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Balk-Møller NC, Larsen TM, Holm L. Experiences From a Web- and App-Based Workplace Health Promotion Intervention Among Employees in the Social and Health Care Sector Based on Use-Data and Qualitative Interviews. J Med Internet Res 2017; 19:e350. [PMID: 29051133 PMCID: PMC5668633 DOI: 10.2196/jmir.7278] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 06/21/2017] [Accepted: 08/31/2017] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND An increasing number of Web- and app-based tools for health promotion are being developed at the moment. The ambition is generally to reach out to a larger part of the population and to help users improve their lifestyle and develop healthier habits, and thereby improve their health status. However, the positive effects are generally modest. To understand why the effects are modest, further investigation into the participants' experiences and the social aspects of using Web- and app-based health promotion tools is needed. OBJECTIVE The objectives of this study were to investigate the motivation behind taking part in and using a Web- and app-based health promotion tool (SoSu-life) at the workplace and to explore the participants' experiences with using the tool. METHODS Qualitative interviews with 26 participants who participated in a 38-week randomized controlled trial of a workplace Web- and app-based tool for health promotion were conducted. Data were supplemented with tracking the frequency of use. The basic features of the tool investigated in the trial were self-reporting of diet and exercise, personalized feedback, suggestions for activities and programs, practical tips and tricks, and a series of social features designed to support and build interactions among the participants at the workplace. RESULTS The respondents reported typically one of the two reasons for signing up to participate in the study: either a personal wish to attain some health benefits or the more social reason that participants did not want to miss out on the social interaction with colleagues. Peer pressure from colleagues had made some participants to sign up even though they did not believe they had an unhealthy behavior. Of the total of 355 participants in the intervention group, 203 (57.2%) left the intervention before it ended. Of the remaining participants, most did not use the tool after the competition at the end of the initial 16-week period. The actual number of active users of the tool throughout the whole intervention period was low; however, the participants reported that lifestyle habits became a topic of conversation. CONCLUSIONS A tool that addresses group interactions at workplaces appears to initiate peer pressure, which helped recruitment for participation. However, active participation was low. A social change was indicated, allowing for more interaction among colleagues around healthy lifestyle issues. Future and more long-term studies are needed to determine whether such social changes could lead to sustained improvements of health.
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Affiliation(s)
| | - Thomas Meinert Larsen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg C, Denmark
| | - Lotte Holm
- Section for Consumption, Bioethics and Governance, Department of Food and Resource Economics, University of Copenhagen, Frederiksberg C, Denmark
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Skrepnik N, Spitzer A, Altman R, Hoekstra J, Stewart J, Toselli R. Assessing the Impact of a Novel Smartphone Application Compared With Standard Follow-Up on Mobility of Patients With Knee Osteoarthritis Following Treatment With Hylan G-F 20: A Randomized Controlled Trial. JMIR Mhealth Uhealth 2017; 5:e64. [PMID: 28487266 PMCID: PMC5442351 DOI: 10.2196/mhealth.7179] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 02/27/2017] [Accepted: 03/23/2017] [Indexed: 12/01/2022] Open
Abstract
Background Osteoarthritis (OA) is a leading cause of disability in the United States. Although no disease-modifying therapies exist, patients with knee OA who increase walking may reduce risk of functional limitations. Objective The objective of the study is to evaluate the impact of a mobile app (OA GO) plus wearable activity monitor/pedometer (Jawbone UP 24) used for 90 days on the mobility of patients with knee OA treated with hylan G-F 20. Methods Patients with knee OA aged 30 to 80 years who were eligible to receive hylan G-F 20 and were familiar with smartphone technology were enrolled in this randomized, multicenter, open-label study. Patients who had a body mass index above 35 kg/m2 were excluded. All patients received a single 6-mL injection of hylan G-F 20 and wore the Jawbone monitor. The patients were then randomized 1:1 to Jawbone and OA GO (Group A; n=107) with visible feedback (unblinded) or Jawbone only (Group B; n=104) with no visible feedback (blinded). The primary endpoint was mean change from baseline in steps per day at day 90 between Groups A and B. Results Baseline characteristics were similar between groups. There were significant differences between the increases in least squares (LS) mean number of steps per day (1199 vs 467, P=.03) and the mean percentage change (35.8% vs 11.5%, P=.02) from baseline in favor of Group A over Group B. There was a greater reduction in pain from baseline during the 6-minute walk test in Group A versus Group B. (LS mean change: −55.3 vs −33.8, P=.007). Most patients (65.4%) and surveys of physicians (67.3%) reported they would be likely or very likely to use/recommend the devices. Patient Activity Measure-13 scores improved from baseline (LS mean change for Groups A and B: 5.0 vs 6.9), with no significant differences between groups. The occurrence of adverse events was similar in the 2 groups. Conclusions Use of a novel smartphone app in conjunction with a wearable activity monitor provided additional improvement on mobility parameters such as steps per day and pain with walking in the 6-minute walk test in patients with knee OA who were treated with hylan G-F 20. Results also highlight the amenability of patients and physicians to using mobile health technology in the treatment of OA and suggest further study is warranted.
