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Zeng K, Dong L, Xu Y, Zheng X. Exploring observed and instructed mHealth use in the middle-aged and elderly people (MAEP): A social learning perspective. Digit Health 2024; 10:20552076241281214. [PMID: 39314813 PMCID: PMC11418324 DOI: 10.1177/20552076241281214] [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: 01/10/2024] [Accepted: 08/20/2024] [Indexed: 09/25/2024] Open
Abstract
Objective Based on social learning theory, this study aimed to explore the intention of middle-aged and elderly people (MAEP) to engage with mobile health (mHealth) and the underlying effects of usability and utility. The goal was to garner insights that could enhance the advancement of mHealth and improve the scope of benefits of mHealth use among MAEP in the future. Methods We employed a survey-based approach to delve into the mHealth use intentions among MAEP individuals aged 45 and above. A total of 371 valid survey responses were collected and analyzed using SmartPLS 3.0 for statistical examination and model verification. Results Our hypotheses tests revealed that vicarious utility fully mediated the relationship between observed use and direct use intention and both indirect use intentions. Instructed usability and instructed utility were found to fully and partially mediate the relationship between instructed use and indirect use intention, respectively. Conclusions This study demonstrates that the observed and instructed use behaviors of MAEP can promote their eventual intention to adopt mHealth through processes of observational and reinforcement learning. These findings underscore the importance of understanding the underlying effects of MAEP's intention to use mHealth is critical to increasing their adoption of mHealth, and thereby potentially improving their health outcomes.
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Affiliation(s)
- Kai Zeng
- School of Management, Zhejiang University of Technology, Hangzhou, China
| | - Lucong Dong
- School of Management, Zhejiang University of Technology, Hangzhou, China
| | - Yujing Xu
- School of Management, Zhejiang University of Technology, Hangzhou, China
| | - Xiaofen Zheng
- School of Management, Zhejiang University of Technology, Hangzhou, China
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Granet J, Peyrusqué E, Ruiz F, Buckinx F, Abdelkader LB, Dang-Vu TT, Sirois MJ, Gouin JP, Pageaux B, Aubertin-Leheudre M. Web-Based Physical Activity Interventions Are Feasible and Beneficial Solutions to Prevent Physical and Mental Health Declines in Community-Dwelling Older Adults During Isolation Periods. J Gerontol A Biol Sci Med Sci 2023; 78:535-544. [PMID: 35675174 PMCID: PMC9384240 DOI: 10.1093/gerona/glac127] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Periods of prolonged lockdown increase the risk of physical inactivity, which can contribute to physical decline among older adults. Online technology could be an innovative solution to promote physical activity (PA) habits in this context. The goal of this study was to examine and compare the acceptability, feasibility, and potential benefits of 2 modalities of web-based PA interventions in older adults during the coronavirus disease 2019 lockdown. METHODS Eighty-three nonphysically active community-dwelling older adults (aged 60 and older) were randomized to a 12-week web-based PA intervention delivered either in a live group (LG; n = 38) or a recorded group (RG; n = 45). Acceptability, feasibility as well as functional capacities, physical performance, quality of life, and PA level were assessed pre and postintervention. RESULTS There were fewer dropouts in the LG than RG (LG: 16% vs RG: 46%). However, adherence rate (LG: 89%; RG: 81%), level of satisfaction (LG: 77% vs RG: 64%), and enjoyment (LG: 68% vs RG: 62%) were similar across groups, even if the participants found the intervention slightly difficult (LG: 58% vs RG: 63%). Both groups significantly improved on functional capacities, physical performance, and quality of life. Only the LG showed significant improvements in perceived health and PA level. The LG showed greater improvements in physical performance and quality of life than the RG. CONCLUSION Web-based PA interventions are feasible, acceptable, and beneficial for improving functional capacities and physical performance during periods of lockdown. However, the interactive web and live modalities appear to be more effective for promoting some of these outcomes than recorded and individual modalities.
