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Kirkpatrick S, Davey Z, Wright PR, Henshall C. Supportive eHealth Technologies and Their Effects on Physical Functioning and Quality of Life for People With Lung Cancer: Systematic Review. J Med Internet Res 2024; 26:e53015. [PMID: 39059003 PMCID: PMC11316152 DOI: 10.2196/53015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 05/01/2024] [Accepted: 05/18/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND Despite advancements in treatment and early diagnosis, people with lung cancer are not living as long as those with other cancers. The more common symptoms of lung cancer, such as breathlessness, fatigue, and depression, can be alleviated by improving patients' physical functioning. Therefore, good symptom management and improved health-related quality of life (HRQoL) are priorities in this patient group. However, current health care services have limited capacity to provide this support. One way to address this issue of health care resources is to empower patients to self-manage their condition using eHealth technologies. OBJECTIVE The purpose of this review was to identify and assess available research on technologies that support persons with lung cancer to improve or maintain their physical functioning, HRQoL, or both. METHODS Six databases-PubMed, Web of Science, CINAHL, MEDLINE, SPORTDiscus, and PsycINFO-were searched from January 1, 1990, to April 30, 2023. Studies were suitable for inclusion if the participants included people with lung cancer aged >18 years who had been exposed to a physical activity, exercise, or training intervention that was delivered via an electronic or web-based application with or without a comparator. Furthermore, the study had to report on the impact of the intervention on physical functioning and HRQoL. Studies that focused on telemedicine without a digital intervention were excluded. The Grading of Recommendations Assessment, Development, and Evaluation system was used to assess the quality of the included papers. Due to the heterogeneity of the studies, a narrative synthesis was undertaken. RESULTS This review is reported in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A total of 794 papers were initially identified through our search, of which, after screening, 8 (1%) were confirmed suitable for inclusion in the review. As 2 (25%) of the 8 papers reported on different stages of the same study, we included only 7 studies in our analysis. The studies were undertaken between 2010 and 2018 across multiple countries and aimed to develop a technology and test its feasibility or acceptance. The 7 technologies identified included web-based applications, mobile apps, and gaming consoles. The studies demonstrated impact on walking distance, muscle strength, balance, dyspnea symptoms, and cancer-related fatigue. HRQoL scores also showed improvement. CONCLUSIONS The findings indicate that eHealth technologies can positively impact physical functioning and well-being for people with lung cancer, but there are limited studies that demonstrate the impact of these digital interventions over longer periods. None of the studies reported on the implementation or adoption of a mobile health or eHealth intervention in routine clinical practice, highlighting the need for further research in this area. TRIAL REGISTRATION PROSPERO CRD42023414094; https://tinyurl.com/39hhbwyx.
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Affiliation(s)
- Suriya Kirkpatrick
- School of Nursing, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, United Kingdom
| | - Zoe Davey
- School of Nursing, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, United Kingdom
| | - Peter Richard Wright
- School of Nursing, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, United Kingdom
| | - Catherine Henshall
- School of Nursing, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, United Kingdom
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Villinger K, Berli C, Scholz U. App-based interventions to improve cancer outcomes rely on informational support from professionals: a systematic review. Health Psychol Rev 2024:1-23. [PMID: 38755755 DOI: 10.1080/17437199.2024.2349617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 04/25/2024] [Indexed: 05/18/2024]
Abstract
The importance of social support for cancer patients is well-established, and mobile applications hold promise for implementation. This systematic review examines app-based interventions with social support components for cancer patients, investigating the use of different support functions from different sources and the impact on cancer-related symptoms and psychological outcomes. A systematic search across five databases (EMBASE, Scopus, PsycINFO, PubMed, Web of Science) yielded 449 records, of which 17 studies (12 controlled designs) were included. Two independent reviewers extracted data and assessed study quality, revealing a high risk of bias across studies. Social support was implemented through different app functions, including contact/chat functions (n = 9), automatic alerts based on app input (n = 6) and discussion forums (n = 5). Social support predominantly focused on informational support (n = 17), mostly from healthcare professionals. Emotional support was less common (n = 7). Results indicated some promising intervention effects for pain, fatigue, nausea/vomiting, insomnia, constipation and overall symptom distress, but heterogeneous effects for health-related quality of life. Overall, results were mixed, but indicate that mobile apps incorporating social support may hold promise for cancer patients. However, future studies should focus on measuring and reporting social support as an intervention mechanism to systematically investigate its specific impact and improve effectiveness.HighlightsApps for cancer patients predominantly include informational social supportEmotional social support is substantially less frequently includedApps focus on formal support sources like healthcare professionalsFirst results are somewhat promising for improving cancer-related symptoms.
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Affiliation(s)
| | - Corina Berli
- Institute of Psychology, University of Bern, Bern, Switzerland
| | - Urte Scholz
- Department of Psychology, University of Zurich, Zurich, Switzerland
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Wolff J, Seidel S, Wuelfing P, Lux MP, zu Eulenburg C, Smollich M, Baumann F, Seitz S, Kuemmel S, Thill M, Tio J, Braun M, Hollaender H, Seitz A, Horn F, Harbeck N, Wuerstlein R. App-based support for breast cancer patients to reduce psychological distress during therapy and survivorship - a multicentric randomized controlled trial. Front Oncol 2024; 14:1354377. [PMID: 38699636 PMCID: PMC11064693 DOI: 10.3389/fonc.2024.1354377] [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: 12/12/2023] [Accepted: 03/04/2024] [Indexed: 05/05/2024] Open
Abstract
Introduction The negative impact of unmanaged psychological distress on quality of life and outcome in breast cancer survivors has been demonstrated. Fortunately, studies indicate that distress can effectively be addressed and even prevented using evidence-based interventions. In Germany prescription-based mobile health apps, known as DiGAs (digital health applications), that are fully reimbursed by health insurances, were introduced in 2020. In this study, the effectiveness of an approved breast cancer DiGA was investigated: The personalized coaching app PINK! Coach supports and accompanies breast cancer patients during therapy and follow-up. Methods PINK! Coach was specifically designed for breast cancer (BC) patients from the day of diagnosis to the time of Follow-up (aftercare). The app offers individualized, evidence-based therapy and side-effect management, mindfulness-based stress reduction, nutritional and psychological education, physical activity tracking, and motivational exercises to implement lifestyle changes sustainably in daily routine. A prospective, intraindividual RCT (DRKS00028699) was performed with n = 434 patients recruited in 7 German breast cancer centers from September 2022 until January 2023. Patients with BC were included independent of their stage of diseases, type of therapy and molecular characteristics of the tumor. Patients were randomized into one of two groups: The intervention group got access to PINK! over 12 weeks; the control group served as a waiting-list comparison to "standard of care." The primary endpoint was psychological distress objectified by means of Patient Health Questionnaire-9 (PHQ-9). Subgroups were defined to investigate the app's effect on several patient groups such as MBC vs. EBC patients, patients on therapy vs. in aftercare, patients who received a chemotherapy vs. patients who did not. Results Efficacy analysis of the primary endpoint revealed a significant reduction in psychological distress (least squares estimate -1.62, 95% confidence interval [1.03; 2.21]; p<0.001) among intervention group patients from baseline to T3 vs, control group. Subgroup analysis also suggested improvements across all clinical situations. Conclusion Patients with breast cancer suffer from psychological problems including anxiety and depression during and after therapy. Personalized, supportive care with the app PINK! Coach turned out as a promising opportunity to significantly improve psychological distress in a convenient, accessible, and low-threshold manner for breast cancer patients independent of their stage of disease (EBC/MBC), therapy phase (aftercare or therapy) or therapy itself (chemotherapy/other therapy options). The app is routinely available in Germany as a DiGA. Clinical Trial Registration: DRKS Trial Registry (DRKS00028699).
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Affiliation(s)
- Josefine Wolff
- Breast Center, Department of Gynecology and Obstetrics, and Comprehensive Cancer Center Ludwig-Maximilian University Munich (LMU) University Hospital, Munich, Germany
- Department Clinical Research, PINK! Gegen Brustkrebs GmbH, Hamburg, Germany
| | - Svenja Seidel
- Department Clinical Research, PINK! Gegen Brustkrebs GmbH, Hamburg, Germany
| | - Pia Wuelfing
- Department Clinical Research, PINK! Gegen Brustkrebs GmbH, Hamburg, Germany
| | - Michael Patrick Lux
- Department of Gynecology and Obstetrics, Frauenklinik St. Louise and St. Josefs-Krankenhaus, St. Vincenz Klinik GmbH, Paderborn, Germany
| | - Christine zu Eulenburg
- Department for Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martin Smollich
- Institute of Nutritional Medicine, University Hospital Schleswig-Holstein, Luebeck, Germany
| | - Freerk Baumann
- Department I of Internal Medicine, University of Cologne, Cologne, Germany
| | - Stephan Seitz
- Department of Obstetrics and Gynecology, Caritas Hospital St. Josef, University of Regensburg, Regensburg, Germany
| | | | - Marc Thill
- Markus Hospital, Breast Center, Frankfurt, Germany
| | - Joke Tio
- Department of Gynecology and Obstetrics, University Hospital of Münster, Münster, Germany
| | - Michael Braun
- Department of Gynecology, Breast Center, Red Cross Hospital, Munich, Germany
| | - Hannah Hollaender
- Breast Center, Department of Gynecology and Obstetrics, and Comprehensive Cancer Center Ludwig-Maximilian University Munich (LMU) University Hospital, Munich, Germany
| | - Angenla Seitz
- Department Clinical Research, PINK! Gegen Brustkrebs GmbH, Hamburg, Germany
| | - Felicitas Horn
- Department Clinical Research, PINK! Gegen Brustkrebs GmbH, Hamburg, Germany
| | - Nadia Harbeck
- Breast Center, Department of Gynecology and Obstetrics, and Comprehensive Cancer Center Ludwig-Maximilian University Munich (LMU) University Hospital, Munich, Germany
| | - Rachel Wuerstlein
- Breast Center, Department of Gynecology and Obstetrics, and Comprehensive Cancer Center Ludwig-Maximilian University Munich (LMU) University Hospital, Munich, Germany
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Monachelli R, Davis SW, Barnard A, Longmire M, Docherty JP, Oakley-Girvan I. Designing mHealth Apps to Incorporate Evidence-Based Techniques for Prolonging User Engagement. Interact J Med Res 2024; 13:e51974. [PMID: 38416858 PMCID: PMC11005439 DOI: 10.2196/51974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 11/14/2023] [Accepted: 02/27/2024] [Indexed: 03/01/2024] Open
Abstract
Maintaining user engagement with mobile health (mHealth) apps can be a challenge. Previously, we developed a conceptual model to optimize patient engagement in mHealth apps by incorporating multiple evidence-based methods, including increasing health literacy, enhancing technical competence, and improving feelings about participation in clinical trials. This viewpoint aims to report on a series of exploratory mini-experiments demonstrating the feasibility of testing our previously published engagement conceptual model. We collected data from 6 participants using an app that showed a series of educational videos and obtained additional data via questionnaires to illustrate and pilot the approach. The videos addressed 3 elements shown to relate to engagement in health care app use: increasing health literacy, enhancing technical competence, and improving positive feelings about participation in clinical trials. We measured changes in participants' knowledge and feelings, collected feedback on the videos and content, made revisions based on this feedback, and conducted participant reassessments. The findings support the feasibility of an iterative approach to creating and refining engagement enhancements in mHealth apps. Systematically identifying the key evidence-based elements intended to be included in an app's design and then systematically testing the implantation of each element separately until a satisfactory level of positive impact is achieved is feasible and should be incorporated into standard app design. While mHealth apps have shown promise, participants are more likely to drop out than to be retained. This viewpoint highlights the potential for mHealth researchers to test and refine mHealth apps using approaches to better engage users.
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Affiliation(s)
| | | | | | | | - John P Docherty
- Weill Cornell Medical College, White Plains, NY, United States
| | - Ingrid Oakley-Girvan
- Medable Inc, Palo Alto, CA, United States
- The Public Health Institute, Oakland, CA, United States
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Duckham RL, Webster T, See K. The development and implementation of the Northern Health lung cancer digital care pathway: a case study in service change. AUST HEALTH REV 2024; 48:148-153. [PMID: 38432683 DOI: 10.1071/ah23279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 02/11/2024] [Indexed: 03/05/2024]
Abstract
This case study details the approach utilised to establish an easy to use, accessible and sustainable method for routine collection of Patient Reported Outcome Measures for patients newly diagnosed with lung cancer. We sought to enhance communication with patients and their families, particularly around shared decision making, their quality of life and symptoms, as well as the impacts of their care or treatment. We detail the co-design methodology utilised with consumers and healthcare providers to develop and implement a multi-lingual, fully automated digital care pathway which has been proven to be highly impactful and powerful for both healthcare providers working within the service and consumers enrolled within the digital pathway. This innovative initiative has changed the practice of the lung cancer service across a health service. Furthermore, its success has evolved the organisational strategy, to embed 'Outcomes for Impact' across the health service.
