A Bluetooth-Based Smartphone App for Detecting Peer Proximity: Protocol for Evaluating Functionality and Validity

BACKGROUND

While ecological momentary assessment (EMA) is commonly used to study social contexts and social influence in the real world, EMA almost exclusively relies on participant self-report of present circumstances, including the proximity to influential peers. There is the potential for developing a proximity sensing approach that uses small Bluetooth beacons and smartphone-based detection and data collection to collect information about interactions between individuals passively in real time.

OBJECTIVE

This paper aims to describe the methods for evaluating the functionality and validity of a Bluetooth-based beacon and a smartphone app to identify when ≥2 individuals are physically proximal.

METHODS

We will recruit 20 participants aged 18 to 29 years with Android smartphones to complete a 3-week study during which beacon detection and self-report data will be collected using a smartphone app (MEI Research). Using an interviewer-administered social network interview, participants will identify up to 3 peers of the same age who are influential on health behavior (alcohol use in this study). These peers will be asked to carry a Bluetooth beacon (Kontakt asset tag) for the duration of the study; each beacon has a unique ID that, when detected, will be recorded by the app on the participant's phone. Participants will be prompted to respond to EMA surveys (signal-contingent reports) when a peer beacon encounter meets our criteria and randomly 3 times daily (random reports) and every morning (morning reports) to collect information about the presence of peers. In all reports, the individualized list of peers will be presented to participants, followed by questions about peer and participant behavior, including alcohol use. Data from multiple app data sets, including beacon encounter specifications, notification, and app logs, participant EMA self-reports and postparticipation interviews, and peer surveys, will be used to evaluate project goals. We will examine the functionality of the technology, including the stability of the app (eg, app crashes and issues opening the app), beacon-to-app detection (ie, does the app detect proximal beacons?), and beacon encounter notification when encounter criteria are met. The validity of the technology will be defined as the concordance between passive detection of peers via beacon-to-app communication and the participant's EMA report of peer presence. Disagreement between the beacon and self-report data (ie, false negatives and false positives) will be investigated in multiple ways (ie, to determine if the reason was technology-related or participant compliance-related) using encounter data and information collected from participants and peers.

RESULTS

Participant recruitment began in February 2023, and enrollment was completed in December 2023. Results will be reported in 2025.

CONCLUSIONS

This Bluetooth-based technology has important applications and clinical implications for various health behaviors, including the potential for just-in-time adaptive interventions that target high-risk behavior in real time.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/50241.

Quantifying SARS-CoV-2 Infection Risk Within the Google/Apple Exposure Notification Framework to Inform Quarantine Recommendations

Most early Bluetooth-based exposure notification apps use three binary classifications to recommend quarantine following SARS-CoV-2 exposure: a window of infectiousness in the transmitter, ≥15 minutes duration, and Bluetooth attenuation below a threshold. However, Bluetooth attenuation is not a reliable measure of distance, and infection risk is not a binary function of distance, nor duration, nor timing. We model uncertainty in the shape and orientation of an exhaled virus-containing plume and in inhalation parameters, and measure uncertainty in distance as a function of Bluetooth attenuation. We calculate expected dose by combining this with estimated infectiousness based on timing relative to symptom onset. We calibrate an exponential dose-response curve based on infection probabilities of household contacts. The probability of current or future infectiousness, conditioned on how long postexposure an exposed individual has been symptom-free, decreases during quarantine, with shape determined by incubation periods, proportion of asymptomatic cases, and asymptomatic shedding durations. It can be adjusted for negative test results using Bayes' theorem. We capture a 10-fold range of risk using six infectiousness values, 11-fold range using three Bluetooth attenuation bins, ∼sixfold range from exposure duration given the 30 minute duration cap imposed by the Google/Apple v1.1, and ∼11-fold between the beginning and end of 14 day quarantine. Public health authorities can either set a threshold on initial infection risk to determine 14-day quarantine onset, or on the conditional probability of current and future infectiousness conditions to determine both quarantine and duration.

