The Effectiveness of Medical Adherence Mobile Health Solutions for Individuals With Epilepsy: Protocol for a Systematic Review.

BACKGROUND: Epilepsy requires continuous management and treatment to optimize patient outcomes. The advancement of digital health has led to the development of various mobile health (mHealth) tools designed to enhance treatment adherence among individuals with epilepsy. These solutions offer crucial support through features such as reminders, educational resources, personalized feedback, assistance with managing costs, shared decision-making, and access to supportive communities. To design effective medication adherence mHealth solutions, it is essential to evaluate the effectiveness of existing mHealth tools, understand the unique circumstances of different patients, and identify the roles of health care professionals within the digital care pathway. Existing studies on epilepsy primarily focus on self-management, whereas the effectiveness and usability of medical adherence mHealth solutions often remain overlooked. Furthermore, the involvement of health care professionals in digital care pathways for epilepsy as well as the impact of adherence mHealth solutions on the patient experience have not been adequately explored. OBJECTIVE: This study aims to assess the effectiveness of current mHealth solutions designed to improve medical adherence among patients with epilepsy. Furthermore, the study will examine the experiences of patients using mHealth solutions for maintaining medical adherence in epilepsy care. Finally, this review intends to determine the roles of health care professionals within mHealth systems aimed at supporting adherence to medication among patients with epilepsy. METHODS: A systematic literature review has been selected as the appropriate method to address the research questions, adhering to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The inclusion and exclusion criteria have been carefully selected, and both qualitative and quantitative analyses will be used to analyze the results. The expected results will mainly focus on the comparison, classification, and analysis of the effectiveness of current medical adherence mHealth tools. Moreover, the patient experiences using available medical adherence mHealth tools for epilepsy will be assessed. Finally, the role of health care professionals in the epilepsy digital care pathway will be explored, with emphasis on medical adherence. RESULTS: The initial search, full-text screening, and data extraction have been carried out. Thirty-three papers were included in the final stage of the review. The study is expected to be completed by October 2024. CONCLUSIONS: To enhance the digital care pathway for epilepsy, a medical adherence mHealth solution should be personalized, manage medications, include an alarm system, track seizures, support consultations, and offer updated treatment plans. This study aims to understand how findings from the research questions can improve mHealth solutions for individuals with epilepsy. Insights from this research on the effectiveness of current mHealth adherence solutions will provide guidance for developing future mHealth systems, making them more efficient and effective in managing epilepsy. TRIAL REGISTRATION: PROSPERO CRD4202347400; https://tinyurl.com/48mfx22e. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/55123.

Stigma and Stigma Resilience: Role of the Undergraduate and the Campus Environment.

RATIONALE: Stigma permeates disability experiences and compounds disability-related challenges. OBJECTIVE: Identify individual and environmental factors of stigmatizing experiences of college students with learning disabilities (LDs) and attention-deficit/hyperactivity disorder (ADHD). METHODOLOGY: A qualitative descriptive design was used with a thematic analysis of 30 transcripts from group discussions among four cohorts of undergraduates with LD/ADHD (N = 52). The Person-Environment-Occupation-Performance Model was used in interpreting the stigmatizing experiences. FINDINGS: The themes Perceived Misconceptions and Stigmatizing Actions describe key social-environmental factors. The theme Overcoming Stigmatizing Experiences elucidates key skills and processes for developing stigma resilience. These skills and processes were anchored in self-awareness and personally contextualized understanding of disability-related challenges and strengths, which were fostered during positive interactions with supportive others, such as instructors and mentors. IMPLICATIONS: Findings illustrate the biopsychosocial nature of stigma and highlight the role of individual and social-environmental factors in building stigma resilience among young adults with LD/ADHD.

Understanding Stigma and Resilience Among College Students with Learning Disabilities and ADHDWe studied how college students with learning disabilities (LDs) and attention-deficit/hyperactivity disorder (ADHD) experience stigma, which means feeling judged or treated unfairly because of their disabilities. We talked to 52 undergraduates in four groups to understand their experiences and found three main things related to stigma. First, students feel like others have wrong ideas about them and their disabilities. Second, they experience actions from others that make them feel stigmatized. Third, they develop ways to overcome these experiences. Students became more resilient to stigma when they understood themselves better and had support from others like teachers and mentors. Stigma is not just a personal thing for students with LD/ADHD; but it is also influenced by the people around them and how they see themselves.

The Use of Patient-Generated Health Data From Consumer-Grade Mobile Devices in Clinical Workflows: Protocol for a Systematic Review.

BACKGROUND: With the rapid advancement of mobile technology, the scope of mobile health (mHealth) has expanded to include consumer-grade devices such as smartphones and wearable sensors. These solutions have typically been used for fitness purposes; however, due to their ubiquitous capabilities for data collection, they have the potential to bridge information gaps and supplement data from clinical visits. Patient-generated health data (PGHD) can be derived from mHealth solutions and be used by health care professionals (HCPs) as complementary tools in the care process, yet their integration into clinical workflows presents a myriad of challenges. PGHD might be a new and unfamiliar source of information for most HCPs, and the majority of mHealth solutions have not been designed to be used by HCPs as active reviewers. As mHealth solutions become more available and attractive to patients, HCPs may see an increase in the influx of data and related inquiries from their patients. This mismatch in expectations can result in disruptions to clinical workflows and negatively impact patient-clinician relationships. For PGHD to be integrated into clinical workflows, its use should be proven beneficial for both patients and HCPs. However, so far, only limited research has been done on the concrete experiences of HCPs as active reviewers of PGHD from consumer-grade mobile devices. OBJECTIVE: We aimed to systematically guide the review of existing literature to identify what types of PGHD from consumer-grade mobile devices are currently being used by HCPs as complementary tools in the care process. METHODS: The PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) 2015 was followed for the design of the search, selection, and data synthesis processes. Electronic searches will be done on PubMed, ACM Digital Library, IEEE Xplore, and Scopus. RESULTS: Preliminary searches have been conducted, and previous related systematic and scoping reviews have been found and evaluated. The review is expected to be completed in February 2023. CONCLUSIONS: This protocol will guide the review of existing literature on the use of PGHD produced by consumer-grade mobile devices. Although there have been previous reviews related to this topic, our proposed approach seeks to understand the specific opinions and experiences of different types of HCPs who are already using PGHD in their clinical practice and the motives for deeming these data useful and worth reviewing. Depending on the studies that will be included, there may be an opportunity to provide a wider understanding of what types of HCPs trust PGHD, despite the possible challenges that its use might convey, potentially contributing with the knowledge to support the design strategies of mHealth tools that could be integrated into clinical workflows. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/39389.

