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Breitenstein SM, Berteletti J, Smoske S, Barger C, Tipps K, Helsabeck NP. Administrative Dashboard for Monitoring Use of a Web-Based Parent Training Intervention: Usability Study. JMIR Form Res 2024; 8:e53439. [PMID: 38289675 PMCID: PMC10865193 DOI: 10.2196/53439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 12/14/2023] [Accepted: 01/03/2024] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND Web-based parent training (PT) programs can strengthen parent-child relationships by equipping caregivers with knowledge and evidence-based strategies to manage behavior. Hybrid facilitation of PT includes facilitator interaction paired with self-administered and web-based PT. Web-based administrative dashboards provide users (eg, administrators, facilitators, and researchers) with an integrated platform to monitor parent progress and activities within a PT program or website. Despite the utility and prevalence of administrative dashboards for web-based behavioral interventions, to our knowledge, no research studies have explored the perspectives and insights of dashboard users to enhance user experience and program delivery. OBJECTIVE The purpose of this study is to evaluate the usability of the administrative dashboard (ezDashboard) for the ezParent program, a 6-module web-based PT program for parents of children aged 2-5 years. METHODS This study used a descriptive, single-group design with administrators who were overseeing the implementation of the ezParent program and trained facilitators for hybrid ezParent delivery. Participants spent at least 30 minutes reviewing and evaluating the ezDashboard and then completed a survey of their experience with the dashboard. The survey included the validated 10-item System Usability Scale and open-ended questions focusing on user performance, navigation ease, and overall usefulness of the ezDashboard. RESULTS Participants (N=15) indicated high usability of the ezDashboard with System Usability Scale scoring a total mean score of 83.5 (SD 16.3). Most participants (n=13, 87%) rated the overall user-friendliness of the ezDashboard as good (n=3, 20%), excellent (n=9, 60%), or best imaginable (n=1, 7%). Open-ended questions revealed the ezDashboard is or would be useful to monitor parent progress and trends in engagement (n=8, 53%) and for reviewing topics for discussion and communicating with parents (n=5, 33%). ezParent administrators (n=4) identified that real-time data for ezParent use helps overall management of program uptake. Suggestions for features to add to the ezDashboard included the ability to track partial progress of program modules (4/14, 29%), total time spent per module (2/14, 14%), and exportable reports (4/14, 29%). Other ideas for improvement included direct messaging capabilities, videoconferencing platform integration, and being able to modify participant account and contact information. CONCLUSIONS Results indicate that the ezDashboard is easy to use and provides functional information to facilitators and administrators in delivering ezParent. Qualitative results indicate that integrating suggested features into the ezDashboard may help provide a smoother experience for facilitators, administrators, and ultimately the parents using the program. Providing resources for facilitators and administrators in real time to monitor intervention participants' progress in a program can be helpful in tracking progress and providing facilitated support in tailoring program content and program completion.
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Affiliation(s)
| | | | - Shea Smoske
- College of Nursing, The Ohio State University, Columbus, OH, United States
| | | | - Kyrie Tipps
- College of Nursing, The Ohio State University, Columbus, OH, United States
| | - Nathan P Helsabeck
- College of Nursing, The Ohio State University, Columbus, OH, United States
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Internet-based parenting intervention: A systematic review. Heliyon 2023; 9:e14671. [PMID: 37020942 PMCID: PMC10068123 DOI: 10.1016/j.heliyon.2023.e14671] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 03/04/2023] [Accepted: 03/14/2023] [Indexed: 03/22/2023] Open
Abstract
Digital technology has become an essential part of people's lives, and the Internet's innovation made it easier for humans to carry out activities. This systematic review aims to examine parenting with a specific internet-based intervention designed to help them gain information about child-rearing. Specifically, it analyses: 1) how the internet-based parenting intervention is studied, 2) how was the study of an internet-based parenting intervention done, and 3) what themes emerged from the systematic review. The finding suggests that most internet-based parenting interventions use transmitting information techniques visually, as the content is displayed through exciting and informative content. Four themes emerged from the thematic analysis: technology-assisted parenting programs, parenting interventions as support for mothers, professional support online, and improved parenting skills. Positive responses from parents as users show that this online parenting intervention can meet their needs and has the potential to continue to be developed. The literature is quite limited regarding assessing internet-based parenting intervention in early childhood education and developmental psychology. Because of that, further research to develop internet-based parenting interventions becomes essential to give parenting professional support.
