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Zhou C, Chen J, Tan F, Lai S, Li X, Pu K, Wu J, Dong Y, Zhao F. Relationship between self-care compliance, trust, and satisfaction among hypertensive patients in China. Front Public Health 2023; 10:1085047. [PMID: 36743158 PMCID: PMC9889937 DOI: 10.3389/fpubh.2022.1085047] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 12/29/2022] [Indexed: 01/20/2023] Open
Abstract
Introduction Hypertension is a growing public health concern worldwide. It is a leading risk factor for all-cause mortality and may lead to complications such as cardiovascular disease, stroke, and kidney failure. Poor compliance of hypertensive patients is one of the major barriers to controlling high blood pressure. Compliance is not ideal among Chinese patients, and increasing patient self-care compliance with hypertension is necessary. Methods This article analyzes the status of self-care compliance, trust, and satisfaction among Chinese hypertensive patients using cross-sectional data from Zhejiang Province. We use a multi-group structural equation model (MGSEM) to compare the interrelationships across genders. Results The study's findings show that the average trust, satisfaction, and compliance scores are 3.92 ± 0.55, 3.98 ± 0.61, and 3.33 ± 0.41, respectively. Female patients exhibit higher average total scores for trust and compliance than male patients. The SEM results indicate that trust has a direct positive association with compliance [β = 0.242, 95% CI: (0.068, 0.402)] and satisfaction [β = 0.260, 95% CI: (0.145, 0.367)], while their satisfaction is not directly associated with compliance. The results of MGSEM show that trust has an indirect effect on compliance in the male group through satisfaction [β = 0.051, P < 0.05, 95% CI: (0.012, 0.116)]. In the female group, trust has a direct effect on satisfaction [β = 0.235, P < 0.05, 95% CI: (0.041, 0.406)] and compliance [β = 0.319, P < 0.01, 95% CI: (0.086, 0.574)]. Discussion This study reveals the mechanisms of self-care compliance, trust, and satisfaction among Chinese hypertensive patients. Its findings may serve as a reference for guiding primary healthcare providers to improve hypertension patients' compliance and implement gender-targeted health interventions.
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Affiliation(s)
- Chi Zhou
- Department of Health Management, School of Public Health, Hangzhou Normal University, Hangzhou, China,*Correspondence: Chi Zhou ✉
| | - Jingchun Chen
- Department of Health Management, School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Fang Tan
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Sihong Lai
- Department of Health Management, School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Xu Li
- Department of Health Management, School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Ke Pu
- Department of Health Management, School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Jiahui Wu
- Department of Health Management, School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Yin Dong
- Department of Hospital Office, The People's Hospital of Yuhuan, Taizhou, China,Yin Dong ✉
| | - Falin Zhao
- Department of Health Management, School of Public Health, Hangzhou Normal University, Hangzhou, China,Falin Zhao ✉
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Yuting Z, Xiaodong T, Qun W. Effectiveness of a mHealth intervention on hypertension control in a low-resource rural setting: A randomized clinical trial. Front Public Health 2023; 11:1049396. [PMID: 36935728 PMCID: PMC10014612 DOI: 10.3389/fpubh.2023.1049396] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 02/06/2023] [Indexed: 03/05/2023] Open
Abstract
Background Despite the increasing popularity of mHealth, little evidence indicates that they can improve health outcomes. Mobile health interventions (mHealth) have been shown as an attractive approach for health-care systems with limited resources. To determine whether mHealth would reduce blood pressure, promote weight loss, and improve hypertension compliance, self-efficacy and life quality in individuals with hypertension living in low-resource rural settings in Hubei, China. Methods In this parallel-group, randomized controlled trial, we recruited individuals from health-care centers, home visits, and community centers in low-resource rural settings in Hubei, China. Of 200 participants who were screened, 148 completed consent, met inclusion criteria, and were randomly assigned in a ratio of 1:1 to control or intervention. Intervention group participants were instructed to use the Monitoring Wearable Device and download a Smartphone Application, which includes reminder alerts, adherence reports, medical instruction and optional family