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1.
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
2.
Vet Clin North Am Exot Anim Pract ; 22(3): 349-366, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31395319

RESUMO

This article reviews the use of the smartphone in exotic pet medicine. The mobile app is the most instinctive use of the smartphone; however, there are very limited software dedicated to the exotic pet specifically. With an adapter, the smartphone can be attached to a regular endoscope and acts as a small endoscopic unit. Additional devices, such as infrared thermography or ultrasound, can be connected to the smartphone through the micro-USB port. The medical use of the smartphone is still in its infancy in veterinary medicine but can bring several solutions to the exotic pet practitioner and improve point-of-care evaluation.


Assuntos
Animais Exóticos , Aplicativos Móveis , Smartphone , Medicina Veterinária/instrumentação , Animais , Cardiologia/instrumentação , Cardiologia/métodos , Cardiologia/tendências , Endoscopia/instrumentação , Endoscopia/veterinária , Humanos , Raios Infravermelhos , Microscopia/instrumentação , Microscopia/métodos , Microscopia/tendências , Microscopia/veterinária , Aplicativos Móveis/normas , Aplicativos Móveis/tendências , Oftalmologia/instrumentação , Oftalmologia/métodos , Oftalmologia/tendências , Smartphone/tendências , Termografia/instrumentação , Termografia/métodos , Termografia/tendências , Termografia/veterinária , Ultrassonografia/instrumentação , Ultrassonografia/métodos , Ultrassonografia/tendências , Ultrassonografia/veterinária , Medicina Veterinária/métodos , Medicina Veterinária/tendências
3.
Nervenarzt ; 90(9): 914-920, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31420690

RESUMO

BACKGROUND: Progressive cognitive deficits are the main clinical symptom of Alzheimer's disease; however, the precise recording of cognitive deficits and assessment of their progression pose major problems in patient care and early interventions. OBJECTIVE: Which problems for care and early intervention result from the current practice of cognitive assessment of patients with memory problems and which opportunities arise from the use of mobile apps? MATERIAL AND METHODS: Evaluation of current care structures, discussion of basic work, expert recommendations and current developments. RESULTS: The current practice of the pencil and paper-based diagnostics of cognitive deficits, which is temporally and spatially bound to a clinical environment, constrains the feasibility, validity and reliability of cognitive assessment and the quantification of progression. This limits the meaningful use of further diagnostic measures, such as magnetic resonance imaging (MRI) and cerebrospinal fluid (CSF) analyses. Recent progress in mobile app-based technologies, illustrated here with the example of the neotiv app, can help to overcome these problems. CONCLUSION: Mobile app-based technologies can help to improve the cognitive assessment of patients with the main symptom of memory complaints. They can reduce overuse and underuse of diagnostic and therapeutic pathways and enable a targeted and meaningful use of advanced diagnostics. In addition, they can structure risk-modifying preventive measures, identify iatrogenic impairment of cognition and in this respect also strengthen patient competence.


Assuntos
Doença de Alzheimer , Disfunção Cognitiva , Aplicativos Móveis , Doença de Alzheimer/complicações , Doença de Alzheimer/diagnóstico , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/etiologia , Progressão da Doença , Humanos , Aplicativos Móveis/normas , Aplicativos Móveis/tendências , Reprodutibilidade dos Testes
4.
J Sports Med Phys Fitness ; 59(8): 1281-1284, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31373188

RESUMO

BACKGROUND: The use of smartphone applications to monitor heart rate has become increasingly popular. However, there is limited research available on the validity of these applications. The purpose of this study was to examine the accuracy of a free heart rate monitoring application on two smartphone platforms while at rest and during moderate intensity exercise. One heart rate monitor application was chosen for two different technological platforms. METHODS: Twenty-four adults aged 18 and older (six males, 18 females) were randomly assigned a platform. Two groups were formed based on the platform being utilized. Both groups were monitored using an electrocardiograph (ECG) and the smart phone application. Heart rate for each participant was recorded while seated before exercise, and during moderate intensity exercise on an elliptical machine. Measurements were recorded in one-minute intervals. RESULTS: Data was analyzed using correlations and t-tests between platforms. All data was analyzed for both resting and exercise heart rate averages. There was no significant difference in heart rate while seated, t-test (-1.33; P=0.197) nor exercise heart rate, t-test (-1.54; P=0.142) when comparing means of the two platforms to an ECG. CONCLUSIONS: The applications chosen for both platforms to monitor heart rate were found to be fairly accurate, especially at rest. There are small user adaptations for monitoring heart rate, but heart rate applications provide a low-cost and efficient method for non-medical heart rate tracking. Future research should investigate the difference in accuracy for skin tone, ethnicity, race, hand size, and callosity of fingertips.