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Tenfelde K, Antheunis M, Krahmer E, Bunt JE. Using Digital Communication Technology to Improve Neonatal Care: Two-Part Explorative Needs Assessment. JMIR Pediatr Parent 2023; 6:e38435. [PMID: 36749606 PMCID: PMC9944133 DOI: 10.2196/38435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 09/23/2022] [Accepted: 10/17/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The birth of a premature infant and subsequent hospitalization are stressful events for parents. Therefore, accurate and easy-to-understand communication between parents and health care professionals is crucial during this period. Mobile health (mHealth) technologies have the potential to improve communication with parents at any time and place and possibly reduce their stress. OBJECTIVE We aimed to conduct a 2-part explorative needs assessment in which the interaction between the pediatrician and parents was examined along with their digital communication technology needs and interest in an mHealth app with the aim of improving interpersonal communication and information exchange. METHODS Overall, 19 consultations between parents of preterm infants and pediatricians were observed to determine which themes are discussed the most and the number of questions asked. Afterward, the parents and the pediatrician were interviewed to evaluate the process of communication and gauge their ideas about a neonatal communication mHealth app. RESULTS The observations revealed the following most prevalent themes: breastfeeding, criteria for discharge, medication, and parents' personal life. Interview data showed that the parents were satisfied with the communication with their pediatrician. Furthermore, both parents and pediatricians expected that a neonatal mHealth app could further improve the communication process and the hospital stay. Parents valued app features such as asking questions, growth graphs, a diary function, hospital-specific information, and medical rounds reports. CONCLUSIONS Both parents of hospitalized preterm infants and pediatricians expect that the hypothetical mHealth app has the potential to cater to the most prevalent themes and improve communication and information exchange. Recommendations for developing such an app and its possible features are also discussed. On the basis of these promising results, it is suggested to further develop and study the effects of the mHealth app together with all stakeholders.
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Affiliation(s)
- Kim Tenfelde
- Department of Communication and Cognition, Tilburg University, Tilburg, Netherlands
| | - Marjolijn Antheunis
- Department of Communication and Cognition, Tilburg University, Tilburg, Netherlands
| | - Emiel Krahmer
- Department of Communication and Cognition, Tilburg University, Tilburg, Netherlands
| | - Jan Erik Bunt
- Department of Pediatrics, Elisabeth-Tweesteden Ziekenhuis, Tilburg, Netherlands
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Novick AM, Kwitowski M, Dempsey J, Cooke DL, Dempsey AG. Technology-Based Approaches for Supporting Perinatal Mental Health. Curr Psychiatry Rep 2022; 24:419-429. [PMID: 35870062 PMCID: PMC9307714 DOI: 10.1007/s11920-022-01349-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/14/2022] [Indexed: 11/21/2022]
Abstract
PURPOSE OF REVIEW This review explores advances in the utilization of technology to address perinatal mood and anxiety disorders (PMADs). Specifically, we sought to assess the range of technologies available, their application to PMADs, and evidence supporting use. RECENT FINDINGS We identified a variety of technologies with promising capacity for direct intervention, prevention, and augmentation of clinical care for PMADs. These included wearable technology, electronic consultation, virtual and augmented reality, internet-based cognitive behavioral therapy, and predictive analytics using machine learning. Available evidence for these technologies in PMADs was almost uniformly positive. However, evidence for use in PMADs was limited compared to that in general mental health populations. Proper attention to PMADs has been severely limited by issues of accessibility, affordability, and patient acceptance. Increased use of technology has the potential to address all three of these barriers by facilitating modes of communication, data collection, and patient experience.
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Affiliation(s)
- Andrew M Novick
- Department of Psychiatry, University of Colorado School of Medicine, 1890 N Revere Ct, MS F546, Aurora, CO, 80045, USA
| | - Melissa Kwitowski
- Department of Psychiatry, University of Colorado School of Medicine, 1890 N Revere Ct, MS F546, Aurora, CO, 80045, USA
| | - Jack Dempsey
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
| | - Danielle L Cooke
- Department of Psychiatry, University of Colorado School of Medicine, 1890 N Revere Ct, MS F546, Aurora, CO, 80045, USA
| | - Allison G Dempsey
- Department of Psychiatry, University of Colorado School of Medicine, 1890 N Revere Ct, MS F546, Aurora, CO, 80045, USA.
