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Randomized pilot trial of cell phone support to improve medication adherence among adolescents and young adults with chronic health conditions. 通过手机支持改善患有慢性疾病的青少年服药依从性的随机试点试验。
Pub Date : 2024-01-01 Epub Date: 2024-03-19 DOI: 10.1186/s44247-024-00069-w
Caitlin S Sayegh, Karen K MacDonell, Ellen Iverson, Breaon Beard, Nancy Chang, My H Vu, Marvin Belzer

Introduction: Adolescents and young adults (AYA) living with chronic medical conditions often struggle to develop medication adherence skills. This pilot trial evaluated the impact of a mobile health coaching intervention, Cell Phone Support (CPS), on medication adherence.

Methods: Interventions in this randomized trial were CPS delivered by phone calls (CPS-C), CPS delivered by text messages (CPS-T), or automated text message reminders (ATR). Participants were AYA with different chronic medical conditions (i.e., sickle cell disease, solid organ transplant, type 2 diabetes), aged 15-20 years (N = 34). We examined the feasibility, acceptability, and preliminary efficacy of each intervention.

Results: We examined the feasibility, acceptability, and preliminary efficacy of both CPS interventions. CPS was feasible and acceptable. There was evidence that participants found CPS to be more useful than ATR. In this pilot trial, participants receiving CPS reported relatively stronger increases in adherence, compared to those assigned to ATR. CPS-C slightly outperformed CPS-T.

Conclusions: Providing coaching to AYA struggling with illness self-management via their cell phones may promote their acquisition of medication adherence skills. Although larger studies are needed to confirm the results of this pilot study, phone calls and text messages are both promising modalities for delivering human cell phone support.

Trial registration: This trial was registered prospectively at ClinicalTrials.gov (NCT04241627) on 1/27/2020.

导言:患有慢性疾病的青少年和年轻成人(AYA)往往很难掌握坚持服药的技能。本试验评估了移动健康指导干预--手机支持(CPS)--对坚持服药的影响:这项随机试验的干预措施包括通过电话提供的 CPS(CPS-C)、通过短信提供的 CPS(CPS-T)或自动短信提醒(ATR)。参与者为患有不同慢性疾病(如镰状细胞病、实体器官移植、2 型糖尿病)的青少年,年龄在 15-20 岁之间(34 人)。我们研究了每种干预措施的可行性、可接受性和初步疗效:我们研究了两种 CPS 干预方法的可行性、可接受性和初步疗效。CPS 是可行和可接受的。有证据表明,参与者认为 CPS 比 ATR 更有用。在这项试点试验中,接受 CPS 的受试者与接受 ATR 的受试者相比,在坚持治疗方面有了更大的提高。CPS-C的效果略优于CPS-T:结论:通过手机为在疾病自我管理中挣扎的青少年提供指导,可促进他们掌握坚持服药的技能。尽管需要更大规模的研究来证实这项试点研究的结果,但电话和短信都是很有前景的手机支持方式:本试验于2020年1月27日在ClinicalTrials.gov(NCT04241627)进行了前瞻性注册。
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引用次数: 0
Virtual, augmented, mixed, and extended reality interventions in healthcare: a systematic review of health economic evaluations and cost-effectiveness 医疗保健中的虚拟现实、增强现实、混合现实和扩展现实干预措施:对卫生经济评价和成本效益的系统审查
Pub Date : 2023-12-15 DOI: 10.1186/s44247-023-00054-9
Aislinn D Gómez Bergin, Michael P Craven
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引用次数: 0
A digital values-based microintervention for chronic back pain patients: lessons learned from a randomised experimental single-case study 针对慢性背痛患者的基于价值观的数字化微干预:从随机实验性单一病例研究中汲取的经验教训
Pub Date : 2023-12-14 DOI: 10.1186/s44247-023-00053-w
Simon Felix Zerth, Hauke Jeldrik Hein, J. Glombiewski, Winfried Rief, J. Riecke
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引用次数: 0
Closing the patient-provider gap along the surgical journey one click at a time: results of a phase I pilot trial of a patient navigation tool 一次点击,缩小手术过程中患者与医疗服务提供者之间的差距:患者导航工具第一阶段试点试验的结果