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Affiliation(s)
- Rachel L Duckham
- Clinical Leadership Effectiveness and Outcomes (CLEO), Northern Health, 185 Cooper Street, Epping, Vic. 3076, Australia; and Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St. Albans, Vic. 3021, Australia; and Institute for Physical Activity and Nutrition (IPAN), Deakin University, Burwood, Vic. 3125, Australia
| | - Tracey Webster
- Clinical Leadership Effectiveness and Outcomes (CLEO), Northern Health, 185 Cooper Street, Epping, Vic. 3076, Australia
| | - Katharine See
- Clinical Leadership Effectiveness and Outcomes (CLEO), Northern Health, 185 Cooper Street, Epping, Vic. 3076, Australia; and Department of Respiratory Medicine, Northern Health, Epping, Vic. 3076, Australia
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Darabos K, Renna M. Ambiguity in cancer-related recommendations among young adults: Relationships with health behaviors and psychological distress. PATIENT EDUCATION AND COUNSELING 2023; 116:107943. [PMID: 37598584 DOI: 10.1016/j.pec.2023.107943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 08/13/2023] [Accepted: 08/15/2023] [Indexed: 08/22/2023]
Abstract
BACKGROUND Young adulthood represents a sensitive period in which cancer-related lifestyle behaviors (e.g., substance use, poor physical activity) are developed and sustained into adulthood, having consequences for cancer morbidity and mortality. However, cancer prevention and control (CPC) recommendations are often ambiguous and multifaceted which may increase health-compromising behaviors and psychological distress among this vulnerable young adult (YA) population. OBJECTIVE We examined relationships between ambiguity in CPC recommendations and health behaviors and psychological distress. METHODS YAs (n = 811, aged 18-39) without cancer were drawn from the Health Information National Trends Survey 2019 data. RESULTS Regression analyses indicated that higher perceived CPC ambiguity was associated with higher health behavior recommendations not being met and higher psychological distress. CONCLUSION Focusing on elucidating CPC recommendations may reduce engagement in negative health behaviors and promote well-being. Future research may benefit from developing effective communication strategies aimed at elucidating health behavior recommendations to help educate this YA population. PRACTICAL VALUE Health care providers should be more aware of, and ready to address the potential ambiguity surrounding CPC recommendations and what that means for engagement in health-promoting and health-compromising behaviors and for psychological well-being.
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Affiliation(s)
- Katie Darabos
- Rutgers University School of Public Health, 683 Hoes Lane West, Piscataway, NJ 08854, USA.
| | - Megan Renna
- University of Southern Mississippi, School of Psychology, 118 College Drive #5025 39406, Hattiesburg, MS 39406, USA
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Watanabe-Galloway S, Ratnapradipa K, Subramanian R, Ramos A, Famojuro O, Schmidt C, Farazi P. Mobile Health (mHealth) Interventions to Increase Cancer Screening Rates in Hispanic/Latinx Populations: A Scoping Review. Health Promot Pract 2023; 24:1215-1229. [PMID: 35869654 DOI: 10.1177/15248399221103851] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023]
Abstract
Hispanic/Latinx persons have disproportionately lower breast, cervical, and colorectal cancer screening rates than non-Hispanic White (NHW) persons. This low participation in cancer screening results in late-stage cancer diagnosis among Hispanic persons compared to NHW persons. Mobile health (mHealth) interventions effectively improve cancer screening rates in the general population; however, few reviews about mHealth interventions are tailored to Hispanic populations. This is important to investigate given that Hispanic persons differ from NHW persons with regard to culture, language, and health care utilization. Therefore, in this study, we investigated: (a) What types of mHealth interventions have been undertaken to increase cancer screening rates among Hispanic persons in the United States? (b) How effective have these interventions been? and (c) What features of these interventions help increase cancer screening rates? Searches conducted during December 2020 identified 10 articles published between January 2017 and December 2020 that met our inclusion criteria. The review revealed that mHealth interventions mainly provided education about cancer and cancer screening using videos, PowerPoint slides, and interactive multimedia. mHealth interventions that effectively improved screening behavior were mainly for easy-to-screen cancers like skin and cervical cancer. Finally, reviewed studies did not provide details on how cultural adaptations were made, and it is unclear what specific features of mHealth interventions increase cancer screening rates among Hispanic persons. Future research should identify and evaluate the effects of different components of culturally tailored interventions on cancer screening. Public health practitioners and health care providers should tailor mHealth approaches to their clients or patients and practice environment.
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Affiliation(s)
| | | | | | - Athena Ramos
- University of Nebraska Medical Center, Omaha, NE, USA
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Yoon J, Lee H, Son H. Effects of an interactive coaching intervention on quality of life and psychological factors for colorectal cancer survivors: A single group pre and posttest design. Eur J Oncol Nurs 2023; 66:102413. [PMID: 37776600 DOI: 10.1016/j.ejon.2023.102413] [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: 05/23/2023] [Revised: 07/25/2023] [Accepted: 09/07/2023] [Indexed: 10/02/2023]
Abstract
OBJECTIVE To develop and evaluate the effects of an interactive coaching intervention, using a self-management mobile application, on quality of life and physical and psychological factors for colorectal cancer survivors. METHODS We developed a self-management mobile application providing social support services for post-treatment CRC survivors and evaluated its effects through baseline and post-intervention surveys. Using the biopsychosocial holistic model as the theoretical framework, automated interactive coaching technology was applied for six weeks to provide supportive services tailored for each user. To evaluate the effects of the application, self-efficacy, health practice index, depression, fear of cancer recurrence, and quality of life measures were administered to participants. A total of 34 men and 5 women were included in the analysis. RESULTS Participants' mean age were 54.10 years and 78% of them had been diagnosed within the last five years. There were significant increases in self-efficacy (z = 2.09, p = .04), health practice index (t = 2.35, p = .02), and quality of life (t = 2.03, p = .05). More specifically, the emotional functional score increased (z = 2.23, p = .03) while both of the total symptom score (t = 2.10, p = .04) and the fatigue symptom score (z = 2.54, p = .01) decreased after six weeks of using the mobile application. CONCLUSIONS Interventions supporting colorectal cancer survivors' self-management are critical for addressing the challenges they face after treatment and improving their quality of life. Providing social support through mobile applications could be a good strategy in terms of usability and effectiveness.
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Affiliation(s)
- Jaehee Yoon
- Wolchon Elementary School, 132, Mokdongjungang-ro, Yangcheon-gu, Seoul, 07989, South Korea.
| | - HyunHae Lee
- Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul, 06974, South Korea
| | - Heesook Son
- Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul, 06974, South Korea.
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Wasserman S, Ould Brahim L, Attiya A, Belzile E, Lambert SD. An Evaluation of Interactive mHealth Applications for Adults Living with Cancer. Curr Oncol 2023; 30:7151-7166. [PMID: 37622999 PMCID: PMC10453401 DOI: 10.3390/curroncol30080518] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 07/18/2023] [Accepted: 07/21/2023] [Indexed: 08/26/2023] Open
Abstract
This study evaluated the quality and usefulness of interactive mobile health (mHealth) applications (apps) for adults with cancer. The PRISMA guidelines were followed to add rigor to the search, as well as to the data collection and analysis. The apps available in the most used app stores (Google Play and Apple) with interactive tailored features were identified. To supplement this, a Google web search was also conducted. The apps were evaluated for their quality using the validated Mobile App Rating Scale (MARS) and for their usefulness using a checklist of end users' desired features derived from the literature. The searches returned 3046 apps and 17 were retained for evaluation. The average quality score of the apps across the sample was 3.62/5 (SD 0.26, range: 3.14-4.06), with Outcomes4me scoring the highest. On average, the apps scored 50% (SD 2.5, range: 31-88%) on the usefulness checklist, with Cancer.net scoring the highest. The lowest-scoring categories were communications features on the usefulness checklist and "information" on the MARS, indicating areas for future work. The findings identified the apps of an acceptable quality and usefulness that could be recommended to those with cancer.
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Affiliation(s)
- Sydney Wasserman
- St. Mary’s Research Centre, Montreal, QC H3T 1M5, Canada; (S.W.); (L.O.B.); (E.B.)
- Ingram School of Nursing, Faculty of Medicine and Health Science, McGill University, Montréal, QC H3A 0G4, Canada
| | - Lydia Ould Brahim
- St. Mary’s Research Centre, Montreal, QC H3T 1M5, Canada; (S.W.); (L.O.B.); (E.B.)
- Ingram School of Nursing, Faculty of Medicine and Health Science, McGill University, Montréal, QC H3A 0G4, Canada
| | - Ameer Attiya
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, QC H3C 3J7, Canada;
| | - Eric Belzile
- St. Mary’s Research Centre, Montreal, QC H3T 1M5, Canada; (S.W.); (L.O.B.); (E.B.)
| | - Sylvie D. Lambert
- St. Mary’s Research Centre, Montreal, QC H3T 1M5, Canada; (S.W.); (L.O.B.); (E.B.)
- Ingram School of Nursing, Faculty of Medicine and Health Science, McGill University, Montréal, QC H3A 0G4, Canada
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Vaffis S, Whaley S, Axon DR, Hall-Lipsy E, Hincapie A, Slack M, Warholak T. Features of Cancer mHealth Apps and Evidence for Patient Preferences: Scoping Literature Review. JMIR Cancer 2023; 9:e37330. [PMID: 37115587 PMCID: PMC10182455 DOI: 10.2196/37330] [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: 02/15/2022] [Revised: 07/28/2022] [Accepted: 12/12/2022] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND Cancer is increasingly being treated as a chronic disease rather than an acute one-time illness. Additionally, oral anticancer therapies, as opposed to intravenous chemotherapy, are now available for an increasing number of cancer indications. Mobile health (mHealth) apps for use on mobile devices (eg, smartphones or tablets) are designed to help patients with medication adherence, symptom tracking, and disease management. Several previous literature reviews have been conducted regarding mHealth apps for cancer. However, these studies did not address patient preferences for the features of cancer mHealth apps. OBJECTIVE The primary aim was to review the scientific literature that describes the features and functions of mHealth apps designed for cancer self-management. METHODS As the purpose of this review was to explore the depth and breadth of research on mHealth app features for cancer self-management, a scoping review methodology was adopted. Four databases were used for this review: PubMed/MEDLINE, Embase, CINAHL, and PsycINFO. Citation and reference searches were conducted for manuscripts meeting the inclusion criteria. A gray literature search was also conducted. Data extracted from manuscripts included author, title, publication date, study type, sampling type, cancer type, treatment, age of participants, features, availability (free or subscription), design input, and patient preferences. Finally, the features listed for each app were compared, highlighting similarities across platforms as well as features unique to each app. RESULTS After the removal of duplicates, 522 manuscripts remained for the title and abstract review, with 51 undergoing full-text review. A total of 7 manuscripts (referred to as studies hereafter) were included in the final scoping review. App features described in each study varied from 2 to 11, with a median of 4 features per app. The most reported feature was a symptom or side effect tracker, which was reported in 6 studies. Two apps specified the inclusion of patients and health care providers during the design, while 1 app noted that IT and communications experts provided design input. The utility of the apps for end users was measured in several ways, including acceptability (measuring the end users' experience), usability (assessing the functionality and performance by observing real users completing tasks), or qualitative data (reports from end users collected from interviews or focus groups). CONCLUSIONS This review explored the literature on cancer mHealth apps. Popular features within these mHealth apps include symptom trackers, cancer education, and medication trackers. However, these apps and features are often developed with little input from patients. Additionally, there is little information regarding patient preferences for the features of existing apps. While the number of cancer-related apps available for download continues to increase, further exploration of patient preferences for app features could result in apps that better meet patient disease self-management needs.
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Affiliation(s)
- Shannon Vaffis
- College of Pharmacy, University of Arizona, Tucson, AZ, United States
| | - Soluna Whaley
- College of Pharmacy, University of Arizona, Tucson, AZ, United States
| | - David Rhys Axon
- College of Pharmacy, University of Arizona, Tucson, AZ, United States
| | | | - Ana Hincapie
- James L Winkle College of Pharmacy, University of Cincinnati, Cincinnati, OH, United States
| | - Marion Slack
- College of Pharmacy, University of Arizona, Tucson, AZ, United States
| | - Terri Warholak
- College of Pharmacy, University of Arizona, Tucson, AZ, United States
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A Scoping Review and a Taxonomy to Assess the Impact of Mobile Apps on Cancer Care Management. Cancers (Basel) 2023; 15:cancers15061775. [PMID: 36980661 PMCID: PMC10046563 DOI: 10.3390/cancers15061775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/01/2023] [Accepted: 03/13/2023] [Indexed: 03/17/2023] Open
Abstract
Mobile Health (mHealth) has a great potential to enhance the self-management of cancer patients and survivors. Our study aimed to perform a scoping review to evaluate the impact and trends of mobile application-based interventions on adherence and their effects on health outcomes among the cancer population. In addition, we aimed to develop a taxonomy of mobile-app-based interventions to assist app developers and healthcare researchers in creating future mHealth cancer care solutions. Relevant articles were screened from the online databases PubMed, EMBASE, and Scopus, spanning the time period from 1 January 2016 to 31 December 2022. Of the 4135 articles initially identified, 55 were finally selected for the review. In the selected studies, breast cancer was the focus of 20 studies (36%), while mixed cancers were the subject of 23 studies (42%). The studies revealed that the usage rate of mHealth was over 80% in 41 of the 55 studies, with factors such as guided supervision, personalized suggestions, theoretical intervention foundations, and wearable technology enhancing adherence and efficacy. However, cancer progression, technical challenges, and unfamiliarity with devices were common factors that led to dropouts. We also proposed a taxonomy based on diverse theoretical foundations of mHealth interventions, delivery methods, psycho-educational programs, and social platforms. We suggest that future research should investigate, improve, and verify this taxonomy classification to enhance the design and efficacy of mHealth interventions.