Assuntos
Frequência Cardíaca/fisiologia , Aplicativos Móveis/normas , Monitorização Fisiológica/instrumentação , Smartphone , Adulto , Eletrocardiografia , Exercício/fisiologia , Feminino , Humanos , Masculino , Adulto Jovem
5.
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
6.
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
7.
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
8.
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
9.
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
10.
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
11.
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
12.
JMIR Mhealth Uhealth ; 7(7): e13436, 2019 07 03.
Artigo em Inglês | MEDLINE | ID: mdl-31271147

RESUMO

BACKGROUND: Nondaily smoking is an increasingly prevalent smoking pattern that poses substantial health risks. OBJECTIVE: We tested the feasibility of using a smartphone app with positive psychology exercises to support smoking cessation in nondaily smokers. METHODS: In this prospective, single-group pilot study, nondaily smokers (n=30) used version 1 of the Smiling Instead of Smoking (SiS) app for 3 weeks while undergoing a quit attempt. The app assigned daily happiness exercises, provided smoking cessation tools, and made smoking cessation information available. Participants answered surveys at baseline and 2, 6, 12, and 24 weeks after their chosen quit day and participated in structured user feedback sessions 2 weeks after their chosen quit day. RESULTS: App usage during the prescribed 3 weeks of use was high, with an average 84% (25.2/30) of participants using the app on any given day. App use was largely driven by completing happiness exercises (73%, 22/30) of participants per day), which participants continued to complete even after the end of the prescribed period. At the end of prescribed use, 90% (27/30) of participants reported that the app had helped them during their quit attempt, primarily by reminding them to stay on track (83%, 25/30) and boosting their confidence to quit (80%, 24/30) and belief that quitting was worthwhile (80%, 24/30). Happiness exercises were rated more favorably than user-initiated smoking cessation tools, and 80% (24/30) of participants proactively expressed in interviews that they liked them. App functionality to engage social support was not well received. Functionality to deal with risky times was rated useful but was rarely used. Within-person changes from baseline to the end of prescribed use were observed for several theorized mechanisms of behavior change, all in the expected direction: confidence increased (on a 0-100 scale, internal cues: b=16.7, 95% CI 7.2 to 26.3, P=.001; external cues: b=15.8, 95% CI 5.4 to 26.1, P=.004), urge to smoke decreased (on a 1-7 scale, b=-0.8, 95% CI -1.3 to -0.3, P=.002), and perceptions of smoking became less positive (on a 1-5 scale, psychoactive benefits: b=-0.5, 95% CI -0.9 to -0.2, P=.006; pleasure: b=-0.4, 95% CI -0.7 to -0.01, P=.03; on a 0-100 scale, importance of pros of smoking: b=-11.3, 95% CI -18.9 to -3.8, P=.004). Self-reported abstinence rates were 40% (12/30) and 53% (16/30) of participants 2 and 24 weeks post quit, respectively, with 30% (9/30) biochemically validated as abstinent 2 weeks post quit. CONCLUSIONS: A smartphone app using happiness exercises to aid smoking cessation was well received by nondaily smokers. Given the high nonadherence and dropout rates for technology-delivered interventions reported in the literature, the high engagement with positive psychology exercises is noteworthy. Observed within-person changes and abstinence rates are promising and warrant further development of this app.