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Donkin L, Merry S, Moor S, Mowat A, Hetrick S, Hopkins S, Seers K, Frampton C, D'Aeth L. Effectiveness of a digital parenting program to improve parental well-being after the Christchurch earthquakes: a cluster-randomized trial (Preprint). JMIR Form Res 2022; 7:e37839. [PMID: 37103986 PMCID: PMC10176136 DOI: 10.2196/37839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 09/13/2022] [Accepted: 11/03/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Up to 6 years after the 2011 Christchurch earthquakes, approximately one-third of parents in the Christchurch region reported difficulties managing the continuously high levels of distress their children were experiencing. In response, an app named Kākano was co-designed with parents to help them better support their children's mental health. OBJECTIVE The objective of this study was to evaluate the acceptability, feasibility, and effectiveness of Kākano, a mobile parenting app to increase parental confidence in supporting children struggling with their mental health. METHODS A cluster-randomized delayed access controlled trial was carried out in the Christchurch region between July 2019 and January 2020. Parents were recruited through schools and block randomized to receive immediate or delayed access to Kākano. Participants were given access to the Kākano app for 4 weeks and encouraged to use it weekly. Web-based pre- and postintervention measurements were undertaken. RESULTS A total of 231 participants enrolled in the Kākano trial, with 205 (88.7%) participants completing baseline measures and being randomized (101 in the intervention group and 104 in the delayed access control group). Of these, 41 (20%) provided full outcome data, of which 19 (18.2%) were for delayed access and 21 (20.8%) were for the immediate Kākano intervention. Among those retained in the trial, there was a significant difference in the mean change between groups favoring Kākano in the brief parenting assessment (F1,39=7, P=.012) but not in the Short Warwick-Edinburgh Mental Well-being Scale (F1,39=2.9, P=.099), parenting self-efficacy (F1,39=0.1, P=.805), family cohesion (F1,39=0.4, P=.538), or parenting sense of confidence (F1,40=0.6, P=.457). Waitlisted participants who completed the app after the waitlist period showed similar trends for the outcome measures with significant changes in the brief assessment of parenting and the Short Warwick-Edinburgh Mental Well-being Scale. No relationship between the level of app usage and outcome was found. Although the app was designed with parents, the low rate of completion of the trial was disappointing. CONCLUSIONS Kākano is an app co-designed with parents to help manage their children's mental health. There was a high rate of attrition, as is often seen in digital health interventions. However, for those who did complete the intervention, there was some indication of improved parental well-being and self-assessed parenting. Preliminary indications from this trial show that Kākano has promising acceptability, feasibility, and effectiveness, but further investigation is warranted. TRIAL REGISTRATION Australia New Zealand Clinical Trials Registry ACTRN12619001040156; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377824&isReview=true.
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Affiliation(s)
- Liesje Donkin
- Department of Psychological Medicine, School of Medicine, Faculty of Medical and Health Sciences, Waipapa Taumata Rau, The University of Auckland, Auckland, New Zealand
- Auckland University of Technology, Auckland, New Zealand
| | - Sally Merry
- Department of Psychological Medicine, School of Medicine, Faculty of Medical and Health Sciences, Waipapa Taumata Rau, The University of Auckland, Auckland, New Zealand
| | - Stephanie Moor
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | | | - Sarah Hetrick
- Department of Psychological Medicine, School of Medicine, Faculty of Medical and Health Sciences, Waipapa Taumata Rau, The University of Auckland, Auckland, New Zealand
- A Better Start: E Tipu e Rea National Science Challenge, Wellington, New Zealand
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Sarah Hopkins
- Department of Psychological Medicine, School of Medicine, Faculty of Medical and Health Sciences, Waipapa Taumata Rau, The University of Auckland, Auckland, New Zealand
| | - Kara Seers
- The National Public Health Service (Te Mana Ora), Te Whatu Ora, Christchurch, New Zealand
| | - Chris Frampton
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Lucy D'Aeth
- The National Public Health Service (Te Mana Ora), Te Whatu Ora, Christchurch, New Zealand
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Dol J, Richardson B, Murphy GT, Aston M, McMillan D, Campbell-Yeo M. Impact of mobile health interventions during the perinatal period on maternal psychosocial outcomes: a systematic review. JBI Evid Synth 2021; 18:30-55. [PMID: 31972680 DOI: 10.11124/jbisrir-d-19-00191] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The objective of this review was to evaluate the effectiveness of mother-targeted mobile health (mHealth) education interventions during the perinatal period on maternal psychosocial outcomes in high-income countries. INTRODUCTION The perinatal period is an exciting yet challenging period for mothers that requires physical, emotional and social adjustment to new norms and expectations. In recent years, there has been an increase in the use of mHealth by new mothers who are seeking health information through online or mobile applications. While there have been systematic reviews on the impact of mHealth interventions on maternal and newborn health in low- and middle-income countries, the impact of these interventions on maternal psychosocial health outcomes in high-income countries remains uncertain. INCLUSION CRITERIA This review considered studies of mHealth education interventions targeting mothers in high-income countries (as defined by the World Bank) during the perinatal period. Interventions must have started between the antenatal period (conception through birth) through six weeks postpartum. All experimental study designs were included. Outcomes included self-efficacy, social support, postpartum anxiety and postpartum depression. METHODS PubMed, CINAHL, PsycINFO and Embase were searched for published studies in English on December 16, 2018. Gray literature was also searched for non-peer reviewed articles, including Google Scholar, mHealth intelligence and clinical trials databases. Critical appraisal was undertaken by two independent reviewers using standardized critical appraisal instruments from JBI. Quantitative data were extracted from included studies independently by two reviewers using the standardized data extraction tool from JBI. All conflicts were solved through consensus with a third reviewer. Quantitative data were, where possible, pooled in statistical meta-analysis using RevMan. Where statistical pooling was not possible, findings were reported narratively. RESULTS Of the 1,607 unique articles identified, 106 full-text papers were screened and 24 articles were critically appraised, with 21 included in the final review. Eleven were quasi-experimental and 10 were randomized controlled trials. The mHealth intervention approach varied, with text message and mobile applications being the most common. Length of intervention ranged from four weeks to six months. The topics of the mHealth intervention varied widely, with the most common topic being postpartum depression. Mothers who received an mHealth intervention targeting postpartum depression showed a decreased score on the Edinburgh Postnatal Depression Scale when measured post-intervention (odds ratio = -6.01, 95% confidence interval = -8.34 to -3.67, p < 0.00001). The outcomes related to self-efficacy, social support and anxiety showed mixed findings of effectiveness (beneficial and no change) across the studies identified. CONCLUSIONS This review provides insight into the effectiveness of mHealth interventions targeting mothers in high-income countries in the perinatal period to enhance four psychosocial outcomes: self-efficacy, social support, anxiety and depression. Despite a wide variety of outcome measurements used, the predominant findings suggest that there are insufficient data to conclude that mHealth interventions can improve self-efficacy and anxiety outcomes. Potential benefits on social support were related to interventions targeting postnatal behaviors. Postpartum depression was the mostly commonly reported outcome. Findings related to the comparison of pre-post outcomes and intervention versus control demonstrated that mHealth interventions targeting postpartum depression were associated with a reduction in postpartum depression.
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Affiliation(s)
- Justine Dol
- Faculty of Health, Dalhousie University, Halifax, Canada.,Aligning Health Needs and Evidence for Transformative Change (AH-NET-C): A Joanna Briggs Institute Centre of Excellence.,World Health Organization/Pan American Health Organization (WHO/PAHO) Collaborating Centre on Health Workforce Planning and Research, Dalhousie University, Halifax, Canada
| | - Brianna Richardson
- Aligning Health Needs and Evidence for Transformative Change (AH-NET-C): A Joanna Briggs Institute Centre of Excellence.,School of Nursing, Faculty of Health, Dalhousie University, Halifax, Canada
| | - Gail Tomblin Murphy
- World Health Organization/Pan American Health Organization (WHO/PAHO) Collaborating Centre on Health Workforce Planning and Research, Dalhousie University, Halifax, Canada.,Nova Scotia Health Authority, Halifax, Canada
| | - Megan Aston
- Aligning Health Needs and Evidence for Transformative Change (AH-NET-C): A Joanna Briggs Institute Centre of Excellence.,School of Nursing, Faculty of Health, Dalhousie University, Halifax, Canada
| | - Douglas McMillan
- Division of Neonatal Perinatal Medicine, Department of Pediatrics, Faculty of Medicine, Dalhousie University and IWK Health Centre, Halifax, Canada
| | - Marsha Campbell-Yeo
- Aligning Health Needs and Evidence for Transformative Change (AH-NET-C): A Joanna Briggs Institute Centre of Excellence.,World Health Organization/Pan American Health Organization (WHO/PAHO) Collaborating Centre on Health Workforce Planning and Research, Dalhousie University, Halifax, Canada.,School of Nursing, Faculty of Health, Dalhousie University, Halifax, Canada.,Division of Neonatal Perinatal Medicine, Department of Pediatrics, Faculty of Medicine, Dalhousie University and IWK Health Centre, Halifax, Canada
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Seo JM, Kim SJ, Na H, Kim JH, Lee H. The Development of the Postpartum Depression Self-Management Mobile Application "Happy Mother". Comput Inform Nurs 2021; 39:439-449. [PMID: 33814539 DOI: 10.1097/cin.0000000000000738] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Postpartum depression is the most common mood disorder that occurs after childbirth, rendering it a significant public health problem. Information and communication technologies hold tremendous promise for expanding the reach of quality mental healthcare and closing the treatment gap for depression. In particular, given that mobile applications are inexpensive and provide information systematically, they are suitable as a method of health management that does not require visiting a medical center. The purposes of this study were to document the process of developing a mobile application for the self-management of postpartum depression and to share usability test results. The mobile application "Happy Mother" was developed based on the first five of seven stages in the mobile application development lifecycle model. Components of cognitive behavioral therapy were adopted to guide content development for "Happy Mother." The usability of the completed mobile application was tested in the following three steps: it increased awareness of mood, promoted self-management, and implemented specific methods a mother can use in her daily life to improve mood, including modifications made based on the results of the usability test.