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Amiri P, Ahmadian L, Khajouei R. The applications and the effectiveness of mHealth interventions to manage lung cancer patients: a systematic review. HEALTH AND TECHNOLOGY 2023. [DOI: 10.1007/s12553-023-00735-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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Wang T, Giunti G, Melles M, Goossens R. Digital Patient Experience: Umbrella Systematic Review. J Med Internet Res 2022; 24:e37952. [PMID: 35925651 PMCID: PMC9389377 DOI: 10.2196/37952] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 05/26/2022] [Accepted: 05/31/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The adoption and use of technology have significantly changed health care delivery. Patient experience has become a significant factor in the entire spectrum of patient-centered health care delivery. Digital health facilitates further improvement and empowerment of patient experiences. Therefore, the design of digital health is served by insights into the barriers to and facilitators of digital patient experience (PEx). OBJECTIVE This study aimed to systematically review the influencing factors and design considerations of PEx in digital health from the literature and generate design guidelines for further improvement of PEx in digital health. METHODS We performed an umbrella systematic review following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) methodology. We searched Scopus, PubMed, and Web of Science databases. Two rounds of small random sampling (20%) were independently reviewed by 2 reviewers who evaluated the eligibility of the articles against the selection criteria. Two-round interrater reliability was assessed using the Fleiss-Cohen coefficient (k1=0.88 and k2=0.80). Thematic analysis was applied to analyze the extracted data based on a small set of a priori categories. RESULTS The search yielded 173 records, of which 45 (26%) were selected for data analysis. Findings and conclusions showed a great diversity; most studies presented a set of themes (19/45, 42%) or descriptive information only (16/45, 36%). The digital PEx-related influencing factors were classified into 9 categories: patient capability, patient opportunity, patient motivation, intervention technology, intervention functionality, intervention interaction design, organizational environment, physical environment, and social environment. These can have three types of impacts: positive, negative, or double edged. We captured 4 design constructs (personalization, information, navigation, and visualization) and 3 design methods (human-centered or user-centered design, co-design or participatory design, and inclusive design) as design considerations. CONCLUSIONS We propose the following definition for digital PEx: "Digital patient experience is the sum of all interactions affected by a patient's behavioral determinants, framed by digital technologies, and shaped by organizational culture, that influence patient perceptions across the continuum of care channeling digital health." In this study, we constructed a design and evaluation framework that contains 4 phases-define design, define evaluation, design ideation, and design evaluation-and 9 design guidelines to help digital health designers and developers address digital PEx throughout the entire design process. Finally, our review suggests 6 directions for future digital PEx-related research.
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Affiliation(s)
- Tingting Wang
- Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
| | - Guido Giunti
- Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
- Digital Health Design and Development, University of Oulu, Oulu, Finland
| | - Marijke Melles
- Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
| | - Richard Goossens
- Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
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14
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Geiss C, Chavez MN, Oswald LB, Ketcher D, Reblin M, Bandera EV, Savard J, Zhou ES, Fox RS, Jim HSL, Gonzalez BD. "I Beat Cancer to Feel Sick:" Qualitative Experiences of Sleep Disturbance in Black Breast Cancer Survivors and Recommendations for Culturally Targeted Sleep Interventions. Ann Behav Med 2022; 56:1110-1115. [PMID: 35759312 DOI: 10.1093/abm/kaac035] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Sleep disturbance is common and distressing among cancer survivors. Black breast cancer survivors (BBCS) suffer disproportionately from sleep disturbance, yet there is limited research on how to address this issue. PURPOSE This study aimed to understand the multifaceted experiences of sleep disturbance among BBCS and how to culturally target a mobile health (mHealth) intervention to improve sleep outcomes in BBCS. METHODS Semi-structured interviews were conducted in a purposive sample of 10 BBCS. Interviews were audio-recorded, transcribed, and coded for key barriers to sleep and potential solutions to incorporate into behavioral interventions using NVivo 12. Inductive applied thematic analysis techniques were employed to identify emergent themes. RESULTS Ten BBCS (mean age = 54, SD = 10) described their experiences of sleep disturbance with themes including: (1) barriers to quality sleep (e.g., cancer worry, personal responsibilities), (2) psychosocial impacts of sleep disturbance (e.g., fatigue, distress), and (3) commonly used strategies to improve sleep. The second section discusses suggestions for developing mHealth interventions to improve sleep for BBCS including: (1) feedback on an existing mHealth intervention and (2) intervention topics suggested by BBCS. CONCLUSIONS Our findings highlight the challenges associated with sleep disturbance in BBCS. Participants report culturally targeted mHealth interventions are needed for BBCS who experience chronic sleep disturbance that affects their overall quality of life. These interventions should address coping with sleep-related issues relevant to many breast cancer survivors and BBCS (e.g., sexual intimacy, fear of cancer recurrence) and should incorporate intervention strategies acceptable to BBCS (e.g., prayer, meditation).
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Affiliation(s)
- Carley Geiss
- Participant Research, Interventions, and Measurements (PRISM) Core, Moffitt Cancer Center, Tampa, FL, USA
| | - Melody N Chavez
- Participant Research, Interventions, and Measurements (PRISM) Core, Moffitt Cancer Center, Tampa, FL, USA
| | - Laura B Oswald
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Dana Ketcher
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Maija Reblin
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Elisa V Bandera
- Division of Cancer Epidemiology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA.,Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA
| | - Josée Savard
- School of Psychology, Université Laval, Quebec, Canada.,CHU de Québec-Université Laval Research Center, Université Laval, Quebec, Canada
| | - Eric S Zhou
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Rina S Fox
- College of Nursing, University of Arizona, Tucson, AZ, USA
| | - Heather S L Jim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Brian D Gonzalez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
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15
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Salmani H, Nahvijou A, Sheikhtaheri A. Smartphone-based application for self-management of patients with colorectal cancer: development and usability evaluation. Support Care Cancer 2022; 30:3249-3258. [PMID: 34984548 DOI: 10.1007/s00520-021-06754-0] [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: 10/21/2021] [Accepted: 12/09/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE Self-management is considered essential for improving the treatment and management of colorectal cancer patients. This study was conducted to develop and evaluate the usability of a smartphone-based application for the self-management of patients with colorectal cancer. METHODS We developed an Android-based application called "Colorectal Cancer Along (ColorectAlong)" for the self-management of colorectal cancer. Seventeen patients, from the Cancer Institute of Iran, evaluated the usability of this application for 2 weeks using a standard questionnaire for user interaction satisfaction (QUIS) version 5.5. The obtained data was analyzed using SPSS software version 26. RESULTS The ColorectAlong application was developed with features covering several areas of colorectal cancer self-management. The areas available for evaluation in the app are patient profile; medication management; nutrition and diet management; pain management; mental health; smoking cessation and alcohol reduction; educational content; and adding reminders, questions, and notes. Our results indicate that the usability of this application is good with an average QUIS score of 8.03 out of 9. CONCLUSION The ColorectAlong application can improve self-management, assist patients, and facilitate access to required information without the need for internet access.
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Affiliation(s)
- Hosna Salmani
- Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Azin Nahvijou
- Cancer Research Center of Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Sheikhtaheri
- Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran. .,Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran.
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16
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Mehdizadeh H, Asadi F, Emami H, Mehrvar A, Nazemi E. mHealth Self-Management System to Supporting Children with a Acute Lymphocytic Leukemia (ALL) and their caregivers in low-middle income country: Qualitative Co-Design Study (Preprint). JMIR Form Res 2022; 6:e36721. [PMID: 35228195 PMCID: PMC9055480 DOI: 10.2196/36721] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 02/27/2022] [Accepted: 02/28/2022] [Indexed: 11/13/2022] Open
Abstract
Background The unique features of smartphones have extended their use in different fields, especially in the health care domain. These features offer new opportunities to support patients with chronic conditions by providing them with information, education, and self-management skills. We developed a digital self-management system to support children with cancer and their caregivers in Iran (low- and middle-income country). Objective This study is aimed at the development and preliminary evaluation of a cancer self-management system (CanSelfMan) tailored to the needs of children with cancer and their parents or caregivers. Methods This study was conducted in collaboration with a multidisciplinary team between January and February 2020 at MAHAK’s Pediatric Cancer Treatment and Research Center. We developed a self-management system in six stages: requirement analysis, conformity assessment, preparation of educational content, app prototyping, preliminary evaluation, and developing the final version. Results A total of 35 people (n=24, 69% parents and n=11, 31% children) volunteered to participate in the study. However, only 63% (15/24) of parents and 73% (8/11) of children were eligible to participate. By adopting a user-centered design approach, we developed a mobile app, CanSelfMan, that includes five main modules (knowledge base, self-management tips, self-assessment report, ask a question, and reminders) that provide access to reliable information about acute lymphocytic leukemia and the self-management skills required for side effect measurement and reporting. A web-based dashboard was also developed for oncologists and included a dashboard to monitor users’ symptoms and answer their questions. Conclusions The CanSelfMan app can support these groups by providing access to reliable information about cancer, facilitating communication between children or parents and health care providers, and helping promote medication adherence through a reminder function. The active participation of the target group can help identify their needs. Therefore, through the involvement of stakeholders such as patients, caregivers, and oncologists in the design process, we improved usability and ensured that the final product was useful. This app is now ready to proceed with feasibility studies.
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Affiliation(s)
- Hamed Mehdizadeh
- Department of Health Information Technology, School of Allied Medical Sciences, Mazandaran University of Medical Sciences, Sari, Iran
| | - Farkhondeh Asadi
- Health Information Technology and Management Department, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hassan Emami
- Health Information Technology and Management Department, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Azim Mehrvar
- MAHAK Hematology Oncology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- AJA University of Medical Sciences, Tehran, Iran
| | - Eslam Nazemi
- Department of Electrical and Computer Engineering, Shahid Beheshti University, Tehran, Iran
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17
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Mobile health applications for the care of patients with breast cancer: A scoping review. Int J Nurs Sci 2021; 8:470-476. [PMID: 34631997 PMCID: PMC8488816 DOI: 10.1016/j.ijnss.2021.07.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 05/29/2021] [Accepted: 07/23/2021] [Indexed: 12/09/2022] Open
Abstract
Objectives In recent years, the use of mobile health applications (mHealth apps) to deliver care for patients with breast cancer has increased exponentially. This study aimed to summarize the available evidence on developing mHealth apps to care for patients with breast cancer and identify the need for systematic efforts. Methods A scoping review was performed according to Arksey and O'Malley's framework, aiming to identify eligible research studies in PubMed, CINAHL, and Web of Science between January 2010 and December 2020. All identified studies were screened, extracted, and analyzed independently by two reviewers. Results A total of 676 studies were retrieved, and eight eligible studies were finally included. Four themes emerged: the involvement of patients and health professionals in the phases of design and development, patients' preferences, the characteristics of patients, and the motivators to use mHealth apps. The results indicated promising prospects for using mHealth apps to care for patients with breast cancer and identified the need for systematic efforts to develop and validate relevant apps. Conclusions The attributes of patient characteristics, needs, and patient-reported outcomes data are vital components for developing mHealth apps for patients with breast cancer. Additionally, collaborative efforts, including patients, nurses, and other significant health professionals, should develop mHealth apps for breast cancer care. Additional research focusing on the design and development of mHealth apps for patients with breast cancer is warranted.
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18
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Morris BB, Rossi B, Fuemmeler B. The role of digital health technology in rural cancer care delivery: A systematic review. J Rural Health 2021; 38:493-511. [PMID: 34480506 DOI: 10.1111/jrh.12619] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE Rural residents face higher cancer incidence rates and mortality rates, disparities that could be mitigated with health technology interventions, yet a digital divide is also apparent. This paper systematically and critically examines existing literature to understand how digital technologies have been used to support rural oncology care. METHODS PubMed, CINAHL Complete, PsycINFO, and Embase were searched using Medical Subject Headings terms and keywords. Studies were eligible if they presented empirical data investigating the use of technology in rural oncology and were published in English in a peer-reviewed journal within the last decade. The Mixed Methods Appraisal Tool was used to assess methodological quality. FINDINGS Digital health has been less extensively utilized in rural oncology compared with the general cancer population and other chronic diseases. We identified 54 studies that used technology in rural cancer care delivery, a comparatively small number, representing a significant gap in the literature. Studies were classified into 4 categories: Telemedicine (n = 32), phone calls (n = 11), Internet (n = 9), and mobile phone (n = 2). Of the 54 articles, 12 were RCTs, 17 were quasi-experimental, 3 were descriptive, 12 were mixed methods, and 10 were qualitative. Most of the studies involved patients only (n = 31) and were not specific to a cancer type (n = 41). CONCLUSIONS Further implementation and expansion of telemedicine and phone-based strategies in rural cancer care delivery are warranted. Rural cancer survivors value digital approaches to their care. However, social and behavioral determinants of health and access to technology must be considered.
