Efficacy of Mobile Health for Self-management of Cardiometabolic Risk Factors: A Theory-Guided Systematic Review.

BACKGROUND: Although mobile health (mHealth) technologies are burgeoning in the research arena, there is a lack of mHealth interventions focused on improving self-management of individuals with cardiometabolic risk factors (CMRFs). OBJECTIVE: The purpose of this article was to critically and systematically review the efficacy of mHealth interventions for self-management of CMRF while evaluating quality, limitations, and issues with disparities using the technology acceptance model as a guiding framework. METHODS: PubMed, CINAHL, EMBASE, and Lilacs were searched to identify research articles published between January 2008 and November 2018. Articles were included if they were published in English, included adults, were conducted in the United States, and used mHealth to promote self-care or self-management of CMRFs. A total of 28 articles were included in this review. RESULTS: Studies incorporating mHealth have been linked to positive outcomes in self-management of diabetes, physical activity, diet, and weight loss. Most mHealth interventions included modalities such as text messaging, mobile applications, and wearable technologies. There was a lack of studies that are (1) in resource-poor settings, (2) theoretically driven, (3) community-engaged research, (4) measuring digital/health literacy, (5) measuring and evaluating engagement, (6) measuring outcomes related to disease self-management, and (7) focused on vulnerable populations, especially immigrants. CONCLUSION: There is still a lack of mHealth interventions created specifically for immigrant populations, especially within the Latino community-the largest growing minority group in the United States. In an effort to meet this challenge, more culturally tailored mHealth interventions are needed.

Ethical Dilemmas for Nursing Students and Faculty: In Their Own Voices.

AIM: The aim of this national study was to explore student and faculty personal experiences of ethical dilemmas in nursing education and clinical practice. BACKGROUND: Nurses encounter complex ethical dilemmas in practice that can lead to moral distress when they cannot "do the right thing" because of external constraints. METHOD: A mixed-methods study via online survey was conducted on senior nursing student members and faculty advisors of the National Student Nurses Association. Over 1,600 students and 600 faculty answered a "two-minute survey" with the question: "Please describe an ethical dilemma you have experienced." RESULTS: Descriptive statistics demonstrated a difference in student and faculty reports about the ethics content they received. The qualitative results from constant comparison of open-ended questions also supported differences in themes from student and faculty perspectives. CONCLUSION: This study supports that students and faculty voice their concerns with different ethical dilemmas in their nursing education experiences.