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Meinke A, Spörri J, Brogli L, Schwab P, Karlen W. Addressing the unresolved challenge of quantifying skiing exposure-A proof of concept using smartphone sensors. Front Sports Act Living 2023; 5:1157987. [PMID: 37229363 PMCID: PMC10203200 DOI: 10.3389/fspor.2023.1157987] [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: 02/03/2023] [Accepted: 04/21/2023] [Indexed: 05/27/2023] Open
Abstract
In epidemiological studies related to winter sports, especially alpine skiing, an unresolved methodological challenge is the quantification of actual on-snow activity exposure. Such information would be relevant for reporting meaningful measures of injury incidence, which refers to the number of new injuries that occur in a given population and time period. Accordingly, accurate determination of the denominator, i.e., actual "activity exposure time", is critical for injury surveillance and reporting. In this perspective article, we explore the question of whether wearable sensors in combination with mHealth applications are suitable tools to accurately quantify the periods in a ski day when the skier is physically skiing and not resting or using a mechanical means of transport. As a first proof of concept, we present exemplary data from a youth competitive alpine skier who wore his smartphone with embedded sensors on his body on several ski days during one winter season. We compared these data to self-reported estimates of ski exposure, as used in athletes' training diaries. In summary, quantifying on-snow activity exposure in alpine skiing using sensor data from smartphones is technically feasible. For example, the sensors could be used to track ski training sessions, estimate the actual time spent skiing, and even quantify the number of runs and turns made as long as the smartphone is worn. Such data could be very useful in determining actual exposure time in the context of injury surveillance and could prove valuable for effective stress management and injury prevention in athletes.
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Affiliation(s)
- Anita Meinke
- Mobile Health Systems Lab, Institute of Robotics and Intelligent Systems, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Jörg Spörri
- Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- University Centre for Prevention and Sports Medicine, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Luzius Brogli
- Mobile Health Systems Lab, Institute of Robotics and Intelligent Systems, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Patrick Schwab
- Mobile Health Systems Lab, Institute of Robotics and Intelligent Systems, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Walter Karlen
- Mobile Health Systems Lab, Institute of Robotics and Intelligent Systems, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
- Institute of Biomedical Engineering, University of Ulm, Ulm, Germany
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2
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Corneli A, Perry B, Des Marais A, Choi Y, Chen H, Lilly R, Ayers D, Bennett J, Kestner L, Meade CS, Sachdeva N, McKellar MS. Participant perceptions on the acceptability and feasibility of a telemedicine-based HIV PrEP and buprenorphine/naloxone program embedded within syringe services programs: a qualitative descriptive evaluation. Harm Reduct J 2022; 19:132. [PMID: 36463214 PMCID: PMC9719634 DOI: 10.1186/s12954-022-00718-1] [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: 09/08/2022] [Accepted: 11/19/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND People who inject drugs (PWID) are at risk for HIV and opioid overdose. We piloted PARTNER UP, a telemedicine-based program to provide PWID with access to both oral pre-exposure prophylaxis (PrEP) for HIV prevention and medication for opioid use disorder (MOUD) through two syringe services programs (SSPs) in North Carolina. We conducted a qualitative evaluation to assess the acceptability and feasibility of PARTNER UP from the participant perspective. METHODS PARTNER UP participants met with a provider for an initial in-person visit at the SSP, followed by weekly telemedicine visits in month 1 and then monthly telemedicine visits until program end at month 6. Using a qualitative descriptive study design, we conducted in-depth interviews with a subsample of PARTNER UP participants at 1 month and 4 months. Informed by the technology acceptance model, we assessed participant perceptions of the usefulness and ease of use of PARTNER UP, as well as their intent to continue to use the program's components. We audio-recorded all interviews with participants' permission and used applied thematic analysis to analyze the verbatim transcripts. RESULTS We interviewed 11 of 17 people who participated in PARTNER UP-10 in the month 1 interview and 8 in the month 4 interview. Nearly all participants were motivated to join for consistent and easy access to buprenorphine/naloxone (i.e., MOUD); only a few joined to access PrEP. Most were comfortable accessing healthcare at the SSP because of their relationship with and trust toward SSP staff, and accessing services at the SSP was preferred compared with other healthcare centers. Some participants described that telemedicine allowed them to be honest and share more information because the visits were not in-person and they chose the location, although the initial in-person meeting was helpful to build provider trust and rapport. Most participants found the visit schedule to be feasible, although half described needing to reschedule at least once. Nearly all participants who were interviewed intended to continue with MOUD after the program ended, whereas none were interested in continuing with PrEP. CONCLUSIONS Participant narratives suggest that the PARTNER UP telemedicine program was acceptable and feasible. Future studies should continue to explore the benefits of embedding both PrEP and MOUD into SSPs with larger numbers of participants. Trial registration Clinicaltrials.gov Identifier: NCT04521920.
