mHealth最新文献

Background: The digital divide significantly influences healthcare accessibility and outcomes, particularly regarding eHealth technologies. Disparities in eHealth adoption between Europe and Southeast Asia underscore the impact of E-government development on eHealth performance. This study focuses on digital literacy as a mediating factor and religious beliefs as a moderating variable, recognizing that these elements can shape the effectiveness of eHealth initiatives.

Methods: A quantitative analysis was conducted using secondary data from 31 geographically diverse countries, representing both developed and emerging economies, spanning the years 2019 to 2022. This period was chosen due to the coronavirus disease 2019 (COVID-19) pandemic, which exacerbated the digital divide in eHealth adoption and accessibility. The analysis examined the relationships between E-government development, digital literacy, religious beliefs, and eHealth performance.

Results: The findings indicate that E-government development positively influences eHealth performance, with digital literacy playing a significant mediating role in this relationship. Additionally, religious beliefs, particularly Atheism, were found to moderate the relationship between E-government development and eHealth performance. Regions with lower levels of religiosity demonstrated a greater receptiveness to eHealth technologies, suggesting that cultural factors significantly affect technology adoption.

Conclusions: The results underscore the necessity of integrating digital literacy initiatives alongside E-government development to enhance eHealth performance effectively. Policymakers should consider the cultural and religious landscape when designing eHealth strategies to ensure equitable access to healthcare resources. By addressing both technological and cultural barriers, it is possible to improve healthcare accessibility and outcomes for diverse populations, ultimately bridging the digital divide in healthcare.

Background: Gaucher disease (GD) is a rare genetic disorder caused by variants in the GBA1 gene, leading to a deficiency of β-glucocerebrosidase. This enzyme deficiency results in glucocerebroside accumulation in macrophages, forming "Gaucher" cells and causing symptoms such as hepatosplenomegaly, anemia, thrombocytopenia, and severe bone issues like osteonecrosis. While enzyme replacement therapy (ERT) and substrate reduction therapy (SRT) have improved the management of non-neuronopathic GD, type 1 Gaucher disease (GD1), patients still face significant challenges. Digital health technologies offer potential solutions by enabling continuous patient monitoring, treatment adherence, and patient-reported outcome measures. The aim of this study was to evaluate the use of a GD-specific app in adults with GD1.

Methods: With input from GD experts and patient groups, the INTEGRA^TM platform was customized to meet the needs of patients with GD, resulting in the development of the MyGauch^TM v1.0 app. This app, integrated with the INTEGRA^TM platform, facilitated patient care through the capture of genetic, clinical, laboratory, and biomarker data and secure data transmission. The app included components for tracking pain, fatigue, physical activity, nutrition, and medication adherence. It featured a structured GD-specific patient-reported outcome measurements (PROMs) questionnaire assessing disease burden and treatment satisfaction. Additional tools included medication reminders, communication with the Gaucher clinic, access to lab results, and educational resources. All components were integrated into a centralized dashboard. Adults (≥18 years) with GD1, access to a mobile phone, and receiving ERT or SRT at enrollment were eligible for the study. Improvement in satisfaction with GD treatment was assessed using a question on treatment satisfaction from the electronic PROMs questionnaire.

Results: The study enrolled 90 adults with GD1 who received ERT or SRT and had access to the necessary technology. The improvement in satisfaction with the medical management of the GD with the use of MyGauch^TM was modest and not associated with demographic, disease, or treatment-related factors. The high non-participation rate, limited use of the app's features, and lack of personalized feedback on physical activity and nutrition were noted as limitations.

Conclusions: Although the development of MyGauch^TM v1.0 represents a novel approach, low user engagement highlights the need for a newer app with improved features and patient education that would enhance patient's health. Future research should prioritize understanding and overcoming obstacles to successfully adopting digital tools in rare disease management and creating more comprehensive self-management solutions tailored to patient behaviors and needs.

Background: Type 2 diabetes mellitus (T2DM) presents a significant global health challenge due to its complex aetiology and widespread impact on various bodily systems. Its prevalence and associated mortality rates have been steadily rising, imposing substantial economic burdens and deteriorating quality of life. With the advent of mobile and computer applications (apps), there has been growing interest in utilizing technology to promote healthier lifestyles among T2DM patients. The Shae platform, an online platform, takes a personalized approach to lifestyle recommendations. This study aims to evaluate the impact of engagement with Shae on T2DM risk using the Australian Type 2 Diabetes Risk Assessment Tool (AUSDRISK) tool and associated lifestyle and anthropometric values, highlighting the potential of targeted and personalized health apps in improving health outcomes and user adherence.

