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Geampana A. Fertility apps, datafication and knowledge production in reproductive health. SOCIOLOGY OF HEALTH & ILLNESS 2024. [PMID: 38823027 DOI: 10.1111/1467-9566.13793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 04/22/2024] [Indexed: 06/03/2024]
Abstract
Despite being the target of much criticism, commercialised digital technologies have proliferated in reproductive health arenas. Fertility applications (apps) are now some of the most popular and ubiquitous digital health tracking technologies, with millions of downloads. Previous scholarship has already underlined the problematic nature of their design and surveillance features. However, less attention has been paid to the wider effects of datafied knowledge availability. This research specifically asks: How does the proliferation of fertility apps shape knowledge (and associated practices) in reproductive health? Drawing on an analysis of key document sources, I here argue that fertility apps act as mediators between stakeholders, data and datafied outputs, thus facilitating: (1) the datafication of fertility awareness knowledge and the production of new datafied knowledge, (2) legitimation discourses and practices and (3) the remaking of private/public expertise and knowledge production networks in reproductive health. To effectively analyse the effects of commercialised reproductive health apps, this work argues for an understanding of data technologies that is informed by critical data studies.
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Affiliation(s)
- Alina Geampana
- Department of Sociology, Faculty of Social Sciences and Health, Durham University, Durham, UK
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2
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Laestadius LI, Van Hoorn K, Wahl M, Witt A, Carlyle KE, Guidry JPD. Promotion of an Algorithm-Based Tool for Pregnancy Prevention by Instagram Influencers. J Womens Health (Larchmt) 2024; 33:141-151. [PMID: 37976205 DOI: 10.1089/jwh.2023.0251] [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] [Indexed: 11/19/2023] Open
Abstract
Objective: Despite growing concerns that some digital algorithm-reliant fertility awareness-based methods of pregnancy prevention are marketed in an inaccurate, opaque, and potentially harmful manner online, there has been limited systematic examination of such marketing practices. This article therefore provides an empirical examination of how social media influencers have promoted the fertility tracking tool Daysy on Instagram. We investigate: (1) how the tool is framed in relation to pregnancy prevention using Health Belief Model (HBM) constructs, and (2) the promotional and disclosure practices adopted by influencers. Materials and Methods: We collected Instagram posts mentioning Daysy made between June 2018 and May 2022 using the tool CrowdTangle. Using a qualitative content analysis approach, we coded a random sample of 400 Daysy posts. This yielded 122 Instagram influencer posts promoting Daysy for pregnancy prevention that we coded for promotional content and HBM constructs. Results: Posts originated primarily from Europe (n = 62, 50.82%) and the United States (n = 37, 30.33%). Findings indicate that barriers to use (n = 18, 15.57%) and the severity of risks from unplanned pregnancy (n = 8, 6.56%) were rarely conveyed, whereas benefits of use (n = 122, 100%) and the severity of risks of hormonal contraception (n = 31, 25.41%) were covered more extensively. Only about one third of posts disclosed any formal relationship to the brand Daysy. Conclusions: With many posts emphasizing benefits and obscuring potential limitations, we argue that accurate and transparent information about the effectiveness and limitations of fertility tracking technologies is critical for supporting informed decision-making and, as such, should remain a public health priority.
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Affiliation(s)
- Linnea I Laestadius
- Zilber College of Public Health, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Kelsey Van Hoorn
- Zilber College of Public Health, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Megan Wahl
- Zilber College of Public Health, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Alice Witt
- Social and Global Studies Centre, School of Global, Urban and Social Studies, RMIT University, Melbourne, Australia
| | - Kellie E Carlyle
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Jeanine P D Guidry
- Department Communication and Cognition, Tilburg University, Tilburg, Netherlands
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3
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Palmer GA, Tomkin G, Martín-Alcalá HE, Mendizabal-Ruiz G, Cohen J. The Internet of Things in assisted reproduction. Reprod Biomed Online 2023; 47:103338. [PMID: 37757612 DOI: 10.1016/j.rbmo.2023.103338] [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: 06/30/2023] [Revised: 08/06/2023] [Accepted: 08/07/2023] [Indexed: 09/29/2023]
Abstract
The Internet of Things (IoT) is a network connecting physical objects with sensors, software and internet connectivity for data exchange. Integrating the IoT with medical devices shows promise in healthcare, particularly in IVF laboratories. By leveraging telecommunications, cybersecurity, data management and intelligent systems, the IoT can enable a data-driven laboratory with automation, improved conditions, personalized treatment and efficient workflows. The integration of 5G technology ensures fast and reliable connectivity for real-time data transmission, while blockchain technology secures patient data. Fog computing reduces latency and enables real-time analytics. Microelectromechanical systems enable wearable IoT and miniaturized monitoring devices for tracking IVF processes. However, challenges such as security risks and network issues must be addressed through cybersecurity measures and networking advancements. Clinical embryologists should maintain their expertise and knowledge for safety and oversight, even with IoT in the IVF laboratory.
