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1.
Diabetes Res Clin Pract ; 212: 111723, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38830484

ABSTRACT

Applicability of smartphone-based digital health in diabetes management still face challenges due tolow user retention or engagement. Thus, this systematic and meta-analysis aimed to estimate the dropout rate from the clinical trials. Search of literature was performedon 4 September 2023 through various databases (PubMed, Scilit, Scopus, Embase, and Web of Science). Those reporting clinical trials of smartphone apps for diabetic controls (either type 1 or type 2 diabetes mellitus) were screened and selected in accordance with PRISMA guideline. Of 5,429 identified records, as many as 36 studies were found eligible with a total of 3,327 patients in the intervention group. The overall dropout rate was 29.6 % (95 %CI: 25 %-34.3 %) with high heterogeneity (p-Het < 0.001;I2 = 84.84 %). Sample size, intervention duration, patients' age and gender, and cultural adaptation on the app appeared to be non-significant moderators (p > 0.05). In sub-group levels, notably high dropout rates were observed in studies performing cultural adaptation (34.6 %) and conducted in high-income countries (31.9 %). Given the high dropout rate, the engagement level toward diabetic management apps in real-world setting is expected to be low. High heterogeneity in this study, however, requires careful interpretation of the foregoing results. PROSPERO: CRD42023460365 (14 September 2023).


Subject(s)
Mobile Applications , Patient Dropouts , Smartphone , Humans , Mobile Applications/statistics & numerical data , Patient Dropouts/statistics & numerical data , Diabetes Mellitus, Type 2/therapy , Clinical Trials as Topic , Diabetes Mellitus, Type 1/therapy , Diabetes Mellitus/therapy
2.
J Allied Health ; 53(2): e103-e114, 2024.
Article in English | MEDLINE | ID: mdl-38834348

ABSTRACT

BACKGROUND: Range of motion (ROM) measurement is an important part of physical therapy assessment and patient progress. Smartphones are user-friendly instruments and if proven to be reliable and valid, clinicians can use them for a variety of tasks including ROM measurement. OBJECTIVES: To determine concurrent validity and intra- and inter-rater reliability of the PhysioMaster application in measuring cervical ROM in both Android and iOS operating systems. METHODS: Forty-five healthy individuals (age 31.75 ± 11.94 yrs; 18 men, 27 women) completed this study. Two raters measured cervical ROM, three times each, using an Android phone for intra-rater and inter-rater reliability. With an interval time of 1-7 days after the first session, measurements were repeated by one of the raters once to measure intersession reliability. Validity was estimated by one of the raters using iPhone and Android phones one at a time while 3D motion analysis (3DMA) recorded cervical movements simultaneously. For reliability, intraclass correlation coefficient (ICC), and for validity, Pearson correlation coefficient and Bland-Altman plots were used. RESULTS: ICC values of ≥0.76 and ≥0.84 demonstrated excellent intra-rater and inter-rater reliability, respectively. For concurrent validity, correlation between each phone and 3DMA was nearly perfect for all movements (0.93 ≤ r ≤ 0.97). CONCLUSION: PhysioMaster appears to be a valid and reliable application for measuring cervical ROM in healthy individuals.


Subject(s)
Cervical Vertebrae , Mobile Applications , Range of Motion, Articular , Smartphone , Humans , Female , Adult , Male , Reproducibility of Results , Cervical Vertebrae/physiology , Young Adult , Middle Aged , Observer Variation
3.
Clin Interv Aging ; 19: 971-979, 2024.
Article in English | MEDLINE | ID: mdl-38827238

ABSTRACT

Purpose: To analyse factors affecting the ability to use the digital asthma monitoring application Mask-Air® in old-age individuals living in inland Portugal. Patients and Methods: In this observational study, patients with medically confirmed asthma who agreed to participate were interviewed and subdivided into Non-users Group: those who could not use the application and Users Group: those who could. Sociodemographic and psychological data, comorbidities, and asthma status were compared between groups. Assessment of reasons for refusal was based on a 6-item questionnaire. Results: Among the 72 sequentially recruited patients (mean age±SD 73.26±5.43 yrs; 61 women; 11 men), 44 (61.1%; mean age±SD 74.64±5.68 yrs; 38 women; 6 men)) were included in Non-users Group and 28 (38.9%; mean age±SD 71.11±4.26 yrs; 23 women; 5 men) in Users Group. Non-users Group patients were significantly older, had lower socioeconomic level, and more frequently had severe asthma (25% vs 3.6%; Odds ratio=0.08 (95% CI=0.01-0.81; p=0.033)) and diabetes (32.6% vs 7.4%; Odds ratio=0.17 (95% CI=0.03-0.80; p=0.025)) than Users Group. The main reasons for not using the App were "Lack of required hardware" (n=35) and "Digital illiteracy" (n=26), but lack of interest to use the App among those who had conditions to use it was uncommon. Conclusion: Most old-age asthmatics living in Beira Interior either lack a smartphone or digital skills, which are significant obstacles to implementing app-based monitoring studies.