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Affiliation(s)
- Ji Min Seo
- Author Affiliations: College of Nursing, Pusan National University, Yangsan (Dr Seo, Ms Kim, and Ms Lee); College of Nursing, The Catholic University of Korea, Seoul (Dr Na), South Korea
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Samadbeik M, Garavand A, Kordi M, Abtin A, Asadi H. Factors Affecting the Acceptance of Mobile Health by Medical Sciences Students: A Cross-Sectional Study. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2021; 25:476-481. [PMID: 33747836 PMCID: PMC7968586 DOI: 10.4103/ijnmr.ijnmr_49_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Revised: 05/19/2020] [Accepted: 06/08/2020] [Indexed: 11/21/2022]
Abstract
Background: The use of mobile health has a pivotal role in the prevention and treatment of many diseases. This study aimed at determining the affecting factors in acceptance of mobile health by using a modified acceptance model, among medical sciences students in the south-west of Iran. Materials and Methods: This cross-sectional, analytical study was conducted in 2017. The research population included all the students of Lorestan University of Medical Sciences (LUMS). The 352 of students selected as the samples of study through a stratified sampling method. Data gathering was done through a valid and reliable questionnaire. The data was analyzed using Linear Structural Relations (LISREL) and Statistical Package for the Social Sciences (SPSS) software. Results: The findings showed that perceived usefulness (t7, 38= 2.16, p = 0.03), performance expectancy (t7, 70= 3.18, p = 0.01), facilitating conditions (t10, 61= 4.17, p < 0.001), and attitude to use (t7, 14= 5.49, p < 0.001) were effective in the behavior intention of mobile health. Moreover, the results showed that the behavior intention of mobile health applications (t10, 77= 8.10, p < 0.001) is effective on its user behavior. Conclusions: The results of our study showed that perceived usefulness, performance expectancy, facilitating conditions, and attitude to use of technology were the affecting factors in the acceptance of mobile health by the students. It is suggested that the policymakers and authorities comprehensively consider these important factors when introducing new technologies.
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Affiliation(s)
- Mahnaz Samadbeik
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Ali Garavand
- Health Management and Information, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Marzieh Kordi
- Department of Health Information Technology, School of Allied Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Atefeh Abtin
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
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Weber JC, Sohn K, Sauers-Ford HS, Hanhauser A, Tancredi DJ, Marcin JP, Hoffman KR. Impact of a Parent Video Viewing Program in the Neonatal Intensive Care Unit. Telemed J E Health 2020; 27:679-685. [PMID: 32985954 DOI: 10.1089/tmj.2020.0251] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: Video visits, or televisits, have become increasingly popular across various medical subspecialties. Within the University of California, Davis, Neonatal Intensive Care Unit, a video visitation program known as FamilyLink allows families to remotely view their babies when they are otherwise unable to visit. This study aimed to explore parents' perceived effects of video camera use as well as the relationship of video visit use with rates of breast milk feedings at hospital discharge. Materials and Methods: Families enrolled in this study completed a series of two identical surveys that gathered self-reported data on their experiences during their infant's hospitalization. Comparisons were made considering whether the FamilyLink program was utilized during the admission as well as changes in self-reported experiences over the time course of the hospital admission. The type of enteral feeding at discharge was recorded and reviewed for each baby. Results: Of 100 families enrolled in the study, 30 were found to have used FamilyLink to visit with their baby. The use of FamilyLink was associated with survey findings of sustained intention to breastfeed or provide breast milk to the baby, as well as increased perceived parental involvement in the baby's care. Improved rates of breast milk feedings at the time of discharge were also found among babies whose families conducted televisits using FamilyLink. Conclusions: Video viewing in the NICU has effected a positive impact on breast milk feedings and parents' feelings of involvement during the admission, with the potential to further improve on families' experiences with a hospitalized baby.