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Affiliation(s)
| | - Andrew Spitzer
- Cedar-Sinai Orthopaedic Center, Los Angeles, CA, United States
| | - Roy Altman
- University of California Los Angeles Medical Center, Los Angeles, CA, United States
| | - John Hoekstra
- National Clinical Research-Richmond, Richmond, VA, United States
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Balk-Møller NC, Poulsen SK, Larsen TM. Effect of a Nine-Month Web- and App-Based Workplace Intervention to Promote Healthy Lifestyle and Weight Loss for Employees in the Social Welfare and Health Care Sector: A Randomized Controlled Trial. J Med Internet Res 2017; 19:e108. [PMID: 28396303 PMCID: PMC5404146 DOI: 10.2196/jmir.6196] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 12/22/2016] [Accepted: 03/14/2017] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND General health promoting campaigns are often not targeted at the people who need them the most. Web- and app-based tools are a new way to reach, motivate, and help people with poor health status. OBJECTIVE The aim of our study was to test a Web- and mobile app-based tool ("SoSu-life") on employees in the social welfare and health care sector in Denmark. METHODS A randomized controlled trial was carried out as a workplace intervention. The tool was designed to help users make healthy lifestyle changes such as losing weight, exercise more, and quit smoking. A team competition between the participating workplaces took place during the first 16 weeks of the intervention. Twenty nursing homes for elderly people in 6 municipalities in Denmark participated in the study. The employees at the nursing homes were randomized either 1:1 or 2:1 on a municipality level to use the SoSu-life tool or to serve as a control group with no intervention. All participants underwent baseline measurements including body weight, waist circumference, body fat percentage, blood pressure, and blood cholesterol level and they filled in a questionnaire covering various aspects of health. The participants were measured again after 16 and 38 weeks. RESULTS A total of 566 (SoSu-life: n=355, control: n=211) participants were included in the study. At 16 weeks there were 369 participants still in the study (SoSu-life: n=227, control: n=142) and 269 participants completed the 38 week intervention (SoSu-life: n=152, control: n=117). At 38 weeks, the SoSu-life group had a larger decrease in body weight (-1.01 kg, P=.03), body fat percentage (-0.8%, P=.03), and waist circumference (-1.8 cm, P=.007) compared with the control group. CONCLUSIONS The SoSu-life Web- and app-based tool had a modest yet beneficial effect on body weight and body fat percentage in the health care sector staff. TRIAL REGISTRATION Clinicaltrials.gov NCT02438059; http://clinicaltrials.gov/ct2/show/NCT02438059 (Archived by WebCite at http://www.webcitation.org/6i6y4p2AS).
