Atsadaporn Niyomyart, Suebsarn Ruksakulpiwat, Chitchanok Benjasirisan, Lalipat Phianhasin, Kabtamu Nigussie, Sutthinee Thorngthip, Gazi Shamita, Jai Thampakkul, Lidya Begashaw
Background: Mobile health (mHealth) offers significant benefits for patients with stroke, facilitating remote monitoring and personalized health care solutions beyond traditional settings. However, there is a dearth of comprehensive data, particularly qualitative insights, on the barriers to mHealth access. Understanding these barriers is crucial for devising strategies to enhance mHealth use among patients with stroke.
Objective: This study aims to examine the recent literature focusing on barriers to mHealth access among patients with stroke.
Methods: A systematic search of PubMed, MEDLINE, Web of Science, and CINAHL Plus Full Text was conducted for literature published between 2017 and 2023. Abstracts and full texts were independently screened based on predetermined inclusion and exclusion criteria. Data synthesis was performed using the convergent integrated analysis framework recommended by the Joanna Briggs Institute.
Results: A total of 12 studies met the inclusion criteria. The majority were qualitative studies (about 42%), followed by mixed methods (25%), pilot studies (about 17%), nonrandomized controlled trials (about 8%), and observational studies (about 8%). Participants included patients with stroke, caregivers, and various health care professionals. The most common mHealth practices were home-based telerehabilitation (30%) and poststroke mHealth and telecare services (20%). Identified barriers were categorized into two primary themes: (1) at the patient level and (2) at the health provider-patient-device interaction level. The first theme includes 2 subthemes: health-related issues and patient acceptability. The second theme encompassed 3 subthemes: infrastructure challenges (including software, networking, and hardware), support system deficiencies, and time constraints.
Conclusions: This systematic review underscores significant barriers to mHealth adoption among patients with stroke. Addressing these barriers in future research is imperative to ensure that mHealth solutions effectively meet patients' needs.
背景：移动医疗（mHealth）为中风患者带来了巨大的益处，促进了远程监控和超越传统环境的个性化医疗解决方案。然而，有关移动医疗使用障碍的综合数据，尤其是定性见解却十分匮乏。了解这些障碍对于制定加强中风患者使用移动医疗的策略至关重要：本研究旨在考察近期有关中风患者使用移动医疗的障碍的文献：系统检索了 PubMed、MEDLINE、Web of Science 和 CINAHL Plus Full Text 中 2017 年至 2023 年间发表的文献。根据预先确定的纳入和排除标准对摘要和全文进行了独立筛选。采用乔安娜-布里格斯研究所（Joanna Briggs Institute）推荐的聚合综合分析框架进行数据综合：共有 12 项研究符合纳入标准。大部分是定性研究（约 42%），其次是混合方法研究（25%）、试点研究（约 17%）、非随机对照试验（约 8%）和观察性研究（约 8%）。参与者包括中风患者、护理人员和各种医疗保健专业人员。最常见的移动医疗实践是基于家庭的远程康复（30%）以及卒中后移动医疗和远程护理服务（20%）。已识别的障碍分为两个主要主题：(1) 患者层面；(2) 医疗服务提供者-患者-设备互动层面。第一个主题包括 2 个子主题：与健康相关的问题和患者的可接受性。第二个主题包括 3 个子主题：基础设施挑战（包括软件、网络和硬件）、支持系统缺陷和时间限制：本系统综述强调了中风患者采用移动医疗的重大障碍。在未来的研究中解决这些障碍是确保移动医疗解决方案有效满足患者需求的当务之急。
{"title":"Current Status of Barriers to mHealth Access Among Patients With Stroke and Steps Toward the Digital Health Era: Systematic Review.","authors":"Atsadaporn Niyomyart, Suebsarn Ruksakulpiwat, Chitchanok Benjasirisan, Lalipat Phianhasin, Kabtamu Nigussie, Sutthinee Thorngthip, Gazi Shamita, Jai Thampakkul, Lidya Begashaw","doi":"10.2196/54511","DOIUrl":"10.2196/54511","url":null,"abstract":"<p><strong>Background: </strong>Mobile health (mHealth) offers significant benefits for patients with stroke, facilitating remote monitoring and personalized health care solutions beyond traditional settings. However, there is a dearth of comprehensive data, particularly qualitative insights, on the barriers to mHealth access. Understanding these barriers is crucial for devising strategies to enhance mHealth use among patients with stroke.</p><p><strong>Objective: </strong>This study aims to examine the recent literature focusing on barriers to mHealth access among patients with stroke.</p><p><strong>Methods: </strong>A systematic search of PubMed, MEDLINE, Web of Science, and CINAHL Plus Full Text was conducted for literature published between 2017 and 2023. Abstracts and full texts were independently screened based on predetermined inclusion and exclusion criteria. Data synthesis was performed using the convergent integrated analysis framework recommended by the Joanna Briggs Institute.</p><p><strong>Results: </strong>A total of 12 studies met the inclusion criteria. The majority were qualitative studies (about 42%), followed by mixed methods (25%), pilot studies (about 17%), nonrandomized controlled trials (about 8%), and observational studies (about 8%). Participants included patients with stroke, caregivers, and various health care professionals. The most common mHealth practices were home-based telerehabilitation (30%) and poststroke mHealth and telecare services (20%). Identified barriers were categorized into two primary themes: (1) at the patient level and (2) at the health provider-patient-device interaction level. The first theme includes 2 subthemes: health-related issues and patient acceptability. The second theme encompassed 3 subthemes: infrastructure challenges (including software, networking, and hardware), support system deficiencies, and time constraints.</p><p><strong>Conclusions: </strong>This systematic review underscores significant barriers to mHealth adoption among patients with stroke. Addressing these barriers in future research is imperative to ensure that mHealth solutions effectively meet patients' needs.</p>","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"12 ","pages":"e54511"},"PeriodicalIF":5.4,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11377914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142035903","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}
<p><strong>Background: </strong>Population studies show that musculoskeletal conditions are a leading contributor to the total burden of healthy life lost, second only to cancer and with a similar burden to cardiovascular disease. Prioritizing the delivery of effective treatments is necessary, and with the ubiquity of consumer smart devices, the use of digital health interventions is increasing. Messaging is popular and easy to use and has been studied for a range of health-related uses, including health promotion, encouragement of behavior change, and monitoring of disease progression. It may have a useful role to play in the management and self-management of musculoskeletal conditions.</p><p><strong>Objective: </strong>Previous reviews on the use of messaging for people with musculoskeletal conditions have focused on synthesizing evidence of effectiveness from randomized controlled trials. In this review, our objective was to map the musculoskeletal messaging literature more broadly to identify information that may inform the design of future messaging interventions and summarize the current evidence of efficacy, effectiveness, and economics.