Smartphone Usage Patterns and Their Physical, Psychological, and Cyber-Behavioral Predictors Among Adolescents in South Korea

BACKGROUND

Adolescents are described as digital natives, with smartphones deeply embedded in their lives. However, limited literature on smartphone usage patterns exists. This study examined adolescents' smartphone usage patterns and their physical, psychosocial, and cyber-behavioral profiles.

METHODS

We used latent profile analysis and a person-centered approach to investigate 11 items on smartphone use purpose and use time. Participants were 2324 first-year middle-school students (aged 13 years) from a nationally representative dataset.

RESULTS

Four distinct profile groups were observed: minimalist users, entertainment users, social users, and multifunctional users. The 4 profiles differed by gender and physical (physical activity and obesity), psychosocial (relationships with their parents, depression, and academic lethargy), and cyber-behavioral (smartphone use time, computer use time, and cyber delinquency) status.

IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY

Our findings have key research and real-world implications for developmental psychologists and school health providers, specifically for those who work with adolescents, to address concerns regarding adolescents' smartphone use.

CONCLUSIONS

Adolescents use smartphones at varying times and for various purposes. A better understanding of adolescents' smartphone usage and purposes can help parents and school health providers develop and implement interventions.

Study on lifestyle habits affecting sleep disorders at the undergraduate education stage in Xuzhou City, China

Background

In China, undergraduate students face both academic and career selection pressures, sleep is an important physiological process for them. Investigate the physical exercise, sleep quality of undergraduate students in the education stage in Xuzhou City, and analyze the factors affecting their sleep quality, to promote the health education and psychological health of undergraduate students.

Materials and methods

The Physical Activity Rating Scale-3 (PARS-3), the Pittsburgh Sleep Quality Index (PSQI), and the demographic information questionnaire were used to survey a whole-group sample of four undergraduate colleges and universities (Xuzhou Institute of Engineering, Xuzhou Medical University, China University of Mining and Technology, Jiangsu Normal University) in Xuzhou by cluster sampling, the general characteristics including gender, grade, height, weight, domicile, race, economic income, etc., were collected, and the data were analyzed and processed using chi-square tests and multi-factor logistic regression.

Results

3,366 valid questionnaires were collected from four undergraduate colleges and universities, including 1,355 males and 2,011 females. The detection rate of exercise in Jiangsu Normal University was lower than that in other universities, and the detection rate of sleep disorders was higher than that in other universities. Xuzhou Medical University, the highest detection rate of large exercise, Xuzhou Institute of Technology, the lowest detection rate of sleep disorders. There were significant differences in the detection rate of large amount of exercise among college students of different genders, grades, body types, and majors (χ2 = 259.172, P < 0.001; χ2 = 34.473, P < 0.001; χ2 = 36.026, P < 0.001; χ2 = 57.908, P < 0.001). There were significant differences in the detection rate of sleep disorders among college students with different gender, grade, family economic status, daily cell phone use time, cell phone purposeless usage, and exercise level (χ2 = 5.806, P = 0.016; χ2 = 47.5, P < 0.001; χ2 = 28.949, P < 0.001; χ2 = 55.866, P < 0.001; χ2 = 147.101, P < 0.001; χ2 = 9.129, P = 0.010). Multivariate logistic regression analysis showed that grade, family economic status, cell phone use time, cell phone purposeless usage is the main influencing factors of sleep disorders in college students.

Conclusion

The sleep problems of undergraduates are serious, especially in Jiangsu Normal University. Scientific and appropriate exercise is an important measure to solve the sleep problems of undergraduates. Colleges and universities should actively carry out health education, college students living habits such as cell phone use should be guided training.

Cell Phone Availability and Usage for mHealth and Intervention Delivery to Persons Living With HIV in a Low-Resource Setting: Cross-sectional Study

BACKGROUND

HIV/AIDS is now a manageable chronic illness owing to effective antiretroviral therapy (ART), which involves routine follow-up care, including regular physical visits to the clinic. In the recent past, and in wake of the COVID-19 pandemic, there has been increased need for virtual care and intervention delivery, a modality known as mobile health (mHealth), which includes cell phone-delivered services for medical and public health practice.

OBJECTIVE

Here we describe cell phone use and its relationship with alcohol use in a cohort of persons living with HIV and latent tuberculosis (TB).

METHODS

We performed a cross-sectional analysis of baseline data from a cohort of persons living with HIV and latent TB in HIV care in southwestern Uganda. We estimated proportions of cell phone and text message use and evaluated their associations with alcohol use-a common modifiable behavior among persons living with HIV. Cell phone use (primary outcome) was defined as owning a cell phone that is turned on at least half of the day. Any alcohol use was defined as any self-reported alcohol use in the prior 3 months or a phosphatidylethanol (an alcohol biomarker) level of ≥8 ng/mL.