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Affiliation(s)
- Nina Charlotte Balk-Møller
- Department of Nutrition, Exercise and Sports, Faculty of Science, Copenhagen University, Frederiksberg C, Denmark
| | - Sanne Kellebjerg Poulsen
- Department of Nutrition, Exercise and Sports, Faculty of Science, Copenhagen University, Frederiksberg C, Denmark
| | - Thomas Meinert Larsen
- Department of Nutrition, Exercise and Sports, Faculty of Science, Copenhagen University, Frederiksberg C, Denmark
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Seifert A, Schlomann A, Rietz C, Schelling HR. The use of mobile devices for physical activity tracking in older adults' everyday life. Digit Health 2017; 3:2055207617740088. [PMID: 29942617 PMCID: PMC6001246 DOI: 10.1177/2055207617740088] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Accepted: 10/06/2017] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVE The tracking of one's own physical activity with mobile devices is a way of monitoring and motivating oneself to remain healthy. Older adults' general use of mobile devices for physical activity tracking has not yet been examined systematically. The study aimed to describe the use of physical activity trackers, smartwatches and smartphones, or tablets for tracking physical activity and to examine the reasons for the use of these technologies. METHODS Participants aged ≥50 years (N = 1013) living in Switzerland were interviewed in a telephone survey. To address the research questions, we calculated descriptive frequency distributions, tested for differences between groups, and performed logistic regression analyses. RESULTS Descriptive and multivariate analyses showed that (a) 20.5% of participants used mobile devices for physical activity tracking; (b) men, younger individuals, those with a strong interest in new technology, and those who frequently exercised had a higher likelihood of using mobile devices for physical activity tracking; and (c) participants more often agreed with reasons for use relating to tracking physical activity and motivating oneself to remain healthy than they did with reasons relating to social factors. CONCLUSIONS The study presented representative data about the actual use of mobile tracking technology in persons over 50 years of age. Today, mainly active and younger elderly (mostly men) with a high interest in technology are using tracking technologies. Results indicate a need for further studies on motivational and usability aspects regarding the use of mobile health tracking devices by older adults.
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Affiliation(s)
- Alexander Seifert
- University Research Priority Program “Dynamics of Healthy Aging”, University of Zurich, Switzerland
- Center of Competence for Gerontology, University of Zurich, Switzerland
| | - Anna Schlomann
- Doctoral Program GROW “Gerontological Research on Well-Being”, University of Cologne, Germany
| | - Christian Rietz
- Working Area Research Methodology, University of Cologne, Germany
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Schoeppe S, Alley S, Van Lippevelde W, Bray NA, Williams SL, Duncan MJ, Vandelanotte C. Efficacy of interventions that use apps to improve diet, physical activity and sedentary behaviour: a systematic review. Int J Behav Nutr Phys Act 2016; 13:127. [PMID: 27927218 PMCID: PMC5142356 DOI: 10.1186/s12966-016-0454-y] [Citation(s) in RCA: 465] [Impact Index Per Article: 58.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Accepted: 11/24/2016] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Health and fitness applications (apps) have gained popularity in interventions to improve diet, physical activity and sedentary behaviours but their efficacy is unclear. This systematic review examined the efficacy of interventions that use apps to improve diet, physical activity and sedentary behaviour in children and adults. METHODS Systematic literature searches were conducted in five databases to identify papers published between 2006 and 2016. Studies were included if they used a smartphone app in an intervention to improve diet, physical activity and/or sedentary behaviour for prevention. Interventions could be stand-alone interventions using an app only, or multi-component interventions including an app as one of several intervention components. Outcomes measured were changes in the health behaviours and related health outcomes (i.e., fitness, body weight, blood pressure, glucose, cholesterol, quality of life). Study inclusion and methodological quality were independently assessed by two reviewers. RESULTS Twenty-seven studies were included, most were randomised controlled trials (n = 19; 70%). Twenty-three studies targeted adults (17 showed significant health improvements) and four studies targeted children (two demonstrated significant health improvements). Twenty-one studies targeted physical activity (14 showed significant health improvements), 13 studies targeted diet (seven showed significant health improvements) and five studies targeted sedentary behaviour (two showed significant health improvements). More studies (n = 12; 63%) of those reporting significant effects detected between-group improvements in the health behaviour or related health outcomes, whilst fewer studies (n = 8; 42%) reported significant within-group improvements. A larger proportion of multi-component interventions (8 out of 13; 62%) showed significant between-group improvements compared to stand-alone app interventions (5 out of 14; 36%). Eleven studies reported app usage statistics, and three of them demonstrated that higher app usage was associated with improved health outcomes. CONCLUSIONS This review provided modest evidence that app-based interventions to improve diet, physical activity and sedentary behaviours can be effective. Multi-component interventions appear to be more effective than stand-alone app interventions, however, this remains to be confirmed in controlled trials. Future research is needed on the optimal number and combination of app features, behaviour change techniques, and level of participant contact needed to maximise user engagement and intervention efficacy.
