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Implementation and Evaluation of a Virtual Transitional Care Intervention Using Automated Text Messaging and Virtual Visits after Emergency Department Discharges: A Retrospective Cohort Study. 急诊科出院后使用自动短信和虚拟访问的虚拟过渡护理干预的实施和评估：一项回顾性队列研究。
IF 6.2 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES
JMIR mHealth and uHealth
Pub Date : 2025-10-10 DOI: 10.2196/77973
Grace Lee, Courtenay R Bruce, Tariq Nisar, Brendan M Holderread, Sarah N Pletcher, Ngoc-Anh Anh Nguyen
<p><strong>Background: </strong>Emergency Department (ED) overcrowding and avoidable revisits represent significant challenges for healthcare systems, with approximately 20% of patients returning to the ED within 30 days of discharge. To reduce avoidable acute care use, many health systems have adopted ED-based transitional care interventions (TCIs). Among the most scalable and cost-effective strategies is automated text messaging outreach, which facilitates timely follow-up and reinforces discharge instructions. Despite its promise, evidence supporting this approach remains limited.</p><p><strong>Objective: </strong>(1) Describe the design, implementation, and outcomes of a novel TCI utilizing SMS text messaging and virtual transitional care visits, and (2) assess its effect on unplanned ED revisits for the same presenting complaint as well as subsequent ambulatory follow-up engagement.</p><p><strong>Methods: </strong>This retrospective observational cohort study included patients discharged from four EDs within a single U.S. health system between September 2023 and September 2024. Patients were categorized into two groups based on their engagement with the intervention: (1) the Completed Virtual Transitional Care Visit group (requested, scheduled, and completed a visit) and the (2) Noncompleted Virtual Transitional Care Visit group (requested, scheduled, but did not complete a visit). The primary outcome was spontaneous, unplanned ED revisits within 90 days. Secondary outcomes included outpatient follow-up and time to first outpatient evaluation. Between group differences were assessed using descriptive statistics and multivariable regression models (P < 0.05).</p><p><strong>Results: </strong>Of the 68,115 discharged patients during the study period, 42.7% (29,100) received an automated text for the virtual transitional care program, and 2.9% (853/29,100) accessed the scheduling link. Of these, 56.5% (482/853) requested a virtual transitional care visit, 49.8% (240/482) scheduled an appointment, and 70.0% (168/240) completed the visit (Completed group). Among the 72 Noncompleted patients, 56.9% no-showed, 31.9% canceled, and 11.1% scheduled two appointments but completed neither. Nearly half (48.6%) of the Noncompleted group had an outpatient follow-up, indicating variable engagement. Demographics, comorbidities, and clinical acuity were similar between groups. The Noncompleted group was nearly twice as likely to return to the ED within 90 days (27.8% vs 15.5%; χ²₁=4.20, P=0.04; OR=2.11, 95% CI 1.02-4.33) while the Completed group was more likely to complete outpatient follow-up (48.6% vs 30.0%; χ²₁=6.60, P=0.01; OR=2.17, 95% CI 1.23-3.83). Time to first outpatient visit did not differ significantly between groups (mean = 15.7 days vs. 19.8 days; Δβ = -1.93; 95% CI: -10.09 to 6.42; P = 0.65).</p><p><strong>Conclusions: </strong>A TCI combining automated text messaging with virtual visits was associated with reduced 90-day spontaneous ED revisit
背景：急诊科（ED）过度拥挤和可避免的复诊对医疗保健系统构成了重大挑战，大约20%的患者在出院后30天内返回急诊室。为了减少可避免的急性护理使用，许多卫生系统采用了基于ed的过渡护理干预措施（tci）。最具可扩展性和成本效益的战略之一是自动短信外展，这有助于及时跟进并加强出院指示。尽管前景看好，但支持这种方法的证据仍然有限。目的：(1)描述一种利用短信和虚拟过渡护理就诊的新型TCI的设计、实施和结果；(2)评估其对同一主诉的计划外急诊科就诊以及随后的门诊随访的影响。方法：这项回顾性观察队列研究纳入了2023年9月至2024年9月期间从美国单一卫生系统的四个急诊科出院的患者。根据患者参与干预的程度，将患者分为两组：(1)完成虚拟过渡护理访问组（请求、安排和完成访问）和(2)未完成虚拟过渡护理访问组（请求、安排但未完成访问）。主要结果是90天内自发的、计划外的ED复诊。次要结局包括门诊随访和到首次门诊评估的时间。采用描述性统计和多变量回归模型评估组间差异（P < 0.05）。结果：在研究期间的68,115名出院患者中，42.7%（29,100）收到了虚拟过渡护理计划的自动文本，2.9%（853/29,100）访问了调度链接。其中，56.5%（482/853）要求进行虚拟过渡护理访问，49.8%（240/482）安排了预约，70.0%（168/240）完成了访问（完成组）。在72名未完成的患者中，56.9%的患者未到诊，31.9%的患者取消了预约，11.1%的患者安排了两次预约，但都没有完成。近一半（48.6%）的未完成组进行了门诊随访，表明参与程度不同。两组之间的人口统计学、合并症和临床敏锐度相似。未完成组在90天内返回ED的可能性几乎是其两倍（27.8% vs 15.5%; χ²₁=4.20，P=0.04； OR=2.11, 95% CI 1.02-4.33），而完成组完成门诊随访的可能性更大（48.6% vs 30.0%; χ²₁=6.60，P=0.01； OR=2.17, 95% CI 1.23-3.83）。首次门诊就诊时间组间无显著差异（平均15.7天vs. 19.8天；Δβ = -1.93; 95% CI: -10.09 ~ 6.42; P = 0.65）。结论：TCI结合自动短信和虚拟就诊可减少90天的自发性急诊科就诊和增加门诊随访。虽然干预在参与的患者中显示出显著的临床效益，但较低的初始参与率（2.9%）突出了在实现人口水平影响方面的重大挑战。未来的努力应集中在优化参与患者的护理服务，同时制定战略，扩大项目覆盖更广泛的急诊科出院人群。临床试验:
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引用次数: 0
Wearable Technologies in Head and Neck Oncology: Scoping Review. 头颈部肿瘤可穿戴技术：范围综述。
IF 6.2 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES
JMIR mHealth and uHealth
Pub Date : 2025-10-10 DOI: 10.2196/72372
Matthew Shammas-Toma, Gianluca Sampieri, Michael Xie, Aishwaria Maxwell, Alex Esemezie, Quynh Pham, Joseph A Cafazzo, Philip Wong, C Jillian Tsai, David P Goldstein, John R de Almeida, Ervin Sejdic, Christopher M K L Yao
<p><strong>Background: </strong>Head and neck cancer (HNC) survivors face profound functional and quality-of-life deficits due to disease- and treatment-related sequelae, ranging from mild fatigue to debilitating dysphagia. Wearable technology, by monitoring biometric data such as step counts or providing swallowing biofeedback, offers a unique method for tracking and monitoring the negative effects of HNC.</p><p><strong>Objective: </strong>The aim of this study was to explore the current applications of wearable technology in HNC.</p><p><strong>Methods: </strong>A scoping review was conducted following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. A search strategy was built, and a literature search was performed across 5 databases. The initial search yielded 5256 studies, which underwent a 2-phase screening process: title and abstract review followed by full-text review. Inclusion criteria included peer-reviewed, English-language articles published between January 2002 and April 2024 that used wearable technology in HNC care. After full-text review, 9 studies met the inclusion criteria. Data were manually extracted and synthesized narratively.