Assuntos
Aplicativos Móveis/normas , Fumantes/psicologia , Abandono do Hábito de Fumar/métodos , Adulto , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Aplicativos Móveis/estatística & dados numéricos , Projetos Piloto , Estudos Prospectivos , /métodos , Autorrelato , Fumantes/estatística & dados numéricos , Abandono do Hábito de Fumar/psicologia , Abandono do Hábito de Fumar/estatística & dados numéricos , Apoio Social
13.
JMIR Mhealth Uhealth ; 7(7): e12900, 2019 07 03.
Artigo em Inglês | MEDLINE | ID: mdl-31271150

RESUMO

BACKGROUND: Antiretroviral (ART) adherence among people living with HIV (PLWH) continues to be a challenge despite advances in HIV prevention and treatment. Mobile health (mHealth) interventions are increasingly deployed as tools for ART adherence. However, little is known about the uptake and attitudes toward commercially available, biprogrammatic mobile apps (ie, designed for both smartphone and short message service [SMS] messaging) among demographically diverse PLWH. OBJECTIVES: The Florida mHealth Adherence Project for PLWH (FL-mAPP) is an innovative pilot study that aimed to determine the acceptability of a commercially available, biprogrammatic mHealth intervention platform to ensure medication adherence and gauge the current attitudes of PLWH toward current and future mHealth apps. METHODS: A predeveloped, commercially available, biprogrammatic mHealth platform (Care4Today Mobile Health Manager, Johnson & Johnson, New Brunswick, NJ) was deployed, with self-reported ART adherence recorded in the app and paper survey at both short term (30-day) or long-term (90-day) follow-ups. Consented participants completed baseline surveys on sociodemographics and attitudes, beliefs, and willingness toward the use of mHealth interventions for HIV care using a 5-point Likert scale. Chi-square tests and multivariate logistic regression analyses identified correlations with successful uptake of the mHealth platform. RESULTS: Among 132 PLWH, 66% (n=87) initially agreed to use the mHealth platform, of which 54% (n=47) successfully connected to the platform. Of the 87 agreeing to use the mHealth platform, we found an approximate 2:1 ratio of persons agreeing to try the smartphone app (n=59) versus the SMS text messages (n=28). Factors correlating with mHealth uptake were above high school level education (adjusted odds ratio 2.65; P=.05), confidence that a clinical staff member would assist with mHealth app use (adjusted odds ratio 2.92, P=.048), belief that PLWH would use such an mHealth app (adjusted odds ratio 2.89; P=.02), and ownership of a smartphone in contrast to a "flip-phone" model (adjusted odds ratio 2.80; P=.05). Of the sample, 70.2% (n=92) reported daily interest in receiving medication adherence reminders via an app (80.4% users versus 64.7% nonusers), although not significantly different among the user groups (P=.06). In addition, 34.8% (n=16) of mHealth users reported a theoretical "daily" interest and 68.2% (n=58) of non-mHealth users reported no interest in using an mHealth app for potentially tracking alcohol or drug intake (P=.002). CONCLUSIONS: This commercially available, biprogrammatic mHealth platform showed feasibility and efficacy for enhanced ART and medication adherence within public health clinics and successfully included older age groups. Successful use of the platform among demographically diverse PLWH is important for HIV implementation science and promising for uptake on a larger scale.


Assuntos
Infecções por HIV/tratamento farmacológico , Conhecimentos, Atitudes e Prática em Saúde , Adesão à Medicação/psicologia , Aplicativos Móveis/normas , Inquéritos e Questionários/normas , Adulto , Idoso , Antirretrovirais/administração & dosagem , Antirretrovirais/uso terapêutico , Distribuição de Qui-Quadrado , Estudos Transversais , Feminino , Florida , Infecções por HIV/psicologia , Humanos , Masculino , Adesão à Medicação/estatística & dados numéricos , Pessoa de Meia-Idade , Aplicativos Móveis/estatística & dados numéricos , Projetos Piloto , Inquéritos e Questionários/estatística & dados numéricos , Telemedicina/métodos , Telemedicina/normas , Telemedicina/estatística & dados numéricos
14.
JMIR Mhealth Uhealth ; 7(7): e13194, 2019 07 05.
Artigo em Inglês | MEDLINE | ID: mdl-31278732

