1
|
Rauzi MR, Tran MK, Plew J, Christiansen CL, Mealer ML, Nearing KA, Stevens-Lapsley JE. Older Veteran Experiences of using Technology during a Multicomponent Telerehabilitation Program: A Convergent Mixed Methods Study. COGENT GERONTOLOGY 2024; 3:2340549. [PMID: 39035459 PMCID: PMC11259315 DOI: 10.1080/28324897.2024.2340549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 04/03/2024] [Indexed: 07/23/2024]
Abstract
Less than half of U.S. veterans meet physical activity guidelines. Even though changing physical activity can be challenging, prior studies have demonstrated that it is possible. Older adults are using technology to aid in such behavior change. However, research that explores the mechanisms of how technology can aid in behavior change is lacking, especially among older veterans. Thus, the purpose of this secondary, convergent mixed methods study was to explore how older veterans engaged with technologies that were used during a multicomponent telerehabilitation program. The study included veterans aged ≥60 years with ≥3 chronic medical conditions and physical function limitation. Quantitative data were collected during the primary randomized controlled trial, and qualitative data were collected via individual interviews following completion of the telerehabilitation program. Data were merged and then analyzed by high vs. low technology engagement groups. Key similarities and differences between groups were identified in five domains: satisfaction with the virtual environment, coping self-efficacy, perceptions of Annie (automated text messaging platform), experiences using the activity monitor, and self-management skills. Findings can help inform the successful integration of similar technologies into physical rehabilitation programs. Further study is warranted to understand additional factors and mechanisms that influence technology engagement in telerehabilitation.
Collapse
Affiliation(s)
- M R Rauzi
- Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, CO
| | - M K Tran
- Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, CO
| | - J Plew
- Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, CO
| | - C L Christiansen
- Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, CO
- VA Eastern Colorado Geriatric Research Education and Clinical Center (GRECC), Aurora, CO
| | - M L Mealer
- Department of Physical Medicine and Rehabilitation, School of Medicine, University of Colorado, Aurora, CO
- Mental Illness Research Education and Clinical Center, VA Eastern Colorado Healthcare System, Aurora, CO, USA
| | - K A Nearing
- VA Eastern Colorado Geriatric Research Education and Clinical Center (GRECC), Aurora, CO
- Division of Geriatric Medicine, School of Medicine, University of Colorado, Aurora, CO
| | - J E Stevens-Lapsley
- Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, CO
- VA Eastern Colorado Geriatric Research Education and Clinical Center (GRECC), Aurora, CO
| |
Collapse
|
2
|
Serre F, Moriceau S, Donnadieu L, Forcier C, Garnier H, Alexandre JM, Dupuy L, Philip P, Levavasseur Y, De Sevin E, Auriacombe M. The Craving-Manager smartphone app designed to diagnose substance use/addictive disorders, and manage craving and individual predictors of relapse: a study protocol for a multicenter randomized controlled trial. Front Psychiatry 2023; 14:1143167. [PMID: 37255691 PMCID: PMC10226427 DOI: 10.3389/fpsyt.2023.1143167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 04/18/2023] [Indexed: 06/01/2023] Open
Abstract
Background The rate of individuals with addiction who are currently treated are low, and this can be explained by barriers such as stigma, desire to cope alone, and difficulty to access treatment. These barriers could be overcome by mobile technologies. EMI (Ecological Momentary Intervention) is a treatment procedure characterized by the delivery of interventions (messages on smartphones) to people in their daily lives. EMI presents opportunities for treatments to be available to people during times and in situations when they are most needed. Craving is a strong predictor of relapse and a key target for addiction treatment. Studies using Ecological Momentary Assessment (EMA) method have revealed that, in daily life, person-specific cues could precipitate craving, that in turn, is associated with a higher probability to report substance use and relapse in the following hours. Assessment and management of these specific situations in daily life could help to decrease addictive use and avoid relapse. The Craving-Manager smartphone app has been designed to diagnose addictive disorders, and assess and manage craving as well as individual predictors of use/relapse. It delivers specific and individualized interventions (counseling messages) composed of evidence-based addiction treatments approaches (cognitive behavioral therapy and mindfulness). The Craving-Manager app can be used for any addiction (substance or behavior). The objective of this protocol is to evaluate the efficacy of the Craving-Manager app in decreasing use (of primary substance(s)/addictive behavior(s)) over 4 weeks, among individuals on a waiting list for outpatient addiction treatment. Methods/design This multicenter double-blind randomized controlled trial (RCT) will compare two parallel groups: experimental group (full interventional version of the app, 4 weeks, EMA + EMI), versus control group (restricted version of the app, 4 weeks, only EMA). Two hundred and seventy-four participants will be recruited in 6 addiction treatment centers in France. Discussion This RCT will provide indication on how the Craving-Manager app will reduce addictive use (e.g., better craving management, better stimulus control) in both substance and behavioral addictions. If its efficacy is confirmed, the app could offer the possibility of an easy to use and personalized intervention accessible to the greatest number of individuals with addiction. Clinical Trial Registration ClinicalTrials.gov: NCT04732676.
Collapse
Affiliation(s)
- Fuschia Serre
- University of Bordeaux, Bordeaux, France
- SANPSY, UMR 6033, CNRS, Bordeaux, France
- Pôle Inter-établissement d’Addictologie, CH Ch. Perrens and CHU de Bordeaux, Bordeaux, France
| | - Sarah Moriceau
- University of Bordeaux, Bordeaux, France
- SANPSY, UMR 6033, CNRS, Bordeaux, France
- Pôle Inter-établissement d’Addictologie, CH Ch. Perrens and CHU de Bordeaux, Bordeaux, France
| | - Léa Donnadieu
- University of Bordeaux, Bordeaux, France
- SANPSY, UMR 6033, CNRS, Bordeaux, France
- Pôle Inter-établissement d’Addictologie, CH Ch. Perrens and CHU de Bordeaux, Bordeaux, France
| | - Camille Forcier
- University of Bordeaux, Bordeaux, France
- SANPSY, UMR 6033, CNRS, Bordeaux, France
- Pôle Inter-établissement d’Addictologie, CH Ch. Perrens and CHU de Bordeaux, Bordeaux, France
| | - Hélène Garnier
- University of Bordeaux, Bordeaux, France
- SANPSY, UMR 6033, CNRS, Bordeaux, France
- Pôle Inter-établissement d’Addictologie, CH Ch. Perrens and CHU de Bordeaux, Bordeaux, France
| | - Jean-Marc Alexandre
- University of Bordeaux, Bordeaux, France
- SANPSY, UMR 6033, CNRS, Bordeaux, France
- Pôle Inter-établissement d’Addictologie, CH Ch. Perrens and CHU de Bordeaux, Bordeaux, France
| | - Lucile Dupuy
- University of Bordeaux, Bordeaux, France
- SANPSY, UMR 6033, CNRS, Bordeaux, France
| | - Pierre Philip
- University of Bordeaux, Bordeaux, France
- SANPSY, UMR 6033, CNRS, Bordeaux, France
| | - Yannick Levavasseur
- University of Bordeaux, Bordeaux, France
- SANPSY, UMR 6033, CNRS, Bordeaux, France
| | - Etienne De Sevin
- University of Bordeaux, Bordeaux, France
- SANPSY, UMR 6033, CNRS, Bordeaux, France
| | - Marc Auriacombe
- University of Bordeaux, Bordeaux, France
- SANPSY, UMR 6033, CNRS, Bordeaux, France
- Pôle Inter-établissement d’Addictologie, CH Ch. Perrens and CHU de Bordeaux, Bordeaux, France
| | | |
Collapse
|
3
|
Ortega-García JA, Sánchez-Sauco MF, Zafra-Rodríguez JA, Cabrera-Rivera LT, Díaz-Martínez F, Llegus-Santiago EM, Delgado-Marín JL, Orenes-Piñero E, Kloosterman N, Bach A, Ojeda-Sánchez C, Ramis R. Subjective well-being, happiness, and environmental health factors related to women planning a pregnancy or pregnant, using mobile health intervention. Digit Health 2023; 9:20552076231177146. [PMID: 37284011 PMCID: PMC10240876 DOI: 10.1177/20552076231177146] [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: 07/26/2022] [Accepted: 05/04/2023] [Indexed: 06/08/2023] Open
Abstract
Objectives To compare the environmental health results in women trying to get pregnant or pregnant using a mobile health application (Green Page) through healthcare professionals or self-completed by women, and to explore the relationship between the subjective well-being of these women with their lifestyles and environmental factors. Methods A descriptive study with mixed methods was conducted in 2018. A mobile health survey was used in two phases. Phase 1 was a cross-sectional study through professionals (n = 1100) followed by phase 2, a convenience sampling through women's self-reporting (n = 3425). A personalized report was downloadable with health recommendations for the well-being of the mother and child. Results Of the 3205 participants (mean age = 33 years, SD = 0.2 years), 1840 were planning a pregnancy and 1365 were pregnant. One in five pregnant women had a low level of happiness. Globally, subjective well-being and happiness were found to be negatively associated with lack of contact with nature, sedentary lifestyle, excess weight, environmental exposure, and older age in pregnancy. Precisely 45%, 60%, and 14% of women were exposed to tobacco, alcohol, and illegal drugs, respectively. The women self-reported levels of risk factors higher than when the tool was used by or through professionals. Conclusions The use of mobile health interventions focused on environmental health during planning or pregnancy periods could help improve the quality of healthcare and foster greater involvement of women in their self-care process, thus promoting empowerment, healthier environments, and lifestyles. Ensuring equity of access and data protection are global challenges to be addressed.