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Affiliation(s)
- Giles A Palmer
- IVF2.0 Ltd, London, UK; International IVF Initiative, New York, New York, USA
| | | | | | - Gerardo Mendizabal-Ruiz
- Conceivable Life Sciences, New York, New York, USA; Departamento de Bioingeniería Traslacional, Universidad de Guadalajara, Guadalajara, Mexico
| | - Jacques Cohen
- IVF2.0 Ltd, London, UK; International IVF Initiative, New York, New York, USA; Althea Science Inc, New York, New York, USA; Conceivable Life Sciences, New York, New York, USA.
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4
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Bouchard T, Yong P, Doyle-Baker P. Establishing a Gold Standard for Quantitative Menstrual Cycle Monitoring. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1513. [PMID: 37763632 PMCID: PMC10533176 DOI: 10.3390/medicina59091513] [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: 08/01/2023] [Revised: 08/18/2023] [Accepted: 08/18/2023] [Indexed: 09/29/2023]
Abstract
Background and Objectives: The Quantum Menstrual Health Monitoring Study will measure four key reproductive hormones in the urine (follicle-stimulating hormone, FSH; estrone-3-glucuronide, E13G; luteinizing hormone, LH; and pregnanediol glucuronide, PDG) to characterize patterns that predict and confirm ovulation, referenced to serum hormones and the gold standard of the ultrasound day of ovulation in participants with regular cycles. These normal cycles will provide a reference for comparison to irregular cycles in subjects with polycystic ovarian syndrome (PCOS) and athletes. Materials and Methods: Participants will track their menstrual cycles for 3 months and be provided with an at-home urine hormone monitor (Mira monitor) to predict ovulation. The day of ovulation will be confirmed with serial ultrasounds completed in a community clinic. Urine results will be compared to serum hormone values. Other markers of menstrual health, such as bleeding patterns and temperature changes, will be determined using a customized app. Three groups will be recruited. Group 1 will include those with consistent regular cycle lengths (between 24-38 days), and will be compared to two groups with irregular cycle lengths (with increased cycle length variability and longer cycles). Group 2 will include those with polycystic ovarian syndrome (PCOS) with irregular cycles and Group 3 will include individuals participating in high levels of exercise with irregular cycles. Hypothesis: The Mira monitor quantitative urine hormone pattern will accurately correlate with serum hormonal levels and will predict (with LH) and confirm (with PDG) the ultrasound day of ovulation in those with regular cycles as well as those with irregular cycles. Rationale: Once the ultrasound validation is complete, tools like the Mira monitor with a customized app may become a new standard for at-home and remote clinical monitoring of the menstrual cycle without having to use labor-intensive follicular-tracking ultrasound or follow serum hormone changes. Conclusions: Precision monitoring of the menstrual cycle is expected to impact individuals who want to increase their menstrual health literacy and guide decisions about fertility.
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Affiliation(s)
- Thomas Bouchard
- Department of Obstetrics & Gynecology, University of British Columbia, Vancouver, BC V6Z 2K8, Canada;
- Department of Family Medicine, University of Calgary, Calgary, AB T3H 0N9, Canada
| | - Paul Yong
- Department of Obstetrics & Gynecology, University of British Columbia, Vancouver, BC V6Z 2K8, Canada;
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Stujenske TM, Mu Q, Pérez Capotosto M, Bouchard TP. Survey Analysis of Quantitative and Qualitative Menstrual Cycle Tracking Technologies. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1509. [PMID: 37763628 PMCID: PMC10534579 DOI: 10.3390/medicina59091509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 08/12/2023] [Accepted: 08/20/2023] [Indexed: 09/29/2023]
Abstract
Background and Objectives: Digital health and personalized medicine are advancing at an unprecedented pace. Users can document their menstrual cycle data in a variety of ways, including smartphone applications (apps), temperature tracking devices, and at-home urine hormone tests. Understanding the needs and goals of women using menstrual cycle tracking technologies is the first step to making these technologies more evidence based. The purpose of this study was to examine the current use of these technologies and explore how they are being used within the context of common hormonal and reproductive disorders, like polycystic ovary syndrome (PCOS), endometriosis, and infertility. Materials and Methods: This was a cross-sectional study evaluating menstrual cycle tracking technology use. Participants were recruited in January-March 2023 using social media groups and a Marquette Method instructor email listserv. Data were collected using an electronic survey with Qualtrics. Data collected included participant demographics, menstrual cycle characteristics, reproductive health history, and menstrual cycle tracking behavior. Results: Three-hundred and sixty-eight participants were included in the analysis. Women had various motivations for tracking their menstrual cycles. Most participants (72.8%) selected "to avoid getting pregnant" as the primary motivation. Three hundred and fifty-six participants (96.7%) reported using a fertility awareness-based method to track and interpret their menstrual cycle data. The Marquette Method, which utilizes urine hormone tracking, was the most frequently used method (n = 274, 68.2%). The most frequently used cycle technology was a urine hormone test or monitor (n = 299, 81.3%), followed by a smartphone app (n = 253, 68.8%), and a temperature tracking device (n = 116, 31.5%). Women with PCOS (63.6%), endometriosis (61.8%), and infertility (75%) in our study reported that the use of tracking technologies aided in the diagnosis. Most participants (87.2%) reported a high degree of satisfaction with their use and that they contributed to their reproductive health knowledge (73.9%). Conclusions: Women in our study reported avoiding pregnancy as their primary motivation for using menstrual cycle tracking technologies, with the most frequently used being a urine hormone test or monitor. Our study results emphasize the need to validate these technologies to support their use for family planning. Given that most women in this study reported using a fertility awareness-based method, the results cannot be generalized to all users of menstrual cycle tracking technologies.
