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Niiberg-Pikksööt T, Laas K, Aluoja A, Braschinsky M. Implementing a digital solution for patients with migraine-Developing a methodology for comparing digitally delivered treatment with conventional treatment: A study protocol. PLOS DIGITAL HEALTH 2024; 3:e0000295. [PMID: 38421955 PMCID: PMC10903846 DOI: 10.1371/journal.pdig.0000295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 01/18/2024] [Indexed: 03/02/2024]
Abstract
Migraine is one of the most frequent and expensive neurological disease in the world. Non-pharmacological and digitally administered treatment options have long been used in the treatment of chronic pain and mental illness. Digital solutions increase the patients' possibilities of receiving evidence-based treatment even when conventional treatment options are limited. The main goal of the study is to assess the efficacy of interdisciplinary digital interventions compared to conventional treatment. The maximum number of participants in this multi-centre, open-label, prospective, randomized study is 600, divided into eight treatment groups. The participants will take part in either a conventional or a digital intervention, performing various tests and interdisciplinary tasks. The primary outcome is expected to be a reduction in the number of headache days. We also undertake to measure various other headache-related burdens as a secondary outcome. The sample size, digital interventions not conducted via video calls, the lack of human connection, limited intervention program, and the conducting of studies only in digitally sophisticated countries are all significant limitations. However, we believe that digitally mediated treatment options are at least as effective as traditional treatment options while also allowing for a significantly higher patient throughput. The future of chronic disease treatment is remote monitoring and high-quality digitally mediated interventions.The study is approved by the Ethics Committee of the University of Tartu for Human Research (Permission No. 315T-17, 10.08.2020) and is registered at ClinicalTrials.gov: NTC05458817 (14.07.2022).
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Affiliation(s)
- Triinu Niiberg-Pikksööt
- Neurosciences, Institute of Clinical Medicine, Faculty of Medicine, University of Tartu, Tartu, Estonia
- Headache Clinic, Department of Neurology, Tartu University Hospital, Tartu, Estonia
- Migrevention OÜ, Tallinn, Estonia
| | - Kariina Laas
- Institute of Psychology, University of Tartu, Tartu, Estonia
| | - Anu Aluoja
- Department of Psychiatry, Institute of Clinical Medicine, Faculty of Medicine, University of Tartu, Tartu, Estonia
- Psychiatry Clinic, Tartu University Hospital, Tartu, Estonia
| | - Mark Braschinsky
- Headache Clinic, Department of Neurology, Tartu University Hospital, Tartu, Estonia
- Migrevention OÜ, Tallinn, Estonia
- Neurology Clinic, University of Tartu, Tartu, Estonia
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Huguet A, Rozario S, Wozney L, McGrath PJ. An Online Psychological Program for Adolescents and Young Adults With Headaches: Iterative Design and Rapid Usability Testing. JMIR Hum Factors 2023; 10:e48677. [PMID: 38085567 PMCID: PMC10751633 DOI: 10.2196/48677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 09/04/2023] [Accepted: 10/05/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Headache disorders are common, debilitating health problems. Cognitive-behavioral therapy (CBT) is recommended but rarely easily available. With the use of the internet and communication technologies among youth and young adults, these individuals could be self-trained in CBT skills. There is an increasing number of internet-based interventions for headaches, but there has been little research into the usability of these interventions because evaluating usability across the intervention development life cycle is costly. We developed an internet-based CBT program, the Specialized Program for Headache Reduction (SPHERE). While developing it, we aimed to improve SPHERE through rapid usability testing cycles. OBJECTIVE This study aims to presents a rapid and affordable usability testing approach that can be performed throughout the intervention development life cycle. This paper also provides evidence of the usability of SPHERE. METHODS We used the "think aloud" usability testing method based on Krug's approach to test user interaction within a lab setting. This was followed by a short posttest interview. We planned to test SPHERE with 3-5 participants testing the same part of the program each cycle. Both the design and development team and the research team actively participated in the usability testing process. Observers independently identified the top 3 usability issues, rated their severity, and conducted debriefing sessions to come to consensus on major issues and generate potential solutions. RESULTS The testing process allowed major usability issues to be identified and rectified rapidly before piloting SPHERE in a real-world context. A total of 2 cycles of testing were conducted. Of the usability issues encountered in cycles 1 and 2, a total of 68% (17/25) and 32% (12/38), respectively, were rated as major, discussed, and fixed. CONCLUSIONS This study shows that rapid usability testing is an essential part of the design process that improves program functionality and can be easy and inexpensive to undertake.