Collapse
Affiliation(s)
- Juan Antonio Ortega-García
- Department of Pediatrics, Global Alliance to Renaturalize Child and Adolescent Health (GreenRooting.org), Spanish Association of Pediatrics, IMIB Arrixaca, University of Murcia, Murcia, Spain
- Pediatric Environmental Health Speciality Unit (PEHSU), Department of Pediatrics, Clinical University Hospital Virgen of Arrixaca, El Palmar, Murcia, Spain
| | - Miguel Felipe Sánchez-Sauco
- Department of Pediatrics, Global Alliance to Renaturalize Child and Adolescent Health (GreenRooting.org), Spanish Association of Pediatrics, IMIB Arrixaca, University of Murcia, Murcia, Spain
- Pediatric Environmental Health Speciality Unit (PEHSU), Department of Pediatrics, Clinical University Hospital Virgen of Arrixaca, El Palmar, Murcia, Spain
| | - José Alberto Zafra-Rodríguez
- Department of Pediatrics, Global Alliance to Renaturalize Child and Adolescent Health (GreenRooting.org), Spanish Association of Pediatrics, IMIB Arrixaca, University of Murcia, Murcia, Spain
- TICARUM, University of Murcia, Murcia, Spain
| | - Laura Teresa Cabrera-Rivera
- Department of Pediatrics, Global Alliance to Renaturalize Child and Adolescent Health (GreenRooting.org), Spanish Association of Pediatrics, IMIB Arrixaca, University of Murcia, Murcia, Spain
- Department of Environmental Health, University of Puerto Rico-Medical Sciences Campus, San Juan, Puerto Rico
- International Exchange Program for Minority Student, Icahn School of Medicine at Mount Sinai, NY, USA
| | - Francisco Díaz-Martínez
- Department of Pediatrics, Global Alliance to Renaturalize Child and Adolescent Health (GreenRooting.org), Spanish Association of Pediatrics, IMIB Arrixaca, University of Murcia, Murcia, Spain
- Pediatric Environmental Health Speciality Unit (PEHSU), Department of Pediatrics, Clinical University Hospital Virgen of Arrixaca, El Palmar, Murcia, Spain
| | - Eduardo Manuel Llegus-Santiago
- Department of Pediatrics, Global Alliance to Renaturalize Child and Adolescent Health (GreenRooting.org), Spanish Association of Pediatrics, IMIB Arrixaca, University of Murcia, Murcia, Spain
- Department of Environmental Health, University of Puerto Rico-Medical Sciences Campus, San Juan, Puerto Rico
- International Exchange Program for Minority Student, Icahn School of Medicine at Mount Sinai, NY, USA
| | - Juan Luis Delgado-Marín
- Department of Obstetrics and Gynecology, Hospital Clínico Universitario Virgen Arrixaca, Fetal Medicine Unit Murcia, IMIB Arrixaca, Región de Murcia, Spain
| | - Esteban Orenes-Piñero
- Department of Pediatrics, Global Alliance to Renaturalize Child and Adolescent Health (GreenRooting.org), Spanish Association of Pediatrics, IMIB Arrixaca, University of Murcia, Murcia, Spain
- Departament of Biochemistry and Molecular Biology, University of Murcia, Murcia, Spain
| | - Nicole Kloosterman
- Department of Pediatrics, Global Alliance to Renaturalize Child and Adolescent Health (GreenRooting.org), Spanish Association of Pediatrics, IMIB Arrixaca, University of Murcia, Murcia, Spain
- MUSC Health University Medical Center, Charleston, SC, USA
| | - Albert Bach
- Department of Pediatrics, Global Alliance to Renaturalize Child and Adolescent Health (GreenRooting.org), Spanish Association of Pediatrics, IMIB Arrixaca, University of Murcia, Murcia, Spain
- Environment and Human Health Laboratory (EH2 Lab), Forest Science and Technology Center of Catalonia, Solsona, Spain
| | - Carlos Ojeda-Sánchez
- Department of Pediatrics, Global Alliance to Renaturalize Child and Adolescent Health (GreenRooting.org), Spanish Association of Pediatrics, IMIB Arrixaca, University of Murcia, Murcia, Spain
- Department of Preventive Medicine, Hospital General Universitario de Guadalajara, Guadalajara, Spain
| | - Rebecca Ramis
- Department of Pediatrics, Global Alliance to Renaturalize Child and Adolescent Health (GreenRooting.org), Spanish Association of Pediatrics, IMIB Arrixaca, University of Murcia, Murcia, Spain
- Cancer and Environmental Epidemiology Unit, National Epidemiology Centre, Carlos III Health Institute and Centre for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública−CIBERESP), Madrid, Spain
| |
Collapse
|
4
|
Ronteltap A, Bukman AJ, Nagelhout GE, Hermans RCJ, Hosper K, Haveman-Nies A, Lupker R, Bolman CAW. Digital health interventions to improve eating behaviour of people with a lower socioeconomic position: a scoping review of behaviour change techniques. BMC Nutr 2022; 8:145. [PMID: 36482430 PMCID: PMC9733085 DOI: 10.1186/s40795-022-00635-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 11/10/2022] [Indexed: 12/13/2022] Open
Abstract
Specific approaches are needed to reach and support people with a lower socioeconomic position (SEP) to achieve healthier eating behaviours. There is a growing body of evidence suggesting that digital health tools exhibit potential to address these needs because of its specific features that enable application of various behaviour change techniques (BCTs). The aim of this scoping review is to identify the BCTs that are used in diet-related digital interventions targeted at people with a low SEP, and which of these BCTs coincide with improved eating behaviour. The systematic search was performed in 3 databases, using terms related to e/m-health, diet quality and socioeconomic position. A total of 17 full text papers were included. The average number of BCTs per intervention was 6.9 (ranged 3-15). BCTs from the cluster 'Goals and planning' were applied most often (25x), followed by the clusters 'Shaping knowledge' (18x) and 'Natural consequences' (18x). Other frequently applied BCT clusters were 'Feedback and monitoring' (15x) and 'Comparison of behaviour' (13x). Whereas some BCTs were frequently applied, such as goal setting, others were rarely used, such as social support. Most studies (n = 13) observed a positive effect of the intervention on eating behaviour (e.g. having breakfast) in the low SEP group, but this was not clearly associated with the number or type of applied BCTs. In conclusion, more intervention studies focused on people with a low SEP are needed to draw firm conclusions as to which BCTs are effective in improving their diet quality. Also, further research should investigate combinations of BCTs, the intervention design and context, and the use of multicomponent approaches. We encourage intervention developers and researchers to describe interventions more thoroughly, following the systematics of a behaviour change taxonomy, and to select BCTs knowingly.
Collapse
Affiliation(s)
- Amber Ronteltap
- grid.438049.20000 0001 0824 9343Knowledge Centre Healthy and Sustainable Living, University of Applied Sciences Utrecht, P.O. box 12011, 3501 AA Utrecht, The Netherlands
| | - Andrea J. Bukman
- grid.438049.20000 0001 0824 9343Knowledge Centre Healthy and Sustainable Living, University of Applied Sciences Utrecht, P.O. box 12011, 3501 AA Utrecht, The Netherlands
| | - Gera E. Nagelhout
- IVO Research Institute, The Hague, The Netherlands ,grid.5012.60000 0001 0481 6099Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Roel C. J. Hermans
- grid.5012.60000 0001 0481 6099Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands ,grid.491176.c0000 0004 0395 4926Netherlands Nutrition Centre, The Hague, The Netherlands
| | | | - Annemien Haveman-Nies
- grid.4818.50000 0001 0791 5666Consumption and Healthy Lifestyles Group, Wageningen University & Research, Wageningen, The Netherlands
| | - Remko Lupker
- grid.36120.360000 0004 0501 5439Faculty of Psychology, Open University of the Netherlands, Heerlen, The Netherlands
| | - Catherine A. W. Bolman
- grid.36120.360000 0004 0501 5439Faculty of Psychology, Open University of the Netherlands, Heerlen, The Netherlands
| |
Collapse
|
5
|
Ahmadi M, Shahrokhi SN, Khavaninzadeh M, Alipour J. Development of a Mobile-Based Self-care Application for Patients with Breast Cancer-Related Lymphedema in Iran. Appl Clin Inform 2022; 13:935-948. [PMID: 36198310 PMCID: PMC9534597 DOI: 10.1055/s-0042-1757295] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 08/20/2022] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND Due to the chronic, progressive, and debilitating nature of breast cancer-related lymphedema (BCRL), it is necessary to observe and maintain self-care management accordingly. This study was conducted to develop a mobile application based on the Android operating system for self-care management of Iranian patients with BCRL. METHODS An applied developmental study was conducted in 2020. The users' information needs assessment as well as design, development, implementation, and evaluation of the mobile app for self-care management of patients with BCRL was done by searching the literature, reviewing the existing mobile applications, and surveying the users' needs. The mobile app was designed using the Android Studio environment and Java programming language in the Android operating system. The usability of the app was evaluated by 30 patients with BCRL using the questionnaire for user interface satisfaction-seventh version (QUIS 7). RESULTS The mobile app for BCRL included demographic information, clinical information, lifestyle and system functions (drug use, nutrition, exercise, smoking cessation, communication, and test time reminder). User usability evaluation of the app content and functions confirmed that it was appropriate and satisfactory for the self-management of women with BCRL. CONCLUSION The mobile app was appropriate in terms of the content, function, and quality for improving the patients' lifestyle and education and self-management of BCRL symptoms according to its usability evaluation from the end-users' (patients) perspective. It is suggested that studies should be performed to confirm the effectiveness and identify the clinical significance of the app.