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Affiliation(s)
- Jordan Granet
- Département des sciences de l'activité physique, Faculté des sciences, Université du Québec à Montréal, Montréal, Canada.,Centre de recherche de l'Institut universitaire de gériatrie de Montréal (CRIUGM), Montréal, Canada
| | - Eva Peyrusqué
- Département des sciences de l'activité physique, Faculté des sciences, Université du Québec à Montréal, Montréal, Canada.,Centre de recherche de l'Institut universitaire de gériatrie de Montréal (CRIUGM), Montréal, Canada
| | - Fabien Ruiz
- Département des sciences de l'activité physique, Faculté des sciences, Université du Québec à Montréal, Montréal, Canada.,Centre de recherche de l'Institut universitaire de gériatrie de Montréal (CRIUGM), Montréal, Canada
| | - Fanny Buckinx
- Département des sciences de l'activité physique, Faculté des sciences, Université du Québec à Montréal, Montréal, Canada.,Centre de recherche de l'Institut universitaire de gériatrie de Montréal (CRIUGM), Montréal, Canada
| | - Lilia Ben Abdelkader
- Département des sciences de l'activité physique, Faculté des sciences, Université du Québec à Montréal, Montréal, Canada.,Centre de recherche de l'Institut universitaire de gériatrie de Montréal (CRIUGM), Montréal, Canada
| | - Thien Thanh Dang-Vu
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal (CRIUGM), Montréal, Canada.,Department of Health, Kinesiology and Applied Physiology, PERFORM Center and Center for Studies in Behavioral Neurobiology, Concordia University, Montréal,Canada
| | | | - Jean-Philippe Gouin
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal (CRIUGM), Montréal, Canada.,Department of Psychology, Concordia University, Montréal, Canada
| | - Benjamin Pageaux
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal (CRIUGM), Montréal, Canada.,École de kinésiologie et des sciences de l'activité physique (EKSAP), Faculté de médecine, Université de Montréal, Montréal, Canada
| | - Mylène Aubertin-Leheudre
- Département des sciences de l'activité physique, Faculté des sciences, Université du Québec à Montréal, Montréal, Canada.,Centre de recherche de l'Institut universitaire de gériatrie de Montréal (CRIUGM), Montréal, Canada
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Hong S, Lee S, Song K, Kim M, Kim Y, Kim H, Kim H. A nurse-led mHealth intervention to alleviate depressive symptoms in older adults living alone in the community: A quasi-experimental study. Int J Nurs Stud 2023; 138:104431. [PMID: 36630872 DOI: 10.1016/j.ijnurstu.2022.104431] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 12/04/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND The prevalence of geriatric depression has increased worldwide, becoming a major contributor to the burden of health care costs. Geriatric depression is difficult to detect in daily life because of its atypical presentation for each person. Therefore, there is an emerging need to develop personalised mHealth interventions for older adults with depression based on data from an ecological momentary assessment. OBJECTIVE To develop and evaluate the effect of a nurse-led mHealth intervention of geriatric depression in older adults living alone. DESIGN A quasi-experimental research design was used, and the study followed the transparent reporting of evaluations with a nonrandomised design statement. SETTING The nurse-led mHealth intervention was developed and evaluated in a community senior centre in Seoul, Korea. PARTICIPANTS Sixty-four older adults living alone with depressive symptoms were recruited between 1 October 2018 and 1 October 2019. METHODS Study participants were randomly assigned to the intervention or control groups by drawing lots. In the intervention group, nurses repeatedly assessed older adults' depressive symptoms using an ecological momentary assessment via a mobile tablet. The intervention consisted of weekly sessions, which included (1) standardised mHealth device training, (2) a nurse-led mHealth programme, and (3) art activities. The control group received care as usual. Intra- and inter-group differences were evaluated using paired t-tests and analysis of covariance was used to assess subjective depression symptoms. A linear mixed-model was used to analyse the relationship between groups and momentary scores over time. RESULTS The average age of the final sample was 76.2 years (SD = 6.06), 63.6 % (28/44) of whom were female. Compared with the control group (n = 23), the intervention group (n = 21) showed a decreased depression score (t = 4.041, p = .027). There was no statistical difference between the intervention and control groups based on traditional scales and the ecological momentary assessment. However, our data from the ecological momentary assessment captures clear fluctuating patterns across the days during the study, which traditional scales could not measure. CONCLUSIONS Most of the older adults successfully participated in a nurse-led mHealth intervention that included multiple components of a non-pharmacological approach to address depression. Mental health nurses should perform critical roles to personalise mHealth activities considering the older adult's autonomy and supportive decision-making, specifically when using high-technological intervention. Future research should maximise the methodological and clinical advantage of an ecological momentary assessment of geriatric depression. REGISTRATION Clinical Research Information Service number KCT0005073.
