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1.
Int J Med Inform ; 134: 104039, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31865054

RESUMO

BACKGROUND: Although mobile app-delivered physical activity (PA) interventions have the potential to promote exercise, poor adherence to these apps is a common issue impeding their effectiveness. Gaining insights into the factors that influence PA app adherence is an important priority for app developers and intervention designers. OBJECTIVE: The objective of this study is to perform a literature review to synthesize the factors influencing PA app adherence and to identify directions for future research in this area. METHODS: A scoping review of prior research was conducted to uncover the factors influencing PA app adherence. Seven online journal databases were searched for relevant articles published from January 1, 2014, to December 31, 2018. The initial search identified 5,572 articles. After a screening and eligibility check based on inclusion criteria, 24 articles were finally selected. The definition of PA app adherence in this review could be categorized along four dimensions derived from previous studies: i.e., frequency of PA app usage, intention/motivation to sustain use of the PA app, degree of function use within the PA app, and the duration of PA app usage. RESULTS: Of the 24 included studies (both qualitative and quantitative), 12 studies were conducted in the U.S. The methods and study designs varied considerably, with the study durations ranging from 2 weeks to 24 months. The synthesized evidence indicates that 89 distinct factors influenced PA app adherence, and these could be classified into three categories: Personal Factors (n = 28), Technology Features (n = 53), and Contextual Factors (n = 8). Nine more detailed sub-categories were also compiled. Factors in sub-categories, such as psychological factors, health-related factors and predefined goals, are essential for physical activity behavior change experts to implement interventions. Factors in technology features, including PA tracking, PA goal setting and customization of exercise, are specifically useful for PA app developers or PA intervention designers. Overall, evidence of causal factors was limited. Only 5 of the 24 articles explored causal factors that affect PA app adherence. Furthermore, longitudinal studies with long durations were also limited. CONCLUSIONS: Uncovering the factors influencing PA app adherence is critical as it can expand our current knowledge and provide guidance for app-delivered PA interventions, as well as the design of PA apps. This scoping review identified and categorized factors that influence PA app adherence in prior studies. Based on the evidence synthesized, users are paying more attention to the "playfulness" and personalized features of PA apps, in addition to basic functional requirements. Also, app glitches are the most common factors found to negatively influence app adherence. Several important directions for future research are highlighted in this review, especially the design of studies to explore causality.


Assuntos
Exercício/psicologia , Aplicativos Móveis/estatística & dados numéricos , Cooperação do Paciente/estatística & dados numéricos , Cooperação e Adesão ao Tratamento/estatística & dados numéricos , Humanos , Motivação , Atividade Motora , Fatores de Tempo
2.
Artigo em Inglês | MEDLINE | ID: mdl-31684169

RESUMO

Improving mental healthcare using mobile apps might be an effective way to increase interest in mental health and respond to the demand for better psychological health. However, few studies have investigated the effectiveness of app-based stress-management programs. This study aimed to assess the efficacy of an app-based stress-management program. A non-equivalent comparison group pretest-posttest design was used. Participants were randomized into the experimental (n = 26) and control (n = 30) groups. The experimental group used an application developed for workers for four weeks. The results indicated that stress, emotional labor, self-efficacy, and well-being were significantly different in the experimental group, but the control group's average scores did not change significantly. On average, the Perceived Stress Scale scores decreased by 1.5 points (p = 0.035) and the Korean Occupational Stress Scale scores decreased by 0.87 points (p = 0.4). However, depression and anxiety were not significantly different. Emotional labor decreased by 0.16 points (p = 0.027), and well-being and self-efficacy mean scores increased by 0.492 (p = 0.005) and 0.162 (p = 0.025), respectively. These findings support the developed application's value for promoting mental health and healthy lifestyles. Further research and supplementation are needed for the application's sustainability.


Assuntos
Promoção da Saúde/métodos , Saúde Mental/estatística & dados numéricos , Aplicativos Móveis/estatística & dados numéricos , Estresse Ocupacional/terapia , Estresse Psicológico/terapia , Ansiedade/terapia , Depressão/terapia , Estudos de Viabilidade , Serviços de Saúde Mental , República da Coreia
3.
Int J Med Inform ; 132: 103987, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31634821

RESUMO

OBJECTIVE: Smartphones have become very popular among oral and maxillofacial surgeons. WhatsApp is an application that enables users to send voice, text, and multimedia messages using the group communication feature. The purpose of this study was to evaluate the efficiency of WhatsApp messaging as a mode of consultation within an oral and maxillofacial surgery team. MATERIALS AND METHODS: A retrospective study on WhatsApp group conversations amongst oral and maxillofacial surgeons was performed between July 2015 and July 2016. A WhatsApp group consisting of senior and junior surgeons was created, and many consultations were recorded. Seven hundred fifty-six consultations were included in the study. In this study, the arrival and response times of messages, types of cases, timing of consultation's end, consultant locations, contents of multimedia messages, and the categories/types of messages were evaluated. During consultations, some cases were discussed with text messages via WhatsApp, and some cases with voice and image messages via WhatsApp, with or without WhatsApp text messages. In addition, several cases were discussed with video messages via WhatsApp. Thus, a total of 1747 messages reflecting four different message types were included in this study: 754 (43%) were text messages, 752 (43%) were photographic images, 213 (12%) were videos, and 28 (nearly 2%) were voice messages. RESULTS: The most frequent consultations concerned impacted teeth (n = 363, 48.01%). Most consultations were resolved using WhatsApp (n = 306, 64.4%), and consultants were often not in the hospital during these consultations (n = 411, 54.3%). Most messages sent by consultants were conclusive (n = 306, 74.4%). CONCLUSION: We conclude that WhatsApp is a simple, free, and practical application, which allows efficient consultation when consultants are not in the hospital.


