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Background: Tele-oncology became a widely used tool during the COVID-19 pandemic, but there was limited understanding of how patient-clinician communication occurred using the technology. Our goal was to identify how communication transpired during tele-oncology consultations compared with in-person appointments. Methods: A convergent parallel mixed-method design was utilized for the web-based survey, and follow-up interviews were conducted with cancer patients from March to December 2020. Participants were recruited from the University of Florida Health Cancer Center and two national cancer organizations. During the survey, participants rated their clinician's patient-centered communication behaviors. Open-ended survey responses and interview data were combined and analyzed thematically using the constant comparative method. Results: A total of 158 participants completed the survey, and 33 completed an interview. Ages ranged from 19 to 88 years (mean = 64.2; standard deviation = 13.0); 53.2% identified as female and 44.9% as male. The majority of respondents (76%) considered communication in tele-oncology equal to in-person visits. Preferences for tele-oncology included the ability to get information from the clinician, with 13.5% rating tele-oncology as better than in-person appointments. Tele-oncology was considered worse than in-person appointments for eye contact (n = 21, 12.4%) and virtual waiting room times (n = 50, 29.4%). The following qualitative themes corresponded with several quantitative variables: (1) commensurate to in-person appointments, (2) uncertainty with the digital platform, (3) lack of a personal connection, and (4) enhanced patient experience. Conclusion: Patient-centered communication behaviors were mostly viewed as equally prevalent during tele-oncology and in-person appointments. Addressing the challenges of tele-oncology is necessary to improve the patient experience.
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COVID-19 , Comunicação , Oncologia , Neoplasias , Relações Médico-Paciente , Telemedicina , Humanos , COVID-19/epidemiologia , Feminino , Masculino , Pessoa de Meia-Idade , Idoso , Adulto , Oncologia/organização & administração , Oncologia/métodos , Telemedicina/organização & administração , Idoso de 80 Anos ou mais , Neoplasias/terapia , SARS-CoV-2 , Adulto Jovem , Pandemias , Satisfação do Paciente , Florida , Assistência Centrada no Paciente/organização & administraçãoRESUMO
Secure messaging (SM) is an important aspect of communication for patients with cancer. SM fosters patient-clinician communication and helps patients with symptom management and treatment support. However, patients are uncertain about how to phrase messages appropriately and have expressed the need for guidance. In response, we designed a user-centered, web-based application named SEND The application focuses on specificity, expression, needs, and directness through interactive video tutorials and quizzes. Our objective was to comprehensively evaluate SEND based on its levels of engagement, satisfaction, acceptability, and appropriateness. We recruited 101 patients with various cancer diagnoses to use SEND and then fill out a survey 1 to 2 weeks later about their experience. Patients' mean age was 64 years; most were male (55%), white (83%), diagnosed with cancer in 2020 with high levels of self-efficacy, and 51% had a bachelor's degree or higher. 65% were engaged in the application, and respondents spent an average of 15 min interacting with SEND Satisfaction was 90.4%, 85.4% found it acceptable, and 88.6% appropriate. There were no statistically significant differences across age, sex, race, education, or year of diagnosis. Results underscore the potential of eHealth interventions, like SEND, in enhancing patient-clinician communication in cancer care. By empowering patients with effective message-writing techniques, SEND has the potential to improve the quality of SM, which can lead to faster response times and more patient-centered responses.
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PURPOSE: Patient-centered communication (PCC) in cancer care is helpful to nurture the patient-clinician relationship and respond to patients' emotions. However, it is unknown how PCC is incorporated into electronic patient-clinician communication. METHODS: In-depth, semi-structured qualitative interviews with clinicians were conducted to understand how PCC was integrated into asynchronous communication between patients and clinicians; otherwise, known as secure messaging. The constant comparative method was used to develop a codebook and formulate themes. RESULTS: Twenty clinicians in medical and radiation oncology participated in audio-recorded interviews. Three main themes addressed how clinicians incorporate PCC within messages: (1) being mindful of the patient-clinician relationship, (2) encouraging participation and partnership, and (3) responding promptly suggests accessibility and approachability. Clinicians recommended that patients could craft more effective messages by being specific, expressing concern, needs, and directness, summarized by the acronym S.E.N.D. CONCLUSIONS: Clinicians value secure messaging to connect with patients and demonstrate their accessibility. They acknowledge that secure messaging can influence the patient-clinician relationship and make efforts to include considerate and supportive language. As secure messaging is increasingly relied upon for patient-clinician communication, patients' message quality must improve to assist clinicians in being able to provide prompt responses inclusive of PCC.