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Affiliation(s)
- Stephanie Schoeppe
- Central Queensland University, School of Health, Medical and Applied Sciences, Physical Activity Research Group, Building 77, Bruce Highway, Rockhampton, QLD 4702 Australia
| | - Stephanie Alley
- Central Queensland University, School of Health, Medical and Applied Sciences, Physical Activity Research Group, Building 77, Bruce Highway, Rockhampton, QLD 4702 Australia
| | - Wendy Van Lippevelde
- Ghent University, Department of Public Health, De Pintelaan 185-4 K3 room 036, 9000 Ghent, Belgium
| | - Nicola A. Bray
- Central Queensland University, School of Health, Medical and Applied Sciences, Physical Activity Research Group, Building 77, Bruce Highway, Rockhampton, QLD 4702 Australia
| | - Susan L. Williams
- Central Queensland University, School of Health, Medical and Applied Sciences, Building 6, Bruce Highway, Rockhampton, QLD 4702 Australia
| | - Mitch J. Duncan
- The University of Newcastle, School of Medicine & Public Health, Priority Research Centre for Physical Activity and Nutrition, University Drive, Callaghan, NSW 2308 Australia
| | - Corneel Vandelanotte
- Central Queensland University, School of Health, Medical and Applied Sciences, Physical Activity Research Group, Building 77, Bruce Highway, Rockhampton, QLD 4702 Australia
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Wildenbos GA, Peute LW, Jaspers MWM. Impact of Patient-centered eHealth Applications on Patient Outcomes: A Review on the Mediating Influence of Human Factor Issues. Yearb Med Inform 2016; 25:113-119. [PMID: 27830238 PMCID: PMC5171552 DOI: 10.15265/iy-2016-031] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To examine the evidence of the impact of patient- centered eHealth applications on patient care and to analyze if and how reported human factor issues mediated the outcomes. METHODS We searched PubMed (2014-2015) for studies evaluating the impact of patient-centered eHealth applications on patient care (behavior change, self-efficacy, and patient health-related outcomes). The Systems Engineering Initiative for Patient Safety (SEIPS 2.0) model was used as a guidance framework to identify the reported human factors possibly impacting the effectiveness of an eHealth intervention. RESULTS Of the 348 potentially relevant papers, 10 papers were included for data analysis. None of the 10 papers reported a negative impact of the eHealth intervention. Seven papers involved a randomized controlled trial (RCT) study. Six of these RCTs reported a positive impact of the eHealth intervention on patient care. All 10 papers reported on human factor issues possibly mediating effects of patient-centered eHealth. Human factors involved patient characteristics, perceived social support, and (type of) interaction between patient and provider. CONCLUSION While the amount of patient-centered eHealth interventions increases, many questions remain as to whether and to what extent human factors mediate their use and impact. Future research should adopt a formal theory-driven approach towards human factors when investigating those factors' influence on the effectiveness of these interventions. Insights could then be used to better tailor the content and design of eHealth solutions according to patient user profiles, so as to enhance eHealth interventions impact on patient behavior, self-efficacy, and health-related outcomes.
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Affiliation(s)
| | | | - M W M Jaspers
- M.W.M. Jaspers, Academisch Medisch Centrum, Meibergdreef 9, 1105 AZ Amsterdam, Postbus 22660, 1100 DD, Amsterdam, Location J1B-114-2, The Netherlands, Tel: +31 20 5665 269, E-mail:
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Jones D, Skrepnik N, Toselli RM, Leroy B. Incorporating Novel Mobile Health Technologies Into Management of Knee Osteoarthritis in Patients Treated With Intra-Articular Hyaluronic Acid: Rationale and Protocol of a Randomized Controlled Trial. JMIR Res Protoc 2016; 5:e164. [PMID: 27506148 PMCID: PMC4995353 DOI: 10.2196/resprot.5940] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 07/01/2016] [Accepted: 07/04/2016] [Indexed: 12/28/2022] Open
Abstract
Background Osteoarthritis (OA) of the knee is one of the leading causes of disability in the United States. One relatively new strategy that could be helpful in the management of OA is the use of mHealth technologies, as they can be used to increase physical activity and promote exercise, which are key components of knee OA management. Objective Currently, no published data on the use of a mHealth approach to comprehensively monitor physical activity in patients with OA are available, and similarly, no data on whether mHealth technologies can impact outcomes are available. Our objective is to evaluate the effectiveness of mHealth technology as part of a tailored, comprehensive management strategy for patients with knee OA. Methods The study will assess the impact of a smartphone app that integrates data from a wearable activity monitor (thereby both encouraging changes in mobility as well as tracking them) combined with education about the benefits of walking on patient mobility. The results from the intervention group will be compared with data from a control group of individuals who are given the same Arthritis Foundation literature regarding the benefits of walking and wearable activity monitors but who do not have access to the data from those monitors. Activity monitors will capture step count estimates and will compare those with patients’ step goals, calories burned, and distance walked. Patients using the novel smartphone app will be able to enter information on their daily pain, mood, and sleep quality. The relationships among activity and pain, activity and mood, and sleep will be assessed, as will patient satisfaction with and adherence to the mobile app. Results We present information on an upcoming trial that will prospectively assess the ability of a mobile app to improve mobility for knee OA patients who are treated with intra-articular hyaluronic acid. Conclusions We anticipate the results of this study will support the concept that mHealth technologies provide continuous, real-time feedback to patients with OA on their overall level of activity for a more proactive, personalized approach to treatment that may help modify behavior and assist with self-management through treatment support in the form of motivational messages and reminders.