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Affiliation(s)
- Soyun Hong
- College of Nursing Brain Korea 21 FOUR Project, Yonsei University, Seoul, Republic of Korea; College of Nursing, Namseoul University, Cheonan-si, Republic of Korea
| | - Sangeun Lee
- College of Nursing, University of Illinois at Chicago, Chicago, United States
| | - Kijun Song
- College of Nursing and Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Republic of Korea
| | - Mijung Kim
- Mapo Senior Welfare Center, Seoul, Republic of Korea
| | - Yuntae Kim
- Mapo Senior Welfare Center, Seoul, Republic of Korea
| | - Hyein Kim
- College of Nursing Brain Korea 21 FOUR Project, Yonsei University, Seoul, Republic of Korea
| | - Heejung Kim
- College of Nursing and Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Republic of Korea.
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Kim HJ, Lee KH, Lee JH, Youk H, Lee HY. The Effect of a Mobile and Wearable Device Intervention on Increased Physical Activity to Prevent Metabolic Syndrome: Observational Study. JMIR Mhealth Uhealth 2022; 10:e34059. [PMID: 35200145 PMCID: PMC8914734 DOI: 10.2196/34059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/20/2021] [Accepted: 12/21/2021] [Indexed: 11/30/2022] Open
Abstract
Background Research on whether wearable devices and app-based interventions can effectively prevent metabolic syndrome (MetS) by increasing physical activity (PA) among middle-aged people living in the rural areas of South Korea remains insufficient. Objective The aim of this study was to determine whether mobile and wearable device interventions can improve health indicators, including PA, in MetS risk groups in rural South Korea. Methods In this clinical trial, performed from December 2019 to June 2020, participants were asked to use a wearable device (GalaxyWatch Active1) alone (standard intervention) or the wearable device and mobile app (Yonsei Health Korea) (enhanced intervention). Clinical measures and International Physical Activity Questionnaire (IPAQ) scores were evaluated initially and after 6 months. The number of steps was monitored through the website. The primary outcome was the difference in PA and clinical measures between the enhanced intervention and standard intervention groups. The secondary outcome was the decrease in MetS factors related to the change in PA. Results A total of 267 participants were randomly selected, 221 of whom completed the 6-month study. Among the 221 participants, 113 were allocated to the enhanced intervention group and 108 were allocated to the standard intervention group. After 6 months, the body weight and BMI for the enhanced intervention group decreased by 0.6 (SD 1.87) and 0.21 (SD 0.76), respectively (P<.001). In both groups, systolic blood pressure, diastolic blood pressure, waist circumference, and glycated hemoglobin A1c (HbA1c) decreased (P<.001). The total PA was approximately 2.8 times lower in the standard intervention group (mean 44.47, SD 224.85) than in the enhanced intervention group (mean 124.36, SD 570.0). Moreover, the enhanced intervention group achieved the recommended level of moderate to vigorous physical activity (MVPA), whereas the standard intervention group did not (188 minutes/week vs 118 minutes/week). Additionally, the number of participants in the enhanced intervention group (n=113) that reached 10,000 daily steps or more after the intervention increased from 9 (8.0%) to 26 (23.1%) (P=.002), whereas this number did not increase significantly in the standard intervention group (n=108), from 8 (7.4%) to 16 (14.8%) (P=.72). The number of participants without any MetS factors increased by 12 (11%) and 8 (7%) in the enhanced and standard intervention group, respectively. Conclusions PA monitoring and an intervention using wearable devices were effective in preventing MetS in a rural population in Korea. Blood pressure, waist circumference, and HbA1c were improved in both intervention groups, which were effective in reducing MetS factors. However, only the participants in the enhanced intervention group continuously increased their MVPA and step counts above the recommended level to prevent MetS. Body weight and BMI were further improved, and a higher number of participants with zero MetS factors was attained from the enhanced intervention. Trial Registration Clinical Research Information Service KCT0005783; https://cris.nih.go.kr/cris/search/detailSearch.do/16123