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Affiliation(s)
| | - Qiyan Mu
- Institute for Natural Family Planning, College of Nursing, Marquette University, Milwaukee, WI 53233, USA;
| | | | - Thomas P. Bouchard
- Department of Family Medicine, University of Calgary, Calgary, AB T3H 0N9, Canada;
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6
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Trépanier LC, Lamoureux É, Bjornson SE, Mackie C, Alberts NM, Gagnon MM. Smartphone apps for menstrual pain and symptom management: A scoping review. Internet Interv 2023; 31:100605. [PMID: 36761398 PMCID: PMC9905939 DOI: 10.1016/j.invent.2023.100605] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 11/25/2022] [Accepted: 01/27/2023] [Indexed: 01/31/2023] Open
Abstract
The past decade marks a surge in the development of mobile apps used to digitally track and monitor aspects of personal health, including menstruation. Despite a plethora of menstruation-related apps, pain and symptom management content available in apps has not been systematically examined. The objective of this study was to evaluate app characteristics, overall quality (i.e., engagement, functionality, design aesthetics, and information), nature and quality of pain and symptom tracking features, and availability and quality of pain-related intervention content. A scoping review of apps targeting facets of the menstrual experience was conducted by searching the Apple App Store. After removal of duplicates and screening, 119 apps targeting menstrual experiences were retained. Pain and menstrual symptoms tracking were available in 64 % of apps. Checkboxes or dichotomous (present/absent) reporting was the most common method of tracking symptoms and was available in 75 % of apps. Only a small subset (n = 13) of apps allowed for charting/graphing of pain symptoms across cycles. Fourteen percent of apps included healthcare professionals or researchers in their development and one app reported use of end-users. Overall app quality measured through the Mobile App Rating Scale (MARS) was found to be acceptable; however, the apps ability to impact pain and symptom management (e.g., impact on knowledge, awareness, behaviour change, etc.) was rated as low. Only 10 % of apps (n = 12) had interventions designed to manage pain. The findings suggest that despite pain and symptom management content being present in apps, this content is largely not evidence-based in nature. More research is needed to understand how pain and symptom management content can be integrated into apps to improve user experiences.
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Affiliation(s)
- Lindsey C.M. Trépanier
- Department of Psychology and Health Studies, University of Saskatchewan, Saskatoon, SK, Canada
| | | | - Sarah E. Bjornson
- Department of Psychology and Health Studies, University of Saskatchewan, Saskatoon, SK, Canada
| | - Cayley Mackie
- Department of Psychology and Health Studies, University of Saskatchewan, Saskatoon, SK, Canada
| | - Nicole M. Alberts
- Department of Psychology, Concordia University, Montréal, QC, Canada
| | - Michelle M. Gagnon
- Department of Psychology and Health Studies, University of Saskatchewan, Saskatoon, SK, Canada,Corresponding author at: University of Saskatchewan, Department of Psychology and Health Studies, 9 Campus Drive, Arts 154, Saskatoon, Saskatchewan, S7N 5A5, Canada.
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7
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Langarizadeh M, Fatemi Aghda SA, Nadjarzadeh A. Design and evaluation of a mobile-based nutrition education application for infertile women in Iran. BMC Med Inform Decis Mak 2022; 22:58. [PMID: 35246119 PMCID: PMC8894566 DOI: 10.1186/s12911-022-01793-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 02/28/2022] [Indexed: 12/04/2022] Open
Abstract
Background The prevalence of infertility in Iran is higher than the world average. Furthermorte, education and nutrition are among the effective factors in improving the quality of life of women with infertility. According to the significant role of smartphones in people's lives as well as health education, the present study aimed to design and evaluate a mobile-based nutrition education application for infertile women.
Methods This quantitative research was conducted in two stages. Initially, the educational contents were determined based on a review of the literature. Later, the obtained contents were given to 10 nutritionists and five infertility specialists to determine the necessity of each item. In the next stage, the application prototype was designed based on the results of the first stage and distributed among 220 infertile women. After two months, the Questionnaire of User Interface Satisfaction was administrated to assess the usability of the developed application. The results were analyzed via SPSS software version 20. Results According to the nutritionists and infertility specialists, the contents determined for the nutrition educational application were categorized under three general sections of user's demographic data, educational contents, required capabilities. The users' mean score of the application usability was calculated as 7.44 out of 9 indicating a good level of satisfaction. Conclusions Nutrition education of women with infertility problems can play a significant role in improving their awareness and treatment outcomes. Due to the increasing use of smartphones, designing a mobile-based nutrition educational application can be of great benefit for women with infertility according to the cultural conditions and characteristics of each community.
