Impact of interventions on the quality of life of cancer patients: a systematic review and meta-analysis of longitudinal research.

The impact of cancer interventions has been conducted in several research due to the significant burden of this non-communicable disease. The interventions that played an important role in the improvement of the patient's quality of life (QoL) and health-related quality of life (HRQL) can be classified into two main groups: pharmaceutical and non-pharmacological methods. However, studies so far often analyze a specific group of interventions for specific types of cancer. Thus, in this systematic review and meta-analysis, we synthesized the overall impact of cancer interventions on patients' quality of life in several cancers.In this research, we followed the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) to search the longitudinal original research on the Web of Science (WOS) database. After that, the Newcastle-Ottawa Scale (NOS) and Jadad Scale were used to assess the quality of non-randomized control trials and randomized control trials, respectively. Then, the characteristics of the included studies were described in the six main fields table and the random effect model with robust estimation was applied to analyze the impact of interventions on the health utility of patients.From the database, 122 longitudinal original research were included in the meta-regression, with most of them having high or fair quality. The European Organization for the research and treatment of cancer scale for quality of life (EORTC-QLQ) was the most used health utility measurement at 65.15%. In the adjusted effect models, the Visual Analogue Scale (VAS) had significant statistics in all models when we compared it with the EQ-5D Scale (p < 0.05) and several types of cancer such as breast, lung, and prostate cancer had significant statistics when comparing with hematological cancer in the model types of cancer (p < 0.01). Moreover, radiotherapy, screening, and a combination of chemotherapy and best supportive care also had significant statistics (p < 0.01) in the model of interventions when compared with radiotherapy applied only. Our research can suggest a vital combination of both pharmaceutical and non-pharmacological interventions to improve the quality of life of some common types of cancer patients.

Efficacy of a Mobile Phone-Based Intervention on Health Behaviors and HIV/AIDS Treatment Management: Randomized Controlled Trial.

BACKGROUND: Antiretroviral therapy (ART) is considered the most important intervention for HIV-positive patients; thus, encouraging the use of and adherence to ART are vital to HIV treatment outcomes. Advances in web and mobile technologies hold potential in supporting HIV treatment management. OBJECTIVE: The aim of this study was to evaluate the feasibility and efficacy of a theory-based mobile health (mHealth) intervention on health behaviors and HIV treatment adherence among patients with HIV/AIDS in Vietnam. METHODS: We performed a randomized controlled trial on 425 HIV patients in two of the largest HIV clinics in Hanoi, Vietnam. Both the intervention group (238 patients) and the control group (187 patients) received regular consultations with doctors and then participated in 1-month and 3-month follow-up visits. Patients in the intervention group received a theory-driven smartphone app to facilitate medication adherence and self-efficacy in HIV patients. Measurements were developed based on the Health Belief Model, which included the visual analog scale of ART Adherence, HIV Treatment Adherence Self-Efficacy Scale, and HIV Symptom Management Self-Efficacy Scale. We also included the 9-item Patient Health Questionnaire (PHQ-9) to assess patients' mental health throughout treatment. RESULTS: In the intervention group, the adherence score increased significantly (ß=1.07, 95% CI .24-1.90) after 1 month, whereas the HIV adherence self-efficacy was significantly higher after 3 months (ß=2.17, 95% CI 2.07-2.27) compared to the control group. There was a positive but low level of change in risk behaviors such as drinking, smoking, and drug use. Factors related to positive change in adherence were being employed and having stable mental well-being (lower PHQ-9 scores). Factors associated with self-efficacy in treatment adherence and symptom management were gender, occupation, younger age, and having no other underlying conditions. A longer duration of ART increased treatment adherence but decreased self-efficacy in symptom management. CONCLUSIONS: Our study demonstrated that the mHealth app could improve the overall ART adherence self-efficacy of patients. Further studies with larger sample sizes and longer follow-up periods are needed to support our findings. TRIAL REGISTRATION: Thai Clinical Trials Registry TCTR20220928003; https://www.thaiclinicaltrials.org/show/TCTR20220928003.