Pub Date : 2023-12-01 DOI: 10.1186/s44247-023-00049-6
Sami Shoucair, Gregory Downing, Jacqueline O’Rourke, Liza Greenberg, Mike Yea, Gunjan Vatas, Paula Kim, Thomas Fishbein, Keith Unger, Emily Winslow
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引用次数: 0
Antenatal care management platform 产前护理管理平台
Pub Date : 2023-12-01 DOI: 10.1186/s44247-023-00052-x
Abdulmalik Aliyi, Bruk Mesfin, Fuad Hassen, Gemechu Dejene, Hawi Wondimu, Mignot Yizengaw, Derartu Dereje, Ahmed Ali Dawud
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引用次数: 0
Differential effects of the individualized gender-sensitive mHealth intervention I-GENDO on eating styles in individuals with overweight and obesity – a randomized controlled trial 个性化性别敏感移动健康干预I-GENDO对超重和肥胖个体饮食方式的差异影响——一项随机对照试验
Pub Date : 2023-11-09 DOI: 10.1186/s44247-023-00041-0
Caroline Seiferth, Tanja Färber, Magdalena Pape, Natalie Schoemann, Anna Dieberger, Stefanie Schroeder, Stephan Herpertz, Jörg Wolstein, Sabine Steins-Loeber
Abstract Background Addressing cognitive behavioral factors is associated with a favorable development of eating styles (i.e., increased levels of restrained eating, decreased levels of external and emotional eating) in individuals with overweight and obesity. Research suggests that the use of digital interventions that consider gender aspects regarding prevalence, comorbidities, and weight-related behaviors could enhance existing treatment options. This randomized controlled trial aimed to evaluate the effectiveness of the self-guided gender-sensitive mobile health intervention I-GENDO on restrained, emotional and external eating, body mass index, and physical activity at the end of the intervention, and at a 9- and 15-month follow-up. Methods Two hundred thirteen individuals (67% female, body mass index: 33.35 ± 3.79 kg/m 2 ) were randomly assigned to the intervention or control group. Multilevel models were calculated to investigate differences between groups. I-GENDO offered interactive modules addressing psychological content associated with obesity. Users were able to self-tailor intervention content based on their individual needs and life realities. Results Restrained eating was higher in the intervention group after the intervention (95% CI: 0.20, 0.36) and at 9-months (95% CI: 0.07, 0.24). At 9-months, emotional eating among women was lower in the intervention group compared to the control group (95% CI: -0.44, -0,19). In the intervention group, external eating was lower after the intervention, which remained significant for women at 9 (95% CI: -0.40, -0.19) and 15-months (95% CI: -0.34, -0.13). Body mass index of men in the intervention group was 1.44 lower at 15-months than in the control group. No significant effects on physical activity were found. Conclusions The I-GENDO intervention was effective in changing restrained eating of both women and men in the long-term, suggesting that a self-guided, gender-sensitive approach is promising. However, the differential effects on the outcome measures indicate that more research is warranted to examine distinct gender-sensitive mechanisms of digital psychological interventions (i.e., dose–response relationship, blended counselling). Trial registration ClinicalTrials.gov identifier: NCT04080193 , 06–09-2019.
