Modulating the fidelity and spatial extent of electrotactile stimulation to elicit the embodiment of a virtual hand.

Restoring tactile feedback in virtual reality can improve user experience and facilitate the feeling of embodiment. Electrotactile stimulation can be an attractive technology in this context as it is compact and allows for high-resolution spatially distributed stimulation. In the present study, a 32-channel tactile glove worn on the fingertips was used to provide tactile sensations during a virtual version of a rubber hand illusion experiment. To assess the benefits of multichannel stimulation, we modulated the spatial extent of feedback and its fidelity. Thirty-six participants performed the experiment in two conditions, in which stimulation was delivered to a single finger or all fingers, and three tactile stimulation types within each condition: no tactile feedback, simple single-point stimulation, and complex sliding stimulation mimicking the movements of the brush. Following each trial, the participants answered a multi-item embodiment questionnaire and reported the proprioceptive drift. The results confirmed that modulating the spatial extent of stimulation, from a single finger to all fingers, was indeed a successful strategy. When stimulating all fingers, tactile stimulation significantly improved all subjective measures compared to receiving no tactile stimulation. However, unexpectedly, the second strategy, that of modulating the fidelity of feedback, was not successful since there was no difference between the simple and complex tactile feedback in any of the measures. The results, therefore, imply that the effects of tactile feedback are better expressed in a more dynamic scenario (i.e., making/breaking contact and delivering stimulation to different body locations), while it still needs to be investigated if further improvements of the complex feedback can make it more effective compared to the simple approach.

mHealth intervention to improve quality of life in patients with chronic diseases during the COVID-19 crisis in Paraguay: A study protocol for a randomized controlled trial.

BACKGROUND: Patients with chronic disease represent an at-risk group in the face of the COVID-19 crisis as they need to regularly monitor their lifestyle and emotional management. Coping with the illness becomes a challenge due to supply problems and lack of access to health care facilities. It is expected these limitations, along with lockdown and social distancing measures, have affected the routine disease management of these patients, being more pronounced in low- and middle-income countries with a flawed health care system. OBJECTIVES: The purpose of this study is to describe a protocol for a randomized controlled trial to test the efficacy of the Adhera® MejoraCare Digital Program, an mHealth intervention aimed at improving the quality of life of patients with chronic diseases during the COVID-19 outbreak in Paraguay. METHOD: A two-arm randomized controlled trial will be carried out, with repeated measures (baseline, 1-month, 3-month, 6-month, and 12-month) under two conditions: Adhera® MejoraCare Digital Program or waiting list. The primary outcome is a change in the quality of life on the EuroQol 5-Dimensions 3-Levels Questionnaire (EQ-5D-3L). Other secondary outcomes, as the effect on anxiety and health empowerment, will be considered. All participants must be 18 years of age or older and meet the criteria for chronic disease. A total of 96 participants will be recruited (48 per arm). CONCLUSIONS: It is expected that the Adhera® MejoraCare Digital Program will show significant improvements in quality of life and emotional distress compared to the waiting list condition. Additionally, it is hypothesized that this intervention will be positively evaluated by the participants in terms of usability and satisfaction. The findings will provide new insights into the viability and efficacy of mHealth solutions for chronic disease management in developing countries and in times of pandemic. TRIAL REGISTRATION: ClinicalTrials.gov NCT04659746.

Digital Health Platform for Emotional and Self-Management Support of Caregivers of Children Receiving Growth Hormone Treatment.

In recent years there has been growing research on the combination of evidence-based behavioral change techniques with mobile-based recommender systems. In this paper, we have focused on understanding the psychological burdens experienced by caregivers of children undergoing growth hormone treatment (GHt) and the perceived barriers to and drivers of the adoption of a digital health solution. This is a mixed-methods formative research study looking into technical acceptance aspects of using digital health for the emotional support of parents of children undergoing GHt. After one month using the ADHERA CARING platform (Adhera Health, Inc., Palo Alto, CA), individual semi-structured interviews were conducted. ADHERA CARING provides tailored emotional and self-management support to caregivers of children undergoing GHt to improve adherence to treatment through positive education, personalized motivational messages, and emotional support. A preliminary thematic analysis and categorization were carried out, based on the Behavioral Intervention Technology (BIT) model. The majority of participants were female. All caregivers positively valued having the tool, especially at the beginning of treatment. Information provided in the educational module was useful and improved self-efficacy. Motivational messages contributed to commitment and reinforced the educational content, thus promoting continuity of treatment and potentially improving treatment efficacy. Most participants (n=10, 80%) accessed all educational units and completed all the 27 quiz questions. Regarding the motivational messages, the overall average rating was 4.55 out of 5.00. ADHERA CARING has the potential to help caregivers to understand the treatment journey. Nevertheless, users have identified that some types of educational content are more valuable at specific stages of the treatment journey, which suggests that personalization of educational content is required to adapt to different stages of the patient journey.