A Smartphone App for Attentional Bias Retraining in Smokers: Mixed Methods Pilot Study.

BACKGROUND: Smoking is a global health threat. Attentional bias influences smoking behaviors. Although attentional bias retraining has shown benefits and recent advances in technology suggest that attentional bias retraining can be delivered via smartphone apps, there is a paucity of research on this topic. OBJECTIVE: This study aims to address this gap by exploring the use of attentional bias retraining via a novel smartphone app using a mixed methods pilot study. In the quantitative phase, it is hypothesized that participants in the training group who undertake attentional bias retraining via the app should have decreased levels of attentional bias, subjective craving, and smoking frequency, compared with those in the control group who do not undertake attentional bias retraining. The qualitative phase explores how the participants perceive and experience the novel app. METHODS: In all, 10 adult smokers (3 females and 7 males) between the ages of 26 and 56 years (mean 34.4 years, SD 9.97 years) were recruited. The participants were randomly allocated to the training and control groups. In weeks 1 and 3, participants from both groups attempted the standard visual probe task and rated their smoking frequency and subjective craving. In week 2, the participants in the training group attempted the modified visual probe task. After week 3, participants from both groups were interviewed about their views and experiences of the novel app. RESULTS: The results of the quantitative analysis did not support this study's hypothesis. The qualitative data were analyzed using thematic analysis. The results yielded 5 themes: ease, helpfulness, unhelpful aspects, barriers, and refinement. CONCLUSIONS: Findings from the qualitative study were consistent with those from previous studies on health-related smartphone apps. The qualitative results were helpful in understanding the user perspectives and experiences of the novel app, indicating that future research in this innovative area is necessary.

Perspectives on Modifying Attentional Biases Amongst Individuals with Tobacco Use Disorder Using Technology: A Review.

Smoking remains a significant health problem. Attentional biases influence smoking behaviours, but have not been the target of psychosocial interventions. The first part of this perspective article will provide an overview of the theoretical constructs underlying attentional biases, methods of measuring attentional biases, and evidence for attentional bias modification amongst individuals with tobacco use disorders. The second part of this article will outline how the advent of technological advances could be harnessed in attentional bias modification for smokers. As there is potential for attentional bias training to be delivered via mobile app, literature was reviewed over the recent decade, 2009 to 2019, to examine available research evidence. The search terms were "web-based" or "mobile based", and "attention bias modification" or "attentional bias" and "smoking" or "tobacco use". The PsycINFO, Scopus, and PubMed databases were initially used to identify papers with the above-mentioned inclusion criteria. Five papers were included in the review. Lastly, an integrated perspective will be provided, from both clinical and research standpoints. In conclusion, more research is needed to address the gaps in knowledge and to provide an evidence base for the implementation of mobile phone technologies for attention retraining in smokers.

Customers' Perceptions of Compliance with a Tobacco Control Law in Restaurants in Hanoi, Vietnam: A Cross-Sectional Study.