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Affiliation(s)
- Anna Huguet
- Department of Psychology, Universitat Rovira i Virgili, Tarragona, Spain
- Izaak Walton Killam Health Centre, Halifax, NS, Canada
| | | | - Lori Wozney
- Mental Health and Addictions, Izaak Walton Killam Health, Halifax, NS, Canada
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Patrick J McGrath
- Izaak Walton Killam Health Centre, Halifax, NS, Canada
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
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Best practices for virtual care to support youth with chronic pain and their families: a rapid systematic review to inform health care and policy during COVID-19 and beyond. Pain Rep 2021; 6:e935. [PMID: 34104841 PMCID: PMC8177877 DOI: 10.1097/pr9.0000000000000935] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 04/05/2021] [Accepted: 04/17/2021] [Indexed: 12/22/2022] Open
Abstract
Supplemental Digital Content is Available in the Text. Evidence-informed guidance to better leverage, implement, and select virtual care platforms for pediatric chronic pain, and identified knowledge gaps are in need of additional research. The COVID-19 pandemic has acutely challenged health systems and catalyzed the need for widescale virtual care and digital solutions across all areas of health, including pediatric chronic pain. The objective of this rapid systematic review was to identify recommendations, guidelines, and/or best practices for using virtual care to support youth with chronic pain and their families (CRD42020184498). MEDLINE, CINAHL, Embase, APA PsychINFO, and Web of Science were searched the week of May 25, 2020, for English language peer-reviewed articles published since 2010 that (1) discussed children and adolescents aged <18 years reporting any type of chronic pain (ie, pain lasting >3 months); (2) focused on any type of virtual care (eg, telephone, telehealth, telemedicine, mHealth, eHealth, online, or digital); and (3) reported on guidelines, best practices, considerations, or recommendations for virtual care. Abstract and full text screening and data extraction were performed in duplicate. Meta-ethnography was used to synthesize concepts across articles. Of 4161 unique records screened, 16 were included addressing diverse virtual care and pediatric chronic pain conditions. Four key themes were identified: (1) opportunities to better leverage virtual care, (2) direct effective implementation of virtual care, (3) selection of virtual care platforms, and (4) gaps in need of further consideration when using virtual care to support youth with chronic pain and their families. No existing guidelines for virtual care for pediatric chronic pain were identified; however, best practices for virtual care were identified and should be used by health professionals, decision makers, and policymakers in implementing virtual care.