</p><p><strong>Methods: </strong>Following a prepublished protocol developed using the Joanna Briggs Institute Manual for Evidence Synthesis, we conducted a comprehensive scoping review of the literature (2010-2022; sources: PubMed, CINAHL, Embase, and PsycINFO) related to SMS text messaging and app-based messaging for people with musculoskeletal conditions. We described our findings using tables, plots, and a narrative summary.</p><p><strong>Results: </strong>We identified a total of 8328 papers for screening, of which 50 (0.6%) were included in this review (3/50, 6% previous reviews and 47/50, 94% papers describing 40 primary studies). Rheumatic diseases accounted for the largest proportion of the included primary studies (19/40, 48%), followed by studies on multiple musculoskeletal conditions or pain sites (10/40, 25%), back pain (9/40, 23%), neck pain (1/40, 3%), and "other" (1/40, 3%). Most studies (33/40, 83%) described interventions intended to promote positive behavior change, typically by encouraging increased physical activity and exercise. The studies evaluated a range of outcomes, including pain, function, quality of life, and medication adherence. Overall, the results either favored messaging interventions or had equivocal outcomes. While the theoretical underpinnings of the interventions were generally well described, only 4% (2/47) of the papers provided comprehensive descriptions of the messaging intervention design and development process. We found no relevant economic evaluations.</p><p><strong>Conclusions: </strong>Messaging has been used for the care and self-management of a range of musculoskeletal conditions with generally favorable outcomes reported. However, with few exceptions, design considerations are poorly described in the literature. Further work is needed to understand and dis
{"title":"Development and Use of Mobile Messaging for Individuals With Musculoskeletal Pain Conditions: Scoping Review.","authors":"Nigel Armfield, Rachel Elphinston, Jenna Liimatainen, Simone Scotti Requena, Chloe-Emily Eather, Sisira Edirippulige, Carrie Ritchie, Sarah Robins, Michele Sterling","doi":"10.2196/55625","DOIUrl":"10.2196/55625","url":null,"abstract":"<p><strong>Background: </strong>Population studies show that musculoskeletal conditions are a leading contributor to the total burden of healthy life lost, second only to cancer and with a similar burden to cardiovascular disease. Prioritizing the delivery of effective treatments is necessary, and with the ubiquity of consumer smart devices, the use of digital health interventions is increasing. Messaging is popular and easy to use and has been studied for a range of health-related uses, including health promotion, encouragement of behavior change, and monitoring of disease progression. It may have a useful role to play in the management and self-management of musculoskeletal conditions.</p><p><strong>Objective: </strong>Previous reviews on the use of messaging for people with musculoskeletal conditions have focused on synthesizing evidence of effectiveness from randomized controlled trials. In this review, our objective was to map the musculoskeletal messaging literature more broadly to identify information that may inform the design of future messaging interventions and summarize the current evidence of efficacy, effectiveness, and economics.</p><p><strong>Methods: </strong>Following a prepublished protocol developed using the Joanna Briggs Institute Manual for Evidence Synthesis, we conducted a comprehensive scoping review of the literature (2010-2022; sources: PubMed, CINAHL, Embase, and PsycINFO) related to SMS text messaging and app-based messaging for people with musculoskeletal conditions. We described our findings using tables, plots, and a narrative summary.</p><p><strong>Results: </strong>We identified a total of 8328 papers for screening, of which 50 (0.6%) were included in this review (3/50, 6% previous reviews and 47/50, 94% papers describing 40 primary studies). Rheumatic diseases accounted for the largest proportion of the included primary studies (19/40, 48%), followed by studies on multiple musculoskeletal conditions or pain sites (10/40, 25%), back pain (9/40, 23%), neck pain (1/40, 3%), and \"other\" (1/40, 3%). Most studies (33/40, 83%) described interventions intended to promote positive behavior change, typically by encouraging increased physical activity and exercise. The studies evaluated a range of outcomes, including pain, function, quality of life, and medication adherence. Overall, the results either favored messaging interventions or had equivocal outcomes. While the theoretical underpinnings of the interventions were generally well described, only 4% (2/47) of the papers provided comprehensive descriptions of the messaging intervention design and development process. We found no relevant economic evaluations.</p><p><strong>Conclusions: </strong>Messaging has been used for the care and self-management of a range of musculoskeletal conditions with generally favorable outcomes reported. However, with few exceptions, design considerations are poorly described in the literature. Further work is needed to understand and dis","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"12 ","pages":"e55625"},"PeriodicalIF":5.4,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11358670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141982360","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}
<p><strong>Background: </strong>Gait speed is a valuable biomarker for mobility and overall health assessment. Existing methods to measure gait speed require expensive equipment or personnel assistance, limiting their use in unsupervised, daily-life conditions. The availability of smartphones equipped with a single inertial measurement unit (IMU) presents a viable and convenient method for measuring gait speed outside of laboratory and clinical settings. Previous works have used the inverted pendulum model to estimate gait speed using a non-smartphone-based IMU attached to the trunk. However, it is unclear whether and how this approach can estimate gait speed using the IMU embedded in a smartphone while being carried in a pants pocket during walking, especially under various walking conditions.</p><p><strong>Objective: </strong>This study aimed to validate and test the reliability of a smartphone IMU-based gait speed measurement placed in the user's front pants pocket in both healthy young and older adults while walking quietly (ie, normal walking) and walking while conducting a cognitive task (ie, dual-task walking).