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1.
BMC Public Health ; 20(1): 475, 2020 Apr 10.
Artículo en Inglés | MEDLINE | ID: mdl-32276613

RESUMEN

BACKGROUND: Recruiting of sufficient numbers of donors of blood products is vital worldwide. In this study we assessed the efficacy and cost-effectiveness of telephone calls and SMS reminders for re-recruitment of inactive blood donors. METHODS: This single-centre, non-blinded, parallel randomised controlled trial in Guangzhou, China included 11,880 inactive blood donors whose last donation was between January 1 and June 30, 2014. The donors were randomly assigned to one of two intervention groups (telephone call or short message service [SMS] communications) or to a control group without intervention. SMS messages with altruistic appeal were adopted in the SMS group; in addition to altruistic appeal, reasons for deferral of blood donation were also asked in the telephone group. All participants were followed up for 1 year. The primary outcome was re-donation rate, and rates in different groups were compared by intention-to-treat (ITT) analysis and estimation of the average treatment effect on the treated (ATT). Secondary outcomes were the self-reported deterrents. Other outcomes included the re-donation interval, and the incremental cost-effectiveness ratio (ICER) of telephone calls and SMS reminders on re-recruitment. RESULTS: ITT analysis revealed no significant differences in the re-donation rate among the three groups. ATT estimations indicated that among compliers, telephone calls significantly increased re-donation compared to both SMS reminders and no intervention. Donor return behaviour was positively associated with receiving reminders successfully, being male, older age, and previous donation history. The SMS reminder prompted donors to return sooner than no reminder within 6 months, and according to ICER calculations, SMS reminders were more cost-effective than telephone calls. Donors reported time constraints as the most main causes of self-deferral in the telephone group, and altruistic appeal had a positive effect on these donors. CONCLUSIONS: Interventions to reactivate inactive blood donors can be effective, with telephone calls prompting more donors to return but at a greater cost than SMS messages. SMS reminder with altruistic appeal can urge donors to re-donate sooner within 6 months than no reminder. TRIAL REGISTRATION: NCT03366441 (Reactivation of Inactive Blood Donors). Retrospectively registered 4 December 2017.


Asunto(s)
Donantes de Sangre/psicología , Sistemas Recordatorios , Teléfono , Envío de Mensajes de Texto , Adulto , Altruismo , Donantes de Sangre/estadística & datos numéricos , China , Análisis Costo-Beneficio , Femenino , Humanos , Masculino , Persona de Mediana Edad , Sistemas Recordatorios/economía , Teléfono/economía , Envío de Mensajes de Texto/economía , Adulto Joven
2.
Med Care ; 58(4): 352-359, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32197029

RESUMEN

BACKGROUND: Challenges to health care efficiency are increasingly addressed with the help of digital communication technology tools (DCTs). OBJECTIVE: The objective of this study was to test whether DCT, compared with Usual Care, can reduce health care clinician burden without increasing asthma-related exacerbations among patients with asthma in a large integrated health care system. RESEARCH DESIGN: The (Breathewell) program was a pragmatic, randomized trial at (Kaiser Permanente Colorado), where asthma nurses screen patients for poor symptom control when beta2-agonist refill requests came within 60 days of previous fill or in the absence of a controller medication fill within 4 months (beta2-agonist overfill). A total of 14,978 adults with asthma were randomized to Usual Care or 1 of 2 DCT intervention groups (Text/Phone call or Email). SUBJECTS: Participants included adults 18 and older with an asthma diagnosis at the time of randomization and no history of chronic obstructive pulmonary disease. MEASURES: Primary outcome measures included asthma-related health care resource utilization (eg, asthma nurse contacts), medication use, and exacerbations. RESULTS: A total of 1933 patients had 4337 events which met beta2-agonist overfill criteria. Of the 2874 events in the intervention arm, 1188 (41%) were resolved by DCT contact and did not require additional clinician contact. Asthma medication use and exacerbations over 12 months did not differ among the 3 groups. CONCLUSIONS: DCT tools can successfully contact adult asthma patients to screen for symptoms and facilitate intervention. The absence of differences in medication fills and health care utilization indicates that the strategic replacement of nursing interventions by digital outreach did not reduce treatment adherence or compromise health care outcomes.


Asunto(s)
Agonistas Adrenérgicos beta/uso terapéutico , Asma/tratamiento farmacológico , Correo Electrónico , Relaciones Enfermero-Paciente , Envío de Mensajes de Texto , Carga de Trabajo , Colorado , Femenino , Humanos , Masculino , Persona de Mediana Edad
3.
Medicine (Baltimore) ; 99(12): e18953, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32195927

