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Manaf ZA, Rosli MHM, Noor NM, Jamil NA, Mazri FH, Shahar S. Exploring dietitians' views on digital nutrition educational tools in Malaysia: a qualitative study. Nutr Res Pract 2024; 18:294-307. [PMID: 38584814 PMCID: PMC10995771 DOI: 10.4162/nrp.2024.18.2.294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 10/30/2023] [Accepted: 03/22/2024] [Indexed: 04/09/2024] Open
Abstract
BACKGROUND/OBJECTIVES Dietitians frequently use nutrition education tools to facilitate dietary counselling sessions. Nevertheless, these tools may require adaptation to keep pace with technological advancements. This study had a 2-fold purpose: first, to identify the types of nutrition education tools currently in use, identify their limitations, and explore dietitians' perspectives on the importance of these tools; second, to investigate the features that dietitians prefer in digital nutrition education tools. SUBJECTS/METHODS A semi-structured face-to-face interview was conducted among 15 dietitians from selected public hospitals, primary care clinics, and teaching hospitals in Malaysia. Inductive thematic analysis of the responses was conducted using NVivo version 12 software. RESULTS Most dietitians used physical education tools including the healthy plate model, pamphlets, food models, and flip charts. These tools were perceived as important as they facilitate the nutrition assessment process, deliver nutrition intervention, and are time efficient. However, dietitians described the current educational tools as impersonal, outdated, limited in availability due to financial constraints, unhandy, and difficult to visualise. Alternatively, they strongly favoured digital education tools that provided instant feedback, utilised an automated system, included a local food database, were user-friendly, developed by experts in the field, and seamlessly integrated into the healthcare system. CONCLUSION Presently, although dietitians have a preference for digital educational tools, they heavily rely on physical nutrition education tools due to their availability despite the perception that these tools are outdated, impersonal, and inconvenient. Transitioning to digital dietary education tools could potentially address these issues.
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Affiliation(s)
- Zahara Abdul Manaf
- Dietetic Program and Centre for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300 Kuala Lumpur, Malaysia
| | - Mohd Hafiz Mohd Rosli
- Dietetic Program and Centre for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300 Kuala Lumpur, Malaysia
- Dietetics Unit, Kapar Health Clinic, Ministry of Health, 42200 Klang, Malaysia
| | - Norhayati Mohd Noor
- Pusat Genius @ Pintar, Universiti Kebangsaan Malaysia, 43600 Bangi, Malaysia
| | - Nor Aini Jamil
- Dietetic Program and Centre for Community Health Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300 Kuala Lumpur, Malaysia
| | - Fatin Hanani Mazri
- Dietetic Program and Centre for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300 Kuala Lumpur, Malaysia
| | - Suzana Shahar
- Dietetic Program and Centre for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300 Kuala Lumpur, Malaysia
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Yudkin JS, Messiah SE, Allicock MA, Barlow SE. Integration of e-Health Strategies for Post-COVID-19 Pandemic Pediatric Weight Management Programs. Telemed J E Health 2024; 30:321-330. [PMID: 37552819 DOI: 10.1089/tmj.2023.0068] [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: 08/10/2023] Open
Abstract
Background: The COVID-19 pandemic catalyzed a renewed urgency to address the obesity pandemic and accelerated the use of technology to treat pediatric obesity. Yet, there are significant incongruities between the existing literature on technology for obesity management and the current health care system that may lead to suboptimal outcomes and increased costs. This study reviewed the types of e-health strategies currently in use, highlighted inconsistencies and overlap in terminology, and identified future research directions in e-health for childhood obesity, including gaps in implementation science. Methods: This narrative literature review synthesized seminal articles from the literature, as well as recent articles, using PubMed and Google Scholar that focused on the use of technology in treating pediatric obesity. This inclusive strategy was intended to elucidate the heterogeneity in how different disciplines are using digital health terminology in pediatric obesity research. Results: Both the prevalence of e-health interventions and its associated terminology are increasing in the peer-reviewed literature, especially since the beginning of the COVID-19 pandemic. Yet, their definitions and usage are unstandardized, leading to a lack of cohesion in the research and between disciplines. There is a gap in implementation science outcomes, including reimbursement, that may significantly impact external validity and uptake. Conclusion: A more systematic and precise approach to researching e-health that can assess specific technologies and combinations of technologies, their short-term and long-term effect sizes, and feasibility can produce the necessary data that may lead to reimbursement policies and, ultimately, improved pediatric weight management outcomes.
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Affiliation(s)
- Joshua S Yudkin
- School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Dallas, Texas, USA
| | - Sarah E Messiah
- School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Dallas, Texas, USA
- Center for Pediatric Population Health, School of Public Health, The University of Texas Health Science Center at Houston, Dallas, Texas, USA
- Department of Pediatrics, McGovern Medical School, Houston, Texas, USA
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Marlyn A Allicock
- School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Dallas, Texas, USA
- Center for Pediatric Population Health, School of Public Health, The University of Texas Health Science Center at Houston, Dallas, Texas, USA
| | - Sarah E Barlow
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Division of Pediatric Gastroenterology, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Children's Health, Children's Medical Center Dallas, Dallas, Texas, USA
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Lares-Michel M, Housni FE, Reyes-Castillo Z, Huertas JR, Aguilera-Cervantes VG, Michel-Nava RM. Sustainable-psycho-nutritional intervention programme for a sustainable diet (the 'NutriSOS' study) and its effects on eating behaviour, diet quality, nutritional status, physical activity, metabolic biomarkers, gut microbiota and water and carbon footprints in Mexican population: study protocol of an mHealth randomised controlled trial. Br J Nutr 2023; 130:1823-1838. [PMID: 36991478 PMCID: PMC10587386 DOI: 10.1017/s0007114523000843] [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: 09/27/2022] [Revised: 02/06/2023] [Accepted: 03/22/2023] [Indexed: 03/31/2023]
Abstract
Mexico is going through an environmental and nutritional crisis related to unsustainable dietary behaviours. Sustainable diets could solve both problems together. This study protocol aims to develop a three-stage, 15-week mHealth randomised controlled trial of a sustainable-psycho-nutritional intervention programme to promote Mexican population adherence to a sustainable diet and to evaluate its effects on health and environmental outcomes. In stage 1, the programme will be designed using the sustainable diets, behaviour change wheel and capability, opportunity, motivation, and behaviour (COM-B) models. A sustainable food guide, recipes, meal plans and a mobile application will be developed. In stage 2, the intervention will be implemented for 7 weeks, and a 7-week follow-up period in a young Mexican adults (18-35 years) sample, randomly divided (1:1 ratio) into a control group (n 50) and an experimental group (n 50), will be divided into two arms at week 8. Outcomes will include health, nutrition, environment, behaviour and nutritional-sustainable knowledge. Additionally, socio-economics and culture will be considered. Thirteen behavioural objectives will be included using successive approaches in online workshops twice a week. The population will be monitored using the mobile application consisting of behavioural change techniques. In stage 3, the effects of the intervention will be assessed using mixed-effects models on dietary intake and quality, nutritional status, physical activity, metabolic biomarkers (serum glucose and lipid profile), gut microbiota composition and dietary water and carbon footprints of the evaluated population. Improvements in health outcomes and a decrease in dietary water and carbon footprints are expected.
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Affiliation(s)
- Mariana Lares-Michel
- Institute of Nutrition and Food Technology ‘José Mataix Verdú’, Biomedical Research Center, University of Granada, Avenida del Conocimiento S/N. Parque Tecnológico de la Salud. Armilla, 18071Granada, Spain
- Instituto de Investigaciones en Comportamiento Alimentario y Nutrición (IICAN), University Center of the South, University of Guadalajara, Av. Enrique Arreola Silva 883, Col. Centro, 49000, Cd. Guzmán, Jalisco, Mexico
| | - Fatima Ezzahra Housni
- Instituto de Investigaciones en Comportamiento Alimentario y Nutrición (IICAN), University Center of the South, University of Guadalajara, Av. Enrique Arreola Silva 883, Col. Centro, 49000, Cd. Guzmán, Jalisco, Mexico
| | - Zyanya Reyes-Castillo
- Instituto de Investigaciones en Comportamiento Alimentario y Nutrición (IICAN), University Center of the South, University of Guadalajara, Av. Enrique Arreola Silva 883, Col. Centro, 49000, Cd. Guzmán, Jalisco, Mexico
| | - Jesús R. Huertas
- Institute of Nutrition and Food Technology ‘José Mataix Verdú’, Biomedical Research Center, University of Granada, Avenida del Conocimiento S/N. Parque Tecnológico de la Salud. Armilla, 18071Granada, Spain
| | - Virginia Gabriela Aguilera-Cervantes
- Instituto de Investigaciones en Comportamiento Alimentario y Nutrición (IICAN), University Center of the South, University of Guadalajara, Av. Enrique Arreola Silva 883, Col. Centro, 49000, Cd. Guzmán, Jalisco, Mexico
| | - Rosa María Michel-Nava
- Tecnológico Nacional de México, Campus Ciudad Guzmán, Avenida Tecnológico 100, Col. Centro, 49000Ciudad Guzmán, Mexico
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Lim JY, Ali NM, Rajikan R, Amit N, Hamid HA, Leong HY, Mohamad M, Koh BQ, Musa A. Need analysis of a dietary application among caregivers of patients with disorders of amino acid metabolism (AAMDs): A mixed-method approach. Int J Med Inform 2023; 177:105120. [PMID: 37295139 DOI: 10.1016/j.ijmedinf.2023.105120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 05/28/2023] [Accepted: 06/02/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND A dietary application can assist the caregivers of AAMDs children in auto-calculating the protein intake, hence improving dietary compliance. However, existing dietary application for patients with AAMDs only focus on delivering the nutritional content of food and monitoring the dietary intake but were lacking in other educational components. OBJECTIVE To assess the uses, needs and preferences towards a dietary application among the caregivers of AAMDs patients. METHODS We conducted a mixed-method study comprising focus group discussion (FGD) and a quantitative questionnaire survey among caregivers of patients aged between 6-month-old to 18-year-old with AAMDs who are receiving active treatment, both medical and dietetic treatment in the genetic clinic, Hospital Kuala Lumpur (HKL). RESULTS A total of 76 and 20 caregivers participated in the survey and FGD respectively. All the caregivers (100%) possessed a smartphone and most of the caregivers (89.5%) had the experience of using smartphone or other technological devices to search for health or medical information. However, majority of the participants were not aware of the existence of any web-based or mobile application related to AAMDs (89.5%). While for the qualitative part, three themes emerged: (1) experience with current source of information; (2) needs for supporting self-management educational contents and needs for technological design application. Most of the caregivers used the nutritional booklet as sources of reference but some of them searched for web-based information. Features perceived by the caregivers included a digital food composition database, sharing diet recall with healthcare providers, self-monitoring diet intake as well as low protein recipes. Besides that, user-friendly and ease to use were also perceived as the important features by the caregivers. CONCLUSION The identified features and needs by the caregivers should be integrated into the design of the apps to promote acceptance and usage.
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Affiliation(s)
- Jing Ying Lim
- Dietetics Program & Centre of Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia; Dietetics Department, Faculty of Medicines and Health Sciences, University Putra Malaysia, Serdang, Selangor, Malaysia
| | - Nazlena Mohamad Ali
- Institute of IR4.0 (IIR4.0), Universiti Kebangsaan Malaysia, Bangi, Selangor, Malaysia.
| | - Roslee Rajikan
- Dietetics Program & Centre of Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Noh Amit
- Clinical Psychology and Behavioural Health Program & Center for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Haslina Abdul Hamid
- Dietetics Program & Center for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Huey Yin Leong
- Genetics Department, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
| | - Maslina Mohamad
- Dietetics & Food Service Department, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
| | - Bi Qi Koh
- Dietetics & Food Service Department, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
| | - Aini Musa
- Dietetics & Food Service Department, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
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Silva M, Hay-Smith EJ, Graham F. Exploring the Use of the Behavior Change Technique Taxonomy and the Persuasive System Design Model in Defining Parent-Focused eHealth Interventions: Scoping Review. J Med Internet Res 2023; 25:e42083. [PMID: 37342082 DOI: 10.2196/42083] [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: 08/22/2022] [Revised: 02/21/2023] [Accepted: 03/08/2023] [Indexed: 06/22/2023] Open
Abstract
BACKGROUND Taxonomies and models are useful tools for defining eHealth content and intervention features, enabling comparison and analysis of research across studies and disciplines. The Behavior Change Technique Taxonomy version 1 (BCTTv1) was developed to decrease ambiguity in defining specific characteristics inherent in health interventions, but it was developed outside the context of digital technology. In contrast, the Persuasive System Design Model (PSDM) was developed to define and evaluate the persuasive content in software solutions but did not have a specific focus on health. Both the BCTTv1 and PSDM have been used to define eHealth interventions in the literature, with some researchers combining or reducing the taxonomies to simplify their application. It is unclear how well the taxonomies accurately define eHealth and whether they should be used alone or in combination. OBJECTIVE This scoping review explored how the BCTTv1 and PSDM capture the content and intervention features of parent-focused eHealth as part of a program of studies investigating the use of technology to support parents with therapy home programs for children with special health care needs. It explored the active ingredients and persuasive technology features commonly found in parent-focused eHealth interventions for children with special health care needs and how the descriptions overlap and interact with respect to the BCTTv1 and PSDM taxonomies. METHODS A scoping review was used to clarify concepts in the literature related to these taxonomies. Keywords related to parent-focused eHealth were defined and used to systematically search several electronic databases for parent-focused eHealth publications. Publications referencing the same intervention were combined to provide comprehensive intervention details. The data set was coded using codebooks developed from the taxonomies in NVivo (version 12; QSR International) and qualitatively analyzed using matrix queries. RESULTS The systematic search found 23 parent-focused eHealth interventions described in 42 articles from various countries; delivered to parents with children aged 1 to 18 years; and covering medical, behavioral, and developmental issues. The predominant active ingredients and intervention features in parent-focused eHealth were concerned with teaching parents behavioral skills, encouraging them to practice and monitor the new skills, and tracking the outcomes of performing the new skills. No category had a complete set of active ingredients or intervention features coded. The two taxonomies conceptually captured different constructs even when their labels appeared to overlap in meaning. In addition, coding by category missed important active ingredients and intervention features. CONCLUSIONS The taxonomies were found to code different constructs related to behavior change and persuasive technology, discouraging the merging or reduction of the taxonomies. This scoping review highlighted the benefit of using both taxonomies in their entirety to capture active ingredients and intervention features important for comparing and analyzing eHealth across different studies and disciplines. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-doi.org/10.15619/nzjp/47.1.05.
