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1.
Prog Orthod ; 22(1): 25, 2021 Sep 13.
Artigo em Inglês | MEDLINE | ID: mdl-34514529

RESUMO

BACKGROUND: Apps have been shown to be an effective tool in changing patients' behaviours in orthodontics and can be used to improve their compliance with treatment. The Behaviour Change Techniques (BCTs) and quality (using MARS) within these apps have previously not been published. OBJECTIVES: 1. To evaluate the quality of these apps aiming to change behaviour. 2. To assess BCTs used in patient focused orthodontic apps. METHODS: The UK Google Play and Apple App Stores were searched to identify all orthodontic apps and 305 apps were identified. All 305 apps were assessed for the presence of BCTs using an accepted taxonomy of BCTs (Behaviour Change Wheel (BCW)), widely utilised in healthcare. Of those containing BCTs, the quality was assessed using the Mobile App Rating Scale (MARS), a validated and multi-dimensional tool which rates apps according to 19 objective criteria. Data collection was carried out by two calibrated, independent assessors and repeated after 6 weeks for 25% of the apps by both assessors. RESULTS: BCTs were found in 31 apps, although only 18 of them were analysed for quality and 13 apps were excluded. Six different BCTs were identified: these were most commonly 'prompts/cues', and 'information about health consequences'. All apps were shown to be of moderate quality (range 3.1-3.7/5). Inter-rater and intra-rater reliability for BCT and quality assessment were excellent. CONCLUSIONS: The current availability of orthodontic apps of sufficient quality to recommend to patients is very limited. There is therefore a need for high-quality orthodontic apps with appropriate BCTs to be created, which may be utilised to improve patients' compliance with treatment.


Assuntos
Aplicativos Móveis , Terapia Comportamental , Humanos , Cooperação do Paciente , Reprodutibilidade dos Testes
2.
BMC Health Serv Res ; 21(1): 926, 2021 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-34488751

RESUMO

BACKGROUND: End-user involvement in developing evidence-based tools for clinical practice may result in increased uptake and improved patient outcomes. Understanding end-user experiences and perceptions about the co-production of knowledge is useful to further the science of integrated knowledge translation (iKT) - a strategy for accelerating the uptake and impact of research. Our study had two main objectives: (1) explore end-user (clinician) experiences of co-producing an evidence-based practice tool; and (2) describe end-user perceptions in knowledge development. METHODS: We used a qualitative study design. We conducted semi-structured interviews with clinicians and used a transcendental phenomenological approach to analyze themes/phenomena. In addition, we explored the interrelated themes between the thematic maps of each objective. RESULTS: Four themes emerged from clinicians' experiences in co-producing the practice tool: ease/convenience of participating, need for support and encouragement, understanding the value of participating, and individual skillsets yield meaningful contributions. Stakeholder roles in knowledge tool development and improving dissemination of evidence and knowledge tools were themes that related to clinician perceptions in knowledge development. The review of interrelated thematic maps depicts an intertwined relationship between stakeholders and dissemination. CONCLUSIONS: End-users provide invaluable insight and perspective into the development of evidence-based clinical tools. Exploring the experiences and perceptions of end-users may support future research endeavours involving iKT, such as the co-production of clinical resources, potentially improving uptake and patient health outcomes.


Assuntos
Terapia Comportamental , Pesquisa Médica Translacional , Humanos , Percepção , Pesquisa Qualitativa
3.
Nutrients ; 13(7)2021 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-34371989

RESUMO

Currently, one of the main public health problems among children and adolescents is poor adherence to healthy habits, leading to increasingly high rates of obesity and the comorbidities that accompany obesity. Early interventions are necessary, and among them, the use of gamification can be an effective method. The objective was to analyse the effect of game-based interventions (gamification) for improving nutritional habits, knowledge, and changes in body composition. A systematic review and meta-analysis were performed in CINAHL, EMBASE, LILACS, MEDLINE, SciELO, and Scopus databases, following the PRISMA recommendations. There was no restriction by year of publication or language. Only randomized controlled trials were included. Twenty-three articles were found. After the intervention, the consumption of fruit and vegetables increased, as well as the knowledge on healthy food groups. The means difference showed a higher nutritional knowledge score in the intervention group 95% CI 0.88 (0.05-1.75). No significant effect of gamification was found for body mass index z-score. Gamification could be an effective method to improve nutritional knowledge about healthier nutritional habits. Promoting the development of effective educational tools to support learning related to nutrition is necessary in order to avoid and prevent chronic diseases.