Collapse
Affiliation(s)
- Maryam Ahmadi
- Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Seyedeh Nafiseh Shahrokhi
- Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Morteza Khavaninzadeh
- Department of General Surgery, School of Medical Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Jahanpour Alipour
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
- Department of Health Information Technology, School of Paramedical, Zahedan University of Medical Sciences, Zahedan, Iran
| |
Collapse
|
6
|
Nasruddin NIN, Murphy J, Armstrong MEG. Physical Activity Surveillance in Children and Adolescents using Smartphone Technology: Systematic Review (Preprint). JMIR Pediatr Parent 2022; 6:e42461. [PMID: 36989033 PMCID: PMC10131756 DOI: 10.2196/42461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 01/30/2023] [Accepted: 02/23/2023] [Indexed: 02/25/2023] Open
Abstract
BACKGROUND Self-reported physical activity (PA) questionnaires have traditionally been used for PA surveillance in children and adolescents, especially in free-living conditions. Objective measures are more accurate at measuring PA, but high cost often creates a barrier for their use in low- and middle-income settings. The advent of smartphone technology has greatly influenced mobile health and has offered new opportunities in health research, including PA surveillance. OBJECTIVE This review aimed to systematically explore the use of smartphone technology for PA surveillance in children and adolescents, specifically focusing on the use of smartphone apps. METHODS A literature search was conducted using 5 databases (PubMed, Scopus, CINAHL, MEDLINE, and Web of Science) and Google Scholar to identify articles relevant to the topic that were published from 2008 to 2023. Articles were included if they included children and adolescents within the age range of 5 to 18 years; used smartphone technology as PA surveillance; had PA behavioral outcomes such as energy expenditure, step count, and PA levels; were written in English; and were published between 2008 and 2023. RESULTS We identified and analyzed 8 studies (5 cross-sectional studies and 3 cohort studies). All participants were aged 12-18 years, and all studies were conducted in high-income countries only. Participants were recruited from schools, primary care facilities, and voluntarily. Five studies used mobile apps specifically and purposely developed for the study, whereas 3 studies used mobile apps downloadable from the Apple App Store and Android Play Store. PA surveillance using these apps was conducted from 24 hours to 4 weeks. CONCLUSIONS Evidence of PA surveillance using smartphone technology in children and adolescents was insufficient, which demonstrated the knowledge gap. Additional research is needed to further study the feasibility and validity of smartphone apps for PA surveillance among children and adolescents, especially in low- and middle-income countries.
Collapse
Affiliation(s)
- Nur Izzatun Nasriah Nasruddin
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom
| | - Joey Murphy
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom
| | - Miranda Elaine Glynis Armstrong
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom
| |
Collapse
|
7
|
Mendi O, Kiymac Sari M, Stoyanov S, Mendi B. Development and validation of the Turkish version of the Mobile App Rating Scale - MARS-TR. Int J Med Inform 2022; 166:104843. [PMID: 35964383 DOI: 10.1016/j.ijmedinf.2022.104843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 06/16/2022] [Accepted: 08/06/2022] [Indexed: 10/15/2022]
Abstract
BACKGROUND The number of mobile health apps (MHAs) is growing rapidly. MHAs have great potential to improve health and health care. However, the quality of available MHAs remains unknown due to the lack of quality assessment regulations and standards for MHAs. The Mobile Application Rating Scale (MARS) is the most widely used instrument to assess the quality of MHAs, and available in English, Italian, Spanish, German, French, Arabic and Japanese. However, the scale is currently not available in the Turkish language. OBJECTIVE This study aimed to cross-culturally adapt the MARS into Turkish and evaluate the validity and reliability of the scale. METHODS The MARS was translated and adapted into Turkish according to the international guidelines. A total of 52 pregnancy tracking apps were evaluated by two independent raters. Internal consistency (Cronbach's alpha), inter-rater reliability (Intraclass Correlation Coefficient [ICC]), convergent validity and concurrent validity were explored. Regarding convergent validity, MARS-TR scores were compared with the ENLIGHT scale. RESULTS The MARS-TR was highly aligned with the original MARS. The MARS-TR showed excellent internal consistency (Cronbach's alpha of 0.95 for both raters) and excellent inter-rater reliability (ICC = 0.94; SEM = 0.02), with a smallest detectable change (95 % confidence level) of 0.05 points for the total score. Cronbach's alphas for the subscales ranged from 0.76 to 0.94 for the two raters. Correlations between the MARS-TR and ENLIGHT demonstrated adequate convergent validity (P < 0.05). No ceiling or floor effects were observed. CONCLUSION The results provide evidence that the Turkish version of MARS is a valid and reliable tool for researchers and experts to assess the quality of MHAs in Turkey.
Collapse
Affiliation(s)
- Onur Mendi
- Faculty of Medicine, Demiroglu Bilim University, Buyukdere Cad. No:120 Esentepe / Sisli, Istanbul, Turkey.
| | - Merve Kiymac Sari
- Florence Nightingale Hospital School of Nursing, Demiroglu Bilim University, Buyukdere Cad. Yazarlar Sok. No:27 Esentepe / Sisli, Istanbul, Turkey.
| | - Stoyan Stoyanov
- School of Design & School of Psychology, Queensland University of Technology (QUT), 5 Cordova Street, Milton, QLD 4064, Australia.
| | - Basak Mendi
- Faculty of Health Sciences, Demiroglu Bilim University, Buyukdere Cad. Yazarlar Sok. No:27 Esentepe / Sisli, Istanbul, Turkey.
| |
Collapse
|
8
|
Zhong J, Liu W, Niu B, Lin X, Deng Y. Role of Built Environments on Physical Activity and Health Promotion: A Review and Policy Insights. Front Public Health 2022; 10:950348. [PMID: 35910910 PMCID: PMC9326484 DOI: 10.3389/fpubh.2022.950348] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 06/21/2022] [Indexed: 11/13/2022] Open
Abstract
As urbanization and motorization continue worldwide, various health issues have emerged as a burden between individuals, families and governments at all levels. Under the prevalence of chronic disease, this review synthesizes research on the impact of the various built environments on the multiple health outcomes from a methodological and mechanistic perspective. Besides, it attempts to provide useful planning and policy implications to promote physical activity and health benefits. The finds show that: (1) Current literature has used a variety of dataset, methods, and models to examine the built environment-health benefit connections from the perspective of physical activity; (2) The prevalence of chronic diseases is inextricably linked to the built environment, and policy interventions related to physical activity and physical and mental wellbeing of urban residents should be emphasized; (3) The impact of the built environment on health is manifested in the way various elements of the physical environment guide the lifestyle of residents, thereby influencing physical activity and travel; (4) Given the changes that have occurred in the built environment during the current urban expansion, the link between urban planning and the public health sector should be strengthened in the future, and the relevant authorities should actively pursue policies that promote urban public health in order to improve the health of residents. Finally, it proposes potential policy insights for urban planning and development toward a healthier city and society.