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Affiliation(s)
- Donald Jones
- Scripps Translational Science Institute, La Jolla, CA, United States.
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Sayakhot P, Carolan-Olah M, Steele C. Use of a web-based educational intervention to improve knowledge of healthy diet and lifestyle in women with Gestational Diabetes Mellitus compared to standard clinic-based education. BMC Pregnancy Childbirth 2016; 16:208. [PMID: 27495978 PMCID: PMC4974775 DOI: 10.1186/s12884-016-0996-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2015] [Accepted: 07/29/2016] [Indexed: 12/01/2022] Open
Abstract
Background This study introduced a web-based educational intervention for Australian women with gestational diabetes mellitus (GDM). The aim was to improve knowledge on healthy diet and lifestyle in GDM. Evaluation of the intervention explored women’s knowledge and understanding of GDM, healthy diet, healthy food, and healthy lifestyle, after using the web-based program compared to women receiving standard clinic-based GDM education. Methods A total of 116 women, aged 18–45 years old, newly diagnosed with GDM, participated (Intervention (n) = 56 and control (n) = 60). Women were randomly allocated to the intervention or control groups and both groups attended a standard GDM education class. Group 1(Intervention) additionally used an online touch screen/computer program. All women completed a questionnaire following the computer program and/or the education class. All questions evaluating levels of knowledge had more than one correct answer and scores were graded from 0 to 1, with each correct component receiving a score, eg. 0.25 per each correct answer in a 4 answer question. Chi-square test was performed to compare the two groups regarding knowledge of GDM. Results Findings indicated that the majority of women in the intervention group reported correct answers for “types of carbohydrate foods” for pregnant women with GDM, compared to the control group (62.5 % vs 58.3 %, respectively). Most women in both groups had an excellent understanding of “fruits and vegetables” (98.2 % vs 98.3 %), and the majority of women in the intervention group understood that they should exercise daily for 30 min, compared to the control group (92.9 % vs 91.7 %). Both groups had a good understanding across all categories, however, the majority of women in the intervention group scored all correct answers (score = 1) in term of foetal effects (17.9 % vs 13.3 %, respectively), maternal predictors (5.4 % vs 5 %), care requirements (39.3 % vs 23.3 %), GDM perceptions (48.2 % vs 46.7 %) and GDM treatment (67.9 % vs 61.7 %), compared to women in the control group. Conclusion The study suggested that both approaches, standard education and standard education plus web-based program, resulted in excellent knowledge scores, but not statistically significant difference between groups. Multiple and immediate access to the web-based education program at home may prove useful as a source of reference for women with GDM. Future study comparing results pre and post intervention is needed. Trial registration ACTRN12615000697583; Date registered: 03/07/2015; Retrospectively registered. Electronic supplementary material The online version of this article (doi:10.1186/s12884-016-0996-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Padaphet Sayakhot
- Victoria University, St Albans Campus, College of Health and Biomedicine, Building 4C, McKechnie Street, St Albans, Victoria, 3021, Australia.
