PositiveLinks and the COVID-19 Response: Importance of Low-Barrier Messaging for PLWH in Non-urban Virginia in a Crisis.

PositiveLinks (PL) is an evidence-based mobile health intervention promoting engagement in care for people living with HIV. PL offers secure, in-app patient-provider messaging. We investigated messaging during the early COVID-19 pandemic, comparing messages exchanged between 01/13/2020 and 03/01/2020 ("Pre-COVID") to messages exchanged between 03/02/2020 and 04/19/2020 ("early COVID") using Poisson regression. We performed qualitative analysis on a subset of messages exchanged between 02/01/2020 and 03/31/2020. Between "Pre-COVID" and "early COVID" periods, weekly member and provider messaging rates increased significantly. Of the messages analyzed qualitatively, most (53.3%) addressed medical topics, and more than a fifth (21.3%) addressed social issues. COVID-related messages often focused on care coordination and risk information; half of COVID messages contained rapport-building. PL patients ("members") and providers used in-app secure messaging to reach out to one another, identifying needs, organizing receipt of healthcare resources, and strengthening patient-care team relationships. These findings underscore the importance of low-barrier messaging during a crisis.

RESUMEN: PositiveLinks (PL) es una intervención de salud móvil basada en evidencia que promueve la participación en la atención de las personas que viven con el VIH. PL ofrece mensajería segura entre paciente y proveedor dentro de la aplicación. Investigamos la mensajería durante la fase temprana de la pandemia de COVID-19, comparando los mensajes intercambiados entre el 13 de enero y el 1 de marzo del 2020 ("pre-COVID") con los mensajes intercambiados entre el 2 de marzo y el 19 de abril del 2020 ("COVID") usando el modelo de regresión de Poisson. Realizamos un análisis cualitativo de un subconjunto de los mensajes intercambiados entre el 1 de febrero y el 31 de marzo del 2020. Entre los períodos "pre-COVID" y "COVID," los índices semanales de mensajes de los miembros y proveedores aumentaron significativamente. De los mensajes analizados cualitativamente, la mayoría (53.3%) abordó temas médicos y más de una quinta parte (21.3%) abordó temas sociales. Los mensajes relacionados con COVID a menudo se centraron en la coordinación de la atención y la información sobre riesgos; la mitad de los mensajes sobre COVID presentó contenido relacionado con el establecimiento de buenas relaciones. Los pacientes de PL ("miembros") y los proveedores utilizaron la mensajería segura dentro de la aplicación para comunicarse entre sí, identificar necesidades, organizar la recepción de recursos de atención médica, y fortalecer las relaciones entre el equipo de atención y el paciente. Este estudio subraya la importancia de facilitar un fácil acceso a la mensajería durante una crisis.

Experiences of health tracking in mobile apps for multiple sclerosis: A qualitative content analysis of user reviews.

BACKGROUND: Mobile health applications (apps) are promising condition self-management tools for people living with multiple sclerosis (MS). However, most existing apps do not include health tracking features. This gap has been raised as a priority research topic, but the development of new self-management apps will require designers to understand the context and needs of those living with MS. Our aim was to conduct a content analysis of publicly available user reviews of existing MS self-management apps to understand desired features and guide the design of future apps. METHODS: We systematically reviewed MS self-management apps which were publicly available in English on the Google Play and iOS app stores. We then conducted sentiment and content analysis of recent user reviews which referenced health tracking and data visualization to understand self-reported experiences and feedback. RESULTS: Searches identified 75 unique apps, of which six met eligibility criteria and had reviews. One hundred and thirty-seven user reviews of these apps were eligible, though most were associated with a single app (n=108). Overall, ratings and sentiment scores skewed highly positive (Median [IQR]: Ratings - 5 [4-5], Sentiment scores - 0.70 [0.44-0.86]), though scores of individual apps varied. Content analysis revealed five themes: reasons for app usage, simple user experience, customization and flexibility, feature requests, and technical issues. Reviewers suggested that app customization, interconnectivity, and consolidated access to desired features should be considered in the design of future apps. User ratings weakly correlated with review sentiment scores (ρ = 0.27 [0.11-0.42]). CONCLUSIONS: Self-tracking options in MS apps are currently limited, though the apps that offer these functions are considered useful by individuals with MS. Additional qualitative research is required to understand how specific app features and opportunities for personalization should be incorporated into new self-management tools for this population.

Health Tracking via Mobile Apps for Depression Self-management: Qualitative Content Analysis of User Reviews.

BACKGROUND: Tracking and visualizing health data using mobile apps can be an effective self-management strategy for mental health conditions. However, little evidence is available to guide the design of mental health-tracking mechanisms. OBJECTIVE: The aim of this study was to analyze the content of user reviews of depression self-management apps to guide the design of data tracking and visualization mechanisms for future apps. METHODS: We systematically reviewed depression self-management apps on Google Play and iOS App stores. English-language reviews of eligible apps published between January 1, 2018, and December 31, 2021, were extracted from the app stores. Reviews that referenced health tracking and data visualization were included in sentiment and qualitative framework analyses. RESULTS: The search identified 130 unique apps, 26 (20%) of which were eligible for inclusion. We included 783 reviews in the framework analysis, revealing 3 themes. Impact of app-based mental health tracking described how apps increased reviewers' self-awareness and ultimately enabled condition self-management. The theme designing impactful mental health-tracking apps described reviewers' feedback and requests for app features during data reporting, review, and visualization. It also described the desire for customization and contexts that moderated reviewer preference. Finally, implementing impactful mental health-tracking apps described considerations for integrating apps into a larger health ecosystem, as well as the influence of paywalls and technical issues on mental health tracking. CONCLUSIONS: App-based mental health tracking supports depression self-management when features align with users' individual needs and goals. Heterogeneous needs and preferences raise the need for flexibility in app design, posing challenges for app developers. Further research should prioritize the features based on their importance and impact on users.

Technological Analysis of the World's Earliest Shamanic Costume: A Multi-Scalar, Experimental Study of a Red Deer Headdress from the Early Holocene Site of Star Carr, North Yorkshire, UK.

Shamanic belief systems represent the first form of religious practice visible within the global archaeological record. Here we report on the earliest known evidence of shamanic costume: modified red deer crania headdresses from the Early Holocene site of Star Carr (c. 11 kya). More than 90% of the examples from prehistoric Europe come from this one site, establishing it as a place of outstanding shamanistic/cosmological significance. Our work, involving a programme of experimental replication, analysis of macroscopic traces, organic residue analysis and 3D image acquisition, metrology and visualisation, represents the first attempt to understand the manufacturing processes used to create these artefacts. The results produced were unexpected--rather than being carefully crafted objects, elements of their production can only be described as expedient.