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Affiliation(s)
- Bonny B Morris
- School of Medicine, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Brianna Rossi
- School of Medicine, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Bernard Fuemmeler
- School of Medicine, Virginia Commonwealth University, Richmond, Virginia, USA
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19
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Oakley-Girvan I, Davis SW, Kurian A, Rosas LG, Daniels J, Palesh OG, Mesia RJ, Kamal AH, Longmire M, Divi V. Development of a Mobile Health App (TOGETHERCare) to Reduce Cancer Care Partner Burden: Product Design Study. JMIR Form Res 2021; 5:e22608. [PMID: 34398787 PMCID: PMC8398739 DOI: 10.2196/22608] [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: 07/20/2020] [Revised: 10/13/2020] [Accepted: 06/18/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Approximately 6.1 million adults in the United States serve as care partners for cancer survivors. Studies have demonstrated that engaging cancer survivors and their care partners through technology-enabled structured symptom collection has several benefits. Given the high utilization of mobile technologies, even among underserved populations and in low resource areas, mobile apps may provide a meaningful access point for all stakeholders for symptom management. OBJECTIVE We aimed to develop a mobile app incorporating user preferences to enable cancer survivors' care partners to monitor the survivors' health and to provide care partner resources. METHODS An iterative information gathering process was conducted that included (1) discussions with 138 stakeholders to identify challenges and gaps in survivor home care; (2) semistructured interviews with clinicians (n=3), cancer survivors (n=3), and care partners (n=3) to identify specific needs; and (3) a 28-day feasibility field test with seven care partners. RESULTS Health professionals noted the importance of identifying early symptoms of adverse events. Survivors requested modules on medication, diet, self-care, reminders, and a version in Spanish. Care partners preferred to focus primarily on the patient's health and not their own. The app was developed incorporating quality-of-life surveys and symptom reporting, as well as resources on home survivor care. Early user testing demonstrated ease of use and app feasibility. CONCLUSIONS TOGETHERCare, a novel mobile app, was developed with user input to track the care partner's health and report on survivor symptoms during home care. The following two clinical benefits emerged: (1) reduced anxiety among care partners who use the app and (2) the potential for identifying survivor symptoms noted by the care partner, which might prevent adverse events. TRIAL REGISTRATION ClinicalTrials.gov NCT04018677; https://clinicaltrials.gov/ct2/show/NCT04018677.
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Affiliation(s)
| | | | | | - Lisa G Rosas
- Stanford University, Stanford, CA, United States
| | | | | | | | | | | | - Vasu Divi
- Stanford University, Stanford, CA, United States
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20
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Petrocchi S, Filipponi C, Montagna G, Bonollo M, Pagani O, Meani F. A Breast Cancer Smartphone App to Navigate the Breast Cancer Journey: Mixed Methods Study. JMIR Form Res 2021; 5:e28668. [PMID: 33970120 PMCID: PMC8145088 DOI: 10.2196/28668] [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: 03/10/2021] [Revised: 04/12/2021] [Accepted: 04/12/2021] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Several mobile apps have been designed for patients with a diagnosis of cancer. Unfortunately, despite the promising potential and impressive spread, their effectiveness often remains unclear. Most mobile apps are developed without any medical professional involvement and quality evidence-based assessment. Furthermore, they are often implemented in clinical care before any research is performed to confirm usability, appreciation, and clinical benefits for patients. OBJECTIVE We aimed to develop a new smartphone app (Centro di Senologia della Svizzera Italiana [CSSI]) specifically designed by breast care specialists and patients together to help breast cancer patients better understand and organize their journey through the diagnosis and treatment of cancer. We describe the development of the app and present assessments to evaluate its feasibility, usefulness, and capability to improve patient empowerment. METHODS A mixed method study with brief longitudinal quantitative data collection and subsequent qualitative semistructured interviews was designed. Twenty breast cancer patients participated in the study (mean age 51 years, SD 10 years). The usability of the app, the user experience, and empowerment were measured after 1 month. The semistructured interviews measured the utility of the app and the necessary improvements. RESULTS The app received good responses from the patients in terms of positive perception of the purpose of the app (7/20, 35%), organizing the cure path and being aware of the steps in cancer management (5/20, 25%), facilitating doctor-patient communication (4/20, 20%), and having detailed information about the resources offered by the hospital (2/20, 10%). Correlation and regression analyses showed that user experience increased the level of empowerment of patients (B=0.31, 95% CI 0.22-0.69; P=.009). The interviews suggested the need to constantly keep the app updated and to synchronize it with the hospital's electronic agenda, and carefully selecting the best time to offer the tool to final users was considered crucial. CONCLUSIONS Despite the very small number of participants in this study, the findings demonstrate the potential of the app and support a fully powered trial to evaluate the empowering effect of the mobile health app. More data will be gathered with an improved version of the app in the second phase involving a larger study sample.
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Affiliation(s)
- Serena Petrocchi
- Institute of Communication and Health, Università della Svizzera Italiana, Lugano, Switzerland
| | - Chiara Filipponi
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan, Italy
| | - Giacomo Montagna
- Breast Surgery Service, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Marta Bonollo
- Gynecology and Obstetrics Service, Centromedico, Mendrisio, Switzerland
| | - Olivia Pagani
- Swiss Group for Clinical Cancer Research, Geneva University Hospitals, Geneva, Switzerland
| | - Francesco Meani
- Department of Obstetrics and Gynecology, Centro di Senologia della Svizzera Italiana, Ente Ospedaliero Cantonale, Viganello, Switzerland
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Virtual Social Network (VSN): A New Opportunity for Cancer Care in the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2020. [DOI: 10.5812/ijcm.109477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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22
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Jones HV, Smith H, Cooksley T, Jones P, Woolley T, Gwyn Murdoch D, Thomas D, Foster B, Wakefield V, Innominato P, Mullard A, Ghosal N, Subbe C. Checklists for Complications During Systemic Cancer Treatment Shared by Patients, Friends, and Health Care Professionals: Prospective Interventional Cohort Study. JMIR Mhealth Uhealth 2020; 8:e19225. [PMID: 32975526 PMCID: PMC7540918 DOI: 10.2196/19225] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 08/09/2020] [Accepted: 08/18/2020] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Advances in cancer management have been associated with an increased incidence of emergency presentations with disease- or treatment-related complications. OBJECTIVE This study aimed to measure the ability of patients and members of their social network to complete checklists for complications of systemic treatment for cancer and examine the impact on patient-centered and health-economic outcomes. METHODS A prospective interventional cohort study was performed to assess the impact of a smartphone app used by patients undergoing systemic cancer therapy and members of their network to monitor for common complications. The app was used by patients, a nominated "safety buddy," and acute oncology services. The control group was made up of patients from the same institution. Measures were based on process (completion of checklists over 60 days), patient experience outcomes (Hospital Anxiety and Depression Scale and the General version of the Functional Assessment of Cancer Therapy at baseline, 1 month, and 2 months) and health-economic outcomes (usage of appointments in primary care and elective and unscheduled hospital admissions). RESULTS At the conclusion of the study, 50 patients had completed 2882 checklists, and their 50 "safety buddies" had completed 318 checklists. Near daily usage was maintained over the 60-day study period. When compared to a cohort of 50 patients with matching disease profiles from the same institution, patients in the intervention group had comparable changes in Hospital Anxiety and Depression Scale and General version of the Functional Assessment of Cancer Therapy. Patients in the Intervention Group required a third (32 vs 97 nights) of the hospital days with overnight stay compared to patients in the Control Group, though the difference was not significant. The question, "I feel safer with the checklist," received a mean score of 4.27 (SD 0.87) on a Likert scale (1-5) for patients and 4.55 (SD 0.65) for family and friends. CONCLUSIONS Patients undergoing treatment for cancer and their close contacts can complete checklists for common complications of systemic treatments and take an active role in systems supporting their own safety. A larger sample size will be needed to assess the impact on clinical outcomes and health economics.
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Affiliation(s)
- Helen V Jones
- Ysbyty Gwynedd, Penrhosgarnedd, Bangor, United Kingdom
| | - Harry Smith
- School of Medicine, Cardiff Univeristy, Cardiff, United Kingdom
| | | | | | - Toby Woolley
- Ysbyty Gwynedd, Penrhosgarnedd, Bangor, United Kingdom
| | | | | | - Betty Foster
- North Wales Cancer Forum, Bangor, United Kingdom
| | | | - Pasquale Innominato
- Ysbyty Gwynedd, Penrhosgarnedd, Bangor, United Kingdom.,Cancer Chronotherapy Team, Warwick Medical School, Coventry, United Kingdom.,European Laboratory U935, Institut National de la Santé et de la Recherche Médicale (INSERM), Paris-Saclay University, Villejuif, France
| | - Anna Mullard
- Ysbyty Gwynedd, Penrhosgarnedd, Bangor, United Kingdom
| | | | - Christian Subbe
- School of Medical Sciences, Bangor University, Bangor, United Kingdom
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23
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Pereira AAC, Destro JR, Picinin Bernuci M, Garcia LF, Rodrigues Lucena TF. Effects of a WhatsApp-Delivered Education Intervention to Enhance Breast Cancer Knowledge in Women: Mixed-Methods Study. JMIR Mhealth Uhealth 2020; 8:e17430. [PMID: 32706726 PMCID: PMC7404019 DOI: 10.2196/17430] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 03/28/2020] [Accepted: 04/03/2020] [Indexed: 12/18/2022] Open
Abstract
Background Breast cancer is the leading cause of cancer-related death in the female population. Health education interventions based on the use of mobile technologies enable the development of health self-care skills and have emerged as alternative strategies for the control of breast cancer. In previous studies, WhatsApp has stood out as a useful tool in health education strategies; however, it has not yet been applied for breast cancer education. Objective This study aimed to analyze the potential of WhatsApp as a health education tool used to improve women's knowledge on the risk reduction of breast cancer. It also aimed to understand how women feel sensitized within the WhatsApp group throughout the intervention and how they incorporate information posted to improve knowledge about early detection and risk reduction methods. Methods The study involved a pre-post health educational intervention with 35 women (aged 45-69 years) included in a WhatsApp group to share information (audio, video, text, and images) over 3 weeks on the early detection and risk reduction of breast cancer. Data were collected through questionnaires on topics related to risk reduction, as well as qualitative content analysis of group interactions. Effectiveness and feasibility were analyzed through conversations and the comparison of the scores obtained in the questionnaires before and after the intervention. Results A total of 293 messages were exchanged (moderator 120 and users 173). The average scores of the participants were 11.21 and 13.68 points before and after the educational intervention, respectively, with sufficient sample evidence that the difference was significant (P<.001). The intervention enabled women to improve their knowledge on all topics addressed, especially “myths and truths,” “incidence,” “clinical manifestations,” and “protective factors.” Some themes emerged from the interactions in the group, including group dynamics, general doubts, personal narratives, religious messages, daily news, and events. Conclusions The use of groups for women in WhatsApp for health education purposes seems to be a viable alternative in strategies on breast cancer control, especially as it provides a space for the exchange of experiences and disinhibition. However, the need for a moderator to answer the questions and the constant distractions by members of the group represent important limitations that should be considered when improving this strategy.
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Affiliation(s)
| | | | - Marcelo Picinin Bernuci
- Universidade Cesumar, Maringá, Brazil.,ICETI-Cesumar Institute of Science, Technology, and Innovation, Maringá, Brazil
| | - Lucas França Garcia
- Universidade Cesumar, Maringá, Brazil.,ICETI-Cesumar Institute of Science, Technology, and Innovation, Maringá, Brazil
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24
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Husebø AML, Karlsen B, Husebø SE. Health professionals' perceptions of colorectal cancer patients' treatment burden and their supportive work to ameliorate the burden - a qualitative study. BMC Health Serv Res 2020; 20:661. [PMID: 32680491 PMCID: PMC7367378 DOI: 10.1186/s12913-020-05520-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 07/08/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Support is pivotal for patients in managing colorectal cancer treatment, as they might be overwhelmed by the burden of treatment. There is scarce knowledge regarding health professionals' perceptions of colorectal cancer patients' burdens and supportive needs. The study aims to describe health professionals' perspectives on treatment burden among patients receiving curative surgical treatment for colorectal cancer during the hospital stay and how they support patients to ameliorate the burden. METHODS This study has a descriptive and explorative qualitative design, using semi-structured interviews with nine health professionals recruited from a gastrointestinal-surgery ward at a university hospital in Norway. Data were analysed by using systematic text condensation. RESULTS Data analysis identified the themes "capturing patients' burdens of colorectal cancer treatment" and "health professionals' support to ameliorate the burden". Patients with colorectal cancer had to face burdens related to a challenging emotional situation, treatment complications and side effects, and an extensive need for information. A trusting patient-carer relationship was therefore perceived as the essence of health professionals' support. Health professionals focused their support on safeguarding patients, motivating patients to self-manage, and involving family and peers as supporters. Patients' journey characteristics and illness severity challenged health professionals' supportive work. CONCLUSION Support from health professionals includes providing patients emotional support and relevant treatment-related information and motivating patients for early post-surgical mobilisation. Health professionals should be aware of identifying colorectal cancer patients' information needs according to the specific treatment stages, which may ameliorate the burden of colorectal cancer treatment and enable patients to self-manage.
