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Alkhaldi O, McMillan B, Ainsworth J. Using the behaviour change wheel to develop a tailored intervention to overcome general practitioners' perceived barriers to referring insomnia patients to digital therapeutic sleepio. BMC Health Serv Res 2024; 24:967. [PMID: 39174968 PMCID: PMC11340175 DOI: 10.1186/s12913-024-11384-3] [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: 05/14/2024] [Accepted: 08/01/2024] [Indexed: 08/24/2024] Open
Abstract
BACKGROUND Digital therapeutic Sleepio has proven effective in improving sleep quality and decreasing symptoms of anxiety. The National Institute for Health and Care Excellence (NICE) guidance recommends Sleepio as an alternative treatment to usual sleep hygiene education and hypnotic medications. General practitioners (GPs) play a critical role in the adoption of digital therapeutics in patient care. Previous interventions did not adopt theoretical frameworks to systematically understand GPs behaviour toward referring patients to digital therapeutics. OBJECTIVES This study aimed to report the systematic and comprehensive development of an intervention to encourage GPs to refer insomnia patients to Sleepio, using the Behaviour Change Wheel (BCW). METHODS The eight steps outlined in the BCW were followed to develop an intervention. The Capability Opportunity Motivation-Behaviour Self-Evaluation Questionnaire (COM-B-Qv1) was adopted to understand GPs perceived facilitators and barriers to refer insomnia patients to Sleepio. The Behaviour Change Technique Taxonomy Version 1 (BCTv1) was thereafter used to identify possible strategies that could be used to facilitate changes in GPs' behaviour in relation to Sleepio. RESULTS The BCW design process resulted in the identification of five intervention functions, three policy categories and five behaviour change techniques (BCTs) as potential active components for an intervention. The intervention includes providing GPs with an orientation about using Sleepio to improve their knowledge and confidence, sending visual reminders to GPs to recommend Sleepio to their patients, providing ongoing technical support. CONCLUSION The BCW can be successfully applied through a systematic process to understand the drivers of GPs' behaviour and to develop an intervention that can encourage them to refer insomnia patients to Sleepio.
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Affiliation(s)
- Ohoud Alkhaldi
- Division of Informatics, Imaging and Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Oxford Road, Manchester, M13 9PM, UK.
- Health Information Management and Technology Department, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
| | - Brian McMillan
- Centre for Primary Care and Health Services Research, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, M13 9PM, UK
| | - John Ainsworth
- Division of Informatics, Imaging and Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Oxford Road, Manchester, M13 9PM, UK
- NIHR Manchester Biomedical Research Centre, Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
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Tan JW, Tan G, Lian X, Chong DKS, Rajalingam P, Dalan R, Mogali SR. Impact of Facilitation on Cognitive Flow in a Novel Diabetes Management Rehearsal Game for Health Professions Education: Mixed Methods, Open-Label, Superiority Randomized Controlled Trial. JMIR Serious Games 2024; 12:e54703. [PMID: 38900700 PMCID: PMC11292155 DOI: 10.2196/54703] [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: 11/20/2023] [Revised: 01/02/2024] [Accepted: 05/31/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND Though the prevalence of diabetes is set to increase, most serious game solutions typically target patient self-management and education. Few games target health care professions education, and even fewer consider the factors that may increase their efficacies. The impact of facilitation, a prominent feature of health professions education, is examined in the context of a rehearsal-based diabetes management serious game. OBJECTIVE In this mixed methods, open-label, superiority randomized controlled trial, we compare student performance, attitudes, and perceptions of a rehearsal-based diabetes management game for health care professionals. METHODS Student participants were randomized into 2 groups to play a diabetes management game. The control group played the game alone, and the intervention group played the same game alongside a facilitator tasked to moderate overall challenge levels and address queries. Both groups were administered the Flow Short Scale, a 13-item measure rated on a 7-point Likert scale ranging from 1 ("not at all") to 7 ("very much") immediately after the game. Students were then invited to voluntary focus group discussions to elicit their attitudes and perceptions of the game. Findings were subject to between-group comparisons and inductive thematic analysis respectively. RESULTS A total of 48 (26 control, 22 intervention) clinical-year undergraduates from the Lee Kong Chian School of Medicine in Singapore participated in this study, with 18 continuing to the focus group discussions. Flow Short Scale results indicated the superiority of the intervention group for overall flow (t46=-2.17, P=.04) and the absorption subdomain (t46=-2.6, P=.01). Qualitative results indicated students viewed facilitation as helpful and appropriate, and were able to identify improvable elements of the game's theoretical foundations and overall design. CONCLUSIONS While serious games are efficacious means of rehearsing previously learned knowledge, facilitation allows for their efficiency to be greatly increased. Such increases are likely crucial in the coming years with the increased digitization of health care professions education and the prevalence of diabetes. TRIAL REGISTRATION ClinicalTrials.gov NCT05637749; https://www.clinicaltrials.gov/study/NCT05637749.
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Affiliation(s)
- Jun Wen Tan
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | | | - Xia Lian
- Department of Endocrinology, Tan Tock Seng Hospital, Singapore, Singapore
| | - Darren Kai Siang Chong
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Preman Rajalingam
- Institute of Learning, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Rinkoo Dalan
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
- Department of Endocrinology, Tan Tock Seng Hospital, Singapore, Singapore
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Alhammad N, Alajlani M, Abd-Alrazaq A, Arvanitis T, Epiphaniou G. Patients and Stakeholders' Perspectives Regarding the Privacy, Security, and Confidentiality of Data Collected via Mobile Health Apps in Saudi Arabia: Protocol for a Mixed Method Study. JMIR Res Protoc 2024; 13:e54933. [PMID: 38776540 PMCID: PMC11153976 DOI: 10.2196/54933] [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: 11/28/2023] [Revised: 01/10/2024] [Accepted: 01/11/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND There is data paucity regarding users' awareness of privacy concerns and the resulting impact on the acceptance of mobile health (mHealth) apps, especially in the Saudi context. Such information is pertinent in addressing users' needs in the Kingdom of Saudi Arabia (KSA). OBJECTIVE This article presents a study protocol for a mixed method study to assess the perspectives of patients and stakeholders regarding the privacy, security, and confidentiality of data collected via mHealth apps in the KSA and the factors affecting the adoption of mHealth apps. METHODS A mixed method study design will be used. In the quantitative phase, patients and end users of mHealth apps will be randomly recruited from various provinces in Saudi Arabia with a high population of mHealth users. The research instrument will be developed based on the emerging themes and findings from the interview conducted among stakeholders, app developers, health care professionals, and users of mHealth apps (n=25). The survey will focus on (1) how to improve patients' awareness of data security, privacy, and confidentiality; (2) feedback on the current mHealth apps in terms of data security, privacy, and confidentiality; and (3) the features that might improve data security, privacy, and confidentiality of mHealth apps. Meanwhile, specific sections of the questionnaire will focus on patients' awareness, privacy concerns, confidentiality concerns, security concerns, perceived usefulness, perceived ease of use, and behavioral intention. Qualitative data will be analyzed thematically using NVivo version 12. Descriptive statistics, regression analysis, and structural equation modeling will be performed using SPSS and partial least squares structural equation modeling. RESULTS The ethical approval for this research has been obtained from the Biomedical and Scientific Research Ethics Committee, University of Warwick, and the Medical Research and Ethics Committee Ministry of Health in the KSA. The qualitative phase is ongoing and 15 participants have been interviewed. The interviews for the remaining 10 participants will be completed by November 25, 2023. Preliminary thematic analysis is still ongoing. Meanwhile, the quantitative phase will commence by December 10, 2023, with 150 participants providing signed and informed consent to participate in the study. CONCLUSIONS The mixed methods study will elucidate the antecedents of patients' awareness and concerns regarding the privacy, security, and confidentiality of data collected via mHealth apps in the KSA. Furthermore, pertinent findings on the perspectives of stakeholders and health care professionals toward the aforementioned issues will be gleaned. The results will assist policy makers in developing strategies to improve Saudi users'/patients' adoption of mHealth apps and addressing the concerns raised to benefit significantly from these advanced health care modalities. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/54933.
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Affiliation(s)
- Nasser Alhammad
- Institute of Digital Healthcare, WMG, University of Warwick, Coventry, United Kingdom
- Health Informatics, Saudi Electronic University, Jeddah, Saudi Arabia
| | - Mohannad Alajlani
- Institute of Digital Healthcare, WMG, University of Warwick, Coventry, United Kingdom
| | - Alaa Abd-Alrazaq
- AI Center for Precision Health, Weill Cornell Medicine, Doha, Qatar
| | | | - Gregory Epiphaniou
- Institute of Digital Healthcare, WMG, University of Warwick, Coventry, United Kingdom
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Lyu X, Zeng J, Lin J, Song Y, Yang T, Hou W. Validation of the Chinese version of the diabetes health profile to predict the impact of mobile health education on quality of life in type 2 diabetes patients. Front Public Health 2024; 12:1330154. [PMID: 38450133 PMCID: PMC10915233 DOI: 10.3389/fpubh.2024.1330154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 02/05/2024] [Indexed: 03/08/2024] Open
Abstract
Purpose The Diabetes Health Profile (DHP18), initially created in the United Kingdom, currently lacks a Chinese version. This study endeavors to authenticate the Chinese adaptation of the DHP18 and assess the influence of mobile health (mHealth) education intervention on the quality of life of individuals living with diabetes. Patients and methods The study included 470 Type 2 diabetes Mellitus (T2DM) patients (204 men, 266 women), spanning an age range of 19-79 years, with an average age of 54 ± 12.40 years. Data analysis employed Jamovie and Mplus software. Moreover, test-retest reliability was evaluated in 52 hospitalized T2DM patients through two repeated measurements taken 4 weeks apart. Results The Chinese version DHP18 scale exhibited high reliability, evidenced by a Cronbach's alpha of 0.88, and coefficient of test-retest reliability of 0.84. Individual subscales also demonstrated strong reliability, ranging from 0.76 to 0.84, with test-retest reliability spanning from 0.71 to 0.74. Confirmatory Factor Analysis (CFA) employing a three-factor structure (χ2 = 294.69, GFI = 0.92, TLI = 0.91, RMSEA = 0.05, SRMR = 0.06) validated the scale's construct validity. Notably, there was a statistically significant difference (p < 0.05) in the quality of life between Type 2 diabetes patients using mHealth education intervention and those without mHealth education intervention. Mediation analysis revealed that Appraisal of Diabetes (ADS) and Self-Management Efficacy (SED) mediated the effects of Psychological Distress (PD) and Behavior Adherence (BA) on quality of life, both significant direct and indirect effects (p < 0.001). In addition, Dietary Abstinence (DE) displayed significant overall impact (β = -0.13, p < 0.001) and indirect influence (β = -0.10, p < 0.01) on diabetic patients' quality of life, though lacking a significant direct effect (β = -0.03, p = 0.38). Conclusion The Chinese version of the Diabetes Health Profile Scale meets stringent psychometric standards and stands as an appropriate measurement tool for Chinese T2DM patients, maintaining comparable results to the original scale's structure. The mHealth education intervention yielded a notably positive impact on the quality of life among T2DM patients. Mediation analysis revealed that the three dimensions of the DHP were mediated by Appraisal of Diabetes and Diabetes Self-Management Efficacy, partially mediated by Psychological Distress and Behavior Adherence, and fully mediated by Dietary Abstinence, providing insight into the positive effects of the mHealth model on the quality of life of diabetic patients.
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Affiliation(s)
- Xiaokang Lyu
- Department of Social Psychology, Nankai University, Tianjin, China
| | - Jinmei Zeng
- Department of Social Psychology, Nankai University, Tianjin, China
| | - Jingna Lin
- Department of Endocrinology, Health Management Center, Tianjin Union Medical Center, Nankai University Affiliated Hospital, Tianjin, China
| | - Yixuan Song
- Department of Endocrinology, Health Management Center, Tianjin Union Medical Center, Nankai University Affiliated Hospital, Tianjin, China
| | - Tingting Yang
- Department of Social Psychology, Nankai University, Tianjin, China
| | - Wenjing Hou
- Department of Endocrinology, Health Management Center, Tianjin Union Medical Center, Nankai University Affiliated Hospital, Tianjin, China
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Moore A, Cepeda J, Franklin B, Abreu G, Dorth S, Barkley E. Dominican Adolescents' Preferences for Content, Design, and Functionality of a Mobile Application for Type 1 Diabetes Mellitus Self-management. Can J Diabetes 2023; 47:665-671. [PMID: 37481124 DOI: 10.1016/j.jcjd.2023.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 07/07/2023] [Accepted: 07/12/2023] [Indexed: 07/24/2023]
Abstract
OBJECTIVE The purpose of this interdisciplinary study was to determine Dominican adolescents' preferences for the content, functionality (i.e. food's glycemic index list, and amount of insulin based on foods' carbohydrate count), and design of a culturally and linguistically relevant mobile application (app) for type 1 diabetes mellitus (T1DM) self-management. The app would facilitate T1DM self-management education and support by addressing providers' challenges in monitoring patients' disease progression and promoting patient adherence to recommended lifestyle changes. Findings inform an app development process that considers the linguistic and cultural values, norms, and structures of people with T1DM and their providers in the Dominican Republic. METHODS Phone interviews were conducted with 23 adolescents (14 to 18 years of age), using a semistructured questionnaire. The research team conducted the data analysis using NVivo through a deductive and inductive approach. RESULTS The findings suggest that, regardless of the context, adolescents with T1DM desire similar features and functionalities in a self-management app. Overall, participants preferred an app with a graphic format that has accessible information, a straightforward design, and instructional videos. Participants also desired that an app provide information and reminders about proper eating and insulin administration timing and be a vehicle to access a social network to foster mutual support and encouragement. CONCLUSIONS Our study highlights adolescents' perspectives on components for inclusion in an app for T1DM self-management. Participants' recommendations for the app's potential usability, contents, and design features will be used to guide the development of a new app to promote engagement and foster better health outcomes.
