JMIR Formative Research最新文献_第3页

Effects of Smart Goggles Used Before Bed on Objectively Measured Sleep and Self-Reported Anxiety, Stress, and Relaxation: A Pilot Study. 睡前使用智能护目镜对客观测量的睡眠和自我报告的焦虑、压力和放松的影响：试点研究。

IF 2 Q3 HEALTH CARE SCIENCES & SERVICES

JMIR Formative Research

Pub Date : 2024-10-29 DOI: 10.2196/58461

Sharon Danoff-Burg, Elie Gottlieb, Morgan A Weaver, Kiara C Carmon, Duvia Lara Ledesma, Holly M Rus

Background: Insufficient sleep is a problem affecting millions. Poor sleep can instigate or worsen anxiety and, conversely, anxiety can lead to or exacerbate poor sleep. Advances in innovative consumer products designed to promote relaxation and support healthy sleep are emerging and their effectiveness can be evaluated accurately using sleep measurement technologies in the home environment.Objective: This pilot study examined the effects of smart goggles used before bed to deliver gentle, slow vibration to the eyes and temples. The hypothesis was that objective sleep, perceived sleep, and self-reported stress, anxiety, relaxation, and sleepiness would improve after using the smart goggles.Methods: A within-subjects, pre-post design was implemented. Healthy adults with subclinical threshold sleep problems (N=20) tracked their sleep nightly using a PSG-validated non-contact biomotion device and completed daily questionnaires (3 weeks baseline, 3 weeks intervention). During the baseline period, participants slept at home as usual. During the intervention period, participants used Therabody SmartGoggles in Sleep mode before bed. This mode, designed for relaxation, delivers gentle eye and temple massage through the inflation of internal compartments to create a kneading sensation and vibrating motors. At night, participants completed questionnaires assessing relaxation, stress, anxiety, and sleepiness immediately before and after goggle use. Daily questionnaires assessed perceived sleep each morning, complementing the objective sleep measurement.Results: Multilevel regression analysis of 676 nights of objective data showed improvements during nights when using the goggles, relative to baseline, in sleep duration (+12 minutes, P=.014); deep sleep, measured in duration (+6 minutes, P=.002), proportion of the night (7% relative increase, P=.020), and BodyScore, an age- and gender-normalized measure of deep sleep (4% increase, P=.002); number of nighttime awakenings (7% decrease, P=.021); total time awake at night after sleep onset (-6 minutes, P=.047); and SleepScore, a measure of overall sleep quality (3% increase, P=.020). Questionnaire data showed that, compared to baseline, participants felt they had better sleep quality (P<.001) and felt more well-rested upon waking (P<.001). Furthermore, immediately after using the goggles each night, compared to immediately before, participants reported feeling sleepier, less stressed, less anxious, and more relaxed (all Ps<.05). A standardized inventory administered before and after the 3-week intervention period indicated reduced anxiety, confirming the nightly analysis (P=.03).Conclusions: Objectively measured sleep quality and duration, as well as perceived sleep, improved when using the goggles before bed compared to baseline. Participants also reported increased feelings of relaxation along wi

背景介绍睡眠不足是一个影响数百万人的问题。睡眠不足会引发或加剧焦虑，反之，焦虑也会导致或加剧睡眠不足。旨在促进放松和支持健康睡眠的创新型消费产品不断涌现，在家庭环境中使用睡眠测量技术可以准确评估这些产品的效果：这项试点研究考察了睡前使用智能护目镜对眼睛和太阳穴进行轻柔、缓慢振动的效果。假设使用智能护目镜后，客观睡眠、感知睡眠以及自我报告的压力、焦虑、放松和嗜睡情况都会得到改善：方法：采用受试者内、前-后设计。有亚临床阈值睡眠问题的健康成年人（20 人）每晚使用经 PSG 验证的非接触式生物运动装置跟踪睡眠情况，并填写每日问卷（基线期 3 周，干预期 3 周）。在基线期，参与者照常在家睡觉。在干预期间，参与者在睡前使用 Therabody 智能护目镜的睡眠模式。该模式专为放松而设计，通过充气的内部隔间产生揉捏感和振动马达，对眼部和太阳穴进行轻柔按摩。晚上，参与者在使用护目镜前后立即填写调查问卷，评估放松、压力、焦虑和嗜睡程度。每天早上的调查问卷对感知睡眠进行评估，对客观睡眠测量进行补充：对 676 个晚上的客观数据进行的多层次回归分析表明，与基线相比，使用护目镜的晚上在睡眠时间（+12 分钟，P=.014）、深度睡眠（+6 分钟，P=.002）、夜间比例（相对增加 7%，P=.P=.002）；夜间觉醒次数（减少 7%，P=.021）；睡眠开始后夜间总清醒时间（-6 分钟，P=.047）；以及衡量总体睡眠质量的 SleepScore（增加 3%，P=.020）。问卷数据显示，与基线相比，参与者认为自己的睡眠质量有所提高（PC结论：与基线相比，客观测量的睡眠质量和持续时间以及感知睡眠在睡前使用护目镜时都有所改善。参与者还表示放松感增强，压力和焦虑减少。今后有必要在这项试点研究的基础上进一步开展研究，以证实本简短报告中提供的初步证据：

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引用次数: 0

Development of the Happy Hands Self-Management App for People with Hand Osteoarthritis: Feasibility Study. 为手部骨关节炎患者开发 "快乐之手 "自我管理应用程序：可行性研究。

IF 2 Q3 HEALTH CARE SCIENCES & SERVICES

JMIR Formative Research

Pub Date : 2024-10-29 DOI: 10.2196/59016

Anne Therese Tveter, Cecilie Varsi, Marit Kristin Maarnes, Stein Jarle Pedersen, Barbara S Christensen, Thale Beate Blanck, Sissel B Nyheim, Tim Pelle, Ingvild Kjeken

Background: Patient education, hand exercises, and the use of assistive devices are recommended as first-line treatments for individuals with hand osteoarthritis (OA). However, the quality of care services for this patient group is suboptimal in primary care.Objective: The overarching goal was to develop and evaluate feasibility of an app-based self-management intervention for people with hand OA. This feasibility study aims to assess self-reported usability and satisfaction, change in outcomes and quality-of-care, exercise adherence and patients' experiences using the app.Methods: The development and feasibility testing followed the first 2 phases of the Medical Research Council framework for the development and evaluation of complex interventions and were conducted in close collaboration with patient research partners (PRPs). A 3-month pre-post mixed methods design was used to evaluate feasibility. Men and women over 40 years of age diagnosed with painful, symptomatic hand OA were recruited. Usability was assessed using the System Usability Scale (0-100), while satisfaction, usefulness, pain, and stiffness were evaluated using a numeric rating scale (NRS score from 0 to 10). The activity performance of the hand was measured using the Measure of Activity Performance of the Hand (MAP-Hand) (1-4), grip strength was assessed with a Jamar dynamometer (kg), and self-reported quality of care was evaluated using the Osteoarthritis Quality Indicator questionnaire (0-100). Participants were deemed adherent if they completed at least 2 exercise sessions per week for a minimum of 8 weeks. Focus groups were conducted to explore participants' experiences using the app. Changes were analyzed using a paired sample t test (mean change and 95% CI), with the significance level set at P<.05.Results: The first version of the Happy Hands app was developed based on the needs and requirements of the PRPs, evidence-based treatment recommendations, and the experiences of individuals living with hand OA. The app was designed to guide participants through a series of informational videos, exercise videos, questionnaires, quizzes, and customized feedback over a 3-month period. The feasibility study included 71 participants (mean age 64 years, SD 8; n=61, 86%, women), of whom 57 (80%) completed the assessment after 3 months. Usability (mean 91.5 points, SD 9.2 points), usefulness (median 8, IQR 7-10), and satisfaction (median 8, IQR 7-10) were high. Significant improvements were observed in self-reported quality of care (36.4 points, 95% CI 29.7-43.1, P<.001), grip strength (right: 2.9 kg, 95% CI 1.7-4.1; left: 3.2 kg, 95% CI 1.9-4.6, P<.001), activity performance (0.18 points, 95% CI 0.11-0.25, P<.001), pain (1.7 points, 95% CI 1.2-2.2, P<.001), and stiffness (1.9 points, 95% CI 1.3-2.4, P=.001) after 3 months. Of the 71 participants, 53 (75%) were adherent to the exercise program.

