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Davey M, Fried L, Chih HJ, Rooney R, Roberts A. Internet-based third-wave Cognitive Behavioral Therapy (CBT) for reducing stress in parents of children and adolescents with chronic conditions: Systematic review and meta-analysis protocol. Health Sci Rep 2024; 7:e70125. [PMID: 39377018 PMCID: PMC11456509 DOI: 10.1002/hsr2.70125] [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: 10/26/2023] [Revised: 07/25/2024] [Accepted: 09/18/2024] [Indexed: 10/09/2024] Open
Abstract
Background Parents of children and adolescents with chronic conditions have an increased risk of stress-related mental health problems, and reduced quality of life. Third wave Cognitive Behavioral Therapy (CBT) interventions have been shown to reduce stress in this parent population. Studies demonstrate that this efficacy endures when these therapies are delivered online. The aim of this protocol is to describe the methodology and methods that will be employed for a systematic review and meta-analysis that investigates the effectiveness of internet-based third-wave CBT interventions for parents of children and adolescents with chronic conditions, and their potential to reduce stress for parents. Methods/Design This systematic review will follow the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) approach. A search of peer-reviewed journal articles published from January 1970 to December 2022 will be undertaken in the following databases: CINHAHL, EMBASE, EMCARE, MEDLINE, PsycINFO. Title and abstract screening together with data extraction will be completed by two reviewers, and will be arbitrated by a third reviewer, should there be any discrepancies. The risk of bias will be assessed using the Cochrane Risk of Bias tool. Data related to the primary outcome (i.e. reduction of stress in parents) will be extracted for analysis. Results This Systematic Review and Meta-Analysis plans to provide a conclusive overview of the available evidence on the effectiveness of internet-based third-wave parent interventions and their ability to reduce stress in parents of children and adolescents with chronic conditions. If the results of this analysis prove positive, further research can be undertaken to support this vulnerable parent population. The findings of the review will be published in a peer-reviewed journal. Discussion Third-wave internet-based approaches may show great promise in supporting parents to cope with the stress/distress associated with parenting a child with a chronic condition. This protocol will guide a systematic literature review of the evidence for internet-based third-wave interventions for this parent population. Registration This systematic review was registered on PROSPERO on 24th June, 2022 (Registration: CRD42022337334).
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Affiliation(s)
- Maria Davey
- Curtin School of Population HealthCurtin UniversityKent StreetBentleyWAAustralia
| | - Leanne Fried
- Telethon Kids InstitutePerth Children's Hospital15 Hospital AvenueNedlandsWAAustralia
| | - Hui Jun Chih
- Curtin School of Population HealthCurtin UniversityKent StreetBentleyWAAustralia
| | - Rosanna Rooney
- Curtin School of Population HealthCurtin UniversityKent StreetBentleyWAAustralia
| | - Alison Roberts
- Child and Adolescent Health ServicePerth Children's Hospital15 Hospital AvenueNedlandsWAAustralia
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Guillari A, Sansone V, Giordano V, Catone M, Rea T. Assessing digital health knowledge, attitudes and practices among nurses in Naples: a survey study protocol. BMJ Open 2024; 14:e081721. [PMID: 38925700 PMCID: PMC11208876 DOI: 10.1136/bmjopen-2023-081721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 06/04/2024] [Indexed: 06/28/2024] Open
Abstract
INTRODUCTION Digital competencies are essential for nurses to actively participate in the digitisation of healthcare systems. Therefore, it is important to assess their skill levels to identify strengths and areas for improvement. METHOD AND ANALYSIS This study aims to investigate nurses' knowledge, attitudes, behaviours, subjective norms and behavioural control regarding digital health. A knowledge-attitude-practice model guided the development of a structured questionnaire divided into six sections. A sample of 480 registered nurses of Naples will be involved in the study. After conducting a pretest, an invitation will be publicised through the institutional communication channels of Nurses Provincial Order of Naples. Nurses will respond via a unique link or quick response code sent through a PEC email system (a legally valid email system, which guarantees delivery and receipt). They will have 30 days to complete the survey, scheduled between May and July 2024. ETHICS AND DISSEMINATION No ethics committee approval was required, as the study does not involve minors, direct or indirect physical or physiological harm to participants, or clinical trials. Anonymity will be guaranteed at all data collection and processing levels. The results will be broadly distributed through conference presentations and peer-reviewed publications. The effective use of digital technologies by healthcare professionals can bring significant improvements to healthcare services and help improve the health of individuals and community health. The study's findings will serve as a foundation for developing and implementing educational programmes related to eHealth and telemedicine, promoting the harmonisation of such programmes.
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Affiliation(s)
- Assunta Guillari
- Public Health Department, Federico II University Hospital, Napoli, Campania, Italy
| | - Vincenza Sansone
- Department of Experimental Medicine, University of Campania Luigi Vanvitelli School of Medicine and Surgery, Napoli, Campania, Italy
| | - Vincenza Giordano
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Roma, Italy
| | - Maria Catone
- Public Health Department, Federico II University Hospital, Napoli, Campania, Italy
| | - Teresa Rea
- Public Health Department, Federico II University Hospital, Napoli, Campania, Italy
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Choi S. Comparison of Self-Tracking Health Practices, eHealth Literacy, and Subjective Well-Being Between College Students With and Without Disabilities: Cross-Sectional Survey. JMIR Form Res 2024; 8:e48783. [PMID: 38598285 PMCID: PMC11043924 DOI: 10.2196/48783] [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: 05/06/2023] [Revised: 03/01/2024] [Accepted: 03/12/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND College students with disabilities need to transition from pediatric-centered care to adult care. However, they may become overwhelmed by multiple responsibilities, such as academic activities, peer relationships, career preparation, job seeking, independent living, as well as managing their health and promoting healthy behaviors. OBJECTIVE As the use of smartphones and wearable devices for collecting personal health data becomes popular, this study aimed to compare the characteristics of self-tracking health practices between college students with disabilities and their counterparts. In addition, this study examined the relationships between disability status, self-tracking health practices, eHealth literacy, and subjective well-being among college students. METHODS The web-based questionnaire was designed using Qualtrics for the cross-sectional online survey. The survey data were collected from February 2023 to April 2023 and included responses from 702 participants. RESULTS More than 80% (563/702, 80.2%) of the respondents participated voluntarily in self-tracking health practices. College students with disabilities (n=83) showed significantly lower levels of eHealth literacy and subjective well-being compared with college students without disabilities (n=619). The group with disabilities reported significantly lower satisfaction (t411=-5.97, P<.001) and perceived efficacy (t411=-4.85, P<.001) when using smartphone health apps and wearable devices. Finally, the study identified a significant correlation between subjective well-being in college students and disability status (β=3.81, P<.001), self-tracking health practices (β=2.22, P=.03), and eHealth literacy (β=24.29, P<.001). CONCLUSIONS Given the significant relationships among disability status, self-tracking health practices, eHealth literacy, and subjective well-being in college students, it is recommended to examine their ability to leverage digital technology for self-care. Offering learning opportunities to enhance eHealth literacy and self-tracking health strategies within campus environments could be a strategic approach to improve the quality of life and well-being of college students.
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Affiliation(s)
- Soyoung Choi
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Urbana, IL, United States
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Sullivan MO, Curtin M, Flynn R, Cronin C, Mahony JO, Trujillo J. Telehealth interventions for transition to self-management in adolescents with allergic conditions: A systematic review. Allergy 2024; 79:861-883. [PMID: 38041398 DOI: 10.1111/all.15963] [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: 10/04/2023] [Revised: 11/14/2023] [Accepted: 11/19/2023] [Indexed: 12/03/2023]
Abstract
Telehealth is an emerging approach that uses technology to provide healthcare remotely. Recent publications have outlined the importance of supporting the transition to self-management of adolescents with allergic conditions. However, no synthesis of the evidence base on the use and impact of telehealth interventions for this purpose has been conducted to date. This review achieves these aims, in addition to exploring the language use surrounding these interventions, and their implementation. Four databases were searched systematically. References were independently screened by two reviewers. Methodological quality was assessed using the Mixed Methods Appraisal Tool. A narrative synthesis was undertaken. Eighteen articles were included, reporting on 15 telehealth interventions. A total of 86% targeted adolescents with asthma. Mobile applications were the most common telehealth modality used, followed by video-conferencing, web-based, virtual reality and artificial intelligence. Five intervention content categories were identified; educational, monitoring, behavioural, psychosocial and healthcare navigational. Peer and/or healthcare professional interaction, gamification and tailoring may increase engagement. The studies showed positive effects of the interventions or no difference from active controls, in self-management outcomes such as knowledge, health outcomes such as quality-of-life, and economic outcomes such as healthcare utilization. The most common implementation outcomes reported were acceptability, appropriateness, feasibility and fidelity.
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Affiliation(s)
- Meg O' Sullivan
- University College Cork, Cork, Ireland
- Cork University Hospital, Cork, Ireland
| | | | | | | | | | - Juan Trujillo
- University College Cork, Cork, Ireland
- Cork University Hospital, Cork, Ireland
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Rezaee R, Ghaffari M, Rabiei R, Kavousi A, Rakhshanderou S. Design and usability evaluation of a mobile application for self-care among Iranian adolescents. BMC Public Health 2024; 24:892. [PMID: 38528452 DOI: 10.1186/s12889-024-18341-z] [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: 08/21/2023] [Accepted: 03/12/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND Mobile phones can be an ideal platform to engage adolescents to maintain, improve, and promote self-care. Therefore, the current study aims to design and evaluate the usability of a mobile application for self-care in adolescents with a user-centered approach. METHODS The current applied developmental study was done in four steps. The first step, polling and examining opinions was conducted through in-depth semi-structured interviews, with the aim of user-centered mobile application design with the involvement of 30 participants. The second step, extracting and compiling the educational content related to the main themes of the self-care app, was obtained from national and international guidelines and instructions, including the World Health Organization, the Center for Disease Control and Prevention, the Ministry of Health and Medical Education, etc. In the third step, the initial version of the mobile application was developed. In the fourth step, app usability was evaluated by 30 participants from the target group, 2 weeks after using the app, using the MAUQ questionnaire. RESULTS In the first step, 789 codes, 12 sub-categories, and 3 categories were extracted. These codes were used in the design of the mobile application. In the second step, educational information was prepared and arranged in 5 sections (physical activity, nutrition, personal hygiene, risky behaviors and safety and events) in the form of text, images and short videos. In the third step, the mobile application was designed based on step 1 and 2. This application operates in online mode and under the Android operating system. the initial version of the mobile application was developed using JavaScript and Typescript programming languages in a Visual Studio Code environment. In the fourth step, the participants the overall level of usability of the application as very good with an average of 6.28 ± 0.55. The highest average score was given to the user interface and satisfaction with an average score of 6.43 ± 0.58. CONCLUSIONS The "My-Care" app is a collaboratively designed smartphone app for adolescents that targets 5 dimensions of physical self-care. This app has the potential to teach, assess, and promote self-care among adolescents.
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Affiliation(s)
- Razieh Rezaee
- Health Education and Health Promotion, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohtasham Ghaffari
- Health Education and Health Promotion, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Rabiei
- Department of Health Information Technology and Management, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amir Kavousi
- School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sakineh Rakhshanderou
- Health Education and Health Promotion, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tabnak Ave., Daneshjou Blvd., Velenjak, Tehran, 19835-35511, Iran.