</p><p><strong>Results: </strong>The included studies examined 3 main types of wearable devices: radioactivity (2 studies), physical activity (4 studies), and throat physiology monitors (3 studies). Radioactivity monitors detected residual radioactivity and thyroidal radioiodine uptake. They demonstrated potential to reduce radioactivity exposure risk and personalize radiation doses for patients with thyroid cancer. Physical activity monitors tracked step counts, heart rate, and sleep habits. Low step counts were significantly associated with increased anxiety, radiation-related toxicity, hospital admission rates, and feeding tube placement. One study also linked poor sleep patterns to declines in quality of life. Throat physiology monitors measured pharyngeal electromyography data as well as extrinsic laryngeal muscle movements. Throat sensors achieved high accuracy in classifying swallowing events and translating muscle movements into speech. While earliest in the development continuum, they are promising tools for swallowing and vocal rehabilitation therapy. Barriers to wearable adoption included wearable discomfort, technical difficulties, and patient withdrawal due to treatment side effects. As the definition of wearable adherence varied widely, we propose that future studies report wearable adherence as "percentage of prescribed wear time achieved" to facilitate cross-study comparisons.</p><p><strong>Conclusions: </strong>Wearable technology may enhance treatment monitoring, prognostication, and rehabilitation in head and neck oncology. Radioactivity and physical activity monitors provide actionable insights for clinical decision-making, while throat physiology monitors offer innovative solutions for speech and swallowing
背景：头颈癌（HNC）幸存者由于疾病和治疗相关的后遗症，从轻度疲劳到衰弱性吞咽困难，面临着严重的功能和生活质量缺陷。可穿戴技术通过监测步数等生物特征数据或提供吞咽生物反馈，为跟踪和监测HNC的负面影响提供了一种独特的方法。目的：本研究旨在探讨可穿戴技术在HNC中的应用现状。方法：根据PRISMA-ScR（系统评价和荟萃分析扩展范围评价的首选报告项目）指南进行范围评价。建立了检索策略，并在5个数据库中进行文献检索。最初的检索产生了5256项研究，这些研究经历了两个阶段的筛选过程：标题和摘要审查，然后是全文审查。纳入标准包括2002年1月至2024年4月期间发表的同行评审的英文文章，这些文章在HNC护理中使用了可穿戴技术。经全文审查，9项研究符合纳入标准。数据由人工提取并以叙述方式合成。结果：纳入的研究检查了3种主要类型的可穿戴设备：放射性（2项研究）、身体活动（4项研究）和喉咙生理监测仪（3项研究）。放射性监测仪检测到残留放射性和甲状腺放射性碘摄取。他们展示了降低放射性暴露风险和个性化甲状腺癌患者辐射剂量的潜力。身体活动监视器跟踪步数、心率和睡眠习惯。低步数与焦虑增加、辐射相关毒性、住院率和喂食管放置显著相关。一项研究还将不良睡眠模式与生活质量下降联系起来。咽喉生理监测测量咽部肌电图数据以及外在喉部肌肉运动。咽喉传感器在分类吞咽事件和将肌肉运动转化为语言方面取得了很高的准确性。虽然在早期的发展过程中，它们是吞咽和声带康复治疗的有希望的工具。采用可穿戴设备的障碍包括可穿戴设备的不适、技术上的困难以及由于治疗副作用导致的患者退出。由于可穿戴依从性的定义差异很大，我们建议未来的研究将可穿戴依从性报告为“达到规定穿着时间的百分比”，以方便交叉研究比较。结论：可穿戴技术可增强头颈部肿瘤患者的治疗监测、预后和康复。放射性和身体活动监测仪为临床决策提供可操作的见解，而喉咙生理监测仪为言语和吞咽治疗提供创新的解决方案。然而，必须解决诸如器械依从性、数据集成和患者舒适度等挑战，以充分发挥其潜力。未来的研究应该优先考虑更大规模的纵向研究，标准化的依从性指标，并考虑整合人工智能来完善预测能力。通过克服这些障碍，可穿戴技术可以改变生存护理，改善HNC患者的功能结果和生活质量。
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引用次数: 0
Use and Application of mHealth Technologies in Perioperative Surgical Care: Narrative Review. 移动健康技术在围手术期外科护理中的使用和应用：叙述性综述。
IF 6.2 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES
JMIR mHealth and uHealth
Pub Date : 2025-10-10 DOI: 10.2196/52206
Maria Camila Sierra, Henry To, Wan Jun Song
<p><strong>Background: </strong>Surgical procedures and their potential complications place substantial strain on patients, clinicians, and health care systems. These strains are driven by the anticipated morbidity and mortality, so that there is resource-intensive postoperative inpatient management. Given the concentration of surgical services within hospital settings, current standard levels of care have limitations such as communication gaps, time lapses before evaluation, and investment of resources, which limit accessibility and generate disparities in delivery of care. However, recent advances in digital health, including telemedicine platforms, mobile health (mHealth), and wearable technologies, present an opportunity to decentralize and extend perioperative care into community settings. This review explored how established mHealth technologies are being integrated into the perioperative pathway and their impact on surgical care delivery and outcomes. It also highlights possible emerging models of remote physician and patient interaction where benefits seem to be outweighing the risks.</p><p><strong>Objective: </strong>The aim of this narrative review was to present collected evidence for the use of established mHealth technologies in the surgical pathway of patients and highlight their readiness and potential in models of standard care.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted across MEDLINE (via PubMed), Web of Science, and Scopus databases between October 2022 and May 2024. Additional sources were identified through reference list screening of relevant systematic reviews. Data were extracted and analyzed based on surgical specialty, type of mHealth intervention, cost-effectiveness, and ethical considerations. Findings were summarized in tables to illustrate key trends and variations across studies. The extracted data were tabulated and described qualitatively to highlight similarities, differences, and possible emerging trends across the studies.</p><p><strong>Results: </strong>A total of 28 articles published between 2008 and 2022 were included for qualitative analysis, with most (n=21, 75%) originating from the United States, Germany, and the United Kingdom. The study designs were predominantly randomized controlled trials (n=9, 32%) and observational studies (n=8, 29%). Collectively, these studies involved 6344 patients undergoing mHealth-based perioperative interventions primarily in general surgery, orthopedics, and oncology. Interventions frequently used smartphones (n=10, 36%) and wearable devices, often in combination with other tracking and measuring systems. Applications included wound monitoring, postoperative follow-up, and patient education. Data collection was multimodal and typically conducted daily, yet only 36% (10/28) of the articles reported defined follow-up periods. Cost-effectiveness was rarely assessed, with only 4% (1/28) of the articles reporting per-patient savings. Overal