背景：建议将患者教育、手部锻炼和使用辅助设备作为手部骨关节炎（OA）患者的一线治疗方法。然而，基层医疗机构为这一患者群体提供的护理服务质量并不理想：总体目标是为手部 OA 患者开发并评估基于应用程序的自我管理干预措施的可行性。这项可行性研究旨在评估自我报告的可用性和满意度、治疗效果和护理质量的变化、坚持锻炼的情况以及患者使用该应用程序的体验：开发和可行性测试遵循医学研究委员会复杂干预措施开发和评估框架的前两个阶段，并与患者研究合作伙伴（PRPs）密切合作进行。采用为期 3 个月的前-后混合方法设计来评估可行性。招募了 40 岁以上被诊断为手部有症状的疼痛性 OA 的男性和女性。可用性采用系统可用性量表（0-100 分）进行评估，满意度、实用性、疼痛和僵硬程度则采用数字评级量表（NRS 分值为 0-10 分）进行评估。手部活动能力采用手部活动能力量表（MAP-Hand）（1-4）进行测量，握力采用贾马尔测力计（公斤）进行评估，护理质量自我报告采用骨关节炎质量指标问卷（0-100）进行评估。如果参与者在至少 8 周内每周至少完成 2 次锻炼，则被视为坚持锻炼。我们还开展了焦点小组讨论，以探讨参与者使用该应用程序的经验。使用配对样本 t 检验（平均变化和 95% CI）对变化进行分析，显著性水平设定为 PResults：第一版 "快乐双手 "应用程序是根据PRP的需求和要求、循证治疗建议以及手部OA患者的经验开发的。该应用程序旨在通过一系列信息视频、锻炼视频、问卷调查、测验和定制反馈，在 3 个月的时间内指导参与者。可行性研究包括 71 名参与者（平均年龄 64 岁，SD 8；n=61，86% 为女性），其中 57 人（80%）在 3 个月后完成了评估。评估的可用性（平均 91.5 分，标准差 9.2 分）、实用性（中位数 8 分，IQR 7-10 分）和满意度（中位数 8 分，IQR 7-10 分）都很高。在自我报告的护理质量方面观察到显著改善（36.4 分，95% CI 29.7-43.1，PC 结论：患者认为基于应用程序的自我管理干预非常实用。结果进一步表明，该干预措施可改善护理质量、握力、活动能力、疼痛和僵硬程度。不过，最终结论还需要通过有影响力的随机对照试验来证实：试验注册：NCT05150171。

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引用次数: 0

Critical Success Factors and Acceptance of the Casemix System Implementation Within the Total Hospital Information System: Exploratory Factor Analysis of a Pilot Study. 在全医院信息系统内实施病例混合系统的关键成功因素和接受度：试点研究的探索性因素分析。

IF 2 Q3 HEALTH CARE SCIENCES & SERVICES

JMIR Formative Research

Pub Date : 2024-10-29 DOI: 10.2196/56898

Noor Khairiyah Mustafa, Roszita Ibrahim, Azimatun Noor Aizuddin, Syed Mohamed Aljunid, Zainudin Awang

Background: The health care landscape is evolving rapidly due to rising costs, an aging population, and the increasing prevalence of diseases. To address these challenges, the Ministry of Health of Malaysia implemented transformation strategies such as the Casemix system and hospital information system to enhance health care quality, resource allocation, and cost-effectiveness. However, successful implementation relies not just on the technology itself but on the acceptance and engagement of the users involved.Objective: This study aims to develop and refine items of a quantitative instrument measuring the critical success factors influencing acceptance of Casemix system implementation within the Ministry of Health's Total Hospital Information System (THIS).Methods: A cross-sectional pilot study collected data from medical doctors at a hospital equipped with the THIS in the federal territory of Putrajaya, Malaysia. This pilot study's minimum sample size was 125, achieved through proportionate stratified random sampling. Data were collected using a web-based questionnaire adapted from the human, organization, and technology-fit evaluation framework and the technology acceptance model. The pilot data were analyzed using exploratory factor analysis (EFA), and the Cronbach α assessed internal reliability. Both analyses were conducted in SPSS (version 25.0; IBM Corp).Results: This study obtained 106 valid responses, equivalent to an 84.8% (106/125) response rate. The Kaiser-Meyer-Olkin measure of sampling adequacy was 0.859, and the Bartlett test of sphericity yielded statistically significant results (P<.001). Principal component analysis identified 9 components explaining 84.07% of the total variance, surpassing the minimum requirement of 60%. In total, 9 unique slopes indicated the identification of 9 components through EFA. While no new components emerged from the other 7 constructs, only the organizational factors construct was divided into 2 components, later named organizational structure and organizational environment. In total, 98% (41/42) of the items had factor loadings of >0.6, leading to the removal of 1 item for the final instrument for the field study. EFA ultimately identified 8 main constructs influencing Casemix implementation within the THIS: system quality, information quality, service quality, organizational characteristics, perceived ease of use, perceived usefulness, intention to use, and acceptance. Internal reliability measured using the Cronbach α ranged from 0.914 to 0.969, demonstrating high reliability.Conclusions: This study provides insights into the complexities of EFA and the distinct dimensions underlying the constructs that influence Casemix system acceptance in the THIS. While the findings align with extensive technology acceptance literature, the results accentuate the necessity for further research t