</p><p><strong>Methods: </strong>A custom-developed smartphone application (app) was used to record gait data from 12 young adults and 12 older adults during normal and dual-task walking. The validity and reliability of gait speed and step length estimations from the smartphone were compared with the gold standard GAITRite mat. A coefficient-based adjustment based upon a coefficient relative to the original estimation of step length was applied to improve the accuracy of gait speed estimation. The magnitude of error (ie, bias and limits of agreement) between the gait data from the smartphone and the GAITRite mat was calculated for each stride. The Passing-Bablok orthogonal regression model was used to provide agreement (ie, slopes and intercepts) between the smartphone and the GAITRite mat.</p><p><strong>Results: </strong>The gait speed measured by the smartphone was valid when compared to the GAITRite mat. The original limits of agreement were 0.50 m/s (an ideal value of 0 m/s), and the orthogonal regression analysis indicated a slope of 1.68 (an ideal value of 1) and an intercept of -0.70 (an ideal value of 0). After adjustment, the accuracy of the smartphone-derived gait speed estimation improved, with limits of agreement reduced to 0.34 m/s. The adjusted slope improved to 1.00, with an intercept of 0.03. The test-retest reliability of smartphone-derived gait speed was good to excellent within supervised laboratory settings and unsupervised home conditions. The adjustment coefficients were applicable to a wide range of step lengths and gait speeds.</p><p><strong>Conclusions: </strong>The inverted pendulum approach is a valid and reliable method for estimating gait speed from a smartphone IMU placed in the pockets of younger and older adults. Adjusting step length by a coefficient derived from the original estimation of step length
背景：步速是移动性和整体健康评估的重要生物标志物。现有的步速测量方法需要昂贵的设备或人员协助，这限制了它们在无人监督的日常生活条件下的应用。配备单个惯性测量单元（IMU）的智能手机的出现，为在实验室和临床环境之外测量步速提供了一种可行且方便的方法。以前的研究曾使用倒立摆模型来估算步速，使用的是连接在躯干上的非智能手机惯性测量单元。然而，目前还不清楚这种方法能否以及如何在行走过程中，尤其是在各种行走条件下，使用嵌入在裤袋中的智能手机 IMU 估算步速：本研究旨在验证和测试基于智能手机IMU的步速测量方法的可靠性，该测量方法被放置在用户前裤兜中，测量对象为健康的年轻人和老年人，测量条件分别为安静行走（即正常行走）和执行认知任务时行走（即双任务行走）：方法：使用定制开发的智能手机应用程序（App）记录12名年轻人和12名老年人在正常行走和双任务行走时的步态数据。将智能手机估算步速和步长的有效性和可靠性与黄金标准 GAITRite mat 进行了比较。为了提高步速估算的准确性，采用了一种基于系数的调整方法，该方法基于相对于原始步长估算的系数。智能手机步态数据和 GAITRite mat 步态数据之间的误差幅度（即偏差和一致性限制）被计算为每个步幅。使用 Passing-Bablok 正交回归模型提供智能手机和 GAITRite mat 之间的一致性（即斜率和截距）：结果：与 GAITRite mat 相比，智能手机测量的步速是有效的。最初的一致性界限为 0.50 米/秒（理想值为 0 米/秒），正交回归分析表明斜率为 1.68（理想值为 1），截距为 -0.70（理想值为 0）。经过调整后，智能手机得出的步速估计值的准确性有所提高，一致性降低到 0.34 米/秒。调整后的斜率提高到 1.00，截距为 0.03。在有监督的实验室环境和无监督的家庭条件下，智能手机衍生步速的测试-再测可靠性为良好至优秀。调整系数适用于各种步长和步速：倒立摆法是一种有效、可靠的方法，可通过放置在年轻人和老年人口袋中的智能手机 IMU 估算步速。根据步长的原始估计值得出的系数调整步长，成功消除了偏差，提高了步速估计的准确性。这种新方法有可能应用于各种环境和人群，但可能需要针对特定数据集进行微调。
{"title":"A Novel Approach for Improving Gait Speed Estimation Using a Single Inertial Measurement Unit Embedded in a Smartphone: Validity and Reliability Study.","authors":"Pei-An Lee, Wanting Yu, Junhong Zhou, Timothy Tsai, Brad Manor, On-Yee Lo","doi":"10.2196/52166","DOIUrl":"10.2196/52166","url":null,"abstract":"<p><strong>Background: </strong>Gait speed is a valuable biomarker for mobility and overall health assessment. Existing methods to measure gait speed require expensive equipment or personnel assistance, limiting their use in unsupervised, daily-life conditions. The availability of smartphones equipped with a single inertial measurement unit (IMU) presents a viable and convenient method for measuring gait speed outside of laboratory and clinical settings. Previous works have used the inverted pendulum model to estimate gait speed using a non-smartphone-based IMU attached to the trunk. However, it is unclear whether and how this approach can estimate gait speed using the IMU embedded in a smartphone while being carried in a pants pocket during walking, especially under various walking conditions.</p><p><strong>Objective: </strong>This study aimed to validate and test the reliability of a smartphone IMU-based gait speed measurement placed in the user's front pants pocket in both healthy young and older adults while walking quietly (ie, normal walking) and walking while conducting a cognitive task (ie, dual-task walking).</p><p><strong>Methods: </strong>A custom-developed smartphone application (app) was used to record gait data from 12 young adults and 12 older adults during normal and dual-task walking. The validity and reliability of gait speed and step length estimations from the smartphone were compared with the gold standard GAITRite mat. A coefficient-based adjustment based upon a coefficient relative to the original estimation of step length was applied to improve the accuracy of gait speed estimation. The magnitude of error (ie, bias and limits of agreement) between the gait data from the smartphone and the GAITRite mat was calculated for each stride. The Passing-Bablok orthogonal regression model was used to provide agreement (ie, slopes and intercepts) between the smartphone and the GAITRite mat.</p><p><strong>Results: </strong>The gait speed measured by the smartphone was valid when compared to the GAITRite mat. The original limits of agreement were 0.50 m/s (an ideal value of 0 m/s), and the orthogonal regression analysis indicated a slope of 1.68 (an ideal value of 1) and an intercept of -0.70 (an ideal value of 0). After adjustment, the accuracy of the smartphone-derived gait speed estimation improved, with limits of agreement reduced to 0.34 m/s. The adjusted slope improved to 1.00, with an intercept of 0.03. The test-retest reliability of smartphone-derived gait speed was good to excellent within supervised laboratory settings and unsupervised home conditions. The adjustment coefficients were applicable to a wide range of step lengths and gait speeds.</p><p><strong>Conclusions: </strong>The inverted pendulum approach is a valid and reliable method for estimating gait speed from a smartphone IMU placed in the pockets of younger and older adults. Adjusting step length by a coefficient derived from the original estimation of step length","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"12 ","pages":"e52166"},"PeriodicalIF":5.4,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11336779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141975655","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}
Daniel Edge, Edward Watkins, Alexandra Newbold, Thomas Ehring, Mads Frost, Tabea Rosenkranz
Background: Delivery of preventative interventions via mobile phone apps offers an effective and accessible way to address the global priority of improving the mental health of adolescents and young adults. A proven risk factor for anxiety and depression is elevated worry and rumination, also known as repetitive negative thinking (RNT).
Objective: This was a prevention mechanism trial that aimed to investigate whether an RNT-targeting self-help mobile phone app (MyMoodCoach) reduces worry and rumination in young adults residing in the United Kingdom. A secondary objective was to test whether the app reduces symptoms of anxiety and depression and improves well-being.