RESUMO

BACKGROUND: A personal health record (PHR) system encourages patients to engage with their own health care by giving them the ability to manage and keep track of their own health data. Of the numerous PHR systems available in the market, many are Web-based patient portals and a few are mobile apps. They have mainly been created by hospitals and electronic health record (EHR) vendors. One major limitation of these hospital-created PHR systems is that patients can only view specific health data extracted from their EHR. Patients do not have the freedom to add important personal health data they collect in their daily lives into their PHR. Therefore, there is an information gap between clinical visits. OBJECTIVE: The aim of this study was to develop and evaluate a new mobile PHR app that can be easily used to manage various types of personal health data to fill the information gap. METHODS: A user-centered approach was used to guide the development and evaluation of the new mobile PHR app. There were three steps in this study: needs assessment, app design and development, and conducting a usability study. First, a large-scale questionnaire study was conducted with the general population to gain an understanding of their needs and expectations with regard to a mobile PHR app. A mobile PHR app for personal medical data tracking and management was then created based on the results of the questionnaire study. End users were actively involved in all stages of the app development. Finally, a usability study was performed with participants to evaluate the usability of the mobile PHR app, which involved asking participants to finish a set of tasks and to respond to a usability questionnaire. RESULTS: In the questionnaire study for needs assessment, there were 609 participants in total. The answers from these participants revealed that they wanted to manage various types of personal health data in a mobile PHR app. Participants also reported some features they desired to have in the app. On the basis of the needs assessment findings, a new mobile PHR app (PittPHR) was created with 6 major modules: health records, history, trackers, contacts, appointments, and resources. This app allows users to customize the trackers according to their needs. In the usability study, there were 15 participants. The usability study participants expressed satisfaction with the app and provided comments and suggestions for further development. CONCLUSIONS: This new mobile PHR app provides options for users to manage a wide range of personal health data conveniently in one place. The app fills the information gap between clinical visits. The study results indicated that this new mobile PHR app meets the need of users and that users welcome this app.


Assuntos
Registros Eletrônicos de Saúde/instrumentação , Aplicativos Móveis/normas , Assistência Centrada no Paciente/métodos , Adolescente , Adulto , Registros Eletrônicos de Saúde/normas , Registros Eletrônicos de Saúde/estatística & dados numéricos , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Aplicativos Móveis/estatística & dados numéricos , Determinação de Necessidades de Cuidados de Saúde/normas , Determinação de Necessidades de Cuidados de Saúde/estatística & dados numéricos , Desenho de Programas de Computador , Inquéritos e Questionários
15.
JMIR Mhealth Uhealth ; 7(7): e14602, 2019 07 09.
Artigo em Inglês | MEDLINE | ID: mdl-31290404

RESUMO

BACKGROUND: Although smartphone apps have shown promise for smoking cessation, there is a need to enhance their low engagement rates. This study evaluated the application of the growth mindset theory, which has demonstrated the potential to improve persistence in behavior change in other domains, as a means to improve engagement and cessation. OBJECTIVE: This study aimed to explore the feasibility, utility, and efficacy of a Web-based growth mindset intervention for addiction when used alongside a smoking cessation app. METHODS: Daily smokers (N=398) were all recruited on the Web and randomly assigned to receive either a cessation app alone or the app plus a Web-delivered growth mindset intervention. The primary outcome was engagement, that is, the number of log-ins to the smoking cessation app. The secondary outcome was 30-day point prevalence abstinence at 2-month follow-up collected through a Web-based survey. RESULTS: The 2-month outcome data retention rate was 91.5% (364/398). In addition, 77.9% (310/398) of the participants in the experimental arm viewed at least 1 page of their growth mindset intervention, and 21.1% (84/398) of the group viewed all the growth mindset intervention. The intention-to-treat analysis did not show statistically significant differences between the experimental and comparison arms on log-ins to the app (19.46 vs 21.61; P=.38). The experimental arm had cessation rates, which trended higher than the comparison arm (17% vs 13%; P=.10). The modified intent-to-treat analysis, including only participants who used their assigned intervention at least once (n=115 in experimental group and n=151 in the control group), showed that the experimental arm had a similar number of log-ins (32.31 vs 28.48; P=.55) but significantly higher cessation rates (21% vs 13%; P=.03) than the comparison arm. CONCLUSIONS: A growth mindset intervention for addiction did not increase engagement rates, although it may increase cessation rates when used alongside a smartphone app for smoking cessation. Future research is required to refine the intervention and assess efficacy with long-term follow-up to evaluate the efficacy of the mindset intervention. TRIAL REGISTRATION: ClinicalTrials.gov NCT03174730; https://clinicaltrials.gov/ct2/show/NCT03174730.