RESULTS

A total of 300 participants (median age 40 years; n=146, 48.7% male) were included in the analysis. Most (n=267, 89.0%) participants had access to a phone and of them, 26 (9.7%) shared the phone with someone else. In total, 262/300 (87.3%) of participants owned a cell phone that is turned on at least half of the time; the majority (n=269, 89.7%) rarely or never sent text messages, and over two-thirds (n=200, 66.9%) rarely or never received text messages. Most (n=214, 71.3%) had any alcohol use in the prior 3 months. In adjusted analyses, any alcohol use was not significantly associated with cell phone use (adjusted odds ratio [aOR] 0.48, 95% CI 0.18-1.25; P=.13) or sending (aOR 0.82, 95% CI 0.28-2.37; P=.71) or receiving (aOR 1.31, 95% CI 0.70-2.47; P=.40) text messages.

CONCLUSIONS

There is hope that mHealth interventions in this population can be carried out using cell phones owing to their popularity; however, the interventions may need to employ methods that do not rely on the sending and receiving of text messages only.

Bans on Cellphone Use While Driving and Traffic Fatalities in the United States

BACKGROUND

As of January 2020, 18 of 50 US states comprehensively banned almost all handheld cellphone use while driving, 3 states and the District of Columbia banned calling and texting, 27 states banned texting on a handheld cellphone, and 2 states had no general cellphone ban for all drivers. However, it remains unknown whether these bans were associated with fewer traffic deaths and whether comprehensive handheld bans are more effective than isolated calling or texting bans. We evaluated whether cellphone bans were associated with fewer driver, non-driver, and total fatalities nationally.

METHODS

We conducted a longitudinal panel analysis of traffic fatality rates by state, year, and quarter. Population-based rate ratios and 95% CIs were estimated comparing state-quarters with and without cellphone bans.

RESULTS

From 1999 through 2016, 616,289 persons including 344,003 drivers died in passenger vehicle crashes in the United States. Relative to no ban, comprehensive handheld bans were associated with lower driver fatality rates (adjusted rate ratio aRR = 0.93, 95% CI = 0.90, 0.97) but not for non-driver fatalities (aRR = 1.01, 95% CI = 0.95, 1.07) or total fatalities (aRR = 0.98, 95% CI = 0.94, 1.01). We found no differences in driver fatalities for calling-only bans (aRR = 1.00, 95% CI = 0.97, 1.03), texting-only bans (aRR = 1.02, 95% CI = 0.99, 1.05), texting plus phone-manipulating bans (aRR = 0.99, 95% CI = 0.93, 1.04), or calling and texting bans (aRR = 0.98, 95% CI = 0.88, 1.09).

CONCLUSIONS

Comprehensive handheld bans were associated with fewer driver fatalities.

Rethinking Cell Phone Use While Driving: Isolated Risk Behavior or a Pattern of Risk-Taking Associated with Impulsivity in Young Drivers?

This study examines whether cell phone use stands apart from a general pattern of risky driving practices associated with crashes and impulsivity-related personality traits in young drivers. A retrospective online survey study recruited 384 young drivers from across the United States using Amazon’s Mechanical Turk to complete a survey measuring risky driving practices (including cell phone use), history of crashes, and impulsivity-related personality traits. Almost half (44.5%) of the drivers reported being involved in at least one crash, and the majority engaged in cell phone use while driving (up to 73%). Factor analysis and structural equation modeling found that cell phone use loaded highly on a latent factor with other risky driving practices that were associated with prior crashes (b = 0.15, [95% CI: 0.01, 0.29]). There was also an indirect relationship between one form of impulsivity and crashes through risky driving (b = 0.127, [95% CI: 0.01, 0.30]). Additional analyses did not find an independent contribution to crashes for frequent cell phone use. These results suggest a pattern of risky driving practices associated with impulsivity in young drivers, indicating the benefit of exploring a more comprehensive safe driving strategy that includes the avoidance of cell phone use as well as other risky practices, particularly for young drivers with greater impulsive tendencies.

Teledentistry and mHealth for Promotion and Prevention of Oral Health: A Systematic Review and Meta-analysis