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Fegran L, Johannessen B, Ludvigsen MS, Westergren T, Høie M, Slettebø Å, Rohde G, Helseth S, Haraldstad K. Experiences of a non-clinical set of adolescents and young adults living with persistent pain: a qualitative metasynthesis. BMJ Open 2021; 11:e043776. [PMID: 33875442 PMCID: PMC8057544 DOI: 10.1136/bmjopen-2020-043776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
PURPOSE Around 15%-30% of adolescents and young adults (AYAs) experience persistent or chronic pain. The purpose of this study was to synthesise evidence from qualitative primary studies on how AYAs in a non-clinical population experience living with persistent pain. METHOD A qualitative metasynthesis guided by Sandelowski and Barroso's guidelines was used. The databases Medline, Embase, Cinahl, PsycINFO, Mednar and ProQuest were searched for studies from 1 January 2005 to 15 February 2021. Inclusion criteria were AYAs aged 13-24 years with first-hand experience of living with persistent, recurrent or episodic non-clinical pain in any body site. Pain associated with a medical diagnosis, malignant diseases, medical procedures or sport activities was excluded. RESULTS Of 2618 screened records, data from nine studies conducted in a Western cultural context including 184 participants (127 female and 57 male aged 11-28 years) were analysed into metasummaries and a metasynthesis. Headaches was the most focused pain condition (n=5), while three of the studies did not specify type of pain. The participants' experiences were characterised by (1) juggling pain with everyday life; (2) exploring sources of information to manage pain; (3) AYAs' use of medication to find relief and (4) non-pharmacological strategies for pain relief. CONCLUSION These AYAs experience of how pain influences everyday life, and their striving to find relief from pain by support from family, friends, professionals and the Internet should be strongly respected. Public health nurses and other healthcare professionals encountering AYAs need to respect their pain experiences, and to support them in healthy coping strategies. Further studies on this issue are needed, especially research focusing on AYAs pain in exposed populations and AYAs from non-Western cultures.
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Affiliation(s)
- Liv Fegran
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Vest-Agder, Norway
- Department of Pediatrics, Sørlandet Sykehus HF, Kristiansand, Norway
| | - Berit Johannessen
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Vest-Agder, Norway
| | - Mette Spliid Ludvigsen
- Department of Clinical Medicine, Randers Regional Hospital, Randers, Midtjylland, Denmark
- Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway
| | - Thomas Westergren
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Vest-Agder, Norway
| | - Magnhild Høie
- Faculty of Health and Sport Sciences, University of Agder, Grimstad, Norway
| | - Åshild Slettebø
- Faculty of Health and Sport Sciences, University of Agder, Grimstad, Norway
| | - Gudrun Rohde
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Vest-Agder, Norway
- Department of Clinical Research, Sørlandet Sykehus HF, Kristiansand, Norway
| | - Sølvi Helseth
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Kristin Haraldstad
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Vest-Agder, Norway
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Minen MT, Jaran J, Boyers T, Corner S. Understanding What People With Migraine Consider to be Important Features of Migraine Tracking: An Analysis of the Utilization of Smartphone‐Based Migraine Tracking With a Free‐Text Feature. Headache 2020; 60:1402-1414. [DOI: 10.1111/head.13851] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 04/15/2020] [Accepted: 04/27/2020] [Indexed: 12/24/2022]
Affiliation(s)
- Mia T. Minen
- Department of Neurology NYU Langone Health New York NY USA
| | - Jana Jaran
- Department of Neuroscience and Behavior Barnard College New York NY USA
| | - Talia Boyers
- Department of Neuroscience and Behavior Barnard College New York NY USA
| | - Sarah Corner
- Department of Neurology NYU Langone Health New York NY USA
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Minen MT, Gumpel T, Ali S, Sow F, Toy K. What are Headache Smartphone Application (App) Users Actually Looking for in Apps: A Qualitative Analysis of App Reviews to Determine a Patient Centered Approach to Headache Smartphone Apps. Headache 2020; 60:1392-1401. [DOI: 10.1111/head.13859] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 04/28/2020] [Accepted: 04/29/2020] [Indexed: 01/20/2023]
Affiliation(s)
- Mia T. Minen
- Division of Headache Department of Neurology NYU Langone Health New York NY USA
| | - Tyler Gumpel
- Department of Biology The City College of New York New York NY USA
| | - Seher Ali
- Department of Biotechnology The City College of New York New York NY USA
| | - Fatoumata Sow
- Department of Biology The City College of New York New York NY USA
| | - Kaitlyn Toy
- Department of Biochemistry The City College of New York New York NY USA
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van de Graaf DL, Schoonman GG, Habibović M, Pauws SC. Towards eHealth to support the health journey of headache patients: a scoping review. J Neurol 2020; 268:3646-3665. [PMID: 32529582 PMCID: PMC8463346 DOI: 10.1007/s00415-020-09981-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 06/04/2020] [Accepted: 06/05/2020] [Indexed: 11/28/2022]
Abstract
Objective The aim of this study is to (1) review the digital health tools that have been used in headache studies, and (2) discuss the effectivity and reliability of these tools. Background Many headache patients travel a long and troublesome journey from first symptoms until a meaningful care plan. eHealth, mHealth, and digital therapeutic modalities have been advocated as the way forward to improve patient care. Method Online databases PubMed, Cinahl, and PsycINFO were searched using a predefined search query. A data extraction form was used to gather relevant data elements from the selected papers. Results A total of 39 studies were selected. The studies included 94,127 participants. The majority of studies focused on diaries (N = 27 out of 39). Digital (cognitive) behavioral therapy were also quite common (N = 7 out of 39). Other digital health tool categories were tele-consultations, telemonitoring and patient portals. Conclusion Many digital health tools for headache patients regarding diaries and behavioral/therapeutical treatment are described in scientific research with limited information on effectivity and reliability. Scientific knowledge with regard to other categories such as tele-consultations, patient portals, telemonitoring including medication adherence, online information resources, wearable, symptom checkers, digital peer support is still scarce or missing.