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Affiliation(s)
- Arelis Moore
- Department of Languages, Clemson University, Clemson, South Carolina, United States.
| | - Jenny Cepeda
- Researcher Instituto de Medicina Tropical & Salud Global/UNIBE, Los Ríos, Santo Domingo, Dominican Republic
| | - Breauna Franklin
- School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | - Gabriela Abreu
- School of Medicine, Iberoamerican University, Los Ríos, Santo Domingo, Dominican Republic
| | - Shelby Dorth
- B.S. Language and International Health, Clemson University, Clemson, South Carolina, United States
| | - Ethan Barkley
- Medical University of South Carolina (MUSC), Charleston, South Carolina, United States
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Ilkic J, Milosevic Georgiev A, Lakic D, Marinkovic V. Exploring experiences of pharmacists and pharmacy students using mHealth apps: A qualitative study of user experience. Int J Qual Stud Health Well-being 2023; 18:2245606. [PMID: 37563837 PMCID: PMC10424590 DOI: 10.1080/17482631.2023.2245606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 08/03/2023] [Indexed: 08/12/2023] Open
Abstract
PURPOSE Pharmacists can enhance mHealth delivery by promoting the awareness and use of health apps, while pharmacy students and early career pharmacists allow broader perspective for further development. This study aimed to explore the experiences and attitudes of pharmacy students and pharmacists, on the use, advantages and possible improvement of available mHealth platforms in Serbia. METHODS One-on-one interviews were conducted online in two phases, during March and April 2020 (n = 40) and during March 2021 (n = 20), using a published, validated interview guide which was adapted for this study. Interviews were transcribed ad verbatim, coded and thematically analysed. RESULTS Although participants recognized room for optimization, most apps had satisfactory user experience. Participants used health apps as a source of updated information and tools in education and work, but also for self-development. During working hours, participants mostly used medication-related apps, however, it was shown that they use different health apps in order to provide the best possible care to patients. CONCLUSIONS Greater insight into usage, expectations, benefits and challenges of mHealth in pharmacy was obtained and can lead into better informed design of health apps to encourage students and pharmacists, both as professionals and individuals, on the path of their continuous improvement.
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Affiliation(s)
- Jovana Ilkic
- Student at Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia
- Department of Social Pharmacy and Pharmaceutical Legislation, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia
| | - Andrijana Milosevic Georgiev
- Department of Social Pharmacy and Pharmaceutical Legislation, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia
- Teaching Assistant with PhD at Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia
| | - Dragana Lakic
- Department of Social Pharmacy and Pharmaceutical Legislation, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia
- At Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia
| | - Valentina Marinkovic
- Department of Social Pharmacy and Pharmaceutical Legislation, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia
- Full Professor and Head of the Department at Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia
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Kumar A, Ross JS, Patel NA, Rathi V, Redberg RF, Dhruva SS. Studies Of Prescription Digital Therapeutics Often Lack Rigor And Inclusivity. Health Aff (Millwood) 2023; 42:1559-1567. [PMID: 37931187 DOI: 10.1377/hlthaff.2023.00384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2023]
Abstract
Little is known about the evidence to support prescription digital therapeutics, which are digital tools that rely primarily on software for diagnosis or treatment that have indications for use regulated by the Food and Drug Administration (FDA) and require a clinician's prescription. We conducted the first retrospective cross-sectional analysis of clinical studies of twenty prescription digital therapeutics authorized by the FDA and available on the market as of November 2022. Our analysis found that just two prescription digital therapeutics had been evaluated in at least one study that was randomized and blinded and that used other rigorous standards of evidence. Two-thirds of clinical studies of prescription digital therapeutics were conducted on a postmarket basis, with less rigorous standards of evidence than the standards used in premarket studies. More than half of studies did not report data on participants' race, and more than 80 percent did not report their ethnicity. More than one-third required English proficiency, and nearly half of nonpediatric studies had an upper age limit. These results suggest the need for a more rigorous and inclusive approach to clinical research supporting FDA-authorized prescription digital therapeutics. A stronger evidence base would increase confidence in these technologies' effectiveness and would enable more informed decision making about their clinical use and coverage.
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Affiliation(s)
- Anika Kumar
- Anika Kumar, University of California San Francisco, San Francisco, California
| | - Joseph S Ross
- Joseph S. Ross, Yale University, New Haven, Connecticut
| | | | - Vinay Rathi
- Vinay Rathi, Medical University of South Carolina, Charleston, South Carolina
| | | | - Sanket S Dhruva
- Sanket S. Dhruva , University of California San Francisco and San Francisco Veterans Affairs Medical Center, San Francisco, California
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Guracho YD, Thomas SJ, Win KT. Smartphone application use patterns for mental health disorders: A systematic literature review and meta-analysis. Int J Med Inform 2023; 179:105217. [PMID: 37748330 DOI: 10.1016/j.ijmedinf.2023.105217] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 09/07/2023] [Accepted: 09/15/2023] [Indexed: 09/27/2023]
Abstract
BACKGROUND Mobile mental health applications play a significant role in mental health care to fill gaps in care for mental disorders. Despite the growth in mobile phone apps for mental health conditions, patients' mental health smartphone application use, perceived usefulness, and future interest in using apps for mental disorders have not been systematically examined. METHODS The authors designed and conducted this systematic review and meta-analysis according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statement. Articles reporting mobile/smartphone applications used for mental disorders describing ownership, application use, perceived helpfulness, future interest to use, use patterns, and attitudes were included. PubMed/MEDLINE, EMBASE, PsychINFO, Scopus, and Google Scholar were searched. Published articles from 2014 up to October 2022 were included. The methodological quality was assessed using the Joanna Briggs Institute critical appraisal tool. The heterogeneity test, publication bias, funnel plots and Egger's test were applied. The outcome was calculated by metaprop command using a random-effects model. RESULTS Ten studies met the eligibility criteria. The pooled prevalence of smartphone ownership, application use for current mental health disorders, perceived usefulness, and future interest in using the app for their mental health problem was 88.63%, 23.29%, 72.80%, and 78.97%, respectively. Heterogeneity and publication bias were detected. CONCLUSIONS The results of this study indicate that despite a considerable number of smartphone users, perceived usefulness, and future interest in using smartphone mental health applications among patients with mental disorders, only about one-fifth use an application for mental health disorders. The results show that there is a large potential to increase the use of apps for patients to support self-care in the growing era of digital mental health. Further research with consumers and mental health professionals is recommended to address barriers and improve mhealth app utilization. REGISTRATION Prospero international prospective register of systematic reviews with ID: CRD42022359416.
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Affiliation(s)
- Yonas Deressa Guracho
- University of Wollongong, Faculty of Engineering and Information Sciences, Wollongong, Australia; Bahir Dar University, College of Medical and Health Sciences, Bahir Dar, Ethiopia.
| | - Susan J Thomas
- University of Wollongong, Faculty of Science Medicine and Health, Wollongong, Australia
| | - Khin Than Win
- University of Wollongong, Faculty of Engineering and Information Sciences, Wollongong, Australia
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Gopalakrishnan TR, Jacob R, Periyandavar I. Does fear drive health app adoption? The role of threat perception in diabetes app usage. Diabetes Metab Syndr 2023; 17:102857. [PMID: 37776693 DOI: 10.1016/j.dsx.2023.102857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 09/10/2023] [Accepted: 09/11/2023] [Indexed: 10/02/2023]
Abstract
BACKGROUND AND AIM This study explores the interplay between fear or threat perception and adoption of health apps among individuals with diabetes. It draws on the concept of "fear" as an emotional response stemming from perceived threat, raising the question of whether threat perception drives the uptake of health apps. METHODS This study investigates the influence of diabetes threat perception on app adoption, akin to the role of fear appeal in behavior change communication. This study employed both a handout questionnaire and an online survey tool, Survey Monkey, for data collection. Using purposive sampling, data were collected from 222 individuals aged 35 years and above with diabetes in Chennai. RESULTS The results indicate that threat perception can trigger health app usage among people with high diabetic conditions, supporting the broader literature on fear appeal. Additionally, the perceived threat of diabetes is elevated among app users. Notably, a significant positive correlation exists between perceived threat of diabetes, daily app usage, and consistent app use. CONCLUSION This study underscores that the extent of perceived harm or vulnerability to threats influences individuals' behavioral changes. It introduces new avenues for encouraging health app usage among high-risk groups.
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Affiliation(s)
- T R Gopalakrishnan
- Department of Journalism and Communication, University of Madras, India.
| | - Rachel Jacob
- Department of Journalism, Madras Christian College, India.
| | - I Periyandavar
- Tamil Nadu Government Multi Super Speciality Hospital, Chennai, India.
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Ng HL, Sellappans R, Loo JSE. A survey of the adoption and perception of mobile health applications among community pharmacists in Malaysia. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2023; 31:489-495. [PMID: 37526297 DOI: 10.1093/ijpp/riad042] [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: 11/24/2022] [Accepted: 06/22/2023] [Indexed: 08/02/2023]
Abstract
OBJECTIVES To determine the adoption and perception of mobile health (mHealth) applications among community pharmacists in Malaysia. METHODS A cross-sectional survey using a self-administered questionnaire was conducted with 300 community pharmacists in the Klang Valley, Malaysia using a stratified sampling approach. The questionnaire consisted of 36 questions with three sections: demographic data, adoption of mHealth applications and perception towards mHealth applications. Descriptive and inferential tests as well as exploratory factor analysis were used to analyse the data. KEY FINDINGS Adoption of mHealth applications by community pharmacists for both professional and personal use was relatively high at 79.7%. Utilised mHealth applications were primarily from the medical references category, while applications for patient monitoring, personal care and fitness were used to a lesser degree. Among mHealth application users, only 65.7% recommended them to their patients. Overall perception towards mHealth applications was positive, but perception towards the benefits and favour of mHealth applications for their patients was lower. This was corroborated by the factor analysis, which identified four main factors explaining 59.9% of variance in the dataset. These factors were perception towards use in their own professional practice, perception on benefits and use in their patients, perception on specific features of mHealth applications, and reliability of mHealth applications. CONCLUSIONS Adoption of mHealth applications among community pharmacists in Malaysia is high. Community pharmacists are more likely to use mHealth applications professionally and personally but less likely to recommend them to patients due to less favourable perceptions on how patients will benefit from mHealth applications.
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Affiliation(s)
- Hui Leng Ng
- School of Pharmacy, Faculty of Health and Medical Sciences, Taylor's University, No. 1 Jalan Taylor's, 47500 Selangor, Malaysia
| | - Renukha Sellappans
- School of Pharmacy, Faculty of Health and Medical Sciences, Taylor's University, No. 1 Jalan Taylor's, 47500 Selangor, Malaysia
- Active Ageing Impact Lab, Taylor's University, No. 1 Jalan Taylor's, 47500 Selangor, Malaysia
| | - Jason S E Loo
- School of Pharmacy, Faculty of Health and Medical Sciences, Taylor's University, No. 1 Jalan Taylor's, 47500 Selangor, Malaysia
- Medical Advancement for Better Quality of Life Impact Lab, Taylor's University, No.1 Jalan Taylor's, 47500 Selangor, Malaysia
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11
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Singh B, Palmer S, Maher C. Evaluation of a supportive care app for coordinating caring networks: an analysis of the first 19,000 users. Front Digit Health 2023; 5:1063277. [PMID: 37266027 PMCID: PMC10229897 DOI: 10.3389/fdgth.2023.1063277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 04/26/2023] [Indexed: 06/03/2023] Open
Abstract
Background Major illnesses such as cancer, and other traumatic life events, can lead to sudden increases in supportive care needs. This study aimed to describe engagement, acceptability and satisfaction with a supportive care networking app under real-world conditions. Methods A total of 10,952 individuals used the app during the study period (2018-2022). The app is designed to enable "captains" to assemble a network of friends and family members to provide timely, and individually tailored, supportive care (including assistance with tasks such as taking children to school, cooking meals, grocery shopping, and transport to appointments). Engagement was determined from server data, whilst acceptability and satisfaction were captured using purposed-designed surveys. Results Users were mostly female (76%) and aged between 30 and 49 years (61%). The most common reason for using the app was sudden illness (web: 81%; mobile: 64%). An average of 42 tasks were requested per network, with a 32% acceptance rate. Significantly more tasks were requested (web: 52.2 tasks per network; mobile: 31.7 tasks per network; p < 0.001) and accepted (web: 43.2%; mobile: 20.2%; p < 0.001) in the web app vs. the mobile app. Task requests in the web app most commonly related to food (43% of requested tasks), social (15% of requested tasks) and children (13% of requested tasks). The task acceptance rate differed by task categories (p < 0.001), with tasks relating to transport, medical appointments and children accepted at the highest rates (56%, 52% and 49%, respectively). Acceptability and satisfaction data suggested that the app was well received and overall, participants were satisfied with the app. Conclusion Findings suggested that this support care networking app achieved widespread uptake for a wide variety of supportive care tasks. Future research focused on optimizing engagement with the mobile app and examining the effectiveness of the app for improving patient and hospital outcomes is warranted.