Assuntos
Internet/instrumentação , Aplicativos Móveis/normas , Abandono do Hábito de Fumar/psicologia , Adulto , Feminino , Seguimentos , Humanos , Internet/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Aplicativos Móveis/estatística & dados numéricos , Projetos Piloto , Smartphone/estatística & dados numéricos , Abandono do Hábito de Fumar/estatística & dados numéricos
16.
BMC Med ; 17(1): 127, 2019 07 17.
Artigo em Inglês | MEDLINE | ID: mdl-31311573

RESUMO

BACKGROUND: Smartphone apps are becoming increasingly popular for supporting diabetes self-management. A key aspect of diabetes self-management is appropriate medication-taking. This study aims to systematically assess and characterise the medication management features in diabetes self-management apps and their congruence with best-practice evidence-based criteria. METHODS: The Google Play and Apple app stores were searched in June 2018 using diabetes-related terms in the English language. Apps with both medication and blood glucose management features were downloaded and evaluated against assessment criteria derived from international medication management and diabetes guidelines. RESULTS: Our search yielded 3369 Android and 1799 iOS potentially relevant apps; of which, 143 apps (81 Android, 62 iOS) met inclusion criteria and were downloaded and assessed. Over half 58.0% (83/143) of the apps had a medication reminder feature; 16.8% (24/143) had a feature to review medication adherence; 39.9% (57/143) allowed entry of medication-taking instructions; 5.6% (8/143) provided information about medication; and 4.2% (6/143) displayed motivational messages to encourage medication-taking. Only two apps prompted users on the use of complementary medicine. Issues such as limited medication logging capacity, faulty reminder features, unclear medication adherence assessment, and visually distracting excessive advertising were observed during app assessments. CONCLUSIONS: A large proportion of diabetes self-management apps lacked features for enhancing medication adherence and safety. More emphasis should be given to the design of medication management features in diabetes apps to improve their alignment to evidence-based best practice.


Assuntos
Diabetes Mellitus Tipo 2/tratamento farmacológico , Adesão à Medicação , Aplicativos Móveis , Autocuidado/métodos , Autogestão/métodos , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/psicologia , Humanos , Adesão à Medicação/psicologia , Adesão à Medicação/estatística & dados numéricos , Aplicativos Móveis/normas , Aplicativos Móveis/estatística & dados numéricos , Autocuidado/normas , Autocuidado/estatística & dados numéricos , Autoeficácia , Autogestão/estatística & dados numéricos , Smartphone
17.
JMIR Mhealth Uhealth ; 7(6): e13381, 2019 06 18.
Artigo em Inglês | MEDLINE | ID: mdl-31215513

RESUMO

BACKGROUND: Little is known of the effect of wearable devices on metabolic impairments in clinical settings. We hypothesized that a wearable device that can monitor and provide feedback on physical activity may help resolve metabolic syndrome. OBJECTIVE: This study aimed to examine the objective effects of the use of these devices on metabolic syndrome resolution. METHODS: Patients diagnosed with metabolic syndrome were recruited. Participants were prescribed regular walking using a wearable device (Coffee WALKIE +Dv.3, GC Healthcare CI, Korea) on their wrist for 12 weeks. Participants received self-feedback on the amount of their exercise through an app on their mobile phone. The information on physical activities of the participants was uploaded automatically to a website. Thus, a trained nurse could provide individuals with feedback regarding the physical activity via telephone consultation on alternate weeks. Blood pressure (BP), body composition, fasting plasma glucose, and lipid profiles were recorded. The primary outcome was metabolic syndrome resolution. The secondary outcome was an improvement in the components of metabolic impairment. RESULTS: Of the 53 participants recruited, 20 participants with a median age of 46 (range 36-50) years completed the trial. There was no significant difference in the amount of calorie expenditure at weeks 4, 8, and 12. After 12 weeks, metabolic syndrome was resolved in 9 of 20 participants (45%), and the mean number of metabolic impairment components per person decreased from 3.4 to 2.9. Particularly, the mean systolic and diastolic BP decreased from mean 136.6 (SD 18.5) mm Hg to mean 127.4 (SD 19.5) mm Hg and from mean 84.0 (SD 8.1) mm Hg to mean 77.4 (SD 14.4) mm Hg (both P=.02), respectively. CONCLUSIONS: This study found that a 12-week intervention via feedback, based on a wearable physical activity monitor, helped metabolic syndrome patients to be more engaged in regular walking and it improved impaired metabolic components, especially in BP. However, some practical challenges regarding patients' adherence and sustained engagement were observed.