Assuntos
Terapia Comportamental/métodos , Dieta Saudável/psicologia , Comportamento Alimentar/psicologia , Jogos de Vídeo/psicologia , Adolescente , Comportamento do Adolescente/psicologia , Composição Corporal , Criança , Comportamento Infantil/psicologia , Pré-Escolar , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Obesidade Pediátrica/prevenção & controle
4.
J Gerontol Nurs ; 47(9): 21-30, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34432573

RESUMO

Despite the high prevalence and negative outcomes associated with poorly managed dementia-related behavioral expressions (BE) during hospitalization, evidence-based interventions for BE management in acute care environments are lacking. To address this gap, we designed, implemented, and evaluated feasibility, utility, and exploratory nurse and patient outcomes associated with a low-cost, nurse-led multicomponent decision support intervention-the Personalized Approach and Targeted Interventions (PROACTIVE) Treatment Approach-which was implemented as a quality improvement program and evaluated with a historical matched comparison group. The intervention was feasibly implemented and improved nurse-sensitive outcomes (stress, confidence), practices (use of nonpharmacological approaches) for BE management, and perceived utility of intervention resources. Patients receiving the PROACTIVE Treatment Approach (N = 40) had higher rates of acetaminophen use, and shorter lengths of stay (N = 40). More rigorous evaluation is needed to better determine optimal implementation strategies and intervention impact. [Journal of Gerontological Nursing, 47(9), 21-30.].


Assuntos
Demência , Enfermagem Geriátrica , Idoso , Terapia Comportamental , Demência/terapia , Hospitalização , Humanos , Melhoria de Qualidade
5.
Behav Cogn Psychother ; 49(5): 569-581, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34396942

RESUMO

BACKGROUND: Despite increased research interest in smartphone mental health applications (MHapps), few studies have examined user engagement and its determinants. MoodMission is a MHapp that targets low mood and anxiety via evidence-based techniques including behavioural activation (BA). AIMS: The present study aimed to investigate (i) whether BA interventions delivered with visual psychoeducation had greater engagement than BA interventions delivered with solely written psychoeducation, (ii) whether BA interventions targeting mastery would have greater engagement than those targeting pleasure, and (iii) the relationship between level of engagement and MHapp benefit. METHOD: Participants downloaded MoodMission and completed activities and within-app evaluations over a 30-day period. Data from 238 MoodMission users were analysed via multi-level modelling and linear regression. RESULTS: The average number of app-based activities completed was 5.46 and the average self-reported engagement level was in the low to moderate range. As hypothesized, higher levels of engagement significantly predicted more positive activity appraisal. CONCLUSIONS: The results suggest that BA technique beliefs are involved in MHapp engagement and future research examining user appraisals of techniques is warranted.


Assuntos
Aplicativos Móveis , Smartphone , Ansiedade , Terapia Comportamental , Depressão , Humanos
6.
J Health Care Poor Underserved ; 32(3): 1096-1101, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34421014

RESUMO

Psychologists housed in two family medicine residency clinics located in underserved communities quickly transitioned their mode of psychotherapy from in-person to completely virtual at the beginning of the COVID-19 pandemic. We share numerous successes and advantages of a telehealth model in serving our community and describe challenges we have encountered.