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Comunicação , HumanosRESUMO
Secure messaging (SM), asynchronous communication between patients and clinicians, is an increasingly popular tool among patients to contact clinicians about their care. Despite patients' enthusiasm, clinicians have been hesitant to embrace the technology to communicate with patients. Using the theoretical and methodological framework of Grounded Practical Theory (GPT), we analyzed and interpreted clinicians' perceptions, attitudes, and approaches toward SM to communicate with patients. Twenty clinicians in medical oncology and radiation oncology participated in audio-recorded, semi-structured interviews. Findings revealed the problems with using SM, such as difficulty interpreting low-quality messages, the amount of time needed to devote to responding, and its potential to negatively affect the patient-clinician relationship. Techniques employed to manage such problems consisted of using different forms of communication and utilizing messaging to expedite workloads. The philosophical rationale of clinicians toward SM was that it can improve patient care and this form of communication is already embedded within existing patient care. Overall, this article clarifies how clinicians can re-conceptualize how they think about SM so that it becomes a productive, informative, and useful aspect of patient care.
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Comunicação , Oncologia , Atitude , HumanosRESUMO
Background: Coronavirus disease 2019 (COVID-19) immediately impacted patient-clinician communication, particularly in the oncology setting. Relatedly, secure messaging (SM) usage greatly increased, yet it is unknown what was discussed and whether the technology was utilized to disseminate information. Aims: This study aimed at identifying the most frequently discussed topics using SM as well as at understanding how the communication process transpired during the early stages of the pandemic. Materials and Methods: A mixed-methods design was utilized, consisting of a content analysis of more than 4,200 secure messages, aggregated into 1,454 patient-clinician discussions. Data were collected from February 2020 to May 2020. Discussions were from various oncology departments and included physicians, physician assistants, and nurses. Based on the identified categories, a thematic analysis was conducted to understand the nuances occurring within discussions. Results: Out of the 1,454 discussions, 26% (n = 373) related to COVID-19. Of the COVID-19 discussion, the most frequently coded category was "changes, adjustments, and re-arranging care" (65%, n = 241), followed by "risk for COVID-19" (24%, n = 90), "precautions inside the hospital" (18%, n = 66), and "precautions outside the hospital" (14%, n = 52). Natural language processing techniques were used to confirm the validity of the results. Thematic analysis revealed that patients were proactive in rescheduling appointments, expressed anxiety about being immunocompromised, and clinicians were uncertain about providing recommendations related to COVID-19. Conclusions: The COVID-19 outbreak revealed the need for responsive and effective public health communication. The SM can disseminate information from trusted sources, clinicians, but can be better utilized to deliver tailored information for specific patient populations.
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COVID-19 , Médicos , COVID-19/epidemiologia , Comunicação , Humanos , PandemiasRESUMO
BACKGROUND: Patient portals have drawn much attention, as they are considered an important tool for health providers in facilitating patient engagement. However, little is known about whether the intensive use of patient portals contributes to improved management of patients' health in terms of their confidence in acquiring health information and exercising self-care. There is a lack of randomized trials with these outcomes measured both pre- and postadoption of patient portals. OBJECTIVE: The aim of this study was to examine the causal relationship between the usage of patient portals and patients' self-efficacy toward obtaining health information and performing self-care. METHODS: This study was a secondary data analysis that used data from a US national survey, the National Cancer Institute's Health Information National Trends Survey 5 Cycle 1. Patient portal usage frequency was used to define the treatment. Survey items measuring self-efficacy on a Likert-type scale were selected as the main outcomes, including patients' confidence in obtaining health information and performing self-care. To establish causality using survey data, we adopted the instrumental variables method. To determine the direction of the causal relationship in the presence of high-dimensional confounders, we further proposed a novel testing framework that employs conditional independence tests in a directed acyclic graph. The average causal effect was measured using the two-stage least squares regression method. RESULTS: We showed that frequently using patient portals improves patients' confidence in obtaining health information. The estimand of the weighted average causal effect was 0.14 (95% CI 0.06-0.23; P<.001). This means that when increasing the portal usage intensity, for instance, from 1-2 times to 3-5 times per year, the expected average increase in confidence level measured on a Likert-type scale would be 0.14. However, we could not conclusively determine the causal effect between patient portal usage and patients' confidence in exercising self-care. CONCLUSIONS: The results support the use of patient portals and encourage better support and education to patients. The proposed statistical method can be used to exploit the potential of national survey data for causal inference studies.