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Affiliation(s)
- Ben Singh
- Alliance for Research in Exercise Nutrition and Activity (ARENA), University of South Australia, Adelaide, SA, Australia
| | - Susan Palmer
- Research and Development Department, The Gather Group Co, Gather Group, Elsternwick VIC, Australia
| | - Carol Maher
- Alliance for Research in Exercise Nutrition and Activity (ARENA), University of South Australia, Adelaide, SA, Australia
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Wong AKC, Bayuo J, Wong FKY, Chow KKS, Wong SM, Lau ACK. The Synergistic Effect of Nurse Proactive Phone Calls With an mHealth App Program on Sustaining App Usage: 3-Arm Randomized Controlled Trial. J Med Internet Res 2023; 25:e43678. [PMID: 37126378 DOI: 10.2196/43678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 02/06/2023] [Accepted: 03/22/2023] [Indexed: 05/02/2023] Open
Abstract
BACKGROUND Although mobile health application (mHealth app) programs have effectively promoted disease self-management behaviors in the last decade, usage rates have tended to fall over time. OBJECTIVE We used a case management approach led by a nurse and supported by a health-social partnership team with the aim of sustaining app usage among community-dwelling older adults and evaluated the outcome differences (i.e, self-efficacy, levels of depression, and total health service usages) between those who continued to use the app. METHODS This was a 3-arm randomized controlled trial. A total of 221 older adults with hypertension, diabetes, or chronic pain were randomized into 3 groups: mHealth (n=71), mHealth with interactivity (mHealth+I; n=74), and the control (n=76). The mHealth application was given to the mHealth and mHealth+I groups. The mHealth+I group also received 8 proactive calls in 3 months from a nurse to encourage use of the app. The control group received no interventions. Data were collected at preintervention (T1), postintervention (T2), and at 3 months' postintervention (T3) to ascertain the sustained effect. RESULTS A total of 37.8% of mHealth+I and 18.3% of mHealth group participants continued using the mHealth app at least twice per week until the end of the sixth month. The difference in app usage across the 2 groups between T2 and T3 was significant (χ21=6.81, P=.009). Improvements in self-efficacy (β=4.30, 95% CI 0.25-8.35, P=.04) and depression levels (β=-1.98, 95% CI -3.78 to -0.19, P=.03) from T1 to T3 were observed in the mHealth group participants who continued using the app. Although self-efficacy and depression scores improved from T1 to T2 in the mHealth+I group, the mean values decreased at T3. Health service usage decreased for all groups from T1 to T2 (β=-1.38, 95% CI -1.98 to -0.78, P<.001), with a marginal increase at T3. CONCLUSIONS The relatively low rates of mHealth app usage at follow-up are comparable to those reported in the literature. More work is needed to merge the technology-driven and in-person aspects of mHealth. TRIAL REGISTRATION ClinicalTrials.gov NCT03878212; https://clinicaltrials.gov/ct2/show/NCT03878212. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1159/000509129.
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Affiliation(s)
| | - Jonathan Bayuo
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, China (Hong Kong)
| | | | | | - Siu Man Wong
- The Hong Kong Lutheran Social Service, Ho Man Tin, China (Hong Kong)
| | - Avis Cheuk Ki Lau
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, China (Hong Kong)
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Alkhaldi O, McMillan B, Maddah N, Ainsworth J. Interventions Aimed at Enhancing Health Care Providers' Behavior Toward the Prescription of Mobile Health Apps: Systematic Review. JMIR Mhealth Uhealth 2023; 11:e43561. [PMID: 36848202 PMCID: PMC10012012 DOI: 10.2196/43561] [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: 10/16/2022] [Revised: 12/12/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Mobile health (mHealth) apps have great potential to support the management of chronic conditions. Despite widespread acceptance of mHealth apps by the public, health care providers (HCPs) are reluctant to prescribe or recommend such apps to their patients. OBJECTIVE This study aimed to classify and evaluate interventions aimed at encouraging HCPs to prescribe mHealth apps. METHODS A systematic literature search was conducted to identify studies published from January 1, 2008, to August 5, 2022, using 4 electronic databases: MEDLINE, Scopus, CINAHL, and PsycINFO. We included studies that evaluated interventions encouraging HCPs to prescribe mHealth apps. Two review authors independently assessed the eligibility of the studies. The "National Institute of Health's quality assessment tool for before-and-after (pretest-posttest design) studies with no control group" and "the mixed methods appraisal tool (MMAT)" were used to assess the methodological quality. Owing to high levels of heterogeneity between interventions, measures of practice change, specialties of HCPs, and modes of delivery, we conducted a qualitative analysis. We adopted the behavior change wheel as a framework for classifying the included interventions according to intervention functions. RESULTS In total, 11 studies were included in this review. Most of the studies reported positive findings, with improvements in a number of outcomes, including increased knowledge of mHealth apps among clinicians, improved self-efficacy or confidence in prescribing, and an increased number of mHealth app prescriptions. On the basis of the behavior change wheel, 9 studies reported elements of environmental restructuring such as providing HCPs with lists of apps, technological systems, time, and resources. Furthermore, 9 studies included elements of education, particularly workshops, class lectures, individual sessions with HCPs, videos, or toolkits. Furthermore, training was incorporated in 8 studies using case studies or scenarios or app appraisal tools. Coercion and restriction were not reported in any of the interventions included. The quality of the studies was high in relation to the clarity of aims, interventions, and outcomes but weaker in terms of sample size, power calculations, and duration of follow-up. CONCLUSIONS This study identified interventions to encourage app prescriptions by HCPs. Recommendations for future research should consider previously unexplored intervention functions such as restrictions and coercion. The findings of this review can help inform mHealth providers and policy makers regarding the key intervention strategies impacting mHealth prescriptions and assist them in making informed decisions to encourage this adoption.
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Affiliation(s)
- Ohoud Alkhaldi
- Division of Informatics, Imaging and Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom.,Health Information Management and Technology Department, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Brian McMillan
- Centre for Primary Care and Health Services Research, The University of Manchester, Manchester, United Kingdom
| | - Noha Maddah
- Division of Informatics, Imaging and Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom.,Department of Health Services and Hospitals Administration, Faculty of Economics and Administration, King Abdulaziz University, Jeddah, Saudi Arabia
| | - John Ainsworth
- Division of Informatics, Imaging and Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
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Zhu Y, Zhao Z, Guo J, Wang Y, Zhang C, Zheng J, Zou Z, Liu W. Understanding Use Intention of mHealth Applications Based on the Unified Theory of Acceptance and Use of Technology 2 (UTAUT-2) Model in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3139. [PMID: 36833830 PMCID: PMC9960455 DOI: 10.3390/ijerph20043139] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 02/06/2023] [Accepted: 02/08/2023] [Indexed: 06/18/2023]
Abstract
The COVID-19 pandemic has significantly impacted the healthcare industry, especially public health resources and resource allocation. With the change in people's lifestyles and increased demand for medical and health care in the post-pandemic era, the Internet and home healthcare have rapidly developed. As an essential part of Internet healthcare, mobile health (mHealth) applications help to fundamentally address the lack of medical resources and meet people's healthcare needs. In this mixed-method study, we conducted in-depth interviews with 20 users in China (mean age = 26.13, SD = 2.80, all born in China) during the pandemic, based on the unified theory of acceptance and use of technology 2 (UTAUT-2) mode, and identified four dimensions of user needs in mHealth scenarios: convenience, control, trust, and emotionality. Based on the interview results, we adjusted the independent variables, deleted the hedonic motivation and the habit, and added the perceived trust and perceived risk as the variables. Using a structural equation model (SEM), we designed the questionnaire according to the qualitative results and collected data from 371 participants (above 18 years old, 43.9% male) online to examine the interrelationships these variables. The results show that performance expectancy (β = 0.40, p < 0.001), effort expectancy (β = 0.40, p < 0.001), social influence (β = 0.14, p < 0.05), facilitating condition (β = 0.15, p < 0.001), and perceived trust (β = 0.31, p < 0.001) had positive effects on use intention. Perceived risk (β = -0.31, p < 0.001) harmed use intention, and price value (β = 0.10, p > 0.5) had no significant effects on use intention. Finally, we discussed design and development guidelines that can enhance user experience of mHealth applications. This research combines the actual needs and the main factors affecting the use intention of users, solves the problems of low satisfaction of user experience, and provides better strategic suggestions for developing mHealth applications in the future.
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Affiliation(s)
- Yancong Zhu
- School of Biological Science and Medical Engineering, Beihang University, Beijing 100191, China
- Faculty of Psychology, Beijing Normal University, Beijing 100875, China
| | - Zhenhong Zhao
- Faculty of Psychology, Beijing Normal University, Beijing 100875, China
| | - Jingxian Guo
- Faculty of Psychology, Beijing Normal University, Beijing 100875, China
| | - Yanna Wang
- Faculty of Psychology, Beijing Normal University, Beijing 100875, China
| | - Chengwen Zhang
- Faculty of Psychology, Beijing Normal University, Beijing 100875, China
| | - Jiayu Zheng
- Faculty of Psychology, Beijing Normal University, Beijing 100875, China
| | - Zheng Zou
- Stanford Center at Peking University, Stanford University, Beijing 100871, China
| | - Wei Liu
- Faculty of Psychology, Beijing Normal University, Beijing 100875, China
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15
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Che Johan NAS, Rasani AAM, Keng SL. Chronic kidney disease patients' views of readiness and ability to use mHealth apps. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2023; 32:74-80. [PMID: 36715528 DOI: 10.12968/bjon.2023.32.2.74] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
BACKGROUND The use of mobile health (mHealth) applications, which provide opportunities to improve health and lessen health inequalities, is increasing. Studies assessing the readiness and ability of patients in Malaysia with chronic kidney disease (CKD) to use mobile phone apps to manage their health are limited. AIMS This study aimed to assess the readiness and ability to use mHealth apps among patients with CKD in north-east Peninsular Malaysia. METHODS A cross-sectional study was undertaken, using a convenience sample of 100 CKD medical inpatients in a tertiary teaching hospital. A structured, self-administered questionnaire on readiness and ability to use mHealth apps was adopted. FINDINGS Nearly one in five patients (18%) actively used health applications. More than three-quarters (77%) were aged >40 years and a similar proportion were ready to use mHealth apps (78%), and nearly half (46%) were confident about connecting their device to wifi. There was a correlation between ability and readiness to use mHealth apps (r=0.4; P<0.05). CONCLUSIONS Fewer than half of participants had a good command of mHealth applications. Therefore, support on the use of these apps is needed, and healthcare managers need to consider this.
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Affiliation(s)
| | | | - Soon Lean Keng
- Associate Professor and Academic Fellow, Nursing Programme, School of Health Sciences, Universiti Sains Malaysia
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16
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Montazeri M, Galavi Z, Ahmadian L. The role of mobile health in prevention, diagnosis, treatment and self-care of COVID-19 from the healthcare professionals' perspectives. Digit Health 2023; 9:20552076231171969. [PMID: 37152239 PMCID: PMC10159248 DOI: 10.1177/20552076231171969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 04/10/2023] [Indexed: 05/09/2023] Open
Abstract
Background To facilitate disease management, understanding the attitude of healthcare professionals regarding the use of this tool can help mobile health (mHealth) program developers develop appropriate interventions. Aims To assess the perspective of healthcare professionals regarding the contribution of mobile-based interventions in the prevention, diagnosis, self-care, and treatment (PDST) of COVID-19. Methods This is a survey study conducted in 2020 in Iran with 81 questions. In this study mHealth functionalities were categorized into four dimensions including innovative, monitoring and screening, remote services, and education and decision-making. The data were analyzed using descriptive statistics, ANOVA, and the Kruskal-Wallis test to compare the attitudes of the different job groups. Results In total, 123 providers participated, and 87.4% of them reported that mHealth technology is moderate to most helpful for the management of COVID-19. Healthcare professionals believed that mHealth technology could be most helpful in self-care and least helpful in the diagnosis of COVID-19. Regarding the functionalities of the mobile application, the results showed that the use of patient decision aids can be most helpful in self-care and the use of computer games can be least helpful in treatment. The participants believed that mHealth is more effective in monitoring and screening dimensions and less effective in providing remote services. Conclusions This study showed that healthcare professionals believed that mHealth technology could have a better contribution to self-care for patients with COVID-19. Therefore, it is better to plan and invest more in the field of self-care to help patients to combat COVID-19. The results of this study revealed which mhealth functionalities work better in four domains of prevention, treatment, self-care, and diagnosis of COVID-19. This can help healthcare authorities to implement appropriate IT-based interventions to combat COVID-19.