Assuntos
Comunicação , Aplicativos Móveis/estatística & dados numéricos , Equipe de Assistência ao Paciente/organização & administração , Melhoria de Qualidade , Smartphone/estatística & dados numéricos , Cirurgia Bucal/organização & administração , Mensagem de Texto/estatística & dados numéricos , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Encaminhamento e Consulta , Estudos Retrospectivos , Adulto Jovem
4.
Int J Med Inform ; 131: 103949, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31561192

RESUMO

OBJECTIVE: The purpose of this work was to conduct an in-depth analysis to understand patients' experiences using a real-time medication monitoring pill bottle linked to an HIV self-management app. METHODS: A descriptive qualitative study design was used. In-depth interviews were conducted using a semi-structured interview guide at the 3-month follow-up visit during a trial of the app for improving medication adherence which began in January 2018. Eligibility criteria were HIV-positive, over the age of 18, ownership of a smartphone, able to speak and understand English and self-report less than 80% adherence to medications in the past 30 days or a viral load of over 20 copies/mL (detectable). All interviews were audio-recorded and transcribed. Using thematic analysis, we explored emerging themes with similar patterns across interviews and organized the themes according to the constructs of the Fit between Individuals, Task and Technology (FITT) framework. RESULTS: Thirty-eight persons living with HIV (PLWH), who were randomized to the intervention arm of the study trial, participated in the interviews. 79.0% of participants reported their race as African American/Black, 63.2% had completed some high school or less, and 79.0% reported an annual median income of less than $20,000. Data was collected until saturation was reached. A total of nine major themes organized by the FITT framework were identified. Three themes related to the fit between individuals and task were: motivation for strict medication adherence, self-efficacy for overall health management, and engagement with medication reminders. Four themes related to the fit between individual and technology were: ease of use, HIV-related stigma and disclosure of HIV status, customized alert of medication time windows based on individual routine set-up, and preference for device design. Two themes related to the fit between task and technology were: system functionality of data transfer from the electronic pill bottle to the app and self-awareness of system syncing signals. CONCLUSIONS: This study demonstrated that tracking medication adherence and receiving push-notification medication reminders through the electronic pill bottle connected to the app encourages and supports PLWH in adhering to their medication regimens. Findings from this work highlight the importance of adequate consideration of the needs of intended users in designing customizable mobile health technology, including HIV-related stigma, disclosure of HIV status and antiretroviral therapy regimens.


Assuntos
Infecções por HIV/tratamento farmacológico , HIV/efeitos dos fármacos , Adesão à Medicação/estatística & dados numéricos , Aplicativos Móveis/estatística & dados numéricos , Autogestão , Telemedicina/estatística & dados numéricos , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Pesquisa Qualitativa , Autoeficácia
5.
Int J Med Inform ; 131: 103972, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31563010

RESUMO

BACKGROUND AND OBJECTIVE: This paper presents Alzheed, a mobile application for monitoring patients with Alzheimer's disease at day centers as well as a set of design recommendations for the development of healthcare mobile applications. The Alzheed project was conducted at Day Center "Dorita de Ojeda" that is focused on the care of patients with Alzheimer's disease. MATERIALS AND METHODS: A software design methodology based on participatory design was employed for the design of Alzheed. This methodology is both iterative and incremental and consists of two main iterative stages: evaluation of low-fidelity prototypes and evaluation of high-fidelity prototypes. Low-fidelity prototypes were evaluated by 11 day center's healthcare professionals (involved in the design of Alzheed), whereas high-fidelity prototypes were evaluated using a questionnaire based on the technology acceptance model (TAM) by the same healthcare professionals plus 30 senior psychology undergraduate students uninvolved in the design of Alzheed. RESULTS: Healthcare professional participants perceived Alzheed as extremely likely to be useful and extremely likely to be usable, whereas senior psychology undergraduate students perceived Alzheed as quite likely to be useful and quite likely to be usable. Particularly, the median and mode of the TAM questionnaire were 7 (extremely likely) for healthcare professionals and 6 (quite likely) for psychology students (for both constructs: perceived usefulness and perceived ease of use). One-sample Wilcoxon signed-rank tests were performed to confirm the significance of the median for each construct. CONCLUSIONS: From the experience of designing Alzheed, it can be concluded that co-designing with healthcare professionals leads to (i) fostering group endorsement, which prevents resistance to change and (ii) helps to meet the needs of both healthcare professionals and patients, guaranteeing the usefulness of the application. In addition, evaluation of mobile healthcare applications by users involved and uninvolved in the application's design process helps to improve the ease of use of the application.