This study was done to see whether it was possible to use a mobile phone application (App) to help old-age asthmatics living in inner Central Portugal better monitor and self-manage their disease. The researchers interviewed a group of 72 patients with proven asthma who agreed to participate in the study. This group was subdivided into two subgroups: Non-users Group (44 patients) included those who could not use the App because they did not have a smartphone; Users Group (28 patients) included those who had all the conditions to use the App. Patients were helped to download the App (called MASK-Air), were given a thorough explanation about it, and about how it should be used on a daily basis to monitor their asthma symptoms. The researchers found that patients in Non-users Group were significantly older, had worse socioeconomic conditions, and more often had severe asthma and diabetes. They also discovered that the main reasons for not using the App were lack of a smartphone and not knowing how to use a smartphone. These results show that lacking a smartphone and not knowing how to use digital tools are frequent situations in old-age asthmatics living in inner Central Portugal, and these may be obstacles for patients in monitoring their own asthma symptoms.


Subject(s)
Asthma , Humans , Male , Female , Portugal , Aged , Mobile Applications , Aged, 80 and over , Surveys and Questionnaires , Smartphone , Comorbidity , Socioeconomic Factors
4.
J Med Internet Res ; 26: e50344, 2024 Jun 05.
Article in English | MEDLINE | ID: mdl-38838309

ABSTRACT

The growing prominence of artificial intelligence (AI) in mobile health (mHealth) has given rise to a distinct subset of apps that provide users with diagnostic information using their inputted health status and symptom information-AI-powered symptom checker apps (AISympCheck). While these apps may potentially increase access to health care, they raise consequential ethical and legal questions. This paper will highlight notable concerns with AI usage in the health care system, further entrenchment of preexisting biases in the health care system and issues with professional accountability. To provide an in-depth analysis of the issues of bias and complications of professional obligations and liability, we focus on 2 mHealth apps as examples-Babylon and Ada. We selected these 2 apps as they were both widely distributed during the COVID-19 pandemic and make prominent claims about their use of AI for the purpose of assessing user symptoms. First, bias entrenchment often originates from the data used to train AI systems, causing the AI to replicate these inequalities through a "garbage in, garbage out" phenomenon. Users of these apps are also unlikely to be demographically representative of the larger population, leading to distorted results. Second, professional accountability poses a substantial challenge given the vast diversity and lack of regulation surrounding the reliability of AISympCheck apps. It is unclear whether these apps should be subject to safety reviews, who is responsible for app-mediated misdiagnosis, and whether these apps ought to be recommended by physicians. With the rapidly increasing number of apps, there remains little guidance available for health professionals. Professional bodies and advocacy organizations have a particularly important role to play in addressing these ethical and legal gaps. Implementing technical safeguards within these apps could mitigate bias, AIs could be trained with primarily neutral data, and apps could be subject to a system of regulation to allow users to make informed decisions. In our view, it is critical that these legal concerns are considered throughout the design and implementation of these potentially disruptive technologies. Entrenched bias and professional responsibility, while operating in different ways, are ultimately exacerbated by the unregulated nature of mHealth.


Subject(s)
Artificial Intelligence , COVID-19 , Mobile Applications , Telemedicine , Humans , Artificial Intelligence/ethics , Bias , SARS-CoV-2 , Pandemics , Social Responsibility
5.
J Med Internet Res ; 26: e50149, 2024 Jun 05.
Article in English | MEDLINE | ID: mdl-38838328

ABSTRACT

BACKGROUND: This study aimed to investigate the relationships between adiposity and circadian rhythm and compare the measurement of circadian rhythm using both actigraphy and a smartphone app that tracks human-smartphone interactions. OBJECTIVE: We hypothesized that the app-based measurement may provide more comprehensive information, including light-sensitive melatonin secretion and social rhythm, and have stronger correlations with adiposity indicators. METHODS: We enrolled a total of 78 participants (mean age 41.5, SD 9.9 years; 46/78, 59% women) from both an obesity outpatient clinic and a workplace health promotion program. All participants (n=29 with obesity, n=16 overweight, and n=33 controls) were required to wear a wrist actigraphy device and install the Rhythm app for a minimum of 4 weeks, contributing to a total of 2182 person-days of data collection. The Rhythm app estimates sleep and circadian rhythm indicators by tracking human-smartphone interactions, which correspond to actigraphy. We examined the correlations between adiposity indices and sleep and circadian rhythm indicators, including sleep time, chronotype, and regularity of circadian rhythm, while controlling for physical activity level, age, and gender. RESULTS: Sleep onset and wake time measurements did not differ significantly between the app and actigraphy; however, wake after sleep onset was longer (13.5, SD 19.5 minutes) with the app, resulting in a longer actigraphy-measured total sleep time (TST) of 20.2 (SD 66.7) minutes. The obesity group had a significantly longer TST with both methods. App-measured circadian rhythm indicators were significantly lower than their actigraphy-measured counterparts. The obesity group had significantly lower interdaily stability (IS) than the control group with both methods. The multivariable-adjusted model revealed a negative correlation between BMI and app-measured IS (P=.007). Body fat percentage (BF%) and visceral adipose tissue area (VAT) showed significant correlations with both app-measured IS and actigraphy-measured IS. The app-measured midpoint of sleep showed a positive correlation with both BF% and VAT. Actigraphy-measured TST exhibited a positive correlation with BMI, VAT, and BF%, while no significant correlation was found between app-measured TST and either BMI, VAT, or BF%. CONCLUSIONS: Our findings suggest that IS is strongly correlated with various adiposity indicators. Further exploration of the role of circadian rhythm, particularly measured through human-smartphone interactions, in obesity prevention could be warranted.