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Affiliation(s)
- Hee Jin Kim
- Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Kang Hyun Lee
- Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Jung Hun Lee
- Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Hyun Youk
- Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Hee Young Lee
- Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
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Tian H, Chen J. A bibliometric analysis on global eHealth. Digit Health 2022; 8:20552076221091352. [PMID: 35433016 PMCID: PMC9006363 DOI: 10.1177/20552076221091352] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 03/15/2022] [Indexed: 02/02/2023] Open
Abstract
Background The current coronavirus disease 2019 pandemic highlights the potential of eHealth. Drawing the knowledge map of eHealth research through data mining and visual analysis technology was helpful to systematically present the research status and future trends of global academic circles. Methods Based on the web of Science Core Collection (SCIE/SSCI) database, using bibliometric theory and visual analysis technology, this work analyzed the global eHealth research publications from 2000 to 2021, and introduced the interdisciplinary characteristics, hot topics and future trends in this field. Results A total of 10188 authors, 891 journals, 3586 institutions, 98 countries using 12 languages had conducted eHealth research in the world. The United States, the Netherlands, Australia and the United Kingdom were the main forces and international cooperation. However, the international co-operation between Eastern and Western countries was still relatively few. The frontier of global eHealth research mainly focused on #0eHealth innovation, #1physical activity, #2generalised anxiety disorder, #3lightweight authentication protocol, #4 eHealth information, #5technology readiness, #6 ehealth literacy scale, #7family carer, #8citance analysis, #9 guiding patient. Clusters #3 lightweight authentication protocol and #9 guiding patient were the latest clusters, indicating the research trend and direction of eHealth in the future. Conclusions Cooperation network framework at the regional, national and global levels and the cooperation of multidisciplinary teams with complementary backgrounds and expertise were needed to realize the in-depth popularization and application of eHealth knowledge. Interdisciplinary international cooperation should be the trend of eHealth research in the future.
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Affiliation(s)
- Hua Tian
- College of Life Science, Xinyang Normal University, Xinyang, China
| | - Jie Chen
- School of Marxism, Xinyang Normal University, Xinyang, China
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Chen Z, Qi H, Wang L. Study on the Types of Elderly Intelligent Health Management Technology and the Influencing Factors of Its Adoption. Healthcare (Basel) 2021; 9:healthcare9111494. [PMID: 34828539 PMCID: PMC8619684 DOI: 10.3390/healthcare9111494] [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: 09/17/2021] [Revised: 10/29/2021] [Accepted: 10/29/2021] [Indexed: 11/16/2022] Open
Abstract
[Background]: In recent years, aging has become a global social problem. Intelligent health management technology (IHMT) provides solutions for the elderly to deal with various health risks. However, the elderly are facing many difficulties in using IHMT. Studying the application types of IHMT and the influencing factors of the elderly’s acceptance of it will help to improve the use behavior of the elderly. [Methods]: This paper summarizes the application types of IHMT, identifies the influencing factors of the elderly’s adaption of IHMT, and makes a systematic comment on the influencing factors. [Results]: We divide the different functions of IHMT for the elderly into four types: self-monitoring, medical care, remote monitoring, and health education. The influencing factors are divided into three types: individual, social, and technology. [Conclusions]: This study finds that IHMT’s application covers all aspects of the health services of the elderly. Among these applications, self-monitoring is the most used. We divided the influencing factors of the elderly’s acceptance of IHMT into three categories and nine subcategories, having 25 variables.
