JMIR Formative Research最新文献

Background: Smartwatches are increasingly used to monitor and motivate physical activity. Patients with cardiovascular disease (CVD) and peripheral artery disease (PAD) often do not meet national physical activity recommendations. They may, thus, benefit from a physical activity program using smartwatches. The Life Plus smartwatch is designed to facilitate activity monitoring by counting steps, but its validity needs to be determined, particularly in patients who may not have a normal gait, such as those with cardiovascular pathology.

Objective: This study evaluates the accuracy of the Life Plus smartwatch (versions 2 and 3) in healthy adults, patients with CVD, and patients with PAD at different walking speeds (1.8, 2.5, 3.2, and 4 km/h) and different localizations (wrists, hips, and ankles) to determine best accuracy.

Methods: In total, 34 participants, comprising healthy individuals (n=10), patients with CVD (n=14), and patients with PAD (n=10), wore 6 Life Plus watches simultaneously (3 of version 2 and 3 of version 3), located on wrists, hips, and ankles. Participants walked on a treadmill for 3-minute sessions at speeds of 1.8, 2.5, 3.2, and 4 km/h; they then performed a 10-minute free walking on the ground and again walked for 3-minute sessions on a treadmill at the same speeds. Actual step counts were recorded through video footage.

Results: When worn at the wrist, no significant difference between the actual number of steps and step count by version 2 watches was found in each group independently (healthy group: P=.25; CVD group: P=.50; and PAD group: P=.37). Significant differences were found with the version 2 watches at the wrist in the healthy group at 3.2 (-5.26%; P=.01) and 4 km/h (-6.13%; P=.008) and in the CVD group at 2.5 (-5.94%; P=.008), 3.2(-13.1%; P=.008), and 4 km/h (-13.96%; P=.004). When worn at the wrist, no significant difference between actual number of steps and step count by version 3 watches was found in the healthy group (P=.02) and the PAD group (P=.90). Significant differences were found with the version 3 watches at the wrist in the CVD group at 3.2 (-6.43%; P=.001) and 4 km/h (-7.3%; P=.01) and in the PAD group at 4 km/h (-5.77%; P=.04).

Conclusions: For optimized counting when worn at the wrist, healthy individuals should prefer version 2 watches for slow walking (1.8 and 2.5 km/h) and version 3 for higher speeds (3.2 and 4 km/h). Patients (CVD and PAD) should prefer version 2 watches at 1.8 km/h and version 3 watches for higher speeds (2.5, 3.2, and 4 km/h).

Background: Research documents that drinking to cope behavior can be disrupted by enhancing emotion regulation and coping skills related to the experience of stress and negative affect. The Alpha Element Self-Coaching Plan incorporates principles of positive psychology and cognitive behavioral therapy to redirect negative thinking and emotions and, therefore, has the potential to benefit individuals who use alcohol to cope with stress.

Objective: This study aimed to evaluate satisfaction and usability of the web-based Alpha Element Self-Coaching Plan in order to inform the development of an expanded digital platform based on the Alpha Element framework.

Methods: Participants enrolled in the web-based program as part of their clinical care were eligible to participate. A total of 20 individuals (14 women and 6 men) between ages 30 and 79 (mean 54.5, SD 14.14) years completed web-based questionnaires to assess product performance in areas such as ease of technology use, quality of videos and handouts, and the value of the activities. Participants also completed the System Usability Scale (SUS) and provided background and demographic information, including alcohol use.

Results: Only 1 participant reported no alcohol use in the past year; 55% (11/20) of participants drank alcohol 2-4 times per month or less and 45% (9/20) reported drinking alcohol 2-3 times per week or more. The average SUS score of 76.38 (SD 17.85) was well above the commonly accepted threshold of 68, indicating high system usability. A majority of the sample (16/19, 84%) agreed or strongly agreed that the activities in the program inspired behavioral changes; and most agreed or strongly agreed that the program was engaging (16/20, 80%), well-organized (18/20, 90%), and easy to follow (17/20, 85%). Only 2 participants endorsed experiencing difficulty using the program on a smartphone. Suggestions for program improvements included expanding the platform, updating the web format, adding user interactivity, and enhancing navigation.

