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1.
Pan Afr Med J ; 33: 305, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31723372

RESUMO

Introduction: Every 90 seconds, a woman dies of complications related to pregnancy and childbirth, resulting in more than 340,000 maternal deaths a year. Antenatal care (ANC) and postnatal care (PNC) are significant determinants of maternal health and, particularly, safe motherhood. Antenatal care is an important predictor of safe delivery and provides health information and services that can improve the health of women and infants. mHealth broadly encompasses the use of mobile telecommunication and multimedia technologies as they are integrated within increasingly mobile and wireless health care delivery systems. This study aimed at assessing the acceptable implementation modalities of mHealth intervention on pregnant Women in Dschang health district, West Region of Cameroon.ng ba. Methods: This was a cross sectional descriptive study in the Dschang health district, West region of Cameroon. Key informants were all pregnant women from 18 years and above and a total of 372 pregnant women were included. This study was carried out from March to July 2017. Results: Majority of the women, that is, 252(67.74%) were married, 117(31.45%) declaredtheir status as being single, while 3(0.81%) were devorced. Out of the 335 women that declared wanting an mHealth intervention, 41.79% of this number preferred SMS texts in the afternoon, 111(33.13%) in the evening, 46(13.73%) anytime and 38(11.34%) in the morning hours. A total of 83.33% women confirmed using telephone services. Conclusion: This study reveals that cell phones would be the acceptable medium of providing pregnancy and postpartum support to women in the Dschang health district. This is justified by the fact that a vast majority of women interviewed had access to a cell phone and referred to it as their desired and accepted means of communication.


Assuntos
Cuidado Pós-Natal/métodos , Cuidado Pré-Natal/métodos , Telemedicina/métodos , Adolescente , Adulto , Camarões , Telefone Celular , Estudos Transversais , Feminino , Humanos , Gravidez , Mensagem de Texto , Adulto Jovem
3.
Pan Afr Med J ; 33: 50, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31448013

RESUMO

Introduction: The World Health Organization estimates that up to half of vaccines are wasted, however only a minority of mHealth programs in Africa have been directed at vaccine supply chain optimisation. We piloted a novel mHealth solution dependent only on short message services (SMS) technology that allowed workers in rural health centres in Zambia to report vaccine stock levels directly to an online platform. Small airtime incentives were offered to encourage users to engage with the system, as well as weekly reminder messages asking for stock updates. Methods: The primary outcome measured was the percentage-of-doses-tracked, calculated over the study period. Each vaccine box was randomly allocated to offer either a standard or double airtime incentive and either weekly or daily reminders, in a 2 x 2 design; ANOVA was used to calculate if any of these factors affected time-to-reply. Results: Over the study period, the total percentage-of-doses-tracked was 39.9%. Within the subset of users who sent at least one message to the platform, the percentage-of-doses-tracked was 93.8%. There was no significant difference in average time-to-reply between the standard airtime incentive and double airtime incentive groups, nor was there a significant difference between the standard reminder and daily follow-up reminder groups. Conclusion: This pilot study found that in an active subgroup of health workers, an incentivised mHealth solution was able to collect tracking data for 93.8% of doses. More research is needed to identify methods to encourage healthcare workers to engage in timely stock reporting practices.


Assuntos
Vacina contra Difteria, Tétano e Coqueluche/provisão & distribução , Serviços de Saúde Rural/organização & administração , Telemedicina/métodos , Mensagem de Texto , Telefone Celular , Agentes Comunitários de Saúde/organização & administração , Humanos , Projetos Piloto , Fatores de Tempo , Zâmbia
4.
Stud Health Technol Inform ; 264: 1986-1987, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438441

RESUMO

In order to develop more persuasive messaging to promote help-seeking for depression, we created six, differently designed visual messages and tested their effectiveness with possible audience members. Different visual designs brought differences in emotional responses to the message and willingness to use the message. Help-seeking intentions for depression increased significantly after exposure to either the plain text message or the visual messages.


Assuntos
Transtorno Depressivo , Mensagem de Texto , Depressão , Humanos , Intenção , Comunicação Persuasiva
5.
BMC Public Health ; 19(1): 1162, 2019 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-31438908