| | - Mary Carolan-Olah
- Victoria University, St Albans Campus, College of Health and Biomedicine, Building 4C, McKechnie Street, St Albans, Victoria, 3021, Australia
| | - Cheryl Steele
- Diabetes Education Service, Endocrinology and Diabetes Centre, Western Health Sunshine Hospital, 176 Furlong Road, Sunshine, Victoria, 3021, Australia
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Domnich A, Arata L, Amicizia D, Signori A, Patrick B, Stoyanov S, Hides L, Gasparini R, Panatto D. Development and validation of the Italian version of the Mobile Application Rating Scale and its generalisability to apps targeting primary prevention. BMC Med Inform Decis Mak 2016; 16:83. [PMID: 27387434 PMCID: PMC4936279 DOI: 10.1186/s12911-016-0323-2] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 06/17/2016] [Indexed: 12/04/2022] Open
Abstract
Background A growing body of literature affirms the usefulness of mobile technologies, including mobile applications (apps), in the primary prevention field. The quality of health apps, which today number in the thousands, is a crucial parameter, as it may affect health-related decision-making and outcomes among app end-users. The mobile application rating scale (MARS) has recently been developed to evaluate the quality of such apps, and has shown good psychometric properties. Since there is no standardised tool for assessing the apps available in Italian app stores, the present study developed and validated an Italian version of MARS in apps targeting primary prevention. Methods The original 23-item version of the MARS assesses mobile app quality in four objective quality dimensions (engagement, functionality, aesthetics, information) and one subjective dimension. Validation of this tool involved several steps; the universalist approach to achieving equivalence was adopted. Following two backward translations, a reconciled Italian version of MARS was produced and compared with the original scale. On the basis of sample size estimation, 48 apps from three major app stores were downloaded; the first 5 were used for piloting, while the remaining 43 were used in the main study in order to assess the psychometric properties of the scale. The apps were assessed by two raters, each working independently. The psychometric properties of the final version of the scale was assessed including the inter-rater reliability, internal consistency, convergent, divergent and concurrent validities. Results The intralingual equivalence of the Italian version of the MARS was confirmed by the authors of the original scale. A total of 43 apps targeting primary prevention were tested. The MARS displayed acceptable psychometric properties. The MARS total score showed an excellent level of both inter-rater agreement (intra-class correlation coefficient of .96) and internal consistency (Cronbach’s α of .90 and .91 for the two raters, respectively). Other types of validity, including convergent, divergent, discriminative, known-groups and scalability, were also established. Conclusions The Italian version of MARS is a valid and reliable tool for assessing the health-related primary prevention apps available in Italian app stores. Electronic supplementary material The online version of this article (doi:10.1186/s12911-016-0323-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Lucia Arata
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Daniela Amicizia
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Alessio Signori
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Bernard Patrick
- School of Medical and Pharmaceutical Sciences, University of Genoa, Genoa, Italy
| | - Stoyan Stoyanov
- Institute of Health & Biomedical Innovation, School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia.,The Young and Well Cooperative Research Centre, Abbotsford, Australia
| | - Leanne Hides
- Institute of Health & Biomedical Innovation, School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia.,The Young and Well Cooperative Research Centre, Abbotsford, Australia
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Kruse CS, Mileski M, Moreno J. Mobile health solutions for the aging population: A systematic narrative analysis. J Telemed Telecare 2016; 23:439-451. [PMID: 27255207 DOI: 10.1177/1357633x16649790] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Introduction The ubiquitous nature of mobile technology coupled with the acceptance of mobile health (mHealth) among the elderly offers an opportunity to augment the existing medical workforce in long-term care. The objective of this review and narrative analysis is to identify and analyse facilitators and barriers to adoption of mHealth for the elderly. Methods Studies over the last year were identified in multiple database indices, and three reviewers examined abstracts ( k = 0.82) and analysed articles for themes which were tallied in affinity diagrams to identify frequency of occurrence in the literature (n = 36). Results The three facilitators mentioned most often were independence (18%), understanding (13%), and visibility (13%). The three barriers mentioned most often were complexity (21%), limited by users (12%) and ineffective (12%). Discussion and conclusions The reviewers concluded that the work done so far illustrates that mHealth enables a perception of independence. Future research should focus on the barriers of complexity of technology and improving existing medical literacy in order to facilitate further adoption.