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Affiliation(s)
- Jennifer C Weber
- Department of Pediatrics, UC Davis Health, Sacramento, California, USA
| | - Kristin Sohn
- Department of Pediatrics, UC Davis Health, Sacramento, California, USA
| | | | - Ashley Hanhauser
- Department of Biological Sciences, University of California, Davis, Davis, California, USA
| | - Daniel J Tancredi
- Department of Pediatrics, UC Davis Health, Sacramento, California, USA
| | - James P Marcin
- Department of Pediatrics, UC Davis Health, Sacramento, California, USA
| | - Kristin R Hoffman
- Department of Pediatrics, UC Davis Health, Sacramento, California, USA
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Palmer MJ, Henschke N, Bergman H, Villanueva G, Maayan N, Tamrat T, Mehl GL, Glenton C, Lewin S, Fønhus MS, Free C. Targeted client communication via mobile devices for improving maternal, neonatal, and child health. Cochrane Database Syst Rev 2020; 8:CD013679. [PMID: 32813276 PMCID: PMC8477611 DOI: 10.1002/14651858.cd013679] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND The global burden of poor maternal, neonatal, and child health (MNCH) accounts for more than a quarter of healthy years of life lost worldwide. Targeted client communication (TCC) via mobile devices (MD) (TCCMD) may be a useful strategy to improve MNCH. OBJECTIVES To assess the effects of TCC via MD on health behaviour, service use, health, and well-being for MNCH. SEARCH METHODS In July/August 2017, we searched five databases including The Cochrane Central Register of Controlled Trials, MEDLINE and Embase. We also searched two trial registries. A search update was carried out in July 2019 and potentially relevant studies are awaiting classification. SELECTION CRITERIA We included randomised controlled trials that assessed TCC via MD to improve MNCH behaviour, service use, health, and well-being. Eligible comparators were usual care/no intervention, non-digital TCC, and digital non-targeted client communication. DATA COLLECTION AND ANALYSIS We used standard methodological procedures recommended by Cochrane, although data extraction and risk of bias assessments were carried out by one person only and cross-checked by a second. MAIN RESULTS We included 27 trials (17,463 participants). Trial populations were: pregnant and postpartum women (11 trials conducted in low-, middle- or high-income countries (LMHIC); pregnant and postpartum women living with HIV (three trials carried out in one lower middle-income country); and parents of children under the age of five years (13 trials conducted in LMHIC). Most interventions (18) were delivered via text messages alone, one was delivered through voice calls only, and the rest were delivered through combinations of different communication channels, such as multimedia messages and voice calls. Pregnant and postpartum women TCCMD versus standard care For behaviours, TCCMD may increase exclusive breastfeeding in settings where rates of exclusive breastfeeding are less common (risk ratio (RR) 1.30, 95% confidence intervals (CI) 1.06 to 1.59; low-certainty evidence), but have little or no effect in settings where almost all women breastfeed (low-certainty evidence). For use of health services, TCCMD may increase antenatal appointment attendance (odds ratio (OR) 1.54, 95% CI 0.80 to 2.96; low-certainty evidence); however, the CI encompasses both benefit and harm. The intervention may increase skilled attendants at birth in settings where a lack of skilled attendants at birth is common (though this differed by urban/rural residence), but may make no difference in settings where almost all women already have a skilled attendant at birth (OR 1.00, 95% CI 0.34 to 2.94; low-certainty evidence). There were uncertain effects on maternal and neonatal mortality and morbidity because the certainty of the evidence was assessed as very low. TCCMD versus non-digital TCC (e.g. pamphlets) TCCMD may have little or no effect on exclusive breastfeeding (RR 0.92, 95% CI 0.79 to 1.07; low-certainty evidence). TCCMD may reduce 'any maternal health problem' (RR 0.19, 95% CI 0.04 to 0.79) and 'any newborn health problem' (RR 0.52, 95% CI 0.25 to 1.06) reported up to 10 days postpartum (low-certainty evidence), though the CI for the latter includes benefit and harm. The effect on health service use is unknown due to a lack of studies. TCCMD versus digital non-targeted communication No studies reported behavioural, health, or well-being outcomes for this comparison. For use of health services, there are uncertain effects for the presence of a skilled attendant at birth due to very low-certainty evidence, and the intervention may make little or no difference to attendance for antenatal influenza vaccination (RR 1.05, 95% CI 0.71 to 1.58), though the CI encompasses both benefit and harm (low-certainty evidence). Pregnant and postpartum women living with HIV TCCMD versus standard care For behaviours, TCCMD may make little or no difference to maternal and infant adherence to antiretroviral (ARV) therapy (low-certainty evidence). For health service use, TCC mobile telephone reminders may increase use of antenatal care slightly (mean difference (MD) 1.5, 95% CI -0.36 to 3.36; low-certainty evidence). The effect on the proportion of births occurring in a health facility is uncertain due to very low-certainty evidence. For health and well-being outcomes, there was an uncertain intervention effect on neonatal death or stillbirth, and infant HIV due to very low-certainty evidence. No studies reported on maternal mortality or morbidity. TCCMD versus non-digital TCC The effect is unknown due to lack of studies reporting this comparison. TCCMD versus digital non-targeted communication TCCMD may increase infant ARV/prevention of mother-to-child transmission treatment adherence (RR 1.26, 95% CI 1.07 to 1.48; low-certainty evidence). The effect on other outcomes is unknown due to lack of studies. Parents of children aged less than five years No studies reported on correct treatment, nutritional, or health outcomes. TCCMD versus standard care Based on 10 trials, TCCMD may modestly increase health service use (vaccinations and HIV care) (RR 1.21, 95% CI 1.08 to 1.34; low-certainty evidence); however, the effect estimates varied widely between studies. TCCMD versus non-digital TCC TCCMD may increase attendance for vaccinations (RR 1.13, 95% CI 1.00 to 1.28; low-certainty evidence), and may make little or no difference to oral hygiene practices (low-certainty evidence). TCCMD versus digital non-targeted communication TCCMD may reduce attendance for vaccinations, but the CI encompasses both benefit and harm (RR 0.63, 95% CI 0.33 to 1.20; low-certainty evidence). No trials in any population reported data on unintended consequences. AUTHORS' CONCLUSIONS The effect of TCCMD for most outcomes is uncertain. There may be improvements for some outcomes using targeted communication but these findings were of low certainty. High-quality, adequately powered trials and cost-effectiveness analyses are required to reliably ascertain the effects and relative benefits of TCCMD. Future studies should measure potential unintended consequences, such as partner violence or breaches of confidentiality.