RESUMO

BACKGROUND: The NHS Health Check (NHS HC) is a cardiovascular risk assessment to prevent cardiovascular disease. Public Health England (PHE) wants to increase uptake. METHODS: We explored the impact of behaviourally informed invitation letters and pre-notification and reminder SMS on uptake of NHS HCs. Patients at 28 General Practices in the London Borough of Southwark who were eligible to receive an NHS HC between 1st November 2013 and 31st December 2014 were included. A double-blind randomised controlled trial with a mixed 2 (pre-notification SMS - yes or no) × 4 (letter - national template control, open-ended, time-limited, social norm) × 2 (reminder SMS - yes or no) factorial design was used. The open-ended letter used simplification, behavioural instruction and a personalised planning prompt for patients to record the date and time of their NHS HC. The time-limited letter was similar but stated the NHS HC was due in a named forthcoming month. The social norms letter was similar to the open-ended letter but included a descriptive social norms message and testimonials from local residents and no planning prompt. The outcome measure was attendance at an NHS HC. RESULTS: Data for 12, 244 invites were analysed. Uptake increased in almost all letter and SMS combinations compared to the control letter without SMS (Uptake 18%), with increases of up to 12 percentage points for the time-limited letter with pre-notification and reminder (Uptake 30%; Adjusted Odds Ratio AOR 1.86; 95% CI 1.45-2.83; p < 0.00); 10 percentage points for the open-ended letter with reminder (Uptake 27%; AOR 1.68; 95% CI 1.31-2.17; p < 0.00) and a 9 percentage point increase using the time-limited letter with reminder (Uptake 27%; AOR 1.61; 95% CI 1.25-2.10; p < 0.00). The reminder SMS increased uptake for all intervention letters. The pre-notification did not add to this effect. CONCLUSIONS: This large randomised controlled trial adds support to the evidence that small, low cost behaviourally informed changes to letter-based invitations can increase uptake of NHS HCs. It also provides novel evidence on the effect of SMS reminders and pre-notification on NHS HC attendance. TRIAL REGISTRATION: Retrospectively Registered (24/01/2014) ISRCTN36027094 .


Assuntos
Doenças Cardiovasculares/prevenção & controle , Promoção da Saúde/métodos , Sistemas de Alerta , Medicina Estatal/estatística & dados numéricos , Mensagem de Texto , Adulto , Método Duplo-Cego , Feminino , Humanos , Londres , Masculino , Pessoa de Meia-Idade , Avaliação de Programas e Projetos de Saúde , Medição de Risco , Fatores de Tempo
6.
BMC Public Health ; 19(1): 1193, 2019 Aug 29.
Artigo em Inglês | MEDLINE | ID: mdl-31464623

RESUMO

BACKGROUND: Despite the extensive implementation of control measures and achievements in morbidity reductions, malaria continues to contribute to substantial morbidity and mortality in children under-five. Innovative approaches involving the use of mobile phones have been suggested to improve health outcomes. However, evidence of its effect on reducing the prevalence of malaria is limited. This study, therefore, aimed to assess the effect of a theory-driven mHealth intervention on the prevalence of malaria among children under-five living in rural districts of Ghana. METHODS: We conducted a quasi-experimental study of a 12-month intervention using a random sample of 332 caregivers with children under-five from two rural districts, assigned to either an intervention or a control group. Caregivers in the intervention group received voice short message service (SMS) on malaria prevention based on a behavior change theory to improve their health behaviors and practice, once a week for twelve months, while caregivers in the control group received none. Pre- and post-intervention assessment of the treatment effect (ATT) on malaria in children under-five was conducted using propensity score and difference-in-difference (DiD) analyses. RESULTS: Among children whose caregivers received the intervention, the prevalence of malaria decreased from 58.4% at baseline to 37.8% at endline (difference: -20.6%; 95% CI: - 31.1, - 10.1) compared with children in the control group, where a reduction of 65.0 to 59.9% (difference - 5.1%; 95% CI: - 15.5, 5.4) was observed. The treatment effect at endline revealed a statistically significant reduction in malaria prevalence (ATT: -0.214; 95% CI: - 0.36, - 0.07) compared with the baseline (ATT: -0.035; 95% CI: - 0.16, 0.09). Overall, the intervention effect showed a significant reduction in the prevalence of malaria among children under-five was positive (DiD: - 0.154; p = 0.043). CONCLUSION: The results of the study indicate the effectiveness of mobile phone SMS as a control tool for reducing the burden of malaria in children under-five.


Assuntos
Malária/prevenção & controle , Telemedicina/métodos , Mensagem de Texto , Adulto , Cuidadores/psicologia , Cuidadores/estatística & dados numéricos , Pré-Escolar , Feminino , Gana/epidemiologia , Comportamentos Relacionados com a Saúde , Humanos , Lactente , Malária/epidemiologia , Masculino , Avaliação de Programas e Projetos de Saúde , População Rural/estatística & dados numéricos , Adulto Jovem
7.
AIDS Behav ; 23(9): 2253-2272, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31401741

RESUMO

A systematic review was conducted to summarize and appraise the eHealth interventions addressing HIV/STI prevention among men who have sex with men (MSM), and characterize features of successful eHealth interventions. Fifty-five articles (17 pilots and 38 full efficacy trials) were included with the predominance of web-based interventions in the United States-based settings. Intervention modalities include web-based, short message service (SMS)/text messges/email reminder, online video-based, computer-assisted, multimedia-based, social network, live chat and chat room, virtual simulation intervention, and smartphone applications. Forty-nine eHealth interventions achieved a short-term behaviour change among participants. Four studies were conducted with 12-month follow-ups; and only one of them could maintain the behaviour change over this longer time period which could be due to the lack of booster interventions. Our study suggests that eHealth interventions can achieve short term behaviour change among MSM, however limited interventions could maintain behaviour change over 12 months. Further eHealth intervention strategies to promote HIV prevention among MSM should be conducted and rigorously evaluated.


