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Chen HH, Hsiung Y, Lee CF, Huang JP, Chi LK, Weng SS. Effects of an mHealth intervention on maternal and infant outcomes from pregnancy to early postpartum for women with overweight or obesity: A randomized controlled trial. Midwifery 2024; 138:104143. [PMID: 39154597 DOI: 10.1016/j.midw.2024.104143] [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: 12/25/2023] [Revised: 08/06/2024] [Accepted: 08/09/2024] [Indexed: 08/20/2024]
Abstract
BACKGROUND Women with overweight (OW) and those with obesity (OB) tend to gain excessive weight during pregnancy, often resulting in adverse outcomes. The long-term effects of mobile health (mHealth) interventions on maternal and infant outcomes remain unclear. AIMS To examine the effects of an mHealth intervention on OW and OB from the course of their pregnancy to six months postpartum. METHODS A randomized controlled trial was conducted in northern Taiwan. Ninety-two pregnant women with a body mass index (BMI)of ≥25 kg/m2 were recruited from prenatal clinics at <17 weeks of gestation. Prepregnancy weight was baseline maternal weight, with data collected subsequently at the last assessment before childbirth and six months postpartum. The intervention group (IG) received the mHealth intervention, while the control group (CG) received standard antenatal care. The trial was registered on ClinicalTrials.gov (identifier: NCT04553731) with the initial registration date of September 16, 2020. FINDINGS The IG tended to have a lower mean body weight than the CG at the last assessment before childbirth (82.23 kg vs 84.35 kg) and at six months postpartum (72.55 Kg vs 72.58 Kg). IG's newborn birth weight was significantly lower than CG's (3074.8 vs. 3313.6 g; p = 0.009). Regression analysis revealed that OB in IG had a significant reduction in weight before childbirth (β = -7.51, p = 0.005) compared to OB in CG. Compared to OW in CG, both OW in IG (β = -243.59, p = 0.027) and OB in IG (β = -324.59, p = 0.049) were associated with decreased newborn birth weight. CONCLUSIONS mHealth helped women with obesity to successfully manage their GWG and body weight before childbirth and newborns' birth weight, despite this effect not persisting to reduce weight retention at six months postpartum.
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Affiliation(s)
- Hung Hui Chen
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan; Second Degree Bachelor of Science in Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Nursing, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan.
| | - Yvonne Hsiung
- Department of Nursing, Mackay Medical College, Taipei, Taiwan.
| | - Ching-Fang Lee
- Department of Nursing, Mackay Medical College, Taipei, Taiwan.
| | - Jian-Pei Huang
- Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan.
| | - Li-Kang Chi
- Department of Physical Education and Sport Sciences, National Taiwan Normal University,Taipei, Taiwan.
| | - Shih-Shien Weng
- Department of Obstetrics and Gynecology, Mackay Memorial Hospital, New Taipei, Taiwan.
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Liu PL, Ye JF. Mobile Patient-Provider Communication and Lifestyle Improvement: Examining the Role of Mobile Technology Identity and Health Empowerment. HEALTH COMMUNICATION 2024:1-13. [PMID: 39258731 DOI: 10.1080/10410236.2024.2402160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/12/2024]
Abstract
In the span of a decade, smartphones have gained popularity and acceptance among both patients and physicians thanks to their advantages in health care delivery. However, research investigating mobile patient-provider communication (MPPC) and its impact on patients' lifestyles is only just beginning. Drawing on the pathway model of health communication and mobile technology (MTI) theory, we developed a research model to explore the effect of MPPC on lifestyle improvement, using health empowerment as a mediator and MTI as a moderator. The findings from 432 participants (Mage = 32.5 years old, female = 212) suggested that after controlling for respondents' age, gender, education, income, and general health status, having greater communication with healthcare providers through mobile devices was positively related to lifestyle improvement and that health empowerment mediated this relationship. Moreover, MTI-emotional energy (MTIE) moderated the direct relationship between MPPC and lifestyle improvement, while MTI-dependency (MTID) moderated the indirect impact of MPPC. Individuals who hold a greater MTIE/MTID were more likely to benefit from MPPC such that they are more likely to be empowered for self-care and maintain healthy lifestyles. This study not only contributes to the growing literature on mobile health communication but also plays a reference role for interventions in patient empowerment and health promotion. Theoretical and practical implications were discussed.
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Cheng YS, Lin CP, Chen LYA, Hwang WR, Lin YC, Chen YC. Short-Term Effects of an eHealth Care Experiential Learning Program Among Patients With Type 2 Diabetes: Randomized Controlled Trial. J Med Internet Res 2024; 26:e53509. [PMID: 39150761 PMCID: PMC11364949 DOI: 10.2196/53509] [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: 10/09/2023] [Revised: 02/07/2024] [Accepted: 06/21/2024] [Indexed: 08/17/2024] Open
Abstract
BACKGROUND Type 2 diabetes is a chronic disease with a significant medical burden. eHealth care integrates medicine and technology to enhance the outcomes of such patients; however, adequate eHealth literacy (eHL) is necessary for that to happen. Fostering eHL is crucial for patients with diabetes to engage with eHealth care and receive quality care and timely support. Experiential learning theory can enhance patients' eHL and skills to use eHealth care technology in their daily care. OBJECTIVE This study explored the effectiveness of an eHealth care experiential learning program in improving eHL, patient health engagement, and eHealth care use status among patients with type 2 diabetes in 3 months. METHODS In this randomized controlled trial, patients under case management services from various clinics in Taiwan were randomly assigned to either the intervention group receiving the 6-session eHealth care experiential learning program or the control group receiving the usual care. Data were collected using structured questionnaires at 3 time points: pretest, postintervention, and 3 months after the intervention. Descriptive data were presented using frequency distribution, percentage, mean, and SD. The outcomes were analyzed using a generalized estimating equation method by intention-to-treat analysis. RESULTS A total of 92 participants (46 in each group) were recruited in this study. Of these, 86 completed the course and follow-up evaluations with a mean age of 62.38 (SD 12.91) years. After completing the intervention, the intervention group had significantly higher posttest scores in eHL (β=19.94, SE 3.52; P<.001), patient health engagement (β=.28, SE 0.13; P=.04), and eHealth use (β=3.96, SE 0.42; P<.001) than the control group. Furthermore, the intervention group maintained these significant improvements in eHL (β=18.19, SE 3.82; P<.001) and eHealth use (β=3.87, SE 0.49; P<.001) after 3 months. CONCLUSIONS Participating in the eHealth care experiential learning program resulted in significant improvements in eHL, patient health engagement, and eHealth use among patients with type 2 diabetes. Our interventional program can inform future clinical practice and policies to strengthen self-management skills and facilitate the use of health technology in caring for patients with chronic diseases. TRIAL REGISTRATION ClinicalTrials.gov NCT05180604; https://clinicaltrials.gov/ct2/show/NCT05180604.