Assuntos
Controle de Doenças Transmissíveis , Área Carente de Assistência Médica , Psicoterapia , Telemedicina , Terapia Comportamental , COVID-19/epidemiologia , COVID-19/prevenção & controle , Humanos , Minnesota/epidemiologia , Pandemias , Comunicação por Videoconferência
7.
Obstet Gynecol Surv ; 76(8): 493-503, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34449852

RESUMO

Importance: Ten years have passed since the Institute of Medicine (IOM) released its recommendations for gestational weight gain (GWG), based on a woman's prepregnancy body mass index. Despite this, the majority of women do not gain the appropriate gestational weight; most women gain too much weight, and a small but substantial number gain too little. Objective: We review the literature concerning GWG, the opinions and practices of clinicians in managing their patients' weight, and how these practices are perceived by patients. We also review several randomized control trials that investigate the efficacy of clinical intervention in managing GWG. Evidence Acquisition: A literature review search was conducted with no limitations on the number of years searched. Results: The number of clinicians who are aware of and use the IOM recommendations has increased, but the prevalence of inappropriate GWG has not decreased. Clinicians report feeling less than confident in their ability to have an impact on their patients' weight gain, and there are discrepancies between what clinicians and patients report regarding counseling. Many randomized control trials demonstrate a beneficial impact of clinical intervention, highlighting the importance of collaboration and technology to provide educational information and support throughout a pregnancy. Conclusions: Pregnancy provides an opportunity for clinicians to have open and direct conversations with their patients about their weight. Providing clinicians with the tools, skillset, and confidence to assist in the management of GWG is essential to the health of women and their children, and warrants further investigation.


Assuntos
Gerenciamento Clínico , Ganho de Peso na Gestação , Papel do Médico , Guias de Prática Clínica como Assunto/normas , Terapia Comportamental , Aconselhamento , Grupos Étnicos , Feminino , Humanos , National Academies of Science, Engineering, and Medicine, U.S., Health and Medicine Division , Gravidez , Fatores Raciais , Tecnologia , Estados Unidos/epidemiologia
8.
J Pak Med Assoc ; 71(7): 1900-1901, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34410271

RESUMO

Obesity has reached pandemic proportions globally and its management requires a multipronged approach to ensure an effectual and sustainable response. Integrating behavioural therapy is an important component in obesity management and would often lead to improvement in the quality of care provided to patients with obesity. Though important, it is often complex and difficult to administer in a busy outpatient department. We propose a Motivation-Opportunity-Capability(MOC) model, using Michie et al's COM-B ideation as an inspiration. This provides a simple framework to understand the behaviour of a patient with obesity and suggest therapeutic strategies more likely to be effective in a person centric manner. Integration of the MOC model in existing obesity management protocols would further help in improving outcomes of therapy and help in providing sustained weight loss.


Assuntos
Motivação , Manejo da Obesidade , Terapia Comportamental , Humanos , Obesidade/terapia , Assistência Centrada no Paciente
9.
J Fam Pract ; 70(4): 189-204, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-34339362

RESUMO

The Task Force has expanded the age range for screening for hepatitis C virus infection in adolescents and adults, and now endorses behavioral counseling for all adults with any CVD risk factors.


Assuntos
Terapia Comportamental/normas , Doenças Cardiovasculares/prevenção & controle , Doenças Cardiovasculares/terapia , Hepatite C/diagnóstico , Programas de Rastreamento/normas , Guias de Prática Clínica como Assunto , Medicina Preventiva/normas , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Estados Unidos , Adulto Jovem
10.
Dev Psychol ; 57(7): 1025-1041, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34435820

RESUMO

We extend decades of research on infants' visual processing by examining their eye gaze during viewing of natural scenes. We examined the eye movements of a racially diverse group of 4- to 12-month-old infants (N = 54; 27 boys; 24 infants were White and not Hispanic, 30 infants were African American, Asian American, mixed race and/or Hispanic) as they viewed images selected from the MIT Saliency Benchmark Project. In general, across this age range infants' fixation distributions became more consistent and more adult-like, suggesting that infants' fixations in natural scenes become increasingly more systematic. Evaluation of infants' fixation patterns with saliency maps generated by different models of physical salience revealed that although over this age range there was an increase in the correlations between infants' fixations and saliency, the amount of variance accounted for by salience actually decreased. At the youngest age, the amount of variance accounted for by salience was very similar to the consistency between infants' fixations, suggesting that the systematicity in these youngest infants' fixations was explained by their attention to physically salient regions. By 12 months, in contrast, the consistency between infants was greater than the variance accounted for by salience, suggesting that the systematicity in older infants' fixations reflected more than their attention to physically salient regions. Together these results show that infants' fixations when viewing natural scenes becomes more systematic and predictable, and that predictability is due to their attention to features other than physical salience. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Fixação Ocular , Percepção Visual , Adulto , Idoso , Terapia Comportamental , Cognição , Movimentos Oculares , Humanos , Lactente , Masculino
11.
BMC Health Serv Res ; 21(1): 890, 2021 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-34461892