RESUMEN

BACKGROUND: Nonadherence to prescribed therapy is a significant challenge at the primary healthcare level of South Africa. There are documented evidence of the potential impact of mobile health technology in improving adherence and compliance to treatment. This study assessed the effect of unidirectional text messaging on adherence to dietary and activity regimens among adults living with diabetes in a rural setting of Eastern Cape, South Africa. METHODS: This was a 2-arm, multicenter, parallel, randomized controlled trial, involving a total of 216 patients with diabetes with uncontrolled glycemic status randomly assigned into the intervention (n = 108) and the control group (n = 108). Participants in the intervention arm received daily educational text messages on diabetes and reminders for 6 months, while the control arm continued with standard care only. A validated, self-developed adherence scale was used to assess participants' adherence to diets and physical activity. Descriptive statistics and linear regression were used to assess changes in adherence and the effect of the intervention on adherence to therapy. RESULTS: On a scale of 8, the mean medication adherence level for the intervention group was 6.90 (SD ±â€Š1.34) while that of the control group was 6.87 (SD ±â€Š1.32) with no statistical difference (P = .88). The adjusted mean change in the medication adherence level was 0.02 (-0.33 to 0.43) with no significant difference (P = .79). There was however a low level of adherence to dietary recommendations (1.52 ±â€Š1.62), and physical activity (1.48 ±â€Š1.58) at baseline, and both groups demonstrated a nonsignificant increase in dietary (P = .98) and physical activity adherence (P = .99) from baseline to the follow-up period. CONCLUSION: There is a moderate level of adherence to medication and a low level of adherence to dietary and physical activity recommendation in this setting. The text messaging intervention did not bring about any significant improvement in medication, dietary and physical activity adherence levels. There is a need to design effective strategies for improving adherence to recommended lifestyle changes in this setting.


Asunto(s)
Diabetes Mellitus/terapia , Cooperación del Paciente/estadística & datos numéricos , Sistemas Recordatorios , Población Rural , Envío de Mensajes de Texto , Factores de Edad , Anciano , Teléfono Celular , Dieta , Ejercicio Físico , Femenino , Humanos , Masculino , Cumplimiento de la Medicación/estadística & datos numéricos , Persona de Mediana Edad , Compuestos Organometálicos , Factores Sexuales , Método Simple Ciego , Sudáfrica
5.
AIDS Patient Care STDS ; 34(2): 59-71, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-32049555

RESUMEN

The use of mobile health technologies (mHealth) to ameliorate HIV care has considerably risen in low- and middle-income countries (LMICs) since 2010. Yet, the discrepancies in the results of accompanying studies warrant an updated and systematic consolidation of all available evidence. We report a systematic review of studies testing whether text/image messages, interactive voice response reminders, or calls promote adherence and retention to antiretroviral therapy (ART) in LMICs. We systematically compiled studies published in English until June 2018 from PubMed/Medline, Web of Science, WHO database, ProQuest Dissertations and Theses, and manual search. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2009 and used frequency analysis to assess reported findings. In total, we compiled 35 published articles: 27 completed studies and 8 protocols. Among the main 27 studies, 17 examine adherence, 5 retention, and 5 both measures. Results indicate that 56% report positive and statistically significantly impacts of mHealth on primary outcomes, the remaining 44% report insignificant results. While 41% of studies found a positive and significant effect for adherence, only 12% improved retention. The evidence shows ambiguous results (with high variability) about the effectiveness of mobile phone-assisted mHealth interventions to boost adherence and retention to ART. The literature also points to short follow-up periods, small samples, and limited geographical coverage. Hence, future research should focus on evaluating longer interventions with more patients spread across wider areas to address whether mHealth can be effectively used in LMICs.


Asunto(s)
Antirretrovirales/uso terapéutico , Teléfono Celular , Infecciones por VIH/tratamiento farmacológico , Cumplimiento de la Medicación , Retención en el Cuidado , Países en Desarrollo , Infecciones por VIH/psicología , Humanos , Telemedicina , Envío de Mensajes de Texto
6.
BMC Infect Dis ; 20(1): 173, 2020 Feb 24.
Artículo en Inglés | MEDLINE | ID: mdl-32093630

RESUMEN

BACKGROUND: Studies report serious adherence problems among youth (individuals age 15-24 years of age) in Uganda. Recent growth in mobile phone ownership has highlighted the potential of using text-based interventions to improve antiretroviral treatment (ART) adherence among Ugandan youth. We piloted a randomized controlled trial of a text-based intervention providing weekly real-time antiretroviral adherence feedback, based on information from a smart pill box, to HIV-positive Ugandan youth. In this paper, we report the acceptability, feasibility, and preliminary impact of the intervention. METHODS: We randomized participants to a control group, or to receive messages with information on either their own adherence levels (Treatment 1 - T1), or their own adherence and peer adherence levels (Treatment 2 - T2). We conducted six focus groups from December 2016 to March 2017 with providers and youth ages 15-24, double coded 130 excerpts, and achieved a pooled Cohen's Kappa of 0.79 and 0.80 based on 34 randomly selected excerpts. RESULTS: The quantitative and qualitative data show that the intervention was deemed acceptable and feasible. After controlling for baseline adherence, the T1 group had 3.8 percentage point lower adherence than the control group (95% CI -9.9, 2.3) and the T2 group had 2.4 percentage points higher adherence than the control group (95% CI -3.0, 7.9). However, there was an increasing treatment effect over time for the T2 group with the largest effect towards the end of the study; a 2.5 percentage point increase in the initial 9-weeks that grows steadily to 9.0 percentage points by the last 9-weeks of the study. We find negative treatment effects for T1 in 3 of the 4 9-week intervals. This pilot study was not designed to detect statistically significant differences. CONCLUSIONS: Improving youth's adherence by supplementing information about their adherence with information about the adherence of peers is a promising new strategy that should be further evaluated in a fully-powered study. Providing one's own adherence information alone appears to have less potential. TRIAL REGISTRATION: NCT02514356 07/30/2015.