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Affiliation(s)
- Mahdieh Montazeri
- Department of Health Information Sciences, Faculty
of Management and Medical Information Sciences, Kerman University of Medical
Sciences, Kerman, Iran
| | - Zahra Galavi
- Department of Health Information Sciences, Faculty
of Management and Medical Information Sciences, Kerman University of Medical
Sciences, Kerman, Iran
| | - Leila Ahmadian
- Department of Health Information Sciences, Faculty
of Management and Medical Information Sciences, Kerman University of Medical
Sciences, Kerman, Iran
- Leila Ahmadian, Department of Health
Information Sciences, Faculty of Management and Medical Information Sciences,
Kerman University of Medical Sciences, Haft-bagh Highway, PO Box 7616911320,
Kerman, Iran. Emails: ,
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Hamideh Kerdar S, Gwiasda M, Berger B, Rathjens L, Schwarz S, Jenetzky E, Martin DD. Predictors of sustained use of mobile health applications: Content analysis of user perspectives from a fever management app. Digit Health 2023; 9:20552076231180418. [PMID: 37312942 PMCID: PMC10259139 DOI: 10.1177/20552076231180418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 05/19/2023] [Indexed: 06/15/2023] Open
Abstract
Objectives Mobile health applications could be means of educating and changing behaviours of their users. Their features and qualities determine the sustainability of use. The FeverApp with two main features of information and documentation is a research-based app. In this observational cohort study, to evaluate the influential predictors of use, users' feedback on the FeverApp, were analyzed. Methods Feedback is given using a structured questionnaire, four Likert items and two open questions regarding positive and negative impressions, available via app menu. Conventional content analysis (inductive approach) on the two open questions was performed. Comments were grouped into 12 codes. These codes were grouped hierarchically in an iterative process into nine subcategories and lastly into two main categories 'format' and 'content'. Descriptive and quantitative analysis were performed. Results Out of 8243 users, 1804 of them answered the feedback questionnaire. The features of the app (N = 344), followed by the information aspect (N = 330) were most frequently mentioned. Documentation process (N = 226), request for new features or improvement of the current ones (N = 193), and functioning (N = 132) were also highlighted in users' feedback. App's ease of use, design and being informative were important for the users. The first impression of the app seems important as the majority of feedback were given during the first month of using the app. Conclusion In-app feedback function could highlight shortcomings and strengths of mobile health apps. Taking users' feedback into consideration could increase the chance of sustained use. Besides ease of use and clear, likeable designs, users want apps that serve their needs while saving time.
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Affiliation(s)
- Sara Hamideh Kerdar
- Faculty of Health/School of Medicine, Witten/Herdecke University, Witten, Germany
| | - Moritz Gwiasda
- Faculty of Health/School of Medicine, Witten/Herdecke University, Witten, Germany
| | - Bettina Berger
- Faculty of Health/School of Medicine, Witten/Herdecke University, Witten, Germany
| | - Larisa Rathjens
- Faculty of Health/School of Medicine, Witten/Herdecke University, Witten, Germany
| | - Silke Schwarz
- Faculty of Health/School of Medicine, Witten/Herdecke University, Witten, Germany
| | - Ekkehart Jenetzky
- Faculty of Health/School of Medicine, Witten/Herdecke University, Witten, Germany
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center of the Johannes-Gutenberg-University, Mainz, Germany
| | - David D Martin
- Faculty of Health/School of Medicine, Witten/Herdecke University, Witten, Germany
- Department of Pediatrics, Eberhard-Karls University Tübingen, Tübingen, Germany
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Ali Sherazi B, Laeer S, Krutisch S, Dabidian A, Schlottau S, Obarcanin E. Functions of mHealth Diabetes Apps That Enable the Provision of Pharmaceutical Care: Criteria Development and Evaluation of Popular Apps. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:64. [PMID: 36612402 PMCID: PMC9819585 DOI: 10.3390/ijerph20010064] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 12/16/2022] [Accepted: 12/19/2022] [Indexed: 06/17/2023]
Abstract
Personal digital health apps for managing diabetes should include functions that enable the provision of pharmaceutical care services and allow within-app communication with pharmacists and other healthcare providers, thereby improving patient outcomes. The primary aim of this study was to assess the functions of diabetes apps that were relevant to providing pharmaceutical care services (i.e., medication management, adherence, non-pharmacological management, interoperability, and communication). Sixteen criteria related to pharmaceutical care were developed and then used to assess ten popular diabetes apps. The highest numbers of pharmaceutical care criteria were met by the apps Diabetes:M and mySugr (11 criteria); Contour™Diabetes, Dario Health, and OneTouch Reveal® (ten); and DiabetesConnect and ESYSTA (nine); followed by Glucose Buddy (eight), meala (seven), and lumind (three). The most prevalent functions were related to promoting adherence and non-pharmacological management, but most criteria relevant to medication management were lacking. Five apps allowed within-app communication between patients and healthcare professionals (HCPs); however, no app included communication with pharmacists. High-quality diabetes apps are powerful tools to support pharmaceutical care and remotely monitor diabetes patients. Improvements are needed as they often lack many medication management functions, including within-app communication with HCPs (especially pharmacists). To maximize diabetes app use and improve outcomes, app developers should consider including pharmacists alongside other healthcare providers when customizing app designs.
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Affiliation(s)
- Bushra Ali Sherazi
- Institute of Clinical Pharmacy and Pharmacotherapy, Heinrich Heine University, Universitätsstraße 1, 40225 Düsseldorf, Germany
- Institute of Pharmacy, Faculty of Pharmaceutical and Allied Health Sciences, Lahore College for Women University, Lahore 54000, Pakistan
| | - Stephanie Laeer
- Institute of Clinical Pharmacy and Pharmacotherapy, Heinrich Heine University, Universitätsstraße 1, 40225 Düsseldorf, Germany
| | | | - Armin Dabidian
- Institute of Clinical Pharmacy and Pharmacotherapy, Heinrich Heine University, Universitätsstraße 1, 40225 Düsseldorf, Germany
| | - Sabina Schlottau
- Institute of Clinical Pharmacy and Pharmacotherapy, Heinrich Heine University, Universitätsstraße 1, 40225 Düsseldorf, Germany
| | - Emina Obarcanin
- Institute of Clinical Pharmacy and Pharmacotherapy, Heinrich Heine University, Universitätsstraße 1, 40225 Düsseldorf, Germany
- Department of Pharmacy, National University Singapore, 18 Science Drive 4, Singapore 117559, Singapore
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Malathi A, Jasim K. Validating the relationship between service quality, patient sensitivity and experience towards medical applications using SERVQUAL. Int J Med Inform 2022; 168:104883. [DOI: 10.1016/j.ijmedinf.2022.104883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 09/26/2022] [Accepted: 09/29/2022] [Indexed: 11/07/2022]
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Sivakumar B, Lemonde M, Stein M, Goldstein S, Mak S, Arcand J. Evaluating Health Care Provider Perspectives on the Use of Mobile Apps to Support Patients With Heart Failure Management: Qualitative Descriptive Study. JMIR Cardio 2022; 6:e40546. [PMID: 36287588 PMCID: PMC9647459 DOI: 10.2196/40546] [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: 06/26/2022] [Revised: 09/29/2022] [Accepted: 09/29/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Nonadherence to diet and medical therapies in heart failure (HF) contributes to poor HF outcomes. Mobile apps may be a promising way to improve adherence because they increase knowledge and behavior change via education and monitoring. Well-designed apps with input from health care providers (HCPs) can lead to successful adoption of such apps in practice. However, little is known about HCPs' perspectives on the use of mobile apps to support HF management. OBJECTIVE The aim of this study is to determine HCPs' perspectives (needs, motivations, and challenges) on the use of mobile apps to support patients with HF management. METHODS A qualitative descriptive study using one-on-one semistructured interviews, informed by the diffusion of innovation theory, was conducted among HF HCPs, including cardiologists, nurses, and nurse practitioners. Transcripts were independently coded by 2 researchers and analyzed using content analysis. RESULTS The 21 HCPs (cardiologists: n=8, 38%; nurses: n=6, 29%; and nurse practitioners: n=7, 33%) identified challenges and opportunities for app adoption across 5 themes: participant-perceived factors that affect app adoption-these include patient age, technology savviness, technology access, and ease of use; improved delivery of care-apps can support remote care; collect, share, and assess health information; identify adverse events; prevent hospitalizations; and limit clinic visits; facilitating patient engagement in care-apps can provide feedback and reinforcement, facilitate connection and communication between patients and their HCPs, support monitoring, and track self-care; providing patient support through education-apps can provide HF-related information (ie, diet and medications); and participant views on app features for their patients-HCPs felt that useful apps would have reminders and alarms and participative elements (gamification, food scanner, and quizzes). CONCLUSIONS HCPs had positive views on the use of mobile apps to support patients with HF management. These findings can inform effective development and implementation strategies of HF management apps in clinical practice.
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Affiliation(s)
- Bridve Sivakumar
- Faculty of Health Science, Ontario Tech University, Oshawa, ON, Canada
| | - Manon Lemonde
- Faculty of Health Science, Ontario Tech University, Oshawa, ON, Canada
| | - Matthew Stein
- Social Research Centre, Ontario Tech University, Oshawa, ON, Canada
| | - Sarah Goldstein
- School of Nutrition, Faculty of Community Services, Toronto Metropolitan University, Toronto, ON, Canada
| | - Susanna Mak
- Division of Cardiology, Department of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Medicine, Sinai Health, Toronto, ON, Canada
| | - JoAnne Arcand
- Faculty of Health Science, Ontario Tech University, Oshawa, ON, Canada
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Maphosa V. Delivering a Drug Information App to Underserved Communities: A User-Centered Design Approach. JOURNAL OF GLOBAL INFORMATION TECHNOLOGY MANAGEMENT 2022. [DOI: 10.1080/1097198x.2022.2132086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Vusumuzi Maphosa
- Department of Information Communication and Technology Services, National University of Science and Technology, Bulawayo, Zimbabwe
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22
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Pérez JC, Aldoney D, García MI, Olhaberry M, Fernández O, Alamo N, Franco P, Pérez F, Fisher J, Rowe H, Coo S. Online intervention to prevent postnatal depression and anxiety in Chilean new mothers: Protocol for a feasibility trial. Health Informatics J 2022; 28:14604582221135440. [DOI: 10.1177/14604582221135440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Symptoms of postpartum depression and anxiety in new mothers are prevalent and negatively impact maternal emotional wellbeing and infant development. Barriers to accessing treatment prevent women from receiving mental health care, a situation that has worsened due to the COVID-19 pandemic. mHealth interventions hold the potential to support women during the transition to parenthood despite these barriers and to promote the use of preventive interventions. This study uses a mixed methods design to assess the feasibility and preliminary effectiveness of a psychoeducational, guided mHealth intervention to prevent postpartum mental health difficulties in women who receive care in primary health centers in Chile. The study will contribute to evidence-based research on the effectiveness of mHealth interventions for new mothers from an understudied cultural background. The findings will also enable the development of a larger randomized controlled trial to assess the effectiveness of the intervention, which, if effective, could significantly contribute to the emotional wellbeing of women and their families.
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Affiliation(s)
- J. Carola Pérez
- Millennium Institute for Research on Depression and Personality (MIDAP), Santiago, Chile; Facultad de Psicología. Universidad del Desarrollo (UDD), Santiago, Chile
| | - Daniela Aldoney
- Facultad de Psicología, Universidad del Desarrollo (UDD), Santiago, Chile
| | - María I García
- Facultad de Psicología, Universidad del Desarrollo (UDD), Santiago, Chile
| | - Marcia Olhaberry
- Millennium Institute for Research on Depression and Personality (MIDAP), Santiago, Chile; School of Psychology, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Olga Fernández
- Millennium Institute for Research on Depression and Personality (MIDAP), Santiago, Chile; Universidad de Chile, Santiago, Chile
| | - Nicolle Alamo
- Millennium Institute for Research on Depression and Personality (MIDAP), Santiago, Chile; School of Social Work, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Pamela Franco
- Millennium Institute for Research on Depression and Personality (MIDAP), Santiago, Chile; School of Psychology, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Francisca Pérez
- Millennium Institute for Research on Depression and Personality (MIDAP), Santiago, Chile; Universidad Alberto Hurtado, Santiago, Chile
| | - Jane Fisher
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Heather Rowe
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Soledad Coo
- Facultad de Psicología, Universidad del Desarrollo (UDD), Santiago, Chile
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Jonasdottir SK, Thordardottir I, Jonsdottir T. Health professionals? Perspective towards challenges and opportunities of telehealth service provision: A scoping review. Int J Med Inform 2022; 167:104862. [PMID: 36179598 DOI: 10.1016/j.ijmedinf.2022.104862] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 08/08/2022] [Accepted: 08/30/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Telehealth, or healthcare offered through the internet, computers, and other devices for communication, is rapidly increasing with changing times and technological advancement. For quality and security of such services, it is crucial that professionals are competent in offering such service. Still, lack of professionals' training has been identified as one of the barriers to implementation of telehealth. Thus, to improve such training, it is crucial to identify professionals' knowledge, experience, and perspectives towards challenges and opportunities of using telehealth. OBJECTIVE The review's objective was to answer the research question: what is known in the literature about challenges and opportunities of telehealth service provision from the perspective of health professionals? METHODS Arksey and O'Malley's five-stage approach for scoping studies was used for the review. Studies were collected across four databases: Scopus, PubMed, ProQuest and EBSCOhost. The data from the 22 included studies were reported by using frequency counts and categorization of health professionals' experiences. RESULTS The findings of the review led to three categories: (1) study demographics, (2) challenges for telehealth, and (3) opportunities for telehealth. The most frequently reported challenges were issues related to communications, inadequate technology, or support, and need for training and knowledge to use the technology. The most frequent categories of opportunities related to improved access to services, benefits related to sharing of information sharing and experience and training of using technology. DISCUSSION Further research is needed to explore health professionals' experience of training, and to understand the type of support, resources, and training content they need to enhance their competency in telehealth provision.
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Saeidnia HR, Kozak M, Ausloos M, Herteliu C, Mohammadzadeh Z, Ghorbi A, Karajizadeh M, Hassanzadeh M. Development of a Mobile App for Self-Care Against COVID-19 Using the Analysis, Design, Development, Implementation, and Evaluation (ADDIE) Model: Methodological Study. JMIR Form Res 2022; 6:e39718. [PMID: 36054441 PMCID: PMC9472509 DOI: 10.2196/39718] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 07/13/2022] [Accepted: 08/10/2022] [Indexed: 12/23/2022] Open
Abstract
Background
Mobile apps have been shown to play an important role in the management, care, and prevention of infectious diseases. Thus, skills for self-care—one of the most effective ways to prevent illness—can be improved through mobile health apps.