背景：外科手术及其潜在的并发症给患者、临床医生和卫生保健系统带来了巨大的压力。这些菌株是由预期的发病率和死亡率驱动的，因此有资源密集型的术后住院管理。鉴于外科手术服务集中在医院内，目前的标准护理水平存在局限性，如沟通差距、评估前的时间间隔和资源投资，从而限制了可及性，并在提供护理方面产生差异。然而，数字卫生领域的最新进展，包括远程医疗平台、移动医疗（mHealth）和可穿戴技术，为将围手术期护理分散并扩展到社区环境提供了机会。本综述探讨了已建立的移动健康技术如何被整合到围手术期途径中，以及它们对手术护理交付和结果的影响。它还强调了可能出现的远程医患互动模式，其中收益似乎大于风险。目的：这篇叙述性综述的目的是为在患者手术路径中使用已建立的移动健康技术提供收集到的证据，并强调它们在标准护理模式中的准备和潜力。方法：在2022年10月至2024年5月期间，对MEDLINE（通过PubMed）、Web of Science和Scopus数据库进行全面的文献检索。通过相关系统评价的参考文献列表筛选确定了其他来源。根据外科专科、移动医疗干预类型、成本效益和伦理考虑因素提取和分析数据。研究结果总结在表格中，以说明各研究的主要趋势和变化。提取的数据被制成表格并定性描述，以突出研究中的相似性、差异性和可能出现的趋势。结果：共纳入2008 - 2022年间发表的28篇文章进行定性分析，其中大部分（n= 21,75%）来自美国、德国和英国。研究设计主要为随机对照试验（n=9, 32%）和观察性研究（n=8, 29%）。总的来说，这些研究涉及6344名接受基于移动健康的围手术期干预的患者，主要是普外科、骨科和肿瘤科。干预措施经常使用智能手机（n=10, 36%）和可穿戴设备，通常与其他跟踪和测量系统相结合。应用包括伤口监测、术后随访和患者教育。数据收集是多模式的，通常每天进行，但只有36%（10/28）的文章报告了明确的随访期。很少评估成本效益，只有4%（1/28）的文章报告了每位患者的节省。总体而言，64%（18/28）的文章由于方法学的限制被评为低质量。结论：基于移动医疗和远程医疗的干预措施通过实现远程监测、患者参与和改善护理连续性，在加强围手术期护理方面显示出前景。未来的研究应侧重于可扩展的实施、真正的成本效益分析、公平获取和融入临床工作流程，以确保在当前的护理模式中广泛适用。
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引用次数: 0
Cerina-Cognitive Behavioral Therapy-Based Mobile App for Managing Generalized Anxiety Disorder Symptoms Among University Students: Results From a Pilot Feasibility Randomized Controlled Trial. 基于cerina -认知行为疗法的移动应用程序管理大学生广泛性焦虑障碍症状：来自一项试点可行性随机对照试验的结果。
IF 6.2 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES
JMIR mHealth and uHealth
Pub Date : 2025-10-09 DOI: 10.2196/70691
Ozlem Eylem-van Bergeijk, Tony Robinson, Matthew Manktelow, Michail Olympios, Siobhan Poulter, Prasannajeet Mane, Maria Panagioti, Joan Condell, Gerard Leavey
<p><strong>Background: </strong>Generalized anxiety disorder (GAD) is common among university students due to academic pressure and financial uncertainty, among other challenges. Despite the need, the receipt of available psychological services is often low.</p><p><strong>Objective: </strong>This study investigates the feasibility of a digital unguided cognitive behavioral therapy (CBT)-based mobile app, Cerina, and examines the likely effects of this intervention in reducing GAD symptoms compared to the waitlist control group.</p><p><strong>Methods: </strong>Eligible students (n=158) with mild to moderate GAD symptoms were self-assessed through web-based questionnaires and were randomly allocated to the intervention group (n=79) or to the waitlist control group (n=79) following their informed consent. The intervention group had direct access to Cerina and followed CBT-based interactive sessions for 6 weeks. The waitlist control group participants had access to optional on-campus well-being services, and they were given access to Cerina 6 weeks after their randomization. Participants completed assessments on anxiety, depression, worry, and usability at three time points. Additionally, upon completing the intervention, they were invited to a web-based interview to understand the implementation of the intervention in more depth.</p><p><strong>Results: </strong>On average, 13% (10/79) intervention group participants dropped out, 61% (36/69) completed the core clinical content (2 sessions), and 12% (7/69) completed the desired number of sessions (6 or 7 sessions). Analyses of the completers (2 or more sessions) revealed significant group differences in GAD (mean 8.4, SD 3.7; t<sub>42</sub>=-2.25; P=.03; d=-0.7) and worry symptoms (mean 42.3, SD 10.8; t<sub>42</sub>=-2.50; P=.02; d=-0.8), as well as functional impairment (mean 16.7, SD 2.44; t<sub>42</sub>=-2.12; P=.04; d=-0.6) in favor of the intervention group at posttest with medium to large effect sizes. The intention-to-treat analyses confirmed significant group differences in GAD (mean 8.47, SD 2.7; t<sub>156</sub>=-2.23; P=.03; d=-0.4), and there were marginally nonsignificant group differences in worry symptoms (mean 41.5, SD 8.40; t<sub>156</sub>=-1.94; P=.05; d=-0.3) in favor of the intervention group at posttest with medium effect sizes. These results suggest that the intervention had a meaningful impact on reducing GAD symptoms and a modest impact on reducing worry symptoms among participants.</p><p><strong>Conclusions: </strong>The Cerina app showed promising results in reducing GAD symptoms among students. This result supports findings from other randomized controlled trials showing that digital CBT-based interventions are effective and feasible for a wide range of age groups and populations experiencing GAD symptoms. The low number of participants completing the recommended number of sessions suggests a usability issue. To address this, the intervention could be refined through an itera
背景：广泛性焦虑障碍（GAD）在大学生中很常见，因为学业压力和经济不确定性以及其他挑战。尽管有这种需要，但现有心理服务的接受率往往很低。目的：本研究探讨了基于数字无指导认知行为疗法（CBT）的移动应用程序Cerina的可行性，并与等待列表对照组相比，研究了这种干预在减轻广泛性焦虑症症状方面的可能效果。方法：通过网络问卷对有轻度至中度广泛性焦虑症症状的符合条件的学生（n=158）进行自我评估，并根据知情同意随机分配到干预组（n=79）或等候名单对照组（n=79）。干预组直接使用Cerina，并进行为期6周的基于cbt的互动会话。等候名单控制组的参与者可以获得可选的校园福利服务，并在随机分组后6周获得Cerina。参与者在三个时间点完成了焦虑、抑郁、担忧和可用性的评估。此外，在完成干预后，他们被邀请参加一个基于网络的访谈，以更深入地了解干预的实施情况。结果：平均13%（10/79）的干预组参与者退出，61%（36/69）的干预组参与者完成了核心临床内容（2次），12%（7/69）的干预组参与者完成了预期的治疗次数（6或7次）。对完成者（2个或更多疗程）的分析显示，干预组在GAD（平均8.4,SD 3.7; t42=-2.25； P= 0.03; d=-0.7）和焦虑症状（平均42.3,SD 10.8; t42=-2.50； P= 0.02; d=-0.8）以及功能障碍（平均16.7,SD 2.44; t42=-2.12； P= 0.04; d=-0.6）方面具有显著的组间差异，后测效果中至大。意向治疗分析证实GAD组间差异显著（平均8.47,SD 2.7; t156=-2.23； P=.03; d=-0.4），焦虑症状组间差异不显著（平均41.5,SD 8.40; t156=-1.94； P=.05; d=-0.3），后测效果中等，有利于干预组。这些结果表明，干预对减轻GAD症状有意义的影响，对减轻参与者的担忧症状有适度的影响。结论：Cerina应用程序在减轻学生GAD症状方面显示出令人鼓舞的效果。这一结果支持了其他随机对照试验的发现，表明基于数字cbt的干预措施对出现广泛性焦虑症症状的广泛年龄组和人群是有效和可行的。完成推荐会话数的参与者数量较少表明存在可用性问题。为了解决这个问题，可以通过用户反馈的迭代设计过程来改进干预措施，并且可以通过扩展评估来评估特定粘性功能在提高可用性和留存率方面的长期影响。试验注册：ClinicalTrials.gov NCT06146530；https://clinicaltrials.gov/study/NCT06146530.International注册报告标识符（irrid）： RR2-10.1136/bmjopen-2023-083554。
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引用次数: 0
Evaluation of Mobile Intermittent Fasting Applications in Chinese App Stores: Quality Evaluations and Content Analysis. 中国应用商店中移动间歇性禁食应用的评价：质量评价和内容分析。
IF 6.2 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES
JMIR mHealth and uHealth
Pub Date : 2025-10-07 DOI: 10.2196/66339
Laihao Fang, Cheng Huang, Bing Lin, Kuanlin Lei, Jiazhen Zhou, Xiaoni Zhong, Yanbing Liu, Jiaxiu Liu

