Families' expectations of an eHealth family-based cardiovascular disease-risk reduction programme.

AIM: Research has shown that families' participation in a cardiovascular disease (CVD) prevention programme could boost early adoption of healthy lifestyle behaviours in families. Behaviour-based, eHealth interventions are a potential means of achieving this. This study aimed to explore expectations of families-parents and children-at risk of CVD towards the design and functionality of an eHealth family-based CVD-risk reduction programme 'Health-e-Hearts'. METHODS AND RESULTS: Three online focus groups were conducted with six families comprising at least one parent at risk of CVD and at least one child aged 5-17 years. The focus groups were video and audio recorded and transcribed. Content analysis was used to synthesize and identify key categories and subcategories regarding development of and engagement with an eHealth programme. Three categories emerged: experiences of health apps and devices; eHealth application needs of family members; and motivators for using an eHealth programme. Experiences included using health apps individually and inconsistently. Needs included personalization, free and easy-to-use, time efficient, and multiple content formats. Motivators for engaging with the programme included goal setting, rewards, and competition. CONCLUSION: Families' expectations of an eHealth family-based CVD-risk reduction programme include the incorporation of personalized, easy-to-use design features and motivators for engaging with the programme. Family involvement in the development of an eHealth programme such as 'Health-e-Hearts' has the potential to boost early adoption of healthy lifestyle behaviours among all family members.

Mining user reviews of COVID contact-tracing apps: An exploratory analysis of nine European apps.

CONTEXT: More than 78 countries have developed COVID contact-tracing apps to limit the spread of coronavirus. However, many experts and scientists cast doubt on the effectiveness of those apps. For each app, a large number of reviews have been entered by end-users in app stores. OBJECTIVE: Our goal is to gain insights into the user reviews of those apps, and to find out the main problems that users have reported. Our focus is to assess the "software in society" aspects of the apps, based on user reviews. METHOD: We selected nine European national apps for our analysis and used a commercial app-review analytics tool to extract and mine the user reviews. For all the apps combined, our dataset includes 39,425 user reviews. RESULTS: Results show that users are generally dissatisfied with the nine apps under study, except the Scottish ("Protect Scotland") app. Some of the major issues that users have complained about are high battery drainage and doubts on whether apps are really working. CONCLUSION: Our results show that more work is needed by the stakeholders behind the apps (e.g., app developers, decision-makers, public health experts) to improve the public adoption, software quality and public perception of these apps.

What do users think of the UK's three COVID-19 contact-tracing apps? A comparative analysis.

OBJECTIVES: Our goal was to gain insights into the user reviews of the three COVID-19 contact-tracing mobile apps, developed for the different regions of the UK: 'NHS COVID-19' for England and Wales, 'StopCOVID NI' for Northern Ireland and 'Protect Scotland' for Scotland. Our two research questions are (1) what are the users' experience and satisfaction levels with the three apps? and (2) what are the main issues (problems) that users have reported about the apps? METHODS: We assess the popularity of the apps and end users' perceptions based on user reviews in app stores. We conduct three types of analysis (data mining, sentiment analysis and topic modelling) to derive insights from the combined set of 25 583 user reviews of the aforementioned three apps (submitted by users until the end of 2020). RESULTS: Results show that end users have been generally dissatisfied with the apps under study, except the Scottish app. Some of the major issues that users have reported are high battery drainage and doubts on whether apps are really working. DISCUSSION: Towards the end of 2020, the much-awaited COVID-19 vaccines started to be available, but still, analysing the users' feedback and technical issues of these apps, in retrospective, is valuable to learn the right lessons to be ready for similar circumstances in future. CONCLUSION: Our results show that more work is needed by the stakeholders behind the apps (eg, apps' software engineering teams, public-health experts and decision makers) to improve the software quality and, as a result, the public adoption of these apps. For example, they should be designed to be as simple as possible to operate (need for usability).

Development of a Digital Lifestyle Modification Intervention for Use after Transient Ischaemic Attack or Minor Stroke: A Person-Based Approach.

This paper describes the development of the 'Brain-Fit' app, a digital secondary prevention intervention designed for use in the early phase after transient ischaemic attack (TIA) or minor stroke. The aim of the study was to explore perceptions on usability and relevance of the app in order to maximise user engagement and sustainability. Using the theory- and evidence-informed person-based approach, initial planning included a scoping review of qualitative evidence to identify barriers and facilitators to use of digital interventions in people with cardiovascular conditions and two focus groups exploring experiences and support needs of people (N = 32) with a history of TIA or minor stroke. The scoping review and focus group data were analysed thematically and findings were used to produce guiding principles, a behavioural analysis and explanatory logic model for the intervention. Optimisation included an additional focus group (N = 12) and individual think-aloud interviews (N = 8) to explore perspectives on content and usability of a prototype app. Overall, thematic analysis highlighted uncertainty about increasing physical activity and concerns that fatigue might limit participation. Realistic goals and progressive increases in activity were seen as important to improving self-confidence and personal control. The app was seen as a useful and flexible resource. Participant feedback from the optimisation phase was used to make modifications to the app to maximise engagement, including simplification of the goal setting and daily data entry sections. Further studies are required to examine efficacy and cost-effectiveness of this novel digital intervention.