Objective
This study aimed to design, develop, and evaluate an educational mobile-based self-care app in order to help the self-prevention of COVID-19 in underdeveloped countries. We intended the app to be easy to use, quick, and inexpensive.
Methods
In 2020 and 2021, we conducted a methodological study. Using the ADDIE (analysis, design, development, implementation, and evaluation) educational model, we developed a self-care management mobile app. According to the ADDIE model, an effective training and performance support tool is built through the 5 phases that comprise its name. There were 27 participants who conducted 2 evaluations of the mobile app’s usability and impact using the mobile health app usability and self-care inventory scales. The study design included pre- and posttesting.
Results
An Android app called MyShield was developed. The results of pre- and posttests showed that on a scale from 0 to 5, MyShield scored a performance average of 4.17 in the physical health dimension and an average of 3.88 in the mental well-being dimension, thereby showing positive effects on self-care skills. MyShield scored highly on the “interface and satisfaction,” “ease of use,” and “usefulness” components.
Conclusions
MyShield facilitates learning self-care skills at home, even during quarantine, increasing acquisition of information. Given its low development cost and the ADDIE educational design on which it is based, the app can be helpful in underdeveloped countries. Thus, low-income countries—often lacking other tools—can use the app as an effective tool for fighting COVID-19, if it becomes a standard mobile app recommended by the government.
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Affiliation(s)
- Hamid Reza Saeidnia
- Department of Knowledge and Information Science, Tarbiat Modares University, Tehran, Iran
| | - Marcin Kozak
- Department of Media, Journalism and Social Communication, University of Information Technology and Management in Rzeszow, Rzeszow, Poland
| | - Marcel Ausloos
- School of Business, University of Leicester, Brookfield, Leicester, United Kingdom
| | - Claudiu Herteliu
- Department of Statistics and Econometrics, Bucharest University of Economic Studies, Bucharest, Romania
| | - Zahra Mohammadzadeh
- Department of Health Information Management and Technology, School of Allied Medical Sciences, Kashan University of Medical Sciences, Kashan, Iran
| | - Ali Ghorbi
- Department of Knowledge and Information Science, University of Tehran, Tehran, Iran
| | - Mehrdad Karajizadeh
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Fars, Iran
| | - Mohammad Hassanzadeh
- Department of Knowledge and Information Science, Tarbiat Modares University, Tehran, Iran
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Cahyono HD, Irawaty D, Adam M. The effect of Benson relaxation application ('Bens app') on reducing fatigue in patients with breast cancer undergoing chemotherapy: A quasi-experimental study. BELITUNG NURSING JOURNAL 2022; 8:304-310. [PMID: 37546495 PMCID: PMC10401370 DOI: 10.33546/bnj.1843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 10/11/2021] [Accepted: 06/04/2022] [Indexed: 08/08/2023] Open
Abstract
Background Fatigue is the most common symptom in patients with breast cancer undergoing chemotherapy. Benson's relaxation technique is considered effective to reduce fatigue, but its effect in combination with smartphone technology is limited. Objective This study aimed to analyze and determine the effect of the Benson relaxation application (Bens app) on fatigue in patients with breast cancer undergoing chemotherapy. Methods A quasi-experimental design with a pretest-posttest comparison group was used. Fifty-six patients were included using consecutive sampling technique, of which 28 were assigned to the experimental group (received Benson relaxation technique using Bens app) and comparison group (obtained Benson relaxation technique using booklet). The Benson relaxation was done two times per day for seven days, and the Brief Fatigue Inventory questionnaire was used to measure the patients' fatigue levels. Data were analyzed using paired and independent t-tests. Results The experimental group (p = 0.001) and the comparison group (p = 0.015) showed a significant reduction in fatigue after receiving the Benson relaxation for seven days. However, there was a statistically significant difference in fatigue between the experiment and comparison groups after the intervention (t55 = 2.481, p = 0.016). Conclusion Benson relaxation could reduce fatigue in patients with breast cancer using the Bens app and booklet. However, the Bens app is considered more effective than a booklet. Therefore, the Bens app can be viewed as an alternative to help patients perform Benson relaxation and integrated into the nurse palliative care program for patients with cancer.
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Affiliation(s)
- Hendra Dwi Cahyono
- Postgraduate Program of Medical-Surgical Nursing, Faculty of Nursing, Universitas Indonesia, Indonesia
| | - Dewi Irawaty
- Department of Medical-Surgical Nursing, Faculty of Nursing, Universitas Indonesia, Indonesia
| | - Muhamad Adam
- Department of Medical-Surgical Nursing, Faculty of Nursing, Universitas Indonesia, Indonesia
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Müller J, Weinert L, Svensson L, Rivinius R, Kreusser MM, Heinze O. Mobile Access to Medical Records in Heart Transplantation Aftercare: Mixed-Methods Study Assessing Usability, Feasibility and Effects of a Mobile Application. Life (Basel) 2022; 12:1204. [PMID: 36013383 PMCID: PMC9410472 DOI: 10.3390/life12081204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/19/2022] [Accepted: 07/26/2022] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND Patient access to medical records can improve quality of care. The phellow application (app) was developed to provide patients access to selected content of their medical record. It was tested at a heart transplantation (HTx) outpatient clinic. The aims of this study were (1) to assess usability of phellow, (2) to determine feasibility of implementation in routine care, and (3) to study the effects app use had on patients' self-management. METHODS Usability was measured quantitatively through the System Usability Scale (SUS). Furthermore, usability, feasibility, and effects on self-management were qualitatively assessed through interviews with users, non-users, and health care providers. RESULTS The SUS rating (n = 31) was 79.9, indicating good usability. Twenty-three interviews were conducted. Although appreciation and willingness-to-use were high, usability problems such as incompleteness of record, technical issues, and complex registration procedures were reported. Improved technical support infrastructure, clearly defined responsibilities, and app-specific trainings were suggested for further implementation. Patients described positive effects on their self-management. CONCLUSIONS To be feasible for implementation in routine care, usability problems should be addressed. Feedback on the effect of app use was encouraging. Accompanying research is crucial to monitor usability improvements and to further assess effects of app use on patients.
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Affiliation(s)
- Julia Müller
- Institute of Medical Informatics, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany
| | - Lina Weinert
- Institute of Medical Informatics, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany
- Section for Translational Health Economics, Department for Conservative Dentistry, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - Laura Svensson
- Institute of Medical Informatics, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany
| | - Rasmus Rivinius
- Department of Cardiology, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Heidelberg/Mannheim, 69120 Heidelberg, Germany
| | - Michael M. Kreusser
- Department of Cardiology, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Heidelberg/Mannheim, 69120 Heidelberg, Germany
| | - Oliver Heinze
- Institute of Medical Informatics, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany
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Alaslawi H, Berrou I, Al Hamid A, Alhuwail D, Aslanpour Z. Diabetes Self-management Apps: Systematic Review of Adoption Determinants and Future Research Agenda. JMIR Diabetes 2022; 7:e28153. [PMID: 35900826 PMCID: PMC9377471 DOI: 10.2196/28153] [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: 03/01/2021] [Revised: 06/30/2021] [Accepted: 03/24/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Most diabetes management involves self-management. Effective self-management of the condition improves diabetes control, reduces the risk of complications, and improves patient outcomes. Mobile apps for diabetes self-management (DSM) can enhance patients' self-management activities. However, they are only effective if clinicians recommend them, and patients use them. OBJECTIVE This study aimed to explore the determinants of DSM apps' use by patients and their recommendations by health care professionals (HCPs). It also outlines the future research agenda for using DSM apps in diabetes care. METHODS We systematically reviewed the factors affecting the adoption of DSM apps by both patients and HCPs. Searches were performed using PubMed, Scopus, CINAHL, Cochrane Central, ACM, and Xplore digital libraries for articles published from 2008 to 2020. The search terms were diabetes, mobile apps, and self-management. Relevant data were extracted from the included studies and analyzed using a thematic synthesis approach. RESULTS A total of 28 studies met the inclusion criteria. We identified a range of determinants related to patients' and HCPs' characteristics, experiences, and preferences. Young female patients were more likely to adopt DSM apps. Patients' perceptions of the benefits of apps, ease of use, and recommendations by patients and other HCPs strongly affect their intention to use DSM apps. HCPs are less likely to recommend these apps if they do not perceive their benefits and may not recommend their use if they are unaware of their existence or credibility. Young and technology-savvy HCPs were more likely to recommend DSM apps. CONCLUSIONS Despite the potential of DSM apps to improve patients' self-care activities and diabetes outcomes, HCPs and patients remain hesitant to use them. However, the COVID-19 pandemic may hasten the integration of technology into diabetes care. The use of DSM apps may become a part of the new normal.
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Affiliation(s)
- Hessah Alaslawi
- Department of Clinical and Pharmaceutical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Ilhem Berrou
- School of Health & Social Wellbeing, University of the West of England, Bristol, United Kingdom
| | | | - Dari Alhuwail
- Department of Information Science, College of Computing Sciences and Engineering, Kuwait University, Kuwait, Kuwait
| | - Zoe Aslanpour
- Department of Clinical and Pharmaceutical Sciences, University of Hertfordshire, Hatfield, United Kingdom
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Jembai JVJ, Wong YLC, Bakhtiar NAMA, Lazim SNM, Ling HS, Kuan PX, Chua PF. Mobile health applications: awareness, attitudes, and practices among medical students in Malaysia. BMC MEDICAL EDUCATION 2022; 22:544. [PMID: 35836223 PMCID: PMC9282901 DOI: 10.1186/s12909-022-03603-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 07/06/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The popularity of mobile health (mHealth) applications (or apps) in the field of health and medical education is rapidly increasing, especially since the COVID-19 pandemic. We aimed to assess awareness, attitudes, practices, and factors associated with the mHealth app usage among medical students. METHODS We conducted a cross-sectional study involving medical students at a government university in Sarawak, Malaysia, from February to April 2021. Validated questionnaires were administered to all consenting students. These questionnaires included questions on basic demographic information as well as awareness, attitude toward, and practices with mHealth apps concerned with medical education, health and fitness, and COVID-19 management. RESULTS Respondents had favorable attitudes toward mHealth apps (medical education [61.8%], health and fitness [76.3%], and COVID-19 management [82.7%]). Respondents' mean attitude scores were four out of five for all three app categories. However, respondents used COVID-19 management apps more frequently (73.5%) than those for medical education (35.7%) and fitness (39.0%). Usage of all three app categories was significantly associated with the respondent's awareness and attitude. Respondents in the top 20% in term of household income and study duration were more likely to use medical education apps. The number of respondents who used COVID-19 apps was higher in the top 20% household income group than in the other income groups. The most common barrier to the use of apps was uncertainty regarding the most suitable apps to choose. CONCLUSION Our study highlighted a discrepancy between awareness of mHealth apps and positive attitudes toward them and their use. Recognition of barriers to using mHealth apps by relevant authorities may be necessary to increase the usage of these apps.
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Affiliation(s)
| | - Yi Lin Charlene Wong
- Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, Kota Saramahan, Sarawak, Malaysia
| | | | - Siti Nursuraya Md Lazim
- Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, Kota Saramahan, Sarawak, Malaysia
| | - Hwei Sung Ling
- Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, Kota Saramahan, Sarawak, Malaysia
| | - Pei Xuan Kuan
- Digital Health Research and Innovation, Institute for Clinical Research, National Institutes of Health Malaysia, Shah Alam, Malaysia
| | - Pin Fen Chua
- Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, Kota Saramahan, Sarawak, Malaysia.
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Kusyanti T, Wirakusumah FF, Rinawan FR, Muhith A, Purbasari A, Mawardi F, Puspitasari IW, Faza A, Stellata AG. Technology-Based (Mhealth) and Standard/Traditional Maternal Care for Pregnant Woman: A Systematic Literature Review. Healthcare (Basel) 2022; 10:healthcare10071287. [PMID: 35885813 PMCID: PMC9322765 DOI: 10.3390/healthcare10071287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/08/2022] [Accepted: 06/15/2022] [Indexed: 11/16/2022] Open
Abstract
The world of health has changed significantly since the advent of smartphones. Smartphones have been widely known to facilitate the search for health information in the mobile Health (mHealth) system, which is used to improve the quality of life for patients, such as communication between doctors and patients. This systematic literature review aims to identify the use of mHealth as a digital communication tool for pregnant women by comparing technology-based and standard-based pregnancy care. The method used is a systematic review of articles related to pregnancy care that utilize mHealth for pregnant women. The articles were obtained from the database based on the PICO framework; we searched articles using seven databases. The selection was adjusted to the inclusion criteria, data extraction, study quality evaluation, and results from synthesis. From the disbursement, 543 articles were obtained and 10 results were obtained after the screening. After a critical appraisal was carried out, four articles were obtained. Advantages can be in the form of increasing knowledge of pregnant women who use mHealth due to the availability of information needed by pregnant women in the mHealth application. mHealth also provides information about their babies, so the impact of mHealth is not only for mothers. mHealth is a promising solution in pregnancy care compared to the standard of maternal care.