Background: Obesity and related disorders are rising globally, especially in China, where they are linked to chronic diseases like diabetes and cardiovascular issues. As intermittent fasting (IF) gains popularity for weight management, the use of IF apps has increased, yet their quality varies significantly. A systematic evaluation of these apps is essential to assess their effectiveness and reliability.

Objective: This study aimed to conduct a comprehensive evaluation of IF apps available in the Chinese mobile app market. We concentrated on evaluating their features, quality, and overall user experience to help users avoid low-quality options and direct app developers to enhance their offers.

Methods: A systematic search was performed across 5 major app stores in China, including the Apple App Store, Huawei AppGallery, Oppo Software Store, Vivo App Store, and Xiaomi Market. "Fasting", "Intermittent Fasting", "Time-Restricted Feeding", "Time-Restricted Fasting", "Time-Restricted Eating" and "Meal Skipping" were used as keywords to identify relevant apps, which were then screened based on inclusion and exclusion criteria. The evaluation was conducted using the user version of the Mobile Application Rating Scale (uMARS). The uMARS assessment examined 4 key subscales: engagement, functionality, aesthetics, and information. Each app was independently evaluated by 2 raters who underwent uniform training to ensure consistency in scoring.

Results: A total of 35 apps were assessed for the study. These apps mostly contain features such as fasting timer (100.0%), recording weight (97.14%), fasting reminder (85.71%), and recording water intake (85.71%). All of the apps have an obvious privacy protection. Most of the apps (79%) have tools for quantifying users' health status. The results showed that the overall average uMARS score across the apps was 4.35 (SD 0.51). The subscale scores were as follows: engagement 4.42 (SD 0.47), functionality 4.65 (SD 0.31), aesthetics 4.19 (SD 0.64), and information 4.15 (SD 0.58). The functionality subscale had the highest mean score, while the aesthetic subscale showed the greatest range of scores, from 2.17 to 5.00. The overall uMARS score was significantly positively correlated with the subscale scores (r=0.786-0.953, P<.001). The user ratings in the app stores did not significantly correlate with the uMARS overall scores (r=-0.290, P=.091). Strong inter-rater reliability was confirmed by intraclass correlation coefficients (ICC=0.809-0.909 across subscales).

Conclusions: All the apps reveal high overall quality but gaps in professional engagement and social features. Limited clinical input may undermine the evidence-based accuracy and long-term applicability of some apps. Developers are encouraged to collaborate with health care professionals to enhance content reliability and incorporate social features to b

背景：肥胖及相关疾病在全球范围内呈上升趋势，尤其是在中国，肥胖与糖尿病和心血管疾病等慢性疾病有关。随着间歇性禁食（IF）在体重管理方面的普及，间歇性禁食应用程序的使用也在增加，但它们的质量差异很大。对这些应用程序进行系统评估对于评估其有效性和可靠性至关重要。目的：本研究旨在对中国移动应用市场上现有的IF应用进行综合评估。我们专注于评估它们的功能、质量和整体用户体验，以帮助用户避免低质量的选择，并指导应用开发者改善他们的产品。方法：系统搜索中国五大应用商店，包括苹果应用商店、华为应用画廊、Oppo软件商店、Vivo应用商店和小米市场。以“禁食”、“间歇性禁食”、“限时进食”、“限时禁食”、“限时进食”和“不吃饭”作为关键词识别相关应用，然后根据纳入和排除标准对其进行筛选。评估采用用户版移动应用评定量表（uMARS）进行。uMARS评估检查了4个关键子量表：参与度、功能、美学和信息。每个应用程序由2名评分员独立评估，他们接受了统一的培训，以确保评分的一致性。结果：研究共评估了35个应用程序。这些应用程序大多包含禁食计时器（100.0%）、记录体重（97.14%）、禁食提醒（85.71%）和记录饮水量（85.71%）等功能。所有的应用程序都有明显的隐私保护。大多数应用程序（79%）都有量化用户健康状况的工具。结果显示，所有应用程序的总体平均uMARS得分为4.35（标准差为0.51）。子量表得分如下：参与4.42 (SD 0.47)，功能4.65 (SD 0.31)，美学4.19 (SD 0.64)，信息4.15 （SD 0.58）。功能分量表的平均得分最高，而审美分量表的得分范围最大，从2.17到5.00。uMARS总体得分与子量表得分呈显著正相关（r=0.786-0.953）。结论：所有应用程序的整体质量较高，但在专业参与和社交功能方面存在差距。有限的临床输入可能会削弱一些应用程序基于证据的准确性和长期适用性。开发人员被鼓励与医疗保健专业人员合作，以提高内容的可靠性，并结合社交功能来提高用户参与度，同时确保强大的隐私保护和合理使用人工智能。
{"title":"Evaluation of Mobile Intermittent Fasting Applications in Chinese App Stores: Quality Evaluations and Content Analysis.","authors":"Laihao Fang, Cheng Huang, Bing Lin, Kuanlin Lei, Jiazhen Zhou, Xiaoni Zhong, Yanbing Liu, Jiaxiu Liu","doi":"10.2196/66339","DOIUrl":"10.2196/66339","url":null,"abstract":"<p><strong>Background: </strong>Obesity and related disorders are rising globally, especially in China, where they are linked to chronic diseases like diabetes and cardiovascular issues. As intermittent fasting (IF) gains popularity for weight management, the use of IF apps has increased, yet their quality varies significantly. A systematic evaluation of these apps is essential to assess their effectiveness and reliability.</p><p><strong>Objective: </strong>This study aimed to conduct a comprehensive evaluation of IF apps available in the Chinese mobile app market. We concentrated on evaluating their features, quality, and overall user experience to help users avoid low-quality options and direct app developers to enhance their offers.</p><p><strong>Methods: </strong>A systematic search was performed across 5 major app stores in China, including the Apple App Store, Huawei AppGallery, Oppo Software Store, Vivo App Store, and Xiaomi Market. \"Fasting\", \"Intermittent Fasting\", \"Time-Restricted Feeding\", \"Time-Restricted Fasting\", \"Time-Restricted Eating\" and \"Meal Skipping\" were used as keywords to identify relevant apps, which were then screened based on inclusion and exclusion criteria. The evaluation was conducted using the user version of the Mobile Application Rating Scale (uMARS). The uMARS assessment examined 4 key subscales: engagement, functionality, aesthetics, and information. Each app was independently evaluated by 2 raters who underwent uniform training to ensure consistency in scoring.</p><p><strong>Results: </strong>A total of 35 apps were assessed for the study. These apps mostly contain features such as fasting timer (100.0%), recording weight (97.14%), fasting reminder (85.71%), and recording water intake (85.71%). All of the apps have an obvious privacy protection. Most of the apps (79%) have tools for quantifying users' health status. The results showed that the overall average uMARS score across the apps was 4.35 (SD 0.51). The subscale scores were as follows: engagement 4.42 (SD 0.47), functionality 4.65 (SD 0.31), aesthetics 4.19 (SD 0.64), and information 4.15 (SD 0.58). The functionality subscale had the highest mean score, while the aesthetic subscale showed the greatest range of scores, from 2.17 to 5.00. The overall uMARS score was significantly positively correlated with the subscale scores (r=0.786-0.953, P<.001). The user ratings in the app stores did not significantly correlate with the uMARS overall scores (r=-0.290, P=.091). Strong inter-rater reliability was confirmed by intraclass correlation coefficients (ICC=0.809-0.909 across subscales).</p><p><strong>Conclusions: </strong>All the apps reveal high overall quality but gaps in professional engagement and social features. Limited clinical input may undermine the evidence-based accuracy and long-term applicability of some apps. Developers are encouraged to collaborate with health care professionals to enhance content reliability and incorporate social features to b","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"13 ","pages":"e66339"},"PeriodicalIF":6.2,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Tailored mHealth Intervention for Improving Antenatal Care Seeking and Its Determinants Among Pregnant Adolescent Girls and Young Women in South Africa: Pilot Randomized Controlled Trial. 一项针对改善南非怀孕少女和年轻妇女产前保健寻求及其决定因素的量身定制的移动健康干预：试点随机对照试验。
IF 6.2 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES
JMIR mHealth and uHealth
Pub Date : 2025-10-03 DOI: 10.2196/59144
Ronel Sewpaul, Ken Resnicow, Rik Crutzen, Natisha Dukhi, Priscilla Reddy
<p><strong>Background: </strong>Adolescent pregnancy is of public health concern due to high rates of pregnancy-related complications and lower antenatal attendance among adolescent girls and young women. Mobile health (mHealth) interventions have the potential to improve pregnancy health behaviors and thereby birth outcomes.</p><p><strong>Objective: </strong>This pilot randomized controlled trial with pre-post design evaluated user acceptability and preliminary efficacy of an mHealth intervention to improve antenatal appointment attendance and its determinants among pregnant adolescent girls and young women in South Africa.</p><p><strong>Methods: </strong>The "Teen MomConnect" intervention entailed both fixed and 2-way tailored SMS text messages about antenatal appointment keeping and pregnancy health behaviors. The intervention content and functionality were adapted from MomConnect, a national mHealth program that sends fixed SMS text messages to pregnant women in South Africa. Pregnant adolescent girls and young women aged 13-20 years were recruited from health facilities and community networks in Cape Town during May-December 2018. Simple 1:1 randomization was used to allocate participants into the control group that received the standard MomConnect maternal health messages or the experimental group that received the Teen MomConnect intervention. A subset of experimental group participants received an in-person motivational interviewing session. Questionnaires were administered at baseline and after the end of the participants' pregnancies. Appointment attendance data were obtained from clinic records. ANOVA, ANCOVA, and logistic regression models assessed the differences in appointments attended, awareness of HIV status, and the psychosocial determinants of antenatal attendance between the control and experimental groups.</p><p><strong>Results: </strong>Overall, 412 adolescent girls and young women were enrolled, of which 254 (62%) completed the posttest survey (64% control, 59% intervention). Patient record data were obtained for 222 of the 412 (54%; in both control and intervention) participants. A total of 84% (63/75) and 72% (54/75) rated the intervention messages highly regarding their content value and their motivational nature for behavior change, respectively. Participants responded to an average of 20% of the 2-way messages they received. Mean appointment attendance did not differ significantly between the experimental (4.86, SD 1.76) and control (4.79, SD 1.74; P=.79) groups. Appointment attendance was higher among intervention participants who responded to ≥50% of messages ("high-responders"; 5.08, SD 1.66) than intervention participants who responded to fewer messages (4.82, SD 1.79) and control participants (4.79, SD 1.74; P=.86). The mean increase in knowledge scores was significantly higher among experimental group high-responders (2.1, SD 3.17) than the control group (0.7, SD 2.73; β=1.50; P=.045).</p><p><strong>Conclusions:
背景：少女怀孕是一个令人关注的公共卫生问题，因为少女和年轻妇女的妊娠相关并发症发生率高，产前护理率低。移动保健（mHealth）干预措施有可能改善妊娠健康行为，从而改善分娩结果。目的：这项事前设计的随机对照试验评估了南非移动健康干预的用户接受度和初步效果，以提高产前预约出勤率及其在怀孕少女和年轻妇女中的决定因素。方法：“青少年妈妈连接”干预包括固定和双向定制短信产前预约和怀孕健康行为。干预的内容和功能改编自MomConnect，这是一个向南非孕妇发送固定短信的国家移动健康项目。2018年5月至12月期间，从开普敦的卫生机构和社区网络招募了13-20岁的怀孕少女和年轻女性。采用简单的1:1随机分配，将参与者分配到接受标准MomConnect孕产妇健康信息的对照组或接受Teen MomConnect干预的实验组。实验组的一部分参与者接受了面对面的动机访谈。调查问卷分别在基线和怀孕结束后进行。预约出勤数据来自门诊记录。方差分析（ANOVA）、方差分析（ANCOVA）和逻辑回归模型评估了对照组和实验组在就诊、艾滋病毒状况意识和产前护理的心理社会决定因素方面的差异。结果：共纳入412名少女和年轻女性，其中254名（62%）完成了测试后调查（对照组64%，干预组59%）。412名参与者中有222名（对照组和干预组均占54%）获得了患者记录数据。分别有84%（63/75）和72%（54/75）的人对干预信息的内容价值和行为改变的动机性质给予高度评价。参与者平均对他们收到的双向信息的20%做出了回应。实验组（4.86,SD 1.76）和对照组（4.79,SD 1.74； P= 0.79）的平均预约出勤率无显著差异。对≥50%的信息作出反应的干预参与者（“高反应者”，5.08,SD 1.66）的预约出勤率高于对较少信息作出反应的干预参与者（4.82,SD 1.79）和对照参与者（4.79,SD 1.74， P= 0.86）。实验组高反应者的知识得分平均增幅（2.1,SD 3.17）显著高于对照组（0.7,SD 2.73; β=1.50； P= 0.045）。结论：参与干预的双向信息传递较低，这可能会影响结果。然而，干预内容被认为是可以接受的。预约出勤率在干预组和对照组之间没有显著差异。可能需要更密集的干预来影响预约依从性。试验注册：泛非临床试验注册中心（PACTR） PACTR201912734889796；https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=9565.International注册报告标识符（irrid）： RR2-10.2196/43654。
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引用次数: 0
Effect of Lifestyle Modification Through Web-Based Telerehabilitation Monitoring Combined With Supervised Sensorimotor Training After Total Knee Arthroplasty: Randomized Controlled Trial. 全膝关节置换术后通过网络远程康复监测结合监督感觉运动训练的生活方式改变的效果：随机对照试验。
IF 6.2 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES
JMIR mHealth and uHealth
Pub Date : 2025-10-02 DOI: 10.2196/64643
Samreen Sadiq, Rabiya Noor, Rizwan Akram