Methods: Participants for this study were drawn from those engaging with the Shae online platform from May 2014 to March 2018, totalling 1,690 participants after accounting for exclusion criteria. Measures included anthropometric data, survey responses, and AUSDRISK risk score calculations. Statistical analysis involved paired sample t-tests and generalized additive model adjusting for relevant variables.

Results: The data primarily comprises females, constituting 86.9% (1,468 individuals), with males making up 13.1% (222 individuals). Notably, both female and male participants showed reductions in average AUSDRISK scores from baseline to follow-up. Female participants saw a decrease from 8.95 to 7.87, while male participants experienced a decrease from 10.82 to 9.79. Additionally, improvements were observed in average anthropometric measures such as body mass index (BMI), body fat index (BFI), and waist-to-height ratio (WHt) across both genders.

Conclusions: While improvements were noted in diabetes risk and anthropometric measures, challenges in reducing sedentary behavior were evident, emphasizing the need for targeted interventions. Reductions in BMI and WHt suggest positive shifts in body composition, crucial for mitigating metabolic risks. Integrating mobile health platforms into diabetes prevention strategies holds promise for enhancing outcomes and empowering individuals to manage their health effectively.

Background: Primary dysmenorrhea (PD) is a prevalent gynecological condition characterized by menstrual pain. Women with PD often experience functional disability, absenteeism, and presenteeism, leading to increased healthcare costs. Health education is a proven strategy for improving self-management behaviors, and mobile health (mHealth) technologies, such as smartphone applications (apps), offer a promising avenue for delivering educational interventions. However, existing menstrual cycle apps have limited functionality and do not focus on PD self-management. We aimed to develop and validate a health education app-ColicApp-to improve knowledge and self-management of PD and to assess adherence, self-efficacy, and satisfaction among users.

Methods: This was a descriptive technology development study. The content of the app was designed based on a literature review, incorporating scientific evidence on PD self-management. A prototype was developed following structured guidelines and included sections on the definition, prevalence, pathophysiology, symptoms, self-care strategies, and pain management techniques. The content was reviewed for accessibility and comprehension by a group of women from the community. The app was validated by women's health physiotherapists and women with PD using the content validity index (CVI) and percentage of absolute agreement. Adherence, self-efficacy, and satisfaction were assessed over three menstrual cycles using standardized instruments. Data were collected online using Google Forms.

Results: The content of the app was evaluated by 22 women's health physiotherapists and 17 women with PD. The experts rated the app with a CVI greater than 0.76, while women with PD rated it greater than 0.80, with overall agreement levels of 96% and 94%, respectively. Participants provided suggestions for improvement, including the addition of explanatory videos for women with low literacy. Among 99 women who used the app, adherence rates were 76.8% in the first cycle, 68.7% in the second cycle, and 55.6% in the third cycle. A significant correlation was observed between adherence in the third cycle and pain reduction. Self-efficacy scores were high, indicating improved confidence in managing PD symptoms. Most participants reported high satisfaction with the app's design, functionality and educational content of the app.

Conclusions: ColicApp was successfully developed and validated as an educational tool for PD self-management. High levels of adherence, self-efficacy, and satisfaction ratings suggest strong clinical applicability. This mHealth intervention has the potential to enhance self-care practices among women with PD and could serve as a valuable resource for both individuals and healthcare professionals. Future studies should evaluate the performance of the app when integrated into operating system platforms.

Background: Home care and teleassistance emerge as effective, patient-centered approaches to meet the healthcare needs of older adults, enabling them to remain in familiar environments while receiving personalized care. Despite technological advancements driving teleassistance, the success of these interventions hinges on the acceptance and adherence of older person and their caregivers. This study explores the impact of teleassistance on older adults' health, focusing on daily and simple care, through a randomized clinical trial.

Methods: Individuals aged 60 years or older were recruited and divided into two groups: the application group (APPG, n=21) and the control group (CG, n=19). Various anthropometric, motor, clinical, and biochemical measures were utilized for participant assessments. Throughout the 14-week experimental period, participants utilized the "Viva" application, receiving teleassistance and educational resources. Personalized support was provided to address any difficulties.

Results: The study demonstrated that the "Viva" application had significant positive impacts on the health and well-being of older adult participants. Specifically, the APPG showed no-table improvements in flexibility [sit and reach (S&R): +5.1 cm, P<0.001], lower limb strength [sit and stand test (S&ST): +5.2 reps, P<0.001], and walking performance [6-minute walk test (6MWT): +41.3 m, P<0.001], compared to the CG. Additionally, the APPG exhibited enhanced overall health (P<0.001), cognitive function [Montreal Cognitive Assessment (MoCA): +4.7 points, P<0.001], and significant reductions in total cholesterol levels (-25 mg/dL, P<0.05). These findings were complemented by improvements in healthy food consumption patterns, reduced daytime sleepiness, and greater health literacy, further emphasizing the application's role in promoting healthy aging and improved quality of life. With technological advances and expanding internet access, telecare has the potential.