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Ehrhardt MJ, Friedman DN, Hudson MM. Health Care Transitions Among Adolescents and Young Adults With Cancer. J Clin Oncol 2024; 42:743-754. [PMID: 38194608 PMCID: PMC11264196 DOI: 10.1200/jco.23.01504] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 10/06/2023] [Accepted: 11/01/2023] [Indexed: 01/11/2024] Open
Abstract
Survivors of adolescent and young adult (AYA) cancers, defined as individuals diagnosed with a primary malignancy between age 15 and 39 years, are a growing population with unique developmental, psychosocial, and health-related needs. These individuals are at excess risk of developing a wide range of chronic comorbidities compared with the general population and, therefore, require lifelong, risk-based, survivorship care to optimize long-term health outcomes. The health care needs of survivors of AYA cancers are particularly complicated given the often heterogeneous and sometimes fragmented care they receive throughout the cancer care continuum. For example, AYA survivors are often treated in disparate settings (pediatric v adult) on dissimilar protocols that include different recommendations for longitudinal follow-up. Specialized tools and techniques are needed to ensure that AYA survivors move seamlessly from acute cancer care to survivorship care and, in many cases, from pediatric to adult clinics while still remaining engaged in long-term follow-up. Systematic, age-appropriate transitional practices involving well-established clinical models of care, survivorship care plans, and survivorship guidelines are needed to facilitate effective transitions between providers. Future studies are necessary to enhance and optimize the clinical effectiveness of transition processes in AYA cancer survivors.
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Affiliation(s)
- Matthew J Ehrhardt
- Department of Oncology, St Jude Children's Research Hospital, Memphis, TN
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN
| | - Danielle Novetsky Friedman
- Department of Pediatrics, Division of General Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Melissa M Hudson
- Department of Oncology, St Jude Children's Research Hospital, Memphis, TN
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN
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Markwart H, Schmidt S, Thyen U, Ernst G, Muehlan H. Transition competence as an indicator of health outcomes related to transition. Child Care Health Dev 2024; 50:e13142. [PMID: 37353994 DOI: 10.1111/cch.13142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 05/23/2023] [Accepted: 05/30/2023] [Indexed: 06/25/2023]
Abstract
BACKGROUND Adolescents and young adults (AYAs) with chronic conditions face a transfer, defined as an actual shift from paediatric to adult-oriented health care. Transition competence as the self-perceived knowledge, skills and abilities regarding the transition process was considered extremely useful. AIM This study was designed to investigate the impact of transition competence before and after the transfer on disease-specific quality of life (QoL) and health care satisfaction of AYAs with diabetes. RESULTS In total, a sample of N = 90 AYAs with diabetes self-reported their transition competence, diabetes-specific QoL and satisfaction with care. Multiple linear regressions were used to analyse the impact of transition competence on satisfaction with care and QoL. Transition competence positively influenced the outcomes of satisfaction with care and QoL. CONCLUSION Young adults with diabetes showed higher transition competence scores than adolescents with diabetes.
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Affiliation(s)
- Henriette Markwart
- Department Methods of Community Medicine, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Silke Schmidt
- Department of Health and Prevention, University Greifswald, Greifswald, Germany
| | - Ute Thyen
- Department of Pediatrics and Adolescent Medicine, University of Luebeck, Luebeck, Germany
| | - Gundula Ernst
- Department of Medical Psychology, Medical School Hannover, Hannover, Germany
| | - Holger Muehlan
- Department of Health and Prevention, University Greifswald, Greifswald, Germany
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Ghozali MT, Satibi S, Forthwengel G. The impact of mobile health applications on the outcomes of patients with chronic kidney disease: a systematic review and meta-analysis. J Med Life 2023; 16:1299-1309. [PMID: 38107714 PMCID: PMC10719786 DOI: 10.25122/jml-2023-0153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 08/11/2023] [Indexed: 12/19/2023] Open
Abstract
Chronic kidney disease is one of the main causes of mortality worldwide. It affects more than 800 million patients globally, accounting for approximately 10% of the general population. The significant burden of the disease prompts healthcare systems to implement adequate preventive and therapeutic measures. This systematic review and meta-analysis aimed to provide a concise summary of the findings published in the existing body of research about the influence that mobile health technology has on the outcomes of patients with the disease. A comprehensive systematic literature review was conducted from inception until March 1st, 2023. This systematic review and meta-analysis included all clinical trials that compared the efficacy of mobile app-based educational programs to that of more conventional educational treatment for the patients. Eleven papers were included in the current analysis, representing 759 CKD patients. 381 patients were randomly assigned to use the mobile apps, while 378 individuals were assigned to the control group. The mean systolic blood pressure was considerably lower in the mobile app group (MD -4.86; 95%-9.60, -0.13; p=0.04). Meanwhile, the mean level of satisfaction among patients who used the mobile app was considerably greater (MD 0.75; 95% CI 0.03, 1.46; p=0.04). Additionally, the mean self-management scores in the mobile app groups were significantly higher (SMD 0.534; 95% CI 0.201, 0.867; p=0.002). Mobile health applications are potentially valuable interventions for patients. This technology improved the self-management of the disease, reducing the mean levels of systolic blood pressure with a high degree of patient satisfaction.
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Affiliation(s)
- Muhammad Thesa Ghozali
- Department of Pharmaceutical Management, School of Pharmacy, Faculty of Medicine and Health Sciences, Universitas Muhammadiyah Yogyakarta, Yogyakarta, Indonesia
| | - Satibi Satibi
- Department of Pharmaceutics, Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Gerhard Forthwengel
- Fakultat III, Hochschule Hannover, University of Applied Sciences and Arts, Hannover, Germany
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Pogge G, Fedele DA, Waters EA, Maki J, Hunleth JM, Prabhakaran S, Bowen DJ, Shepperd JA. Exploring Caregiver Interest in and Preferences for Interventions for Children With Risk of Asthma Exacerbation: Web-Based Survey. JMIR Form Res 2023; 7:e46341. [PMID: 37531188 PMCID: PMC10433025 DOI: 10.2196/46341] [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: 02/07/2023] [Revised: 06/14/2023] [Accepted: 06/15/2023] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND Maintaining control of asthma symptoms is the cornerstone of asthma treatment guidelines in the United States. However, suboptimal asthma control and asthma exacerbations among young people are common and are associated with many negative outcomes. Interventions to improve asthma control are needed. For such interventions to be successful, it is necessary to understand the types of interventions that are appealing to caregivers of children with different levels of risk of exacerbation. OBJECTIVE This study aimed to evaluate whether caregivers of children with high (vs low) risk of asthma exacerbation show different levels of interest in and preferences for potential intervention programs and delivery methods. METHODS We contracted with Ipsos to administer a web-based survey to caregivers of children with asthma who were residing in the United States. Caregivers (N=394) reported their interest (1=not at all; 3=a lot) in 9 possible intervention programs and 8 possible intervention delivery methods. Caregivers also indicated their preferences by selecting the 3 intervention programs and 3 delivery methods that "most" interested them. Finally, caregivers completed 2 open-ended questions asking what other resources might be useful for managing their children's asthma. We classified children as having a high risk of exacerbation if they had an exacerbation in the past 3 months (n=116) and a low risk of exacerbation if otherwise (n=278). RESULTS Caregivers reported higher levels of interest in all intervention programs and delivery methods if they cared for a child with a high risk rather than a low risk of exacerbation. However, regardless of the child's risk status, caregivers expressed the highest levels of interest in programs to increase their child's self-management skills, to help pay for asthma care, and to work with the school to manage asthma. Caregivers expressed the highest levels of interest in delivery methods that maintained personal control over accessing information (websites, videos, printed materials, and smartphone apps). Caregivers' preferences were consistent with their interests; programs and delivery methods that were rated as high in interest were also selected as one of the 3 that "most" interested them. Although most caregivers did not provide additional suggestions for the open-ended questions, a few caregivers suggested intervention programs and delivery methods that we had not included (eg, education about avoiding triggers and medication reminders). CONCLUSIONS Similar interests and preferences among caregivers of children with high and low risk of exacerbation suggest a broad need for support in managing childhood asthma. Providers could help caregivers by directing them toward resources that make asthma care more affordable and by helping their children with asthma self-management. Interventions that accommodate caregivers' concerns about having personal control over access to asthma information are likely to be more successful than interventions that do not.
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Affiliation(s)
- Gabrielle Pogge
- Department of Psychology, University of Florida, Gainesville, FL, United States
| | - David A Fedele
- Department of Psychology, University of Florida, Gainesville, FL, United States
| | - Erika A Waters
- Division of Public Health Sciences, Washington University in St Louis, St Louis, MO, United States
| | - Julia Maki
- Division of Public Health Sciences, Washington University in St Louis, St Louis, MO, United States
| | - Jean M Hunleth
- Division of Public Health Sciences, Washington University in St Louis, St Louis, MO, United States
| | | | - Deborah J Bowen
- Department of Bioethics and Humanities, University of Washington, Seattle, WA, United States
| | - James A Shepperd
- Department of Psychology, University of Florida, Gainesville, FL, United States
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Pohoreski K, Horwitz SL, Gidrewicz D. Gluten-Free Diet Knowledge and Adherence in Adolescents with Celiac Disease: A Cross-Sectional Study. JPGN REPORTS 2023; 4:e330. [PMID: 37600611 PMCID: PMC10435025 DOI: 10.1097/pg9.0000000000000330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 05/12/2023] [Indexed: 08/22/2023]
Abstract
Objectives This study examined the relationship between knowledge of, and adherence to, the gluten-free diet (GFD) in a local population of adolescents with celiac disease (CD). The secondary objectives were to identify information sources used to learn about the GFD and to compare adolescents' and parents' knowledge of the GFD. Methods Adolescents (12-17 years) with CD and their parents from pediatric gastroenterology clinics in Calgary, Alberta, completed an online survey containing a knowledge assessment (Gluten-Free Diet Quiz [GFD-Q]), an adherence scale, questions about GFD information sources, and demographic/clinical information. GFD-Q scores were deemed "sufficient knowledge" with correct identification of 3/3 gluten-containing foods, ≥4/7 gluten-free foods, and ≥ 4/7 foods that may contain gluten; otherwise, scores were termed "insufficient knowledge". Results Of the 40 adolescent-parent pairs, 15 of 40 adolescents (37%) had sufficient knowledge, and 25 of 40 adolescents (63%) had insufficient knowledge. Within the insufficient knowledge group, 14 of 25 (56%) did not correctly identify enough allowed gluten-free foods. Parents scored higher on the GFD-Q (67% had sufficient knowledge). Adolescents reported overall adherence to the GFD (88%), with adherence being similar between the sufficient and insufficient knowledge groups (80% versus 92%). The most helpful information sources included physicians, another person with CD, parent(s), and Google; apps were infrequently used. Conclusion Adolescents report good adherence; however, they struggle with GFD knowledge, particularly in identifying gluten-free foods. Further research is required to explore GFD educational tools, including mobile apps and dietician-led teaching sessions.
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Affiliation(s)
- Katherine Pohoreski
- From the Department of Pediatrics, University of Calgary, Alberta Children’s Hospital, Calgary, AB, Canada
| | - Simonne L Horwitz
- Department of Pediatrics, University of Toronto, The Hospital for Sick Children, Toronto, ON, Canada
| | - Dominica Gidrewicz
- From the Department of Pediatrics, University of Calgary, Alberta Children’s Hospital, Calgary, AB, Canada
- Department of Pediatrics, Section of Pediatric Gastroenterology, Hepatology & Nutrition, University of Calgary, Calgary, AB, Canada
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Farre A, Lunt L, Lee R, Verstappen S, McDonagh JE. Addressing education and employment outcomes in the provision of healthcare for young people with physical long-term conditions: A systematic review and mixed methods synthesis. PATIENT EDUCATION AND COUNSELING 2023; 112:107765. [PMID: 37086594 DOI: 10.1016/j.pec.2023.107765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 04/13/2023] [Accepted: 04/16/2023] [Indexed: 05/03/2023]
Abstract
OBJECTIVE To identify and synthesise the experiences and benefits of addressing vocational issues in the provision of healthcare for young people (YP) with long-term conditions (LTCs). METHODS We searched 10 bibliographic databases. Restrictions were applied on publication date (1996-2020) and language (English). Two reviewers independently screened records against eligibility criteria. Articles reporting relevant qualitative and/or quantitative research were included. Quality appraisal was undertaken following study selection. Qualitative data were synthesised thematically, and quantitative data narratively. A cross-study synthesis integrated qualitative and quantitative findings. RESULTS 43 articles were included. Thematic synthesis of qualitative studies (n = 23) resulted in seven recommendations for intervention (psychological support; information/signposting; skills training; career advice; healthcare-school/workplace collaboration; social support; flexible/responsive care). The narrative synthesis summarised results of 17 interventions (n = 20 quantitative studies). The cross-study synthesis mapped interventions against recommendations. Transitional care was the intervention type that most comprehensively met our proposed recommendations. CONCLUSIONS Evidence from YP perspectives highlights that vocational development is an important area to address in healthcare provision. Robust intervention studies in this area are lacking. PRACTICE IMPLICATIONS Our evidence-based recommendations for intervention can support health professionals to better address vocational issues/outcomes. With minimal adaptations, transitional care interventions would be particularly well suited to deliver this.