Wireless Module for Nondestructive Testing/Structural Health Monitoring Applications Based on Solitary Waves

In recent years, there has been an increasing interest in the use of highly nonlinear solitary waves (HNSWs) for nondestructive evaluation and structural health monitoring applications. HNSWs are mechanical waves that can form and travel in highly nonlinear systems, such as granular particles in Hertzian contact. The easiest setup consists of a built-in transducer in drypoint contact with the structure or material to be inspected/monitored. The transducer is made of a monoperiodic array of spherical particles that enables the excitation and detection of the solitary waves. The transducer is wired to a data acquisition system that controls the functionality of the transducer and stores the time series for post-processing. In this paper, the design and testing of a wireless unit that enables the remote control of a transducer without the need to connect it to sophisticated test equipment are presented. Comparative tests and analyses between the measurements obtained with the newly designed wireless unit and the conventional wired configuration are provided. The results are corroborated by an analytical model that predicts the dynamic interaction between solitary waves and materials with different modulus. The advantages and limitations of the proposed wireless platform are given along with some suggestions for future developments.

Objective and perceptual comparisons of two bluetooth hearing aid assistive devices

PURPOSE

With the advent of Bluetooth technology, many of the assistive listening devices for hearing have become manufacturer specific, with little objective information about the performance provided.

METHOD

Thirty native English-speaking adults (mean age 29.8) with normal hearing were tested pseudo-randomly with two major hearing aid manufacturers' proprietary Bluetooth connectivity devices paired to the accompanying manufacturer's specific hearing aids. Sentence recognition performance was objectively measured for each system with signals transmitted via a land-line to the same iPhone in two conditions.

RESULTS

There was a significant effect of participant's performance according to listening condition. There was no significant effect between device manufacturers according to listening condition, but there was a significant effect in participant's perception of "quality of sound".

CONCLUSIONS

Despite differences in signal transmission for each devise, when worn by participants both the systems performed equally. In fact, participants expressed personal preferences for specific technology that was largely due to their perceived quality of sound while listening to recorded signals. While further research is necessary to investigate other measures of benefit for Bluetooth connectivity devices, preliminary data suggest that in order to ensure comfort and compatibility, not only should objective measures of the patient benefit be completed, but also assessing the patient's perception of benefit is equally important. Implications for Rehabilitation All professionals who work with individuals with hearing loss, become aware of the differences in the multiple choices for assistive technology readily available for hearing loss. With the ever growing dispensing of Bluetooth connectivity devices coupled to hearing aids, there is an increased burden to determine whether performance differences could exist between manufacturers. There is a growing need to investigate other measures of benefit for Bluetooth hearing aid connectivity devices that not only include objective measures, but also patient perception of benefit.

Going mobile with a multiaccess service for the management of diabetic patients

BACKGROUND

Diabetes mellitus is one of the chronic diseases exploiting the largest number of telemedicine systems. Our research group has been involved since 1996 in two projects funded by the European Union proposing innovative architectures and services according to the best current medical practices and advances in the information technology area.

METHOD

We propose an enhanced architecture for telemedicine giving rise to a multitier application. The lower tier is represented by a mobile phone hosting the patient unit able to acquire data and provide first-level advice to the patient. The patient unit also facilitates interaction with the health care center, representing the higher tier, by automatically uploading data and receiving back any therapeutic plan supplied by the physician. On the patient's side the mobile phone exploits Bluetooth technology and therefore acts as a hub for a wireless network, possibly including several devices in addition to the glucometer.

RESULTS

A new system architecture based on mobile technology is being used to implement several prototypes for assessing its functionality. A subsequent effort will be undertaken to exploit the new system within a pilot study for the follow-up of patients cared at a major hospital located in northern Italy.

CONCLUSION

We expect that the new architecture will enhance the interaction between patient and caring physician, simplifying and improving metabolic control. In addition to sending glycemic data to the caring center, we also plan to automatically download the therapeutic protocols provided by the physician to the insulin pump and collect data from multiple sensors.