Evaluation of a mobile application for preventing the use of alcohol and other drugs among adolescents / Evaluación de una aplicación móvil para la prevención del consumo de alcohol y otras drogas en adolescentes / Avaliação de aplicativo móvel para prevenção do uso de álcool e outras drogas por adolescentes

ABSTRACT Objective: to evaluate a mobile application developed to prevent the use of alcohol and/or other drugs among adolescent students. Method: methodological study with a quantitative approach carried out from July 2018 to July 2021 based on the stages of Contextualized Learning Design for technology development: analysis, design, development, implementation and evaluation. The content evaluation was carried out by 22 experts. The application's graphic design and usability were tested by 13 teenagers representing the target audience. Results: the mobile application "Educação Para Prevenção" [Education For Prevention] addressed the following psychoactive substances: alcohol, marijuana, cigarettes, ecstasy, crack, cocaine, inhalants (glue and poppers) and amphetamines, dealing with topics such as concepts, physiological and behavioral effects, use during adolescence, prevention and harm reduction strategies. The average Content Validity Index score was 0.87. There was a high level of agreement among adolescents regarding the graphic design and the usability (96.6%) of the application. Conclusion: the results show that the experts and the adolescents considered the application valid, and nurses will be able to use it as a facilitating instrument in health education actions in schools, aiming to prevent the use of alcohol and/or other drugs among adolescents. It is recommended that an intervention study be carried out to evaluate the effect of the technology developed.

RESUMEN Objetivo: evaluar una aplicación móvil desarrollada para prevenir el consumo de alcohol y/u otras drogas por parte de estudiantes adolescentes. Método: estudio metodológico, con enfoque cuantitativo, realizado de julio de 2018 a julio de 2021, basado en las etapas del Diseño Instruccional Contextualizado para la construcción de tecnología: análisis, diseño, desarrollo, implementación y evaluación. La evaluación del contenido se llevó a cabo por 22 expertos. El aspecto gráfico y la usabilidad de la aplicación fueron testeados por 13 adolescentes que representaban al público objetivo. Resultados: la aplicación móvil "Educação Para Prevenção" (Educación para la Prevención) abordó sustancias psicoactivas: alcohol, marihuana, cigarrillos, éxtasis, crack, cocaína, inhalantes (pegamento/lanzaperfume) y anfetaminas, abordando temas como conceptos, efectos fisiológicos y conductuales, uso durante la adolescencia, estrategias de prevención y reducción de daños. El Índice de Validación de Contenido promedio fue de 0,87. Hubo un alto nivel de acuerdo entre los adolescentes sobre el aspecto gráfico y la usabilidad (96,6%) de la aplicación. Conclusión: los resultados demuestran que expertos y adolescentes consideraron válida la aplicación, por lo que los enfermeros podrán utilizarla como instrumento facilitador en acciones de educación en salud en la escuela, con el objetivo de prevenir el uso de alcohol y/u otras drogas entre los adolescentes. Se recomienda realizar un estudio de intervención para evaluar el efecto de la tecnología desarrollada.

RESUMO Objetivo: avaliar um aplicativo móvel desenvolvido para prevenir o uso de álcool e/ou outras drogas por estudantes adolescentes. Método: estudo metodológico, de abordagem quantitativa, realizado no período de julho de 2018 a julho de 2021, baseado nas etapas do Design Instrucional Contextualizado para construção de tecnologia: análise, desenho, desenvolvimento, implementação e avaliação. A avaliação de conteúdo foi realizada por 22 especialistas. O aspecto gráfico e a usabilidade do aplicativo foram testados por 13 adolescentes representantes do público-alvo. Resultados: o aplicativo móvel "EPP: Educação Para Prevenção" abordou as substâncias psicoativas: álcool, maconha, cigarro, ecstasy, crack, cocaína, inalantes (cola e lança-perfume) e anfetaminas, tratando de temas como conceitos, efeitos fisiológicos e comportamentais, uso durante a adolescência, estratégias de prevenção e redução de danos. A média do Índice de Validação de Conteúdo foi de 0,87. Verificou-se elevado nível de concordância entre os adolescentes quanto ao aspecto gráfico e à usabilidade (96,6%) do aplicativo. Conclusão: os resultados demonstram que os especialistas e os adolescentes consideraram o aplicativo válido, e os enfermeiros poderão utilizá-lo como um instrumento facilitador nas ações de educação em saúde na escola, visando à prevenção do uso de álcool e/ou outras drogas entre adolescentes. Recomenda-se a realização de um estudo de intervenção para avaliar o efeito da tecnologia desenvolvida.