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Affiliation(s)
- Anne Marie Lunde Husebø
- Department of Gastrointestinal Surgery, Stavanger University Hospital, N-4019, Stavanger, Norway.
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, N-4036, Stavanger, Norway.
| | - Bjørg Karlsen
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, N-4036, Stavanger, Norway
| | - Sissel Eikeland Husebø
- Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, N-4036, Stavanger, Norway
- Department of Surgery, Stavanger University Hospital, N-4011, Stavanger, Norway
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Ngo V, Matsumoto CG, Joseph JG, Bell JF, Bold RJ, Davis A, Reed SC, Kim KK. The Personal Health Network Mobile App for Chemotherapy Care Coordination: Qualitative Evaluation of a Randomized Clinical Trial. JMIR Mhealth Uhealth 2020; 8:e16527. [PMID: 32452814 PMCID: PMC7284410 DOI: 10.2196/16527] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Revised: 01/30/2020] [Accepted: 02/01/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Cancer care coordination addresses the fragmented and inefficient care of individuals with complex care needs. The complexity of care coordination can be aided by innovative technology. Few examples of information technology-enabled care coordination exist beyond the conventional telephone follow-up. For this study, we implemented a custom-designed app, the Personal Health Network (PHN)-a Health Insurance Portability and Accountability Act-compliant social network built around a patient to enable patient-centered health and health care activities in collaboration with clinicians, care team members, caregivers, and others designated by the patient. The app facilitates a care coordination intervention for patients undergoing chemotherapy. OBJECTIVE This study aimed to understand patient experiences with PHN technology and assess their perspectives on the usability and usefulness of PHNs with care coordination during chemotherapy. METHODS A two-arm randomized clinical trial was conducted to compare the PHN and care coordination with care coordination alone over a 6-month period beginning with the initiation of chemotherapy. A semistructured interview guide was constructed based on a theoretical framework of technology acceptance addressing usefulness, usability, and the context of use of the technology within the participant's life and health care setting. All participants in the intervention arm were interviewed on completion of the study. Interviews were recorded and transcribed verbatim. A summative thematic analysis was completed for the transcribed interviews. Features of the app were also evaluated. RESULTS A total of 27 interviews were completed. The resulting themes included the care coordinator as a partner in care, learning while sick, comparison of other technology to make sense of the PHN, communication, learning, usability, and usefulness. Users expressed that the nurse care coordinators were beneficial to them because they helped them stay connected to the care team and answered their questions. They shared that the mobile app gave them access to the health information they were seeking. Users expressed that the mobile app would be more useful if it was fully integrated with the electronic health record. CONCLUSIONS The findings highlight the value of care coordination from the perspectives of cancer patients undergoing chemotherapy and the important role of technology, such as the PHN, in enhancing this process by facilitating better communication and access to information regarding their illness.
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Affiliation(s)
- Victoria Ngo
- Betty Irene Moore School of Nursing, University of California, Davis, Sacramento, CA, United States
| | - Cynthia G Matsumoto
- Betty Irene Moore School of Nursing, University of California, Davis, Sacramento, CA, United States
| | - Jill G Joseph
- Betty Irene Moore School of Nursing, University of California, Davis, Sacramento, CA, United States
| | - Janice F Bell
- Betty Irene Moore School of Nursing, University of California, Davis, Sacramento, CA, United States
| | - Richard J Bold
- Comprehensive Cancer Center, University of California Davis Health, Sacramento, CA, United States
| | - Andra Davis
- Washington State University College of Nursing - Vancouver, Vancouver, WA, United States
| | - Sarah C Reed
- Division of Social Work, California State University Sacramento, Sacramento, CA, United States
| | - Katherine K Kim
- Betty Irene Moore School of Nursing, University of California, Davis, Sacramento, CA, United States
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Advances and future directions in the use of mobile health in supportive cancer care: proceedings of the 2019 MASCC Annual Meeting symposium. Support Care Cancer 2020; 28:4059-4067. [DOI: 10.1007/s00520-020-05513-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Accepted: 05/05/2020] [Indexed: 12/19/2022]
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Chow PI, Showalter SL, Gerber M, Kennedy EM, Brenin D, Mohr DC, Lattie EG, Gupta A, Ocker G, Cohn WF. Use of Mental Health Apps by Patients With Breast Cancer in the United States: Pilot Pre-Post Study. JMIR Cancer 2020; 6:e16476. [PMID: 32293570 PMCID: PMC7191345 DOI: 10.2196/16476] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 12/19/2019] [Accepted: 01/27/2020] [Indexed: 12/16/2022] Open
Abstract
Background Nearly half of the patients with breast cancer experience clinically significant mental distress within the first year of receiving their cancer diagnosis. There is an urgent need to identify scalable and cost-efficient ways of delivering empirically supported mental health interventions to patients with breast cancer. Objective The aim of this study was to evaluate the feasibility of in-clinic recruitment for a mobile phone app study and to evaluate the usability and preliminary impact of a suite of mental health apps (IntelliCare) with phone coaching on psychosocial distress symptoms in patients recently diagnosed with breast cancer. Methods This pilot study adopted a within-subject, 7-week pre-post study design. A total of 40 patients with breast cancer were recruited at a US National Cancer Institute–designated clinical cancer center. Self-reported distress (Patient Health Questionnaire-4) and mood symptoms (Patient-Reported Outcomes Measurement Information System depression and anxiety scales) were assessed at baseline and postintervention. App usability was assessed at postintervention. Results The minimum recruitment threshold was met. There was a significant decrease in general distress symptoms, as well as symptoms of depression and anxiety, from baseline to postintervention. Overall, participants reported high levels of ease of app use and learning. Scores for app usefulness and satisfaction were reinforced by some qualitative feedback suggesting that tailoring the apps more for patients with breast cancer could enhance engagement. Conclusions There is a dire need for scalable, supportive interventions in cancer. The results from this study inform how scalable mobile phone–delivered programs with additional phone support can be used to support patients with breast cancer. International Registered Report Identifier (IRRID) RR2-10.2196/11452
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Affiliation(s)
- Philip I Chow
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA, United States
| | - Shayna L Showalter
- Department of Surgery, University of Virginia, Charlottesville, VA, United States
| | - Matthew Gerber
- Department of Engineering Systems and Environment, University of Virginia, Charlottesville, VA, United States
| | - Erin M Kennedy
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, United States
| | - David Brenin
- Department of Surgery, University of Virginia, Charlottesville, VA, United States
| | - David C Mohr
- Center for Behavioral Intervention Technologies, Northwestern University, Chicago, IL, United States
| | - Emily G Lattie
- Center for Behavioral Intervention Technologies, Northwestern University, Chicago, IL, United States
| | - Alisha Gupta
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, United States
| | - Gabrielle Ocker
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, United States
| | - Wendy F Cohn
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, United States
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Chow PI, Drago F, Kennedy EM, Cohn WF. A Novel Mobile Phone App Intervention With Phone Coaching to Reduce Symptoms of Depression in Survivors of Women's Cancer: Pre-Post Pilot Study. JMIR Cancer 2020; 6:e15750. [PMID: 32027314 PMCID: PMC7055784 DOI: 10.2196/15750] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 11/13/2019] [Accepted: 12/09/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Psychological distress is a major issue among survivors of women's cancer who face numerous barriers to accessing in-person mental health treatments. Mobile phone app-based interventions are scalable and have the potential to increase access to mental health care among survivors of women's cancer worldwide. OBJECTIVE This study aimed to evaluate the acceptability and preliminary efficacy of a novel app-based intervention with phone coaching in a sample of survivors of women's cancer. METHODS In a single-group, pre-post, 6-week pilot study in the United States, 28 survivors of women's cancer used iCanThrive, a novel app intervention that teaches skills for coping with stress and enhancing well-being, with added phone coaching. The primary outcome was self-reported symptoms of depression (Center for Epidemiologic Studies Depression Scale). Emotional self-efficacy and sleep disruption were also assessed at baseline, 6-week postintervention, and 4 weeks after the intervention period. Feedback obtained at the end of the study focused on user experience of the intervention. RESULTS There were significant decreases in symptoms of depression and sleep disruption from baseline to postintervention. Sleep disruption remained significantly lower at 4-week postintervention compared with baseline. The iCanThrive app was launched a median of 20.5 times over the intervention period. The median length of use was 2.1 min. Of the individuals who initiated the intervention, 87% (20/23) completed the 6-week intervention. CONCLUSIONS This pilot study provides support for the acceptability and preliminary efficacy of the iCanThrive intervention. Future work should validate the intervention in a larger randomized controlled study. It is important to develop scalable interventions that meet the psychosocial needs of different cancer populations. The modular structure of the iCanThrive app and phone coaching could impact a large population of survivors of women's cancer.
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Affiliation(s)
- Philip I Chow
- University of Virginia, Charlottesville, VA, United States
| | - Fabrizio Drago
- University of Virginia, Charlottesville, VA, United States
| | - Erin M Kennedy
- University of Virginia, Charlottesville, VA, United States
| | - Wendy F Cohn
- University of Virginia, Charlottesville, VA, United States
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Houghton LC, Howland RE, McDonald JA. Mobilizing Breast Cancer Prevention Research Through Smartphone Apps: A Systematic Review of the Literature. Front Public Health 2019; 7:298. [PMID: 31781525 PMCID: PMC6851054 DOI: 10.3389/fpubh.2019.00298] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 10/02/2019] [Indexed: 12/21/2022] Open
Abstract
Background: Breast cancer rates have been increasing worldwide, particularly among young women, suggesting important interactions between genes and health behaviors. At the same time, mobile technology, including smartphones applications (apps), has emerged as a new tool for delivering healthcare and health-related services. As of 2018, there were nearly 600 publicly available breast cancer apps designed to provide disease and treatment information, to manage disease, and to raise overall awareness. However, the extent to which apps are incorporated into breast cancer prevention research is unknown. Therefore, the objective of this review was to determine how mobile applications are being used for breast cancer prevention among women across the cancer control continuum. Methods: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched PubMed and Web of Science Core Collection databases using the keywords breast cancer, smartphone, mobile application, and phone app. Full-length journal articles available in English that addressed the research question were included. We categorized articles by prevention type (primary, secondary, and tertiary) and phase of research (protocol, development, feasibility, pilot, measurement, and effectiveness), and identified common themes and gaps. Results: Our search yielded 82 studies (69 unique) that used apps in breast cancer prevention research across 20 countries. Approximately half of the named apps were publicly available. The majority (73%) of studies targeted tertiary prevention; 15% targeted secondary and 13% targeted primary prevention. Apps were used across all phases of research with the predominant phase being feasibility in tertiary prevention (34%), effectiveness in secondary prevention (63%), and development (30%) and effectiveness (30%) in primary prevention. Common uses included assessing outcomes relevant to clinical care coordination, quality of life, increasing self-efficacy and screening behaviors, and tracking and managing health behaviors. Conclusions: We identified the following gaps: few effectiveness studies in tertiary prevention, minimal use of apps for breast cancer etiology or early detection, and few interventions in those at average risk of breast cancer. These findings suggest that while mobile apps can inform breast cancer prevention across the continuum, more work is needed to incorporate apps into primary prevention.
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Affiliation(s)
- Lauren C. Houghton
- Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY, United States
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY, United States
| | - Renata E. Howland
- Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY, United States
| | - Jasmine A. McDonald
- Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY, United States
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY, United States
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Mobile applications in oncology: A systematic review of health science databases. Int J Med Inform 2019; 133:104001. [PMID: 31706229 DOI: 10.1016/j.ijmedinf.2019.104001] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 06/21/2019] [Accepted: 10/01/2019] [Indexed: 02/07/2023]
Abstract
INTRODUCTION In recent years there has been an exponential growth in the number of mobile applications (apps) relating to the early diagnosis of cancer and prevention of side effects during cancer treatment. For health care professionals and users, it can thus be difficult to determine the most appropriate app for given needs and assess the level of scientific evidence supporting their use. Therefore, this review aims to examine the research studies that deal with this issue and determine the characteristics of the apps involved. METHODOLOGY This study involved a systematic review of the scientific literature on randomized clinical trials that use apps to improve cancer management among patients, using the Pubmed (Medline), Latin America and the Caribbean in Health Sciences (LILACS), and Cochrane databases. The search was limited to articles written in English and Spanish published in the last 10 years. A search of the App Store for iOS devices and Google Play for Android devices was performed to find the apps identified in the included research articles. RESULTS In total, 54 articles were found to analyze the development of an application in the field of oncology. These articles were most frequently related to the use of apps for the early detection of cancer (n = 28), particularly melanoma (n = 9). In total, 21 studies reflected the application used. The apps featured in nine articles were located using the App Store and Google Play (n = 9), of which five were created to manage cancer-related issues. The rest of the apps were designed for use in the general population (n = 4). CONCLUSIONS There is an increasing number of research articles that study the use of apps in the field of oncology; however, these mobile applications tend to disappear from app stores after the studies are completed.