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Affiliation(s)
- Mindy Silva
- Rehabilitation Teaching and Research Unit, University of Otago, Wellington, New Zealand
| | - E Jean Hay-Smith
- Rehabilitation Teaching and Research Unit, University of Otago, Wellington, New Zealand
| | - Fiona Graham
- Rehabilitation Teaching and Research Unit, University of Otago, Wellington, New Zealand
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Bounds DT, Stiles-Shields C, Schueller SM, Odgers CL, Karnik NS. Ethical considerations for developing pediatric mhealth interventions for teens with socially complex needs. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2023; 36:7-16. [PMID: 36134754 PMCID: PMC9898213 DOI: 10.1111/jcap.12396] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 08/03/2022] [Accepted: 09/11/2022] [Indexed: 02/06/2023]
Abstract
TOPIC Mobile Health (mHealth) stands as a potential means to better reach, assess, and intervene with teens with socially complex needs. These youth often face overlapping adversities including medical illness and a history of experiencing adverse childhood experiences (ACEs). Clinicians are faced with navigating ethical decisions when developing mHealth tools for teens who have socially complex needs. Many tools have been developed for adults from the general population. However, despite the development of thousands of mHealth interventions, developers tend to focus on designing for usability, engagement, and efficacy, with less attention on the ethical considerations of making such tools. PURPOSE To safely move mHealth interventions from research into clinical practice, ethical standards must be met during the design phase. In this paper we adapt the Four Box Model (i.e., medical indications, preferences of patients, quality of life, and contextual features) to guide mHealth developers through ethical considerations when designing mHealth interventions for teens who present with a medical diagnosis and a history of ACEs. SOURCES A review of language, inclusive features, data sharing, and usability is presented using both the Four Box Model and potential scenarios to guide each consideration. CONCLUSIONS To better support designers of mHealth tools we present a framework for evaluating applications to determine overlap with ethical design and are well suited for use in clinical practice with underserved pediatric patients.
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Affiliation(s)
- Dawn T Bounds
- Irvine, Sue & Bill Gross School of Nursing, University of California, Irvine, California, USA
- Department of Psychiatry and Behavioral Sciences, Section of Community Behavioral Health, Rush University, Chicago, Illinois, USA
| | - Colleen Stiles-Shields
- Department of Psychiatry and Behavioral Sciences, Section of Community Behavioral Health, Rush University, Chicago, Illinois, USA
- Institute for Juvenile Research, University of Illinois at Chicago, Illinois, USA
| | - Stephen M Schueller
- Department of Psychological Science, University of California-Irvine, Irvine, California, USA
| | - Candice L Odgers
- Department of Psychological Science, University of California-Irvine, Irvine, California, USA
- Social Science Research Institute, Duke University, Durham, North Carolina, USA
| | - Niranjan S Karnik
- Department of Psychiatry and Behavioral Sciences, Section of Community Behavioral Health, Rush University, Chicago, Illinois, USA
- Institute for Juvenile Research, University of Illinois at Chicago, Illinois, USA
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Zhu Q, Li Y, Su Y, Huang L, Liu J, Lin W. WeChat-based mobile health management for short-stature children with long-term growth hormone therapy: A nonexperimental study. Digit Health 2023; 9:20552076231179849. [PMID: 37312945 PMCID: PMC10259112 DOI: 10.1177/20552076231179849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 05/17/2023] [Indexed: 06/15/2023] Open
Abstract
Objective To evaluate the role of a WeChat-based mobile platform in growth hormone therapy. Method Growth hormone therapy and health education information for height growth were embedded in a WeChat-based mobile platform, and the platform was evaluated through medical staff assessments, patient volunteer assessments and quantitative scoring criteria. Results In the medical staff evaluation, both clinicians and nurses had a positive attitude towards the mobile platform, believing that the design of the mobile platform was clearly visualized and easy to operate. In family volunteers' evaluations, the summary of β-testing results showed that 90-100% of parents had a positive attitude towards the WeChat-based mobile platform. Parents of the patients and doctors and nurses assessed the mobile platform by reviewing quantitative scoring standards developed by professional researchers. All scores were >16 (the average score was 18-19.3). Children treated with growth hormone therapy were included for compliance tracking for one year, and patient adherence was described in this study. Conclusion The interaction based on the WeChat platform and the health education of the public have greatly increased the interaction between doctors and patients, and improved patient satisfaction and compliance.
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Affiliation(s)
- Qingling Zhu
- Department of Children Health Care, Quanzhou Women and Children's Hospital, Quanzhou, China
| | - Ying Li
- The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Yajun Su
- Department of Children Health Care, Quanzhou Women and Children's Hospital, Quanzhou, China
| | - Liuhong Huang
- Department of Children Health Care, Quanzhou Women and Children's Hospital, Quanzhou, China
| | - Jiajia Liu
- Department of Children Health Care, Quanzhou Women and Children's Hospital, Quanzhou, China
| | - Weihua Lin
- Department of Children Health Care, Quanzhou Women and Children's Hospital, Quanzhou, China
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Fidjeland TG, Øen KG. Parents' Experiences Using Digital Health Technologies in Paediatric Overweight and Obesity Support: An Integrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:ijerph20010410. [PMID: 36612733 PMCID: PMC9819819 DOI: 10.3390/ijerph20010410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/22/2022] [Accepted: 12/23/2022] [Indexed: 05/08/2023]
Abstract
This study aimed to explore parents' perspectives regarding the use of digital health technologies in paediatric overweight and obesity weight support. A systematic search in 'Academic Search Premier', 'British Nursing Index', 'Cumulative Index to Nursing and Allied Health', and 'Health Research Premium Collection' was conducted in November 2021. Inclusion criteria were English or Nordic peer-reviewed articles published after 2010, overweight and obese children aged 2-10, weight support using digital health technologies, and parental experiences examined. An integrative review was conducted using Joanna Briggs Institute quality appraisal checklists and a constant comparison analysis method. In total, 14 articles were analysed that included SMS, telephone, apps, websites, and social media as the main technology groups. A limitation of this review was the heterogenicity of the studies. The results indicate that parents, mostly mothers, had a positive experience, finding technologies helpful and easy to use, and expressed optimism toward future use. An option for interacting with others and the possibility of personalising support were enjoyed or requested. In conclusion, digital health technologies can be a suitable tool to empower the parents of children with overweight and obesity concerns, whose perspective should be considered during the design and support phases.
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Gonzalez-Ramirez M, Sanchez-Carrera R, Cejudo-Lopez A, Lozano-Navarrete M, Salamero Sánchez-Gabriel E, Torres-Bengoa MA, Segura-Balbuena M, Sanchez-Cordero MJ, Barroso-Vazquez M, Perez-Barba FJ, Troncoso AM, Garcia-Parrilla MC, Cerezo AB. Short-Term Pilot Study to Evaluate the Impact of Salbi Educa Nutrition App in Macronutrients Intake and Adherence to the Mediterranean Diet: Randomized Controlled Trial. Nutrients 2022; 14:nu14102061. [PMID: 35631202 PMCID: PMC9146242 DOI: 10.3390/nu14102061] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 05/06/2022] [Accepted: 05/12/2022] [Indexed: 01/19/2023] Open
Abstract
Promoting a healthy diet is a relevant strategy for preventing non-communicable diseases. This study aims to evaluate the impact of an innovative tool, the SAlBi educa nutrition app, in primary healthcare dietary counseling to improve dietary profiles as well as adherence to the Mediterranean diet. A multi-center randomized control trial comprising 104 participants was performed. Both control (n = 49) and intervention (n = 55) groups attended four once-weekly sessions focusing on healthy eating habits and physical activity, over one month. As well as attending the meetings, the intervention group used the app, which provides self-monitoring and tailored dietary advice based on the Mediterranean diet model. In a second intervention (one arm trial), the potential of SAlBi educa was evaluated for three months during the COVID-19 pandemic. At 4 weeks, the intervention group had significantly increased their carbohydrate intake (7.7% (95% CI: 0.16 to 15.2)) and decreased their total fat intake (−5.7% (95% CI: −10.4 to −1.15)) compared to the control group. Significant differences were also found for carbohydrates (3.5% (95% CI: −1.0 to 5.8)), total fats (−5.9% (95% CI: −8.9 to −3.0)), fruits and vegetables (266.3 g/day (95% CI: 130.0 to 402.6)), legumes (7.7g/day (95% CI: 0.2 to 15.1)), starchy foods (36.4 g/day (95% CI: 1.1 to 71.7)), red meat (−17.5 g/day (95% CI: −34.0 to −1.1)), and processed meat (−6.6 g/day (95% CI: −13.1 to −0.1)) intakes during the COVID-19 pandemic. SAlBi educa is a useful tool to support nutrition counseling in primary healthcare, including in special situations such as the COVID-19 pandemic. Trial registration: ISRCTN57186362.
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Affiliation(s)
- Marina Gonzalez-Ramirez
- Departamento de Nutrición y Bromatología, Toxicología y Medicina Legal, Facultad de Farmacia, Universidad de Sevilla, 41012 Sevilla, Spain; (M.G.-R.); (R.S.-C.); (A.M.T.); (M.C.G.-P.)
- Fundación Pública Andaluza para la Gestión de la Investigación en Salud de Sevilla (FISEVI), Hospital Universitario Virgen Macarena, 41013 Sevilla, Spain
| | - Rocio Sanchez-Carrera
- Departamento de Nutrición y Bromatología, Toxicología y Medicina Legal, Facultad de Farmacia, Universidad de Sevilla, 41012 Sevilla, Spain; (M.G.-R.); (R.S.-C.); (A.M.T.); (M.C.G.-P.)
- Fundación Pública Andaluza para la Gestión de la Investigación en Salud de Sevilla (FISEVI), Hospital Universitario Virgen Macarena, 41013 Sevilla, Spain
| | - Angela Cejudo-Lopez
- Centro de Salud Bellavista, Distrito Sanitario de Atención Primaria Sevilla, 41013 Sevilla, Spain; (A.C.-L.); (F.J.P.-B.)
| | | | - Elena Salamero Sánchez-Gabriel
- Centro de Salud Puerta Este “Dr. Pedro Vallina”, Distrito Sanitario de Atención Primaria Sevilla, 41020 Sevilla, Spain; (E.S.S.-G.); (M.A.T.-B.)
| | - M. Alfonso Torres-Bengoa
- Centro de Salud Puerta Este “Dr. Pedro Vallina”, Distrito Sanitario de Atención Primaria Sevilla, 41020 Sevilla, Spain; (E.S.S.-G.); (M.A.T.-B.)
| | - Manuel Segura-Balbuena
- Centro de Salud Esperanza Macarena, Distrito Sanitario de Atención Primaria Sevilla, 41003 Sevilla, Spain;
| | - Maria J. Sanchez-Cordero
- Centro de Salud Los Bermejales, Distrito Sanitario de Atención Primaria Sevilla, 41013 Sevilla, Spain; (M.J.S.-C.); (M.B.-V.)
| | - Mercedes Barroso-Vazquez
- Centro de Salud Los Bermejales, Distrito Sanitario de Atención Primaria Sevilla, 41013 Sevilla, Spain; (M.J.S.-C.); (M.B.-V.)
| | - Francisco J. Perez-Barba
- Centro de Salud Bellavista, Distrito Sanitario de Atención Primaria Sevilla, 41013 Sevilla, Spain; (A.C.-L.); (F.J.P.-B.)
| | - Ana M. Troncoso
- Departamento de Nutrición y Bromatología, Toxicología y Medicina Legal, Facultad de Farmacia, Universidad de Sevilla, 41012 Sevilla, Spain; (M.G.-R.); (R.S.-C.); (A.M.T.); (M.C.G.-P.)
| | - M. Carmen Garcia-Parrilla
- Departamento de Nutrición y Bromatología, Toxicología y Medicina Legal, Facultad de Farmacia, Universidad de Sevilla, 41012 Sevilla, Spain; (M.G.-R.); (R.S.-C.); (A.M.T.); (M.C.G.-P.)
| | - Ana B. Cerezo
- Departamento de Nutrición y Bromatología, Toxicología y Medicina Legal, Facultad de Farmacia, Universidad de Sevilla, 41012 Sevilla, Spain; (M.G.-R.); (R.S.-C.); (A.M.T.); (M.C.G.-P.)