RESUMO

BACKGROUND: Older patients are at severe risk of harm from medicines following a hospital to home transition. Interventions aiming to support successful care transitions by improving medicines management have been implemented. This study aimed to explore which behavioural constructs have previously been targeted by interventions, which individual behaviour change techniques have been included, and which are yet to be trialled. METHOD: This study mapped the behaviour change techniques used in 24 randomised controlled trials to the Behaviour Change Technique Taxonomy. Once elicited, techniques were further mapped to the Theoretical Domains Framework to explore which determinants of behaviour change had been targeted, and what gaps, if any existed. RESULTS: Common behaviour change techniques used were: goals and planning; feedback and monitoring; social support; instruction on behaviour performance; and prompts/cues. These may be valuable when combined in a complex intervention. Interventions mostly mapped to between eight and 10 domains of the Theoretical Domains Framework. Environmental context and resources was an underrepresented domain, which should be considered within future interventions. CONCLUSION: This study has identified behaviour change techniques that could be valuable when combined within a complex intervention aiming to support post-discharge medicines management for older people. Whilst many interventions mapped to eight or more determinants of behaviour change, as identified within the Theoretical Domains Framework, careful assessment of the barriers to behaviour change should be conducted prior to intervention design to ensure all appropriate domains are targeted.


Assuntos
Assistência ao Convalescente , Transferência de Pacientes , Idoso , Terapia Comportamental , Humanos , Alta do Paciente , Atenção Primária à Saúde , Ensaios Clínicos Controlados Aleatórios como Assunto
12.
Artigo em Inglês | MEDLINE | ID: mdl-34444471

RESUMO

Complex transportation systems often produce combined exposure to aircraft and road noise. Depending on the noise source, the annoyance response is different, and a masking effect occurs between the noise sources within the combined noise. Considering these characteristics, partial loudness was adopted to evaluate noise annoyance. First, a partial loudness model incorporating binaural inhibition was proposed and validated. Second, short- and long-term annoyance models were developed using partial loudness. Finally, the annoyance of combined noise was visualized as a map. These models can evaluate the annoyance by considering both the intensity and frequency characteristics of the noise. In addition, it is possible to quantify the masking effect that occurs between noise sources. Combined noise annoyance maps depict the degree of annoyance of residents and show the background noise effect, which is not seen on general noise maps.


Assuntos
Ruído dos Transportes , Aeronaves , Terapia Comportamental , Exposição Ambiental , Ruído dos Transportes/efeitos adversos
13.
BMC Musculoskelet Disord ; 22(1): 669, 2021 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-34372822

RESUMO

BACKGROUND: The National Institute for Health and Care Excellence recommends the use of digital and mobile health technologies to facilitate behaviour change interventions. Due to its high prevalence and dependence upon patient self-management strategies, osteoarthritis is one musculoskeletal condition which may benefit from such approaches. This is particularly pertinent due to the increasing use of remote monitoring technologies to collect patient data and facilitate self-management in individuals outside of hospital clinics. In practice however, application of digital behaviour change interventions is difficult due to insufficient reporting of behaviour change theories in the current literature. When digital technologies are employed to alter behaviour change in osteoarthritis, they often focus on physical activity. Currently, such interventions focus of self-efficacy but do not often explicitly report the behaviour change techniques they use to facilitate these changes. METHODS: This paper proposes a new model of integrating specific behaviour change principles (persuasive design) in an integrated model of remote monitoring and digital behaviour change interventions for osteoarthritis. RESULTS: There is potential to combine remote monitoring systems of patient data through digital and mobile technologies with behaviour change principles to improve physical activity behaviours in individuals with osteoarthritis. The use of persuasive design principles (e.g. prompts or nudges) through mobile notifications and strategic system design can be directed to enhance behaviour change. A validated measure of behaviour change, such as the patient activation measure, will allow effective evaluation of such systems. CONCLUSIONS: Digital behaviour change interventions should be directed towards the underlying principles of behaviour change they employ, although this is not commonly reported in practice. Such interventions can be integrated within remote monitoring pathways using persuasive design techniques to enhance patient activation. This approach can enhance self-management in individuals with musculoskeletal conditions, such as osteoarthritis.