Conclusions: These data suggest that participants were generally satisfied with the web-based Alpha Element Self-Coaching Plan, and rated usability of the program as favorable. Importantly, a significant portion of participants reported that the program inspired behavioral changes. More research is needed with a larger sample to obtain specific data about alcohol consumption and investigate associations between alcohol use and program components, as well as examine gender differences. Data collected from this study will be used to expand the platform and improve user experience.

Background: The use of mobile apps to promote knowledge level, practice, and behavioral change potential has become increasingly common. However, studies on apps targeting social welfare employees working in the home-care setting to prevent pressure injury (PI) are lacking. The care manager (CM) plays a key role in connecting the demand and supply of home-care services. PI is more prevalent in the home-care setting, where resources are limited, than in acute settings.

Objective: The research hypothesis was that CMs who use a mobile app will have improved general knowledge and heightened practice for PI prevention, compared to that before using the app. This study aimed to assess the effectiveness of a PI prevention support mobile app prototyping model (Pips-Map) in improving the knowledge level, practice, and behavioral change potential of CMs in PI prevention in the home-care setting.

Methods: This was conducted between December 2021 and December 2023 as a single-arm, pre-post pilot study including 27 CMs who worked in a Japanese city. Pips-Map was used for 6 months in daily practice, and a self-administered test questionnaire was used to assess participants' knowledge and practice in PI prevention before or after using Pips-Map. At the end of the posttest, a validated App Behavior Change Scale was used to analyze behavioral change potential. This study followed the Consolidated Standards of Reporting Trials (CONSORT) extension to pilot and feasibility trials.

Results: In total, 19 participants were analyzed. Out of 55 points, the total mean knowledge score significantly increased from 30.9 (SD 5.9) in the pretest group to 36.1 (SD 5.9) in the posttest group (P=.0003). The number of participants with a total score of >70% (adequate knowledge level) increased from 2 (11%) to 7 (36.8%), but the difference was not statistically significant (P=.07). For the level of practice, out of 21 points, the total score increased from 15.2 (SD 3.1) in the pretest group to 16.2 (SD 3.0) in the posttest group, but no statistically significant differences were observed (P=.16). The behavior change scale revealed that participants positively evaluated the Pips-Map to provide information on PI prevention guidelines but had concerns regarding inadequate usability and financial incentives of Pips-Map.

Conclusions: The use of Pips-Map for 6 months in actual practice increased the knowledge level of Japanese CMs in PI prevention, but it did not change the level of practice. Considering the need for updating apps that aim to promote behavioral change, this study identified some limitations of Pips-Map. Thus, revisions must be made to adapt Pips-Map to home-based care needs.

Background: Patients with advanced cancer and their family caregivers often experience poor quality of life (QOL). Self-report measures are commonly used to quantify QOL of family caregivers but may have limitations such as recall bias and social desirability bias. Variables derived from passively obtained smartphone GPS data are a novel approach to measuring QOL that may overcome these limitations and enable detection of early signs of mental and physical health (PH) deterioration.

Objective: This study explored the feasibility of a digital phenotyping approach by assessing participant adherence and examining correlations between smartphone GPS data and QOL levels among family caregivers and patients with advanced cancer.

Methods: This was a secondary analysis involving 7 family caregivers and 4 patients with advanced cancer that assessed correlations between GPS sensor data captured by a personally owned smartphone and QOL self-report measures over 12 weeks through linear correlation coefficients. QOL as measured by the Patient-Reported Outcomes Measurement Information System (PROMIS) Global Health 10 was collected at baseline, 6, and 12 weeks. Using a Beiwe smartphone app, GPS data were collected and processed into variables including total distance, time spent at home, transition time, and number of significant locations.

Results: The study identified relevant temporal correlations between QOL and smartphone GPS data across specific time periods. For instance, in terms of PH, associations were observed with the total distance traveled (12 and 13 wk, with r ranging 0.37 to 0.38), time spent at home (-4 to -2 wk, with r ranging from -0.41 to -0.49), and transition time (-4 to -2 wk, with r ranging -0.38 to -0.47).

Conclusions: This research offers insights into using passively obtained smartphone GPS data as a novel approach for assessing and monitoring QOL among family caregivers and patients with advanced cancer, presenting potential advantages over traditional self-report measures. The observed correlations underscore the potential of this method to detect early signs of deteriorating mental health and PH, providing opportunities for timely intervention and support.