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Affiliation(s)
| | - Guus G Schoonman
- Department of Neurology, Elizabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | - Mirela Habibović
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.,Department of Cardiology, Elizabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | - Steffen C Pauws
- TiCC-Tilburg University, Tilburg, The Netherlands.,Philips Research, Healthcare, Eindhoven, The Netherlands
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Mitchell KM, Holtz BE, McCarroll A. Patient-Centered Methods for Designing and Developing Health Information Communication Technologies: A Systematic Review. Telemed J E Health 2019; 25:1012-1021. [PMID: 30576258 DOI: 10.1089/tmj.2018.0236] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Background: Chronic disease management and maintaining healthy behaviors to prevent disease are important lifelong considerations. Adherence to prescribed management and behaviors often falls short of physician recommendations, which can result in negative health outcomes. Information communication technologies (ICTs) offer an approach to combat this issue. However, uptake and sustainability of ICTs have mixed results. One reason could be that technologies are often created without an understanding of the complexities of patient needs. Therefore, the intent of this study is to explore the current landscape of patient-centered design and development of health ICTs through a systematic review. Materials and Methods: Systematic literature searches were conducted in the databases EBSCO, PubMed, and Web of Science between October 2016 and February 2017. Each paper was critically evaluated for each data extraction classification, and was categorized based on the chronic disease or health focus, method of patient-centered design, resulting themes, and use of theory. Results: The study search resulted in 3,748 articles total. After duplicates and articles not meeting criteria were removed, 57 articles were selected for assessment. Four main themes emerged: participant experience, technological requirements, behavioral and knowledge components, and social components. Conclusions: Adhering to chronic disease management and healthy behaviors are both crucial to attain positive health outcomes. ICTs can play an interesting role in aiding disease management and healthy behavior promotion, but involving end-users and applying a theoretical foundation in the design and development of these technologies should be considered.