Assuntos
Exercício/psicologia , Retroalimentação , Síndrome Metabólica/terapia , Dispositivos Eletrônicos Vestíveis/normas , Adulto , Feminino , Humanos , Masculino , Síndrome Metabólica/psicologia , Pessoa de Meia-Idade , Aplicativos Móveis/normas , Aplicativos Móveis/estatística & dados numéricos , Projetos Piloto , República da Coreia , Dispositivos Eletrônicos Vestíveis/estatística & dados numéricos
18.
JMIR Mhealth Uhealth ; 7(6): e14239, 2019 06 18.
Artigo em Inglês | MEDLINE | ID: mdl-31215514

RESUMO

BACKGROUND: Healthy eating and fitness mobile apps are designed to promote healthier living. However, for young people, body dissatisfaction is commonplace, and these types of apps can become a source of maladaptive eating and exercise behaviors. Furthermore, such apps are designed to promote continuous engagement, potentially fostering compulsive behaviors. OBJECTIVE: The aim of this study was to identify potential risks around healthy eating and fitness app use and negative experience and behavior formation among young people and to inform the understanding around how current commercial healthy eating and fitness apps on the market may, or may not, be exasperating such behaviors. METHODS: Our research was conducted in 2 phases. Through a survey (n=106) and 2 workshops (n=8), we gained an understanding of young people's perceptions of healthy eating and fitness apps and any potential harm that their use might have; we then explored these further through interviews with experts (n=3) in eating disorder and body image. Using insights drawn from this initial phase, we then explored the degree to which leading apps are preventing, or indeed contributing to, the formation of maladaptive eating and exercise behaviors. We conducted a review of the top 100 healthy eating and fitness apps on the Google Play Store to find out whether or not apps on the market have the potential to elicit maladaptive eating and exercise behaviors. RESULTS: Participants were aged between 18 and 25 years and had current or past experience of using healthy eating and fitness apps. Almost half of our survey participants indicated that they had experienced some form of negative experiences and behaviors through their app use. Our findings indicate a wide range of concerns around the wider impact of healthy eating and fitness apps on individuals at risk of maladaptive eating and exercise behavior, including (1) guilt formation because of the nature of persuasive models, (2) social isolation as a result of personal regimens around diet and fitness goals, (3) fear of receiving negative responses when targets are not achieved, and (4) feelings of being controlled by the app. The app review identified logging functionalities available across the apps that are used to promote the sustained use of the app. However, a significant number of these functionalities were seen to have the potential to cause negative experiences and behaviors. CONCLUSIONS: In this study, we offer a set of responsibility guidelines for future researchers, designers, and developers of digital technologies aiming to support healthy eating and fitness behaviors. Our study highlights the necessity for careful considerations around the design of apps that promote weight loss or body modification through fitness training, especially when they are used by young people who are vulnerable to the development of poor body image and maladaptive eating and exercise behaviors.


Assuntos
Comportamento Aditivo/etiologia , Comportamento Alimentar/psicologia , Monitores de Aptidão Física/normas , Aplicativos Móveis/normas , Adulto , Comportamento Aditivo/psicologia , Comportamento Compulsivo/etiologia , Comportamento Compulsivo/psicologia , Educação/métodos , Feminino , Monitores de Aptidão Física/estatística & dados numéricos , Humanos , Masculino , Aplicativos Móveis/estatística & dados numéricos , Inquéritos e Questionários
19.
JMIR Mhealth Uhealth ; 7(6): e12631, 2019 06 18.
Artigo em Inglês | MEDLINE | ID: mdl-31215516