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Affiliation(s)
- Yu-Shan Cheng
- School of Nursing, The University of Texas at Austin, Austin, TX, United States
| | - Cheng-Pei Lin
- Institute of Community Health Care, College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, United Kingdom
| | - Lu-Yen Anny Chen
- Institute of Clinical Nursing, College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | | | - Yi-Chun Lin
- Rong-Yang Clinic, Taipei, Taiwan
- Division of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yu-Chi Chen
- Institute of Clinical Nursing, College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan
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Jin Z, Zhu L, Zhou S, Lu C. Managing Post-Stroke Fatigue Using a Mobile Health Called iHealth After Intracerebral Hemorrhage. J Multidiscip Healthc 2024; 17:2389-2397. [PMID: 38770170 PMCID: PMC11104438 DOI: 10.2147/jmdh.s465902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 05/13/2024] [Indexed: 05/22/2024] Open
Abstract
Background Post-stroke Fatigue (PSF) after Intracerebral Hemorrhage (ICH) is a long-term symptom in stroke survivors. However, the pathogenesis of PSF remains inadequately understood and sufficient evidence-based treatments are lacking. Mobile health (mHealth) technology offers a promising approach to expanding access to high-quality and culturally tailored evidence-based mental care. Aim This study examined the role of mHealth called iHealth in the management of PSF after ICH. Methods A total of 225 patients diagnosed with intracerebral hemorrhage (ICH) were included in the study and randomly assigned to either the Mobile Health Intervention Group (mHI Group) or the non-Mobile Health Intervention Group (non-mHI). The management involved the utilization of a digital healthcare application named iHealth, which incorporated digital questionnaires, fatigue scale tests, and online videos for the purpose of administering the Patient Fatigue Reporting Measurement Information System (PFRMIS) short form as part of the initial patient assessment following ICH. The study was conducted remotely via video conferencing over a 12-week period in mHI Group, with fatigue assessments being conducted 3 months post-ICH onset in two groups. Results Following the administration of PSF by iHealth, Univariate Logistic analyses indicated a significant association between fatigue and the type of activity, with patients who were sedentary or did nothing experiencing higher levels of fatigue (β=2.332, p<0.001; β=2.517, p<0.001). Multivariate Logistic analyses demonstrated a positive association between the intensity of physical activity and decreased emotional well-being and family support, as well as increased fatigue. (p=0.001, p=0.002, p=0.001). The FSS results demonstrated a significantly reduced incidence of PSF in the MHI group in comparison to non-mHI group following the conclusion of the programme. (13.1% vs 40%, p<0.001). Conclusion This study explored the effectiveness of the iHealth app for PSF following ICH, indicating that iHealth is a clinically valuable tool that warrants further dissemination.
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Affiliation(s)
- Zhuhua Jin
- Department of Information Management, First Affiliated Hospital of Anhui University of Science and Technology, First People’s Hospital of Huainan, Huainan, Anhui Province, People’s Republic of China
- School of Economics and Management, Anhui University of Science and Technology, Huainan, 232001, People’s Republic of China
| | - Lei Zhu
- Department of Neurology, First Affiliated Hospital of Anhui University of Science and Technology, First People’s Hospital of Huainan, Huainan, Anhui Province, People’s Republic of China
| | - Shuping Zhou
- School of Economics and Management, Anhui University of Science and Technology, Huainan, 232001, People’s Republic of China
- First Affiliated Hospital of Anhui University of Science and Technology, First People’s Hospital of Huainan, Huainan, Anhui Province, People’s Republic of China
| | - Chao Lu
- School of Economics and Management, Anhui University of Science and Technology, Huainan, 232001, People’s Republic of China
- First Affiliated Hospital of Anhui University of Science and Technology, First People’s Hospital of Huainan, Huainan, Anhui Province, People’s Republic of China
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Liu PL. Understanding mHealth Adoption and Lifestyle Improvement: An Empirical Test of the Antecedents and Mediating Mechanisms. JOURNAL OF HEALTH COMMUNICATION 2024; 29:155-165. [PMID: 38205945 DOI: 10.1080/10810730.2024.2303641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
The potential of using mobile phones for health care service delivery has been well acknowledged. Despite that mobile health (mHealth) related research has proliferated in the past decade, mHealth is still in the fledgling stage with a low adoption rate. There is a research gap in understanding factors influencing mHealth adoption and examining the effects of mHealth use on health outcomes. The purpose of this study was thus to explore influential factors of mHealth use, and test mediation pathways through which mHealth use impacts healthy lifestyle behaviors (e.g. sleep, exercise, and social participation). Survey results from 432 online participants illustrate that performance expectancy, social influence, support conditions, and perceived reliability were significantly associated with mHealth use. However, the impact of effort expectancy on mHealth use was statistically nonsignificant. Moreover, the results indicate that mHealth use can not only contribute to the improvement of healthy lifestyle behaviors directly but also exert an impact through the mediating effect of health competence. Knowing what factors motivate people's mHealth use and how mHealth use contributes to lifestyle improvement can help trigger interventions to boost mHealth adoption and improve public health. Implications and limitations are discussed.
