Usability of a mobile application for health professionals in home care services: a user-centered approach.

The use of mobile devices by healthcare professionals has led to rapid growth in the development of mobile healthcare applications designed to improve healthcare services. This study was conducted to assess the acceptability and usability of a mobile application for health professionals in relation to their work in hospitalization at home. A mixed methods approach was used. Acceptance, included the satisfaction of the professionals, attitudes toward using the application, and intention or willingness to continue using the application. Usability tests were performed in laboratory analyzing five controlled clinical tasks, and the interaction of the participants with the mobile application was based on the six basic facial expressions published by the American Psychological Association. Perceived satisfaction was assessed using the computer system usability questionnaire. Thirty-two participants completed the task scenarios and questionnaire. More than 90 per cent of participants were able to complete the tasks with only some difficult with vital signs. Satisfaction had a score of 6.18/7 (SD: 0.76), and recommendation of the mobile application had a score of 6.21/7 (SD: 0.81). This study showed a significant usability and acceptability of this mobile application, in terms of effectiveness, efficiency, and satisfaction.

Correction: Evaluation Criteria for Weight Management Apps: Validation Using a Modified Delphi Process.

[This corrects the article DOI: 10.2196/16899.].

Correction: Assessment of the Efficacy, Safety, and Effectiveness of Weight Control and Obesity Management Mobile Health Interventions: Systematic Review.

[This corrects the article DOI: 10.2196/12612.].

Evaluation Criteria for Weight Management Apps: Validation Using a Modified Delphi Process.

BACKGROUND: The use of apps for weight management has increased over recent years; however, there is a lack of evidence regarding the efficacy and safety of these apps. The EVALAPPS project will develop and validate an assessment instrument to specifically assess the safety and efficacy of weight management apps. OBJECTIVE: The aim of this study was to reach a consensus among stakeholders on a comprehensive set of criteria to guide development of the EVALAPPS assessment instrument. A modified Delphi process was used in order to verify the robustness of the criteria that had been identified through a literature review and to prioritize a set of the identified criteria. METHODS: Stakeholders (n=31) were invited to participate in a 2-round Delphi process with 114 initial criteria that had been identified from the literature. In round 1, participants rated criteria according to relevance on a scale from 0 ("I suggest this criterion is excluded") to 5 ("This criterion is extremely relevant"). A criterion was accepted if the median rating was 4 or higher and if the relative intraquartile range was equal to 0.67 or lower. In round 2, participants were asked about criteria that had been discarded in round 1. A prioritization strategy was used to identify crucial criteria according to (1) the importance attributed by participants (criteria with a mean rating of 4.00 or higher), (2) the level of consensus (criteria with a score of 4 or 5 by at least 80% of the participants). RESULTS: The response rate was 83.9% (26/31) in round 1 and 90.3% (28/31) in round 2. A total of 107 out of 114 criteria (93.9%) were accepted by consensus-105 criteria in round 1 and 2 criteria in round 2. After prioritization, 53 criteria were deemed crucial. These related mainly to the dimensions of security and privacy (13/53, 24.5%) and usability (9/53, 17.0%), followed by activity data (5/53, 9.4%), clinical effectiveness (5/53, 9.4%), and reliability (5/53, 9.4%). CONCLUSIONS: Results confirmed the robustness of the criteria that were identified, with those relating to security and privacy being deemed most relevant by stakeholders. Additionally, a specific set of criteria based on health indicators (activity data, physical state data, and personal data) was also prioritized.

Assessment of the Efficacy, Safety, and Effectiveness of Weight Control and Obesity Management Mobile Health Interventions: Systematic Review.

BACKGROUND: The use of apps to tackle overweight and obesity by tracking physical and dietary patterns and providing recommendations and motivation strategies to achieve personalized goals has increased over recent years. However, evidence of the efficacy, effectiveness, and safety of these apps is severely lacking. OBJECTIVE: The aim of this study was to identify efficacy, safety, and effectiveness criteria used to assess weight control, overweight, and obesity management in mobile health (mHealth) interventions through a systematic review. METHODS: PubMed, PsycINFO, Scopus, UK Trial Database, ClinicalTrials.gov, and the Cochrane Library were surveyed up to May 2018. All types of clinical studies were considered. A total of 2 independent reviewers assessed quality using Scottish Intercollegiate Guidelines Network (SIGN) criteria. Ratings were used to provide an overall score for each study (low, moderate, or high). Data were synthesized in evidence tables. RESULTS: From 233 potentially relevant publications, only 28 studies were included. Of these, 13 (46%) were randomized control trials, 11 were single-arm studies (39%), 3 were nonrandomized controlled trials (11%), and 1 study was a cluster randomized trial (4%). The studies were classified as low (15), high (7), and moderate (6) quality according to SIGN criteria. All studies focused on efficacy, with only 1 trial mentioning safety and another 1 effectiveness. In 11 studies, the apps were used as stand-alone interventions, the others were multicomponent studies that included other tools for support such as sensors or websites. The main management tool included in the apps was feedback messaging (24), followed by goal-setting mechanisms (20) and self-monitoring (19). The majority of studies took weight or body mass index loss as the main outcome (22) followed by changes in physical activity (14) and diet (12). Regarding outputs, usability, adherence, and engagement (17) were the most reported, followed by satisfaction (7) and acceptability (4). CONCLUSIONS: There is a remarkable heterogeneity among these studies and the majority have methodological limitations that leave considerable room for improvement. Further research is required to identify all relevant criteria for assessing the efficacy of mHealth interventions in the management of overweight and obesity. TRIAL REGISTRATION: PROSPERO CRD42017056761; https://tinyurl.com/y2zhxtjx.