Assuntos
Osteoartrite , Autogestão , Telemedicina , Terapia Comportamental , Exercício Físico , Humanos , Osteoartrite/diagnóstico , Osteoartrite/terapia
14.
BMJ ; 374: n1840, 2021 08 17.
Artigo em Inglês | MEDLINE | ID: mdl-34404631

RESUMO

OBJECTIVE: To determine if the characteristics of behavioural weight loss programmes influence the rate of change in weight after the end of the programme. DESIGN: Systematic review and meta-analysis. DATA SOURCES: Trial registries, 11 electronic databases, and forward citation searching (from database inception; latest search December 2019). Randomised trials of behavioural weight loss programmes in adults with overweight or obesity, reporting outcomes at ≥12 months, including at the end of the programme and after the end of the programme. REVIEW METHODS: Studies were screened by two independent reviewers with discrepancies resolved by discussion. 5% of the studies identified in the searches met the inclusion criteria. One reviewer extracted the data and a second reviewer checked the data. Risk of bias was assessed with Cochrane's risk of bias tool (version 1). The rate of change in weight was calculated (kg/month; converted to kg/year for interpretability) after the end of the programme in the intervention versus control groups by a mixed model with a random intercept. Associations between the rate of change in weight and prespecified variables were tested. RESULTS: Data were analysed from 249 trials (n=59 081) with a mean length of follow-up of two years (longest 30 years). 56% of studies (n=140) had an unclear risk of bias, 21% (n=52) a low risk, and 23% (n=57) a high risk of bias. Regain in weight was faster in the intervention versus the no intervention control groups (0.12-0.32 kg/year) but the difference between groups was maintained for at least five years. Each kilogram of weight lost at the end of the programme was associated with faster regain in weight at a rate of 0.13-0.19 kg/year. Financial incentives for weight loss were associated with faster regain in weight at a rate of 1-1.5 kg/year. Compared with programmes with no meal replacements, interventions involving partial meal replacements were associated with faster regain in weight but not after adjustment for weight loss during the programme. Access to the programme outside of the study was associated with slower regain in weight. Programmes where the intensity of the interaction reduced gradually were also associated with slower regain in weight in the multivariable analysis, although the point estimate suggested that the association was small. Other characteristics did not explain the heterogeneity in regain in weight. CONCLUSION: Faster regain in weight after weight loss was associated with greater initial weight loss, but greater initial weight loss was still associated with reduced weight for at least five years after the end of the programme, after which data were limited. Continued availability of the programme to participants outside of the study predicted a slower regain in weight, and provision of financial incentives predicted faster regain in weight; no other clear associations were found. STUDY REGISTRATION: PROSPERO CRD42018105744.


Assuntos
Terapia Comportamental/métodos , Trajetória do Peso do Corpo , Obesidade/terapia , Sobrepeso/terapia , Programas de Redução de Peso/métodos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/fisiopatologia , Sobrepeso/fisiopatologia , Avaliação de Programas e Projetos de Saúde , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento , Perda de Peso
15.
Nutrients ; 13(7)2021 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-34210069

RESUMO

The purpose of this study was to conduct in-depth individual interviews with 30 African American adolescents with overweight and obesity and their families (caregiver/adolescent dyads) to gain a better understanding of how to integrate stress and coping essential elements into an existing family-based health promotion program for weight loss. Interview data from 30 African American adolescents with overweight and obesity (Mage = 15.30 ± 2.18; MBMI%-ile = 96.7 ± 3.90) were transcribed and coded for themes using inductive and deductive approaches by two independent coders. Inter-rater reliability was acceptable (r = 0.70-0.80) and discrepancies were resolved to 100% agreement. The themes were guided by the Relapse Prevention Model, which focuses on assessing barriers of overall coping capacity in high stress situations that may undermine health behavior change (physical activity, diet, weight loss). Prominent themes included feeling stressed primarily in response to relationship conflicts within the family and among peers, school responsibilities, and negative emotions (anxiety, depression, anger). A mix of themes emerged related to coping strategies ranging from cognitive reframing and distraction to avoidant coping. Recommendations for future programs include addressing sources of stress and providing supportive resources, as well as embracing broader systems such as neighborhoods and communities. Implications for future intervention studies are discussed.