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Affiliation(s)
- Amy Corneli
- grid.26009.3d0000 0004 1936 7961Department of Population Health Sciences, Duke University School of Medicine, 215 Morris St, Durham, NC 27701 USA ,grid.26009.3d0000 0004 1936 7961Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC USA ,grid.26009.3d0000 0004 1936 7961Department of Medicine, Duke University School of Medicine, Durham, NC USA
| | - Brian Perry
- grid.26009.3d0000 0004 1936 7961Department of Population Health Sciences, Duke University School of Medicine, 215 Morris St, Durham, NC 27701 USA
| | - Andrea Des Marais
- grid.26009.3d0000 0004 1936 7961Department of Population Health Sciences, Duke University School of Medicine, 215 Morris St, Durham, NC 27701 USA
| | - Yujung Choi
- grid.26009.3d0000 0004 1936 7961Department of Population Health Sciences, Duke University School of Medicine, 215 Morris St, Durham, NC 27701 USA
| | - Hillary Chen
- grid.26009.3d0000 0004 1936 7961Department of Population Health Sciences, Duke University School of Medicine, 215 Morris St, Durham, NC 27701 USA
| | - Rebecca Lilly
- North Carolina Harm Reduction Coalition, Wilmington, NC USA ,Present Address: Port City Harm Reduction, Wilmington, NC USA
| | - Denae Ayers
- Queen City Harm Reduction, Charlotte, NC USA
| | - Jesse Bennett
- North Carolina Harm Reduction Coalition, Wilmington, NC USA
| | | | - Christina S. Meade
- grid.26009.3d0000 0004 1936 7961Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC USA
| | - Nidhi Sachdeva
- grid.26009.3d0000 0004 1936 7961Department of Population Health Sciences, Duke University School of Medicine, 215 Morris St, Durham, NC 27701 USA ,grid.10698.360000000122483208Present Address: North Carolina Association of County Commissioners, Raleigh, NC USA
| | - Mehri S. McKellar
- grid.26009.3d0000 0004 1936 7961Department of Medicine, Duke University School of Medicine, Durham, NC USA
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Schretzlmaier P, Hecker A, Ammenwerth E. Suitability of the Unified Theory of Acceptance and Use of Technology 2 Model for Predicting mHealth Acceptance Using Diabetes as an Example: Qualitative Methods Triangulation Study. JMIR Hum Factors 2022; 9:e34918. [PMID: 35262493 PMCID: PMC8943545 DOI: 10.2196/34918] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 01/27/2022] [Accepted: 02/03/2022] [Indexed: 11/13/2022] Open
Abstract
Background In recent years, the use of mobile health (mHealth) apps to manage chronic diseases has increased significantly. Although mHealth apps have many benefits, their acceptance is still low in certain areas and groups. Most mHealth acceptance studies are based on technology acceptance models. In particular, the Unified Theory of Acceptance and Use of Technology 2 (UTAUT2) model was developed to predict technology acceptance in a consumer context. However, to date, only a few studies have used the UTAUT2 model to predict mHealth acceptance and confirm its suitability for the health sector. Thus, it is unclear whether the UTAUT2 model is suitable for predicting mHealth acceptance and whether essential variables for a health-related context are missing. Objective This study aims to validate the suitability of UTAUT2 for predicting mHealth acceptance. Methods In this study, diabetes was used as an example as mHealth apps are a significant element of diabetes self-management. In addition, diabetes is one of the most common chronic diseases affecting young and older people worldwide. An explorative literature review and guided interviews with 11 mHealth or technology acceptance experts and 8 mHealth users in Austria and Germany were triangulated to identify all relevant constructs for predicting mHealth acceptance. The interview participants were recruited by purposive sampling until theoretical saturation was reached. Data were analyzed using structured content analysis based on inductive and deductive approaches. Results This study was able to confirm the relevance of all exogenous UTAUT2 constructs. However, it revealed two additional constructs that may also need to be considered to better predict mHealth acceptance: trust and perceived disease threat. Conclusions This study showed that the UTAUT2 model is suitable for predicting mHealth acceptance. However, the model should be extended to include 2 additional constructs for use in the mHealth context.