Background: Total knee arthroplasty (TKA) is commonly performed to manage end-stage knee osteoarthritis, yet postsurgical recovery varies significantly among patients. Lifestyle modification and rehabilitation interventions play a critical role in optimizing outcomes. While telerehabilitation has shown promise in enhancing accessibility and compliance, its role in supporting lifestyle behavior change alongside supervised sensorimotor training remains underexplored.

Objective: This study aimed to evaluate the effects of a home-based lifestyle modification program delivered through web-based telerehabilitation monitoring in addition to supervised sensorimotor training, in improving physical function, pain, balance, quality of life (QOL), and adherence in patients undergoing TKA.

Methods: A single-blinded randomized controlled trial was conducted among 52 participants undergoing primary TKA, who were randomly assigned to either the intervention group (IG) (supervised sensorimotor training plus a telerehabilitation-supported lifestyle modification program) or the control group (CG) (supervised sensorimotor training alone and a traditional home exercise plan). The intervention lasted 22 weeks, and participants were assessed at baseline (presurgery), 14 weeks, and 22 weeks postsurgery. Outcome measures included joint position sense (JPS), musculoskeletal ultrasound of the rectus femoris muscle, Berg Balance Scale, knee function using the Knee Injury and Osteoarthritis Outcome Score, and QOL via EuroQol 5-dimension 5-level questionnaire.

Results: Significant improvements were observed in the IG across all outcomes compared with the CG. Notably, the IG showed greater improvements in musculoskeletal ultrasound thickness. JPS showed superior accuracy in the experimental group (baseline [3.2 degrees] to 22 wk postsurgery [0.05 degrees]) compared with the CG (baseline [3.1 degrees] to 22 wk postsurgery [1.8 degrees]), with significant improvements noted (P=.001, Cohen d=3.1 vs 0.7), Knee Injury and Osteoarthritis Outcome Score subscales (pain, symptoms, activities of daily living, sport, and QOL), and JPS (mean absolute error 0.05 vs 1.8 degrees). Berg Balance Scale demonstrated significant gains in balance for the experimental group (baseline [34] to 22 wk postsurgery [53]) relative to the CG (baseline [37] to 22 wk postsurgery [48]), with substantial differences observed (P=.001, Cohen d=1.8 vs 0.4). The EuroQol 5-dimension 5-level questionnaire health-related QOL scores were markedly higher for the experimental group (baseline [45.4] to 22 wk postsurgery [88.1]) compared with the CG (baseline [42.8] to 22 wk postsurgery [70.9]), indicating substantial gains in overall health status (P=.001, Cohen d=2.4 vs 1.3). The IG also reported higher compliance, with 81.8% (18/22) achieving over 90% adherence compared with 68.18% (15/22) in the CG.

