mHealth最新文献

Background: The increasing prevalence of irritable bowel syndrome (IBS) in Saudi Arabia has led to a growing interest in understanding how patients seek health information online. While it is known that digital platforms, such as search engines, social media, and artificial intelligence (AI) chatbots, are commonly used for health information seeking, there is limited knowledge about the specific behaviors of IBS patients in this context and how these behaviors correlate with their self-care activities. This study aimed to explore online health information-seeking behavior and its correlation with self-care activities among patients with IBS in Saudi Arabia, focusing on the use of these digital platforms.

Methods: A cross-sectional survey was conducted at King Khalid University Hospital in Riyadh, Saudi Arabia, from January to July 2023. The survey, available in both English and Arabic, targeted IBS patients aged 16 years or older. The questionnaire covered demographics, general internet usage, online health information-seeking behavior, and IBS knowledge and awareness.

Results: In this study, 451 IBS patients completed the survey. Notably, 95.1% of participants were internet users, primarily accessing health information through mobile phones and search engines. The results highlighted a significant correlation between online health information-seeking behaviors and self-care practices (P=0.009) like exercise and dietary adjustments, despite a moderate basic knowledge [standard deviation (SD) 2.26%] of IBS. Symptomatically, 93.3% experienced abdominal pain weekly, yet 63% did not fully meet the Rome criteria for IBS. Common management strategies included hydration, diet modifications, and exercise. About 28.4% visited the emergency room (ER) for severe symptoms, and 20% regularly consulted doctors every 3-6 months. Surprisingly, 80% were unaware of the FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) diet, often suggested for IBS.

Conclusions: The research indicates a rise in digital health literacy among IBS patients in Saudi Arabia, highlighting the need for accurate and culturally appropriate online resources. It suggests that healthcare professionals and policymakers should direct patients to reliable information and address the digital divide to enhance self-care and IBS management outcomes.

Background: Colorectal cancer (CRC) screening uptake among South Asian immigrants in the US is the lowest (61.1%) of all immigrant groups (e.g., 65.9% among East Asians and 71.3% among Hispanics). Culture-specific factors influence their reluctance to screen for CRC, despite the availability of easily accessible, non-invasive screening tools, like the fecal immunochemical test (FIT). The current study utilizes a virtual health assistant (VHA) tailored to inform and educate Bangladeshi immigrants about FIT.

Methods: We conducted usability tests to understand Bangladeshi immigrants' informational needs, barriers, facilitators, and visual and linguistic preferences. After 20 minutes of interaction with the VHA, we conducted semi-structured interviews with 30 participants. Participants also filled out a questionnaire of demographic information and VHA gender and ethnic appearance preferences. A qualitative content analysis using the constant comparative method generated themes.

Results: A total of 30 participants (16 women, 14 men) with a mean age of 39.2 years participated. Informational needs included eight themes: (I) risk-reducing behaviors/habits, (II) post-intervention (information desired after interacting with the VHA), (III) CRC-related content (e.g., symptoms, causes, impact on the body, etc.), (IV) financial considerations of FIT, (V) personalized content/options, (VI) pre-test information (how to prepare for the FIT kit use, e.g., "do I need to fast?"), (VII) comparison to other CRC screening options, and (VIII) more specificity of information (i.e., using more measurable language, avoiding vague language like "some", "more", etc.). Major barriers were (I) lack of control, (II) lack of sophistication in VHA animation features, (III) lack of interactiveness, and (IV) lack of a trustworthy source. Facilitators were (I) convenience (of using VHA), (II) social cues (of interacting with a VHA), and (III) content (provided by the VHA). In terms of VHA's appearance, which was a combination of its apparent gender and ethnicity, participants demonstrated varied preferences but the majority (n=17) preferred gender concordant VHA. As for linguistic preference, participants generally mentioned either English or an option to choose a language for themselves while claiming that other Bangladeshi immigrants would prefer the Bangla language.

Conclusions: Participants were open to using a VHA to learn about CRC, either instead of or along with talking to a clinician about it. However, recommendations to improve animated features of the VHA included more detailed and Bangladeshi population-specific information and provided choices to select preferred languages and appearance of the VHA. Future studies should empirically test the required levels of tailoring to effectively increase CRC screening among Bangladeshi immigrants.

Background: The coronavirus disease 2019 (COVID-19) pandemic necessitated rapid adoption of telehealth services to maintain healthcare access for treating substance use disorders (SUDs) and mental health care (MHC). However, the impacts of telehealth expansion policies adopted in 2020 on access to addiction treatment in North Dakota (ND) and Minnesota (MN) remain unclear. This study examines the impact of the COVID-19 pandemic on utilization of telehealth services for SUDs and MHC in ND and MN.