- Correspondence: ; Tel.: +34-954-556-760
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10
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Gonzalez-Ramirez M, Cejudo-Lopez A, Lozano-Navarrete M, Salamero Sánchez-Gabriel E, Torres-Bengoa MA, Segura-Balbuena M, Sanchez-Cordero MJ, Barroso-Vazquez M, Perez-Barba FJ, Troncoso AM, Garcia-Parrilla MC, Cerezo AB. SAlBi educa (Tailored Nutrition App for Improving Dietary Habits): Initial Evaluation of Usability. Front Nutr 2022; 9:782430. [PMID: 35520281 PMCID: PMC9063930 DOI: 10.3389/fnut.2022.782430] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 03/14/2022] [Indexed: 12/13/2022] Open
Abstract
In recent years, the use of applications to improve dietary habits has increased. Although numerous nutrition apps are available on the market, only few have been developed by health and nutrition professionals based on scientific evidence and subsequently tested to prove their usability. The main objective of this study was to design, develop, and evaluate the usability of a tailored nutrition application to be used to promote healthy eating habits. In order to decide app design and content, three focus groups took place with fifteen professionals from primary healthcare, nutrition, and food science and computer science, as well as expert users. For the general and feedback message design, a reference model based on the scientific literature was developed. To address the multi-perspective approach of users' and external healthcare professionals' feedback, a one-day pilot testing with potential users and healthcare professionals was conducted with four focus groups. To evaluate the relevance and potential usability of the app a 1-month pilot test was conducted in a real-life environment. A total of 42 volunteers participated in the one-day pilot testing, and 39 potential users participated in the 1-month pilot test. The SAlBi educa app developed includes an online dietary record, a self-monitoring tool to evaluate dietary patterns, general and feedback messages, and examples of traditional Mediterranean recipes. The usability study showed that volunteers think that SAlBi educa is pleasant (59%) and easy to learn to use (94%). Over 84% of the volunteers declared that the nutritional messages were clear and useful. Volunteers stated that general and tailored recommendations, as well as self-monitoring, were SAlBi educa's most motivating and useful features. SAlBi educa is an innovative, user-friendly nutritional education tool with the potential to engage and help individuals to follow dietary habits based on the Mediterranean model.
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Affiliation(s)
- Marina Gonzalez-Ramirez
- Fundación Pública Andaluza para la Gestión de la Investigación en Salud de Sevilla (FISEVI), Hospital Universitario Virgen Macarena, Sevilla, Spain
- Departamento de Nutrición y Bromatología, Toxicología y Medicina Legal, Facultad de Farmacia, Universidad de Sevilla, Sevilla, Spain
| | - Angela Cejudo-Lopez
- Centro de Salud Bellavista, Distrito Sanitario de Atención Primaria Sevilla, Sevilla, Spain
| | - Mauricio Lozano-Navarrete
- UGC Salud Pública Sevilla, Distrito Sanitario de Atención Primaria Sevilla, Área de Promoción de la Salud, Sevilla, Spain
| | | | - M. Alfonso Torres-Bengoa
- Centro de Salud Puerta Este “Dr. Pedro Vallina”, Distrito Sanitario de Atención Primaria Sevilla, Sevilla, Spain
| | - Manuel Segura-Balbuena
- Centro de Salud Esperanza Macarena, Distrito Sanitario de Atención Primaria Sevilla, Sevilla, Spain
| | | | | | | | - Ana M. Troncoso
- Departamento de Nutrición y Bromatología, Toxicología y Medicina Legal, Facultad de Farmacia, Universidad de Sevilla, Sevilla, Spain
| | - M. Carmen Garcia-Parrilla
- Departamento de Nutrición y Bromatología, Toxicología y Medicina Legal, Facultad de Farmacia, Universidad de Sevilla, Sevilla, Spain
| | - Ana B. Cerezo
- Departamento de Nutrición y Bromatología, Toxicología y Medicina Legal, Facultad de Farmacia, Universidad de Sevilla, Sevilla, Spain
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11
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Elliott A, Lang S, Truby H, Brennan L, Gibson S. Tackling the challenge of treating obesity using design research methods: A scoping review. Obes Rev 2022; 23:e13360. [PMID: 34545669 DOI: 10.1111/obr.13360] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 08/06/2021] [Accepted: 08/20/2021] [Indexed: 01/10/2023]
Abstract
Design research methods, including user-centered design, human-centered design, and design thinking, are iterative processes and frameworks that engage stakeholders to inform the design of initiatives, programs, or research interventions. Design research methods are not yet widely applied in healthcare. To date, there is a limited understanding of how design research methodologies can be applied to develop client-centered weight loss interventions. This scoping review explores the extent, range, and nature of research projects that used design research methods to guide the development of an obesity treatment intervention. A systematic search of eight databases identified projects that used design research methods to develop a weight loss intervention or strategy. The method and practical application of design research processes for each eligible article were extracted and explored. Design research methods were used to generate ideas or guide the development of a mobile application (n = 6), mHealth device (n = 1), eHealth solution (n = 1), health promotion program (n = 1), or patient-clinician communication tools (n = 2). There was considerable variation in the application of design research processes between studies. Design research methods may provide an iterative, flexible framework to facilitate the development of client-centered, inclusive interventions and strategies. Design research methods may support research teams to move away from the one-size-fits-all approach to obesity treatment.
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Affiliation(s)
- Andrea Elliott
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Monash University, Clayton, Victoria, Australia
| | - Sarah Lang
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Monash University, Clayton, Victoria, Australia
| | - Helen Truby
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Linda Brennan
- School of Media and Communication, RMIT University, Melbourne, Victoria, Australia
| | - Simone Gibson
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Monash University, Clayton, Victoria, Australia
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12
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Arthurs N, Tully L, O’Malley G, Browne S. Usability and Engagement Testing of mHealth Apps in Paediatric Obesity: A Narrative Review of Current Literature. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1453. [PMID: 35162470 PMCID: PMC8834793 DOI: 10.3390/ijerph19031453] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 01/07/2022] [Accepted: 01/19/2022] [Indexed: 02/01/2023]
Abstract
Mobile health (mHealth) platforms have become increasingly popular for delivering health interventions in recent years and particularly in light of the COVID-19 pandemic. Childhood obesity treatment is an area where mHealth interventions may be useful due to the multidisciplinary nature of interventions and the need for long-term care. Many mHealth apps targeting youth exist but the evidence base underpinning the methods for assessing technical usability, user engagement and user satisfaction of such apps with target end-users or among clinical populations is unclear, including for those aimed at paediatric overweight and obesity management. This review aims to examine the current literature and provide an overview of the scientific methods employed to test usability and engagement with mHealth apps in children and adolescents with obesity. A narrative literature review was undertaken following a systematic search. Four academic databases were searched. Inclusion criteria were studies describing the usability of mHealth interventions for childhood obesity treatment. Following the application of inclusion and exclusion criteria, fifty-nine articles were included for full-text review, and seven studies met the criteria for usability and engagement in a clinical paediatric population with obesity. Six apps were tested for usability and one for engagement in childhood obesity treatment. Sample sizes ranged from 6-1120 participants. The included studies reported several heterogenous measurement instruments, data collection approaches, and outcomes. Recommendations for future research include the standardization and validation of instruments to measure usability and engagement within mHealth studies in this population.
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Affiliation(s)
- Niamh Arthurs
- W82GO Child and Adolescent Obesity Service, Children’s Health Ireland at Temple Street, D01 XD99 Dublin, Ireland;
- School Public Health, Physiotherapy & Sports Science, University College Dublin, D04 V1W8 Dublin, Ireland;
| | - Louise Tully
- School of Physiotherapy, Division of Population Health Sciences, RCSI University of Medicine and Health Sciences, D02 YN77 Dublin, Ireland;
| | - Grace O’Malley
- W82GO Child and Adolescent Obesity Service, Children’s Health Ireland at Temple Street, D01 XD99 Dublin, Ireland;
- School of Physiotherapy, Division of Population Health Sciences, RCSI University of Medicine and Health Sciences, D02 YN77 Dublin, Ireland;
| | - Sarah Browne
- School Public Health, Physiotherapy & Sports Science, University College Dublin, D04 V1W8 Dublin, Ireland;
- School of Physiotherapy, Division of Population Health Sciences, RCSI University of Medicine and Health Sciences, D02 YN77 Dublin, Ireland;
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13
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de Oliveira NLZ, Peduzzi M, Agreli HLF, Dos Santos Matsumoto K. Implementation of evidence-based nutritional management in primary health care settings: a systematic scoping review. Aust J Prim Health 2021; 28:1-17. [PMID: 34905725 DOI: 10.1071/py20280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 08/22/2021] [Indexed: 11/23/2022]
Abstract
Scientific evidence is used to inform clinical nutritional guidelines in order to prevent diseases and promote health. However, little is known about the process of implementing evidence-based clinical nutritional guidelines in health services. This scoping review aims to map the steps in the implementation of evidence-based nutritional management within primary health care, as well as the facilitators and barriers to implementation. Electronic databases and the grey literature were searched for original studies on the implementation of evidence-based dietary recommendations and/or nutritional counselling in primary health care settings conducted by health practitioners. Studies were selected by independent reviewers. Extracted data were analysed and grouped into thematic categories and are presented in a narrative synthesis. In all, 26 studies were included. A review of the studies demonstrated four steps in the process of implementing evidence-based nutritional management in primary care: (1) acknowledging health needs in the catchment area and determining the characteristics of services and health professionals; (2) developing continuing education aimed at practitioners; (3) integrating nutritional management into interprofessional practice; and (4) adapting the interventions using a patient-centred care approach. The predominant facilitators were providers' pre-intervention training and the provision of support materials. Barriers included time constraints, a lack of resources and an incompatibility of the interventions with living conditions and patients' health needs.
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Affiliation(s)
- Nara Letícia Zandonadi de Oliveira
- University of Sao Paulo, School of Nursing, Department of Professional Orientation, Avenida Dr Enéas de Carvalho Aguiar, 419, São Paulo, SP, Brazil; and Corresponding author
| | - Marina Peduzzi
- University of Sao Paulo, School of Nursing, Department of Professional Orientation, Avenida Dr Enéas de Carvalho Aguiar, 419, São Paulo, SP, Brazil
| | | | - Karen Dos Santos Matsumoto
- State University of Rio de Janeiro, Social Medicine Institute, Rua São Francisco Xavier, 524, Rio de Janeiro, RJ, Brazil
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14
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Tsiouris KM, Tsakanikas VD, Gatsios D, Fotiadis DI. A Review of Virtual Coaching Systems in Healthcare: Closing the Loop With Real-Time Feedback. Front Digit Health 2021; 2:567502. [PMID: 34713040 PMCID: PMC8522109 DOI: 10.3389/fdgth.2020.567502] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 08/28/2020] [Indexed: 12/04/2022] Open
Abstract
This review focuses on virtual coaching systems that were designed to enhance healthcare interventions, combining the available sensing and system-user interaction technologies. In total, more than 1,200 research papers have been retrieved and evaluated for the purposes of this review, which were obtained from three online databases (i.e.,PubMed, Scopus and IEEE Xplore) using an extensive set of search keywords. After applying exclusion criteria, the remaining 41 research papers were used to evaluate the status of virtual coaching systems over the past 10 years and assess current and future trends in this field. The results suggest that in home coaching systems were mainly focused in promoting physical activity and a healthier lifestyle, while a wider range of medical domains was considered in systems that were evaluated in lab environment. In home patient monitoring with IoT devices and sensors was mostly limited to activity trackers, pedometers and heart rate monitoring. Real-time evaluations and personalized patient feedback was also found to be rather lacking in home coaching systems and this is the most alarming find of this analysis. Feasibility studies in controlled environment and an ongoing active research on Horizon 2020 funded projects, show that the future trends in this field are aiming to close the loop with automated patient monitoring, real-time evaluations and more precise interventions.
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Affiliation(s)
- Kostas M Tsiouris
- Biomedical Engineering Laboratory, School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece.,Unit of Medical Technology and Intelligent Information Systems, Department of Material Science and Engineering, University of Ioannina, Ioannina, Greece
| | - Vassilios D Tsakanikas
- Unit of Medical Technology and Intelligent Information Systems, Department of Material Science and Engineering, University of Ioannina, Ioannina, Greece
| | - Dimitrios Gatsios
- Unit of Medical Technology and Intelligent Information Systems, Department of Material Science and Engineering, University of Ioannina, Ioannina, Greece.,Department of Neurology, Medical School, University of Ioannina, Ioannina, Greece
| | - Dimitrios I Fotiadis
- Unit of Medical Technology and Intelligent Information Systems, Department of Material Science and Engineering, University of Ioannina, Ioannina, Greece.,Department of Biomedical Research, Institute of Molecular Biology and Biotechnology, Foundation for Research and Technology - Hellas, Ioannina, Greece
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15
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Larsen B, Greenstadt ED, Olesen BL, Marcus BH, Godino J, Zive MM. An mHealth Physical Activity Intervention for Latina Adolescents: Iterative Design of the Chicas Fuertes Study. JMIR Form Res 2021; 5:e26195. [PMID: 34128823 PMCID: PMC8277403 DOI: 10.2196/26195] [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: 12/01/2020] [Revised: 02/17/2021] [Accepted: 04/17/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Only 3% of Latina teens meet the national physical activity (PA) guidelines, and these habits appear to persist into adulthood. Developing effective interventions to increase PA in Latina teens is necessary to prevent disease and reduce disparities. Mobile technologies may be especially appropriate for this population, but mobile health (mHealth) intervention content must be designed in collaboration with the target population. OBJECTIVE This study aims to develop an mHealth PA intervention for Latina adolescents using a multistage iterative process based on the principles of human-centered design and multiple iterations of the design phase of the IDEAS (Integrate, Design, Assess, Share) framework. METHODS On the basis of the feedback from a previous pilot study, the planned intervention included visual social media posts and text messaging, a commercial wearable tracker, and a primarily visual website. The development of the requested mHealth intervention components was accomplished through the following 2 phases: conducting focus groups with the target population and testing the usability of the final materials with a youth advisory board (YAB) comprising Latina adolescents. Participants for focus groups (N=50) were girls aged 13-18 years who could speak and read in English and who were recruited from local high schools and after-school programs serving a high proportion of Latinos. Facilitated discussions focused on experience with PA and social media apps and specific feedback on intervention material prototypes and possible names and logos. Viable products were designed based on their feedback and then tested for usability by the YAB. YAB members (n=4) were Latinas aged 13-18 years who were not regularly active and were recruited via word of mouth and selected through an application process. RESULTS The focus group discussions yielded the following findings: PA preferences included walking, running, and group fitness classes, whereas the least popular activities were running, swimming, and biking. Most participants (n=48, 96%) used some form of social media, with Instagram being the most favored. Participants preferred text messages to be sent no more than once per day, be personalized, and be positively worded. The focus group participants preferred an intervention directly targeting Latinas and social media posts that were brightly colored, included girls of all body types, and provided specific tips and information. Modified intervention materials were generally perceived favorably by the YAB members, who provided suggestions for further refinement, including the shortening of texts and the incorporation of some Spanish phrases. CONCLUSIONS Latina teens were generally enthusiastic about an mHealth PA intervention, provided that the materials were targeted specifically to them and their preferences. Through multiple iterations of development and feedback from the target population, we gained insight into the needs of Latina teens and joined with industry partners to build a viable final product.
