mHealth Apps for Hypertension Self-Management: Interview Study Among Patient-Users.

BACKGROUND: Hypertension is a major risk factor for cardiovascular disease, affecting over a billion people worldwide. Mobile health (mHealth) apps have emerged as effective tools for managing hypertension, offering capabilities for monitoring blood pressure, fostering lifestyle changes, and improving treatment adherence. OBJECTIVE: This study aimed to explore patient-users' perspectives on the hypertension care mHealth app Hypertension.APP, focusing on its accessibility, expected benefits, potential risks, and role in hypertension management in Germany. METHODS: A qualitative study was conducted involving semistructured interviews with 20 patient-users of a hypertension care mHealth app, Hypertension.APP. Participants were recruited between January and June 2023 using purposive sampling. Verbatim transcripts were analyzed using qualitative content analysis. RESULTS: Participants primarily discovered the app independently, driven by recent hypertension diagnoses and insufficient information from health care professionals regarding effective self-management strategies for their blood pressure. They valued the app for its continuous monitoring and feedback capabilities, aiding in understanding their condition and making lifestyle adjustments. Risks were perceived as minimal, mainly concerning data privacy and potential overreliance on the app. The app became integral to patient-users' hypertension management by offering consistent information and support. The integration into formal health care was limited, as patient-users felt that health care professionals did not accept the use of the technology or might have even felt intimidated to use it. CONCLUSIONS: Among the sample studied, mHealth apps like Hypertension.APP were valued for their continuous monitoring and educational content, aiding in hypertension management. The findings suggest potential benefits of mHealth apps for effective hypertension care among patients who are health- and digitally literate as well as self-effective. There is a critical need for better integration of these apps into routine health care practices, as perceived by the app users. Given the small and specific sample of this qualitative study, further quantitative research with a broader and more varied participant group is necessary to validate these findings. TRIAL REGISTRATION: Deutsches Register Klinischer Studien DRKS00029761; https://tinyurl.com/r33ru22s.

Digital preventive measures for arterial hypertension (DiPaH) - a mixed-methods study protocol for health services research.

Introduction: Digital health measures promise to further improve the quality of cardiovascular care but have not yet been widely implemented in routine care. The research project Digital preventive measures for arterial hypertension (DiPaH) will systematically identify structural and individual factors in different stakeholders that influence the use of digital preventive measures in patients with arterial hypertension in Germany. Special focus is given to remote and sparsely populated areas, the age-specific impact, as well as influence of digital health literacy. Methods and analysis: The DiPaH project is an exploratory cross-sectional study with a mixed-methods design, in which written surveys and interviews with patients and physicians will be conducted. In addition, secondary data from a health insurance company will be analyzed. In module 1, individuals from the database of the health insurance company with confirmed arterial hypertension will be interviewed (1,600 questionnaires, 30 interviews). Module 2 includes users of digital prevention offers and apps (400 questionnaires, 40 interviews) and in module 3, family physicians and cardiologists will be interviewed (400 questionnaires, 40 interviews). In a final module, the overall results will be analyzed and recommendations for interventions in clinical care will be derived. Discussion: The DiPaH project will contribute to a patient-oriented and demand-based improvement of arterial hypertension prevention services in health care. Challenges and barriers will be analyzed and the respective target groups identified based on their prevention needs and social characteristics to enable a patient-centered implementation of digital prevention of arterial hypertension and cardiovascular services in general, and finally to improve cardiovascular outcomes. Clinical trial registration: https://drks.de/search/de/trial/DRKS00029761, identifier DRKS00029761.

Priming of grasp affordance in an ambiguous object: evidence from ERPs, source localization, and motion tracking.

Object affordance refers to possibilities to interact with the objects in our environment, such as grasping. Previous research shows that objects that afford an action activate the motor system and attract attention, for example they elicit an enhanced frontal negativity and posterior P1 in the event-related potential. An effect on posterior N1 is discussed. However, previous findings might have resulted from physical differences between affording and non-affording stimuli, rather than affordance per se. Here we replicated the frontal negativity and posterior P1 effects and further explored the posterior N1 in affordance processing under constant visual input. An ambiguous target was primed either with an affording (pencils) or non-affording (trees) context. Although physically always identical, the target elicited an enhanced frontal negativity and posterior P1 in the pencil prime condition. Posterior N1 was reduced and grip aperture in a grasping task was smaller in the affording context. Source localization revealed stronger activation in occipital and parietal regions for targets in pencil versus tree prime trials. Thus, we successfully show that an ambiguous object primed with an affording context is processed differently than when primed with a non-affording context. This could be related to the ambiguous object acquiring a potential for action through priming.