The Tobacco Harm Prevention Law has been promulgated in 2012 in Vietnam, prohibiting smoking in public places such as restaurants except for designated smoking areas. However, currently, evidence about Vietnamese customers’ and restaurants’ compliance with the Law is constrained. This study aimed to explore customers’ perceptions; attitudes and practices towards the compliance with tobacco control regulations in the restaurants in Hanoi, Vietnam. A cross-sectional study was performed in October 2015 with 1746 customers in 176 communes in Hanoi, Vietnam. Data about customers’ perceptions on how restaurants comply with the smoking control law and whether customers smoking actively or experienced SHS in restaurants in the last 30 days were collected. Multivariable mixed effects logistic regression model was used to determine the factors related to smoking in the restaurant. Most customers were aware of the law on Tobacco Harm Prevention (79%; n = 1320) and regulations that prohibited smoking in restaurants (78.4%; n = 1137). While 75.8% (n = 1285) of customers perceived that they did not see or rarely saw no-smoking signs, 17.7% (n = 481) of customers reported that they frequently saw direct marketing of tobacco in visited restaurants. About one-fourth of customers witnessed that the staff reminded customers not to smoke inside restaurants (28.8%; n = 313), and 65% (n = 1135) sometimes or always were exposed to secondhand smoke in their visited restaurants. People who were female (OR = 0.02, 95% CI = 0.01⁻0.05) were less likely to report their smoking in the restaurant than their counterparts. Those having higher age (OR = 1.03; 95% CI = 1.01⁻1.06), high school education (OR = 2.14, 95% CI = 1.07⁻4.26), being office workers (OR = 3.24, 95% CI = 1.33⁻7.92) or unemployed (OR = 4.45; 95% CI = 1.09⁻18.15) had a higher likelihood of reporting to be restaurant smokers than those having lower high education or students, respectively. This study highlighted a low level of perceived compliance with the smoke-free law in Vietnamese restaurants. Improving the monitoring systems for the enforcement of the smoking law in restaurants should be prioritized; restaurant owners should implement 100% smoke-free environments as following the best practice towards the tobacco control law along with educational campaigns to promote the awareness of restaurant owners and customers about the tobacco control law.

Prevalence of All-Cause Mortality and Suicide among Bariatric Surgery Cohorts: A Meta-Analysis.

INTRODUCTION: Prior meta-analysis has reported mortality rates among post-operative bariatric patients, but they have not considered psychiatric factors like suicide contributing to mortality. OBJECTIVES: The current meta-analysis aims to determine the pooled prevalence for mortality and suicide amongst cohorts using reported suicides post bariatric surgery. It is also the aim of the current meta-analytical study to determine moderators that could account for the heterogeneity found. RESULTS: In our study, the pooled prevalence of mortality in the studies which reported suicidal mortality was 1.8% and the prevalence of suicide was 0.3%. Mean body mass index (BMI) and the duration of follow-up appear to be significant moderators. CONCLUSIONS: Given the prevalence of suicide post bariatric surgery, it is highly important for bariatric teams to consider both the medical and psychiatric well-being of individuals pre- and post-operatively.

Alcohol and tobacco use among methadone maintenance patients in Vietnamese rural mountainside areas.

INTRODUCTION: The expansion of methadone maintenance treatment (MMT) program requires more data about the factors affecting the effectiveness of treatment, especially behavioral data such as smoking and alcohol use among patients. This study aimed to examine the prevalence of tobacco and alcohol consumption and identify related factors among MMT patients in the Vietnamese rural mountainside. METHODS: We interviewed 241 MMT patients in two clinics in Tuyen Quang, a mountainous province in Vietnam. Patients were asked to report the smoking status (current smoker or not), nicotine dependence (by Fagerström test for nicotine dependence - FTND) and alcohol use (by using the Alcohol Use Disorders Identification Test - AUDIT-C). EuroQol-5 dimensions-5 levels (EQ-5D-5L) and EQ-Visual analogue scale (EQ-VAS) were employed to measure health-related quality of life. Multivariate logistic and Tobit regressions were used to identify the associated factors. RESULTS: The majority of respondents were current smokers (75.7%) and a low proportion were hazardous drinkers (18.3%). People receiving treatment in a rural clinic (OR = 0.45; 95%CI = 0.22-0.92) and had problems in usual activities (OR = 0.20; 95%CI = 0.06-0.70) were less likely to be smokers. Q-VAS score (Coef. = 0.03; 95%CI = 0.02-0.05) and having problems in mobility (Coef. = 0.72; 95%CI = 0.03-1.42) was found to be associated with the increase of nicotine dependence. In terms of alcohol drinking, people with other jobs were more likely to drink hazardously compared to unemployed patients (OR = 2.86; 95%CI = 1.20-6.82). Similarly, patients having higher duration of MMT had higher likelihood of being hazardous drinkers (OR = 1.07; 95%CI = 1.01-1.13). CONCLUSIONS: This study highlights the low rate of alcohol abusers but a considerably high proportion of current smokers among MMT patients in the rural mountainside area. Alcohol and tobacco counseling programs combined with social and family support also play an essential role in alcohol and tobacco control. In addition, implementing mass community-based behavioral change campaigns to reduce drug addiction-related stigmatization should also be prioritized.