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Affiliation(s)
- Albert Farre
- School of Health Sciences, University of Dundee, Dundee, UK.
| | - Laura Lunt
- Centre for Epidemiology Versus Arthritis, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK; NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | - Rebecca Lee
- Centre for Epidemiology Versus Arthritis, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK; NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | - Suzanne Verstappen
- Centre for Epidemiology Versus Arthritis, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK; NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | - Janet E McDonagh
- Centre for Epidemiology Versus Arthritis, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK; NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester, UK; Department of Paediatric and Adolescent Rheumatology, Royal Manchester Children's Hospital, Manchester University NHS Foundation Trust, Manchester, UK
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Poku BA, Atkin KM, Kirk S. Self-management interventions for children and young people with sickle cell disease: A systematic review. Health Expect 2023; 26:579-612. [PMID: 36597596 PMCID: PMC10010100 DOI: 10.1111/hex.13692] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 12/03/2022] [Accepted: 12/11/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Increasing numbers of interventions are being developed to support self-management for children and young people (CYP) with sickle cell disease (SCD), but no systematic review has systematically synthesized this evidence regarding their characteristics, effectiveness, acceptability and feasibility for all published intervention types. METHODS The Joanna Briggs Institute guidelines for mixed-method reviews were followed. A systematic search of eight databases and key journals was conducted from their inception to November 2021. Primary research of self-management interventions targeting CYP with SCD aged 8-24 years and reporting any health/social outcome and acceptability data were included. Design-specific standardized critical appraisal instruments were used. Two independent reviewers screened and appraised the articles. A third reviewer resolved disagreements. RESULTS Of 1654 articles identified, 38 studies were included. Methodological quality was moderate. Most studies evaluated SCD education, psycho-behavioural, psychosocial and skills training and/or social support interventions. They appear to demonstrate short-term improvements in knowledge, social functioning and medical adherence outcomes. Interventions that were multifaceted in content, combined technological platforms and in-person group-based formats and involved peers, family and care providers were more acceptable and effective. The long-term impact of interventions was limited, including CYP's involvement in the intervention development and implementation. CONCLUSIONS There is inconclusive evidence for any self-management programme. Nonetheless, support from family, peers and care providers appears to be important for self-management interventions' effectiveness and acceptability. Future research needs to prioritize CYP involvement in both intervention design and delivery, their wider social context and include CYP with SCD from non-Black backgrounds. PATIENT AND PUBLIC CONTRIBUTION Three young people with SCD recruited acted as the review advisors. They were formally trained in the review process and involved in every aspect of the review: the design, conduct and interpretation of the findings. CYP involvement in the interventions' development and implementation was analysed as part of the review. This systematic review was conducted as part of a wider research project titled: Understanding fatigue experiences of CYP with SCD to guide the co-development of a fatigue self-management intervention. Two of the young advisors involved in the review were also involved in the development of the project funding application.
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Affiliation(s)
- Brenda A Poku
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester, Manchester, UK
| | | | - Sue Kirk
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester, Manchester, UK
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Litchfield I, Barrett T, Hamilton-Shield JP, Moore THM, Narendran P, Redwood S, Searle A, Uday S, Wheeler J, Greenfield S. Developments in the design and delivery of self-management support for children and young people with diabetes: A narrative synthesis of systematic reviews. Diabet Med 2023; 40:e15035. [PMID: 36576331 DOI: 10.1111/dme.15035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 11/22/2022] [Accepted: 12/23/2022] [Indexed: 12/29/2022]
Abstract
AIMS Facilitated self-management support programmes have become central to the treatment of chronic diseases including diabetes. For many children and young people with diabetes (CYPD), the impact on glycated haemoglobin (HbA1c ) and a range of self-management behaviours promised by these programmes remain unrealised. This warrants an appraisal of current thinking and the existing evidence to guide the development of programmes better targeted at this age group. METHODS Create a narrative review of systematic reviews produced in the last 3 years that have explored the impact on CYPD of the four key elements of self-management support programmes: education, instruction and advice including peer support; psychological counselling via a range of therapies; self-monitoring, including diaries and telemetric devices; and telecare, the technology-enabled follow-up and support by healthcare providers. RESULTS Games and gamification appear to offer a promising means of engaging and educating CYPD. Psychological interventions when delivered by trained practitioners, appear to improve HbA1c and quality of life although effect sizes were small. Technology-enabled interactive diaries can increase the frequency of self-monitoring and reduce levels of HbA1c . Telecare provided synchronously via telephone produced significant improvements in HbA1c . CONCLUSIONS The cost-effective flexibility of increasing the reliance on technology is an attractive proposition; however, there are resource implications for digital connectivity in underserved populations. The need remains to improve the understanding of which elements of each component are most effective in a particular context, and how to optimise the influence and input of families, caregivers and peers.
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Affiliation(s)
- Ian Litchfield
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Timothy Barrett
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
- Department of Diabetes and Endocrinology, Birmingham Women's and Children's Hospital, Birmingham, UK
| | - Julian P Hamilton-Shield
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- The Royal Hospital for Children in Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - T H M Moore
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Parth Narendran
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
- Queen Elizabeth Hospital, Birmingham, UK
| | - Sabi Redwood
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Aidan Searle
- NIHR Bristol BRC Nutrition Theme, University Hospitals Bristol and Weston Foundation Trust, Bristol, UK
| | - Suma Uday
- Department of Diabetes and Endocrinology, Birmingham Women's and Children's Hospital, Birmingham, UK
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
| | - Jess Wheeler
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Sheila Greenfield
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
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14
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Tietz F, Adams I, Lücke E, Schreiber J. Inhalation Devices in 7- to 15-Year-Old Children with Asthma - A Patient Preference Study. Patient Prefer Adherence 2023; 17:951-959. [PMID: 37038436 PMCID: PMC10082580 DOI: 10.2147/ppa.s381486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 01/11/2023] [Indexed: 04/12/2023] Open
Abstract
Background Inhalation therapy is the cornerstone of treatment of bronchial asthma. A patient-specific selection of inhalation devices is necessary, as preference for a device plays an important role in terms of error rates in handling and adherence to therapy. However, there is no industry-independent study providing information on children's preferences for common inhaler types. The aim of the present study was to investigate the preference of asthmatic children for inhaler types commonly used in Germany. The effects of age, gender and the type of school visited on device preferences as well as the frequency of patient education and the role of health care providers in the choice for an inhaler were investigated. Methods Eighty children were included in this prospective cross-sectional study (age: 10.87 ± 2.62 years). The analysis was based on a questionnaire and validated checklists. All participants tested the use of nine placebo inhalers (Breezhaler, Diskus, Respimat, Spiromax, Turbohaler, Autohaler, metered-dose inhaler, Easyhaler and Novolizer) in a randomized order. For each device, patients were asked to assess handling, rate different device characteristics and name the device they would prefer most or least. Results The most favored device was the Novolizer. Moreover, the Spiromax scored highest in numerous categories such as suitability in emergencies and "easiest" device to use. Patient preferences with respect to the addressed inhaler features were not significantly related to age, gender or school type. Conclusion The Novolizer and the Spiromax showed higher preference in pediatric patients as compared to other tested devices. Overall, there were significant differences in terms of preference when comparing the tested inhalers in different aspects.
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Affiliation(s)
- Franziska Tietz
- Department of Pneumonology, University Medicine, Magdeburg, Germany
| | - Ines Adams
- Department of Pediatrics, University Medicine, Magdeburg, Germany
| | - Eva Lücke
- Department of Pneumonology, University Medicine, Magdeburg, Germany
| | - Jens Schreiber
- Department of Pneumonology, University Medicine, Magdeburg, Germany
- Correspondence: Jens Schreiber, Department of Pneumology, University Medicine Magdeburg, Leipziger Straße 44, Magdeburg, 39120, Germany, Tel +49 391 67 15421, Fax +49 391 67 13356, Email
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Buis L, Smahel D. Individual and Parental Factors of Adolescents' mHealth App Use: Nationally Representative Cross-sectional Study. JMIR Mhealth Uhealth 2022; 10:e40340. [PMID: 36525286 PMCID: PMC9804093 DOI: 10.2196/40340] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 10/11/2022] [Accepted: 10/21/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Knowledge of the characteristics of adolescents who use mobile health (mHealth) apps to monitor health and how these characteristics differ from those of app nonusers is limited. OBJECTIVE We aimed to determine mHealth app use based on adolescent and parental factors, including sociodemographics, digital skills, and health indicators, in a nationally representative sample of Czech adolescents (N=2500). METHODS Adolescents aged 11 to 16 years and one of their parents participated in an online survey in 2021. A professional research agency recruited the participants. Quotas were used to ensure the sample's representativeness. The sociodemographic factors were the adolescents' age, gender, and parental perceived financial security. The adolescents also provided information about their screen time, eHealth literacy, BMI, health anxiety, physical activity, and sleep quality. Parents reported their digital skills, mobile phone attitudes, and the mediation of their children's online health information-seeking behaviors. We evaluated the differences between the users and nonusers of mHealth apps and identified the significant predictors of mHealth app use. Next, we separately examined how these factors were associated with the use of mHealth apps that track calorie intake or expenditure, number of steps, weight, or sports activity (eg, exercise, running, and working out), as well as other mHealth apps (eg, those that track sleep and heart rate). RESULTS More than half of the adolescents (1429/2455, 58.21%) reported using mHealth apps. App users were relatively older and, more often, girls. Apps that counted the number of steps were used most frequently, and adolescents whose parents reported higher perceived financial security used them more regularly. Overall, being older and physically active and having higher eHealth literacy skills were associated with using mHealth apps. Adolescents with higher BMI, health anxiety, and lower sleep quality more frequently used mHealth apps to track calorie intake or expenditure, weight, and health indicators. mHealth apps to track physical activity were used more regularly by girls. There was a positive association between parental mediation of online health information-seeking behaviors and adolescents' mHealth app use. CONCLUSIONS These findings demonstrated that older age, physical activity, and eHealth literacy skills were the common underlying factors of adolescents' mHealth app use. We initially showed parents as significant role models for their children's adoption of, and engagement with, mHealth apps when they actively mediate their online health information-seeking behaviors. Improving the eHealth literacy skills of adolescents through parental guidance might enhance health technology use in this population. Tracking eating behaviors, weight, and health were more prevalent for adolescents who reported higher BMI, health anxiety, and lower sleep quality. Future research studies should examine the determinants and health outcomes of adolescents' mHealth app use longitudinally.