The dental profession has experienced a dramatic acceleration in the use of communication systems and information-based technologies over recent years, originating new paradigms for the prevention and promotion of oral health. The purpose of this systematic review was to determine the effect of teledentistry-based (telematic) strategies, reported in randomized controlled trials and quasi-randomized trials, with a focus on oral health prevention and promotion-related outcomes in patients of all ages. We searched Medline via PubMed, SCOPUS, and Web of Science from inception until August 2020, regardless of the language of publication. We selected studies for inclusion and conducted data extraction, assessed risk of bias (Cochrane tool), and evaluated the certainty of the evidence (GRADE approach) in duplicate and independently. Out of 898 potentially eligible references, we selected 43 for full-text screening, of which 19 studies proved eligible: 18 randomized controlled trials and 1 quasi-randomized study. Virtual interventions were mostly asynchronous via apps (n = 9), text messages (n = 9), or computer-aided learning (n = 1). The use of teledentistry as compared with conventional strategies may result in a large reduction in the plaque index (standardized mean difference, -1.18; 95% CI, -1.54 to -0.82; I² = 92%; low certainty) and will likely result in a large reduction in the gingival index (standardized mean difference, -2.17; 95% CI, -3.15 to -1.19; I² = 97%; moderate certainty) and in the incidence of white spot lesions (risk ratio, 0.48; 95% CI, 0.35 to 0.66; I² = 0%; moderate certainty), with an increased effect over time. Evidence suggests that teledentistry, particularly mHealth (messages and apps), is a promising clinical tool for preventing and promoting oral health, especially under the accelerated virtualization of dentistry. Future studies should include a broader spectrum of the population, including adults and elders, to better inform policy and implementation of teledentistry (PROSPERO: CRD42020192685).

Association of the Use of the Mobile Phone with Physical Fitness and Academic Performance: A Cross-Sectional Study

The aim of this study was to analyse the association of the use of the mobile phone with physical fitness (PF) and academic performance in secondary school students and its gender-related differences. A total of 501 high school students participated in the study (236 girls and 265 boys; 12–18 years). Use of the mobile phone and sample distributions were done with the Mobile-Related Experience Questionnaire (CERM): low use of mobile phone (LMP = 10–15 points), medium use of mobile phone (MMP = 16–23 points) and high use of mobile phone (HMP = 24–40 points). PF via Eurofit test battery and academic performance were recorded, and gender was used as a differentiating factor. The HMP group registered lower values than the LMP group for academic performance (Spanish: 4.78 ± 2.26 vs. 3.90 ± 1.96 points; p = 0.007, Mathematics: 4.91 ± 2.23 vs. 4.00 ± 1.84 points; p = 0.007) and PF (Abdominals: 6.83 ± 2.40 vs. 5.41 ± 2.46 points; p < 0.001, Broad jump: 6.24 ± 3.02 vs. 4.94 ± 2.28 points; p = 0.013). The boy students showed greater values than girl students for PF in the LMP (medicine-ball-throw: 6.34 ± 2.24 vs. 5.28 ± 1.86 points, p = 0.007) and MMP (medicine-ball-throw: 6.49 ± 2.52 vs. 5.02 ± 1.68 points; p < 0.001) groups, but no gender-related differences were found in the HMP group. In conclusion, high use of the mobile phone was related to worse results in the PF tests and academic performance. Gender-related differences were found for academic performance regardless of the use of the mobile, but for physical fitness no gender differences were found in HMP group.

Mobile phone use and social interactions among caregivers can reduce their ability to provide constant supervision to children at Australian public swimming pools

ISSUE ADDRESSED

Caregivers have a crucial role to play in keeping children safe at public swimming pool facilities, with the most common factor contributing to childhood drowning being a lapse in adult supervision.

METHODS

A mixed methods approach was used to collect observations (n = 301) and interviews (n = 10) with caregivers of children aged 0-10 years at two public swimming pool facilities located in the Perth metropolitan area, Western Australia (WA).

RESULTS

Of the 449 children observed, children aged 6-10 years were significantly less likely to be provided with ideal supervision (26%) compared to younger children aged 0-5 years (62%). Of the caregivers who were using their mobile phone while supervising children (n = 100, 22% of children observed), none provided ideal supervision. Overall supervision levels among caregivers differed with gender, with only 44% (n = 74) of female caregivers providing ideal supervision, compared to 72% (n = 96) of male caregivers. The 10 interviews revealed several themes, including the following: caregivers' perceptions of their supervision responsibilities; barriers to supervision; and awareness and perceptions of a communications campaign designed by the Royal Life Saving WA Branch, known as Watch Around Water (WAW).

CONCLUSION

Caregiver supervision at public swimming pools remains an important issue, particularly the use of mobile phones and its deleterious impact on supervision. The WAW program plays an integral role in educating caregivers of supervision responsibilities. Furthermore, this study adds to the limited evaluation of the WAW program, and thus will help guide future improvements to ensure caregiver supervision is consistent. SO WHAT?: Further research is needed to create strategies to reduce mobile phone use among caregivers, in order to provide safer swimming environments.