Assuntos
Infecções por HIV/prevenção & controle , Promoção da Saúde/métodos , Homossexualidade Masculina , Doenças Sexualmente Transmissíveis/prevenção & controle , Telemedicina , Adulto , Humanos , Masculino , Comportamento de Redução do Risco , Mensagem de Texto
8.
Cyberpsychol Behav Soc Netw ; 22(8): 521-528, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31403856

RESUMO

Sexting is widely prevalent among young adults; however, the impact of sexting on mental health is not fully understood. This study aimed to investigate sexting behavior among young adults (18-30 years) attending an Australian music festival and the impact of sexting on mental health. A paper survey was completed by 776 respondents. Psychological distress (Kessler 6) was classified as "distressed" or "not distressed." Univariate and logistic regressions were used to test the associations between sexting and distress. In the past 12 months, 53.1 percent of respondents had sent a sexually explicit message, 43.1 percent had sent a sexually explicit image, 61.2 percent had received a sexually explicit message, and 55.1 percent had received a sexually explicit image. Three quarters of respondents (73.1 percent) felt that sexting could have a positive impact. No association was found between the frequency of sending and receiving sexually explicit images or messages in univariate analyses. However, the more unwanted messages/images were received in the past year, the more likely respondents were to be distressed as seen in univariate analyses. After adjusting for gender, sexual orientation, and alcohol, people who received 5 or more unsolicited messages were 2.4 times more likely to be distressed (odds ratio = 2.42, 95% confidence interval = 1.33-4.40, p = 0.004). In conclusion, this study showed that sexting is common and that the more unsolicited sexts that were received, the higher the distress level. Policymakers and program developers should be aware of the positive and negative impact of sexting.


Assuntos
Comportamento Sexual/psicologia , Estresse Psicológico/epidemiologia , Mensagem de Texto/estatística & dados numéricos , Adolescente , Adulto , Austrália/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Saúde Mental , Música , Prevalência , Estresse Psicológico/etiologia , Inquéritos e Questionários , Adulto Jovem
9.
BMC Public Health ; 19(1): 975, 2019 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-31331299

RESUMO

BACKGROUND: Dietary guidelines typically specify rather complex goals and indicators for healthy food choices, such as nutrient and energy content patterns. However, translating these complex goals into practice in real life is often a major obstacle for many people. The present studies propose an intervention strategy for boosting healthy food choices by prompting consumers at a meaningful moment with a simple behavioural trigger, that is to eat a colourful lunch. Effectivity and feasibility of this intervention strategy were tested in two laboratory experiments and one real-life, smartphone-based Ecological Momentary Intervention. METHODS: In Studies 1 and 2, 83 / 42 participants self-served four meals (colourful, typical, healthy, and low-calorie) / three meals (colourful, typical, and varied) from a Fake Food Buffet. In Study 3, 80 participants recorded images of 1,210 lunch meals over a period of 3 weeks using mobile visual food recording. In the second week, participants additionally received a daily smartphone prompt to eat a colourful lunch. In all studies, participants were asked to rate the prompts' feasibility. RESULTS: Prompting participants to eat a colourful meal increased the proportion of healthy foods consumed compared to typical meals in all three studies. In Studies 1 and 2, colourful meals contained more fruit and vegetables, while in Study 3 the prompt increased vegetable consumption. Furthermore, participants evaluated colourful meals to be the tastiest (Study 1) and most pleasant, and reported that the prompt was easy to follow and act upon. CONCLUSIONS: Results suggest that prompting individuals to eat colourful meals is a promising strategy to facilitate healthy food choices in daily life. TRIAL REGISTRATION: German Clinical Trials Register, DRKS00017552 (Study 3; retrospectively registered on 24th June 2019).