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Affiliation(s)
| | - David Smahel
- Interdisciplinary Research Team on Internet and Society, Faculty of Social Studies, Masaryk University, Brno, Czech Republic
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16
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Yeung J, Virella Pérez YI, Samarasinghe SC, Forsyth V, Agarwalla V, Steinbeck K. Study protocol: a pragmatic trial reviewing the effectiveness of the TransitionMate mobile application in supporting self-management and transition to adult healthcare services for young people with chronic illnesses. BMC Health Serv Res 2022; 22:1443. [PMID: 36447255 PMCID: PMC9706969 DOI: 10.1186/s12913-022-08536-8] [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: 08/12/2021] [Accepted: 09/07/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Transition from paediatric to adult heath care services is a challenging time for many adolescents with chronic illnesses and may include deterioration in illness control as a consequence of inadequate self-management skills, poor understanding of their chronic illness and failure to engage with adult services. Successful transfer of health care requires the development of self-management skills and increased autonomy. Mobile technology has been proposed as a modality to assist this process. Evidence is limited and generally restricted to illness specific applications. The TransitionMate app (TMApp) is a generic (non-illness specific) mobile application designed to support young people with chronic illness in their transition from paediatric to adult health care services. The overall aim of the study is to assess the effectiveness of TMApp in improving engagement and retention of adolescents with chronic illness within adult healthcare services, as well as preventing the deterioration in illness control and unplanned hospitalisations. METHODS The TransitionMate trial is a dual centre, pragmatic, single arm, mixed methods cohort study conducted within two university teaching tertiary paediatric hospitals in Australia. Data collection points are planned at 0, 6, 12 and 18 months. Outcome indicators include: usage of TransitionMate, engagement with adult services, quantitative markers of illness control, and unplanned hospital admissions. Data are collected through telephone interviews with the participants, their primary healthcare providers, electronic medical records and de-identified mobile application analytics. The development of the application involved co-design with recently transitioned young people with a number of chronic illnesses as well as online user experience in younger adolescents. DISCUSSION The TransitionMate study is the first identified trial of a generic mobile application designed to support adolescents with chronic illnesses during the transition process. Results are expected to provide novel insights into the value of technological tools in the transition space, especially their effectiveness in improving both the transition process and clinical outcomes of adolescents with chronic illnesses. Furthermore, the approach of a pragmatic study design may help identify research methods better designed to overcome inherent challenges in research involving adolescents, transition of care and use of mobile application technology. TRIAL REGISTRATION Registered retrospectively as of 30/1/2020 with Australian New Zealand Clinical Trials Registry: ACTRN12620000074998 .
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Affiliation(s)
- Jeffrey Yeung
- grid.1013.30000 0004 1936 834XThe Clinical School at The Children’s Hospital Westmead, Specialty of Child and Adolescent Health, The Faculty of Medicine and Health, The University of Sydney, Sydney, Australia ,grid.413973.b0000 0000 9690 854XThe Academic Department of Adolescent Medicine, The Children’s Hospital Westmead, Sydney, Australia
| | - Yisselle I. Virella Pérez
- grid.1013.30000 0004 1936 834XThe Clinical School at The Children’s Hospital Westmead, Specialty of Child and Adolescent Health, The Faculty of Medicine and Health, The University of Sydney, Sydney, Australia ,grid.413973.b0000 0000 9690 854XThe Academic Department of Adolescent Medicine, The Children’s Hospital Westmead, Sydney, Australia
| | - Shehani C. Samarasinghe
- grid.1013.30000 0004 1936 834XThe Clinical School at The Children’s Hospital Westmead, Specialty of Child and Adolescent Health, The Faculty of Medicine and Health, The University of Sydney, Sydney, Australia ,grid.413973.b0000 0000 9690 854XThe Academic Department of Adolescent Medicine, The Children’s Hospital Westmead, Sydney, Australia
| | - Vhari Forsyth
- grid.1013.30000 0004 1936 834XThe Clinical School at The Children’s Hospital Westmead, Specialty of Child and Adolescent Health, The Faculty of Medicine and Health, The University of Sydney, Sydney, Australia ,grid.413973.b0000 0000 9690 854XThe Academic Department of Adolescent Medicine, The Children’s Hospital Westmead, Sydney, Australia
| | - Vathsala Agarwalla
- grid.413973.b0000 0000 9690 854XThe Academic Department of Adolescent Medicine, The Children’s Hospital Westmead, Sydney, Australia
| | - Katharine Steinbeck
- grid.1013.30000 0004 1936 834XThe Clinical School at The Children’s Hospital Westmead, Specialty of Child and Adolescent Health, The Faculty of Medicine and Health, The University of Sydney, Sydney, Australia ,grid.413973.b0000 0000 9690 854XThe Academic Department of Adolescent Medicine, The Children’s Hospital Westmead, Sydney, Australia
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Schretzlmaier P, Hecker A, Ammenwerth E. Extension of the Unified Theory of Acceptance and Use of Technology 2 model for predicting mHealth acceptance using diabetes as an example: a cross-sectional validation study. BMJ Health Care Inform 2022; 29:bmjhci-2022-100640. [PMID: 36379608 PMCID: PMC9668013 DOI: 10.1136/bmjhci-2022-100640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 10/28/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES Mobile health applications are instrumental in the self-management of chronic diseases like diabetes. Technology acceptance models such as Unified Theory of Acceptance and Use of Technology 2 (UTAUT2) have proven essential for predicting the acceptance of information technology. However, earlier research has found that the constructs "perceived disease threat" and "trust" should be added to UTAUT2 in the mHealth acceptance context. This study aims to evaluate the extended UTAUT2 model for predicting mHealth acceptance, represented by behavioral intention, using mobile diabetes applications as an example. METHODS We extended UTAUT2 with the additional constructs "perceived disease threat" and "trust". We conducted a web-based survey in German-speaking countries focusing on patients with diabetes and their relatives who have been using mobile diabetes applications for at least 3 months. We analysed 413 completed questionnaires by structural equation modelling. RESULTS We could confirm that the newly added constructs "perceived disease threat" and "trust" indeed predict behavioural intention to use mobile diabetes applications. We could also confirm the UTAUT2 constructs "performance expectancy" and "habit" to predict behavioural intention to use mobile diabetes applications. The results show that the extended UTAUT2 model could explain 35.0% of the variance in behavioural intention. DISCUSSION Even if UTAUT2 is well established in the information technologies sector to predict technology acceptance, our results reveal that the original UTAUT2 should be extended by "perceived disease threat" and "trust" to better predict mHealth acceptance. CONCLUSION Despite the newly added constructs, UTAUT2 can only partially predict mHealth acceptance. Future research should investigate additional mHealth acceptance factors, including how patients perceive trust in mHealth applications.
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Affiliation(s)
- Patrik Schretzlmaier
- Institute of Medical Informatics, UMIT TIROL—Private University for Health Sciences and Health Technology, Hall, Tirol, Austria
| | - Achim Hecker
- Institute for Management and Economics in Healthcare, UMIT TIROL—Private University for Health Sciences and Health Technology, Hall, Tirol, Austria,DBU Digital Business University of Applied Sciences, Berlin, Germany
| | - Elske Ammenwerth
- Institute of Medical Informatics, UMIT TIROL—Private University for Health Sciences and Health Technology, Hall, Tirol, Austria
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Dimenäs SL, Östberg A, Lundin M, Lundgren J, Abrahamsson KH. Adolescents' experiences of a theory-based behavioural intervention for improved oral hygiene: A qualitative interview study. Int J Dent Hyg 2022; 20:609-619. [PMID: 35925040 PMCID: PMC9804348 DOI: 10.1111/idh.12606] [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: 10/12/2021] [Revised: 02/16/2022] [Accepted: 07/31/2022] [Indexed: 01/05/2023]
Abstract
OBJECTIVES Adequate oral hygiene, that is self-performed infection control, is crucial to prevent periodontal disease. Epidemiological studies reveal poor oral hygiene conditions among Swedish adolescents and indicate a need for more effective prevention programs. The aim of the current study was to analyse adolescents' experiences of a person-centred, theory-based, oral health education program for improved oral hygiene. METHODS Data were obtained by interviewing 19 adolescents treated by dental hygienists in accord with the person-centred education program in a preceding clinical field study (ClinicalTrials.gov NCT02906098). Study participants were selected to reflect a variation of male and female adolescents, treated at clinics in areas with various socio-demographic profiles within Region Västra Götaland, Sweden. Interviews were audio-taped, transcribed verbatim and analysed with qualitative content analysis. RESULTS A main theme was identified: 'Adolescents on a guided and challenging journey towards beneficial oral hygiene behavior'. The results elucidate the importance of a person-centred approach in therapy. The adolescents described insight on a personal level about the importance of improved oral hygiene as fundamental for behavioural change. Planning and monitoring of the behaviour, with guidance and support by the dental hygienist, was considered to facilitate change and encouraged further behavioural efforts. However, the adolescents expressed a need of reminders and support to keep up oral hygiene routines over time. CONCLUSIONS The study brings knowledge on factors of importance in educational interventions to increase beneficial health behaviours among adolescents and emphasize areas for further improvements of such interventions.
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Affiliation(s)
- Sandra L. Dimenäs
- Department of Periodontology, Institute of Odontology, The Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden,Clinic of Periodontics, Public Dental ServiceRegion Västra GötalandGothenburgSweden
| | - Anna‐Lena Östberg
- Department of Behavioral and Community Dentistry, Institute of Odontology, The Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden
| | - Mona Lundin
- Department of Education, Communication and Learning, Faculty of EducationUniversity of GothenburgGothenburgSweden
| | - Jesper Lundgren
- Department of Psychology, Faculty of Social SciencesUniversity of GothenburgGothenburgSweden
| | - Kajsa H. Abrahamsson
- Department of Periodontology, Institute of Odontology, The Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden,Clinic of Periodontics, Public Dental ServiceRegion Västra GötalandGothenburgSweden
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The Effect of a Patient Education Multimodal Digital Platform on Knowledge Acquisition, Self-efficacy, and Patient Satisfaction. Comput Inform Nurs 2022; 41:356-364. [PMID: 36071664 DOI: 10.1097/cin.0000000000000939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This study examined the impact of digital training instrument based on multimodal learning approach on surgical ward hospitalized patient education-related variables. The study was conducted as a multisite study in a large medical center as a two-arm, controlled trial with randomized cluster sampling. All patients meeting the inclusion criteria were offered the opportunity to participate. The control group (n = 40) received nurse explanation on home self-injection of enoxaparin sodium, whereas the intervention group (n = 40) received a tablet for multimodal learning specifically developed for this study. All participants completed before-and-after questionnaires evaluating knowledge acquisition, change in self-efficacy, and patient satisfaction. Results showed that the intervention group gained significantly more knowledge than the control group (P < .01). There was no significant difference in the level of self-efficacy change between the groups, and it was found that the control group patients were more satisfied with the training process (P = .01). This study shows that the use of a digital application for the benefit of patients' self-injection learning is effective in achieving educational goals such as knowledge acquisition and therefore can be a helpful resource for caregivers. Yet, these applications are not a substitute for attention provided by professionals, which is highly valued by patients.
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Moses JC, Adibi S, Wickramasinghe N, Nguyen L, Angelova M, Islam SMS. Smartphone as a Disease Screening Tool: A Systematic Review. SENSORS (BASEL, SWITZERLAND) 2022; 22:3787. [PMID: 35632195 PMCID: PMC9145643 DOI: 10.3390/s22103787] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 05/06/2022] [Accepted: 05/13/2022] [Indexed: 05/07/2023]
Abstract
Disease screening identifies a disease in an individual/community early to effectively prevent or treat the condition. COVID-19 has restricted hospital visits for screening and other healthcare services resulting in the disruption of screening for cancer, diabetes, and cardiovascular diseases. Smartphone technologies, coupled with built-in sensors and wireless technologies, enable the smartphone to function as a disease-screening and monitoring device with negligible additional costs and potentially higher quality results. Thus, we sought to evaluate the use of smartphone applications for disease screening and the acceptability of this technology in the medical and healthcare sectors. We followed a systematic review process using four databases, including Medline Complete, Web of Science, Embase, and Proquest. We included articles published in English examining smartphone application utilisation in disease screening. Further, we presented and discussed the primary outcomes of the research articles and their statistically significant value. The initial search yielded 1046 studies for the initial title and abstract screening. Of the 105 articles eligible for full-text screening, we selected nine studies and discussed them in detail under four main categories: an overview of the literature reviewed, participant characteristics, disease screening, and technology acceptance. According to our objective, we further evaluated the disease-screening approaches and classified them as clinically administered screening (33%, n = 3), health-worker-administered screening (33%, n = 3), and home-based screening (33%, n = 3). Finally, we analysed the technology acceptance among the users and healthcare practitioners. We observed a significant statistical relationship between smartphone applications and standard clinical screening. We also reviewed user acceptance of these smartphone applications. Hence, we set out critical considerations to provide equitable healthcare solutions without barriers when designing, developing, and deploying smartphone solutions. The findings may increase research opportunities for the evaluation of smartphone solutions as valid and reliable screening solutions.