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Affiliation(s)
- Tatik Kusyanti
- Doctoral Study Program, Faculty of Medicine, Universitas Padjadjaran, Jl. Eyckman No. 38, Bandung 40161, Indonesia
- Department of Midwifery, Bandung Health Polytechnic, Jl. Sederhana No. 2, Bandung 40161, Indonesia
- Center of Excellence, Bandung Health Polytechnic, Jl. Pajajaran 56, Bandung 40171, Indonesia
- Correspondence:
| | - Firman Fuad Wirakusumah
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Padjadjaran, Jl. Eyckman No. 38, Bandung 40161, Indonesia;
- Department of Obstetrics and Gynecology, Dr. Hasan Sadikin General Hospital, Jl. Pasteur No. 38, Bandung 40161, Indonesia
| | - Fedri Ruluwedrata Rinawan
- Center for Health System Study and Health Workforce Education Innovation, Faculty of Medicine, Universitas Padjadjaran, Jl. Eyckman No. 38, Bandung 40161, Indonesia;
- Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Jalan Ir. Soekarno KM. 21, Jatinangor, Sumedang 45363, Indonesia
- Indonesian Society for Remote Sensing Branch, Gedung Labtek IX-C lt.3 Jalan Ganesha 10, Institut Teknologi Bandung, Bandung 40132, Indonesia
| | - Abdul Muhith
- Department of Nursing Science, Universitas Nahdlatul Ulama, Surabaya 60237, Indonesia;
| | - Ayi Purbasari
- Informatics Engineering Study Program, Faculty of Engineering, Universitas Pasundan, Jl. Dr. Setiabudi No. 193, Bandung 40153, Indonesia;
| | - Fitriana Mawardi
- Department of Family and Community Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia;
| | - Indriana Widya Puspitasari
- Master of Midwifery Study Program, Faculty of Medicine, Universitas Padjadjaran, Jl. Eyckman No. 38, Bandung 40161, Indonesia; (I.W.P.); (A.G.S.)
| | - Afina Faza
- Master of Public Health Study Program, Faculty of Medicine, Universitas Padjadjaran, Jalan Eyckman No. 38 Gedung RSP Unpad Lantai 4, Bandung 40161, Indonesia;
- School of Economic and Business, Telkom University, Bandung 40257, Indonesia
| | - Alyxia Gita Stellata
- Master of Midwifery Study Program, Faculty of Medicine, Universitas Padjadjaran, Jl. Eyckman No. 38, Bandung 40161, Indonesia; (I.W.P.); (A.G.S.)
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Hein HJ, Glombiewski JA, Rief W, Riecke J. Effects of a video intervention on physicians' acceptance of pain apps: a randomised controlled trial. BMJ Open 2022; 12:e060020. [PMID: 35470200 PMCID: PMC9039411 DOI: 10.1136/bmjopen-2021-060020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES The aim of our study was to determine and enhance physicians' acceptance, performance expectancy and credibility of health apps for chronic pain patients. We further investigated predictors of acceptance. DESIGN Randomised experimental trial with a parallel-group repeated measures design. SETTING AND PARTICIPANTS 248 physicians working in various, mainly outpatient settings in Germany. INTERVENTION AND OUTCOME Physicians were randomly assigned to either an experimental group (short video about health apps) or a control group (short video about chronic pain). Primary outcome measure was acceptance. Performance expectancy and credibility of health apps were secondary outcomes. In addition, we assessed 101 medical students to evaluate the effectiveness of the video intervention in young professionals. RESULTS In general, physicians' acceptance of health apps for chronic pain patients was moderate (M=9.51, SD=3.53, scale ranges from 3 to 15). All primary and secondary outcomes were enhanced by the video intervention: A repeated-measures analysis of variance yielded a significant interaction effect for acceptance (F(1, 246)=15.28, p=0.01), performance expectancy (F(1, 246)=6.10, p=0.01) and credibility (F(1, 246)=25.61, p<0.001). The same pattern of results was evident among medical students. Linear regression analysis revealed credibility (β=0.34, p<0.001) and performance expectancy (β=0.30, p<0.001) as the two strongest factors influencing acceptance, followed by scepticism (β=-0.18, p<0.001) and intuitive appeal (β=0.11, p=0.03). CONCLUSIONS AND RECOMMENDATIONS Physicians' acceptance of health apps was moderate, and was strengthened by a 3 min video. Besides performance expectancy, credibility seems to be a promising factor associated with acceptance. Future research should focus on ways to implement acceptability-increasing interventions into routine care.
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Affiliation(s)
- Hauke Jeldrik Hein
- Clinical Psychology and Psychotherapy, Department of Psychology, Philipps-University Marburg, Marburg, Germany
| | - Julia Anna Glombiewski
- Pain and Psychotherapy Research Lab, Department of Psychology, University of Koblenz-Landau, Landau, Germany
| | - Winfried Rief
- Clinical Psychology and Psychotherapy, Department of Psychology, Philipps-University Marburg, Marburg, Germany
| | - Jenny Riecke
- Clinical Psychology and Psychotherapy, Department of Psychology, Philipps-University Marburg, Marburg, Germany
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Jones AC, Grout L, Wilson N, Nghiem N, Cleghorn C. The Cost-effectiveness of a Mass Media Campaign to Promote Smartphone Apps for Weight Loss: Updated Modeling Study. JMIR Form Res 2022; 6:e29291. [PMID: 35438643 PMCID: PMC9066337 DOI: 10.2196/29291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 06/21/2021] [Accepted: 12/16/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Evidence suggests that smartphone apps can be effective in the self-management of weight. Given the low cost, broad reach, and apparent effectiveness of weight loss apps, governments may seek to encourage their uptake as a tool to reduce excess weight in the population. Mass media campaigns are 1 mechanism for promoting app use. However, the cost and potential cost-effectiveness are important considerations. OBJECTIVE The aim of our study was to use modeling to assess the health impacts, health system costs, cost-effectiveness, and health equity of a mass media campaign to promote high-quality smartphone apps for weight loss in New Zealand. METHODS We used an established proportional multistate life table model that simulates the 2011 New Zealand adult population over the lifetime, subgrouped by age, sex, and ethnicity (Māori [Indigenous] or non-Māori). The risk factor was BMI. The model compared business as usual to a one-off mass media campaign intervention, which included the pooled effect size from a recent meta-analysis of smartphone weight loss apps. The resulting impact on BMI and BMI-related diseases was captured through changes in health gain (quality-adjusted life years) and in health system costs. The difference in total health system costs was the net sum of intervention costs and downstream cost offsets because of altered disease rates. An annual discount rate of 3% was applied to health gains and health system costs. Multiple scenarios and sensitivity analyses were conducted, including an equity adjustment. RESULTS Across the remaining lifetime of the modeled 2011 New Zealand population, the mass media campaign to promote weight loss app use had an estimated overall health gain of 181 (95% uncertainty interval 113-270) quality-adjusted life years and health care costs of -NZ $606,000 (-US $408,000; 95% uncertainty interval -NZ $2,540,000 [-US $1,709,000] to NZ $907,000 [US $610,000]). The mean health care costs were negative, representing overall savings to the health system. Across the outcomes examined in this study, the modeled mass media campaign to promote weight loss apps among the general population would be expected to provide higher per capita health gain for Māori and hence reduce health inequities arising from high BMI, assuming that the intervention would be as effective for Māori as it is for non-Māori. CONCLUSIONS A modeled mass media campaign to encourage the adoption of smartphone apps to promote weight loss among the New Zealand adult population is expected to yield an overall gain in health and to be cost-saving to the health system. Although other interventions in the nutrition and physical activity space are even more beneficial to health and produce larger cost savings (eg, fiscal policies and food reformulation), governments may choose to include strategies to promote health app use as complementary measures.
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Affiliation(s)
- Amanda C Jones
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Leah Grout
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Nick Wilson
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Nhung Nghiem
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Christine Cleghorn
- Department of Public Health, University of Otago, Wellington, New Zealand
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O'Neill M, Houghton C, Crilly G, Dowling M. A qualitative evidence synthesis of users' experience of mobile health applications in the self-management of type 2 diabetes. Chronic Illn 2022; 18:22-45. [PMID: 33583207 DOI: 10.1177/1742395320983877] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM The aim of this qualitative evidence synthesis was to identify and synthesise qualitative research relating to experiences of using mobile health (mHealth) applications to aid self-management of Type 2 Diabetes. METHODS Using a systematic search strategy, 11 databases were searched (Medline, CINAHL, PsychInfo, PubMed, Web of Science, Embase, Cochrane Library, Scopus, ProQuest A&1, ProQuest UK & Ireland, Mednar). "Best fit" framework synthesis was used guided by the Health Information Technology Acceptance Model (HITAM). Assessment of methodological limitations was conducted using Critical Appraisal Skills Programme (CASP) and confidence in the review findings were guided by GRADE-CERQual. RESULTS Fourteen eligible studies were included in the synthesis (7 qualitative and 5 mixed methods). Key themes identified under the health, information and technology zones of the HITAM revealed the benefits of mHealth apps, barriers to their use, their perceived usefulness and ease of use. DISCUSSION Most people used the apps for feedback on their self-management and found them helpful in their communication with health care providers. Some embraced the technology and found it easy to use while others found mHealth apps to be counterintuitive.
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Affiliation(s)
| | - Catherine Houghton
- School of Nursing and Midwifery, National University of Ireland, Galway, University Road, Galway, Ireland
| | | | - Maura Dowling
- School of Nursing and Midwifery, National University of Ireland, Galway, University Road, Galway, Ireland
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Pilot implementation to assess the feasibility and care team impact of an app-based interactive care plan to remotely monitor breast cancer survivors. J Cancer Surviv 2022; 16:13-23. [PMID: 35107791 PMCID: PMC8809246 DOI: 10.1007/s11764-021-01136-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 11/06/2021] [Indexed: 01/22/2023]
Abstract
Purpose
To assess the feasibility of an app-based, electronic health record (EHR)-integrated, interactive care plan (ICP) for breast cancer (BC) survivors. Methods A single-arm pilot study was conducted with female BC survivors. ICP tasks included quarterly quality of life (QOL) questionnaire; monthly assessments of fatigue, insomnia, sexual dysfunction, hot flashes, and recurrence symptoms; and daily activity reminders. Embedded decision trees escalated recurrence symptoms to providers. On-demand education was available for self-management of treatment-related toxicities. The primary objective was to assess patients’ engagement with ICP tasks against feasibility thresholds of 75% completion rate. Secondary objectives were evaluation of the system’s functionality to track and escalate symptoms appropriately, and care team impact measured by volume of escalation messages generated. We report preliminary results 6 months after the last patient enrolled. Results Twenty-three patients enrolled August to November 2020. Mean age was 50.1 years. All patients engaged with at least one ICP task. The monthly average task completion rates were 62% for the QOL questionnaire, 59% for symptom assessments, and 37% for activity reminders. Task completion rate decreased over time. Eleven of 253 symptoms and QOL questionnaires (4.3%) generated messages for care escalation. Conclusion Implementation of an app-based, EHR-integrated ICP in BC survivors was feasible and created minimal provider burden; however, patient engagement was below the feasibility threshold suggesting that changes may enhance broad implementation and adoption. Implications for Cancer Survivors An ICP may facilitate remote monitoring, symptom control, and recurrence surveillance for cancer survivors as strategies to enhance patient engagement are applied. Supplementary Information The online version contains supplementary material available at 10.1007/s11764-021-01136-1.
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Hasan N, Bao Y. A mixed-method approach to assess users' intention to use mobile health (mHealth) using PLS-SEM and fsQCA. ASLIB J INFORM MANAG 2022. [DOI: 10.1108/ajim-07-2021-0211] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
PurposeDespite the enormous potential of mobile health (mHealth), identifying the asymmetric relationship among the predictors towards intention to use (ITU) of mHealth tends to remain unresolved. This study aims to investigate the predictors and their asymmetric effects on ITU of mHealth through patients and healthcare professionals.Design/methodology/approachAn integrated information systems (IS) model with four additional constructs has been developed to analyze symmetric and asymmetric effects on ITU of mHealth. An exploratory survey on 452 mHealth users with prior experience was conducted to evaluate the model using a mixed-method approach including partial least squares-based structural equation modeling (PLS-SEM) and fuzzy-set qualitative comparative analysis (fsQCA) technique.FindingsThe findings show that facilitating conditions, personal awareness building, perceived enjoyment, effort expectancy and perceived usefulness have predictive power for ITU of mHealth. In contrast, fsQCA reveals four more alternative solutions, including the main drivers explored by PLS-SEM. The results indicate that various conditions that were not crucial in PLS-SEM analysis are shown to be sufficient conditions in fsQCA.Research limitations/implicationsThis study contributes to theory by integrating self-actualization factors (i.e. personal awareness building, patients as decision support unit) into the IS model. And practically, this study makes an essential contribution to users' ITU of mHealth, enabling relevant stakeholders to build strategies to implement mHealth successfully.Originality/valueWhile mHealth has revolutionized healthcare and the prior literature only showed linear relationships, this empirical study revealed asymmetrical relationships among the determinants of ITU of mHealth. Thus, this study extends to the growing body of literature on the use of mHealth technology in the least developing nation.
