mHealth最新文献

Background: Prescription digital therapeutics (DTx) are software-based medical interventions regulated by the Food and Drug Administration (FDA). Ensuring accessibility and equity is crucial, as effectiveness depends on patient engagement. This scoping review examines whether clinical validation studies adequately assess health equity, cultural competence, and digital accessibility. This study aimed to evaluate the extent to which FDA-mandated clinical trials of DTx products report diverse participant characteristics, cultural adaptations, and digital literacy considerations.

Methods: A systematic search of PubMed, Google Scholar, and ClinicalTrials.gov identified clinical validation studies of FDA-approved DTx products. Studies were assessed for health equity factors using the PROGRESS-Plus framework and categorized based on reporting of cultural competence, linguistic accessibility, and digital literacy.

Results: Thirty-two studies covering six FDA-approved DTx products were included. Over 60% reported participant demographics (gender, race/ethnicity, education level), but fewer than 15% addressed other health equity factors. Fifteen studies excluded participants who were not fluent in English. No studies incorporated cultural adaptation frameworks or linguistic translations. Two studies found digital literacy significantly affected intervention effectiveness.

Conclusions: Clinical validation studies of DTx lack sufficient assessment of health equity, cultural competence, and digital accessibility. Addressing these gaps is essential to ensure equitable access and effectiveness for diverse populations.

Background: Congenital pseudarthrosis of the tibia (CPT) is a rare and refractory congenital malformation with a prolonged and complex treatment course, imposing substantial caregiving burdens and psychological distress on the parents of affected children. Conventional postoperative management, limited by time and space, fails to provide individualized and dynamic rehabilitation and psychological support. Remote management via a smart wearable-enhanced WeChat platform offers a promising alternative. This study aimed to evaluate the effects of this remote management approach on the mental health, sleep, and overall well-being of parents of children with CPT.

Methods: A double-blind randomized controlled design was adopted in this study. A total of 78 primary caregivers of 78 CPT patients were assigned to the standard education and care (SEC) group (n=39) and the WeChat-platform intelligent management (WPIM) group (n=39) using block randomization. Both groups received standard peri-operative education and outpatient follow-up after discharge. The WPIM group additionally implemented an intelligent intervention system based on the WeChat platform: (I) real-time monitoring of postoperative rehabilitation exercise data through smartwatches (Huawei GT3), including biomechanical parameters such as daily gait characteristics, weight-bearing time, activity intensity, and heart rate variability; (II) establishment of personalized exercise prescriptions based on machine-learning algorithms, with automatic warnings triggered when the monitored data deviated from the preset rehabilitation trajectory; (III) formation of a multidisciplinary team (orthopedic surgeons, rehabilitation therapists, and psychologists) for online guidance twice a week, and dynamic adjustment of the training program in combination with the data from wearable devices; (IV) development of a dedicated WeChat mini-program for visual tracking of exercise compliance, and embedding of a cognitive-behavioral therapy module to improve the psychological adaptation of parents. The Family Caregiver Task Inventory (FCTI), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), and Pittsburgh Sleep Quality Index (PSQI) were used for evaluation.

Results: There were no statistically significant differences in the demographic characteristics of the caregivers of CPT patients between the two groups. After the intervention, the FCTI, SAS, SDS, and PSQI scores of the caregivers in the WPIM group were significantly lower than those in the SEC group (P<0.05).

Conclusions: WPIM is a feasible and effective intervention measure that can reduce the family care burden and anxiety of parents of CPT patients.

Trial registration: This study was registered at Chinese Clinical Trial Registry (ChiCTR2500066877).

Background and objective: Mobile health (mHealth) has emerged as an innovative and cost-effective tool for enhancing patient education, reinforcing user engagement, and improving continuity of care. While the utility is well documented in outpatient settings, its implementation within emergency departments (ED) remains an emerging field that may help alleviate unique acute care challenges. This is particularly important because EDs often serve as a safety net and the only point of healthcare access for underserved populations, meaning that successful digital integration could significantly bridge gaps by which ED-based interventions aid in preventative care. This review aimed to evaluate the effect of digital health interventions on the health of ED patients.

Methods: This study was a narrative review of randomized controlled trials (RCTs) evaluating mHealth interventions in the ED and their effects on health behaviors. Three primary databases were used to scan the literature: PubMed, Scopus, and The Cochrane Database of Systematic Reviews. Studies were limited to a 10-year span between January 2014-2024, set in the United States, and focused on health outcomes.

