa were also noted as effective in providing psychological support to health care workers attending to patients.
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Affiliation(s)
| | - Morgen Mutsau
- Centre for Applied Social Sciences, University of Zimbabwe, Harare, Zimbabwe
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97
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Willems SJ, Coppieters MW, Pronk Y, Diks MJF, van der Heijden KWAP, Rooker S, Scholten-Peeters GGM. A Clinical Journey Mobile Health App for Perioperative Patients: Cross-sectional Study. JMIR Hum Factors 2021; 8:e20694. [PMID: 33555262 PMCID: PMC7899805 DOI: 10.2196/20694] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 10/06/2020] [Accepted: 12/23/2020] [Indexed: 01/05/2023] Open
Abstract
Background Mobile eHealth apps are important tools in personal health care management. The Patient Journey app was developed to inform patients with musculoskeletal disorders during their perioperative period. The app contains timely information, video exercises, and functional tasks. Although the Patient Journey app and other health apps are widely used, little research is available on how patients appreciate these apps. Objective The primary aim of this study was to evaluate the user-friendliness of the Patient Journey app in terms of its usability and the attitudes of users toward the app. The secondary aim was to evaluate positive and negative user experiences. Methods A web-based questionnaire was sent to 2114 patients scheduled for surgery for a musculoskeletal disorder. Primary outcomes were usability (measured with the System Usability Scale) and user attitudes regarding the Patient Journey app (assessed with the second part of the eHealth Impact Questionnaire). The secondary outcomes were evaluated with multiple choice questions and open-ended questions, which were analyzed via inductive thematic content analyses. Results Of the 940 patients who responded, 526 used the Patient Journey app. The usability of the app was high (System Usability Scale: median 85.0, IQR 72.5-92.5), and users had a positive attitude toward the Information and Presentation provided via the app (eHealth Impact Questionnaire: median 78.0, IQR 68.8-84.4). The app did not adequately improve the users’ confidence in discussing health with others (eHealth Impact Questionnaire: median 63.9, IQR 50.0-75.0) or motivation to manage health (eHealth Impact Questionnaire: median 61.1, IQR 55.6-72.2). Three core themes emerged regarding positive and negative user experiences: (1) content and information, (2) expectations and experiences, and (3) technical performance. Users experienced timely information and instructions positively and found that the app prepared and guided them optimally through the perioperative period. Negative user experiences were overly optimistic information, scarcely presented information about pain (medication), lack of reference data, insufficient information regarding clinical course deviations and complications, and lack of interaction with clinicians. Conclusions The Patient Journey app is a usable, informative, and presentable tool to inform patients with musculoskeletal disorders during their perioperative period. The qualitative analyses identified aspects that can further improve the user experiences of the app.
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Affiliation(s)
- Stijn J Willems
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Michel W Coppieters
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Menzies Health Institute Queensland, Griffith University, Brisbane & Gold Coast, Australia
| | - Yvette Pronk
- Department of Orthopaedics and Research, Kliniek ViaSana, Mill, Netherlands
| | - Miranda J F Diks
- Department of Orthopaedics and Research, Kliniek ViaSana, Mill, Netherlands
| | | | - Servan Rooker
- Department of Orthopaedics and Research, Kliniek ViaSana, Mill, Netherlands.,Department of Epidemiology and Social Medicine, University of Antwerp, Antwerp, Belgium
| | - Gwendolyne G M Scholten-Peeters
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
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98
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Zimmermann BM, Fiske A, Prainsack B, Hangel N, McLennan S, Buyx A. Early Perceptions of COVID-19 Contact Tracing Apps in German-Speaking Countries: Comparative Mixed Methods Study. J Med Internet Res 2021; 23:e25525. [PMID: 33503000 PMCID: PMC7872326 DOI: 10.2196/25525] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 12/17/2020] [Accepted: 01/09/2021] [Indexed: 01/07/2023] Open
Abstract
