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Minen M, George A, Lebowitz N, Katara A, Snyder I. Headache providers' perspectives of headache diaries in the era of increasing technology use: a qualitative study. Front Neurol 2024; 14:1270555. [PMID: 38322798 PMCID: PMC10844531 DOI: 10.3389/fneur.2023.1270555] [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: 07/31/2023] [Accepted: 12/31/2023] [Indexed: 02/08/2024] Open
Abstract
Background No matter what type of headache is being considered across various populations, one of the mainstays of headache medicine is headache tracking. This self-management tool enables patients and their providers to understand patients' underlying symptoms and the effects of treatments they have tried. This is important to determining whether headaches are related to menses for women's health, to determining the time of headache occurrence, e.g., hypnic headache, and the location and duration of symptoms, e.g., trigeminal autonomic cephalgia. Prior research has investigated what people with headaches perceive about headache diary use and how people with headaches utilize electronic headache diaries. However, headache providers' perspectives on the important factors related to headache diaries are less known. Previously, using the Modified Delphi Process, a panel of four experts opined what they perceived as the most important factors for a headache diary. We sought to better understand headache providers' perspectives about headache diary/app usage from providers working in various institutions nationwide. Methods We conducted 20 semi-structured qualitative interviews of headache providers across the US from various institutions and asked them their perspectives on headache diary use. We transcribed the interviews, which two independent coders then coded. Themes and subthemes were developed using grounded theory qualitative analysis. Results Six themes emerged: (1) Providers were generally agnostic regarding the headache tracking method, but nearly all recommend the use of smartphones for tracking; (2) Providers had concerns regarding the accessibility of headache trackers; (3) Providers noted benefits to integrating headache tracking data into the EMR but had mixed opinions on how this integration might be done; (4) Providers had mixed opinions regarding the utility and interpretation of the data, specifically regarding data accuracy and efficiency; (5) Providers generally felt that headache tracking lends itself to more collaborative plan management; (6) Providers recommend behavioral health apps for patients but stated that there are few digital behavioral health interventions for headache specifically. Conclusion Interviews of headache providers, recommenders, and users of headache data are vital informants who can provide a robust amount of information about headache diary development, use in different populations, integration, and more.
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Affiliation(s)
- Mia Minen
- Department of Neurology, NYU Langone Health, New York, NY, United States
| | - Alexis George
- Department of Neurology, NYU Langone Health, New York, NY, United States
| | - Naomi Lebowitz
- Barnard College, New York, NY, United States
- Ferkauf Graduate School of Psychology, New York, NY, United States
| | - Aarti Katara
- Barnard College, New York, NY, United States
- Ferkauf Graduate School of Psychology, New York, NY, United States
| | - Ivy Snyder
- Department of Psychology, Yeshiva University, New York, NY, United States
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Lancaster BD, Sweenie R, Noser AE, Roberts CM, Ramsey RR. Sleep mHealth Applications and Behavior Change Techniques Evaluation. Behav Sleep Med 2023; 21:757-773. [PMID: 36628485 PMCID: PMC10330944 DOI: 10.1080/15402002.2022.2161548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVES Mobile health apps may be an effective way to increase sleep management skills. Although little has been documented about the content and quality of available sleep management apps, providers often make app recommendations to help with sleep self-management. The objective of this study was to systematically evaluate the content and quality of commercially available sleep apps. METHODS Following a systematic search of the Apple App and Google Play stores, 56 sleep management apps were evaluated. App content was evaluated using the taxonomy of behavior change techniques (BCTs), and app quality was assessed using the Mobile App Rating Scale. RESULTS Sleep management apps included 0-15 BCTs (M = 6.89) and 0-9 sleep BCTs (M = 4.87). App quality ranged from 2.51 to 4.80 (M = 3.78) out of 5.00. Sleepiest Sleep Sounds Stories, ShutEye: Sleep Tracker, and Mintal Tracker: Sleep Recorder included the highest number of sleep BCTs and highest quality scores. CONCLUSIONS While the content and quality of sleep management apps is variable, the findings are promising as many apps included a high number of BCTs and high quality. Although evidence of efficacy through randomized controlled trials is necessary to establish efficacy, this review can aid in app selection in the interim.
