Pub Date : 2023-12-01DOI: 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
{"title":"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","authors":"Sami Shoucair, Gregory Downing, Jacqueline O’Rourke, Liza Greenberg, Mike Yea, Gunjan Vatas, Paula Kim, Thomas Fishbein, Keith Unger, Emily Winslow","doi":"10.1186/s44247-023-00049-6","DOIUrl":"https://doi.org/10.1186/s44247-023-00049-6","url":null,"abstract":"","PeriodicalId":72426,"journal":{"name":"BMC digital health","volume":" 699","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138610746","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}
Pub Date : 2023-12-01DOI: 10.1186/s44247-023-00052-x
Abdulmalik Aliyi, Bruk Mesfin, Fuad Hassen, Gemechu Dejene, Hawi Wondimu, Mignot Yizengaw, Derartu Dereje, Ahmed Ali Dawud
{"title":"Antenatal care management platform","authors":"Abdulmalik Aliyi, Bruk Mesfin, Fuad Hassen, Gemechu Dejene, Hawi Wondimu, Mignot Yizengaw, Derartu Dereje, Ahmed Ali Dawud","doi":"10.1186/s44247-023-00052-x","DOIUrl":"https://doi.org/10.1186/s44247-023-00052-x","url":null,"abstract":"","PeriodicalId":72426,"journal":{"name":"BMC digital health","volume":" 44","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138619246","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}
Pub Date : 2023-11-09DOI: 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.
{"title":"Differential effects of the individualized gender-sensitive mHealth intervention I-GENDO on eating styles in individuals with overweight and obesity – a randomized controlled trial","authors":"Caroline Seiferth, Tanja Färber, Magdalena Pape, Natalie Schoemann, Anna Dieberger, Stefanie Schroeder, Stephan Herpertz, Jörg Wolstein, Sabine Steins-Loeber","doi":"10.1186/s44247-023-00041-0","DOIUrl":"https://doi.org/10.1186/s44247-023-00041-0","url":null,"abstract":"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.","PeriodicalId":72426,"journal":{"name":"BMC digital health","volume":" 9","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135192161","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}
Pub Date : 2023-11-07DOI: 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.
{"title":"A novel telehealth tool using a snack activity to identify autism spectrum disorder","authors":"Zenghui Ma, Yan Jin, Ruoying He, Qinyi Liu, Xing Su, Jialu Chen, Disha Xu, Jianhong Cheng, Tiantian Zheng, Yanqing Guo, Xue Li, Jing Liu","doi":"10.1186/s44247-023-00047-8","DOIUrl":"https://doi.org/10.1186/s44247-023-00047-8","url":null,"abstract":"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.","PeriodicalId":72426,"journal":{"name":"BMC digital health","volume":"49 8","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135432491","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}
Pub Date : 2023-10-17DOI: 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.
{"title":"21st century medicine and emerging biotechnological syndromes: a cross-disciplinary systematic review of novel patient presentations in the age of technology","authors":"Isabel Straw, Geraint Rees, Parashkev Nachev","doi":"10.1186/s44247-023-00044-x","DOIUrl":"https://doi.org/10.1186/s44247-023-00044-x","url":null,"abstract":"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.","PeriodicalId":72426,"journal":{"name":"BMC digital health","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135944200","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}
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.
