1
|
Dawson J, Lambert K, Campbell KL, Kelly JT. Incorporating digital platforms into nutritional care in chronic kidney disease. Semin Dial 2024; 37:350-359. [PMID: 34235785 DOI: 10.1111/sdi.12998] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 06/15/2021] [Indexed: 11/29/2022]
Abstract
Digital health is increasingly recognized for its value to enhance patient care and clinical care processes. People with chronic kidney disease often find dietary self-management challenging. There is promising evidence that digital health interventions can support people with chronic kidney disease to self-manage their diet, by providing more frequent access to nutritional information and dietitians and by facilitating regular monitoring and feedback. There is some emerging evidence of the impact of digital interventions in chronic kidney disease; however, more research is needed to provide meaningful interpretation of how digital interventions can enhance current practice. Importantly, a number of factors need to be considered when designing, developing, implementing, and evaluating the impact of digital interventions. Consideration of the nutrition service and patients' needs, motivation and digital literacy, type of digital intervention, and the ability to embed the digital intervention into current care processes are critical. This paper overviews the current literature on digital health and self-management, factors to consider when embedding digital interventions and platforms into nutrition care and practical considerations for designing and implementing digital health interventions to enhance the nutritional care of people with chronic kidney disease.
Collapse
Affiliation(s)
- Jessica Dawson
- Nutrition and Dietetics Department, St George Hospital, Sydney, New South Wales, Australia
| | - Kelly Lambert
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia
| | - Katrina L Campbell
- Healthcare Excellence and Innovation, Metro North Hospital and Health Service, Brisbane, Queensland, Australia
- Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Southport, Queensland, Australia
- Centre of Applied Health Economics, School of Medicine, Griffith University, Nathan Campus, Nathan, Queensland, Australia
| | - Jaimon T Kelly
- Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Southport, Queensland, Australia
- Centre of Applied Health Economics, School of Medicine, Griffith University, Nathan Campus, Nathan, Queensland, Australia
| |
Collapse
|
2
|
Binks P, Venkatesan S, Everitt A, Gurruwiwi GG, Dhurrkay RG, Bukulatjpi SM, Ross C, Alley T, Hosking K, Vintour-Cesar E, McKinnon M, Sullivan RP, Davis JS, Hefler M, Davies J. An evaluation and refinement of the "Hep B Story" app, tailored to meet the community's cultural needs. BMC Health Serv Res 2024; 24:710. [PMID: 38849881 PMCID: PMC11162029 DOI: 10.1186/s12913-024-11149-y] [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: 04/15/2024] [Accepted: 05/27/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND Hepatitis B is endemic amongst the Australian Aboriginal population in the Northern Territory. A participatory action research project identified the lack of culturally appropriate education tools and led to the development of the "Hep B Story" app in the Aboriginal language Yolŋu Matha. This paper describes a formal evaluation of the app's first version, which informed improvements and translation into a further ten Aboriginal languages. METHODS The evaluation employed Participatory Action Research (PAR) principles to work within Indigenous research methodologies and prioritise Indigenous knowledge to improve the app iteratively. Semi-structured interviews and focus groups were conducted across the Northern Territory with 11 different language groups. Local Community Based Researchers and Aboriginal Research team members coordinated sessions. The recorded, translated conversations were transcribed verbatim and thematically analysed using an inductive and deductive approach. RESULTS Between November 2018 and September 2020, 94 individuals from 11 language groups participated in 25 semi-structured interviews and 10 focus groups. All participants identified as Aboriginal. Most participants felt the app would be culturally appropriate for Aboriginal communities in the Northern Territory and improve knowledge surrounding hepatitis B. The information gathered from these interviews allowed for identifying five main themes: support for app, relationships, concept versus language, shame, and perceptions of images, along with errors that required modification. CONCLUSIONS A "real-life" evaluation of the app was comprehensively completed using a PAR approach blended with Indigenous research methods. This evaluation allowed us to develop an updated and enhanced version of the app before creating the additional ten language versions. An iterative approach alongside strong community engagement was pivotal in ensuring the app's cultural safety and appropriateness. We recommend avoiding the use of knowledge-based evaluations in an Aboriginal setting to ensure relevant and culturally appropriate feedback is obtained.
Collapse
Affiliation(s)
- Paula Binks
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.
| | - Sudharsan Venkatesan
- Department of Infectious Diseases, Royal Darwin and Palmerston Hospitals, Northern Territory Health, Darwin, NT, Australia
| | - Anngie Everitt
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - George Garambaka Gurruwiwi
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Roslyn Gundjirryirr Dhurrkay
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Sarah Mariyalawuy Bukulatjpi
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
- Miwatj Health Aboriginal Corporation, Nhulunbuy, East Arnhem Land, NT, Australia
| | - Cheryl Ross
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Tiana Alley
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Kelly Hosking
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
- Public Health Directorate, Office of the Chief Health Officer, Northern Territory Health, Darwin, NT, Australia
| | - Emily Vintour-Cesar
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Melita McKinnon
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Richard P Sullivan
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
- Department of Infectious Diseases and Immunology, School of Clinical Medicine, St George and Sutherland Hospital, UNSW Medicine and Health, Sydney, NSW, Australia
| | - Joshua S Davis
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - Marita Hefler
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Jane Davies
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
- Department of Infectious Diseases, Royal Darwin and Palmerston Hospitals, Northern Territory Health, Darwin, NT, Australia
| |
Collapse
|
3
|
Gumede SB, de Wit JBF, Venter WDF, Wensing AMJ, Lalla‐Edward ST. Intervention strategies to improve adherence to treatment for selected chronic conditions in sub-Saharan Africa: a systematic review. J Int AIDS Soc 2024; 27:e26266. [PMID: 38924296 PMCID: PMC11197966 DOI: 10.1002/jia2.26266] [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: 09/03/2023] [Accepted: 04/23/2024] [Indexed: 06/28/2024] Open
Abstract
INTRODUCTION Evidence-based intervention strategies to improve adherence among individuals living with chronic conditions are critical in ensuring better outcomes. In this systematic review, we assessed the impact of interventions that aimed to promote adherence to treatment for chronic conditions. METHODS We systematically searched PubMed, Web of Science, Scopus, Google Scholar and CINAHL databases to identify relevant studies published between the years 2000 and 2023 and used the QUIPS assessment tool to assess the quality and risk of bias of each study. We extracted data from eligible studies for study characteristics and description of interventions for the study populations of interest. RESULTS Of the 32,698 total studies/records screened, 2814 were eligible for abstract screening and of those, 497 were eligible for full-text screening. A total of 82 studies were subsequently included, describing a total of 58,043 patients. Of the total included studies, 58 (70.7%) were related to antiretroviral therapy for HIV, 6 (7.3%) were anti-hypertensive medication-related, 12 (14.6%) were anti-diabetic medication-related and 6 (7.3%) focused on medication for more than one condition. A total of 54/82 (65.9%) reported improved adherence based on the described study outcomes, 13/82 (15.9%) did not have clear results or defined outcomes, while 15/82 (18.3%) reported no significant difference between studied groups. The 82 publications described 98 unique interventions (some studies described more than one intervention). Among these intervention strategies, 13 (13.3%) were multifaceted (4/13 [30.8%] multi-component health services- and community-based programmes, 6/13 [46.2%] included individual plus group counselling and 3/13 [23.1%] included SMS or alarm reminders plus individual counselling). DISCUSSION The interventions described in this review ranged from adherence counselling to more complex interventions such as mobile health (mhealth) interventions. Combined interventions comprised of different components may be more effective than using a single component in isolation. However, the complexity involved in designing and implementing combined interventions often complicates the practicalities of such interventions. CONCLUSIONS There is substantial evidence that community- and home-based interventions, digital health interventions and adherence counselling interventions can improve adherence to medication for chronic conditions. Future research should answer if existing interventions can be used to develop less complicated multifaceted adherence intervention strategies.
Collapse
Affiliation(s)
- Siphamandla Bonga Gumede
- Ezintsha, Faculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
- Department of Interdisciplinary Social ScienceUtrecht UniversityUtrechtthe Netherlands
| | - John B. F. de Wit
- Department of Interdisciplinary Social ScienceUtrecht UniversityUtrechtthe Netherlands
- Centre for Social Research in HealthUNSWSydneyNew South WalesAustralia
| | - Willem D. F. Venter
- Ezintsha, Faculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Annemarie M. J. Wensing
- Department of Medical MicrobiologyUniversity Medical Center UtrechtUtrechtthe Netherlands
- Ndlovu Research ConsortiumElandsdoornSouth Africa
| | | |
Collapse
|
4
|
Cheah KJ, Abdul Manaf Z, Fitri Mat Ludin A, Razalli NH, Mohd Mokhtar N, Md Ali SH. Mobile Apps for Common Noncommunicable Disease Management: Systematic Search in App Stores and Evaluation Using the Mobile App Rating Scale. JMIR Mhealth Uhealth 2024; 12:e49055. [PMID: 38532298 PMCID: PMC11004629 DOI: 10.2196/49055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 11/12/2023] [Accepted: 11/15/2023] [Indexed: 03/28/2024] Open
Abstract
Background The success of mobile apps in improving the lifestyle of patients with noncommunicable diseases through self-management interventions is contingent upon the emerging growth in this field. While users of mobile health (mHealth) apps continue to grow in number, little is known about the quality of available apps that provide self-management for common noncommunicable diseases such as diabetes, hypertension, and obesity. Objective We aimed to investigate the availability, characteristics, and quality of mHealth apps for common noncommunicable disease health management that included dietary aspects (based on the developer's description), as well as their features for promoting health outcomes and self-monitoring. Methods A systematic search of English-language apps on the Google Play Store (Google LLC) and Apple App Store (Apple Inc) was conducted between August 7, 2022, and September 13, 2022. The search terms used included weight management, obesity, diabetes, hypertension, cardiovascular diseases, stroke, and diet. The selected mHealth apps' titles and content were screened based on the description that was provided. Apps that were not designed with self-management features were excluded. We analyzed the mHealth apps by category and whether they involved health care professionals, were based on scientific testing, and had self-monitoring features. A validated and multidimensional tool, the Mobile App Rating Scale (MARS), was used to evaluate each mHealth app's quality based on a 5-point Likert scale from 1 (inadequate) to 5 (excellent). Results Overall, 42 apps were identified. Diabetes-specific mHealth apps accounted for 7% (n=3) of the market, hypertension apps for 12% (n=5), and general noncommunicable disease management apps for 21% (n=9). About 38% (n=16) of the apps were for managing chronic diseases, while 74% (n=31) were for weight management. Self-management features such as weight tracking, BMI calculators, diet tracking, and fluid intake tracking were seen in 86% (n=36) of the apps. Most mHealth apps (n=37, 88%) did not indicate whether there was involvement of health professionals in app development. Additionally, none of the apps reported scientific evidence demonstrating their efficacy in managing health. The overall mean MARS score was 3.2 of 5, with a range of 2.0 to 4.1. Functionality was the best-rated category (mean score 3.9, SD 0.5), followed by aesthetics (mean score 3.2, SD 0.9), information (mean score 3.1, SD 0.7), and engagement (mean score 2.9, SD 0.6). Conclusions The quality of mHealth apps for managing chronic diseases was heterogeneous, with roughly half of them falling short of acceptable standards for both quality and content. The majority of apps contained scant information about scientific evidence and the developer's history. To increase user confidence and accomplish desired health outcomes, mHealth apps should be optimized with the help of health care professionals. Future studies on mHealth content analysis should focus on other diseases as well.
Collapse
Affiliation(s)
- Khang Jin Cheah
- Center for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Zahara Abdul Manaf
- Center for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Arimi Fitri Mat Ludin
- Center for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nurul Huda Razalli
- Center for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | | | - Sawal Hamid Md Ali
- Electronic and Systems Engineering, Faculty of Engineering and Built Environment, Universiti Kebangsaan Malaysia, Selangor, Malaysia
| |
Collapse
|
5
|
Hayat J, Ramadhan M, Gonnah AR, Alfadhli A, Al-Naseem AO. The Role of Mobile Health Technology in Perioperative Spinal Care: A Systematic Scoping Review and Narrative Synthesis. Cureus 2024; 16:e54254. [PMID: 38496189 PMCID: PMC10944329 DOI: 10.7759/cureus.54254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2024] [Indexed: 03/19/2024] Open
Abstract
Smartphone applications play a crucial role in contemporary healthcare by aiming to enhance patient care through technology. Mobile health (mHealth) applications have proven to have transformative potential in enhancing patients' outcomes in candidates undergoing orthopedic and spinal surgery. In the context of the pervasive use of smartphones and the exponential growth of mHealth apps, totaling over 99,000 in 2021, the applications had a significant impact on lifestyle management, supporting initiatives like smoking cessation with motivational reminders and progress tracking. Patient compliance is significantly enhanced, reducing surgery cancellations and improving outcomes through effective adherence to pre-operative treatments and instructions. Physiotherapy receives a substantial boost as mHealth facilitates video-guided exercises, potentially improving compliance and treatment outcomes. Data collection takes on innovative dimensions, with mHealth apps capturing post-operative metrics like physical activity, offering valuable insights into patient recovery trends. Remote care is streamlined through features like photo uploads and direct messaging, proving especially beneficial in times of crises such as the COVID-19 pandemic. Despite these merits, challenges emerge, including issues related to technological literacy, potential discrimination due to paywalls, and concerns about patient data confidentiality. Overcoming these challenges requires standardized approaches, legislative measures, and ongoing research to refine and optimize mHealth applications for diverse healthcare settings.
Collapse
Affiliation(s)
- Jafar Hayat
- General Surgery, Sheikh Jaber Al-Ahmad Al-Sabah Hospital, Kuwait City, KWT
| | - Mohammed Ramadhan
- General Surgery, Sheikh Jaber Al-Ahmad Al-Sabah Hospital, Kuwait City, KWT
- Medicine, Ministry of Health, Kuwait, Hawally, KWT
- School of Medical Sciences, The University of Manchester, Manchester, GBR
| | - Ahmed R Gonnah
- Medicine, Imperial College Healthcare NHS Trust, London, GBR
| | - Alwaleed Alfadhli
- Faculty of Medicine, Royal College of Surgeons in Ireland, Dublin, IRL
| | | |
Collapse
|
6
|
Lee J, Su Z, Chen Y. Mobile Apps for Children's Health and Wellbeing: Design Features and Future Opportunities. AMIA ... ANNUAL SYMPOSIUM PROCEEDINGS. AMIA SYMPOSIUM 2024; 2023:1027-1036. [PMID: 38222362 PMCID: PMC10785842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Abstract
Mobile health apps hold great potential for promoting children's health and wellbeing. However, there is limited understanding of how these technologies are currently designed to support children with their health concerns or wellness goals. To gain insight into the current landscape of mobile apps designed for children's health, we retrieved and reviewed 43 apps from IOS and Google Play store that are specifically marketed for children. Our qualitative analysis identified the dominant health focuses and goals of children's mobile health apps. We analyzed the primary users and their expectations as well as the methods of engagement and involvement adopted. Based on our findings, we discussed the opportunities to support children with chronic illnesses through mobile apps, design for dual use, and design for age appropriateness and digital health safety. This study provides insights and recommendations for app designers, health researchers, and policymakers on strategies for engaging children and parents while also promoting children's health and wellbeing through mobile technology.