研究背景认知行为因素与超重和肥胖个体良好的饮食方式发展相关(即,增加克制饮食水平,减少外部和情绪性饮食水平)。研究表明,使用考虑患病率、合并症和体重相关行为的性别方面的数字干预措施可以增强现有的治疗方案。本随机对照试验旨在评估自我引导的性别敏感移动健康干预I-GENDO在干预结束时以及9个月和15个月随访时对克制、情绪和外部饮食、体重指数和身体活动的有效性。方法将213例患者随机分为干预组和对照组,其中女性67%,体重指数为33.35±3.79 kg/ m2。计算多水平模型来研究组间差异。I-GENDO提供了解决与肥胖相关的心理内容的互动模块。用户能够根据他们的个人需求和生活现实自我定制干预内容。结果干预组在干预后(95% CI: 0.20, 0.36)和9个月时(95% CI: 0.07, 0.24)克制饮食的发生率更高。在9个月时,干预组女性的情绪化进食比对照组低(95% CI: -0.44, -0,19)。在干预组中,干预后的外部进食减少,在9个月(95% CI: -0.40, -0.19)和15个月(95% CI: -0.34, -0.13)时,这种情况对女性来说仍然很显著。干预组15个月时的体重指数比对照组低1.44。没有发现对身体活动有显著影响。从长期来看,I-GENDO干预在改变女性和男性克制饮食方面都是有效的,这表明一种自我引导的、性别敏感的方法是有希望的。然而,对结果测量的不同影响表明,有必要进行更多的研究,以检查数字心理干预的不同性别敏感机制(即剂量-反应关系,混合咨询)。临床试验注册:ClinicalTrials.gov标识符:NCT04080193, 06-09-2019。
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引用次数: 0
A novel telehealth tool using a snack activity to identify autism spectrum disorder 一种新型的远程医疗工具,使用零食活动来识别自闭症谱系障碍
Pub Date : 2023-11-07 DOI: 10.1186/s44247-023-00047-8
Zenghui Ma, Yan Jin, Ruoying He, Qinyi Liu, Xing Su, Jialu Chen, Disha Xu, Jianhong Cheng, Tiantian Zheng, Yanqing Guo, Xue Li, Jing Liu
Abstract Background The COVID-19 pandemic has caused an unprecedented need for accessible health care services and significantly accelerated the development processes of telehealth tools for autism spectrum disorder (ASD) early screening and diagnosis. This study aimed to examine the feasibility and utility of a time-efficient telehealth tool combining a structured snack time assessment activity and a novel behaviour coding scheme for identifying ASD. Methods A total of 134 1–6-year-old individuals with ASD (age in months: mean = 51.3, SD = 13.1) and 134 age- and sex-matched typically developing individuals (TD) (age in months: mean = 54, SD = 9.44) completed a 1-min snack time interaction assessment with examiners. The recorded videos were then coded by trained coders for 17 ASD-related behaviours; the beginning and end points and the form and function of each behaviour were recorded, which took 10–15 min. Coded details were transformed into 62 indicators representing the count, duration, rate, and proportion of those behaviours. Results Twenty indicators with good reliability were selected for group difference, univariate and multivariate analyses. Fifteen behaviour indicators differed significantly between the ASD and TD groups and remained significant after Bonferroni correction, including the children’s response to the examiner’s initiation, eye gaze, pointing, facial expressions, vocalization and verbalization, and giving behaviours. Five indicators were included in the final prediction model: total counts of eye gaze, counts of standard pointing divided by the total counts of pointing, counts of appropriate facial expressions, counts of socially oriented vocalizations and verbalizations divided by the total counts of vocalizations and verbalizations, and counts of children using giving behaviours to respond to the examiner's initiations divided by the total counts of the examiner's initiation of snack requisitions. The ROC curve revealed a good prediction performance with an area under the curve (AUC) of 0.955, a sensitivity of 92.5% and a specificity of 84.3%. Conclusion Our results suggest that the snack activity-based ASD telehealth approach shows promise in primary health care settings for early ASD screening.