support. Changes in the index of Cardiovascular health risk factors from baseline to end of follow-up. Secondary outcomes were change in hypertension compliance, self-efficacy and life quality at 12 weeks. Results Participants (n = 134; 66 in the intervention group and 68 controls) had a mean age of 61.73 years, 61.94% were male. After 12 weeks, the mean (SD) systolic blood pressure decreased by 8.52 (19.73) mm Hg in the intervention group and by 1.25 (12.47) mm Hg in the control group (between-group difference, -7.265 mm Hg; 95% CI, -12.89 to -1.64 mm Hg; P = 0.012), While, there was no difference in the change in diastolic blood pressure between the two groups (between-group difference, -0.41 mm Hg; 95% CI, -3.56 to 2.74 mm Hg; P = 0.797). After 12 weeks of follow-up, the mean (SD) hypertension compliance increased by 7.35 (7.31) in the intervention group and by 3.01 (4.92) in the control group (between-group difference, 4.334; 95% CI, 2.21 to -6.46; P < 0.01), the mean (SD) hypertension compliance increased by 12.89 (11.95) in the intervention group and by 5.43 (10.54) in the control group (between-group difference, 7.47; 95% CI, 3.62 to 11.31; P < 0.01), the mean (SD) physical health increased by 12.21 (10.77) in the intervention group and by 1.54 (7.18) in the control group (between-group difference, 10.66; 95% CI, 7.54-13.78; P < 0.01), the mean (SD) mental health increased by 13.17 (9.25) in the intervention group and by 2.55 (5.99) in the control group (between-group difference, 10.93; 95% CI, 7.74 to 14.12; P < 0.01). Conclusions Among participants with uncontrolled hypertension, individuals randomized to use a monitoring wearable device with a smartphone application had a significant improvement in self-reported hypertension compliance, self-efficacy, life quality, weight loss and diastolic blood pressure, but no change in systolic blood pressure compared with controls.
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Affiliation(s)
- Zhang Yuting
- Health Science Centre, Shenzhen University, Shenzhen, China
| | - Tan Xiaodong
- School of Public Health, Wuhan University, Wuhan, China
| | - Wang Qun
- Health Science Centre, Shenzhen University, Shenzhen, China
- *Correspondence: Wang Qun
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Bennett JP, Liu YE, Kelly NN, Quon BK, Wong MC, McCarthy C, Heymsfield SB, Shepherd JA. Next generation smartwatches to estimate whole body composition using bioimpedance analysis: accuracy and precision in a diverse multiethnic sample. Am J Clin Nutr 2022; 116:1418-1429. [PMID: 35883219 DOI: 10.1093/ajcn/nqac200] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 06/07/2022] [Accepted: 07/19/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Novel advancements in wearable technologies include continuous measurement of body composition via smart watches. The accuracy and stability of devices are unknown. OBJECTIVES This study evaluated smart watches with integrated bioimpedance (BIA) sensors for their ability to measure and monitor change in body composition. DESIGN Participants recruited across body mass indexes received duplicate body composition measures using two wearable smart watch (W-BIA) models in sitting and standing positions and multiple versions of each watch were used to evaluate inter- and intra-model precision. Duplicate laboratory-grade octapolar bioimpedance (8-BIA) and criterion dual-energy X-ray absorptiometry (DXA) scans were acquired to compare estimates between the watches and laboratory methods. Test-retest precision and least significant changes assessed the ability to monitor change in body composition. RESULTS Of 109 participants recruited, 75 subjects completed the full manufacturer-recommended protocol. No significant differences were observed between W-BIA watches in position or between watch models. Significant fat-free mass (FFM) differences (p < 0.05) were observed between both W-BIA and 8-BIA when compared to DXA, though the systematic biases to the criterion were correctable. No significant difference was observed between the W-BIA and the laboratory-grade BIA technology for FFM (55.3 ± 14.5 kg for W-BIA versus 56.0 ± 13.8 kg for 8-BIA, p > 0.05, CCC = 0.97). FFM was less precise on the watches than DXA (CV = 0.7%, RMSE = 0.4 kg versus CV = 1.3%, RMSE = 0.7 kg for W-BIA), requiring more repeat measures to equal the same confidence in body composition change over time as DXA. CONCLUSIONS After systematic correction, smart watch BIA devices are capable of stable, reliable and accurate body composition with precision comparable but lower than laboratory measures. These devices allow for measurement in environments not accessible to laboratory systems such as the home, training centers, and geographically remote locations.