Collapse
Affiliation(s)
- Jingjing Zhong
- Department of Geography and Spatial Information Technology, Ningbo University, Ningbo, China
- Ningbo Universities Collaborative Innovation Center for Land and Marine Spatial Utilization and Governance Research at Ningbo University, Ningbo, China
| | - Wenting Liu
- Department of Geography and Spatial Information Technology, Ningbo University, Ningbo, China
| | - Buqing Niu
- Department of Geography and Spatial Information Technology, Ningbo University, Ningbo, China
- Ningbo Universities Collaborative Innovation Center for Land and Marine Spatial Utilization and Governance Research at Ningbo University, Ningbo, China
| | - Xiongbin Lin
- Department of Geography and Spatial Information Technology, Ningbo University, Ningbo, China
- Ningbo Universities Collaborative Innovation Center for Land and Marine Spatial Utilization and Governance Research at Ningbo University, Ningbo, China
| | - Yanhua Deng
- Zhiweibing Center, Ningbo Municipal Hospital of Traditional Chinese Medicine, Ningbo, China
| |
Collapse
|
9
|
De Santis KK, Jahnel T, Matthias K, Mergenthal L, Al Khayyal H, Zeeb H. Evaluation of Digital Interventions for Physical Activity Promotion: Scoping Review. JMIR Public Health Surveill 2022; 8:e37820. [PMID: 35604757 PMCID: PMC9171604 DOI: 10.2196/37820] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/06/2022] [Accepted: 04/09/2022] [Indexed: 02/06/2023] Open
Abstract
Background Digital interventions are interventions supported by digital tools or technologies, such as mobile apps, wearables, or web-based software. Digital interventions in the context of public health are specifically designed to promote and improve health. Recent reviews have shown that many digital interventions target physical activity promotion; however, it is unclear how such digital interventions are evaluated. Objective We aimed to investigate evaluation strategies in the context of digital interventions for physical activity promotion using a scoping review of published reviews. We focused on the target (ie, user outcomes or tool performance), methods (ie, tool data or self-reported data), and theoretical frameworks of the evaluation strategies. Methods A protocol for this study was preregistered and published. From among 300 reviews published up to March 19, 2021 in Medline, PsycINFO, and CINAHL databases, 40 reviews (1 rapid, 9 scoping, and 30 systematic) were included in this scoping review. Two authors independently performed study selection and data coding. Consensus was reached by discussion. If applicable, data were coded quantitatively into predefined categories or qualitatively using definitions or author statements from the included reviews. Data were analyzed using either descriptive statistics, for quantitative data (relative frequencies out of all studies), or narrative synthesis focusing on common themes, for qualitative data. Results Most reviews that were included in our scoping review were published in the period from 2019 to 2021 and originated from Europe or Australia. Most primary studies cited in the reviews included adult populations in clinical or nonclinical settings, and focused on mobile apps or wearables for physical activity promotion. The evaluation target was a user outcome (efficacy, acceptability, usability, feasibility, or engagement) in 38 of the 40 reviews or tool performance in 24 of the 40 reviews. Evaluation methods relied upon objective tool data (in 35/40 reviews) or other data from self-reports or assessments (in 28/40 reviews). Evaluation frameworks based on behavior change theory, including goal setting, self-monitoring, feedback on behavior, and educational or motivational content, were mentioned in 22 out of 40 reviews. Behavior change theory was included in the development phases of digital interventions according to the findings of 20 out of 22 reviews. Conclusions The evaluation of digital interventions is a high priority according to the reviews included in this scoping review. Evaluations of digital interventions, including mobile apps or wearables for physical activity promotion, typically target user outcomes and rely upon objective tool data. Behavior change theory may provide useful guidance not only for development of digital interventions but also for the evaluation of user outcomes in the context of physical activity promotion. Future research should investigate factors that could improve the efficacy of digital interventions and the standardization of terminology and reporting in this field. International Registered Report Identifier (IRRID) RR2-10.2196/35332
Collapse
Affiliation(s)
- Karina Karolina De Santis
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology- BIPS, Bremen, Germany.,Leibniz-Science Campus Digital Public Health Bremen, Bremen, Germany
| | - Tina Jahnel
- Leibniz-Science Campus Digital Public Health Bremen, Bremen, Germany.,Faculty 11 Human and Health Sciences, University of Bremen, Bremen, Germany
| | - Katja Matthias
- Faculty of Electrical Engineering and Computer Science, University of Applied Science Stralsund, Stralsund, Germany
| | - Lea Mergenthal
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology- BIPS, Bremen, Germany
| | - Hatem Al Khayyal
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology- BIPS, Bremen, Germany.,Leibniz-Science Campus Digital Public Health Bremen, Bremen, Germany.,Faculty of Engineering and Mathematics, Bielefeld University of Applied Science, Bielefeld, Germany
| | - Hajo Zeeb
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology- BIPS, Bremen, Germany.,Leibniz-Science Campus Digital Public Health Bremen, Bremen, Germany.,Faculty 11 Human and Health Sciences, University of Bremen, Bremen, Germany
| |
Collapse
|
10
|
Kawichai S, Songtaweesin WN, Wongharn P, Phanuphak N, Cressey TR, Moonwong J, Vasinonta A, Saisaengjan C, Chinbunchorn T, Puthanakit T. A Mobile Phone App to Support Adherence to Daily HIV Pre-exposure Prophylaxis Engagement Among Young Men Who Have Sex With Men and Transgender Women Aged 15 to 19 Years in Thailand: Pilot Randomized Controlled Trial. JMIR Mhealth Uhealth 2022; 10:e25561. [PMID: 35451976 PMCID: PMC9073624 DOI: 10.2196/25561] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 02/11/2021] [Accepted: 12/09/2021] [Indexed: 12/19/2022] Open
Abstract
Background Widespread smartphone use provides opportunities for mobile health HIV prevention strategies among at-risk populations. Objective This study aims to investigate engagement in a theory-based (information–motivation–behavioral skills model) mobile phone app developed to support HIV pre-exposure prophylaxis (PrEP) adherence among Thai young men who have sex with men (YMSM) and young transgender women (YTGW) in Bangkok, Thailand. Methods A randomized controlled trial was conducted among HIV-negative YMSM and YTGW aged 15-19 years initiating daily oral PrEP. Participants were randomized to receive either youth-friendly PrEP services (YFS) for 6 months, including monthly contact with site staff (clinic visits or telephone follow-up) and staff consultation access, or YFS plus use of a PrEP adherence support app (YFS+APP). The target population focus group discussion findings and the information–motivation–behavioral skills model informed app development. App features were based on the 3Rs—risk assessment of self-HIV acquisition risk, reminders to take PrEP, and rewards as redeemable points. Dried blood spots quantifying of tenofovir diphosphate were collected at months 3 and 6 to assess PrEP adherence. Tenofovir diphosphate ≥350-699 fmol/punch was classified as fair adherence and ≥700 fmol/punch as good adherence. Data analysis on app use paradata and exit interviews were conducted on the YFS+APP arm after 6 months of follow-up. Results Between March 2018 and June 2019, 200 participants with a median age of 18 (IQR 17-19) years were enrolled. Overall, 74% (148/200) were YMSM; 87% (87/100) of participants who received YFS+APP logged in to the app and performed weekly HIV acquisition risk assessments (log-in and risk assessment [LRA]). The median duration between the first and last log-in was 3.5 (IQR 1.6-5.6) months, with a median frequency of 6 LRAs (IQR 2-10). Moreover, 22% (22/100) of the participants in the YFS+APP arm were frequent users (LRA≥10) during the 6-month follow-up period. YMSM were 9.3 (95% CI 1.2-74.3) times more likely to be frequent app users than YTGW (P=.04). Frequent app users had higher proportions (12%-16%) of PrEP adherence at both months 3 and 6 compared with infrequent users (LRA<10) and the YFS arm, although this did not reach statistical significance. Of the 100 participants in the YFS+APP arm, 23 (23%) were interviewed. The risk assessment function is perceived as the most useful app feature. Further aesthetic adaptations and a more comprehensive rewards system were suggested by the interviewees. Conclusions Higher rates of PrEP adherence among frequent app users were observed; however, this was not statistically significant. A short app use duration of 3 months suggests that they may be useful in establishing habits in taking daily PrEP, but not long-term adherence. Further studies on the specific mechanisms of mobile phone apps that influence health behaviors are needed. Trial Registration ClinicalTrials.gov NCT03778892; https://clinicaltrials.gov/ct2/show/NCT03778892
Collapse
Affiliation(s)
- Surinda Kawichai
- Center of Excellence for Pediatric Infectious Diseases and Vaccines, Chulalongkorn University, Bangkok, Thailand
| | | | - Prissana Wongharn
- Center of Excellence for Pediatric Infectious Diseases and Vaccines, Chulalongkorn University, Bangkok, Thailand
| | | | - Tim R Cressey
- The Program for HIV Prevention and Treatment/ Unité Mixte de recherches Internationale 174, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand.,Department of Molecular and Clinical Pharmacology, University of Liverpool, Liverpool, United Kingdom
| | - Juthamanee Moonwong
- Center of Excellence for Pediatric Infectious Diseases and Vaccines, Chulalongkorn University, Bangkok, Thailand
| | | | - Chutima Saisaengjan
- Center of Excellence for Pediatric Infectious Diseases and Vaccines, Chulalongkorn University, Bangkok, Thailand
| | | | - Thanyawee Puthanakit
- Center of Excellence for Pediatric Infectious Diseases and Vaccines, Chulalongkorn University, Bangkok, Thailand.,Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| |
Collapse
|
11
|
Al Ansari FS, Alfayez A, Alsalman D, Alanezi F, Alhodaib H, Al-Rayes S, Aljabri D, Alrawiai S, Alakrawi Z, Saadah A, Al-Juwair MM, Aljaffary A, AlThani B, Mushcab H, Alanzi TM, AlNujaidi H, Al-Saif AK, Attar R, Alumran A, Al-Mubarak S, Alyousef S. Using mobile health applications to enhance physical activity in Saudi Arabia: a cross-sectional study on users' perceptions. Int Health 2022; 15:47-55. [PMID: 35348719 PMCID: PMC9808522 DOI: 10.1093/inthealth/ihac008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 12/15/2021] [Accepted: 03/17/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND This research aims to assess the users' perceptions of usability and quality of mobile health applications used for promoting physical activity in Saudi Arabia. METHODS This was a quantitative cross-sectional study. A survey was developed based on the Technology Acceptance Model (TAM) and the Mobile Application Rating Scale (MARS) and distributed among the Saudi population through social media to assess the users' perceptions of using mobile applications to enhance physical activity. The survey questionnaire consisted of 27 questions in six sections, including demographics (nine items), perceived usefulness (three items), perceived ease of use (three items), attitudes (three items), user experience (six items) and subjective quality (three items). All the participants were in Saudi Arabia and >15 y of age. RESULTS A total of 195 m-Health users participated in the survey. Of the total participants, 25.1% were overweight and 21.0% were obese. The workout frequency of most users was rarely (32.3%) and three to four times a week (29.2%). In addition, 55.9% of the users agreed that the application they use served all fitness levels and >80% either agreed or strongly agreed that it was easy for them to learn how to use the application. More than 70% of users agreed or strongly agreed that the application enhanced their knowledge of workouts and physical activity and >90% would recommend the application to others. There were no differences identified between the male and female participants and younger (<40 y) and older (>40 y) participants with respect to perceived usefulness and ease of use, attitudes, experiences and subjective quality. However, significant differences were observed between participants <40 y and >40 y of age in terms of perceived ease of use of mHealth applications. CONCLUSION mHealth users across Saudi Arabia believe that the mHealth applications have good usability and quality factors. As a result, they can motivate people and help them achieve their goals in relation to physical activities.