Assuntos
Cor , Comportamento do Consumidor/estatística & dados numéricos , Preferências Alimentares/psicologia , Promoção da Saúde/métodos , Refeições , Adolescente , Adulto , Estudos de Viabilidade , Feminino , Humanos , Almoço , Masculino , Mensagem de Texto , Adulto Jovem
10.
BMC Public Health ; 19(1): 915, 2019 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-31288772

RESUMO

BACKGROUND: Antiretroviral therapy is effective in preventing the progression of HIV to AIDS, but adherence to HIV medication is lower than ideal. A previous Cochrane review concluded that SMS interventions increased adherence to HIV medication, but more recent trials have reported mixed results. Our review aims to provide an up-to-date synthesis of the effects of interventions delivered by mobile phone on adherence. METHODS: We searched Cochrane, Medline, CINAHL, EMBASE and Global Health for randomised control trials (RCTs) of interventions delivered by mobile phones, designed to increase adherence to antiretroviral medication. Risk of bias was assessed using the Cochrane risk of bias tool. We calculated relative risk ratios (RR) or standardised mean difference (SMD) with 95% confidence interval (CI). Trials were analysed depending on delivery mechanism and intervention characteristics. We conducted meta-analysis for primary objective outcome measures. RESULTS: We identified 19 trials. No trials were at low risk of bias. Interventions were delivered as follows; nine via text message, five via mobile phone call, one via mobile phone imagery and four via mixed interventions. There was no effect when interventions delivered by text message were pooled in the RR1.25 (CI 0.97 to 1.61) P = 0.08. The SMD 0.42 (0.03 to 0.81) p = 0.04 showed a moderate effect to improve adherence. There was mixed evidence of the effect of text messages delivered daily, weekly, at scheduled or triggered times, however, messages with link to support, interactivity and three or more behavior change techniques (BCTs) all improved adherence. Of the five trials delivered by mobile phone call, one reported a reduction in HIV viral load. One trial using mobile phone imagery reported a reduction in HIV viral load. Three trials that delivered interventions by text message and mobile phone counselling reported improved biological outcomes. CONCLUSION: Specific interventions, of proven effectiveness should be considered for implementation, rather than mobile phone-based interventions in general. Interventions targeting a wider range of barriers to adherence may be more effective than existing interventions. The effects and cost-effectiveness of such interventions should be evaluated in a randomised controlled trial alongside long term objective and clinically important outcomes.


Assuntos
Antirretrovirais/uso terapêutico , Telefone Celular , Infecções por HIV/tratamento farmacológico , Adesão à Medicação/estatística & dados numéricos , Aconselhamento/métodos , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Mensagem de Texto
11.
BMC Public Health ; 19(1): 964, 2019 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-31319846

RESUMO

BACKGROUND: Smoking during pregnancy has adverse health consequences for the mother and fetus. E-cigarettes could aid with smoking cessation but there is limited research on the prevalence and patterns of e-cigarette use, and their association with smoking cessation among pregnant smokers. METHODS: We conducted a secondary analysis of a randomized controlled trial of a text-messaging program for smoking cessation among a U.S. national cohort of pregnant smokers (n = 428). Outcomes assessed were trajectories of e-cigarettes use from baseline to one-month follow-up, and longitudinal association between e-cigarette use at baseline and smoking cessation at one-month follow-up. RESULTS: At baseline, 74 (17.29%) pregnant smokers used e-cigarettes in the past 30 days and 36 (8.41%) used e-cigarettes in the past 7 days. The primary reason stated for using e-cigarettes during pregnancy was for quitting. E-cigarette use between baseline and 1-month was inconsistent. Of 36 dual-users at baseline, 20 (55.56%) stopped using e-cigarettes by the 1-month follow-up and 14 initiated e-cigarette use. There was no evidence of an association between e-cigarette use at baseline and the primary smoking cessation outcome, 7-day point prevalence abstinence [adjusted odds ratio = 0.79, 95% confidence intervals = 0.33-1.92]. CONCLUSIONS: A secondary analysis of a national sample of pregnant smokers indicates that use of e-cigarettes is inconsistent and is not associated with improved smoking cessation outcomes. There is an urgent need to further examine the risk and benefits of e-cigarette use, especially during pregnancy.


Assuntos
Complicações na Gravidez/epidemiologia , Complicações na Gravidez/terapia , Abandono do Hábito de Fumar/métodos , Vaping/epidemiologia , Vaping/terapia , Adulto , Feminino , Seguimentos , Humanos , Estudos Longitudinais , Razão de Chances , Gravidez , Complicações na Gravidez/psicologia , Prevalência , Estudos Prospectivos , Abandono do Hábito de Fumar/psicologia , Mensagem de Texto , Resultado do Tratamento , Vaping/psicologia
12.
BMC Public Health ; 19(1): 674, 2019 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-31151390