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Affiliation(s)
- Britta Larsen
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, San Diego, CA, United States
| | - Emily D Greenstadt
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, San Diego, CA, United States
| | - Brittany L Olesen
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, San Diego, CA, United States
| | - Bess H Marcus
- Department of Behavioral and Social Sciences, Brown University, Providence, RI, United States
| | - Job Godino
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, San Diego, CA, United States
| | - Michelle M Zive
- Department of Pediatrics, University of California, San Diego, San Diego, CA, United States
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16
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Fakih El Khoury C, Crutzen R, Schols JM, Halfens RJ, Karavetian M. Adequate Management of Phosphorus in Patients Undergoing Hemodialysis Using a Dietary Smartphone App: Prospective Pilot Study. JMIR Form Res 2021; 5:e17858. [PMID: 34061034 PMCID: PMC8207257 DOI: 10.2196/17858] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 11/18/2020] [Accepted: 04/04/2021] [Indexed: 12/28/2022] Open
Abstract
Background The renal diet is complex and requires alterations of the diet and careful monitoring of various nutrients. Elevated serum phosphorus is common among patients undergoing hemodialysis, and it is associated with many complications. Smartphone technology could be used to support both dietitians and patients by providing a source of accessible and reliable information. Objective The aim of this pilot is to assess the potential efficacy of an intervention using the educational and self-monitoring mobile app KELA.AE on the phosphorous management in hemodialysis patients. Results will be used to improve both the app and a planned, rigorous large-scale trial intended to assess app efficacy. Methods This is a prospective pilot study performed at the hemodialysis unit of Al Qassimi Hospital (Emirate of Sharjah, United Arab Emirates). All patients were assessed for eligibility and, based on inclusion criteria, considered for enrollment. Participants met with a dietitian once a week and used the mobile app regularly for 2 weeks. Outcomes (knowledge, self-reported nonadherence, dietary intake, anthropometry, and biochemical data) were measured. This pilot is reported as per guidelines for nonrandomized pilot and feasibility studies and in line with the CONSORT (Consolidated Standards of Reporting Trials) 2010 checklist for reporting pilot or feasibility trials. Results Of 26 subjects, 23 successfully completed the pilot. Patient dietary knowledge about phosphorous management improved from 51.4% (SD 13.9) to 68.1% (SD 13.3) after intervention with a large effect size (d=1.22, 95% CI 0.59 to 1.85). Dietary protein intake increased from a mean of 0.9 g/kg (SD 0.3) per day to a mean of 1.3 g/kg (SD 0.5) per day with a large effect size (d=1.07, 95% CI 0.45 to 1.69). Phosphorus to protein ratio dropped from a mean of 18.4 mg/g protein to 13.5 mg/g protein with a large effect size (d=0.83, 95% CI 0.22 to 1.43). There was no evidence of change in phosphorous intake, self-reported nonadherence, and serum phosphorus. Conclusions The findings of this prospective pilot reveal the potential efficacy of a smartphone app as a supportive nutrition education tool for phosphorus management in patients undergoing hemodialysis. This pilot study showed that the KELA.AE app has the potential to improve knowledge and dietary choices. A rigorous randomized controlled trial should be performed to evaluate the efficacy, assessing app use of a long-term intervention.
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Affiliation(s)
- Cosette Fakih El Khoury
- Department of Health Services Research, Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | - Rik Crutzen
- Department of Health Promotion, Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | - Jos Mga Schols
- Department of Health Services Research, Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | - Ruud Jg Halfens
- Care and Public Health Research Institute, Department of Health Services Research, Maastricht University, Maastricht, Netherlands
| | - Mirey Karavetian
- Department of Health Sciences, Zayed University, Dubai, United Arab Emirates
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17
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Asensio-Cuesta S, Blanes-Selva V, Conejero JA, Frigola A, Portolés MG, Merino-Torres JF, Rubio Almanza M, Syed-Abdul S, Li YCJ, Vilar-Mateo R, Fernandez-Luque L, García-Gómez JM. A User-Centered Chatbot (Wakamola) to Collect Linked Data in Population Networks to Support Studies of Overweight and Obesity Causes: Design and Pilot Study. JMIR Med Inform 2021; 9:e17503. [PMID: 33851934 PMCID: PMC8087340 DOI: 10.2196/17503] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 10/05/2020] [Accepted: 02/20/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Obesity and overweight are a serious health problem worldwide with multiple and connected causes. Simultaneously, chatbots are becoming increasingly popular as a way to interact with users in mobile health apps. OBJECTIVE This study reports the user-centered design and feasibility study of a chatbot to collect linked data to support the study of individual and social overweight and obesity causes in populations. METHODS We first studied the users' needs and gathered users' graphical preferences through an open survey on 52 wireframes designed by 150 design students; it also included questions about sociodemographics, diet and activity habits, the need for overweight and obesity apps, and desired functionality. We also interviewed an expert panel. We then designed and developed a chatbot. Finally, we conducted a pilot study to test feasibility. RESULTS We collected 452 answers to the survey and interviewed 4 specialists. Based on this research, we developed a Telegram chatbot named Wakamola structured in six sections: personal, diet, physical activity, social network, user's status score, and project information. We defined a user's status score as a normalized sum (0-100) of scores about diet (frequency of eating 50 foods), physical activity, BMI, and social network. We performed a pilot to evaluate the chatbot implementation among 85 healthy volunteers. Of 74 participants who completed all sections, we found 8 underweight people (11%), 5 overweight people (7%), and no obesity cases. The mean BMI was 21.4 kg/m2 (normal weight). The most consumed foods were olive oil, milk and derivatives, cereals, vegetables, and fruits. People walked 10 minutes on 5.8 days per week, slept 7.02 hours per day, and were sitting 30.57 hours per week. Moreover, we were able to create a social network with 74 users, 178 relations, and 12 communities. CONCLUSIONS The Telegram chatbot Wakamola is a feasible tool to collect data from a population about sociodemographics, diet patterns, physical activity, BMI, and specific diseases. Besides, the chatbot allows the connection of users in a social network to study overweight and obesity causes from both individual and social perspectives.
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Affiliation(s)
- Sabina Asensio-Cuesta
- Instituto de Tecnologías de la Información y Comunicaciones, Universitat Politècnica de València, Valencia, Spain
| | - Vicent Blanes-Selva
- Instituto de Tecnologías de la Información y Comunicaciones, Universitat Politècnica de València, Valencia, Spain
| | - J Alberto Conejero
- Instituto Universitario de Matemática Pura y Aplicada, Universitat Politècnica de València, Valencia, Spain
| | - Ana Frigola
- Department of Nutrition and Food Science, Universitat de València, Valencia, Spain
| | - Manuel G Portolés
- Instituto Universitario de Matemática Pura y Aplicada, Universitat Politècnica de València, Valencia, Spain
| | | | - Matilde Rubio Almanza
- Department of Endocrinology and Nutrition, Hospital La Fe, Universitat de València, Valencia, Spain
| | - Shabbir Syed-Abdul
- International Center for Health Information Technology, Taipei Medical University, Taipei, Taiwan
| | - Yu-Chuan Jack Li
- International Center for Health Information Technology, Taipei Medical University, Taipei, Taiwan
| | - Ruth Vilar-Mateo
- Unidad Mixta de Tic aplicadas a la reingeniería de procesos socio-sanitarios, Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | | | - Juan M García-Gómez
- Instituto de Tecnologías de la Información y Comunicaciones, Universitat Politècnica de València, Valencia, Spain
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Choi J, Chung C, Woo H. Diet-Related Mobile Apps to Promote Healthy Eating and Proper Nutrition: A Content Analysis and Quality Assessment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073496. [PMID: 33800531 PMCID: PMC8037032 DOI: 10.3390/ijerph18073496] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 03/25/2021] [Accepted: 03/26/2021] [Indexed: 12/31/2022]
Abstract
Dietary mobile applications (apps) continue to hold promise for facilitating a healthy diet and managing nutrition. However, few studies have objectively evaluated the content and quality of such apps in Korea. The present study assessed the content and quality of dietary mobile apps using the Mobile App Rating Scale (MARS). We selected 29 dietary apps based on keywords and eligibility criteria for inclusion in the analyses. We conducted regression analyses to examine the association between app content and MARS scores. Most of the apps featured a tracking tool, while few featured rewards or follow-up management. Our quality assessment revealed that the top-rated apps have distinct levels of quality in terms of MARS scores. The regression analyses showed that the ways in which the apps provide information and motivate the users are statistically significant predictors of app quality. Our findings may facilitate the selection of dietary apps in Korea and provide guidelines for app developers regarding potential improvements in terms of content and quality.
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Affiliation(s)
- Jihye Choi
- Department of Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston School of Public Health, Houston, TX 77030, USA;
| | - Chongwook Chung
- Department of Biomedical Engineering, Ulsan National Institute of Science and Technology, Ulsan 44919, Korea;
| | - Hyekyung Woo
- Department of Health Administration, Kongju National University, Chungnam 32588, Korea
- Correspondence:
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19
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Saparamadu AADNS, Fernando P, Zeng P, Teo H, Goh A, Lee JMY, Lam CWL. User-Centered Design Process of an mHealth App for Health Professionals: Case Study. JMIR Mhealth Uhealth 2021; 9:e18079. [PMID: 33769297 PMCID: PMC8088861 DOI: 10.2196/18079] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 06/19/2020] [Accepted: 08/10/2020] [Indexed: 01/16/2023] Open
Abstract
Background User-centered design processes are infrequently employed and not fully explored for building mobile health (mHealth) apps that are particularly targeted to health professionals as end users. The authors have used a user-centered design–based approach to build an mHealth app for health professionals, tasked to deliver medical laboratory-related information on a daily basis. Objective Our objective is to generate a simple and functional user-centered design process for mHealth apps for health professionals. This paper presents the key learnings from design activities. Methods A stratified random sample of doctors and nurses was recruited for the study. The design activities were planned in the following sequence: focus group discussion for situation analysis and information architecture, design activity 1 for wireframe designing, design activity 2 for wireframe testing, and user testing sessions 1 and 2. Results The final design and functions of the app, information architecture, and interactive elements were largely influenced by the participatory design–based user-centered design activities. As a result of the design process, we could identify the mental models of processing requests for information and personal preferences based on the experience. These findings were directly or indirectly incorporated into the app design.
Furthermore, finding alternative ways of working within time constraints and cultural barriers and the methods employed to manage the challenges of interdisciplinary discourse stood out among the lessons learned. Conclusions We recommend a user-centered design process based on a participatory design approach in mHealth app design, enriched with focus group discussions where possible.
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Affiliation(s)
| | - Piyum Fernando
- School of Arts, Media, and Engineering, Arizona State University, Tempe, AZ, United States
| | - Peizi Zeng
- Department of Laboratory Medicine, Ng Teng Fong General Hospital, Singapore, Singapore
| | - Henry Teo
- Department of Laboratory Medicine, Ng Teng Fong General Hospital, Singapore, Singapore
| | - Andrew Goh
- Department of Laboratory Medicine, Ng Teng Fong General Hospital, Singapore, Singapore
| | - Joanne Mee Yin Lee
- Department of Laboratory Medicine, Ng Teng Fong General Hospital, Singapore, Singapore
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20
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Healthy Lifestyle Management of Pediatric Obesity with a Hybrid System of Customized Mobile Technology: The PediaFit Pilot Project. Nutrients 2021; 13:nu13020631. [PMID: 33669174 PMCID: PMC7919673 DOI: 10.3390/nu13020631] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 01/28/2021] [Accepted: 02/08/2021] [Indexed: 12/12/2022] Open
Abstract
Pediatric obesity management strategies suffer from a high rate of dropout and persistence of weight excess, despite the use of new tools, such as automated mobile technology (MT). We aimed to compare the efficacy of two 6-month personalized MT protocols in terms of better engagement, adherence to follow-up visits and improved anthropometric and lifestyle parameters. MT contacts consisted of three personalized/not automated What's App® self-monitoring or challenge messages per week. Messages, sent by a dedicated coach were inserted between three-monthly in-presence regular visits with (PediaFit 1.2) or without (PediaFit 1.1) monthly free-of charge short recall visits carried out by a specialized pediatric team. The sample included 103 children (mean age 10 years, range 6-14) recruited in the Pediatric Obesity Clinic between January 2017 and February 2019, randomized into Intervention group (IG) (n = 24 PediaFit 1.1; n = 30 PediaFit 1.2) and Control group (CG) (total n = 49). Controls received standard treatment only (indications for healthy nutrition and physical activity, and three months in presence regular visits). Overall, both IGs achieved significantly better results than the CGs for all considered parameters. Comparison of the two IGs at the sixth month in particular showed an IG 1.2 statistically significantly lower drop-out rate (10% vs. 62%, p = 0.00009), along with significantly improved BMI (p = 0.003), Screen Time (p = 0.04) and fruit and vegetables consumption (p = 0.02). The study suggests that the hybrid association of messaging through personalized/not automated MT plus monthly free-of charge recall visits may improve the prefixed outcomes of MT weight loss intervention programs.