Collapse
Affiliation(s)
- Jamie Lee
- University of California, Irvine, Irvine, CA, USA
| | - Zhaoyuan Su
- University of California, Irvine, Irvine, CA, USA
| | - Yunan Chen
- University of California, Irvine, Irvine, CA, USA
| |
Collapse
|
7
|
Shaw G, Castro BA, Gunn LH, Norris K, Thorpe RJ. The Association of eHealth Literacy Skills and mHealth Application Use Among US Adults With Obesity: Analysis of Health Information National Trends Survey Data. JMIR Mhealth Uhealth 2024; 12:e46656. [PMID: 38198196 PMCID: PMC10809169 DOI: 10.2196/46656] [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: 02/22/2023] [Revised: 09/01/2023] [Accepted: 09/18/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND Physical inactivity and a poor diet are modifiable behaviors that contribute to obesity. Obesity is a well-recognized risk factor for chronic diseases, including diabetes. Mobile health (mHealth) apps can play an important adjuvant role in preventing and treating chronic diseases and promoting positive health behavior change among people with obesity, and eHealth literacy skills have the potential to impact mHealth app use. OBJECTIVE The purpose of this study was to explore the associations between the 2 dimensions, access and application, of eHealth literacy skills and mHealth app use among US adults (≥18 years of age) with obesity (BMI ≥30 kg/m2). METHODS Data were obtained from February to June 2020 using the Health Information National Trends Survey 5. A total of 1079 respondents met the inclusion criteria of adults with obesity and owners of smartphones. Individual associations between mHealth app use and sociodemographic variables were explored using weighted chi-square and 2-tailed t tests. A multivariable weighted logistic regression model was fitted, and adjusted odds ratios (ORs) of using mHealth apps with corresponding 95% CIs were reported across multiple sociodemographic variables. An Ising model-weighted network visualization was produced. A receiver operating characteristic curve was calculated, and the area under the curve was reported with the corresponding Delong 95% CI. RESULTS A majority of respondents were female (550/923, 59.6%) or non-Hispanic White (543/923, 58.8%). Individuals in households earning less than US $50,000 comprised 41.4% (382/923) of the sample. All sociodemographic variables were found to be univariately significant at the 5% level, except employment and region. Results from the multivariable weighted logistic regression model showed that the adjusted odds of using an mHealth app are 3.13 (95% CI 1.69-5.80) and 2.99 (95% CI 1.67-5.37) times higher among those with an access eHealth literacy skill of using an electronic device to look for health or medical information for themselves and an application eHealth literacy skill of using electronic communications with a doctor or doctor's office, respectively. Several sociodemographic variables were found to be significant, such as education, where adjusted ORs comparing subgroups to the lowest educational attainment were substantial (ORs ≥7.77). The network visualization demonstrated that all eHealth literacy skills and the mHealth app use variable were positively associated to varying degrees. CONCLUSIONS This work provides an initial understanding of mHealth app use and eHealth literacy skills among people with obesity, identifying people with obesity subpopulations who are at risk of a digital health divide. Future studies should identify equitable solutions for people with obesity (as well as other groups) and their use of mHealth apps.
Collapse
Affiliation(s)
- George Shaw
- Department of Public Health Sciences, School of Data Science, University of North Carolina at Charlotte, Charlotte, NC, United States
| | - Bianca A Castro
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC, United States
| | - Laura H Gunn
- Department of Public Health Sciences, School of Data Science, University of North Carolina at Charlotte, Charlotte, NC, United States
| | - Keith Norris
- The University of California Los Angeles Division of General Internal Medicine and Health Services Research, University of California, Los Angeles, Los Angeles, CA, United States
| | - Roland J Thorpe
- Department of Health, Behavior and Society, Johns Hopkins University, Baltimore, MD, United States
| |
Collapse
|
8
|
Mahmood A, Kim H, Chang CF, Kedia S, Arshad H, Dillon PJ. mHealth Apps Use and Their Associations With Healthcare Decision-Making and Health Communication Among Informal Caregivers: Evidence From the National Cancer Institute's Health Information National Trends Survey. Am J Health Promot 2024; 38:40-52. [PMID: 37708496 DOI: 10.1177/08901171231202861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
PURPOSE The current study investigates associations between mHealth apps and healthcare decision-making and health communication among informal caregivers in the US. DESIGN Cross-sectional study employing secondary data. SETTING The Health Information National Trends Survey (HINTS5, Cycles 2 through 4, 2018 - 2020). SAMPLE Self-identified informal caregivers (n = 1386; had mHealth apps = 61.3%, female = 63.2%, some college or more in education = 80.3%) who reported owning at least a smartphone or a tablet computer (i.e., ownership of a "smart device"). MEASURES Sociodemographic characteristics, reports of having mHealth apps, smart device utilization in healthcare decision-making and health communication. ANALYSIS Accounting for the complex design features of the HINTS data, we constructed multiple hierarchical logistic regressions to compute adjusted odds ratios (aOR) and their 95% confidence intervals (CI). RESULTS Compared to caregivers without mHealth apps, those with the apps had higher odds of utilizing their smart devices to make a health-related decision, such as how to treat a disease or a medical condition (aOR = 1.65; 95% CI: 1.13-2.39, P < .01), or engage in health-related discussions with a healthcare provider (aOR = 2.36; 95% CI: 1.54-3.61, P < .001). CONCLUSION Having mHealth apps was associated with a higher likelihood of using smart devices in healthcare decision-making and health communication by informal caregivers. Empowering caregivers to make informed health-related decisions and communicate effectively with healthcare providers are both crucial to health promotion and well-being. Future studies should investigate facilitators as well as barriers to using mHealth apps and smart devices in health-promoting strategies involving informal caregivers.
Collapse
Affiliation(s)
- Asos Mahmood
- Center for Health System Improvement, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
- Department of Medicine-General Internal Medicine, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Hyunmin Kim
- School of Health Professions, The University of Southern Mississippi, Hattiesburg, MS, USA
| | - Cyril F Chang
- Fogelman College of Business and Economics, The University of Memphis, Memphis, TN, USA
| | - Satish Kedia
- Division of Social and Behavioral Sciences, School of Public Health, The University of Memphis, Memphis, TN, USA
| | - Hassan Arshad
- Division of Social and Behavioral Sciences, School of Public Health, The University of Memphis, Memphis, TN, USA
| | - Patrick J Dillon
- School of Communication Studies, Kent State University at Stark, North Canton, OH, USA
| |
Collapse
|
9
|
Nkabane-Nkholongo E, Mokgatle M, Bickmore T, Julce C, Thompson D, JAck B. Change in Sexual and Reproductive Health Knowledge among Young Women Using the Conversational Agent "Nthabi" in Lesotho: A Clinical Trial. RESEARCH SQUARE 2023:rs.3.rs-3788533. [PMID: 38234736 PMCID: PMC10793503 DOI: 10.21203/rs.3.rs-3788533/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
Background Young women worldwide face problems like unwanted pregnancy and sexually transmitted infections. Providing sexual and reproductive health education to this population remains a priority. It is unknown if using digital health interventions to deliver health education in human resource-constrained settings is effective. Methods We conducted a clinical trial of the Nthabi intervention to determine participant's knowledge before and after discussion of family planning, folic acid and healthy eating among young women aged 18-28 years in two rural districts of Lesotho who used the Nthabi conversational agent system on either smartphones or tablets for up to six weeks. The number of correct pre- and post-test responses were compared using generalized linear models that directly estimated the proportions and percentages of correct responses. Results Of the 172 participants enrolled, the mean age was 22.5 years, 91% were unmarried, 69% completed high school, 23% were unemployed and 66% were students. The mean number of interactions with Nthabi was Family planning was chosen to be discussed by 82 (52.2%), of the 172 participants and of those, 49 (59.8%) completed the content on this topic, and 26 (53.1%) completed the post-test. For the 11 questions about family planning, there were 717 (76.6%) correct responses on the pre-test and 320 (89.9%) on the post-test (p = 0.0233). Folic acid was chosen to be discussed by 74 (47.1%) of 172 participants, and of those, 27 (36.5%) completed the content on this topic, and all 27 (100%) completed the post-test. For the 5 questions about folic acid use, there were 181 (45.3%) correct responses on the pre-test and 111 (71.6%) on the post-test (p < 0.0001). The number of correct responses on the post-test was positively associated with the number of sessions that the participant engaged with Nthabi. Conclusion The Nthabi conversational agent system increased knowledge of family planning methods and folic acid use among young women in Lesotho. Digital health interventions like Nthabi offer new opportunities to deliver reproductive health information in countries that have limited human resources for health. Trial Registration ClinicalTrials.gov ID: NCT04354168.
Collapse
|
10
|
Mahmoodi Kahriz B, Snuggs S, Sah A, Clot S, Lamport D, Forrest J, Helme-Guizon A, Wilhelm MC, Caldara C, Anin CV, Vogt J. Unveiling Consumer Preferences and Intentions for Cocreated Features of a Combined Diet and Physical Activity App: Cross-Sectional Study in 4 European Countries. JMIR Hum Factors 2023; 10:e44993. [PMID: 38079197 PMCID: PMC10750232 DOI: 10.2196/44993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 06/27/2023] [Accepted: 08/24/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Numerous mobile health apps are marketed globally, and these have specific features including physical activity tracking, motivational feedback, and recipe provision. It is important to understand which features individuals prefer and whether these preferences differ between consumer groups. OBJECTIVE In this study, we aimed to identify consumers' most preferred features and rewards for a mobile app that targets healthy eating and physical activity and to reduce the number of individual mobile health app features to a smaller number of key categories as perceived by consumers. In addition, we investigated the impact of differences in consumers' BMI and self-efficacy on their intention to use and willingness to pay for such an app. Finally, we identified the characteristics of different target groups of consumers and their responses toward app features via cluster analysis. METHODS A total of 212 participants from France, Italy, the United Kingdom, and Germany were recruited via the web to answer questions about app features, motivation, self-efficacy, demographics, and geographic factors. It is important to note that our study included an evenly distributed sample of people in the age range of 23 to 50 years (23-35 and 35-50 years). The app features in question were generated from a 14-day cocreation session by a group of consumers from the United Kingdom and the Republic of Ireland. RESULTS "Home work out suggestions," "exercise tips," and "progress charts" were the most preferred app features, whereas "gift vouchers" and "shopping discounts" were the most preferred rewards. "Connections with other communication apps" was the least preferred feature, and "charitable giving" was the least preferred reward. Importantly, consumers' positive attitude toward the "social support and connectedness and mindfulness" app feature predicted willingness to pay for such an app (β=.229; P=.004). Differences in consumers' health status, motivational factors, and basic demographics moderated these results and consumers' intention to use and willingness to pay for such an app. Notably, younger and more motivated consumers with more experience and knowledge about health apps indicated more positive attitudes and intentions to use and willingness to pay for this type of app. CONCLUSIONS This study indicated that consumers tend to prefer app features that are activity based and demonstrate progress. It also suggested a potential role for monetary rewards in promoting healthy lifestyle behaviors. Moreover, the results highlighted the role of consumers' health status, motivational factors, and socioeconomic status in predicting their app use. These results provide up-to-date, practical, and pragmatic information for the future design and operation of mobile health apps.
Collapse
Affiliation(s)
| | - Sarah Snuggs
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
| | - Anumeha Sah
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
| | - Sophie Clot
- Department of Economics, University of Reading, Reading, United Kingdom
| | - Daniel Lamport
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
| | - Joseph Forrest
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
| | | | | | - Cindy Caldara
- Grenoble Alpes University, Grenoble INP, CERAG, Grenoble, France
| | | | - Julia Vogt
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
| |
Collapse
|
11
|
Praha N, Sriyuktasuth A, Puwarawuttipanit W, Chuengsaman P, Kusakunniran W. Factors Influencing Telehealth Service Use and Health Outcomes in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis: Cross-Sectional Study. J Med Internet Res 2023; 25:e48623. [PMID: 38051557 PMCID: PMC10731559 DOI: 10.2196/48623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 10/11/2023] [Accepted: 10/31/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND Several studies have demonstrated the efficacy and user acceptance of telehealth in managing patients with chronic conditions, including continuous ambulatory peritoneal dialysis (CAPD). However, the rates of telehealth service use in various patient groups have been low and have declined over time, which may affect important health outcomes. Telehealth service use in patients undergoing CAPD has been recognized as a key challenge that needs to be examined further. OBJECTIVE This study aimed to explore the rates of telehealth service use over 4 months, identify factors influencing its use, and examine the relationship between telehealth service use and health outcomes in Thai people undergoing CAPD. METHODS This cross-sectional study, which was a part of a pragmatic randomized controlled trial study, was conducted at a dialysis center in Bangkok, Thailand. The study included patients who were undergoing CAPD. These patients were randomly enrolled in the intervention group to receive telehealth service and additional standard care for 4 months. Data were collected using self-reported questionnaires, including a demographic form, Functional, Communicative, and Critical Health Literacy Scale, Perceived Usefulness Questionnaire, Brief Illness Perception Questionnaire, Patient-Doctor Relationship Questionnaire, and Kidney Disease Quality of Life 36 Questionnaire. Additionally, Google Analytics was used to obtain data on the actual use of the telehealth service. These data were analyzed using descriptive statistics, repeated-measures ANOVA, and regression analyses. RESULTS A total of 159 patients were included in this study. The mean rate of telehealth service use throughout the period of 4 months was 62.06 (SD 49.71) times. The rate of telehealth service use was the highest in the first month (mean 23.48, SD 16.28 times) and the lowest in the third month (mean 11.09, SD 11.48 times). Independent variables explained 27.6% of the sample variances in telehealth service use. Older age (β=.221; P=.002), higher perceived usefulness (β=.414; P<.001), unemployment (β=-.155; P=.03), and positive illness perception (β=-.205; P=.004) were associated with a significantly higher rate of telehealth service use. Regarding the relationship between telehealth service use and health outcomes, higher rates of telehealth service use were linked to better quality of life (β=.241; P=.002) and lower peritonitis (odds ratio 0.980, 95% CI 0.962-0.997; P=.03). CONCLUSIONS This study provides valuable insights into factors impacting telehealth service use, which in turn affect health outcomes in patients undergoing CAPD.
Collapse
Affiliation(s)
- Nattaya Praha
- Faculty of Nursing, Mahidol University, Bangkok, Thailand
| | | | | | | | - Worapan Kusakunniran
- Faculty of Information and Communication Technology, Mahidol University, Nakhon Pathom, Thailand
| |
Collapse
|
12
|
Alluhaidan AS, Chatterjee S, Drew DE, Ractham P, Kaewkitipong L. Empowerment Enabled by Information and Communications Technology and Intention to Sustain a Healthy Behavior: Survey of General Users. JMIR Hum Factors 2023; 10:e47103. [PMID: 37991814 PMCID: PMC10701653 DOI: 10.2196/47103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 08/30/2023] [Accepted: 10/05/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Most people with chronic conditions fail to adhere to self-management behavioral guidelines. In the last 2 decades, several mobile health apps and IT-based systems have been designed and developed to help patients change and sustain their healthy behaviors. However, these systems often lead to short-term behavior change or adherence while the goal is to engage the population toward long-term behavior change. OBJECTIVE This study aims to contribute to the development of long-term health behavior changes or to help people sustain their healthy behavior. For this purpose, we built and tested a theoretical model that includes enablers of empowerment and an intention to sustain a healthy behavior when patients are assisted by information and communications technology. METHODS Structural equation modeling was used to analyze 427 survey returns collected from a diverse population of participants and patients. Notably, the model testing was performed for physical activity as a generally desirable healthy goal. RESULTS Message aligned with personal goals, familiarity with technology tools, high self-efficacy, social connection, and community support played a significant role (P<.001) in empowering individuals to maintain a healthy behavior. The feeling of being empowered exhibited a strong influence, with a path coefficient of 0.681 on an intention to sustain healthy behavior. CONCLUSIONS The uniqueness of this model is its recognition of needs (ie, social connection, community support, and self-efficacy) to sustain a healthy behavior. Individuals are empowered when they are assisted by family and community, specifically when they possess the knowledge, skills, and self-awareness to ascertain and achieve their goals. This nascent theory explains what might lead to more sustainable behavior change and is meant to help designers build better apps that enable people to conduct self-care routines and sustain their behavior.