背景：由于成本上升、人口老龄化和疾病流行率增加，医疗保健领域正在迅速发展。为应对这些挑战，马来西亚卫生部实施了病例混合系统和医院信息系统等转型战略，以提高医疗质量、资源分配和成本效益。然而，成功的实施不仅依赖于技术本身，还依赖于相关用户的接受和参与：本研究旨在开发和完善一种定量工具，用于衡量影响卫生部医院综合信息系统（THIS）中病例混合系统实施的关键成功因素：一项横断面试点研究从马来西亚普特拉贾亚联邦地区一家配备了全医院信息系统（THIS）的医院的医生处收集数据。该试点研究的最小样本量为 125 个，通过比例分层随机抽样实现。数据收集采用了基于网络的调查问卷，该问卷改编自人力、组织和技术适应性评估框架以及技术接受模型。试验数据采用探索性因素分析法（EFA）进行分析，并采用 Cronbach α 评估内部可靠性。这两项分析均在 SPSS（25.0 版；IBM 公司）中进行：本研究共收到 106 份有效问卷，回复率为 84.8%（106/125）。Kaiser-Meyer-Olkin 抽样充分性测量结果为 0.859，Bartlett 球形度检验结果具有统计学意义（P0.6，导致实地研究的最终工具删除了一个项目）。EFA 最终确定了影响 THIS 中 Casemix 实施的 8 个主要构念：系统质量、信息质量、服务质量、组织特征、感知易用性、感知有用性、使用意向和接受度。使用 Cronbach α 测量的内部信度在 0.914 到 0.969 之间，显示出较高的信度：本研究深入揭示了 EFA 的复杂性，以及影响 THIS 中 Casemix 系统接受度的不同维度。虽然研究结果与大量的技术接受文献相吻合，但其结果也强调了进一步研究的必要性，以便就成功采用 Casemix 的最关键因素达成共识。所开发的工具是朝着更好地理解马来西亚医疗保健系统转型所面临的多维挑战迈出的重要一步，为未来的实地调查和在其他医院的更广泛应用奠定了基础。

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引用次数: 0

Short-Term Outcomes of a Healthy Relationship Intervention for the Prevention of Sexual Harassment and Sexual Assault in the US Military: Pilot Pretest-Postest Study. 美国军队中预防性骚扰和性侵犯的健康关系干预措施的短期效果：试验性前测-后测研究。

IF 2 Q3 HEALTH CARE SCIENCES & SERVICES

JMIR Formative Research

Pub Date : 2024-10-29 DOI: 10.2196/64412

Belinda Hernandez, Ross Shegog, Christine Markham, Susan Emery, Elizabeth Baumler, Laura Thormaehlen, Rejane Andina Teixeira, Yanneth Rivera, Olive Pertuit, Chelsey Kanipe, Iraina Witherspoon, Janis Doss, Victor Jones, Melissa Peskin

Background: Sexual harassment (SH) and sexual assault (SA) are serious public health problems among US service members. Few SH and SA prevention interventions have been developed exclusively for the military. Code of Respect (X-CoRe) is an innovative web-based, multilevel, SA and SH intervention designed exclusively for the active-duty Air Force. The program's goal is to increase Airmen's knowledge and skills to build and maintain respectful relationships, ultimately reducing SH and SA and enhancing Airmen's overall well-being and mission readiness.

Objective: This pilot study aimed to assess the short-term psychosocial impact (eg, knowledge, attitudes, and self-efficacy) of the web-based component of X-CoRe on a sample of junior enlisted and midlevel Airmen.

Methods: Airmen from a military installation located in the Northeastern United States were recruited to complete the 10 web-based modules in X-CoRe (9/15, 60% male; 7/15, 54% aged 30-35 years). Participants were given pretests and posttests to measure short-term psychosocial outcomes associated with SH and SA. Descriptive statistics and paired 2-tailed t tests were conducted to assess differences from preintervention to postintervention time points.

Results: After completing X-CoRe, participants had a significantly greater understanding of active consent (P=.04), confidence in their healthy relationship skills (P=.045), and confidence to intervene as bystanders (P=.01). Although not statistically significant (P>.05), mean scores in attitudes about SH, couple violence, and cyberbullying; perceptions of sexual misconduct as part of military life; and relationship skills self-efficacy with a romantic partner and friend also improved.

Conclusions: The findings from this study demonstrate X-CoRe's effectiveness in improving critical determinants of SH and SA, making it a promising intervention for SH and SA prevention. More rigorous research is needed to determine X-CoRe's impact on SH and SA victimization and the long-term impact on associated psychosocial determinants.

背景：性骚扰（SH）和性侵犯（SA）是美国军人中严重的公共卫生问题。很少有专门针对军队开发的性骚扰和性侵犯预防干预措施。尊重守则》（X-CoRe）是一项基于网络、多层次的创新性性骚扰和性侵犯干预措施，专为现役空军设计。该计划的目标是提高空军飞行员建立和维护相互尊重关系的知识和技能，最终减少SH和SA，提高空军飞行员的整体健康水平和任务准备状态：这项试点研究旨在评估 X-CoRe 网络版对初级和中级飞行员的短期社会心理影响（如知识、态度和自我效能）：从位于美国东北部的一个军事设施招募空军士兵完成 X-CoRe 的 10 个基于网络的模块（9/15，60% 为男性；7/15，54% 年龄在 30-35 岁之间）。对参与者进行了前测和后测，以测量与 SH 和 SA 相关的短期社会心理结果。通过描述性统计和配对双尾 t 检验来评估干预前和干预后时间点的差异：结果：完成 X-CoRe 后，参与者对主动同意的理解（P=.04）、对自身健康人际关系技能的信心（P=.045）以及作为旁观者进行干预的信心（P=.01）都有了显著提高。虽然没有统计学意义（P>.05），但他们对性暴力、情侣暴力和网络欺凌的态度、将性行为不当视为军事生活一部分的看法以及与恋爱伙伴和朋友建立关系的技能自我效能感的平均得分也有所提高：本研究的结果表明，X-CoRe 能有效改善 SH 和 SA 的关键决定因素，使其成为一种很有前途的 SH 和 SA 预防干预措施。要确定 X-CoRe 对 SH 和 SA 受害情况的影响以及对相关社会心理决定因素的长期影响，还需要进行更严格的研究。

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引用次数: 0

Home Transcutaneous Electrical Stimulation Rehabilitation Program for Patients With Ankylosing Spondylitis: Crossover Trial. 针对强直性脊柱炎患者的家庭经皮电刺激康复计划：交叉试验

IF 2 Q3 HEALTH CARE SCIENCES & SERVICES

JMIR Formative Research

Pub Date : 2024-10-28 DOI: 10.2196/58048

Yu-Chih Lin, Chen-Ching Wu, Wan-Yu Sung, Jeng-Hsien Yen, Yi-Ching Lin

Background: Maintaining physical function and preserving spinal flexibility have been challenging in managing ankylosing spondylitis (AS). Most rehabilitation programs, including manual therapy, massage, hydrotherapy, and acupuncture, cannot be performed at home. The effect of transcutaneous electrical nerve stimulation (TENS) was validated in treating AS, but no home TENS system has explored its efficacy to date.

Objective: This study aims to evaluate the efficacy of a home TENS system with a novel treatment program for patients with AS.

Methods: The modified WeHeal TS-200 TENS and galvanic response system provided home-based TENS treatment for patients with AS. Patients were divided into a 2-month course group and a 1-month course group. After the first treatment course, patients went through a washout period for the same duration of their treatment course. Participants could decide whether to accept the second course of treatment. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Schober test, finger-to-floor flexion test, enthesis score, cytokines, chemokines, inflammatory factors, and immunoglobulins were measured to evaluate its efficacy. The clinical trial protocol (1096607481) received approval from the Ministry of Health and Welfare in Taiwan.

Results: A total of 9 patients (5 in a 2-month course group and 4 in a 1-month course group) completed the first treatment course, and 5 patients (4 in a 2-month course group and 1 in a 1-month course group) completed the sequential treatment course. The weighted results showed that patients reported an improving BASFI score (mean difference -0.9, SD 1.7; P=.03) after treatment. Looking into the trajectories, declined BASFI and BASDAI scores were noticed during treatments; this score increased during the washout period. There were improving trends in the Schober test (mean difference 1.9, SD 4.9; P=.11) and finger-to-floor flexion test (mean difference -0.6, SD 9.5; P=.79), but the results were not statistically significant. The response of cytokines, chemokines, inflammatory factors, and immunoglobulins before and after treatment did not show a consistent trend, and all results were not statistically significant (all P>.05).