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Affiliation(s)
- Mostafa Langarizadeh
- Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Ali Fatemi Aghda
- Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
| | - Azadeh Nadjarzadeh
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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8
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Pichon A, Jackman KB, Winkler IT, Bobel C, Elhadad N. The messiness of the menstruator: assessing personas and functionalities of menstrual tracking apps. J Am Med Inform Assoc 2022; 29:385-399. [PMID: 34613388 PMCID: PMC8757321 DOI: 10.1093/jamia/ocab212] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 09/08/2021] [Accepted: 09/20/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The aim of this study was to examine trends in the intended users and functionalities advertised by menstrual tracking apps to identify gaps in personas and intended needs fulfilled by these technologies. MATERIALS AND METHODS Two types of materials were collected: a corpus of scientific articles related to the identities and needs of menstruators and a corpus of images and descriptions of menstrual tracking apps collected from the Google and Apple app stores. We conducted a scoping review of the literature to develop themes and then applied these as a framework to analyze the app corpus, looking for alignments and misalignments between the 2 corpora. RESULTS A review of the literature showed a wide range of disciplines publishing work relevant to menstruators. We identified 2 broad themes: "who are menstruators?" and "what are the needs of menstruators?" Descriptions of menstrual trackers exhibited misalignments with these themes, with narrow characterizations of menstruators and design for limited needs. DISCUSSION We synthesize gaps in the design of menstrual tracking apps and discuss implications for designing around: (1) an irregular menstrual cycle as the norm; (2) the embodied, leaky experience of menstruation; and (3) the varied biologies, identities, and goals of menstruators. An overarching gap suggests a need for a human-centered artificial intelligence approach for model and data provenance, transparency and explanations of uncertainties, and the prioritization of privacy in menstrual trackers. CONCLUSION Comparing and contrasting literature about menstruators and descriptions of menstrual tracking apps provide a valuable guide to assess menstrual technology and their responsiveness to users and their needs.
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Affiliation(s)
- Adrienne Pichon
- Biomedical Informatics, Columbia University, New York, New York,
USA
| | - Kasey B Jackman
- School of Nursing, Columbia University, New York, New York,
USA
- New York-Presbyterian Hospital, New York, New York, USA
| | - Inga T Winkler
- Institute for the Study of Human Rights, Columbia University, New
York, New York, USA
- Legal Studies, Central European University, Vienna, Austria
| | - Chris Bobel
- Women’s, Gender, and Sexuality Studies, University of
Massachusetts, Boston, Massachusetts, USA
| | - Noémie Elhadad
- Biomedical Informatics, Columbia University, New York, New York,
USA
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9
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Moreillon B, Equey T, Astolfi T, Salamin O, Faiss R. Removal of the influence of plasma volume fluctuations for the athlete biological passport and stability of haematological variables in active women taking oral contraception. Drug Test Anal 2022; 14:1004-1016. [PMID: 34994063 PMCID: PMC9306693 DOI: 10.1002/dta.3218] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 12/20/2021] [Accepted: 12/21/2021] [Indexed: 01/06/2023]
Abstract
The haematological module of the athlete biological passport (ABP) monitors longitudinal haematological variations that could be indicative of blood manipulation. This study applied a multi‐parametric model previously validated in elite cyclists to compare inferred and actual PV variations, whereas the potential influence of the oral contraceptive pill (OCP) cycle on the ABP blood biomarkers and plasma volume (PV) in 14 physically active women taking OCPs was also investigated. Blood and serum samples were collected each week for 8 weeks, and the ABP haematological variables were determined according to the World Anti‐Doping Agency guidelines. Transferrin (sTFN), ferritin (FERR), albumin (ALB), calcium (Ca), creatinine (CRE), total protein (TP) and low‐density lipoprotein (LDL) were additionally computed as ‘volume‐sensitive’ variables in a multivariate analysis to determine individual estimations of PV variations. Actual PV variations were indirectly measured using a validated carbon monoxide rebreathing method. We hypothesised ABP markers to be stable during a standard OCP cycle and estimated PV variations similar to measured PV variations. Measured PV variations were in good agreement with the predictions and allowed to explain an atypical passport finding (ATPF). The ABP biomarkers, Hbmass and PV were stable over 8 weeks. Significant differences occurred only between Week 7 and Week 1, with lower levels of haemoglobin concentration ([Hb]), haematocrit (HCT) and red blood cell count (RBC)(−4.4%, p < 0.01; −5.1%, p < 0.01; −5.2%, p < 0.01) and higher levels of PV at week 7 (+9%, p = 0.05). We thus concluded that estimating PV variations may help interpret individual ABP haematological profiles in women.