Asunto(s)
Antirretrovirales/uso terapéutico , Infecciones por VIH/tratamiento farmacológico , Envío de Mensajes de Texto , Cumplimiento y Adherencia al Tratamiento , Adolescente , Teléfono Celular , Estudios de Factibilidad , Femenino , Grupos Focales , Humanos , Masculino , Aceptación de la Atención de Salud , Proyectos Piloto , Uganda , Adulto Joven
7.
BMC Public Health ; 20(1): 131, 2020 Jan 30.
Artículo en Inglés | MEDLINE | ID: mdl-32000743

RESUMEN

BACKGROUND: People increase their risk of melanoma unless they are protected from the harmful effects of sun exposure during childhood and adolescence. We aimed to assess the feasibility of a three-component sun protection intervention- presentation, action planning, and SMS messages - and trial parameters. METHODS: This feasibility wait-list trial was conducted in the United Kingdom in 2018. Students aged 13-15 years were eligible. Feasibility outcomes were collected for recruitment rates; data availability rates for objective measurements of melanin and erythema using a Mexameter and self-reported sunburn occurrences, severity and body location, tanning, sun protection behaviours and Skin Self-Examination (SSE) collected before (baseline) and after the school summer holidays (follow-up); intervention reach, adherence, perceived impact and acceptability. Quantitative data were analysed using descriptive statistics; qualitative data were analysed thematically. RESULTS: Five out of eight schools expressing an interest in participating with four allocated to act as intervention and one control. Four parents/carers opted their child out of the study. Four hundred and eighty-seven out of 724 students on the school register consented to the study at baseline (67%). Three hundred and eighty-five were in intervention group schools. Objective skin measurements were available for 255 (66%) of the intervention group at baseline and 237 (61%) of the group at follow up. Melanin increased; erythema decreased. Complete self-report data were available for 247 (64%) students in the intervention group. The number of students on the school register who attended the presentation and given the booklet was 379 (98%) and gave their mobile phone number was 155 (40%). No intervention component was perceived as more impactful on sun protection behaviours. Adolescents did not see the relevance of sun protection in the UK or for their age group. CONCLUSIONS: This is the first study to use a Mexameter to measure skin colour in adolescents. Erythema (visible redness) lasts no more than three days and its measurement before and after a six week summer holiday may not yield relevant or meaningful data. A major challenge is that adolescents do not see the relevance of sun protection and SSE. TRIAL REGISTRATION: International Standard Randomised Controlled Trial Number ISRCTN11141528. Date registered 0/2/03/2018; last edited 31/05/2018. Retrospectively registered.


Asunto(s)
Conductas Relacionadas con la Salud , Educación en Salud/métodos , Melanoma/prevención & control , Neoplasias Cutáneas/prevención & control , Luz Solar/efectos adversos , Adolescente , Estudios de Factibilidad , Femenino , Humanos , Intención , Masculino , Melanoma/epidemiología , Medición de Riesgo , Autoinforme , Autoexamen/psicología , Autoexamen/estadística & datos numéricos , Neoplasias Cutáneas/epidemiología , Estudiantes/psicología , Estudiantes/estadística & datos numéricos , Baño de Sol/psicología , Baño de Sol/estadística & datos numéricos , Quemadura Solar/epidemiología , Quemadura Solar/prevención & control , Envío de Mensajes de Texto , Reino Unido/epidemiología , Listas de Espera
8.
PLoS One ; 15(1): e0227037, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31899785

RESUMEN

We present a link-centric approach to study variation in the mobile phone communication patterns of individuals. Unlike most previous research on call detail records that focused on the variation of phone usage across individual users, we examine how the calling and texting patterns obtained from call detail records vary among pairs of users and how these patterns are affected by the nature of relationships between users. To demonstrate this link-centric perspective, we extract factors that contribute to the variation in the mobile phone communication patterns and predict demographics-related quantities for pairs of users. The time of day and the channel of communication (calls or texts) are found to explain most of the variance among pairs that frequently call each other. Furthermore, we find that this variation can be used to predict the relationship between the pairs of users, as inferred from their age and gender, as well as the age of the younger user in a pair. From the classifier performance across different age and gender groups as well as the inherent class overlap suggested by the estimate of the bounds of the Bayes error, we gain insights into the similarity and differences of communication patterns across different relationships.


