Dataset of motivational factors for using mobile health applications and systems.

We created and carried out a cross-sectional anonymous structured questionnaire on what motivates users of mobile health applications and wearables to share their collected health related data. The questionnaire was distributed online in English, French, and Norwegian. In addition, a flyer with information of where to locate the online questionnaire was distributed during a Swiss health conference. We used snowball sampling and encouraged participants to forward the questionnaires to friends, family, and others. Data were collected between October 2018 and March 2020. 58.1 % (n = 473) responded to the English survey, 34.3 % (n = 279) responded to the French survey, and 7.6 % (n = 62) responded to the Norwegian survey. The questionnaire contained 38 questions divided into seven themes: Background and health goals, Wearables and sensors, Mobile applications, Logging of health data, Data sharing- and integration, Social media and entertainment, and Demographics (age, gender, country of origin, chronic disease status, and chronic disease caretaker status). Answer options were single answer, multiple-choice, open-ended, or on a 4-point Likert scale. Questions were defined based on 16 in-person interviews with people without any chronic disorder, people with diabetes, and people with sickle cell disease. All questions were optional. Data were collected from 814 participants. All answers to the open-ended questions have been translated into English. This dataset is especially interesting for researchers interesting in what motivates people with and without chronic disease across countries to use mHealth tools and share their collected health data. Only a subset of variables has been analyzed so far and new research questions on motivation can potentially be answered using this dataset.

Exploring key-stakeholder perceptions on non-communicable disease care during the COVID-19 pandemic in Kenya.

Introduction: over one third of total Disability-Adjusted-Life-Years lost in Kenya are due to non-communicable diseases (NCD). In response, the Government declared significant commitment towards improving NCD care. The COVID-19 pandemic increased the burden on the already overstretched health systems in Kenya. The aims of this study are to assess whether health care providers perceived NCD care to be optimal during the pandemic and explore how to improve responses to future emergencies. Methods: this cross-sectional online survey included healthcare personnel with non-clinical roles (public health workers and policy-makers) and those delivering health care (doctors and nurses). Respondents were recruited between May and September 2021 by random sampling, completed by snowball sampling. Results: among 236 participants (42% in clinical, 58% in non-clinical roles) there was an overall consensus between respondents on NCD care being disrupted and compromised during the pandemic in Kenya. Detracted supplies, funding, and technical resources affected the continuity of NCDs' response, despite government efforts. Respondents agreed that the enhanced personnel capacity and competencies to manage COVID-19 patients were positive, but noted a lack of guidance for redirecting care for chronic diseases, and advocated for digital innovation as a solution. Conclusion: this paper explores the perceptions of key stakeholders involved in the management of NCDs in Kenya to improve planning for future emergency responses. Gaps were identified in health system response and preparedness capacity during the pandemic including the perceived need to strengthen NCD services, with solutions offered to guide resilience efforts to protect the health system from disruption.

An Online Survey of the Perceptions of Clinical and Non-Clinical Professionals on Healthcare for Non-Communicable Diseases and COVID-19 Measures During the Pandemic in Malaysia.

Objectives: This study assesses the opinions of health professionals in Malaysia on the disruption of non-communicable disease (NCD) services during the COVID-19 pandemic from March 2020 to January 2022. Methods: We conducted a cross-sectional online survey with 191 non-clinical public health workers and clinical health service workers in Malaysia from November 2021 to January 2022. Participants were recruited by the Malaysian Ministry of Health using major networks including key experts and practitioners. Secondary respondents were subsequently enrolled through snowballing. Results: The most notable issues raised by the survey participants relate to NCD service disruption, the redirection of NCD care resources, and NCD care being overburdened post-pandemic. Respondents also reported accounts of resilience and prompt reaction from the healthcare system, as well as calls for innovation. Conclusion: Most respondents perceived that the challenges arising from COVID-19 were mostly managed well by the healthcare system, which was able to provide the necessary services to NCD patients during this health emergency. However, the study identifies gaps in the health system response and preparedness capacity, and highlights solutions for strengthening NCD services.