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Affiliation(s)
- Basile Moreillon
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | | | - Tiffany Astolfi
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland.,Research and Expertise in anti-Doping sciences (REDs), University of Lausanne, Lausanne, Switzerland
| | - Olivier Salamin
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland.,Research and Expertise in anti-Doping sciences (REDs), University of Lausanne, Lausanne, Switzerland
| | - Raphael Faiss
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland.,Research and Expertise in anti-Doping sciences (REDs), University of Lausanne, Lausanne, Switzerland
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10
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Riley S, Paskova K. A post-phenomenological analysis of using menstruation tracking apps for the management of premenstrual syndrome. Digit Health 2022; 8:20552076221144199. [PMID: 36532109 PMCID: PMC9756356 DOI: 10.1177/20552076221144199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 11/21/2022] [Indexed: 09/19/2023] Open
Abstract
Objectives Menstruation tracking digital applications (MTA) are a popular technology, yet there is a lacuna of research on how women use this technology for the management of PMS. Theoretical frameworks for understanding users' experiences are also underdeveloped in this nascent field. The objectives of the study were therefore twofold, to propose a theoretical framework for understanding women's use of MTA and apply it to the analysis of users' experiences in the management of PMS. Method A novel theoretical framework was proposed, informed by post-phenomenology, postfeminist healthism, feminist new materialism and digital health technologies as public pedagogy. This framework focuses analytic attention on affective relationships between subjectivity, bodily sensations, digital technology, and discourse. It was used to structure the analysis of five in-depth timeline interviews with women in Aotearoa New Zealand who experienced benefits from using MTA to manage PMS symptoms. Results Three pedagogical relationships were identified: a pedagogy of empowerment, where users learnt to control, predict and manage their PMS symptoms in line with healthism; a pedagogy of appreciation, where users learnt to understand their menstruating bodies as amazing, a valued part of them, and awe-inspiring that radically overturned past internalised stigma; and an 'untrustworthy teacher' who eroded this affirmative learning through inaccuracy, positioning users in dis-preferred categories, or being 'creepy'. Conclusions MTA offers huge possibilities for challenging menstrual stigma that need to be nurtured, developed, and protected; and there are benefits for analysing MTA within wider scholarship on postfeminist healthism.
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Affiliation(s)
- Sarah Riley
- School of Psychology, Massey University, Wellington, New Zealand
| | - Klara Paskova
- School of Psychology, Massey University, Wellington, New Zealand
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11
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Robertson I, Harrison C, Ng KYB, Macklon N, Cheong Y, Boivin J. OUP accepted manuscript. Hum Reprod 2022; 37:1007-1017. [PMID: 35348672 PMCID: PMC9071224 DOI: 10.1093/humrep/deac046] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 01/21/2022] [Indexed: 11/14/2022] Open
Affiliation(s)
- I Robertson
- Faculty of Medicine, Human Development and Health, Princess Anne Hospital, University of Southampton, Southampton, UK
| | - C Harrison
- School of Psychology, Cardiff Fertility Studies Research Group, Cardiff University, Cardiff, UK
| | - K Y B Ng
- Faculty of Medicine, Human Development and Health, Princess Anne Hospital, University of Southampton, Southampton, UK
| | | | - Y Cheong
- Faculty of Medicine, Human Development and Health, Princess Anne Hospital, University of Southampton, Southampton, UK
- Correspondence address. School of Psychology, Cardiff Fertility Studies Research Group, Cardiff University, Tower Building, 70 Park Place, Cardiff 10 CF10 3AT, UK. E-mail: (J.B.); Complete Fertility Southampton, Princess Anne Hospital, University of Southampton, Faculty of Medicine, Human Development and health, Southampton SO16 5YA, UK. E-mail: (Y.C.)
| | - J Boivin
- School of Psychology, Cardiff Fertility Studies Research Group, Cardiff University, Cardiff, UK
- Correspondence address. School of Psychology, Cardiff Fertility Studies Research Group, Cardiff University, Tower Building, 70 Park Place, Cardiff 10 CF10 3AT, UK. E-mail: (J.B.); Complete Fertility Southampton, Princess Anne Hospital, University of Southampton, Faculty of Medicine, Human Development and health, Southampton SO16 5YA, UK. E-mail: (Y.C.)
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12
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Broad A, Biswakarma R, Harper JC. A survey of women’s experiences of using period tracker applications: Attitudes, ovulation prediction and how the accuracy of the app in predicting period start dates affects their feelings and behaviours. WOMEN'S HEALTH 2022; 18:17455057221095246. [PMID: 35465788 PMCID: PMC9047811 DOI: 10.1177/17455057221095246] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction: Using an online survey, the aim of this study was to ask women about their
real-life experiences of using period tracker apps, their attitudes towards
using their app, the information the app provided regarding ovulation and
how the accuracy of the app in predicting period start dates affects their
feelings and behaviours if their period comes earlier or later than
predicted. Methods: This mixed-methods observational study was conducted by an online survey of
50 multiple-choice and open-ended questions. The survey was generated with
Qualtrics XM® and promoted via social media. It was open to any
person who had used a period tracker. Results: From 375 total responses, 330 complete responses were obtained, giving a
completion rate of 88.0%. Respondents were aged between 14 and 54, with a
mean age of 26.0 (±7.81). When asked what was the best thing about using the
app, 29.7% (98/330) of respondents selected ‘To know when I’m ovulating’.