Methods: A web-based, single-blind, 2-arm parallel-group randomized controlled trial was conducted with 236 people aged between 16 and 24 years, who self-reported high levels of worry or rumination. Eligible participants were randomized to an active intervention group (usual practice, plus up to 6 weeks of using the RNT-targeting mobile app, n=119) or a waitlist control group (usual practice with no access to the app until after 6 weeks, n=117). The primary outcome was changes in worry and rumination 6 weeks after randomization. Secondary outcomes included changes in well-being and symptoms of anxiety and depression after 6 weeks and changes in all measures after 12 weeks.
Results: Participants randomly allocated to use the RNT-targeting self-help app showed significantly lower levels of rumination (mean difference -2.92, 95% CI -5.57 to -0.28; P=.03; ηp2=0.02) and worry (mean difference -3.97, 95% CI -6.21 to -1.73; P<.001; ηp2=0.06) at 6-week follow-up, relative to the waitlist control. Similar differences were observed for well-being (P<.001), anxiety (P=.03), and depression (P=.04). The waitlist control group also showed improvement when given access to the app after 6 weeks. Improvements observed in the intervention group after 6 weeks of using the app were maintained at the 12-week follow-up point.
Conclusions: The MyMoodCoach app had a significant positive effect on worry and rumination, well-being, anxiety, and depression in young adults, relative to waitlist controls, providing proof-of-principle that an unguided self-help app can effectively reduce RNT. This app, therefore, has potential for the prevention of anxiety and depression although longer-term effects on incidence need to be directly evaluated.
{"title":"Evaluating the Effects of a Self-Help Mobile Phone App on Worry and Rumination Experienced by Young Adults: Randomized Controlled Trial.","authors":"Daniel Edge, Edward Watkins, Alexandra Newbold, Thomas Ehring, Mads Frost, Tabea Rosenkranz","doi":"10.2196/51932","DOIUrl":"10.2196/51932","url":null,"abstract":"<p><strong>Background: </strong>Delivery of preventative interventions via mobile phone apps offers an effective and accessible way to address the global priority of improving the mental health of adolescents and young adults. A proven risk factor for anxiety and depression is elevated worry and rumination, also known as repetitive negative thinking (RNT).</p><p><strong>Objective: </strong>This was a prevention mechanism trial that aimed to investigate whether an RNT-targeting self-help mobile phone app (MyMoodCoach) reduces worry and rumination in young adults residing in the United Kingdom. A secondary objective was to test whether the app reduces symptoms of anxiety and depression and improves well-being.</p><p><strong>Methods: </strong>A web-based, single-blind, 2-arm parallel-group randomized controlled trial was conducted with 236 people aged between 16 and 24 years, who self-reported high levels of worry or rumination. Eligible participants were randomized to an active intervention group (usual practice, plus up to 6 weeks of using the RNT-targeting mobile app, n=119) or a waitlist control group (usual practice with no access to the app until after 6 weeks, n=117). The primary outcome was changes in worry and rumination 6 weeks after randomization. Secondary outcomes included changes in well-being and symptoms of anxiety and depression after 6 weeks and changes in all measures after 12 weeks.</p><p><strong>Results: </strong>Participants randomly allocated to use the RNT-targeting self-help app showed significantly lower levels of rumination (mean difference -2.92, 95% CI -5.57 to -0.28; P=.03; η<sub>p</sub><sup>2</sup>=0.02) and worry (mean difference -3.97, 95% CI -6.21 to -1.73; P<.001; η<sub>p</sub><sup>2</sup>=0.06) at 6-week follow-up, relative to the waitlist control. Similar differences were observed for well-being (P<.001), anxiety (P=.03), and depression (P=.04). The waitlist control group also showed improvement when given access to the app after 6 weeks. Improvements observed in the intervention group after 6 weeks of using the app were maintained at the 12-week follow-up point.</p><p><strong>Conclusions: </strong>The MyMoodCoach app had a significant positive effect on worry and rumination, well-being, anxiety, and depression in young adults, relative to waitlist controls, providing proof-of-principle that an unguided self-help app can effectively reduce RNT. This app, therefore, has potential for the prevention of anxiety and depression although longer-term effects on incidence need to be directly evaluated.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT04950257; https://www.clinicaltrials.gov/ct2/show/NCT04950257.</p><p><strong>International registered report identifier (irrid): </strong>RR2-10.1186/s12888-021-03536-0.</p>","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"12 ","pages":"e51932"},"PeriodicalIF":5.4,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11350318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141975656","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}
Background: Hypertension is highly prevalent among patients undergoing hemodialysis, with a significant proportion experiencing poorly controlled blood pressure (BP). Digital BP management in this population has been underutilized. Objective: This study aimed to explore the efficacy of a Web-based home blood pressure monitoring (HBPM) program in improving pre-dialysis BP control and enhancing knowledge, perception and adherence to HBPM among hypertensive patients undergoing hemodialysis. Methods: A multicenter, open-label, randomized controlled trial was conducted at two hemodialysis units. Patients were randomly allocated in a 1:1 ratio to either the Web-based HBPM program as the intervention group or to usual care as the control group over a 6-month period. The primary outcomes were the pre-dialysis BP control rate, defined as less than 140/90 mmHg, and the pre-dialysis systolic blood pressure (SBP), diastolic blood pressure (DBP), assessed from baseline to the 6-month follow-up. Secondary outcomes included patient knowledge, perception, and adherence to HBPM, evaluated using the home blood pressure monitoring knowledge questionnaire (HBPMKQ), home blood pressure monitoring perception scale (HBPMPS), and home blood pressure monitoring adherence scale (HBPMAS), respectively. The generalized estimating equations analysis was utilized to analyze the primary outcomes in the intention-to-treat analysis. Results: Of the 165 patients enrolled in the program (n=84, Web-based HBPM