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Affiliation(s)
- Jonathan P Bennett
- Graduate Program in Human Nutrition, University of Hawai'i Manoa, Agricultural Science Building, 1955 East-West Rd, Honolulu, Hawaii, 96822, USA.,Department of Epidemiology, University of Hawai'i Cancer Center, 701 Ilalo St, Honolulu, Hawaii, 96813 USA
| | - Yong En Liu
- Department of Epidemiology, University of Hawai'i Cancer Center, 701 Ilalo St, Honolulu, Hawaii, 96813 USA
| | - Nisa N Kelly
- Department of Epidemiology, University of Hawai'i Cancer Center, 701 Ilalo St, Honolulu, Hawaii, 96813 USA
| | - Brandon K Quon
- Department of Epidemiology, University of Hawai'i Cancer Center, 701 Ilalo St, Honolulu, Hawaii, 96813 USA
| | - Michael C Wong
- Graduate Program in Human Nutrition, University of Hawai'i Manoa, Agricultural Science Building, 1955 East-West Rd, Honolulu, Hawaii, 96822, USA.,Department of Epidemiology, University of Hawai'i Cancer Center, 701 Ilalo St, Honolulu, Hawaii, 96813 USA
| | - Cassidy McCarthy
- Pennington Biomedical Research Center, Louisiana State University, 6400 Perkins Rd, Baton Rouge, Louisiana, 70808 USA
| | - Steven B Heymsfield
- Pennington Biomedical Research Center, Louisiana State University, 6400 Perkins Rd, Baton Rouge, Louisiana, 70808 USA
| | - John A Shepherd
- Graduate Program in Human Nutrition, University of Hawai'i Manoa, Agricultural Science Building, 1955 East-West Rd, Honolulu, Hawaii, 96822, USA.,Department of Epidemiology, University of Hawai'i Cancer Center, 701 Ilalo St, Honolulu, Hawaii, 96813 USA
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Design of a Planner-Based Intervention to Facilitate Diet Behaviour Change in Type 2 Diabetes. SENSORS 2022; 22:s22072795. [PMID: 35408411 PMCID: PMC9002653 DOI: 10.3390/s22072795] [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: 02/04/2022] [Revised: 03/28/2022] [Accepted: 03/29/2022] [Indexed: 11/17/2022]
Abstract
Diet behaviour is influenced by the interplay of the physical and social environment as well as macro-level and individual factors. In this study, we focus on diet behaviour at an individual level and describe the design of a behaviour change artefact to support diet behaviour change in persons with type 2 diabetes. This artefact was designed using a human-centred design methodology and the Behaviour Change Wheel framework. The designed artefact sought to support diet behaviour change through the addition of healthy foods and the reduction or removal of unhealthy foods over a 12-week period. These targeted behaviours were supported by the enabling behaviours of water consumption and mindfulness practice. The artefact created was a behaviour change planner in calendar format, that incorporated behaviour change techniques and which focused on changing diet behaviour gradually over the 12-week period. The behaviour change planner forms part of a behaviour change intervention which also includes a preparatory workbook exercise and one-to-one action planning sessions and can be customised for each participant.
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Yen HY, Huang WH. The efficacy of commercial smartwatches with a blood pressure-monitoring feature: A pilot randomized controlled trial. J Nurs Scholarsh 2021; 54:324-331. [PMID: 34791761 DOI: 10.1111/jnu.12740] [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: 06/10/2021] [Revised: 10/13/2021] [Accepted: 10/22/2021] [Indexed: 01/04/2023]
Abstract
PURPOSE The purpose was to explore the efficacy of a commercial smartwatch with a blood pressure-monitoring feature. DESIGN A randomized controlled trial. METHODS Sixty healthy young adults were recruited. Participants were randomly allocated to wear a commercial smartwatch, one with and one without a blood pressure-monitoring feature for 12 weeks. Data were collected using Omron HEM-907, Inbody 270S, and the International Physical Activity Questionnaire. FINDINGS Results revealed a significant effect and group-by-time interaction on diastolic blood pressure. After 12 weeks in participants who wore a smartwatch with a blood pressure-monitoring feature, the systolic and diastolic blood pressure and resting heart rate had decreased. CONCLUSION Using commercial smartwatches with a blood pressure-monitoring feature is a feasible approach to support self-management, increase awareness, and promote physical activity for health promotion, obesity and chronic disease prevention. CLINICAL RELEVANCE Wearable technologies may be an innovative strategy for preventing high blood pressure by continuous self-monitoring and healthy behavior modifications.