Collapse
Affiliation(s)
- Ala Saleh Alluhaidan
- Department of Information Systems, College of Computer & Information Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Samir Chatterjee
- Center for Information Systems & Technology, Claremont Graduate University, Claremont, CA, United States
| | - David E Drew
- School of Educational Studies, Claremont Graduate University, Claremont, CA, United States
| | - Peter Ractham
- Center of Excellence in Operations and Information Management, Thammasat Business School, Thammasat University, Bangkok, Thailand
| | - Laddawan Kaewkitipong
- Center of Excellence in Operations and Information Management, Thammasat Business School, Thammasat University, Bangkok, Thailand
| |
Collapse
|
13
|
Eguchi A, Kawamura Y, Kawashima T, Ghaznavi C, Ishimura K, Kohsaka S, Matsuo S, Mizuno S, Sasaki Y, Takahashi A, Tanoue Y, Yoneoka D, Miyata H, Nomura S. The Efficacy of an mHealth App in Facilitating Weight Loss Among Japanese Fitness Center Members: Regression Analysis Study. JMIR Form Res 2023; 7:e48435. [PMID: 37938885 PMCID: PMC10666009 DOI: 10.2196/48435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 08/09/2023] [Accepted: 08/29/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Self-tracking smartphone apps have emerged as promising tools to encourage healthy behaviors. In this longitudinal study, we used gym use data from members of a major fitness club that operates gyms throughout Japan from January 2014 to December 2019. OBJECTIVE Our objective was to assess the extent to which a health and fitness self-tracking mobile app introduced to gym members on January 1, 2018, contributed to their weight loss. The app allows users to input information regarding diet, sleep, weight, and gym exercise so that they can receive personalized feedback from an artificial intelligence chatbot to improve their health behaviors. METHODS We used linear regression to quantify the association between app use and weight loss. The primary outcome of the study was the weight loss achieved by each gym user, which was calculated as the difference between their initial and final weights in kilograms, as recorded in the app. Individuals who did not attend the gym or failed to use the mobile app at least twice during the study period were excluded from the analysis. The model accounted for age, gender, distance between the gym and the member's residence, average weekly number of times a member used the gym, user's gym membership length in weeks, average weekly number of times a member input information into the app, and the number of weeks that the app was used at least once. RESULTS Data from 26,589 participants were analyzed. Statistically significant associations were detected between weight loss and 2 metrics related to app use: the average weekly frequency of use and the total number of weeks in which the app was used at least once. One input per week was found to be associated with a loss of 62.1 (95% CI 53.8-70.5) g, and 1 week of app use was associated with 21.7 (95% CI 20.5-22.9) g of weight loss from the day of the first input to that of the final input to the app. Furthermore, the average number of times that a member used the gym weekly was also shown to be statistically significantly associated with weight loss: 1 use per week was associated with 255.5 (95% CI 228.5-282.6) g of weight loss. CONCLUSIONS This empirical study demonstrated a significant association between weight loss among gym members and not only the frequency of weekly gym use but also the use of a health and fitness self-tracking app. However, further work is needed to examine the mechanisms through which mobile apps affect health behaviors and to identify the specific app features that are most effective in promoting weight loss.
Collapse
Affiliation(s)
- Akifumi Eguchi
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan
| | - Yumi Kawamura
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan
| | - Takayuki Kawashima
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan
- Department of Mathematical and Computing Science, Tokyo Institute of Technology, Tokyo, Japan
| | - Cyrus Ghaznavi
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan
- Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | | | - Shun Kohsaka
- Department of Cardiology, School of Medicine, Keio University, Tokyo, Japan
| | - Satoru Matsuo
- Communication Design Division, RENAISSANCE INC, Tokyo, Japan
| | | | | | - Arata Takahashi
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan
| | - Yuta Tanoue
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan
- Faculty of Marine Technology, Tokyo University of Marine Science and Technology, Tokyo, Japan
| | - Daisuke Yoneoka
- Center for Surveillance, Immunization, and Epidemiologic Research, National Institute of Infectious Diseases, Tokyo, Japan
- Tokyo Foundation for Policy Research, Tokyo, Japan
| | - Hiroaki Miyata
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan
- Tokyo Foundation for Policy Research, Tokyo, Japan
| | - Shuhei Nomura
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan
- Tokyo Foundation for Policy Research, Tokyo, Japan
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| |
Collapse
|
14
|
Fareed N, Swoboda C, Wang Y, Strouse R, Hoseus J, Baker C, Joseph JJ, Venkatesh K. An Evidence-Based Framework for Creating Inclusive and Personalized mHealth Solutions-Designing a Solution for Medicaid-Eligible Pregnant Individuals With Uncontrolled Type 2 Diabetes. JMIR Diabetes 2023; 8:e46654. [PMID: 37824196 PMCID: PMC10603563 DOI: 10.2196/46654] [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: 02/20/2023] [Revised: 06/21/2023] [Accepted: 08/02/2023] [Indexed: 10/13/2023] Open
Abstract
Mobile health (mHealth) apps can be an evidence-based approach to improve health behavior and outcomes. Prior literature has highlighted the need for more research on mHealth personalization, including in diabetes and pregnancy. Critical gaps exist on the impact of personalization of mHealth apps on patient engagement, and in turn, health behaviors and outcomes. Evidence regarding how personalization, engagement, and health outcomes could be aligned when designing mHealth for underserved populations is much needed, given the historical oversights with mHealth design in these populations. This viewpoint is motivated by our experience from designing a personalized mHealth solution focused on Medicaid-enrolled pregnant individuals with uncontrolled type 2 diabetes, many of whom also experience a high burden of social needs. We describe fundamental components of designing mHealth solutions that are both inclusive and personalized, forming the basis of an evidence-based framework for future mHealth design in other disease states with similar contexts.
Collapse
Affiliation(s)
- Naleef Fareed
- Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, OH, United States
| | - Christine Swoboda
- Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University, Columbus, OH, United States
| | - Yiting Wang
- Department of Research Information Technology, College of Medicine, The Ohio State University, Columbus, OH, United States
| | - Robert Strouse
- Department of Research Information Technology, College of Medicine, The Ohio State University, Columbus, OH, United States
| | | | | | - Joshua J Joseph
- Division of Endocrinology, Diabetes and Metabolism, College of Medicine, The Ohio State University, Columbus, OH, United States
| | - Kartik Venkatesh
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University, Columbus, OH, United States
| |
Collapse
|
15
|
Boo S, Oh H. Perceptions of registered nurses on facilitators and barriers of implementing the AI-IoT-based healthcare pilot project for older adults during the COVID-19 pandemic in South Korea. Front Public Health 2023; 11:1234626. [PMID: 37886046 PMCID: PMC10598465 DOI: 10.3389/fpubh.2023.1234626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 09/25/2023] [Indexed: 10/28/2023] Open
Abstract
Objective This study explored the perceptions of registered nurses on the facilitators and barriers to implementing an AI/IoT (Artificial Intelligence/Internet of Things)-based healthcare pilot project, designed to prevent frailty and improve health behaviors by providing Bluetooth-enabled smart devices (including blood pressure and blood glucose meters) for the older adults aged over 65 years and above in South Korea. Methods Using a qualitative descriptive methodology, interviews and qualitative surveys were conducted with 15 registered nurses from 11 public health centers. Data were analyzed using qualitative content analysis. Results The study found that the AI·IoT-based healthcare pilot project was well received by participants, leading to increased client satisfaction and improved health behaviors. Government support and funding were crucial facilitators of project implementation. However, technical challenges and disparities in digital literacy among older adults pose significant barriers. Conclusion The findings highlight the potential of AI·IoT technologies in improving the healthcare of older adults. Efforts to address technological challenges and enhance digital literacy among vulnerable populations are necessary for successfully implementing such interventions. Government support and ongoing training for healthcare professionals can help optimize the AI·IoT-based healthcare services for older adults.
Collapse
Affiliation(s)
- Sunjoo Boo
- College of Nursing Research Institute of Nursing Science, Suwon, Republic of Korea
| | - Hyunjin Oh
- College of Nursing, Gachon University, Incheon, Republic of Korea
| |
Collapse
|
16
|
Wu Y, Wang X, Gao F, Liao J, Zeng J, Fan L. Mobile nutrition and health management platform for perioperative recovery: an interdisciplinary research achievement using WeChat Applet. Front Med (Lausanne) 2023; 10:1201866. [PMID: 37293309 PMCID: PMC10244757 DOI: 10.3389/fmed.2023.1201866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 05/10/2023] [Indexed: 06/10/2023] Open
Abstract
Background In recent years, the number of people using mobile applications to promote health and welfare has exponentially increased. However, there are fewer applications in the field of ERAS. How to promote the rapid rehabilitation of patients with malignant tumor surgery during perioperative period and the mastery of its long-term nutritional state is a problem to be solved. Objective The purpose of this study is to design and develop a mobile application, and use Internet technology to better manage nutritional health to achieve rapid recovery of patients with malignant tumor surgery. Methods This study is divided into three stages: (1) Design: use participating design to make the MHEALTH APP adapt to the clinical practice of nutritional health management; (2) Development: the WeChat Applet of Nutrition and Health Assessment (WANHA) developed using the Internet technology development, and web management programs. (3) Procedure test: patients and medical staff evaluate WANHA's quality (UMARS), availability (SUS), and satisfaction, and conduct semi-structured interviews. Results In this study, 192 patients with malignant tumor surgery, 20 medical staff used WANHA. Patients with nutritional risks are supported by supporting treatment. The results show that patients who have not been treated during the perioperative period, the incidence of postoperative complications (22.4%) and the average hospitalization time after surgery decreased significantly. The incidence of nutritional risks is nearly more than the preoperative level. 45 patients and 20 medical staff participated in the survey of WANHA's SUS, UMARS, and satisfaction. In the interview, most patients and medical personnel believe that the procedure can improve the current medical services and nutritional health knowledge levels, promote the communication of medical staff and patients, and strengthen the nutritional health management of patients with malignant tumors under the concept of ERAS. Conclusion WeChat Applet of Nutrition and Health Assessment is a MHEALTH APP that enhances the nutrition and health management of patients with perioperative period. It can play a huge role in improving medical services, increasing patient satisfaction, and ERAS.
Collapse
Affiliation(s)
- YuJia Wu
- Department of Anesthesiology, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biometal Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Xin Wang
- Department of Anesthesiology, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biometal Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Feng Gao
- Department of Anesthesiology, The Sixth People’s Hospital of Chongqing, Chongqing, China
| | - JinRong Liao
- Department of Anesthesiology, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biometal Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Jie Zeng
- Department of Anesthesiology, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biometal Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Lin Fan
- Department of Anesthesiology, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biometal Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| |
Collapse
|
17
|
Alten R, Moss S, Hahne S, Muriset AT, Gruben D, Latymer M. High Usability and Applicability Ratings for the New SmartClic ®/ClicWise ® Injection Device: Evidence from a Health Care Professional Opinion Study. Rheumatol Ther 2023; 10:477-487. [PMID: 36689125 PMCID: PMC10011277 DOI: 10.1007/s40744-022-00520-2] [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: 04/01/2022] [Accepted: 12/08/2022] [Indexed: 01/24/2023] Open
Abstract
INTRODUCTION The SmartClic®/ClicWise® autoinjector is a new reusable, multi-use, single-patient device for the administration of subcutaneously administered biologics in the treatment of chronic conditions, including rheumatoid arthritis. The device will be used in conjunction with a mobile application (app). The aim of this study was to collect feedback on the usability, functionality, and applicability of the device and the companion app from health care professionals (HCPs) who perform injections as part of their role and care for patients with rheumatic conditions. METHODS The study was conducted from September to October 2020 in Germany. HCPs participated in a training session for the device and gained experience by performing simulated injections with water. Following the simulations, HCPs answered questions on the ease of use, feature design, effectiveness, and injection speed of the SmartClic/ClicWise device and estimate the patient training time required. They also answered questions on the functionality of the proposed app after attending a storyboard presentation. Responses were recorded as multiple-choice answers, Likert scale ratings (seven-point scale), or open-ended comments. The mean, median, and mode scores were recorded. RESULTS Twenty-five HCPs (mean age, 38.2 years; females, n = 22 [88%]; registered nurses, n = 19 [76%]) participated in the study. HCP feedback on questions related to the SmartClic/ClicWise device was positive overall, with mean scores > 4.50 across questions; mean scores < 5.00 were reported on 2/40 questions. Twenty-four of 25 participants (96%) estimated that a training time of ≤ 20 min would suffice for patients learning to use the device. Positive feedback was also reported on questions related to the companion app, with mean scores > 5.70. CONCLUSIONS Initial feedback from HCPs on the SmartClic/ClicWise device and proposed app was generally favorable, suggesting they will provide an acceptable alternative for self-administration of biologics for patients with rheumatoid arthritis and other chronic conditions.
Collapse
Affiliation(s)
- Rieke Alten
- Department of Internal Medicine, Rheumatology, Clinical Immunology, Osteology at Schlosspark-Klinik, University Medicine Berlin, Berlin, Germany
| | | | | | | | | | - Mark Latymer
- Inflammation and Immunology Global Medical Affairs, Pfizer Biopharmaceuticals Group, Ramsgate Road, Sandwich, CT13 9NJ, UK.
| |
Collapse
|
18
|
Che Johan NAS, Rasani AAM, Keng SL. Chronic kidney disease patients' views of readiness and ability to use mHealth apps. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2023; 32:74-80. [PMID: 36715528 DOI: 10.12968/bjon.2023.32.2.74] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
BACKGROUND The use of mobile health (mHealth) applications, which provide opportunities to improve health and lessen health inequalities, is increasing. Studies assessing the readiness and ability of patients in Malaysia with chronic kidney disease (CKD) to use mobile phone apps to manage their health are limited. AIMS This study aimed to assess the readiness and ability to use mHealth apps among patients with CKD in north-east Peninsular Malaysia. METHODS A cross-sectional study was undertaken, using a convenience sample of 100 CKD medical inpatients in a tertiary teaching hospital. A structured, self-administered questionnaire on readiness and ability to use mHealth apps was adopted. FINDINGS Nearly one in five patients (18%) actively used health applications. More than three-quarters (77%) were aged >40 years and a similar proportion were ready to use mHealth apps (78%), and nearly half (46%) were confident about connecting their device to wifi. There was a correlation between ability and readiness to use mHealth apps (r=0.4; P<0.05). CONCLUSIONS Fewer than half of participants had a good command of mHealth applications. Therefore, support on the use of these apps is needed, and healthcare managers need to consider this.