Opinions of patients with persistent asthma regarding the use of mobile applications for disease monitoring

Summary

Background. We assessed adherence to treatment and management needs of adults with persistent asthma and their interest in using apps for asthma management. Secondarily, we explored opinions of patients about an app to assess and improve adherence to treatment. Methods. A cross-sectional study was conducted with 40 adults with persistent asthma (49.9 ± 15.8 years) recruited at outpatient clinics from a district hospital. Participants answered a survey on sociodemographic, asthma control, treatment adherence and use of mobile devices, social networks and apps. Four patients participated in a prospective extension of the study, in which they were invited to use the InspirerMundi app. Results. 48 percent of the participants had at least greater-equal than 1 exacerbation in the previous year and 85 percent had uncontrolled asthma. Self-reported adherence to treatment showed that one in four participants had low adherence. At least daily, 55 percent of participants navigated on the internet with their smartphone-tablet, 35 percent used apps and 93 percent social networks. Nine (22 percent) participants had previously used health-fitness apps and 65 percent would like to use apps to improve inhaler adherence. Conclusions. Most participants had uncontrolled asthma, reported high adherence to treatment and were daily users of social networks and the internet. Only 1/4 used apps but 2/3 would like to use apps to support asthma management.

The Additive Effects of Cell Phone Use and Dental Hygiene Practice on Finger Muscle Strength: A Pilot Study

Purpose: The purpose of this study was to determine strength of muscles involved with instrumentation (scaling) by dental hygienists and the additive effects of cellular (mobile) phone usage, as indicated by measurements of muscular force generation.Methods: A convenience sample of licensed dental hygienists currently in clinical practice (n=16) and an equal number of individuals not currently using devices/tools repetitively for work (n=16), agreed to participate in this pilot study. All participants completed a modified cell phone usage questionnaire to determine their use pattern and frequency. Upon completion of the questionnaire, participants' force production in six muscle groups was measured using a hand-held dynamometer. Descriptive statistics were used to analyze the data.Results: A total of 16 licensed dental hygienists (n=16) and 16 participants with no history of using tools/devices repetitively for work (n=16), comprised the experimental and control groups, repectively. The control group generated greater muscle force than the experimental group for the abductor pollicis longus (p=0.045). Significant differences were identified when comparing the low mobile phone users in the experimental group to the control group for the flexor pollicis brevis (p=0.031), abductor pollicis longus (p=0.031), and flexor digitorum (p=0.006), with the control group demonstrating higher muscle force. Years in clinical practice and mobile phone use was shown to have a significant effect on muscular force generation for the flexor pollicis brevis (F=3.645, df=3, p=0.020) and flexor digitorum (F=3.560, df=3, p=0.022); subjects who practiced dental hygiene the longest produced the least amount of muscle force.Conclusion: Results from this pilot study indicate there are no significant additive effects of cell phone use and dental hygiene practice on finger muscles used for instrumentation. However, results indicate that dental hygiene practice demonstrated significant effects on muscular strength as compared to individuals who do not use tools/devices repetitively for work. The small sample size may have impacted results and the study should be repeated with a larger sample.

Developing SMS Content to Promote Papanicolaou Triage Among Women Who Performed HPV Self-collection Test: Qualitative Study

Background

SMS interventions are effective in promoting a variety of health behaviors; however, there is limited information regarding the use of SMS for cervical cancer screening and follow-up care. The Application of Communication and Information Technologies to Self-Collection study aims to evaluate a multicomponent mobile health intervention to increase triage adherence among women with human papillomavirus (HPV)–positive self-collected tests in Jujuy, Argentina. Here, we describe the formative results used to design the content of the SMS to be tested in the trial.

Objective

This study aimed to understand the cultural and contextual elements, women’s beliefs, and perceptions regarding the use of SMS by the health care system and women’s preferences about the message content.

Methods

We conducted five focus groups (FGs), stratified by rural or urban residence and age. All participants were aged 30 years or older and had performed HPV self-collection. Participatory techniques, including brainstorming, card-based classification, and discussions were used to debate the advantages and disadvantages of messages. We openly coded the discussions for agreements and preferences regarding the SMS content. Messages for both HPV-negative and HPV-positive women were validated through interviews with health authorities and 14 HPV-tested women. The final versions of the messages were pilot-tested.

Results

A total of 48 women participated in the FGs. Participants rejected receiving both negative and positive HPV results by SMS because, for them, the delivery of results should be done in a face-to-face interaction with health professionals. They stressed the importance of the SMS content informing them that results were available for pick up and reflecting the kind of relationship that they have with the community health workers and the nearest health center. Women considered that a personalized SMS was important, as was the use of a formal yet warm tone. Owing to confidentiality issues, not using the word “HPV” was also a key component of the desired SMS content; therefore, the final message included the term “self-collection” without the mention of HPV infection. Results from the validation stage and pilot test showed high acceptability of the final version of the message.

Conclusions

The results suggest that SMS is accepted when notifying women about the availability of the HPV test result, but it should not replace the delivery of results in face-to-face, doctor-patient encounters. In addition, messages must be tailored and must have a persuasive tone to motivate women to adhere to the triage.