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Bednorz A, Mak JKL, Jylhävä J, Religa D. Use of Electronic Medical Records (EMR) in Gerontology: Benefits, Considerations and a Promising Future. Clin Interv Aging 2023; 18:2171-2183. [PMID: 38152074 PMCID: PMC10752027 DOI: 10.2147/cia.s400887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 11/05/2023] [Indexed: 12/29/2023] Open
Abstract
Electronic medical records (EMRs) have many benefits in clinical research in gerontology, enabling data analysis, development of prognostic tools and disease risk prediction. EMRs also offer a range of advantages in clinical practice, such as comprehensive medical records, streamlined communication with healthcare providers, remote data access, and rapid retrieval of test results, ultimately leading to increased efficiency, enhanced patient safety, and improved quality of care in gerontology, which includes benefits like reduced medication use and better patient history taking and physical examination assessments. The use of artificial intelligence (AI) and machine learning (ML) approaches on EMRs can further improve disease diagnosis, symptom classification, and support clinical decision-making. However, there are also challenges related to data quality, data entry errors, as well as the ethics and safety of using AI in healthcare. This article discusses the future of EMRs in gerontology and the application of AI and ML in clinical research. Ethical and legal issues surrounding data sharing and the need for healthcare professionals to critically evaluate and integrate these technologies are also emphasized. The article concludes by discussing the challenges related to the use of EMRs in research as well as in their primary intended use, the daily clinical practice.
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Affiliation(s)
- Adam Bednorz
- John Paul II Geriatric Hospital, Katowice, Poland
- Institute of Psychology, Humanitas Academy, Sosnowiec, Poland
| | - Jonathan K L Mak
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Juulia Jylhävä
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center (GEREC), University of Tampere, Tampere, Finland
| | - Dorota Religa
- Division of Clinical Geriatrics, Department of Neurobiology, Care sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Theme Inflammation and Aging, Karolinska University Hospital, Huddinge, Sweden
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Zheng S, Edney SM, Goh CH, Tai BC, Mair JL, Castro O, Salamanca-Sanabria A, Kowatsch T, van Dam RM, Müller-Riemenschneider F. Effectiveness of holistic mobile health interventions on diet, and physical, and mental health outcomes: a systematic review and meta-analysis. EClinicalMedicine 2023; 66:102309. [PMID: 38053536 PMCID: PMC10694579 DOI: 10.1016/j.eclinm.2023.102309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 10/16/2023] [Accepted: 10/26/2023] [Indexed: 12/07/2023] Open
Abstract
Background Good physical and mental health are essential for healthy ageing. Holistic mobile health (mHealth) interventions-including at least three components: physical activity, diet, and mental health-could support both physical and mental health and be scaled to the population level. This review aims to describe the characteristics of holistic mHealth interventions and their effects on related behavioural and health outcomes among adults from the general population. Methods In this systematic review and meta-analysis, we searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials, PsycINFO, Scopus, China National Knowledge Infrastructure, and Google Scholar (first 200 records). The initial search covered January 1, 2011, to April 13, 2022, and an updated search extended from April 13, 2022 to August 30, 2023. Randomised controlled trials (RCTs) and non-randomised studies of interventions (NRSIs) were included if they (i) were delivered via mHealth technologies, (ii) included content on physical activity, diet, and mental health, and (iii) targeted adults (≥18 years old) from the general population or those at risk of non-communicable diseases (NCDs) or mental disorders. Studies were excluded if they targeted pregnant women (due to distinct physiological responses), individuals with pre-existing NCDs or mental disorders (to emphasise prevention), or primarily utilised web, email, or structured phone support (to focus on mobile technologies without exclusive human support). Data (summary data from published reports) extraction and risk-of-bias assessment were completed by two reviewers using a standard template and Cochrane risk-of-bias tools, respectively. Narrative syntheses were conducted for all studies, and random-effects models were used in the meta-analyses to estimate the pooled effect of interventions for outcomes with comparable data in the RCTs. The study was registered in PROSPERO, CRD42022315166. Findings After screening 5488 identified records, 34 studies (25 RCTs and 9 pre-post NRSIs) reported in 43 articles with 5691 participants (mean age 39 years, SD 12.5) were included. Most (91.2%, n = 31/34) were conducted in high-income countries. The median intervention duration was 3 months, and only 23.5% (n = 8/34) of studies reported follow-up data. Mobile applications, short-message services, and mobile device-compatible websites were the most common mHealth delivery modes; 47.1% (n = 16/34) studies used multiple mHealth delivery modes. Of 15 studies reporting on weight change, 9 showed significant reductions (6 targeted on individuals with overweight or obesity), and in 10 studies reporting perceived stress levels, 4 found significant reductions (all targeted on general adults). In the meta-analysis, holistic mHealth interventions were associated with significant weight loss (9 RCTs; mean difference -1.70 kg, 95% CI -2.45 to -0.95; I2 = 89.00%) and a significant reduction in perceived stress levels (6 RCTs; standardised mean difference [SMD] -0.32; 95% CI -0.52 to -0.12; I2 = 14.52%). There were no significant intervention effects on self-reported moderate-to-vigorous physical activity (5 RCTs; SMD 0.21; 95%CI -0.25 to 0.67; I2 = 74.28%) or diet quality scores (5 RCTs; SMD 0.21; 95%CI -0.47 to 0.65; I2 = 62.27%). All NRSIs were labelled as having a serious risk of bias overall; 56% (n = 14/25) of RCTs were classified as having some concerns, and the others as having a high risk of bias. Interpretation Findings from identified studies suggest that holistic mHealth interventions may aid reductions in weight and in perceived stress levels, with small to medium effect sizes. The observed effects on diet quality scores and self-reported moderate-to-vigorous physical activity were less clear and require more research. High-quality RCTs with longer follow-up durations are needed to provide more robust evidence. To promote population health, future research should focus on vulnerable populations and those in middle- and low-income countries. Optimal combinations of delivery modes and components to improve efficacy and sustain long-term effects should also be explored. Funding National Research Foundation, Prime Minister's Office, Singapore, under its Campus for Research Excellence and Technological Enterprise (CREATE) Programme and Physical Activity and Nutrition Determinants in Asia (PANDA) Research Programme.