Methods: We conducted a quasi-experimental study design using Medicaid telehealth claims data from 2018 to 2022. Segmented regression analysis of interrupted time series (ITS) data was employed to assess the impact of the COVID-19 pandemic (March 2020) on telehealth service utilization.

Results: From 2018 to 2022, there were 580,186 telehealth claims for SUDs (MN: 545,676; ND: 34,510) and 3.4 million claims for MHC (MN: 3.3 million; ND: 85,391). The mean telehealth utilization rate for SUDs was 5.2 vs. 7.3 per 1,000 beneficiaries and for MHC was 12.6 vs. 45.2 per 1,000 beneficiaries in ND and MN, respectively. The pandemic led to significant increases in telehealth use: ND (SUDs: +22.7/1,000; MHC: +59.8/1,000) and MN (SUDs: +30/1,000; MHC: +185.5/1,000). ND saw smaller initial increases but more gradual declines over time (SUDs: -0.42/1,000/month; MHC: -1.03/1,000/month) compared to MN (SUDs: -0.43/1,000/month; MHC: -2.78/1,000/month).

Conclusions: The COVID-19 pandemic significantly increased Medicaid telehealth utilization for SUDs and MHC in both states. MN experienced larger initial increases with steeper declines, while ND showed more sustainable utilization trends, indicating potential for sustained improvements in access to behavioral health services.

The virus infection severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during pregnancy is a risk factor for developmental problems. Our objectives were to explore feasibility measures and verify the reliability of synchronously employing the Alberta Infant Motor Scale (AIMS) remotely in infants with prenatal exposure to SARS-CoV-2. Additionally, we explored the motor performance of these infants relative to an unexposed normative sample. An exploratory cross-sectional study was carried out and included 20 infants (10.65±4.99 months) whose mothers tested positive for coronavirus disease 2019 (COVID-19) during pregnancy. Infants were assessed with the AIMS remotely and synchronously via video call by a physical therapist. The calls were recorded. Three independent observers scored the recordings. Parents and assessors answered questions regarding barriers to and facilities for the assessments. A higher proportion of parents (90%) found it easy to understand and replicate the commands provided by the therapist during the assessment (P<0.001). The assessors reported not encountering difficulty in most assessments. Interobserver reliability was good in the standing posture [95% confidence interval (CI): 0.734-0.942, P<0.001] and excellent (95% CI: 0.970-0.996, P<0.001) in prone, supine, and sitting. Intra-rater reliability was excellent (95% CI's: 0.876-1.000, P's<0.001) in all postures. There were no differences between the motor performance of exposed infants compared to the unexposed normative sample. It was feasible to assess the motor performance of infants exposed to SARS-CoV-2 via video call with good to excellent inter- and intra-rater reliabilities, making it an important approach when social distancing is needed.

Background: Hospital-at-home (H@H) models have gained recognition as a safe and potentially cost-effective solution for the current rising global healthcare needs. However, despite these models' potential, their adoption has been limited partly due to patients refusing care at home. This systematic review analyses the reasons behind their refusal.

Methods: We searched five databases: Embase, Google Scholar, PubMed, Scopus, and Web of Science, limiting our search to papers from 2005 to 2024. Our search focused on papers reporting patient-provided reasons for declining treatment in a H@H setting without language or country restrictions. In addition to reasons for refusal, we extracted patient demographics and predictors for refusal to ensure a broad understanding of the factors influencing patient decisions. The quality of the studies included was evaluated using the Mixed Methods Appraisal Tool (MMAT) version 2018.

Results: From the 1,067 articles identified, seven met our inclusion criteria. The papers reported reasons from 418 patients participating in diverse H@H models from the United States, United Kingdom, Spain, and Singapore, primarily focusing on acute home-based care. The most common reasons for declination included concerns about model effectiveness, safety at home, preference for in-hospital care, physician advice, family burden, and visitor concerns. Additionally, common significant demographic factors associated with decliners were the enrollment site, partnership or marital status, risk of adverse outcomes, and previous healthcare utilization.

Conclusions: Understanding patients' motivations for declining H@H is crucial for its successful implementation. Targeted communication strategies and collaboration between healthcare providers are paramount to ensure that patients understand the benefits and safety of H@H models. Future research should explore effective communication and engagement techniques to address patient apprehensions and broaden H@H adoption.

Background: The increasing prevalence of artificial intelligence (AI)-driven mental health conversational agents necessitates a comprehensive understanding of user engagement and user perceptions of this technology. This study aims to fill the existing knowledge gap by focusing on Wysa, a commercially available mobile conversational agent designed to provide personalized mental health support.

Methods: A total of 159 user reviews posted between January, 2020 and March, 2024, on the Wysa app's Google Play page were collected. Thematic analysis was then used to perform open and inductive coding of the collected data.