Exploring key-stakeholder perceptions on non-communicable disease care during the COVID-19 pandemic in Kenya

Introduction: over one third of total Disability-Adjusted-Life-Years lost in Kenya are due to non-communicable diseases (NCD). In response, the Government declared significant commitment towards improving NCD care. The COVID-19 pandemic increased the burden on the already overstretched health systems in Kenya. The aims of this study are to assess whether health care providers perceived NCD care to be optimal during the pandemic and explore how to improve responses to future emergencies. Methods: this cross-sectional online survey included healthcare personnel with non-clinical roles (public health workers and policy-makers) and those delivering health care (doctors and nurses). Respondents were recruited between May and September 2021 by random sampling, completed by snowball sampling. Results: among 236 participants (42% in clinical, 58% in non-clinical roles) there was an overall consensus between respondents on NCD care being disrupted and compromised during the pandemic in Kenya. Detracted supplies, funding, and technical resources affected the continuity of NCDs response, despite government efforts. Respondents agreed that the enhanced personnel capacity and competencies to manage COVID-19 patients were positive, but noted a lack of guidance for redirecting care for chronic diseases, and advocated for digital innovation as a solution. Conclusion: this paper explores the perceptions of key stakeholders involved in the management of NCDs in Kenya to improve planning for future emergency responses. Gaps were identified in health system response and preparedness capacity during the pandemic including the perceived need to strengthen NCD services, with solutions offered to guide resilience efforts to protect the health system from disruption.

Toward a Conversational Agent to Support the Self-Management of Adults and Young Adults With Sickle Cell Disease: Usability and Usefulness Study.

Sickle cell disease (SCD) is the most common genetic blood disorder in the world and affects millions of people. With aging, patients encounter an increasing number of comorbidities that can be acute, chronic, and potentially lethal (e.g., pain, multiple organ damages, lung disease). Comprehensive and preventive care for adults with SCD faces disparities (e.g., shortage of well-trained providers). Consequently, many patients do not receive adequate treatment, as outlined by evidence-based guidelines, and suffer from mistrust, stigmatization or neglect. Thus, adult patients often avoid necessary care, seek treatment only as a last resort, and rely on self-management to maintain control over the course of the disease. Hopefully, self-management positively impacts health outcomes. However, few patients possess the required skills (e.g., disease-specific knowledge, self-efficacy), and many lack motivation for effective self-care. Health coaching has emerged as a new approach to enhance patients' self-management and support health behavior changes. Recent studies have demonstrated that conversational agents (chatbots) could effectively support chronic patients' self-management needs, improve self-efficacy, encourage behavior changes, and reduce disease-severity. To date, the use of chatbots to support SCD self-management remains largely under-researched. Consequently, we developed a high-fidelity prototype of a fully automated health coaching chatbot, following patient-important requirements and preferences collected during our previous work. We recruited a small convenience sample of adults with SCD to examine the usability and perceived usefulness of the system. Participants completed a post-test survey using the System Usability Scale and the Usefulness Scale for Patient Information Material questionnaire. Thirty-three patients participated. The majority (64%) was affected by the most clinically severe SCD genotypes (Hb SS, HbSß0). Most participants (94%) rated the chatbots as easy and fun to use, while 88% perceived it as useful support for patient empowerment. In the qualitative phase, 72% of participants expressed their enthusiasm using the chatbot, and 82% emphasized its ability to improve their knowledge about self-management. Findings suggest that chatbots could be used to promote the acquisition of recommended health behaviors and self-care practices related to the prevention of the main symptoms of SCD. Further work is needed to refine the system, and to assess clinical validity.

mHealth: Where Is the Potential for Aiding Informal Caregivers?

The health and well-being of informal caregivers often take a backseat to those that they care for. While systems, technologies, and services that provide care and support for those with chronic illnesses are established and continuously improved, those that support informal caregivers are less explored. An international survey about motivations to use mHealth technologies was posted to online platforms related to chronic illnesses. We focused on responses regarding the facilitators and challenges of achieving health goals, including the use of mHealth technologies, for the subgroup who identified as "Caregivers". Findings indicate that mHealth technology is not yet the most important motivational factor for achieving health goals in this group, but greater future potential is suggested.

User Expectations and Willingness to Share Self-Collected Health Data.

The rapid improvement in mobile health technologies revolutionized what and how people can self-record and manage data. This massive amount of information accumulated by these technologies has potentially many applications beyond personal need, i.e. for public health. A challenge with collecting this data is to motivate people to share this data for the benefit of all. The purpose of this study is to survey and examine factors that may motivate sharing this data. We asked 447 participants four questions related to health data sharing and motivation. Participants with a chronic disease were concerned about data sharing but also willing to share health data if personalized feedback is provided. Functionality, ease of use, and privacy are regarded as crucial features of health apps.

Citizens' Participation in Health and Scientific Research in Switzerland.

Understanding motivation and resistance factors affecting citizen participation in health and scientific research allows to find solutions to improve citizen engagement and interest in science. Through a survey, we identified the main factors influencing citizens' participation in scientific research, and their wishes to be more informed. Results show that the respondents' reasons to participate in research were altruistic motivations, in line with other studies carried out in developed countries. The main factor influencing the non-participation is the lack of opportunity, highlighting the importance to better inform citizens about ongoing studies.