Asunto(s)
Teléfono Celular/tendencias , Comunicación , Adolescente , Adulto , Factores de Edad , Anciano , Demografía , Humanos , Persona de Mediana Edad , Registros , Factores Sexuales , Envío de Mensajes de Texto , Adulto Joven
9.
PLoS One ; 15(1): e0225892, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31923189

RESUMEN

BACKGROUND: Unhealthy dietary behaviour-high intake of fat, sugar, and salt, and low intake of fruits and vegetables-is a major risk factor for chronic diseases. There is a lack of evidence-based interventions to promote healthy dietary intake among Indian populations. Therefore, we tested the effectiveness of an information technology-enabled 'SMART Eating' intervention to reduce the intake of fat, sugar and salt, and to increase the intake of fruits and vegetables. METHODS: In Chandigarh, a North Indian city, a cluster randomized controlled trial was implemented in twelve geographical clusters, based on the type of housing (i.e., LIG: Low-income group; MIG; Middle-income group, and HIG: High-income group-a proxy for socio-economic status). Computer-generated randomization was used to allocate clusters to intervention and comparison arms after pairing on the basis of socioeconomic status and geographical distance between clusters. The sample size was 366 families per arm (N = 732). One adult per family was randomly selected as an index case to measure the change in the outcomes. For behaviour change, a multi-channel communication approach was used, which included information technology-short message service (SMS), email, social networking app and 'SMART Eating' website, and interpersonal communication along with distribution of a 'SMART Eating' kit-kitchen calendar, dining table mat, and measuring spoons. The intervention was implemented at the family level over a period of six months. The comparison group received pamphlets on nutrition education. Outcome measurements were made at 0 and 6 months post-intervention at the individual level. Primary outcomes were changes in mean dietary intakes of fat, sugar, salt, and fruit and vegetables. Secondary outcomes included changes in body mass index (BMI), blood pressure, haemoglobin, fasting plasma glucose (FPG), and serum lipids. Mixed-effects linear regression models were used to determine the net change in the outcomes in the intervention group relative to the comparison group. RESULTS: Participants' mean age was 53 years, a majority were women (76%), most were married (90%) and 51% had completed a college degree. All families had mobile phones, and more than 90% of these families had access to Internet through mobile phones. The intervention group had significant net mean changes of -12.5 g/day (p<0.001), -11.4 g/day (p<0.001), -0.5 g/day (p<0.001), and +71.6 g/day (p<0.001) in the intake of fat, sugar, salt, and fruit and vegetables, respectively. Similarly, significant net changes occurred for secondary outcomes: BMI -0.25 kg/m2, diastolic blood pressure -2.77 mm Hg, FPG -5.7 mg/dl, and triglycerides -24.2mg/dl. The intervention had no effect on haemoglobin, systolic blood pressure, low-density lipoprotein cholesterol, or high-density lipoprotein cholesterol. CONCLUSION: The IT-enabled 'SMART Eating' intervention was found to be effective in reducing fat, sugar, and salt intake, and increasing fruit and vegetable consumption among urban adults from diverse socio-economic backgrounds. TRIAL REGISTRATION: Clinical Trial Registry of India CTRI/2016/11/007457.


Asunto(s)
Conducta Alimentaria , Promoción de la Salud , Evaluación de Programas y Proyectos de Salud , Adulto , Anciano , Biomarcadores/análisis , Glucemia/análisis , Presión Sanguínea , Índice de Masa Corporal , Femenino , Educación en Salud , Hemoglobinas/análisis , Humanos , Internet , Lípidos/sangre , Masculino , Persona de Mediana Edad , Clase Social , Red Social , Envío de Mensajes de Texto
10.
BMC Infect Dis ; 20(1): 42, 2020 Jan 14.
Artículo en Inglés | MEDLINE | ID: mdl-31937260

RESUMEN

BACKGROUND: Compliance to anti-TB treatment is crucial in achieving cure and avoiding the emergence of drug resistance. Electronic health (eHealth) interventions are included in the strategy to end the global Tuberculosis (TB) epidemic by 2035. Evidences showed that mobile messaging systems could improve patient adherence to clinic appointment for diagnosis and treatment. This review aimed to assess the effect of mobile-phone messaging on anti-TB treatment success. METHODS: All randomized controlled trial (RCT) and quasi-experimental studies done prior to August 26, 2019 were included in the review. Studies were retrieved from PubMed, EMBASE, Cochrane and ScienceDirect databases including, grey and non-indexed literatures from Google and Google scholar. Quality of studies were independently assessed using Cochrane Risk of Bias Assessment Tool. A qualitative synthesis and quantitative pooled estimation were used to measure the effect of phone messaging on TB treatment success rate. PRISMA flow diagrams were used to summarize article selection process. RESULTS: A total of 1237 articles were identified, with 14 meeting the eligibility criteria for qualitative synthesis. Eight studies with a total of 5680 TB patients (2733 in intervention and 2947 in control groups) were included in meta-analysis. The pooled effect of mobile-phone messaging revealed a small increase in treatment success compared to standard of care (RR 1.04, 95% CI 1.02 to 1.06), with low heterogeneity (I2 = 7%, p < 0.0002). In the review, performance, detection and attrition biases were reported as major risk of biases. CONCLUSIONS: Mobile-phone messaging showed a modest effect in improving anti-TB treatment success; however, the quality of evidence was low. Further controlled studies are needed to increase the evidence-base on the role of mHealth interventions to improve TB care. PROTOCOL REGISTRATION NUMBER: CRD420170744339. http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42017074439.