Cell Phone Use Habits Among the Spanish Population: Contribution of Applications to Problematic Use

Mobile phone abuse may be associated with health problems as well as with interferences in daily life. However, beyond the mobile as a device, the contributions of specific utilities and applications to the problematic mobile phone use remains to be analyzed. To address this important question we conducted 1,126 online interviews in Spain with participants aged 16 to 65 who are representative of the general population. The aim of the study was to analyze the patterns and differences of cell phone use based on habitual use, abuse, and problematic use, considering the most frequently used utilities and applications. Additional variables used were personal perception of cell phones, intensity of use, and participant's lifestyle with regard to entertainment and the maintenance of healthy habits. Further, we aimed to analyze difference between problematic and non-problematic mobile phone users in the utilization of applications, controlling for additional variables such as age, gender, educational level, consumption of tobacco and alcohol and illegal drugs. Results show that problematic use is consistent with the self-perception of abuse and is related to internet browsing, social media, music, and mobile games; particular applications of interest include Facebook, music applications, and Twitter. Furthermore, among problematic users, a pattern of interference with other activities or inappropriate use in certain contexts is observed, with a differential pattern of entertainment and abandonment of healthy habits. Finally, two binary logistic regression analyses demonstrated that beyond the cell phones themselves, specific utilities and applications such as browsing, chatting, or downloading and listening to music contribute to the differences between problematic and non-problematic users. Specifically, the use of Facebook, Twitter, and music applications have the greatest power to discriminate between the two types of users.

Perceived stress and resilience and their relationship with the use of mobile phone among nursing students

OBJECTIVES

The study sought to explore the relationship between levels of stress and resilience with the use of the mobile phone in nursing students.

METHODS

Cross-sectional study conducted with 102 nursing students from several Nursing schools in India who were invited to participate in the research. The data were gathered by using the following instruments: Perceived Stress Scale (PSS) by Cohen, The Connor-Davidson Resilience scale (CD-RISC), and Mobile Phone Involvement Questionnaire (MPIQ) by Walsh.

RESULTS

Most of the participants were women (94.1%), studying in the undergraduate (70.6%), with a mean age of 25.2 years. In all, 77.5% of the students had stress perception between moderate and high, 20.6% had high resilience capacity, and 25.5% were frequent mobile phone users. Perceived stress was correlated significantly and negatively with age and resilience capacity. Graduate students had greater capacity to recover than undergraduate students.

CONCLUSIONS

This study indicates the negative relation of resilience capacity with stress and the use of mobile phones among nursing students. Hence, it is necessary for institutions preparing nurses to develop intervention strategies to enhance the resilience capacity, improve skills to manage stress, and healthy use of the mobile phone.

Mobile Helpline and Reversible Contraception: Lessons From a Controlled Before-and-After Study in Rural India

BACKGROUND

Researchers and activists have expressed concerns over the lack of availability and nonuse of reversible, modern, contraceptive methods in India for decades. New attempts to increase access, availability, and acceptance of reversible contraceptives need to be developed, instead of relying solely on female sterilization. Mobile health (mHealth) initiatives may offer one way to serve underprivileged populations who face challenges in sexual and reproductive health (SRH) in countries such as India.

OBJECTIVE

This study aimed to examine the outcome of an mHealth intervention for enhancing knowledge of, and practices related to, reversible contraceptives in rural Western India.

METHODS

We implemented a nonrandomized controlled trial (before-and-after study in an intervention area and a control area) in the Indian state of Maharashtra. The intervention in this case was a mobile-based SRH helpline provided by a nongovernmental organization (NGO). Baseline and follow-up surveys were carried out in two government-run primary health center areas, one each in the intervention and control area, and 405 respondents were surveyed in the two rounds. An interview-based structured questionnaire suitable for a low-literacy environment was used to collect data. The effect of the intervention was estimated using logistic regression, adjusted for gender, by calculating robust standard errors to take into account the clustering of individuals by the area (intervention or control). In each regression model, the effect of intervention was estimated by including a term for interaction between the intervention area and the period before and after the intervention. The exponent of the regression coefficient of the interaction term corresponding to the period after the intervention, along with the 95% CI, is reported here. The odds ratio for the control village multiplied by this exponent gives the odds ratio for the intervention village. Calls received in the intervention were recorded and their topics analyzed.

RESULTS

The current use of reversible contraception (18% increase in intervention area vs 2% increase in control area; 95% CI) has seen changes. The proportion of respondents who had heard of contraception methods from an NGO rose in the intervention area by 23% whereas it decreased in the control area by 1% (95% CI). However, the general level of awareness of reversible contraception, shown by the first contraceptive method that came to respondents' mind, did not improve. Demand for wider SRH information beyond contraception was high. Men and adolescents, in addition to married women, made use of the helpline.