group; n=81, control group), 145 completed the follow-up assessment. During follow-up period, 11 instances of hypotension occurred in 9 patients in the Web-based HBPM group, compared to 15 events in 14 patients in the control group. The pre-dialysis BP control rate increased from 29.8% to 47.6% in the Web-based HBPM group after the 6-month intervention, while in the control group, it decreased from 37% to 24.7% (x2 =16.82, P <.001; OR = 5.11, 95%CI 2.14–12.23, P <.001). The Web-based HBPM group demonstrated a significant reduction after the 6-month intervention in the pre-dialysis SBP (t =2.46, P =.02; β = −6.09, 95%CI −10.94 – −1.24, P =.01), and the pre-dialysis DBP (t =3.20, P =.002; β = −4.93, 95%CI −7.93 – −1.93, P =.001). Scores on HBPMKQ (t = -9.18, P <.001), HBPMPS (t = −10.65, P <.001), and HBPMAS (t =−8.04, P <.001) were significantly higher after 6-months of intervention. Conclusions: Implementation of a Web-based HBPM program can enhance pre-dialysis BP control, and the knowledge, perception, and adherence to HBPM among patients undergoing hemodialysis. This Web-based HBPM program should be promoted in appropriate clinical settings. Clinical Trial: China Clinical Trial Registration Center ChiCTR2100051535; https://www.chictr.org.cn/showproj.html?proj=133286
{"title":"Efficacy of a Web-Based Home Blood Pressure Monitoring Program in Improving Predialysis Blood Pressure Control Among Patients Undergoing Hemodialysis: Randomized Controlled Trial","authors":"Tingting Chen, Wenbo Zhao, Qianqian Pei, Yanru Chen, Jinmei Yin, Min Zhang, Cheng Wang, Jing Zheng","doi":"10.2196/53355","DOIUrl":"https://doi.org/10.2196/53355","url":null,"abstract":"Background: Hypertension is highly prevalent among patients undergoing hemodialysis, with a significant proportion experiencing poorly controlled blood pressure (BP). Digital BP management in this population has been underutilized. Objective: This study aimed to explore the efficacy of a Web-based home blood pressure monitoring (HBPM) program in improving pre-dialysis BP control and enhancing knowledge, perception and adherence to HBPM among hypertensive patients undergoing hemodialysis. Methods: A multicenter, open-label, randomized controlled trial was conducted at two hemodialysis units. Patients were randomly allocated in a 1:1 ratio to either the Web-based HBPM program as the intervention group or to usual care as the control group over a 6-month period. The primary outcomes were the pre-dialysis BP control rate, defined as less than 140/90 mmHg, and the pre-dialysis systolic blood pressure (SBP), diastolic blood pressure (DBP), assessed from baseline to the 6-month follow-up. Secondary outcomes included patient knowledge, perception, and adherence to HBPM, evaluated using the home blood pressure monitoring knowledge questionnaire (HBPMKQ), home blood pressure monitoring perception scale (HBPMPS), and home blood pressure monitoring adherence scale (HBPMAS), respectively. The generalized estimating equations analysis was utilized to analyze the primary outcomes in the intention-to-treat analysis. Results: Of the 165 patients enrolled in the program (n=84, Web-based HBPM group; n=81, control group), 145 completed the follow-up assessment. During follow-up period, 11 instances of hypotension occurred in 9 patients in the Web-based HBPM group, compared to 15 events in 14 patients in the control group. The pre-dialysis BP control rate increased from 29.8% to 47.6% in the Web-based HBPM group after the 6-month intervention, while in the control group, it decreased from 37% to 24.7% (x2 =16.82, P <.001; OR = 5.11, 95%CI 2.14–12.23, P <.001). The Web-based HBPM group demonstrated a significant reduction after the 6-month intervention in the pre-dialysis SBP (t =2.46, P =.02; β = −6.09, 95%CI −10.94 – −1.24, P =.01), and the pre-dialysis DBP (t =3.20, P =.002; β = −4.93, 95%CI −7.93 – −1.93, P =.001). Scores on HBPMKQ (t = -9.18, P <.001), HBPMPS (t = −10.65, P <.001), and HBPMAS (t =−8.04, P <.001) were significantly higher after 6-months of intervention. Conclusions: Implementation of a Web-based HBPM program can enhance pre-dialysis BP control, and the knowledge, perception, and adherence to HBPM among patients undergoing hemodialysis. This Web-based HBPM program should be promoted in appropriate clinical settings. Clinical Trial: China Clinical Trial Registration Center ChiCTR2100051535; https://www.chictr.org.cn/showproj.html?proj=133286","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"200 1","pages":""},"PeriodicalIF":5.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141945475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
I Wayan Pulantara, Yuhan Wang, Lora E Burke, Susan M Sereika, Zhadyra Bizhanova, Jacob K Kariuki, Jessica Cheng, Britney Beatrice, India Loar, Maribel Cedillo, Molly B Conroy, Bambang Parmanto
Unlabelled: The integration of health and activity data from various wearable devices into research studies presents technical and operational challenges. The Awesome Data Acquisition Method (ADAM) is a versatile, web-based system that was designed for integrating data from various sources and managing a large-scale multiphase research study. As a data collecting system, ADAM allows real-time data collection from wearable devices through the device's application programmable interface and the mobile app's adaptive real-time questionnaires. As a clinical trial management system, ADAM integrates clinical trial management processes and efficiently supports recruitment, screening, randomization, data tracking, data reporting, and data analysis during the entire research study process. We used a behavioral weight-loss intervention study (SMARTER trial) as a test case to evaluate the ADAM system. SMARTER was a randomized controlled trial that screened 1741 participants and enrolled 502 adults. As a result, the ADAM system was efficiently and successfully deployed to organize and manage the SMARTER trial. Moreover, with its versatile integration capability, the ADAM system made the necessary switch to fully remote assessments and tracking that are performed seamlessly and promptly when the COVID-19 pandemic ceased in-person contact. The remote-native features afforded by the ADAM system minimized the effects of the COVID-19 lockdown on the SMARTER trial. The success of SMARTER proved the comprehensiveness and efficiency of the ADAM system. Moreover, ADAM was designed to be generalizable and scalable to fit other studies with minimal editing, redevelopment, and customization. The ADAM system can benefit various behavioral interventions and different populations.