Asunto(s)
Teléfono Celular , Telemedicina/métodos , Envío de Mensajes de Texto , Tuberculosis/terapia , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Citas y Horarios , Femenino , Humanos , Masculino , Persona de Mediana Edad , Ensayos Clínicos Controlados no Aleatorios como Asunto , Cooperación del Paciente , Ensayos Clínicos Controlados Aleatorios como Asunto , Resultado del Tratamiento , Tuberculosis/diagnóstico , Adulto Joven
11.
J Psychol ; 154(2): 111-128, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31566509

RESUMEN

Relying on conceptualization of sexting as a deviant behavior, which appear to be related with mental health problems, we examined the relationship between sexting and psychological distress. A one-year longitudinal study was performed among 216 girls and 143 boys, aged from 15 to 17 years (M = 16.32, SD = .64). Participants completed the Sexting Behavior Questionnaire and the Depression Anxiety and Stress Scale at both time points of the study. The results showed that the prevalence for receiving sexts between the two time points was around 30%, and for sending sexts around 60%. The prevalence rates of receiving and sending sexually explicit context were quite stable over time, though they varied significantly across gender. Participants usually had sexted with a current or (ex)partner or friends. The number of person with whom participants exchange sexts did not exceed five. Anxiety and stress symptoms were more prevalent among sexters who receive sexts at the baseline than follow-up study (p < .05). Stress has been found to be significant predictors of sending sext at the baseline study (p < .05), while depression of receiving and sending at the follow-up study (p < .001). This study confirms that sexting is common among youth, and appears to be associated with negative consequences.


Asunto(s)
Conducta del Adolescente , Conducta Sexual/psicología , Conducta Sexual/estadística & datos numéricos , Envío de Mensajes de Texto/estadística & datos numéricos , Adolescente , Ansiedad/epidemiología , Depresión/epidemiología , Femenino , Estudios de Seguimiento , Humanos , Estudios Longitudinales , Masculino , Prevalencia , Estudios Prospectivos , Instituciones Académicas , Parejas Sexuales , Encuestas y Cuestionarios
12.
Eur J Dent Educ ; 24(1): 121-125, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31631472

RESUMEN

INTRODUCTION: WhatsApp is an instant multimedia messaging and social media software which can be used for multiple purposes such as data, text, photographs and document transfer. Due to its versatility and multiple utilities, WhatsApp has been used within the educational setting in medicine and dentistry, proving a positive attitude of students towards its use. AIM: To compare the reception time and the response time of WhatsApp with the traditional electronic email within the dental educational environment. METHOD: A two-group comparative study was designed. Four multiple choice questions were sent via WhatsApp (group WA) and via electronic mail (group eM) to dental students. Data collected focused on the reception time and response time of students. Specifications of WhatsApp were used to collect data whilst an email tracker was used for the eM group. Excel software and Stata/IC version 15.1 software were used for data analysis. RESULTS: Seventy-four dental students from the University x (anonymised for reviewing purposes) dental school agreed to take part in this experience. However, 59 provided their responses (80%). Forty-four were females, and 15 were males. Twenty-seven participants were randomly allocated to the WA group and 32 to the eM group. The statistical analysis revealed a significant difference between groups: Reception time, P: .0286 value and response time, P: .0448 value indicating that the WA group was significantly faster in terms of reception and response time. CONCLUSION: This pilot study suggests that WhatsApp is more efficient in terms of reception and response time than electronic emails.


Asunto(s)
Educación en Odontología , Correo Electrónico , Envío de Mensajes de Texto , Femenino , Humanos , Masculino , Proyectos Piloto , Estudiantes de Odontología
13.
J Am Acad Orthop Surg ; 28(1): e41-e46, 2020 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-31860543