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Comportamento de Busca de Informação , Portais do Paciente/normas , Autoeficácia , Feminino , Humanos , Masculino , Inquéritos e QuestionáriosRESUMO
BACKGROUND: The promotion of flavors, perceptions of "coolness," and general curiosity are characteristics of electronic nicotine delivery systems (ENDS) that have appealed to young adults. However, little is known about the characteristics of popular social media posts related to ENDS on the social media network, Instagram. Methods: Content analysis was performed using the Content Appealing to Youth (CAY) index. Over 700 posts were collected from August 2019 - December 2019 by searching the Instagram hashtags, #vape and #vapelife. Frequencies and percentages were calculated for each of the six major categories and 35 sub-categories. Results: Nearly all of the images were color photographs and 84% featured an ENDS device (mod) as the focal point. The style of the device was often matte (75%) in only one or two main colors (55%). Warnings about age restrictions and nicotine were included in 28% of images, but commonly used promotional tactics, such as humor, presence of vapor puffs, and flavors were rarely utilized. Conclusions: Instagram posts featuring ENDS are visually appealing and like cigarette packaging, may have the capacity to influence perceptions about the product. Since it is culturally normative for appealing images to be shared on Instagram, greater attention should be placed on media literacy skills to educate young adults about ENDS viewed on social media.
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Sistemas Eletrônicos de Liberação de Nicotina , Mídias Sociais , Produtos do Tabaco , Vaping , Adolescente , Humanos , Nicotina , Adulto JovemRESUMO
Patient-centered communication (PCC) is integral to providing high-quality health care and is recommended to be incorporated during face-to-face consultations. Electronic communication, such as the use of secure messaging (SM) within patient portals, is a popular form of patient-provider communication, but preliminary studies have shown that PCC is rarely utilized by providers in SM. As a consequence, the patient-provider relationship can be negatively affected, especially for cancer patients who have greater electronic health information needs than the general population. Therefore, our objective was to determine the importance of SM to cancer patients and to identify which attributes of PCC are preferred to be incorporated into secure messages. Five focus groups were conducted, comprised of patients with a current or previous cancer diagnosis (three all-female; two all-male). Participants recalled their own experiences and reviewed simulated messages. Three main topics emerged from the thematic analysis: (1) the normalization of SM, (2) SM quality can affect perceptions of care, and (3) patients need guidance. Overall, participants valued the ability to communicate with their care team using SM and indicated that electronic communication may have the potential to have just as big of an impact on a patient's care than in-person communication.
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Neoplasias , Portais do Paciente , Comunicação , Feminino , Grupos Focais , Humanos , Masculino , Assistência Centrada no PacienteRESUMO
Information seeking is an active health behavior that influences cancer fatalism; however, people commonly experience challenges in accessing high-quality and actionable health information that is personally relevant. This is especially common among older and rural adults who have a high cancer risk. The purpose of this study was to examine the theoretical assumption that enhancing perceived confidence to overcome health information seeking challenges will alleviate cancer fatalism. In 2017, 895 adults from a large southeastern medical university's cancer catchment area participated in a random digit dial survey. Participants were Millennials (18-35; 19%), Generation X (36-51; 23%), Baby Boomers (52-70; 40%), and Silent Generation (71-95; 16.9%) who had equal representation across metro (78.9%) and nonmetro (21.1%) counties. Younger generations (Millennials and Generation X) held stronger fatalistic cancer beliefs ("It seems like everything causes cancer," "When I think about cancer, I automatically think about death") than older generations. Most participants believed that precautionary efforts exist to reduce their chances of getting cancer, which was strongest among individuals residing in metro counties. In controlling for generation and geographic residence, individuals who experienced challenges in the process of accessing health information had stronger fatalistic beliefs about cancer prevention; however, this relationship was most pronounced among individuals with confidence to ultimately obtain information that they needed. This study contributes to evidence for health information equity in combatting fatalistic cancer beliefs. Findings have important implications for the optimized dissemination of culturally adapted cancer education and skill-based training to efficiently access and evaluate relevant cancer education.