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Affiliation(s)
- Jeban Chandir Moses
- School of Information Technology, Deakin University, Burwood, VIC 3125, Australia; (J.C.M.); (S.A.); (M.A.)
| | - Sasan Adibi
- School of Information Technology, Deakin University, Burwood, VIC 3125, Australia; (J.C.M.); (S.A.); (M.A.)
| | - Nilmini Wickramasinghe
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Hawthorn, VIC 3122, Australia;
| | - Lemai Nguyen
- Department of Information Systems and Business Analytics, Deakin Business School, Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia;
| | - Maia Angelova
- School of Information Technology, Deakin University, Burwood, VIC 3125, Australia; (J.C.M.); (S.A.); (M.A.)
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Nievas Soriano BJ, Uribe-Toril J, Ruiz-Real JL, Parrón-Carreño T. Pediatric apps: what are they for? A scoping review. Eur J Pediatr 2022; 181:1321-1327. [PMID: 35048178 DOI: 10.1007/s00431-021-04351-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 12/13/2021] [Accepted: 12/14/2021] [Indexed: 01/22/2023]
Abstract
In recent years, there has been a surge in the development of mHealth apps. Nevertheless, there are no scoping reviews that analyze the scientific peer-reviewed articles of these tools. This research systematically reviews the scientific literature published on health apps targeting children in peer-reviewed journals. It aims to answer four questions: what is the primary purpose of these apps; for what medical specialties and main topics were they developed; whom do they target; and how they were analyzed. The study followed PRISMA methodology, and the search process used the Web of Science Core Collection. The selected terms for the search were "pediatr*" and "app." The initial search resulted in 303 papers which, after applying filters, excluded 187 papers. In the end, 116 articles were deemed appropriate for addressing our research questions and were thoroughly reviewed. The primary purpose of pediatric health apps is to support clinical decision-making, patient education, and patient self-management. The most frequent topics covered are cancer, obesity, and asthma. Hematological oncology and endocrinology are the most frequent medical specialties addressed. The apps mainly target children, their caregivers, or both groups. Most of the apps were analyzed using observational studies, predominantly conducted in the USA, with an average participant sample size of 842. No analyses of development costs were found. These findings can be helpful for the development of future pediatric health apps. What is Known: • Health care has become increasingly digital due to digital health technologies, which have helped to expand the scope of health care. • Digital health technology can be used to improve the health of children. • The increasing availability of smartphones for children and families may enable the use of apps to deliver, promote, and sustain interventions which could lead to long-term improvements in health. What is New: • The most frequent topics covered were cancer, obesity, and asthma. Hematology-oncology and endocrinology were the most frequent medical specialties addressed. • The principal aims of the pediatric health apps were to facilitate clinical decision support, patient education, and patient self-management. • The apps mainly targeted children, their caregivers, or both groups. • Most of them had been analyzed using observational studies.
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Affiliation(s)
| | - Juan Uribe-Toril
- Faculty of Economics and Business, University of Almeria, 04120, Almería, Spain.
| | - José Luis Ruiz-Real
- Faculty of Economics and Business, University of Almeria, 04120, Almería, Spain
| | - Tesifón Parrón-Carreño
- Nursing, Physiotherapy and Medicine Department, University of Almería, 04120, Almería, Spain
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22
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User-centred development of an mHealth app for youth with type 1 diabetes: the challenge of operationalizing desired features and feasibility of offering financial incentives. HEALTH AND TECHNOLOGY 2022. [DOI: 10.1007/s12553-022-00656-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Digital Technologies for Children and Parents Sharing Self-Management in Childhood Chronic or Long-Term Conditions: A Scoping Review. CHILDREN (BASEL, SWITZERLAND) 2021; 8:children8121203. [PMID: 34943399 PMCID: PMC8700031 DOI: 10.3390/children8121203] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 11/24/2021] [Accepted: 12/09/2021] [Indexed: 01/20/2023]
Abstract
Worldwide, the prevalence of chronic (or long-term) conditions in children and young people from birth to 18 years (children) is increasing. Promoting competent and effective self-management skills early in the trajectory is important to improve adherence to treatment and optimise quality of life. Successful self-management, therefore, requires parents and children who are developmentally able to develop a range of complex skills, including the use of digital technologies. This scoping review aimed to identify primary research investigating digital technologies for children and parents sharing self-management in childhood chronic illnesses. A comprehensive search of electronic databases was conducted. Nineteen papers were included, assessed for quality and methodological rigour using the Hawker tool and thematically analysed. Three themes were identified: (i) the feasibility and acceptability of using technology, (ii) the usability of technologies and (iii) the effect of technologies on adherence and self-management skills. The results indicate that technologies such as mobile apps and websites can assist the management of long-term conditions, are an acceptable method of delivering information and can promote the development of effective self-management skills by parents and children. However, future technology design must include children and parents in all stages of development.
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The efficacy of web or mobile-based interventions to alleviate emotional symptoms in people with advanced cancer: a systematic review and meta-analysis. Support Care Cancer 2021; 30:3029-3042. [PMID: 34735601 DOI: 10.1007/s00520-021-06496-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 08/09/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE This review aims to critically evaluate the efficacy of web or mobile-based (WMB) interventions impacting emotional symptoms in patients with advanced cancer. METHOD Articles published from 1991 to 2019 were identified using PubMed, PsycINFO, CINAHL, and Scopus. Only interventions involving adults with advanced cancer using a WMB intervention to manage emotional symptoms were included. Risk of bias was assessed using ROBINS-I and ROB2 tools. Studies that reported mean symptom scores were pooled using a random-effects model, and standardized mean difference (SMD) and 95% CIs were calculated. RESULTS Twenty-three of the 1177 screened studies met the inclusion criteria, and a total sample of 2558 patients were included. The sample was 57% female, and 33% had advanced cancer with mean age of 57.15 years. Thirteen studies evaluated anxiety, nineteen evaluated depression, and eleven evaluated distress. Intervention components included general information, tracking, communication, multimedia choice, interactive online activities, tailoring/feedback, symptom management support content, and self-monitoring. Overall pooled results showed that WMB interventions' effects on decreasing anxiety (SMD - 0.20, - 0.45 to 0.05, I2 = 72%), depression (SMD - 0.10, - 0.30 to 0.11, I2 = 73%), and distress (SMD - 0.20, - 0.47 to 0.06, I2 = 60%) were not significant for randomized controlled trials (RCTs). In contrast, WMB interventions significantly decreased symptoms of anxiety (p = .002) in a sub-group analysis of non-RCTs. CONCLUSION This meta-analysis demonstrated that WMB interventions were not efficacious in alleviating emotional symptoms in adults with advanced cancer. Considering the diversity of interventions, the efficacy of WMB interventions and its impacts on emotional symptoms should be further explored.
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Abstract
Patient Generated Health Data (PGHD) is defined as data generated by and from patients.1 The use of PGHD has rapidly increased with the widespread availability of smart phone mobile health applications (mHealth apps) and wearable devices. Currently, the vast majority of PGHD is generated via the use of mHealth apps and wearables like "Fitbit" or medical devices such as a continuous glucose monitoring device. There are many benefits of PGHD including increased monitoring of children's chronic health conditions outside clinical care to supplement ambulatory clinic visits, improved health outcomes, increased patient awareness and engagement and improved patient-provider communication. When leveraged properly, PGHD can be a powerful tool in delivering safe, effective, patient centered, efficient and equitable care as outlined by the Institute of Medicine (IOM).2 The challenges that limit collection, use and acceptance of PGHD include limited access to the internet, inability to incorporate PGHD into clinical workflows, data privacy and security concerns and apprehension about accuracy and safety of mHealth apps. These issues can lead to a lack of use or compliance with devices or apps associated with PGHD. To ensure optimal health benefits, agreement to leverage PGHD should be a joint decision between the clinician and the patient/caregiver. Future steps to ensure safety and clinical relevance of PGHD include involving regulatory authorities, device manufacturers and professional bodies to develop standards for mHealth apps and wearables to promote uncomplicated PGHD integration into workflows, easy and secure sharing of PGHD. Wearable technology, medical devices and smart phone apps become more advanced and widespread among the population, there will be an increasing potential for PGHD to facilitate personalized, efficient, and collaborative care resulting in improved health outcomes for children and adolescent and young adult. More research and innovation is needed to facilitate this transition.
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Saliasi I, Martinon P, Darlington E, Smentek C, Tardivo D, Bourgeois D, Dussart C, Carrouel F, Fraticelli L. Promoting Health via mHealth Applications Using a French Version of the Mobile App Rating Scale: Adaptation and Validation Study. JMIR Mhealth Uhealth 2021; 9:e30480. [PMID: 34463623 PMCID: PMC8441605 DOI: 10.2196/30480] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 06/25/2021] [Accepted: 07/06/2021] [Indexed: 12/18/2022] Open
Abstract
Background In the recent decades, the number of apps promoting health behaviors and health-related strategies and interventions has increased alongside the number of smartphone users. Nevertheless, the validity process for measuring and reporting app quality remains unsatisfactory for health professionals and end users and represents a public health concern. The Mobile Application Rating Scale (MARS) is a tool validated and widely used in the scientific literature to evaluate and compare mHealth app functionalities. However, MARS is not adapted to the French culture nor to the language. Objective This study aims to translate, adapt, and validate the equivalent French version of MARS (ie, MARS-F). Methods The original MARS was first translated to French by two independent bilingual scientists, and their common version was blind back-translated twice by two native English speakers, culminating in a final well-established MARS-F. Its comprehensibility was then evaluated by 6 individuals (3 researchers and 3 nonacademics), and the final MARS-F version was created. Two bilingual raters independently completed the evaluation of 63 apps using MARS and MARS-F. Interrater reliability was assessed using intraclass correlation coefficients. In addition, internal consistency and validity of both scales were assessed. Mokken scale analysis was used to investigate the scalability of both MARS and MARS-F. Results MARS-F had a good alignment with the original MARS, with properties comparable between the two scales. The correlation coefficients (r) between the corresponding dimensions of MARS and MARS-F ranged from 0.97 to 0.99. The internal consistencies of the MARS-F dimensions engagement (ω=0.79), functionality (ω=0.79), esthetics (ω=0.78), and information quality (ω=0.61) were acceptable and that for the overall MARS score (ω=0.86) was good. Mokken scale analysis revealed a strong scalability for MARS (Loevinger H=0.37) and a good scalability for MARS-F (H=0.35). Conclusions MARS-F is a valid tool, and it would serve as a crucial aid for researchers, health care professionals, public health authorities, and interested third parties, to assess the quality of mHealth apps in French-speaking countries.
