JMIR mHealth and uHealth最新文献

Intensive, repeated self-report measures are an important tool for behavioral and medical researchers and practitioners who are concerned with the dynamic interplay among variables at a granular level. Many mobile health applications rely on accurate measurement of immediate states and environments for both assessment and intervention delivery. Techniques for capturing repeated momentary assessments yield data with several salutary qualities: recall bias is minimized relative to assessments that rely on much longer recall periods; measurements are taken in individuals' everyday environments; and dense, repeated measures allow a new window into the processes transpiring between individuals and their environments. In this paper, we highlight several features of repeatedly completing momentary assessments that may change the nature or quality of the data collected over time. Several lines of inquiry are discussed that call into question the presumption that there is invariance in how people complete repeated assessments over time. A result of this possibility could be a reduction in data quality. We present 4 phenomena, with selected results, that may induce noninvariance in repeated measures: the amount of time required to complete assessments, the rate of missing data, the degree of careless responding, and the presence of several components of reactivity. In each of these areas, we found evidence that changes could occur over time, and we consider how data might be affected by such changes. Our conclusion is that researchers should be aware that changes can occur over time and that these changes may affect data quality.

Background: Wearable sensor technologies such as inertial measurement units, smartwatches, and multisensor systems have emerged as valuable tools in clinical and real-world health monitoring. These devices enable continuous, noninvasive tracking of gait, mobility, and functional health across diverse populations. However, challenges remain in sensor placement standardization, data processing consistency, and real-world validation.

Objective: This systematic review aimed to evaluate recent literature on the clinical and research applications of wearable sensors. Specifically, it investigated how these technologies are used to assess mobility, predict disease risk, and support rehabilitation. It also identified limitations and proposed future research directions.

Methods: This review was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. We searched the PubMed, Scopus, and Web of Science databases up to March 9, 2025. Inclusion criteria focused on studies using wearable sensors in clinical or real-world environments. A total of 30 eligible studies were identified for qualitative synthesis. Data extracted included study design, population characteristics, sensor type and placement, machine learning algorithms, and clinical outcomes.

Results: Of the included studies, 43% (13/30) were observational, 27% (8/30) were experimental, and 10% (3/30) were randomized controlled trials. Inertial measurement unit-based sensors were used in 67% (20/30) of the studies, with wrist-worn devices being the most common (13/20, 65%). Machine learning techniques were frequently applied, with random forest (6/30, 20%) and deep learning (5/30, 17%) models predominating. Clinical applications spanned Parkinson disease, stroke, multiple sclerosis, and frailty, with several studies (4/30, 13%) reporting high predictive accuracy for fall risk and mobility decline (area under the receiver operating characteristic curve up to 0.97).

Conclusions: Wearable sensors show strong potential for mobility monitoring, disease risk assessment, and rehabilitation tracking in clinical and real-world settings. However, challenges remain in standardizing sensor protocols and data analysis. Future research should focus on large-scale, longitudinal studies; harmonized machine learning pipelines; and integration with cloud-based health systems to improve scalability and clinical translation.

Unlabelled: Shoulder pain is prevalent in people living with spinal cord injury. Technology and digital rehabilitation tools are increasingly available, but this has not yet included the provision of a self-guided exercise intervention focused on managing shoulder pain for people living with spinal cord injury. We drew on the person-based approach (PBA) to intervention development to design a Shoulder Pain Intervention delivered over the interNet (SPIN) to address this gap. However, in preparation for the design process, we found very few published examples of how the PBA had been operationalized. The aim of this paper is to provide a detailed explanation of our approach and how we operationalized the PBA in the design of SPIN to maximize relevance and engagement. Our design process followed the key PBA steps, combining additional evidence and theoretical components. Each step ensured that guiding principles were formulated and followed to maximize the probability that SPIN would be fit for purpose. We followed 3 steps: (1) we drew on themes from preparatory research (existing and primary) to identify the key behavioral issues, needs and challenges, and existing features to form the basis of SPIN design; (2) we formatted guiding principles that included articulating specific design objectives to provide a framework to identify system requirements; and (3) we selected and refined intervention features using existing literature, behavioral theory, and tools such as the "Behaviour Change Wheel." We have designed SPIN by incorporating a deep understanding of the users' needs and best available evidence to maximize engagement and positive outcomes. In this paper, we have made clear how we operationalized the PBA phases, including how existing evidence, theory, tools, and methods were leveraged to support the PBA process. In explicating our process, we have provided a blueprint to guide future researchers using this approach.