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Affiliation(s)
- Zhu Chen
- School of Nursing, Peking University, Beijing 100191, China;
| | - Huiying Qi
- Department of Health Informatics and Management, School of Health Humanities, Peking University, Beijing 100191, China;
- Correspondence: ; Tel.: +86-10-82805574
| | - Luman Wang
- Department of Health Informatics and Management, School of Health Humanities, Peking University, Beijing 100191, China;
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Park E, Kwon M. Testing the Digital Health Literacy Instrument for Adolescents: Cognitive Interviews. J Med Internet Res 2021; 23:e17856. [PMID: 33720031 PMCID: PMC8074835 DOI: 10.2196/17856] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 07/21/2020] [Accepted: 01/10/2021] [Indexed: 02/01/2023] Open
Abstract
Background Despite the increasing number of youth seeking health information on the internet, few studies have been conducted to measure digital health literacy in this population. The digital health literacy instrument (DHLI) is defined as a scale that measures the ability to operate digital devices and read and write in web-based modes, and it assesses seven subconstructs: operational skills, navigation skills, information searching, evaluating reliability, determining relevance, adding self-generated content to a web-based app, and protecting privacy. Currently, there is no validation process of this instrument among adolescents. Objective This study aims to explore the usability and content validity of DHLI. Methods Upon the approval of institutional review board protocol, cognitive interviews were conducted. A total of 34 adolescents aged 10-18 years (n=17, 50% female) participated in individual cognitive interviews. Two rounds of concurrent cognitive interviews were conducted to assess the content validity of DHLI using the thinking aloud method and probing questions. Results Clarity related to unclear wording, undefined technical terms, vague terms, and difficult vocabularies was a major issue identified. Problems related to potentially inappropriate assumptions were also identified. In addition, concerns related to recall bias and socially sensitive phenomena were raised. No issues regarding response options or instrument instructions were noted. Conclusions The initial round of interviews provided a potential resolution to the problems identified with comprehension and communication, whereas the second round prompted improvement in content validity. Dual rounds of cognitive interviews provided substantial insights into survey interpretation when introduced to US adolescents. This study examined the validity of the DHLI and suggests revision points for assessing adolescent digital health literacy.
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Affiliation(s)
- Eunhee Park
- School of Nursing, University at Buffalo, Buffalo, NY, United States
| | - Misol Kwon
- School of Nursing, University at Buffalo, Buffalo, NY, United States
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Lee JS, Kang MA, Lee SK. Effects of the e-Motivate4Change Program on Metabolic Syndrome in Young Adults Using Health Apps and Wearable Devices: Quasi-Experimental Study. J Med Internet Res 2020; 22:e17031. [PMID: 32729838 PMCID: PMC7426802 DOI: 10.2196/17031] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 05/22/2020] [Accepted: 06/14/2020] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND The health behaviors of young adults lag behind those of other age groups, and active health management is needed to improve health behaviors and prevent chronic diseases. In addition, developing good lifestyle habits earlier in life could reduce the risk of metabolic syndrome (MetS) later on. OBJECTIVE The aim of this study is to investigate the effects of the e-Motivate4Change program, for which health apps and wearable devices were selected based on user needs. The program was developed for the prevention and management of MetS in young adults. METHODS This experimental study used a nonequivalent control group. In total, 59 students from 2 universities in Daegu, Korea participated in the study (experimental group n=30; control group n=29). Data were collected over 4 months, from June 1 to September 30, 2018. The experimental group received a 12-week e-Motivate4Change program intervention, and the control group received MetS education and booklets without the e-Motivate4Change program intervention. RESULTS After the program, the experimental group had significantly higher scores for health-related lifestyle (t=3.86; P<.001) and self-efficacy (t=6.00; P<.001) than did the control group. Concerning BMI, there were significant effects by group (F=1.01; P<.001) and for the group × time interaction (F=4.71; P=.034). Concerning cholesterol, there were significant main effects for group (F=4.32; P=.042) and time (F=9.73; P<.001). CONCLUSIONS The e-Motivate4Change program effectively improved participants' health-related lifestyle scores and self-efficacy, and significantly reduced their BMI and cholesterol levels. The program can be used to identify and prevent MetS among young adults.