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Affiliation(s)
- Katharine M Mitchell
- Department of Advertising and Public Relations, Michigan State University, East Lansing, Michigan
| | - Bree E Holtz
- Department of Advertising and Public Relations, Michigan State University, East Lansing, Michigan
| | - Alexis McCarroll
- Department of Media and Information, Michigan State University, East Lansing, Michigan
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Minen MT, Torous J, Raynowska J, Piazza A, Grudzen C, Powers S, Lipton R, Sevick MA. Electronic behavioral interventions for headache: a systematic review. J Headache Pain 2016; 17:51. [PMID: 27160107 PMCID: PMC4864730 DOI: 10.1186/s10194-016-0608-y] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Accepted: 02/17/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is increasing interest in using electronic behavioral interventions as well as mobile technologies such as smartphones for improving the care of chronic disabling diseases such as migraines. However, less is known about the current clinical evidence for the feasibility and effectiveness of such behavioral interventions. OBJECTIVE To review the published literature of behavioral interventions for primary headache disorders delivered by electronic means suitable for use outside of the clinician's office. METHODS An electronic database search of PubMed, PsycINFO, and Embase was conducted through December 11, 2015. All eligible studies were systematically reviewed to examine the modality in which treatment was delivered (computer, smartphone, watch and other), types of behavioral intervention delivered (cognitive behavioral therapy [CBT], biofeedback, relaxation, other), the headache type being treated, duration of treatment, adherence, and outcomes obtained by the trials to examine the overall feasibility of electronic behavioral interventions for headache. RESULTS Our search produced 291 results from which 23 eligible articles were identified. Fourteen studies used the internet via the computer, 2 used Personal Digital Assistants, 2 used CD ROM and 5 used other types of devices. None used smartphones or wearable devices. Four were pilot studies (N ≤ 10) which assessed feasibility. For the behavioral intervention, CBT was used in 11 (48 %) of the studies, relaxation was used in 8 (35 %) of the studies, and biofeedback was used in 5 (22 %) of the studies. The majority of studies (14/23, 61 %) used more than one type of behavioral modality. The duration of therapy ranged from 4-8 weeks for CBT with a mean of 5.9 weeks. The duration of other behavioral interventions ranged from 4 days to 60 months. Outcomes measured varied widely across the individual studies. CONCLUSIONS Despite the move toward individualized medicine and mHealth, the current literature shows that most studies using electronic behavioral intervention for the treatment of headache did not use mobile devices. The studies examining mobile devices showed that the behavioral interventions that employed them were acceptable to patients. Data are limited on the dose required, long term efficacy, and issues related to the security and privacy of this health data. This study was registered at the PROSPERO International Prospective Register of Systematic Reviews (CRD42015032284) (Prospero, 2015).
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Affiliation(s)
- Mia Tova Minen
- Department of Neurology, NYU Langone Medical Center, 240 East 38th Street 20th floor, New York, NY, 10016, USA.
- NYU Langone Headache Center, Department of Neurology, NYU School of Medicine, New York, NY, USA.
| | - John Torous
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Allison Piazza
- Department of Library Services, NYU School of Medicine, New York, USA
| | - Corita Grudzen
- Department of Emergency Medicine, NYU Langone Medical Center, NYU School of Medicine, New York, NY, USA
| | - Scott Powers
- Cincinnati Children's Medical Center, Headache Center, Office for Clinical and Translational Research, Center for Child Behavior and Nutrition Research and Training, Pediatrics Cincinnati, Cincinnati, Ohio, USA
| | - Richard Lipton
- Montefiore Headache Center, Department of Neurology, Albert Einstein College of Medicine, Neurology, Bronx, USA
| | - Mary Ann Sevick
- Center for Behavioral Change, Department of Population Health, NYU School of Medicine, New York, NY, USA
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Goodwin J, Cummins J, Behan L, O’Brien SM. Development of a mental health smartphone app: perspectives of mental health service users. J Ment Health 2016; 25:434-440. [DOI: 10.3109/09638237.2015.1124392] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- John Goodwin
- Department of Nursing and Midwifery, University of Cork, Cork, Republic of Ireland,
- St. Michaels Unit, North Lee Mental Health Services, Cork, Republic of Ireland,
| | - John Cummins
- Department of Nursing and Midwifery, University of Cork, Cork, Republic of Ireland,
- Community Mental Health Team, North Lee Mental Health Services, Cork, Republic of Ireland,
| | - Laura Behan
- Department of Allied Psychology, University of Cork, Cork, Republic of Ireland,
| | - Sinead M. O’Brien
- Home Based Crisis Team, North Lee Mental Health Services, Cork, Republic of Ireland, and
- Department of Psychiatry, University of Cork, Cork, Republic of Ireland