Preliminary Evaluation of a mHealth Coaching Conversational Artificial Intelligence for the Self-Care Management of People with Sickle-Cell Disease.

Adherence to the complex set of recommended self-care practices among people with Sickle-Cell Disease (SCD) positively impacts health outcomes. However, few patients possess the required skills (i.e. disease-specific knowledge, adequate levels of self-efficacy). Consequently, adherence rates remain low and only 1% of patients are empowered enough to master the self-care practices. Health coaching and therapeutic patient education have emerged as new approaches to enhance patients' self-management and support health behavior changes. This preliminary feasibility study examined patients' perceived usefulness of the information provided by a chatbot we developed following patient-important requirements collected during our preliminary studies. Participants tested the chatbot and completed a post-test survey. A total of 19 patients were enrolled and 2 withdrew. 15 respondents (15/17, 88%) gave a score of at least 3/4 to the question "The chatbot contains all the information I need". Results suggest that mHealth coaching apps could be used to promote the knowledge acquisition of recommended health behaviors related to the prevention of SCD main symptoms.

Factors Influencing Motivation and Engagement in Mobile Health Among Patients With Sickle Cell Disease in Low-Prevalence, High-Income Countries: Qualitative Exploration of Patient Requirements.

BACKGROUND: Sickle cell disease (SCD) is a hematological genetic disease affecting over 25 million people worldwide. The main clinical manifestations of SCD, hemolytic anemia and vaso-occlusion, lead to chronic pain and organ damages. With recent advances in childhood care, high-income countries have seen SCD drift from a disease of early childhood mortality to a neglected chronic disease of adulthood. In particular, coordinated, preventive, and comprehensive care for adults with SCD is largely underresourced. Consequently, patients are left to self-manage. Mobile health (mHealth) apps for chronic disease self-management are now flooding app stores. However, evidence remains unclear about their effectiveness, and the literature indicates low user engagement and poor adoption rates. Finally, few apps have been developed for people with SCD and none encompasses their numerous and complex self-care management needs. OBJECTIVE: This study aimed to identify factors that may influence the long-term engagement and user adoption of mHealth among the particularly isolated community of adult patients with SCD living in low-prevalence, high-income countries. METHODS: Semistructured interviews were conducted. Interviews were audiotaped, transcribed verbatim, and analyzed using thematic analysis. Analysis was informed by the Braun and Clarke framework and mapped to the COM-B model (capability, opportunity, motivation, and behavior). Results were classified into high-level functional requirements (FRs) and nonfunctional requirements (NFRs) to guide the development of future mHealth interventions. RESULTS: Overall, 6 males and 4 females were interviewed (aged between 21 and 55 years). Thirty FRs and 31 NFRs were extracted from the analysis. Most participants (8/10) were concerned about increasing their physical capabilities being able to stop pain symptoms quickly. Regarding the psychological capability aspects, all interviewees desired to receive trustworthy feedback on their self-care management practices. About their physical opportunities, most (7/10) expressed a strong desire to receive alerts when they would reach their own physiological limitations (ie, during physical activity). Concerning social opportunity, most (9/10) reported wanting to learn about the self-care practices of other patients. Relating to motivational aspects, many interviewees (6/10) stressed their need to learn how to avoid the symptoms and live as normal a life as possible. Finally, NFRs included inconspicuousness and customizability of user experience, automatic data collection, data shareability, and data privacy. CONCLUSIONS: Our findings suggest that motivation and engagement with mHealth technologies among the studied population could be increased by providing features that clearly benefit them. Self-management support and self-care decision aid are patients' major demands. As the complexity of SCD self-management requires a high cognitive load, pervasive health technologies such as wearable sensors, implantable devices, or inconspicuous conversational user interfaces should be explored to ease it. Some of the required technologies already exist but must be integrated, bundled, adapted, or improved to meet the specific needs of people with SCD.

[Bigdata, artificial intelligence and blockchain for dummies]. / BigData, intelligence artificielle, blockchain : guide pratique.

Digitalization is transforming every aspect of life, it is also transforming deeply medicine. The digitalization era is characterized by a large production of new data streams while existing processes are progressively migrated, such as writing or imaging. The very large and fast-growing amount of data available requires new storage, transport and analytical tools. This paper presents some of them, such as natural language processing, artificial intelligence, and graph databases. A short introduction to the technology of blockchain is also provided, as it is increasingly used in some non-monetary transaction in medicine, such as data exchanges and consent management.