Conclusions: The home TENS device demonstrated a potential role in AS management. It may improve accessibility and adherence for patients with AS and provide remote monitoring for clinicians. Further research can compare the effectiveness of electrotherapy at home or in a medical setting and focus on integrating the home TENS system and exercise program to enhance patients' physical functions and spinal flexibility.

背景：在治疗强直性脊柱炎（AS）的过程中，保持身体功能和脊柱灵活性一直是一项挑战。大多数康复项目，包括手法治疗、按摩、水疗和针灸，都无法在家中进行。经皮神经电刺激（TENS）治疗强直性脊柱炎的效果已得到验证，但迄今为止还没有家用 TENS 系统对其疗效进行过探讨：本研究旨在评估家用 TENS 系统对强直性脊柱炎患者的疗效：改良的WeHeal TS-200 TENS和电刺激反应系统为强直性脊柱炎患者提供家庭TENS治疗。患者被分为 2 个月疗程组和 1 个月疗程组。第一个疗程结束后，患者会经历一个与疗程时间相同的冲洗期。参与者可决定是否接受第二个疗程。通过测量巴斯强直性脊柱炎疾病活动指数（BASDAI）、巴斯强直性脊柱炎功能指数（BASFI）、舒伯试验、手指到地面屈曲试验、内固定评分、细胞因子、趋化因子、炎症因子和免疫球蛋白来评估疗效。临床试验方案（1096607481）获得了台湾卫生福利部的批准：共有 9 名患者（2 个月疗程组 5 人，1 个月疗程组 4 人）完成了第一个疗程，5 名患者（2 个月疗程组 4 人，1 个月疗程组 1 人）完成了连续疗程。加权结果显示，患者在治疗后的 BASFI 评分有所提高（平均差-0.9，标准差 1.7；P=.03）。从轨迹上看，在治疗期间，BASFI 和 BASDAI 分数有所下降；而在冲洗期，该分数有所上升。舒伯试验（平均差异为 1.9，标准差为 4.9；P=.11）和手指落地屈伸试验（平均差异为-0.6，标准差为 9.5；P=.79）有改善趋势，但结果无统计学意义。治疗前后细胞因子、趋化因子、炎症因子和免疫球蛋白的反应未显示出一致的趋势，所有结果均无统计学意义（P>.05）：结论：家用 TENS 设备在强直性脊柱炎治疗中具有潜在作用。结论：家用 TENS 设备在强直性脊柱炎治疗中发挥了潜在作用，它可以提高强直性脊柱炎患者的可及性和依从性，并为临床医生提供远程监控。进一步的研究可以比较在家或在医疗机构进行电疗的效果，并重点关注如何将家用 TENS 系统与锻炼计划相结合，以增强患者的身体机能和脊柱灵活性。

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引用次数: 0

eHealth Communication Intervention to Promote Human Papillomavirus Vaccination Among Middle-School Girls: Development and Usability Study. 促进初中女生接种人类乳头瘤病毒疫苗的电子健康传播干预措施：开发和可用性研究。

IF 2 Q3 HEALTH CARE SCIENCES & SERVICES

JMIR Formative Research

Pub Date : 2024-10-28 DOI: 10.2196/59087

Youlim Kim, Hyeonkyeong Lee, Jeongok Park, Yong-Chan Kim, Dong Hee Kim, Young-Me Lee

Background: As the age of initiating sexual intercourse has gradually decreased among South Korean adolescents, earlier vaccination of adolescents for human papillomavirus (HPV) is necessary before their exposure to HPV. Health communication includes "cues to action" that lead to preventive health behaviors, and recently, social networking services, which operate with fewer time and space constraints, have been used in various studies as a form of eHealth communication.

Objective: This study aims to investigate the feasibility and usability of an eHealth communication intervention for HPV vaccination in middle-school girls aimed at the girls and their mothers.

Methods: The eHealth communication intervention for HPV vaccination was developed using a 6-step intervention mapping process: needs assessments, setting program outcomes, selection of a theory-based method and practical strategies, development of the intervention, implementation plan, and testing the validity of the intervention.

Results: A review of 10 studies identified effective health communication messages, delivery methods, and theories for HPV vaccination among adolescents. Barriers including low knowledge, perceived threat, and the inconvenience of taking 2 doses of the vaccine were identified through focus groups, suggesting a need for youth-friendly and easy-to-understand information for adolescents delivered via mobile phones. The expected outcomes and the performance objectives are specifically tailored to reflect the vaccination intention. Behavior change techniques were applied using trusted sources and a health belief model. Health messages delivered through a KakaoTalk chatbot improved awareness and self-efficacy. Quality control was ensured with the use of a log system. The experts' chatbot usability average score was 80.13 (SD 8.15) and the average score of girls was 84.06 (SD 7.61).

Conclusions: Future studies need to verify the effectiveness of health communication strategies in promoting HPV vaccination and the effectiveness of scientific intervention using a chatbot as a delivery method for the intervention.

背景：随着韩国青少年开始性生活的年龄逐渐降低，有必要在他们接触人乳头瘤病毒（HPV）之前为他们接种人乳头瘤病毒疫苗。健康传播包括引导预防性健康行为的 "行动提示"，最近，社交网络服务因其运行时空限制较少，已在多项研究中被用作电子健康传播的一种形式：本研究旨在调查针对中学女生及其母亲的 HPV 疫苗接种电子健康传播干预的可行性和可用性：针对 HPV 疫苗接种的电子健康传播干预措施采用了 6 步干预规划流程：需求评估、设定计划成果、选择基于理论的方法和实用策略、制定干预措施、实施计划以及测试干预措施的有效性：通过对 10 项研究的回顾，确定了针对青少年接种 HPV 疫苗的有效健康传播信息、传播方法和理论。通过焦点小组发现了一些障碍，包括知识水平低、感受到的威胁以及接种两剂疫苗带来的不便，这表明有必要通过手机向青少年提供适合年轻人且易于理解的信息。预期结果和绩效目标是为反映疫苗接种意向而专门定制的。采用了可信来源和健康信念模型等行为改变技术。通过 KakaoTalk 聊天机器人传递的健康信息提高了认知度和自我效能。使用日志系统确保了质量控制。专家的聊天机器人可用性平均得分为 80.13 分（标准差为 8.15 分），女孩的平均得分为 84.06 分（标准差为 7.61 分）：未来的研究需要验证健康传播策略在促进HPV疫苗接种中的有效性，以及使用聊天机器人作为干预方法的科学干预的有效性。

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引用次数: 0

Home-Based Connected Devices Combined With Statistical Process Control for the Early Detection of Respiratory Exacerbations by Patients With Cystic Fibrosis: Pilot Interventional Study With a Pre-Post Design. 基于家庭的联网设备与统计过程控制相结合，用于早期检测囊性纤维化患者的呼吸道恶化：采用预后设计的试点干预研究。

IF 2 Q3 HEALTH CARE SCIENCES & SERVICES

JMIR Formative Research

Pub Date : 2024-10-28 DOI: 10.2196/51753

Enora Le Roux, Moreno Ursino, Ivana Milovanovic, Paul Picq, Jeremie Haignere, Gilles Rault, Dominique Pougheon Bertrand, Corinne Alberti

Background: Currently, patients with cystic fibrosis do not routinely monitor their respiratory function at home.