Conclusions:

背景：全膝关节置换术（TKA）是治疗终末期膝关节骨性关节炎的常用方法，但不同患者的术后恢复情况差异很大。生活方式改变和康复干预在优化结果中起着关键作用。虽然远程康复在提高可及性和依从性方面表现出了希望，但它在支持生活方式行为改变以及监督感觉运动训练方面的作用仍未得到充分探索。目的：本研究旨在评估通过基于网络的远程康复监测和监督感觉运动训练提供的基于家庭的生活方式改变计划在改善TKA患者的身体功能，疼痛，平衡，生活质量（QOL）和依从性方面的效果。方法：采用单盲随机对照试验，对52名接受原发性TKA的参与者进行了随机对照试验，他们被随机分配到干预组（IG）（有监督的感觉运动训练加远程康复支持的生活方式改变计划）和对照组（CG）（有监督的感觉运动训练和传统的家庭运动计划）。干预持续了22周，参与者在基线（手术前）、术后14周和术后22周进行评估。结果测量包括关节位置感（JPS）、股直肌肌肉骨骼超声、Berg平衡量表、膝关节损伤和骨关节炎结局评分的膝关节功能，以及EuroQol 5维5级问卷的生活质量。结果：与CG相比，IG在所有结果中均有显著改善。值得注意的是，IG显示肌肉骨骼超声厚度有更大的改善。与CG（基线[3.1度]至术后22周[1.8度]）相比，实验组JPS显示出更高的准确性（基线[3.2度]至术后22周[0.05度]），有显著改善（P= 0.001, Cohen d=3.1 vs 0.7），膝关节损伤和骨关节炎结局评分亚量表（疼痛、症状、日常生活活动、运动和生活质量）和JPS（平均绝对误差0.05 vs 1.8度）。Berg平衡量表显示实验组（基线[37]至术后22周[53]）相对于CG（基线[37]至术后22周[48]）的平衡有显著提高，差异有统计学意义（P= 0.001, Cohen d=1.8 vs 0.4）。与CG组（基线[42.8]至术后22周[70.9]）相比，实验组的EuroQol 5维5级问卷健康相关生活质量评分（基线[45.4]至术后22周[88.1]）明显更高，表明整体健康状况有明显改善（P= 0.001, Cohen d=2.4 vs 1.3）。IG组也报告了更高的依从性，81.8%（18/22）的患者达到90%以上的依从性，而CG组为68.18%（15/22）。结论：通过远程康复监测的以家庭为基础的生活方式改变计划显著改善了TKA后个体的功能和患者报告的结果。这些发现支持通过远程康复监测将生活方式改变项目整合到tka后的康复途径中，以优化康复结果。
{"title":"Effect of Lifestyle Modification Through Web-Based Telerehabilitation Monitoring Combined With Supervised Sensorimotor Training After Total Knee Arthroplasty: Randomized Controlled Trial.","authors":"Samreen Sadiq, Rabiya Noor, Rizwan Akram","doi":"10.2196/64643","DOIUrl":"10.2196/64643","url":null,"abstract":"<p><strong>Background: </strong>Total knee arthroplasty (TKA) is commonly performed to manage end-stage knee osteoarthritis, yet postsurgical recovery varies significantly among patients. Lifestyle modification and rehabilitation interventions play a critical role in optimizing outcomes. While telerehabilitation has shown promise in enhancing accessibility and compliance, its role in supporting lifestyle behavior change alongside supervised sensorimotor training remains underexplored.</p><p><strong>Objective: </strong>This study aimed to evaluate the effects of a home-based lifestyle modification program delivered through web-based telerehabilitation monitoring in addition to supervised sensorimotor training, in improving physical function, pain, balance, quality of life (QOL), and adherence in patients undergoing TKA.</p><p><strong>Methods: </strong>A single-blinded randomized controlled trial was conducted among 52 participants undergoing primary TKA, who were randomly assigned to either the intervention group (IG) (supervised sensorimotor training plus a telerehabilitation-supported lifestyle modification program) or the control group (CG) (supervised sensorimotor training alone and a traditional home exercise plan). The intervention lasted 22 weeks, and participants were assessed at baseline (presurgery), 14 weeks, and 22 weeks postsurgery. Outcome measures included joint position sense (JPS), musculoskeletal ultrasound of the rectus femoris muscle, Berg Balance Scale, knee function using the Knee Injury and Osteoarthritis Outcome Score, and QOL via EuroQol 5-dimension 5-level questionnaire.</p><p><strong>Results: </strong>Significant improvements were observed in the IG across all outcomes compared with the CG. Notably, the IG showed greater improvements in musculoskeletal ultrasound thickness. JPS showed superior accuracy in the experimental group (baseline [3.2 degrees] to 22 wk postsurgery [0.05 degrees]) compared with the CG (baseline [3.1 degrees] to 22 wk postsurgery [1.8 degrees]), with significant improvements noted (P=.001, Cohen d=3.1 vs 0.7), Knee Injury and Osteoarthritis Outcome Score subscales (pain, symptoms, activities of daily living, sport, and QOL), and JPS (mean absolute error 0.05 vs 1.8 degrees). Berg Balance Scale demonstrated significant gains in balance for the experimental group (baseline [34] to 22 wk postsurgery [53]) relative to the CG (baseline [37] to 22 wk postsurgery [48]), with substantial differences observed (P=.001, Cohen d=1.8 vs 0.4). The EuroQol 5-dimension 5-level questionnaire health-related QOL scores were markedly higher for the experimental group (baseline [45.4] to 22 wk postsurgery [88.1]) compared with the CG (baseline [42.8] to 22 wk postsurgery [70.9]), indicating substantial gains in overall health status (P=.001, Cohen d=2.4 vs 1.3). The IG also reported higher compliance, with 81.8% (18/22) achieving over 90% adherence compared with 68.18% (15/22) in the CG.</p><p><strong>Conclusions: </st","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"13 ","pages":"e64643"},"PeriodicalIF":6.2,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
WhatsApp-Based Coaching Program to Support Smoking and Vaping Cessation Among Young People: Pre-Post Study on Acceptance and Preliminary Efficacy. 基于whatsapp的年轻人戒烟辅导项目：接受度和初步效果的前后研究
IF 6.2 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES
JMIR mHealth and uHealth
Pub Date : 2025-10-02 DOI: 10.2196/65301
Severin Haug, Lisa Caputo, Andreas Wenger, Nikolai Kiselev, Olivia Studhalter, Michael P Schaub
<p><strong>Background: </strong>The use of tobacco cigarettes and electronic nicotine products is widespread among young people in Switzerland. At the same time, the instant messaging platform WhatsApp (Meta Platforms, Inc) is the most frequently used smartphone app in this population group. The provision of individually tailored, evidence-based coaching messages via WhatsApp seems promising to support smoking cessation in adolescents and young adults.</p><p><strong>Objective: </strong>This study aims to test the feasibility, acceptance, and preliminary efficacy of a newly developed, semiautomated WhatsApp-based intervention program to support smoking and vaping cessation and reduction in adolescents and young adults.</p><p><strong>Methods: </strong>Recruitment took place in Switzerland in 2023 and 2024 via various channels, both online and offline. For a period of 11 weeks, regular users of cigarettes or electronic cigarettes, aged between 16 and 30 years, received individually tailored messages on how to deal with cravings or stressful situations and how to stop or reduce smoking. A separate WhatsApp channel provided the opportunity to ask individual questions to a counselor. A one-group pre-post design was used to obtain preliminary information on the acceptability and potential efficacy of the program.</p><p><strong>Results: </strong>A total of 167 young people (mean age 23.2, SD 4.0 years; n=95, 56.9% women and n=72, 43.1% men) who regularly smoked tobacco cigarettes (n=81, 48.5%), vaped electronic nicotine products (n=17, 10.2%), or used both (n=69, 41.3%) were recruited for participation in the program. Of these, 100 (59.9%) intended to stop smoking or vaping while 67 (40.1%) aimed at reducing their use. The participants actively engaged in an average of 5.5 (SD 3.5) of the 11 program weeks, the average number of interactions with the program was 26.8 (SD 26.1), and the average duration from the start of the program to the last interaction was 45.0 (SD 31.1) days. The follow-up survey at the end of the 11-week coaching program was completed by 108 (64.7%) participants. The generalized estimating equation (GEE) analyses revealed significant reductions in the mean number of days in the last 30 days on which tobacco cigarettes were used from 20.6 (SD 11.8) at baseline to 14.0 (SD 12.0) at post assessment (incidence rate ratio [IRR] 0.68, P<.001) and for electronic nicotine products from 11.1 1 (SD 13.1) days at baseline to 7.7 (SD 11.3) days at follow-up (IRR 0.71, P=.005). Overall, 6/108 (5.6%) participants in the follow-up survey stated that they neither consumed tobacco cigarettes nor electronic nicotine products in the last 30 days.</p><p><strong>Conclusions: </strong>The WhatsApp-based program appears to be a feasible, moderately accepted, and promising intervention for reducing the consumption of tobacco cigarettes and electronic nicotine products among young people. A larger-scale randomized controlled trial would be reasonable in orde
背景：瑞士年轻人普遍使用烟草香烟和电子尼古丁产品。与此同时，即时通讯平台WhatsApp （Meta Platforms, Inc .）是这一人群中使用频率最高的智能手机应用。通过WhatsApp提供量身定制的、基于证据的指导信息，似乎有望帮助青少年和年轻人戒烟。目的：本研究旨在测试新开发的基于whatsapp的半自动化干预程序的可行性、可接受性和初步效果，以支持青少年和年轻人戒烟和减少吸烟。方法：于2023年和2024年在瑞士通过线上和线下多种渠道进行招聘。在11周的时间里，年龄在16到30岁之间的香烟或电子烟的经常使用者收到了关于如何处理渴望或压力情况以及如何戒烟或减少吸烟的个性化信息。一个单独的WhatsApp频道提供了向咨询师提出个人问题的机会。采用单组岗前设计来获得该方案的可接受性和潜在疗效的初步信息。结果：共有167名经常吸烟（n=81, 48.5%）、吸电子尼古丁产品（n=17, 10.2%）或两者都使用（n=69, 41.3%）的年轻人（平均年龄23.2岁，标准差4.0岁；n=95，女性56.9%,n=72，男性43.1%）被招募参加该项目。其中，100人（59.9%）打算戒烟或吸电子烟，67人（40.1%）的目标是减少吸烟或吸电子烟。在11个计划周中，参与者平均积极参与5.5 (SD 3.5)，与计划的平均互动次数为26.8 (SD 26.1)，从计划开始到最后一次互动的平均持续时间为45.0 （SD 31.1）天。在11周的训练计划结束时，108名参与者（64.7%）完成了随访调查。广义估计方程（GEE）分析显示，在过去30天内，吸烟的平均天数显著减少，从基线时的20.6天（SD 11.8）减少到后评估时的14.0天（SD 12.0）（发病率比[IRR] 0.68）。结论：基于whatsapp的项目似乎是一种可行的、可接受的、有希望的干预措施，可以减少年轻人吸烟和电子尼古丁产品的消费。为了对该方案的有效性作出更有根据的陈述，进行大规模的随机对照试验是合理的。