{"title":"Impact of a digital and conventional prevention program on work ability, physical health, and mental health among employees with initial impairments","authors":"Detlef Schmidt, Julian Fritsch, Katharina Feil, Susanne Weyland, Darko Jekauc","doi":"10.1186/s44247-023-00043-y","DOIUrl":"https://doi.org/10.1186/s44247-023-00043-y","url":null,"abstract":"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.","PeriodicalId":72426,"journal":{"name":"BMC digital health","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136077600","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}
Pub Date : 2023-10-13DOI: 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。
{"title":"The effectiveness and user experience of a biofeedback intervention program for stress management supported by virtual reality and mobile technology: a randomized controlled study","authors":"Jasmine I. Kerr, Raphael P. Weibel, Mara Naegelin, Andrea Ferrario, Victor R. Schinazi, Roberto La Marca, Christoph Hoelscher, Urs M. Nater, Florian von Wangenheim","doi":"10.1186/s44247-023-00042-z","DOIUrl":"https://doi.org/10.1186/s44247-023-00042-z","url":null,"abstract":"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; $$n=44$$ <mml:math xmlns:mml=\"http://www.w3.org/1998/Math/MathML\"> <mml:mrow> <mml:mi>n</mml:mi> <mml:mo>=</mml:mo> <mml:mn>44</mml:mn> </mml:mrow> </mml:math> ) or a wait-list control (WLC; $$n=43$$ <mml:math xmlns:mml=\"http://www.w3.org/1998/Math/MathML\"> <mml:mrow> <mml:mi>n</mml:mi> <mml:mo>=</mml:mo> <mml:mn>43</mml:mn> </mml:mrow> </mml:math> ) 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","PeriodicalId":72426,"journal":{"name":"BMC digital health","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135806046","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}
Pub Date : 2023-10-05DOI: 10.1186/s44247-023-00040-1
Valerie Dieter, Peter Martus, Pia Janssen, Inga Krauss
Abstract Background Current health care demonstrates an insufficient provision and utilization of physical exercises despite their recommendation as a first-line treatment in clinical guidelines for patients with knee osteoarthritis (OA). Mobile health (m-health) technologies offer new opportunities to guide and monitor home-based exercise programs by using mobile devices and inertial sensors in combination with a digital application (app). This study will evaluate patient benefits resulting from the use of the specific digital health application re.flex for patients with knee OA. Methods This monocentric, two-arm, randomized controlled parallel-group trial will evaluate the effectiveness of the app- and sensor-guided exercise program re.flex for patients with moderate-to-severe knee OA. We aim to recruit 200 participants via newspapers, newsletters and information events. Participants will be randomly allocated to the intervention group and the control group in a 1:1 ratio. Participants in the control group will not receive any study intervention or instruction for any change to their previous health care utilization. Despite this, they are allowed to make use of usual care provided by their treating physician. The intervention group comprises a 12-week home training program with three sessions per week in addition to usual care. Exercises will be guided and monitored by use of the training app (re.flex) and two accelerometers that are attached proximally and distally to the affected knee joint. Pre- and postmeasurements will take place at baseline (t0) and after 12 weeks (t1). Primary outcomes will be osteoarthritis-specific pain and physical function measured with the Knee Osteoarthritis Outcome Score (KOOS) subscales Pain and Function in daily living (ADL). Second, further self-reported health outcomes, a performance measurement, app logfiles and safety will be assessed. Intervention effects will be calculated by baseline-adjusted analysis of covariance (ANCOVA) using an intention-to-treat approach. Multiple imputation will be applied. Discussion Re.flex can bridge part of the gap between recommendations for strengthening exercises in patients with knee OA and the insufficient actual care situation. This randomized controlled trial is designed to provide conclusions on the effectiveness of the health application re.flex for the population under study and will provide further insight into adherence rates and the safety of its use. Trial registration The trial was registered on 20/01/2023 at www.drks.de (ID: DRKS00030932).
{"title":"Evaluation of a 12-week app-guided exercise intervention in patients with knee osteoarthritis (re.flex): a study protocol for a randomized controlled trial","authors":"Valerie Dieter, Peter Martus, Pia Janssen, Inga Krauss","doi":"10.1186/s44247-023-00040-1","DOIUrl":"https://doi.org/10.1186/s44247-023-00040-1","url":null,"abstract":"Abstract Background Current health care demonstrates an insufficient provision and utilization of physical exercises despite their recommendation as a first-line treatment in clinical guidelines for patients with knee osteoarthritis (OA). Mobile health (m-health) technologies offer new opportunities to guide and monitor home-based exercise programs by using mobile devices and inertial sensors in combination with a digital application (app). This study will evaluate patient benefits resulting from the use of the specific digital health application re.flex for patients with knee OA. Methods This monocentric, two-arm, randomized controlled parallel-group trial will evaluate the effectiveness of the app- and sensor-guided exercise program re.flex for patients with moderate-to-severe knee OA. We aim to recruit 200 participants via newspapers, newsletters and information events. Participants will be randomly allocated to the intervention group and the control group in a 1:1 ratio. Participants in the control group will not receive any study intervention or instruction for any change to their previous health care utilization. Despite this, they are allowed to make use of usual care provided by their treating physician. The intervention group comprises a 12-week home training program with three sessions per week in addition to usual care. Exercises will be guided and monitored by use of the training app (re.flex) and two accelerometers that are attached proximally and distally to the affected knee joint. Pre- and postmeasurements will take place at baseline (t0) and after 12 weeks (t1). Primary outcomes will be osteoarthritis-specific