RESUMO

BACKGROUND: The HealthyFood (HF) program offers members up to 25% cash back monthly on healthy food purchases. In this randomized controlled trial, we tested the efficacy of financial incentives combined with text messages in increasing healthy food purchases among HF members. METHODS: Members receiving the lowest (10%) cash back level were randomized to one of six arms: Arm 1 (Usual Care): 10% cash back, no weekly text, standard monthly text; Arm 2: 10% cash back, generic weekly text, standard monthly text; Arm 3: 10% cash back, personalized weekly text, standard monthly text; Arm 4: 25% cash back, personalized weekly text, standard monthly text; Arm 5: 10 + 15%NET cash back, personalized weekly text, standard monthly text; and, Arm 6: 10 + 15%NET cash back, personalized weekly text, unbundled monthly text. In the 10 + 15%NET cash back, the cash back amount was the baseline 10% plus 15% of the net difference between healthy and unhealthy spending. The generic text included information on HF and healthy eating, while the personalized text had individualized feedback on purchases. The standard monthly text contained the cash back amount. The unbundled monthly text included the amount lost due to unhealthy purchases. The primary outcome was the average monthly percent healthy food spending. Secondary outcomes were the percent unhealthy food spending, and the percent healthy and unhealthy food items. RESULTS: Of the members contacted, 20 opted out, and 2841 met all inclusion criteria. There were no between-arm differences in the examined outcomes. The largest mean (standard deviation) difference in percent healthy spending was between Arm 1 (24.8% [11%]) and Arm 2 (26.8% [13%]), and the largest mean difference in percent unhealthy spending was also between Arm 1 (24.4% [20%]) and Arm 2 (21.7% [17%]), but no differences were statistically significant after correction for multiple comparisons. CONCLUSIONS: None of the tested financial incentive structures or text strategies differentially affected food purchasing. Notably, more than doubling the cash back amount and introducing a financial disincentive for unhealthy purchases did not affect purchasing. These findings speak to the difficulty of changing shopping habits and to the need for innovative strategies to shift complex health behaviors. TRIAL REGISTRATION: NCT02486588 Increasing Engagement with a Healthy Food Benefit. The trial was prospectively registered on July 1, 2015.


Assuntos
Comportamento do Consumidor/economia , Retroalimentação , Dieta Saudável/economia , Motivação , Mensagem de Texto , Adulto , Comportamento do Consumidor/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Programas e Projetos de Saúde
13.
BMC Public Health ; 19(1): 715, 2019 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-31238914

RESUMO

BACKGROUND: Cigarette smoking is a main cause of preventable morbidity and mortality. Many young adults begin smoking in the military, with smoking rates higher among soldiers than in the general population. Among other health effects, smoking impairs performance among soldiers. Smoking cessation programs in the military are challenging due to the unique settings and low access to smoking cessation resources. Studies have shown that text-messaging smoking cessation programs are feasible and effective, but there is a lack of studies on soldiers. OBJECTIVE: To evaluate the feasibility of a text-messaging smoking cessation program tailored for soldiers. METHODS: We recruited 81 soldiers who smoked, 76.5% of whom were male. Following enrollment, participants filled out a baseline survey and were given a text messaging program for 6 months. Participants could send predetermined keywords and immediately receive a response from a list of messages that were constructed as a response to the specific keyword. Participants filled out a follow-up survey at 1 month. Additionally, we retrieved and analyzed program usage data, including keywords sent and received, for the entire program period. Based on the follow-up survey and the program usage data, we assessed feasibility of the recruitment methods, participants' engagement and satisfaction and technical usability of the program. RESULTS: At 1 month, 20.6% reported that they had not smoked in the past week. A high percentage of the participants were engaged in the program, with 82.5% sending at least one valid keyword. The lowest self-efficacy group had higher chances of leaving the program (50.0%) while for the highest group there were much lower chances (4.8%). Most of the soldiers (96.8%) found the program easy to use and would recommend it to a friend (84.1%). CONCLUSIONS: The study demonstrates that a text-messaging smoking cessation program is feasible in a military setting. Further development and evaluation of digital smoking cessation tools tailored for soldiers are warranted.


Assuntos
Militares/psicologia , Abandono do Hábito de Fumar/métodos , Fumar/psicologia , Mensagem de Texto , Adolescente , Adulto , Estudos de Viabilidade , Feminino , Seguimentos , Humanos , Israel/epidemiologia , Masculino , Pessoa de Meia-Idade , Militares/estatística & dados numéricos , Avaliação de Programas e Projetos de Saúde , Fumar/epidemiologia , Inquéritos e Questionários , Adulto Jovem
14.
BMC Public Health ; 19(Suppl 2): 542, 2019 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-31159752