Assuntos
Doença de Alzheimer/diagnóstico , Assistência à Saúde/normas , Aplicativos Móveis/estatística & dados numéricos , Aplicativos Móveis/normas , Monitorização Fisiológica/métodos , Projetos de Pesquisa , Software , Feminino , Pessoal de Saúde , Humanos , Estudantes , Inquéritos e Questionários
6.
Artigo em Inglês | MEDLINE | ID: mdl-31540404

RESUMO

Air pollution epidemiology studies of ambient fine particulate matter (PM2.5) and ozone (O3) often use outdoor concentrations as exposure surrogates. Failure to account for the variability of the indoor infiltration of ambient PM2.5 and O3, and time indoors, can induce exposure errors. We developed an exposure model called TracMyAir, which is an iPhone application ("app") that determines seven tiers of individual-level exposure metrics in real-time for ambient PM2.5 and O3 using outdoor concentrations, weather, home building characteristics, time-locations, and time-activities. We linked a mechanistic air exchange rate (AER) model, a mass-balance PM2.5 and O3 building infiltration model, and an inhaled ventilation model to determine outdoor concentrations (Tier 1), residential AER (Tier 2), infiltration factors (Tier 3), indoor concentrations (Tier 4), personal exposure factors (Tier 5), personal exposures (Tier 6), and inhaled doses (Tier 7). Using the application in central North Carolina, we demonstrated its ability to automatically obtain real-time input data from the nearest air monitors and weather stations, and predict the exposure metrics. A sensitivity analysis showed that the modeled exposure metrics can vary substantially with changes in seasonal indoor-outdoor temperature differences, daily home operating conditions (i.e., opening windows and operating air cleaners), and time spent outdoors. The capability of TracMyAir could help reduce uncertainty of ambient PM2.5 and O3 exposure metrics used in epidemiology studies.


Assuntos
Poluentes Atmosféricos/análise , Exposição Ambiental , Monitoramento Ambiental/métodos , Aplicativos Móveis/estatística & dados numéricos , Ozônio/análise , Material Particulado/análise , Humanos , Modelos Teóricos , North Carolina , Smartphone
7.
Artigo em Inglês | MEDLINE | ID: mdl-31547286

RESUMO

In an increasingly urbanised world where mental health is currently in crisis, interventions to increase human engagement and connection with the natural environment are one of the fastest growing, most widely accessible, and cost-effective ways of improving human wellbeing. This study aimed to provide an evaluation of a smartphone app-based wellbeing intervention. In a randomised controlled trial study design, the app prompted 582 adults, including a subgroup of adults classified by baseline scores on the Recovering Quality of Life scale as having a common mental health problem (n = 148), to notice the good things about urban nature (intervention condition) or built spaces (active control). There were statistically significant and sustained improvements in wellbeing at one-month follow-up. Importantly, in the noticing urban nature condition, compared to a built space control, improvements in quality of life reached statistical significance for all adults and clinical significance for those classified as having a mental health difficulty. This improvement in wellbeing was partly explained by significant increases in nature connectedness and positive affect. This study provides the first controlled experimental evidence that noticing the good things about urban nature has strong clinical potential as a wellbeing intervention and social prescription.


Assuntos
Saúde Mental/estatística & dados numéricos , Aplicativos Móveis/estatística & dados numéricos , Natureza , Qualidade de Vida/psicologia , Smartphone , Adulto , Ambiente Construído/estatística & dados numéricos , Inglaterra , Feminino , Humanos , Masculino , Distribuição Aleatória , Adulto Jovem
8.
Comput Inform Nurs ; 37(8): 413-419, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31394560

RESUMO

The use of mobile applications in chronic disease management has grown significantly over the past decade. When properly designed, these apps provide a convenient, safe, high-quality service to patients. In this study, a health management app was developed, and its usability among patients with diabetes mellitus was examined. A convenience sample of 136 patients, referred to two academic centers from December 2016 to July 2017, was enrolled. Upon completion of informed consent, the participants were asked to install the app on their smartphone. Two weeks later, they were required to complete a postapplication usability questionnaire, comprising 21 questions classified into six domains. The response rate was 89%. The highest scores were given for "ease of use and learnability"; the lowest-scored domains were "interaction quality" and "reliability." Urban residents, participants with lower educational qualifications, and retirees were significantly more satisfied with the app. Overall, patients with diabetes mellitus perceived the app as useful for disease management. However, the overall usability of health apps is expected to improve when a multidisciplinary team (health professionals, computer engineers, art designers) is involved in the development process.