Background: The fear of pain (FOP) and fear avoidance belief (FAB) play a crucial role in the occurrence and development of chronic pain. However, the dynamics of these factors in postsurgical pain appear to differ, with the FOP often learned from others rather than directly caused by painful experiences. Psychological resilience refers to an individual's capacity to adapt effectively to adversity, challenges, and threats, and may play a significant role in overcoming the FOP and avoidance behavior.

Objective: The aim of this study was to investigate the role of psychological resilience in overcoming the FOP and avoidance behavior among surgical patients undergoing lung surgery.

Methods: Participants were recruited at the Wuhan Union Hospital. Psychological resilience was measured using the Connor-Davidson Resilience Scale. The FOP was assessed using the simplified Chinese version of the Fear of Pain-9 items. The FAB was measured using the Physical Activity subscale of the Fear-Avoidance Beliefs Questionnaire. Activity recovery was assessed through questions related to social activities and household responsibilities. The adaptive least absolute shrinkage and selection operator (Lasso) regression analysis under nested cross-validation was used to identify key factors affecting postoperative FOP and activity recovery.

Results: A total of 144 participants were included in the final analysis. The results showed that preoperative FOP (coefficient=8.620) and FAB (coefficient=8.560) were mainly positively correlated with postoperative FOP, while psychological resilience (coefficient=-5.822) and age (coefficient=-2.853) were negatively correlated with it. These average R2 of these models was 73% (SD 6%). Psychological resilience was the most important factor in predicting activity recovery, and these models obtained an average accuracy of 0.820 (SD 0.024) and an average area under the curve of 0.926 (SD 0.044).

Conclusions: Psychological resilience was negatively associated with the postoperative FOP and positively with activity recovery in patients who underwent lung surgery. Patients with higher resilience are more likely to cope effectively with postsurgical pain and recover activities sooner. These findings highlight the importance of assessing and potentially enhancing psychological resilience in the perioperative period to improve postoperative outcomes.

Background: The Tobacco Heating System (THS; commercialized as IQOS) is a smoke-free heated tobacco product introduced in the United States in 2019 and authorized by the US Food and Drug Administration as a modified risk tobacco product (MRTP) in 2020. THS consists of a holder and specially designed tobacco sticks that are heated instead of burned to produce a nicotine-containing aerosol. THS was available in Atlanta, Georgia; Richmond, Virginia; Charlotte, North Carolina; the Northern Virginia region; and South Carolina before its market removal in November 2021.

Objective: This study aims to describe selected sociodemographic characteristics and self-reported health history of adults who used IQOS (AUIs), their tobacco use patterns (eg, tobacco use history, exclusive and dual-use, and switching from cigarette smoking), their risk perceptions of the product, and their understanding of MRTP messages.

Methods: The IQOS Cross-Sectional Postmarket Adult Consumer Study was a study of AUIs aged 21 years or older who were recruited from a consumer database via direct postal mail and emails. Participants completed the online survey between September and November 2021.

Results: The survey was completed by 645 current and 43 former AUIs who had used at least 100 tobacco sticks (considered established THS use) before the assessment. Of the 688 participants, 424 (61.6%) were male, 502 (73.0%) were non-Hispanic White, and the mean age was 45 years. The vast majority (680/688, 98.8%) of AUIs had ever smoked combusted cigarettes before first trying THS and 628 (91.3%) had smoked cigarettes in the 30 days before first using THS. At the time of assessment, 161 (23.4%) reported using e-cigarettes (vs 229, 33.3%, before THS use), 92 (13.4%) reported smoking cigars (vs 114, 16.6%, before THS use), and 338 (49.1%) were still smoking after an average of 1 year of THS use. Among those currently using THS who were still smoking (n=298), 249 (83.6%) smoked fewer cigarettes compared with before first trying THS; 362 of 688 (52.6%) AUIs reported having no physical health conditions evaluated in this study and almost three-quarters reported having no mental health conditions. Among all AUIs, over 563 (81.8%) had never used a cessation treatment or had not used it in the past 12 months, and 555 (80.7%) AUIs demonstrated a correct understanding of the MRTP message and AUIs perceived THS as having a lower risk than cigarettes (43.8 vs 64.4 on a 100-point composite score scale).

Conclusions: This study provides evidence that THS can help adult smokers in the United States completely switch away from cigarettes or reduce smoking.