Respondents were asked if their period ever started earlier than the app
predicted; 54.9% (189/330) said it had and 72.1% (238/330) said it had
started later than predicted. When asked how they felt if their period
arrived earlier or later than expected, thematic analysis of periods
starting earlier revealed four themes: feeling unaffected, being
frustrated/unprepared, feeling anxious/stressed and feeling
confused/intrigued. Thematic analysis when their period arrived later
revealed six themes: anxious/concerned about pregnancy, disappointed about
pregnancy, seeking advice/informing healthcare professionals, thoughts about
menopause, feeling unaffected and being better prepared. Conclusion: Period trackers need to be clearer on their intended use and reliability,
especially for period due date and ovulation. Qualitative analysis shows the
impact of inaccurate predictions on aspects of the users’ health. This study
calls for period tracker app companies to update their apps to provide
transparency to their users about their intended use and capabilities.
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Affiliation(s)
- Anna Broad
- EGA Institute for Women’s Health, University College London, London, UK
| | - Rina Biswakarma
- Institute for Education, University College London, London, UK
| | - Joyce C Harper
- EGA Institute for Women’s Health, University College London, London, UK
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Abstract
Mobile health applications (apps) have transformed the possibilities for health promotion and disease self-management; however, their promise is not fully realized owing to their reliance on commercial ecosystems for development and distribution. This review provides an overview of the types of mobile health apps and describes key stakeholders in terms of how apps are used, developed, and regulated. I outline key challenges facing consumers, public health professionals, and policy makers in evaluating the quality of health apps and summarize what is known about the impact of apps on health outcomes and health equity. I suggest that factors within the wider mobile ecosystem largely define the impact of health apps and, most notably, practices around the collection and commercialization of user data. Finally, I suggest that upstream public health strategies, grounded in an understanding of corporate influences on health, are necessary to promote healthy digital environments in which mobile health app innovation can flourish. Expected final online publication date for the Annual Review of Public Health, Volume 43 is April 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
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Affiliation(s)
- Quinn Grundy
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada;
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14
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Robertson I, Ogundiran O, Cheong Y. Digital support tools for fertility patients - a narrative systematic review. HUM FERTIL 2021:1-10. [PMID: 34311669 DOI: 10.1080/14647273.2021.1953711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Digital support tools, including smartphone apps, are increasingly being used alongside fertility treatments. These tools aim to harness the power of information and technology to improve care, facilitate communication and support patients through stressful treatment cycles. To warrant patient engagement, digital support tools must be perceived as useful. This review identifies and narratively analyses tools developed for fertility patients to date, discusses salient included features and evaluates user reviews. A systematic search of the app markets and electronic literature databases identified 46 digital support tools for fertility patients. The identified web-based tools focussed on psychosocial support, whereas the smartphone apps primarily have practical features, with some incorporating coping support. User feedback was collated from the Google and Apple app marketplaces and analysed using thematic analysis. Patients have high expectations of support apps, in particular the user experience. Nine published studies of web-based digital support tools were identified, but there was a complete absence of peer-reviewed studies of smartphone support apps for fertility patients. This review identifies the increasing range of available digital tools to support patients having fertility treatments and highlights the very limited evidence on which clinicians and patients can currently evaluate these tools.
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Affiliation(s)
- Isla Robertson
- University of Southampton, Southampton, UK.,Complete Fertility Centre, Southampton, UK
| | | | - Ying Cheong
- University of Southampton, Southampton, UK.,Complete Fertility Centre, Southampton, UK
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15
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Schantz JS, Fernandez CSP, Anne Marie ZJ. Menstrual Cycle Tracking Applications and the Potential for Epidemiological Research: A Comprehensive Review of the Literature. CURR EPIDEMIOL REP 2021; 8:9-19. [PMID: 34055569 DOI: 10.1007/s40471-020-00260-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Purpose of review We reviewed published studies on menstrual cycle tracking applications (MCTAs) in order to describe the potential of MCTAs for epidemiologic research. Recent Findings A search of PubMed, Web of Science, and Scopus for MCTA literature yielded 150 articles. After exclusions, there were 49 articles that addressed the primary interest areas: 1) characteristics of MCTA users in research, 2) reasons women use or continue using MCTAs, 3) accuracy of identifying ovulation and utility at promoting and preventing pregnancy, and 4) quality assessments of MCTAs across several domains. Summary MCTAs are an important tool for the advancement of epidemiologic research on menstruation. MCTA studies should describe the characteristics of their user-base and missing data patterns. Describing the motivation for using MCTAs throughout a user's life and validating the data collected should be prioritized in future research.