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Affiliation(s)
- Shenglin Zheng
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore
| | - Sarah Martine Edney
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Chin Hao Goh
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Bee Choo Tai
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Jacqueline Louise Mair
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore
| | - Oscar Castro
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore
| | - Alicia Salamanca-Sanabria
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A∗STAR), Singapore
| | - Tobias Kowatsch
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore
- Institute for Implementation Science in Health Care, University of Zürich, Zürich, Switzerland
- School of Medicine, University of St. Gallen, St. Gallen, Switzerland
- Centre for Digital Health Interventions, Department of Management, Technology and Economics ETH Zürich, Zürich, Switzerland
| | - Rob M. van Dam
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
- Departments of Exercise and Nutrition Sciences and Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Falk Müller-Riemenschneider
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
- Digital Health Centre, Berlin Institute of Health, Charité – Universitätsmedizin Berlin, Berlin, Germany
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Alluhaidan AS, Chatterjee S, Drew DE, Ractham P, Kaewkitipong L. Empowerment Enabled by Information and Communications Technology and Intention to Sustain a Healthy Behavior: Survey of General Users. JMIR Hum Factors 2023; 10:e47103. [PMID: 37991814 PMCID: PMC10701653 DOI: 10.2196/47103] [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: 03/08/2023] [Revised: 08/30/2023] [Accepted: 10/05/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Most people with chronic conditions fail to adhere to self-management behavioral guidelines. In the last 2 decades, several mobile health apps and IT-based systems have been designed and developed to help patients change and sustain their healthy behaviors. However, these systems often lead to short-term behavior change or adherence while the goal is to engage the population toward long-term behavior change. OBJECTIVE This study aims to contribute to the development of long-term health behavior changes or to help people sustain their healthy behavior. For this purpose, we built and tested a theoretical model that includes enablers of empowerment and an intention to sustain a healthy behavior when patients are assisted by information and communications technology. METHODS Structural equation modeling was used to analyze 427 survey returns collected from a diverse population of participants and patients. Notably, the model testing was performed for physical activity as a generally desirable healthy goal. RESULTS Message aligned with personal goals, familiarity with technology tools, high self-efficacy, social connection, and community support played a significant role (P<.001) in empowering individuals to maintain a healthy behavior. The feeling of being empowered exhibited a strong influence, with a path coefficient of 0.681 on an intention to sustain healthy behavior. CONCLUSIONS The uniqueness of this model is its recognition of needs (ie, social connection, community support, and self-efficacy) to sustain a healthy behavior. Individuals are empowered when they are assisted by family and community, specifically when they possess the knowledge, skills, and self-awareness to ascertain and achieve their goals. This nascent theory explains what might lead to more sustainable behavior change and is meant to help designers build better apps that enable people to conduct self-care routines and sustain their behavior.
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Affiliation(s)
- Ala Saleh Alluhaidan
- Department of Information Systems, College of Computer & Information Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Samir Chatterjee
- Center for Information Systems & Technology, Claremont Graduate University, Claremont, CA, United States
| | - David E Drew
- School of Educational Studies, Claremont Graduate University, Claremont, CA, United States
| | - Peter Ractham
- Center of Excellence in Operations and Information Management, Thammasat Business School, Thammasat University, Bangkok, Thailand
| | - Laddawan Kaewkitipong
- Center of Excellence in Operations and Information Management, Thammasat Business School, Thammasat University, Bangkok, Thailand
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Zheng S, Edney SM, Mair JL, Kowatsch T, Castro O, Salamanca-Sanabria A, Müller-Riemenschneider F. Holistic mHealth interventions for the promotion of healthy ageing: protocol for a systematic review. BMJ Open 2023; 13:e066662. [PMID: 37130675 PMCID: PMC10163532 DOI: 10.1136/bmjopen-2022-066662] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/04/2023] Open
Abstract
INTRODUCTION Maintaining physical and mental health is essential for healthy ageing. It can be supported by modifying lifestyle factors such as physical activity and diet. Poor mental health, in turn, contributes to the opposing effect. The promotion of healthy ageing may therefore benefit from holistic interventions integrating physical activity, diet and mental health. These interventions can be scaled up to the population level by using mobile technologies. However, systematic evidence regarding the characteristics and effectiveness of such holistic mHealth interventions remains limited. This paper presents a protocol for a systematic review that aims to provide an overview of the current state of the evidence for holistic mHealth interventions, including their characteristics and effects on behavioural and health outcomes in general adult populations . METHODS AND ANALYSIS We will conduct a comprehensive search for randomised controlled trials and non-randomised studies of interventions published between January 2011 and April 2022 in MEDLINE, Embase, Cochrane Central Register of Controlled Trials, PsycINFO, Scopus, China National Knowledge Infrastructure and Google Scholar (first 200 records). Eligible studies will be mHealth interventions targeting general adult populations with content on physical activity, diet and mental health. We will extract information on all relevant behavioural and health outcomes, as well as those related to intervention feasibility. Screening and data extraction processes will be carried out independently by two reviewers. Cochrane risk-of-bias tools will be used to assess risk of bias. We will provide a narrative overview of the findings from eligible studies. With sufficient data, a meta-analysis will be conducted. ETHICS AND DISSEMINATION Ethical approval is not required because this study is a systematic review based on published data. We intend to publish our findings in a peer-reviewed journal and present the study at international conferences. PROSPERO REGISTRATION NUMBER CRD42022315166.