Increasing trends of acute myocardial infarction in Spain: the MONICA-Catalonia Study.

AIMS: To assess coronary mortality and morbidity secular trends in Spain. METHODS AND RESULTS: Acute coronary events occurring in both sexes at ages 35-74 years between 1985 and 1997, were monitored in a geographical area of Catalonia, through a population-based registry. Information was collected from annual discharge lists of 78 hospitals and from death certificates, and validated following the methods and quality control of the World Health Organization MONItoring Trends and Determinants in CArdiovascular Disease Project (MONICA). Registration included 19 119 valid events (14 221 in men, 4898 in women) of which 30% were fatal and 41% were definite acute myocardial infarctions. Average attack rates were 315 per 100 000 (95% CI 300-329) and 80 (75-86) in men and women, respectively. Incidence (first-ever event) rates were 209 (194-224) and 56 (52-60) per 100 000. Attack rates increased annually by 2.1% (0.3-4.1) and 1.8% (-0.9 to +4.6). Average 28-day case fatality was 46% (44-47) in men decreasing significantly by 1.4 and 53% (51-55) in women with no change. Fatal trends remained stable. Nationwide morbidity statistics showed similar trends. CONCLUSION: Acute coronary syndromes are rising in Spanish men.

Tendencias de la prevalencia, conocimiento, tratamiento y control de la hipertensión arterial entre 1986 y 1996: estudio monica-cataluña / Trends in prevalence, awareness, treatment and control of arterial hypertension between 1986 and 1996: the MONICA-Catalonia study

FUNDAMENTO: Describir las tendencias temporales de la presión arterial (PA) y de la prevalencia, conocimiento, tratamiento y control de la hipertensión arterial (HTA) entre 1986 y 1996, en el estudio MONICA-Cataluña. SUJETOS Y MÉTODO: Tres exámenes de salud transversales en muestras aleatorias independientes de la población general de 25 a 64 años realizados en 1986-1988, 1990-1992 y 1994-1996 según el protocolo del estudio MONICA de la OMS. La PA se midió dos veces consecutivas con esfigmomanómetro de mercurio de cero aleatorio. RESULTADOS: Se examinaron 2.571, 2.934 y 3.485 individuos en cada examen, representando tasas de respuesta del 74, 67 y 72 por ciento, respectivamente. La media de la PA sistólica (PAS) ajustada por edad descendió 2 y 4 mmHg (p < 0,001), alcanzando 120 y 114 mmHg en 19941996, en varones y mujeres, respectivamente. La PA diastólica (PAD) no varió ni en varones (73-74 mmHg) ni en mujeres (70-71 mmHg). La prevalencia de HTA ( 160/95 mmHg y/o en tratamiento farmacológico) ajustada por edad fue del 8 por ciento (varones) y del 10 por ciento (mujeres) en 1994-1996, y la de HTA ( 140/90 mmHg y/o en tratamiento farmacológico) fue del 15 por ciento en ambos sexos. El conocimiento de la hipertensión (HTA 140/90) aumentó del 67 al 76 por ciento. Los hipertensos tratados aumentaron del 22 al 40 por ciento (varones) y del 44 al 54 por ciento (mujeres). El uso de diuréticos y bloqueadores beta descendió, y aumentó el de inhibidores de la enzima conversiva de la angiotensina (IECA). Al final del período, el 52 por ciento de los hipertensos estaba controlado. La PAS descendió también en los normotensos/as, pero no la PAD. CONCLUSIONES: Entre 1986 y 1996, la prevalencia de HTA en Cataluña permaneció estable, aunque el conocimiento, tratamiento y control mejoraron sustancialmente. La PAS disminuyó, mientras que la PAD no varió (AU)