Subject(s)
Actigraphy , Adiposity , Algorithms , Circadian Rhythm , Smartphone , Humans , Female , Actigraphy/instrumentation , Actigraphy/methods , Male , Adult , Circadian Rhythm/physiology , Middle Aged , Obesity/physiopathology , Mobile Applications , Sleep/physiology
6.
Front Public Health ; 12: 1340707, 2024.
Article in English | MEDLINE | ID: mdl-38855456

ABSTRACT

Introduction: Food-insecure households commonly rely on food pantries to supplement their nutritional needs, a challenge that was underscored during the COVID-19 pandemic. Food pantries, and the food banks that supply them, face common challenges in meeting variable client volume and dietary needs under normal and emergency (e.g., pandemic, natural disaster) conditions. A scalable digital strategy that has the capacity to streamline the emergency food distribution system, while promoting healthy food options, managing volunteer recruitment and training, and connecting to emergency management systems in times of need, is urgently required. To address this gap, we are developing a working mobile application (app) called the Support Application for Food PAntrieS (SAFPAS) and will evaluate its feasibility and impact on food pantry staff preparedness, stocking, and client uptake of healthful foods and beverages in two urban United States settings. Methods: This paper describes the protocol for a randomized controlled trial of the SAFPAS mobile application. We will conduct formative research in Baltimore, Maryland and Detroit, Michigan to develop and refine the SAFPAS app and increase scalability potential to other urban settings. Then we will test the app in 20 food pantries in Baltimore randomized to intervention or comparison. The impact of the app will be evaluated at several levels of the emergency food system, including food pantry clients (n = 360), food pantry staff and volunteers (n = 100), food pantry stock, and city agencies such as the local food bank and Office of Emergency Management. The primary outcome of the SAFPAS trial is to improve the healthfulness of the foods received by food pantry clients, measured using the Food Assessment Scoring Tool (FAST). Post-trial, we will conduct additional formative research in Detroit to prepare the app for scale-up. Discussion: We anticipate that SAFPAS will improve alignment in the supply and demand for healthy foods among food pantry clients, food pantries, and city agencies which supply food in Baltimore. Real-time, bidirectional communication between entities across the system allows for increased situational awareness at all levels during normal and emergency operations. By conducting formative research in Detroit, we hope to increase the scalability of the SAFPAS app to additional settings nationwide. Clinical trial registration: NCT87654321. https://classic.clinicaltrials.gov/ct2/show/NCT05880004.


Subject(s)
COVID-19 , Food Assistance , Mobile Applications , Humans , COVID-19/prevention & control , Baltimore , Food Supply , Food Insecurity , Food Security , SARS-CoV-2 , Diet, Healthy
7.
JMIR Hum Factors ; 11: e54739, 2024 Jun 11.
Article in English | MEDLINE | ID: mdl-38861707

ABSTRACT

BACKGROUND: Increased pre-exposure prophylaxis (PrEP) use is urgently needed to substantially decrease HIV incidence among Black sexual minority men. Low perceived risk for HIV (PRH) is a key unaddressed PrEP barrier for Black sexual minority men. Peers and smartphone apps are popular intervention tools to promote community health behaviors, but few studies have used these together in a multicomponent strategy. Therefore, we designed a multicomponent intervention called POSSIBLE that used an existing smartphone app called PrEPme (Emocha Mobile Health, Inc) and a peer change agent (PCA) to increase PRH as a gateway to PrEP. OBJECTIVE: This paper aims to describe the feasibility and preliminary impact of POSSIBLE on PRH and willingness to accept a PrEP referral among Black sexual minority men. METHODS: POSSIBLE was a theoretically guided, single-group, 2-session pilot study conducted among Black sexual minority men from Baltimore, Maryland between 2019 and 2021 (N=69). POSSIBLE integrated a PCA and the PrEPme app that allows users to self-monitor sexual risk behaviors and chat with the in-app community health worker to obtain PrEP service information. PRH was assessed using the 8-item PRH scale before and after baseline and follow-up study visits. At the end of each study visit, the PCA referred interested individuals to the community health worker to learn more about PrEP service options. RESULTS: The average age of participants was 32.5 (SD 8.1, range 19-62) years. In total, 55 (80%) participants were retained for follow-up at month 1. After baseline sessions, 29 (42%) participants were willing to be referred to PrEP services, 20 (69%) of those confirmed scheduled appointments with PrEP care teams. There were no statistically significant differences in PRH between baseline and follow-up visits (t122=-1.36; P=.17). CONCLUSIONS: We observed no statistically significant improvement in PRH between baseline and month 1. However, given the high retention rate and acceptability, POSSIBLE may be feasible to implement. Future research should test a statistically powered peer-based approach on PrEP initiation among Black sexual minority men. TRIAL REGISTRATION: ClinicalTrials.gov NCT04533386; https://clinicaltrials.gov/study/NCT04533386.