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Affiliation(s)
- Patrik Schretzlmaier
- Institute of Medical Informatics, UMIT - Private University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
| | - Achim Hecker
- Institute for Management and Economics in Healthcare, UMIT - Private University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria.,DBU Digital Business University of Applied Sciences, Berlin, Germany
| | - Elske Ammenwerth
- Institute of Medical Informatics, UMIT - Private University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
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4
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Usefulness of Digital Serious Games in Engineering for Diverse Undergraduate Students. EDUCATION SCIENCES 2022. [DOI: 10.3390/educsci12010027] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The use of educational digital games as supplemental tools to course instruction materials has increased over the last several decades and especially since the COVID-19 pandemic. Though these types of instructional games have been employed in the majority of STEM disciplines, less is known about how diverse populations of students interpret and define the value of these games towards achieving academic and professional pursuits. A mixed-method sequential exploratory research design method that was framed on the Technology Acceptance Model, Game-Based Learning Theory and Expectancy Value Theory was used to examine how 201 students perceived the usefulness of an intuitive education game that was designed to teach engineering mechanics used in designing civil structures. We found that students had different expectations of educational digital games than games designed for entertainment used outside of classroom environments. Several students thought that the ability to design their own structures and observe structure failure in real-time was a valuable asset in understanding how truss structures responded to physical loading conditions. However, few students thought the educational game would be useful for exam (14/26) or job interview (19/26) preparation. Students associated more value with engineering games that illustrate course content and mathematical calculations used in STEM courses than those that do not include these elements.
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Alshehri F, Alshaikh F. Exploring the Constituent Elements of a Successful Mobile Health Intervention for Prediabetic Patients in King Saud University Medical City Hospitals in Saudi Arabia: Cross-sectional Study. JMIR Form Res 2021; 5:e22968. [PMID: 34061762 PMCID: PMC8335605 DOI: 10.2196/22968] [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: 08/10/2020] [Revised: 05/29/2021] [Accepted: 05/31/2021] [Indexed: 01/08/2023] Open
Abstract
Background Self-management of prediabetic patients is crucial since they are at high risk of developing type 2 diabetes. Mobile health (mHealth) apps could contribute to potentially reducing the burden of diabetes by supporting the self-management of prediabetic patients. Objective This study aimed to explore the constituent elements of a successful mHealth intervention for prediabetic patients in King Saud University Medical City (KSUMC) hospitals in Saudi Arabia using the Centre for eHealth Research (CeHRes) roadmap. Methods This study used the CeHRes roadmap as a developmental guideline for proposing mHealth app features for self-management of prediabetic patients and was performed in 3 phases with one round in each phase. First, a contextual inquiry was conducted via an online self-administered questionnaire for both health care providers and patients. Second, the value specification phase elaborated on the outcomes from the contextual inquiry phase. Finally, prototype user design was performed in cocreation with end users. The design phase was also conducted via an online self-administered questionnaire to evaluate the proposed features of mHealth apps by prediabetic patients. Results A total of 20 health care providers participated in the study. The results revealed that the most powerful intervention for prediabetes was a combination of medication, physical activity, and healthy diet plans (12/20, 60%). Furthermore, the most common challenge faced by prediabetes patients was patient adherence to healthy diet and physical activity recommendations (10/20, 50%). Almost all patients believed that mHealth apps would be useful for prediabetic patients. A