RESUMEN

INTRODUCTION: Patient-reported outcome (PRO) instruments typically are delivered via paper or computer; we validated administration of hip-specific instruments over a mobile phone software communication platform outside a clinical encounter. METHODS: Consecutive patients (n = 69) presenting to a hip preservation clinic completed the Hip Disability and Osteoarthritis Outcome Score Short Form physical function and pain subscales (HOOS-PS and HOOS-PAIN) using standard collection techniques. The subsequent day, patients completed these instruments via a text messaging software program. Text reminders were sent to encourage completion of unanswered questions. Correlation between in-office and mobile phone delivery of PROs was assessed. RESULTS: The intraclass correlation coefficient between in-clinic and mobile phone delivery of HOOS-PS and HOOS-PAIN was 0.72 (95% confidence interval, 0.58 to 0.81) and 0.80 (95% confidence interval, 0.69 to 0.87), respectively. Completion rate of 93% (64 of the 69) was observed using mobile phone and software messaging. Nine patients completed their PRO after being sent a text message reminder. Fifty-one percent of patients completed all PRO questions within 5 minutes; 26% took between 5 and 10 minutes, and 16% took 10 to 30 minutes for completion. DISCUSSION: HOOS-PS and HOOS-PAIN PRO instruments administered via text messaging with automated reminders demonstrate good to excellent reproducibility, no minimal detectable change between communication methods, and a high completion rate in adolescents and young adults with hip pain. Mobile phone delivery via automated software may be a valid method for administration of other PROs, allowing for communication with patients anytime and anywhere. LEVEL OF EVIDENCE: Level IV, case series.


Asunto(s)
Indicadores de Salud , Enfermedades Musculoesqueléticas/diagnóstico , Medición de Resultados Informados por el Paciente , Envío de Mensajes de Texto , Adolescente , Adulto , Artralgia , Teléfono Celular , Evaluación de la Discapacidad , Femenino , Cadera , Humanos , Masculino , Persona de Mediana Edad , Visita a Consultorio Médico , Dolor/diagnóstico , Reproducibilidad de los Resultados , Encuestas y Cuestionarios , Adulto Joven
14.
Support Care Cancer ; 28(1): 99-112, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-30982092

RESUMEN

PURPOSE: Exercise is important in lung cancer, yet most people do not meet the physical activity guidelines. The aim of this study was to characterise the views and experiences of participants with inoperable lung cancer who completed a home-based rehabilitation program. METHODS: Ninety-two participants were recruited (45 intervention group [IG], 47 usual care). Individual semi-structured interviews were conducted with participants randomised to the IG of a trial of home-based exercise, behaviour change and symptom management. Data were independently coded by two researchers, cross-checked and analysed using content analysis with a summary of arising themes. RESULTS: Of the IG (25/45), 55% were interviewed: mean (SD) age 67 (13) years; male 52%; disease stage n (%) III = 9 (36), IV = 11 (44); radical treatment intent n (%) 13 (52). The majority of participants reported program benefits, both in the physical domain (reduced sedentary time and improved strength, fitness and function) and the mental domain (motivation to keep healthy, preventing boredom). Support to self-manage symptoms was well received and many participants reported increased confidence in managing their symptoms. Exercise enablers included having expert health professional support; motivation to be stronger and better prepared for future challenges; and having an achievable and familiar program that was monitored. Treatment side-effects, pain from comorbidities and the weather were exercise barriers. For the majority of participants the use of a Fitbit™ activity tracker, text message exercise reminders and an exercise diary helped to promote adherence. CONCLUSIONS: This home-based rehabilitation program was acceptable to most participants with multiple benefits reported including improved fitness, motivation and ability to manage symptoms.


Asunto(s)
Carcinoma de Pulmón de Células no Pequeñas/rehabilitación , Terapia por Ejercicio/métodos , Servicios de Atención de Salud a Domicilio , Neoplasias Pulmonares/rehabilitación , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma de Pulmón de Células no Pequeñas/patología , Ejercicio Físico/fisiología , Femenino , Humanos , Entrevistas como Asunto , Neoplasias Pulmonares/patología , Masculino , Persona de Mediana Edad , Motivación , Automanejo , Nivel de Atención , Evaluación de Síntomas , Envío de Mensajes de Texto , Resultado del Tratamiento
15.
Pediatrics ; 145(1)2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-31879276

RESUMEN

BACKGROUND AND OBJECTIVES: Latino children in immigrant families experience health care disparities. Text messaging interventions for this population may address disparities. The objective of this study was to evaluate the impact of a Spanish-language text messaging intervention on infant emergency department use and well care and vaccine adherence. METHODS: The Salud al Día intervention, an educational video and interactive text messages throughout the child's first year of life, was evaluated via randomized controlled trial conducted in an urban, academic pediatric primary care practice from February 2016 to December 2017. Inclusion criteria were publicly insured singleton infant <2 months of age; parent age >18, with Spanish as the preferred health care language; and at least 1 household cellular phone. Primary outcomes were abstracted from the electronic medical record at age 15 months. Intention-to-treat analyses were used. RESULTS: A total of 157 parent-child dyads were randomly assigned to Salud al Día (n = 79) or control groups (n = 78). Among all participants, mean parent age was 29.3 years (SD: 6.2 years), mean years in the United States was 7.3 (SD: 5.3 years), and 87% of parents had limited or marginal health literacy. The incidence rate ratio for emergency department use for the control versus intervention group was 1.48 (95% confidence interval: 1.04-2.12). A greater proportion of intervention infants received 2 flu vaccine doses compared with controls (81% vs 67%; P = .04). CONCLUSIONS: This Spanish-language text messaging intervention reduced emergency department use and increased flu vaccine receipt among a population at high risk for health care disparities. Tailored text message interventions are a promising method for addressing disparities.