Key content and findings: Twenty-one studies that met the inclusion criteria were assessed and categorized across five domains: (I) substance use, (II) sexual health, (III) chronic disease and medication adherence, (IV) linkage to care and (V) injury prevention and safety. Text and app-based interventions were common (86%). They showed moderate effects on behaviors such as reducing binge drinking and improving medication adherence, though results for hemoglobin A1c and asthma morbidity were mixed. Interventions that were bidirectional, culturally tailored, or rooted in behavioral change theory presented greater success in affecting outcomes.

Conclusions: mHealth in the ED offers an innovative strategy to promote health equity by enhancing patient education and improving scientific and patient-centered health outcomes. Current literature mainly focuses on interventions with shorter-term follow-up; future directives should focus on long-term outcomes, cost-effectiveness and how to efficiently implement digital interventions into the unique ED setting.

Background: Enhanced recovery after surgery (ERAS) programs are designed to reduce postoperative complications and accelerate recovery. Despite their proven benefits, maintaining patient adherence to these protocols remains a significant challenge. Mobile health (mHealth) applications have been introduced as potential tools to support adherence and improve perioperative outcomes; however, their effectiveness within ERAS pathways has not been clearly established. This review aims to evaluate the impact of mobile applications on protocol compliance, recovery, and clinical outcomes among surgical patients enrolled in ERAS programs.

Methods: PubMed, EMBASE, and the Cochrane Library were systematically searched through February 2025 to identify studies comparing ERAS care with and without mobile application support. Due to heterogeneity in study design, outcomes, and app functionalities, a meta-analysis was not performed. The primary outcome was adherence to ERAS protocols. Secondary outcomes included quality of recovery, patient and clinician satisfaction, postoperative complication rates, hospital length of stay (LOS), and readmissions.

Results: Eight studies encompassing 1,623 patients were included. Mobile app use was associated with improved adherence to ERAS components, particularly early mobilization and oral intake. Some studies reported higher Quality of Recovery-15 (QoR-15) scores and greater patient satisfaction, although these differences were not always statistically significant. The clinician reported reductions in unnecessary visits and improved communication. No study reported an increased rate of complications. One study found that non-adherent patients had a significantly higher risk of 30-day readmission; another reported reduced infection rates and better pain control. The risk of bias was moderate in most studies.

Conclusions: mHealth applications integrated into ERAS protocols may improve adherence, recovery quality, and patient engagement without increasing adverse outcomes. However, the overall quality of evidence remains limited due to heterogeneity and a predominance of non-randomized studies.

Background: There is a discrepancy between the number of people who report a mental health need and the number of people who use mental health services. The SolanoConnex web-app was developed to address this disparity in a diverse county by enhancing access to existing mental health services, with this paper describing the participatory and iterative development process.

Methods: The web-app was developed in a five-stage process beginning with (I) secondary data analysis and landscape data collection, followed by a participatory approach to (II) design the product using fictitious, representative patient profiles developed by an advisory board to test the algorithm, (III) develop the web-app. The web-app was (IV) beta-tested via one-on-one interviews during which participants had access to beta versions of the app and were asked to respond to a structured feedback questionnaire. Finally, the web-app was (V) launched with continued assessment of the product.

Results: The advisory board patient profiles and beta-testing feedback led to changes in how priority information such as insurance and cost details, services in a preferred language, and services tailored to specific marginalized groups appeared, and the wording used to describe mental health in the dials. The activity of matching fictitious, representative patient profile to services with early versions of the app led to a reduction in how many clicks it took to get to a services page. These changes resulted in an easy-to-use, jargon-free and intuitive interface providing the necessary information to access mental health services that was tailored to the specific needs and attitudes of the local community. Modifications continue to be made as necessary.

Conclusions: The rigorous multi-stage process with participation and oversight from numerous local stakeholders ensured the development of an end-product that addressed the county-specific gaps and barriers in accessing mental and emotional health services. The lessons derived from this process can benefit those attempting to develop a similar tool to address public health disparities.

[This corrects the article DOI: 10.21037/mhealth-24-72.].

Background: Head and neck cancer (HNC) survivors and their caregivers face significant challenges at the end of treatment and interventions are critically needed to support their needs. The Healthy Eating and Recovery Together (HEART) intervention includes a needs assessment and tailored care plan for dyads and an application (App) for caregivers. The objectives of this trial were to evaluate the feasibility, acceptability, and short-term effects of HEART on unmet needs and depression in HNC survivors and caregivers.