total of 48 prediabetic patients participated in the study. The results indicated that the most powerful intervention for prediabetic patients is a combination of healthy diet and physical activity plans (21/48, 44%), and the most frequent challenge that may lead the patients to discontinue the current intervention was the commitment to a physical activity plan (35/48, 75%). Furthermore, 15% (17/48) of patients use well-being and health apps to manage their current health status. The most common difficulties faced by the patients were navigating app features (mean 2.02 [SD 1.7]) followed by the app language (mean 1.88 [SD 2.0]); these difficulties occurred at a significantly higher rate among those with secondary or lower educational levels as compared to undergraduate and postgraduate levels (P<.05). Finally, the features proposed in the prototype design scored more than 2.5 points higher and indicate the need for these features to be included in the mHealth app. Conclusions This study aimed to provide real-world insights into the development of an mHealth app for a diabetes prevention intervention by involving both health care providers and prediabetic patients in KSUMC hospitals. Therefore, the proposed app, which comprises all necessary features, may aid patients with prediabetes in self-management and making changes in their lifestyle.
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Affiliation(s)
- Fayz Alshehri
- Executive Department of Information Technology, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Fahdah Alshaikh
- Community Health Department, Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
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6
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Bonten TN, Rauwerdink A, Wyatt JC, Kasteleyn MJ, Witkamp L, Riper H, van Gemert-Pijnen LJ, Cresswell K, Sheikh A, Schijven MP, Chavannes NH. Online Guide for Electronic Health Evaluation Approaches: Systematic Scoping Review and Concept Mapping Study. J Med Internet Res 2020. [PMID: 32784173 DOI: 10.2196/1777] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2023] Open
Abstract
BACKGROUND Despite the increase in use and high expectations of digital health solutions, scientific evidence about the effectiveness of electronic health (eHealth) and other aspects such as usability and accuracy is lagging behind. eHealth solutions are complex interventions, which require a wide array of evaluation approaches that are capable of answering the many different questions that arise during the consecutive study phases of eHealth development and implementation. However, evaluators seem to struggle in choosing suitable evaluation approaches in relation to a specific study phase. OBJECTIVE The objective of this project was to provide a structured overview of the existing eHealth evaluation approaches, with the aim of assisting eHealth evaluators in selecting a suitable approach for evaluating their eHealth solution at a specific evaluation study phase. METHODS Three consecutive steps were followed. Step 1 was a systematic scoping review, summarizing existing eHealth evaluation approaches. Step 2 was a concept mapping study asking eHealth researchers about approaches for evaluating eHealth. In step 3, the results of step 1 and 2 were used to develop an "eHealth evaluation cycle" and subsequently compose the online "eHealth methodology guide." RESULTS The scoping review yielded 57 articles describing 50 unique evaluation approaches. The concept mapping study questioned 43 eHealth researchers, resulting in 48 unique approaches. After removing duplicates, 75 unique evaluation approaches remained. Thereafter, an "eHealth evaluation cycle" was developed, consisting of six evaluation study phases: conceptual and planning, design, development and usability, pilot (feasibility), effectiveness (impact), uptake (implementation), and all phases. Finally, the "eHealth methodology guide" was composed by assigning the 75 evaluation approaches to the specific study phases of the "eHealth evaluation cycle." CONCLUSIONS Seventy-five unique evaluation approaches were found in the literature and suggested by eHealth researchers, which served as content for the online "eHealth methodology guide." By assisting evaluators in selecting a suitable evaluation approach in relation to a specific study phase of the "eHealth evaluation cycle," the guide aims to enhance the quality, safety, and successful long-term implementation of novel eHealth solutions.