pain and physical function measured with the Knee Osteoarthritis Outcome Score (KOOS) subscales Pain and Function in daily living (ADL). Second, further self-reported health outcomes, a performance measurement, app logfiles and safety will be assessed. Intervention effects will be calculated by baseline-adjusted analysis of covariance (ANCOVA) using an intention-to-treat approach. Multiple imputation will be applied. Discussion Re.flex can bridge part of the gap between recommendations for strengthening exercises in patients with knee OA and the insufficient actual care situation. This randomized controlled trial is designed to provide conclusions on the effectiveness of the health application re.flex for the population under study and will provide further insight into adherence rates and the safety of its use. Trial registration The trial was registered on 20/01/2023 at www.drks.de (ID: DRKS00030932).","PeriodicalId":72426,"journal":{"name":"BMC digital health","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134947206","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}
Pub Date : 2023-10-03DOI: 10.1186/s44247-023-00038-9
Andrey Mostovov, Damien Jacobs, Leila Farid, Paul Dhellin, Guillaume Baille
Abstract Background The six-minute walk test (6MWT) is widely used to assess functional capacity in patients with various diseases. Use of wearable devices can make this test more accurate and easier to administer, and may even enhance it by providing additional information. The purpose of this study was to evaluate the validity of FeetMe® insoles for assessing the total six-minute walking distance (6MWD) by comparing the FeetMe® estimates and those obtained by a rater to the ground truth measured with a surveyor’s wheel. Results Data were analyzed from healthy volunteers who performed the 6MWT on 10-m and 30-m tracks while wearing FeetMe® insoles ( n = 32), and being simultaneously assessed by a rater ( n = 33) and followed by an investigator with a surveyor’s wheel. The mean average error (MAE) of the estimates was below 13 m on both tracks for FeetMe®, whereas it ranged from 16.24 m to 38.88 m on the 30-m and 10-m tracks for the rater. Conclusion The FeetMe® insoles provided a more accurate estimate and showed greater agreement with the ground truth than the rater, and the accuracy of the FeetMe® estimates did not vary according to the track length. We conclude that the FeetMe insoles are a valid solution for measuring the 6MWD.
{"title":"Validation of the six-minute walking distance measured by FeetMe® insoles","authors":"Andrey Mostovov, Damien Jacobs, Leila Farid, Paul Dhellin, Guillaume Baille","doi":"10.1186/s44247-023-00038-9","DOIUrl":"https://doi.org/10.1186/s44247-023-00038-9","url":null,"abstract":"Abstract Background The six-minute walk test (6MWT) is widely used to assess functional capacity in patients with various diseases. Use of wearable devices can make this test more accurate and easier to administer, and may even enhance it by providing additional information. The purpose of this study was to evaluate the validity of FeetMe® insoles for assessing the total six-minute walking distance (6MWD) by comparing the FeetMe® estimates and those obtained by a rater to the ground truth measured with a surveyor’s wheel. Results Data were analyzed from healthy volunteers who performed the 6MWT on 10-m and 30-m tracks while wearing FeetMe® insoles ( n = 32), and being simultaneously assessed by a rater ( n = 33) and followed by an investigator with a surveyor’s wheel. The mean average error (MAE) of the estimates was below 13 m on both tracks for FeetMe®, whereas it ranged from 16.24 m to 38.88 m on the 30-m and 10-m tracks for the rater. Conclusion The FeetMe® insoles provided a more accurate estimate and showed greater agreement with the ground truth than the rater, and the accuracy of the FeetMe® estimates did not vary according to the track length. We conclude that the FeetMe insoles are a valid solution for measuring the 6MWD.","PeriodicalId":72426,"journal":{"name":"BMC digital health","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135738747","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}
Abstract Background In this study, we aimed to describe patient characteristics and medication adherence among medication access mobile application users and nonusers. Methods This was a cross-sectional study of a randomly selected sample of patients who refilled their medications either through the mobile application ‘MNG-HA Care’ or by phone call to a government-funded multispecialty hospital in Riyadh, Saudi Arabia. Data were collected through an online survey and filed either via WhatsApp or by phone call. Medication adherence was assessed using the five-item Medication Adherence Report Scale (MARS-5). Results A total of 280 respondents were recruited, and their mean age was 48.8 years (standard deviation (SD): 17.8). More than 75% of application users and nonusers were younger (18–64 years) and lived in urban areas, 58% were male, 37.5% held a bachelor’s degree, and 40% were unemployed. The number of respondents who accessed the mobile application (mobile application users) was 212, and 64.2% of them were adherent to their medications. Sixty-eight of the respondents used a phone call for refills (mobile application nonusers), and 77.9% of them were adherent to their medications. The most common self-reported reasons for using the application were to book an appointment and to request a medication refill. The most common self-reported reasons for not using the application were respondents’ lack of knowledge about the availability of the application and preference for speaking directly to the health care provider. Adjusted multivariate logistic regression analysis revealed that medication adherence was not associated with application use (Odds Ratio (OR): 0.65; 95% CI: 0.33–1.29). However, male patients had significantly higher adherence than females (OR 2.68, 95% CI 1.31 to 5.51), and employed patients had significantly lower adherence than unemployed patients (OR 0.37, 95% CI 0.17 to 0.81). Conclusions Providing patients with access to their medication list through a mobile application alone did not significantly impact medication adherence. Further research is needed to explore the potential benefits of incorporating additional features, such as medication instructions and reminders within mobile applications, to improve medication adherence.