CONCLUSIONS

A mobile helpline that one can confidentially approach at a time most convenient to the client can help provide necessary information and support to those who need reversible contraception or other sexual health information. Services that integrate mHealth in a context-sensitive way to other face-to-face health care services add value to SRH services in rural India.

A Two-Way Interactive Text Messaging Application for Low-Income Patients with Chronic Medical Conditions: Design-Thinking Development Approach

Background

Two-way interactive text messaging between patient and community health workers (CHWs) through mobile phone SMS (short message service) text messaging is a form of digital health that can potentially enhance patient engagement in young adults and families that have a child with chronic medical conditions such as diabetes mellitus, sickle cell disease, and asthma. These patients have complex needs, and a user-centered way can be useful for designing a tool to address their needs.

Objective

The aim of this study was to utilize the user-centered approach of design thinking to develop a two-way interactive communication SMS text messaging tool for communication between patients or caregivers and CHWs.

Methods

We applied a design thinking methodology for development of the SMS text messaging tool. We collected qualitative data from 127 patients/caregivers and 13 CHWs, health care professionals, and experts. In total, 4 iterative phases were used to design the final prototype.

Results

The design thinking process led to the final SMS text messaging tool that was transformed from a one-dimensional, template-driven prototype (phases 1 and 2) into a dynamic, interactive, and individually tailored tool (phases 3 and 4). The individualized components consider social factors that influence patients’ ability to engage such as transportation issues and appointment reminders. SMS text messaging components also include operational factors to support staff such as patient contact lists, SMS text messaging templates, and technology chat support.

Conclusions

Design thinking can develop a tool to meet the engagement needs of patients with complex health care needs and be user-friendly for health care staff.

Social Networking App Use Among Primary Health Care Professionals: Web-Based Cross-Sectional Survey

Background

Several studies have been conducted to analyze the role social networks play in communication between patients and health professionals. However, there is a shortage of studies in relation to communication among primary health professionals, in a professional context, using the various mobile phone apps available.

Objective

The objective of our study was to explore mobile phone social networking app use among primary health care professionals for work-related purposes, by comparing the most widely used apps in the market.

Methods

We undertook a cross-sectional study using an anonymous Web survey among a convenience sample of 1635 primary health care professionals during August and September 2017.

Results

Of 483 participants in the survey, 474 (98.1%, 95% CI 97.1%-99.4%) were health professionals who commonly accessed social networking sites and 362 (74.9%, 95% CI 71.1%-78.8%) accessed the sites in a work-related context. Of those 362 respondents, 219 (96.7%, 95% CI 94.8%-98.5%) preferred WhatsApp for both personal and professional uses. Of the 362 respondents who used social networking sites in a work-related context, 276 (76.2%, 95% CI 71.9%-80.6%) rated social networking sites as useful or very useful to solve clinical problems, 261 (72.1%, 95% CI 67.5%-76.7%) to improve their professional knowledge, and 254 (70.2%, 95% CI 65.5%-74.9%) to speed up the transmission of clinical information. Most of them (338/362, 94.8%, 95% CI 92.5%-97.0%) used social networking sites for interprofessional communications, and 204 of 362 (56.4%, 95% CI 51.2%-61.5%) used them for pharmacological-related consultations.

Conclusions

Health professionals frequently accessed social networking sites using their mobile phones and often for work-related issues. This trend suggests that social networking sites may be useful tools in primary care settings, but we need to ensure the security of the data transfer process to make sure that social networking sites are used appropriately. Health institutions need to increase information and training activities to ensure the correct use of these tools.

Cell Phone Use and Happiness Among Chinese Older Adults: Does Rural/Urban Residence Status Matter?

This study explores the relationship between cell phone use and self-reported happiness among older adults in Mainland China and whether rural/urban residence status moderates this relationship. The analysis is based on a sample of 6,952 respondents over the age of 60, from the 2010 wave of China Family Panel Studies. Findings show that using own cell phone is positively associated with self-reported happiness among Chinese older adults (odds ratio [ OR] = 1.283, p < .001). This relationship remains for respondents residing in rural areas ( OR = 1.616, p < .01) but not for their urban counterparts. Findings reflect on how the happiness of Chinese older adults has been affected by a growing shift in the traditional family values due to the unprecedented economic growth. Results also highlight the disparities between state support for older adults in rural and urban areas as well as the necessity to develop relevant policies to improve the subjective well-being of China's rapidly growing population of older adults.

Epidemiology of Handheld Cell Phone Use While Driving: A Study from a South Indian City

Background:

Using cell phones while driving contribute to distractions which can potentially cause minor or major road traffic injuries and also stress among other drivers. With this background, the study was done to ascertain the proportion of handheld cell phone use while driving among road users in Mysore city and also patterns of the use by the day of week, type of road, and type of vehicle.