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Affiliation(s)
- Tobias N Bonten
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, Netherlands
- National eHealth Living Lab, Leiden, Netherlands
| | - Anneloek Rauwerdink
- Department of Surgery, Amsterdam Gastroenterology and Metabolism, Amsterdam UMC, Amsterdam, Netherlands
| | - Jeremy C Wyatt
- Wessex Institute, University of Southampton, Southampton, United Kingdom
| | - Marise J Kasteleyn
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, Netherlands
- National eHealth Living Lab, Leiden, Netherlands
| | - Leonard Witkamp
- Department of Medical Informatics, Amsterdam UMC, Amsterdam, Netherlands
- Ksyos Health Management Research, Amstelveen, Netherlands
| | - Heleen Riper
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit, Amsterdam, Netherlands
| | - Lisette Jewc van Gemert-Pijnen
- Department of Psychology, Health and Technology, Centre for eHealth and Wellbeing Research, University of Twente, Enschede, Netherlands
| | - Kathrin Cresswell
- Centre of Medical Informatics, Usher Institute, The University of Edinburgh, Medical School, Edinburgh, United Kingdom
| | - Aziz Sheikh
- Centre of Medical Informatics, Usher Institute, The University of Edinburgh, Medical School, Edinburgh, United Kingdom
| | - Marlies P Schijven
- Department of Surgery, Amsterdam Gastroenterology and Metabolism, Amsterdam UMC, Amsterdam, Netherlands
| | - Niels H Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, Netherlands
- National eHealth Living Lab, Leiden, Netherlands
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7
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Bonten TN, Rauwerdink A, Wyatt JC, Kasteleyn MJ, Witkamp L, Riper H, van Gemert-Pijnen LJ, Cresswell K, Sheikh A, Schijven MP, Chavannes NH. Online Guide for Electronic Health Evaluation Approaches: Systematic Scoping Review and Concept Mapping Study. J Med Internet Res 2020; 22:e17774. [PMID: 32784173 PMCID: PMC7450369 DOI: 10.2196/17774] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 05/09/2020] [Accepted: 06/03/2020] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Despite the increase in use and high expectations of digital health solutions, scientific evidence about the effectiveness of electronic health (eHealth) and other aspects such as usability and accuracy is lagging behind. eHealth solutions are complex interventions, which require a wide array of evaluation approaches that are capable of answering the many different questions that arise during the consecutive study phases of eHealth development and implementation. However, evaluators seem to struggle in choosing suitable evaluation approaches in relation to a specific study phase. OBJECTIVE The objective of this project was to provide a structured overview of the existing eHealth evaluation approaches, with the aim of assisting eHealth evaluators in selecting a suitable approach for evaluating their eHealth solution at a specific evaluation study phase. METHODS Three consecutive steps were followed. Step 1 was a systematic scoping review, summarizing existing eHealth evaluation approaches. Step 2 was a concept mapping study asking eHealth researchers about approaches for evaluating eHealth. In step 3, the results of step 1 and 2 were used to develop an "eHealth evaluation cycle" and subsequently compose the online "eHealth methodology guide." RESULTS The scoping review yielded 57 articles describing 50 unique evaluation approaches. The concept mapping study questioned 43 eHealth researchers, resulting in 48 unique approaches. After removing duplicates, 75 unique evaluation approaches remained. Thereafter, an "eHealth evaluation cycle" was developed, consisting of six evaluation study phases: conceptual and planning, design, development and usability, pilot (feasibility), effectiveness (impact), uptake (implementation), and all phases. Finally, the "eHealth methodology guide" was composed by assigning the 75 evaluation approaches to the specific study phases of the "eHealth evaluation cycle." CONCLUSIONS Seventy-five unique evaluation approaches were found in the literature and suggested by eHealth researchers, which served as content for the online "eHealth methodology guide." By assisting evaluators in selecting a suitable evaluation approach in relation to a specific study phase of the "eHealth evaluation cycle," the guide aims to enhance the quality, safety, and successful long-term implementation of novel eHealth solutions.