Subject(s)
Black or African American , Feasibility Studies , HIV Infections , Sexual and Gender Minorities , Humans , Male , Pilot Projects , HIV Infections/prevention & control , HIV Infections/psychology , Adult , Sexual and Gender Minorities/psychology , Black or African American/psychology , Middle Aged , Pre-Exposure Prophylaxis/methods , Mobile Applications , Baltimore/epidemiology
8.
Hematology ; 29(1): 2365078, 2024 Dec.
Article in English | MEDLINE | ID: mdl-38864489

ABSTRACT

BACKGROUND: Several non-invasive technologies are nowadays available in the market which claim to determine the hemoglobin levels instantly without the requirement of the blood sample. But no study has shown the significance of such non-invasive devices on a routine basis for determining their impact on anemia reduction programs. This study is conducted to determine the impact of regular hemoglobin screening on the women population to determine its potential in reducing anemia, using a digitalized non-invasive device. METHOD: A cross-sectional study was conducted on 203 women of reproductive age group, residing in the Moradabad district. Repetitive readings were taken after a time interval of a minimum of 1 month for determining the impact of regular screening. The entire data collection process was carried out using the EzeCheck mobile app. RESULTS: It was observed that the prevalence of anemia was reduced upon the second time screening and was accepted by the women population. Repetitive testing has a significant impact on reducing anemia prevalence. Also, the simplified non-invasive technology for estimating the hemoglobin values, makes the user more comfortable to take the test. CONCLUSION: Non-invasive devices should be used regularly to keep track of hemoglobin levels which will help in the effective treatment of anemia. The mobile app-based testing could help to easily evaluate the reports of the patients from any remote location with instant result interpretation and health assistance.


Subject(s)
Anemia , Hemoglobins , Mass Screening , Humans , Female , Anemia/diagnosis , Anemia/epidemiology , Anemia/blood , Hemoglobins/analysis , Cross-Sectional Studies , Adult , Prevalence , Mass Screening/methods , Mobile Applications , Middle Aged
9.
BMC Health Serv Res ; 24(1): 710, 2024 Jun 07.
Article in English | MEDLINE | ID: mdl-38849881

ABSTRACT

BACKGROUND: Hepatitis B is endemic amongst the Australian Aboriginal population in the Northern Territory. A participatory action research project identified the lack of culturally appropriate education tools and led to the development of the "Hep B Story" app in the Aboriginal language Yolŋu Matha. This paper describes a formal evaluation of the app's first version, which informed improvements and translation into a further ten Aboriginal languages. METHODS: The evaluation employed Participatory Action Research (PAR) principles to work within Indigenous research methodologies and prioritise Indigenous knowledge to improve the app iteratively. Semi-structured interviews and focus groups were conducted across the Northern Territory with 11 different language groups. Local Community Based Researchers and Aboriginal Research team members coordinated sessions. The recorded, translated conversations were transcribed verbatim and thematically analysed using an inductive and deductive approach. RESULTS: Between November 2018 and September 2020, 94 individuals from 11 language groups participated in 25 semi-structured interviews and 10 focus groups. All participants identified as Aboriginal. Most participants felt the app would be culturally appropriate for Aboriginal communities in the Northern Territory and improve knowledge surrounding hepatitis B. The information gathered from these interviews allowed for identifying five main themes: support for app, relationships, concept versus language, shame, and perceptions of images, along with errors that required modification. CONCLUSIONS: A "real-life" evaluation of the app was comprehensively completed using a PAR approach blended with Indigenous research methods. This evaluation allowed us to develop an updated and enhanced version of the app before creating the additional ten language versions. An iterative approach alongside strong community engagement was pivotal in ensuring the app's cultural safety and appropriateness. We recommend avoiding the use of knowledge-based evaluations in an Aboriginal setting to ensure relevant and culturally appropriate feedback is obtained.


Subject(s)
Community-Based Participatory Research , Focus Groups , Hepatitis B , Mobile Applications , Adult , Female , Humans , Male , Middle Aged , Cultural Competency , Hepatitis B/ethnology , Hepatitis B/prevention & control , Interviews as Topic , Northern Territory , Australian Aboriginal and Torres Strait Islander Peoples
10.
Eur Rev Med Pharmacol Sci ; 28(10): 3479-3492, 2024 May.
Article in English | MEDLINE | ID: mdl-38856123

ABSTRACT

OBJECTIVE: Mobile health (mHealth) technologies have emerged as promising tools in the field of neuro-physiotherapy, offering innovative solutions for enhancing clinical decision-making processes. This scoping review explores the existing literature on the use of mHealth applications in neuro-physiotherapy with a specific focus on their impact on clinical decision-making. MATERIALS AND METHODS: The PubMed, Google Scholar, Cochrane Library, ScienceDirect, and Scopus databases were comprehensively searched for both qualitative and quantitative peer-reviewed articles written in the English language and published till 2023 that focus on mHealth applications in neuro-physiotherapy and clinical decision-making. RESULTS: The key findings from the 14 included studies highlighted the diverse array of mHealth applications employed in neuro-physiotherapy, ranging from wearable sensors and mobile apps to virtual reality platforms. Synthesis of the evidence from these studies demonstrated the potential of these technologies in clinical decision-making and improving patient outcomes, patients' and therapists' perspectives of these applications, their clinical clues, and the challenges with their use. CONCLUSIONS: The findings from the review underscore the need for continued exploration of these technologies to optimize their effectiveness in rehabilitation settings and ultimately improve clinical decision-making and patient care in neuro-physiotherapy.