Methods:

The study was conducted in Mysore, Karnataka, India. Four stretches of roads were observed thrice daily for 1 week. The total number of vehicles passing through the stretch and the number and characteristics of drivers using hand-held cell was noted. Pearson's Chi-square test was used to ascertain the significance of the difference in proportions.

Results:

The overall proportion of cell phone users was calculated as 1.41/100 vehicles. The observed use of handheld cell phones was 1.78 times higher on nonbusy roads than busy roads (Χ² = 25.79, P < 0.0001). More than 50% of the handheld phone users were driving a two wheeler, the proportion being 50.5% in busy roads, and 67% in nonbusy roads. There was no difference in the proportion of cell phone use by time of the day or across different days of the week.

Conclusions:

The proportion of drivers who use cell phones is found to be relatively lower, and use of cell phones was higher on nonbusy roads.

Reliability of Self-Reported Mobile Phone Ownership in Rural North-Central Nigeria: Cross-Sectional Study

Background

mHealth practitioners seek to leverage the ubiquity of the mobile phone to increase the impact and robustness of their interventions, particularly in resource-limited settings. However, data on the reliability of self-reported mobile phone access is minimal.

Objective

We sought to ascertain the reliability of self-reported ownership of and access to mobile phones among a population of rural dwellers in north-central Nigeria.

Methods

We contacted participants in a community-based HIV testing program by phone to determine actual as opposed to self-reported mobile phone access. A phone script was designed to conduct these calls and descriptive analyses conducted on the findings.

Results

We dialed 349 numbers: 110 (31.5%) were answered by participants who self-reported ownership of the mobile phone; 123 (35.2%) of the phone numbers did not ring at all; 28 (8.0%) rang but were not answered; and 88 (25.2%) were answered by someone other than the participant. We reached a higher proportion of male participants (68/133, 51.1%) than female participants (42/216, 19.4%; P<.001).

Conclusions

Self-reported access to mobile phones in rural and low-income areas in north-central Nigeria is higher than actual access. This has implications for mHealth programming, particularly for women’s health. mHealth program implementers and researchers need to be cognizant of the low reliability of self-reported mobile phone access. These observations should therefore affect sample-size calculations and, where possible, alternative means of reaching research participants and program beneficiaries should be established.

[Follow-up study on the association between problematic cell phone use and cognitive function of college students in Chizhou City in 2014-2015]

OBJECTIVE

To estimate the association between problematic cell phone use and reasoning ability in adolescent.

METHODS

In a stratified cluster sampling design, problematic cell phone use and reasoning ability were evaluated in 929 college students from three universities for twice in one year's follow-up investigation from June 2014 to May 2015.

RESULTS

The cross-sectional analysis showed that the score of problematic cell phone use was significantly associated with the score of reasoning ability( the baseline β =-0. 101, 95% CI-0. 168--0. 034; the follow-up in one year's β =-0. 161, 95% CI-0. 255--0. 067). However, the score of problematic cell phone use on the baseline was not associated with the score of reasoning ability in one year late. Interestingly, after controlling of multiple confounding factors and the score of problematic cell phone use on the baseline, the scores of reasoning ability in one year late decreased 0. 40 points( 95%CI-0. 60--0. 20), by the score of problematic cell phone use in one year lateincreased ten percent compared to that on the baseline.

CONCLUSION

Higher problematic cell phone use is significantly associated with poorer reasoning ability in college students.

Cell Phone Information Seeking Explains Blood Pressure in African American Women

Although cell phone use and Internet access via cell phone is not marked by racial disparities, little is known about how cell phone use relates to blood pressure and health information seeking behaviors. The purposes of this study were to (a) describe Internet activities, cell phone use, and information seeking; (b) determine differences in blood pressure and information seeking between cell phone information seekers and nonseekers; and (c) examine cell phone information seeking as a predictor of blood pressure in African American women. Participants ( N = 147) completed a survey and had their blood pressure measured. Independent-sample t tests showed a significant difference in systolic blood pressure in cell phone information seekers and nonseekers. Linear regression revealed cell phone information seeking as an independent predictor of systolic blood pressure, despite confounders. It is possible that cell phone information seekers were using health information to make decisions about self-management of blood pressure.