Background The main German-speaking countries (Germany, Austria, and Switzerland) have implemented digital contact tracing apps to assist the authorities with COVID-19 containment strategies. Low user rates for these apps can affect contact tracing and, thus, its usefulness in controlling the spread of the novel coronavirus. Objective This study aimed to assess the early perceptions of people living in the German-speaking countries and compare them with the frames portrayed in the newspapers during the first wave of the COVID-19 pandemic. Methods We conducted qualitative interviews with 159 participants of the SolPan project. Of those, 110 participants discussed contact tracing apps and were included in this study. We analyzed articles regarding contact tracing apps from 12 newspapers in the German-speaking countries. Results Study participants perceived and newspaper coverage in all German-speaking countries framed contact tracing apps as governmental surveillance tools and embedded them in a broader context of technological surveillance. Participants identified trust in authorities, respect of individual privacy, voluntariness, and temporary use of contact tracing apps as prerequisites for democratic compatibility. Newspapers commonly referenced the use of such apps in Asian countries, emphasizing the differences in privacy regulation among these countries. Conclusions The uptake of digital contact tracing apps in German-speaking countries may be undermined due to privacy risks that are not compensated by potential benefits and are rooted in a deeper skepticism towards digital tools. When authorities plan to implement new digital tools and practices in the future, they should be very transparent and proactive in communicating their objectives and the role of the technology—and how it differs from other, possibly similar, tools. It is also important to publicly address ethical, legal, and social issues related to such technologies prior to their launch.
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Affiliation(s)
- Bettina Maria Zimmermann
- Institute of History and Ethics in Medicine, Technical University Munich, Munich, Germany.,Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
| | - Amelia Fiske
- Institute of History and Ethics in Medicine, Technical University Munich, Munich, Germany
| | - Barbara Prainsack
- Department of Political Science, University of Vienna, Vienna, Austria
| | - Nora Hangel
- Institute of History and Ethics in Medicine, Technical University Munich, Munich, Germany
| | - Stuart McLennan
- Institute of History and Ethics in Medicine, Technical University Munich, Munich, Germany.,Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
| | - Alena Buyx
- Institute of History and Ethics in Medicine, Technical University Munich, Munich, Germany
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Ali SM, Lau WJ, McBeth J, Dixon WG, van der Veer SN. Digital manikins to self-report pain on a smartphone: A systematic review of mobile apps. Eur J Pain 2021; 25:327-338. [PMID: 33113241 PMCID: PMC7839759 DOI: 10.1002/ejp.1688] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 10/19/2020] [Accepted: 10/22/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Chronic pain is the leading cause of disability. Improving our understanding of pain occurrence and treatment effectiveness requires robust methods to measure pain at scale. Smartphone-based pain manikins are human-shaped figures to self-report location-specific aspects of pain on people's personal mobile devices. METHODS We searched the main app stores to explore the current state of smartphone-based pain manikins and to formulate recommendations to guide their development in the future. RESULTS The search yielded 3,938 apps. Twenty-eight incorporated a pain manikin and were included in the analysis. For all apps, it was unclear whether they had been tested and had end-user involvement in the development. Pain intensity and quality could be recorded in 28 and 13 apps, respectively, but this was location specific in only 11 and 4. Most manikins had two or more views (n = 21) and enabled users to shade or select body areas to record pain location (n = 17). Seven apps allowed personalising the manikin appearance. Twelve apps calculated at least one metric to summarise manikin reports quantitatively. Twenty-two apps had an archive of historical manikin reports; only eight offered feedback summarising manikin reports over time. CONCLUSIONS Several publically available apps incorporated a manikin for pain reporting, but only few enabled recording of location-specific pain aspects, calculating manikin-derived quantitative scores, or generating summary feedback. For smartphone-based manikins to become adopted more widely, future developments should harness manikins' digital nature and include robust validation studies. Involving end users in the development may increase manikins' acceptability as a tool to self-report pain. SIGNIFICANCE This review identified and characterised 28 smartphone apps that included a pain manikin (i.e. pain drawings) as a novel approach to measure pain in large populations. Only few enabled recording of location-specific pain aspects, calculating quantitative scores based on manikin reports, or generating manikin feedback. For smartphone-based manikins to become adopted more widely, future studies should harness the digital nature of manikins, and establish the measurement properties of manikins. Furthermore, we believe that involving end users in the development process will increase acceptability of manikins as a tool for self-reporting pain.
