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Narayan A, Goncharova M, Goncharov M, Gostine A, Shah NR, Kaplan RM. Continuous monitoring of eating and sleeping behaviors in the home environments of older adults: a case study demonstration. Front Public Health 2024; 11:1277714. [PMID: 38283288 PMCID: PMC10811267 DOI: 10.3389/fpubh.2023.1277714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 12/01/2023] [Indexed: 01/30/2024] Open
Abstract
Accurate observation of patient functioning is necessary for rigorous clinical research and for improving the quality of patient care. However, clinic or laboratory environments systematically differ from the contexts of everyday life. Further, assessments that are completed in a single institutional session may not be generalizable. Here, we describe a computer vision methodology that measures human functioning continuously in the environments where patients live, sleep, and eat.
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Affiliation(s)
- Aditya Narayan
- Stanford University School of Medicine, Palo Alto, CA, United States
| | | | | | - Andrew Gostine
- Artisight, Chicago, IL, United States
- Northwestern Medicine, Chicago, IL, United States
| | - Nirav R. Shah
- Department of Medicine, Clinical Excellence Research Center, Stanford University, Palo Alto, CA, United States
| | - Robert M. Kaplan
- Department of Medicine, Clinical Excellence Research Center, Stanford University, Palo Alto, CA, United States
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2
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Waalen J. Mobile Health and Preventive Medicine. Med Clin North Am 2023; 107:1097-1108. [PMID: 37806725 DOI: 10.1016/j.mcna.2023.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
Wearable devices providing health-related data (mobile health [mHealth]) have grown in numbers and types of data available over the past 2 decades. Applications in prevention with some of the longest track records are activity trackers to promote fitness (primary prevention), mobile electrocardiogram devices to detect arrhythmias (secondary prevention), and continuous glucose monitoring to improve glycemic control in type 2 diabetes (tertiary prevention). Continued integration of multiple diverse data streams and improved interfaces with individuals (such as artificial intelligence-driven health coaches), and health care teams (as in the hospital-at-home concept), promise to optimize use of mHealth to improve clinical and public health outcomes.
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Affiliation(s)
- Jill Waalen
- University of California, San Diego/San Diego State University General Preventive Medicine Residency Program & Scripps Research Translational Institute, 3344 North Torrey Pines Court, La Jolla, CA 92037, USA.
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3
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Woods N, Turner-Cobb JM. 'It's like Taking a Sleeping Pill': Student Experience of Autonomous Sensory Meridian Response (ASMR) to Promote Health and Mental Wellbeing. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2337. [PMID: 36767701 PMCID: PMC9915972 DOI: 10.3390/ijerph20032337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/18/2023] [Accepted: 01/26/2023] [Indexed: 06/18/2023]
Abstract
Autonomous Sensory Meridian Response (ASMR) is purposely elicited by some individuals to promote health and mental wellbeing. The aim of the current study was to explore how ASMR is used and its perceived benefits in a student population. We employed semi-structured qualitative interviews, with eight female students who self-reported as ASMR-sensitive users. Inductive thematic analysis, underpinned by a phenomenological framework, was applied to the data. Two themes, each with three subthemes, were identified; these highlighted the journey from first discovering ASMR to present experience and the use of ASMR to promote health and mental wellbeing both directly and indirectly. For some, ASMR was used daily, whilst for others it was used in a relapsing-remitting fashion: usage increased when struggling with mental wellbeing and was most often used as a tool to induce sleep or distraction when feeling anxious. Participants also reported ASMR-eliciting content as intriguing, and that the phenomenon was regarded as taboo. ASMR appears to play an important role in promoting health and mental wellbeing; frequency of use, preferred triggers, and purpose of use varied, highlighting its flexible and subjective nature. It provides a potential cost-effective tool in populations such as students where mental health needs are burgeoning.