Assuntos
Diabetes Mellitus/terapia , Aplicativos Móveis/estatística & dados numéricos , Autocuidado/tendências , Telemedicina , Interface Usuário-Computador , Doença Crônica , Feminino , Humanos , Irã (Geográfico) , Masculino , Pessoa de Meia-Idade , Smartphone , Inquéritos e Questionários
9.
Int J Med Inform ; 130: 103948, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31442846

RESUMO

With the emergence of an always-on culture and the private smartphones always within reach, professional and recreational contexts overlap. Little empirical knowledge is available on prevailing online habits among healthcare personnel and whether gender matters in this context. To investigate health technology-related preferences, we conducted an online survey among a purposive sample of employees and students at the Medical University of Vienna, Austria. In total, 905 participants (59.0%, 540/905, females) provided self-reported information on use of online services and mobile health applications (apps) as well as respective gender-specific internal and external apperceptions. Mann-Whitney U tests and binary regression analysis assessed respective gender differences. The structured German questionnaire was validated by principal component analysis. The study found a moderate familiarity with health technologies. As for gender differences, prevailing health app use was high among both male and female participants (39, 141/365, and 42%, 229/540, respectively), with apps for tracking activity and nutrition habits most commonly used. Approval for monitoring health and lifestyle parameters, eHealth and telemedicine knowledge levels, and online health information retrieval predicted health app use, whereas gender did not. Socio-demographic attributes including gender influence not only private online habits of users, but might also affect acceptance of health technologies and their professional use in a clinical setting. Thus, addressing the gender dimension already in concept stages of digital devices and services for healthcare and lifestyle could speed up private and public adoption of health technologies.


Assuntos
Tecnologia Biomédica/estatística & dados numéricos , Monitores de Aptidão Física/estatística & dados numéricos , Corpo Clínico/psicologia , Aplicativos Móveis/estatística & dados numéricos , Smartphone/estatística & dados numéricos , Estudantes/psicologia , Adulto , Áustria , Estudos Transversais , Feminino , Humanos , Masculino , Fatores Sexuais , Inquéritos e Questionários , Telemedicina/estatística & dados numéricos , Universidades
10.
Int J Med Inform ; 129: 75-80, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31445292

RESUMO

BACKGROUND: Early postoperative discharge after joint arthroplasty may lead to decreased wound monitoring. A mobile woundcare app with an integrated algorithm to detect complications may lead to improved monitoring and earlier treatment of complications. In this study, the ease of use and perceived usefulness of such a mobile app was investigated. OBJECTIVE: Primary objective was to investigate the ease of use and perceived usefulness of using a woundcare app. Secondary objectives were the number of alerts created, the amount of days the app was actually used and patient-reported wound infection. METHODS: Patients that received a joint arthroplasty were enrolled in a prospective cohort study. During 30 postoperative days, patients scored their surgical wound by daily answering of questions in the app. An inbuilt algorithm advised patients to contact their treating physician if needed. On day 15 and day 30, additional questionnaires in the app investigated ease of use and perceived usefulness. RESULTS: Sixty-nine patients were included. Median age was 68 years. Forty-one patients (59.4%) used the app until day 30. Mean grade for ease of use (on a Likert-scale of 1-5) were 4.2 on day 15 and 4.2 on day 30; grades for perceived usefulness were 4.1 on day 15 and 4.0 on day 30. Out of 1317 days of app use, an alert was sent to patients on 29 days (2.2%). Concordance between patient-reported outcome and physician-reported outcome was 80%. CONCLUSIONS: Introduction of a woundcare app with an alert communication on possible wound problems resulted in a high perceived usefulness and ease of use. Future studies will focus on validation of the algorithm and the association between postoperative wound leakage and the incidence of prosthetic joint infection.


Assuntos
Artroplastia , Aplicativos Móveis , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Aplicativos Móveis/estatística & dados numéricos , Cuidados Pós-Operatórios , Estudos Prospectivos , Inquéritos e Questionários , Cicatrização
11.
BMC Public Health ; 19(1): 1127, 2019 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-31420026

RESUMO

BACKGROUND: The Ultraviolet (UV) Index provides a reliable means of monitoring the strength of UV radiation at the Earth's surface, which can be used to indicate the potential for skin damage. This qualitative study aims to examine public understanding of the UV Index among Australians who routinely use UV forecast information as well as those who do not. METHODS: Recent use of the SunSmart app (a popular mobile and tablet app that provides UV forecast information) served as a proxy for use of UV forecast information. Six focus groups were conducted with 'new users', who trialled the SunSmart app for the first time in the two weeks preceding the group discussion. In addition, 15 in-depth interviews were conducted with 'existing users', who routinely used the SunSmart app. Thematic discourse analysis was undertaken to compare views and experiences. RESULTS: Misperceptions about UV radiation were common. Participants learnt new information about UV radiation, the UV Index, and the times of the day that sun protection is recommended. Among adults who were using UV forecast information for the first time, this learning rarely translated to new behaviours; for these participants, the UV Index forecast information and recommendations were inconsistent with their own observation of the weather and subsequent judgement about their propensity to burn. Thus new users considered the UV forecast information to be overly cautious. In contrast, existing users recognised their inability to judge the UV Index level; for these participants, UV forecast information provided by the SunSmart app was incorporated into their daily routines and used to inform their sun protection behaviours. CONCLUSIONS/IMPLICATIONS: No matter how broadly UV forecast information is promoted, it is unlikely to improve sun protection behaviours across the Victorian population due to the low level of basic understanding of UV radiation. Public education strategies that correct the commonly held misperception that temperature and/or sunshine can reliably predict the potential for UV damage are required. Improved public awareness about UV radiation and how the UV Index can be used to prevent skin cancer may help Australians to develop more effective sun protection habits.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Aplicativos Móveis/estatística & dados numéricos , Neoplasias Cutâneas/prevenção & controle , Raios Ultravioleta/efeitos adversos , Adolescente , Adulto , Austrália , Feminino , Grupos Focais , Previsões , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Adulto Jovem
12.
Cyberpsychol Behav Soc Netw ; 22(8): 543-551, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31403855