Factors Associated with Cigarette Smoking and Motivation to Quit among Street Food Sellers in Vietnam.

Since 2013, smoke-free signs in public places, including in restaurants and food stores, have been introduced in Vietnam, aiming to prevent passive smoking. Although extensive research has been carried out on second-hand smoking among clients in public places (e.g., hospitals, restaurants) in Vietnam, no single study exists which captures the current practice of smoking among street food outlets. This study aims to estimate the prevalence of smoking and identify factors associated with smoking status and cessation motivation amongst food sellers in Vietnam. A cross-sectional study involving 1733 food providers at outlets was conducted in 29 districts in Hanoi capital, Vietnam, in 2015. The prevalence of smoking amongst food sellers was determined to be 8.5% (25% for men and 0.8% for women). The enforcement of the smoke-free policy remains modest, since only 7.9% observed outlets complied with the law, providing a room designated for smokers. Although approximately 80% of the participants were aware of the indoor smoke-free regulations in public places, such as restaurants and food stores, 40.2% of smokers reported no intention of quitting smoking. A percentage of 37.6% of current smokers reported that despite having intentions to quit, they did not receive any form of support for smoking cessation. Being male and having hazardous drinking habits and a poor quality of life were all factors that were significantly associated with smoking status. Additionally, having awareness of smoking's adverse effects and being frequently supervised by the authority were associated with a greater motivation to quit. This study highlights the importance of an accompanying education and smoking cessation program in addition to the frequent inspection and reinforcement of smoke-free policy in food stores. This research extends on our knowledge of smoking prevalence and its factors related to smoking events and motivation to quit among street food outlets. Overall, this study strengthens the idea that more government efforts towards preventing passive smoking and smoking cessation education are necessary in restaurants and other street food outlets.

Feasibility of e-Health Interventions on Smoking Cessation among Vietnamese Active Internet Users.

Introduction: Although e-health interventions are widely implemented as a supportive measure to smoking cessation, there is a lack of evidence in the feasibility of its application among Vietnamese youths, which is considered to be one of the most frequent internet using populations. This study assessed the quitting attempts among smokers and their preference and willingness to pay for smartphone-based cessation supporting applications in a sample of active internet users approached. Methods: A total of 1082 participants were recruited for the online-based survey from August to October 2015 in Vietnam. Information on sociodemographic characteristics, health information seeking behaviors on the internet, smoking status, quitting attempts and willingness to pay for smartphone-based cessation supporting applications were collected. Multivariate logistic regression was used to determine the associated factors with current smoking and willingness to pay for the smoking cessation application. Results: About 11% of participants were current smokers while 73.4% had attempted to quit smoking. Only 26.8% of the individuals indicated that they were willing to utilize a smartphone application to assist them in quitting. Participants who were male, had partners/spouse and lived at other places were more likely to smoke cigarette. Meanwhile, people who spent 50-70% of their online time to read health information were less likely to smoke. Results also show that living with family and never sharing health information on the internet were negatively associated with a participant's willingness to pay for the smartphone application. Meanwhile, people who highly trusted health information were more likely to be willing to pay for the application. Conclusions: This prevalence of smoking and associated factors can provide potential indicators for creating several public health interventions in the new environment with the increasing development of information technology. This study implies that in order to expand the coverage of smoking cessation interventions, we recommend the integration of e-health interventions with clinical- or telephone-based conventional models by providing smartphone applications and information on the internet from reliable sources.