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Affiliation(s)
- Hsin-Yen Yen
- School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei, Taiwan
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Chen Z, Qi H, Wang L. Study on the Types of Elderly Intelligent Health Management Technology and the Influencing Factors of Its Adoption. Healthcare (Basel) 2021; 9:healthcare9111494. [PMID: 34828539 PMCID: PMC8619684 DOI: 10.3390/healthcare9111494] [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: 09/17/2021] [Revised: 10/29/2021] [Accepted: 10/29/2021] [Indexed: 11/16/2022] Open
Abstract
[Background]: In recent years, aging has become a global social problem. Intelligent health management technology (IHMT) provides solutions for the elderly to deal with various health risks. However, the elderly are facing many difficulties in using IHMT. Studying the application types of IHMT and the influencing factors of the elderly’s acceptance of it will help to improve the use behavior of the elderly. [Methods]: This paper summarizes the application types of IHMT, identifies the influencing factors of the elderly’s adaption of IHMT, and makes a systematic comment on the influencing factors. [Results]: We divide the different functions of IHMT for the elderly into four types: self-monitoring, medical care, remote monitoring, and health education. The influencing factors are divided into three types: individual, social, and technology. [Conclusions]: This study finds that IHMT’s application covers all aspects of the health services of the elderly. Among these applications, self-monitoring is the most used. We divided the influencing factors of the elderly’s acceptance of IHMT into three categories and nine subcategories, having 25 variables.
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Affiliation(s)
- Zhu Chen
- School of Nursing, Peking University, Beijing 100191, China;
| | - Huiying Qi
- Department of Health Informatics and Management, School of Health Humanities, Peking University, Beijing 100191, China;
- Correspondence: ; Tel.: +86-10-82805574
| | - Luman Wang
- Department of Health Informatics and Management, School of Health Humanities, Peking University, Beijing 100191, China;
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Zhang Y, Fang Y, Xu Y, Xiong P, Zhang J, Yang J, Ran L, Tan X. Adherence with blood pressure monitoring wearable device among the elderly with hypertension: The case of rural China. Brain Behav 2020; 10:e01599. [PMID: 32385965 PMCID: PMC7303401 DOI: 10.1002/brb3.1599] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Revised: 02/02/2020] [Accepted: 02/21/2020] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION Wearable blood pressure (BP) monitor devices are increasingly adopted owing to the promotion of hypertension management program. However, little is known about the adherence and its associated factors in older adults (OAs) with hypertension. METHODS The aim of this study was to determine factors associated with adherence to wearable BP monitor. In total, 212 OAs with hypertension in a remote rural area in China were asked to wear a BP monitor over 1-month period. The following information on associated factors for adherence was collected, including demographic characteristics, cardiovascular health measurements, technology fluency, the Compliance of Hypertensive Patients' Scale, and the Health-related Quality of Life Survey. As a result, the mean age of the 212 hypertension participants was 71.32 years (SD = 6.81). RESULTS During the 30-day survey, 50.94% of the participants with daily recoded BP wristband data were assigned as "BP device users." The binary logistic regression model revealed that lower lifestyle compliance, lower medication compliance and higher total hypertension compliance were significant predictors for adherence. However, there were no differences concerning cardiovascular health factors, technology fluency, and health-related quality of life between device users and nonusers. CONCLUSION Individuals reporting a higher level of total compliance in hypertension management were more likely to wear a BP monitor device among OAs with hypertension. In addition, further research is needed to determine how wearable mHealth technology can be used to develop better hypertension self-management education programs for this population.
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Affiliation(s)
- Yuting Zhang
- Department of Occupational and Environmental HealthSchool of Health SciencesWuhan UniversityWuhanChina
| | - Yuan Fang
- Department of NursingThe Second Affiliated Hospital of Bengbu Medical CollegeBengbuChina
| | - Yi Xu
- Department of Occupational and Environmental HealthSchool of Health SciencesWuhan UniversityWuhanChina
| | - Peng Xiong
- Department of Preventive Medicine and Public HealthSchool of MedicineJinan UniversityGuangzhouChina
| | - Jingyi Zhang
- Department of Occupational and Environmental HealthSchool of Health SciencesWuhan UniversityWuhanChina
| | - Jinru Yang
- College of Clinical MedicineWuhan University of Science and TechnologyWuhanChina
| | - Li Ran
- Department of Occupational and Environmental HealthSchool of Health SciencesWuhan UniversityWuhanChina
| | - Xiaodong Tan
- Department of Occupational and Environmental HealthSchool of Health SciencesWuhan UniversityWuhanChina
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