RESUMO

The aim of this study was to evaluate the usage of a reminiscence app by people living with dementia and their family carers, by comparing event log data generated from app usage alongside the qualitative experience of the process. A cross-comparative analysis of electronic event logging data with qualitative interview data was conducted. Electronic event logging data were obtained for 28 participating dyads (n = 56) and the interview sample comprised 14 people living with dementia and 16 family carers (n = 30). A thematic analysis framework was used in the analysis of interview transcripts and the identification of recurrent themes. The cross-comparison of electronic event log data and qualitative data revealed 25 out of 28 dyads regularly engaged with a reminiscence app, with the analysis of usage patterns revealing four clusters classifying different levels of user engagement. The cross-comparison of data revealed that the nature of the relationship was a significant factor in ongoing user engagement. The comparative analysis of the electronic event logs as "ground truth" in combination with the qualitative lived experience can provide a deeper understanding on the usage of a reminiscence app for those living with dementia and their family carers. This work not only shows the benefits of using automated event log data mining but also shows its clear limitations without using complementary qualitative data analysis. As such, this work also provides key insights into using mixed methods for evaluating human-computer interaction technologies.


Assuntos
Cuidadores/psicologia , Demência/psicologia , Processamento Eletrônico de Dados/estatística & dados numéricos , Aplicativos Móveis/estatística & dados numéricos , Participação dos Interessados/psicologia , Adulto , Idoso , Feminino , Humanos , Masculino , Memória , Pessoa de Meia-Idade , Pesquisa Qualitativa
13.
J Med Syst ; 43(10): 313, 2019 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-31451942

RESUMO

Nowadays, smartphones represent an invaluable tool to access educational material; however, the available information is not always accurate or evidence-based. Therefore, we aimed to evaluate the use of technology by medical students and assess the effect of a newly developed mobile app for the study of human physiology. We used a standardised questionnaire to assess the profile of educational technology use, from which a mobile app (PhysioQuiz) was developed. The effectiveness and user opinion were assessed in a randomised controlled study (n = 110). Of 1022 students enrolled in medical school, 489 (47.9%) participated in the study. Of the respondents, 96.7% used mobile applications, with the main purpose being entertainment (94.7%) and study (81.9%). Only 6.1% reported use of physiology apps. PhysioQuiz use did not yield higher average grades (p = 0.48); however, user opinion demonstrated that it was useful for assisted learning (82.1%) and identification of non-learned content (78.6%) and considered a tool for self-assessment (89.3%). Mobile app use is widespread among medical students but there is a lack of human physiology education apps. A newly developed app for the study of human physiology was useful for assisted learning and considered a tool for self-assessment.


Assuntos
Educação Médica/métodos , Tecnologia Educacional , Aplicativos Móveis/estatística & dados numéricos , Estudantes de Medicina/estatística & dados numéricos , Estudos Transversais , Humanos , Fisiologia/educação , Smartphone
14.
Rev Bras Enferm ; 72(4): 1020-1027, 2019 Aug 19.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31432961

RESUMO

OBJECTIVE: Developing a mobile application for the teaching of the International Classification for Nursing Practice. METHODS: Methodological applied research for technological production, performed in three phases of the contextualized instructional design model: analysis, design and development. RESULTS: The application has an initial screen, which provides information about the team and its purpose. Then, four moblets are listed, including presentation, user's guide consisting of five modules, educational games and five clinical cases. The references on which the application was based are also presented. FINAL CONSIDERATIONS: It was possible to develop an application with the potential to promote the knowledge of nursing students and professionals about this classification system.


Assuntos
Aplicativos Móveis/normas , Terminologia Padronizada em Enfermagem , Estudantes de Enfermagem/estatística & dados numéricos , Ensino/normas , Bacharelado em Enfermagem/métodos , Bacharelado em Enfermagem/tendências , Humanos , Aplicativos Móveis/estatística & dados numéricos , Ensino/estatística & dados numéricos
15.
JMIR Mhealth Uhealth ; 7(7): e12587, 2019 07 11.
Artigo em Inglês | MEDLINE | ID: mdl-31298221