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Affiliation(s)
- Ina Saliasi
- Health, Systemic, Process, Research Unit 4129, University Claude Bernard Lyon 1, University of Lyon, Lyon, France
| | - Prescilla Martinon
- Health, Systemic, Process, Research Unit 4129, University Claude Bernard Lyon 1, University of Lyon, Lyon, France
| | - Emily Darlington
- Health, Systemic, Process, Research Unit 4129, University Claude Bernard Lyon 1, University of Lyon, Lyon, France
| | - Colette Smentek
- Health, Systemic, Process, Research Unit 4129, University Claude Bernard Lyon 1, University of Lyon, Lyon, France
| | - Delphine Tardivo
- Laboratory Anthropology, Health Law, and Medical Ethics, UMR 7268, Aix-Marseille University 2, Marseille, France
| | - Denis Bourgeois
- Health, Systemic, Process, Research Unit 4129, University Claude Bernard Lyon 1, University of Lyon, Lyon, France
| | - Claude Dussart
- Health, Systemic, Process, Research Unit 4129, University Claude Bernard Lyon 1, University of Lyon, Lyon, France
| | - Florence Carrouel
- Health, Systemic, Process, Research Unit 4129, University Claude Bernard Lyon 1, University of Lyon, Lyon, France
| | - Laurie Fraticelli
- Health, Systemic, Process, Research Unit 4129, University Claude Bernard Lyon 1, University of Lyon, Lyon, France
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Moses JC, Adibi S, Shariful Islam SM, Wickramasinghe N, Nguyen L. Application of Smartphone Technologies in Disease Monitoring: A Systematic Review. Healthcare (Basel) 2021; 9:889. [PMID: 34356267 PMCID: PMC8303662 DOI: 10.3390/healthcare9070889] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 07/03/2021] [Accepted: 07/09/2021] [Indexed: 12/21/2022] Open
Abstract
Technologies play an essential role in monitoring, managing, and self-management of chronic diseases. Since chronic patients rely on life-long healthcare systems and the current COVID-19 pandemic has placed limits on hospital care, there is a need to explore disease monitoring and management technologies and examine their acceptance by chronic patients. We systematically examined the use of smartphone applications (apps) in chronic disease monitoring and management in databases, namely, Medline, Web of Science, Embase, and Proquest, published from 2010 to 2020. Results showed that app-based weight management programs had a significant effect on healthy eating and physical activity (p = 0.002), eating behaviours (p < 0.001) and dietary intake pattern (p < 0.001), decreased mean body weight (p = 0.008), mean Body Mass Index (BMI) (p = 0.002) and mean waist circumference (p < 0.001). App intervention assisted in decreasing the stress levels (paired t-test = 3.18; p < 0.05). Among cancer patients, we observed a high acceptance of technology (76%) and a moderately positive correlation between non-invasive electronic monitoring data and questionnaire (r = 0.6, p < 0.0001). We found a significant relationship between app use and standard clinical evaluation and high acceptance of the use of apps to monitor the disease. Our findings provide insights into critical issues, including technology acceptance along with regulatory guidelines to be considered when designing, developing, and deploying smartphone solutions targeted for chronic patients.
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Affiliation(s)
- Jeban Chandir Moses
- School of Information Technology, Deakin University, 1 Gheringhap St, Geelong, VIC 3220, Australia;
| | - Sasan Adibi
- School of Information Technology, Deakin University, 1 Gheringhap St, Geelong, VIC 3220, Australia;
| | | | - Nilmini Wickramasinghe
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Hawthorn, VIC 3122, Australia;
| | - Lemai Nguyen
- Department of Information Systems and Business Analytics, Deakin Business School, 221 Burwood Highway, Burwood, VIC 3125, Australia;
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Lin PJ, Fanjiang YY, Wang JK, Lu CW, Lin KC, Cheong IM, Pan KY, Chen CW. Long-term effectiveness of an mHealth-tailored physical activity intervention in youth with congenital heart disease: A randomized controlled trial. J Adv Nurs 2021; 77:3494-3506. [PMID: 34151444 DOI: 10.1111/jan.14924] [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: 07/29/2020] [Revised: 03/25/2021] [Accepted: 05/24/2021] [Indexed: 12/29/2022]
Abstract
AIMS To evaluate the long-term effectiveness of the Care & Organize Our Lifestyle (COOL) programme, a self-regulation theory-based mHealth programme, on improving disease knowledge and physical activity in youth with congenital heart disease (CHD). DESIGN A three-arm parallel-group randomized controlled trial. METHODS A total 143 participants with simple and moderate CHD aged 15-24 years were recruited from June 2016 to February 2018. The 12-month programme compared two active intervention groups to a standard-care control group (n = 47). Participants in one active intervention group (n = 49) were provided with COOL Passport, a mobile healthcare application. Those in the other group (n = 47) were provided with access to the Health Promotion Cloud system and use of game-based interactive platforms along with COOL Passport. Outcomes were the Leuven Knowledge Questionnaire for Congenital Heart Disease and the International Physical Activity Questionnaire-Taiwan Show-Card Version. RESULTS After 12 months, 103 participants remained; the overall attrition rate was 28%. No significant differences were observed between the groups in any domain of disease knowledge after 6 months or 1 year. Neither active group exhibited significantly greater physical activity intensity than the standard-care control group in any month during the 1 year. CONCLUSION The mHealth-tailored intervention of the COOL programme did not improve disease knowledge or physical activity in young adults with CHD. IMPACT The application of the COOL Passport and Health Promotion Cloud system and use of game-based interactive platforms must be modified and verified in future studies and may have clinical potential. TRIAL REGISTRATION The registry of clinical trials was ClinicalTrials.gov: NCT04264650.
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Affiliation(s)
- Pei-Jung Lin
- Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan
| | - Yong-Yi Fanjiang
- Department of Computer Science and Information Engineering, Fu-Jen Catholic University, New Taipei, Taiwan
| | - Jou-Kou Wang
- Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
| | - Chun-Wei Lu
- Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
| | - Kuan-Chia Lin
- Institute of Hospital and Health Care Administration, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - In-Mei Cheong
- Department of Dietetics, Macau Yin Kui Hospital, Macau, Macao
| | - Kuan-You Pan
- Taiwanese Society of Suicidology, Taipei, Taiwan
| | - Chi-Wen Chen
- College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan
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Differences in perceptions of transition readiness between parents and teens with congenital heart disease: do parents and teens agree? Cardiol Young 2021; 31:957-964. [PMID: 33423711 DOI: 10.1017/s1047951120004813] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND Amongst patients with CHD, the time of transition to adulthood is associated with lapses in care leading to significant morbidity. The purpose of this study was to identify differences in perceptions between parents and teens in regard to transition readiness. METHODS Responses were collected from 175 teen-parent pairs via the validated CHD Transition Readiness survey and an information request checklist. The survey was distributed via an electronic tablet at a routine clinic visit. RESULTS Parents reported a perceived knowledge gap of 29.2% (the percentage of survey items in which a parent believes their teen does not know), compared to teens self-reporting an average of 25.9% of survey items in which they feel deficient (p = 0.01). Agreement was lowest for long-term medical needs, physical activities allowed, insurance, and education. In regard to self-management behaviours, agreement between parent and teen was slight to moderate (weighted κ statistic = 0.18 to 0.51). For self-efficacy, agreement ranged from slight to fair (weighted κ = 0.16 to 0.28). Teens were more likely to request information than their parents (79% versus 65% requesting at least one item) particularly in regard to pregnancy/contraception and insurance. CONCLUSION Parents and teens differ in several key perceptions regarding knowledge, behaviours, and feelings related to the management of heart disease. Specifically, parents perceive a higher knowledge deficit, teens perceive higher self-efficacy, and parents and teens agree that self-management is low.
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Mehta P, Moore SL, Bull S, Kwan BM. Building MedVenture - A mobile health application to improve adolescent medication adherence - Using a multidisciplinary approach and academic-industry collaboration. Digit Health 2021; 7:20552076211019877. [PMID: 34104467 PMCID: PMC8145584 DOI: 10.1177/20552076211019877] [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: 11/12/2020] [Accepted: 05/01/2021] [Indexed: 02/05/2023] Open
Abstract
Objective Mobile health (mHealth) tools are increasingly used to support medication adherence yet few have been designed specifically for the pediatric population. This paper describes the development of a medication adherence application (MedVenture) using the integration of patient and healthcare provider input, health behavior theory, and user engagement strategies for adolescents with chronic gastrointestinal disease. Methods MedVenture was created by a multidisciplinary research team consisting of a gastroenterologist, a social health psychologist, software developers, and digital health researchers. Healthcare providers and adolescent patients were interviewed to identify barriers to medication adherence, explore ways that technologies could best support medication adherence for both patients and providers, and determine user requirements and core design features for a digital health tool. Intervention mapping was used to match themes from qualitative content analysis to known efficacious adherence strategies, according to a conceptual framework based on self-determination theory. Iterative design with review by the research team and two rounds of user testing informed the final prototype. Results Three themes were identified from content analysis: 1) lack of routine contributes to nonadherence, 2) adolescents sometimes purposefully forgo medications, and 3) healthcare providers would prefer a tool that promotes patient self-management rather than one that involves patient-provider interaction. These findings, combined with evidence-based adherence and user engagement strategies, resulted in the development of MedVenture – a game-based application to improve planning and habit formation. Conclusions Academic-industry collaboration incorporating stakeholders can facilitate the development of mobile health tools designed specifically for adolescents with chronic disease.
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Affiliation(s)
- Pooja Mehta
- Department of Pediatrics, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO, USA
| | - Susan L Moore
- Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Sheana Bull
- Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Bethany M Kwan
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, USA
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Meyer S, Naveh G. Mobile Application for Promoting Gluten-Free Diet Self-Management in Adolescents with Celiac Disease: Proof-of-Concept Study. Nutrients 2021; 13:nu13051401. [PMID: 33919430 PMCID: PMC8143340 DOI: 10.3390/nu13051401] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 04/16/2021] [Accepted: 04/17/2021] [Indexed: 12/24/2022] Open
Abstract
Celiac disease (CD) is a chronic disease treated by maintaining and managing a lifelong restrictive gluten-free diet. The purpose of this study was to develop a mobile application, Plan My C-Day, to promote self-management skills among youth with CD during adolescence—a time when decreased adherence often occurs—and examine its usability among adolescents with CD. Plan My C-Day contains three simulations of activities involving eating out and actions to take when preparing for these events. It was developed and pilot tested by 13 adolescents with CD. Application use and user perception data were collected and analyzed. Participants chose 160 actions within the simulations. For over 75% of participants, the time to complete the simulation decreased from the first to the third (last) simulation by an average of 50%. The average reported usability perception was 3.71 on a scale of 1 to 5, with system ease of use and ease of learning obtaining the highest scores. This study demonstrated that the Plan My C-Day mobile application’s self-management content, features, and functions operated well and that the simulations were easy to understand and complete. Further development will include the option to add self-created activities and adaptation to different languages and cultures.
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Affiliation(s)
- Sonya Meyer
- Department of Occupational Therapy, Ariel University, Ariel 40700, Israel
- Correspondence: ; Tel.: +972-52-336-8057
| | - Gali Naveh
- Department of Industrial Engineering and Management, Shamoon College of Engineering, Beer-Sheva 8410802, Israel;
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Zaeh SE, Lu MA, Blake KV, Ruvalcaba E, Ayensu-Asiedu C, Wise RA, Holbrook JT, Eakin MN. "It is kind of like a responsibility thing": transitional challenges in asthma medication adherence among adolescents and young adults. J Asthma 2021; 59:956-966. [PMID: 33653199 DOI: 10.1080/02770903.2021.1897836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Nonadherence to asthma medications is prevalent among adolescents and young adults (AYAs) with asthma, leading to worsened control of asthma symptoms and more frequent exacerbations. AYAs have unique developmental transitional challenges that may alter medication adherence. We aimed to use a socio-ecological framework to explore the effect of transitional challenges from adolescence to young adulthood on asthma controller medication adherence and to identify possible strategies to promote medication adherence. METHODS We conducted qualitative semi-structured interviews by phone with 7 adolescents (14 to 17 years), their respective caregivers, and 7 young adults (18 to 30 years). Participants were recruited from a respiratory clinical trial network and pulmonary clinics in 4 states at 6 different sites through convenience sampling. Interviews were audio recorded, transcribed and coded using thematic analyses. RESULTS Participants identified personal challenges affecting adherence to asthma medications during the transition from adolescence to young adulthood including responsibility for asthma self-management, understanding of asthma condition and severity, embarrassment, and life demands. Health systems factors including medication cost, challenges with insurance, difficulties obtaining refills, and difficulty with access to medications at school also impacted asthma medication adherence. Participants recommended adherence strategies including improved access to inhalers, incorporating asthma medications into daily routines, and using reminders. CONCLUSIONS Focusing on the transitional challenges of AYAs during the time period from adolescence to young adulthood is necessary for supporting their asthma medication adherence and creating future interventions. Socio-ecological and systems factors should also be targeted for improved asthma medication adherence. Supplemental data for this article can be accessed online at https://doi.org/10.1080/02770903.2021.1897836.