Objective: This study aims to assess the clinical validity of using different connected health devices at home to measure 5 physiological parameters to help prevent exacerbations on a personalized basis from the perspective of patient empowerment.

Methods: A multicenter interventional pilot study including 36 patients was conducted. Statistical process control-the cumulative sum control chart (CUSUM)-was used with connected health device measures with the objective of sending patients alerts at a relevant time in order to identify their individual risk of exacerbations. Associated patient education was delivered. Quantitative and qualitative data were collected.

Results: One-half (18/36) of the patients completed the protocol through the end of the study. During the 12-month intervention, 6162 measures were collected with connected health devices, 387 alerts were sent, and 33 exacerbations were reported. The precision of alerts to detect exacerbations was weak for all parameters, which may be partly related to the low compliance of patients with the measurements. However, a decrease in the median number of exacerbations from 12 months before the study to after the 12-month intervention was observed for patients.

Conclusions: The use of connected health devices associated with statistical process control showed that it was not acceptable for all patients, especially because of the burden related to measurements. However, the results suggest that it may be promising, after adaptations, for early identification and better management of exacerbations.

Trial registration: ClinicalTrials.gov NCT03304028; https://clinicaltrials.gov/study/NCT03304028.

背景：目前，囊性纤维化患者并未在家中对其呼吸功能进行常规监测：本研究旨在从患者赋权的角度出发，评估在家中使用不同的联网健康设备测量 5 项生理参数以帮助个性化预防病情恶化的临床有效性：方法：开展了一项多中心干预试点研究，共纳入 36 名患者。统计过程控制--累积总和控制图（CUSUM）--被用于联网健康设备的测量，目的是在相关时间向患者发送警报，以确定其个人病情加重的风险。同时还提供了相关的患者教育。收集了定量和定性数据：二分之一（18/36）的患者在研究结束时完成了方案。在为期 12 个月的干预期间，通过联网健康设备收集了 6162 项测量数据，发送了 387 次警报，报告了 33 次病情加重。就所有参数而言，警报检测病情恶化的精确度较低，这可能与患者对测量的依从性较低有部分关系。不过，从研究前的12个月到干预后的12个月，观察到患者的病情加重次数中位数有所下降：与统计过程控制相关的联网健康设备的使用表明，并非所有患者都能接受，特别是由于与测量相关的负担。然而，研究结果表明，经过调整后，这种方法在早期识别和更好地管理病情恶化方面大有可为：试验注册：ClinicalTrials.gov NCT03304028；https://clinicaltrials.gov/study/NCT03304028。

{"title":"Home-Based Connected Devices Combined With Statistical Process Control for the Early Detection of Respiratory Exacerbations by Patients With Cystic Fibrosis: Pilot Interventional Study With a Pre-Post Design.","authors":"Enora Le Roux, Moreno Ursino, Ivana Milovanovic, Paul Picq, Jeremie Haignere, Gilles Rault, Dominique Pougheon Bertrand, Corinne Alberti","doi":"10.2196/51753","DOIUrl":"https://doi.org/10.2196/51753","url":null,"abstract":"Background: Currently, patients with cystic fibrosis do not routinely monitor their respiratory function at home.Objective: This study aims to assess the clinical validity of using different connected health devices at home to measure 5 physiological parameters to help prevent exacerbations on a personalized basis from the perspective of patient empowerment.Methods: A multicenter interventional pilot study including 36 patients was conducted. Statistical process control-the cumulative sum control chart (CUSUM)-was used with connected health device measures with the objective of sending patients alerts at a relevant time in order to identify their individual risk of exacerbations. Associated patient education was delivered. Quantitative and qualitative data were collected.Results: One-half (18/36) of the patients completed the protocol through the end of the study. During the 12-month intervention, 6162 measures were collected with connected health devices, 387 alerts were sent, and 33 exacerbations were reported. The precision of alerts to detect exacerbations was weak for all parameters, which may be partly related to the low compliance of patients with the measurements. However, a decrease in the median number of exacerbations from 12 months before the study to after the 12-month intervention was observed for patients.Conclusions: The use of connected health devices associated with statistical process control showed that it was not acceptable for all patients, especially because of the burden related to measurements. However, the results suggest that it may be promising, after adaptations, for early identification and better management of exacerbations.Trial registration: ClinicalTrials.gov NCT03304028; https://clinicaltrials.gov/study/NCT03304028.","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Exploring the Potential of Electronic Patient-Generated Health Data for Evaluating Treatment Response to Intramuscular Steroids in Rheumatoid Arthritis: Case Series. 探索患者生成的电子健康数据在评估类风湿关节炎肌肉注射类固醇治疗反应方面的潜力：病例系列。

IF 2 Q3 HEALTH CARE SCIENCES & SERVICES

JMIR Formative Research

Pub Date : 2024-10-28 DOI: 10.2196/55715

Mariam Al-Attar, Kesmanee Assawamartbunlue, Julie Gandrup, Sabine N van der Veer, William G Dixon

Background: Mobile health devices are increasingly available, presenting exciting opportunities to remotely collect high-frequency, electronic patient-generated health data (ePGHD). This novel data type may provide detailed insights into disease activity outside usual clinical settings. Assessing treatment responses, which can be hampered by the infrequency of appointments and recall bias, is a promising, novel application of ePGHD. Drugs with short treatment effects, such as intramuscular steroid injections, illustrate the challenge, as patients are unlikely to accurately recall treatment responses at follow-ups, which often occur several months later. Retrospective assessment means that responses may be over- or underestimated. High-frequency ePGHD, such as daily, app-collected, patient-reported symptoms between clinic appointments, may bridge this gap. However, the potential of ePGHD remains untapped due to the absence of established definitions for treatment response using ePGHD or established methodological approaches for analyzing this type of data.Objective: This study aims to explore the feasibility of evaluating treatment responses to intramuscular steroid therapy in a case series of patients with rheumatoid arthritis tracking daily symptoms using a smartphone app.Methods: We report a case series of patients who collected ePGHD through the REmote Monitoring Of Rheumatoid Arthritis (REMORA) smartphone app for daily remote symptom tracking. Symptoms were tracked on a 0-10 scale. We described the patients' longitudinal pain scores before and after intramuscular steroid injections. The baseline pain score was calculated as the mean pain score in the 10 days prior to the injection. This was compared to the pain scores in the days following the injection. "Response" was defined as any improvement from the baseline score on the first day following the injection. The response end time was defined as the first date when the pain score exceeded the pre-steroid baseline.Results: We included 6 patients who, between them, received 9 steroid injections. Average pre-injection pain scores ranged from 3.3 to 9.3. Using our definitions, 7 injections demonstrated a response. Among the responders, the duration of response ranged from 1 to 54 days (median 9, IQR 7-41), average pain score improvement ranged from 0.1 to 5.3 (median 3.3, IQR 2.2-4.0), and maximum pain score improvement ranged from 0.1 to 7.0 (median 4.3, IQR 1.7 to 6.0).Conclusions: This case series demonstrates the feasibility of using ePGHD to evaluate treatment response and is an important exploratory step toward developing more robust methodological approaches for analysis of this novel data type. Issues highlighted by our analysis include the importance of accounting for one-off data points, varying response start times, and confounders such as other medications. Future analy