Efficacy of mHealth Interventions for Improving the Pain and Disability of Individuals With Chronic Low Back Pain: Systematic Review and Meta-Analysis.

Background: Low back pain is one of the main causes of disability worldwide. Individuals with chronic conditions have been widely affected by the COVID-19 pandemic. In this context, mobile health (mHealth) has become popular, mostly due to the widespread use of smartphones. Despite the considerable number of apps for low back pain available in app stores, the effectiveness of these technologies is not established, and there is a lack of evidence regarding the effectiveness of the isolated use of mobile apps in the self-management of low back pain. Objective: We summarized the evidence on the effectiveness of mHealth interventions on pain and disability for individuals with chronic low back pain. Methods: We conducted a systematic review and meta-analysis comparing mHealth to usual care or no intervention. The search terms used were related to low back pain and mHealth. Only randomized controlled trials were included. The primary outcomes were pain intensity and disability, and the secondary outcome was quality of life. Searches were carried out in the following databases, without date or language restriction: PubMed, Scopus, Embase, Physiotherapy Evidence Database (PEDro), the Cochrane Library, and OpenGrey, in addition to article references. The risk of bias was analyzed using the PEDro scale. Data were summarized descriptively and through meta-analysis (pain intensity and disability). In the meta-analysis, eligible studies were combined while considering clinical and methodological homogeneity. The certainty of evidence was assessed using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) criteria. Results: A total of 5 randomized controlled trials were included, totaling 894 participants (447 allocated to the mHealth group and 445 to the usual care group), and they had similar methodological structure and interventions. Follow-up ranged from 6 weeks to 12 months. The studies did not demonstrate significant differences for pain intensity (mean difference -0.86, 95% CI -2.29 to 0.58; P=.15) and disability (standardized mean difference -0.24, 95% CI -0.69 to 0.20; P=.14) when comparing mHealth and usual care. All studies showed biases, with emphasis on nonconcealed allocation and nonblinding of the outcome evaluator. The certainty of evidence was rated as low for the analyzed outcomes. Conclusions: mHealth alone was no more effective than usual care or no treatment in improving pain intensity and disability in individuals with low back pain. Due to the biases found and the low certainty of evidence, the evidence remains inconclusive, and future quality clinical trials are needed.

MEWAR: Development of a Cross-Platform Mobile Application and Web Dashboard System for Real-Time Mosquito Surveillance in Northeast Brazil.

Mosquito surveillance is a crucial process for understanding the population dynamics of mosquitoes, as well as implementing interventional programs for controlling and preventing the spread of mosquito-borne diseases. Environmental surveillance agents who performing routine entomological surveys at properties in areas where mosquito-borne diseases are endemic play a critical role in vector surveillance by searching and destroying mosquito hotspots as well as collate information on locations with increased infestation. Currently, the process of recording information on paper-based forms is time-consuming and painstaking due to manual effort. The introduction of mobile surveillance applications will therefore improve the process of data collection, timely reporting, and field worker performance. Digital-based surveillance is critical in reporting real-time data; indeed, the real-time capture of data with phones could be used for predictive analytical models to predict mosquito population dynamics, enabling early warning detection of hotspots and thus alerting fieldworker agents into immediate action. This paper describes the development of a cross-platform digital system for improving mosquito surveillance in Brazil. It comprises of two components: a dashboard for managers and a mobile application for health agents. The former enables managers to assign properties to health workers who then survey them for mosquitoes and to monitor the progress of inspection visits in real-time. The latter, which is primarily designed as a data collection tool, enables the environmental surveillance agents to act on their assigned tasks of recording the details of the properties at inspections by filling out digital forms built into the mobile application, as well as details relating to mosquito infestation. The system presented in this paper was co-developed with significant input with environmental agents in two Brazilian cities where it is currently being piloted.