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Affiliation(s)
- Shenglin Zheng
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore
| | - Sarah Martine Edney
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Jacqueline Louise Mair
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore
| | - Tobias Kowatsch
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore
- Institute for Implementation Science in Health Care, University of Zürich, Zürich, Switzerland
- School of Medicine, University of St. Gallen, St. Gallen, Switzerland
- Centre for Digital Health Interventions, Department of Management, Technology and Economics, ETH Zürich, Zürich, Switzerland
| | - Oscar Castro
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore
| | - Alicia Salamanca-Sanabria
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore
| | - Falk Müller-Riemenschneider
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
- Digital Health Centre, Berlin Institute of Health, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Kapeller A, Loosman I. Empowerment through health self-testing apps? Revisiting empowerment as a process. MEDICINE, HEALTH CARE, AND PHILOSOPHY 2023; 26:143-152. [PMID: 36592301 PMCID: PMC9806806 DOI: 10.1007/s11019-022-10132-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 11/24/2022] [Accepted: 11/28/2022] [Indexed: 05/13/2023]
Abstract
Empowerment, an already central concept in public health, has gained additional relevance through the expansion of mobile health (mHealth). Especially direct-to-consumer self-testing app companies mobilise the term to advertise their products, which allow users to self-test for various medical conditions independent of healthcare professionals. This article first demonstrates the absence of empowerment conceptualisations in the context of self-testing apps by engaging with empowerment literature. It then contrasts the service these apps provide with two widely cited empowerment definitions by the WHO, which describe the term as a process that, broadly, leads to knowledge and control of health decisions. We conclude that self-testing apps can only partly empower their users, as they, we argue, do not provide the type of knowledge and control the WHO definitions describe. More importantly, we observe that this shortcoming stems from the fact that in the literature on mHealth and in self-testing marketing, empowerment is understood as a goal rather than a process. This characterises a shift in the meaning of empowerment in the context of self-testing and mHealth, one that reveals a lack of awareness for relational and contextual factors that contribute to empowerment. We argue that returning to a process-understanding of empowerment helps to identify these apps' deficits, and we conclude the article by briefly suggesting several strategies to increase self-testing apps' empowerment function.
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Affiliation(s)
- Alexandra Kapeller
- Department of Thematic Studies – Technology and Social Change, Linköping University, Linköping, Sweden
| | - Iris Loosman
- Department of Philosophy and Ethics, Eindhoven University of Technology, Eindhoven, The Netherlands
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11
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Wang X, Markert C, Sasangohar F. Investigating Popular Mental Health Mobile Application Downloads and Activity During the COVID-19 Pandemic. HUMAN FACTORS 2023; 65:50-61. [PMID: 33682467 DOI: 10.1177/0018720821998110] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
OBJECTIVE This article analyzes the changes in downloads and activity of users of select popular mental health mobile applications (mHealth apps) during coronavirus disease 2019 (COVID-19). BACKGROUND The outbreak of the COVID-19 crisis has shown a negative impact on public mental health. Mobile health has the potential to help address the psychological needs of existing and new patients during the pandemic and beyond. METHOD Downloads data of 16 widely used apps were analyzed. The quality of apps was reviewed using the Mobile Application Rating Scale (MARS) framework. Correlation analysis was conducted to investigate the relationship between app quality and app popularity. RESULTS Among the 16 apps, 10 were meditational in nature, 13 showed increased downloads, with 11 apps showing above 10% increase in the downloads after the pandemic started. The popular apps were satisfactory in terms of functionality and esthetics but lacked clinical grounding and evidence base. There exists a gap between app quality and app popularity. CONCLUSION This study provided evidence for increased downloads of mental mHealth apps (primarily meditation apps) during the COVID-19 pandemic but revealed several gaps and opportunities to address deficiencies in evidence-based design, usability and effective assessment, and integration into current workflows. APPLICATION The COVID-19 pandemic is a potential turning point for mHealth applications for mental health care. Whereas the evidence suggests a need for alternative delivery of care, human factors and ergonomics methods should be utilized to ensure these tools are user-centered, easy to use, evidence-based, well-integrated with professional care, and used sustainably.
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Affiliation(s)
| | | | - Farzan Sasangohar
- 2655 Texas A&M University, College Station, USA
- Houston Methodist Hospital, Texas, USA
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12
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Wang X, Zhao YC. Understanding older adults' intention to use patient-accessible electronic health records: Based on the affordance lens. Front Public Health 2023; 10:1075204. [PMID: 36761325 PMCID: PMC9902947 DOI: 10.3389/fpubh.2022.1075204] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 12/28/2022] [Indexed: 01/26/2023] Open
Abstract
Background Given the aging population and the rapid development of the digital society, concerns about promoting older adults' health skills are increasing. Patient-accessible electronic health records (PAEHRs) are implemented globally for aging health safeguards. The demand for using health-related information communication technologies (ICTs) among older adults and the factors that promote their usage intention of PAEHRs need to be studied. Methods Drawing upon affordance theory, we constructed a research model that integrates four affordance types, aggregation, interactivity, collaboration, and communication, to identify the effects of affordances and attachment to platforms and doctors that contribute to older adults' usage intention on PAEHRs. Online survey data from 498 older adults (above 60 years) were collected and analyzed using partial least square-structural equation modeling. Results Our findings demonstrated how PAEHR's affordances facilitate older adults' attachment to platforms and doctors. We found that aggregation (γ = 0.417, P < 0.001) and interactivity (γ = 0.397, P < 0.001) can positively influence older adults' attachment to the PAEHR platform, and collaboration (γ = 0.407, P < 0.001) affordance can positively influence older adults' attachment to doctors on the PAEHR platform. Furthermore, seniors' attachment to the platform (γ = 0.598, P < 0.001) and attachment to the doctor (γ = 0.156, P < 0.01) can both positively influence their usage intention, and attachment to the platform had a positive relationship with attachment to doctors (γ = 0.230, P < 0.001) on the PAEHR. Conclusion This study enriched the understanding of elders' attachment to doctors on PAEHRs and contributed to the literature on health-related ICT usage targets of older adults. Our findings also shed light on inspiring operators of health-related ICTs to formulate appropriate strategies for aging-friendly design to guide older adults to adopt health-related ICTs in their everyday health information practices.