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Affiliation(s)
- Tobias N Bonten
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, Netherlands
- National eHealth Living Lab, Leiden, Netherlands
| | - Anneloek Rauwerdink
- Department of Surgery, Amsterdam Gastroenterology and Metabolism, Amsterdam UMC, Amsterdam, Netherlands
| | - Jeremy C Wyatt
- Wessex Institute, University of Southampton, Southampton, United Kingdom
| | - Marise J Kasteleyn
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, Netherlands
- National eHealth Living Lab, Leiden, Netherlands
| | - Leonard Witkamp
- Department of Medical Informatics, Amsterdam UMC, Amsterdam, Netherlands
- Ksyos Health Management Research, Amstelveen, Netherlands
| | - Heleen Riper
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit, Amsterdam, Netherlands
| | - Lisette Jewc van Gemert-Pijnen
- Department of Psychology, Health and Technology, Centre for eHealth and Wellbeing Research, University of Twente, Enschede, Netherlands
| | - Kathrin Cresswell
- Centre of Medical Informatics, Usher Institute, The University of Edinburgh, Medical School, Edinburgh, United Kingdom
| | - Aziz Sheikh
- Centre of Medical Informatics, Usher Institute, The University of Edinburgh, Medical School, Edinburgh, United Kingdom
| | - Marlies P Schijven
- Department of Surgery, Amsterdam Gastroenterology and Metabolism, Amsterdam UMC, Amsterdam, Netherlands
| | - Niels H Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, Netherlands
- National eHealth Living Lab, Leiden, Netherlands
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Eysenbach G, Bendixsen C, Patrick T. A Model for Assessing Necessary Conditions for Rural Health Care's Mobile Health Readiness: Qualitative Assessment of Clinician-Perceived Barriers. JMIR Mhealth Uhealth 2019; 7:e11915. [PMID: 31702564 PMCID: PMC6874803 DOI: 10.2196/11915] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 06/06/2019] [Accepted: 09/04/2019] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Mobile health (mHealth) technology dissemination has penetrated rural and urban areas alike. Yet, health care organization oversight and clinician adoption have not kept pace with patient use. mHealth could have a unique impact on health and quality of life for rural populations. If organizations are prepared to manage mHealth, clinicians may improve the quality of care for their patients, both rural and urban. However, many organizations are not yet prepared to prescribe or prohibit third-party mHealth technologies. OBJECTIVE This study explored organizational readiness for rural mHealth adoption, the use of patient-reported data by clinical care teams, and potential impact on improving rural health care delivery. METHODS Semistructured, open-ended interviews were used to investigate clinicians' current practices, motivators, and perceived barriers to their use of mHealth technologies in rural settings. RESULTS A total of 13 clinicians were interviewed, and 53.8% (7/13) reported encouraging use of mHealth apps or wearable devices with rural patients. Perceived barriers to adoption were categorized into three primary themes: (1) personal (clinician), (2) patient, and (3) organizational. Organizational was most prominent, with subcodes of time, uniformity, and policy or direction. Thematic analysis revealed code-category linkages that identify the complex nature of a rural health care organization's current climate from a clinician's perspective. A thematic map was developed to visualize the flow from category to code. Identified linkages guided the development of a refined rural mHealth readiness model. CONCLUSIONS Clinicians (including physicians) have limited time for continuing education, research, or exploration of emerging technologies. Clinicians are motivated to learn more, but they need guidance through organization-led directives. Rural health care institutions should consider investing in mHealth analysis, tool development, and formal recommendations of sanctioned tools for clinicians to use with patients.