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Affiliation(s)
- Brittany D. Lancaster
- Center for Children’s Healthy Lifestyles & Nutrition, 610 E 22nd St, Kansas City, MO, 64108
- Department of Pediatrics, University of Kansas Medical Center, 3901 Rainbow Boulevard, MS 4004, Kansas City, KS, 66160
| | - Rachel Sweenie
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Amy E. Noser
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Caroline M. Roberts
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Rachelle R. Ramsey
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
- Department of Pediatrics, University of Cincinnati College of Medicine
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Noser AE, Lancaster BD, Hommel KA, Roberts CM, King JA, Alt E, Fredericks EM, Ramsey RR. Use of Behavior Change Techniques and Quality of Commercially Available Inflammatory Bowel Disease Apps. Dig Dis Sci 2023:10.1007/s10620-023-07884-7. [PMID: 36933116 DOI: 10.1007/s10620-023-07884-7] [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: 05/01/2022] [Accepted: 02/15/2023] [Indexed: 03/19/2023]
Abstract
BACKGROUND Inclusion of evidence-based behavior change techniques (e.g., self-monitoring) in mobile health apps has the potential to promote adherence to inflammatory bowel disease treatment. While inflammatory bowel disease management apps exist, the extent to which they incorporate behavior change techniques remains unknown. AIMS The present study systematically evaluated the content and quality of free, commercially available inflammatory bowel disease management apps. METHODS Apps were identified using a systematic search of the Apple App and Google Play stores. Apps were evaluated using Abraham and Michie's taxonomy of 26 behavior change techniques. A literature search was conducted to identify behavior change techniques specific and relevant for people with inflammatory bowel disease. App quality was assessed using the Mobile App Rating Scale with scores ranging from 1 (Inadequate) to 5 (Excellent). RESULTS A total of 51 inflammatory bowel disease management apps were evaluated. Apps included 0-16 behavior change techniques (Mean = 4.55) and 0-10 inflammatory bowel disease management behavior change techniques (Mean = 3.43). App quality ranged from 2.03 to 4.62 (Mean = 3.39) out of 5.00. Two apps, My IBD Care: Crohn's & Colitis and MyGiHealth GI Symptom Tracker, included the highest number of overall and inflammatory bowel disease management behavior change techniques along with high-quality scores. Bezzy IBD was the only app with a high number of overall and inflammatory bowel disease management behavior change techniques with a primary focus on social support/change. CONCLUSION Most inflammatory bowel disease management apps reviewed included evidence-based inflammatory bowel disease management behavior change techniques.
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Affiliation(s)
- Amy E Noser
- Department of Family Medicine and Community Health, University of Minnesota Medical School, 717 Delaware Street SE, Minneapolis, MN, 55414, USA.
| | - Brittany D Lancaster
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Kevin A Hommel
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Caroline M Roberts
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Jessica A King
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Elizabeth Alt
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | | | - Rachelle R Ramsey
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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Noser A, Gibler R, Ramsey R, Wells R, Seng E, Hommel K. Digital headache self-management interventions for patients with a primary headache disorder: A systematic review of randomized controlled trials. Headache 2022; 62:1105-1119. [PMID: 36286601 PMCID: PMC10336649 DOI: 10.1111/head.14392] [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: 11/10/2021] [Revised: 07/18/2022] [Accepted: 07/19/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE This article systematically reviews the empirical literature examining the efficacy of digital headache management interventions for patients with a primary headache disorder. BACKGROUND Digital headache management interventions provide opportunities to improve access to behavioral headache interventions to underserved groups. METHODS A systematic search of PubMed, Scopus, and EBSCO (PsycInfo, Education Research Complete, ERIC, Health Source: Nursing/Academic Edition, Psychology and Behavioral Sciences Collection) and reference review was conducted. Included studies had to recruit a sample with a primary headache diagnosis, be a randomized controlled trial including a digital component, assess a headache outcome (i.e., frequency, duration, severity, intensity, disability) or quality of life, and be published in English. Two authors independently extracted data for included studies. The methodological quality of studies was assessed using the revised Cochrane risk-of-bias tool. RESULTS Thirteen studies with unique interventions met inclusion criteria. More than half of the studies were pilots; however, nearly 70% (9/13) demonstrated significant between-group or within-group improvements on one or more headache-related outcomes. All interventions included some form of relaxation training and the majority were delivered via interactive website. While fewer than half the studies report participant race and/or ethnicity, of those that do, 83% (5/6) reported a predominately White/Caucasian sample. CONCLUSIONS Efficacy testing of digital headache interventions is in its infancy with the majority of these studies relying on pilot studies with small samples comprised of homogenous patient populations. Interactive websites were the most common digital medium to deliver digital headache management interventions and have demonstrated promising results. Further testing using large-scale randomized controlled trials and exploration of other digital tools is warranted. Future studies with more diverse samples are needed to inform health equity of digital headache interventions.