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13
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Liu JYW, Man DWK, Lai FHY, Cheung TCC, Cheung AKP, Cheung DSK, Choi TKS, Fong GCH, Kwan RYC, Lam SC, Ng VTY, Wong H, Yang L, Shum DHK. A Health App for Post-Pandemic Years (HAPPY) for people with physiological and psychosocial distress during the post-pandemic era: Protocol for a randomized controlled trial. Digit Health 2023; 9:20552076231210725. [PMID: 37928335 PMCID: PMC10623948 DOI: 10.1177/20552076231210725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 10/03/2023] [Indexed: 11/07/2023] Open
Abstract
Objective This article describes a protocol for a randomized controlled trial to evaluate the effects of a three-level Health App for Post-Pandemic Years (HAPPY) on alleviating post-pandemic physiological and psychosocial distress. Methods Convenience and snowball sampling methods will be used to recruit 814 people aged 18+ with physiological and/or psychosocial distress. The experimental group will receive a 24-week intervention consisting of an 8-week regular supervision phase and a 16-week self-help phase. Based on their assessment results, they will be assigned to receive interventions on mindfulness, energy conservation techniques, or physical activity training. The waitlist control group will receive the same intervention in Week 25. The primary outcome will be changes in psychosocial distress, measured using the Kessler Psychological Distress Scale (K10). Secondary outcomes will include changes in levels of fatigue (Chinese version of the Brief Fatigue Inventory), sleep quality (Chinese version of the Pittsburgh Sleep Quality Index), pain intensity (Numeric Rating Scale), positive appraisal (Short version of the 18-item Cognitive Emotion Regulation Questionnaire), self-efficacy (Chinese version of the General Self-efficacy Scale), depression and anxiety (Chinese version of the 21-item Depression Anxiety Stress Scale), and event impact (Chinese version of the 22-item Impact of Event Scale-Revised). All measures will be administered at baseline (T0), Week 8 after the supervision phase (T1), and 24 weeks post-intervention (T2). A generalized estimating equations model will be used to examine the group, time, and interaction (Time × Group) effect of the interventions on the outcome assessments (intention-to-treat analysis) across the three time points, and to compute a within-group comparison of objective physiological parameters and adherence to the assigned interventions in the experimental group. Conclusions The innovative, three-level mobile HAPPY app will promote beneficial behavioral strategies to alleviate post-pandemic physiological and psychosocial distress. Trial registration ClinicalTrials.gov, NCT05459896. Registered on 15 July 2022.
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Affiliation(s)
- Justina Yat-Wa Liu
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
- Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - David Wai-Kwong Man
- President's Office, Tung Wah College, Hong Kong SAR, China
- Mental Health Research Centre, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Frank Ho-Yin Lai
- Mental Health Research Centre, The Hong Kong Polytechnic University, Hong Kong SAR, China
- Department of Social Work, Education and Community Wellbeing, Northumbria University, Newcastle, UK
| | - Teris Cheuk-Chi Cheung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
- Mental Health Research Centre, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Amy Ka-Po Cheung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Daphne Sze-Ki Cheung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
- Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong SAR, China
- Mental Health Research Centre, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Thomas Kup-Sze Choi
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Gabriel Ching-Hang Fong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | | | | | - Vincent To-Yee Ng
- University Research Facility in Big Data Analytics, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Heung Wong
- University Research Facility in Big Data Analytics, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Lin Yang
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - David Ho-Keung Shum
- Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong SAR, China
- Mental Health Research Centre, The Hong Kong Polytechnic University, Hong Kong SAR, China
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
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14
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Berkanish P, Pan S, Viola A, Rademaker Q, Devine KA. Technology-Based Peer Support Interventions for Adolescents with Chronic Illness: A Systematic Review. J Clin Psychol Med Settings 2022; 29:911-942. [PMID: 35147830 PMCID: PMC8853345 DOI: 10.1007/s10880-022-09853-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2022] [Indexed: 01/11/2023]
Abstract
Technology may help adolescents with chronic illnesses overcome barriers to accessing peer support, which has been associated with better quality of life and health outcomes. This review aimed to describe technology-based peer support interventions for adolescents with chronic illness following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Of 3781 articles identified, 32 met inclusion criteria. The most common technologies were websites with discussion forums (n = 18), chat messaging (n = 9), and video conferencing (n = 7). Most studies (69%) focused on feasibility and had small sample sizes. Results support the feasibility and acceptability of these interventions. Results suggested positive effects on social support, but were mixed on isolation, quality of life, and disease self-management. There were too few adequately powered randomized controlled trials to determine efficacy of these interventions at this time. Future work should use rigorous methods to evaluate efficacy and account for rapid shifts in technology for adolescent communication.
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Affiliation(s)
| | - Samuel Pan
- Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, USA
| | - Adrienne Viola
- Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, USA
| | | | - Katie A Devine
- Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, USA.
- Rutgers Cancer Institute of New Jersey and Rutgers, The State University of New Jersey, 195 Little Albany Street, New Brunswick, NJ, 08903, USA.
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15
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Deep-Learning-Assisted Multi-Dish Food Recognition Application for Dietary Intake Reporting. ELECTRONICS 2022. [DOI: 10.3390/electronics11101626] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Artificial intelligence (AI) is among the major emerging research areas and industrial application fields. An important area of its application is in the preventive healthcare domain, in which appropriate dietary intake reporting is critical in assessing nutrient content. The traditional dietary assessment is cumbersome in terms of dish accuracy and time-consuming. The recent technology in computer vision with automatic recognition of dishes has the potential to support better dietary assessment. However, due to the wide variety of available foods, especially local dishes, improvements in food recognition are needed. In this research, we proposed an AI-based multiple-dish food recognition model using the EfficientDet deep learning (DL) model. The designed model was developed taking into consideration three types of meals, namely single-dish, mixed-dish, and multiple-dish, from local Taiwanese cuisine. The results demonstrate high mean average precision (mAP) = 0.92 considering 87 types of dishes. With high recognition performance, the proposed model has the potential for a promising solution to enhancing dish reporting. Our future work includes further improving the performance of the algorithms and integrating our system into a real-world mobile and cloud-computing-based system to enhance the accuracy of current dietary intake reporting tasks.