Collapse
Affiliation(s)
- Fatimah Salah Al Ansari
- Health Information Management and Technology Department, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Asma Alfayez
- Health Information Management and Technology Department, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Demah Alsalman
- Health Information Management and Technology Department, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | | | - Hala Alhodaib
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyad, Saudi Arabia
| | - Saja Al-Rayes
- Health Information Management and Technology Department, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Duaa Aljabri
- Health Information Management and Technology Department, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Sumaiah Alrawiai
- Health Information Management and Technology Department, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Zahraa Alakrawi
- Health Information Management and Technology Department, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Amjad Saadah
- Health Information Management and Technology Department, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Mona M Al-Juwair
- Health Information Management and Technology Department, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Afnan Aljaffary
- Health Information Management and Technology Department, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Bashair AlThani
- College of Business Administration, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Hayat Mushcab
- Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
| | - Turki M Alanzi
- Health Information Management and Technology Department, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Heba AlNujaidi
- College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Atheer K Al-Saif
- College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Razaz Attar
- Princess Nourah Bint Abdul Rahman University, Saudi Arabia
| | - Arwa Alumran
- Health Information Management and Technology Department, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Sama'a Al-Mubarak
- Health Information Management and Technology Department, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | | |
Collapse
|
12
|
Clarkson P, Stephenson A, Grimmett C, Cook K, Clark C, Muckelt PE, O’Gorman P, Saynor Z, Adams J, Stokes M, McDonough S. Digital tools to support the maintenance of physical activity in people with long-term conditions: A scoping review. Digit Health 2022; 8:20552076221089778. [PMID: 35433017 PMCID: PMC9005829 DOI: 10.1177/20552076221089778] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 03/09/2022] [Indexed: 11/17/2022] Open
Abstract
Objective This scoping review aimed to bring together and identify digital tools that support people with one or more long-term conditions to maintain physical activity and describe their components and theoretical underpinnings. Methods Searches were conducted in Cumulative Index to Nursing and Allied Health Literature, Medline, EMBASE, IEEE Xplore, PsycINFO, Scopus, Google Scholar and clinical trial databases, for studies published between 2009 and 2019, across a range of long-term conditions. Screening and data extraction was undertaken by two independent reviewers and the Preferred Reporting Items for Scoping Reviews guidelines informed the review's conduct and reporting. Results A total of 38 results were identified from 34 studies, with the majority randomised controlled trials or protocols, with cardiovascular disease, type 2 diabetes mellitus and obesity the most common long-term conditions. Comorbidities were reported in >50% of studies but did not clearly inform intervention development. Most digital tools were web-browser-based ± wearables/trackers, telerehabilitation tools or gaming devices/components. Mobile device applications and combination short message service/activity trackers/wearables were also identified. Most interventions were supported by a facilitator, often for goal setting/feedback and/or monitoring. Physical activity maintenance outcomes were mostly reported at 9 months or 3 months post-intervention, while theoretical underpinnings were commonly social cognitive theory, the transtheoretical model and the theory of planned behaviour. Conclusions This review mapped the literature on a wide range of digital tools and long-term conditions. It identified the increasing use of digital tools, in combination with human support, to help people with long-term conditions, to maintain physical activity, commonly for under a year post-intervention. Clear gaps were the lack of digital tools for multimorbid long-term conditions, longer-term follow-ups, understanding participant's experiences and informs future questions around effectiveness.
Collapse
Affiliation(s)
- Paul Clarkson
- School of Health Sciences, University of Southampton, Southampton, UK
- National Institute for Health Research Applied Research Collaboration Wessex, Southampton, UK
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, Southampton, UK
| | - Aoife Stephenson
- School of Physiotherapy, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Chloe Grimmett
- School of Health Sciences, University of Southampton, Southampton, UK
- National Institute for Health Research, Southampton Biomedical Research Unit, Southampton, UK
| | - Katherine Cook
- Faculty of Health and Wellbeing, School of Health and Care Professions, University of Winchester, Winchester, UK
| | - Carol Clark
- Department of Rehabilitation and Sport Sciences, Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK
| | - Paul E Muckelt
- School of Health Sciences, University of Southampton, Southampton, UK
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, Southampton, UK
| | - Philip O’Gorman
- School of Physiotherapy, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Zoe Saynor
- Physical Activity, Health and Rehabilitation Thematic Research Group, Faculty of Science and Health, School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
| | - Jo Adams
- School of Health Sciences, University of Southampton, Southampton, UK
- National Institute for Health Research Applied Research Collaboration Wessex, Southampton, UK
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, Southampton, UK
| | - Maria Stokes
- School of Health Sciences, University of Southampton, Southampton, UK
- National Institute for Health Research Applied Research Collaboration Wessex, Southampton, UK
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, Southampton, UK
- National Institute for Health Research, Southampton Biomedical Research Unit, Southampton, UK
| | - Suzanne McDonough
- School of Health Sciences, University of Southampton, Southampton, UK
- School of Physiotherapy, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| |
Collapse
|
13
|
De Santis KK, Jahnel T, Sina E, Wienert J, Zeeb H. Digitization and Health in Germany: Cross-sectional Nationwide Survey. JMIR Public Health Surveill 2021; 7:e32951. [PMID: 34813493 PMCID: PMC8612128 DOI: 10.2196/32951] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 09/20/2021] [Accepted: 10/03/2021] [Indexed: 12/22/2022] Open
Abstract
Background Digital technologies are shaping medicine and public health. Objective The aim of this study was to investigate the attitudes toward and the use of digital technologies for health-related purposes using a nationwide survey. Methods We performed a cross-sectional study using a panel sample of internet users selected from the general population living in Germany. Responses to a survey with 28 items were collected using computer-assisted telephone interviews conducted in October 2020. The items were divided into four topics: (1) general attitudes toward digitization, (2) COVID-19 pandemic, (3) physical activity, and (4) perceived digital health (eHealth) literacy measured with the eHealth Literacy Scale (eHEALS; sum score of 8=lowest to 40=highest perceived eHealth literacy). The data were analyzed in IBM-SPSS24 using relative frequencies. Three univariate multiple regression analyses (linear or binary logistic) were performed to investigate the associations among the sociodemographic factors (age, gender, education, and household income) and digital technology use. Results The participants included 1014 internet users (n=528, 52.07% women) aged 14 to 93 years (mean 54, SD 17). Among all participants, 66.47% (674/1014) completed up to tertiary (primary and secondary) education and 45.07% (457/1017) reported a household income of up to 3500 Euro/month (1 Euro=US $1.18). Over half (579/1014, 57.10%) reported having used digital technologies for health-related purposes. The majority (898/1014, 88.56%) noted that digitization will be important for therapy and health care, in the future. Only 25.64% (260/1014) reported interest in smartphone apps for health promotion/prevention and 42.70% (433/1014) downloaded the COVID-19 contact-tracing app. Although 52.47% (532/1014) reported that they come across inaccurate digital information on the COVID-19 pandemic, 78.01% (791/1014) were confident in their ability to recognize such inaccurate information. Among those who use digital technologies for moderate physical activity (n=220), 187 (85.0%) found such technologies easy to use and 140 (63.6%) reported using them regularly (at least once a week). Although the perceived eHealth literacy was high (eHEALS mean score 31 points, SD 6), less than half (43.10%, 400/928) were confident in using digital information for health decisions. The use of digital technologies for health was associated with higher household income (odds ratio [OR] 1.28, 95% CI 1.11-1.47). The use of digital technologies for physical activity was associated with younger age (OR 0.95, 95% CI 0.94-0.96) and more education (OR 1.22, 95% CI 1.01-1.46). A higher perceived eHealth literacy score was associated with younger age (β=–.22, P<.001), higher household income (β=.21, P<.001), and more education (β=.14, P<.001). Conclusions Internet users in Germany expect that digitization will affect preventive and therapeutic health care in the future. The facilitators and barriers associated with the use of digital technologies for health warrant further research. A gap exists between high confidence in the perceived ability to evaluate digital information and low trust in internet-based information on the COVID-19 pandemic and health decisions.