The Effect of a Pace Training Session on Internal Load and Neuromuscular Parameters in Taekwondo Athletes.

This study aimed to verify the effect of a pace training session at an intensity corresponding to the kick frequency at the anaerobic threshold (KFAT) on the internal load response and motor response performance of the roundhouse kick. Twelve black belt taekwondo athletes underwent two evaluation sessions: (1) performed the progressive specific test for taekwondo (PSTT) to identify the heart rate deflection point (HRDP) and the KFAT; (2) performed three 2-min rounds with a 1-min interval. Heart rate (HR) throughout each round and motor response performance before and after sessions were measured. The Student's T-test or Wilcoxon test was used, and p < 0.05 was adopted. During round 1, a lower internal load was observed (167 ± 10 bpm) compared with HRDP (179 ± 8 bpm; p = 0.035). During rounds 2 (178 ± 10 bpm; p = 0.745) and 3 (179 ± 8 bpm; p = 1), no differences were observed for an internal load and HRDP. Motor response performance showed no differences. However, a potentiation in the post countermovement jump test compared with rounds 1 (p = 0.012) and 2 (p = 0.028) was observed. The internal load (HR) observed at the intensity corresponding to KFAT can be considered in the prescription of training when the aim is to control the internal load responses without inducing fatigue.

Desenvolvimento e validação de uma tecnologia MHEALTH para a promoção do autocuidado de adolescentes com diabetes / Development and validation of a MHEALTH technology for the promotion of self-care for adolescents with diabetes

Resumo No cenário do Diabetes Mellitus tipo 1 (DM1), uma prática incentivada é o autocuidado. Dessa forma, objetivou-se elaborar e validar um aplicativo móvel (APP) para a promoção do autocuidado em adolescentes com DM1. O método foi divido em duas etapas: elaboração e validação, que vão desde a revisão de literatura, benchmarking, construção do protótipo e validação por especialistas. A construção do APP foi subsidiada pelos sete passos propostos pela American Association of Diabetes Educators. Foram desenhadas as telas e selecionaram-se as possíveis funções; após o desenho, o protótipo do APP foi desenvolvido e nomeado como "DM Agendinha". O processo de validação de conteúdo foi mediado pelo instrumento Suitability Assessment of Materials, por meio do qual o percentual obtido foi de 85,3%, caracterizando o APP como "Material Superior". Para a validação técnica, empregou-se o questionário Smartphone Usability questionnaire, que obteve um Índice de Validade de Conteúdo global de 0,96. Conclui-se, portanto, que o uso desse material por parte dos adolescentes favorecerá a aquisição de novos conhecimentos e a adesão de práticas saudáveis, tendo em vista que se trata de uma tecnologia de caráter eletrônico e de fácil compreensão.

Abstract Self-care is encouraged in the type 1 Diabetes Mellitus (DM1) setting. Thus, this research aimed to develop and validate a mobile application (APP) to promote self-care for adolescents with DM1. The method was divided into two stages: development and validation, ranging from literature review, benchmarking, prototype construction to validation by specialists. The APP construction was subsidized by the seven steps proposed by the American Association of Diabetes Educators. The screens were designed and possible functions were selected. After the design, the APP prototype was developed and named "DM Agendinha". The content validation process was mediated by the Suitability Assessment of Materials tool, where the percentage obtained was 85.3%, characterizing the APP as "Superior Material". The Smartphone Usability questionnaire was employed for technical validation, and the APP reached a global Content Validity Index of 0.96. We concluded, therefore, that the use of this material by adolescents will favor the acquisition of new knowledge and adherence to healthy practices, considering that it is a highly intelligible electronic technology.

Community health worker-based hearing screening on a mobile platform: A scalable protocol piloted in Haiti.