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21
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Lobo EH, Frølich A, Kensing F, Rasmussen LJ, Livingston PM, Grundy J, Abdelrazek M. mHealth applications to support caregiver needs and engagement during stroke recovery: A content review. Res Nurs Health 2020; 44:213-225. [PMID: 33341958 DOI: 10.1002/nur.22096] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 11/23/2020] [Accepted: 12/03/2020] [Indexed: 12/15/2022]
Abstract
Caregiving in stroke results in severe physical, psychological, and social impacts on the caregiver. Over the past few years, researchers have explored the use of mHealth technologies to support healthcare-related activities due to their ability to provide real-time care at any given place or time. The purpose of this content review is to investigate mHealth apps in supporting stroke caregiving engagement based on three aspects: motivation, value, and satisfaction. We searched app stores and repositories for apps related to stroke caregiving published up to September 2020. Extracted apps were reviewed and filtered using inclusion criteria, and then downloaded onto compatible devices to determine eligibility. Results were compared with evidence-based frameworks to identify the ability of these apps in engaging and supporting the caregiver. Forty-seven apps were included in this review that enabled caregivers to support their needs, such as adjustment to new roles and relationships, involvement in care and caring for oneself using several different functionalities. These functionalities include information resources, risk assessment, remote monitoring, data sharing, reminders and so on. However, no single app was identified that focuses on all aspects of stroke caregiving. We also identified several challenges faced by users through their reviews and the factors associated with value and satisfaction. Our findings can add to the knowledge of existing mHealth technologies and their functionalities to support stroke caregiving needs, and the importance of considering user engagement in the design. They can be used by developers and researchers looking to design better mHealth apps for stroke caregiving.
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Affiliation(s)
- Elton H Lobo
- Faculty of Science, Engineering and Built Environment, Deakin University, Geelong, Victoria, Australia.,Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Anne Frølich
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Innovation and Research Centre for Multimorbidity, Slagelse Hospital, Region Zealand, Denmark
| | - Finn Kensing
- Department of Computer Science, University of Copenhagen, Copenhagen, Denmark
| | - Lene J Rasmussen
- Department of Cellular and Molecular Medicine, University of Copenhagen, Copenhagen, Denmark.,Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
| | | | - John Grundy
- Faculty of Information Technology, Monash University, Melbourne, Victoria, Australia
| | - Mohamed Abdelrazek
- Faculty of Science, Engineering and Built Environment, Deakin University, Geelong, Victoria, Australia
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22
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Perego P, Rashid R, Gluud C, Jakobsen JC, Andreoni G, Lissau I. Comparison of different mobile health applications for intervention in children and adolescent with overweight: a protocol for systematic review with meta-analysis and trial sequential analysis. BMJ Open 2020; 10:e032570. [PMID: 33293302 PMCID: PMC7722812 DOI: 10.1136/bmjopen-2019-032570] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 07/07/2020] [Accepted: 08/12/2020] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION Overweight in children is increasing worldwide. Innovative smartphone health applications (mHealth apps) have either sought to deliver single or multi-component interventions for the management of overweight in children. However, the clinical effects of these apps are poorly explored. The objective of the review will be to compare the benefits and harms of different categories of mHealth apps for intervention of overweight in children. METHODS AND ANALYSIS We will include randomised clinical trials irrespective of publication type, year, status or language. Children and adolescents between 0 to 18 years will be referred to as children in the remaining part of the paper. Children with all degrees of overweight included obesity and morbidly obese in the remaining part of the paper will be referred to as overweight. We plan to classify different apps according to type of intervention, measurement device, coaching and reward system. The following databases will be used: Cochrane Library, Excerpta Medica database (Embase), PsycINFO, PubMed, IEEE Explore and Web of Science, CINAHL and LILACS. Primary outcomes will be body mass index z-score, quality of life and serious adverse event. Secondary outcomes will be body weight, self-efficacy, anxiety, depression and adverse event not considered serious. Study inclusion, data extraction and bias risk assessment will be conducted independently by at least two authors. We will assess the risk of bias through eight domains and control risks of random errors with Trial Sequential Analysis. The quality of the evidence will be assessed using Grading of Recommendations Assessment, Development and Evaluation Tool (GRADE). ETHICS AND DISSEMINATION As the protocol is for a systematic reviews, we have not included any patient data and we do not require ethical approval. This review will be published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER CRD42019120266.
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Affiliation(s)
- Paolo Perego
- Design Department, Politecnico di Milano, Milano, MI, Italy
| | - Rajeeb Rashid
- Department of Child Life and Health, The University of Edinburgh, Edinburgh, UK
| | - Christian Gluud
- The Copenhagen Trial Unit, Centre for Clinical Intervention Research, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Janus C Jakobsen
- The Copenhagen Trial Unit, Centre for Clinical Intervention Research, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Cardiology, Holbaek Sygehus, Holbaek, Sjaelland, Denmark
| | | | - Inge Lissau
- Clinical Research Centre, University Hospital Copenhagen, Copenhagen, Hvidovre, Denmark
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Effectiveness of Diet Habits and Active Life in Vocational Training for Higher Technician in Dietetics: Contrast between the Traditional Method and the Digital Resources. Nutrients 2020; 12:nu12113475. [PMID: 33198316 PMCID: PMC7698261 DOI: 10.3390/nu12113475] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 11/07/2020] [Accepted: 11/11/2020] [Indexed: 01/05/2023] Open
Abstract
Vocational training of students in diet habits and active lifestyle habits has recently become an important issue, given the health problems caused as a result of a poor diet. The objective of this study is to analyze the effectiveness of different training actions (traditional method and digital resources) carried out in a program of dietary habits and active lifestyle at the vocational training stage. A quasi-experimental design of the pre-post type was developed. A sample of 177 participants was chosen. The instrument to collect the data was the validated ECHAES questionnaire. The results show that all study groups demonstrated similar averages across all dimensions, except in the digital resource post-test design, where the averages were higher than the rest. There was a significant relationship between the traditional teaching method and the post-test digital resources design in all dimensions. There was also a significant relationship between the pre-test and post-test of the traditional teaching method and the digital resource group in the dimensions. It can be concluded that both the traditional and the innovative method lead to learning in the vocational training student, although the values achieved by the group where the innovative method was adopted were much higher than in the traditional group.
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24
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Li J, Maharjan B, Xie B, Tao C. A Personalized Voice-Based Diet Assistant for Caregivers of Alzheimer Disease and Related Dementias: System Development and Validation. J Med Internet Res 2020; 22:e19897. [PMID: 32955452 PMCID: PMC7536606 DOI: 10.2196/19897] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 07/22/2020] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND The world's aging population is increasing, with an expected increase in the prevalence of Alzheimer disease and related dementias (ADRD). Proper nutrition and good eating behavior show promise for preventing and slowing the progression of ADRD and consequently improving patients with ADRD's health status and quality of life. Most ADRD care is provided by informal caregivers, so assisting caregivers to manage patients with ADRD's diet is important. OBJECTIVE This study aims to design, develop, and test an artificial intelligence-powered voice assistant to help informal caregivers manage the daily diet of patients with ADRD and learn food and nutrition-related knowledge. METHODS The voice assistant is being implemented in several steps: construction of a comprehensive knowledge base with ontologies that define ADRD diet care and user profiles, and is extended with external knowledge graphs; management of conversation between users and the voice assistant; personalized ADRD diet services provided through a semantics-based knowledge graph search and reasoning engine; and system evaluation in use cases with additional qualitative evaluations. RESULTS A prototype voice assistant was evaluated in the lab using various use cases. Preliminary qualitative test results demonstrate reasonable rates of dialogue success and recommendation correctness. CONCLUSIONS The voice assistant provides a natural, interactive interface for users, and it does not require the user to have a technical background, which may facilitate senior caregivers' use in their daily care tasks. This study suggests the feasibility of using the intelligent voice assistant to help caregivers manage patients with ADRD's diet.
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Affiliation(s)
- Juan Li
- North Dakota State University, Fargo, ND, United States
| | | | - Bo Xie
- University of Texas, Austin, TX, United States
| | - Cui Tao
- University of Texas Health Science Center at Houston, Houston, TX, United States
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25
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Alenazi HA, Jamal A, Batais MA. Identification of Type 2 Diabetes Management Mobile App Features and Engagement Strategies: Modified Delphi Approach. JMIR Mhealth Uhealth 2020; 8:e17083. [PMID: 32678798 PMCID: PMC7519429 DOI: 10.2196/17083] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Revised: 04/25/2020] [Accepted: 06/03/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Diabetes is a significant public health issue. Saudi Arabia has the highest prevalence of type 2 diabetes mellitus (T2DM) in the Arab world. Currently, it affects 31.6% of the general population, and the prevalence of T2DM is predicted to rise to 45.36% by 2030. Mobile health (mHealth) offers improved and cost-effective care to people with T2DM. However, the efficiency of engagement strategies and features of this technology need to be reviewed and standardized according to stakeholder and expert perspectives. OBJECTIVE The main objective of this study was to identify the most agreed-upon features for T2DM self-management mobile apps; the secondary objective was to identify the most agreed-upon strategies that prompt users to use these apps. METHODS In this study, a 4-round modified Delphi method was applied by experts in the domain of diabetes care. RESULTS In total, 11 experts with a mean age of 47.09 years (SD 11.70) consented to participate in the study. Overall, 36 app features were generated. The group of experts displayed weak agreement in their ranking of intervention components (Kendall W=0.275; P<.001). The top 5 features included insulin dose adjustment according to carbohydrate counting and blood glucose readings (5.36), alerting a caregiver of abnormal or critical readings (6.09), nutrition education (12.45), contacts for guidance if required (12.64), and offering patient-specific education tailored to the user's goals, needs, and blood glucose readings (12.90). In total, 21 engagement strategies were generated. Overall, the experts showed a moderate degree of consensus in their strategy rankings (Kendall W=0.454; P<.001). The top 5 engagement strategies included a user-friendly design (educational and age-appropriate design; 2.82), a free app (3.73), allowing the user to communicate or send information/data to a health care provider (HCP; 5.36), HCPs prescribing the mobile app in the clinic and asking about patients' app use compliance during clinical visits (6.91), and flexibility and customization (7.91). CONCLUSIONS This is the first study in the region consisting of a local panel of experts from the diabetes field gathering together. We used an iterative process to combine the experts' opinions into a group consensus. The results of this study could thus be useful for health app developers and HCPs and inform future decision making on the topic.
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Affiliation(s)
| | - Amr Jamal
- Family and Community Medicine Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia.,Research Chair of Evidence-Based Healthcare and Knowledge Translation, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed A Batais
- Family and Community Medicine Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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26
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Infant’s growth and nutrition monitoring system. SN APPLIED SCIENCES 2020. [DOI: 10.1007/s42452-020-03264-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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27
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Gilbert E, Collins R, Webster V, Boyd N, Maple-Brown L, Boyle J, Smith-Vaughan H. Using co-design to develop a culturally responsive reproductive health learning resource for Aboriginal and Torres Strait Islander youth. Health Promot J Austr 2020; 32 Suppl 1:179-185. [PMID: 32726480 DOI: 10.1002/hpja.392] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 07/21/2020] [Indexed: 11/12/2022] Open
Abstract
ISSUE ADDRESSED Healthy behaviours prior to conception can improve pregnancy outcomes and intergenerational health. Adolescence is an important period to promote preconception health, but education resources need to be age and culturally appropriate. Few studies have addressed preconception awareness and knowledge among Aboriginal and Torres Strait Islander youth, and few culturally appropriate resources exist. METHODS A mixed methods, co-design process engaging Aboriginal and Torres Strait Islander youth and an Indigenous Reference Group (IRG). Additionally, a survey was carried out to identify preconception health awareness and interest among a broader youth audience. RESULTS Several main themes emerged from consultation meetings with youth reflecting an awareness of preconception health, but limited understanding. Youth revealed an interest in fertility, and a need for more information on lifestyle factors associated with infertility. Preconception information related to the opposite sex was seen as important as well as information incorporating current local knowledge and world views. Among the survey respondents, 46% (11/24) had a pre-existing understanding of preconception health. Optimising lifestyle behaviours prior to pregnancy was perceived as important for women (21/24; 88%), but less so for men (16/24; 67%), highlighting a gap in knowledge regarding the importance of preconception health for men. CONCLUSION The co-designed resource "Getting healthy before pregnancy" is available in print and electronically, with illustrations and synchronised audio overlay in Aboriginal English or East-side Kriol. The resource includes information on preconception health and behavioural risk factors. SO WHAT We present a co-designed preconception health resource for evaluation with Aboriginal and Torres Strait Islander youth.
