mHealth最新文献

Background: Reports show that in 2020 approximately 3.6 million live births were recorded in the United States, with an estimated 9-13% of these infants requiring neonatal intensive care unit (NICU) admission due to complex medical needs. In the NICUs, where newborns require specialized attention, an interplay unfolds between parents and their infants. Within these sterile walls, each touch, each whispered word, carries significance, creating strong connections during medical treatments.

Methods: Our research seeks to examine the intricate relationship between parents and infants in the NICU through careful scientific investigation. Specifically, this paper serves as a foundational review of literature that highlights the importance of continuing research in this field.

Results: By examining existing studies, we aim to underscore the importance of attachment between mothers and infants, the necessity of evaluating their individual stress responses, and monitoring physiological changes. Also, we intend to better understand the mutual relationship between mother and child in the NICU setting.

Conclusions: Ultimately, by identifying specific interventions that can mitigate the emotional and physiological stresses experienced by both mothers and infants in the NICU, we aim to identify technological needs of the kangaroo care (KC) program and integrate these findings into routine care practices. We expect that this investigation insights will encourage more research on how to promote a more nurturing environment that supports the health and well-being of both mother and child during a NICU stay.

Background: Parents learning about their children with medical complexity often use numerous health-related resources, including mobile health applications (mHealth apps). mHealth apps could provide broad access to key information and support, lower healthcare costs, and improve care. The quality of mHealth apps for this population has been a concern, but is currently unknown. The objective of this systematic review was to identify and evaluate the quality of publicly available mHealth apps designed for parents who are preparing or caring for medically complex infants.

Methods: A systematic search strategy was applied to identify mHealth apps in the Apple and Google Play app stores in November 2022 and replicated in August 2024. Apps with no cost, in English, designed for parents of infants with perinatal medical complexity requiring hospitalization were included. Apps for healthy pregnancies, children >1 year, non-parental caregivers or healthcare professionals, primarily for tracking/monitoring, or unrelated activities/products were excluded. Independent raters used the Mobile Application Rating Scale (MARS) subscales of Engagement, Functionality, Aesthetics, and Information to evaluate quality for each app. Mean ratings were calculated by subscale and for overall app quality.

Results: From 1,917 identified apps, 32 apps were downloaded and fully screened. The final sample of 15 unique apps were available on the Apple App Store, with six also available on the Google Play Store. Most apps focused on prematurity (n=6), followed by the neonatal intensive care experience (n=4), congenital heart disease (n=4), and hypoxic-ischemic encephalopathy (n=1). MARS ratings of the overall sample (mean =3.61, median =3.58; range, 2.65-4.68) indicated 20% (3/15) were of good quality and 67% (10/15) were of acceptable quality. Apps showed strengths in Functionality and Information and performed worst in Engagement.

Conclusions: The poorest quality found in Engagement suggests that most of these apps do not effectively target users' interests or needs. Notably, many suffered from a lack of recent updates or became unavailable. This decline appears to parallel the increasing integration of digital health technologies within healthcare systems, which could prompt testing of mHealth apps on health outcomes. High-quality mHealth apps that are valued by parents and offer evidence-based information and support are needed to extend care.

Background and objective: With the evolution of technology, the delivery modes of healthcare have been completely transformed. Since the first use of telemedicine in the late 20th century, it has continued to evolve with advancement of technology. Today, telemedicine does not need sophisticated equipment and expensive platforms. Using a singular device to offer a wide range of services is both desired and necessary to provide higher-quality care at greater quantities. The inclusion of smartphone-telemedicine in many high-income countries proves a plausible framework to build upon for inclusion in low- and middle-income countries (LMIC). The primary goal of this review is to analyze existing literature on smartphone-based telemedicine and assess the scalability of this form of care to provide both accessible and equal care for all.

Methods: This is a narrative review that analyzed English published literature in PubMed, Medline, Cochrane Reviews, and Google Scholar over the last 50 years.

Key content and findings: Smartphone-based telemedicine can be divided mainly to mHealth and teleconsultation. Both applications are proven cost-effective at different extents and can augment health in different capacities. While mHealth is more suitable for health behavior change, smartphone teleconsultations can be employed in direct patient care. Smartphones' applicability to different settings and flexibility make them ideal for telemedicine. This form of telemedicine might be more suitable for low-resource settings and LMIC due to compatibility with current infrastructure, ease of use, lower cost and high availability. However, ease of use comes with risk of overutilization and providers' burnout. Privacy, digital divide and health literacy are other barriers of accessing smartphone-based telemedicine. Growing smartphone penetration and technology advancement carry future potentials for scaling up smartphone telemedicine in LMIC to advance equity and equality. Still, policies and regulations need to be implemented to protect privacy while using smartphones for telemedicine.

Conclusions: Smartphone-based telemedicine is an applicable form of telemedicine for low-resource settings and LMIC. Not all mHealth applications are suitable for LMIC, but investing in smartphone-based telemedicine for teleconsultation can save lives and lower the cost of care to reach everyone efficiently without a huge burden in a cost-effective manner for many LMIC.