{"title":"Data Collection and Management of mHealth, Wearables, and Internet of Things in Digital Behavioral Health Interventions With the Awesome Data Acquisition Method (ADAM): Development of a Novel Informatics Architecture.","authors":"I Wayan Pulantara, Yuhan Wang, Lora E Burke, Susan M Sereika, Zhadyra Bizhanova, Jacob K Kariuki, Jessica Cheng, Britney Beatrice, India Loar, Maribel Cedillo, Molly B Conroy, Bambang Parmanto","doi":"10.2196/50043","DOIUrl":"10.2196/50043","url":null,"abstract":"<p><strong>Unlabelled: </strong>The integration of health and activity data from various wearable devices into research studies presents technical and operational challenges. The Awesome Data Acquisition Method (ADAM) is a versatile, web-based system that was designed for integrating data from various sources and managing a large-scale multiphase research study. As a data collecting system, ADAM allows real-time data collection from wearable devices through the device's application programmable interface and the mobile app's adaptive real-time questionnaires. As a clinical trial management system, ADAM integrates clinical trial management processes and efficiently supports recruitment, screening, randomization, data tracking, data reporting, and data analysis during the entire research study process. We used a behavioral weight-loss intervention study (SMARTER trial) as a test case to evaluate the ADAM system. SMARTER was a randomized controlled trial that screened 1741 participants and enrolled 502 adults. As a result, the ADAM system was efficiently and successfully deployed to organize and manage the SMARTER trial. Moreover, with its versatile integration capability, the ADAM system made the necessary switch to fully remote assessments and tracking that are performed seamlessly and promptly when the COVID-19 pandemic ceased in-person contact. The remote-native features afforded by the ADAM system minimized the effects of the COVID-19 lockdown on the SMARTER trial. The success of SMARTER proved the comprehensiveness and efficiency of the ADAM system. Moreover, ADAM was designed to be generalizable and scalable to fit other studies with minimal editing, redevelopment, and customization. The ADAM system can benefit various behavioral interventions and different populations.</p>","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"12 ","pages":"e50043"},"PeriodicalIF":5.4,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11322796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901822","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}
Lorraine R Buis, Junhan Kim, Ananda Sen, Dongru Chen, Katee Dawood, Reema Kadri, Rachelle Muladore, Melissa Plegue, Caroline R Richardson, Zora Djuric, Candace McNaughton, David Hutton, Lionel P Robert, Sun Young Park, Phillip Levy
[This corrects the article DOI: 10.2196/57863.].
[此处更正了文章 DOI：10.2196/57863]。
{"title":"Correction: The Effect of an mHealth Self-Monitoring Intervention (MI-BP) on Blood Pressure Among Black Individuals With Uncontrolled Hypertension: Randomized Controlled Trial.","authors":"Lorraine R Buis, Junhan Kim, Ananda Sen, Dongru Chen, Katee Dawood, Reema Kadri, Rachelle Muladore, Melissa Plegue, Caroline R Richardson, Zora Djuric, Candace McNaughton, David Hutton, Lionel P Robert, Sun Young Park, Phillip Levy","doi":"10.2196/64632","DOIUrl":"10.2196/64632","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.2196/57863.].</p>","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"12 ","pages":"e64632"},"PeriodicalIF":5.4,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11336500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141897461","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}
Theresa Pauly, Janina Lüscher, Lea Olivia Wilhelm, Melanie Alexandra Amrein, George Boateng, Tobias Kowatsch, Elgar Fleisch, Guy Bodenmann, Urte Scholz
Background: Technology has become an integral part of our everyday life, and its use to manage and study health is no exception. Romantic partners play a critical role in managing chronic health conditions as they tend to be a primary source of support.
Objective: This study tests the feasibility of using commercial wearables to monitor couples' unique way of communicating and supporting each other and documents the physiological correlates of interpersonal dynamics (ie, heart rate linkage).
Methods: We analyzed 617 audio recordings of 5-minute duration (384 with concurrent heart rate data) and 527 brief self-reports collected from 11 couples in which 1 partner had type II diabetes during the course of their typical daily lives. Audio data were coded by trained raters for social support. The extent to which heart rate fluctuations were linked among couples was quantified using cross-correlations. Random-intercept multilevel models explored whether cross-correlations might differ by social contexts and exchanges.
Results: Sixty percent of audio recordings captured speech between partners and partners reported personal contact with each other in 75% of self-reports. Based on the coding, social support was found in 6% of recordings, whereas at least 1 partner self-reported social support about half the time (53%). Couples, on average, showed small to moderate interconnections in their heart rate fluctuations (r=0.04-0.22). Couples also varied in the extent to which there was lagged linkage, that is, meaning that changes in one partner's heart rate tended to precede changes in the other partner's heart rate. Exploratory analyses showed that heart rate linkage was stronger (1) in rater-coded partner conversations (vs moments of no rater-coded partner conversations: rdiff=0.13; P=.03), (2) when partners self-reported interpersonal contact (vs moments of no self-reported interpersonal contact: rdiff=0.20; P<.001), and (3) when partners self-reported social support exchanges (vs moments of no self-reported social support exchange: rdiff=0.15; P=.004).
Conclusions: Our study provides initial evidence for the utility of using wearables to collect biopsychosocial data in couples managing a chronic health condition in daily life. Specifically, heart rate linkage might play a role in fostering chronic disease management as a couple. Insights from collecting such data could inform future technology interventions to promote healthy lifestyle engagement and adaptive chronic disease management.
International registered report identifier (irrid): RR2-10.2196/13685.
{"title":"Using Wearables to Study Biopsychosocial Dynamics in Couples Who Cope With a Chronic Health Condition: Ambulatory Assessment Study.","authors":"Theresa Pauly, Janina Lüscher, Lea Olivia Wilhelm, Melanie Alexandra Amrein, George Boateng, Tobias Kowatsch, Elgar Fleisch, Guy Bodenmann, Urte Scholz","doi":"10.2196/49576","DOIUrl":"10.2196/49576","url":null,"abstract":"<p><strong>Background: </strong>Technology has become an integral part of our everyday life, and its use to manage and study health is no exception. Romantic partners play a critical role in managing chronic health conditions as they tend to be a primary source of support.</p><p><strong>Objective: </strong>This study tests the feasibility of using commercial wearables to monitor couples' unique way of communicating and supporting each other and documents the physiological correlates of interpersonal dynamics (ie, heart rate linkage).</p><p><strong>Methods: </strong>We analyzed 617 audio recordings of 5-minute duration (384 with concurrent heart rate data) and 527 brief self-reports collected from 11 couples in which 1 partner had type II diabetes during the course of their typical daily lives. Audio data were coded by trained raters for social support. The extent to which heart rate fluctuations were linked among couples was quantified using cross-correlations. Random-intercept multilevel models explored whether cross-correlations might differ by social contexts and exchanges.