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16
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O'Connor SR, Kee F, Thompson DR, Cupples ME, Donnelly M, Heron N. A review of the quality and content of mobile apps to support lifestyle modifications following a transient ischaemic attack or 'minor' stroke. Digit Health 2021; 7:20552076211065271. [PMID: 34950500 PMCID: PMC8689637 DOI: 10.1177/20552076211065271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 11/19/2021] [Indexed: 12/27/2022] Open
Abstract
Objective Secondary prevention is recommended to reduce cardiovascular risk after transient ischaemic attack (TIA) or ‘minor’ stroke. Mobile health interventions can provide accessible, cost-effective approaches to address modifiable risk factors, such as physical inactivity, hypertension and being overweight. The objective of this study was to evaluate the quality of apps for supporting lifestyle change following a TIA or ‘minor’ stroke. Methods Systematic searches of Google Play and the Apple Store were carried out to identify mobile apps released between 1 November 2019 and 1 October 2021. Keywords were used including stroke, TIA, lifestyle, prevention and recovery. Quality was assessed using the Mobile Application Rating Scale (MARS). Common components were identified with the Behaviour Change Technique (BCT) Taxonomy. Descriptive statistics were used to summarize the performance results for each app. Results Searches identified 2545 potential apps. Thirty remained after removing duplicates and screening titles and descriptions. Six were eligible after full review of their content. All apps included at least one BCT (range: 1–16 BCTs). The most frequent BCTs included ‘information about health consequences’ (n = 5/6), ‘verbal or visual communication from a credible source’ (n = 4/6) and ‘action planning’ (n = 4/6). The mean MARS score was 2.57/5 (SD: 0.51; range: 1.78–3.36). No apps were of ‘good’ overall quality (scoring more than 4/5). Conclusions This is the first review of mobile health interventions for this population. Only a small number of apps were available. None were targeted specifically at people with a TIA or ‘minor’ stroke. Overall quality was low. Further work is needed to develop and test accessible, user designed, and evidence-informed digital interventions in this population.
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Affiliation(s)
- Seán R O'Connor
- School of Psychology, Queen's University Belfast, Belfast, UK
| | - Frank Kee
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - David R Thompson
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | | | - Michael Donnelly
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Neil Heron
- Centre for Public Health, Queen's University Belfast, Belfast, UK.,School of Primary, Community and Social Care, Keele University, Staffordshire, UK
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17
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The Role of Big Data in Aging and Older People’s Health Research: A Systematic Review and Ecological Framework. SUSTAINABILITY 2021. [DOI: 10.3390/su132111587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Big data has been prominent in studying aging and older people’s health. It has promoted modeling and analyses in biological and geriatric research (like cellular senescence), developed health management platforms, and supported decision-making in public healthcare and social security. However, current studies are still limited within a single subject, rather than flourished as interdisciplinary research in the context of big data. The research perspectives have not changed, nor has big data brought itself out of the role as a modeling tool. When embedding big data as a data product, analysis tool, and resolution service into different spatial, temporal, and organizational scales of aging processes, it would present as a connection, integration, and interaction simultaneously in conducting interdisciplinary research. Therefore, this paper attempts to propose an ecological framework for big data based on aging and older people’s health research. Following the scoping process of PRISMA, 35 studies were reviewed to validate our ecological framework. Although restricted by issues like digital divides and privacy security, we encourage researchers to capture various elements and their interactions in the human-environment system from a macro and dynamic perspective rather than simply pursuing accuracy.
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18
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Teckie S, Solomon J, Kadapa K, Sanchez K, Orner D, Kraus D, Kamdar DP, Pereira L, Frank D, Diefenbach M. A Mobile Patient-Facing App for Tracking Patient-Reported Outcomes in Head and Neck Cancer Survivors: Single-Arm Feasibility Study. JMIR Form Res 2021; 5:e24667. [PMID: 33739291 PMCID: PMC8075070 DOI: 10.2196/24667] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 12/02/2020] [Accepted: 01/17/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Patients with head and neck cancer (HNC) frequently experience disease-related symptoms and treatment adverse effects that impact their overall quality of life. Cancer-specific mobile health apps for patient-related outcomes allow patients to communicate with their clinicians and proactively track their symptoms, which have been shown to improve clinical management and disease outcomes. OBJECTIVE The purpose of this study was to evaluate the feasibility of LogPAL, a novel iPhone-based mobile health app designed to help HNC survivors track and manage their posttreatment symptoms. METHODS Patients who completed curative treatment for HNC in the preceding 24 months were recruited from 2 clinical sites within a single institution. Upon enrollment, participants completed a brief sociodemographic survey, downloaded the app onto their iPhone devices, and were asked to complete a series of biweekly questionnaires (based on the Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events) via the app for an 8-week study period. The primary feasibility endpoints included retention (retaining >80% of the enrolled participants for the duration of the study period), adherence (>50% of the participants completing 100% of the questionnaires over the study period), and usability (a mean system usability scale [SUS] score >68). Additional postintervention questions were collected to assess perceived usefulness, acceptance, and overall satisfaction. RESULTS Between January and October 2019, 38 participants were enrolled in the study. Three participants dropped out, and 3 were classified as nonusers. The remaining 32 (87%) were eligible for analysis. Their mean age was 57.8 (SD 12.3) years (range 24-77 years, 81% [26/32] male). Overall, 375 of 512 (73.2%) questionnaires were completed, with 17 (53%) of the 32 participants adherent. Participant-reported usability was acceptable; the mean SUS score was 71.9 (95% CI 64.3-79.5) with high satisfaction of LogPAL usefulness and likelihood to recommend to other cancer survivors. CONCLUSIONS This single-arm prospective pilot study showed that LogPAL is a feasible, regularly used, accepted app for HNC survivors, justifying a full-scale pilot. Based on the findings from this study, future iterations will aim to improve usability and test intervention efficacy.
