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INTRODUCTION: Although physical activity (PA) reduces cardiovascular disease (CVD) risk, physical inactivity remains a pressing public health concern, especially among African American (AA) women in the USA. PA interventions focused on AA women living in resource-limited communities with scarce PA infrastructure are needed. Mobile health (mHealth) technology can increase access to PA interventions. We describe the development of a clinical protocol for a multilevel, community-based, mHealth PA intervention for AA women. METHODS AND ANALYSIS: An mHealth intervention targeting AA women living in resource-limited Washington, DC communities was developed based on the socioecological framework for PA. Over 6 months, we will use a Sequential Multi-Assignment, Randomized Trial approach to compare the effects on PA of location-based remote messaging (named 'tailored-to-place') to standard remote messaging in an mHealth intervention. Participants will be randomised to a remote messaging intervention for 3 months, at which point the intervention strategy will adapt based on individuals' PA levels. Those who do not meet the PA goal will be rerandomised to more intensive treatment. Participants will be followed for another 3 months to determine the contribution of each mHealth intervention to PA level. This protocol will use novel statistical approaches to account for the adaptive strategy. Finally, effects of PA changes on CVD risk biomarkers will be characterised. ETHICS AND DISSEMINATION: This protocol has been developed in partnership with a Washington, DC-area community advisory board to ensure feasibility and acceptability to community members. The National Institutes of Health Intramural IRB approved this research and the National Heart, Lung, and Blood Institute provided funding. Once published, results of this work will be disseminated to community members through presentations at community advisory board meetings and our quarterly newsletter. TRIAL REGISTRATION NUMBER: NCT03288207.
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Aplicativos Móveis , Telemedicina , Adulto , Idoso , Exercício Físico , Feminino , Humanos , Pessoa de Meia-Idade , Gravidez , Estudos Prospectivos , Resultado do TratamentoRESUMO
Thirty million Americans currently have diabetes, and a substantial portion do not reach the goals of clinical treatment. This is in part due to the complex barriers to effective self-care faced by people with diabetes. This study uses a patient work perspective, focusing on the everyday, lived experience of managing diabetes. Our primary research goal was to explore how the work of self-care is embedded in the other routines of everyday living. We found that everyday objects and spaces were instrumental in the incorporation of diabetes work into daily routines. Objects anchored diabetes tasks by linking illness-specific artifacts to space and time (e.g. a morning routine), and by enabling the performance on diabetes tasks while on the move in either planned or unplanned ways.
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Atividades Cotidianas/psicologia , Diabetes Mellitus/psicologia , Resiliência Psicológica , Autocuidado/psicologia , Adulto , Feminino , Humanos , Masculino , Pesquisa Qualitativa , Análise Espaço-Temporal , Análise e Desempenho de Tarefas , Fluxo de TrabalhoRESUMO
Under section "Introduction", the first sentence in the 4th paragraph was incorrectly published. The correct sentence is given below.
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INTRODUCTION: Opioid overdose rescue situations are time-critical, high-stress scenarios that frequently require nonmedical first responders or bystanders to intervene and administer naloxone to avoid opioid-induced fatalities. Training nonmedical personnel to respond during such mentally constraining situations presents the human factors challenge of how best to design a safe and effective lay delivery system. This paper comparatively evaluates the ease of use of two nasal naloxone administration products: NARCAN® Nasal Spray and a naloxone prefilled syringe with nasal atomizer (PFS-NA). METHODS: We evaluated the use requirements and usability of NARCAN® Nasal Spray versus a naloxone PFS-NA using a systems-oriented method. First, we determined the use requirements of different user groups. Next, we focused on constructing a human factors task analysis of both products. Finally, we conducted a comparative risk assessment of the tasks that were different between the two products. RESULTS: Inexperienced users, such as nonmedical first responders and bystanders, are at the highest risk of incorrectly administering naloxone, particularly in high-stress emergency opioid overdose situations. The device Preparation and Medication Delivery tasks most differentiate the use of NARCAN® Nasal Spray and a PFS-NA. The level of task complexity and number of steps within those tasks is substantially greater for a PFS-NA than for the NARCAN® Nasal Spray. CONCLUSIONS: NARCAN® Nasal Spray requires fewer steps and is easier to administer than a naloxone PFS-NA. Thus, using NARCAN® Nasal Spray should increase the likelihood that nonmedical personnel correctly deliver naloxone in time-critical, high-stress opioid overdose rescue situations. FUNDING: ADAPT Pharma, Inc.
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Engenharia Biomédica/organização & administração , Tecnologia Biomédica/organização & administração , Desenho de Equipamento/métodos , Equipamentos e Provisões , Assistência Centrada no Paciente/organização & administração , Engenharia Biomédica/métodos , Tecnologia Biomédica/métodos , Assistência Centrada no Paciente/métodos , Melhoria de QualidadeRESUMO
OBJECTIVE: This study evaluated the individual and combined effects of voice (vs. manual) input and head-up (vs. head-down) display in a driving and device interaction task. BACKGROUND: Advances in wearable technology offer new possibilities for in-vehicle interaction but also present new challenges for managing driver attention and regulating device usage in vehicles. This research investigated how driving performance is affected by interface characteristics of devices used for concurrent secondary tasks. A positive impact on driving performance was expected when devices included voice-to-text functionality (reducing demand for visual and manual resources) and a head-up display (HUD) (supporting greater visibility of the driving environment). METHOD: Driver behavior and performance was compared in a texting-while-driving task set during a driving simulation. The texting task was completed with and without voice-to-text using a smartphone and with voice-to-text using Google Glass's HUD. RESULTS: Driving task performance degraded with the addition of the secondary texting task. However, voice-to-text input supported relatively better performance in both driving and texting tasks compared to using manual entry. HUD functionality further improved driving performance compared to conditions using a smartphone and often was not significantly worse than performance without the texting task. CONCLUSION: This study suggests that despite the performance costs of texting-while-driving, voice input methods improve performance over manual entry, and head-up displays may further extend those performance benefits. APPLICATION: This study can inform designers and potential users of wearable technologies as well as policymakers tasked with regulating the use of these technologies while driving.