Asunto(s)
Servicio de Urgencia en Hospital/estadística & datos numéricos , Emigrantes e Inmigrantes/educación , Mal Uso de los Servicios de Salud/prevención & control , Hispanoamericanos/educación , Envío de Mensajes de Texto , Adulto , Intervalos de Confianza , Emigrantes e Inmigrantes/estadística & datos numéricos , Alfabetización en Salud/estadística & datos numéricos , Disparidades en Atención de Salud/etnología , Disparidades en Atención de Salud/estadística & datos numéricos , Hispanoamericanos/estadística & datos numéricos , Humanos , Lactante , Vacunas contra la Influenza/administración & dosificación , Lenguaje
16.
Medicine (Baltimore) ; 98(52): e18353, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31876709

RESUMEN

BACKGROUND: To determine the effectiveness of text message reminders (TMR) on medication adherence (MA) and to investigate the effects of TMR on clinical outcomes. METHODS: The PubMed, Cochrane library, EMbase, and China Biology Medicine databases were searched for randomized-controlled trials with TMR as the intervention for patients with coronary heart disease. Two reviewers independently extracted data and assessed the risk of bias. Meta-analysis was conducted using Stata 15.0 software. RESULTS: In total, 1678 patients in 6 trials were included. Compared with the control group, the MA was 2.85 times greater among the intervention group (RR [relative risk] 2.85; 95% confidence interval [CI] 1.07-7.58). TMR reduced systolic blood pressure (BP) (weighted mean difference) = -6.51; 95% CI -9.79 to -3.23), cholesterol (standard mean difference = -0.26; 95% CI -0.4 to -0.12) and increased the number of patients with BP <140/90 mm Hg (RR 1.39; 95% CI 1.26-1.54). CONCLUSION: TMR significantly promoted MA and reduced systolic BP, cholesterol level, and body mass index, but had no effect on mortality, diastolic BP, or lipoproteins. However, substantial heterogeneity existed in our analyses.


Asunto(s)
Enfermedad Coronaria/tratamiento farmacológico , Cumplimiento de la Medicación , Sistemas Recordatorios , Envío de Mensajes de Texto , Humanos
17.
Arch. argent. pediatr ; 117(6): S264-S276, dic. 2019. tab
Artículo en Español | LILACS, BINACIS | ID: biblio-1051632

RESUMEN

Introducción: No existen datos en la Argentina acerca de la adopción de tecnologías de información y comunicación (TIC) por parte de los pediatras. Objetivos: Estimar la prevalencia de uso de historia clínica electrónica (HCE) y de mensajería electrónica. Describir percepción de ventajas y desventajas. Población y métodos: Estudio observacional, exploratorio, descriptivo y transversal. Se envió una encuesta autoadministrada al padrón de socios de la Sociedad Argentina de Pediatría entre julio y septiembre de 2017. Resultados: De 14.604 socios, se recibieron 3468 respuestas (el 23,7 %); 2680 fueron completas (el 18,4 %). El porcentaje de uso de HCE fue del 44 %. Se destacaron ventajas: acceso a la información (el 23,2 %), agilización del trabajo (el 20,1 %), resguardo seguro de información (el 14,3 %), disponibilidad (el 11,9 %), cálculo de percentiles (el 11,1 %) y realización de estadísticas (el 9,2 %). Las desventajas percibidas fueron cuestiones técnicas (el 32 %), temor a pérdida de información (el 20 %), dudas sobre cuestiones legales (el 15,8 %). El 49,8 % consideró implementar el uso de HCE en el próximo año.El 76,9 % usaba aplicaciones para recibir consultas de sus pacientes. El WhatsApp (el 46,6 %) fue la plataforma más utilizada. El 74 % consideraba que las consultas no presenciales deberían ser remuneradas. Conclusión: El 44 % de los pediatras que respondieron utilizaba HCE. El 49,8 % consideró implementar algún sistema de HCE durante el año siguiente al estudio. La mensajería electrónica era ampliamente utilizada (el 76,9 %) en todos los rangos etarios.


Introduction: There are not data in Argentina about the percentages of use of Information and Communication Technologies by pediatricians yet. Objectives: To estimate the prevalence of the use of Electronic Health Records (EHR) and Electronic Messaging. To describe the perception of advantages and disadvantages. Population and methods: Observational, exploratory, descriptive and transversal study. Five submissions of a self-administered survey were made to the list of partners of the Sociedad Argentina de Pediatría between July and September of 2017. Results: Of 14,604 partners, 3468 responses were received (23.7 %); 2680 were complete (18.4 %). The overall percentage of use of EHR was 44 %. There were advantages: access to information (23.2 %), streamlining work (20.1 %), secure information backup (14.3 %) and availability (11.9 %), calculation of percentiles (11.1 %) and statistics (9.2 %). The perceived disadvantages: technical issues (32 %), fear of information loss (20 %), doubts about legal issues (15.8 %). The use of EHR was going to be implemented by 49.8 % of respondents in the next year. Applications to receive consultations from their patients were used by 76.9 % of pediatricians. WhatsApp (46.6 %) was the most integrated platform. It was considered by 74 % that non face to face consultations should be remunerated. Conclusion: EHR was used by 44 % of pediatricians who responded. And 49.8 % were considering the implementation of some EHR system during the next year. Electronic messaging was widespread (76.9 %) in all age ranges.