La société en général, la médecine en particulier, sont emportées par la vague de la digitalisation. Ce phénomène s'appuie sur une production d'immenses quantités de données, parfois du fait de la dématérialisation de processus, comme l'écriture ou la photographie, parfois du fait de l'acquisition de nouvelles données, comme la géolocalisation. Ceci nécessite de nouveaux instruments pour le transport, le stockage et le traitement de l'information. Cet article présente quelques enjeux et instruments utilisés, telles les techniques de traitement du langage naturel, de l'intelligence artificielle et des bases de données en graphes. Enfin, nous décrivons brièvement la technologie de la blockchain, qui est de plus en plus proposée en médecine pour des processus non monétaires, tels que l'échange de données ou la gestion du consentement.

Motivational Factors for User Engagement with mHealth Apps.

The widespread adoption of smartphones creates an enormous potential to improve healthcare services. Numerous apps, sensors, and devices are developed for health self-management purposes. However, adoption rates remain low and long-term user engagement is a major issue. The goal of this study is to identify major motivational factors that can facilitate prolonged use of mobile health systems. To this end, we conducted 16 interviews with representatives of various cultural backgrounds, disease history, age, and gender. Participants' experiences indicated that existing systems were unable to answer their self-management needs properly. People with a disease history favored learning from data, as well as from others via social media integration. People without chronic disease felt more reserved about social media integration. In conclusion, systems that collect and share personal data should have a clear opt-in or opt-out option to motivate usage. Additionally, researchers and mobile health system developers could achieve long-term adoption by giving clear answers to privacy and trust issues, while offering people strong added value according to their individual needs.

User-Centric eHealth Tool to Address the Psychosocial Effects of Sickle Cell Disease.

Sickle cell disease (SCD) is the most prevalent blood inherited disorder in the world. Patients suffer from several chronic issues, comorbidities and high-mortality rates. Despite its prevalence, the disease remains largely ignored. A literature review was conducted and a questionnaire was sent to patients in order to understand the potential of e-health tools to support people with SCD. Additionally, focus groups have been conducted to detail respondents' answers. The results showed that patients felt isolated and misunderstood. They also highlighted patients' wishes for a social network able to make them feel less scattered. Using participatory-design techniques, we designed a prototype of user-centric interface for an online self-supportive SCD patient community. The mock-ups include chatrooms, forums and videoconferences capabilities. They illustrate how SCD patients' social networking and caregivers-patient relationship needs could be met. Future work will focus on the implementation and evaluation of the system.

Exploring the Challenges and Opportunities of eHealth Tools for Patients with Sickle Cell Disease.

Sickle cell disease (SCD) is the most prevalent inherited blood disorder in the world. The symptoms decrease the quality of life of patients and can cause premature death. Self-help solutions for chronic patients are rising and increase the quality of life of patients. We are interested to identify the usefulness of eHealth tools for patients with SCD. We did a literature review to identify the main problems faced by patients and the existing eHealth solutions. The results show a low number of studies in the field but a multi-disciplinary interest. Positive health benefits for patients are reported as well as the need for more research. Patients and caregivers lack of education about the disease, healthy behaviors are unknown and clinical best practices underused. E-health tools can offer an appropriate support for the self-management of SCD by improving the quality of life of patients, by enhancing patient health literacy and by allowing clinicians to make better decisions.

Challenges and issues of geolocation in clinical environment.

Reaching a good indoor geolocation without deploying extensive and expensive infrastructure is a challenge, because satellite positioning system is not available indoors. Geolocation could be of major use in healthcare facilities; to help care providers, visitors and patients to navigate, to improve movements and flows efficiency or to implement location-awareness systems. A system able to provide the location of a person in a hospital requires precision, multi-floors and obstacles management and should also perform in basements and outdoors. Such system needs also to be insensitive to environmental variations occurring in a hospital. These changes may be various kinds of obstacles. These can be the displacement of metallic objects, metallic machines, strong magnetic fields or simply human displacement. A system conforming to the above requirements can also answer various security questions, operational workflow management but also assist movement of people.

Technological choices for mobile clinical applications.

The rise of cheaper and more powerful mobile devices make them a new and attractive platform for clinical applications. The interaction paradigm and portability of the device facilitates bedside human-machine interactions. The better accessibility to information and decision-support anywhere in the hospital improves the efficiency and the safety of care processes. In this study, we attempt to find out what are the most appropriate Operating System (OS) and Software Development Kit (SDK) to support the development of clinical applications on mobile devices. The Android platform is a Linux-based, open source platform that has many advantages. Two main SDKs are available on this platform: the native Android and the Adobe Flex SDK. Both of them have interesting features, but the latter has been preferred due its portability at comparable performance and ease of development.