Background: While there is growing evidence demonstrating the usefulness of integrating social features within mobile health approaches, little research has explored how African American women use mobile platforms to facilitate physical activity within the context of a group-based physical activity intervention.

Objective: The primary aim of this study was to qualitatively describe how African American women used private group messaging boards on the Fitbit mobile app (eg, the type of social and motivational strategies) during a 10-week group-based physical activity intervention. The secondary aim of this study was to quantitatively test whether greater engagement on the Fitbit mobile app (number of posts per week) was associated with greater daily physical activity (ie, steps and total minutes of physical activity) across 10 weeks.

Methods: Data were collected from 54 African American women who participated in the Together Everyone Achieves More Physical Activity trial (mean age 51.57, SD 13.89 y). Participants completed weekly in-person group sessions, set group-based weekly physical activity goals, and used the Fitbit mobile app for ongoing group communication and support, including posting in a private group. This study used a QUAN-qual mixed methods design to describe how participants used the private group messaging boards on the Fitbit mobile app and to evaluate whether engagement on the Fitbit app was associated with greater physical activity (ie, steps and total minutes of physical activity) across the 10-week intervention.

Results: The mean number of posts per week ranged from 1.79 (SD 2.95) in week 1 to 1.11 (SD 2.49) in week 10, with a maximum of 5.06 (SD 7.62) posts in week 5. A thematic content analysis revealed that the private groups reflected numerous topics, including motivational strategies, cognitive strategies, group strategies, informal positive communication, and sharing pictures. The quantitative analyses revealed that participants who posted at least once per week engaged in more steps (P=.006) and total minutes of physical activity (P=.02).

Conclusions: Participants engaged in ongoing social support, positive communication, and vicarious learning through the Fitbit app, suggesting several important directions for future research, including potential interpersonal mechanisms and best practices for enhancing social support and physical activity among African American women.

Background: Digital therapeutics represents a promising approach to support the management of hypertension. Rural regions in China face substantial challenges in hypertension prevention and management. Given the rapid growth in use of the internet and mobile technologies, particularly smartphones, we developed a user-friendly WeChat mini-program "E-controlled pressure (eKongya)" to assist village physicians in managing patients with hypertension.

Objective: This trial aimed to investigate the efficacy of digital interventions for blood pressure (BP) control in patients with hypertension.

Methods: This open-label cluster-randomized controlled study was conducted in 8 villages in China. Individuals with systolic BP (SBP) ≥140 mm Hg or diastolic BP (DBP) ≥90 mm Hg were recruited. Eight villages were randomly assigned in a 1:1 ratio to the digital intervention group or control group. The primary end point was the hypertension control rate at 24 weeks among the study participants. The secondary end points were the changes in mean SBP and DBP from baseline to 24 weeks. All analyses were performed using the full analysis set.

Results: Between June and July 2024, a total of 95 participants were enrolled and allocated to the digital intervention group (n=48, 51%) or the control group (n=47, 49%). After 24 weeks, data were available from 87 (92%) participants, and the mean age was 63.8 (SD 9.7) years, with 48% (n=42) being female participants. The digital intervention group (25/44, 57%) had a higher percentage of participants with controlled BP compared to the control group (21/43, 49%), although this difference was not statistically significant (P=.60). Logistic regression analysis showed that the digital interventions did not significantly increase the hypertension control rate (odds ratio 0.73, 95% CI 0.31-1.69; P=.46). In the intervention group, SBP decreased from 158.0 (SD 18.4) mm Hg at baseline to 137.5 (SD 13.0) mm Hg at 24 weeks and DBP decreased from 93.8 (SD 10.3) mm Hg to 85.3 (SD 11.6) mm Hg. In the control group during that same period, SBP decreased from 161.1 (SD 18.2) mm Hg to 139.6 (SD 13.2) mm Hg, and DBP decreased from 99.2 (SD 9.2) mm Hg to 83.4 (SD 12.1) mm Hg. After adjusting for baseline SBP or DBP, the mean change from baseline to 24 weeks was comparable between the digital intervention and control groups for both SBP (between-group difference -1.6, 95% CI -7.2 to 3.9; P=.56) and DBP (between-group difference 3.3, 95% CI -1.8 to 8.5; P=.21). No major program-related safety events occurred up to 24 weeks.

Conclusions: Our study demonstrated that the digital interventions increased the hypertension control rate in rural areas, although this improvement was not statistically significant. Nevertheless, providing convenient BP measurements and health education to these patients notably enhanced hypertension control rates.