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Affiliation(s)
| | - Casper Bendixsen
- Marshfield Clinic Research Institute, National Farm Medicine Center, Marshfield, WI, United States
| | - Timothy Patrick
- University of Wisconsin-Milwaukee, Health Informatics, Milwaukee, WI, United States
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9
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Wickström W, Spreco A, Bargoria V, Elinder F, Hansson PO, Dahlström Ö, Timpka T. Perceptions of Overuse Injury Among Swedish Ultramarathon and Marathon Runners: Cross-Sectional Study Based on the Illness Perception Questionnaire Revised (IPQ-R). Front Psychol 2019; 10:2406. [PMID: 31695664 PMCID: PMC6817950 DOI: 10.3389/fpsyg.2019.02406] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Accepted: 10/09/2019] [Indexed: 11/24/2022] Open
Abstract
Background Long-distance runners’ understandings of overuse injuries are not well known which decreases the possibilities for prevention. The common sense model (CSM) outlines that runners’ perceptions of a health problem can be described using the categories identity, consequence, timeline, personal control, and cause. The aim of this study was to use the CSM to investigate perceptions of overuse injury among long-distance runners with different exercise loads. Methods The study used a cross-sectional design. An adapted version of the illness perception questionnaire revised (IPQ-R) derived from the CSM was used to investigate Swedish ultramarathon and marathon runners’ perceptions of overuse injuries. Cluster analysis was employed for categorizing runners into high and low exercise load categories. A Principal Component Analysis was thereafter used to group variables describing injury causes. Multiple logistic regression methods were finally applied using high exercise load as endpoint variable and CSM items representing perceptions of injury identity, consequence, timeline, personal control, and causes as explanatory variables. Results Complete data sets were collected from 165/443 (37.2%) runners. The symptoms most commonly associated with overuse injury were pain (80.1% of the runners), stiff muscles (54.1%), and stiff joints (42.0%). Overuse injury was perceived to be characterized by the possibility of personal control (stated by 78.7% of the runners), treatability (70.4%), and that the injury context was comprehensible (69.3%). The main injury causes highlighted were runner biomechanics (stated by 78.3%), the runner’s personality (72.4%), and running surface biomechanics (70.0%). Among men, a belief in that personality contributes to overuse injury increased the likelihood of belonging to the high exercise load category [Odds ratio (OR) 2.10 (95% Confidence interval (95% CI) 1.38–3.19); P = 0.001], while beliefs in that running biomechanics [OR 0.56 (95% CI 0.37–0.85); P = 0.006) and mileage (OR 0.72 (95% CI 0.54–0.96); P = 0.026] causes injury decreased the likelihood. In women, a strong perception that overuse injuries can be controlled by medical interventions decreased the likelihood of high exercise load [OR 0.68 (95% CI 0.52–0.89); P = 0.005]. Conclusion This study indicates that recognition among long-distance runners of the association between own decisions in overuse injury causation is accentuated by increased exercise loads.