Collapse
Affiliation(s)
| | | | - Soon Lean Keng
- Associate Professor and Academic Fellow, Nursing Programme, School of Health Sciences, Universiti Sains Malaysia
| |
Collapse
|
19
|
Fareed N, Swoboda C, Singh P, Boettcher E, Wang Y, Venkatesh K, Strouse R. Developing and testing an integrated patient mHealth and provider dashboard application system for type 2 diabetes management among Medicaid-enrolled pregnant individuals based on a user-centered approach: Mixed-methods study. Digit Health 2023; 9:20552076221144181. [PMID: 36644662 PMCID: PMC9834416 DOI: 10.1177/20552076221144181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 11/21/2022] [Indexed: 01/11/2023] Open
Abstract
Background A tailored and integrated technology solution (patient mHealth application and provider dashboard) can provide a 360° view of Medicaid-enrolled patients with type 2 diabetes (T2D) during pregnancy that could improve health outcomes and address health inequities. Objectives To develop a set of user specifications for the mHealth and dashboard applications, develop prototypes based on user needs, and collect initial impressions of the prototypes to subsequently develop refined tools that are ready for deployment. Methods Study activities followed a double-diamond framework with a participatory design mindset. Activities were divided into two phases focused on a qualitative inquiry about participant needs and values (phase 1) and design, development, and usability testing of low and high-fidelity prototypes (phase 2). Results We identified themes that exemplified pregnancy experience among Medicaid-enrolled individuals with T2D. Patients (n = 7) and providers (n = 7) expressed a core set of expectations for the mHealth and dashboard applications. Participants provided feedback to improve the mHealth and dashboard. For both applications, participants reported scores for the NASA Task load Survey (TLX) that were in the 20th percentile of national TLX scores. Conclusions Digital health tools have the ability to transform health care among Medicaid-enrolled patients with T2D during pregnancy, with the goal of managing their blood glucose levels, which is a precursor to experiencing a successful pregnancy and birth. Distilling patient and provider needs and preferences-then using them, along with prior studies and theory, to develop applications-holds great potential in tackling complicated health care issues.
Collapse
Affiliation(s)
- Naleef Fareed
- CATALYST – The Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University, Institute for Behavioral Medicine Research, Columbus, OH, USA,Naleef Fareed, 460 Medical Center Drive, Columbus, OH 43210, USA.
| | - Christine Swoboda
- CATALYST – The Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University, Institute for Behavioral Medicine Research, Columbus, OH, USA
| | - Priti Singh
- CATALYST – The Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University, Institute for Behavioral Medicine Research, Columbus, OH, USA
| | - Emma Boettcher
- Department of Research Information Technology, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Yiting Wang
- Department of Research Information Technology, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Kartik Venkatesh
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University, Columbus, OH, USA
| | - Robert Strouse
- Department of Research Information Technology, College of Medicine, The Ohio State University, Columbus, OH, USA
| |
Collapse
|
20
|
Factors associated with long-term use of digital devices in the electronic Framingham Heart Study. NPJ Digit Med 2022; 5:195. [PMID: 36572707 PMCID: PMC9792462 DOI: 10.1038/s41746-022-00735-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 11/29/2022] [Indexed: 12/28/2022] Open
Abstract
Long-term use of digital devices is critical for successful clinical or research use, but digital health studies are challenged by a rapid drop-off in participation. A nested e-cohort (eFHS) is embedded in the Framingham Heart Study and uses three system components: a new smartphone app, a digital blood pressure (BP) cuff, and a smartwatch. This study aims to identify factors associated with the use of individual eFHS system components over 1-year. Among 1948 eFHS enrollees, we examine participants who returned surveys within 90 days (n = 1918), and those who chose to use the smartwatch (n = 1243) and BP cuff (n = 1115). For each component, we investigate the same set of candidate predictors for usage and use generalized linear mixed models to select predictors (P < 0.1, P value from Z test statistic), adjusting for age, sex, and time (app use: 3-month period, device use: weekly). A multivariable model with the predictors selected from initial testing is used to identify factors associated with use of components (P < 0.05, P value from Z test statistic) adjusting for age, sex, and time. In multivariable models, older age is associated with higher use of all system components. Female sex and higher education levels are associated with higher completion of app-based surveys whereas higher scores for depressive symptoms, and lower than excellent self-rated health are associated with lower use of the smartwatch over the 12-month follow-up. Our findings show that sociodemographic and health related factors are significantly associated with long-term use of digital devices. Future research is needed to test interventional strategies focusing on these factors to evaluate improvement in long-term engagement.
Collapse
|
21
|
Barbaric A, Munteanu C, Ross H, Cafazzo JA. A Voice App Design for Heart Failure Self-management: Proof-of-Concept Implementation Study. JMIR Form Res 2022; 6:e40021. [PMID: 36542435 DOI: 10.2196/40021] [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: 06/13/2022] [Revised: 10/13/2022] [Accepted: 10/26/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Voice user interfaces are becoming more prevalent in health care and are commonly being used for patient engagement. There is a growing interest in identifying the potential this form of interface has on patient engagement with digital therapeutics (DTx) in chronic disease management. Making DTx accessible through an alternative interaction model also has the potential to better meet the needs of some patients, such as older adults and those with physical and cognitive impairments, based on existing research. OBJECTIVE This study aimed to evaluate how participants with heart failure interacted with a voice app version of a DTx, Medly, through a proof-of-concept implementation study design. The objective was to understand whether the voice app would enable the participants to successfully interact with the DTx, with a focus on acceptability and feasibility. METHODS A mixed methods concurrent triangulation design was used to better understand the acceptability and feasibility of the use of the Medly voice app with the study participants (N=20) over a 4-week period. Quantitative data included engagement levels, accuracy rates, and questionnaires, which were analyzed using descriptive statistics. Qualitative data included semistructured interviews and were analyzed using a qualitative descriptive approach. RESULTS The overall average engagement level was 73% (SD 9.5%), with a 14% decline between results of weeks 1 and 4. The biggest difference was between the average engagement levels of the oldest and youngest demographics, 84% and 43%, respectively, but these results were not significant-Kruskal-Wallis test, H(2)=3.8 (P=.14). The Medly voice app had an overall accuracy rate of 97.8% and was successful in sending data to the clinic. From an acceptability perspective, the voice app was ranked in the 80th percentile, and overall, the users felt that the voice app was not a lot of work (average of 2.1 on a 7-point Likert scale). However, the overall average score for whether users would use it in the future declined by 13%. Thematic analysis revealed the following: the theme feasibility of clinical integration had 2 subthemes, namely users adapted to the voice app's conversational style and device unreliability, and the theme voice app acceptability had 3 subthemes, namely the device integrated well within household and users' lives, users blamed themselves when problems arose with the voice app, and voice app was missing specific, desirable user features. CONCLUSIONS In conclusion, participants were largely successful in using the Medly voice app despite some of the barriers faced, proving that an app such as this could be feasible to be deployed in the clinic. Our data begin to piece together the patient profile this technology may be most suitable for, namely those who are older, have flexible schedules, are confident in using technology, and are experiencing other medical conditions.
Collapse
Affiliation(s)
- Antonia Barbaric
- Centre for Digital Therapeutics, Techna Institute, University Health Network, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada
| | - Cosmin Munteanu
- Institute for Communication, Culture, Information, and Technology, University of Toronto, Mississauga, ON, Canada.,Technologies for Aging Gracefully Lab, University of Toronto, Toronto, ON, Canada
| | - Heather Ross
- Ted Rogers Centre for Heart Research, University Health Network, Toronto, ON, Canada.,Department of Medicine, University of Toronto, Toronto, ON, Canada.,Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada
| | - Joseph A Cafazzo
- Centre for Digital Therapeutics, Techna Institute, University Health Network, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada.,Department of Computer Science, University of Toronto, Toronto, ON, Canada.,Healthcare Human Factors, Techna Institute, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
22
|
Barbaric A, Munteanu C, Ross H, Cafazzo JA. Design of a Patient Voice App Experience for Heart Failure Management: Usability Study. JMIR Form Res 2022; 6:e41628. [PMID: 36472895 PMCID: PMC9768654 DOI: 10.2196/41628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 09/26/2022] [Accepted: 10/12/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The use of digital therapeutics (DTx) in the prevention and management of medical conditions has increased through the years, with an estimated 44 million people using one as part of their treatment plan in 2021, nearly double the number from the previous year. DTx are commonly accessed through smartphone apps, but offering these treatments through additional platforms can improve the accessibility of these interventions. Voice apps are an emerging technology in the digital health field; not only do they have the potential to improve DTx adherence, but they can also create a better user experience for some user groups. OBJECTIVE This research aimed to identify the acceptability and feasibility of offering a voice app for a chronic disease self-management program. The objective of this project was to design, develop, and evaluate a voice app of an already-existing smartphone-based heart failure self-management program, Medly, to be used as a case study. METHODS A voice app version of Medly was designed and developed through a user-centered design process. We conducted a usability study and semistructured interviews with patients with heart failure (N=8) at the Peter Munk Cardiac Clinic in Toronto General Hospital to better understand the user experience. A Medly voice app prototype was built using a software development kit in tandem with a cloud computing platform and was verified and validated before the usability study. Data collection and analysis were guided by a mixed methods triangulation convergence design. RESULTS Common themes were identified in the results of the usability study, which involved 8 participants with heart failure. Almost all participants (7/8, 88%) were satisfied with the voice app and felt confident using it, although half of the participants (4/8, 50%) were unsure about using it in the future. Six main themes were identified: changes in physical behavior, preference between voice app and smartphone, importance of music during voice app interaction, lack of privacy concerns, desired reassurances during voice app interaction, and helpful aids during voice app interaction. These findings were triangulated with the quantitative data, and it concluded that the main area for improvement was related to the ease of use; design changes were then implemented to better improve the user experience. CONCLUSIONS This work offered preliminary insight into the acceptability and feasibility of a Medly voice app. Given the recent emergence of voice apps in health care, we believe that this research offered invaluable insight into successfully deploying DTx for chronic disease self-management using this technology.
Collapse
Affiliation(s)
- Antonia Barbaric
- Centre for Digital Therapeutics, Techna Institute, University Health Network, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada
| | - Cosmin Munteanu
- Institute for Communication, Culture, Information, and Technology, University of Toronto, Mississauga, ON, Canada
- Technologies for Aging Gracefully Lab, University of Toronto, Toronto, ON, Canada
| | - Heather Ross
- Ted Rogers Centre for Heart Research, University Health Network, Toronto, ON, Canada
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada
| | - Joseph A Cafazzo
- Centre for Digital Therapeutics, Techna Institute, University Health Network, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada
- Department of Computer Science, University of Toronto, Toronto, ON, Canada
- Healthcare Human Factors, Techna Institute, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
23
|
Qian Y, Ni Z, Zheng H, Liu Z, Ma F. Factors influencing users’ post replying behavior in a senior online community: An empirical investigation. TELEMATICS AND INFORMATICS 2022. [DOI: 10.1016/j.tele.2022.101926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
|
24
|
Nelson LA, Alfonsi SP, Lestourgeon LM, Mayberry LS. Disparities in mobile phone use among adults with type 2 diabetes participating in clinical trials 2017-2021. JAMIA Open 2022; 5:ooac095. [PMID: 36380850 PMCID: PMC9648685 DOI: 10.1093/jamiaopen/ooac095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 09/27/2022] [Accepted: 10/25/2022] [Indexed: 11/20/2023] Open
Abstract
Despite smartphone ownership becoming ubiquitous, it is unclear whether and where disparities persist in experience using health apps. In 2 diverse samples of adults with type 2 diabetes collected 2017-2018 and 2020-2021, we examined adjusted disparities in smartphone ownership and health app use by age, gender, race, education, annual household income, health insurance status, health literacy, and hemoglobin A1c. In the earlier sample (N = 422), 87% owned a smartphone and 49% of those had ever used a health app. Participants with lower income or limited health literacy had ≥50% lower odds of owning a smartphone. Comparatively, in the later sample (N = 330), almost all participants (98%) owned a smartphone and 70% of those had ever used a health app; however, disparities in health app use closely mirrored disparities in smartphone ownership from 2017 to 2018. Our findings suggest device ownership is necessary but insufficient for assuming people will use apps to support their health.
Collapse
Affiliation(s)
- Lyndsay A Nelson
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Center for Health Behavior and Health Education, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Samuel P Alfonsi
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Lauren M Lestourgeon
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Center for Health Behavior and Health Education, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Lindsay S Mayberry
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Center for Health Behavior and Health Education, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| |
Collapse
|
25
|
Mahmood A, Kim H, Kedia S, Dillon P. Wearable Activity Tracker Use and Physical Activity Among Informal Caregivers in the United States: Quantitative Study. JMIR Mhealth Uhealth 2022; 10:e40391. [PMID: 36422886 PMCID: PMC9732754 DOI: 10.2196/40391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 10/13/2022] [Accepted: 10/21/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND With an increase in aging population and chronic medical conditions in the United States, the role of informal caregivers has become paramount as they engage in the care of their loved ones. Mounting evidence suggests that such responsibilities place substantial burden on informal caregivers and can negatively impact their health. New wearable health and activity trackers (wearables) are increasingly being used to facilitate and monitor healthy behaviors and to improve health outcomes. Although prior studies have examined the efficacy of wearables in improving health and well-being in the general population, little is known about their benefits among informal caregivers. OBJECTIVE This study aimed to examine the association between use of wearables and levels of physical activity (PA) among informal caregivers in the United States. METHODS We used data from the National Cancer Institute's Health Information National Trends Survey 5 (cycle 3, 2019 and cycle 4, 2020) for a nationally representative sample of 1273 community-dwelling informal caregivers-aged ≥18 years, 60% (757/1273) female, 75.7% (990/1273) had some college or more in education, and 67.3% (885/1273) had ≥1 chronic medical condition-in the United States. Using jackknife replicate weights, a multivariable logistic regression was fit to assess an independent association between the use of wearables and a binary outcome: meeting or not meeting the current World Health Organization's recommendation of PA for adults (≥150 minutes of at least moderate-intensity PA per week). RESULTS More than one-third (466/1273, 37.8%) of the informal caregivers met the recommendations for adult PA. However, those who reported using wearables (390/1273, 31.7%) had slightly higher odds of meeting PA recommendations (adjusted odds ratios 1.1, 95% CI 1.04-1.77; P=.04) compared with those who did not use wearables. CONCLUSIONS The results demonstrated a positive association between the use of wearables and levels of PA among informal caregivers in the United States. Therefore, efforts to incorporate wearable technology into the development of health-promoting programs or interventions for informal caregivers could potentially improve their health and well-being. However, any such effort should address the disparities in access to innovative digital technologies, including wearables, to promote health equity. Future longitudinal studies are required to further support the current findings of this study.