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Osborn J, Ajakaiye A, Cooksley T, Subbe CP. Do mHealth applications improve clinical outcomes of patients with cancer? A critical appraisal of the peer-reviewed literature. Support Care Cancer 2019; 28:1469-1479. [PMID: 31273501 PMCID: PMC6989578 DOI: 10.1007/s00520-019-04945-4] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 06/18/2019] [Indexed: 01/05/2023]
Abstract
Purpose Patients undergoing systemic anti-cancer treatment experience distressing side effects, and these symptoms are often experienced outside the hospital setting. The impact of usage of cancer-related mobile health (mHealth) applications on patient-related outcomes requires investigation. Methods A critical appraisal of the literature was performed for the following question: ‘In patients with cancer have mHealth applications been compared with usual care to examine impact on commonly used clinical outcomes’. Literature searches were undertaken with the help of a research librarian and included Medline, Cochrane Collaboration, clinical trial databases and grey searches. Results Seventeen studies including between 12 and 2352 patients were identified and reviewed. Smartphone applications or internet portals collected data on symptoms or patient activity. Several studies showed statistically significant differences in patient-reported outcomes when symptom monitoring using mobile health application was compared to usual care. Change in mobility was the only outcome that was related directly to toxicity. Only limited data on mortality, cancer-related morbidity including complications of care, health-economic outcomes or long-term outcomes were reported. Conclusions Studies on mHealth applications might improve aspects of symptom control in patients with cancer, but there is currently little evidence for impact on other outcomes. This requires future research in interventional studies.
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Affiliation(s)
- Jemima Osborn
- Ysbyty Gwynedd, Penrhosgarnedd, Bangor, Gwynedd, LL57 2PW, UK
| | - Anu Ajakaiye
- Ysbyty Gwynedd, Penrhosgarnedd, Bangor, Gwynedd, LL57 2PW, UK
| | - Tim Cooksley
- The Christie NHS Foundation Trust, Wilmslow Rd, Manchester, M20 4BX, UK
| | - Christian P Subbe
- Ysbyty Gwynedd, Penrhosgarnedd, Bangor, Gwynedd, LL57 2PW, UK. .,School of Medical Sciences, Bangor University, Brigantia Building, Penrallt Road, Bangor, Gwynedd, LL57 2AS, UK.
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Mehdizadeh H, Asadi F, Mehrvar A, Nazemi E, Emami H. Smartphone apps to help children and adolescents with cancer and their families: a scoping review. Acta Oncol 2019; 58:1003-1014. [PMID: 30915872 DOI: 10.1080/0284186x.2019.1588474] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Introduction: Considering the importance of empowering patients and their families by providing appropriate information and education, it seems smartphone apps provide a good opportunity for this group. The purpose of this review was to identify studies which used smartphone apps to help children and adolescents with cancer and their families. Method: Arksey and O'Malley's framework was employed in this review. To examine the evidence on the design and use of smartphone apps for the target group, PubMed, Embase, Scopus and Web of Science databases were searched from 2007 to November 2018. Results: Twenty-four articles met the inclusion criteria, with 33% being conducted in the USA and 21% in Canada. Moreover, in 20 studies (83%), app was specifically designed for children and adolescents, with only three studies (13%) for parents and one study (4%) for both. The main modules of smartphone apps in these studies included symptom assessment (90%), provision of information and education (74%), communication with caregivers (57%), social support (30%) and calendar and reminder (21%). Conclusions: Due to the easy access to smartphones without a costly infrastructure compared to landline phones, the use of mobile health (m-Health) has become a suitable method of providing healthcare services, especially for cancer. Use of smartphone apps, increases patient and families' access to reliable and suitable education and information regarding the disease. Thus, healthcare policy-makers in developing or underdeveloped countries can exploit the health-related potentials of m-Health following the experience of developed countries.
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Affiliation(s)
- Hamed Mehdizadeh
- Department of Health Information Technology and Management, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farkhondeh Asadi
- Department of Health Information Technology and Management, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Azim Mehrvar
- MAHAK Hematology Oncology Research Center (MAHAK-HORC), MAHAK Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Eslam Nazemi
- Department of Electrical and Computer Engineering, Shahid Beheshti University, Tehran, Iran
| | - Hassan Emami
- Department of Health Information Technology and Management, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Jongerius C, Russo S, Mazzocco K, Pravettoni G. Research-Tested Mobile Apps for Breast Cancer Care: Systematic Review. JMIR Mhealth Uhealth 2019; 7:e10930. [PMID: 30741644 PMCID: PMC6388100 DOI: 10.2196/10930] [Citation(s) in RCA: 81] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 10/20/2018] [Accepted: 10/30/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The use of mobile health (mHealth) apps in clinical settings is increasing widely. mHealth has been used to promote prevention, improve early detection, manage care, and support survivors and chronic patients. However, data on the efficacy and utility of mHealth apps are limited. OBJECTIVE The main objective of this review was to provide an overview of the available research-tested interventions using mHealth apps and their impact on breast cancer care. METHODS A systematic search of Medline, PsycINFO, Embase, and Scopus was performed to identify relevant studies. From the selected studies, the following information was extracted: authors, publication date, study objectives, study population, study design, interventions' features, outcome measures, and results. RESULTS We identified 29 empirical studies that described a health care intervention using an mHealth app in breast cancer care. Of these, 7 studies were about the use of an mHealth application in an intervention for breast cancer prevention and early detection, 12 targeted care management, and 10 focused on breast cancer survivors. CONCLUSIONS Our results indicate consistent and promising findings of interventions using mHealth apps that target care management in breast cancer. Among the categories of mHealth apps focusing on survivorship, mHealth-based interventions showed a positive effect by promoting weight loss, improving the quality of life, and decreasing stress. There is conflicting and less conclusive data on the effect of mHealth apps on psychological dimensions. We advocate further investigation to confirm and strengthen these findings. No consistent evidence for the impact of interventions using mHealth apps in breast cancer prevention and early detection was identified due to the limited number of studies identified by our search. Future research should continue to explore the impact of mHealth apps on breast cancer care to build on these initial recommendations.
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Affiliation(s)
- Chiara Jongerius
- Department of Medical Psychology, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Selena Russo
- Kids Cancer Centre, Sydney Children's Hospital, University of New South Wales, Sydney, Australia
| | - Ketti Mazzocco
- Department of Oncology and Hemato-oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Gabriella Pravettoni
- Department of Oncology and Hemato-oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
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Vogel RI, Niendorf K, Petzel S, Lee H, Teoh D, Blaes AH, Argenta P, Rivard C, Winterhoff B, Lee HY, Geller MA. A patient-centered mobile health application to motivate use of genetic counseling among women with ovarian cancer: A pilot randomized controlled trial. Gynecol Oncol 2019; 153:100-107. [PMID: 30718125 DOI: 10.1016/j.ygyno.2019.01.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 01/17/2019] [Accepted: 01/22/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Despite current guidelines recommending women with ovarian cancer receive genetic risk evaluation by a genetic counselor, utilization has historically been low. We sought to assess the feasibility and effectiveness of a week-long mobile Application for Genetic Information on Cancer (mAGIC) intervention aimed to persuade women with ovarian cancer to pursue genetic counseling. METHODS The mobile application intervention was based on the Fogg Behavior Model, and consisted of three parts: (1) identifying barriers, (2) developing motivators, and (3) providing triggers to action. The Health Belief Model was used to guide content development. We conducted a prospective, randomized, controlled pilot trial among 104 untested women with a history of epithelial ovarian, primary peritoneal or fallopian tube cancer with the primary objective of increasing uptake of cancer genetic counseling services. RESULTS Utilization of cancer genetic counseling services improved in both study arms over historical controls, however there was no statistically significant difference between them (intervention: 54.5% versus control: 38.6%; p = 0.14). However, compared to controls, women randomized to the mAGIC intervention demonstrated greater knowledge of hereditary cancer (0-10 scale; 9.4 ± 1.0 vs. 7.1 ± 1.5; p < 0.0001), which persisted for at least three months. Additionally, 96% of women in the intervention group reported they had talked with their family about genetic counseling compared to 77% in the control group (p = 0.01). CONCLUSIONS The mAGIC intervention did not result in increased uptake of genetic counseling, however it provided significant secondary benefits, including increased participants' knowledge about hereditary ovarian cancer, self-efficacy, and their reported communication with family members. ClinicalTrials.gov Identifier: NCT02877862.
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Affiliation(s)
- Rachel I Vogel
- Department of Obstetrics, Gynecology and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN, United States of America
| | - Kristin Niendorf
- Department of Surgery, Division of Colon and Rectal Surgery, University of Minnesota, Minneapolis, MN, United States of America
| | - Sue Petzel
- Department of Obstetrics, Gynecology and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN, United States of America
| | - Heewon Lee
- Department of Obstetrics, Gynecology and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN, United States of America
| | - Deanna Teoh
- Department of Obstetrics, Gynecology and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN, United States of America
| | - Anne H Blaes
- Department of Medicine, Division of Hematology, Oncology, and Transplantation, University of Minnesota, Minneapolis, MN, United States of America
| | - Peter Argenta
- Department of Obstetrics, Gynecology and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN, United States of America
| | - Colleen Rivard
- Department of Obstetrics, Gynecology and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN, United States of America
| | - Boris Winterhoff
- Department of Obstetrics, Gynecology and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN, United States of America
| | - Hee Yun Lee
- School of Social Work, University of Alabama, Tuscaloosa, AL, United States of America
| | - Melissa A Geller
- Department of Obstetrics, Gynecology and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN, United States of America.
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Richards R, Kinnersley P, Brain K, McCutchan G, Staffurth J, Wood F. Use of Mobile Devices to Help Cancer Patients Meet Their Information Needs in Non-Inpatient Settings: Systematic Review. JMIR Mhealth Uhealth 2018; 6:e10026. [PMID: 30552082 PMCID: PMC6315262 DOI: 10.2196/10026] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 06/20/2018] [Accepted: 07/10/2018] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The shift from inpatient to outpatient cancer care means that patients are now required to manage their condition at home, away from regular supervision by clinicians. Subsequently, research has consistently reported that many patients with cancer have unmet information needs during their illness. Mobile devices, such as mobile phones and tablet computers, provide an opportunity to deliver information to patients remotely. To date, no systematic reviews have evaluated how mobile devices have been used specifically to help patients meet to their information needs. OBJECTIVE A systematic review was conducted to identify studies that describe the use of mobile interventions to enable patients with cancer meet their cancer-related information needs in non-inpatient settings, and to describe the effects and feasibility of these interventions. METHODS MEDLINE, Embase, and PsycINFO databases were searched up until January 2017. Search terms related to "mobile devices," "information needs," and "cancer" were used. There were no restrictions on study type in order to be as inclusive as possible. Study participants were patients with cancer undergoing treatment. Interventions had to be delivered by a mobile or handheld device, attempt to meet patients' cancer-related information needs, and be for use in non-inpatient settings. Critical Appraisal Skills Programme checklists were used to assess the methodological quality of included studies. A narrative synthesis was performed and findings were organized by common themes found across studies. RESULTS The initial search yielded 1020 results. We included 23 articles describing 20 studies. Interventions aimed to improve the monitoring and management of treatment-related symptoms (17/20, 85%), directly increase patients' knowledge related to their condition (2/20, 10%), and improve communication of symptoms to clinicians in consultations (1/20, 5%). Studies focused on adult (17/20; age range 24-87 years) and adolescent (3/20; age range 8-18 years) patients. Sample sizes ranged from 4-125, with 13 studies having 25 participants or fewer. Most studies were conducted in the United Kingdom (12/20, 52%) or United States (7/20, 30%). Of the 23 articles included, 12 were of medium quality, 9 of poor quality, and 2 of good quality. Overall, interventions were reported to be acceptable and perceived as useful and easy to use. Few technical problems were encountered. Adherence was generally consistent and high (periods ranged from 5 days to 6 months). However, there was considerable variation in use of intervention components within and between studies. Reported benefits of the interventions included improved symptom management, patient empowerment, and improved clinician-patient communication, although mixed findings were reported for patients' health-related quality of life and anxiety. CONCLUSIONS The current review highlighted that mobile interventions for patients with cancer are only meeting treatment or symptom-related information needs. There were no interventions designed to meet patients' full range of cancer-related information needs, from information on psychological support to how to manage finances during cancer, and the long-term effects of treatment. More comprehensive interventions are required for patients to meet their information needs when managing their condition in non-inpatient settings. Controlled evaluations are needed to further determine the effectiveness of these types of intervention.