Assuntos
Adaptação Psicológica , Comportamento do Adolescente/psicologia , Afro-Americanos/psicologia , Obesidade Pediátrica/psicologia , Estresse Psicológico/psicologia , Adolescente , Terapia Comportamental , Criança , Dieta/psicologia , Família/psicologia , Relações Familiares/psicologia , Feminino , Comportamentos Relacionados com a Saúde , Promoção da Saúde/métodos , Humanos , Masculino , Obesidade Pediátrica/terapia , Pesquisa Qualitativa , Ensaios Clínicos Controlados Aleatórios como Assunto , Programas de Redução de Peso
17.
Nutrients ; 13(6)2021 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-34203025

RESUMO

Clinical decision support systems (CDSS) are data aggregation tools based on computer technology that assist clinicians to promote healthy weight management and prevention of cardiovascular diseases. We carried out a randomised controlled 3-month trial to implement lifestyle modifications in breast cancer (BC) patients by means of CDSS during the COVID-19 pandemic. In total, 55 BC women at stages I-IIIA were enrolled. They were randomly assigned either to Control group, receiving general lifestyle advice (n = 28) or the CDSS group (n = 27), to whom the CDSS provided personalised dietary plans based on the Mediterranean diet (MD) together with physical activity guidelines. Food data, anthropometry, blood markers and quality of life were evaluated. At 3 months, higher adherence to MD was recorded in the CDSS group, accompanied by lower body weight (kg) and body fat mass percentage compared to control (p < 0.001). In the CDSS arm, global health/quality of life was significantly improved at the trial endpoint (p < 0.05). Fasting blood glucose and lipid levels (i.e., cholesterol, LDL, triacylglycerols) of the CDSS arm remained unchanged (p > 0.05) but were elevated in the control arm at 3 months (p < 0.05). In conclusion, CDSS could be a promising tool to assist BC patients with lifestyle modifications during the COVID-19 pandemic.


Assuntos
Neoplasias da Mama , COVID-19 , Sistemas de Apoio a Decisões Clínicas , Dieta Mediterrânea , Estilo de Vida , Obesidade/prevenção & controle , Pandemias , Tecido Adiposo/metabolismo , Adulto , Terapia Comportamental , Glicemia/metabolismo , Índice de Massa Corporal , Peso Corporal , LDL-Colesterol/sangue , Feminino , Nível de Saúde , Humanos , Pessoa de Meia-Idade , Obesidade/etiologia , Cooperação do Paciente , Qualidade de Vida , SARS-CoV-2 , Triglicerídeos/sangue
18.
JMIR Mhealth Uhealth ; 9(7): e29689, 2021 07 14.
Artigo em Inglês | MEDLINE | ID: mdl-34259639