{"title":"WhatsApp-Based Coaching Program to Support Smoking and Vaping Cessation Among Young People: Pre-Post Study on Acceptance and Preliminary Efficacy.","authors":"Severin Haug, Lisa Caputo, Andreas Wenger, Nikolai Kiselev, Olivia Studhalter, Michael P Schaub","doi":"10.2196/65301","DOIUrl":"10.2196/65301","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The use of tobacco cigarettes and electronic nicotine products is widespread among young people in Switzerland. At the same time, the instant messaging platform WhatsApp (Meta Platforms, Inc) is the most frequently used smartphone app in this population group. The provision of individually tailored, evidence-based coaching messages via WhatsApp seems promising to support smoking cessation in adolescents and young adults.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to test the feasibility, acceptance, and preliminary efficacy of a newly developed, semiautomated WhatsApp-based intervention program to support smoking and vaping cessation and reduction in adolescents and young adults.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Recruitment took place in Switzerland in 2023 and 2024 via various channels, both online and offline. For a period of 11 weeks, regular users of cigarettes or electronic cigarettes, aged between 16 and 30 years, received individually tailored messages on how to deal with cravings or stressful situations and how to stop or reduce smoking. A separate WhatsApp channel provided the opportunity to ask individual questions to a counselor. A one-group pre-post design was used to obtain preliminary information on the acceptability and potential efficacy of the program.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 167 young people (mean age 23.2, SD 4.0 years; n=95, 56.9% women and n=72, 43.1% men) who regularly smoked tobacco cigarettes (n=81, 48.5%), vaped electronic nicotine products (n=17, 10.2%), or used both (n=69, 41.3%) were recruited for participation in the program. Of these, 100 (59.9%) intended to stop smoking or vaping while 67 (40.1%) aimed at reducing their use. The participants actively engaged in an average of 5.5 (SD 3.5) of the 11 program weeks, the average number of interactions with the program was 26.8 (SD 26.1), and the average duration from the start of the program to the last interaction was 45.0 (SD 31.1) days. The follow-up survey at the end of the 11-week coaching program was completed by 108 (64.7%) participants. The generalized estimating equation (GEE) analyses revealed significant reductions in the mean number of days in the last 30 days on which tobacco cigarettes were used from 20.6 (SD 11.8) at baseline to 14.0 (SD 12.0) at post assessment (incidence rate ratio [IRR] 0.68, P&lt;.001) and for electronic nicotine products from 11.1 1 (SD 13.1) days at baseline to 7.7 (SD 11.3) days at follow-up (IRR 0.71, P=.005). Overall, 6/108 (5.6%) participants in the follow-up survey stated that they neither consumed tobacco cigarettes nor electronic nicotine products in the last 30 days.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The WhatsApp-based program appears to be a feasible, moderately accepted, and promising intervention for reducing the consumption of tobacco cigarettes and electronic nicotine products among young people. A larger-scale randomized controlled trial would be reasonable in orde","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"13 ","pages":"e65301"},"PeriodicalIF":6.2,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effects of Remote Patient Monitoring on Health Care Utilization in Patients With Noncommunicable Diseases: Systematic Review and Meta-Analysis. 远程患者监测对非传染性疾病患者医疗保健利用的影响：系统回顾和荟萃分析
IF 6.2 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES
JMIR mHealth and uHealth
Pub Date : 2025-10-01 DOI: 10.2196/68464
Geir Smedslund, Nina Østerås, Christine Hillestad Hestevik
<p><strong>Background: </strong>Management of noncommunicable diseases (NCDs) is an increasing challenge for health care systems. Although remote patient monitoring presents a promising solution by utilizing technology to monitor patients outside clinical settings, there is a lack of knowledge about the effect on resource utilization.</p><p><strong>Objective: </strong>This systematic review aimed to review the effects of remote patient monitoring on health care resource utilization by patients with NCDs.</p><p><strong>Methods: </strong>Eligible randomized controlled trials (RCTs) involved digital transmission of health data from patients to health care personnel. Outcomes included hospitalizations, length of stay, outpatient visits, and emergency visits. A systematic literature search was performed in Medline, Embase, and Cochrane Central Register of Controlled Trials in June 2024. Titles, abstracts, and full texts were screened individually by 2 authors. Risk of bias was assessed, and data were extracted, analyzed, and pooled in meta-analysis when possible. Confidence in the estimates was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.</p><p><strong>Results: </strong>We included 40 RCTs published between 2017 and 2024. The largest group of NCDs was cardiovascular disease (16 studies). Remote patient monitoring may slightly decrease the proportion of hospitalizations compared with usual care (risk ratio [RR] 0.86, 95% CI 0.77 to 0.95; low certainty). Compared with usual care, remote patient monitoring had fewer or an equal number of hospitalizations (mean difference -0.13, 95% CI -0.29 to 0.03; low certainty). Hospital length of stay may be slightly reduced with remote patient monitoring compared with usual care (mean difference -0.84, 95% CI -1.61 to -0.06 days; low certainty). The proportion of outpatient visits showed probably little to no difference between remote patient monitoring and usual care (RR 0.94, 95% CI 0.87 to 1.02; moderate certainty). Compared with usual care, remote patient monitoring had slightly more outpatient visits, but the CI was wide (mean difference 0.41, 95% CI -0.22 to 1.03; low certainty). The results indicate a small or no difference between remote patient monitoring and usual care regarding proportion of emergency visits (RR 0.91, 95% CI 0.79 to 1.05; low certainty). We are uncertain whether remote patient monitoring increases or decreases the number of emergency visits, as the evidence was of very low certainty.</p><p><strong>Conclusions: </strong>This systematic review showed that remote patient monitoring possibly led to lower proportions of patients being hospitalized, fewer hospitalizations, and shorter hospital length of stay compared with usual care. Patients undergoing remote monitoring had possibly more outpatient visits compared with usual care. The proportions of patients with outpatient visits or emergency visits were probably similar. Finally, we h
背景：非传染性疾病（NCDs）的管理是卫生保健系统面临的日益严峻的挑战。尽管通过利用技术来监测临床环境之外的患者，远程患者监测提供了一个很有前途的解决方案，但缺乏对资源利用影响的了解。目的：本系统综述旨在探讨远程监护对非传染性疾病患者医疗资源利用的影响。方法：符合条件的随机对照试验（RCTs）涉及从患者到卫生保健人员的健康数据的数字传输。结果包括住院次数、住院时间、门诊次数和急诊次数。于2024年6月在Medline、Embase和Cochrane Central Register of Controlled Trials中进行了系统的文献检索。题目、摘要和全文分别由两位作者进行筛选。对偏倚风险进行评估，并对数据进行提取、分析，并在可能的情况下进行荟萃分析。采用建议分级评估、发展和评估（GRADE）方法评估评估结果的可信度。结果：我们纳入了2017年至2024年间发表的40项随机对照试验。最大的非传染性疾病组是心血管疾病（16项研究）。与常规护理相比，远程患者监护可能会略微降低住院比例（风险比[RR] 0.86, 95% CI 0.77至0.95；低确定性）。与常规护理相比，远程患者监测的住院人数较少或相同（平均差异-0.13,95% CI -0.29至0.03；低确定性）。与常规护理相比，远程患者监护可略微缩短住院时间（平均差异-0.84,95% CI -1.61至-0.06天；低确定性）。门诊就诊的比例在远程患者监测和常规护理之间可能几乎没有差异（RR 0.94, 95% CI 0.87至1.02；中等确定性）。与常规护理相比，远程患者监测的门诊次数略多，但CI较宽（平均差异0.41,95% CI -0.22至1.03；低确定性）。结果表明，远程患者监护和常规护理在急诊就诊比例方面差异很小或没有差异（RR 0.91, 95% CI 0.79至1.05；低确定性）。由于证据的确定性非常低，我们不确定远程患者监测是否会增加或减少急诊就诊次数。结论：本系统综述显示，与常规护理相比，远程患者监测可能降低患者住院比例，减少住院次数，缩短住院时间。与常规护理相比，接受远程监测的患者可能有更多的门诊就诊。门诊和急诊患者的比例可能相似。最后，我们对急诊次数的把握非常低。结果应谨慎考虑，因为证据的确定性是中等到非常低。我们没有发现关于住院的结果。
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引用次数: 0
How Engagement Changes Over Time in a Digital Eating Disorder App: Observational Study. 在一个数字饮食失调应用中，参与度如何随时间变化：观察性研究。
IF 6.2 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES
JMIR mHealth and uHealth
Pub Date : 2025-09-30 DOI: 10.2196/68824
Rachael E Flatt, Laura M Thornton, Jenna Tregarthen, Stuart Argue, Cynthia M Bulik