</p><p><strong>Results: </strong>Sixty percent of audio recordings captured speech between partners and partners reported personal contact with each other in 75% of self-reports. Based on the coding, social support was found in 6% of recordings, whereas at least 1 partner self-reported social support about half the time (53%). Couples, on average, showed small to moderate interconnections in their heart rate fluctuations (r=0.04-0.22). Couples also varied in the extent to which there was lagged linkage, that is, meaning that changes in one partner's heart rate tended to precede changes in the other partner's heart rate. Exploratory analyses showed that heart rate linkage was stronger (1) in rater-coded partner conversations (vs moments of no rater-coded partner conversations: r<sub>diff</sub>=0.13; P=.03), (2) when partners self-reported interpersonal contact (vs moments of no self-reported interpersonal contact: r<sub>diff</sub>=0.20; P<.001), and (3) when partners self-reported social support exchanges (vs moments of no self-reported social support exchange: r<sub>diff</sub>=0.15; P=.004).</p><p><strong>Conclusions: </strong>Our study provides initial evidence for the utility of using wearables to collect biopsychosocial data in couples managing a chronic health condition in daily life. Specifically, heart rate linkage might play a role in fostering chronic disease management as a couple. Insights from collecting such data could inform future technology interventions to promote healthy lifestyle engagement and adaptive chronic disease management.</p><p><strong>International registered report identifier (irrid): </strong>RR2-10.2196/13685.</p>","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"12 ","pages":"e49576"},"PeriodicalIF":5.4,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11333870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141893453","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}
<p><strong>Background: </strong>It is not known whether an intervention made mandatory as a physical education (PE) class assignment and aimed at promoting physical activity (PA) in adolescents can create a healthy walking habit, which would allow further improvements to be achieved after the mandatory and promoted intervention has been completed.</p><p><strong>Objective: </strong>The aims of this study were to (1) investigate whether, after a period of using a step tracker mobile app made mandatory and promoted as a PE class assignment, adolescents continue to use it when its use is no longer mandatory and promoted; (2) determine whether there are changes in the PA level, body composition, and fitness of adolescents when the use of the app is mandatory and promoted and when it is neither mandatory nor promoted; and (3) analyze whether the covariates maturity status, gender, and specific app used can have an influence.</p><p><strong>Methods: </strong>A total of 357 students in compulsory secondary education (age: mean 13.92, SD 1.91 y) participated in the study. A randomized controlled trial was conducted consisting of 2 consecutive 10-week interventions. Participants' PA level, body composition, and fitness were measured at baseline (T1), after 10 weeks of mandatory and promoted app use (T2), and after 10 weeks of nonmandatory and nonpromoted app use (T3). Each participant in the experimental group (EG) used 1 of 4 selected step tracker mobile apps after school hours.</p><p><strong>Results: </strong>The results showed that when the use of the apps was neither mandatory nor promoted as a PE class assignment, only a few adolescents (18/216, 8.3%) continued the walking practice. After the mandatory and promoted intervention period (T1 vs T2), a decrease in the sum of 3 skinfolds (mean difference [MD] 1.679; P=.02) as well as improvements in the PA level (MD -0.170; P<.001), maximal oxygen uptake (MD -1.006; P<.001), countermovement jump test (MD -1.337; P=.04), curl-up test (MD -3.791; P<.001), and push-up test (MD -1.920; P<.001) in the EG were recorded. However, the changes between T1 and T2 were significantly greater in the EG than in the control group only in the PA level and curl-up test. Thus, when comparing the measurements taken between T1 and T3, no significant changes in body composition (P=.07) or fitness (P=.84) were observed between the EG and the control group. The covariates maturity status, gender, and specific app used showed a significant effect in most of the analyses performed.</p><p><strong>Conclusions: </strong>A period of mandatory and promoted use of step tracker mobile apps benefited the variables of body composition and fitness in adolescents but did not create a healthy walking habit in this population; therefore, when the use of these apps ceased to be mandatory and promoted, the effects obtained disappeared.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT06164041; https://clinicaltrials.gov/study/NCT06
{"title":"Physical Activity, Body Composition, and Fitness Variables in Adolescents After Periods of Mandatory, Promoted or Nonmandatory, Nonpromoted Use of Step Tracker Mobile Apps: Randomized Controlled Trial.","authors":"Adrián Mateo-Orcajada, Raquel Vaquero-Cristóbal, Jorge Mota, Lucía Abenza-Cano","doi":"10.2196/51206","DOIUrl":"10.2196/51206","url":null,"abstract":"<p><strong>Background: </strong>It is not known whether an intervention made mandatory as a physical education (PE) class assignment and aimed at promoting physical activity (PA) in adolescents can create a healthy walking habit, which would allow further improvements to be achieved after the mandatory and promoted intervention has been completed.</p><p><strong>Objective: </strong>The aims of this study were to (1) investigate whether, after a period of using a step tracker mobile app made mandatory and promoted as a PE class assignment, adolescents continue to use it when its use is no longer mandatory and promoted; (2) determine whether there are changes in the PA level, body composition, and fitness of adolescents when the use of the app is mandatory and promoted and when it is neither mandatory nor promoted; and (3) analyze whether the covariates maturity status, gender, and specific app used can have an influence.</p><p><strong>Methods: </strong>A total of 357 students in compulsory secondary education (age: mean 13.92, SD 1.91 y) participated in the study. A randomized controlled trial was conducted consisting of 2 consecutive 10-week interventions. Participants' PA level, body composition, and fitness were measured at baseline (T1), after 10 weeks of mandatory and promoted app use (T2), and after 10 weeks of nonmandatory and nonpromoted app use (T3). Each participant in the experimental group (EG) used 1 of 4 selected step tracker mobile apps after school hours.</p><p><strong>Results: </strong>The results showed that when the use of the apps was neither mandatory nor promoted as a PE class assignment, only a few adolescents (18/216, 8.3%) continued the walking practice. After the mandatory and promoted intervention period (T1 vs T2), a decrease in the sum of 3 skinfolds (mean difference [MD] 1.679; P=.02) as well as improvements in the PA level (MD -0.170; P<.001), maximal oxygen uptake (MD -1.006; P<.001), countermovement jump test (MD -1.337; P=.04), curl-up test (MD -3.791; P<.001), and push-up test (MD -1.920; P<.001) in the EG were recorded. However, the changes between T1 and T2 were significantly greater in the EG than in the control group only in the PA level and curl-up test. Thus, when comparing the measurements taken between T1 and T3, no significant changes in body composition (P=.07) or fitness (P=.84) were observed between the EG and the control group. The covariates maturity status, gender, and specific app used showed a significant effect in most of the analyses performed.</p><p><strong>Conclusions: </strong>A period of mandatory and promoted use of step tracker mobile apps benefited the variables of body composition and fitness in adolescents but did not create a healthy walking habit in this population; therefore, when the use of these apps ceased to be mandatory and promoted, the effects obtained disappeared.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT06164041; https://clinicaltrials.gov/study/NCT06","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"12 ","pages":"e51206"},"PeriodicalIF":5.4,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11322691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141855552","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}