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Brannon GE, Ray M, Cho P, Baum M, Beg MS, Bevers T, Schembre SM, Basen-Engquist K, Liao Y. A qualitative study to explore the acceptability and usefulness of personalized biofeedback to motivate physical activity in cancer survivors. Digit Health 2022; 8:20552076221129096. [PMID: 36238756 PMCID: PMC9551329 DOI: 10.1177/20552076221129096] [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: 06/14/2022] [Accepted: 09/11/2022] [Indexed: 11/07/2022] Open
Abstract
Objective Many cancer survivors do not meet recommended levels of exercise, despite the
benefits physical activity offers. This study aimed to understand
experiences of insufficiently active overweight/obese breast or colorectal
cancer survivors, in efforts to (1) examine regular physical activity
barriers, and (2) determine perceptions and acceptability of a remotely
delivered physical activity intervention utilizing wearable sensors and
personalized feedback messages. Methods In-person and virtual small group interviews were conducted engaging
overweight/obese cancer survivors (n = 16, 94% female, 94%
breast cancer survivors) in discussions resulting in 314 pages of
transcribed data analyzed by multiple coders. Results All participants expressed needing to increase physical activity, identifying
lack of motivation centering on survivorship experiences and symptom
management as the most salient barrier. They indicated familiarity with
activity trackers (i.e., Fitbit) and expressed interest in biosensors (i.e.,
continuous glucose monitors [CGMs]) as CGMs show biological metrics in
real-time. Participants reported (1) personalized feedback messages can
improve motivation and accountability; (2) CGM acceptability is high given
survivors’ medical history; and (3) glucose data is a relevant health
indicator and they appreciated integrated messages (between Fitbit and CGM)
in demonstrating how behaviors immediately affect one's body. Conclusions This study supports the use of wearable biosensors and m-health interventions
to promote physical activity in cancer survivors. Glucose-based biofeedback
provides relevant and motivating information for cancer survivors regarding
their daily activity levels by demonstrating the immediate effects of
physical activity. Integrating biofeedback into physical activity
interventions could be an effective behavioral change strategy to promote a
healthy lifestyle in cancer survivors.
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Affiliation(s)
- Grace E. Brannon
- Department of Communication, University of Texas at
Arlington, Arlington, TX, USA
| | - Madison Ray
- Department of Communication, University of Texas at
Arlington, Arlington, TX, USA
| | - Patrick Cho
- Department of Behavioral Science, The University of Texas MD Anderson Cancer
Center, Houston, TX, USA
| | - Miranda Baum
- Department of Behavioral Science, The University of Texas MD Anderson Cancer
Center, Houston, TX, USA
| | - Muhammad Shaalan Beg
- Division of Hematology/Medical Oncology,
University of
Texas Southwestern Medical Center, Dallas,
TX, USA
| | - Therese Bevers
- Department of Clinical Cancer Prevention,
The University
of Texas MD Anderson Cancer Center,
Houston, TX, USA
| | - Susan M. Schembre
- Department of Family and Community Medicine, College of Medicine,
University of Arizona, Tucson, Arizona, USA
| | - Karen Basen-Engquist
- Department of Behavioral Science, The University of Texas MD Anderson Cancer
Center, Houston, TX, USA
| | - Yue Liao
- Department of Behavioral Science, The University of Texas MD Anderson Cancer
Center, Houston, TX, USA,Department of Kinesiology, University of Texas at
Arlington, Arlington, TX, USA,Yue Liao, Department of Kinesiology,
University of Texas at Arlington, 500 West Nedderman Drive, MAC 147, Arlington,
TX 76019, USA. E-mail:
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Ekstedt M, Kirsebom M, Lindqvist G, Kneck Å, Frykholm O, Flink M, Wannheden C. Design and Development of an eHealth Service for Collaborative Self-Management among Older Adults with Chronic Diseases: A Theory-Driven User-Centered Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:ijerph19010391. [PMID: 35010652 PMCID: PMC8744716 DOI: 10.3390/ijerph19010391] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 12/23/2021] [Accepted: 12/28/2021] [Indexed: 05/07/2023]
Abstract
The increasing prevalence of chronic conditions and multimorbidity poses great challenges to healthcare systems. As patients' engagement in self-managing their chronic conditions becomes increasingly important, eHealth interventions are a promising resource for the provision of adequate and timely support. However, there is inconclusive evidence about how to design eHealth services to meet the complex needs of patients. This study applied an evidence-based and theory-informed user-centered design approach in three phases to identify the needs of older adults and healthcare professionals in the collaborative management of multimorbidity (phase 1), develop an eHealth service to address these needs (phase 2), and test the feasibility and acceptance of the eHealth service in a clinical setting (phase 3). Twenty-two user needs were identified and a web-based application-ePATH (electronic Patient Activation in Treatment at Home)-with separate user interfaces for patients and healthcare professionals was developed. The feasibility study with two nurses and five patients led to a redesign and highlighted the importance of adequately addressing not only varying user needs but also the complex nature of healthcare organizations when implementing new services and processes in chronic care management.