背景：移动健康设备越来越多，为远程收集高频电子患者健康数据（ePGHD）提供了令人兴奋的机会。这种新型数据类型可在常规临床环境之外提供有关疾病活动的详细见解。评估治疗反应可能会受到预约不频繁和回忆偏差的影响，而 ePGHD 是一种前景广阔的新型应用。肌肉注射类固醇等治疗效果短暂的药物就说明了这一难题，因为患者不可能在复诊时准确回忆起治疗反应，而复诊往往是在几个月之后。回顾性评估意味着反应可能被高估或低估。高频率的 ePGHD（如每天通过应用程序收集患者在门诊之间报告的症状）可以弥补这一缺陷。然而，由于缺乏使用 ePGHD 进行治疗反应的既定定义或分析此类数据的既定方法，ePGHD 的潜力仍未得到开发：本研究旨在探索在使用智能手机应用程序跟踪日常症状的类风湿关节炎患者病例系列中评估肌肉注射类固醇疗法治疗反应的可行性：我们报告了一系列通过类风湿关节炎远程监测（REMORA）智能手机应用收集 ePGHD 的患者病例，这些应用用于日常远程症状跟踪。症状追踪采用 0-10 分制。我们描述了肌肉注射类固醇前后患者的纵向疼痛评分。基线疼痛评分按注射前 10 天的平均疼痛评分计算。这与注射后几天的疼痛评分进行了比较。"反应 "的定义是注射后第一天与基线分数相比的任何改善。反应结束时间定义为疼痛评分超过类固醇注射前基线的第一个日期：我们共纳入了 6 名患者，他们共接受了 9 次类固醇注射。注射前的平均疼痛评分从 3.3 到 9.3 不等。根据我们的定义，7 次注射显示出反应。在有反应者中，反应持续时间从 1 天到 54 天不等（中位数为 9 天，IQR 为 7-41），平均疼痛评分改善幅度从 0.1 到 5.3 不等（中位数为 3.3，IQR 为 2.2-4.0），最大疼痛评分改善幅度从 0.1 到 7.0 不等（中位数为 4.3，IQR 为 1.7-6.0）：本病例系列证明了使用 ePGHD 评估治疗反应的可行性，也是朝着为分析这种新型数据类型开发更稳健的方法迈出的重要探索性一步。我们的分析所强调的问题包括考虑一次性数据点、不同的反应开始时间以及其他药物等混杂因素的重要性。未来需要在更大的人群中对 ePGHD 进行分析，以解决我们的分析所强调的问题，并为时间序列数据中的治疗反应制定有意义的共识定义。

{"title":"Exploring the Potential of Electronic Patient-Generated Health Data for Evaluating Treatment Response to Intramuscular Steroids in Rheumatoid Arthritis: Case Series.","authors":"Mariam Al-Attar, Kesmanee Assawamartbunlue, Julie Gandrup, Sabine N van der Veer, William G Dixon","doi":"10.2196/55715","DOIUrl":"https://doi.org/10.2196/55715","url":null,"abstract":"Background: Mobile health devices are increasingly available, presenting exciting opportunities to remotely collect high-frequency, electronic patient-generated health data (ePGHD). This novel data type may provide detailed insights into disease activity outside usual clinical settings. Assessing treatment responses, which can be hampered by the infrequency of appointments and recall bias, is a promising, novel application of ePGHD. Drugs with short treatment effects, such as intramuscular steroid injections, illustrate the challenge, as patients are unlikely to accurately recall treatment responses at follow-ups, which often occur several months later. Retrospective assessment means that responses may be over- or underestimated. High-frequency ePGHD, such as daily, app-collected, patient-reported symptoms between clinic appointments, may bridge this gap. However, the potential of ePGHD remains untapped due to the absence of established definitions for treatment response using ePGHD or established methodological approaches for analyzing this type of data.Objective: This study aims to explore the feasibility of evaluating treatment responses to intramuscular steroid therapy in a case series of patients with rheumatoid arthritis tracking daily symptoms using a smartphone app.Methods: We report a case series of patients who collected ePGHD through the REmote Monitoring Of Rheumatoid Arthritis (REMORA) smartphone app for daily remote symptom tracking. Symptoms were tracked on a 0-10 scale. We described the patients' longitudinal pain scores before and after intramuscular steroid injections. The baseline pain score was calculated as the mean pain score in the 10 days prior to the injection. This was compared to the pain scores in the days following the injection. \"Response\" was defined as any improvement from the baseline score on the first day following the injection. The response end time was defined as the first date when the pain score exceeded the pre-steroid baseline.Results: We included 6 patients who, between them, received 9 steroid injections. Average pre-injection pain scores ranged from 3.3 to 9.3. Using our definitions, 7 injections demonstrated a response. Among the responders, the duration of response ranged from 1 to 54 days (median 9, IQR 7-41), average pain score improvement ranged from 0.1 to 5.3 (median 3.3, IQR 2.2-4.0), and maximum pain score improvement ranged from 0.1 to 7.0 (median 4.3, IQR 1.7 to 6.0).Conclusions: This case series demonstrates the feasibility of using ePGHD to evaluate treatment response and is an important exploratory step toward developing more robust methodological approaches for analysis of this novel data type. Issues highlighted by our analysis include the importance of accounting for one-off data points, varying response start times, and confounders such as other medications. Future analy","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Outcomes of a Comprehensive Mobile Vaping Cessation Program in Adults Who Vape Daily: Cohort Study. 针对每天吸食大麻的成年人的综合移动戒烟计划的成果：队列研究。

IF 2 Q3 HEALTH CARE SCIENCES & SERVICES

JMIR Formative Research

Pub Date : 2024-10-28 DOI: 10.2196/57376

Jennifer D Marler, Craig A Fujii, MacKenzie T Utley, Daniel J Balbierz, Joseph A Galanko, David S Utley