Conclusions: With technological advances and expanding internet access, telecare has the potential to revolutionize care for older adults by enabling them to safely and autonomously remain at home while receiving personalized support. This study demonstrated significant improvements in health outcomes, including reduced sedentary time, enhanced physical activity, better sleep quality, lower cholesterol levels, improved cognitive function, and healthier dietary habits in the teleassisted group. These results highlight teleassistance as an essential strategy for promoting healthy and active aging, reducing the risk of chronic diseases, and improving the overall quality of life for older adults.

Trial registration: This study is registered in the Brazilian Clinical Trials Registry (RBR-6wgkzs8).

Wireless communication devices and networks are currently prevalent in human environment. Some persons claim to be sensitive to emitted by them microwave radiation. Commonly, this sensitivity is called electromagnetic hypersensitivity (EHS) or microwave disease. However, because of the yet scientifically unproven link between radiation exposures and EHS symptoms, this sensitivity is also called idiopathic environmental intolerance attributed to electromagnetic fields (IEI-EMF). The sensitivity is not recognized by the World Health Organization as a disease or as being caused by exposures to wireless radiation. There are no medical tests for detecting sensitivity to wireless radiation. Physicians are not being educated to deal with persons who claim to be sensitive to wireless radiation. However, some persons who consider themselves to be sensitive to wireless radiation exposures claim to have medical diagnoses made by physicians or other health professionals. This project looked at the contradiction of the lack of diagnostic criteria for sensitivity to wireless radiation with the medical diagnoses claimed by some of the self-declared sensitive persons. Analysis of questionnaire responses of 142 self-declared sensitive persons suggests that, currently, it is not possible to diagnose sensitivity to wireless radiation exposures. The claimed medical diagnoses appear to be based on the anecdotal evidence presented by the self-declared sensitive persons. In some cases, medical tests were used but these tests lacked scientific proof of their ability to detect the sensitivity of a person to wireless radiation exposure. The proof of the existence of sensitivity to wireless radiation remains inadequate. However, logically and by analogy to other environmental stressors, it is likely that individual sensitivity to wireless radiation exists. Because provocation studies in wireless radiation-exposed volunteers alone seem unable to provide definite answers, further research using both, provocation and biochemical methods with controlled wireless radiation exposures in volunteers is necessary to discover diagnostic biomarkers of EHS.

Background: Digital storytelling (DST) encourages participants to use technology to create narratives and share personal experiences. Although DST can amplify the voices of groups experiencing marginalization, it is unclear how DST has been used among young adults of color. We also lack a comprehensive understanding of DST's role in addressing health-related outcomes. We conducted a systematic review to examine the role of DST in influencing health-related knowledge, attitudes, and behaviors among young adults of color.

Methods: We searched three databases for peer-reviewed literature between January 1, 2000, through December 31, 2023, for references examining DST methods among young adults (aged 18-39 years) of color that included at least one health-related outcome. We used a two-stage review process to assess eligibility. Data were analyzed by DST type and health outcome.

Results: From 877 references, we identified 33 eligible articles, most of which were from Canada and the USA. Studies addressed infectious diseases (n=13), including human immunodeficiency virus (HIV); mental health issues (n=10); maternal and reproductive health (n=5); and behavioral or other health themes (n=5). Across health areas, studies were divided by DST type: media creation (e.g., participants created digital stories) or media consumption (e.g., participants or other community members were exposed to stories). Studies using media creation often use qualitative methods to identify social determinants of health or reveal complex health-related issues. Studies using media consumption often used quantitative methods to measure knowledge, attitudes, and behaviors. Across health topics, DST demonstrated some effect in changing health knowledge and attitudes, but mixed results in terms of shifting health behaviors.

Conclusions: DST can amplify the voices of young adults of color, especially regarding complex issues, such as managing HIV or mental health issues. Media creation studies explored lived experiences, while media consumption studies showed that DST was effective at improving knowledge and attitudes related to certain health issues. More randomized controlled trials may be necessary to better assess the effect of DST interventions on modifying health behaviors. Researchers should also consider the value of DST beyond health outcomes intended to be measured, including the ability to empower young adults of color to be more fully engaged throughout the research process.

Background: African American men experience higher rates of chronic diseases including diabetes, cardiovascular disease, and obesity compared to other race and gender groups. This population also has high levels of inactivity, one of the major risk facts for chronic disease. Due to the promise shown by mobile applications (apps) in providing tailored and easily accessible health interventions, we aimed to build an app designed for African American men to initiate and maintain their physical activity (PA) called MobileMen.