RESUMO

BACKGROUND: Exercise interventions are typically delivered to people with cancer and survivors via supervised clinical rehabilitation. However, motivating and maintaining activity changes outside of the clinic setting remains challenging. This study investigated the feasibility, acceptability and efficacy of an individually-tailored, text message-enhanced intervention that focused on increasing whole-of-day activity both during and beyond a 4-week, supervised clinical exercise rehabilitation program for people with cancer and survivors. METHODS: Participants (n = 36; mean ± SD age 64.8 ± 9.6 years; 44.1 ± 30.8 months since treatment) were randomized 1:1 to receive the text message-enhanced clinical exercise rehabilitation program, or the standard clinical exercise rehabilitation program alone. Activity was assessed at baseline, 4-weeks (end of the standard program) and 12-weeks (end of enhanced program) using both device (activPAL accelerometer; sitting, standing, light-stepping, moderate-stepping) and self-report [Multimedia Activity Recall for Children and Adults (MARCA); sedentary, light, moderate-to-vigorous physical activity (MVPA)] methods. The MARCA also assessed time use domains to provide context to activity changes. Changes and intervention effects were evaluated using linear mixed models, adjusting for baseline values and potential confounders. RESULTS: The study had high retention (86%) and participants reported high levels of satisfaction [4.3/5 (±0.8)] with the intervention. Over the first 4 weeks, MARCA-assessed MVPA increased [+ 53.2 (95%CI: 2.9, 103.5) min/d] between groups, favoring the text message-enhanced program, but there were no significant intervention effects on sedentary behavior. By 12 weeks, relative to the standard group, participants in the text message-enhanced group sat less [activPAL overall sitting: - 48.2 (- 89.9, - 5.6) min/16 h awake; MARCA: -80.1 (- 156.5, - 3.8) min/d] and were participating in more physical activity [activPAL light stepping: + 7.0 (0.4, 13.6: min/16 h awake; MARCA MVPA: + 67.3 (24.0, 110.6) min/d]. The time-use domains of Quiet Time [- 63.3 (- 110.5, - 16.0) min/d] and Screen Time [- 62.0 (- 109.7, - 14.2) min/d] differed significantly between groups. CONCLUSIONS: Results demonstrate feasibility, acceptability and efficacy of a novel, text message-enhanced clinical exercise rehabilitation program to support changes in whole-of-day activity, including both physical activity and sedentary behavior. Changes were largely seen at 12-week follow-up, indicating potential for the intervention to result in continued improvement and maintenance of behavior change following a supervised exercise intervention. TRIAL REGISTRATION: This trial is registered with the Australian New Zealand Clinical Trials Registry ( ACTRN12616000641493 ; date registered 17/5/16).


Assuntos
Actigrafia/métodos , Terapia por Exercício/estatística & dados numéricos , Neoplasias/reabilitação , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Mensagem de Texto/estatística & dados numéricos , Adulto , Austrália , Sobreviventes de Câncer , Criança , Exercício , Estudos de Viabilidade , Feminino , Humanos , Masculino , Motivação , Neoplasias/psicologia , Comportamento Sedentário , Autorrelato
15.
BMC Public Health ; 19(1): 739, 2019 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-31196026

RESUMO

BACKGROUND: Beginning in 2017 we have conducted a 3-arm randomised controlled trial (RCT) to determine the effectiveness of an early obesity intervention in the first two years of life using either telephone or Short Message Service (SMS) support for mothers. The trial recruited 1155 mothers from their third trimester of pregnancy. This protocol is for a new trial to build on the existing trial using the mother-child dyads retained at 24 months for recruitment to the new RCT. The aim of this new trial is to test whether use of a combination of telephone and SMS interventions is effective in promoting healthy eating and physical activity, as well as reducing child body mass index (BMI) at 3 years of age. METHODS: We will conduct a parallel RCT with an estimated sample of 750 mother-child dyads retained from the existing trial at 24 months. Mothers who completed the 24 months survey, including a telephone survey and measurement of child's height and weight will be invited to participate in the new trial. Informed consent will be obtained at the 24 months survey. The participating mother-child dyads will then be randomly allocated to the intervention (combined telephone and text messaging intervention) or the control group. The intervention will comprise three staged telephone consultations and text messages after each of the three intervention booklets is mailed to mothers at specific time-points between two and three years of child age. The main trial outcome measures include a) BMI and BMI z-score measured at 36 months, b) diet, physical activity and screen time c) cost-effectiveness, and d) feasibility and acceptability of the intervention. DISCUSSION: This unique opportunity to link two studies will expedite project start up time, utilise existing research infrastructure and systems to run the study, and optimise the use of an already engaged population of study participants. It can address a significant knowledge gap regarding early obesity prevention for children aged 2 to 3 years. The feasibility and effectiveness of the combined telephone and SMS intervention will indicate whether this is a scaleable, broad-reach and low-cost early obesity intervention. TRIAL REGISTRATION: The trial was registered with the Australian Clinical Trial Registry ( ACTRN12618001571268 ) on 20/09/2018.