Background: In the United States, e-cigarettes, or vapes, are the second most commonly used tobacco product. Despite abundant smartphone app-based cigarette cessation programs, there are few such programs for vaping and even fewer supporting data.Objective: This exploratory, prospective, single-arm, remote cohort study of the Pivot vaping cessation program assessed enrollment and questionnaire completion rates, participant engagement and retention, changes in attitudes toward quitting vaping, changes in vaping behavior, and participant feedback. We aimed to establish early data to inform program improvements and future study design.Methods: American adults aged ≥21 years who vaped daily, reported ≥5 vape sessions per day, and planned to quit vaping within 6 months were recruited on the web. Data were self-reported via app- and web-based questionnaires. Outcomes included engagement and retention (ie, weeks in the program, number of Pivot app openings, and number of messages sent to the coach), vaping attitudes (ie, success in quitting and difficulty staying quit), vaping behavior (ie, quit attempts, Penn State Electronic Cigarette Dependence Index, 7- and 30-day point-prevalence abstinence [PPA], and continuous abstinence [defined as ≥7-day PPA at 12 weeks+30-day PPA at 26 weeks+0 vaping sessions since 12 weeks]), and participant feedback.Results: In total, 73 participants onboarded (intention-to-treat sample); 68 (93%) completed the 12- and 26-week questionnaires (completer samples). On average, participants were active in Pivot for 13.8 (SD 7.3) weeks, had 87.3 (SD 99.9) app sessions, and sent 37.6 (SD 42.3) messages to their coach over 26 weeks. Mean success in quitting and difficulty staying quit (scale of 1-10) improved from baseline to 12 weeks-4.9 (SD 2.9) to 7.0 (SD 3.0) and 4.0 (SD 2.8) to 6.2 (SD 3.1), respectively (P<.001 in both cases). Most participants (64/73, 88%) made ≥1 quit attempt. At 26 weeks, intention-to-treat 7-day PPA, 30-day PPA, and continuous abstinence rates were 48% (35/73), 45% (33/73), and 30% (22/73), respectively. In total, 45% (33/73) of the participants did not achieve 7-day PPA at 26 weeks; their mean Penn State Electronic Cigarette Dependence Index score decreased from baseline (13.9, SD 3.1) to 26 weeks (10.8, SD 4.5; mean change -3.2, SD 3.9; P<.001); 48% (16/33) of these participants improved in the e-cigarette dependence category. At 2 weeks, 72% (51/71) of respondents reported that using Pivot increased their motivation to quit vaping; at 4 weeks, 79% (55/70) reported using Pivot decreased the amount they vaped per day.Conclusions: In this first evaluation of Pivot in adult daily vapers, questionnaire completion rates were >90%, average program engagement duration was approximately 14 weeks, and most participants reported increased motivation to quit vaping. These and early cessation outcomes

背景：在美国，电子烟或吸食器是第二大最常用的烟草产品。尽管有大量基于智能手机应用程序的戒烟计划，但针对吸食电子烟的此类计划却很少，支持数据更是少之又少：这项探索性、前瞻性、开放标签、单臂、远程、初步队列研究评估了 Pivot 吸烟戒烟计划的注册率和问卷完成率、参与者的参与度和保持率、对戒烟态度的改变、吸烟行为的改变以及参与者的反馈。目的是在上述各方面建立早期数据，为项目改进和未来研究设计提供依据：方法：在线招募年龄≥ 21 岁、每天吸食、每天吸食次数≥ 5 次且计划在未来 6 个月内戒烟的美国成年人。在开始使用 Pivot 之前，参与者要完成在线筛选表、筛选电话、电子知情同意书、注册和入职培训。数据通过应用程序和网络问卷进行自我报告。结果主要集中在参与度和保持率（即参与计划的周数、打开 Pivot 应用程序的次数、向教练发送信息的次数）；吸烟态度（即戒烟成功率、保持戒烟的难度）；吸烟行为（即戒烟尝试、宾夕法尼亚州立大学电子烟戒烟率）、戒烟尝试、宾夕法尼亚州立大学电子烟依赖指数、7 天和 30 天的戒烟点[PPA]、持续戒烟[定义为 12 周内≥ 7 天的 PPA + 26 周内 30 天的 PPA + 12 周以来没有吸食过电子烟]]；以及参与者反馈：73名参与者完成了入职培训（意向治疗[ITT]样本）；68/73（93%）人完成了12周和26周的问卷调查（完成者样本）。平均而言，参与者在 Pivot 上活跃了 13.8 周（标准差为 7.3 周），使用了 87.3 次（标准差为 99.9 次）应用程序，并在 26 周内向教练发送了 37.6 条（标准差为 42.3 条）信息。从基线到 12 周，戒烟成功率和持续戒烟难度（1-10 分）均有所提高：成功戒烟率从 4.9 (SD 2.9) 提高到 7.0 (SD 3.0)，持续戒烟率从 4.0 (SD 2.8) 提高到 6.2 (SD 3.1)；P 均小于 0.001。大多数参与者（64/73，88%）尝试戒烟≥1次。26 周时，ITT 7 天 PPA、30 天 PPA 和持续戒烟率分别为分别为 35/73（48%）、33/73（45%）和 22/73（30%）。有 33 名参与者在 26 周时未达到 7 天 PPA；他们的宾州电子烟依赖指数平均得分从基线（13.9，SD 3.1）下降到 26 周（10.8，SD 4.5）（平均变化-3.2，SD 3.9，P < .001）；近一半（16/33，48%）的电子烟依赖类别有所改善。2周后，51/71人（72%）表示使用Pivot提高了他们戒烟的积极性；4周后，55/70人（79%）表示使用Pivot减少了他们每天的吸烟量：在对成人日常吸食者使用 Pivot 的首次评估中，问卷完成率大于 90%，参与计划的平均时间约为 14 周，大多数参与者表示戒烟的积极性有所提高。这些结果和早期戒烟结果表明，Pivot 可在戒烟中发挥作用，并将为今后的相关研究和计划改进提供信息：临床试验：ClinicalTrials.gov NCT05642598；https://clinicaltrials.gov/study/NCT05642598。

{"title":"Outcomes of a Comprehensive Mobile Vaping Cessation Program in Adults Who Vape Daily: Cohort Study.","authors":"Jennifer D Marler, Craig A Fujii, MacKenzie T Utley, Daniel J Balbierz, Joseph A Galanko, David S Utley","doi":"10.2196/57376","DOIUrl":"10.2196/57376","url":null,"abstract":"Background: In the United States, e-cigarettes, or vapes, are the second most commonly used tobacco product. Despite abundant smartphone app-based cigarette cessation programs, there are few such programs for vaping and even fewer supporting data.Objective: This exploratory, prospective, single-arm, remote cohort study of the Pivot vaping cessation program assessed enrollment and questionnaire completion rates, participant engagement and retention, changes in attitudes toward quitting vaping, changes in vaping behavior, and participant feedback. We aimed to establish early data to inform program improvements and future study design.Methods: American adults aged ≥21 years who vaped daily, reported ≥5 vape sessions per day, and planned to quit vaping within 6 months were recruited on the web. Data were self-reported via app- and web-based questionnaires. Outcomes included engagement and retention (ie, weeks in the program, number of Pivot app openings, and number of messages sent to the coach), vaping attitudes (ie, success in quitting and difficulty staying quit), vaping behavior (ie, quit attempts, Penn State Electronic Cigarette Dependence Index, 7- and 30-day point-prevalence abstinence [PPA], and continuous abstinence [defined as ≥7-day PPA at 12 weeks+30-day PPA at 26 weeks+0 vaping sessions since 12 weeks]), and participant feedback.Results: In total, 73 participants onboarded (intention-to-treat sample); 68 (93%) completed the 12- and 26-week questionnaires (completer samples). On average, participants were active in Pivot for 13.8 (SD 7.3) weeks, had 87.3 (SD 99.9) app sessions, and sent 37.6 (SD 42.3) messages to their coach over 26 weeks. Mean success in quitting and difficulty staying quit (scale of 1-10) improved from baseline to 12 weeks-4.9 (SD 2.9) to 7.0 (SD 3.0) and 4.0 (SD 2.8) to 6.2 (SD 3.1), respectively (P<.001 in both cases). Most participants (64/73, 88%) made ≥1 quit attempt. At 26 weeks, intention-to-treat 7-day PPA, 30-day PPA, and continuous abstinence rates were 48% (35/73), 45% (33/73), and 30% (22/73), respectively. In total, 45% (33/73) of the participants did not achieve 7-day PPA at 26 weeks; their mean Penn State Electronic Cigarette Dependence Index score decreased from baseline (13.9, SD 3.1) to 26 weeks (10.8, SD 4.5; mean change -3.2, SD 3.9; P<.001); 48% (16/33) of these participants improved in the e-cigarette dependence category. At 2 weeks, 72% (51/71) of respondents reported that using Pivot increased their motivation to quit vaping; at 4 weeks, 79% (55/70) reported using Pivot decreased the amount they vaped per day.Conclusions: In this first evaluation of Pivot in adult daily vapers, questionnaire completion rates were >90%, average program engagement duration was approximately 14 weeks, and most participants reported increased motivation to quit vaping. These and early cessation outcomes","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142347098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cocreation of a Video Feedback Tool for Managing Self-Care at Home With Pairs of Older Adults: Remote Experience-Based Co-Design Study. 共同创造一种视频反馈工具，用于管理结对老年人的居家自理：基于经验的远程协同设计研究。