Collapse
Affiliation(s)
- Asos Mahmood
- Center for Health System Improvement, University of Tennessee Health Science Center, Memphis, TN, United States
- Department of Medicine, General Internal Medicine, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Hyunmin Kim
- School of Health Professions, The University of Southern Mississippi, Hattiesburg, MS, United States
| | - Satish Kedia
- School of Public Health, The University of Memphis, Memphis, TN, United States
| | - Patrick Dillon
- School of Communication Studies, Kent State University, North Canton, OH, United States
| |
Collapse
|
26
|
Chen Y, Liu W. Utilization and out-of-pocket expenses of primary care among the multimorbid elderly in China: A two-part model with nationally representative data. Front Public Health 2022; 10:1057595. [PMID: 36504938 PMCID: PMC9730339 DOI: 10.3389/fpubh.2022.1057595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 11/11/2022] [Indexed: 11/25/2022] Open
Abstract
Background Multimorbidity has become an essential public health issue that threatens human health and leads to an increased disease burden. Primary care is the prevention and management of multimorbidity by providing continuous, comprehensive patient-centered services. Therefore, the study aimed to investigate the determinants of primary care utilization and out-of-pocket expenses (OOPE) among multimorbid elderly to promote rational utilization of primary care and reduce avoidable economic burdens. Methods The study used data from CHARLS 2015 and 2018, which included a total of 4,384 multimorbid elderly aged 60 and above. Guided by Grossman theory, determinants such as education, gender, marriage, household economy, and so on were included in this study. A two-part model was applied to evaluate primary care utilization and OOPE intensity in multimorbid populations. And the robustness testing was performed to verify research results. Results Primary care visits rate and OOPE indicated a decline from 2015 to 2018. Concerning primary outpatient care, the elderly who were female (OR = 1.51, P < 0.001), married (OR = 1.24, P < 0.05), living in rural areas (OR = 1.77, P < 0.001) and with poor self-rated health (OR = 2.23, P < 0.001) had a significantly higher probability of outpatient utilization, whereas those with middle school education (OR = 0.61, P < 0.001) and better household economy (OR = 0.96, P < 0.001) had a significantly less likelihood of using outpatient care. Rural patients (β = -0.72, P < 0.05) may have lower OOPE, while those with better household economy (β = 0.29, P < 0.05; β = 0.58, P < 0.05) and poor self-rated health (β = 0.62, P < 0.001) occurred higher OOPE. Regarding primary inpatient care, adults who were living in rural areas (OR = 1.48, P < 0.001), covered by Urban Employee Basic Medical Insurance (UEBMI) or Urban Rural Basic Medical Insurance (URBMI) (OR = 2.46, P < 0.001; OR = 1.81, P < 0.001) and with poor self-rated health (OR = 2.30, P < 0.001) had a significantly higher probability of using inpatient care, whereas individuals who were female (OR = 0.74, P < 0.001), with middle school education (OR = 0.40, P < 0.001) and better household economy (OR = 0.04, P < 0.001) had a significantly lower tendency to use inpatient care. Significantly, more OOPE occurred by individuals who were women (β = 0.18, P < 0.05) and with better household economy (β = 0.40, P < 0.001; β = 0.62, P < 0.001), whereas those who were covered by URBMI (β = -0.25, P < 0.05) and satisfied with their health (β = -0.21, P < 0.05) had less OOPE. Conclusion To prompt primary care visits and reduce economic burden among subgroups, more policy support is in need, such as tilting professional medical staff and funding to rural areas, enhancing awareness of disease prevention among vulnerable groups and so on.
Collapse
|
27
|
Scherer J, Youssef Y, Dittrich F, Albrecht UV, Tsitsilonis S, Jung J, Pförringer D, Landgraeber S, Beck S, Back DA. Proposal of a New Rating Concept for Digital Health Applications in Orthopedics and Traumatology. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14952. [PMID: 36429670 PMCID: PMC9690508 DOI: 10.3390/ijerph192214952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/29/2022] [Accepted: 11/11/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Health-related mobile applications (apps) are rapidly increasing in number. There is an urgent need for assessment tools and algorithms that allow the usability and content criteria of these applications to be objectively assessed. The aim of this work was to establish and validate a concept for orthopedic societies to rate health apps to set a quality standard for their safe use. METHODS An objective rating concept was created, consisting of nine quality criteria. A self-declaration sheet for app manufacturers was designed. Manufacturers completed the self-declaration, and the app was examined by independent internal reviewers. The pilot validation and analysis were performed on two independent health applications. An algorithm for orthopedic societies was created based on the experiences in this study flow. RESULTS "Sprunggelenks-App" was approved by the reviewers with 45 (98%) fulfilled criteria and one (2%) unfulfilled criterion. "Therapie-App" was approved, with 28 (61%) met criteria, 6 (13%) unfulfilled criteria and 12 (26%) criteria that could not be assessed. The self-declaration completed by the app manufacturer is recommended, followed by a legal and technical rating performed by an external institution. When rated positive, the societies' internal review using independent raters can be performed. In case of a positive rating, a visual certification can be granted to the manufacturer for a certain time frame. CONCLUSION An objective rating algorithm is proposed for the assessment of digital health applications. This can help societies to improve the quality assessment, quality assurance and patient safety of those apps. The proposed concept must be further validated for inter-rater consistency and reliability.
Collapse
Affiliation(s)
- Julian Scherer
- Department of Traumatology, University Hospital Zurich, Raemistr. 100, 8091 Zürich, Switzerland
| | - Yasmin Youssef
- Department of Orthopedic, Trauma and Plastic Surgery, University Hospital Leipzig, Liebigstr. 20, 04103 Leipzig, Germany
| | - Florian Dittrich
- Joint Centre Bergisch Land, Department for Orthopaedics, Sana Fabricius Clinic Remscheid, Brüderstraße 65, 42853 Remscheid, Germany
- Department of Orthopedics and Orthopedic Surgery, Universität des Saarlandes-Campus Homburg, Kirrberger Straße, 66421 Homburg, Germany
| | - Urs-Vito Albrecht
- Medizinische Fakultät OWL, AG 4-Digitale Medizin, Universität Bielefeld, 33501 Bielefeld, Germany
| | - Serafeim Tsitsilonis
- Center for Musculoskeletal Surgery, Charité–Universitätsmedizin Berlin, Augustenburger Pl. 1, 13353 Berlin, Germany
| | - Jochen Jung
- ATOS Klinik Heidelberg, Department of Orthopaedic Surgery, Bismarckstr. 9-15, 69115 Heidelberg, Germany
| | - Dominik Pförringer
- Trauma Surgery, Klinikum rechts der Isar, Technical University of Munich, Clinic and Policlinic for Trauma Surgery, Ismaninger Str. 22, 81675 Munich, Germany
| | - Stefan Landgraeber
- Department of Orthopedics and Orthopedic Surgery, Universität des Saarlandes-Campus Homburg, Kirrberger Straße, 66421 Homburg, Germany
| | - Sascha Beck
- Clinic for Orthopaedics and Trauma Surgery, Sportsclinic Hellersen, Paulmannshöher Str. 17, 58515 Lüdenscheid, Germany
| | - David A. Back
- Bundeswehr Hospital Berlin, Department for Traumatology and Orthopedics, Scharnhorststr. 13, 10115 Berlin, Germany
| |
Collapse
|
28
|
Gill P, King K, Flego A. The use of e-& mHealth technology-based interventions to improve modifiable lifestyle risk factors amongst individuals with severe mental illness (SMI): a scoping review. AUSTRALIAN PSYCHOLOGIST 2022. [DOI: 10.1080/00050067.2022.2107889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- Parveen Gill
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Kylie King
- Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia
| | - Anna Flego
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| |
Collapse
|
29
|
Ajayi KV, Wachira E, Onyeaka HK, Montour T, Olowolaju S, Garney W. The Use of Digital Health Tools for Health Promotion Among Women With and Without Chronic Diseases: Insights From the 2017-2020 Health Information National Trends Survey. JMIR Mhealth Uhealth 2022; 10:e39520. [PMID: 35984680 PMCID: PMC9440408 DOI: 10.2196/39520] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 07/16/2022] [Accepted: 07/25/2022] [Indexed: 11/13/2022] Open
Abstract
Background In the United States, almost 90% of women are at risk of at least one chronic condition. However, the awareness, management, and monitoring of these conditions are low and present a substantial public health problem. Digital health tools can be leveraged to reduce the alarmingly high rates of chronic condition–related mortality and morbidity in women. Objective This study aimed to investigate the 4-year trend of digital health use for health promotion among women with chronic conditions in the United States. Methods Data for this study were obtained from the 2017 to 2020 iterations of the Health Information Trends Survey 5. Separate weighted logistic regression models were conducted to test the unadjusted and adjusted association of the study variables and each digital health use. The 95% CI, adjusted odds ratio (aOR), and P value (.05) were reported. Analysis was conducted using Stata 17 software. Results In total, 8573 women were included in this study. The weighted prevalence of the use of a smartphone or tablet for various activities were as follows: track health goals, 50.3% (95% CI 48.4%-52.2%; 3279/7122); make a health decision, 43.6% (95% CI 41.9%-45.3%; 2998/7101); and discuss with a provider, 40% (95% CI 38.2%-41.8%; 2834/7099). In the preceding 12 months, 33% (95% CI 30.9%-35.2%; 1395/4826) of women used an electronic wearable device, 18.7% (95% CI 17.3%-20.2%; 1532/7653) shared health information, and 35.2% (95% CI 33.2%-37.3%; 2262/6349) sent or received an SMS text message with a health professional. Between 2017 and 2020, the weighted prevalence of having 0, 1, and multiple chronic conditions were 37.4% (2718/8564), 33.4% (2776/8564), and 29.3% (3070/8564), respectively. However, slightly above half (52.2%, 95% CI 0.50%-0.53%; 4756/8564) of US women reported having at least one chronic disease. Women with multiple chronic conditions had higher odds of using their tablet or smartphone to achieve a health-related goal (aOR 1.43, 95% CI 1.16-1.77; P=.001) and discuss with their provider (aOR 1.55 95% CI 1.20-2.00; P=.001) than those without any chronic conditions. Correspondingly, in the past 12 months, the odds of using an electronic wearable device (aOR 1.40, 95% CI 1.00-1.96; P=.04), sharing health information (aOR 1.91, 95% CI 1.46-2.51; P<.001), and communicating via SMS text messaging with a provider (aOR 1.31, 95% CI 1.02-1.68; P=.03) were significantly higher among women with chronic conditions than those without a chronic condition. Conclusions This study suggests that women with chronic conditions accept and integrate digital health tools to manage their care. However, certain subpopulations experience a digital disconnect that may exacerbate existing health inequities. Implications for research and opportunities to leverage and integrate digital health tools to prevent, monitor, manage, and treat chronic conditions in women are discussed.
Collapse
Affiliation(s)
- Kobi V Ajayi
- Department of Health & Kinesiology, Texas A&M University, College Station, TX, United States
| | - Elizabeth Wachira
- Department of Health and Human Performance, Texas A&M University, Commerce, TX, United States
| | - Henry K Onyeaka
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States
- Department of Psychiatry, McLean Hospital, Belmont, MA, United States
| | - Tyra Montour
- Department of Health & Kinesiology, Texas A&M University, College Station, TX, United States
| | - Samson Olowolaju
- Department of Demography, College for Health, Community and Policy, University of Texas, San Antonio, TX, United States
| | - Whitney Garney
- Department of Health & Kinesiology, Texas A&M University, College Station, TX, United States
| |
Collapse
|
30
|
Huang X, Zeng J, Zhao N, Fan L, Ruan D, Wang J, Hong X, Yu C. Experience of using a smartphone WeChat applet for dental anxiety assessment and preoperative evaluation: A nationwide multicenter study. Front Public Health 2022; 10:900899. [PMID: 35923975 PMCID: PMC9342676 DOI: 10.3389/fpubh.2022.900899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 06/27/2022] [Indexed: 11/13/2022] Open
Abstract
IntroductionDental anxiety is a multivariate phenomenon that regularly occurs during a dental procedure. Although it may lead to patients' safety concerns and adverse events in routine treatment, it is often ignored. The purpose of this research is to develop a novel WeChat Applet for dental anxiety (WADA) with the following features and aims: (1) to help patients with dental anxiety management; (2) provide patient with a physical status self-evaluation; and(3) provide a platform for online assessment and tele-consultancy by dentists. We aimed to test and verify whether such an applet could play a beneficial role before and after a dental procedure and facilitate management of high-risk patients during the COVID-19 pandemic.Materials and methodsDuring the 12-month survey period (August 2020 to July 2021), a total of 180 patients aged 3–74 years from eight different cities (n = 180 at the end of treatment, n = 25 for the System Usability Scale (SUS) and follow-up interview) and 20 medical staff from eight different cities (n =20 for follow-up interview) were evaluated by WADA. At the end of the survey period, the results of the interviews were analyzed thematically.ResultsWADA assessment results from 180 patients and follow-up interview results from 45 participants were analyzed. In this study with a male to female ratio of 2:3, 75% were found to be suffering from dental anxiety, 86% were found with postoperative complications, and 11 cases were found to have contraindications to surgery. The total SUS score for WADA is 72.25 above the mean score, proving that WADA is a relevant and useful tool before and after dental treatment. Based on the results of the interviews, the following themes were identified: patient satisfaction; dentists' effectiveness; multi-center data integration; and increase its frequency of usage.ConclusionsThe WADA was developed for dental procedures and is effective for reducing treatment risks, improving patients' satisfaction and dentists' convenience, especially in terms of facilitating management of high-risk patient during the COVID-19 pandemic.
Collapse
Affiliation(s)
- Xilu Huang
- Department of Anesthesiology, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Jie Zeng
- Department of Anesthesiology, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Nan Zhao
- Department of Anesthesiology, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Lin Fan
- Department of Anesthesiology, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Dijiao Ruan
- Department of Anesthesiology, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Jing Wang
- Department of Anesthesiology, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Xiaomei Hong
- Engineering Research Center of Fujian University for Stomatological Biomaterials, Xiamen Medical College, Xiamen, China
| | - Cong Yu
- Department of Anesthesiology, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
- *Correspondence: Cong Yu
| |
Collapse
|
31
|
Reifsnider E. President's pen: An introduction and highlighting mHealth. Res Nurs Health 2022; 45:148. [DOI: 10.1002/nur.22212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 01/21/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Elizabeth Reifsnider
- College of Nursing and Health Innovation Arizona State University Phoenix Arizona USA
| |
Collapse
|
32
|
Affinito L, Fontanella A, Montano N, Brucato A. How physicians can empower patients with digital tools. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-020-01370-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Abstract
Background
While there is broad consensus that the use of digital tools would significantly improve patient empowerment, to date, an improvement in health outcomes has been elusive.
Objective
The objective of this study was to assess how to improve the ability of physicians to empower patients with digital tools.
Methods
We conducted a web-based survey using SurveyMonkey over nearly 6 months. A questionnaire was sent with an email, explaining the aims of the survey and providing a link to complete the web-based questionnaire, to the heads of each of the 37 medical national societies adhering to the EFIM (European Federation of Internal Medicine), inviting them to disseminate the questionnaire among their members.
Results
Two hundred and eighteen responses were received. They suggest that the main success factors in increasing and improving patient empowerment with digital tools and realizing health goals are clinical evidence, followed by patient/physician involvement in the design, tools designed around the real needs of the patient, and reimbursement. Most of the respondents who have already prescribed digital tools for patient empowerment are just enough satisfied with the results achieved by their patients. Interestingly, 18% of the respondents had spent more than 30 min on the visit of patient to doctor. However, the majority devoted only 5–9 min to illustrating the suggested digital tools.
Conclusions
According to the respondents, clinical evidence, motivation, physician and patient’s involvement in design, and reimbursement, as well as organizations’ appropriate business models and support, are the main determinants of the diffusion and effective adoption of digital tools for successful patient empowerment in internal medicine.
Collapse
|
33
|
O'Neill M, Houghton C, Crilly G, Dowling M. A qualitative evidence synthesis of users' experience of mobile health applications in the self-management of type 2 diabetes. Chronic Illn 2022; 18:22-45. [PMID: 33583207 DOI: 10.1177/1742395320983877] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM The aim of this qualitative evidence synthesis was to identify and synthesise qualitative research relating to experiences of using mobile health (mHealth) applications to aid self-management of Type 2 Diabetes. METHODS Using a systematic search strategy, 11 databases were searched (Medline, CINAHL, PsychInfo, PubMed, Web of Science, Embase, Cochrane Library, Scopus, ProQuest A&1, ProQuest UK & Ireland, Mednar). "Best fit" framework synthesis was used guided by the Health Information Technology Acceptance Model (HITAM). Assessment of methodological limitations was conducted using Critical Appraisal Skills Programme (CASP) and confidence in the review findings were guided by GRADE-CERQual. RESULTS Fourteen eligible studies were included in the synthesis (7 qualitative and 5 mixed methods). Key themes identified under the health, information and technology zones of the HITAM revealed the benefits of mHealth apps, barriers to their use, their perceived usefulness and ease of use. DISCUSSION Most people used the apps for feedback on their self-management and found them helpful in their communication with health care providers. Some embraced the technology and found it easy to use while others found mHealth apps to be counterintuitive.