Background and objective: With the increased adoption of digital health solutions, such as telehealth, there is a need to consider current practices and considerations towards digital health Literacy. The objective of this review is to explore what digital health literacy considerations have been detailed in cystic fibrosis telehealth papers.

Methods: The found papers published from a recent systematic review exploring telehealth within cystic fibrosis care were taken and analysed. These papers were obtained from PubMed, Web of Science, and Scopus databases and included any paper written in English up to May 2021. Data pertaining to Health Literacy, Digital Literacy/Competency, Digital Health Literacy, Training, Readiness Assessments, and Sustained Use were extrapolated using Elicit AI Research Assistant 2024.

Key content and findings: From the 26 papers, the data of interest was sparse and mostly unavailable for this review. This may be due to several reasons; however the implication of this mitigation is discussed with reference to the digital divide, health in-equalities, and safety.

Conclusions: This review highlights that a structured approach to assess digital health literacy of care teams and people with cystic fibrosis is critical to the future success of safe telehealth use, and other digital health solutions.

Background: Youth from racial and ethnic minoritized groups have experienced an increase in suicidal thoughts and behaviors (STBs) in recent years. Mobile health technology (mHealth) and digital phenotyping hold promise as means to measure STBs and related risk factors in these groups. Such tools are more likely to be successful when designed with input from the youth and caregivers who will use the technology. This study aimed to refine a digital phenotyping smartphone application, GeoMood, customized to measure STBs and relevant risk factors, such as family conflict and experiences of discrimination. The app was designed to collect passive data from smartphones (e.g., location, phone usage), as well as short-response survey data via ecological momentary assessments (EMAs) to further understand digital phenotypes of STBs.

Methods: We conducted semi-structured qualitative interviews with five youths of color and five caregivers to obtain feedback and refine the smartphone application, GeoMood. The ultimate goal of the interviews was to assess the app's potential acceptability from the two sets of users for whom the app was developed. Both youth and caregivers reviewed the youth version, which differs from the caregiver version content by the inclusion of items addressing suicidal behavior. Interviews were analyzed using a qualitative manifest analytic approach.

Results: Youth found the app to be an acceptable tool for measuring STBs. Caregivers were concerned about assessing self-injury explicitly.

Conclusions: Youth and caregiver feedback confirms openness by participating youth to using mHealth tools for measurement of STBs, but caregivers experience hesitation with the direct questions of such tools. Feedback was useful in refining the mobile tool and suggests multimodal assessment (text and emoji prompts) may appeal to users. Results from this study may improve the acceptability of future apps designed to measure and address disparities among particularly vulnerable groups of youth.

While telehealth was widely used to provide human immunodeficiency virus (HIV) care during the coronavirus disease 2019 (COVID-19) pandemic, research evaluating viral suppression by visit type is conflicting. This study assessed variation in viral load (VL) testing and outcomes by visit type for routine HIV care visits among people living with HIV (PWH) at a large academic health center in central North Carolina (NC). Electronic health records (EHRs) data from the Duke University Infectious Disease (ID) Clinic in NC were extracted in aggregated form. Pearson's Chi-square (χ²) tests were used to examine variation in VL testing and virologic suppression (VS) in 2022 by visit type patterns in the first year of the pandemic. Tipping point (TP) sensitivity analyses were conducted. EHR data from 1,835 PWH were included. Between March 16, 2020 and March 15, 2021, 53% of PWH received in-person HIV care only, 32% received a combination of telehealth and in-person care, and 15% received telehealth care only. About 20% of PWH did not have any VL test recorded in 2022. Among PWH with a VL test, 90% were virologically suppressed at all tests in 2022. Visit type was significantly associated with VL testing (P<0.001). The proportion of people who had no VL test in 2022 was larger among telehealth only users (31%) as compared to in-person only or PWH who received a combination (19% and 18%, respectively). VS in 2022 did not differ by visit type pattern in the first year of the pandemic (P=0.36) among PWH with a VL test in 2022. TP analyses identified that the proportion of unsuppressed VL tests among PWH without any VL test in 2022 would need to be multiplied by 2.1 to result in a statistically significant difference in VS by visit type (P=0.045). Our findings indicate that VL outcomes among telehealth users who had VL testing results documented in EHR at least one year later did not differ from in-person HIV care users. However, VL testing uptake was lower among telehealth only users suggesting the need for strategies such as remote VL testing to ensure regular VL testing among PWH who use telehealth HIV care.

Background: Numerous mobile phone applications have been developed with the goal of producing behavior changes that lead to weight loss and enhanced health. However, the evidence basis for these applications is often lacking, which renders them ineffective for altering health behaviors. Therefore, the purpose of this study was to examine the potential benefits of a novel mobile application, The FASTer Way to Fat Loss^® (FW).

Methods: Forty-two overweight, but otherwise healthy women were recruited for this parallel study and randomly assigned to an exercise and nutrition education only control (CON, n=21) or an integrated mobile application group (FW, n=21), which included exercise training and dietary modifications that were overseen by an individually assigned coach. Both groups were assessed at baseline and 6 weeks post-intervention for body composition, blood health indices, and multiple questionnaires for self-esteem and body image. Absolute mean differences within and between groups were measured using unpaired t-tests with statistical significance set at P<0.05.