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Affiliation(s)
- Joelle S Schantz
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
| | - Claudia S P Fernandez
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
| | - Z Jukic Anne Marie
- Epidemiology Branch, National Institute of Environmental Health Sciences, Durham, NC 27709
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16
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Costa Figueiredo M, Huynh T, Takei A, Epstein DA, Chen Y. Goals, life events, and transitions: examining fertility apps for holistic health tracking. JAMIA Open 2021; 4:ooab013. [PMID: 33718804 PMCID: PMC7940095 DOI: 10.1093/jamiaopen/ooab013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 01/11/2021] [Accepted: 02/15/2021] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVE Fertility is becoming increasingly supported by consumer health technologies, especially mobile apps that support self-tracking activities. However, it is not clear whether the apps support the variety of goals and life events of those who menstruate, especially during transitions between them. METHODS Thirty-one of the most popular fertility apps were evaluated, analyzing data from three sources: the content of app store pages, app features, and user reviews. FINDINGS Results suggest that fertility apps are designed to support specific life goals of people who menstruate, offering several data collection features and limited feedback options. However, users often desire holistic tracking that encompasses a variety of goals, life events, and the transitions among them. DISCUSSION These findings suggest fertility patients can benefit more from holistic self-tracking and provide insights for future design of consumer health technologies that better support holistic fertility tracking. CONCLUSION Fertility apps have the potential to support varied experiences of people who menstruate. But to achieve that, apps need to expand their support by offering ways for more users to perform holistic, personalized, and personally meaningful tracking, so they can derive long-term benefit from the data they collect.
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Affiliation(s)
- Mayara Costa Figueiredo
- Department of Informatics, Donald Bren School of Informatics and Computer Science, University of California, Irvine, Irvine, California, USA
| | - Thu Huynh
- Department of Informatics, Donald Bren School of Informatics and Computer Science, University of California, Irvine, Irvine, California, USA
| | - Anna Takei
- Department of Informatics, Donald Bren School of Informatics and Computer Science, University of California, Irvine, Irvine, California, USA
| | - Daniel A Epstein
- Department of Informatics, Donald Bren School of Informatics and Computer Science, University of California, Irvine, Irvine, California, USA
| | - Yunan Chen
- Department of Informatics, Donald Bren School of Informatics and Computer Science, University of California, Irvine, Irvine, California, USA
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17
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Worsfold L, Marriott L, Johnson S, Harper JC. Period tracker applications: What menstrual cycle information are they giving women? WOMEN'S HEALTH (LONDON, ENGLAND) 2021; 17:17455065211049905. [PMID: 34629005 PMCID: PMC8504278 DOI: 10.1177/17455065211049905] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Period tracking applications (apps) allow women to track their menstrual cycles and receive a prediction for their period dates. The majority of apps also provide predictions of ovulation day and the fertile window. Research indicates apps are basing predictions on assuming women undergo a textbook 28-day cycle with ovulation occurring on day 14 and a fertile window between days 10 and 16. OBJECTIVE To determine how the information period tracker apps give women on their period dates, ovulation day and fertile window compares to expected results from big data. METHODS Five women's profiles for 6 menstrual cycles were created and entered into 10 apps. Cycle length and ovulation day for the sixth cycle were Woman 1-Constant 28 day cycle length, ovulation day 16; Woman 2-Average 23 day cycle length, ovulation day 13; Woman 3-Average 28 day cycle length, ovulation day 17; Woman 4-Average 33 day cycle length, ovulation day 20; and Woman 5-Irregular, average 31 day cycle length, ovulation day 14. RESULTS The 10 period tracker apps examined gave conflicting information on period dates, ovulation day and the fertile window. For cycle length, the apps all predicted woman 1's cycles correctly but for women 2-5, the apps predicted 0 to 8 days shorter or longer than expected. For day of ovulation, for women 1-4, of the 36 predictions, 3 (8%) were exactly correct, 9 predicted 1 day too early (25%) and 67% of predictions were 2-9 days early. For woman 5, most of the apps predicted a later day of ovulation. CONCLUSION Period tracker apps should ensure they only give women accurate information, especially for the day of ovulation and the fertile window which can only be predicted if using a marker of ovulation, such as basal body temperature, ovulation sticks or cervical mucus.