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Affiliation(s)
- Emily Gilbert
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Clayton, VIC, Australia
| | | | - Vanya Webster
- Menzies School of Health Research, Casuarina, NT, Australia
| | - Nicole Boyd
- Menzies School of Health Research, Casuarina, NT, Australia
| | - Louise Maple-Brown
- Menzies School of Health Research, Casuarina, NT, Australia.,Division of Medicine, Royal Darwin Hospital, Darwin, NT, Australia
| | - Jacqueline Boyle
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Clayton, VIC, Australia
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Gonzalez-Ramirez M, Cejudo-Lopez A, Lozano-Navarrete M, Salamero Sánchez-Gabriel E, Torres-Bengoa A, Segura-Balbuena M, Sanchez-Cordero MJ, Barroso-Vazquez M, Perez-Barba FJ, Troncoso AM, Garcia-Parrilla MC, Cerezo AB. SAlBi educa: A promising, tailored nutrition app for promoting healthy eating habits (Preprint). JMIR Form Res 2020. [DOI: 10.2196/23060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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29
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Education and Diet in the Scientific Literature: A Study of the Productive, Structural, and Dynamic Development in Web of Science. SUSTAINABILITY 2020. [DOI: 10.3390/su12124838] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Nutrition-related education is necessary to protect and improve the health status of schoolchildren and to minimize the risk of future diseases. The objective of this research was to analyze the trajectory and transcendence of the concepts “education” and “diet” in the Web of Science literature. The methodology focused on bibliometry, analyzing both the performance and the structural and dynamic development of the concepts through a co-word analysis. A total of 1247 documents were analyzed, and the results show that scientific production experienced a turning point in 2009, in comparison to the level of production reported in previous years. The medium of papers and the language of English were the most common. In relation to the research topic, before 2014, scientific production focused on medical and disease-related aspects; however, since 2014, it has focused on disease prevention and feeding. It was therefore concluded that the theme “diet and education” has been researched for more than 20 years, although it is only in the last decade that it has become more relevant—particularly studies focusing on disease prevention and the type of food, specifically fruit, which is presented as the most outstanding issue for researchers in this field of knowledge.
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Tully L, Burls A, Sorensen J, El-Moslemany R, O'Malley G. Mobile Health for Pediatric Weight Management: Systematic Scoping Review. JMIR Mhealth Uhealth 2020; 8:e16214. [PMID: 32490849 PMCID: PMC7301268 DOI: 10.2196/16214] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 01/13/2020] [Accepted: 01/23/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The prevalence and consequences of obesity among children and adolescents remain a leading global public health concern, and evidence-based, multidisciplinary lifestyle interventions are the cornerstone of treatment. Mobile electronic devices are widely used across socioeconomic categories and may provide a means of extending the reach and efficiency of health care interventions. OBJECTIVE We aimed to synthesize the evidence regarding mobile health (mHealth) for the treatment of childhood overweight and obesity to map the breadth and nature of the literature in this field and describe the characteristics of published studies. METHODS We conducted a systematic scoping review in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews, by searching nine academic databases in addition to gray literature for studies describing acceptability, usability, feasibility, effectiveness, adherence, or cost-effectiveness of interventions assessing mHealth for childhood obesity treatment. We also hand searched the reference lists of relevant articles. Studies aimed at the prevention of overweight or obesity were excluded, as were studies in which mHealth was not the primary mode of treatment delivery for at least one study arm or was not independently assessed. A random portion of all abstracts and full texts was double screened by a second reviewer to ensure consistency. Data were charted according to study characteristics, including design, participants, intervention content, behavior change theory (BCT) underpinning the study, mode of delivery, and outcomes measured. RESULTS We identified 42 eligible studies assessing acceptability (n=7), usability (n=2), feasibility or pilot studies (n=15), treatment effect (n=17), and fidelity (n=1). Change in BMI z-scores or percentiles was most commonly measured, among a variety of dietary, physical activity, psychological, and usability or acceptability measures. SMS, mobile apps, and wearable devices made up the majority of mobile interventions, and 69% (29/42) of the studies specified a BCT used. CONCLUSIONS Pediatric weight management using mHealth is an emerging field, with most work to date aimed at developing and piloting such interventions. Few large trials are published, and these are heterogeneous in nature and rarely reported according to the Consolidated Standards of Reporting Trials for eHealth guidelines. There is an evidence gap in the cost-effectiveness analyses of such studies.
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Affiliation(s)
- Louise Tully
- School of Physiotherapy, Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Amanda Burls
- School of Health Sciences, Division of Health Services Research and Management, City University of London, London, United Kingdom
| | - Jan Sorensen
- Healthcare Outcomes Research Centre, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Riyad El-Moslemany
- Department of Psychology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Grace O'Malley
- School of Physiotherapy, Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
- W82GO Child and Adolescent Weight Management Service, Children's Health Ireland at Temple Street, Dublin, Ireland
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Brown JM, Savaglio R, Watson G, Kaplansky A, LeSage A, Hughes J, Kapralos B, Arcand J. Optimizing Child Nutrition Education With the Foodbot Factory Mobile Health App: Formative Evaluation and Analysis. JMIR Form Res 2020; 4:e15534. [PMID: 32301743 PMCID: PMC7195667 DOI: 10.2196/15534] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 11/25/2019] [Accepted: 01/27/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Early nutrition interventions to improve food knowledge and skills are critical in enhancing the diet quality of children and reducing the lifelong risk of chronic disease. Despite the rise of mobile health (mHealth) apps and their known effectiveness for improving health behaviors, few evidence-based apps exist to help engage children in learning about nutrition and healthy eating. OBJECTIVE This study aimed to describe the iterative development and user testing of Foodbot Factory, a novel nutrition education gamified app for children to use at home or in the classroom and to present data from user testing experiments conducted to evaluate the app. METHODS An interdisciplinary team of experts in nutrition, education (pedagogy), and game design led to the creation of Foodbot Factory. First, a literature review and an environmental scan of the app marketplace were conducted, and stakeholders were consulted to define the key objectives and content of Foodbot Factory. Dietitian and teacher stakeholders identified priority age groups and learning objectives. Using a quasi-experimental mixed method design guided by the Iterative Convergent Design for Mobile Health Usability Testing approach, five app user testing sessions were conducted among students (ages 9-12 years). During gameplay, engagement and usability were assessed via direct observations with a semistructured form. After gameplay, qualitative interviews and questionnaires were used to assess user satisfaction, engagement, usability, and knowledge gained. RESULTS The environmental scan data revealed that few evidence-based nutrition education apps existed for children. A literature search identified key nutrients of concern for Canadian children and techniques that could be incorporated into the app to engage users in learning. Foodbot Factory included characters (2 scientists and Foodbots) who initiate fun and engaging dialogue and challenges (minigames), with storylines incorporating healthy eating messages that align with the established learning objectives. A total of five modules were developed: drinks, vegetables and fruit, grain foods, animal protein foods, and plant protein foods. Seven behavior change techniques and three unique gamified components were integrated into the app. Data from each user testing session were used to inform and optimize the next app iteration. The final user testing session demonstrated that participants agreed that they wanted to play Foodbot Factory again (12/17, 71%), that the app is easy to use (12/17, 71%) and fun (14/17, 88%), and that the app goals were clearly presented (15/17, 94%). CONCLUSIONS Foodbot Factory is an engaging and educational mHealth intervention for the Canadian public that is grounded in evidence and developed by an interdisciplinary team of experts. The use of an iterative development approach is a demonstrated method to improve engagement, satisfaction, and usability with each iteration. Children find Foodbot Factory to be fun and easy to use, and can engage children in learning about nutrition.
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Affiliation(s)
- Jacqueline Marie Brown
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, ON, Canada
| | - Robert Savaglio
- Faculty of Business & Information Technology, University of Ontario Institute of Technology, Oshawa, ON, Canada
| | - Graham Watson
- Faculty of Business & Information Technology, University of Ontario Institute of Technology, Oshawa, ON, Canada
| | - Allison Kaplansky
- Faculty of Community Services, Ryerson University, Toronto, ON, Canada
| | - Ann LeSage
- Faculty of Education, University of Ontario Institute of Technology, Oshawa, ON, Canada
| | - Janette Hughes
- Faculty of Education, University of Ontario Institute of Technology, Oshawa, ON, Canada
| | - Bill Kapralos
- Faculty of Business & Information Technology, University of Ontario Institute of Technology, Oshawa, ON, Canada
| | - JoAnne Arcand
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, ON, Canada
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32
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Brazendale K, Beets MW, Weaver RG, Turner-McGrievy B, Brazendale AB, Chandler JL, Moore JB, Huberty JL, Lemley J, Brownson RC. The application of mHealth to monitor implementation of best practices to support healthy eating and physical activity in afterschool programs. Glob Health Promot 2020; 27:33-40. [PMID: 29809105 PMCID: PMC11467714 DOI: 10.1177/1757975918768442] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Childhood obesity continues to be a global epidemic and many child-based settings (e.g. school, afterschool programs) have great potential to make a positive impact on children's health behaviors. Innovative and time-sensitive methods of gathering health behavior information for the purpose of evaluation and strategically deploying support are needed in these settings. PURPOSE The aim is to (1) demonstrate the feasibility of mobile health (mHealth) for monitoring implementation of healthy eating and physical activity (HEPA) standards and, (2) illustrate the utility of mHealth for identifying areas where support is needed, within the afterschool setting. METHODS Site leaders (N = 175) of afterschool programs (ASPs) were invited to complete an online observation checklist via a mobile web app (Healthy Eating and Physical Activity Mobile, HEPAm) once per week during ASP operating hours. Auto-generated weekly text reminders were sent to site leaders' mobile devices during spring and fall 2015 and 2016 and spring 2017 school semesters. Data from HEPAm was separated into HEPA variables, and expressed as a percent of checklists where an item was present. A higher percentage for a given item would indicate an afterschool has higher compliance with current HEPA standards. RESULTS A total of 141 site leaders of ASPs completed 13,960 HEPAm checklists. The average number of checklists completed per ASP was 43 (range 1-220) for healthy eating and 50 (range 1-230) for physical activity. For healthy eating, the most common challenge for ASPs was 'Staff educating children about healthy eating', and for physical activity checklists, 'Girls only physical activity is provided at ASP'. CONCLUSION HEPAm was widely used and provided valuable information that can be used to strategically deploy HEPA support to ASPs. This study gives confidence to the adoption of mHealth strategies as a means for public health practitioners to monitor compliance of an initiative or intervention.
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Eccher C, Gios L, Zanutto A, Bizzarri G, Conforti D, Forti S. TreC platform. An integrated and evolving care model for patients' empowerment and data repository. J Biomed Inform 2020; 102:103359. [PMID: 31917253 DOI: 10.1016/j.jbi.2019.103359] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 11/12/2019] [Accepted: 12/15/2019] [Indexed: 02/01/2023]
Abstract
INTRODUCTION Health care has been deeply revolutionized by the new wave of information and communication technology (ICT) development, particularly related to the electronic/personal health record (PHR). The present paper describes the original design and implementation approach followed in the Trentino Province (Italy) to promote an Integrated Care Model for patients' empowerment and data repository, by means of an evolving Personal Health Record - PHR platform, named TreC (Trentino Citizens Clinical Record). MATERIALS AND METHODS The TreC Platform is conceived as a communication hub among different stakeholders. The core assumption of the TreC platform strategy is to consider the citizen/patient as main manager and owner of both his/her own health and his/her contacts with the health care systems. RESULTS Over the years, the TreC platform has represented the core pillar in the digitalization process promoted at Province level. This has been strategically embedded in the multi-faceted e-government strategy endorsed by the Province of Trento. So far (October 2018), more than 89,000 citizens within the Province of Trento are using TreC platform as a way to communicate with the health care system and access their own personal health records. CONCLUSIONS The experience gained through the TreC platform implementation and its results are promising, supporting the idea that a PHR platform can represent a key driving factor in improving health care quality and efficiency, both from a patient and a health care staff perspective.
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Affiliation(s)
- Claudio Eccher
- Center for Information and Communication Technology, Fondazione Bruno Kessler, Trento, Italy.
| | - Lorenzo Gios
- TrentinoSalute 4.0, Competence Center for Digital Health, Trento, Italy
| | - Alberto Zanutto
- Center for Information and Communication Technology, Fondazione Bruno Kessler, Trento, Italy
| | | | | | - Stefano Forti
- Center for Information and Communication Technology, Fondazione Bruno Kessler, Trento, Italy
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Tropea P, Schlieter H, Sterpi I, Judica E, Gand K, Caprino M, Gabilondo I, Gomez-Esteban JC, Busnatu S, Sinescu C, Kyriazakos S, Anwar S, Corbo M. Rehabilitation, the Great Absentee of Virtual Coaching in Medical Care: Scoping Review. J Med Internet Res 2019; 21:e12805. [PMID: 31573902 PMCID: PMC6774233 DOI: 10.2196/12805] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 07/25/2019] [Accepted: 07/27/2019] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND In the last few years, several studies have focused on describing and understanding how virtual coaches (ie, coaching program or smart device aiming to provide coaching support through a variety of application contexts) could be key drivers for health promotion in home care settings. As there has been enormous technological progress in the field of artificial intelligence and data processing in the past decade, the use of virtual coaches gains an augmented attention in the considerations of medical innovations. OBJECTIVE This scoping review aimed at providing an overview of the applications of a virtual coach in the clinical field. In particular, the review focused on the papers that provide tangible information for coaching activities with an active implication for engaging and guiding patients who have an ongoing plan of care. METHODS We aimed to investigate the use of the term virtual coach in the clinical field performing a methodical review of the relevant literature indexed on PubMed, Scopus, and Embase databases to find virtual coach papers focused on specific activities dealing with clinical or medical contexts, excluding those aimed at surgical settings or electronic learning purposes. RESULTS After a careful revision of the inclusion and exclusion criteria, 46 records were selected for the full-text review. Most of the identified articles directly or indirectly addressed the topic of physical activity. Some papers were focused on the use of virtual coaching (VC) to manage overweight or nutritional issues. Other papers dealt with technological interfaces to facilitate interactions with patients suffering from different chronic clinical conditions such as heart failure, chronic obstructive pulmonary disease, depression, and chronic pain. CONCLUSIONS Although physical activity is a healthy practice that is most encouraged by a virtual coach system, in the current scenario, rehabilitation is the great absentee. This paper gives an overview of the tangible applications of this tool in the medical field and may inspire new ideas for future research on VC.