(Dis)Ability-informed Mentors Support Occupational Performance for College Students with Learning Disabilities and Attention-Deficit/Hyperactivity Disorders through Problem Solving and a Focus on Strengths.

INTRODUCTION: Students with learning disabilities (LD) and Attention-Deficit/Hyperactivity Disorder (LD/ADHD) are well-represented on college campuses. However, they experience challenges to meeting occupational and role expectations associated with being in college. Mentors serve as natural supports for young people within college environments. This study investigates the ways in which graduate-student mentors, who were supported in understanding LD/ADHD and their mentee's strengths and challenges through an occupational lens, provided problem solving supports for undergraduate mentees with LD/ADHD. METHODS: Thematic qualitative analysis was used to investigate problem solving supports provided by mentors (N = 57) of undergraduate mentees (N = 52) with LD/ADHD. RESULTS: Three themes, Executive Functioning, Adult Life Skills, and Academics, represent areas in which mentors worked with mentees in guiding and co-creating strategies to address academic, social, and daily life challenges. Mentors' understandings of their mentees' disability-related challenges and strengths within everyday life situations was important for fostering the occupational performance of mentees. CONCLUSION: The inclusion of biopsychosocial approaches is needed in the development of disability-related mentorship interventions where occupational therapists can leverage disciplinary understanding of disabilities and the fostering of occupational performance to support social functioning and participation in college.

Strategies for Coping with Time-Related and Productivity Challenges of Young People with Learning Disabilities and Attention-Deficit/Hyperactivity Disorder.

Learning disabilities (LD) and attention deficit hyperactivity disorder (ADHD) are characterized by neurological differences that result in difficulties meeting learning and productivity expectations. Young people with LD and ADHD experience difficulties in self-managing academic, social, daily living, and health/wellness demands. Students with LD/ADHD must work longer and harder than peers, which makes managing time and productivity a critical skill for school success. This study examined the strategies that college students with LD/ADHD used to overcome obstacles related to time and productivity within their everyday life contexts. A qualitative phenomenological design was used to examine the phenomenon of coping and productive-task performance through strategy use among 52 college students with LD/ADHD. Strategies classified as habit and routine use, reframing, and symptom-specific strategies were identified. Strategy use for addressing time-related and productivity challenges are multidimensional and entailed a mix of cognitive, behavioral, psychological, and socio-environmental strategies. Effective strategy use across life's contexts was critical to self-managing as a young person with a chronic developmental condition within a college context. The findings provide a much-needed understanding of the multi-faceted challenges and solutions within young adult contexts that are important for guiding the development of interventions for young people with LD/ADHD.

Beyond Academics: A Model for Simultaneously Advancing Campus-Based Supports for Learning Disabilities, STEM Students' Skills for Self-Regulation, and Mentors' Knowledge for Co-regulating and Guiding.

Learning disabilities are highly prevalent on college campuses, yet students with learning disabilities graduate at lower rates than those without disabilities. Academic and psychosocial supports are essential for overcoming challenges and for improving postsecondary educational opportunities for students with learning disabilities. A holistic, multi-level model of campus-based supports was established to facilitate culture and practice changes at the institutional level, while concurrently bolstering mentors' abilities to provide learning disability-knowledgeable support, and simultaneously creating opportunities for students' personal and interpersonal development. Mixed methods were used to investigate implementation of coordinated personal, interpersonal, and institutional level supports for undergraduate science, technology, engineering, and math (STEM) students with learning disabilities. A one-group pre-test post-test strategy was used to examine undergraduate outcomes. Participants included 52 STEM undergraduates with learning disabilities, 57 STEM graduate student mentors, 34 STEM faculty mentors, and 34 university administrators and personnel as members of a university-wide council. Enrolled for 2 years, undergraduates were engaged in group meetings involving psychoeducation and reflective discussions, development of self-advocacy projects, and individual mentorship. Undergraduates reported improved self-efficacy (p = 0.001), campus connection (p < 0.001), professional development (p ≤ 0.002), and self-advocacy (p < 0.001) after two academic years. Graduate student mentors increased their understanding about learning disabilities and used their understanding to support both their mentees and other students they worked with. Council members identified and created opportunities for delivering learning disability-related trainings to faculty, mentors and advisors on campus, and for enhancing coordination of student services related to learning and related disorders. Disability-focused activities became integrated in broader campus activities regarding diversity. This research explicates a role that college campuses can play in fostering the wellbeing and the academic and career development of its students with developmental learning and related disorders. It offers an empirically tested campus-based model that is multilevel, holistic, and strengths-based for supporting positive outcomes of young people with learning disabilities in STEM. Moreover, findings advance the knowledge of supports and skills that are important for self-regulating and navigating complex and multi-faceted disability-related challenges within both the postsecondary educational environment and the young adults' sociocultural context.