Assuntos
Obesidade Pediátrica/prevenção & controle , Programas de Redução de Peso/métodos , Programas de Redução de Peso/organização & administração , Austrália , Índice de Massa Corporal , Pré-Escolar , Análise Custo-Benefício , Exercício , Estudos de Viabilidade , Feminino , Dieta Saudável , Humanos , Masculino , Relações Mãe-Filho , Mães/psicologia , Gravidez , Avaliação de Programas e Projetos de Saúde , Telefone , Mensagem de Texto , Programas de Redução de Peso/economia
16.
Int J Med Inform ; 128: 18-23, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31160007

RESUMO

BACKGROUND: Almost two thirds of patients diagnosed with cancer are age 65 years or older. In order to follow up on older patients with cancer receiving chemotherapy at home, we implemented remote phone monitoring conducted by skilled oncology nurses. However, given the rising number of patients assessed and the limited time that hospital professionals can spend on their patients after discharge, we needed to modernize this program. In this paper we present the preliminary results and the ongoing evaluation. METHOD: We implemented a semi-automated messaging application to upgrade the current follow-up procedures. The primary aim is to collect patient's key data over time and to free up nurses' time so that during phone calls they can focus on education and support. The Chatbot feasibility was assessed in a sub-sample of unselected patients before its wider dissemination and pragmatic evaluation. MAIN RESULTS: During the first deployment period, 9 unselected patients benefited from the Chatbot (mean 83 y.o.) with a total of 52 completed remote evaluations. Each participant answered 6 questionnaires over 7 weeks with an 86% compliance rate. The average completion time for the questionnaires was 3.5 min and the answer rate was 100%. The 'free text' field was used in 58% of the questionnaires. The Chatbot solution is currently proposed to all eligible patients thanks to the regional cancer network support. We are measuring acceptability, health outcomes and health network impact. DISCUSSION AND CONCLUSION: The results of this first phase are encouraging. The integration of the solution into the health care organization was feasible and acceptable. Moreover, the answers revealed serious health (e.g. fever) or adherence (e.g. blood test) issues that require timely interventions. The major strength of this solution is to rely on end-users' current knowledge of technologies (text-messaging), which allows a seamless integration into a complex clinical network.


Assuntos
Avaliação Geriátrica/métodos , Monitorização Fisiológica/normas , Neoplasias/tratamento farmacológico , Smartphone/estatística & dados numéricos , Mensagem de Texto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Cooperação do Paciente , Inquéritos e Questionários
17.
Nat Commun ; 10(1): 2648, 2019 06 14.
Artigo em Inglês | MEDLINE | ID: mdl-31201322

RESUMO

Polarization affects many forms of social organization. A key issue focuses on which affective relationships are prone to change and how their change relates to performance. In this study, we analyze a financial institutional over a two-year period that employed 66 day traders, focusing on links between changes in affective relations and trading performance. Traders' affective relations were inferred from their IMs (>2 million messages) and trading performance was measured from profit and loss statements (>1 million trades). Here, we find that triads of relationships, the building blocks of larger social structures, have a propensity towards affective balance, but one unbalanced configuration resists change. Further, balance is positively related to performance. Traders with balanced networks have the "hot hand", showing streaks of high performance. Research implications focus on how changes in polarization relate to performance and polarized states can depolarize.


Assuntos
Comércio , Tomada de Decisões/fisiologia , Modelos Psicológicos , Assunção de Riscos , Rede Social , Humanos , Cadeias de Markov , Mensagem de Texto/estatística & dados numéricos
18.
Medicine (Baltimore) ; 98(22): e15681, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31145281

RESUMO

BACKGROUND: Studies that used short message service (SMS) programs as an intervention to promote health care have shown beneficial results in the control of risk factors for ischemic heart disease in patients of high-income countries, but evidence is lacking in low or middle-income countries. AIMS: The purpose of this study is to evaluate whether the use of SMS increases risk factor control within 6 months after discharge by acute coronary syndrome (ACS) in a middle-income country. METHODS: It will be a 2-arm, parallel, double-blind, randomized clinical trial of 160 patients discharged after an ACS from a single center with 6 months of follow-up. The intervention group will receive 4 SMS per week offering advice, motivation and information about medication adherence, increase of regular physical activity, adoption of healthy dietary measures, and smoking cessation (if appropriate). The primary outcome is achieving 4 or 5 points in a risk factor control score, which combines the cluster effect of 5 main modifiable risk factors for ACS [low-density lipoprotein cholesterol, LDL-C <70 mg/dL, blood pressure <140/90 mm Hg, regular exercise (≥5 days/week × 30 minutes of moderate exercise per session), nonsmoker status, and body mass index, BMI <25 kg/m]. Secondary outcomes are plasma LDL-C level, level of physical activity, blood pressure, medication adherence, proportion of nonsmokers, BMI, rehospitalization, cardiovascular death, and death from any cause. This study, as a randomized clinical trial protocol, followed the recommendations of the Standard Protocol Items (SPIRIT). EXPECTED OUTCOMES: This study aims to provide evidence of whether SMS interventions are effective in improving cardiovascular disease risk factors control in post-ACS patients in a middle-income country. CLINICALTRIALS. GOV IDENTIFIER: NCT03414190 (First posted on January 29, 2018; last update on May 14, 2018) - Retrospectively registered.