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Comportamento de Busca de Informação , Neoplasias , Adulto , Comportamentos Relacionados com a Saúde , Conhecimentos, Atitudes e Prática em Saúde , Humanos , População RuralRESUMO
Patient portals are becoming widespread throughout health-care systems. Initial research has demonstrated that they positively impact patient-provider communication and patients' health knowledge, but little is known about the impact of patient portals in the cancer setting, where highly complex and uncertain medical data are available for patients to view. To better understand communicative behaviors and perceptions of the patient portal and how it is utilized in oncology, in-depth, semi-structured interviews were conducted with 48 participants: 35 patients and 13 oncologists. Thematic analysis identified that portals help to enhance participation during in-person consultations, increase patients' self-advocacy, and build rapport with providers. However, patients' comfort level with reviewing information via the portal depended upon the severity of the test. Oncologists worried about patient anxiety and widening health disparities, but acknowledged that the portal can motivate them to expedite communication about laboratory and scan results. As patient portals become more widely used in all medical settings, oncologists should become more engaged with how patients are viewing their medical information and consider the portal within the framework of patient-centered care by valuing patients' communication preferences.
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Comunicação , Oncologia , Portais do Paciente , Relações Médico-Paciente , Adulto , Feminino , Humanos , Entrevistas como Assunto , Masculino , VirginiaRESUMO
Cigarette smoking in the U.S. is declining, but e-cigarette (e-cig) use is rapidly expanding. E-cig brands utilize social media for promotion and have the autonomy to disseminate messages that encourage the use of their products. The current study categorized the most frequent strategies among popular e-cig brands on Twitter. A content analysis of over 1800 tweets was performed based on Philip Morris brand personality characteristics. Most tweets emphasized e-cigs' economic value (24.2%) and normalized their use by portraying e-cigs as "cool" (23.1%). E-cig brands are employing similar strategies as tobacco companies and easily connecting to young adults through social media.
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Sistemas Eletrônicos de Liberação de Nicotina , Marketing , Mídias Sociais/tendências , HumanosRESUMO
BACKGROUND: Legislation mandates that clinicians make patients' medical information available digitally. This has resulted in hurriedly installing patient portals that do not fully meet the needs of patients or clinicians. This study examined a specific portal, MyPreventiveCare (MPC), a patient-centered portal designed to promote preventive care to consumers, to elicit recommendations from patients and clinicians about how it could be more beneficial by uncovering their uses and gratifications (U&G). MATERIALS AND METHODS: In-depth interviews with 31 patients and two clinician focus groups were conducted. Multiple methods were utilized, such as grounded theory coding to develop themes and content analysis to classify responses according to the U&G framework. RESULTS: Four main categories emerged that users desire to be included in health portals: integration with technology (27%), coordination of care (27%), incorporation of lifestyle (26%), and increased control (20%). Additional analysis revealed that health portals are mainly utilized to fulfill cognitive and affective needs, with over 80% of recommendations related to the U&G categories of cognitive and affective needs. Cognitive (60%), affective (21%), social integrative (10%), personal integrative (9%), and tension release (0%). CONCLUSIONS: Portals will continue to evolve and become important health communication tools if they address the user's perspective and are inclusive of new technological advances. Specifically, portals must become more user centric and incorporate aspects of the patients' lifestyle and integrate health information technology.
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Acesso à Informação , Comunicação em Saúde/métodos , Registros de Saúde Pessoal , Portais do Paciente , Satisfação do Paciente , Telemedicina/métodos , Adulto , Feminino , Humanos , Masculino , Informática Médica , Pessoa de Meia-IdadeRESUMO
Once promised to revolutionize health care, patient portals have yet to fully achieve their potential of improving communication between patients and clinicians. In fact, their use can be detrimental to many consumers due to their limited literacy and numeracy skills. This study demonstrates how applying the Centers for Disease Control and Prevention's Clear Communication Index to a patient portal can be used to identify opportunities for better patient communication and engagement. The Clear Communication Index contains 20 scored items grounded in communication science to enhance patients' understanding of health information. The Index was applied to one portal used by over 80,000 patients in 12 primary care practices: MyPreventiveCare. This portal was selected because of its ability to personalize preventive and chronic care information by internally using content featuring health literacy principles and linking patients' externally to trusted materials. Thirty-seven frequently visited portal pages (17 internal and 20 external) were evaluated based on the Index's four main variables. The overall score for the portal was 72%, which falls below the 90% threshold to be considered clear communication. Internal content scored higher than external (75% vs. 69%). Specific changes to improve the score include simpler language, more specific examples, and clearer numerical explanations.