Collapse
Affiliation(s)
- Karina Karolina De Santis
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.,Leibniz Science Campus Digital Public Health, Bremen, Germany
| | - Tina Jahnel
- Leibniz Science Campus Digital Public Health, Bremen, Germany.,Faculty 11; Human and Health Sciences, University of Bremen, Bremen, Germany
| | - Elida Sina
- Leibniz Science Campus Digital Public Health, Bremen, Germany.,Department of Epidemiological Methods and Etiological Research, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
| | - Julian Wienert
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.,Leibniz Science Campus Digital Public Health, Bremen, Germany.,Faculty of Social Sciences, IU International University of Applied Sciences, Bad Reichenhall, Germany
| | - Hajo Zeeb
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.,Leibniz Science Campus Digital Public Health, Bremen, Germany.,Faculty 11; Human and Health Sciences, University of Bremen, Bremen, Germany
| |
Collapse
|
14
|
Sanders GJ, Cooke C, Gately P. Exploring reasons for attrition among vulnerable and under-served sub-groups across an online integrated healthy lifestyles service during COVID-19. SAGE Open Med 2021; 9:20503121211054362. [PMID: 34707867 PMCID: PMC8543558 DOI: 10.1177/20503121211054362] [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: 02/16/2021] [Accepted: 10/01/2021] [Indexed: 11/26/2022] Open
Abstract
Objectives: Reported health behaviour change intervention attrition rates vary considerably, from 10% to more than 80%, depending on the type and setting of the treatment programme. A better understanding of the determinants of programme adherence is required. Between March and August 2020, a convenience sample of 44 individual telephone interviews, as well as 42 online Qualtrics surveys took place. The objective was to explore perceived barriers, facilitators, and opportunities for participation, sustained participation as well as initial non-participation to better understand reasons for attrition in online delivery during the COVID-19 lockdown among vulnerable and under-served groups within an Integrated Healthy Lifestyle Service (IHLS). Methods: A convenience sample of 44 individual telephone interviews, as well as 42 online Qualtrics surveys resulted in a total of 86 (33 male) individuals comprising intervention clients. Clients included children and young people (n = 16), manual workers (n = 7), Black, Asian or Minority Ethnic (n = 19), physical disability (n = 8), learning disability (n = 6), and those from areas of high deprivation (n = 19), as well as Integrated Healthy Lifestyle Service practitioners (n = 11). Results: The study revealed that more resources and support are needed for Black, Asian or Minority Ethnic; manual worker; learning disability; and high-deprivation sub-groups in order to reduce attrition rates. Specifically, a lack of technological equipment and competence of using such equipment was identified as key barriers to initial and sustained attendance among these vulnerable and under-served sub-groups during the COVID-19 lockdown. Conclusion: The pattern of differences in attrition during the COVID-19 lockdown suggests that further research is required to explore how best to ensure online health behaviour change offers are scalable and accessible to all.
Collapse
Affiliation(s)
| | - Carlton Cooke
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - Paul Gately
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| |
Collapse
|
15
|
Hutchesson MJ, Gough C, Müller AM, Short CE, Whatnall MC, Ahmed M, Pearson N, Yin Z, Ashton LM, Maher C, Staiano AE, Mauch CE, DeSmet A, Vandelanotte C. eHealth interventions targeting nutrition, physical activity, sedentary behavior, or obesity in adults: A scoping review of systematic reviews. Obes Rev 2021; 22:e13295. [PMID: 34159684 DOI: 10.1111/obr.13295] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 04/28/2021] [Accepted: 05/05/2021] [Indexed: 12/11/2022]
Abstract
A vast body of evidence regarding eHealth interventions for nutrition, physical activity, sedentary behavior, and obesity exists. This scoping review of systematic reviews aimed to evaluate the current level of evidence in this growing field. Seven electronic databases were searched for systematic reviews published until October 27, 2019. The systematic reviews must have included adult participants only and have evaluated eHealth behavioral interventions with the primary aim of changing nutrition, physical activity, and sedentary behavior or treating or preventing overweight and obesity. One hundred and six systematic reviews, published from 2006 to 2019, were included. Almost all (n = 98) reviews evaluated the efficacy of interventions. Over half (n = 61) included interventions focused on physical activity, followed by treatment of obesity (n = 28), nutrition (n = 22), prevention of obesity (n = 18), and sedentary behavior (n = 6). Many reviews (n = 46) evaluated one type of eHealth intervention only, while 60 included two or more types. Most reviews (n = 67) were rated as being of critically low methodological quality. This scoping review identified an increasing volume of systematic reviews evaluating eHealth interventions. It highlights several evidence gaps (e.g., evaluation of other outcomes, such as reach, engagement, or cost effectiveness), guiding future research efforts in this area.
Collapse
Affiliation(s)
- Melinda J Hutchesson
- School of Health Sciences, College of Health, Medicine and Wellbeing, and Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, New South Wales, Australia
| | - Claire Gough
- Flinders Digital Health Research Centre, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia.,Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | | | - Camille E Short
- Melbourne School of Psychological Sciences and Melbourne School of Health Sciences, Faculty of Dentistry, Medicine and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Megan C Whatnall
- School of Health Sciences, College of Health, Medicine and Wellbeing, and Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, New South Wales, Australia
| | - Mavra Ahmed
- Department of Nutritional Sciences and Joannah and Brian Lawson Centre for Child Nutrition, University of Toronto, Toronto, Ontario, Canada
| | - Nicole Pearson
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia
| | - Zenong Yin
- UT Health San Antonio Graduate School of Biomedical Sciences, University of Texas, San Antonio, Texas, USA
| | - Lee M Ashton
- School of Health Sciences, College of Health, Medicine and Wellbeing, and Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, New South Wales, Australia
| | - Carol Maher
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Amanda E Staiano
- Population and Public Health, Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Chelsea E Mauch
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia.,Nutrition and Health Program, Health & Biosecurity Business Unit, CSIRO, Canberra, ACT, Australia
| | - Ann DeSmet
- Faculty of Psychology and Educational Sciences, Université Libre de Bruxelles, Brussels, Belgium.,Department of Communication Studies, University of Antwerp, Antwerp, Belgium
| | - Corneel Vandelanotte
- Physical Activity Research Group, Appleton Institute, Central Queensland University, Rockhampton, Queensland, Australia
| |
Collapse
|
16
|
Dardier G, Jabot F, Pouliquen F. Can Air Quality Citizen-Sensors Turn into Clean Air Ambassadors? Insights from a Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10046. [PMID: 34639347 PMCID: PMC8508063 DOI: 10.3390/ijerph181910046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 09/12/2021] [Accepted: 09/17/2021] [Indexed: 11/16/2022]
Abstract
While the figure of ambassador is being increasingly called upon in the field of environmental health, its scope remains fuzzy and its success factors have been little studied. This article presents the results of a qualitative study performed over three years on a French citizen-sensor scheme for air quality. The scheme draws on volunteer citizens to measure fine particles by means of micro-sensors. Volunteers are also tasked with raising awareness in their entourage about environmental issues with the aim of changing people's behaviour. We investigated this strategy and sought to identify the conditions that enable citizens to become effective clean air ambassadors. The scheme's intervention logic was first reconstructed and a literature review of similar projects was conducted. Then, three surveys were carried out with the scheme's volunteers. Each survey consisted of an observation of the volunteers' practices and individual interviews (70 in all) in order to understand these citizen-sensors motivations and experiences, and characterize how they fulfilled their role. We concluded that, for citizen sensing, the scope and role of ambassador should be reconsidered insofar as these citizens serve as peer leaders and mediators. In this respect, we try to define the success factors for citizen-sensing-based ambassadors programmes.
Collapse
Affiliation(s)
- Guilhem Dardier
- EHESP, F-35000 Rennes, France; (F.J.); (F.P.)
- Univ Rennes, EHESP, CNRS, ARENES—UMR 6051, F-35000 Rennes, France
| | - Françoise Jabot
- EHESP, F-35000 Rennes, France; (F.J.); (F.P.)