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Marcano Belisario JS, Jamsek J, Huckvale K, O'Donoghue J, Morrison CP, Car J. Comparison of self-administered survey questionnaire responses collected using mobile apps versus other methods. Cochrane Database Syst Rev 2015; 2015:MR000042. [PMID: 26212714 PMCID: PMC8152947 DOI: 10.1002/14651858.mr000042.pub2] [Citation(s) in RCA: 111] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Self-administered survey questionnaires are an important data collection tool in clinical practice, public health research and epidemiology. They are ideal for achieving a wide geographic coverage of the target population, dealing with sensitive topics and are less resource-intensive than other data collection methods. These survey questionnaires can be delivered electronically, which can maximise the scalability and speed of data collection while reducing cost. In recent years, the use of apps running on consumer smart devices (i.e., smartphones and tablets) for this purpose has received considerable attention. However, variation in the mode of delivering a survey questionnaire could affect the quality of the responses collected. OBJECTIVES To assess the impact that smartphone and tablet apps as a delivery mode have on the quality of survey questionnaire responses compared to any other alternative delivery mode: paper, laptop computer, tablet computer (manufactured before 2007), short message service (SMS) and plastic objects. SEARCH METHODS We searched MEDLINE, EMBASE, PsycINFO, IEEEXplore, Web of Science, CABI: CAB Abstracts, Current Contents Connect, ACM Digital, ERIC, Sociological Abstracts, Health Management Information Consortium, the Campbell Library and CENTRAL. We also searched registers of current and ongoing clinical trials such as ClinicalTrials.gov and the World Health Organization (WHO) International Clinical Trials Registry Platform. We also searched the grey literature in OpenGrey, Mobile Active and ProQuest Dissertation & Theses. Lastly, we searched Google Scholar and the reference lists of included studies and relevant systematic reviews. We performed all searches up to 12 and 13 April 2015. SELECTION CRITERIA We included parallel randomised controlled trials (RCTs), crossover trials and paired repeated measures studies that compared the electronic delivery of self-administered survey questionnaires via a smartphone or tablet app with any other delivery mode. We included data obtained from participants completing health-related self-administered survey questionnaire, both validated and non-validated. We also included data offered by both healthy volunteers and by those with any clinical diagnosis. We included studies that reported any of the following outcomes: data equivalence; data accuracy; data completeness; response rates; differences in the time taken to complete a survey questionnaire; differences in respondent's adherence to the original sampling protocol; and acceptability to respondents of the delivery mode. We included studies that were published in 2007 or after, as devices that became available during this time are compatible with the mobile operating system (OS) framework that focuses on apps. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data from the included studies using a standardised form created for this systematic review in REDCap. They then compared their forms to reach consensus. Through an initial systematic mapping on the included studies, we identified two settings in which survey completion took place: controlled and uncontrolled. These settings differed in terms of (i) the location where surveys were completed, (ii) the frequency and intensity of sampling protocols, and (iii) the level of control over potential confounders (e.g., type of technology, level of help offered to respondents). We conducted a narrative synthesis of the evidence because a meta-analysis was not appropriate due to high levels of clinical and methodological diversity. We reported our findings for each outcome according to the setting in which the studies were conducted. MAIN RESULTS We included 14 studies (15 records) with a total of 2275 participants; although we included only 2272 participants in the final analyses as there were missing data for three participants from one included study.Regarding data equivalence, in both controlled and uncontrolled settings, the included studies found no significant differences in the mean overall scores between apps and other delivery modes, and that all correlation coefficients exceeded the recommended thresholds for data equivalence. Concerning the time taken to complete a survey questionnaire in a controlled setting, one study found that an app was faster than paper, whereas the other study did not find a significant difference between the two delivery modes. In an uncontrolled setting, one study found that an app was faster than SMS. Data completeness and adherence to sampling protocols were only reported in uncontrolled settings. Regarding the former, an app was found to result in more complete records than paper, and in significantly more data entries than an SMS-based survey questionnaire. Regarding adherence to the sampling protocol, apps may be better than paper but no different from SMS. We identified multiple definitions of acceptability to respondents, with inconclusive results: preference; ease of use; willingness to use a delivery mode; satisfaction; effectiveness of the system informativeness; perceived time taken to complete the survey questionnaire; perceived benefit of a delivery mode; perceived usefulness of a delivery mode; perceived ability to complete a survey questionnaire; maximum length of time that participants would be willing to use a delivery mode; and reactivity to the delivery mode and its successful integration into respondents' daily routine. Finally, regardless of the study setting, none of the included studies reported data accuracy or response rates. AUTHORS' CONCLUSIONS Our results, based on a narrative synthesis of the evidence, suggest that apps might not affect data equivalence as long as the intended clinical application of the survey questionnaire, its intended frequency of administration and the setting in which it was validated remain unchanged. There were no data on data accuracy or response rates, and findings on the time taken to complete a self-administered survey questionnaire were contradictory. Furthermore, although apps might improve data completeness, there is not enough evidence to assess their impact on adherence to sampling protocols. None of the included studies assessed how elements of user interaction design, survey questionnaire design and intervention design might influence mode effects. Those conducting research in public health and epidemiology should not assume that mode effects relevant to other delivery modes apply to apps running on consumer smart devices. Those conducting methodological research might wish to explore the issues highlighted by this systematic review.