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Affiliation(s)
- Rebecca Richards
- Division of Population Medicine, Cardiff University, Cardiff, United Kingdom
| | - Paul Kinnersley
- Centre for Medical Education, Cardiff University, Cardiff, United Kingdom
| | - Kate Brain
- Division of Population Medicine, Cardiff University, Cardiff, United Kingdom
| | - Grace McCutchan
- Division of Population Medicine, Cardiff University, Cardiff, United Kingdom
| | - John Staffurth
- Section of Oncology, Palliative Care Medicine, Cardiff University, Cardiff, United Kingdom
| | - Fiona Wood
- Division of Population Medicine, Cardiff University, Cardiff, United Kingdom
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Remotely Monitoring Cancer-Related Fatigue Using the Smart-Phone: Results of an Observational Study. INFORMATION 2018. [DOI: 10.3390/info9110271] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Cancer related fatigue is a chronic disease that may persist up to 10 years after successful cancer treatment and is one of the most prevalent problems in cancer survivors. Cancer related fatigue is a complex symptom that is not yet explained completely and there are only a few remedies with proven evidence. Patients do not necessarily follow a treatment plan with regular follow ups. As a consequence, physicians lack of knowledge how their patients are coping with their fatigue in daily life. To overcome this knowledge gap, we developed a smartphone-based monitoring system. A developed Android app provides activity data from smartphone sensors and applies experience based sampling to collect the patients’ subjective perceptions of their fatigue and interference of fatigue with the patients’ daily life. To evaluate the monitoring system in an observational study, we recruited seven patients suffering from cancer related fatigue and tracked them over two to three weeks. We collected around 2700 h of activity data and over 500 completed questionnaires. We analysed the average completion of answering the digital questionnaires and the wearing time of the smartphone. A within-subject analysis of the perceived fatigue, its interference and measured physical activity yielded in patient specific fatigue and activity patterns depending on the time of day. Physical activity level correlated stronger with the interference of fatigue than with the fatigue itself and the variance of the acceleration correlates stronger than absolute activity values. With this work, we provide a monitoring system used for cancer related fatigue. We show with an observational study that the monitoring system is accepted by our study cohort and that it provides additional details about the perceived fatigue and physical activity to a weekly paper-based questionnaire.
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Leafman JS, Mathieson K. Perceptions of telemedicine for patient education among online support group patients with chronic or rare conditions. COGENT MEDICINE 2018. [DOI: 10.1080/2331205x.2018.1525148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- Joan S Leafman
- College of Graduate Health Studies, Still Research Institute Scientist, A.T. Still University, 5850 E. Still Circle, Mesa, AZ 85206
| | - Kathleen Mathieson
- College of Graduate Health Studies, Still Research Institute Scientist, A.T. Still University, 5850 E. Still Circle, Mesa, AZ 85206
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Alanzi TM, Alobrah A, Alhumaidi R, Aloraifi S. Evaluation of the SnapChat mobile social networking application for breast cancer awareness among Saudi students in the Dammam Region of the Kingdom of Saudi Arabia. BREAST CANCER-TARGETS AND THERAPY 2018; 10:113-119. [PMID: 30034251 PMCID: PMC6047612 DOI: 10.2147/bctt.s166135] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Purpose The main aim of this study was to investigate the feasibility and the effectiveness of the SnapChat social networking mobile application in increasing the awareness of breast cancer among the Saudi female students in the Dammam region of Saudi Arabia. Patients and methods An intervention study was carried out with 200 participants divided among 2 groups: a control group and an intervention group. The control group did not receive any awareness materials, and the intervention group received awareness about breast cancer through SnapChat using videos, texts, and pictures. A questionnaire-based survey was conducted at the beginning and at the end of the study to assess the change in the awareness among the participants. Results A significant improvement in the breast cancer awareness was found in the intervention group with P=0.001. The mean knowledge was found to be increased from 8.7±2.8 to 14.8±3.01 (mean ± SD). Conclusion The SnapChat mobile social networking application can be effectively used in creating breast cancer awareness among the Saudi population.
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Affiliation(s)
- Turki M Alanzi
- Health Information Management and Technology Department, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia,
| | - Alanoud Alobrah
- Health Information Management and Technology Department, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia,
| | - Reem Alhumaidi
- Health Information Management and Technology Department, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia,
| | - Shahad Aloraifi
- Health Information Management and Technology Department, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia,
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Cheong IY, An SY, Cha WC, Rha MY, Kim ST, Chang DK, Hwang JH. Efficacy of Mobile Health Care Application and Wearable Device in Improvement of Physical Performance in Colorectal Cancer Patients Undergoing Chemotherapy. Clin Colorectal Cancer 2018; 17:e353-e362. [DOI: 10.1016/j.clcc.2018.02.002] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Revised: 02/05/2018] [Accepted: 02/12/2018] [Indexed: 11/16/2022]
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Watson NJ, Martin SA, Keating JL. The impact of wrist fracture, surgical repair and immobilization on patients: a qualitative study. Clin Rehabil 2018; 32:841-851. [DOI: 10.1177/0269215518754614] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Narelle J Watson
- Faculty Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
- Western Centre for Health Research & Education, Sunshine Hospital, St. Albans, VIC, Australia
| | - Sally A Martin
- Western Centre for Health Research & Education, Sunshine Hospital, St. Albans, VIC, Australia
| | - Jennifer L Keating
- Department of Physiotherapy, School of Primary and Allied Health Care, Faculty Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
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Baseman J, Revere D, Baldwin LM. A Mobile Breast Cancer Survivorship Care App: Pilot Study. JMIR Cancer 2017; 3:e14. [PMID: 28951383 PMCID: PMC5635232 DOI: 10.2196/cancer.8192] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 08/21/2017] [Accepted: 08/29/2017] [Indexed: 12/27/2022] Open
Abstract
Background Cancer survivors living in rural areas experience unique challenges due to additional burdens, such as travel and limited access to specialists. Rural survivors of breast cancer have reported poorer outcomes, poorer mental health and physical functioning, and lower-than-average quality of life compared to urban survivors. Objective To explore the feasibility and acceptability of developing a mobile health survivorship care app to facilitate care coordination; support medical, psychosocial, and practical needs; and improve survivors' long-term health outcomes. Methods An interactive prototype app, SmartSurvivor, was developed that included recommended survivorship care plan components. The prototype's feasibility and acceptability were tested by a sample of breast cancer survivors (n=6), primary care providers (n=4), and an oncologist (n=1). Results Overall, both survivors and providers felt that SmartSurvivor was a potentially valuable tool to support long-term survivorship care plan objectives. Portability, accessibility, and having one place for all contact, treatment, symptom tracking, and medication summaries was highly valued. Conclusions Our pilot study indicates that SmartSurvivor is a feasible and acceptable approach to meeting survivorship care objectives and the needs of both breast cancer survivors and their health care providers. Exploration of mobile health options for supporting survivorship care plan needs is a promising area of research.
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Affiliation(s)
- Janet Baseman
- Department of Epidemiology, University of Washington, Seattle, WA, United States
| | - Debra Revere
- Department of Health Services, University of Washington, Seattle, WA, United States
| | - Laura-Mae Baldwin
- Department of Family Medicine, University of Washington, Seattle, WA, United States
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Drummond JL, Were MC, Arrossi S, Wools-Kaloustian K. Cervical cancer data and data systems in limited-resource settings: Challenges and opportunities. Int J Gynaecol Obstet 2017; 138 Suppl 1:33-40. [DOI: 10.1002/ijgo.12192] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Jennifer L. Drummond
- National Foundation for the Centers for Disease Control and Prevention; Atlanta GA USA
| | - Martin C. Were
- Department of Biomedical Informatics; Vanderbilt University; Nashville TN USA
- Department of Medicine; Vanderbilt University; Nashville TN USA
- Vanderbilt Institute for Global Health; Nashville TN USA
| | - Silvina Arrossi
- Centro de Estudios de Estado y Sociedad/Consejo Nacional de Investigaciones Científicas y técnicas; Buenos Aires Argentina
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Davis SW, Oakley-Girvan I. Achieving value in mobile health applications for cancer survivors. J Cancer Surviv 2017; 11:498-504. [PMID: 28342093 DOI: 10.1007/s11764-017-0608-1] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Accepted: 02/16/2017] [Indexed: 01/12/2023]
Abstract
PURPOSE This study aimed to identify appropriate development and testing strategies for mobile health applications for cancer survivors. METHODS In January of 2016, we conducted a PubMed search for mobile applications for cancer survivors. A total of 32 articles were selected for inclusion, including 13 review articles, and 19 articles describing an mHealth application or intervention. We assessed mobile app development and testing strategies and standards as described in these articles. RESULTS We identified seven elements of patient empowerment applications for cancer survivors, strategies for application development that take advantage of smartphone capabilities, issues for consideration in developing new applications, and steps for creating user-centered mobile health applications that provide meaningful value for cancer survivors. However, few mobile health apps implemented empowerment elements, underwent rigorous design approaches, or included assessment of use in the cancer survivor population. CONCLUSIONS There is tremendous potential for mobile health apps to benefit cancer survivors. However, there are specific issues for consideration in developing new applications and steps for creating user-centered applications which are not routinely used. This diminishes the value for the cancer survivor population but could be easily addressed through standardized development and testing procedures. IMPLICATIONS FOR CANCER SURVIVORS Smartphone applications have the potential to improve the cancer survivorship experience, but users should look for evidence that the application was appropriately developed and tested.
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Affiliation(s)
- Sharon Watkins Davis
- Cancer Prevention Institute of California, 2201 Walnut Ave, Ste 300, Fremont, CA, 94538, USA
| | - Ingrid Oakley-Girvan
- Cancer Prevention Institute of California, 2201 Walnut Ave, Ste 300, Fremont, CA, 94538, USA. .,Department of Health Research and Policy, Stanford Cancer Institute and Canary Center at Stanford for Cancer Early Detection, Stanford University School of Medicine, Stanford, CA, 94305, USA.
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Ginossar T, Shah SFA, West AJ, Bentley JM, Caburnay CA, Kreuter MW, Kinney AY. Content, Usability, and Utilization of Plain Language in Breast Cancer Mobile Phone Apps: A Systematic Analysis. JMIR Mhealth Uhealth 2017; 5:e20. [PMID: 28288954 PMCID: PMC5368351 DOI: 10.2196/mhealth.7073] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 01/13/2017] [Accepted: 01/29/2017] [Indexed: 12/17/2022] Open
Abstract
Background Breast cancer is one of the leading contributors to preventable illness and death among women. Although mobile phone apps provide unprecedented opportunity to engage women along the cancer continuum, little is known about the availability, content, and usability of breast cancer mobile phone apps. Objective This study analyzed the content and adherence to literate design standards of all breast cancer-related apps available on the App Store and Google Play, as well as the relationship between their content, user ratings, and price. Methods Following identification and downloading of all available breast cancer mobile phone apps in October 2015, 101 apps were confirmed as focusing on breast cancer. Based on prior research, we adapted and applied a content analysis scheme that was specific to breast cancer apps, including their main purpose, relevance to the cancer care continuum, and adherence to usability standards outlined by the Institute of Medicine (IOM). Results The most common aim of apps was educational (73/101, 72.3%), followed by behavior change (24/101, 23.9%), fundraising (20/101, 19.8%), and advocacy (14/101, 13.9%). On the cancer continuum, primary prevention (strategies to prevent cancer cells from occurring) was mentioned in almost one-third of the apps (30/101, 29.7%). Less than half of the apps (46/101, 45.5%) presented information about mammography and/or breast clinical exam, and 53 apps (52.5%) discussed breast self-exam (which is no longer recommended). Symptoms of cancer prediagnosis, such as a lump, were discussed in almost half of the apps (48/101, 47.5%) and a similar number of apps included information about genetic risk for breast cancer (47/101, 46.5%). Information about breast cancer diagnosis was included in 42 apps (41.58%) and 43 (42.6%) apps discussed treatment options. Survivorship issues were addressed in 17 (16.8%) apps. Only one (1.0%) app discussed hospice. Adherence to usability recommendations was low. The median composite score was 3 (mean 2.60, SD 1.20) of the six recommended usability items. With eight plain language items, the median of the composite health literacy score was 5 (mean 5.06, SD 2.00). Most apps did not use easy-to-understand words (44/101, 43.6%) and few (24/101, 23.8%) defined key terms. Conclusions Current breast cancer apps provide important information about breast cancer, but the most common topic covered is breast self-examination, a non-evidence-based screening strategy. Apps that focus on evidence-based strategies on the cancer continuum are needed, with a notable pressing need for apps that would address survivorship and end of life. Finally, developers of breast cancer apps should adhere to IOM standards to meet the needs of diverse populations and reduce current disparities.