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Affiliation(s)
- Ji-Soo Lee
- Keimyung University, Daegu, Republic of Korea
| | - Min-Ah Kang
- Keimyung University, Daegu, Republic of Korea
- Gyeongnam Center for Infectious Disease Control and Prevention, Changwon, Republic of Korea
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Kim H, Lee SH, Cho NB, You H, Choi T, Kim J. User-Dependent Usability and Feasibility of a Swallowing Training mHealth App for Older Adults: Mixed Methods Pilot Study. JMIR Mhealth Uhealth 2020; 8:e19585. [PMID: 32663161 PMCID: PMC7418014 DOI: 10.2196/19585] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 06/11/2020] [Accepted: 06/14/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Swallowing difficulties (ie, dysphagia) are common among older adults, with a 13% to 54% prevalence. Adequate interventions to improve the swallowing function of older adults would reduce morbidity and enhance health-related quality of life outcomes. Mobile health (mHealth) apps may help alleviate dysphagia symptoms by providing programs that maximize the intensity and frequency of training without requiring high costs or regular clinic visits. OBJECTIVE The aim of this pilot study was to assess the usability of swallowing training apps by quantitatively and qualitatively evaluating older adults' self-reported data, taking into consideration their educational levels and exposure to mobile technology. We conducted surveys and brief interviews while the participants used a swallowing intervention app we developed. We subsequently identified and resolved individual-specific usability issues to improve future implementation of the app protocol for older persons with swallowing difficulties. METHODS A total of 11 participants (10 women, 91%; mean age 75.7 years, SD 3.93) from two district-run senior welfare centers took part in this study. The participants were divided into a high-potential group and a low-potential group based on their total number of years of education and smart device usage. To investigate the usability of the app twice (ie, in the second week of the intervention and the postintervention stage), we used mixed methods consisting of both quantitative approaches, namely the System Usability Scale (SUS) and modified Computer Self-Efficacy Scale (mCSES) surveys, and qualitative approaches (ie, interviews). RESULTS The quantitative results of the SUS and mCSES surveys revealed that the high-potential group was more inclined to adopt and learn new technology than the low-potential group. Specifically, within the high-potential group, a Wilcoxon signed-rank test indicated that the postintervention mCSES scores (median 65.50) were significantly higher than those in the second week of intervention (median 54.00; z=-2.023, P=.04). Additionally, the usability scores in the low-potential group were within the "marginal acceptability" range even after completion of an 8-week intervention program. Qualitative analyses via semi-structured interviews yielded promising outcomes regarding app acceptability, training program utilization, emotional responses, and learning experience. CONCLUSIONS To the best of the authors' knowledge, this usability and feasibility study is the first report of a swallowing training app designed to improve the swallowing function of older adults. Future research should consider several issues, such as user characteristics, pretraining education, and the intensity and innate characteristics of the intervention program.