背景2019冠状病毒病(COVID-19)大流行引发了前所未有的卫生保健服务需求,并显著加快了用于自闭症谱系障碍(ASD)早期筛查和诊断的远程医疗工具的开发进程。本研究旨在研究一种时间效率高的远程医疗工具的可行性和实用性,该工具结合了结构化的零食时间评估活动和一种新的行为编码方案来识别ASD。方法对134例1 ~ 6岁ASD患者(平均年龄51.3个月,SD = 13.1)和134例年龄和性别匹配的典型发育者(平均年龄54个月,SD = 9.44)进行1 min零食时间互动评估。录制的视频随后由训练有素的编码员对17种自闭症相关行为进行编码;记录每项行为的起点和终点以及形式和功能,耗时10-15分钟。将编码细节转化为代表这些行为的数量、持续时间、比率和比例的62个指标。结果选取信度较好的20个指标进行组差分析、单因素分析和多因素分析。15项行为指标在ASD和TD组之间存在显著差异,并且在Bonferroni矫正后仍然具有显著性,包括儿童对考官开始的反应、眼神注视、指指、面部表情、发声和言语化以及给予行为。在最终的预测模型中包括五个指标:眼睛注视的总数、标准指向的总数除以指向的总数、适当的面部表情的总数、社会导向的发声和言语的总数除以发声和言语的总数,以及使用给予行为回应考官发起的总数除以考官发起的零食请求的总数。ROC曲线预测效果良好,曲线下面积(AUC)为0.955,灵敏度为92.5%,特异性为84.3%。结论:我们的研究结果表明,基于零食活动的ASD远程医疗方法在初级卫生保健机构中具有早期ASD筛查的前景。
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引用次数: 0
21st century medicine and emerging biotechnological syndromes: a cross-disciplinary systematic review of novel patient presentations in the age of technology 21世纪医学和新兴生物技术综合征:技术时代新患者表现的跨学科系统综述
Pub Date : 2023-10-17 DOI: 10.1186/s44247-023-00044-x
Isabel Straw, Geraint Rees, Parashkev Nachev
Abstract Background Biotechnological syndromes refer to the illnesses that arise at the intersection of human physiology and digital technology. Now that we experience health and illness through so much technology (e.g. wearables, telemedicine, implanted devices), the medium is redefining our expression of symptoms, the observable signs of pathology and the range of diseases that may occur. Here, we systematically review all case reports describing illnesses related to digital technology in the past ten years, in order to identify novel biotechnological syndromes, map out new causal pathways of disease, and identify gaps in care that have disadvantaged a community of patients suffering from these digital complaints. Methods PubMed, MEDLINE, Scopus, Cochrane Library and Web of Science were searched for case reports and case series that described patient cases involving biotechnological syndromes from 01/01/2012 to 01/02/2022. For inclusion the technology had to play a causative role in the disease process and had to be digital (as opposed to simple electronic). Results Our search returned 7742 articles, 1373 duplicates were removed, 671 met the criteria for full review and 372 were included in the results. Results were categorised by specialty, demonstrating that syndromes were most common in Cardiology ( n = 162), Microbiology and Infectious Diseases ( n = 36), and Emergency and Trauma ( n = 26). Discussion The 372 unique patient cases demonstrated a range of severity from mild (e.g., injuries related to Pokemon Go) to moderate (e.g. pacemaker-generated rib fractures) and severe (e.g. ventilator software bugs causing cardiac arrest). Syndromes resulted from both consumer technology (e.g. gaming addictions) and medical technologies (e.g. errors in spinal stimulators). Cases occurred at both the individual level (e.g. faulty insulin pumps) and at the population level (e.g. harm from healthcare cyberattacks). Limitations This was a retrospective systematic review of heterogeneous reports, written in English, which may only reflect a small proportion of true prevalence rates in the population.