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More than 75,000 health care professionals worldwide share information and discuss treatments on Twitter, making it one of the most popular and influential social media sites for health. This engaging medium has enormous potential for establishing relationships and disseminating information among physicians, their colleagues, and patients. However, little is known about how physicians navigate Twitter and what challenges and benefits come from using the platform. By conducting in-depth interviews with 17 physicians who interact with Twitter at least once per week, it was revealed that physicians overcome concerns of privacy and time constraints to learn and share new research, connect with colleagues, manage online personas, and develop relationships with patients on a new level that goes beyond the typical office visit. Implications include the possibility of enriched patient-provider relationships due to physicians divulging opinions and personal information in a public forum to minimize established power structures and enable better communication. This exploratory study establishes that Twitter is fertile ground for future research to explore how the medium can influence patient behavior, alter attitudes, and influence communication between patients and providers.
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Disseminação de Informação/métodos , Médicos/psicologia , Recompensa , Mídias Sociais/estatística & dados numéricos , Feminino , Humanos , Masculino , PrivacidadeRESUMO
BACKGROUND: Patient portals have yet to achieve their full potential for enhancing health communication and improving health outcomes. Although the Patient Protection and Affordable Care Act in the United States mandates the utilization of patient portals, and usage continues to rise, their impact has not been as profound as anticipated. OBJECTIVE: The objective of our case study was to evaluate how well portals convey information to patients. To demonstrate how multiple methodologies could be used to evaluate and improve the design of patient-centered portals, we conducted an in-depth evaluation of an exemplar patient-centered portal designed to promote preventive care to consumers. METHODS: We used 31 critical incident patient interviews, 2 clinician focus groups, and a thematic content analysis to understand patients' and clinicians' perspectives, as well as theoretical understandings of the portal's use. RESULTS: We gathered over 140 critical incidents, 71.8% (102/142) negative and 28.2% (40/142) positive. Positive incident categories were (1) instant medical information access, (2) clear health information, and (3) patient vigilance. Negative incident categories were (1) standardized content, (2) desire for direct communication, (3) website functionality, and (4) difficulty interpreting laboratory data. Thematic analysis of the portal's immediacy resulted in high scores in the attributes enhances understanding (18/23, 78%), personalization (18/24, 75%), and motivates behavior (17/24, 71%), but low levels of interactivity (7/24, 29%) and engagement (2/24, 8%). Two overarching themes emerged to guide portal refinements: (1) communication can be improved with directness and interactivity and (2) perceived personalization must be greater to engage patients. CONCLUSIONS: Results suggest that simple modifications, such as increased interactivity and personalized messages, can make portals customized, robust, easily accessible, and trusted information sources.
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Registros Eletrônicos de Saúde/estatística & dados numéricos , Comunicação em Saúde/métodos , Portais do Paciente/estatística & dados numéricos , Patient Protection and Affordable Care Act/estatística & dados numéricos , Acesso à Informação , Adolescente , Adulto , Idoso , Feminino , Grupos Focais , Humanos , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
With nearly 30% of the adult U.S. population acting as caregivers for sick, disabled, or elderly family members, it is imperative that caregivers become better equipped to cope with this challenging role. Although caregiving is regarded as an arduous endeavor, caring for an older family member may actually produce positive experiences. This study examines how caregivers use communication as a tool to cope with caring for an older family member. Over a span of 15 months, more than 150 caregiver stories were gathered from AgingCare.com, analyzed thematically, and categorized. The results show that stories utilize emotion-based techniques, including humor (20%), positive framing (16%), and acceptance (11%), to reveal that lasting, meaningful bonds can develop between caregivers and caregivers' relatives. These techniques allow caregivers to redefine their familial role and to find comfort in disheartening situations. Thus, coping is a truly communicative event since emotions can facilitate behaviors directed at ailing family members.
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Adaptação Psicológica , Cuidadores/psicologia , Comunicação , Relações Familiares/psicologia , Idoso , Idoso de 80 Anos ou mais , Emoções , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Papel (figurativo)RESUMO
PURPOSE: Identify how early COVID-19 public health messages incorporated in the tenets of the extended parallel process model (EPPM). SETTING: YouTube videos developed by governmental departments, medical institutions, news organizations, and non-profit organizations in the United States were aggregated. METHOD: This qualitative study conducted a keyword search to identify public service announcements (PSAs). The sample was further refined after searching PSAs that contained fear appeals. A thematic analysis was performed by using the constant comparative method. SAMPLE: A total of forty-three videos was included in the final analysis. RESULT: Two themes emerged regarding messages aimed at arousing the perceived severity of threat. These themes include emphasizing the consequences of being infected and utilizing personal narratives. Perceived susceptibility of threat was aroused by emphasizing that some groups have higher risks than others. Two themes emerged around arousing perceived response efficacy: (1) the authority of professionals; and (2) altruism and personal responsibility. One way was identified to arouse perceived self-efficacy, which is informing the protective measures. CONCLUSION: Multiple strategies were used in PSAs about COVID-19 to arouse fear during the early stages of the pandemic. The utilization of self-efficacy was oversimplified, by not providing details about the rationale for the recommended behavior.