Association between community-based self-reported COVID-19 symptoms and social deprivation explored using symptom tracker apps: a repeated cross-sectional study in Northern Ireland.

OBJECTIVES: The aim of the study was to investigate the spatial and temporal relationships between the prevalence of COVID-19 symptoms in the community-level and area-level social deprivation. DESIGN: Spatial mapping, generalised linear models, using time as a factor and spatial-lag models were used to explore the relationship between self-reported COVID-19 symptom prevalence as recorded through two smartphone symptom tracker apps and a range of socioeconomic factors using a repeated cross-sectional study design. SETTING: In the community in Northern Ireland, UK. The analysis period included the earliest stages of non-pharmaceutical interventions and societal restrictions or 'lockdown' in 2020. PARTICIPANTS: Users of two smartphone symptom tracker apps recording self-reported health information who recorded their location as Northern Ireland, UK. PRIMARY OUTCOME MEASURES: Population standardised self-reported COVID-19 symptoms and correlation between population standardised self-reported COVID-19 symptoms and area-level characteristics from measures of multiple deprivation including employment levels and population housing density, derived as the mean number of residents per household for each census super output area. RESULTS: Higher self-reported prevalence of COVID-19 symptoms was associated with the most deprived areas (p<0.001) and with those areas with the lowest employment levels (p<0.001). Higher rates of self-reported COVID-19 symptoms within the age groups, 18-24 and 25-34 years were found within the most deprived areas during the earliest stages of non-pharmaceutical interventions and societal restrictions ('lockdown'). CONCLUSIONS: Through spatial regression of self-reporting COVID-19 smartphone data in the community, this research shows how a lens of social deprivation can deepen our understanding of COVID-19 transmission and prevention. Our findings indicate that social inequality, as measured by area-level deprivation, is associated with disparities in potential COVID-19 infection, with higher prevalence of self-reported COVID-19 symptoms in urban areas associated with area-level social deprivation, housing density and age.

Interaction of oil drops with surfaces of different interfacial energy and topography.

During a marine oil spill, the oil can interact with and potentially wet a variety of surfaces such as corals, skin/shells of marine animals, and bird feathers. We present both qualitative and quantitative data for the interaction of a dodecane droplet submerged in water with surfaces varying in both surface energy and roughness. Flat, unstructured silicon surfaces with water in air contact angles of 0°, 43°, 66°, 87°, 96°, and 108° were tested first to obtain base readings, after which photolithography was used to introduce structured surfaces representative of marine biological systems. We find that the more hydrophilic a surface, the less prone it is to oil contamination. Also, the Cassie-Baxter approximation holds up for submerged oil in water systems and can be used to predict contact angles of oil on solid rough surfaces submerged in an aqueous environment. Furthermore, the addition of surface structure, even on strongly hydrophobic (oleophilic) surfaces, greatly reduced (≈75% reduction in F(adhesion)) a surface's affinity for oil.

Nocturnal enuresis: application of evidence-based medicine in community practice.

AIM: To report the outcomes and follow-up at 2 years of children with monosymptomatic nocturnal enuresis (MNE) managed in a private paediatric community practice utilising body-worn alarms and supportive programmes. METHODS: 522 consecutive children presenting with MNE were assessed and managed with a comprehensive supportive programme and body-worn alarm. Data were recorded prospectively and outcomes assessed at 6 and 24 months. RESULTS: 505 proceeded with management. A total of 79.0% achieved initial dryness within a median of 10 weeks. Of those achieving initial dryness 73.0% had remained dry at 6-month follow-up and 64% had remained dry at 24 months. A total of 99.2% follow-up was achieved. Nineteen per cent of children required more than 16 weeks management with 56% achieving dryness. More girls achieved dryness than boys and in a shorter time. There was no gender difference in relapse rates at 6 and 24 months. No difference in achieving initial success was found with respect to initial severity of wetting, nor age. Relapse rates were unrelated to gender, age, or initial severity. CONCLUSION: MNE can be successfully managed using body-worn alarms achieving good initial and long-term complete dryness, without the need for expensive pharmacologic intervention. A strong supportive programme can make the management less arduous for child and family.