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Affiliation(s)
- Sewit Teckie
- Academic Department of Radiation Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, NY, United States.,Department of Radiation Medicine, Northwell Health Cancer Institute, Lake Success, NY, United States
| | - Jeffrey Solomon
- Center for Health Innovations and Outcomes Research, Department of Medicine, Northwell Health, Manhasset, NY, United States
| | - Karthik Kadapa
- Center for Research Informatics & Innovation, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United States
| | - Keisy Sanchez
- Center for Health Innovations and Outcomes Research, Department of Medicine, Northwell Health, Manhasset, NY, United States
| | - David Orner
- Academic Department of Radiation Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, NY, United States.,Department of Radiation Medicine, Northwell Health Cancer Institute, Lake Success, NY, United States
| | - Dennis Kraus
- Department of Otolaryngology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States.,Department of Otolaryngology, Northwell Health Cancer Institute, Lake Success, NY, United States
| | - Dev P Kamdar
- Department of Otolaryngology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States.,Department of Otolaryngology, Northwell Health Cancer Institute, Lake Success, NY, United States
| | - Lucio Pereira
- Department of Otolaryngology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States.,Department of Otolaryngology, Northwell Health Cancer Institute, Lake Success, NY, United States
| | - Douglas Frank
- Department of Otolaryngology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States.,Department of Otolaryngology, Northwell Health Cancer Institute, Lake Success, NY, United States
| | - Michael Diefenbach
- Center for Health Innovations and Outcomes Research, Department of Medicine, Northwell Health, Manhasset, NY, United States
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19
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Velmovitsky PE, Miranda PADSES, Vaillancourt H, Donovska T, Teague J, Morita PP. A Blockchain-Based Consent Platform for Active Assisted Living: Modeling Study and Conceptual Framework. J Med Internet Res 2020; 22:e20832. [PMID: 33275111 PMCID: PMC7748951 DOI: 10.2196/20832] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 08/14/2020] [Accepted: 10/30/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Recent advancements in active assisted living (AAL) technologies allow older adults to age well in place. However, sensing technologies increase the complexity of data collection points, making it difficult for users to consent to data collection. One possible solution for improving transparency in the consent management process is the use of blockchain, an immutable and timestamped ledger. OBJECTIVE This study aims to provide a conceptual framework based on technology aimed at mitigating trust issues in the consent management process. METHODS The consent management process was modeled using established methodologies to obtain a mapping of trust issues. This mapping was then used to develop a conceptual framework based on previous monitoring and surveillance architectures for connected devices. RESULTS In this paper, we present a model that maps trust issues in the informed consent process; a conceptual framework capable of providing all the necessary underlining technologies, components, and functionalities required to develop applications capable of managing the process of informed consent for AAL, powered by blockchain technology to ensure transparency; and a diagram showing an instantiation of the framework with entities comprising the participants in the blockchain network, suggesting possible technologies that can be used. CONCLUSIONS Our conceptual framework provides all the components and technologies that are required to enhance the informed consent process. Blockchain technology can help overcome several privacy challenges and mitigate trust issues that are currently present in the consent management process of data collection involving AAL technologies.
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Affiliation(s)
| | | | | | | | | | - Plinio Pelegrini Morita
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
- Research Institute for Aging, University of Waterloo, Waterloo, ON, Canada
- Department of Systems Design Engineering, University of Waterloo, Waterloo, ON, Canada
- eHealth Innovation, Techna Institute, University Health Network, Toronto, ON, Canada
- Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
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20
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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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Taheri-Kharameh Z, Malmgren Fänge A, Ekvall Hansson E, Bashirian S, Heidarimoghadam R, Poorolajal J, Barati M. Development of a mobile application to screen and manage fall risks in older people. Disabil Rehabil Assist Technol 2020; 17:362-367. [PMID: 32608287 DOI: 10.1080/17483107.2020.1785562] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objective: Falls and related injuries are known to be the major health problem leading to disability and mortality among older adults. Identification and management of fall risks aimed to prevent falling is considered to be essential. The aim of this study was to develop a mobile application for screening and management of fall risks based for older adults.Method and materials: First, we determined product features based on literature reviews. Then we asked 10 experts to assess the importance of capabilities. The application was designed in Android environment based on the STEADI toolkit. Finally, the usability and satisfaction of the application were assessed among 30 older adults by means of a usability questionnaire, and the final version was modified.Results: The experts rated the majority of feasibility features to be important. The application consisted of falls risk self-assessment, and the Timed Up and Go (TUG) test to measure individual fall risks, fall prevention education, and suggestions for training based on the individuals' level of fall risk among older adults. The results of the usability assessment showed that the users were satisfied with the application, 8.83 out of 10.Conclusion: The mobile application can be used to screen and manage fall risks in older adults. It may help health providers to identify older adults at low, moderate, and high risks of falls provide education and training to minimise falls and fall-related injuries.Implications for rehabilitationFalls are a major health problem in older people. A great proportion of falls and falls related injuries are preventable.Given the availability and accessibility of various mobile health application and the increasing mobile device usage among older adults, mobile application can be used as a platform for delivering fall prevention programmes such as education and exercise training.The mobile application may be a valuable tool in the fall prevention and their consequences either in old adult.
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Affiliation(s)
- Zahra Taheri-Kharameh
- Spiritual Health Research Center, School of Paramedical Sciences, Qom University of Medical Sciences, Qom, Iran
| | | | | | - Saeed Bashirian
- Department of Public Health, School of Health, Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Rashid Heidarimoghadam
- Department of Ergonomics, School of Health, Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Jalal Poorolajal
- Research Center for Health Sciences, Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Majid Barati
- Department of Public Health, School of Health, Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
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