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Affiliation(s)
- Mirjam Ekstedt
- Department Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institutet, 171 77 Stockholm, Sweden;
- Department of Health and Caring Sciences, Faculty of Health and Life Sciences, Linnaeus University, 391 82 Kalmar, Sweden
- Correspondence: (M.E.); (C.W.); Tel.: +46-(0)480-44-63-99 (M.E.); +46-(0)8-524-839-34 (C.W.)
| | - Marie Kirsebom
- Department of Health and Caring Sciences, Faculty of Health and Life Sciences, Linnaeus University, 351 95 Växjö, Sweden; (M.K.); (G.L.)
| | - Gunilla Lindqvist
- Department of Health and Caring Sciences, Faculty of Health and Life Sciences, Linnaeus University, 351 95 Växjö, Sweden; (M.K.); (G.L.)
| | - Åsa Kneck
- Department of Health Care Sciences, Ersta Sköndal Bräcke University College, Stigbergsgatan 30, Box 111 89, 100 61 Stockholm, Sweden;
| | - Oscar Frykholm
- Department Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institutet, 171 77 Stockholm, Sweden;
| | - Maria Flink
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 141 83 Stockholm, Sweden;
- Women’s Health and Allied Health Professionals Theme, Karolinska University Hospital, 141 86 Stockholm, Sweden
| | - Carolina Wannheden
- Department Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institutet, 171 77 Stockholm, Sweden;
- Correspondence: (M.E.); (C.W.); Tel.: +46-(0)480-44-63-99 (M.E.); +46-(0)8-524-839-34 (C.W.)
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Scott IA, Carter SM, Coiera E. Exploring stakeholder attitudes towards AI in clinical practice. BMJ Health Care Inform 2021; 28:bmjhci-2021-100450. [PMID: 34887331 PMCID: PMC8663096 DOI: 10.1136/bmjhci-2021-100450] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 11/14/2021] [Indexed: 12/31/2022] Open
Abstract
Objectives Different stakeholders may hold varying attitudes towards artificial intelligence (AI) applications in healthcare, which may constrain their acceptance if AI developers fail to take them into account. We set out to ascertain evidence of the attitudes of clinicians, consumers, managers, researchers, regulators and industry towards AI applications in healthcare. Methods We undertook an exploratory analysis of articles whose titles or abstracts contained the terms ‘artificial intelligence’ or ‘AI’ and ‘medical’ or ‘healthcare’ and ‘attitudes’, ‘perceptions’, ‘opinions’, ‘views’, ‘expectations’. Using a snowballing strategy, we searched PubMed and Google Scholar for articles published 1 January 2010 through 31 May 2021. We selected articles relating to non-robotic clinician-facing AI applications used to support healthcare-related tasks or decision-making. Results Across 27 studies, attitudes towards AI applications in healthcare, in general, were positive, more so for those with direct experience of AI, but provided certain safeguards were met. AI applications which automated data interpretation and synthesis were regarded more favourably by clinicians and consumers than those that directly influenced clinical decisions or potentially impacted clinician–patient relationships. Privacy breaches and personal liability for AI-related error worried clinicians, while loss of clinician oversight and inability to fully share in decision-making worried consumers. Both clinicians and consumers wanted AI-generated advice to be trustworthy, while industry groups emphasised AI benefits and wanted more data, funding and regulatory certainty. Discussion Certain expectations of AI applications were common to many stakeholder groups from which a set of dependencies can be defined. Conclusion Stakeholders differ in some but not all of their attitudes towards AI. Those developing and implementing applications should consider policies and processes that bridge attitudinal disconnects between different stakeholders.