- Univ Rennes, EHESP, CNRS, ARENES—UMR 6051, F-35000 Rennes, France
| | | |
Collapse
|
17
|
Domin A, Spruijt-Metz D, Theisen D, Ouzzahra Y, Vögele C. Smartphone-Based Interventions for Physical Activity Promotion: Scoping Review of the Evidence Over the Last 10 Years. JMIR Mhealth Uhealth 2021; 9:e24308. [PMID: 34287209 PMCID: PMC8339983 DOI: 10.2196/24308] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 02/12/2021] [Accepted: 04/16/2021] [Indexed: 01/19/2023] Open
Abstract
Background Several reviews of mobile health (mHealth) physical activity (PA) interventions suggest their beneficial effects on behavior change in adolescents and adults. Owing to the ubiquitous presence of smartphones, their use in mHealth PA interventions seems obvious; nevertheless, there are gaps in the literature on the evaluation reporting processes and best practices of such interventions. Objective The primary objective of this review is to analyze the development and evaluation trajectory of smartphone-based mHealth PA interventions and to review systematic theory- and evidence-based practices and methods that are implemented along this trajectory. The secondary objective is to identify the range of evidence (both quantitative and qualitative) available on smartphone-based mHealth PA interventions to provide a comprehensive tabular and narrative review of the available literature in terms of its nature, features, and volume. Methods We conducted a scoping review of qualitative and quantitative studies examining smartphone-based PA interventions published between 2008 and 2018. In line with scoping review guidelines, studies were not rejected based on their research design or quality. This review, therefore, includes experimental and descriptive studies, as well as reviews addressing smartphone-based mHealth interventions aimed at promoting PA in all age groups (with a subanalysis conducted for adolescents). Two groups of studies were additionally included: reviews or content analyses of PA trackers and meta-analyses exploring behavior change techniques and their efficacy. Results Included articles (N=148) were categorized into 10 groups: commercial smartphone app content analyses, smartphone-based intervention review studies, activity tracker content analyses, activity tracker review studies, meta-analyses of PA intervention studies, smartphone-based intervention studies, qualitative formative studies, app development descriptive studies, qualitative follow-up studies, and other related articles. Only 24 articles targeted children or adolescents (age range: 5-19 years). There is no agreed evaluation framework or taxonomy to code or report smartphone-based PA interventions. Researchers did not state the coding method, used various evaluation frameworks, or used different versions of behavior change technique taxonomies. In addition, there is no consensus on the best behavior change theory or model that should be used in smartphone-based interventions for PA promotion. Commonly reported systematic practices and methods have been successfully identified. They include PA recommendations, trial designs (randomized controlled trials, experimental trials, and rapid design trials), mixed methods data collection (surveys, questionnaires, interviews, and focus group discussions), scales to assess app quality, and industry-recognized reporting guidelines. Conclusions Smartphone-based mHealth interventions aimed at promoting PA showed promising results for behavior change. Although there is a plethora of published studies on the adult target group, the number of studies and consequently the evidence base for adolescents is limited. Overall, the efficacy of smartphone-based mHealth PA interventions can be considerably improved through a more systematic approach of developing, reporting, and coding of the interventions.
Collapse
Affiliation(s)
- Alex Domin
- Research Group: Self-Regulation and Health, Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Donna Spruijt-Metz
- USC mHealth Collaboratory, Center for Economic and Social Research, University of Southern California, Los Angeles, CA, United States
| | - Daniel Theisen
- ALAN - Maladies Rares Luxembourg, Kockelscheuer, Luxembourg
| | - Yacine Ouzzahra
- Research Support Department, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Claus Vögele
- Research Group: Self-Regulation and Health, Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| |
Collapse
|
18
|
Han M, Rhee SY. Effect of Adherence to Smartphone App Use on the Long-term Effectiveness of Weight Loss in Developing and OECD Countries: Retrospective Cohort Study. JMIR Mhealth Uhealth 2021; 9:e13496. [PMID: 34255708 PMCID: PMC8314148 DOI: 10.2196/13496] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 03/27/2020] [Accepted: 05/17/2021] [Indexed: 02/06/2023] Open
Abstract
Background Globally, 71% of deaths occur due to noncommunicable diseases (NCDs). Poor diet quality and physical activity have a significant impact on NCDs. At present, behavior change interventions using smartphone apps have rapidly increased worldwide to prevent NCDs. However, most previous studies on the use and effectiveness of apps have been conducted in Organization for Economic Co-operation and Development (OECD) countries. As such, relevant research in low-income countries is scarce. Objective This retrospective cohort study aims to investigate the characteristics of adherence to the use of the Noom app. We also aim to compare the effects of using the app on body weight changes over time according to adherence to the use of the app between users in low-income and OECD countries. In addition, the differences in weight loss are compared among users who use the free and paid versions of the app. Methods A secondary data analysis was conducted using repeated measures. The data were collected from users in low-income countries (n=312) and OECD countries (n=8041) who used the app for 12 months. The app provided programs for the self-monitoring of physical activity, dietary intake, and body weight. Descriptive statistics, independent two-tailed t tests, chi-square tests, and linear mixed models were used for the analysis. Results During the first 3 months of using the Noom app, users from OECD countries entered data into the app more frequently; however, users in low-income countries entered data more frequently from 3 months to 12 months. Users in OECD countries consumed significantly more calories than those in low-income countries for 12 months. The body weight of all users significantly decreased over time (−1.8 kg; P<.001); however, no statistically significant differences in the change in body weight for 12 months were observed between users from low-income and OECD countries (β=−.2; P=.19). The users who frequently monitored their lunch (β=−.1; P<.001), dinner (β=−.1; P<.001), body weight (β=−.1; P<.001), evening snack (β=−.1; P<.001), and exercise (β=−.03; P<.001) exhibited significant weight loss over time. We found no significant differences in the body weight changes between users who used the free and paid versions of the app (β=−.2; P=.19). Conclusions This study found that using the app has a significant effect on weight loss regardless of users’ country of residence. The results of this study suggest that the frequency of monitoring health-related behaviors by entering data into the app plays a pivotal role in losing weight. In conclusion, regardless of where users live and what versions of the app they use, it is important to monitor health-related behaviors by frequently entering data into the app to efficiently lose weight.
Collapse
Affiliation(s)
| | - Sang Youl Rhee
- Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Republic of Korea
| |
Collapse
|
19
|
Syrkiewicz-Świtała M, Detyna B, Sosada N, Detyna J, Świtała R, Bitkowska A, Szkutnik J. Mobile applications and eating habits among women and men – Polish experiences. Biocybern Biomed Eng 2021. [DOI: 10.1016/j.bbe.2021.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
20
|
Stevens N, Cambon L, Alla F. [Innovative transformation of the health system through a preventive transition]. Rev Epidemiol Sante Publique 2021; 69:235-240. [PMID: 34053796 DOI: 10.1016/j.respe.2021.04.138] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 01/14/2021] [Accepted: 04/26/2021] [Indexed: 10/21/2022] Open
Abstract
Given today's evolution of the healthcare system, organizational transformations, technological developments and major challenges, innovation has taken on primordial importance. In this context and with considerable support, many experimentations have taken place. Unfortunately, few have managed to scale up. What results is a congeries of innovations without a future, possibly avoidable squandering of resources, a number of missed opportunities, and the grim prospect of inventor burnout. As regards prevention, innovation is at the heart of an anticipated "preventive transition" of the health system that has yet to achieve operational status. In this article we attempt to redesign the contours of innovation in health, considering it first and foremost in regard to its social utility. We will go on to explore the limitations of innovative practices that delay the arrival of advances in health. Four types of obstacles appear: faulty evaluation; insufficient dialogue between researchers, stakeholders and decision-makers; lack of visibility and, finally, conceptions and perceptions of innovation characterized by tunnel vision. In the concluding section of this paper, we will present several tracks through which the innovation process could be impelled to drive health system transformation. They consist in: (i) incorporating an evaluative and comprehensive research into innovation processes, (ii) elaborating "bottom-up" approaches giving special consideration to innovations instigated by stakeholders and brought to fruition under real-life conditions, (iii) breaking from standardization by thinking from the outset of the adaptability of innovations and, finally, (iv) tying in the experimental approach with a decision-making process.
Collapse
Affiliation(s)
- N Stevens
- Bordeaux Population Health Research Center. UMR 1219 CIC-EC 1401, Université de Bordeaux, Bordeaux, France.
| | - L Cambon
- Bordeaux Population Health Research Center. UMR 1219 CIC-EC 1401, Université de Bordeaux, Bordeaux, France; Chaire de prévention, ISPED, Université de Bordeaux, Bordeaux, France
| | - F Alla
- Bordeaux Population Health Research Center. UMR 1219 CIC-EC 1401, Université de Bordeaux, Bordeaux, France; Département Prévention, CHU, Bordeaux, France
| |
Collapse
|
21
|
Affret A, Luc A, Baumann C, Bergman P, Le Faou AL, Pasquereau A, Arwidson P, Alla F, Cambon L. Effectiveness of the e-Tabac Info Service application for smoking cessation: a pragmatic randomised controlled trial. BMJ Open 2020; 10:e039515. [PMID: 33109670 PMCID: PMC7592285 DOI: 10.1136/bmjopen-2020-039515] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To compare the effectiveness of the mobile e-Tabac Info Service (e-TIS) application (app) for helping adult smokers quit smoking with current practices. DESIGN Pragmatic randomised controlled trial with a 1-year follow-up (2017-2018). SETTING France, population-wide level. PARTICIPANTS 2806 adult smokers who wished to quit smoking were recruited via the website of the French National Mandatory Health Insurance fund. Of them, 1400 were randomised to the e-TIS app arm and 1406 were randomised to the current practices arm (control). INTERVENTION The app involved personalised interactive contacts that included questionnaires, advice, activities and text messages. All contacts were individually tailored and based on each smoker's progress.In the control group, recommended practices for quitting smoking were described on a non-interactive website. PRIMARY AND SECONDARY OUTCOMES MEASURES The primary outcome was 7-day point prevalence abstinence (PPA) at 6 months. The secondary outcomes included continuous abstinence rates at 6 and 12 months, minimum 24-hour point abstinence at 3 months, minimum 30-day point abstinence at 12 months and number and duration of quit attempts. RESULTS There was no difference between the e-TIS and control arms for the primary outcome (12.6% vs 13.7% for 7-day PPA at 6 months, p=0.3949, intention-to-treat analysis). However, e-TIS participants with high levels of exposure to the app, which was defined by the completion of at least eight activities or questionnaires, showed higher rates of smoking cessation than the control participants (17.6% vs 12.9% for 7-day PPA at 6 months, p=0.0169, per-protocol analysis). CONCLUSION Use of the e-TIS app was not associated with a higher rate of smoking cessation. However, high level of exposure to the e-TIS app may have been more effective than current practices. TRIAL REGISTRATION NUMBER NCT02841683.