RESUMO

BACKGROUND: The postpartum period is a vulnerable time for the pelvic floor. Early implementation of pelvic floor muscle exercises, appropriately termed as pelvic floor muscle training (PFMT), in the postpartum period has been advocated because of its established effectiveness. The popularity of mobile health (mHealth) devices highlights their perceived utility. The effectiveness of various mHealth technologies with claims to support pelvic floor health and fitness is yet to be substantiated through systematic inquiry. OBJECTIVE: The aim of this study was to determine the acceptability, feasibility, and potential effect on outcomes of an mHealth device purposed to facilitate pelvic floor muscle training among postpartum women. METHODS: A 16-week mixed methods pilot study was conducted to evaluate outcomes and determine aspects of acceptability and feasibility of an mHealth device. All participants received standardized examination of their pelvic floor muscles and associated instruction on the correct performance of PFMT. Those randomized to the iBall intervention received instructions on its use. Schedules for utilization of the iBall and PFMT were not prescribed, but all participants were informed of the standard established recommendation of PFMT, which includes 3 sets of 10 exercises, 3 to 4 times a week, for the duration of the intervention period. Quantitative data included the measurement of pelvic floor muscle parameters (strength, endurance, and coordination) following the PERFECT assessment scheme: Incontinence Impact Questionnaire scores and the Urogenital Distress Inventory (UDI-6) scores. Aspects of acceptability and feasibility were collected through one-to-one interviews. Interview transcripts were analyzed using Thorne's interpretive description approach. RESULTS: A total of 23 women with a mean age of 32.2 years were randomized to an intervention group (n=13) or a control group (n=10). Both groups improved on all measures. The only statistically significant change was the UDI-6 score within both groups at 16 weeks compared with baseline. There was no statistically significant difference between the intervention group and control group on any outcomes. Most participants using the iBall (n=10, 77%) indicated value in the concept of the mHealth solution. Technical difficulties (n=10, 77%), a cumbersome initiation process (n=8, 61%), and discomfort from the device (n=8, 61%) were reasons impeding intervention acceptability. Most participants (n=17, 74%) indicated that the initial assessment and training was more useful than the mHealth solution, a tenet that was echoed by all control group participants. CONCLUSIONS: Our pilot study demonstrated the potential for mHealth solution-enhanced PFMT in the early postpartum period. Usability issues in hardware and software hindered feasibility and acceptance by the participants. Our findings can inform the redesign of mHealth solutions that may be of value if acceptability and feasibility issues can be overcome. TRIAL REGISTRATION: ClinicalTrials.gov NCT02865954; https://clinicaltrials.gov/ct2/show/NCT02865954.


Assuntos
Terapia por Exercício/instrumentação , Aplicativos Móveis/normas , Mães/psicologia , Diafragma da Pelve/fisiologia , Adulto , Terapia por Exercício/métodos , Terapia por Exercício/normas , Estudos de Viabilidade , Feminino , Humanos , Aplicativos Móveis/estatística & dados numéricos , Mães/estatística & dados numéricos , Projetos Piloto , Período Pós-Parto/psicologia , Inquéritos e Questionários
16.
JMIR Mhealth Uhealth ; 7(7): e13844, 2019 07 02.
Artigo em Inglês | MEDLINE | ID: mdl-31267978

RESUMO

BACKGROUND: In the emerging era of digitalization and electronic health, skin cancer-related apps represent useful tools to support dermatologic consultation and examination. Yet, little is known about how patients perceive the value of such apps. OBJECTIVE: The aim of this study was to investigate patient attitudes and their awareness toward skin cancer-related apps. METHODS: A cross-sectional study including 200 patients from the oncological outpatient unit was conducted at the University Hospital (LMU Munich, Germany) between September and December 2018. Patients were asked to complete a self-administered questionnaire on the popularity and usefulness of health-related and skin cancer-related apps. A descriptive analysis was performed with the expression of categorical variables as frequencies and percentages. For continuous variables, the median and range were indicated. Contingency tables and chi-square tests were performed to investigate associations between sociodemographic data and selected items of the questionnaire. RESULTS: A total of 98.9% (195/197) of patients had never used skin cancer-related apps or could not remember. In 49.7% (93/187) of cases, patients were unsure about the usefulness of skin cancer apps, whereas 42.6% (78/183) thought that skin cancer apps could supplement or support the professional skin examination performed by a physician. However, 47.9% (90/188) were interested in acquiring more information by their dermatologists about skin cancer apps. Young age (P=.002), male gender (P=.02), a previous history of melanoma (P=.004), and higher educational level (P=.002) were significantly associated with a positive attitude. Nevertheless, 55.9% (105/188) preferred a printed patient brochure on skin cancer to downloading and using an app. CONCLUSIONS: The experience and knowledge of skin cancer-related apps was surprisingly low in this population, although there was a high general interest in more information about such apps. Printed patient brochures were the preferred information source.


Assuntos
Aplicativos Móveis/normas , Pacientes/psicologia , Higiene da Pele/instrumentação , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Alfabetização em Saúde/normas , Alfabetização em Saúde/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Aplicativos Móveis/estatística & dados numéricos , Pacientes/estatística & dados numéricos , Higiene da Pele/métodos , Higiene da Pele/normas , Neoplasias Cutâneas/prevenção & controle , Neoplasias Cutâneas/psicologia , Inquéritos e Questionários
17.
JMIR Mhealth Uhealth ; 7(7): e12347, 2019 07 02.
Artigo em Inglês | MEDLINE | ID: mdl-31267980