生物技术综合征是指在人体生理学和数字技术交叉领域出现的疾病。既然我们通过如此多的技术(例如可穿戴设备、远程医疗、植入设备)体验健康和疾病,媒体正在重新定义我们对症状的表达、可观察到的病理迹象和可能发生的疾病范围。在这里,我们系统地回顾了过去十年中描述与数字技术相关疾病的所有病例报告,以确定新的生物技术综合征,绘制出疾病的新因果途径,并确定使遭受这些数字投诉的患者社区处于不利地位的护理差距。方法检索PubMed、MEDLINE、Scopus、Cochrane Library和Web of Science,检索2012年1月1日至2022年2月1日涉及生物技术综合征的病例报告和病例系列。为了纳入,该技术必须在疾病过程中发挥致病作用,并且必须是数字化的(而不是简单的电子技术)。结果共检索到7742篇文献,删除重复文献1373篇,671篇符合完整评价标准,372篇纳入结果。结果按专业分类,表明综合征在心脏病学(n = 162)、微生物学和传染病(n = 36)以及急诊和创伤(n = 26)中最常见。372例独特的患者病例显示了从轻度(例如,与Pokemon Go相关的伤害)到中度(例如,起搏器产生的肋骨骨折)和严重(例如,呼吸机软件错误导致心脏骤停)的严重程度。综合症是由消费技术(如游戏成瘾)和医疗技术(如脊髓刺激器的错误)造成的。病例发生在个人层面(如胰岛素泵故障)和群体层面(如医疗网络攻击造成的伤害)。局限性:这是一项对异质报告的回顾性系统综述,这些报告以英文撰写,可能只反映了人群中一小部分真实患病率。
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引用次数: 0
Impact of a digital and conventional prevention program on work ability, physical health, and mental health among employees with initial impairments 数字和传统预防计划对有初始损伤的员工的工作能力、身体健康和心理健康的影响
Pub Date : 2023-10-16 DOI: 10.1186/s44247-023-00043-y
Detlef Schmidt, Julian Fritsch, Katharina Feil, Susanne Weyland, Darko Jekauc
Abstract Background This quasi-experimental study aimed to compare the effectiveness of a digital prevention intervention on work ability, physical health, and mental health with a conventional prevention program for employees with initial impairments. The study recruited 245 participants, of whom 173 completed the study, 98 (65 female, 66.3%) in the intervention group and 75 (55 female, 73.3%) in the control group. Both groups received prevention programs, with the intervention group using the Caspar digital platform and the control group using the conventional BETSI/RV Fit program. There were three measurement points in the study: T0 before the intervention, T1 in the middle of the intervention, and T2 at the end of the intervention. Participants’ health was assessed using the SF-12 health status questionnaire, while their work ability was measured using the short version of the Work Ability Index. Results Repeated-measures analyses of variance indicated that both prevention programs were effective in improving work ability and mental health, while physical health did not show any significant improvement. Additionally, the results of the study suggest that younger individuals benefited more from the digital prevention intervention, while older individuals benefited more from the conventional prevention program. Conclusion The study emphasizes the need for further research and improvements in both research and practice. Future studies should include larger sample sizes, randomized controlled trials, and follow-up assessments to enhance understanding of the effectiveness and the durability of effects of prevention programs.
摘要背景本研究旨在比较数字化预防干预与传统预防干预对初始障碍员工工作能力、身体健康和心理健康的影响。研究共招募245名参与者,其中173人完成了研究,干预组98人(女性65人,66.3%),对照组75人(女性55人,73.3%)。两组均接受预防方案,干预组使用Caspar数字平台,对照组使用传统的BETSI/RV Fit方案。本研究共有三个测量点:干预前T0,干预中T1,干预结束T2。参与者的健康状况用SF-12健康状况问卷进行评估,而他们的工作能力用简短版的工作能力指数进行测量。结果重复测量方差分析表明,两种预防方案在改善工作能力和心理健康方面均有效,而身体健康方面无显著改善。此外,研究结果表明,年轻人从数字预防干预中获益更多,而老年人从传统预防计划中获益更多。结论本研究强调在研究和实践中都需要进一步的研究和改进。未来的研究应该包括更大的样本量、随机对照试验和后续评估,以提高对预防项目效果的有效性和持久性的理解。
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引用次数: 0
The effectiveness and user experience of a biofeedback intervention program for stress management supported by virtual reality and mobile technology: a randomized controlled study 虚拟现实和移动技术支持的压力管理生物反馈干预程序的有效性和用户体验:一项随机对照研究
Pub Date : 2023-10-13 DOI: 10.1186/s44247-023-00042-z
Jasmine I. Kerr, Raphael P. Weibel, Mara Naegelin, Andrea Ferrario, Victor R. Schinazi, Roberto La Marca, Christoph Hoelscher, Urs M. Nater, Florian von Wangenheim