Methods: We conducted focus groups (n=24) with African American men to gain insight on the features and design aspects to include in the app prototype. We then used an iterative design process by conducting multiple rounds of beta (n=14) and useability (n=16) testing to create a prototype that was easy to use, visually pleasing, and culturally tailored. A satisfaction and helpfulness questionnaire and the System Usability Scale (SUS) were used as quantitative measures in addition to qualitative data provided by participants. Tasks were given to participants to test for ability to navigate and use the app features.

Results: The average satisfaction and helpfulness ratings from participants were 3.9/5 and 3.7/5 for beta testing and 4.3/5 and 4.1/5 for usability testing, which met the pre-determined criteria of ≥3.5. Only one of the satisfaction questions, which was about cultural tailoring for African American men, was below the pre-determined criteria (2.7). By round two of usability testing, the majority of tasks were able to be completed by all of the participants and the mean SUS score was 90.36 out of 100 which exceeded a priori feasibility criterion of a mean rating of 68.0. The feedback on the finalized features was positive, and participants expressed that they would use the app if it were on the market.

Conclusions: Based on both the qualitative and quantitative data obtained from multiple iterative design rounds, the MobileMen app was well received by the target population and is ready to be tested on a larger scale for effectiveness. The app is easy to use and contains culturally tailored features.

Background: Fibromyalgia is a syndrome characterized by widespread chronic pain, associated with fatigue, sleep disturbances, and cognitive impairment, among others. Effective management of fibromyalgia requires an integrated pharmacological and non-pharmacological approach that involves the patient in self-care. M-health devices are widely used as complementary resources for chronic pain management and patient empowerment. The objective of this study is to define the content of a mobile application, FibroApp, for the non-pharmacological management of fibromyalgia, based on the perspectives of patients and expert professionals.

Methods: FibroApp was developed through a qualitative design, with the unit of analysis being meaningful discourse fragments from interviews with key informants (rheumatologists, physiatrists, physical and occupational therapists, psychiatrists, and patients diagnosed with fibromyalgia). Atlas.ti software was used for the analysis and triangulation of literature and qualitative findings.

Results: The content of FibroApp, in consensus with the interviewees-both patients and experts-includes modules on physical activity or exercise, education, cognitive stimulation, reminders, and freely accessible supplementary material. The study highlighted the importance of social support, educational resources, and personalized exercise programs as essential components of the app.

Conclusions: The development of FibroApp underscores the potential of mHealth applications in enhancing the management of fibromyalgia by providing a multifaceted tool that addresses the physical, emotional, and educational needs of patients. The integration of social support, education, physical activity, and relaxation techniques within a mobile application offers a promising approach to improving the quality of life for individuals with fibromyalgia. Further research is needed to evaluate the app's effectiveness in larger, diverse populations.

Background: Globally, preschoolers' physical activity (PA) levels are lower than recommended. Digital interventions involving child-centered approaches hold promise for increasing PA behaviors. The objective of this cross-sectional study was to evaluate the acute effects of 3 custom mobile apps, Foods & Moves, on preschooler's PA outcomes in comparison with traditional physical education (PE) activities as part of the HEalthy EnviROnments (HEROs) Study.

Methods: Thirty-one children (17 boys, X_age =4.3±0.5 years; 42% Hispanic) participated in a 6-week parent-child intervention aimed at enhancing healthy eating and PA behaviors. Children's PA outcomes, including percentage of time spent in moderate PA (MPA%), vigorous PA (VPA%), moderate-to-vigorous PA (MVPA%), and cadence (steps/minute), were collected by ActiGraph GT9X Link accelerometers on each of the 3 apps (Jungle Gym, Jungle Gym-2, Spin-n-Move) and 2 traditional PE activities (obstacle course and PA skill building) during weekly workshops.

Results: Linear models revealed condition differences in VPA% [F(4,147) =10.18, P<0.001, η² =0.22], MVPA% [F(4,147) =13.46, P<0.001, η² =0.26], and cadence [F(4,147) =20.88, P<0.001, η² =0.35]. Pairwise comparisons indicated that VPA% for PA skill building, Jungle Gym, and Jungle Gym-2 was higher than the obstacle course (all P<0.001). MVPA% and cadence in PA skill building, Jungle Gym, Jungle Gym-2, and Spin-n-Move were higher compared to the obstacle course (all P<0.001).

Conclusions: The Foods & Moves apps prompted a considerable proportion of high-intensity PA, which is comparable to or higher than traditional PE activities, demonstrating the potential to use digital strategies to promote PA in preschoolers.