Subject(s)
Clinical Decision-Making , Telemedicine , Humans , Physical Therapy Modalities , Mobile Applications
11.
JMIR Mhealth Uhealth ; 12: e49040, 2024 Jun 10.
Article in English | MEDLINE | ID: mdl-38857491

ABSTRACT

BACKGROUND: Different kinds of mobile apps are used to promote communications between patients and doctors. Studies have investigated patients' mobile app adoption behavior; however, they offer limited insights into doctors' personal preferences among a variety of choices of mobile apps. OBJECTIVE: This study aimed to investigate the nuanced adoption behaviors among doctors in China, which has a robust adoption of mobile apps in health care, and to explore the constraints influencing their selection of specific mobile apps. This paper addressed 3 research questions: (1) Which doctors opt to adopt mobile apps to communicate with patients? (2) What types of mobile apps do they choose? (3) To what degree do they exercise personal choice in adopting specific mobile apps? METHODS: We used thematic content analysis of qualitative data gathered from semistructured interviews with 11 doctors in Hangzhou, which has been recognized for its advanced adoption of mobile technology in social services, including health care services. The selection of participants was purposive, encompassing diverse departments and hospitals. RESULTS: In total, 5 themes emerged from the data analysis. First, the interviewees had a variety of options for communicating with patients via mobile apps, with the predominant ones being social networking apps (eg, WeChat) and medical platforms (eg, Haodf). Second, all interviewees used WeChat to facilitate communication with patients, although their willingness to share personal accounts varied (they are more likely to share with trusty intermediaries). Third, fewer than half of the doctors adopted medical platforms, and they were all from tertiary hospitals. Fourth, the preferences for in-person, WeChat, or medical platform communication reflected the interviewees' perceptions of different patient cohorts. Lastly, the selection of a particular kind of mobile app was significantly influenced by the doctors' affiliation with hospitals, driven by their professional obligations to fulfill multiple tasks assigned by the hospitals or the necessity of maintaining social connections with their colleagues. CONCLUSIONS: Our findings contribute to a nuanced understanding of doctors' adoption behavior regarding specific types of mobile apps for patient communication, instead of addressing such adoption behavior of a wide range of mobile apps as equal. Their choices of a particular kind of app were positioned within a social context where health care policies (eg, limited funding for public hospitals, dominance of public health care institutions, and absence of robust referral systems) and traditional culture (eg, trust based on social connections) largely shape their behavioral patterns.


Subject(s)
Mobile Applications , Physicians , Qualitative Research , Humans , Mobile Applications/statistics & numerical data , Mobile Applications/standards , Mobile Applications/trends , China , Male , Female , Adult , Physicians/psychology , Physicians/statistics & numerical data , Middle Aged , Physician-Patient Relations , Communication , Interviews as Topic/methods
12.
Arch Iran Med ; 27(6): 313-322, 2024 Jun 01.
Article in English | MEDLINE | ID: mdl-38855801

ABSTRACT

BACKGROUND: Cardiovascular disease (CVD) is a major global health concern, the leading cause of death and disability. Thus, preventive interventions targeting modifiable risk factors are essential. Mobile-health technologies have emerged as promising tools for improving prevention by modifying risk factors. We created the "Green Heart" mobile app to help coronary artery disease (CAD) patients control their risk factors. The app has three modules: smoking cessation, dyslipidemia (DLP) control, and blood pressure (BP) management. This study evaluated the app's performance in monitoring hypertension (HTN) and DLP among known CAD cases. METHODS: A randomized controlled trial enrolled 1590 CAD subjects, including 1114 hypertensive patients and 1488 subjects with DLP, and assigned them randomly to paper-based education or application-based groups. RESULTS: Regarding HTN, after 6 months, we finally analyzed 545 and 546 hypertensive patients, assigned to the conventional and app groups, respectively. Patients in the app group were more likely to have their BP managed successfully (88.6% vs. 78.5%; P<0.001). The app group showed higher odds of successful BP management (odds ratio [OR]: 2.13; 95% CI: 1.51 - 3.03). Regarding DLP, we analyzed 728 patients in the conventional and 714 patients in the app group. A higher percentage of patients in the app group (24.8%) had low-density lipoprotein cholesterol (LDL-C) levels less than 70 mg/dL (16.1%; P<0.001). The app group showed higher odds of reducing LDL-C (OR: 1.72; 95% CI: 1.32-2.26). CONCLUSION: We found that using the Green Heart app in the self-monitoring setting significantly improved BP and DLP management across the study population.


Subject(s)
Dyslipidemias , Hypertension , Mobile Applications , Self-Management , Smartphone , Humans , Male , Hypertension/therapy , Hypertension/prevention & control , Dyslipidemias/therapy , Female , Middle Aged , Aged , Self-Management/methods , Coronary Artery Disease/therapy , Coronary Artery Disease/prevention & control , Smoking Cessation/methods , Blood Pressure , Iran , Patient Education as Topic/methods , Adult , Telemedicine
13.
Arch Sex Behav ; 53(6): 2361-2376, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38844742

ABSTRACT

This linkage study examined the prevalence of traditional gender expressions in the textual and visual profile cues on mobile dating applications (MDA) (nbiographies = 396, npictures = 1352) of 396 young adults' (Mage = 22.39 years, SD = 2.86, 73% women) with attention to users' gender, sexual orientation, and platform type. For 184 users (Mage = 22.10 years, SD = 2.91, 75% women) media content data were linked to self-report survey data. Results showed that individuals aligned their self-presentations with traditional gender roles and expectations, and this link depended on their gender. No significant differences according to individuals' sexual orientation or platform type were found. Individuals' (hyper-) gender orientation also related to engagement in traditional gender expressions. Specifically, women with a stronger feminine gender orientation expressed more traditional femininity in their MDA profiles. For men, no significant associations between (aspects of) a masculine gender orientation and expressing traditional masculinity in their MDA profiles were found. Future research should further disentangle selective gendered self-presentations.