RESUMO

BACKGROUND: There is a robust market for mobile health (mHealth) apps focused on self-guided interventions to address a high prevalence of mental health disorders and behavioral health needs in the general population. Disseminating mental health interventions via mHealth technologies may help overcome barriers in access to care and has broad consumer appeal. However, development and testing of mental health apps in formal research settings are limited and far outpaced by everyday consumer use. In addition to prioritizing efficacy and effectiveness testing, researchers should examine and test app design elements that impact the user experience, increase engagement, and lead to sustained use over time. OBJECTIVE: The aim of this study was to evaluate the objective and subjective quality of apps that are successful across both research and consumer sectors, and the relationships between objective app quality, subjective user ratings, and evidence-based behavior change techniques. This will help inform user-centered design considerations for mHealth researchers to maximize design elements and features associated with consumer appeal, engagement, and sustainability. METHODS: We conducted a user-centered design analysis of popular consumer apps with scientific backing utilizing the well-validated Mobile Application Rating Scale (MARS). Popular consumer apps with research support were identified via a systematic search of the App Store iOS (Apple Inc) and Google Play (Google LLC) and literature review. We evaluated the quality metrics of 19 mental health apps along 4 MARS subscales, namely, Engagement, Functionality, Aesthetics, and Information Quality. MARS total and subscale scores range from 1 to 5, with higher scores representing better quality. We then extracted user ratings from app download platforms and coded apps for evidence-based treatment components. We calculated Pearson correlation coefficients to identify associations between MARS scores, App Store iOS/Google Play consumer ratings, and number of evidence-based treatment components. RESULTS: The mean MARS score was 3.52 (SD 0.71), consumer rating was 4.22 (SD 0.54), and number of evidence-based treatment components was 2.32 (SD 1.42). Consumer ratings were significantly correlated with the MARS Functionality subscale (r=0.74, P<.001), Aesthetics subscale (r=0.70, P<.01), and total score (r=0.58, P=.01). Number of evidence-based intervention components was not associated with MARS scores (r=0.085, P=.73) or consumer ratings (r=-0.329, P=.16). CONCLUSIONS: In our analysis of popular research-supported consumer apps, objective app quality and subjective consumer ratings were generally high. App functionality and aesthetics were highly consistent with consumer appeal, whereas evidence-based components were not. In addition to designing treatments that work, we recommend that researchers prioritize aspects of app design that impact the user experience for engagement and sustainability (eg, ease of use, navigation, visual appeal). This will help translate evidence-based interventions to the competitive consumer app market, thus bridging the gap between research development and real-world implementation.


Assuntos
Aplicativos Móveis , Telemedicina , Terapia Comportamental , Estética , Humanos , Saúde Mental
19.
Artigo em Inglês | MEDLINE | ID: mdl-34299931

RESUMO

This review aimed to identify the behavioral change techniques (BCTs) used in behavioral interventions for tobacco cessation at dental practices in relation to their effect on tobacco use. Six scientific databases were searched for behavior change interventions for tobacco cessation and were coded using the BCT taxonomy of behavioral support for smoking cessation (BCTTsm). Fifteen interventions were identified, and data related to intervention characteristics were abstracted. Sixteen BCTs were identified, mainly related to increased motivation and teaching regulatory skills. Goal setting was the most commonly used BCT. Ten out of fifteen interventions effectively impacted tobacco cessation outcomes (OR = 2 to 5.25). Effective interventions more frequently included goal setting, written materials, readiness to quit and ability assessment, tobacco-use assessment, self-efficacy boost, listing reasons for quitting, action planning and environment restructuring. Other BCTs were not clearly associated with an increased effect. Among the behavioral interventions, certain techniques were associated with successful tobacco quitting. Tobacco cessation interventions in a dental setting appear to benefit from using BCTs that increase motivation and teach regulatory skills. The identified BCTs in this review could provide a source to better inform researchers and dentists about the active ingredients in behavior change interventions for tobacco cessation in a dental setting.


Assuntos
Abandono do Hábito de Fumar , Abandono do Uso de Tabaco , Terapia Comportamental , Humanos , Motivação , Saúde Bucal
20.
Artigo em Inglês | MEDLINE | ID: mdl-34299700

RESUMO

In recent years, the relevance of eHealth interventions has become increasingly evident. However, a sequential procedural application to cocreating eHealth interventions is currently lacking. This paper demonstrates the implementation of a participatory design (PD) process to inform the design of an eHealth intervention aiming to enhance well-being. PD sessions were conducted with 57 people across four sessions. Within PD sessions participants experienced prototype activities, provided feedback and designed program interventions. A 5-week eHealth well-being intervention focusing on lifestyle, habits, physical activity, and meditation was proposed. The program is suggested to be delivered through online workshops and online community interaction. A five-step PD process emerged; namely, (1) collecting best practices, (2) participatory discovery, (3) initial proof-of-concept, (4) participatory prototyping, and (5) pilot intervention proof-of-concept finalisation. Health professionals, behaviour change practitioners and program planners can adopt this process to ensure end-user cocreation using the five-step process. The five-step PD process may help to create user-friendly programs.


Assuntos
Telemedicina , Terapia Comportamental , Pessoal de Saúde , Humanos
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