RESUMO

BACKGROUND: Hospital-based health promotion resources to assist pregnant women in adopting a healthy lifestyle and optimizing gestational weight gain are important, but with limited effects. Increasingly, women are using mobile apps to access health information during the antenatal period. OBJECTIVE: The aims of the study were to investigate app-usage by Chinese women during pregnancy and to gain a better understanding of their views and attitudes toward apps containing health information. METHODS: A mixed methods study design was applied. Study participants were recruited from 2 maternity hospitals in Shanghai, China, between March and July 2018. A self-administered Web-based survey was conducted with 535 pregnant Chinese women on their sources of health information and reasons for using apps during pregnancy. A total of 4 semistructured focus groups were also conducted with the pregnant women (n=28). RESULTS: The use of pregnancy-related apps and the internet was common among the respondents. Almost half of the women had used pregnancy-related apps. Specifically, the use of apps for health information declined as pregnancy progressed from 70% (35/50) in the first trimester to 41.3% (143/346) in the third trimester. The main reason for using an app was to monitor fetal development (436/535, 81.5%), followed by learning about nutrition and recording diet in pregnancy (140/535, 26.2%). The women found that the apps were useful and convenient and can support lifestyle modifications during pregnancy. However, some apps also contained misinformation or incorrect information that could cause anxiety as reported by the participants. Many women expressed the need for developing an app containing evidence-based, well-informed, and tailored health information to support them during pregnancy. CONCLUSIONS: The study suggests that apps were widely used by many Chinese women during pregnancy to monitor fetal development, to obtain diet and physical activity information, and to track their body changes. The women highly appreciated the evidence-based information, expert opinions, and tailored advice available on apps. Smartphone apps have the potential to deliver health information for pregnant women.


Assuntos
Troca de Informação em Saúde/normas , Aplicativos Móveis/normas , Gestantes/psicologia , Adulto , China , Estudos Transversais , Feminino , Grupos Focais/métodos , Troca de Informação em Saúde/estatística & dados numéricos , Humanos , Aplicativos Móveis/estatística & dados numéricos , Gravidez , Pesquisa Qualitativa
20.
JMIR Mhealth Uhealth ; 7(6): e8130, 2019 06 18.
Artigo em Inglês | MEDLINE | ID: mdl-31215518

RESUMO

BACKGROUND: Young people with sickle cell disease (SCD) often demonstrate low medication adherence and low motivation for effectively self-managing their condition. The growing sophistication of mobile phones and their popularity among young people render them a promising platform for increasing medication adherence. However, so far, few apps targeting SCD have been developed from research with the target population and underpinned with theory and evidence. OBJECTIVE: The aim of this study was to develop a theory-and-evidence-based medication adherence app to support children and adolescents with SCD. METHODS: The Behavior Change Wheel (BCW), a theoretically based intervention development framework, along with a review of the literature, 10 interviews with children and adolescents with SCD aged between 12 and 18 years, and consultation with experts informed app development. Thematic analysis of interviews provided relevant theoretical and evidence-based components to underpin the design and development of the app. RESULTS: Findings suggested that some patients had lapses in memory for taking their medication (capability); variation in beliefs toward the effectiveness of medication and confidence in self-managing their condition (motivation); a limited time to take medication; and barriers and enablers within the changing context of social support during the transition into adulthood (opportunity). Steps were taken to select the appropriate behavioral change components (involving behavior change techniques [BCTs] such as information on antecedents, prompts/cues; self-monitoring of the behavior; and social support) and translate them into app features designed to overcome these barriers to medication adherence. CONCLUSIONS: Patients with SCD have complex barriers to medication adherence necessitating the need for comprehensive models of behavior change to analyze the problem. Children and adolescents require an app that goes beyond simple medication reminders and takes into account the patient's beliefs, emotions, and environmental barriers to medication adherence.


Assuntos
Anemia Falciforme/tratamento farmacológico , Terapia Comportamental/instrumentação , Adesão à Medicação/psicologia , Adolescente , Anemia Falciforme/psicologia , Terapia Comportamental/métodos , Terapia Comportamental/normas , Criança , Feminino , Humanos , Masculino , Adesão à Medicação/estatística & dados numéricos , Aplicativos Móveis/normas , Aplicativos Móveis/estatística & dados numéricos , Pesquisa Qualitativa , Autogestão/métodos , Autogestão/psicologia , Autogestão/estatística & dados numéricos , Apoio Social , Inquéritos e Questionários
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