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Borah M, Deka C. Cross-sectional study on awareness and usage of Government COVID-19 mobile health applications among adult smartphone users of Assam. APOLLO MEDICINE 2022. [DOI: 10.4103/am.am_70_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Research on the Impact of mHealth Apps on the Primary Healthcare Professionals in Patient Care. Appl Bionics Biomech 2021; 2021:7611686. [PMID: 34912474 PMCID: PMC8668363 DOI: 10.1155/2021/7611686] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 11/10/2021] [Accepted: 11/17/2021] [Indexed: 11/25/2022] Open
Abstract
The goal of this study was to develop and use a questionnaire in order to analyse the effects of eHealth apps on patient care using Jordanian population. A two-stage cross-sectional research was conducted. A questionnaire was developed in the beginning to evaluate its consistency and legitimacy using Cronbach's alpha coefficient, a multitrait connection atmosphere; the multivariate technique is component examination. In the study's another phase, correlation and regression are used to determine the influence of eHealth apps on patient care. The five major axes of the final surveys were healthcare efficiency, teaching, notices, consultation, and follow-up. Individuals from diverse demographic aspects, such as gender, age, job experience, and education level, have no differing perspectives on cell phone use in their amenities, according to a staff's viewpoint evaluation. In general, mobile health applications had a good influence on health services and healthcare, which would be an important setting for the operative use of mobile headphones in public policy; such a background would affect in workers' intents to practice and adopt mHealth.
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Rahi S. Assessing individual behavior towards adoption of telemedicine application during COVID-19 pandemic: evidence from emerging market. LIBRARY HI TECH 2021. [DOI: 10.1108/lht-01-2021-0030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThis study attempts to gain insight into what factors influence individual behavior towards the adoption of telemedicine application during coronavirus disease 2019 (COVID-19) pandemic. The research model incorporates two well-known theories namely the extended unified theory of acceptance and use of technology (UTAUT2) and DeLone and McLean information success model to examine individual behavior towards the adoption of telemedicine application.Design/methodology/approachThe research design of this study is based on quantitative research approach. During research survey, 350 valid responses were received from Pakistani citizens and examined to understand citizen's behavior towards the adoption of telemedicine applications. The research model was empirically tested with the latest statistical approach namely variance-based structural equation modeling (VB-SEM).FindingsThe results of the structural equation modeling have revealed that altogether performance expectancy, social influence, effort expectancy, facilitating condition, habit, hedonic motivation, price values, information quality, system quality and service quality explained 77.9% variance in determining user behavior towards adoption of telemedicine application. The predictive relevance of the research model was found substantial in measuring user behavior to adopt telemedicine applications. The research framework is further extended with moderating role of perceived severity between the relationship of user intention and actual usage behavior. Results confirmed that the positive relationship between intention to adopt telemedicine health application and usage behavior will be stronger when perceived severity is higher.Practical implicationsTheoretically, this study integrates extended UTAUT2 and DeLone and McLean information success model and contributes to e-health literature. Practically, this research suggests that by improving user performance expectancy and effort expectancy, managers and healthcare professionals can boost user confidence towards the adoption of telemedicine applications.Originality/valueThis study is unique as it integrates the extended UTAUT2 with DeLone and McLean information success model and perceived severity to investigate user behavior towards adoption of telemedicine application during COVID-19 pandemic. Additionally, the integration of theories contributes to information system literature in the context of the adoption of telemedicine applications.
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Tahsin F, Tracy S, Chau E, Harvey S, Loganathan M, McKinstry B, Mercer SW, Nie J, Ramsay T, Thavorn K, Palen T, Sritharan J, Steele Gray C. Exploring the relationship between the usability of a goal-oriented mobile health application and non-usage attrition in patients with multimorbidity: A blended data analysis approach. Digit Health 2021; 7:20552076211045579. [PMID: 34868614 PMCID: PMC8642112 DOI: 10.1177/20552076211045579] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 08/24/2021] [Indexed: 11/16/2022] Open
Abstract
Background Mobile health applications are increasingly used to support the delivery of health care services to a variety of patients. Based on data obtained from a pragmatic trial of the electronic Patient Reported Outcome (ePRO) app designed to support goal-oriented care primary care, this study aims to (1) examine how patient-reported usability changed over the one-year intervention period, and (2) explore participant attrition rate of the electronic Patient Reported Outcome app over one year study period. Methods We performed a secondary analysis of 44 older adults with complex chronic needs enrolled in the electronic Patient Reported Outcome-digital health intervention. App usage and attrition were measured using device-generated usage logs; usability was measured using the patient-reported post-study system usability questionnaire collected at 3, 6, 9, and 12 months. Research memos were used to interpret potential contextual contributing factors to patients' overall usage and usability score pattern. A data triangulation method of both quantitative and qualitative data was used to analyze and interpret study findings. Results While there was gradual attrition in the use of the ePRO app, patients' usability scores remained consistent throughout the study period. Qualitative memos suggested patients' encounters with technical difficulties and relationship dynamics with primary providers influenced patients' adherence to the ePRO app. Conclusion This study highlights that the patient-provider relationship is a key determining factor that influences complex patients' continued engagement with a Mobile health app. The finding calls attention to the measurement of usability of a Mobile health app, its impact on attrition, and contributing factors that influence patients' attrition. Trial registration: Clinicaltrials.gov Identified NCT02917954.
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Affiliation(s)
- Farah Tahsin
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Canada
| | - Shawn Tracy
- Bridgepoint Collaboratory for Research and Innovation, Canada
| | - Edward Chau
- Bridgepoint Collaboratory for Research and Innovation, Canada
| | | | | | - Brian McKinstry
- Centre for Populations Health Sciences, Usher Institute, University of Edinburgh, UK
| | - Stewart W Mercer
- Centre for Populations Health Sciences, Usher Institute, University of Edinburgh, UK
| | - Jason Nie
- Institute for Better Health, Trillium Health Partners, Mississauga, Canada
| | - Tim Ramsay
- Ottawa Hospital Research Institute, School of Epidemiology and Public Health, University of Ottawa, Canada
| | - Kednapa Thavorn
- Ottawa Hospital Research Institute, School of Epidemiology and Public Health, University of Ottawa, Canada
| | | | | | - Carolyn Steele Gray
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Canada.,Bridgepoint Collaboratory for Research and Innovation, Canada
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mHealth for research. Digit Health 2021. [DOI: 10.1016/b978-0-12-820077-3.00005-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Rahi S, Khan MM, Alghizzawi M. Factors influencing the adoption of telemedicine health services during COVID-19 pandemic crisis: an integrative research model. ENTERP INF SYST-UK 2020. [DOI: 10.1080/17517575.2020.1850872] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Samar Rahi
- Hailey College of Banking and Finance, University of the Punjab, Lahore, Pakistan
| | | | - Mahmoud Alghizzawi
- Faculty of Business and management, Universiti Sultan Zainal Abidin, Malaysia
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Yamin MAY, Alyoubi BA. Adoption of telemedicine applications among Saudi citizens during COVID-19 pandemic: An alternative health delivery system. J Infect Public Health 2020; 13:1845-1855. [PMID: 33172819 DOI: 10.1016/j.jiph.2020.10.017] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 10/09/2020] [Accepted: 10/20/2020] [Indexed: 11/27/2022] Open
Abstract
This study aims to investigate individual behavior towards adoption of telemedicine application based on wireless sensor network applications (WSN) during COVID-19 pandemic. Therefore, the research model extends the unified theory of acceptance and use of technology with the task technology fit model, awareness and self-efficacy to determine user intention to adopt wireless sensor network application for medical assistance. A research survey was conducted towards Saudi citizens in voluntary setting. In response, 348 valid responses were retrieved. Sample size was computed with prior-power analysis using G-power software. The research model is empirically tested with latest statistical approach namely structural equation modeling (SEM). Findings of the structural model indicate that wireless sensor network application was jointly predicted by performance expectancy, social influence, effort expectancy, facilitating condition, task technology fit, awareness and self-efficacy and explained substantial variance R2 79.5% in individual behavior to adopt wireless sensor network application. The effect size analysis (f2) revealed that task technology fit and facilitating condition were the most important factors to determine user intention to adopt wireless sensor network application. The current study contributes to theory by extending the unified theory of acceptance and use of technology with task technology fit model, self-efficacy and awareness and enrich information system literature in the context of user intention to adopt wireless sensor network application. Practically, this study suggest that health consultant should focus on technology fitness including wireless devices and the number of facilities to operate wireless sensor network which in turn boost user confidence towards adoption of wireless sensor network application for health consultation. This study develops a unique research model that inspects user behavior towards adoption of wireless sensor network technology for better health care system. The findings of this study answer how to monitor COVID-19 while using of wireless sensor network applications. Moreover, this study is useful for clinical management through virtual environment and guides health advisors, software developers and physicians to design user friendly telemedicine application by using wireless sensor network technology.
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Affiliation(s)
- Mohammad Ali Yousef Yamin
- University of Jeddah, College of Business, Department of Human Resources Management, Jeddah, Saudi Arabia.
| | - Bader A Alyoubi
- University of Jeddah, College of Business, Department of Management Information Systems, Jeddah, Saudi Arabia.
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Mandracchia F, Llauradó E, Tarro L, Valls RM, Solà R. Mobile Phone Apps for Food Allergies or Intolerances in App Stores: Systematic Search and Quality Assessment Using the Mobile App Rating Scale (MARS). JMIR Mhealth Uhealth 2020; 8:e18339. [PMID: 32936078 PMCID: PMC7527917 DOI: 10.2196/18339] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 05/27/2020] [Accepted: 06/25/2020] [Indexed: 12/14/2022] Open
Abstract
Background Food allergies and intolerances are increasing worldwide, and mobile phone apps could be a promising tool for self-management of these issues. Objective This study aimed to systemically search and assess food allergy or intolerance apps in app stores using the multidimensional Mobile App Rating Scale (MARS) to rate the objective and subjective quality and to identify critical points for future improvements. Methods This systematic search identified apps through the keywords “food allergy,” “food intolerance,” and “allergens” in English, Spanish, and Italian in the Apple App Store (iOS) and Google Play Store (Android). The inclusion criteria were a user star rating of ≥3 (of 5 stars) to limit the selection to the most highly rated apps; ≥1000 reviews as an indicator of reliability; and the most recent update performed up to 2017. Then, the apps were divided according to their purpose (searching for allergen-free “food products,” “restaurants,” or recipes in “meal planners”) and evaluated on a scale of 1 to 5 points using the MARS in terms of (1) app classification category with a descriptive aim; (2) app subjective and objective quality categories comprised of engagement, functionality, esthetics, and information sections (Medline was searched for eligible apps to check whether they had been tested in trials); and (3) an optional app-specific section. Furthermore, the output and input features were evaluated. Differences between MARS sections and between app purposes and correlations among MARS sections, star ratings, and numbers of reviews were evaluated. Results Of the 1376 apps identified, 14 were included: 12 related to food allergies and intolerances that detect 2-16 food allergens and 2 related only to gluten intolerance. The mean (SD) MARS scores (maximum 5 points) were 3.8 (SD 0.4) for objective quality, highlighting whether any app had been tested in trials; 3.5 (SD 0.6) for subjective quality; and 3.6 (SD 0.7) for the app-specific section. Therefore, a rating ≥3 points indicated overall acceptable quality. From the between-section comparison, engagement (mean 3.5, SD 0.6) obtained significantly lower scores than functionality (mean 4.1, SD 0.6), esthetics (mean 4, SD 0.5), and information (mean 3.8, SD 0.4). However, when the apps were compared by purpose, critical points were identified: meal planner apps showed significantly higher engagement (mean 4.1, SD 0.4) than food product (mean 3.0, SD 0.6; P=.05) and restaurant (mean 3.2, SD 0.3; P=.02) apps. Conclusions In this systematic search of food allergy or intolerance apps, acceptable MARS quality was identified, although the engagement section for food product and restaurant purpose apps should be improved and the included apps should be tested in trials. The critical points identified in this systematic search can help improve the innovativeness and applicability of future food allergy and intolerance apps.
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Affiliation(s)
- Floriana Mandracchia
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Healthy Environment Chair, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, Reus, Spain
| | - Elisabet Llauradó
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Healthy Environment Chair, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, Reus, Spain
| | - Lucia Tarro
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Healthy Environment Chair, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, Reus, Spain.,Unit of Nutrition and Health, EURECAT-Technology Centre of Catalonia, Reus, Spain
| | - Rosa Maria Valls
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Healthy Environment Chair, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, Reus, Spain
| | - Rosa Solà
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Healthy Environment Chair, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, Reus, Spain.,Unit of Nutrition and Health, EURECAT-Technology Centre of Catalonia, Reus, Spain.,Hospital Universitari Sant Joan de Reus, Reus, Spain
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Affiliation(s)
| | | | - Chuanyu Gao
- Addenbrooke’s Hospital Cambridge University Hospital Foundation Trust Cambridge UK
- British Urology Researchers in Surgical Training (BURST)
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Scherr TF, Moore CP, Thuma P, Wright DW. Evaluating Network Readiness for mHealth Interventions Using the Beacon Mobile Phone App: Application Development and Validation Study. JMIR Mhealth Uhealth 2020; 8:e18413. [PMID: 32720909 PMCID: PMC7420690 DOI: 10.2196/18413] [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: 02/25/2020] [Revised: 04/24/2020] [Accepted: 05/13/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Mobile health (mHealth) interventions have the potential to transform the global health care landscape. The processing power of mobile devices continues to increase, and growth of mobile phone use has been observed worldwide. Uncertainty remains among key stakeholders and decision makers as to whether global health interventions can successfully tap into this trend. However, when correctly implemented, mHealth can reduce geographic, financial, and social barriers to quality health care. OBJECTIVE The aim of this study was to design and test Beacon, a mobile phone-based tool for evaluating mHealth readiness in global health interventions. Here, we present the results of an application validation study designed to understand the mobile network landscape in and around Macha, Zambia, in 2019. METHODS Beacon was developed as an automated mobile phone app that continually collects spatiotemporal data and measures indicators of network performance. Beacon was used in and around Macha, Zambia, in 2019. Results were collected, even in the absence of network connectivity, and asynchronously uploaded to a database for further analysis. RESULTS Beacon was used to evaluate three mobile phone networks around Macha. Carriers A and B completed 6820/7034 (97.0%) and 6701/7034 (95.3%) downloads and 1349/1608 (83.9%) and 1431/1608 (89.0%) uploads, respectively, while Carrier C completed only 62/1373 (4.5%) file downloads and 0/1373 (0.0%) file uploads. File downloads generally occurred within 4 to 12 seconds, and their maximum download speeds occurred between 2 AM and 5 AM. A decrease in network performance, demonstrated by increases in upload and download durations, was observed beginning at 5 PM and continued throughout the evening. CONCLUSIONS Beacon was able to compare the performance of different cellular networks, show times of day when cellular networks experience heavy loads and slow down, and identify geographic "dead zones" with limited or no cellular service. Beacon is a ready-to-use tool that could be used by organizations that are considering implementing mHealth interventions in low- and middle-income countries but are questioning the feasibility of the interventions, including infrastructure and cost. It could also be used by organizations that are looking to optimize the delivery of an existing mHealth intervention with improved logistics management.