OBJECTIVE: To establish the feasibility of a systematic, community health worker (CHW)-based hearing screening program that gathers Health Insurance Portability and Accountability Act-compliant electronic data (otoscopic images of tympanic membrane and audiometric evaluation) on a smartphone in an effort to streamline treatment options in resource-limited communities. METHODS: This is a cross-sectional study in which four schools were screened in Port-au-Prince, Haiti, during in April 2018. A total of 122 subjects (61% female) aged 5-17 years underwent an initial brief audiometric screen followed by a more comprehensive air conduction audiometric evaluation if they failed their initial screen. Participants with more than 35-dB loss in any frequency on their comprehensive audiometric evaluation received endoscopic otoscopy. RESULTS: Seventy-five percent of subjects (91/122) passed their initial screen. Of those who failed, 9% (4/44 ears) had a severe or profound hearing loss on comprehensive evaluation. Abnormal otoscopic findings (11/36 ears, 31%) included are cerumen impaction (n = 6), myringosclerosis (n = 3), tympanic membrane perforation (n = 1), and tympanic membrane retraction (n = 1). The average duration of the initial testing was 100 seconds (SD = 74 seconds), whereas the duration of comprehensive testing was 394 seconds (SD = 175 seconds). Extrapolating from these data, we estimate that a group of seven trained CHWs could gather formal audiologic and otologic data points for 100 children per hour using this protocol. CONCLUSIONS: A systematic approach that utilizes local resources (CHWs) and existing infrastructure (cell phones and the Internet) can significantly reduce the burden of hearing healthcare specialists while simultaneously facilitating early diagnosis and management of disabling hearing loss in low-resourced settings. LEVEL OF EVIDENCE: Level 4.

The Potential of mHealth Applications in Improving Resistant Hypertension Self-Assessment, Treatment and Control.

PURPOSE OF REVIEW: To review the evidence supporting the use of mobile health (mHealth) apps to improve resistant hypertension self-assessment, treatment and control. RECENT FINDINGS: mHealth apps have been used to directly measure blood pressure (BP) levels, either using the oscillometric method with automated inflatable cuffs or using pulse wave signals detected by smartphone technology without the need for cuffs. These app-based BP monitors tend to over or underestimate BP levels when compared to a gold standard aneroid sphygmomanometer. However, the differences in BP measurements are within the acceptable range of 5 mmHg pre-defined by the European Society of Hypertension International Protocol Revision 2010. mHealth apps are also used as tools to support physicians in improving hypertension treatment. App-based clinical decision support systems are innovative solutions, in which patient information is entered in the app and management algorithms provide recommendations for hypertension treatment. The use of these apps has been shown to be feasible and easily integrated into the workflow of healthcare professionals, and, therefore particularly useful in resource-limited settings. In addition, apps can be used to improve hypertension control by facilitating regular BP monitoring, communication between patients and health professionals, and patient education; as well as by reinforcing behaviours through reminders, including medication-taking and appointment reminders. Several studies provided evidence supporting the use of apps for hypertension control. Although some of the results are promising, there is still limited evidence on the benefits of using such mHealth tools, as these studies are relatively small and with a short-term duration. Recent research has shown that mHealth apps can be beneficial in terms of improving hypertension self-assessment, treatment and control, being especially useful to help differentiate and manage true and pseudo-resistant hypertension. However, future research, including large-scale randomised clinical trials with user-centred design, is crucial to further evaluate the potential scalability and effectiveness of such mHealth apps in the resistant hypertension context.

[MOBILE TECHNOLOGY AS A POTENTIAL TOOL IN RESEARCH ON STIGMA ASSOCIATED WITH HIV/AIDS AMONG MEDICAL STUDENTS]. / TECNOLOGÍA MÓVIL COMO HERRAMIENTA POTENCIAL EN LA INVESTIGACIÓN SOBRE ESTIGMA ASOCIADO AL VIH/SIDA ENTRE ESTUDIANTES DE MEDICINA.

The identification and reduction of manifestations of stigma associated with HIV/ AIDS among health professionals continues facing significant challenges. Some of these are the measurement of stigma in complex setting such as clinical scenarios. However, with the emergence of mobile technology in recent years, such as smartphones and tablets, possibilities for exploration and reduction of stigma manifestations are enhanced. This article aims to reflect on the ability of the iPad to help assess manifestations of stigma associated with HIV/AIDS within a controlled clinical setting with medical students. It is based on a research experience that was carried out to measure behavioral manifestations of stigma associated with HIV/AIDS among medical students in Puerto Rico. The study integrated the use of iPad in the data's collection, storage and analysis. This article highlights the use of existing applications (Apps) for iPad for the implementation of digital tools to measure stigma towards HIV/AIDS. In discussing the experience of researchers, the iPad's potential and it applications for research on stigma are highlighted. Also, implications for the use of mobile technology in social research are discussed.