Development of a Mobile Phone Addiction Craving Scale and Its Validation in a Spanish Adult Population

In some people, problematic cell phone use can lead to situations in which they lose control, similar to those observed in other cases of addiction. Although different scales have been developed to assess its severity, we lack an instrument that is able to determine the desire or craving associated with it. Thus, with the objective of evaluating craving for cell phone use, in this study, we develop and present the Mobile Phone Addiction Craving Scale (MPACS). It consists of eight Likert-style items, with 10 response options, referring to possible situations in which the interviewee is asked to evaluate the degree of restlessness that he or she feels if the cell phone is unavailable at the moment. It can be self-administered or integrated in an interview when abuse or problems are suspected. With the existence of a single dimension, reflected in the exploratory factor analysis (EFA), the scale presents adequate reliability and internal consistency (α = 0.919). Simultaneously, we are able to show significantly increased correlations (r = 0.785, p = 0.000) with the Mobile Phone Problematic Use Scale (MPPUS) and state anxiety (r = 0.330, p = 0.000). We are also able to find associations with impulsivity, measured using the urgency, premeditation, perseverance, and sensation seeking scale, particularly in the dimensions of negative urgency (r = 0.303, p = 0.000) and positive urgency (r = 0.290, p = 0.000), which confirms its construct validity. The analysis of these results conveys important discriminant validity among the MPPUS user categories that are obtained using the criteria by Chow et al. (1). The MPACS demonstrates higher levels of craving in persons up to 35 years of age, reversing with age. In contrast, we do not find significant differences among the sexes. Finally, a receiver operating characteristic (ROC) analysis allows us to establish the scores from which we are able to determine the different levels of craving, from the absence of craving to that referred to as addiction. Based on these results, we can conclude that this scale is a reliable tool that complements ongoing studies on problematic cell phone use.

Safety climate and the distracted driving experiences of truck drivers

BACKGROUND

For truck drivers, distracted driving is a workplace behavior that increases occupational injury risk. We propose safety climate as an appropriate lens through which researchers can examine occupational distracted driving.

METHODS

Using a mixed methods study design, we surveyed truck drivers using the Safety Climate Questionnaire (SCQ) complemented by semi-structured interviews of experts on distracted driving and truck safety. Safety climate was assessed by using the entire SCQ as an overall climate score, followed by factor analysis that identified the following safety climate factors: Communications and Procedures; Management Commitment; and Work Pressure.

RESULTS

In multivariate regression, the overall safety climate scale was associated with having ever experienced a crash and/or distraction-involved swerving. Interview participants described how these SCQ constructs could affect occupational distracted driving.

CONCLUSION

To reduce distraction-related crashes in their organizations, management can adhere to safe policies and procedures, invest in engineering controls, and develop safer communication procedures.

Distracted driving: prevalence, problems, and prevention

While the number of motor vehicle crashes has declined over the years, crashes resulting from distracted driving are increasing in the United States resulting in significant morbidity and mortality. The national public seems to be aware of the dangers associated with using technology while driving, but continues to engage in this dangerous behaviour, and may be unaware of or underestimate the impact of cell phone use on their own driving performance. Problems associated with distracted driving are not limited to novice or teenage drivers; multifaceted universal prevention efforts aimed at impacting large segments of the population may have the greatest impact. Legislation limiting drivers' cell phone use has had little impact, possibly due to low regulation and enforcement. Behaviour change programmes, improved vehicle safety, and public awareness campaigns have been developed as potential preventive efforts to reduce accidents caused by distracted drivers.

Increasing following headway with prompts, goal setting, and feedback in a driving simulator

We evaluated the effects of prompting, goal setting, and feedback on following headway of young drivers in a simulated driving environment and assessed whether changes produced in following headway were associated with reductions in hard braking when drivers were and were not using cell phones. Participants were 4 university students. During baseline, drivers spent half of the time talking on cell phones while driving. At the start of the intervention, drivers were prompted to increase following headway while on the cell phones and were provided a specific target for following headway. Drivers were given feedback on increasing following headway when on cell phones at the end of each session. The intervention package was associated with an increase in following headway and a decrease in hard braking when participants were on and off the cell phones. Cell phone use did not affect any of the measures.

Role of mobile health in the care of culturally and linguistically diverse US populations

Emerging trends in the health-related use of cell phones include the proliferation of mobile health applications for the care and monitoring of patients with chronic diseases and the rise in cell phone usage by Latinos and African Americans in the United States. This article reviews public policy in four areas with the goal of improving the care of patients belonging to culturally and linguistically diverse populations: 1) mobile health service access and the physician's duty of care, 2) affordability of and reimbursement for health related services via mobile phone, 3) protocols for mobile health enabled patient health data collection and distribution, and 4) cultural and linguistic appropriateness of health related messages delivered via cell phone. The review demonstrates the need for policy changes that would allow for reimbursement of both synchronous and asynchronous patient-provider communication, subsidize broadband access for lower-income patients, introduce standards for confidentiality of health data transmitted via cell phone as well as amplify existing cultural and linguistic standards to encompass mobile communication, and consider widespread public accessibility when certifying new technologies as "medical devices." Federal and state governments must take prompt action to ensure that the benefits of mobile health are accessible to all Americans.