Collapse
Affiliation(s)
| | - Catherine Houghton
- School of Nursing and Midwifery, National University of Ireland, Galway, University Road, Galway, Ireland
| | | | - Maura Dowling
- School of Nursing and Midwifery, National University of Ireland, Galway, University Road, Galway, Ireland
| |
Collapse
|
34
|
Jones E, Poyade M, Varsou O. Developing and evaluating a prototype public health mobile app on the UK NHS Abdominal Aortic Aneurysm Screening Programme. J Vis Commun Med 2022; 45:160-168. [DOI: 10.1080/17453054.2022.2037409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Ella Jones
- University of Glasgow, Glasgow, UK
- Glasgow School of Art, Glasgow, UK
| | | | | |
Collapse
|
35
|
Bricca A, Pellegrini A, Zangger G, Ahler J, Jäger M, Skou ST. The Quality of Health Apps and Their Potential to Promote Behavior Change in Patients With a Chronic Condition or Multimorbidity: Systematic Search in App Store and Google Play. JMIR Mhealth Uhealth 2022; 10:e33168. [PMID: 35119367 PMCID: PMC8857691 DOI: 10.2196/33168] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 10/29/2021] [Accepted: 12/07/2021] [Indexed: 12/17/2022] Open
Abstract
Background Mobile apps offer an opportunity to improve the lifestyle of patients with chronic conditions or multimorbidity. However, for apps to be recommended in clinical practice, their quality and potential for promoting behavior change must be considered. Objective We aimed to investigate the quality of health apps for patients with a chronic condition or multimorbidity (defined as 2 or more chronic conditions) and their potential for promoting behavior change. Methods We followed the Cochrane Handbook guidelines to conduct and report this study. A systematic search of apps available in English or Danish on App Store (Apple Inc) and Google Play (Google LLC) for patients with 1 or more of the following common and disabling conditions was conducted: osteoarthritis, heart conditions (heart failure and ischemic heart disease), hypertension, type 2 diabetes mellitus, depression, and chronic obstructive pulmonary disease. For the search strategy, keywords related to these conditions were combined. One author screened the titles and content of the identified apps. Subsequently, 3 authors independently downloaded the apps onto a smartphone and assessed the quality of the apps and their potential for promoting behavior change by using the Mobile App Rating Scale (MARS; number of items: 23; score: range 0-5 [higher is better]) and the App Behavior Change Scale (ABACUS; number of items: 21; score: range 0-21 [higher is better]), respectively. We included the five highest-rated apps and the five most downloaded apps but only assessed free content for their quality and potential for promoting behavior change. Results We screened 453 apps and ultimately included 60. Of the 60 apps, 35 (58%) were available in both App Store and Google Play. The overall average quality score of the apps was 3.48 (SD 0.28) on the MARS, and their overall average score for their potential to promote behavior change was 8.07 (SD 2.30) on the ABACUS. Apps for depression and apps for patients with multimorbidity tended to have higher overall MARS and ABACUS scores, respectively. The most common app features for supporting behavior change were the self-monitoring of physiological parameters (eg, blood pressure monitoring; apps: 38/60, 63%), weight and diet (apps: 25/60, 42%), or physical activity (apps: 22/60, 37%) and stress management (apps: 22/60, 37%). Only 8 out of the 60 apps (13%) were completely free. Conclusions Apps for patients with a chronic condition or multimorbidity appear to be of acceptable quality but have low to moderate potential for promoting behavior change. Our results provide a useful overview for patients and clinicians who would like to use apps for managing chronic conditions and indicate the need to improve health apps in terms of their quality and potential for promoting behavior change.
Collapse
Affiliation(s)
- Alessio Bricca
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Denmark
| | - Alessandro Pellegrini
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Denmark
| | - Graziella Zangger
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Denmark
| | - Jonas Ahler
- The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Denmark
| | - Madalina Jäger
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Denmark
| | - Søren T Skou
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Denmark
| |
Collapse
|
36
|
Yoon J, Lee M, Ahn JS, Oh D, Shin SY, Chang YJ, Cho J. Development and Validation of Digital Health Technology Literacy Assessment Questionnaire. J Med Syst 2022; 46:13. [PMID: 35072816 PMCID: PMC8784987 DOI: 10.1007/s10916-022-01800-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 01/17/2022] [Indexed: 11/23/2022]
Abstract
In clinical practice, assessing digital health literacy is important to identify patients who may encounter difficulties adapting to digital health using digital technology and service. We developed the Digital Health Technology Literacy Assessment Questionnaire (DHTL-AQ) to assess the ability to use digital health technology, services, and data. The DHTL-AQ was developed in three phases. In the first phase, the conceptual framework and domains and items were generated from a systematic literature review using relevant theory and surveys. In the second phase, a cross-sectional survey with 590 adults age ≥ 18 years was conducted at an academic hospital in Seoul, Korea in January and February 2020 to test face validity of the items. Then, psychometric validation was conducted to determine the final items and cut-off scores of the DHTL-AQ. The eHealth literacy scale, the Newest Vital Sign, and 10 mobile app task ability assessments were examined to test validity. The final DHTL-AQ includes 34 items in two domains (digital functional and digital critical literacy) and 4 categories (Information and Communications Technology terms, Information and Communications Technology icons, use of an app, evaluating reliability and relevance of health information). The DHTL-AQ had excellent internal consistency (overall Cronbach’s α = 0.95; 0.87–0.94 for subtotals) and acceptable model fit (CFI = 0.821, TLI = 0.807, SRMR = 0.065, RMSEA = 0.090). The DHTL-AQ was highly correlated with task ability assessment (r = 0.7591), and moderately correlated with the eHealth literacy scale (r = 0.5265) and the Newest Vital Sign (r = 0.5929). The DHTL-AQ is a reliable and valid instrument to measure digital health technology literacy.
Collapse
|
37
|
Eze CE, West BT, Dorsch MP, Coe AB, Lester CA, Buis LR, Farris K. Predictors of Smartphone and Tablet Use Among Patients With Hypertension: Secondary Analysis of Health Information National Trends Survey Data. J Med Internet Res 2022; 24:e33188. [PMID: 35072647 PMCID: PMC8822436 DOI: 10.2196/33188] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 11/11/2021] [Accepted: 12/03/2021] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Uncontrolled hypertension leads to significant morbidity and mortality. The use of mobile health technology, such as smartphones, for remote blood pressure (BP) monitoring has improved BP control. An increase in BP control is more significant when patients can remotely communicate with their health care providers through technologies and receive feedback. Little is known about the predictors of remote BP monitoring among hypertensive populations. OBJECTIVE The objective of this study is to quantify the predictors of smartphone and tablet use in achieving health goals and communicating with health care providers via SMS text messaging among hypertensive patients in the United States. METHODS This study was a cross-sectional, secondary analysis of the 2017 and 2018 Health Information National Trends Survey 5, cycles 1 and 2 data. A total of 3045 respondents answered "Yes" to the question "Has a doctor or other healthcare provider ever told you that you had high blood pressure or hypertension?", which defined the subpopulation used in this study. We applied the Health Information National Trends Survey full sample weight to calculate the population estimates and 50 replicate weights to calculate the SEs of the estimates. We used design-adjusted descriptive statistics to describe the characteristics of respondents who are hypertensive based on relevant survey items. Design-adjusted multivariable logistic regression models were fitted to estimate predictors of achieving health goals with the help of smartphone or tablet and sending or receiving an SMS text message to or from a health care provider in the last 12 months. RESULTS An estimated 36.9%, SE 0.9% (183,285,150/497,278,883) of the weighted adult population in the United States had hypertension. The mean age of the hypertensive population was 58.3 (SE 0.48) years. Electronic communication with the doctor or doctor's office through email or internet (odds ratio 2.93, 95% CI 1.85-4.63; P<.001) and having a wellness app (odds ratio 1.82, 95% CI 1.16-2.86; P=.02) were significant predictors of using SMS text message communication with a health care professional, adjusting for other demographic and technology-related variables. The odds of achieving health-related goals with the help of a tablet or smartphone declined significantly with older age (P<.001) and ownership of basic cellphones (P=.04). However, they increased significantly with being a woman (P=.045) or with being married (P=.03), having a wellness app (P<.001), using devices other than smartphones or tablets to monitor health (P=.008), making health treatment decisions (P=.048), and discussing with a provider (P=.02) with the help of a tablet or smartphone. CONCLUSIONS Intervention measures accounting for age, gender, marital status, and the patient's technology-related health behaviors are required to increase smartphone and tablet use in self-care and SMS text message communication with health care providers.
Collapse
Affiliation(s)
- Chinwe E Eze
- College of Pharmacy, University of Michigan, Ann Arbor, MI, United States
| | - Brady T West
- Institute for Social Research, University of Michigan, Ann Arbor, MI, United States
| | - Michael P Dorsch
- College of Pharmacy, University of Michigan, Ann Arbor, MI, United States
| | - Antoinette B Coe
- College of Pharmacy, University of Michigan, Ann Arbor, MI, United States
| | - Corey A Lester
- College of Pharmacy, University of Michigan, Ann Arbor, MI, United States
| | - Lorraine R Buis
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Karen Farris
- College of Pharmacy, University of Michigan, Ann Arbor, MI, United States
| |
Collapse
|
38
|
Melo ES, Antonini M, Costa CRB, Pontes PS, Gir E, Reis RK. Validação de livro eletrônico interativo para redução do risco cardiovascular em pessoas vivendo com HIV. Rev Lat Am Enfermagem 2022; 30:e3512. [PMID: 35293564 PMCID: PMC8966051 DOI: 10.1590/1518-8345.5568.3512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 10/01/2021] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivo Validar um material educativo digital interativo no formato de livro eletrônico sobre prevenção e redução do risco cardiovascular na perspectiva das pessoas vivendo com vírus da imunodeficiência humana. Método Trata-se de um estudo metodológico baseado na teoria de pesquisa de avaliação, do tipo análise de resultados, que envolve produção tecnológica. Os dados foram coletados em todo o Brasil por meio de um questionário virtual composto por itens para avaliação geral, visual, linguagem, usabilidade, conteúdo e aparência do material educativo. Para atestar a validade, adotou-se o Índice de Concordância mínimo de 80%. Resultados Participaram do estudo 309 pessoas vivendo com vírus da imunodeficiência humana, a maioria (84,3%) do sexo masculino, com idade entre 19 e 65 anos e ensino superior completo (29,3%). Mais de 90% dos participantes avaliaram o livro como adequado para tirar dúvidas e realizar cuidados preventivos à saúde cardiovascular. Todos os itens avaliados alcançaram índice acima de 0,80. A avaliação geral de todos os itens alcançou média de 0,92, sendo a avaliação geral (0,97) e o conteúdo (0,94). Conclusão O material educativo mostrou-se válido, adequado e pertinente para promover a alfabetização em saúde, e poderá contribuir com a promoção da saúde e prevenção de doenças cardiovasculares.
Collapse
Affiliation(s)
- Elizabete Santos Melo
- Universidade Paulista, Brazil; Universidade Brasil, Brasil; Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brasil
| | - Marcela Antonini
- Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brasil; Universidade de São Paulo, Brazil
| | | | | | - Elucir Gir
- Universidade de São Paulo, Brazil; Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil
| | - Renata Karina Reis
- Universidade de São Paulo, Brazil; Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil
| |
Collapse
|
39
|
Sun Y, Li Y, He FJ, Liu H, Sun J, Luo R, Guo C, Zhang P. Process Evaluation of an Application-Based Salt Reduction Intervention in School Children and Their Families (AppSalt) in China: A Mixed-Methods Study. Front Public Health 2022; 10:744881. [PMID: 35359790 PMCID: PMC8963959 DOI: 10.3389/fpubh.2022.744881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 02/15/2022] [Indexed: 11/25/2022] Open
Abstract
Background Salt reduction is a cost-effective, and rather challenging public health strategy for controlling chronic diseases. The AppSalt program is a school-based multi-component mobile health (mhealth) salt reduction program designed to tackle the high salt intake in China. This mixed-methods process evaluation was conducted to investigate the implementation of this program across sites, identify factors associated with the implementation, and collect evidence to optimize the intervention design for future scale-up. Methods Mixed methods were used sequentially to collect data regarding five process evaluation dimensions: fidelity, dose delivered, dose received, reach, and context. Quantitative data were collected during the intervention process. Participation rate of intervention activities was calculated and compared across cities. The quantitative data was used for the selection of representative intervention participants for the qualitative interviews. Qualitative data were collected in face-to-face semi-structured interviews with purposively selected students (n = 33), adult family members (n = 33), teachers (n = 9), heads of schools (n = 9), key informants from local health, and education departments (n = 8). Thematic analysis technique was applied to analyze the interview transcripts using NVivo. The qualitative data were triangulated with the quantitative data during the interpretation phase. Results The total number of families recruited for the intervention was 1,124. The overall retention rate of the AppSalt program was 97%. The intervention was implemented to a high level of fidelity against the protocol. About 80% of intervention participants completed all the app-based salt reduction courses, with a significant difference across the three cities (Shijiazhuang: 95%; Luzhou: 73%; Yueyang: 64%). The smartphone app in this program was perceived as a feasible and engaging health education tool by most intervention participants and key stakeholders. Through the interviews with participants and key stakeholders, we identified some barriers to implementing this program at primary schools, including the left-behind children who usually live with their grandparents and have limited access of smartphones; perceived adverse effects of smartphones on children (e.g., eyesight damage); and overlooked health education curriculum at Chinese primary schools. Conclusion This process evaluation demonstrated the feasibility and acceptability of using smartphone applications delivered through the education system to engage families in China to reduce excessive salt intake. Clinical Trial Registration The AppSalt study was registered at www.chictr.org.cn, identifier: ChiCTR1800017553. The date of registration is August 3, 2018.