Subject(s)
Gender Role , Mobile Applications , Humans , Female , Male , Young Adult , Adult , Sexual Behavior/psychology , Sexual Behavior/statistics & numerical data , Masculinity , Femininity , Gender Identity , Interpersonal Relations , Courtship/psychology
14.
JMIR Aging ; 7: e50107, 2024 Jun 07.
Article in English | MEDLINE | ID: mdl-38848116

ABSTRACT

BACKGROUND: Assistive technologies can help people living with dementia maintain their everyday activities. Nevertheless, there is a gap between the potential and use of these materials. Involving future users may help close this gap, but the impact on people with dementia is unclear. OBJECTIVE: We aimed to determine if user-centered development of smartwatch-based interventions together with people with dementia is feasible. In addition, we evaluated the extent to which user feedback is plausible and therefore helpful for technological improvements. METHODS: We examined the interactions between smartwatches and people with dementia or people with mild cognitive impairment. All participants were prompted to complete 2 tasks (drinking water and a specific cognitive task). Prompts were triggered using a smartphone as a remote control and were repeated up to 3 times if participants failed to complete a task. Overall, 50% (20/40) of the participants received regular prompts, and 50% (20/40) received intensive audiovisual prompts to perform everyday tasks. Participants' reactions were observed remotely via cameras. User feedback was captured via questionnaires, which included topics like usability, design, usefulness, and concerns. The internal consistency of the subscales was calculated. Plausibility was also checked using qualitative approaches. RESULTS: Participants noted their preferences for particular functions and improvements. Patients struggled with rating using the Likert scale; therefore, we assisted them with completing the questionnaire. Usability (mean 78 out of 100, SD 15.22) and usefulness (mean 9 out of 12) were rated high. The smartwatch design was appealing to most participants (31/40, 76%). Only a few participants (6/40, 15%) were concerned about using the watch. Better usability was associated with better cognition. The observed success and self-rated task comprehension were in agreement for most participants (32/40, 80%). In different qualitative analyses, participants' responses were, in most cases, plausible. Only 8% (3/40) of the participants were completely unaware of their irregular task performance. CONCLUSIONS: People with dementia can have positive experiences with smartwatches. Most people with dementia provided valuable information. Developing assistive technologies together with people with dementia can help to prioritize the future development of functional and nonfunctional features.


Subject(s)
Dementia , Self-Help Devices , Smartphone , User-Centered Design , Humans , Dementia/psychology , Dementia/therapy , Dementia/rehabilitation , Male , Female , Aged , Aged, 80 and over , Surveys and Questionnaires , Activities of Daily Living/psychology , Cognitive Dysfunction/psychology , Cognitive Dysfunction/rehabilitation , Cognitive Dysfunction/therapy , Middle Aged , Mobile Applications
15.
JMIR Mhealth Uhealth ; 12: e54642, 2024 Jun 07.
Article in English | MEDLINE | ID: mdl-38848554

ABSTRACT

BACKGROUND: In emergency departments (EDs), triage nurses are under tremendous daily pressure to rapidly assess the acuity level of patients and log the collected information into computers. With self-service technologies, patients could complete data entry on their own, allowing nurses to focus on higher-order tasks. Kiosks are a popular working example of such self-service technologies; however, placing a sufficient number of unwieldy and fixed machines demands a spatial change in the greeting area and affects pretriage flow. Mobile technologies could offer a solution to these issues. OBJECTIVE: The aim of this study was to investigate the use of mobile technologies to improve pretriage flow in EDs. METHODS: The proposed stack of mobile technologies includes patient-carried smartphones and QR technology. The web address of the self-registration app is encoded into a QR code, which was posted directly outside the walk-in entrance to be seen by every ambulatory arrival. Registration is initiated immediately after patients or their proxies scan the code using their smartphones. Patients could complete data entry at any site on the way to the triage area. Upon completion, the result is saved locally on smartphones. At the triage area, the result is automatically decoded by a portable code reader and then loaded into the triage computer. This system was implemented in three busy metropolitan EDs in Shanghai, China. Both kiosks and smartphones were evaluated randomly while being used to direct pretriage patient flow. Data were collected during a 20-day period in each center. Timeliness and usability of medical students simulating ED arrivals were assessed with the After-Scenario Questionnaire. Usability was assessed by triage nurses with the Net Promoter Score (NPS). Observations made during system implementation were subject to qualitative thematic analysis. RESULTS: Overall, 5928 of 8575 patients performed self-registration on kiosks, and 7330 of 8532 patients checked in on their smartphones. Referring effort was significantly reduced (43.7% vs 8.8%; P<.001) and mean pretriage waiting times were significantly reduced (4.4, SD 1.7 vs 2.9, SD 1.0 minutes; P<.001) with the use of smartphones compared to kiosks. There was a significant difference in mean usability scores for "ease of task completion" (4.4, SD 1.5 vs 6.7, SD 0.7; P<.001), "satisfaction with completion time" (4.5, SD 1.4 vs 6.8, SD 0.6; P<.001), and "satisfaction with support" (4.9, SD 1.9 vs 6.6, SD 1.2; P<.001). Triage nurses provided a higher NPS after implementation of mobile self-registration compared to the use of kiosks (13.3% vs 93.3%; P<.001). A modified queueing model was identified and qualitative findings were grouped by sequential steps. CONCLUSIONS: This study suggests patient-carried smartphones as a useful tool for ED self-registration. With increased usability and a tailored queueing model, the proposed system is expected to minimize pretriage waiting for patients in the ED.