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Affiliation(s)
- Melissa J Palmer
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | | | | | | | | | - Tigest Tamrat
- Department of Sexual and Reproductive Health, World Health Organization, Geneva, Switzerland
| | - Garrett L Mehl
- Department of Sexual and Reproductive Health, World Health Organization, Geneva, Switzerland
| | | | - Simon Lewin
- Norwegian Institute of Public Health, Oslo, Norway
- Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
| | | | - Caroline Free
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK
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11
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Fealy S, Chan S, Wynne O, Dowse E, Ebert L, Ho R, Zhang MWB, Jones D. The Support for New Mums Project: A protocol for a pilot randomized controlled trial designed to test a postnatal psychoeducation smartphone application. J Adv Nurs 2019; 75:1347-1359. [PMID: 30740767 DOI: 10.1111/jan.13971] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 11/13/2018] [Accepted: 12/06/2018] [Indexed: 11/30/2022]
Abstract
AIM To report a pilot trial protocol for testing the effectiveness of the Support for New Mums smartphone application in a cohort of first-time mothers. DESIGN A pilot/feasibility randomized controlled trial using a two-group pre-test and repeated post-test design. METHOD This protocol follows the Standard Protocol Items: Recommendations for Intervention Trials (SPIRIT) guidelines. The Intervention group will receive access to the smartphone application for 6 weeks post birth. Both Intervention and control groups will receive standardized institutional postnatal care services. Trial funding was gained from respective grant sponsors in May and November 2016. DISCUSSION The Support for New Mums smartphone application could be a novel method for addressing the gap in provision of postpartum care services providing psychoeducation and improving maternal parental self-efficacy for Australian childbearing women. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12618001580268.
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Affiliation(s)
- Shanna Fealy
- School of Nursing and Midwifery, The University of Newcastle Australia, Callaghan, NSW, Australia.,School of Medicine and Public Health, The University of Newcastle Australia, Callaghan, NSW, Australia.,Priority Research Centre for Health Behaviour, The University of Newcastle Australia, Callaghan, NSW, Australia
| | - Sally Chan
- School of Nursing and Midwifery, The University of Newcastle Australia, Callaghan, NSW, Australia.,Priority Research Centre for Brain & Mental Health, The University of Newcastle Australia, Callaghan, NSW, Australia
| | - Olivia Wynne
- School of Medicine and Public Health, The University of Newcastle Australia, Callaghan, NSW, Australia.,Priority Research Centre for Reproductive Science: Mothers and Babies, University of Newcastle Australia, Callaghan, NSW, Australia
| | - Eileen Dowse
- School of Nursing and Midwifery, The University of Newcastle Australia, Callaghan, NSW, Australia
| | - Lyn Ebert
- School of Nursing and Midwifery, The University of Newcastle Australia, Callaghan, NSW, Australia
| | - Roger Ho
- Department of Psychological Medicine, National University of Singapore, Singapore
| | - Melvyn W B Zhang
- Institute of Mental Health Singapore, National Addictions Management Service, Singapore
| | - Donovan Jones
- School of Nursing and Midwifery, The University of Newcastle Australia, Callaghan, NSW, Australia.,Priority Research Centre for Health Behaviour, The University of Newcastle Australia, Callaghan, NSW, Australia.,Priority Research Centre for Brain & Mental Health, The University of Newcastle Australia, Callaghan, NSW, Australia
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12
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Shorey S, Yang YY, Dennis CL. A Mobile Health App-Based Postnatal Educational Program (Home-but not Alone): Descriptive Qualitative Study. J Med Internet Res 2018; 20:e119. [PMID: 29674314 PMCID: PMC5934535 DOI: 10.2196/jmir.9188] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 01/21/2018] [Accepted: 01/23/2018] [Indexed: 11/21/2022] Open
Abstract