Collapse
Affiliation(s)
- Yuewen Sun
- Nutrition and Lifestyle Department, The George Institute for Global Health at Peking University Health Science Center, Beijing, China
| | - Yuan Li
- Nutrition and Lifestyle Department, The George Institute for Global Health at Peking University Health Science Center, Beijing, China.,Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Feng J He
- Barts and The London School of Medicine and Dentistry, Institute of Preventive Medicine, Queen Mary University of London, London, United Kingdom
| | - Hueiming Liu
- Health Systems Science Department, The George Institute for Global Health, Sydney, NSW, Australia
| | - Jingwen Sun
- Nutrition and Lifestyle Department, The George Institute for Global Health at Peking University Health Science Center, Beijing, China
| | - Rong Luo
- Nutrition and Lifestyle Department, The George Institute for Global Health at Peking University Health Science Center, Beijing, China
| | - Chunlei Guo
- Nutrition and Lifestyle Department, The George Institute for Global Health at Peking University Health Science Center, Beijing, China
| | - Puhong Zhang
- Nutrition and Lifestyle Department, The George Institute for Global Health at Peking University Health Science Center, Beijing, China.,Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| |
Collapse
|
40
|
Engler K, Vicente S, Ma Y, Hijal T, Cox J, Ahmed S, Klein M, Achiche S, Pant Pai N, de Pokomandy A, Lacombe K, Lebouché B. Implementation of an electronic patient-reported measure of barriers to antiretroviral therapy adherence with the Opal patient portal: Protocol for a mixed method type 3 hybrid pilot study at a large Montreal HIV clinic. PLoS One 2021; 16:e0261006. [PMID: 34969046 PMCID: PMC8717992 DOI: 10.1371/journal.pone.0261006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 07/12/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Adherence to antiretroviral therapy (ART) remains problematic. Regular monitoring of its barriers is clinically recommended, however, patient-provider communication around adherence is often inadequate. Our team thus decided to develop a new electronically administered patient-reported outcome measure (PROM) of barriers to ART adherence (the I-Score) to systematically capture this data for physician consideration in routine HIV care. To prepare for a controlled definitive trial to test the I-Score intervention, a pilot study was designed. Its primary objectives are to evaluate patient and physician perceptions of the I-Score intervention and its implementation strategy. METHODS This one-arm, 6-month study will adopt a mixed method type 3 implementation-effectiveness hybrid design and be conducted at the Chronic Viral Illness Service of the McGill University Health Centre (Montreal, Canada). Four HIV physicians and 32 of their HIV patients with known or suspected adherence problems will participate. The intervention will involve having patients complete the I-Score through a smartphone application (Opal), before meeting with their physician. Both patients and physicians will have access to the I-Score results, for consideration during the clinic visits at Times 1, 2 (3 months), and 3 (6 months). The implementation strategy will focus on stakeholder involvement, education, and training; promoting the intervention's adaptability; and hiring an Application Manager to facilitate implementation. Implementation, patient, and service outcomes will be collected (Times 1-2-3). The primary outcome is the intervention's acceptability to patients and physicians. Qualitative data obtained, in part, through physician focus groups (Times 2-3) and patient interviews (Times 2-3) will help evaluate the implementation strategy and inform any methodological adaptations. DISCUSSION This study will help plan a definitive trial to test the efficacy of the I-Score intervention. It will generate needed data on electronic PROM interventions in routine HIV care that will help improve understanding of conditions for their successful implementation. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT04702412; https://clinicaltrials.gov/.
Collapse
Affiliation(s)
- Kim Engler
- Center for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Serge Vicente
- Department of Mathematics and Statistics, University of Montreal, Montreal, Quebec, Canada
| | - Yuanchao Ma
- Center for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Tarek Hijal
- Department of Radiation Oncology, Cedars Cancer Center, McGill University Health Centre, Montreal, Quebec, Canada
| | - Joseph Cox
- Division of Infectious Disease, Department of Medicine, Chronic Viral Illness Service, McGill University Health Centre, Montreal, Quebec, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Sara Ahmed
- School of Physical & Occupational Therapy, McGill University, Montreal, Quebec, Canada
| | - Marina Klein
- Center for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- Division of Infectious Disease, Department of Medicine, Chronic Viral Illness Service, McGill University Health Centre, Montreal, Quebec, Canada
- Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Sofiane Achiche
- Department of Mechanical Engineering, École Polytechnique de Montréal, Montreal, Quebec, Canada
| | - Nitika Pant Pai
- Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Alexandra de Pokomandy
- Center for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- Division of Infectious Disease, Department of Medicine, Chronic Viral Illness Service, McGill University Health Centre, Montreal, Quebec, Canada
- Department of Family Medicine, McGill University, Montreal, Quebec, Canada
| | - Karine Lacombe
- Sorbonne Université, Inserm IPLESP, Hôpital St Antoine, Assistance Publique -Hôpitaux de Paris, Paris, France
| | - Bertrand Lebouché
- Center for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- Division of Infectious Disease, Department of Medicine, Chronic Viral Illness Service, McGill University Health Centre, Montreal, Quebec, Canada
- Department of Family Medicine, McGill University, Montreal, Quebec, Canada
| |
Collapse
|
41
|
Paulsamy P, Easwaran V, Ashraf R, Alshahrani SH, Venkatesan K, Qureshi AA, Arrab MM, Prabahar K, Periannan K, Vasudevan R, Kandasamy G, Chidambaram K, Pappiya EM, Venkatesan K, Manoharan V. Association of Maternal Observation and Motivation (MOM) Program with m-Health Support on Maternal and Newborn Health. Healthcare (Basel) 2021; 9:healthcare9121629. [PMID: 34946355 PMCID: PMC8702075 DOI: 10.3390/healthcare9121629] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 11/20/2021] [Accepted: 11/21/2021] [Indexed: 02/01/2023] Open
Abstract
Maternal and child nutrition has been a critical component of health, sustainable development, and progress in low- and middle-income countries (LMIC). While a decrement in maternal mortality is an important indicator, simply surviving pregnancy and childbirth does not imply better maternal health. One of the fundamental obligations of nations under international human rights law is to enable women to endure pregnancy and delivery as an aspect of their enjoyment of reproductive and sexual health and rights and to live a dignified life. The aim of this study was to discover the correlation between the Maternal Observation and Motivation (MOM) program and m-Health support for maternal and newborn health. A comparative study was done among 196 pregnant mothers (study group-94; control group-102 mothers) with not less than 20 weeks of gestation. Maternal outcomes such as Hb and weight gain and newborn results such as birth weight and crown-heel length were obtained at baseline and at 28 and 36 weeks of gestation. Other secondary data collected were abortion, stillbirth, low birth weight, major congenital malformations, twin or triplet pregnancies, physical activity, and maternal well-being. The MOM intervention included initial face-to-face education, three in-person visits, and eight virtual health coaching sessions via WhatsApp. The baseline data on Hb of the mothers show that 31 (32.98%) vs. 27 (28.72%) mothers in the study and control group, respectively, had anemia, which improved to 27.66% and 14.98% among study group mothers at 28 and 36 weeks of gestation (p < 0.001). The weight gain (p < 0.001), level of physical activity (p < 0.001), and maternal well-being (p < 0.01) also had significant differences after the intervention. Even after controlling for potentially confounding variables, the maternal food practices regression model revealed that birth weight was directly correlated with the consumption of milk (p < 0.001), fruits (p < 0.01), and green vegetables (p < 0.05). As per the physical activity and maternal well-being regression model, the birth weight and crown-heel length were strongly related with the physical activity and maternal well-being of mothers at 36 weeks of gestation (p < 0.05). Combining the MOM intervention with standard antenatal care is a safe and effective way to improve maternal welfare while upholding pregnant mothers' human rights.
Collapse
Affiliation(s)
- Premalatha Paulsamy
- College of Nursing, Mahalah Branch for Girls, King Khalid University, Khamis Mushaiyt 61421, Saudi Arabia; (P.P.); (S.H.A.); (M.M.A.)
| | - Vigneshwaran Easwaran
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha 62529, Saudi Arabia; (V.E.); (G.K.)
| | - Rizwan Ashraf
- Department of Pharmacology, University College of Medicine and Dentistry, The University of Lahore, Lahore 55150, Pakistan;
| | - Shadia Hamoud Alshahrani
- College of Nursing, Mahalah Branch for Girls, King Khalid University, Khamis Mushaiyt 61421, Saudi Arabia; (P.P.); (S.H.A.); (M.M.A.)
| | - Krishnaraju Venkatesan
- Department of Pharmacology, College of Pharmacy, King Khalid University, Abha 62529, Saudi Arabia; (A.A.Q.); (R.V.); (K.C.)
- Correspondence:
| | - Absar Ahmed Qureshi
- Department of Pharmacology, College of Pharmacy, King Khalid University, Abha 62529, Saudi Arabia; (A.A.Q.); (R.V.); (K.C.)
| | - Mervat Moustafa Arrab
- College of Nursing, Mahalah Branch for Girls, King Khalid University, Khamis Mushaiyt 61421, Saudi Arabia; (P.P.); (S.H.A.); (M.M.A.)
- Family and Community Health Nursing, Faculty of Nursing, Menoufia University, Shibin el Kom 32511, Egypt
| | - Kousalya Prabahar
- Department of Pharmacy Practice, Faculty of Pharmacy, University of Tabuk, Tabuk 71491, Saudi Arabia;
| | - Kalaiselvi Periannan
- Department of Mental Health Nursing, Oxford School of Nursing & Midwifery, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford OX3 0FL, UK;
| | - Rajalakshimi Vasudevan
- Department of Pharmacology, College of Pharmacy, King Khalid University, Abha 62529, Saudi Arabia; (A.A.Q.); (R.V.); (K.C.)
| | - Geetha Kandasamy
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha 62529, Saudi Arabia; (V.E.); (G.K.)
| | - Kumarappan Chidambaram
- Department of Pharmacology, College of Pharmacy, King Khalid University, Abha 62529, Saudi Arabia; (A.A.Q.); (R.V.); (K.C.)
| | - Ester Mary Pappiya
- Regional Nursing Administration, Directorate of General Health Affair, Ministry of Health, Najran 21431, Saudi Arabia;
| | - Kumar Venkatesan
- Department of Pharmaceutical Chemistry, College of Pharmacy, King Khalid University, Abha 62529, Saudi Arabia;
| | - Vani Manoharan
- Georgia CTSA, Emory University Hospital, Atlanta, GA 30078, USA;
| |
Collapse
|
42
|
Onyeaka H, Firth J, Kessler RC, Lovell K, Torous J. Use of smartphones, mobile apps and wearables for health promotion by people with anxiety or depression: An analysis of a nationally representative survey data. Psychiatry Res 2021; 304:114120. [PMID: 34303946 DOI: 10.1016/j.psychres.2021.114120] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 07/06/2021] [Accepted: 07/13/2021] [Indexed: 12/14/2022]
Abstract
People with mental illness have increased cardiovascular risk factors, which contributes significantly to mortality in this population. Digital interventions have emerged as promising models to promote physical health, although their potential for use in mental health populations is relatively unexplored. We examined the potential for using digital tools for health promotion by people with common mental disorders like anxiety or depression. Using data from the 2019 edition of the Health Information National Trends Survey (HINTS 5), we evaluated differences between individuals with self-reported history of diagnosed depression/anxiety and the general population with respect to ownership, usage, and perceived usefulness of digital tools for managing their health. Overall, individuals with anxiety or depression were as likely as the general population to use digital devices for their care. Those with anxiety or depression who had health apps were more likely to report intentions to lose weight than those without health apps. Significant sociodemographic predictors of digital tools usage included gender, age, income, and education level. People with anxiety or depression own and use digital health tools at similarly high rates to the general population, suggesting that these tools present a novel opportunity for health promotion among people with these disorders.
Collapse
Affiliation(s)
- Henry Onyeaka
- Department of Psychiatry, Massachusetts General Hospital/McLean Hospital, Harvard Medical School, Boston, MA, United States
| | - Joseph Firth
- Division of Psychology and Mental Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom; NICM Health Research Institute, Western Sydney University, Westmead, Australia; Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
| | - Ronald C Kessler
- Department of HealthCare Policy, Harvard Medical School, Boston, United States
| | - Karina Lovell
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom; Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
| | - John Torous
- Department of Psychiatry, Beth Israeli Deaconess Medical Center, Harvard Medical School, Boston, MA, United States.
| |
Collapse
|
43
|
The Association of Mobile Health Applications with Self-Management Behaviors among Adults with Chronic Conditions in the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910351. [PMID: 34639651 PMCID: PMC8507726 DOI: 10.3390/ijerph181910351] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/25/2021] [Accepted: 09/27/2021] [Indexed: 11/17/2022]
Abstract
Background: Mobile applications related to health and wellness (mHealth apps) are widely used to self-manage chronic conditions. However, research on whether mHealth apps facilitate self-management behaviors of individuals with chronic conditions is sparse. We aimed to evaluate the association of mHealth apps with different types of self-management behaviors among patients with chronic diseases in the United States. Methods: This is a cross-sectional observational study. We used data from adult participants (unweighted n = 2340) of the Health Information National Trends Survey in 2018 and 2019. We identified three self-management behaviors: (1) resource utilization using electronic personal health records; (2) treatment discussions with healthcare providers; and (3) making healthcare decisions. We analyzed the association of mHealth apps to self-management behaviors with multivariable logistic and ordinal regressions. Results: Overall, 59.8% of adults (unweighted number = 1327) used mHealth apps. Adults using mHealth apps were more likely to use personal health records (AOR = 3.11, 95% CI 2.26–4.28), contact healthcare providers using technology (AOR = 2.70, 95% CI 1.93–3.78), and make decisions on chronic disease management (AOR = 2.59, 95% CI 1.93–3.49). The mHealth apps were associated with higher levels of self-management involvement (AOR = 3.53, 95% CI 2.63–4.72). Conclusion: Among individuals with chronic conditions, having mHealth apps was associated with positive self-management behaviors.
Collapse
|
44
|
Mobile health strategies for blood pressure self-management in urban populations with digital barriers: systematic review and meta-analyses. NPJ Digit Med 2021; 4:114. [PMID: 34294852 PMCID: PMC8298448 DOI: 10.1038/s41746-021-00486-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 06/21/2021] [Indexed: 12/17/2022] Open
Abstract
Mobile health (mHealth) technologies improve hypertension outcomes, but it is unknown if this benefit applies to all populations. This review aimed to describe the impact of mHealth interventions on blood pressure outcomes in populations with disparities in digital health use. We conducted a systematic search to identify studies with systolic blood pressure (SBP) outcomes located in urban settings in high-income countries that included a digital health disparity population, defined as mean age ≥65 years; lower educational attainment (≥60% ≤high school education); and/or racial/ethnic minority (<50% non-Hispanic White for US studies). Interventions were categorized using an established self-management taxonomy. We conducted a narrative synthesis; among randomized clinical trials (RCTs) with a six-month SBP outcome, we conducted random-effects meta-analyses. Twenty-nine articles (representing 25 studies) were included, of which 15 were RCTs. Fifteen studies used text messaging; twelve used mobile applications. Studies were included based on race/ethnicity (14), education (10), and/or age (6). Common intervention components were: lifestyle advice (20); provision of self-monitoring equipment (17); and training on digital device use (15). In the meta-analyses of seven RCTs, SBP reduction at 6-months in the intervention group (mean SBP difference = -4.10, 95% CI: [-6.38, -1.83]) was significant, but there was no significant difference in SBP change between the intervention and control groups (p = 0.48). The use of mHealth tools has shown promise for chronic disease management but few studies have included older, limited educational attainment, or minority populations. Additional robust studies with these populations are needed to determine what interventions work best for diverse hypertensive patients.
Collapse
|
45
|
Cislo C, Clingan C, Gilley K, Rozwadowski M, Gainsburg I, Bradley C, Barabas J, Sandford E, Olesnavich M, Tyler J, Mayer C, DeMoss M, Flora C, Forger DB, Cunningham JL, Tewari M, Choi SW. Monitoring beliefs and physiological measures in students at risk for COVID-19 using wearable sensors and smartphone technology: Protocol for a mobile health study. JMIR Res Protoc 2021; 10:e29561. [PMID: 34115607 PMCID: PMC8386373 DOI: 10.2196/29561] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 06/03/2021] [Accepted: 06/04/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has impacted lives significantly and greatly affected an already vulnerable population, college students, in relation to mental health and public safety. Social distancing and isolation have brought about challenges to student's mental health. Mobile health apps and wearable sensors may help to monitor students at risk for COVID-19 and support their mental well-being. OBJECTIVE Through the use of a wearable sensor and smartphone-based survey completion, this study aimed to monitor students at risk for COVID-19. METHODS We conducted a prospective study of students, undergraduate and graduate, at a public university in the Midwest. Students were instructed to download the Fitbit, Social Rhythms, and Roadmap 2.0 apps onto their personal mobile devices (Android or iOS). Subjects consented to provide up to 10 saliva samples during the study period. Surveys were administered through the Roadmap 2.0 app at five timepoints - at baseline, 1-month later, 2-months later, 3-months later, and at study completion. The surveys gathered information regarding demographics, COVID-19 diagnoses and symptoms, and mental health resilience, with the aim of documenting the impact of COVID-19 on the college student population. RESULTS This study enrolled 2,158 college students between September 2020 and January 2021. Subjects are currently being followed on-study for one academic year. Data collection and analysis are ongoing. CONCLUSIONS This study examined student health and well-being during the COVID-19 pandemic. It also assessed the feasibility of wearable sensor use and survey completion in a college student population, which may inform the role of our mobile health tools on student health and well-being. Finally, using wearable sensor data, biospecimen collection, and self-reported COVID-19 diagnosis, our results may provide key data towards the development of a model for the early prediction and detection of COVID-19. CLINICALTRIAL ClinicalTrials.gov NCT04766788.