5-Minutes Mindfulness for palliative care: Integrating evidence and good design.

In psychiatry, mindfulness based intervention has been increasingly popular as a means of psychosocial intervention over the last decade. With the alvanche of technological advances, there has been a myriad of mindfulness based applications. Recent reviews have highlighted how these applications are lacking in functionalities and without demonstrated efficacy. Other reviews have emphasized that there is a need to take into consideration the design of an application, due to placebo effects. It is the aim of this technical note to illustrate how the 5-Minutes Mindfulness application, which is an application designed to provide mindfulness exercises to relieve distress and suffering amongst palliative patients, have been conceptualized. The conceptualized application builds on previous evidence of the efficacy of 5-Minutes Mindfulness demonstrated by pilot and randomized trials. In terms of design, the currently conceptualized application has been designed such that placebo effects could be controlled for.

Internet addiction and sleep quality among Vietnamese youths.

INTRODUCTION: Internet addiction has been a major behavioral disorder over the past decade. Prior meta-analytic review has demonstrated the association between Internet addiction and psychiatric disorders, as well as sleep related disorders. AIMS AND OBJECTIVES: There remains a paucity of literature about Internet addiction and sleep related disorders in low and middle income countries like Vietnam. It is the aim of this exploratory study to determine the association. METHODOLOGY: An online cross-sectional study was conducted between August through to October 2015. Respondent drive sampling technique was utilized in the recruitment of participants. The short form version of the Young's Internet addiction test was administered and sleep related disorders was ascertained by means of a self-report questionnaire. Chi-squared, t-test and ANOVA were used to determine whether there were any significant differences amongst the variables considered. Multivariate logistic regressions were also used in the analysis, in order to identify factors associated with Internet addiction. RESULTS: 21.2% Of the participants were diagnosed with Internet addiction. 26.7% of those with Internet addiction also reported that they have had sleep related difficulties. 77.2% of these participants were receptive towards seeking medical treatment. Our current study also highlighted that being single and those who were using tobacco products were not at heightened risk of developing associated sleep related issues. CONCLUSIONS: Our current study is largely a cross-sectional exploratory study that has shown that there is a significant prevalence of both Internet addiction and sleep related disorders amongst Vietnamese youth.

Using Online Respondent Driven Sampling for Vietnamese Youths' Alcohol Use and Associated Risk Factors.

OBJECTIVES: The average alcohol consumption per capita among Vietnamese adults has consistently increased. Although alcohol-related disorders have been extensively studied, there is a paucity of research shedding light on this issue among Internet users. The study aimed to examine the severity of alcohol-related disorders and other associated factors that might predispose individuals towards alcohol usage in a sample of youths recruited online. METHODS: An online cross-sectional study was conducted with 1,080 Vietnamese youths. A standardized questionnaire was used. Respondent-driven sampling was applied to recruit participants. Multivariate logistic and Tobit regressions were utilized to identify the associated factors. RESULTS: About 59.5% of the males and 12.7% of the total youths declared that they were actively using alcohol. From the total sample, a cumulative total of 32.3% of the participants were drinking alcohol, with 21.8% and 25.0% of the participants being classified as drinking hazardously and binge drinkers, respectively. The majority of the participants (60.7%) were in the pre-contemplative stage. CONCLUSIONS: A high prevalence of hazardous drinking was recognized among online Vietnamese youths. In addition, we found relationships between alcohol use disorder and other addictive disorders, such as tobacco smoking and water-pipe usage. Our results highlighted that the majority of the individuals are not receptive to the idea of changing their alcohol habits, and this would imply that there ought to be more government effort towards the implementation of effective alcohol control policies.