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COVID-19 , Comunicação Persuasiva , Humanos , Estados Unidos , COVID-19/prevenção & controle , Medo , Saúde Pública , Teoria PsicológicaRESUMO
Smartwatches are a type of wearable device that enable continuous monitoring of an individual's activities and critical health metrics. As the number of older adults age 65+ continues to grow in the U.S., so does their usage of smartwatches, making it necessary to understand the real-world uptake and use of these devices to monitor health. In this study, older adults with a relatively high level of education and digital skills were provided with a smartwatch equipped with a mobile application (ROAMM) that was worn for a median of 14 days. Usability surveys were distributed, and a qualitative analysis was performed about participants' experience using the smartwatch and ROAMM application. Constructs from the Technology Acceptance Model and Consolidated Framework for Implementation Research were incorporated into in-depth interviews, which were recorded and transcribed. Data were analyzed using the constant comparative method. Interviews among 30 older adults revealed the following main themes: 1) familiarization with the device and adoption and acceptance, 2) factors encouraging usage, such as a doctor's endorsement or the appeal of tracking one's health, and 3) barriers to usage, such as insufficient education and training and the desire for additional functionality. Overall, participants found the smartwatch easy to use and were likely to continue using the device in a long-term study. Data generated from smartwatches have the potential to engage individuals about their health and could inspire them to participate more actively during clinical encounters.
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Objective: Identify how patients and clinicians incorporate patient-centered communication (PCC) within secure messaging. Methods: A random sample of 199 secure messages from patient portal communication between patients and clinicians were collected and analyzed. Via manual annotation, the task of tagging target words/phrases in text, we identified five components of PCC: information giving, information seeking, emotional support, partnership, and shared decision-making. Textual analysis was also performed to understand the context of PCC expressions within messages. Results: Information-giving was the predominant (n = 346, 68.1%) PCC category used in secure messaging, more than double of the other four PCC codes, information-seeking (n = 82, 16.1%), emotional support (n = 52, 10.2%), shared decision making (n = 5, 1.0%), combined. The textual analysis revealed that clinicians informed patients about appointment reminders and new protocols while patients reminded clinicians about upcoming procedures and outcomes of test results conducted by other clinicians. Although less common, patients expressed statements of concern, uncertainty, and fear; enabling clinicians to provide support. Conclusion: Secure messaging is mainly used for exchanging information, but other aspects of PCC emerge using this channel of communication. Innovation: Meaningful discussions can occur via secure messaging, and clinicians should be mindful of incorporating PCC when communicating with patients through secure messaging.
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BACKGROUND: Early detection of mobility decline is critical to prevent subsequent reductions in quality of life, disability, and mortality. However, traditional approaches to mobility assessment are limited in their ability to capture daily fluctuations that align with sporadic health events. We aim to describe findings from a pilot study of our Real-time Online Assessment and Mobility Monitor (ROAMM) smartwatch application, which uniquely captures multiple streams of data in real time in ecological settings. METHODS: Data come from a sample of 31 participants (Mage = 74.7, 51.6% female) who used ROAMM for approximately 2 weeks. We describe the usability and feasibility of ROAMM, summarize prompt data using descriptive metrics, and compare prompt data with traditional survey-based questionnaires or other established measures. RESULTS: Participants were satisfied with ROAMM's function (87.1%) and ranked the usability as "above average." Most were highly engaged (average adjusted compliance = 70.7%) and the majority reported being "likely" to enroll in a 2-year study (77.4%). Some smartwatch features were correlated with their respective traditional measurements (eg, certain GPS-derived life-space mobility features (r = 0.50-0.51, p < .05) and ecologically measured pain (r = 0.72, p = .01), but others were not (eg, ecologically measured fatigue). CONCLUSIONS: ROAMM was usable, acceptable, and effective at measuring mobility and risk factors for mobility decline in our pilot sample. Additional work with a larger and more diverse sample is necessary to confirm associations between smartwatch-measured features and traditional measures. By monitoring multiple data streams simultaneously in ecological settings, this technology could uniquely contribute to the evolution of mobility measurement and risk factors for mobility loss.