Celia Cruz-Cobo, María Ángeles Bernal-Jiménez, Germán Calle, Livia Luciana Gheorghe, Alejandro Gutiérrez-Barrios, Dolores Cañadas, Josep A Tur, Rafael Vázquez-García, María José Santi-Cano
<p><strong>Background: </strong>Cardiac rehabilitation is fundamental among patients recovering from a coronary event, and mHealth technology may constitute a useful tool that provides guidelines based on scientific evidence in an entertaining, attractive, and user-friendly format.</p><p><strong>Objective: </strong>This study aimed to compare the efficacy of an mHealth intervention involving the eMOTIVA app and that of usual care regarding compliance with cardiac rehabilitation guidelines in terms of lifestyle, cardiovascular risk factors, and satisfaction among patients with acute coronary syndrome.</p><p><strong>Methods: </strong>A randomized controlled clinical trial with a parallel group design was conducted. It included 300 patients (mHealth group, 150; control group, 150) who underwent percutaneous coronary intervention for acute coronary syndrome. Both groups underwent evaluations initially (during hospitalization) and after 3 and 6 months (face-to-face consultations). The eMOTIVA app incorporates a virtual classroom providing audio and video information about a healthy lifestyle, a section for self-recording cardiovascular risk factors, and a section for feedback messages and gamification. The primary outcome variables were (1) adherence to the Mediterranean diet and the frequency of consumption of food; (2) physical activity level, sedentary time, and exercise capacity; (3) smoking cessation and nicotine dependence; (4) level of knowledge about cardiovascular risk factors; and (5) app satisfaction and usability.</p><p><strong>Results: </strong>The study analyzed 287 patients (mHealth group, 145; control group, 142). Most participants were male (207/300, 69.0%), and the mean age was 62.53 (SD 8.65) years. Significant improvements were observed in the mHealth group compared with the control group at 6 months in terms of (1) adherence to the Mediterranean diet (mean 11.92, SD 1.70 vs 8.92, SD 2.66 points; P<.001) and frequency of eating foods (red meat [≤1/week]: 141/143, 97.9% vs 96/141, 68.1%; industrial pastries [<2/week]: 129/143, 89.6% vs 80/141, 56.8%; oily fish [≥2/week]: 124/143, 86.1% vs 64/141, 41.4%; vegetables [≥2/day]: 130/143, 90.3% vs 78/141, 55.3%; fruit [≥2/day]: 128/143, 88.9% vs 85/141, 60.2%; all P<.001); (2) physical activity (mean 2112.66, SD 1196.67 vs 1372.60, SD 944.62 metabolic equivalents/week; P<.001) and sedentary time (mean 8.38, SD 1.88 vs 9.59, SD 2.09 hours; P<.001); (3) exercise capacity (distance: mean 473.49, SD 102.28 vs 447.25, SD 93.68 meters; P=.04); and (4) level of knowledge (mean 117.85, SD 3.83 vs 111.00, SD 7.11 points; P<.001). App satisfaction was high (mean 42.53, SD 6.38 points), and its usability was excellent (mean 95.60, SD 4.03 points).</p><p><strong>Conclusions: </strong>With the eMOTIVA app, favorable results were obtained in the intervention group in terms of adherence to the Mediterranean diet, frequency of eating certain foods, physical activity, sedentary time, exercise capacity, kn
{"title":"Efficacy of a Mobile Health App (eMOTIVA) Regarding Compliance With Cardiac Rehabilitation Guidelines in Patients With Coronary Artery Disease: Randomized Controlled Clinical Trial.","authors":"Celia Cruz-Cobo, María Ángeles Bernal-Jiménez, Germán Calle, Livia Luciana Gheorghe, Alejandro Gutiérrez-Barrios, Dolores Cañadas, Josep A Tur, Rafael Vázquez-García, María José Santi-Cano","doi":"10.2196/55421","DOIUrl":"10.2196/55421","url":null,"abstract":"<p><strong>Background: </strong>Cardiac rehabilitation is fundamental among patients recovering from a coronary event, and mHealth technology may constitute a useful tool that provides guidelines based on scientific evidence in an entertaining, attractive, and user-friendly format.</p><p><strong>Objective: </strong>This study aimed to compare the efficacy of an mHealth intervention involving the eMOTIVA app and that of usual care regarding compliance with cardiac rehabilitation guidelines in terms of lifestyle, cardiovascular risk factors, and satisfaction among patients with acute coronary syndrome.</p><p><strong>Methods: </strong>A randomized controlled clinical trial with a parallel group design was conducted. It included 300 patients (mHealth group, 150; control group, 150) who underwent percutaneous coronary intervention for acute coronary syndrome. Both groups underwent evaluations initially (during hospitalization) and after 3 and 6 months (face-to-face consultations). The eMOTIVA app incorporates a virtual classroom providing audio and video information about a healthy lifestyle, a section for self-recording cardiovascular risk factors, and a section for feedback messages and gamification. The primary outcome variables were (1) adherence to the Mediterranean diet and the frequency of consumption of food; (2) physical activity level, sedentary time, and exercise capacity; (3) smoking cessation and nicotine dependence; (4) level of knowledge about cardiovascular risk factors; and (5) app satisfaction and usability.</p><p><strong>Results: </strong>The study analyzed 287 patients (mHealth group, 145; control group, 142). Most participants were male (207/300, 69.0%), and the mean age was 62.53 (SD 8.65) years. Significant improvements were observed in the mHealth group compared with the control group at 6 months in terms of (1) adherence to the Mediterranean diet (mean 11.92, SD 1.70 vs 8.92, SD 2.66 points; P<.001) and frequency of eating foods (red meat [≤1/week]: 141/143, 97.9% vs 96/141, 68.1%; industrial pastries [<2/week]: 129/143, 89.6% vs 80/141, 56.8%; oily fish [≥2/week]: 124/143, 86.1% vs 64/141, 41.4%; vegetables [≥2/day]: 130/143, 90.3% vs 78/141, 55.3%; fruit [≥2/day]: 128/143, 88.9% vs 85/141, 60.2%; all P<.001); (2) physical activity (mean 2112.66, SD 1196.67 vs 1372.60, SD 944.62 metabolic equivalents/week; P<.001) and sedentary time (mean 8.38, SD 1.88 vs 9.59, SD 2.09 hours; P<.001); (3) exercise capacity (distance: mean 473.49, SD 102.28 vs 447.25, SD 93.68 meters; P=.04); and (4) level of knowledge (mean 117.85, SD 3.83 vs 111.00, SD 7.11 points; P<.001). App satisfaction was high (mean 42.53, SD 6.38 points), and its usability was excellent (mean 95.60, SD 4.03 points).</p><p><strong>Conclusions: </strong>With the eMOTIVA app, favorable results were obtained in the intervention group in terms of adherence to the Mediterranean diet, frequency of eating certain foods, physical activity, sedentary time, exercise capacity, kn","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"12 ","pages":"e55421"},"PeriodicalIF":5.4,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11310647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141758764","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}
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