Background: Engagement with digital mental health interventions is often measured as a summary-level variable and remains underresearched despite its importance for meaningful symptom change. This study deepens understanding of engagement in a digital eating disorder intervention, recovery record, by measuring engagement with unique components of the app, on 2 different devices (phone and watch), and at a summary level.

Objective: This study described and modeled how individuals engaged with the app across a variety of measures of engagement and identified baseline predictors of engagement.

Methods: Participants with current binge-eating behavior were recruited as part of the Binge Eating Genetics Initiative study to use a digital eating disorder intervention for 4 weeks. Demographic and severity of illness variables were captured in the baseline survey at enrollment, and engagement data were captured through both an iPhone and Apple Watch version of the intervention. Engagement was characterized by log type (urge, behavior, mood, or meal), device type (logs on phone or watch), and overall usage (total logs) and averaged each week for 4 weeks. Descriptives were tabulated for demographic and engagement variables, and multilevel growth models were conducted for each measure of engagement with baseline characteristics and time as predictors.

Results: Participants (N=893) self-reported as primarily White (743/871, 85%), non-Hispanic (801/893, 90%), females (772/893, 87%) with a mean age of 29.6 (SD 7.4) years and mean current BMI of 32.5 (SD 9.8) kg/m2 and used the app for a mean of 24 days. Most logs were captured on phones (217,143/225,927; 96%), and mood logs were the most used app component (174,818/282,136; 62% of logs). All measures of engagement declined over time, as illustrated by the visualizations, but each measure of engagement illustrated unique participant trajectories over time. Time was a significant negative predictor in every multilevel model. Sex and ethnicity were also significant predictors across several measures of engagement, with female and Hispanic participants demonstrating greater engagement than male and non-Hispanic counterparts. Other baseline characteristics (age, current BMI, and binge episodes in the past 28 days) were significant predictors of 1 measure of engagement each.

Conclusions: This study highlighted that engagement is far more complex and nuanced than is typically described in research, and that specific components and mode of delivery may have unique engagement profiles and predictors. Future work would benefit from developing early engagement models informed by baseline characteristics to predict intervention outcomes, thereby tailoring digital eating disorder interventions at the individual level.

背景：参与数字心理健康干预通常作为一个总结水平变量来衡量，尽管它对有意义的症状改变很重要，但仍未得到充分研究。本研究通过在两种不同的设备（手机和手表）上测量应用程序的独特组件的参与度，并在总结层面上加深了对数字饮食失调干预、恢复记录参与度的理解。目的：本研究描述并模拟了用户如何通过各种粘性测量方法与应用互动，并确定了粘性的基线预测指标。方法：目前暴食行为的参与者被招募为暴食遗传学倡议研究的一部分，使用数字饮食失调干预4周。在入组时的基线调查中捕获了人口统计学和疾病严重程度变量，并通过iPhone和Apple Watch版本的干预捕获了参与数据。用户粘性以日志类型（冲动、行为、情绪或饮食）、设备类型（手机或手表日志）和总体使用情况（总日志）为特征，平均每周4周。将人口统计和参与变量的描述制成表格，并以基线特征和时间作为预测因子，对参与的每项测量进行多层次增长模型。结果：参与者（N=893）自我报告主要为白人（743/871,85%）、非西班牙裔（801/893,90%）、女性（772/893,87%），平均年龄为29.6 （SD 7.4）岁，平均当前BMI为32.5 (SD 9.8) kg/m2，平均使用该应用程序24天。大多数日志是在手机上捕获的（217,143/225,927,96%），情绪日志是最常用的应用组件（174,818/282,136,62%的日志）。正如可视化所示，所有的参与度指标都随着时间的推移而下降，但每一项参与度指标都表明了参与者在一段时间内的独特轨迹。时间是各多层模型的显著负向预测因子。性别和种族也是几项参与度指标的重要预测因素，女性和西班牙裔参与者比男性和非西班牙裔参与者表现出更高的参与度。其他基线特征（年龄、当前体重指数和过去28天内的暴饮暴食）是每项参与测量的重要预测因素。结论：该研究强调，用户粘性比研究中通常描述的要复杂和微妙得多，特定的组成部分和交付模式可能具有独特的用户粘性特征和预测因素。未来的工作将受益于开发基于基线特征的早期参与模型，以预测干预结果，从而在个人层面定制数字化饮食失调干预措施。
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