Abstract Background Heart rate variability biofeedback (HRV-BF) can be used for stress management. Recent feasibility studies suggest that delivering HRV-BF in virtual reality (VR) is associated with better user experience (UX) and might yield more beneficial changes in HRV than two-dimensional screens. The effectiveness of a VR-supported HRV-BF intervention program has, however, not been investigated yet. Methods In this study, 87 healthy women and men were assigned to a VR-supported HRV-BF intervention (INT; $$n=44$$ n = 44 ) or a wait-list control (WLC; $$n=43$$ n = 43 ) group. The INT came to the lab for four weekly HRV-BF sessions in VR using a head-mounted display. Between lab sessions, participants were asked to perform breathing exercises without biofeedback supported by a mobile application. Stress-related psychological and psychophysiological outcomes were assessed pre- and post-intervention and at a follow-up four weeks after the intervention in both groups. A psychosocial stress test was conducted post-intervention to investigate changes in stress reactivity. UX was assessed after each HRV-BF session in the INT. Results Analysis revealed that LF increased significantly from pre- to post-, whereas pNN50 increased and chronic stress decreased significantly from pre-intervention to follow-up in the INT compared to the WLC. Anxiety and mental fatigue decreased significantly, while mindfulness and health-related quality of life increased significantly from pre- to post- and from pre-intervention to follow-up in the INT compared to the WLC (all small effects). The two groups did not differ in their stress reactivity post-intervention. As for UX in the INT, the degree of feeling autonomous concerning technology adoption significantly decreased over time. Competence, involvement, and immersion, however, increased significantly from the first to the last HRV-BF session, while hedonic motivation significantly peaked in the second session and then gradually returned to first-session levels. Conclusions This HRV-BF intervention program, supported by VR and mobile technology, was able to significantly improve stress indicators and stress-related symptoms and achieved good to very good UX. Future studies should control for potential placebo effects and emphasize higher degrees of personalization and adaptability to increase autonomy and, thereby, long-term health and well-being. These findings may serve as a first step towards future HRV-BF applications of cutting-edge, increasingly accessible technologies, such as wearables, VR, and smartphones, in the service of mental health and healthcare. Trial registration The study was registered retrospectively as a clinical
心率变异性生物反馈(HRV-BF)可用于压力管理。最近的可行性研究表明,在虚拟现实(VR)中提供HRV- bf与更好的用户体验(UX)相关,并且可能比二维屏幕产生更有益的HRV变化。然而,vr支持的HRV-BF干预方案的有效性尚未得到调查。方法在这项研究中,87名健康男女被分配到vr支持的HRV-BF干预(INT;$$n=44$$ n = 44)或等候名单控制(WLC;$$n=43$$ n = 43)组。INT每周一次来到实验室,使用头戴式显示器在VR中进行HRV-BF会话。在实验期间,参与者被要求在没有移动应用程序支持的生物反馈的情况下进行呼吸练习。在干预前和干预后以及干预后四周的随访中,对两组的压力相关心理和心理生理结果进行评估。干预后进行心理社会压力测试以调查应激反应的变化。UX在INT的每次HRV-BF会议后进行评估。结果分析显示,与WLC相比,干预前至随访期间,INT组的LF显著升高,pNN50显著升高,慢性应激显著降低。与WLC相比,INT组的焦虑和精神疲劳显著减少,而正念和健康相关生活质量从干预前到干预后以及从干预前到随访均显著增加(均为小影响)。两组在干预后的应激反应上没有差异。至于INT中的用户体验,随着时间的推移,技术采用的自主程度显著降低。然而,从第一次到最后一次HRV-BF会话,能力、投入和沉浸感显著增加,而享乐动机在第二次会话显著达到顶峰,然后逐渐回到第一次会话的水平。结论该HRV-BF干预方案在VR和移动技术的支持下,能够显著改善应激指标和应激相关症状,获得良好至极好的UX。未来的研究应控制潜在的安慰剂效应,并强调更高程度的个性化和适应性,以增加自主性,从而提高长期的健康和福祉。这些发现可能是未来将可穿戴设备、虚拟现实和智能手机等日益普及的尖端技术应用于心理健康和医疗保健领域的第一步。该研究在ISRCTN注册中心(ISRCTN11331226, 2023年5月26日)回顾性注册为临床试验。
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引用次数: 0
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BMC digital health
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