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Affiliation(s)
- Peppino Tropea
- Department of Neurorehabilitation Sciences, Casa Cura Policlinico, Milano, Italy
| | - Hannes Schlieter
- Chair of Wirtschaftsinformatik, esp. Systems Development, Faculty of Business and Economics, Technische Universität Dresden, Dresden, Germany
| | - Irma Sterpi
- Department of Neurorehabilitation Sciences, Casa Cura Policlinico, Milano, Italy
| | - Elda Judica
- Department of Neurorehabilitation Sciences, Casa Cura Policlinico, Milano, Italy
| | - Kai Gand
- Chair of Wirtschaftsinformatik, esp. Systems Development, Faculty of Business and Economics, Technische Universität Dresden, Dresden, Germany
| | - Massimo Caprino
- Department of Neurorehabilitation Sciences, Casa Cura Policlinico, Milano, Italy
| | - Inigo Gabilondo
- Neurology Department, Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Hospital Universitario Cruces, Barakaldo, Bizkaia, Spain.,Ikerbasque: The Basque Foundation for Science, Bilbao, Spain
| | - Juan Carlos Gomez-Esteban
- Neurology Department, Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Hospital Universitario Cruces, Barakaldo, Bizkaia, Spain
| | - Stefan Busnatu
- Universitatea de Medicina si Farmacie "Carol Davila", Bucuresti, Romania
| | - Crina Sinescu
- Universitatea de Medicina si Farmacie "Carol Davila", Bucuresti, Romania
| | - Sofoklis Kyriazakos
- Department of Business Development and Technology, Aarhus University, Aarhus, Denmark
| | - Sadia Anwar
- Department of Business Development and Technology, Aarhus University, Aarhus, Denmark
| | - Massimo Corbo
- Department of Neurorehabilitation Sciences, Casa Cura Policlinico, Milano, Italy
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Li Y, Ding J, Wang Y, Tang C, Zhang P. Nutrition-Related Mobile Apps in the China App Store: Assessment of Functionality and Quality. JMIR Mhealth Uhealth 2019; 7:e13261. [PMID: 31364606 PMCID: PMC6691672 DOI: 10.2196/13261] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Revised: 06/02/2019] [Accepted: 06/18/2019] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND There are an increasing number of mobile apps that provide dietary guidance to support a healthy lifestyle and disease management. However, the characteristics of these nutrition-related apps are not well analyzed. OBJECTIVE This study aimed to evaluate the functionality and quality of nutrition-related apps in China. METHODS Mobile apps providing dietary guidance were screened in the Chinese iOS and Android app stores in November 2017, using stepwise searching criteria. The first screening consisted of extracting information from the app descriptions. Apps that (1) were free, (2) contain information on diet and nutrition, and (3) were last updated after January 1, 2016, were downloaded for further analysis. Nutritional functionalities were determined according to the Chinese Dietary Guidelines framework. Market-related functionalities were developed from previous studies and tailored to downloaded apps. The quality of apps was assessed with the user version of the Mobile App Rating Scale (uMARS). RESULTS Out of 628 dietary guidance apps screened, 44 were nutrition-related. Of these, guidance was provided on diet exclusively (11/44, 25%), fitness (17/44, 39%), disease management (11/44, 25%), or maternal health (5/44, 11%). Nutritional functionalities included nutritional information inquiry (40/44, 91%), nutrition education (35/44, 80%), food record (34/44, 77%), diet analysis (34/44, 77%), and personalized recipes (21/44, 48%). Dietary analysis and suggestions mainly focused on energy intake (33/44, 75%) and less on other factors such as dietary structure (10/44, 23%). Social communication functionalities were available in 42 apps (96%), user incentives were supported in 26 apps (59%), and intelligent recognition technology was available in 8 apps (18%). The median score for the quality of the 44 apps, as determined on a 5-point uMARS scale, was 3.6 (interquartile range 0.7). CONCLUSIONS Most nutrition-related apps are developed for health management rather than for dietary guidance exclusively. Although basic principles of energy balance are used, their nutritional functionality was relatively limited and not individualized. More efforts should be made to develop nutrition-related apps with evidence-based nutritional knowledge, comprehensive and personalized dietary guidance, and innovative technology.
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Affiliation(s)
- Yuan Li
- The George Institute for Global Health at Peking University Health Science Center, Beijing, China.,Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Jingmin Ding
- The George Institute for Global Health at Peking University Health Science Center, Beijing, China
| | - Yishan Wang
- The George Institute for Global Health at Peking University Health Science Center, Beijing, China
| | - Chengyao Tang
- Public Health Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Puhong Zhang
- The George Institute for Global Health at Peking University Health Science Center, Beijing, China.,Faculty of Medicine, University of New South Wales, Sydney, Australia
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Debon R, Coleone JD, Bellei EA, De Marchi ACB. Mobile health applications for chronic diseases: A systematic review of features for lifestyle improvement. Diabetes Metab Syndr 2019; 13:2507-2512. [PMID: 31405669 DOI: 10.1016/j.dsx.2019.07.016] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 07/08/2019] [Indexed: 01/02/2023]
Abstract
AIMS To identify mobile health applications with features for improving the lifestyle of patients with chronic diseases. METHODS We performed a systematic literature review between November 2017 and May 2018 on the Virtual Health Library's interface. A total of 816 records were identified. In the selection process, 24 studies met inclusion criteria for analysis. Study characteristics were extracted and synthesized. RESULTS We identified applications with similar functionalities, such as the use of reminders and medical monitoring. Most of them addressed the treatment of conditions related to an already diagnosed chronic disease, including Diabetes Mellitus, Hypertension, Cardiovascular Diseases, Asthma, Neoplasms, and chronic conditions in general. The main lifestyle changes were the reduction of body weight, promotion of healthy eating, and adherence to the regular practice of physical exercises. CONCLUSIONS Technology can facilitate health care with simple messages and alerts that aid in adherence to treatment. Changes in lifestyle with the use of applications are remarkable. Benefits may be even greater if more applications address the importance of prevention and not just treatment.
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Affiliation(s)
- Raquel Debon
- Graduate Program in Human Aging, School of Physical Education and Physiotherapy, University of Passo Fundo (UPF), Passo Fundo, RS, Brazil
| | - Joane Diomara Coleone
- Graduate Program in Human Aging, School of Physical Education and Physiotherapy, University of Passo Fundo (UPF), Passo Fundo, RS, Brazil
| | - Ericles Andrei Bellei
- Graduate Program in Applied Computing, Institute of Exact Sciences and Geosciences, University of Passo Fundo (UPF), Passo Fundo, RS, Brazil.
| | - Ana Carolina Bertoletti De Marchi
- Graduate Program in Human Aging, School of Physical Education and Physiotherapy, University of Passo Fundo (UPF), Passo Fundo, RS, Brazil; Graduate Program in Applied Computing, Institute of Exact Sciences and Geosciences, University of Passo Fundo (UPF), Passo Fundo, RS, Brazil
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Jeminiwa RN, Hohmann NS, Fox BI. Developing a Theoretical Framework for Evaluating the Quality of mHealth Apps for Adolescent Users: A Systematic Review. J Pediatr Pharmacol Ther 2019; 24:254-269. [PMID: 31337988 DOI: 10.5863/1551-6776-24.4.254] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To assess adolescents' preferred mobile app features and to propose a framework for evaluating health-related mobile apps for adolescents. METHODS PubMed, CINAHL, PsycINFO, ERIC, HealthIT.gov, and ClinicalTrials.gov were systematically searched in August 2017. Studies pertaining to app development, feasibility, or usability that reported preferred app features and rating criteria on mHealth (mobile health) apps intended for adolescents were included. Quality assessment was performed using the Mixed Methods Appraisal Tool. Qualitative synthesis was performed to develop themes reflecting best practices for evaluating the quality of mHealth apps for adolescents. Using a grounded theory approach, we constructed a theoretical framework of rating criteria that can be used to inform development of an evaluation tool for mHealth apps targeted to adolescents. RESULTS Thirteen articles were included. Most commonly preferred features include ability to track test results or self-management progress, connect to social media, and gain points or prizes through app gamification. Common rating criteria include degree of app customizability, ease of use, visual appeal, and interactivity. Five emerging dimensions were used in the theoretical framework: Technical Quality; Engagement; Support System; Autonomy; and Safety, Privacy, and Trust. CONCLUSIONS We found that adolescents prefer mHealth apps that are customizable, offer peer support through social media, sustain engagement via gamification, and support the ability to visualize health trends via simplified graphs. Findings may help in the development of mHealth apps that are preferred by adolescents, as well as the development of a quality evaluation tool for mHealth apps targeted to this population.
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Schild S, Sedlmayr B, Schumacher AK, Sedlmayr M, Prokosch HU, St Pierre M. A Digital Cognitive Aid for Anesthesia to Support Intraoperative Crisis Management: Results of the User-Centered Design Process. JMIR Mhealth Uhealth 2019; 7:e13226. [PMID: 31033445 PMCID: PMC6658227 DOI: 10.2196/13226] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Revised: 02/05/2019] [Accepted: 02/09/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Stressful situations during intraoperative emergencies have negative impact on human cognitive functions. Consequently, task performance may decrease and patient safety may be compromised. Cognitive aids can counteract these effects and support anesthesiologists in their crisis management. The Professional Association of German Anesthesiologists set up a project to develop a comprehensive set of digital cognitive aids for intraoperative emergencies. A parallel development for several software platforms and stationary and mobile devices will accommodate the inhomogeneity of the information technology infrastructure within German anesthesia departments. OBJECTIVE This paper aimed to provide a detailed overview of how the task of developing a digital cognitive aid for intraoperative crisis management in anesthesia was addressed that meets user requirements and is highly user-friendly. METHODS A user-centered design (UCD) process was conducted to identify, specify, and supplement the requirements for a digital cognitive aid. The study covered 4 aspects: analysis of the context of use, specification of user requirements, development of design solutions, and evaluation of design solutions. Three prototypes were developed and evaluated by end users of the application. Following each evaluation, the new requirements were prioritized and used for redesign. For the first and third prototype, the System Usability Scale (SUS) score was determined. The second prototype was evaluated with an extensive Web-based questionnaire. The evaluation of the third prototype included a think-aloud protocol. RESULTS The chosen methods enabled a comprehensive collection of requirements and helped to improve the design of the application. The first prototype achieved an average SUS score of 74 (SD 12), indicating good usability. The second prototype included the following main revisions: 2-column layout, initial selection of patient type (infant, adult, or parturient), 4 offered search options, and the option to check off completed action steps. Its evaluation identified the following major revision points: add quick selection for resuscitation checklists, design the top bar and tabs slightly larger, and add more pictograms to the text. The third prototype achieved an average SUS score of 77 (SD 15). The evaluation of the think-aloud protocol revealed a good intuitiveness of the application and identified a missing home button as the main issue. CONCLUSIONS Anesthesiology-as an acute medical field-is particularly characterized by its high demands on decision making and action in dynamic, or time-critical situations. The integration of usability aspects is essential for everyday and emergency suitability. The UCD process allowed us to develop a prototypical digital cognitive aid, exhibiting high usability and user satisfaction in the demanding environment of anesthesiological emergencies. Both aspects are essential to increase the acceptance of the application in later stages. The study approach, combining different methods for determining user requirements, may be useful for other implementation projects in a highly demanding environment.