Co-financing for viral load monitoring during the course of antiretroviral therapy among patients with HIV/AIDS in Vietnam: A contingent valuation survey.

BACKGROUND: Viral load testing is considered the gold standard for monitoring HIV treatment; however, given its high cost, some patients cannot afford viral load testing if this testing is not subsidized. Since foreign aid for HIV/AIDS in Vietnam is rapidly decreasing, we sought to assess willingness to pay (WTP) for viral load and CD4 cell count tests among HIV-positive patients, and identified factors that might inform future co-payment schemes. METHODS: A multi-site cross-sectional survey was conducted with 1133 HIV-positive patients on antiretroviral therapy (ART) in Hanoi and Nam Dinh. Patients' health insurance coverage, quality of life, and history of illicit drug use were assessed. A contingent valuation approach was employed to measure patients' WTP for CD4 cell count and viral load testing. RESULTS: HIV-positive patients receiving ART at provincial sites reported more difficulty obtaining health insurance (HI) and had the overall the poorest quality of life. Most patients (90.9%) were willing to pay for CD4 cell count testing; here, the mean WTP was valued at US$8.2 (95%CI = 7.6-8.8 US$) per test. Most patients (87.3%) were also willing to pay for viral load testing; here, mean WTP was valued at US$18.6 (95%CI = 16.3-20.9 US$) per test. High income, high education level, and hospitalization were positively associated with WTP, while co-morbidity with psychiatric symptoms and trouble paying for health insurance were both negatively related to WTP. CONCLUSIONS: These findings raise concerns that HIV-positive patients in Vietnam might have low WTP for CD4 cell count and viral load testing. This means that without foreign financial subsidies, many of these patients would likely go without these important tests. Treating psychiatric co-morbidities, promoting healthcare services utilization, and removing barriers to accessing health insurance may increase WTP for monitoring of HIV/AIDS treatment among HIV+-positive Vietnamese patients.

Smartphone applications for immersive virtual reality therapy for internet addiction and internet gaming disorder.

There have been rapid advances in technologies over the past decade and virtual reality technology is an area which is increasingly utilized as a healthcare intervention in many disciplines including that of Medicine, Surgery and Psychiatry. In Psychiatry, most of the current interventions involving the usage of virtual reality technology is limited to its application for anxiety disorders. With the advances in technology, Internet addiction and Internet gaming disorders are increasingly prevalent. To date, these disorders are still being treated using conventional psychotherapy methods such as cognitive behavioural therapy. However, there is an increasing number of research combining various other therapies alongside with cognitive behavioural therapy, as an attempt possibly to reduce the drop-out rates and to make such interventions more relevant to the targeted group of addicts, who are mostly adolescents. To date, there has been a prior study done in Korea that has demonstrated the comparable efficacy of virtual reality therapy with that of cognitive behavioural therapy. However, the intervention requires the usage of specialized screens and devices. It is thus the objective of the current article to highlight how smartphone applications could be designed and be utilized for immersive virtual reality treatment, alongside low cost wearables.

Analysis of the Information Quality of Bariatric Surgery Smartphone Applications Using the Silberg Scale.

There is a paucity of literature that has evaluated the information quality of the current bariatric and obesity applications. Our objective was to evaluate the quality of currently available smartphone applications for bariatric-patient care using the Silberg scale. The two most widely used smartphone application online stores were searched in June 2014 and a total of 39 applications were evaluated. The average Silberg score of the 39 applications was 4.0 ± 1.76. The current gaps of information quality include the lack of provision of appropriate references, full disclosure of sponsorship, and accurate disclosure whether the application has been modified in the past month.

Pilot implementation and user preferences of a Bariatric After-care application.