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Affiliation(s)
- Tamar Ginossar
- Department of Communication and Journalism, University of New Mexico, Albuquerque, NM, United States
| | - Sayyed Fawad Ali Shah
- Department of Communication and Journalism, University of New Mexico, Albuquerque, NM, United States
| | - Andrew J West
- Department of Communication and Journalism, University of New Mexico, Albuquerque, NM, United States
| | - Joshua M Bentley
- Department of Strategic Communication, Texas Christian University, Fort Worth, TX, United States
| | - Charlene A Caburnay
- Health Communication Research Laboratory, Brown School of Social Work, Washington University in Saint Louis, Saint Louis, MO, United States
| | - Matthew W Kreuter
- Health Communication Research Laboratory, Brown School of Social Work, Washington University in Saint Louis, Saint Louis, MO, United States
| | - Anita Y Kinney
- Department of Internal Medicine, Health Science Center, University of New Mexico, Albuquerque, NM, United States
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Oakley-Girvan I, Londono C, Canchola A, Watkins Davis S. Text Messaging May Improve Abnormal Mammogram Follow-Up in Latinas. Oncol Nurs Forum 2016; 43:36-43. [PMID: 26679443 DOI: 10.1188/16.onf.36-43] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To develop and pilot test a text message notification process to reduce follow-up time for women with abnormal mammograms.
. DESIGN Formative analysis; randomized trial with delayed intervention control group.
. SETTING Tiburcio Vasquez Health Clinic (TVHC), a federally qualified health center in Hayward, California.
. SAMPLE 29 Spanish-speaking Latinas with abnormal mammograms.
. METHODS A Spanish text message was developed based on findings from two focus groups and five interviews with TVHC healthcare providers. Thirteen women were assigned to receive text messages within 24 hours of receipt of abnormal mammogram by TVHC (intervention group) and 16 to receive text messages four weeks later (delayed intervention group).
. MAIN RESEARCH VARIABLES Number of days between the abnormal mammogram and the return for follow-up appointment.
. FINDINGS The median number of days from the abnormal mammogram report to the return for follow-up was 23 days for the intervention group and 59 days for the delayed intervention group (p = 0.0569).
. CONCLUSIONS This study successfully developed a text message that, in Latinas, may decrease the time from receipt of an abnormal mammogram report to attendance at a follow-up visit.
. IMPLICATIONS FOR NURSING This simple, low-cost approach could result in earlier detection of breast cancers, lowering morbidity and mortality among Latinas.
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Petit A, Cambon L. Exploratory study of the implications of research on the use of smart connected devices for prevention: a scoping review. BMC Public Health 2016; 16:552. [PMID: 27401769 PMCID: PMC4940750 DOI: 10.1186/s12889-016-3225-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2016] [Accepted: 06/24/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Smart devices and mobile applications are now an integral part of all aspects of everyday life. They are particularly numerous in the field of health, contributing to the movement called ehealth. What is the potential role of these devices as prevention supports? The purpose of this article is to provide an exploratory analysis of the use, efficacy and contribution to conventional prevention strategies. METHODS To address this issue, we conducted a scoping-review on the basis of 105 publications from the fields of medicine and human sciences. RESULTS Three dimensions of the use of smart devices in the field of health were identified: 1/a quantification tool allowing the users to measure their activities; 2/a tool of self-positioning in the community; 3/an interface between the medical world and the population, modifying the hierarchy of knowledge. However, few published studies have investigated the determinants of the efficacy of these devices and their impact on individual behaviours and professional health practices. CONCLUSION Based on the hypothesis of possible integration of these devices in prevention policies, it would be interesting to investigate two research issues: how and under what psycho-socio-environmental conditions can smart devices contribute to the adoption of positive health behaviours? To what degree does the use of smart devices modify the health care professional-patient relationship? Finding answers to these questions could help to define the real place of these devices in prevention strategies by determining their complementarity with respect to other prevention strategies, and the conditions of their efficacy on behaviours and inequalities.
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Affiliation(s)
- Audrey Petit
- />Chaire de recherche en prévention des cancers, UMR6051, CRAPE, EHESP, Rennes, France
- />EHESP, 20 Avenue George Sand, 93210 Saint-Denis, France
| | - Linda Cambon
- />Chaire de recherche en prévention des cancers, UMR6051, CRAPE, EHESP, Rennes, France
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Drott J, Vilhelmsson M, Kjellgren K, Berterö C. Experiences With a Self-Reported Mobile Phone-Based System Among Patients With Colorectal Cancer: A Qualitative Study. JMIR Mhealth Uhealth 2016; 4:e66. [PMID: 27282257 PMCID: PMC4919552 DOI: 10.2196/mhealth.5426] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Revised: 03/17/2016] [Accepted: 04/22/2016] [Indexed: 11/16/2022] Open
Abstract
Background In cancer care, mobile phone-based systems are becoming more widely used in the assessment, monitoring, and management of side effects. Objective To explore the experiences of patients with colorectal cancer on using a mobile phone-based system for reporting neurotoxic side effects. Methods Eleven patients were interviewed (ages 44-68 years). A semistructured interview guide was used to perform telephone interviews. The interviews were transcribed verbatim and analyzed with qualitative content analysis. Results The patients' experiences of using a mobile phone-based system were identified and constructed as: “being involved,” “pacing oneself,” and “managing the questions.” “Being involved” refers to their individual feelings. Patients were participating in their own care by being observant of the side effects they were experiencing. They were aware that the answers they gave were monitored in real time and taken into account by health care professionals when planning further treatment. “Pacing oneself” describes how the patients can have an impact on the time and place they choose to answer the questions. Answering the questionnaire was easy, and despite the substantial number of questions, it was quickly completed. “Managing the questions” pointed out that the patients needed to be observant because of the construction of the questions. They could not routinely answer all the questions. Patients understood that side effects can vary during the cycles of treatment and need to be assessed repeatedly during treatment. Conclusions This mobile phone-based system reinforced the patients’ feeling of involvement in their own care. The patients were comfortable with the technology and appreciated that the system was not time consuming.
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Affiliation(s)
- Jenny Drott
- Division of Nursing Science, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
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Best AL, Spencer SM, Friedman DB, Hall IJ, Billings D. The Influence of Spiritual Framing on African American Women's Mammography Intentions: A Randomized Trial. JOURNAL OF HEALTH COMMUNICATION 2016; 21:620-628. [PMID: 27142231 PMCID: PMC4946341 DOI: 10.1080/10810730.2015.1114055] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Spiritual framing of breast cancer communication may provide a useful strategy for addressing disparate rates of breast cancer mortality among African American women. The efficacy of a spiritually framed breast cancer screening (BCS) message was compared with that of a traditional BCS message. Specifically, 200 African American women were randomly assigned to review either a spiritually framed or traditional BCS message and complete a self-administered survey, including a thought-listing form. Message efficacy was measured by number of thoughts generated (elaboration), ratio of positive to negative thoughts (polarity), and intention to obtain and/or recommend a mammogram. Multiple linear regression and structural equation modeling were used to assess direct and indirect (mediated) associations among variables. Spiritual framing was positively associated with greater elaboration (β = .265, SE = .36, p < .001) and more positive polarity (β = .237, SE = .04, p < .001) . Spiritual framing also had a significant indirect effect on mammography intentions through polarity (standardized indirect effect = .057, 95% confidence interval [.024, .106], p < .001). These results indicate that spiritual framing may improve the efficacy of BCS messages among African American women by eliciting more positive thoughts about screening. Interventions targeting African American women might consider the role of spirituality when tailoring messages to encourage regular mammography use.
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Affiliation(s)
- Alicia L Best
- a Department of Community and Family Health , College of Public Health, University of South Florida , Tampa , Florida , USA
| | - S Melinda Spencer
- b Department of Health Promotion, Education, and Behavior, Arnold School of Public Health , University of South Carolina , Columbia , South Carolina , USA
| | - Daniela B Friedman
- b Department of Health Promotion, Education, and Behavior, Arnold School of Public Health , University of South Carolina , Columbia , South Carolina , USA
- c Behavior & Cancer Prevention and Control Program, Arnold School of Public Health , University of South Carolina , Columbia , South Carolina , USA
| | - Ingrid J Hall
- d Division of Cancer Prevention and Control , Centers for Disease Control and Prevention , Atlanta , Georgia , USA
| | - Deborah Billings
- b Department of Health Promotion, Education, and Behavior, Arnold School of Public Health , University of South Carolina , Columbia , South Carolina , USA
- e South Carolina Contraceptive Access Campaign , Columbia , South Carolina , USA
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Smith R, Menon J, Rajeev JG, Feinberg L, Kumar RK, Banerjee A. Potential for the use of mHealth in the management of cardiovascular disease in Kerala: a qualitative study. BMJ Open 2015; 5:e009367. [PMID: 26576813 PMCID: PMC4654349 DOI: 10.1136/bmjopen-2015-009367] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES To assess the potential for using mHealth in cardiovascular disease (CVD) management in Kerala by exploring: (1) experiences and challenges of current CVD management; (2) current mobile phone use; (3) expectations of and barriers to mobile phone use in CVD management. DESIGN Qualitative, semistructured, individual interviews. SETTING 5 primary health centres in Ernakulam district, Kerala, India. PARTICIPANTS 15 participants in total from 3 stakeholder groups: 5 patients with CVD and/or its risk factors, 5 physicians treating CVD and 5 Accredited Social Health Activists (ASHAs). Patients were sampled for maximum variation on the basis of age, sex, CVD diagnoses and risk factors. All participants had access to a mobile phone. RESULTS The main themes identified relating to the current challenges of CVD were poor patient disease knowledge, difficulties in implementing primary prevention and poor patient lifestyles. Participants noted phone calls as the main function of current mobile phone use. The expectations of mHealth use are to: improve accessibility to healthcare knowledge; provide reminders of appointments, medication and lifestyle changes; save time, money and travel; and improve ASHA job efficacy. All perceived barriers to mHealth were noted within physician interviews. These included fears of mobile phones negatively affecting physicians' roles, the usability of mobile phones, radiation and the need for physical consultations. CONCLUSIONS There are three main potential uses of mHealth in this population: (1) as an educational tool, to improve health education and lifestyle behaviours; (2) to optimise the use of limited resources, by overcoming geographical barriers and financial constraints; (3) to improve use of healthcare, by providing appointment and treatment reminders in order to improve disease prevention and management. Successful mHealth design, which takes barriers into account, may complement current practice and optimise use of limited resources.
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Affiliation(s)
- Rebecca Smith
- University of Birmingham, Medical School, Birmingham, UK
| | - Jaideep Menon
- Department of Preventive Cardiology, Amrita Institute of Medical Sciences & Research Centre, Kochi, Kerala, India
| | | | - Leo Feinberg
- University of Birmingham, Medical School, Birmingham, UK
| | - Raman Krishan Kumar
- Department of Paediatric Cardiology, Amrita Institute of Medical Sciences & Research Centre, Kochi, Kerala, India
| | - Amitava Banerjee
- University of Birmingham Centre for Cardiovascular Sciences, Birmingham, UK
- Farr Institute of Health Informatics Research, University College London, London, UK
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Weaver KE, Ellis SD, Denizard-Thompson N, Kronner D, Miller DP. Crafting Appealing Text Messages to Encourage Colorectal Cancer Screening Test Completion: A Qualitative Study. JMIR Mhealth Uhealth 2015; 3:e100. [PMID: 26537553 PMCID: PMC4704950 DOI: 10.2196/mhealth.4651] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Revised: 09/11/2015] [Accepted: 09/22/2015] [Indexed: 11/27/2022] Open
Abstract
Background mHealth interventions that incorporate text messages have great potential to increase receipt of preventive health services such as colorectal cancer screening. However, little is known about older adult perspectives regarding the receipt of text messages from their health care providers. Objective To assess whether older adults would value and access text messages from their physician’s practice regarding colorectal cancer screening. Methods We conducted four focus groups with 26 adults, aged 50 to 75 years, who had either recently completed or were overdue for colorectal cancer screening. A trained moderator followed a semistructured interview guide covering participant knowledge and attitudes regarding colorectal cancer screening, potential barriers to colorectal cancer screening, attitudes about receiving electronic communications from a doctor’s office, and reactions to sample text messages. Results Participant responses to three primary research questions were examined: (1) facilitators and barriers to colorectal cancer screening, (2) attitudes toward receiving text messages from providers, and (3) characteristics of appealing text messages. Two themes related to facilitators of colorectal cancer screening were perceived benefits/need and family experiences and encouragement. Themes related to barriers included unpleasantness, discomfort, knowledge gaps, fear of complications, and system factors. Four themes emerged regarding receipt of text messages from health care providers: (1) comfort and familiarity with technology, (2) privacy concerns/potential for errors, (3) impact on patient-provider relationship, and (4) perceived helpfulness. Many participants expressed initial reluctance to receiving text messages but responded favorably when shown sample messages. Participants preferred messages that contained content that was important to them and were positive and reassuring, personalized, and friendly to novice texters (eg, avoided the use of texting shorthand phrases and complicated replies); they did not want messages that contain bad news or test results. They wanted the ability to choose alternative options such as email or phone calls. Conclusions Older adults are receptive to receiving cancer screening text messages from health care providers. Sharing sample messages with patients may increase acceptance of this tool in the clinic setting. Supportive tailored text messaging reminders could enhance uptake of colorectal cancer screening by enhancing patient self-efficacy and providing cues to action to complete colonoscopy or fecal occult blood testing.
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Affiliation(s)
- Kathryn E Weaver
- Wake Forest School of Medicine, Department of Social Sciences and Health Policy, Winston-Salem, NC, United States.
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