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Affiliation(s)
- Syed Mustafa Ali
- Centre for Epidemiology Versus ArthritisUniversity of ManchesterManchesterUK
- Centre for Health InformaticsDivision of Informatics, Imaging and Data SciencesUniversity of ManchesterManchesterUK
- NIHR Manchester Musculoskeletal Biomedical Research CentreCentral Manchester University Hospitals NHS Foundation TrustManchesterUK
| | - Wei J. Lau
- Manchester Academic Health Science Centre (MAHSC)University of ManchesterManchesterUK
| | - John McBeth
- Centre for Epidemiology Versus ArthritisUniversity of ManchesterManchesterUK
- Centre for Health InformaticsDivision of Informatics, Imaging and Data SciencesUniversity of ManchesterManchesterUK
- NIHR Manchester Musculoskeletal Biomedical Research CentreCentral Manchester University Hospitals NHS Foundation TrustManchesterUK
| | - William G. Dixon
- Centre for Epidemiology Versus ArthritisUniversity of ManchesterManchesterUK
- Centre for Health InformaticsDivision of Informatics, Imaging and Data SciencesUniversity of ManchesterManchesterUK
- NIHR Manchester Musculoskeletal Biomedical Research CentreCentral Manchester University Hospitals NHS Foundation TrustManchesterUK
| | - Sabine N. van der Veer
- Centre for Epidemiology Versus ArthritisUniversity of ManchesterManchesterUK
- Centre for Health InformaticsDivision of Informatics, Imaging and Data SciencesUniversity of ManchesterManchesterUK
- NIHR Manchester Musculoskeletal Biomedical Research CentreCentral Manchester University Hospitals NHS Foundation TrustManchesterUK
- Manchester Academic Health Science Centre (MAHSC)University of ManchesterManchesterUK
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100
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Keaver L, Loftus A, Quinn L. A review of iPhone and Android apps for cancer patients and survivors: assessing their quality, nutrition information and behaviour change techniques. J Hum Nutr Diet 2021; 34:572-584. [PMID: 33453133 DOI: 10.1111/jhn.12857] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 12/18/2020] [Accepted: 12/22/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND The present study reviewed the quality, nutrition content and behaviour change techniques (BCTs) of apps aimed at those with cancer. METHODS The Apple App Store and Androids' Google Play were searched in March 2020. Apps were scored for accountability as per Silberg's standards, quality as per the Mobile Application Rating Scale, and BCTs using the CALO-RE Taxonomy. Nutrition content was summarised and a checklist developed from the European Society for Parenteral and Enteral Nutrition (ESPEN) cancer and nutrition guidelines and the World Cancer Research Fund (WCRF) guidelines for Cancer Survivors. RESULTS Twelve apps were identified, mean (SD) accountability score was 2.7/8 (2.0) (range 0-6) and quality score was 2.9/5 (0.6) (range 1.7-3.7). Overall, 11 BCTs were used (range 0-8 per app). Nutrition content focussed on healthy eating and meeting energy needs. There was a lack of strategies for implementation and no indication of whether the advice was more suited for specific cancer types, stages or treatment. Limited reference was made to recommendations of ESPEN and the WCRF. A strong positive relationship between quality and number of BCTs was found (r = 0.805, n = 9, P = 0.01). CONCLUSIONS Little nutrition information is currently included on publicly available apps aimed at those with a cancer diagnosis.
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Affiliation(s)
- Laura Keaver
- Department of Health and Nutritional Science, Institute of Technology Sligo, Sligo, Ireland
| | - Amy Loftus
- Department of Health and Nutritional Science, Institute of Technology Sligo, Sligo, Ireland
| | - Laoise Quinn
- Department of Health and Nutritional Science, Institute of Technology Sligo, Sligo, Ireland
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