Results: Seven major themes emerged from the user reviews: "a trusting environment promotes wellbeing", "ubiquitous access offers real-time support", "AI limitations detract from the user experience", "perceived effectiveness of Wysa", "desire for cohesive and predictable interactions", "humanness in AI is welcomed", and "the need for improvements in the user interface". These themes highlight both the benefits and limitations of the AI-driven mental health conversational agents.

Conclusions: Users find that Wysa is effective in fostering a strong connection with its users, encouraging them to engage with the app and take positive steps towards emotional resilience and self-improvement. However, its AI needs several improvements to enhance user experience with the application. The findings contribute to the design and implementation of more effective, ethical, and user-aligned AI-driven mental health support systems.

Background: Mobile health (mHealth) apps are becoming a promising tool to motivate sustainable lifestyle and behavior changes, including modifications to diet and exercise. However, most current mHealth apps do not have meaningful, and sustained user acceptance, particularly, among adolescents. They perceive mHealth apps designed for adults to be tedious and visually unexciting, which discourage adolescent usage. Researchers and adolescent mHealth app developers would benefit from a foundational understanding of which functions and features adolescents feel would most motivate app use. Capturing caregivers' and health care providers' inputs are also important as both groups play an integral role in adolescent health care decision-making. The purpose of the study is to explore and analyze mHealth app features identified by adolescents, caregivers, and health care providers that have the potential to inspire continued use, thereby resulting in sustained health behavior changes in adolescents.

Methods: We used inductive thematic analysis of qualitative data obtained from semi-structured focus groups conducted via Zoom©. Important features of mHealth apps that encourage adoption and continued use were explored with 25 participants, including adolescents, their caregivers, and health care providers.

Results: Common features facilitating continual usage of mHealth apps that were identified as significant by participating adolescents, their caregivers and health care providers were: look and feel of the app, customization, educational information/recommendations, and integration with electronic health record. Features such as gamification and social interaction that are usually lacking in current adolescent mHealth apps were well recognized as meaningful for motivational purposes.

Conclusions: The findings suggest that adolescents and caregivers identify an app as valuable when it is user-friendly and intuitive and appreciate features that are motivating and can engage users in positive behaviors. Health care providers prefer mHealth apps that are user-friendly and can be effectively integrated into the cycle of care, thereby enabling delivery of efficient and value-based health care. Thus, mHealth app designs that are informed by health care providers' clinical experience and needs, in combination with app features that are desired and supported by both adolescents and their caregivers, have the potential to motivate widespread adoption and long-term use, which could result in improved health behaviors and outcomes among adolescents.

Background: Social distancing due to the pandemic is accelerating the fragmentation of Korean society in the megatrend of continuous individualization after industrialization. In this context, consumers are turning to direct-to-consumer (DTC) genetic testing for tailored skin healthcare strategies. However, there are still concerns about the safety of personal information in DTC genetic testing. The purpose of this review article is to examine the sustainable safety of DTC genetic testing for customized dermatology products, focusing on skin healthcare market after coronavirus disease 2019 (COVID-19).

Methods: A systematic review approach was used in this study. Using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) flow chart, a total of 920 references were selected from PubMed, Medline, and Scopus. The composition of a total of 59 references from professional papers was finally reviewed. To this end, the most relevant recent literature was added, and the reference period was limited to 2018 to 2023 based on a 6-year period.

Results: With the practice of mask wearing since COVID-19, various methods are being used to strengthen the skin's immune system, and maintain and promote skin health. There is a need to have a method to increase the safety of DTC genetic testing for sustainable skin healthcare market.

Conclusions: It is concluded that there is a need to continue to develop more sustainable and safer security applications (apps) in the field of customized dermatology cosmetics to address the privacy issues and improve the accuracy of DTC genetic testing.

Background: Over fifty percent of individuals with overweight and obesity are emotional eaters. Emotional eating can be theorized as a conditioned response to eat for reasons that are not associated with physiological hunger. We conducted this proof-of-concept study to gather evidence that a mobile app that delivers a common non-meditative mindfulness exercise called RAIN, in a step-by-step image sequence can improve emotional eating and other outcomes over a 3-week period.

Methods: Forty-nine Canadian adults who self reported as emotional eaters (mean age =30.7 years) were recruited through social media and participated in a workshop in which RAIN and its use on the app were introduced. Participants were asked to use the app every time that they experienced a non-homeostatic craving to eat for three weeks. Emotional eating, reactivity to food cravings, perceived loss of control around food, distress tolerance, and eating-specific mindfulness were assessed pre- and post-intervention.

Results: Improvements on all outcomes were found (r-range, -0.58 to -0.28). The feasibility of the mobile application was demonstrated by a low attrition rate (8%), high user satisfaction, and strong app engagement metrics.

Conclusions: The data provide proof-of-concept evidence that a mobile app that delivers a mindfulness exercise in a step-by-step image sequence has potential to be effective and thus identifies a new approach that may reduce emotional eating in an accessible and affordable manner.