Assuntos
Síndrome Coronariana Aguda/terapia , Avaliação de Resultados (Cuidados de Saúde)/métodos , Prevenção Secundária/métodos , Telemedicina/métodos , Mensagem de Texto , Síndrome Coronariana Aguda/sangue , Pressão Sanguínea , LDL-Colesterol/sangue , Método Duplo-Cego , Exercício , Terapia por Exercício , Feminino , Humanos , Renda , Masculino , Adesão à Medicação , Motivação , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores de Risco
19.
Diabetes Res Clin Pract ; 153: 184-190, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31063856

RESUMO

AIMS: There is potential to provide public health interventions through text messaging for patients with Type 2 diabetes mellitus (T2DM). Our objective was to ascertain if lifestyle focused text messaging addressing cardiovascular risk factors in patients with coronary heart disease (CHD) and T2DM, was more effective than usual care. METHODS: This is a secondary analysis of the TEXT ME study, a randomised clinical trial of a 6-month text messaging intervention in patients with coronary heart disease. The measured outcomes include cholesterol, blood pressure (BP), body mass index (BMI), HbA1c, waist/hip circumference and smoking status. Our objective was to ascertain if lifestyle focused text messaging in patients with T2DM was more effective than usual care, and to determine if the intervention was more effective in patients with T2DM compared to those without. RESULTS: 229 participants in the TEXT ME study had T2DM (32%), 111 participants in the intervention group and 118 in the control group. At 6 months, the mean difference in systolic BP was -7.6 mmHg (95%CI -11.8, -3.37, p = 0.0003) and diastolic BP -3.7 mmHg (95%CI -6.12, -1.24, p = 0.0032). The mean difference in low density lipoprotein in the intervention arm, compared to the control arm, was -0.05 mmol/L (95%CI -0.27, 0.18, p = 0.813), and in triglycerides was -0.29 mmol/L (95%CI -0.59, 0.01, p = 0.035) respectively. The mean difference in BMI was -0.89 kg/m2 (95%CI -2.74, 0.95, p < 0.0001) in the intervention group, waist circumference -3.98 cm (95%CI -8.57, 0.61, p < 0.0001) and hip circumference -3.26 cm (95%CI -7.67, 1.16, p = 0.0006). Intervention subjects with diabetes were less likely to be smokers at 6 months. The mean difference in HbA1c between the control and intervention group was not significant (p = 0.126). The intervention was as effective in patients with diabetes, compared to those without. CONCLUSION: Among patients with coronary heart disease with T2DM, lifestyle-focused text messaging resulted in significant risk factor reduction.


Assuntos
Doença das Coronárias/psicologia , Diabetes Mellitus Tipo 2/psicologia , Telemedicina/métodos , Mensagem de Texto/instrumentação , Feminino , Humanos , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Fatores de Risco
20.
BMC Res Notes ; 12(1): 267, 2019 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-31088559

RESUMO

OBJECTIVE: Mobile Health approaches show promise as a delivery mode for alcohol screening and brief intervention. The 'YourCall' trial evaluated the effect of a low-intensity mobile phone text message brief intervention compared with usual care on hazardous drinking and alcohol-related harms among injured adults. This paper extends our previously published primary outcome analysis which revealed a significant reduction in hazardous drinking associated with the intervention at 3 months, with the effect maintained across 12 months follow-up. The objective of the current study was to evaluate the effect of the intervention on alcohol-related harms and troubles and help-seeking behaviours (secondary outcomes) at 12-months follow-up. RESULTS: A parallel two-group, single-blind, randomised controlled trial was conducted in 598 injured inpatients aged 16-69 years identified as having medium-risk hazardous drinking. Logistic regression models applied to 12-month follow-up data showed no significant differences between intervention and control groups in self-reported alcohol-related harms and troubles and help-seeking behaviours. Although this text message intervention led to a significant reduction in hazardous alcohol consumption (previously published primary outcome), changes in self-reported alcohol-related harms and troubles and help seeking behaviours at 12-months follow up (secondary outcomes) were small and non-significant. TRIAL REGISTRATION: ACTRN12612001220853. Retrospectively registered 19 November 2012.


Assuntos
Comportamento , Etanol/efeitos adversos , Mensagem de Texto , Adolescente , Adulto , Feminino , Humanos , Masculino , Inquéritos e Questionários , Adulto Jovem
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