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Affiliation(s)
- Amy Noser
- Cincinnati Children’s Hospital Medical Center - Behavioral Medicine & Clinical Psychology, Behavioral Medicine & Clinical Psychology, Cincinnati, Cincinnati, Ohio, United States
| | - Robert Gibler
- Cincinnati Children’s Hospital Medical Center - Behavioral Medicine & Clinical Psychology, Behavioral Medicine & Clinical Psychology, Cincinnati, Cincinnati, Ohio, United States
| | - Rachelle Ramsey
- Cincinnati Children’s Hospital Medical Center - Behavioral Medicine & Clinical Psychology, Behavioral Medicine & Clinical Psychology, Cincinnati, Cincinnati, Ohio, United States
| | - Rebecca Wells
- Wake Forest School of Medicine – Neurology, Winston-Salem, North Carolina, United States
| | - Elizabeth Seng
- Yeshiva University - Ferkauf Graduate School of Psychology, Bronx, New York, United States
| | - Kevin Hommel
- Cincinnati Children’s Hospital Medical Center - Pediatrics, Cincinnati, Ohio, United States
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Spina E, Tedeschi G, Russo A, Trojsi F, Iodice R, Tozza S, Iovino A, Iodice F, Abbadessa G, di Lorenzo F, Miele G, Maida E, Cerullo G, Sparaco M, Silvestro M, Leocani L, Bonavita S, Manganelli F, Lavorgna L. Telemedicine application to headache: a critical review. Neurol Sci 2022; 43:3795-3801. [PMID: 35075575 PMCID: PMC8786371 DOI: 10.1007/s10072-022-05910-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 01/19/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Migraine affects more than a billion people all over the world and requires critical employment of healthcare resources. Telemedicine could be a reasonable tool to manage people suffering from headaches, and it received a big push from the COVID-19 pandemic. OBJECTIVE This review aims to propose a practical approach for the virtual management of these patients. METHODS To do this, we conducted a literature search, including 32 articles relevant to the topic treated in this review. RESULTS The most challenging step in telemedicine applied to practical neurology remains the clinical assessment, but through a careful headache history and a recently proposed entirely virtual neurological assessment, this hitch can be easily overcome. Electronic diary compilations and virtual administration of disability-measuring scales, conversely, are the key features of effective long-term follow-up although we do not have apps that met the criteria of scientific reliability. Furthermore, tele-rehabilitation seems to be effective and has demonstrated to be a solution to alternatively treat chronic patients at home, and can be considered part of the remote management of headache patients. Moreover, virtual management of headaches finds an application in specific communities of patients, as pediatric patients and for rural communities of low- and middle-income countries suffer from health disparities, with inadequate resources and knowledge gaps. CONCLUSION Telemedicine could be promising for patients with no regular or convenient access to headache specialists and seems to be a priority in managing migraine patients to avoid non-urgent hospitalizations.