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Affiliation(s)
- Stefanie Schild
- Department of Medical Informatics, Biometrics and Epidemiology, Chair of Medical Informatics, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Brita Sedlmayr
- Center for Evidence-based Healthcare, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
| | - Ann-Kathrin Schumacher
- Department of Medical Informatics, Biometrics and Epidemiology, Chair of Medical Informatics, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Martin Sedlmayr
- Carl Gustav Carus Faculty of Medicine, Institute for Medical Informatics and Biometry, Technische Universität Dresden, Dresden, Germany
| | - Hans-Ulrich Prokosch
- Department of Medical Informatics, Biometrics and Epidemiology, Chair of Medical Informatics, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Michael St Pierre
- Anästhesiologische Klinik, Universitätsklinikum Erlangen, Erlangen, Germany
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- Berufsverband Deutscher Anästhesisten, Nürnberg, Germany
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Mortenson WB, Singh G, MacGillivray M, Sadeghi M, Mills P, Adams J, Sawatzky B. Development of a Self-Management App for People with Spinal Cord Injury. J Med Syst 2019; 43:145. [PMID: 31011881 DOI: 10.1007/s10916-019-1273-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 04/03/2019] [Indexed: 12/27/2022]
Abstract
With decreasing inpatient rehabilitation lengths of stay, there may be a greater risk of spinal cord injury (SCI) populations being discharged into the community without the self-management skills needed to prevent secondary complications. Recent advancements in mobile health has made mobile apps a feasible method of delivering population-based, self-management interventions to address SCI-specific secondary complications. The objective of this study is to describe stakeholder perspectives on the development of a functional mobile app to facilitate self-management skills needed to prevent secondary complications following recent SCI during inpatient rehabilitation. A user-centered design approach was used that involved an evolving mobile app and the collection of prospective qualitative data. Stakeholders from three groups were enrolled in the study: individuals admitted for rehabilitation following SCI (n = 20) and informal (n = 7) and formal (n = 48) caregivers. Iterative feedback was gathered from rehabilitation inpatients during ongoing interactions and via post-discharge exit questionnaires, from informal caregivers via one-on-one interviews, and from formal caregivers via series of focus groups at various phases throughout the design process. Three main themes emerged from the analysis: (1) being individualized and user friendly (i.e., developing an app that is simple and easy to use to facilitate universal uptake), (2) targeting goals to promote self-management (i.e., adopting self-management skills relative to personal goals and confidence), and (3) increasing participation and support-seeking to facilitate lifestyle change (i.e., encouraging leisure activities to facilitate community integration). Key stakeholder perspectives contributed to the development of a self-management mobile app that will be evaluated in future research.
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Affiliation(s)
- W Ben Mortenson
- International Collaboration on Repair Discoveries, Vancouver, Canada.
- G.F. Strong Rehabilitation Centre, Vancouver, Canada.
- Department of Occupational Sciences and Occupational Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada.
| | - Gurkaran Singh
- International Collaboration on Repair Discoveries, Vancouver, Canada
- Rehabilitation Sciences, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Megan MacGillivray
- International Collaboration on Repair Discoveries, Vancouver, Canada
- Rehabilitation Sciences, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Mahsa Sadeghi
- Department of Neurology, Wayne State School of Medicine & Detroit Medical Centre, Detroit, MI, USA
| | - Patricia Mills
- G.F. Strong Rehabilitation Centre, Vancouver, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | | | - Bonita Sawatzky
- International Collaboration on Repair Discoveries, Vancouver, Canada
- Department of Orthopaedics, Faculty of Medicine, University of British Columbia, Vancouver, Canada
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Fedele DA, McConville A, Moon J, Thomas JG. Topical Review: Design Considerations When Creating Pediatric Mobile Health Interventions: Applying the IDEAS Framework. J Pediatr Psychol 2019; 44:343-348. [PMID: 30346561 PMCID: PMC6415655 DOI: 10.1093/jpepsy/jsy084] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 08/25/2018] [Accepted: 09/24/2018] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To present a guiding framework from the perspective of psychologists and technologists to develop effective mobile health (mHealth) interventions for pediatric populations. METHODS This topical review uses the IDEAS framework as an organizational method to summarize current strategies to conceptualize, design, evaluate, and disseminate mHealth interventions. RESULTS Incorporating theories of behavior change and feedback from target populations are essential when developing mHealth interventions. Following user-centered approaches that fully incorporate end users into design and development stages increases the likelihood that the intervention will be acceptable. Iterative design cycles and prototyping are important steps to gather user feedback to optimize an mHealth intervention. Broad sharing of knowledge and products generated during intervention development also is recommended. Assessment of behavioral principles, intervention components, or a full intervention package should be conducted to evaluate usability and efficacy. CONCLUSIONS Pediatric health-care researchers and clinicians are increasingly using mHealth technology to target health behaviors and improve related outcomes. Pediatric psychologists should consider applying the design strategies outlined in the IDEAS framework to produce and disseminate mHealth interventions tailored to the specific needs of pediatric populations.
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Affiliation(s)
- David A Fedele
- Department of Clinical & Health Psychology, University of Florida
| | | | | | - J Graham Thomas
- Department of Psychiatry and Human Behavior, Warren Alpert School of Medicine at Brown University and The Miriam Hospital
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Edwards EA, Caton H, Lumsden J, Rivas C, Steed L, Pirunsarn Y, Jumbe S, Newby C, Shenvi A, Mazumdar S, Smith JQ, Greenhill D, Griffiths CJ, Walton RT. Creating a Theoretically Grounded, Gamified Health App: Lessons From Developing the Cigbreak Smoking Cessation Mobile Phone Game. JMIR Serious Games 2018; 6:e10252. [PMID: 30497994 PMCID: PMC6293248 DOI: 10.2196/10252] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 06/25/2018] [Accepted: 07/28/2018] [Indexed: 12/11/2022] Open
Abstract
Background Gaming techniques are increasingly recognized as effective methods for changing behavior and increasing user engagement with mobile phone apps. The rapid uptake of mobile phone games provides an unprecedented opportunity to reach large numbers of people and to influence a wide range of health-related behaviors. However, digital interventions are still nascent in the field of health care, and optimum gamified methods of achieving health behavior change are still being investigated. There is currently a lack of worked methodologies that app developers and health care professionals can follow to facilitate theoretically informed design of gamified health apps. Objective This study aimed to present a series of steps undertaken during the development of Cigbreak, a gamified smoking cessation health app. Methods A systematic and iterative approach was adopted by (1) forming an expert multidisciplinary design team, (2) defining the problem and establishing user preferences, (3) incorporating the evidence base, (4) integrating gamification, (5) adding behavior change techniques, (6) forming a logic model, and (7) user testing. A total of 10 focus groups were conducted with 73 smokers. Results Users found the app an engaging and motivating way to gain smoking cessation advice and a helpful distraction from smoking; 84% (62/73) of smokers said they would play again and recommend it to a friend. Conclusions A dedicated gamified app to promote smoking cessation has the potential to modify smoking behavior and to deliver effective smoking cessation advice. Iterative, collaborative development using evidence-based behavior change techniques and gamification may help to make the game engaging and potentially effective. Gamified health apps developed in this way may have the potential to provide effective and low-cost health interventions in a wide range of clinical settings.
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Affiliation(s)
- Elizabeth A Edwards
- Centre for Primary Care and Public Health, Blizard Institute, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.,Asthma UK Centre for Applied Research, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Hope Caton
- Faculty of Science, Engineering Computing, Kingston University, London, United Kingdom
| | - Jim Lumsden
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom.,School of Psychological Science, University of Bristol, Bristol, United Kingdom
| | - Carol Rivas
- Centre for Primary Care and Public Health, Blizard Institute, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.,Social Science Research Unit, University College London, London, United Kingdom
| | - Liz Steed
- Centre for Primary Care and Public Health, Blizard Institute, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.,Asthma UK Centre for Applied Research, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Yutthana Pirunsarn
- Faculty of Science, Engineering Computing, Kingston University, London, United Kingdom
| | - Sandra Jumbe
- Centre for Primary Care and Public Health, Blizard Institute, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.,Asthma UK Centre for Applied Research, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Chris Newby
- Centre for Primary Care and Public Health, Blizard Institute, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.,Asthma UK Centre for Applied Research, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Aditi Shenvi
- Centre for Complexity Science, University of Warwick, Coventry, United Kingdom
| | - Samaresh Mazumdar
- Centre for Primary Care and Public Health, Blizard Institute, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.,Asthma UK Centre for Applied Research, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Jim Q Smith
- Department of Statistics, University of Warwick, Coventry, United Kingdom
| | - Darrel Greenhill
- Faculty of Science, Engineering Computing, Kingston University, London, United Kingdom
| | - Chris J Griffiths
- Centre for Primary Care and Public Health, Blizard Institute, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.,Asthma UK Centre for Applied Research, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Robert T Walton
- Centre for Primary Care and Public Health, Blizard Institute, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.,Asthma UK Centre for Applied Research, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
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Orlemann T, Reljic D, Zenker B, Meyer J, Eskofier B, Thiemt J, Herrmann HJ, Neurath MF, Zopf Y. A Novel Mobile Phone App (OncoFood) to Record and Optimize the Dietary Behavior of Oncologic Patients: Pilot Study. JMIR Cancer 2018; 4:e10703. [PMID: 30459139 PMCID: PMC6280033 DOI: 10.2196/10703] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 07/26/2018] [Accepted: 08/14/2018] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Catabolism and tumor-specific therapy lead to reduced nutrient intake and weight loss in cancer patients. Maintaining a specific individualized diet can be challenging for the patient as the nutritional counseling options are limited. Monitoring of nutrient intake and frequent feedback are, however, vital for successful nutritional therapy because they support the patient's compliance and realization of dietary therapeutic goals. OBJECTIVE This study aimed at investigating the feasibility and applicability of a novel mobile phone app to assess and evaluate dietary behaviors in oncologic patients. METHODS To determine dietary habits and food preferences in oncologic patients, initially 1400 nutritional records were evaluated and analyzed. The results provided the basis for creating a nutritional mobile phone app. Key requirements for the app included simple handling, recording the daily intake, and a comparison of nutrient targets and current status. In total, 39 cancer patients were recruited for the study; 15 patients dropped out prior to the study. All patients received a nutritional anamnesis, nutritional analysis, and nutritional counseling. Individual energy and nutrient aims were defined. The intervention group (n=12) additionally used the app. Weight and body composition of each group were evaluated after 4 weeks. RESULTS The app group gained significantly more weight (P=.045; mean weight 1.03 kg vs -1.46 kg). Also, skeletal muscle mass showed a significant increase in the app group (P=.009; mean skeletal muscle mass 0.58 kg vs -0.61 kg) compared with the control group. There was no significant difference between groups relating to the daily protein intake (P=.06). Additionally, there was a decrease in macronutrient intake during the study period in the control group. CONCLUSIONS Our study indicates that patients who track their daily dietary habits using a mobile phone app are more likely to reach their nutritional goals than the control patients. Further large-scale studies are needed to confirm these initial findings and test the applicability on a broader basis.
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Affiliation(s)
- Till Orlemann
- Hector Center for Nutrition, Exercise, and Sports, Department of Internal Medicine 1, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Dejan Reljic
- Hector Center for Nutrition, Exercise, and Sports, Department of Internal Medicine 1, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Björn Zenker
- Embedded Systems Institute, Department of Informatics, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Julia Meyer
- Hector Center for Nutrition, Exercise, and Sports, Department of Internal Medicine 1, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Bjoern Eskofier
- Machine Learning and Data Analytics Lab, Department of Computer Science, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Jana Thiemt
- Machine Learning and Data Analytics Lab, Department of Computer Science, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Hans Joachim Herrmann
- Hector Center for Nutrition, Exercise, and Sports, Department of Internal Medicine 1, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Markus Friedrich Neurath
- Department of Internal Medicine 1, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Yurdagül Zopf
- Hector Center for Nutrition, Exercise, and Sports, Department of Internal Medicine 1, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
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Maimone R, Guerini M, Dragoni M, Bailoni T, Eccher C. PerKApp: A general purpose persuasion architecture for healthy lifestyles. J Biomed Inform 2018; 82:70-87. [PMID: 29729482 DOI: 10.1016/j.jbi.2018.04.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 04/20/2018] [Accepted: 04/23/2018] [Indexed: 10/17/2022]
Abstract
Automatically monitoring and supporting healthy lifestyle is a recent research trend, fostered by the availability of low-cost monitoring devices, and it can significantly contribute to the prevention of chronic diseases deriving from incorrect diet and lack of physical activity. In this paper, we present a general purpose architecture for persuasion scenarios and behavioral change. The architecture is designed to be easily portable across languages and domains and has been implemented and evaluated in a specific system for Workplace Health Promotion (WHP) called PerKApp. PerKApp provides a fully fledged platform supporting the remote monitoring of workers lifestyle by providing real-time feedback through persuasive context-based messages when necessary.
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Rotter M, Amato K, Nigg CR. Physical activity stages of change surveillance data shows that the majority of Hawai'i's Keiki (Children) meet the guidelines. J Sports Sci 2017; 36:1009-1014. [PMID: 28673126 DOI: 10.1080/02640414.2017.1348615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Targeting Native Hawaiian and other Pacific Islander (NHOPI) children based on their physical activity (PA) stages of change (SOC) may improve intervention effectiveness. No known SOC surveillance system exists for NHOPI jurisdictions. The purpose was to determine the PA SOC prevalence over 5 years in children living in Hawai'i. Self-reported PA SOC from 5 cohorts (3-6 grade students) in Hawai'i were compared between cohorts and sex. The combined PA SOC distribution (n = 1726, 50.7% female) was: Precontemplation, 7.5%; Contemplation, 7.6%; Preparation, 9.9%; Action, 33.4%; Maintenance, 41.5%. There were no significant difference between cohorts 1 and 2 (n = 258), χ2 (16) = 21.75, p = 0.15; 2 and 3 (n = 129), χ2 (16) = 17.51, p = 0.35; 3 and 4 (n = 171), χ2 (16) = 17.28, p = 0.77; 4 and 5 (n = 129), χ2 (16) = 17.51, p = 0.35; and for all cohorts between males and females (p > 0.05). Most participants were in Action and Maintenance. Prevention efforts should emphasize maintaining PA levels. Extending PA behavior surveillance systems to include intention in NHOPI jurisdictions is warranted.
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Affiliation(s)
- Markus Rotter
- a German Research Center for Environmental Health , Helmholtz Zentrum München , Neuherberg , Germany
| | - Kaitlyn Amato
- b Office of Public Health Studies , University of Hawaii , Honolulu , HI , USA
| | - Claudio R Nigg
- b Office of Public Health Studies , University of Hawaii , Honolulu , HI , USA
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