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Affiliation(s)
| | - Michael Mileski
- School of Health Administration, Texas State University, USA
| | - Joshua Moreno
- School of Health Administration, Texas State University, USA
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Urrea B, Misra S, Plante TB, Kelli HM, Misra S, Blaha MJ, Martin SS. Mobile Health Initiatives to Improve Outcomes in Primary Prevention of Cardiovascular Disease. CURRENT TREATMENT OPTIONS IN CARDIOVASCULAR MEDICINE 2015; 17:59. [PMID: 26474892 DOI: 10.1007/s11936-015-0417-7] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OPINION STATEMENT Cardiovascular disease affects more than a third of American adults and is the leading cause of mortality in the USA. Over the last 40 years, several behavioral and medical risk factors have been recognized as major contributors to cardiovascular disease. Effective management of many of these risk factors, particularly behavioral risk factors, remains challenging. With the growth of mobile health (mHealth) technology, a variety of novel strategies are now available to facilitate the delivery of interventions directed at reducing these risk factors. In this review, we discuss recent clinical studies and technologic innovations leveraging smartphone devices, social media, and wearable health tracking devices to facilitate behavioral interventions directed at three important and highly prevalent behavioral risk factors for cardiovascular disease: smoking, physical inactivity, and sub-optimal nutrition. We believe this technology has significant potential to provide low-cost, scalable, and individualized tools to improve management of these important cardiovascular disease risk factors.
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Affiliation(s)
- Bruno Urrea
- Ciccarone Center for the Prevention of Heart Disease, Division of Cardiology, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Carnegie 568, Baltimore, MD, 21287, USA.
| | - Satish Misra
- Division of Cardiology, Johns Hopkins University School of Medicine, Carnegie 592, Baltimore, MD, 21287, USA.
| | - Timothy B Plante
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, 2024 E Monument St, Suite 2-617, Baltimore, MD, 21287, USA.
| | - Heval M Kelli
- Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, 1462 Clifton Rd NE, Suite #513, Atlanta, GA, 30329, USA.
| | - Sanjit Misra
- Stanford Health Care, 300 Pasteur Dr, Stanford, CA, 94305, USA.
| | - Michael J Blaha
- Ciccarone Center for the Prevention of Heart Disease, Division of Cardiology, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Blalock 524, Baltimore, MD, 21287, USA.
| | - Seth S Martin
- Ciccarone Center for the Prevention of Heart Disease, Division of Cardiology, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Carnegie 591, Baltimore, MD, 21287, USA.
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Jahangiry L, Shojaeizadeh D, Abbasalizad Farhangi M, Yaseri M, Mohammad K, Najafi M, Montazeri A. Interactive web-based lifestyle intervention and metabolic syndrome: findings from the Red Ruby (a randomized controlled trial). Trials 2015; 16:418. [PMID: 26390998 PMCID: PMC4578667 DOI: 10.1186/s13063-015-0950-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 09/09/2015] [Indexed: 12/02/2022] Open
Abstract
Background Metabolic syndrome is a growing public health problem worldwide. Several interventions have been proposed to specifically target the problem. This study evaluated the effectiveness of an interactive web-based lifestyle for management of metabolic syndrome. Methods This randomized controlled trial was conducted from June through August 2012 in Tehran, Iran. Participants were individuals with metabolic syndrome who had registered on the study website. Interested eligible participants were invited for a free clinic visit and clinical assessment. They were randomly assigned to the intervention (n = 80) or control (n = 80) group. The intervention group received an interactive web-based program called the Healthy Heart Profile and were followed for 6 months. The control group received general information on metabolic syndrome. Anthropometric measures, glycemic status, and lipid profile were evaluated at baseline, and at 3- and 6-month follow-up assessments. Metabolic syndrome was defined according to The National Cholesterol Education Program Adult Treatment Panel (ATP) III report except for waist circumference, which was modified to ≥90 cm for both genders for the Iranian population. Results In total, 1,437 individuals registered on the study website. The mean age of participants was 44.2 years (SD = 10.0). There were no significant differences between the intervention and control groups on any baseline variable except that participants in the intervention group recorded higher levels of LDL. The results showed a decrease in metabolic syndrome in both groups. These reductions were significantly greater in the intervention group at the 3- and 6-month follow-ups. The intervention group showed significantly greater decreases (P < 0.05) over the control group for, respectively, systolic blood pressure (3-month: −10 versus −6 mmHg; 6-month: −11 versus −8 mmHg), diastolic blood pressure (3-month: −10 versus −4 mmHg; 6-month: −11 versus −6 mmHg), weight (3-month: −2 versus −1 kg; 6-month: −4 versus −1 kg), body mass index (3-month: −0.5 versus −0.2 kg/m2; 6-month: −1.1 versus −0.4 kg/m2) and improvement in HDL (3-month: 2 versus 0.64 mg/dl; 6-month: 6 versus 4 mg/dl). Conclusion The findings suggest that the web-based interactive program was beneficial for individuals with metabolic syndrome. Comprehensive interactive web-based prevention programs are promising to help involve patients in improving management of metabolic syndrome and adopting a healthy lifestyle. Trial registration IRCT201111198132N1. Registered 27 May 2013. Electronic supplementary material The online version of this article (doi:10.1186/s13063-015-0950-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Leila Jahangiry
- Department of Health Education and Health Promotion, School of Public Health, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Davoud Shojaeizadeh
- Department of Health Education and Health Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - Mahdieh Abbasalizad Farhangi
- Department of Community Nutrition, Faculty of Health and Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Mehdi Yaseri
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - Kazem Mohammad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - Mahdi Najafi
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Ali Montazeri
- Mental Health Research Group, Health Metrics Research Center, Iranian Institutes for Health Sciences Research, ACECR, Tehran, Iran. .,Faculty of Humanity Sciences, University of Science and Culture, ACECR, Tehran, Iran.