Results: Compared to the CON group (0.56±1.54 kg), the FW group significantly reduced total mass (-1.21±1.82 kg; P=0.002), fat mass (0.42±1.38 vs. -1.45±1.23 kg; P<0.001), body fat percentage (0.23%±1.33% vs. -1.24%±1.32%; P=0.001), and body mass index (0.24±0.59 vs. -0.46±0.60 kg/m²; P<0.001); whereas no significant between-group differences were detected for lean body mass (P=0.86). Additionally, total cholesterol was significantly reduced in the FW group (-5.2±14.9 mg/dL) compared to the CON group (8.7±22.8 mg/dL; P=0.03). There were no other significant between-group differences in blood lipid profiles, blood health indices, or subjective measures of self-esteem and body image.

Conclusions: An integrated, multifactorial smartphone application (FASTer Way^®) elicited positive changes in body composition and total cholesterol in six-weeks. Future research should investigate these effects in other populations to better generalize these results.

Trial registration: ClinicalTrials.gov NCT05813548.

The biopsychosocial model of pain acknowledges that pain experiences are shaped by an interplay between biological, psychological, and socio-environmental factors. In clinical practice, two disparate avenues for addressing pain include the widespread interventional paradigm and the rapidly growing holistic model of lifestyle medicine. Traditional pain management often emphasizes pharmacological and invasive approaches. In contrast, lifestyle medicine focuses on optimizing factors such as nutrition, exercise, sleep, stress management, avoidance of toxic substances, and social connectedness to reduce the pain experience. Within the paradigm of lifestyle medicine, specific nutrition plans may help mitigate inflammation, physical activity can alleviate symptoms of chronic pain conditions, and improved sleep can improve pain thresholds. Avoidance of toxic substances like tobacco and illicit drugs, utilization of mind-body stress reduction techniques, and fostering social connections are crucial for enhancing overall well-being and decreasing pain perception. However, there may be some drawbacks to the lifestyle medicine approach. The perception of time investment, the specialized training required for physicians, and the financial aspect can pose significant barriers. Lifestyle medicine is typically more time-intensive, requires more consultation time from physicians and the healthcare team, necessitates stronger adherence from patients, and involves more coaching and follow-up from healthcare providers. The services, treatment, and coaching are often not covered by insurance, which is a financial barrier to providing this kind of care. Despite these challenges, lifestyle medicine offers promising benefits for chronic pain management. Addressing its limitations through telemedicine and integrating it with interventional methods, affords the potential for a comprehensive approach to managing chronic pain in the future.

Background: Pelvic floor muscle training (PFMT) is a treatment that can be used during pregnancy. The main aim of this study was to evaluate adherence to PFMT and self-efficacy using a mobile application (app) named GoMAP. The secondary objective was to evaluate the correlation between self-efficacy and adherence of participants who used the GoMAP app.

Methods: This is a feasibility study. The participants were pregnant women who underwent an 8-week PFMT protocol, provided through a previously validated GoMAP app. To assess self-efficacy, the Self-Efficacy Scale for practicing Pelvic Floor Exercises was applied four times-every two weeks after starting the PFMT program on the GoMAP app. Adherence was evaluated daily by a frequency questionnaire that was completed as the participant performed the exercise program. The data are expressed as mean ± standard deviation and percentage, and the Pearson correlation test was performed between quantitative variables. A 5% significance level was adopted.

Results: Eighteen pregnant women completed the 8-week exercise protocol. The mean Self-Efficacy Scale after eight weeks of PFMT was 75.8±14.8 and the average adherence of pregnant women to the protocol was 30.4±14.0 days. The adherence and self-efficacy variables showed a strong correlation after eight weeks of PFMT (r=0.79, P<0.001).

Conclusions: Women who used the GoMAP app demonstrated good adherence and self-confidence when performing the PFMT exercises. The app could be an important therapeutic resource when conducting a PFMT program for pregnant women.

Background: Mobile health (mHealth) offers easy accessibility to healthcare information and services, promoting positive behaviour change. However, user engagement to mHealth diminishes over time, resulting in significant dropout rates. This study aims to investigate the factors contributing to the discontinuation of mHealth use and examine how persuasive elements influence users' intention to continue using mHealth. It also seeks to identify the key motivators and barriers affecting mHealth engagement.

Methods: A survey was conducted to assess persuasive elements, motivators, and barriers related to mHealth usage. The survey included measures to evaluate users' perceived persuasiveness of mHealth, the factors influencing their intention to continue using it, and both the motivators and barriers to its sustained use.

Results: The analysis revealed that unobtrusiveness had the strongest positive correlation with the intention to continue using mHealth. Additionally, a positive association was found between users' perception of mHealth's persuasiveness and their intention to continue using it. The study also identified key motivators that encourage mHealth adoption and several barriers that hinder long-term engagement.

Conclusions: These findings highlight the importance of developing strategies to enhance the long-term adoption of mHealth solutions and reduce dropout rates. Future research is needed to explore effective interventions for sustaining mHealth usage and addressing the barriers that lead to disengagement.