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Affiliation(s)
- Sandra E Zaeh
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Monica A Lu
- Eudowood Division of Pediatric Respiratory Sciences, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Kathryn V Blake
- Center for Pharmacogenomics and Translational Research, Nemours Children's Health System, Jacksonville, FL, USA
| | - Elizabeth Ruvalcaba
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Christabelle Ayensu-Asiedu
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Robert A Wise
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Janet T Holbrook
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Michelle N Eakin
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, MD, USA
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Velloza J, Kapogiannis B, Bekker LG, Celum C, Hosek S, Delany-Moretlwe S, Baggaley R, Dalal S. Interventions to improve daily medication use among adolescents and young adults: what can we learn for youth pre-exposure prophylaxis services? AIDS 2021; 35:463-475. [PMID: 33252486 PMCID: PMC7855564 DOI: 10.1097/qad.0000000000002777] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 10/30/2020] [Accepted: 11/09/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Oral pre-exposure prophylaxis (PrEP) is an important HIV prevention method and studies have shown that young people ages 15-24 have difficulty adhering to daily PrEP. The field of PrEP delivery for young people is relatively nascent and lessons about potential PrEP adherence interventions could be learned from the larger evidence base of adherence interventions for other daily medications among youth. DESIGN Systematic review of adherence support interventions for adolescents. METHODS We searched PubMed, CINAHL, EMBASE, and PsycINFO through January 2020 for oral contraceptive pill (OCP), antiretroviral therapy (ART), asthma, and diabetes medication adherence interventions. We reviewed primary articles about OCP adherence interventions and reviewed systematic reviews for ART, asthma, and diabetes medication adherence interventions. Studies were retained if they included participants' ages 10-24 years; measured OCP, ART, asthma, or diabetes medication adherence; and were systematic reviews, randomized trials, or quasi-experimental studies. RESULTS Fifteen OCP articles and 26 ART, diabetes, and asthma systematic reviews were included. Interventions that improved medication adherence for OCPs, ART, asthma, and diabetes treatment included reminder text messages, computer-based and phone-based support, and enhanced counseling. Multi-month prescriptions and same-day pill starts also were found to improve OCP adherence and continuation. Adolescent-friendly clinics and peer-based counseling significantly improved ART adherence, and telemedicine interventions improved diabetes medication adherence. CONCLUSION Interventions that improve medication adherence among youth include enhanced counseling, extended pill supply, adolescent-friendly services, and text message reminders. PrEP programs could incorporate and evaluate such interventions for their impact on PrEP adherence and continuation among at-risk adolescents.
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Affiliation(s)
- Jennifer Velloza
- Department of Global Health, University of Washington, Seattle, Washington
| | - Bill Kapogiannis
- Maternal and Pediatric Infectious Disease Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA
| | - Linda-Gail Bekker
- The Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa
| | - Connie Celum
- Department of Global Health, University of Washington, Seattle, Washington
- Department of Medicine, University of Washington, Seattle, Washington
| | - Sybil Hosek
- Department of Psychiatry, Stroger Hospital of Cook County, Chicago, Illinois, USA
| | - Sinead Delany-Moretlwe
- Wits Reproductive Health and HIV Institute (Wits RHI), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Rachel Baggaley
- Global HIV, Hepatitis and STIs Programmes, World Health Organization, Geneva, Switzerland
| | - Shona Dalal
- Global HIV, Hepatitis and STIs Programmes, World Health Organization, Geneva, Switzerland
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Gauci J, Bloomfield J, Lawn S, Towns S, Steinbeck K. Effectiveness of self-management programmes for adolescents with a chronic illness: A systematic review. J Adv Nurs 2021; 77:3585-3599. [PMID: 33630315 DOI: 10.1111/jan.14801] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 12/31/2020] [Accepted: 01/16/2021] [Indexed: 12/14/2022]
Abstract
AIM To assess what is known about the effectiveness of face-to-face self-management programmes designed specifically for adolescents (10-19 years) with a chronic illness. DESIGN A systematic review and synthesis without meta-analysis (SWiM). DATA SOURCES Six international web-based reference libraries were searched with a date range of 1946 to July 2020. REVIEW METHOD The PRISMA statement and SWiM guideline were used for reporting the methods and results. The PICO format was used to develop a focused clinical question and the eligibility criteria of our review. Quality assessment of the included studies was performed using the Cochrane Effective Practice Organisation of Care criteria. RESULTS Eight studies (four randomized controlled trials and four descriptive designs) met the inclusion criteria and were published between 2003 and 2017. Results of the review: Three studies demonstrated measures of illness control which showed initial improvements in adherence as a result of the interventions but failed to demonstrate sustained adherence over time. Booster sessions were identified as an effective strategy to improve adherence, but were often omitted. CONCLUSIONS There is a limited body of evidence on the effectiveness of self-management programmes specifically developed for adolescents with a chronic illness, an important but under researched area. Future research lies in the development of more rigorous studies that focus on quantitative outcome measures for evaluating the effectiveness of self-management programmes to guide the development of future programmes. IMPACT It is crucial for adolescents with a chronic illness to develop independence and the self-management skills required to effectively manage their chronic condition as they transition to adulthood. On current evidence, in planning future self-management interventions should include booster sessions. Nurses with additional training and experience have a key role in supporting adolescents with a chronic illness to develop self-management skills as they assume responsibility for their own healthcare.
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Affiliation(s)
- Jaunna Gauci
- Department of Adolescent Medicine, The Children's Hospital at Westmead, Sydney, NSW, Australia.,Discipline of Child & Adolescent Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Jacqueline Bloomfield
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Sharon Lawn
- Flinders Human Behaviour and Health Research Unit, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Susan Towns
- Department of Adolescent Medicine, The Children's Hospital at Westmead, Sydney, NSW, Australia.,Discipline of Child & Adolescent Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Katharine Steinbeck
- Discipline of Child & Adolescent Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.,The Academic Department of Adolescent Medicine, The Children's Hospital at Westmead, Sydney, NSW, Australia
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Efficient Clinical Counseling for Sickle Cell Disease. J Natl Med Assoc 2021; 113:382-387. [PMID: 33610309 DOI: 10.1016/j.jnma.2021.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 01/22/2021] [Indexed: 11/22/2022]
Abstract
Sickle cell anemia (SCA) is a chronic illness that requires frequent health care visits for preventative management. Adherence to national guidelines such as the National Heart Lung and Blood Institute (NHLBI) Expert Panel Report on the Evidence-Based Management of Sickle Cell Disease can be challenging to both the clinician and the patient. Utilizing effective communication strategies with patients and their families can improve clinician/patient relationships, as well as adherence to national guidelines. Aims of this overview are to review challenges faced in outpatient subspecialty medicine and describe evidence-based techniques for more effective communication for patients with sickle cell anemia.
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Eberle C, Löhnert M, Stichling S. Effectiveness of Disease-Specific mHealth Apps in Patients With Diabetes Mellitus: Scoping Review. JMIR Mhealth Uhealth 2021; 9:e23477. [PMID: 33587045 PMCID: PMC7920757 DOI: 10.2196/23477] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 11/08/2020] [Accepted: 11/30/2020] [Indexed: 12/20/2022] Open
Abstract
Background According to the World Health Organization, the worldwide prevalence of diabetes mellitus (DM) is increasing dramatically and DM comprises a large part of the global burden of disease. At the same time, the ongoing digitalization that is occurring in society today offers novel possibilities to deal with this challenge, such as the creation of mobile health (mHealth) apps. However, while a great variety of DM-specific mHealth apps exist, the evidence in terms of their clinical effectiveness is still limited. Objective The objective of this review was to evaluate the clinical effectiveness of mHealth apps in DM management by analyzing health-related outcomes in patients diagnosed with type 1 DM (T1DM), type 2 DM (T2DM), and gestational DM. Methods A scoping review was performed. A systematic literature search was conducted in MEDLINE (PubMed), Cochrane Library, EMBASE, CINAHL, and Web of Science Core Collection databases for studies published between January 2008 and October 2020. The studies were categorized by outcomes and type of DM. In addition, we carried out a meta-analysis to determine the impact of DM-specific mHealth apps on the management of glycated hemoglobin (HbA1c). Results In total, 27 studies comprising 2887 patients were included. We analyzed 19 randomized controlled trials, 1 randomized crossover trial, 1 exploratory study, 1 observational study, and 5 pre-post design studies. Overall, there was a clear improvement in HbA1c values in patients diagnosed with T1DM and T2DM. In addition, positive tendencies toward improved self-care and self-efficacy as a result of mHealth app use were found. The meta-analysis revealed an effect size, compared with usual care, of a mean difference of –0.54% (95% CI –0.8 to –0.28) for T2DM and –0.63% (95% CI –0.93 to –0.32) for T1DM. Conclusions DM-specific mHealth apps improved the glycemic control by significantly reducing HbA1c values in patients with T1DM and T2DM patients. In general, mHealth apps effectively enhanced DM management. However, further research in terms of clinical effectiveness needs to be done in greater detail.
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Affiliation(s)
- Claudia Eberle
- Medicine with Specialization in Internal Medicine and General Medicine, Hochschule Fulda-University of Applied Sciences, Fulda, Germany
| | - Maxine Löhnert
- Medicine with Specialization in Internal Medicine and General Medicine, Hochschule Fulda-University of Applied Sciences, Fulda, Germany
| | - Stefanie Stichling
- Medicine with Specialization in Internal Medicine and General Medicine, Hochschule Fulda-University of Applied Sciences, Fulda, Germany
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Factors Associated With Nonadherence to Antiretroviral Therapy Among Young People Living With Perinatally Acquired HIV in England. J Assoc Nurses AIDS Care 2021; 31:574-586. [PMID: 32467489 PMCID: PMC7497417 DOI: 10.1097/jnc.0000000000000171] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Young people living with perinatally acquired HIV may be at risk of poor adherence to antiretroviral therapy; identification of predictors, using a conceptual framework approach proposed previously by others, is important to identify those at higher risk. In 261 young people with perinatally acquired HIV in England, 70 (27%) reported 3-day nonadherence, 82 (31%) last month nonadherence, and 106 (41%) nonadherence on either measure. Of those reporting nonadherence on both measures, 52% (23/44) had viral load of <50 copies/ml, compared with 88% (127/145) of those reported being fully adherent. In multivariable analysis, young person and medication theme factors were associated with nonadherence. The main predictors of 3-day nonadherence were antiretroviral therapy containing a boosted protease inhibitor and poorer quality of life. Predictors of last month nonadherence were having told more people about one's HIV status, worse self-perception about having HIV, and boosted protease inhibitor-based regimens. The consistency of individual young person and medication factors in predicting nonadherence gives insight into where interventions may best be targeted to improve adherence.
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Shamambo L, Niemann M, Jonas R, Douglass LM. Mentorship for Youth With Chronic Neurological Conditions in the Digital Era: An Innovative Approach to Supporting Transition. Semin Pediatr Neurol 2020; 36:100857. [PMID: 33308521 DOI: 10.1016/j.spen.2020.100857] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This article aims to highlight the impact of mentorship on the lives of youth with chronic conditions (YCC). Here, we focus on the concepts of mentoring and technology as a means to support transitioning YCC. This is in response to the urgent need for effective healthcare transition strategies and the increasing importance and prevalence of technology in healthcare and health systems. This article also highlights an e-mentoring program for youth with epilepsy, an intervention that bridges the fields of mentoring, transition, and technology. While there is need for further research in these areas, consideration of these factors are highly relevant to the effort to improve health for this generation of YCC.