Mobile Technology Applications in Cancer Palliative Care.

Mobile devices frequently used in other specialties can find great utility in palliative care. For healthcare professionals, the use of mobile technology not only can bring additional resources to the care, but it can actually radically change the cancer remote care practices. The Brazilian National Cancer Institute (INCA) has developed the largest cancer home care program in Latin America, which currently benefits more than 500 patients. The purpose of this paper is to show the development of an ICT environment of mobile applications developed to support the palliative cancer care program at INCA.

[ARIA 2016 executive summary: Integrated care pathways for predictive medicine throughout the life cycle in Argentina]. / Resumen ejecutivo de ARIA 2016: vías integradas de atención para la medicina predictiva a lo largo del ciclo de vida en Argentina.

The ARIA initiative was started during a World Health Organization workshop in 1999. The initial goals were to propose a new classification for allergic rhinitis, to promote the concept of multi-morbidity in asthma and rhinitis and to develop guidelines with stakeholders for world-wide use. ARIA is now focused on the implementation of emerging technologies for individualized and predictive medicine. MASK: MACVIA-Aria Sentinel Network uses mobile technology to develop care pathways that enable management by a multidisciplinary group or by patients themselves. An App for iOS and Android uses a visual analogue scale to assess symptom control and work productivity, as well as a clinical decision support system; it is associated with an interoperable tablet for health professionals. The escalation strategy uses recommendations of the European Innovation Partnership on Active and Healthy Ageing. The aim of ARIA's new approach is to provide an active and healthy life to people affected by rhinitis, regardless of age, gender or socioeconomic status, in order to reduce social and health inequalities caused by the disease.

La iniciativa ARIA (Rinitis Alérgica y su Impacto en el Asma) se inició durante un taller de la Organización Mundial de la Salud en 1999. Los objetivos iniciales fueron proponer una nueva clasificación de rinitis alérgica, promover el concepto de multimorbilidad en asma y rinitis y desarrollar guías con todas las partes interesadas para su en todos los países y poblaciones. ARIA, difundida e implementada en más de 70 naciones, ahora se centra en la implementación de tecnologías emergentes para la medicina individualizada y predictiva. MASK (MACVIA [Contre les Maladies Chroniques pour un Vieillissement Actif] Aria Sentinel Network) utiliza la tecnología móvil para desarrollar vías de atención que permitan el manejo de la rinitis y del asma por un grupo multidisciplinario o por los propios pacientes. Una aplicación (app) para iOS y Android está disponible en 20 países y 15 idiomas; utiliza una escala analógica visual para evaluar el control de los síntomas y la productividad del trabajo, así como un sistema de apoyo para las decisiones clínicas. Se asocia con una tabla interoperable (que permite intercambiar información) para médicos y otros profesionales de la salud. La estrategia de escalamiento utiliza las recomendaciones de la Asociación Europea de Innovación para el Envejecimiento Activo y Saludable. El objetivo del nuevo enfoque ARIA es proporcionar una vida activa y saludable a las personas afectadas por la rinitis, cualquiera que sea su edad, sexo o condición socioeconómica, con el fin de reducir las desigualdades sociales y de salud causadas por la enfermedad.

Assessment of mobile device and SMS Use for Diet and Exercise Information Among Rural Mexican-American adolescents.

This is a pilot study regarding the use of mobile technology and short message service (SMS) for diet and exercise among rural Mexican American adolescents (RMAA). Authors used convenience sampling to recruit RMAA seeking care at a rural healthcare clinic and conducted three focus groups (n=12). Content analysis was used to identify categories and subcategories. Participants applied diet and exercise information in their lives based on an interaction with community and through the use of use mobile devices. Culturally sensitive use of mobile devices and SMS may be a tool to provide rural adolescent populations with resources.