RESUMO

BACKGROUND: Youth homelessness is a substantial issue, and many youths experiencing homelessness have mental health issues as both a cause and consequence of homelessness. These youths face many barriers to receiving traditional mental health services, and as a result, only a few youths experiencing homelessness receive any form of mental health care. OBJECTIVE: This project aimed to develop and determine the feasibility and acceptability of engaging young adults (ie, individuals aged 18-24 years) experiencing homelessness in a remotely delivered mental health intervention. This intervention provided brief emotional support and coping skills, drawing from cognitive behavioral principles as an introduction into psychosocial support. The intervention was piloted in a homeless shelter network. METHODS: A total of 35 young adults experiencing homelessness participated in a single-arm feasibility pilot trial. Participants received a mobile phone, a service and data plan, and 1 month of support from a coach consisting of up to 3 brief phone sessions, text messaging, and mobile mental health apps. We evaluated feasibility by looking at completion of sessions as well as the overall program and acceptability with satisfaction ratings. We also collected clinical symptoms at baseline and the end of the 1-month support period. We used validity items to identify participants who might be responding inappropriately and thus only report satisfaction ratings and clinical outcomes from valid responses. RESULTS: Most participants (20/35, 57%) completed all 3 of their phone sessions, with an average of 2.09 sessions (SD 1.22) completed by each participant. Participants sent an average of 15.06 text messages (SD 12.62) and received an average of 19.34 messages (SD 12.70). We found higher rates of satisfaction among the participants with valid responses, with 100% (23/23) of such participants indicating that they would recommend participation to someone else and 52% (12/23) reporting that they were very or extremely satisfied with their participation. We found very little change from pre- to posttreatment on measures of depression (d=0.27), post-traumatic stress disorder (d=0.17), and emotion regulation (d=0.10). CONCLUSIONS: This study demonstrated that it was feasible to engage homeless young adults in mental health services in this technology-based intervention with high rates of satisfaction. We did not find changes in clinical outcomes; however, we had a small sample size and a brief intervention. Technology might be an important avenue to reach young adults experiencing homelessness, but additional work could explore proper interventions to deliver with such a platform. TRIAL REGISTRATION: ClinicalTrials.gov NCT03620682; https://clinicaltrials.gov/ct2/show/NCT03620682.


Assuntos
Jovens em Situação de Rua/psicologia , Serviços de Saúde Mental/tendências , Aplicativos Móveis/normas , Adaptação Psicológica , Adolescente , Chicago , Estudos de Viabilidade , Feminino , Jovens em Situação de Rua/estatística & dados numéricos , Humanos , Masculino , Serviços de Saúde Mental/estatística & dados numéricos , Aplicativos Móveis/estatística & dados numéricos , Projetos Piloto , Psicometria/instrumentação , Psicometria/métodos , Inquéritos e Questionários , Mensagem de Texto/instrumentação , Mensagem de Texto/normas , Mensagem de Texto/estatística & dados numéricos , Adulto Jovem
18.
JMIR Mhealth Uhealth ; 7(7): e13817, 2019 07 10.
Artigo em Inglês | MEDLINE | ID: mdl-31293246

RESUMO

BACKGROUND: Mobile phones and tablets are being increasingly integrated into the daily lives of many people worldwide. Mobile health (mHealth) apps have promising possibilities for optimizing health systems, improving care and health, and reducing health disparities. However, health care apps often seem to be underused after being downloaded. OBJECTIVE: The aim of this paper is to reach a better understanding of people's perceptions, beliefs, and experience of mHealth apps as well as to determine how highly they appreciate these tools. METHODS: A systematic review was carried out on qualitative studies published in English, on patients' perception of mHealth apps between January 2013 and June 2018. Data extracted from these articles were synthesized using a meta-ethnographic approach and an interpretative method. RESULTS: A total of 356 articles were selected for screening, and 43 of them met the inclusion criteria. Most of the articles included populations inhabiting developed countries and were published during the last 2 years, and most of the apps on which they focused were designed to help patients with chronic diseases. In this review, we present the strengths and weaknesses of using mHealth apps from the patients' point of view. The strengths can be categorized into two main aspects: engaging patients in their own health care and increasing patient empowerment. The weaknesses pointed out by the participants focus on four main topics: trustworthiness, appropriateness, personalization, and accessibility of these tools. CONCLUSIONS: Although many of the patients included in the studies reviewed considered mHealth apps as a useful complementary tool, some major problems arise in their optimal use, including the need for more closely tailored designs, the cost of these apps, the validity of the information delivered, and security and privacy issues. Many of these issues could be resolved with more support from health providers. In addition, it would be worth developing standards to ensure that these apps provide patients accurate evidence-based information.