Subject(s)
Emergency Service, Hospital , Mobile Applications , Triage , Humans , Triage/methods , Triage/statistics & numerical data , Triage/standards , Emergency Service, Hospital/statistics & numerical data , Emergency Service, Hospital/organization & administration , Mobile Applications/statistics & numerical data , Mobile Applications/standards , Male , Female , Adult , Middle Aged , Efficiency, Organizational/statistics & numerical data , Smartphone/statistics & numerical data , Smartphone/instrumentation
16.
J Med Internet Res ; 26: e45469, 2024 Jun 07.
Article in English | MEDLINE | ID: mdl-38848556

ABSTRACT

BACKGROUND: Early weight loss is an established predictor for treatment outcomes in weight management interventions for people with obesity. However, there is a paucity of additional, reliable, and clinically actionable early predictors in weight management interventions. Novel blended-care weight management interventions combine coach and app support and afford new means of structured, continuous data collection, informing research on treatment adherence and outcome prediction. OBJECTIVE: Against this backdrop, this study analyzes app engagement as a predictor for weight loss in large-scale, real-world, blended-care interventions. We hypothesize that patients who engage more frequently in app usage in blended-care treatment (eg, higher logging activity) lose more weight than patients who engage comparably less frequently at 3 and 6 months of intervention. METHODS: Real-world data from 19,211 patients in obesity treatment were analyzed retrospectively. Patients were treated with 3 different blended-care weight management interventions, offered in Switzerland, the United Kingdom, and Germany by a digital behavior change provider. The principal component analysis identified an overarching metric for app engagement based on app usage. A median split informed a distinction in higher and lower engagers among the patients. Both groups were matched through optimal propensity score matching for relevant characteristics (eg, gender, age, and start weight). A linear regression model, combining patient characteristics and app-derived data, was applied to identify predictors for weight loss outcomes. RESULTS: For the entire sample (N=19,211), mean weight loss was -3.24% (SD 4.58%) at 3 months and -5.22% (SD 6.29%) at 6 months. Across countries, higher app engagement yielded more weight loss than lower engagement after 3 but not after 6 months of intervention (P3 months<.001 and P6 months=.59). Early app engagement within the first 3 months predicted percentage weight loss in Switzerland and Germany, but not in the United Kingdom (PSwitzerland<.001, PUnited Kingdom=.12, and PGermany=.005). Higher age was associated with stronger weight loss in the 3-month period (PSwitzerland=.001, PUnited Kingdom=.002, and PGermany<.001) and, for Germany, also in the 6-month period (PSwitzerland=.09, PUnited Kingdom=.46, and PGermany=.03). In Switzerland, higher numbers of patients' messages to coaches were associated with higher weight loss (P3 months<.001 and P6 months<.001). Messages from coaches were not significantly associated with weight loss (all P>.05). CONCLUSIONS: Early app engagement is a predictor of weight loss, with higher engagement yielding more weight loss than lower engagement in this analysis. This new predictor lends itself to automated monitoring and as a digital indicator for needed or adapted clinical action. Further research needs to establish the reliability of early app engagement as a predictor for treatment adherence and outcomes. In general, the obtained results testify to the potential of app-derived data to inform clinical monitoring practices and intervention design.


Subject(s)
Mobile Applications , Obesity , Weight Loss , Humans , Retrospective Studies , Female , Male , Middle Aged , Adult , Obesity/therapy , Weight Reduction Programs/methods , Weight Reduction Programs/statistics & numerical data , Germany , United Kingdom , Switzerland
17.
JMIR Res Protoc ; 13: e50650, 2024 Jun 06.
Article in English | MEDLINE | ID: mdl-38842927