Asunto(s)
Humanos , Adulto , Persona de Mediana Edad , Anciano , Informática Médica/estadística & datos numéricos , Comunicación , Argentina , Estudios Transversales , Tecnología de la Información/estadística & datos numéricos , Registros Electrónicos de Salud , Envío de Mensajes de Texto , Pediatras
18.
PLoS One ; 14(12): e0226408, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31877156

RESUMEN

Recent advances in computer-aided text analysis (CATA) have allowed organizational scientists to construct reliable and convenient measures from open texts. As yet, there is a lack of research into using CATA to analyze responses to open survey questions and constructing text-based measures of psychological constructs. In our study, we demonstrated the potential of CATA methods for the construction of text-based job satisfaction measures based on responses to a completely open and semi-open question. To do this, we employed three sentiment analysis techniques: Linguistic Inquiry and Word Count 2015, SentimentR and SentiStrength, and quantified the forms of measurement error they introduced: specific factor error, algorithm error and transient error. We conducted an initial test of the text-based measures' validity, assessing their convergence with closed-question job satisfaction measures. We adopted a time-lagged survey design (Nwave 1 = 996; Nwave 2 = 116) to test our hypotheses. In line with our hypotheses, we found that specific factor error is higher in the open question text-based measure than in the semi-open question text-based measure. As expected, algorithm error was substantial for both the open and semi-open question text-based measures. Transient error in the text-based measures was higher than expected, as it generally exceeded the transient error in the human-coded and the closed job satisfaction question measures. Our initial test of convergent and discriminant validity indicated that the semi-open question text-based measure is especially suitable for measuring job satisfaction. Our article ends with a discussion of limitations and an agenda for future research.


Asunto(s)
Satisfacción en el Trabajo , Envío de Mensajes de Texto/normas , Adulto , Algoritmos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Psicometría , Encuestas y Cuestionarios
19.
BMC Public Health ; 19(1): 1550, 2019 Nov 21.
Artículo en Inglés | MEDLINE | ID: mdl-31752774

RESUMEN

BACKGROUND: There is high prevalence of prediabetes and type 2 diabetes mellitus (T2DM) in Saudi Arabia that is still increasing. Early diagnosis of prediabetes, and immediate, effective intervention is yet unestablished. Conventional health promotion approaches are used to educate prediabetic patients. Behavior modification is very effective in prediabetics to delay T2DM. Thus, the main objective of this study is to examine the effect of the new behavioral model, the Transtheoretical Model short messages (text 4 change) to modify lifestyle to prevent or delay the onset of T2DM, through promotion of a healthy diet and increased physical activity, in impaired glucose tolerance patients. Another objective is to estimate the impact of this model on markers of cardiovascular and metabolic risks as T2DM is one of the modifiable risk factors to prevent cardiovascular diseases. METHODS: This is a randomized controlled trial. One thousand and sixteen, eligible Saudi adults will be recruited from the Heart Health Promotion study (HHP), which was conducted at the King Saud University from July 2013 to April 2014. These adults were at a higher risk of developing T2DM within 2-3 years. The research team's database has a contact list and they will recruit individuals over 6-8 weeks. All participants will be randomized at a 1:1 ratio into two groups, receive group education about lifestyle modifications and written information about diet and physical activity. Text 4 change SMS texts will be sent only to the intervention group. All participants will be assessed at baseline, 6, 12, 18, 24, 30, and 36 months for behavioral change using a World Health Organization (WHO) STEPS questionnaire and for glycated hemoglobin, biochemical and anthropometric measurements using standard methods. DISCUSSION: This new approach for promoting the importance of behavior modification in prediabetics is expected to delay and/or prevent the development of T2DM in Saudi Arabia, subsequently reducing the risk of cardiovascular morbidity and mortality too. Results from this study will promote an innovative and high-tech way to decrease the burden of cardiovascular diseases in Saudi Arabia. TRIAL REGISTRATION: International Standard Randomized Control Trial, registration number ISRCTN10857643. Registered 4 June, 2018.


Asunto(s)
Diabetes Mellitus Tipo 2/prevención & control , Intolerancia a la Glucosa/terapia , Promoción de la Salud/métodos , Estado Prediabético/psicología , Envío de Mensajes de Texto , Adulto , Diabetes Mellitus Tipo 2/epidemiología , Ejercicio Físico/psicología , Femenino , Humanos , Estilo de Vida , Masculino , Modelos Psicológicos , Estado Prediabético/epidemiología , Evaluación de Programas y Proyectos de Salud , Proyectos de Investigación , Arabia Saudita/epidemiología
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