Collapse
Affiliation(s)
- Christine Cislo
- Division of Pediatric Hematology Oncology, Department of Pediatrics, University of Michigan, 1500 E. Medical Center DrD4118 Medical Professional Building, Ann Arbor, US
| | - Caroline Clingan
- Division of Pediatric Hematology Oncology, Department of Pediatrics, University of Michigan, 1500 E. Medical Center DrD4118 Medical Professional Building, Ann Arbor, US
| | - Kristen Gilley
- Division of Pediatric Hematology Oncology, Department of Pediatrics, University of Michigan, 1500 E. Medical Center DrD4118 Medical Professional Building, Ann Arbor, US
| | - Michelle Rozwadowski
- Division of Pediatric Hematology Oncology, Department of Pediatrics, University of Michigan, 1500 E. Medical Center DrD4118 Medical Professional Building, Ann Arbor, US
- Division of Hematology Oncology, Department of Internal Medicine, University of Michigan, Ann Arbor, US
| | - Izzy Gainsburg
- Management and Organizations Area, Ross School of Business, University of Michigan, Ann Arbor, US
| | - Christina Bradley
- Management and Organizations Area, Ross School of Business, University of Michigan, Ann Arbor, US
| | - Jenny Barabas
- Division of Hematology Oncology, Department of Internal Medicine, University of Michigan, Ann Arbor, US
| | - Erin Sandford
- Division of Hematology Oncology, Department of Internal Medicine, University of Michigan, Ann Arbor, US
| | - Mary Olesnavich
- Division of Hematology Oncology, Department of Internal Medicine, University of Michigan, Ann Arbor, US
| | - Jonathan Tyler
- Division of Pediatric Hematology Oncology, Department of Pediatrics, University of Michigan, 1500 E. Medical Center DrD4118 Medical Professional Building, Ann Arbor, US
- Department of Mathematics, University of Michigan, Ann Arbor, US
| | - Caleb Mayer
- Department of Mathematics, University of Michigan, Ann Arbor, US
| | - Matthew DeMoss
- Division of Pediatric Hematology Oncology, Department of Pediatrics, University of Michigan, 1500 E. Medical Center DrD4118 Medical Professional Building, Ann Arbor, US
- Division of Hematology Oncology, Department of Internal Medicine, University of Michigan, Ann Arbor, US
| | - Christopher Flora
- Division of Hematology Oncology, Department of Internal Medicine, University of Michigan, Ann Arbor, US
| | - Daniel B Forger
- Department of Mathematics, University of Michigan, Ann Arbor, US
| | - Julia Lee Cunningham
- Management and Organizations Area, Ross School of Business, University of Michigan, Ann Arbor, US
| | - Muneesh Tewari
- Division of Hematology Oncology, Department of Internal Medicine, University of Michigan, Ann Arbor, US
- Rogel Comprehensive Cancer Center, University of Michigan, Ann Arbor, US
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, US
| | - Sung Won Choi
- Division of Pediatric Hematology Oncology, Department of Pediatrics, University of Michigan, 1500 E. Medical Center DrD4118 Medical Professional Building, Ann Arbor, US
- Rogel Comprehensive Cancer Center, University of Michigan, Ann Arbor, US
| |
Collapse
|
46
|
Ghani M, Adler C, Yeung H. Patient Factors Associated with Interest in Teledermatology: Cross-sectional Survey. JMIR DERMATOLOGY 2021; 4:e21555. [PMID: 37625162 PMCID: PMC10501513 DOI: 10.2196/21555] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 08/09/2020] [Accepted: 04/17/2021] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Teledermatology is a conduit for patients communicating with dermatologists on the internet, which bypasses in-person visits. It holds promise to address access needs for dermatologic care; however, the interest in using teledermatology is unknown in underserved populations with potential barriers to the use of health care technology. OBJECTIVE This study aimed to characterize the association between demographic characteristics with interest in exchanging digital images or videos of skin lesions with health care providers electronically. METHODS We examined data from the Health Information National Trends Survey (HINTS) 4 cycle 4 (2014) of the National Cancer Institute. HINTS is a cross-sectional, nationally representative household survey conducted annually, which collects information on demographics, perceptions and use of health information, and provides information on how cancer risks are perceived. HINTS 4 cycle 4 had a sample of 3677 participants. We examined the outcome to the question, "how interested are you in exchanging digital images or videos (eg, photos of skin lesions) with a health care provider electronically?" We dichotomized the outcome by a high level of interest (responding with "very") and those who did not have a high level of interest (responding with "somewhat," "a little," or "not at all") in exchanging images or videos. We used a multivariable logistic regression model developed through backwards selection, with all final covariates associated with varying levels of teledermatology use at P<.05. Sensitivity analysis was performed by changing the outcome dichotomy to model those who were "not at all" interested. Two-sided tests were performed with P<.05 considered significant. RESULTS Among 3447 respondents, 888 (weighted prevalence=26.2%) were "very" interested in participating in teledermatology. A higher interest in using teledermatology was associated with a younger age, higher educational attainment, higher household income, internet usage, type of mobile device ownership, history of electronic medical information exchange with a clinician within the past 12 months, and high level of trust in web-based information on cancer (for all, P<.01), but not with the female gender, race or ethnicity, health insurance status, or having a regular medical provider. CONCLUSIONS Modifiable access barriers to teledermatology adoption include trust, experience with teledermatology, and use of health apps. Teledermatology program implementation should address these specific factors within the digital divide to promote equitable access to care across diverse patient populations.
Collapse
Affiliation(s)
- Maham Ghani
- City University of New York School of Medicine, City University of New York, New york, NY, United States
| | - Colin Adler
- Department of Dermatology, Emory University School of Medicine, Emory University, Atlanta, GA, United States
| | - Howa Yeung
- Department of Dermatology, Emory University School of Medicine, Emory University, Atlanta, GA, United States
- Regional Telehealth Service, Veterans Affairs Veterans Integrated Service Network 7, Decatur, GA, United States
| |
Collapse
|
47
|
Paulsen MM, Varsi C, Andersen LF. Process evaluation of the implementation of a decision support system to prevent and treat disease-related malnutrition in a hospital setting. BMC Health Serv Res 2021; 21:281. [PMID: 33766017 PMCID: PMC7995565 DOI: 10.1186/s12913-021-06236-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 02/26/2021] [Indexed: 12/15/2022] Open
Abstract
Background Malnutrition is present in 30% of hospitalized patients and has adverse outcomes for the patient and the healthcare system. The current practice for nutritional care is associated with many barriers. The MyFood decision support system was developed to prevent and treat malnutrition. Methods This paper reports on a process evaluation that was completed within an effectiveness trial. MyFood is a digital tool with an interface consisting of an app and a website. MyFood includes functions to record and evaluate dietary intake. It also provides reports to nurses, including tailored recommendations for nutritional treatment. We used an effectiveness-implementation hybrid design in a randomized controlled trial. The RE-AIM (Reach, Efficiency, Adoption, Implementation, Maintenance) framework was used to perform a process evaluation alongside the randomized controlled trial, using a combination of quantitative and qualitative methods. An implementation plan, including implementation strategies, was developed to plan and guide the study. Results Reach: In total, 88% of eligible patients consented to participate (n = 100). Adoption: Approximately 75% of the nurses signed up to use MyFood and 50% used the reports. Implementation: MyFood empowered the patients in their nutritional situation and acted as a motivation to eat to reach their nutritional target. The compliance of using MyFood was higher among the patients than the nurses. A barrier for use of MyFood among the nurses was different digital systems which were not integrated and the log-in procedure to the MyFood website. Despite limited use by some nurses, the majority of the nurses claimed that MyFood was useful, better than the current practice, and should be implemented in the healthcare system. Conclusions This study used a process evaluation to interpret the results of a randomized controlled trial more in-depth. The patients were highly compliant, however, the compliance was lower among the nurses. MyFood empowered the patients in their nutritional situation, the usability was considered as high, and the experiences and attitudes towards MyFood were primarily positive. Focus on strategies to improve the nurses’ compliance may in the future improve the MyFood system’s potential. Trial registration The trial was registered in ClinicalTrials.gov 26/01/2018 (NCT03412695). Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06236-3.
Collapse
Affiliation(s)
- Mari Mohn Paulsen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, box 1110 Blindern, 0317, Oslo, Norway. .,National Advisory Unit on Disease-related Undernutrition, Division of Cancer Medicine, Oslo University Hospital, Rikshospitalet, Sognsvannsveien 20, 0372, Oslo, Norway.
| | - Cecilie Varsi
- Center for Digital Health Research, Oslo University Hospital, Division of Medicine, Aker hospital, box 4959 Nydalen, 0424, Oslo, Norway
| | - Lene Frost Andersen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, box 1110 Blindern, 0317, Oslo, Norway
| |
Collapse
|
48
|
Factors Affecting Health-Promoting Behaviors in Patients with Cardiovascular Disease. Healthcare (Basel) 2021; 9:healthcare9010060. [PMID: 33435583 PMCID: PMC7827905 DOI: 10.3390/healthcare9010060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 12/31/2020] [Accepted: 01/05/2021] [Indexed: 11/29/2022] Open
Abstract
Cardiovascular disease is the leading cause of death globally and the second most common cause of death in South Korea. Health-promoting behaviors recommended for patients with cardiovascular disease include control of diet, physical activity, cessation of smoking, medication adherence, and adherence to medical recommendations. This study aimed to determine the relationship between depression, anxiety, perception of health status, and health-promoting behavior in patients from South Korea who have suffered from cardiovascular disease. The study population comprised 161 patients at the cardiovascular center at H Hospital who were diagnosed with cardiovascular disease. Descriptive statistics and stepwise multiple regression were employed to analyze the data. Negative correlations existed between depression, perception of health status, and health-promoting behavior. By contrast, a positive correlation existed between the perception of health status and health-promoting behavior. The main factors affecting health-promoting behaviors were alcohol consumption, duration of diagnosis, perception of health status, and depression. These variables explained 15.8% of the variance. To prevent adverse cardiac events, patients who suffer from cardiovascular disease should be assessed as soon as possible to identify psychiatric symptoms, thereby developing a potential intervention aimed at decreasing negative illness consequences.
Collapse
|
49
|
Lin AW, Baik SH, Aaby D, Tello L, Linville T, Alshurafa N, Spring B. eHealth Practices in Cancer Survivors With BMI in Overweight or Obese Categories: Latent Class Analysis Study. JMIR Cancer 2020; 6:e24137. [PMID: 33156810 PMCID: PMC7746487 DOI: 10.2196/24137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 10/19/2020] [Accepted: 11/05/2020] [Indexed: 12/11/2022] Open
Abstract
Background eHealth technologies have been found to facilitate health-promoting practices among cancer survivors with BMI in overweight or obese categories; however, little is known about their engagement with eHealth to promote weight management and facilitate patient-clinician communication. Objective The objective of this study was to determine whether eHealth use was associated with sociodemographic characteristics, as well as medical history and experiences (ie, patient-related factors) among cancer survivors with BMI in overweight or obese categories. Methods Data were analyzed from a nationally representative cross-sectional survey (National Cancer Institute’s Health Information National Trends Survey). Latent class analysis was used to derive distinct classes among cancer survivors based on sociodemographic characteristics, medical attributes, and medical experiences. Logistic regression was used to examine whether class membership was associated with different eHealth practices. Results Three distinct classes of cancer survivors with BMI in overweight or obese categories emerged: younger with no comorbidities, younger with comorbidities, and older with comorbidities. Compared to the other classes, the younger with comorbidities class had the highest probability of identifying as female (73%) and Hispanic (46%) and feeling that clinicians did not address their concerns (75%). The older with comorbidities class was 6.5 times more likely than the younger with comorbidities class to share eHealth data with a clinician (odds ratio [OR] 6.53, 95% CI 1.08-39.43). In contrast, the younger with no comorbidities class had a higher likelihood of using a computer to look for health information (OR 1.93, 95% CI 1.10-3.38), using an electronic device to track progress toward a health-related goal (OR 2.02, 95% CI 1.08-3.79), and using the internet to watch health-related YouTube videos (OR 2.70, 95% CI 1.52-4.81) than the older with comorbidities class. Conclusions Class membership was associated with different patterns of eHealth engagement, indicating the importance of tailored digital strategies for delivering effective care. Future eHealth weight loss interventions should investigate strategies to engage younger cancer survivors with comorbidities and address racial and ethnic disparities in eHealth use.
Collapse
Affiliation(s)
- Annie Wen Lin
- Department of Nutrition, Benedictine University, Lisle, IL, United States.,Department of Preventive Medicine, Northwestern University, Chicago, IL, United States
| | - Sharon H Baik
- Department of Supportive Care Medicine, City of Hope Medical Cancer Center, Duarte, CA, United States.,Department of Medical Social Sciences, Northwestern University, Chicago, IL, United States
| | - David Aaby
- Department of Preventive Medicine, Northwestern University, Chicago, IL, United States
| | - Leslie Tello
- Department of Nutrition, Benedictine University, Lisle, IL, United States
| | - Twila Linville
- Department of Preventive Medicine, Northwestern University, Chicago, IL, United States
| | - Nabil Alshurafa
- Department of Preventive Medicine, Northwestern University, Chicago, IL, United States
| | - Bonnie Spring
- Department of Preventive Medicine, Northwestern University, Chicago, IL, United States
| |
Collapse
|
50
|
Rhee SY, Kim C, Shin DW, Steinhubl SR. Present and Future of Digital Health in Diabetes and Metabolic Disease. Diabetes Metab J 2020; 44:819-827. [PMID: 33389956 PMCID: PMC7801756 DOI: 10.4093/dmj.2020.0088] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 08/18/2020] [Indexed: 12/19/2022] Open
Abstract
The use of information and communication technology (ICT) in medical and healthcare services goes beyond everyday life. Expectations of a new medical environment, not previously experienced by ICT, exist in the near future. In particular, chronic metabolic diseases such as diabetes and obesity, have a high prevalence and high social and economic burden. In addition, the continuous evaluation and monitoring of daily life is important for effective treatment and management. Therefore, the wide use of ICTbased digital health systems is required for the treatment and management of these diseases. In this article, we compiled a variety of digital health technologies introduced to date in the field of diabetes and metabolic diseases.
Collapse
Affiliation(s)
- Sang Youl Rhee
- Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Korea
- Department of Digital Health, Scripps Research Translational Institute, La Jolla, CA, USA
| | - Chiweon Kim
- Department of Internal Medicine, Seoul Wise Hospital, Uiwang, Korea
| | - Dong Wook Shin
- Department of Family Medicine/Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Department of Digital Health, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul, Korea
| | - Steven R. Steinhubl
- Department of Digital Health, Scripps Research Translational Institute, La Jolla, CA, USA
| |
Collapse
|