ABSTRACT

BACKGROUND: High-risk alcohol consumption among young adults frequently occurs in the presence of peers who are also drinking. A high-risk drinking situation may consist of particular social network members who have a primary association with drinking. Fine-grained approaches such as ecological momentary assessment (EMA) are growing in popularity for studying real-time social influence, but studies using these approaches exclusively rely on participant self-report. Passive indicators of peer presence using Bluetooth-based technology to detect real-time interactions have the potential to assist in the development of just-in-time interventions. OBJECTIVE: This study seeks to examine the feasibility and acceptability of using a Bluetooth-based sensor and smartphone app to measure social contact in real-world drinking situations. METHODS: Young adults (N=20) who drink heavily and report social drinking will be recruited from the community to participate in a 3-week EMA study. Using a social network interview, index participants will identify and recruit 3 of their friends to carry a Bluetooth beacon. Participants will complete a series of EMA reports on their own personal Android devices including random reports; morning reports; first-drink reports; and signal-contingent reports, which are triggered following the detection of a beacon carried by a peer participant. EMA will assess alcohol use and characteristics of the social environment, including who is nearby and who is drinking. For items about peer proximity and peer drinking, a customized peer list will be presented to participants. Feedback about the study protocol will be ascertained through weekly contact with both index and peer participants, followed by a qualitative interview at the end of the study. We will examine the feasibility and acceptability of recruitment, enrollment of participants and peers, and retention. Feasibility will be determined using indexes of eligibility, enrollment, and recruitment. Acceptability will be determined through participant enrollment and retention, protocol compliance, and participant-reported measures of acceptability. Feasibility and acceptability for peer participants will be informed by enrollment rates, latency to enrollment, compliance with carrying the beacon, and self-reported reasons for compliance or noncompliance with beacon procedures. Finally, EMA data about peer proximity and peer drinking will support the validity of the peer selection process. RESULTS: Participant recruitment began in February 2023, and enrollment was completed in December 2023. Results will be reported in 2025. CONCLUSIONS: The protocol allows us to examine the feasibility and acceptability of a Bluetooth-based sensor for the detection of social contact between index participants and their friends, including social interactions during real-world drinking situations. Data from this study will inform just-in-time adaptive interventions seeking to address drinking in the natural environment by providing personalized feedback about a high-risk social context and alerting an individual that they are in a potentially unsafe situation. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/50650.


Subject(s)
Alcohol Drinking , Feasibility Studies , Humans , Alcohol Drinking/psychology , Young Adult , Male , Female , Adult , Mobile Applications , Ecological Momentary Assessment , Adolescent , Peer Group
19.
Support Care Cancer ; 32(7): 426, 2024 Jun 12.
Article in English | MEDLINE | ID: mdl-38864924

ABSTRACT

PURPOSE: Despite the rapid expansion of mHealth apps, their adoption has not always been based on evidence of effectiveness on patient outcomes. This systematic review aimed to determine the effect of mHealth apps on adherence and symptom to oral anticancer medications (OAMs) and identify the app design that led to such effects. METHODS: Pubmed, Cochrane Central, PsycINFO, EMBASE, and WoS were searched from inception to April 2023. Randomised controlled trials (RCTs) that evaluated effects of mHealth apps on primary outcomes OAM adherence and symptom burden were included. Two reviewers independently assessed risk-of-bias using Cochrane Risk-of-Bias version 2 and extracted the data. Quality of evidence was assessed using GRADE. The protocol was registered in PROSPERO (CRD42023406024). RESULTS: Four RCTs involving 806 patients with cancer met the eligibility criteria. mHealth apps features included a combinations of symptom reporting, medication reminder, automated alert to care team, OAM and side effect information, one study implemented structured follow-up by a nurse. The intervention group showed no significant difference in OAM adherence (relative ratio 1.20; 95% CI 1.00 to 1.43), but significantly improved symptoms to OAMs with a lower standardised mean symptom burden score of 0.49 (SMD - 0.49; 95% CI - 0.93 to - 0.06), and a 25% lower risk of grade 3 or 4 toxicity (risk ratio 0.75; 95% CI 0.58 to 0.95) compared to usual care. CONCLUSION: These findings suggest a potential role for mHealth app in managing OAM side effect. Further research should explore the role of AI-guided algorithmic pathways on the interactive features of mHealth apps.


Subject(s)
Antineoplastic Agents , Medication Adherence , Mobile Applications , Neoplasms , Telemedicine , Humans , Antineoplastic Agents/administration & dosage , Antineoplastic Agents/adverse effects , Antineoplastic Agents/therapeutic use , Neoplasms/drug therapy , Administration, Oral , Randomized Controlled Trials as Topic
20.
PLoS One ; 19(6): e0302844, 2024.
Article in English | MEDLINE | ID: mdl-38848353

ABSTRACT

BACKGROUND: Mobile health (mHealth) applications (apps) show promise in supporting epilepsy self-management (eSM). To delve deeper into this potential, we conducted a systematic review of epilepsy mHealth apps available on both iOS and Android platforms, examining articles related to eSM. This review allowed us to identify important domains related to eSM. Furthermore, based on the findings, we developed an epilepsy mHealth app framework that aims to improve self-management for the local population. This study aims to assess the practicality and usability of the proposed mHealth app framework designed to improve eSM. We will conduct an expert panel review to evaluate the effectiveness and feasibility of the framework. MATERIAL AND METHODS: Content validity was assessed by an expert panel comprising epileptologists and pharmacists. The validation process involved scoring the items within each domain of the framework to evaluate their practicality and usability (quantitative component). In addition, a panel discussion was conducted to further explore and discuss the qualitative aspects of the items. RESULTS: A total of 4 domains with 15 items were highly rated for their practicality and usefulness in eSM. CONCLUSIONS: The locally validated framework will be useful for developing eSM mobile apps. Seizure Tracking, Medication Adherence, Treatment Management, and Healthcare Communication emerged as the most crucial domains for enhancing eSM.


Subject(s)
Epilepsy , Mobile Applications , Self-Management , Telemedicine , Humans , Epilepsy/therapy , Self-Management/methods , Medication Adherence
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