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Dallinga JM, Mennes M, Alpay L, Bijwaard H, Baart de la Faille-Deutekom M. App use, physical activity and healthy lifestyle: a cross sectional study. BMC Public Health 2015; 15:833. [PMID: 26316060 PMCID: PMC4552464 DOI: 10.1186/s12889-015-2165-8] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Accepted: 08/18/2015] [Indexed: 01/16/2023] Open
Abstract
Background Physical inactivity is a growing public health concern. Use of mobile applications (apps) may be a powerful tool to encourage physical activity and a healthy lifestyle. For instance, apps may be used in the preparation of a running event. However, there is little evidence for the relationship between app use and change in physical activity and health in recreational runners. The aim of this study was to determine the relationship between the use of apps and changes in physical activity, health and lifestyle behaviour, and self-image of short and long distance runners. Methods A cross sectional study was designed. A random selection of 15,000 runners (of 54,000 participants) of a 16 and 6.4 km recreational run (Dam tot Damloop) in the Netherlands was invited to participate in an online survey two days after the run. Anthropometrics, app use, activity level, preparation for running event, running physical activity (RPA), health and lifestyle, and self-image were addressed. A chi-squared test was conducted to analyse differences between app users and non-app users in baseline characteristics as well as in RPA, healthy lifestyle and perceived health. In addition, a multivariate logistic regression analysis was performed to determine if app use could predict RPA, perceived health and lifestyle, and self-image. Results Of the 15,000 invited runners, 28 % responded. For both distances, app use was positively related to RPA and feeling healthier (p < 0.05). Also, app use was positively related to feeling better about themselves, feeling like an athlete, motivating others to participate in running, and losing weight (p < 0.01). Furthermore, for 16 km runners app use was positively related to eating healthier, feeling more energetic and reporting a higher chance to maintain sport behaviour (p < 0.05). Conclusions These results suggest that use of mobile apps has a beneficial role in the preparation of a running event, as it promotes health and physical activity. Further research is now needed to determine a causal relationship between app use and physical and health related behaviour. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-2165-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Joan Martine Dallinga
- School of Sports and Nutrition, Amsterdam University of Applied Sciences, Dr. Meurerlaan 8, 1067 SM, Amsterdam, The Netherlands. .,Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Blijdorplaan 15, 2015 CE, Haarlem, The Netherlands.
| | - Matthijs Mennes
- School of Sports and Nutrition, Amsterdam University of Applied Sciences, Dr. Meurerlaan 8, 1067 SM, Amsterdam, The Netherlands.
| | - Laurence Alpay
- Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Blijdorplaan 15, 2015 CE, Haarlem, The Netherlands.
| | - Harmen Bijwaard
- Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Blijdorplaan 15, 2015 CE, Haarlem, The Netherlands.
| | - Marije Baart de la Faille-Deutekom
- School of Sports and Nutrition, Amsterdam University of Applied Sciences, Dr. Meurerlaan 8, 1067 SM, Amsterdam, The Netherlands. .,Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Blijdorplaan 15, 2015 CE, Haarlem, The Netherlands.
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