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Affiliation(s)
- José S Marcano Belisario
- School of Public Health, Imperial College LondonGlobal eHealth Unit, Department of Primary Care and Public HealthLondonUK
| | - Jan Jamsek
- University of LjubljanaFaculty of MedicineVrazov trg 2LjubljanaSlovenia1000
| | - Kit Huckvale
- School of Public Health, Imperial College LondonGlobal eHealth Unit, Department of Primary Care and Public HealthLondonUK
| | - John O'Donoghue
- School of Public Health, Imperial College LondonDepartment of Primary Care and Public HealthRoom 326, The Reynolds BuildingSt Dunstans RoadLondonUKW6 8RP
| | - Cecily P Morrison
- School of Public Health, Imperial College LondonGlobal eHealth Unit, Department of Primary Care and Public HealthLondonUK
| | - Josip Car
- Imperial College & Nanyang Technological UniversityLee Kong Chian School of Medicine3 Fusionopolis Link, #03‐08Nexus@one‐northSingaporeSingapore138543
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Huguet A, McGrath PJ, Wheaton M, Mackinnon SP, Rozario S, Tougas ME, Stinson JN, MacLean C. Testing the Feasibility and Psychometric Properties of a Mobile Diary (myWHI) in Adolescents and Young Adults With Headaches. JMIR Mhealth Uhealth 2015; 3:e39. [PMID: 25956377 PMCID: PMC4441754 DOI: 10.2196/mhealth.3879] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2014] [Revised: 02/14/2015] [Accepted: 03/02/2015] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Headaches are prevalent among teens and young adults. Self-monitoring is essential for managing headaches and can be accomplished with the help of electronic headache diaries. An increasing number of electronic headache diaries exist, yet the absence of quality standards compromises their use for research and clinical purposes. OBJECTIVE Our goal was to develop and test the usability, feasibility, and psychometric properties of an electronic diary iPhone application for self-monitoring by adolescents and young adults with headaches. METHODS We used an iterative participatory design to develop and test our electronic headache diary. Participants aged 14-28 years old with recurrent headaches were recruited internationally. Screening and consent were conducted online. Following completion of an online pre-questionnaire, participants downloaded the diary to use in their natural environment for 14 days. An online post-questionnaire was completed following testing. The diary's usability and feasibility were tested first and determined to be complete when improvements to the diary did not result in a statistically significant impact on indicators of feasibility and adherence. Interviews were conducted with participants of usability and feasibility testing. The psychometric properties of the diary were then tested, and a case study analysis of one participant was completed. RESULTS Three cycles to test the usability and feasibility were conducted. Each cycle included 11-19 unique participants ranging in age from 16 to 28 years. Following the testing period for each cycle, 15% to 25% of participants took part in the post-cycle interview. Participants perceived the final version of the diary as useful, easy to learn, and efficient to use. Psychometric properties were then tested with a sample of 65 participants (6 aged 14-17 years old; 59 aged 18-28 years old). All items in the diary had substantial between- and within-subjects variability (percent of variance for the two participant groups ranged from 20.64 to 75.60 and 23.74 to 79.21, respectively). Moreover, the Migraine Disability Assessment (MIDAS) included in the diary had adequate between-subjects reliability (R1F=0.66, RKF=0.98), but low within-subjects reliability (RC=0.51). Critical elements of the diary demonstrated adequate convergent and concurrent validity, particularly in the older age group (18-28 years). The validity of some critical elements of the diary could not be explored in the younger age group due to the small subgroup size. The case study provides an example of the potential utility of the diary. CONCLUSIONS Our electronic headache diary was shown to be a usable and feasible self-monitoring tool when used by adolescents and young adults with headaches for 14 days. This study provides preliminary support of its psychometric properties. Our diary has the potential for helping users to better understand their headaches and, consequently, to change behaviors to improve self-management of their headaches. Its effectiveness as a component of an intervention will be the focus of future research.