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Affiliation(s)
| | - Carson Paige Moore
- Department of Chemistry, Vanderbilt University, Nashville, TN, United States
| | | | - David Wilson Wright
- Department of Chemistry, Vanderbilt University, Nashville, TN, United States
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Alwashmi MF, Fitzpatrick B, Farrell J, Gamble JM, Davis E, Nguyen HV, Farrell G, Hawboldt J. Perceptions of Patients Regarding Mobile Health Interventions for the Management of Chronic Obstructive Pulmonary Disease: Mixed Methods Study. JMIR Mhealth Uhealth 2020; 8:e17409. [PMID: 32706697 PMCID: PMC7413289 DOI: 10.2196/17409] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 05/10/2020] [Accepted: 06/14/2020] [Indexed: 01/20/2023] Open
Abstract
Background Using a mobile health (mHealth) intervention consisting of a smartphone and compatible medical device has the potential to enhance chronic obstructive pulmonary disease (COPD) treatment outcomes while mitigating health care costs. Objective This study aims to describe the demographics, use, and access to smartphones of patients with COPD. It also aims to explore and develop an understanding of potential facilitators and barriers that might influence patients using mHealth interventions for COPD management. Methods This was an explanatory, sequential mixed methods study. Patients who attended respirology clinics completed a questionnaire on technology access and use. We conducted semistructured individual interviews with the patients. Interview topics included the following: demographics, mHealth use, perceptions toward challenges of mHealth adoption, factors facilitating mHealth adoption, and preferences regarding features of mHealth interventions for COPD management. Results A total of 100 adults completed the survey but 22 participants were excluded because they were not diagnosed with COPD. Of these, 10 patients with COPD participated in the interview. The quantitative component revealed that many patients with COPD owned a mobile phone, but only about one-fourth of the participants (18/77, 23%) owned a smartphone. The likelihood of owning a smartphone was not associated with age, sex, marital status, or geographical location, but patients with high educational status were more likely to own a smartphone. The qualitative component found that patients with COPD, in general, had a positive attitude toward mHealth adoption for COPD management, but several facilitators and barriers were identified. The main facilitators of mHealth adoption are possible health benefits for patients, ease of use, educating patients, and credibility. Alternatively, the barriers to adoption are technical issues, lack of awareness, potential limited uptake from older adults, privacy and confidentiality issues, finances, and lack of interest in mHealth Conclusions It is important to understand the perceptions of patients with COPD regarding the adoption of innovative mHealth interventions for COPD management. This study identifies some potential facilitators and barriers that may inform the successful development and implementation of mHealth interventions for COPD management.
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Affiliation(s)
- Meshari F Alwashmi
- Memorial University of Newfoundland and Labrador, St. John's, NL, Canada
| | | | - Jamie Farrell
- Memorial University of Newfoundland and Labrador, St. John's, NL, Canada
| | - John-Michael Gamble
- School of Pharmacy, Faculty of Science, University of Waterloo, Waterloo, ON, Canada
| | - Erin Davis
- Memorial University of Newfoundland and Labrador, St. John's, NL, Canada
| | - Hai Van Nguyen
- Memorial University of Newfoundland and Labrador, St. John's, NL, Canada
| | - Gerard Farrell
- Memorial University of Newfoundland and Labrador, St. John's, NL, Canada
| | - John Hawboldt
- Memorial University of Newfoundland and Labrador, St. John's, NL, Canada
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Degroote L, Van Dyck D, De Bourdeaudhuij I, De Paepe A, Crombez G. Acceptability and feasibility of the mHealth intervention 'MyDayPlan' to increase physical activity in a general adult population. BMC Public Health 2020; 20:1032. [PMID: 32600352 PMCID: PMC7325032 DOI: 10.1186/s12889-020-09148-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 06/18/2020] [Indexed: 11/29/2022] Open
Abstract
Background Electronic health (eHealth) and mobile health (mHealth) interventions have the potential to tackle the worldwide problem of physical inactivity. However, they often suffer from large attrition rates. Consequently, feasibility and acceptability of interventions have become important matters in the creation of e- and mHealth interventions. The aim of this study was to evaluate participants’ opinions regarding acceptability and feasibility of a self-regulation, app-based intervention called ‘MyDayPlan’. ‘MyDayPlan’ provides an innovative daily cycle providing several self-regulation techniques throughout the day that guide users towards an active lifestyle via various self-regulation techniques. Methods Semi-structured interviews were conducted with 20 adults after using the app for 2 weeks. A directed content analysis was performed using NVivo Software. Results ‘MyDayPlan’ was well-received and seems to be feasible and acceptable with inactive adults. The straightforward lay out and ease of use of the app were appreciated. Furthermore, the incorporation of the techniques ‘action planning’, and ‘prompting review of behavioral goals’ was positively evaluated. However, the users gave some recommendations: implementation of activity trackers to self-monitor physical activity could be of added value. Furthermore, increasing intuitiveness by minimizing text input and providing more preprogrammed options could further increase the ease of use. Finally, users indicated that they would benefit from more guidance during the “coping planning” component (barrier identification/problem solving), for example by receiving more tailored examples. Conclusions Based on these findings, adaptations will be made to the ‘MyDayPlan’ app before evaluating its effectiveness. Furthermore, involving potential end users and evaluating acceptability and feasibility during the development of an e- and mHealth intervention is key. Also, creating interventions with a large ease of use and straightforward layout that provides tailored support during action and coping planning is key.
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Affiliation(s)
- L Degroote
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium. .,Research Foundation Flanders, Brussels, Belgium. .,Department of Clinical-Experimental and Health Psychology, Ghent University, Ghent, Belgium.
| | - D Van Dyck
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - I De Bourdeaudhuij
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - A De Paepe
- Department of Clinical-Experimental and Health Psychology, Ghent University, Ghent, Belgium
| | - G Crombez
- Department of Clinical-Experimental and Health Psychology, Ghent University, Ghent, Belgium
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Ndayizigamiye P, Kante M, Shingwenyana S. An adoption model of mHealth applications that promote physical activity. COGENT PSYCHOLOGY 2020. [DOI: 10.1080/23311908.2020.1764703] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- Patrick Ndayizigamiye
- Department of Applied Information Systems, University of Johannesburg, Johannesburg, South Africa
| | - Macire Kante
- Department of Applied Information Systems, University of Johannesburg, Johannesburg, South Africa
| | - Shalati Shingwenyana
- Department of Applied Information Systems, University of Johannesburg, Johannesburg, South Africa
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Queiroz FFDSN, Brasil CCP, Silva RMD, Bezerra IC, Collares PMC, Vasconcelos Filho JED. Evaluation of the 'Gestação' application from the perspective of semiotics: pregnant women's views. CIENCIA & SAUDE COLETIVA 2020; 26:485-492. [PMID: 33605326 DOI: 10.1590/1413-81232021262.41002020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 04/27/2020] [Indexed: 11/22/2022] Open
Abstract
Evaluating health-related applications is necessary for their adequacy and dissemination in society. The GestAção application was evaluated based on the opinion of 13 pregnant women followed up in prenatal care consultations at three public health services and at a private institution in Fortaleza, Ceará, Brazil. Data emerged from an evaluation carried out from June to December 2017, including semi-structured interviews. Data were analyzed from content analysis in thematic and semiotic modality. Thus, the theme "meanings attributed to the application by pregnant women" emerged, which is associated with the following cores of meaning: provision of safe and diverse information; possibility of changing behavior and motivations for using the application. It is considered that semiotics allowed to understand the meanings attributed to the application from the interaction of pregnant women with the tool. The GestAção application was considered satisfactory, motivating to use, informative, safe and promoter of changes in the context of gestational health. Participants' views allow the evaluated technology to compose strategies aimed at promoting health care for pregnant women.
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Affiliation(s)
| | - Christina César Praça Brasil
- Programa de Pós-Graduação em Saúde Coletiva, Universidade de Fortaleza (Unifor). Av. Washington Soares 1321, Edson Queiroz. 60811-905 Fortaleza CE Brasil.
| | - Raimunda Magalhães da Silva
- Programa de Pós-Graduação em Saúde Coletiva, Universidade de Fortaleza (Unifor). Av. Washington Soares 1321, Edson Queiroz. 60811-905 Fortaleza CE Brasil.
| | - Indara Cavalcante Bezerra
- Programa de Pós-Graduação em Saúde Coletiva, Universidade de Fortaleza (Unifor). Av. Washington Soares 1321, Edson Queiroz. 60811-905 Fortaleza CE Brasil.
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Abduo H, Curtain C, Othman N. Use of Smartphone Applications for Diabetes Management in Kuwait: A Pilot Study. JOURNAL OF CONSUMER HEALTH ON THE INTERNET 2020. [DOI: 10.1080/15398285.2020.1750827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Heba Abduo
- Pharmacy Unit, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Colin Curtain
- School of Pharmacy and Pharmacology, University of Tasmania, Hobart, Australia
| | - Nashwa Othman
- Education & Training Unit, Dasman Diabetes Institute, Kuwait City, Kuwait
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Ball E, Newton S, Rohricht F, Steed L, Birch J, Dodds J, Cantalapiedra Calvete C, Taylor S, Rivas C. mHealth: providing a mindfulness app for women with chronic pelvic pain in gynaecology outpatient clinics: qualitative data analysis of user experience and lessons learnt. BMJ Open 2020; 10:e030711. [PMID: 32165550 PMCID: PMC7069307 DOI: 10.1136/bmjopen-2019-030711] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To determine whether a pre-existing smartphone app to teach mindfulness meditation is acceptable to women with chronic pelvic pain (CPP) and can be integrated into clinical practice within the National Health Service (NHS) CPP pathways, and to inform the design of a potential randomised clinical trial. DESIGN A prestudy patient and public involvement (PPI) group to collect feedback on the acceptability of the existing app and study design was followed by a three-arm randomised feasibility trial. In addition, we undertook interviews and focus groups with patients and staff to explore app usability and acceptability. We also obtained participant comments on the research process, such as acceptability of the study questionnaires. SETTING Two gynaecology clinics within Barts Health NHS, London, UK. PARTICIPANTS Patients with CPP lasting ≥6 months with access to smartphone or personal computer and understanding of basic English. INTERVENTION The intervention was mindfulness meditation content plus additional pain module delivered by a smartphone app. Active controls received muscle relaxation content from the same app. Passive (waiting list) controls received usual care. MAIN OUTCOME MEASURES Themes on user feedback, app usability and integration, and reasons for using/not using the app. RESULTS The use of the app was low in both active groups. Patients in the prestudy PPI group, all volunteers, were enthusiastic about the app (convenience, content, portability, flexibility, ease of use). Women contributing to the interview or focus group data (n=14), from a 'real world' clinic (some not regular app users), were less positive, citing as barriers lack of opportunities/motivation to use the app and lack of familiarity and capabilities with technology. Staff (n=7) were concerned about the potential need for extra support for them and for the patients, and considered the app needed organisational backing and peer acceptance. CONCLUSION The opinions of prestudy PPI volunteers meeting in their private time may not represent those of patients recruited at a routine clinic appointment. It may be more successful to codesign/codevelop an app with typical users than to adapt existing apps for use in real-world clinical populations. TRIAL REGISTRATION NUMBER ISRCTN10925965.
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Affiliation(s)
- Elizabeth Ball
- Department of Obstetrics and Gynaecology, Barts Health NHS Trust, London, UK
- Centre for Women's Health, Institute of Population Health Sciences, Queen Mary University of London, London, UK
- Centre for Maternal and Child Health Research, City University London, London, UK
| | - Sian Newton
- Centre for Women's Health, Institute of Population Health Sciences, Queen Mary University of London, London, UK
| | - Frank Rohricht
- Centre for Psychiatry, Wolfson Institute for Preventive Medicine, Queen Mary University of London, London, UK
- East London NHS Foundation Trust, London, UK
| | - Liz Steed
- Centre for Primary Care and Mental Health, Institute of Population Health Sciences, Queen Mary University of London, London, UK
| | | | - Julie Dodds
- Centre for Women's Health, Institute of Population Health Sciences, Queen Mary University of London, London, UK
| | | | - Stephanie Taylor
- Centre for Primary Care and Mental Health, Institute of Population Health Sciences, Queen Mary University of London, London, UK
| | - Carol Rivas
- UCL Social Research Institute, University College London, London, UK
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