Background The postnatal period poses numerous challenges for new parents. Various educational programs are available to support new parents during this stressful period. However, the usefulness of educational programs must be evaluated to ascertain their credibility. Objective The aim of this descriptive, qualitative study was to explore the views of parents of newborns with regard to the content and delivery of a mobile health (mHealth) app–based postnatal educational program. Methods A qualitative semistructured interview guide was used to collect data from 17 participants who belonged to the intervention group of a randomized controlled trial. The intervention, a 4-week-long access to a mHealth app–based educational program, was evaluated. The interviews were conducted in English and at the participants’ homes. Thematic analysis was used to analyze the data. The Consolidated Criteria for Reporting Qualitative Research checklist was used to report the findings. Results The interviews revealed 4 main themes: (1) positive features of the mHealth app, (2) advice from midwives, (3) experiences gained from using the mHealth app, and (4) recommendations for the future. The participants evaluated the educational program to be a good source of information that was tailored to the local context. The different modes of delivery, including audio and video, accentuated the accessibility of information. The parents evaluated that the facilitator of the featured communication platform, a midwife, provided trustworthy advice. Belongingness to a virtual community beyond the hospital endowed the parents the confidence that they were not alone and were supported by other parents and health care professionals. Conclusions According to the parents, the mHealth app–based educational program was helpful in supporting a multi-ethnic sample of parents during the postnatal period. This insight indicates that the program could be implemented in a wide community of parents in the postnatal period. The helpfulness of the educational program is a testament of the potential benefits of using telemedicine among new parents postnatally. Resources can also be dedicated toward extending the duration of access to the app beyond 1 month and developing relevant content for parents across the perinatal period.
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Affiliation(s)
- Shefaly Shorey
- Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore, Singapore
| | - Yen Yen Yang
- Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore, Singapore
| | - Cindy-Lee Dennis
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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13
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Breitenstein SM, Brager J, Ocampo EV, Fogg L. Engagement and Adherence With ezPARENT, an mHealth Parent-Training Program Promoting Child Well-Being. CHILD MALTREATMENT 2017; 22:295-304. [PMID: 28870112 DOI: 10.1177/1077559517725402] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Mobile health (mHealth) interventions use mobile technology (tablets and smartphones) delivery platforms for interventions to improve health outcomes. Despite growing acceptance, there is little understanding of how consumers engage with and adhere to mHealth interventions. This study analyzes usage data from the intervention arm ( n = 42) of a randomized clinical trial testing the efficacy of the ezPARENT program and provides recommendations for using engagement and adherence metrics. Engagement was measured by parent usage (duration, frequency, and activity) of ezPARENT and adherence using an adherence index (the sum of individual modules completed, number of visits to ezPARENT, and maximum time between visits). Parents spent M = 37.15 min per module and had M = 13.55 program visits in the 3-month intervention period. Parents visited the program over a period of M = 69.5 days and completed 82% of the modules. These data provide support that parents will use intervention programs delivered digitally; engagement and adherence metrics are useful in evaluating program uptake.
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Affiliation(s)
| | - Jenna Brager
- 2 Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | | | - Louis Fogg
- 1 Rush University College of Nursing, Chicago, IL, USA
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14
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Shorey S, Lau Y, Dennis CL, Chan YS, Tam WW, Chan YH. A randomized-controlled trial to examine the effectiveness of the ‘Home-but not Alone’ mobile-health application educational programme on parental outcomes. J Adv Nurs 2017; 73:2103-2117. [DOI: 10.1111/jan.13293] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2017] [Indexed: 01/09/2023]
Affiliation(s)
- Shefaly Shorey
- Alice Lee Centre for Nursing Studies; Yong Loo Lin School of Medicine; National University of Singapore, National University Health System; Singapore
| | - YingY. Lau
- Alice Lee Centre for Nursing Studies; Yong Loo Lin School of Medicine; National University of Singapore; Singapore
| | | | - Yah Shih Chan
- Alice Lee Centre for Nursing Studies; Yong Loo Lin School of Medicine; National University of Singapore; Singapore
| | - Wilson W.S. Tam
- Alice Lee Centre for Nursing Studies; Yong Loo Lin School of Medicine; National University of Singapore; Singapore
| | - Yiong Huak Chan
- Biostatistics Unit; Yong Loo Lin School of Medicine; National University of Singapore; National University Health System; Singapore
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