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Affiliation(s)
- Luwi Shamambo
- Division of Child Neurology, Boston Medical Center, Boston, MA.
| | - Madeline Niemann
- Division of Child Neurology, Department of Pediatrics, Boston Medical Center, Boston, MA
| | - Rinat Jonas
- Division of Child Neurology, Department of Pediatrics, Boston Medical Center, Boston, MA
| | - Laurie M Douglass
- Division of Child Neurology, Department of Pediatrics, Boston Medical Center, Boston, MA
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Kan K, Shaunfield S, Kanaley M, Chadha A, Boon K, Morales L, Davis MM, Vojta D, Gupta RS. Health provider perspectives of electronic medication monitoring in outpatient asthma care: a qualitative investigation using the consolidated framework for implementation research. J Asthma 2020; 59:342-351. [PMID: 33198550 DOI: 10.1080/02770903.2020.1846745] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Little is known about the implementation challenges health providers might face with the use of digital health in outpatient asthma care. To qualitatively explore the experience of health providers with electronic medication monitoring (EMM) using an implementation science framework. METHODS Using the Consolidated Framework of Implementation Research (CFIR), we conducted interviews (n = 10) exploring health providers' experience with EMM with asthma patients from 5 primary care or specialty clinics. The EMM tracked albuterol and inhaled corticosteroid (ICS) use, and health providers called parents whenever ICS adherence waned, or albuterol use increased. Interviews were audio-recorded, transcribed, and deductively analyzed using directed content analysis. RESULTS Health providers reported the intervention's primary advantage, compared with current asthma care, was the ability to monitor medication use at-home. Most felt the intervention improved care delivery. Nurses and medical assistants described a process of phone calls and checking alerts, that had varying levels of administrative burden and complexity. Health providers felt that sustained implementation of the intervention model would require additional employees to handle the administrative and clinical workload. Half of the interviewed providers were unsure if patient needs were met by the intervention, while some cited technology syncing issues, others liked the enhanced interactions for asthma education. CONCLUSION Health providers reported positive experiences supporting parents and children with asthma using EMM but also highlighted intervention components that needed improvement or refinement to yield successful implementation in outpatient pediatric clinics. Recommendations for enhancing the intervention for a scaled-up implementation were discussed.
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Affiliation(s)
- Kristin Kan
- Mary Ann & J. Milburn Smith Child Health Research, Outreach and Advocacy Center, Stanley Manne Children's Research Institute, Ann & Robert H. Lurie's Children's Hospital of Chicago, Chicago, IL, USA.,Department of Pediatrics, Division of Academic General Pediatrics and Primary Care, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Sara Shaunfield
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Madeleine Kanaley
- Institute of Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Avneet Chadha
- Medical School, Rush University Medical College, Chicago, IL, USA
| | - Kathy Boon
- Institute of Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Luis Morales
- Mary Ann & J. Milburn Smith Child Health Research, Outreach and Advocacy Center, Stanley Manne Children's Research Institute, Ann & Robert H. Lurie's Children's Hospital of Chicago, Chicago, IL, USA
| | - Matthew M Davis
- Mary Ann & J. Milburn Smith Child Health Research, Outreach and Advocacy Center, Stanley Manne Children's Research Institute, Ann & Robert H. Lurie's Children's Hospital of Chicago, Chicago, IL, USA.,Department of Pediatrics, Division of Academic General Pediatrics and Primary Care, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Institute of Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Deneen Vojta
- Global Research & Development, UnitedHealth Group, Minnetonka, MN, USA
| | - Ruchi S Gupta
- Mary Ann & J. Milburn Smith Child Health Research, Outreach and Advocacy Center, Stanley Manne Children's Research Institute, Ann & Robert H. Lurie's Children's Hospital of Chicago, Chicago, IL, USA.,Department of Pediatrics, Division of Academic General Pediatrics and Primary Care, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Institute of Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Blower S, Swallow V, Maturana C, Stones S, Phillips R, Dimitri P, Marshman Z, Knapp P, Dean A, Higgins S, Kellar I, Curtis P, Mills N, Martin-Kerry J. Children and young people's concerns and needs relating to their use of health technology to self-manage long-term conditions: a scoping review. Arch Dis Child 2020; 105:1093-1104. [PMID: 32444448 PMCID: PMC7588410 DOI: 10.1136/archdischild-2020-319103] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 04/22/2020] [Accepted: 04/24/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND The use of patient-facing health technologies to manage long-term conditions is increasing; however, children and young people may have particular concerns or needs before deciding to use different health technologies. AIMS To identify children and young people's reported concerns or needs in relation to using health technologies to self-manage long-term conditions. METHODS A scoping review was conducted. We searched MEDLINE, PsycINFO and CINAHL in February 2019. Searches were limited to papers published between January 2008 and February 2019. We included any health technology used to manage long-term conditions. A thematic synthesis of the data from the included studies was undertaken. We engaged children with long-term conditions (and parents) to support review design, interpretation of findings and development of recommendations. RESULTS Thirty-eight journal articles were included, describing concerns or needs expressed by n=970 children and/or young people aged 5-18 years. Most included studies were undertaken in high-income countries with children aged 11 years and older. Studies examined concerns with mobile applications (n=14), internet (n=9), social media (n=3), interactive online treatment programmes (n=3), telehealth (n=1), devices (n=3) or a combination (n=5). Children and young people's main concerns were labelling and identity; accessibility; privacy and reliability; and trustworthiness of information. DISCUSSION This review highlights important concerns that children and young people may have before using technology to self-manage their long-term condition. In future, research should involve children and young people throughout the development of technology, from identifying their unmet needs through to design and evaluation of interventions.
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Affiliation(s)
- Sarah Blower
- Department of Health Sciences, University of York, York, UK
| | - Veronica Swallow
- College of Health, Wellbeing & Life Sciences, Sheffield Hallam University, Sheffield, South Yorkshire, UK
| | - Camila Maturana
- York Trials Unit, University of York, York, North Yorkshire, UK
| | - Simon Stones
- School of Healthcare, University of Leeds, Leeds, West Yorkshire, UK
| | - Robert Phillips
- Centre for Reviews and Dissemination, University of York, York, North Yorkshire, UK
| | - Paul Dimitri
- NIHR Children and Young People MedTech Cooperative, Sheffield Children's Hospital NHS Foundation Trust, Sheffield, Sheffield, UK
| | - Zoe Marshman
- School of Clinical Dentistry, The University of Sheffield, Sheffield, Sheffield, UK
| | - Peter Knapp
- Department of Health Sciences and Hull York Medical School, University of York, York, North Yorkshire, UK
| | - Alexandra Dean
- York Trials Unit, University of York, York, North Yorkshire, UK
| | | | - Ian Kellar
- School of Psychology, University of Leeds, Leeds, West Yorkshire, UK
| | - Penny Curtis
- School of Nursing and Midwifery, The University of Sheffield, Sheffield, Sheffield, UK
| | - Nathaniel Mills
- NIHR Children and Young People MedTech Co-operative and NIHR Devices for Dignity MedTech Co-operative, Sheffield Children's NHS Trust, Sheffield, UK
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Chung RJ, Mackie AS, Baker A, de Ferranti SD. Cardiovascular Risk and Cardiovascular Health Behaviours in the Transition From Childhood to Adulthood. Can J Cardiol 2020; 36:1448-1457. [PMID: 32585325 DOI: 10.1016/j.cjca.2020.05.041] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 05/23/2020] [Accepted: 05/26/2020] [Indexed: 01/17/2023] Open
Abstract
The prevention and management of cardiovascular risk factors during the transition from childhood to adulthood is critically important in defining cardiovascular health trajectories. Unfortunately, many young people fall out of clinical care during this important time, leading to worsening cardiovascular risk and missed opportunities to modify future outcomes. The field of health care transition has evolved to support young people with complex health needs in developing self-management and self-advocacy skills to promote positive health outcomes despite changes in health care providers and resources. While transitional care efforts are largely focused on childhood-onset chronic illnesses such as sickle cell disease and cystic fibrosis, young people with cardiovascular risk factors such as hypertension, obesity, and dyslipidemia also stand to benefit from structured supports to ensure continuity in care and positive health behaviours. On the backdrop of the broader health care transition literature, we offer practical insights and suggestions for ensuring that young people with cardiovascular risk factors experience uninterrupted high-quality care and support as they enter the adult health care system. Starting transition preparation in early adolescence, actively engaging all key stakeholders throughout the process, and remaining mindful of the developmental underpinnings and social context of transition are keys to success.
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Affiliation(s)
- Richard J Chung
- Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina, USA.
| | - Andrew S Mackie
- Division of Cardiology, Stollery Children's Hospital, Edmonton, Alberta, Canada; Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Annette Baker
- Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Sarah D de Ferranti
- Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts, USA
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Views of adolescents and their parents on mobile apps for epilepsy self-management. Epilepsy Behav 2020; 106:107039. [PMID: 32247177 DOI: 10.1016/j.yebeh.2020.107039] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Revised: 03/10/2020] [Accepted: 03/10/2020] [Indexed: 11/24/2022]
Abstract
INTRODUCTION New technologies are ubiquitous in our everyday lives, and this is especially true for teenagers. Very few mobile apps have been designed for adolescents with epilepsy. In order to better understand their expectations as well as those of their parents, we conducted a survey on this topic. METHODS The survey consisted of an anonymous self-administered questionnaire that was distributed to adolescents with epilepsy aged 10 to 18 years old and their parents. Questionnaires contained 15 questions including 8 multiple choice questions, 5 groups of multiple questions with a rating scale ranging from 1 to 6, and 2 open-ended questions covering the scope of the interest of epilepsy self-management apps, seizure and epilepsy management, antiseizure medications, and information on epilepsy. RESULTS Surveys were answered by 17 teenagers and 19 parents. It showed that adolescents embrace new technologies. Parents' highest expectations regarding mobile apps contents were seizure management and emergency information, while adolescents were expecting contents on epilepsy daily life, as well as a tool that would improve antiseizure medication compliance. CONCLUSION Parents and adolescents' expectations on the content of an epilepsy app were different.
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Campagna BR, Weatherley K, Shemesh E, Annunziato RA. Adherence to Medication During Transition to Adult Services. Paediatr Drugs 2020; 22:501-509. [PMID: 32889685 PMCID: PMC7474320 DOI: 10.1007/s40272-020-00414-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The transition from childhood and adolescence to adulthood is often tumultuous. For individuals with a chronic medical condition, this progression also includes a gradual transition to independence in healthcare management as well as a transfer in care location at some set point. As adolescents navigate these sometimes challenging processes, there is a significant risk for a decline in adequate health behaviors, which can have dire consequences. One of the most vital components of the transfer to adult care is medication adherence. Poor medication adherence puts patients at risk for worse outcomes, with the most profound being increased mortality for many conditions. In recent years, acknowledgment of the need to create evidence-based methods to aid patients during the transition period has been growing. This paper seeks to provide an overview of current research and recommendations for interventions to increase adherence to medication regimens during this period.
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Affiliation(s)
- Bianca R. Campagna
- grid.256023.0000000008755302XDepartment of Psychology, Fordham University, 441 E. Fordham Road, Bronx, NY 10458 USA ,grid.59734.3c0000 0001 0670 2351Department of Pediatrics, Icahn School of Medicine at Mount Sinai, Kravis Children’s Hospital, New York, NY USA
| | - Kristen Weatherley
- grid.59734.3c0000 0001 0670 2351Department of Pediatrics, Icahn School of Medicine at Mount Sinai, Kravis Children’s Hospital, New York, NY USA
| | - Eyal Shemesh
- grid.59734.3c0000 0001 0670 2351Department of Pediatrics, Icahn School of Medicine at Mount Sinai, Kravis Children’s Hospital, New York, NY USA
| | - Rachel A. Annunziato
- grid.256023.0000000008755302XDepartment of Psychology, Fordham University, 441 E. Fordham Road, Bronx, NY 10458 USA ,grid.59734.3c0000 0001 0670 2351Department of Pediatrics, Icahn School of Medicine at Mount Sinai, Kravis Children’s Hospital, New York, NY USA
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