Assuntos
Antropologia Cultural/métodos , Aplicativos Móveis/normas , Pacientes/psicologia , Percepção , Pesquisa Qualitativa , Antropologia Cultural/estatística & dados numéricos , Humanos , Aplicativos Móveis/estatística & dados numéricos , Satisfação do Paciente/estatística & dados numéricos , Pacientes/estatística & dados numéricos , Telemedicina/instrumentação , Telemedicina/métodos , Telemedicina/normas
19.
JMIR Mhealth Uhealth ; 7(7): e12445, 2019 07 08.
Artigo em Inglês | MEDLINE | ID: mdl-31287064

RESUMO

BACKGROUND: Physical inactivity, now the fourth leading cause of death, is a primary element of noncommunicable diseases. Despite a great number of attempts, there is still a lack of effective approaches that can motivate sedentary populations to increase their levels of physical activity over a sustained period. Incentives for exercise can provide an immediate reward for increasing activity levels, but because of limited funding to provide rewards, previous programs using this approach have only shown short-term changes in behavior. Sweatcoin (Sweatco Ltd, UK) is an app-based platform that converts physical movement into virtual currency. The currency can be exchanged for goods and services on their marketplace, providing a continuous incentive to be active. This study investigates the physical activity behavior change observed in Sweatcoin users over a 6-month period of app usage. OBJECTIVE: The aim of this study was to investigate the change in physical activity (measured using daily step count) of a sample of Sweatcoin users, the longevity of the change, and whether this change can be predicted by demographic and other lifestyle variables. METHODS: Activity data from a sample of 5892 Sweatcoin users were used to analyze daily step count. Activity change was measured in terms of the percentage change in average daily step count for each month after registration, relative to that in the 3 months before using the app. Users were grouped according to having no or negative, moderate, or high activity change. A subset of users completed a questionnaire that allowed differences between groups in terms of activity and demographic status to be investigated using regression analyses. RESULTS: Daily step count increased by 19% on average over the 6 months following registration (P<.001). Of the questionnaire respondents, 728 were valid responses. A multinomial logistic regression identified the key drivers of moderate and high activity behavior change relative to no or negative change based on the defined groupings. There was a clear impact of seasonality, with those registering for the app in winter (odds ratio [OR] 4.67; P=.001) and spring (OR 5.05; P=.001) being more likely to show high positive activity behavior change than those registering in summer. More striking were the results identifying those classified as overweight (measured through body mass index [BMI]; OR 1.83; P=.02) and less active (based on a self-reported scale of physical activity; OR 0.88; P=.048), being most likely to show high levels of physical activity change following registration with the app. CONCLUSIONS: The results highlight that an incentives-based app can induce significant physical activity behavior change, sustained over a 6-month period. Importantly, the results suggest that those typically lacking motivation to exercise (sedentary and high BMI) are most likely to be incentivized to increase their activity levels.


Assuntos
Terapia Comportamental/normas , Exercício/psicologia , Aplicativos Móveis/normas , Adulto , Terapia Comportamental/instrumentação , Terapia Comportamental/métodos , Índice de Massa Corporal , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Aplicativos Móveis/estatística & dados numéricos , Motivação , Inquéritos e Questionários
20.
JMIR Mhealth Uhealth ; 7(7): e11926, 2019 07 04.
Artigo em Inglês | MEDLINE | ID: mdl-31274112

RESUMO

BACKGROUND: Smartphones have allowed for the development and use of apps. There is now a proliferation of mobile health interventions for physical activity, healthy eating, smoking and alcohol cessation or reduction, and improved mental well-being. However, the strength or potential of these apps to lead to behavior change remains uncertain. OBJECTIVE: The aim of this study was to review a large sample of healthy lifestyle apps at a single point in time (June to July 2018) to determine their potential for promoting health-related behavior change with a view to sharing this information with the public. In addition, the study sought to test a wide range of apps using a new scale, the App Behavior Change Scale (ABACUS). METHODS: Apps focusing on 5 major modifiable lifestyle behaviors were identified using a priori key search terms across the Australian Apple iTunes and Google Play stores. Lifestyle behavior categories were selected for their impact on health and included smoking, alcohol use, physical activity, nutrition, and mental well-being. Apps were included if they had an average user rating between 3 and 5, if they were updated in the last 18 months, if the description of the app included 2 of 4 behavior change features, and if they were in English. The selected behavior change apps were rated in 2 ways using previously developed rating scales: the Mobile App Rating Scale (MARS) for functionality and the ABACUS for potential to encourage behavior change. RESULTS: The initial search identified 212,352 apps. After applying the filtering criteria, 5018 apps remained. Of these, 344 were classified as behavior change apps and were reviewed and rated. Apps were given an average MARS score of 2.93 out of 5 (SD 0.58, range 1.42-4.16), indicating low-to-moderate functionality. Scores for the ABACUS ranged from 1 to 17, out of 21, with an average score of 7.8 (SD 2.8), indicating a low-to-moderate number of behavior change techniques included in apps. The ability of an app to encourage practice or rehearsal, in addition to daily activities, was the most commonly identified feature across all apps (310/344, 90.1%), whereas the second most common feature was the ability of the user to easily self-monitor behavior (289/344, 84.0%). CONCLUSIONS: The wide variety of apps included in this 2018 study and the limited number of behavior change techniques found in many apps suggest an opportunity for improvement in app design that will promote sustained and significant lifestyle behavior change and, therefore, better health. The use of the 2 scales for the review and rating of the apps was successful and provided a method that could be replicated and tested in other behavior change areas.


Assuntos
Terapia Comportamental/instrumentação , Aplicativos Móveis/normas , Austrália , Terapia Comportamental/métodos , Terapia Comportamental/normas , Humanos , Aplicativos Móveis/estatística & dados numéricos
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