BACKGROUND: The respective rates of obesity in Canada and the United states are estimated to be 24.1% and 34.1%. Due to the increased incidence of obesity, Bariatric surgery has been recognized as one of the treatment options. Patients who have undergone Bariatric surgery tend to need chronic long-term follow-up with a multi-disciplinary team. In the past decade, there has been massive advancement and development in Internet, Web-based and Smartphone technologies. However, there seemed to be a pacuity of applications in this area that enables post-bariatric patients to self-manage their own condition. In addition, past research have highlighted the limited evidence based with regards to currently available bariatric applications, mainly due to the lack of medical professionals involvement. OBJECTIVE: Our current research objective is to illustrate the development of a Bariatric After-care smartphone application and to highlight user preferences with regards to the features integrated within the application. METHODOLOGY: The Bariatric Aftercare application was developed between the months of March 2014 to April 2014. Making use of low-cost online web-based application developmental technologies, the authors embarked on the development of the web-based application. Patients who attended their routine follow-up appointments are given the links to the web-based application. They were also recruited to participate in an online user evaluation survey to identify their preferences with regards to the features integrated. RESULTS: Since the inception of the web-based application to date, there has been a cumulative total of 385 unique assess to the online web-based application. There is a slight change in the confidence levels of the participants with regards to using the application to help them self-manage their own condition. The majority of the users have indicated that they preferred the information pertaining to what happens during each consult with members of the multidisciplinary team and also greatly valued the feature with regards to the ability to re-schedule their appointments. The vast majority also found the additional resources to be helpful. CONCLUSIONS: This is one of the first studies to demonstrate the potential use of smartphone innovations in Bariatric After-care self-management. The current study has shown that users are generally receptive towards such an innovative implementation and has also highlighted some of their preferences with regards to such a self-management application for self-management of their health condition post bariatric surgery. In addition, the authors have also managed to demonstrate how clinicians could be involved in the formulation of a bariatric care application, which has an evidence base.

Online and smartphone based cognitive behavioral therapy for bariatric surgery patients: Initial pilot study.

BACKGROUND: The respective rates of obesity in Canada and the United states are estimated to be 24.1% and 34.1%. Due to the increased incidence of obesity, Bariatric surgery has been recognized as one of the treatment options. Despite the success of Bariatric surgery, studies have proposed that it has neglected the contributions of other factors, such as psychological factors in the causation as well as the maintenance of obesity amongst individuals. Cognitive behavioral therapy (CBT) is largely a psychosocial intervention that has been shown to be efficacious, as studies have demonstrated that even brief CBT interventions could help in the reduction of binge eating and maintenance of weight loss. Previously identified problems with regards to the integration and the provision of such interventions include that of geographical barriers. In order to overcome the geographical barriers, telephone-based CBT has been conceptualized. Over the past decade, there has been massive advancement and development in Internet, Web-based and smartphone technologies, but there is still a paucity of applications in this area. OBJECTIVE: Our current research objective is to determine if bariatric surgery patients will be receptive towards an online and smartphone based CBT intervention. METHODOLOGY: The Bariatric Surgery Online CBT portal and Smartphone companion application was developed between July 2013 and December 2013. A low-cost methodology of developing the online portal was adopted. In terms of development, 4 core development phases were adopted. These included that of: a) Formulation of users' requirements, b) System design and development, c) System evaluation and d) System deployment and pilot application. The bariatric surgery workgroup from the Toronto Western Hospital helped with the recruitment of the subjects from the outpatient specialist service. Links to the web-portal was provided to each of the participants recruited. RESULTS: Since the inception of the online portal to date, in terms of usage rates, there have been a total of 2408 visitors to the online portal. The majority of the visitors are from Canada (n= 1879). From the analytics, a total of 8 users have participated in the pre-assessment questionnaire and have attempted and tried to use the individual modules. Since the inception of the pilot study from January 2014 till October 2014, 4 individuals have completed at least 3 modules available on the online portal. CONCLUSIONS: This is one of the first few studies that have demonstrated the potential feasibility of having an online and smartphone cognitive behavioral portal to serve the psychological needs of bariatric surgery patients.