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Affiliation(s)
- HyangHee Kim
- Graduate Program in Speech-Language Pathology, Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sang-Ho Lee
- Graduate Program in Speech-Language Pathology, Yonsei University, Seoul, Republic of Korea
| | - Nam-Bin Cho
- Graduate Program in Speech-Language Pathology, Yonsei University, Seoul, Republic of Korea
| | - Heecheon You
- Department of Industrial and Management Engineering, Pohang University of Science and Technology, Pohang, Republic of Korea
| | | | - Jinwon Kim
- Department of Industrial and Management Engineering, Pohang University of Science and Technology, Pohang, Republic of Korea
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Kim H, Kim S, Kong SS, Jeong YR, Kim H, Kim N. Possible Application of Ecological Momentary Assessment to Older Adults' Daily Depressive Mood: Integrative Literature Review. JMIR Ment Health 2020; 7:e13247. [PMID: 32484442 PMCID: PMC7298638 DOI: 10.2196/13247] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 01/31/2020] [Accepted: 03/31/2020] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Ecological momentary assessment is a method of investigating individuals' real-time experiences, behaviors, and moods in their natural environment over time. Despite its general usability and clinical value for evaluating daily depressive mood, there are several methodological challenges when applying ecological momentary assessment to older adults. OBJECTIVE The aims of this integrative literature review were to examine possible uses of the ecological momentary assessment methodology with older adults and to suggest strategies to increase the feasibility of its application in geriatric depression research and practice. METHODS We searched 4 electronic databases (MEDLINE, CINAHL, PsycINFO, and EMBASE) and gray literature; we also hand searched the retrieved articles' references. We limited all database searches to articles published in peer-reviewed journals from 2009 to 2019. Search terms were "ecological momentary assessment," "smartphone assessment," "real time assessment," "electronic daily diary," "mHealth momentary assessment," "mobile-based app," and "experience sampling method," combined with the relevant terms of depression. We included any studies that enrolled older adults even as a subgroup and that reported depressive mood at least once a day for more than 2 days. RESULTS Of the 38 studies that met the inclusion criteria, only 1 study enrolled adults aged 65 years or older as the entire sample; the remainder of the reviewed studies used mixed samples of both younger and older adults. Most of the analyzed studies (18/38, 47%) were quantitative, exploratory (descriptive, correlational, and predictive), and cohort in design. Ecological momentary assessment was used to describe the fluctuating pattern of participants' depressive moods primarily and to examine the correlation between mood patterns and other health outcomes as a concurrent symptom. We found 3 key methodological issues: (1) heterogeneity in study design and protocol, (2) issues with definitions of dropout and adherence, and (3) variation in how depressive symptoms were measured with ecological momentary assessment. Some studies (8/38, 21%) examined the age difference of participants with respect to dropout or poor compliance rate. Detailed participant burden was reported, such as technical problems, aging-related health problems, or discomfort while using the device. CONCLUSIONS Ecological momentary assessment has been used for comprehensive assessment of multiple mental health indicators in relation to depressive mood. Our findings provide methodological considerations for further studies that may be implemented using ecological momentary assessment to assess daily depressive mood in older adults. Conducting more feasibility studies focusing on older adults with standardized data collection protocols and mixed-methods research is required to reflect users' experiences. Further telepsychiatric evaluation and diagnosis based on ecological momentary assessment data should involve standardized and sophisticated strategies to maximize the potential of ecological momentary assessment for older adults with depression in the community setting.
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Affiliation(s)
- Heejung Kim
- College of Nursing, Yonsei University, Seoul, Republic of Korea.,Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Republic of Korea
| | - Sunah Kim
- College of Nursing, Yonsei University, Seoul, Republic of Korea.,Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Republic of Korea
| | - Seong Sook Kong
- School of Nursing, College of Medicine, Soonchunhyang University, Cheonan, Republic of Korea
| | | | - Hyein Kim
- Severance Hospital, Seoul, Republic of Korea
| | - Namhee Kim
- College of Nursing, Yonsei University, Seoul, Republic of Korea
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