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Affiliation(s)
- Anna Huguet
- IWK Health Centre, Centre for Research in Family Health, Halifax, NS, Canada.
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Hundert AS, Huguet A, McGrath PJ, Stinson JN, Wheaton M. Commercially available mobile phone headache diary apps: a systematic review. JMIR Mhealth Uhealth 2014; 2:e36. [PMID: 25138438 PMCID: PMC4147710 DOI: 10.2196/mhealth.3452] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Revised: 07/07/2014] [Accepted: 07/07/2014] [Indexed: 11/25/2022] Open
Abstract
Background Headache diaries are often used by headache sufferers to self-monitor headaches. With advances in mobile technology, mobile electronic diary apps are becoming increasingly common. Objective This review aims to identify and evaluate all commercially available mobile headache diary apps for the two most popular mobile phone platforms, iOS and Android. Methods The authors developed a priori a set of 7 criteria that define an ideal headache diary app intended to help headache sufferers better understand and manage their headaches, while providing relevant data to health professionals. The app criteria were intended as minimum requirements for an acceptable headache diary app that could be prescribed by health care professionals. Each app was evaluated and scored against each criterion. Results Of the 38 apps identified, none of the apps met all 7 app criteria. The 3 highest scoring apps, meeting 5 of the app criteria, were iHeadache (developed by Better QOL), ecoHeadache (developed by ecoTouchMedia), and Headache Diary Pro (developed by Froggyware). Only 18% of the apps were created with scientific or clinical headache expertise and none of the apps reported on psychometric properties. Conclusions Despite the growing market and demand, there is a concerning lack of scientific expertise and evidence base associated with headache diary apps.
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When in doubt, ask the audience: potential users' perceptions of Internet-delivered cognitive behavioural therapy for chronic pain. Pain Res Manag 2014; 19:173-8. [PMID: 24911177 DOI: 10.1155/2014/451373] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Although research has demonstrated that Internet-delivered cognitive behavioural therapy (ICBT) for chronic pain helps with adjustment to pain, it remains unclear how this treatment option would initially be perceived by individuals with chronic pain. OBJECTIVES To explore initial perceptions of ICBT and to examine variables that correlate with an expressed interest in ICBT as a treatment option among individuals with chronic pain. METHODS A total of 129 individuals with chronic pain completed a survey assessing perceptions of ICBT and individual difference variables that could be correlated with expressed interest in ICBT (eg, demographic characteristics, pain, computer self-efficacy). RESULTS Results showed that most participants perceived ICBT as a potentially valuable service with multiple benefits. Being female, having greater pain severity and interference, and having greater computer self-efficacy and lower computer anxiety were positively correlated with interest in receiving ICBT. CONCLUSIONS Combined with previous research on treatment efficacy of ICBT for chronic pain, the results should serve to stimulate further research on integrating ICBT within existing health care services.
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