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Affiliation(s)
- Emanuele Spina
- Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples "Federico II" Via Pansini, 5, 81028, Naples, Italy.
| | - Gioacchino Tedeschi
- Department of Advanced Medical and Surgical Sciences, AOU University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Antonio Russo
- 1st Clinic Of Neurology, AOU University of Campania "Luigi Vanvitelli,", Caserta, Italy
| | - Francesca Trojsi
- Department of Advanced Medical and Surgical Sciences, AOU University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Rosa Iodice
- Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples "Federico II" Via Pansini, 5, 81028, Naples, Italy
| | - Stefano Tozza
- Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples "Federico II" Via Pansini, 5, 81028, Naples, Italy
| | - Aniello Iovino
- Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples "Federico II" Via Pansini, 5, 81028, Naples, Italy
| | | | - Gianmarco Abbadessa
- Department of Advanced Medical and Surgical Sciences, AOU University of Campania "Luigi Vanvitelli", Caserta, Italy
| | | | - Giuseppina Miele
- 1st Clinic Of Neurology, AOU University of Campania "Luigi Vanvitelli,", Caserta, Italy
| | - Elisabetta Maida
- Department of Advanced Medical and Surgical Sciences, AOU University of Campania "Luigi Vanvitelli", Caserta, Italy
| | | | - Maddalena Sparaco
- 1st Clinic Of Neurology, AOU University of Campania "Luigi Vanvitelli,", Caserta, Italy
| | - Marcello Silvestro
- 1st Clinic Of Neurology, AOU University of Campania "Luigi Vanvitelli,", Caserta, Italy
| | - Letizia Leocani
- Experimental Neurophysiology Unit, Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Simona Bonavita
- Department of Advanced Medical and Surgical Sciences, AOU University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Fiore Manganelli
- Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples "Federico II" Via Pansini, 5, 81028, Naples, Italy
| | - Luigi Lavorgna
- 1st Clinic Of Neurology, AOU University of Campania "Luigi Vanvitelli,", Caserta, Italy
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Healthy Dwelling: Design of Biophilic Interior Environments Fostering Self-Care Practices for People Living with Migraines, Chronic Pain, and Depression. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042248. [PMID: 35206441 PMCID: PMC8871637 DOI: 10.3390/ijerph19042248] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/11/2022] [Accepted: 02/13/2022] [Indexed: 12/22/2022]
Abstract
The benefits of biophilic interior design have been recognized by healthcare facilities, but residential environments receive relatively less attention with respect to improving the health of people living with chronic diseases. Recent “stay-at-home” restrictions due to the COVID-19 pandemic further emphasized the importance of creating interior spaces that directly and indirectly support physical and mental health. In this viewpoint article, we discuss opportunities for combining biophilic interventions with interior design, fostering disease-specific self-care. We provide examples of designing residential spaces integrating biophilic interventions, light therapy, relaxation opportunities, mindfulness meditation, listening to music, physical activities, aromatherapy, and quality sleep. These modalities can provide the clinical benefits of reducing migraine headaches and chronic pain, as well as improving depressive symptoms. The disease-specific interior environment can be incorporated into residential homes, workplaces, assisted-living residences, hospitals and hospital at home programs. This work aims to promote a cross-disciplinary dialogue towards combining biophilic design and advances in lifestyle medicine to create therapeutic interior environments and to improve healthcare outcomes.
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Behavioral Health, Telemedicine, and Opportunities for Improving Access. Curr Pain Headache Rep 2022; 26:919-926. [PMID: 36418847 PMCID: PMC9684808 DOI: 10.1007/s11916-022-01096-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW The purpose of this review is to summarize advances in behavioral treatments for pain and headache disorders, as well as recent innovations in telemedicine for behavioral treatments. RECENT FINDINGS Research for behavioral treatments continues to support their use as part of a multidisciplinary approach to comprehensive management for pain and headache conditions. Behavioral treatments incorporate both behavioral change and cognitive interventions and have been shown to improve outcomes beyond that of medical management alone. The onset of the COVID-19 public health emergency necessitated the rapid uptake of nontraditional modalities for behavioral treatments, particularly telemedicine. Telemedicine has long been considered the answer to several barriers to accessing behavioral treatments, and as a result of COVID-19 significant progress has been made evaluating a variety of telemedicine modalities including synchronous, asynchronous, and mobile health applications. Researchers are encouraged to continue investigating how best to leverage these modalities to improve access to behavioral treatments and to continue evaluating the efficacy of telemedicine compared to traditional in-person care. Comprehensive pain and headache management should include behavioral treatments to address a variety of behavior change and cognitive targets. Policy changes and advances in telemedicine for behavioral treatments provide the opportunity to address historical barriers limiting access.
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