Collapse
Affiliation(s)
- Aurélie Affret
- Population Health Research Center, UMR 1219, CIC-EC 1401, Université Bordeaux, Bordeaux, Nouvelle Aquitaine, France
| | | | | | - Pierre Bergman
- Caisse nationale de l'assurance maladie, Paris, Île-de-France, France
| | | | | | | | - François Alla
- Population Health Research Center, UMR 1219, CIC-EC 1401, Université Bordeaux, Bordeaux, Nouvelle Aquitaine, France
| | - Linda Cambon
- Population Health Research Center, UMR 1219, CIC-EC 1401, Université Bordeaux, Bordeaux, Nouvelle Aquitaine, France
| |
Collapse
|
22
|
Chehade MJ, Yadav L, Jayatilaka A, Gill TK, Palmer E. Personal digital health hubs for multiple conditions. Bull World Health Organ 2020; 98:569-575. [PMID: 32773902 PMCID: PMC7411320 DOI: 10.2471/blt.19.249136] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 05/08/2020] [Accepted: 05/11/2020] [Indexed: 12/16/2022] Open
Abstract
Multimorbidity is the presence of more than one chronic disease condition in an individual. Health-related, socioeconomic, cultural and environmental factors, as well as patient behaviour, all influence the outcomes of multimorbidity. Addressing these complex and often interacting biopsychosocial factors therefore requires a shift in treatment from a physical damage model towards person-centred integrated care with increased patient agency. Education influences behaviour and can be used to empower patients and their carers with greater agency, thus allowing greater responsibility for and control over the management of patient care. In this paper we reflect on our own learning as a community of health practitioners from different disciplines. Recognizing the increasing importance of patient agency in driving the evolution of health care, we describe the concept of a web-based personal digital health hub for integrated patient care. Informed by collaboration between patient, health and education communities, we share our early experience in the implementation of a health hub around a cohort of patients with hip fractures. We also describe a vision for future health care based on the co-creation of digital health hubs centred on patients' and carers' needs. The health hub could allow important advances and efficiencies to be achieved in workforce practice and education; patient and carer engagement in self-care; and the collection of patient-reported health data required for ongoing research and improvements in health care.
Collapse
Affiliation(s)
- Mellick J Chehade
- Discipline of Orthopaedics & Trauma, University of Adelaide, Level 5G 584, Royal Adelaide Hospital, Port Road Adelaide, South Australia, Australia 5000
| | - Lalit Yadav
- Discipline of Orthopaedics & Trauma, University of Adelaide, Level 5G 584, Royal Adelaide Hospital, Port Road Adelaide, South Australia, Australia 5000
| | - Asangi Jayatilaka
- School of Computer Science, University of Adelaide, Adelaide, Australia
| | - Tiffany K Gill
- Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Edward Palmer
- School of Education, Faculty of Arts, University of Adelaide, Adelaide, Australia
| |
Collapse
|
23
|
Eysenbach G, Zanini C, Amann J, Scheel-Sailer A, Brach M, Stucki G, Rubinelli S. Selecting Evidence-Based Content for Inclusion in Self-Management Apps for Pressure Injuries in Individuals With Spinal Cord Injury: Participatory Design Study. JMIR Mhealth Uhealth 2020; 8:e15818. [PMID: 32432559 PMCID: PMC7270844 DOI: 10.2196/15818] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 03/17/2020] [Accepted: 03/25/2020] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Technological solutions, particularly mobile health (mHealth), have been shown to be potentially viable approaches for sustaining individuals' self-management of chronic health conditions. Theory-based interventions are more successful, as evidence-based information is an essential prerequisite for appropriate self-management. However, several reviews have shown that many existing mobile apps fail to be either theoretically grounded or based on evidence. Although some authors have attempted to address these two issues by focusing on the design and development processes of apps, concrete efforts to systematically select evidence-based content are scant. OBJECTIVE The objective of this study was to present a procedure for the participatory identification of evidence-based content to ground the development of a self-management app. METHODS To illustrate the procedure, we focused on the prevention and management of pressure injuries (PIs) in individuals with spinal cord injury (SCI). The procedure involves the following three steps: (1) identification of existing evidence through review and synthesis of existing recommendations on the prevention and self-management of PIs in SCI; (2) a consensus meeting with experts from the field of SCI and individuals with SCI to select the recommendations that are relevant and applicable to community-dwelling individuals in their daily lives; and (3) consolidation of the results of the study. RESULTS In this case study, at the end of the three-step procedure, the content for an mHealth intervention was selected in the form of 98 recommendations. CONCLUSIONS This study describes a procedure for the participatory identification and selection of disease-specific evidence and professional best practices to inform self-management interventions. This procedure might be especially useful in cases of complex chronic health conditions, as every recommendation in these cases needs to be evaluated and considered in light of all other self-management requirements. Hence, the agreement of experts and affected individuals is essential to ensure the selection of evidence-based content that is considered to be relevant and applicable.
Collapse
Affiliation(s)
| | - Claudia Zanini
- Swiss Paraplegic Research, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Julia Amann
- Swiss Paraplegic Research, Nottwil, Switzerland.,Department of Health Sciences and Technology, Health Ethics and Policy Lab, ETH Zürich, Zürich, Switzerland
| | - Anke Scheel-Sailer
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.,Swiss Paraplegic Centre, Nottwil, Switzerland
| | - Mirjam Brach
- Swiss Paraplegic Research, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Gerold Stucki
- Swiss Paraplegic Research, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Sara Rubinelli
- Swiss Paraplegic Research, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| |
Collapse
|
24
|
Peels DA, Verboon P, van Stralen MM, Bolman C, Golsteijn RHJ, Mudde AN, de Vries H, Lechner L. Motivational factors for initiating and maintaining physical activity among adults aged over fifty targeted by a tailored intervention. Psychol Health 2020; 35:1184-1206. [PMID: 32133871 DOI: 10.1080/08870446.2020.1734202] [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: 10/24/2022]
Abstract
Objective: To provide insight into the motivational working mechanisms (i.e. mediators) of an effective physical activity (PA) intervention for adults aged over fifty.Design: The mediation model (N = 822) was investigated in an RCT for the total intervention population, participants who were not norm-active at baseline (targeting PA initiation) and norm-active participants (targeting PA maintenance) separately.Main Outcome Measures: Potential mediators (attitude, self-efficacy, intention, action planning and coping planning) of the effect on PA (6-months) were assessed at baseline, 3 and/or 6 months.Results: The intervention resulted in a decrease in intention (B= -.209; p=.017), and an increase in action planning (B=.214; p=.018) and PA (B=.220; p=.002). Intention and action planning did not mediate the effect on PA. Self-efficacy, although not significantly influenced by the intervention, was found to be the only motivational variable that predicted change in PA (B=.164; p=.007). These results were confirmed among participants initiating PA. Among norm-active participants no significant intervention effects were identified.Conclusion: The motivational factors cannot explain the intervention effect on PA. Most likely, the effect can be explained by an interaction between the motivational factors together. Differences between participants initiating versus maintaining PA, highlight the importance of performing mediation analyses per subgroup.
Collapse
Affiliation(s)
| | - Peter Verboon
- Department of Psychology, Open University, Heerlen, Netherlands
| | - Maartje M van Stralen
- Faculty of Science, Prevention and Public Health, Amsterdam Public Health Research Institute, VU University, Amsterdam, Netherlands
| | | | | | - Aart N Mudde
- Department of Psychology, Open University, Heerlen, Netherlands
| | - Hein de Vries
- Department of Health Promotion, Maastricht University Medical Centre+, Maastricht, Netherlands.,Care and Public Health Research Institute (Caphri), Maastricht University Medical Centre+, Maastricht, Netherlands
| | - Lilian Lechner
- Department of Psychology, Open University, Heerlen, Netherlands
| |
Collapse
|