Methods: In a single arm clinical trial, HNC caregivers and survivors (n=23 dyads) completed baseline surveys followed by an in-person or virtual HEART session; caregivers used the HEART App for 4 weeks and dyads completed a 6-week follow-up survey.

Results: HEART feasibility was demonstrated in session completion (100%), content covered (>80%) and App use metrics (mean =20 logins over 4 weeks). The needs assessment triggered an average of 4 referrals per dyad yet acceptance rates were low. HEART acceptability was demonstrated with both dyads and nurses rating the intervention (>75%) and App [mean System Usability Scale (SUS) =75] favorably. Unmet needs remained stable over time in dyads (P>0.05) while depressive symptoms decreased in survivors (P=0.02).

Conclusions: Digital health interventions are promising to address HNC survivor and caregiver challenges. HEART demonstrated favorable feasibility and acceptability. With further enhancements to streamline this multi-component intervention and its delivery, timing and participant engagement, HEART merits further study in a larger randomized controlled trial.

Background: Community health workers (CHWs) are an essential and rapidly growing part of the public health workforce. CHW activities are traditionally conducted in person, such as in clinics and at community events; social media could further extend their impact. Many health professionals use social media for disseminating health information, engaging patients, and promoting positive health change, while also navigating risks, such as privacy concerns. Training could be an effective approach to equipping CHWs with skills to maximize social media's benefits while mitigating risks. Furthermore, artificial intelligence (AI) tools are increasingly popular for creating, refining, or tailoring social media content and could be useful for CHWs who use social media. In this study, we conducted qualitative interviews to explore the potential benefits and drawbacks of using social media as a CHW tool, CHW preferences for social media skills training, and interest in learning how to use AI for social media content creation.

Methods: We recruited CHWs in Louisiana, USA, through targeted e-mails to a CHW professional organization and agencies that employ CHWs. Between October 2024 and February 2025, we conducted 15 interviews. Interviews were audio-recorded and transcribed for analysis. We used deductive and general inductive approaches to analyze transcripts and generate themes. Results were finalized with input from experienced CHWs.

Results: We identified five themes related to the benefits and drawbacks of social media use: reach and engagement, privacy and confidentiality, health education, organizational policy and expectations, and time and effort. For example, in terms of reach and engagement, CHWs highlighted social media as being particularly effective for reaching specific groups, such as young people, but also recognized that many clients they serve live in rural areas with limited internet access. All participants were supportive of a social media skills training, except for one. Participants commented on the format, teaching approaches, and content they would like to see in a social media skills training program for CHWs, such as incorporating interactive elements and teaching how to develop culturally sensitive content and navigate personal-professional boundaries. Many CHWs expressed hesitancy about training on how to use AI for content creation, noting concerns about authenticity and accuracy.

Conclusions: Social media could be a powerful tool for boosting outreach efforts and expanding access to health information. However, using social media can present challenges in maintaining personal-professional boundaries and the privacy and confidentiality of CHWs and their clients. Results from our study can be used to inform the development and testing of a social media skills training that is responsive to CHW needs.

Background: Rural areas have a shortage of dental care resources and geographical remoteness, which is a major issue. Teledentistry, a new technology, provides dental care remotely and can reduce the care gap between rural and urban areas. However, the utilization of teledentistry has not been fully understood in rural settings. This study reviewed the current status and potential of dental care services for teledentistry in rural areas.

Methods: We searched for papers in MEDLINE/PubMed and CENTRAL published up to May 2024 with keywords of "rural" and "teledentistry" and conducted a scoping review based on the contents of the papers. Literature was limited to original articles, and conference abstracts, letters, editorials, and review papers were excluded. The target populations were subjects living in rural areas. Studies that compared the application with non-application of teledentistry and the remote approach with face-to-face approach were eligible.

Results: Thirteen eligible papers were identified and divided into four categories of utilization. Four of the papers studied dental screening (checkups), five of pathological diagnoses, two of oral health support, and two of referrals to specialists. These papers covered studies in populations with a wide range of ages, from children to the elderly. The time reduction for access to services, acceptable satisfaction, and potential cost reduction were partly described. Overall, it was determined that teledentistry could indeed be useful.

Conclusions: The current review demonstrates the useful applications of teledentistry in rural areas. Although the introduction of teledentistry may be considered suitable for dental care services in rural areas, further studies are required to establish it. With the development of photography, artificial intelligence, and communication systems, teledentistry will be a future challenge.