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Affiliation(s)
- William Wickström
- Athletics Research Center, Linköping University, Linköping, Sweden.,Department of Health and Care Development, and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Armin Spreco
- Athletics Research Center, Linköping University, Linköping, Sweden.,Department of Health and Care Development, and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Victor Bargoria
- Athletics Research Center, Linköping University, Linköping, Sweden.,Department of Health and Care Development, and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.,Department of Orthopaedics and Rehabilitation, Moi University, Eldoret, Kenya
| | - Fredrik Elinder
- Athletics Research Center, Linköping University, Linköping, Sweden.,Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Per-Olof Hansson
- Athletics Research Center, Linköping University, Linköping, Sweden.,Department of Management and Engineering, Linköping University, Linköping, Sweden
| | - Örjan Dahlström
- Athletics Research Center, Linköping University, Linköping, Sweden.,Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
| | - Toomas Timpka
- Athletics Research Center, Linköping University, Linköping, Sweden.,Department of Health and Care Development, and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
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Egan S, Brama P, McGrath D. Irish Equine Industry Stakeholder Perspectives of Objective Technology for Biomechanical Analyses in the Field. Animals (Basel) 2019; 9:ani9080539. [PMID: 31398822 PMCID: PMC6720583 DOI: 10.3390/ani9080539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 08/01/2019] [Accepted: 08/05/2019] [Indexed: 11/16/2022] Open
Abstract
Wearable sensing technologies are increasingly used in human and equine gait research to improve ecological validity of research findings. It is unclear how these tools have penetrated the equine industry or what perspectives industry stakeholders' hold in relation to these relatively new devices. Semi-structured interviews were conducted with Irish equine industry stakeholders to understand their perception of objective tools for biomechanical analysis in the field. The study participants came from professional/elite backgrounds in both the sport horse (n = 6) and thoroughbred (n = 6) sectors. The interview data were analysed using thematic analysis, resulting in four analytical themes. The first theme conveys the importance of tacit knowledge and experience in the holistic analysis of a horse. Theme two highlights that the perfect horse does not exist therefore, equine athlete management is complex and requires a multi-layered problem-solving approach. Theme three describes an awareness among stakeholders of technologies, however they are sceptical of their value. The final theme identified that one of the key barriers to technology adoption is the economic value of the horse and the cost of implementing technology herd-wide. Our findings highlight the need for a user-centred design in this domain, which requires greater consultation and learning between technology developers and equine stakeholders to develop fit-for-purpose analysis and monitoring tools.
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Affiliation(s)
- Sonja Egan
- Institute for Sport and Health, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland.
| | - Pieter Brama
- Section Veterinary Clinical Sciences, School of Veterinary Medicine, University College Dublin, Dublin, Ireland
| | - Denise McGrath
- Institute for Sport and Health, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
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Rossmann C, Riesmeyer C, Brew-Sam N, Karnowski V, Joeckel S, Chib A, Ling R. Appropriation of Mobile Health for Diabetes Self-Management: Lessons From Two Qualitative Studies. JMIR Diabetes 2019; 4:e10271. [PMID: 30924786 PMCID: PMC6460309 DOI: 10.2196/10271] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 10/12/2018] [Accepted: 01/24/2019] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND To achieve clarity on mobile health's (mHealth's) potential in the diabetes context, it is necessary to understand potential users' needs and expectations, as well as the factors determining their mHealth use. Recently, a few studies have examined the user perspective in the mHealth context, but their explanatory value is constrained because of their limitation to adoption factors. OBJECTIVE This paper uses the mobile phone appropriation model to examine how individuals with type 1 or type 2 diabetes integrate mobile technology into their everyday self-management. The study advances the field beyond mere usage metrics or the simple dichotomy of adoption versus rejection. METHODS Data were gathered in 2 qualitative studies in Singapore and Germany, with 21 and 16 respondents, respectively. Conducting semistructured interviews, we asked respondents about their explicit use of diabetes-related apps, their general use of varied mobile technologies to manage their disease, and their daily practices of self-management. RESULTS The analysis revealed that although some individuals with diabetes used dedicated diabetes apps, most used tools across the entire mobile-media spectrum, including lifestyle and messaging apps, traditional health information websites and forums. The material indicated general barriers to usage, including financial, technical, and temporal restrictions. CONCLUSIONS In sum, we find that use patterns differ regarding users' evaluations, expectancies, and appropriation styles, which might explain the inconclusive picture of effects studies in the diabetes mHealth context.
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Affiliation(s)
- Constanze Rossmann
- Department of Media and Communication Science, University of Erfurt, Erfurt, Germany
| | | | - Nicola Brew-Sam
- Department of Media and Communication Science, University of Erfurt, Erfurt, Germany
| | | | - Sven Joeckel
- Department of Media and Communication Science, University of Erfurt, Erfurt, Germany
| | - Arul Chib
- Wee Kim Wee School of Communication and Information, Nanyang Technological University, Singapore, Singapore
| | - Rich Ling
- Wee Kim Wee School of Communication and Information, Nanyang Technological University, Singapore, Singapore
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