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Affiliation(s)
- Ian A Scott
- Internal Medicine and Clinical Epidemiology, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia .,School of Clinical Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Stacy M Carter
- Australian Centre for Health Engagement Evidence and Values, School of Health and Society, University of Wollongong, Wollongong, New South Wales, Australia
| | - Enrico Coiera
- Centre for Clinical Informatics, Macquarie University, Sydney, New South Wales, Australia
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Brannon GE, Mitchell S, Ray MA, Bhai S, Beg MS, Basen-Engquist KM, Liao Y. A Qualitative Examination of COVID-19's Impacts on Physical Activity and Perceptions of Remote Delivery Interventions. Am J Health Promot 2021; 36:472-476. [PMID: 34786991 PMCID: PMC8851044 DOI: 10.1177/08901171211053845] [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] [Indexed: 11/23/2022]
Abstract
Purpose The COVID-19 pandemic is correlated with decreased physical activity (PA). Transitioning to remote work may impact people’s acceptability and preferences for remotely delivered behavioral interventions, including PA. The objective was to examine perceptions of COVID-19 impacts on PA engagement and motivation, and perspectives related to remotely delivered PA interventions. Design Cross-sectional small-group interview. Setting Harris County, Texas. Participants: Insufficiently active, overweight/obese adults (16 healthy adults [aged 25–52 years], and 7 cancer survivors [aged 50–74 years]). Method Group discussion was guided by semi-structured questions. Audio-transcribed data (278 pages) was analyzed using Braun and Clarke’s process centering identification, analysis, organization, description, and reports. Results Overall, participants expressed a decreased level of PA due to the pandemic. Difficulties (e.g., care-taking activities, working from home, and safety concerns) negatively affected motivation. Participants indicated high acceptability of remotely delivered PA interventions, with advantages of virtual technology features (e.g., did not have to maintain a gym membership) and even accountability in maintaining a PA routine (e.g., using virtual groups to engage in community support). Conclusion Participants described COVID-19 negatively affects access to PA opportunities yet also expressed willingness to engage in remotely delivered PA interventions instead of in-person programs because of their COVID-19 experiences. Remote interventions can greatly increase accessibility and offer opportunities to provide personalized motivation and accountability that people need to be more physically active.
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Affiliation(s)
- Grace Ellen Brannon
- Department of Communication, University of Texas at Arlington, Arlington, TX, USA
| | - Sophia Mitchell
- Department of Communication, University of Texas at Arlington, Arlington, TX, USA
| | - Madison A Ray
- Department of Communication, University of Texas at Arlington, Arlington, TX, USA
| | - Salman Bhai
- Department of Neurology, University of Texas Southwestern Medical Center, Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, TX, USA
| | - Muhammad Shaalan Beg
- Division of Hematology and Medical Oncology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX
| | - Karen M Basen-Engquist
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Yue Liao
- Department of Kinesiology, University of Texas at Arlington, Arlington, TX, USA
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Young AT, Amara D, Bhattacharya A, Wei ML. Patient and general public attitudes towards clinical artificial intelligence: a mixed methods systematic review. LANCET DIGITAL HEALTH 2021; 3:e599-e611. [PMID: 34446266 DOI: 10.1016/s2589-7500(21)00132-1] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 06/15/2021] [Accepted: 06/17/2021] [Indexed: 12/14/2022]
Abstract
Artificial intelligence (AI) promises to change health care, with some studies showing proof of concept of a provider-level performance in various medical specialties. However, there are many barriers to implementing AI, including patient acceptance and understanding of AI. Patients' attitudes toward AI are not well understood. We systematically reviewed the literature on patient and general public attitudes toward clinical AI (either hypothetical or realised), including quantitative, qualitative, and mixed methods original research articles. We searched biomedical and computational databases from Jan 1, 2000, to Sept 28, 2020, and screened 2590 articles, 23 of which met our inclusion criteria. Studies were heterogeneous regarding the study population, study design, and the field and type of AI under study. Six (26%) studies assessed currently available or soon-to-be available AI tools, whereas 17 (74%) assessed hypothetical or broadly defined AI. The quality of the methods of these studies was mixed, with a frequent issue of selection bias. Overall, patients and the general public conveyed positive attitudes toward AI but had many reservations and preferred human supervision. We summarise our findings in six themes: AI concept, AI acceptability, AI relationship with humans, AI development and implementation, AI strengths and benefits, and AI weaknesses and risks. We suggest guidance for future studies, with the goal of supporting the safe, equitable, and patient-centred implementation of clinical AI.
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Affiliation(s)
- Albert T Young
- School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Dominic Amara
- School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | | | - Maria L Wei
- Department of Dermatology, University of California, San Francisco, San Francisco, CA, USA; Dermatology Service, San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA.
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