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Affiliation(s)
- Lauren Worsfold
- Institute for Women's Health, University College London, London, UK
| | - Lorrae Marriott
- Statistics and Data Management, SPD Development Company Ltd, Bedford, UK
| | - Sarah Johnson
- Clinical and Regulatory Affairs, SPD Development Company Ltd, Bedford, UK
| | - Joyce C Harper
- Institute for Women's Health, University College London, London, UK
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18
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Ahn SH, Lee I, Cho S, Kim HI, Baek HW, Lee JH, Park YJ, Kim H, Yun BH, Seo SK, Park JH, Choi YS, Lee BS. Predictive Factors of Conception and the Cumulative Pregnancy Rate in Subfertile Couples Undergoing Timed Intercourse With Ultrasound. Front Endocrinol (Lausanne) 2021; 12:650883. [PMID: 33935968 PMCID: PMC8082069 DOI: 10.3389/fendo.2021.650883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 03/24/2021] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to determine predictive factors for pregnancy and assess the cumulative pregnancy rate (CPR) and live birth rate (CLBR) in subfertile couples undergoing timed intercourse (TI) using ultrasound. This retrospective cohort study included 285 women (854 cycles) who started TI with ultrasound between January 2017 and October 2019. The overall clinical pregnancy rate was 28.1% (80/285) per couple and 9.4% (80/854) per cycle. Pregnant women had a higher body mass index (BMI), higher percentage of irregular menstrual cycles, a shorter duration of subfertility, lower serum follicle-stimulating hormone levels, and higher anti-Müllerian hormone levels than non-pregnant women. A longer duration of subfertility (≥24 months vs. <12 months; odds ratio: 0.193; 95% confidence interval: 0.043-0.859) and endometriosis (vs. ovulatory factors; odds ratio: 0.282; 95% confidence interval: 0.106-0.746) as causes of subfertility were unfavorable factors that independently affected clinical pregnancy. In subgroup analysis, old age ≥ 35 years [vs. < 35 years; odds ratio: 0.279; 95% confidence interval: 0.083-0.938), a longer duration of infertility ≥24 months (vs. <24 months; odds ratio: 0.182; 95% confidence interval: 0.036-0.913) and a higher BMI ≥ 25 kg/m2(vs. >25 kg/m2; odds ratio: 3.202; 95% confidence interval: 1.020-10.046) in couples with ovulatory factor and a longer duration of infertility ≥24 months (vs. <24 months; odds ratio: 0.185; 95% confidence interval: 0.042-0.819) in couples with non-ovulatory factors were significant independent predictive factors for pregnancy. No significant differences were found in the cycle characteristics between pregnant and non-pregnant women. The CPR substantially increased during the first three cycles and significantly increased until the sixth cycle. No significant increase was observed in the CPR after the sixth cycle. The CLBRs substantially increased during the first three cycles and significantly increased until the fourth cycle. No significant increase was observed in the CLBRs after the fifth cycle. When comparing CPRs and CLBRs according to subfertile causes, CRPs was significantly different and CLBRs was different with borderline significance. Our findings may indicate that women with a longer duration of subfertility or subfertility due to endometriosis have poor outcomes during TI with ultrasound. Women who failed to achieve conception by the fourth or fifth cycle of TI with ultrasound may be encouraged to consider advancing to the next treatment strategy.
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Affiliation(s)
- So Hyun Ahn
- Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
- Institute of Women’s Life Medical Science, Yonsei University College of Medicine, Seoul, South Korea
| | - Inha Lee
- Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
- Institute of Women’s Life Medical Science, Yonsei University College of Medicine, Seoul, South Korea
| | - SiHyun Cho
- Institute of Women’s Life Medical Science, Yonsei University College of Medicine, Seoul, South Korea
- Department of Obstetrics and Gynecology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Hye In Kim
- Institute of Women’s Life Medical Science, Yonsei University College of Medicine, Seoul, South Korea
- Department of Obstetrics and Gynecology, Yongin Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Hye Won Baek
- Institute of Women’s Life Medical Science, Yonsei University College of Medicine, Seoul, South Korea
- Department of Obstetrics and Gynecology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Jae Hoon Lee
- Institute of Women’s Life Medical Science, Yonsei University College of Medicine, Seoul, South Korea
- Department of Obstetrics and Gynecology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Yun Jeong Park
- Institute of Women’s Life Medical Science, Yonsei University College of Medicine, Seoul, South Korea
- Department of Obstetrics and Gynecology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Heeyon Kim
- Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
- Institute of Women’s Life Medical Science, Yonsei University College of Medicine, Seoul, South Korea
| | - Bo Hyon Yun
- Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
- Institute of Women’s Life Medical Science, Yonsei University College of Medicine, Seoul, South Korea
| | - Seok Kyo Seo
- Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
- Institute of Women’s Life Medical Science, Yonsei University College of Medicine, Seoul, South Korea
| | - Joo Hyun Park
- Institute of Women’s Life Medical Science, Yonsei University College of Medicine, Seoul, South Korea
- Department of Obstetrics and Gynecology, Yongin Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Young Sik Choi
- Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
- Institute of Women’s Life Medical Science, Yonsei University College of Medicine, Seoul, South Korea
- *Correspondence: Young Sik Choi,
| | - Byung Seok Lee
- Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
- Institute of Women’s Life Medical Science, Yonsei University College of Medicine, Seoul, South Korea
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19
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The Quantified Woman: Exploring Perceptions on Health App Use among Austrian Females of Reproductive Age. REPRODUCTIVE MEDICINE 2020. [DOI: 10.3390/reprodmed1020010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Smartphones have become the most important commodity for today’s digitalized society. Besides direct interpersonal communication, their most used features are third-party applications (apps). Apps for monitoring health parameters (health apps) are extremely popular, and their users are part of the Quantified Self movement. Little knowledge is available on how health apps are perceived by a female target audience, the Quantified Woman. We conducted a study among Austrian females of reproductive age (n = 150) to analyze prevalence, perceived benefits, and readiness for health app use. In the cross-sectional online German survey, nearly all participants used these apps (98.0%), predominantly for monitoring physical activity and female health (both 31.3%). For the latter, participants used a large variety of different apps for monitoring contraception and menstruation. Perceived benefits and readiness of health app use were only of medium range. Our study assessed aspects of health app use in an understudied segment of the general population. From a Public Health perspective, the Quantified Woman could be empowered by health data collection by enabling her to take active control over how her health graphs develop. We suggest assuring data security and privacy for sensitive female health data collected by health apps.
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