IF 2 Q3 HEALTH CARE SCIENCES & SERVICES

JMIR Formative Research

Pub Date : 2024-10-28 DOI: 10.2196/57219

Susanna Strandberg, Mirjam Ekstedt, Cecilia Fagerström, Sofia Backåberg

Background: Involving older adults in co-design processes is essential in developing digital technologies and health care solutions to enhance self-care management at home, especially for older adults with chronic illness and their companions. Remote co-design approaches could provide technologically sustainable solutions that address their personal needs.

Objective: This study aimed to cocreate and test the usability of a video feedback tool to facilitate self-care management at home.

Methods: This experience-based co-design approach involved collaboration between 4 pairs of older adults, 4 researchers, and 2 service designers in three steps: (1) six iterative workshops (5 remote and 1 in person) to cocreate self-care exercises within an existing video feedback tool by identifying factors influencing self-care management; (2) developing and refining the self-care exercises based on suggestions from the older adults; and (3) usability testing of the cocreated exercises with the 4 pairs of older adults in their homes. Among the older adults (68-78 years), 3 adults had heart failure and 1 adult had hypertension. Data were analyzed inductively through thematic analysis and deductively using the USABILITY (Use of Technology to Engage in Adaptation by Older Adults and/or Those With Low or Limited Literacy) framework.

Results: The identified influencing factors guiding the contents and format development of 2 new self-care exercises were that pairs of older adults support and learn from each other in performing self-care, which increases their motivation and engagement in practicing self-care at home. The usability test of the 2 new self-care exercises, "Breathing exercises" and "Picking up from the floor," revealed that the pairs found the exercises and the video feedback component valuable for learning and understanding, for example, by comparison of performances highlighting movement variability. However, they found it difficult to manage the video feedback tool on their own, and a support structure or tailored education or training was requested.

Conclusions: This study emphasizes that the video feedback tool holds the potential to facilitate learning and understanding in self-care management, which may support motivation. The studied video feedback tool can be beneficial for pairs of older adults managing self-care at home as a complement to traditional health care services, but an accurate supporting structure is required. The effectiveness of the video feedback tool and its integration into existing health care services still need to be assessed and improved through careful design and structured support.

背景：让老年人参与到共同设计过程中，对于开发数字技术和医疗保健解决方案以加强居家自我护理管理至关重要，尤其是对于患有慢性疾病的老年人及其陪伴者而言。远程共同设计方法可以提供技术上可持续的解决方案，满足他们的个人需求：本研究旨在共同设计和测试视频反馈工具的可用性，以促进居家自我护理管理：这种基于经验的共同设计方法涉及 4 对老年人、4 名研究人员和 2 名服务设计师在三个步骤中的合作：(1）6 次迭代研讨会（5 次远程研讨会和 1 次面对面研讨会），通过确定影响自我护理管理的因素，在现有视频反馈工具中共同创建自我护理练习；（2）根据老年人的建议开发和完善自我护理练习；（3）在 4 对老年人家中对共同创建的练习进行可用性测试。在这些老年人（68-78 岁）中，3 人患有心力衰竭，1 人患有高血压。我们通过主题分析对数据进行了归纳分析，并使用 USABILITY（老年人和/或识字率低或识字有限者使用技术参与适应）框架对数据进行了演绎分析：结果发现，指导 2 个新的自我护理练习的内容和形式开发的影响因素是，结对的老年人在进行自我护理时相互支持和学习，从而提高了他们在家中进行自我护理的积极性和参与度。对 "呼吸练习 "和 "从地上拾起 "这两个新的自我保健练习进行的可用性测试表明，这对老年人认为练习和视频反馈部分对于学习和理解很有价值，例如，通过比较表演突出了动作的可变性。然而，他们发现自己很难独立管理视频反馈工具，因此要求提供支持结构或有针对性的教育或培训：本研究强调，视频反馈工具具有促进学习和理解自我护理管理的潜力，这可能有助于激发学习动机。所研究的视频反馈工具可作为传统医疗保健服务的补充，对老年人在家中进行自我护理有帮助，但需要一个准确的支持结构。视频反馈工具的有效性及其与现有医疗保健服务的整合仍有待评估，并通过精心设计和结构化支持加以改进。

{"title":"Cocreation of a Video Feedback Tool for Managing Self-Care at Home With Pairs of Older Adults: Remote Experience-Based Co-Design Study.","authors":"Susanna Strandberg, Mirjam Ekstedt, Cecilia Fagerström, Sofia Backåberg","doi":"10.2196/57219","DOIUrl":"10.2196/57219","url":null,"abstract":"Background: Involving older adults in co-design processes is essential in developing digital technologies and health care solutions to enhance self-care management at home, especially for older adults with chronic illness and their companions. Remote co-design approaches could provide technologically sustainable solutions that address their personal needs.Objective: This study aimed to cocreate and test the usability of a video feedback tool to facilitate self-care management at home.Methods: This experience-based co-design approach involved collaboration between 4 pairs of older adults, 4 researchers, and 2 service designers in three steps: (1) six iterative workshops (5 remote and 1 in person) to cocreate self-care exercises within an existing video feedback tool by identifying factors influencing self-care management; (2) developing and refining the self-care exercises based on suggestions from the older adults; and (3) usability testing of the cocreated exercises with the 4 pairs of older adults in their homes. Among the older adults (68-78 years), 3 adults had heart failure and 1 adult had hypertension. Data were analyzed inductively through thematic analysis and deductively using the USABILITY (Use of Technology to Engage in Adaptation by Older Adults and/or Those With Low or Limited Literacy) framework.Results: The identified influencing factors guiding the contents and format development of 2 new self-care exercises were that pairs of older adults support and learn from each other in performing self-care, which increases their motivation and engagement in practicing self-care at home. The usability test of the 2 new self-care exercises, \"Breathing exercises\" and \"Picking up from the floor,\" revealed that the pairs found the exercises and the video feedback component valuable for learning and understanding, for example, by comparison of performances highlighting movement variability. However, they found it difficult to manage the video feedback tool on their own, and a support structure or tailored education or training was requested.Conclusions: This study emphasizes that the video feedback tool holds the potential to facilitate learning and understanding in self-care management, which may support motivation. The studied video feedback tool can be beneficial for pairs of older adults managing self-care at home as a complement to traditional health care services, but an accurate supporting structure is required. The effectiveness of the video feedback tool and its integration into existing health care services still need to be assessed and improved through careful design and structured support.","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142500824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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