摘要背景在本研究中，我们旨在描述药物获取移动应用程序用户和非用户的患者特征和药物依从性。这是一项横断面研究，随机选择患者样本，通过移动应用程序“MNG-HA Care”或通过电话向沙特阿拉伯利雅得政府资助的多专科医院补充药物。数据通过在线调查收集，并通过WhatsApp或电话提交。用药依从性采用5项用药依从性报告量表(MARS-5)进行评估。结果共纳入调查对象280人，平均年龄48.8岁(标准差:17.8)。超过75%的应用程序用户和非用户是年轻人(18-64岁)，居住在城市地区，58%是男性，37.5%拥有学士学位，40%失业。访问移动应用程序(移动应用程序用户)的受访者人数为212人，其中64.2%的人坚持服药。68名受访者使用电话补药(不使用移动应用程序)，77.9%的人坚持服药。使用该应用程序的最常见的自我报告原因是预约和请求药物补充。自我报告的不使用该应用程序的最常见原因是受访者对该应用程序的可用性缺乏了解，并且倾向于直接与卫生保健提供者交谈。调整后的多因素logistic回归分析显示，药物依从性与应用程序使用无关(优势比(OR): 0.65;95% ci: 0.33-1.29)。然而，男性患者的依从性明显高于女性(OR 2.68, 95% CI 1.31至5.51)，就职患者的依从性明显低于未就职患者(OR 0.37, 95% CI 0.17至0.81)。结论仅通过移动应用程序向患者提供药物清单对药物依从性没有显著影响。需要进一步的研究来探索在移动应用程序中加入额外功能的潜在好处，例如药物说明和提醒，以提高药物依从性。
{"title":"Description of patient characteristics and medication adherence among medication access mobile application users and nonusers: a single-center questionnaire-based cross-sectional study","authors":"Ghadah Assiri, Dalal Alabdulkarim, Asrar Alanazi, Sarah Altamimi, Nadin Lafi Alanazi, Wael Khawagi","doi":"10.1186/s44247-023-00039-8","DOIUrl":"https://doi.org/10.1186/s44247-023-00039-8","url":null,"abstract":"Abstract Background In this study, we aimed to describe patient characteristics and medication adherence among medication access mobile application users and nonusers. Methods This was a cross-sectional study of a randomly selected sample of patients who refilled their medications either through the mobile application ‘MNG-HA Care’ or by phone call to a government-funded multispecialty hospital in Riyadh, Saudi Arabia. Data were collected through an online survey and filed either via WhatsApp or by phone call. Medication adherence was assessed using the five-item Medication Adherence Report Scale (MARS-5). Results A total of 280 respondents were recruited, and their mean age was 48.8 years (standard deviation (SD): 17.8). More than 75% of application users and nonusers were younger (18–64 years) and lived in urban areas, 58% were male, 37.5% held a bachelor’s degree, and 40% were unemployed. The number of respondents who accessed the mobile application (mobile application users) was 212, and 64.2% of them were adherent to their medications. Sixty-eight of the respondents used a phone call for refills (mobile application nonusers), and 77.9% of them were adherent to their medications. The most common self-reported reasons for using the application were to book an appointment and to request a medication refill. The most common self-reported reasons for not using the application were respondents’ lack of knowledge about the availability of the application and preference for speaking directly to the health care provider. Adjusted multivariate logistic regression analysis revealed that medication adherence was not associated with application use (Odds Ratio (OR): 0.65; 95% CI: 0.33–1.29). However, male patients had significantly higher adherence than females (OR 2.68, 95% CI 1.31 to 5.51), and employed patients had significantly lower adherence than unemployed patients (OR 0.37, 95% CI 0.17 to 0.81). Conclusions Providing patients with access to their medication list through a mobile application alone did not significantly impact medication adherence. Further research is needed to explore the potential benefits of incorporating additional features, such as medication instructions and reminders within mobile applications, to improve medication adherence.","PeriodicalId":72426,"journal":{"name":"BMC digital health","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135791439","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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