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A discrete choice experiment to examine the factors influencing consumers' willingness to purchase health apps. 一个离散选择实验来检验影响消费者购买健康应用的意愿的因素。
Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-01-01 DOI: 10.21037/mhealth-22-39
Zhenzhen Xie, Hao Liu, Calvin Or

Background: The benefits of health apps can only be realized when consumers purchase them for use. Thus, it is important to understand what factors influence consumers' willingness to purchase health apps. Therefore, this study aimed to examine the influence of health app attributes and sociodemographic characteristics on consumers' willingness to purchase health apps, and how the value of the health app attributes varies for individuals with different sociodemographic characteristics.

Methods: A questionnaire-based discrete choice experiment (DCE) was conducted with a random sample of 561 adults. A standard logit regression was applied to assess the influence of health app attributes and sociodemographic characteristics on consumers' willingness to purchase health apps, and marginal willingness to pay (MWTP) was calculated for each factor using regression coefficients. Interaction effects were also examined to determine how the value of health app attributes varies by sociodemographic characteristics.

Results: Usefulness, ease of use, security and privacy, and attitudes of healthcare professionals toward consumers' use of health apps were the attributes of health apps that positively influenced consumers' willingness to purchase them. Conversely, smartphone storage consumption, mobile Internet data consumption, and app price negatively influenced consumers' willingness to purchase the apps. For sociodemographic characteristics, being male, having a household size greater than three, having a monthly household income of HK$30,000 or more, having a lower education level (below diploma), having previously used health apps, and having previously purchased health apps were associated with a higher willingness to purchase health apps.

Conclusions: Health app attributes that influenced consumers' willingness to purchase the apps and populations that were less willing to purchase health apps were identified. Efforts should be made to improve health app attributes and enhance the promotion of health apps among these underserved populations.

背景:健康应用的好处只有在消费者购买使用时才能实现。因此,了解影响消费者购买健康应用意愿的因素非常重要。因此,本研究旨在考察健康app属性和社会人口学特征对消费者购买健康app意愿的影响,以及不同社会人口学特征的个体对健康app属性价值的差异。方法:采用基于问卷的离散选择实验(DCE)方法,随机抽取561名成人进行调查。采用标准logit回归评估健康应用属性和社会人口学特征对消费者购买健康应用意愿的影响,并利用回归系数计算各因素的边际支付意愿(MWTP)。还研究了交互效应,以确定健康应用程序属性的价值如何随社会人口统计学特征而变化。结果:有用性、易用性、安全性和隐私性以及医疗专业人员对消费者使用健康应用的态度是健康应用的属性,这些属性对消费者的购买意愿产生了积极的影响。相反,智能手机存储消费、移动互联网数据消费和应用价格对消费者购买应用的意愿产生负向影响。在社会人口学特征方面,男性、家庭人数超过三人、家庭月收入在30,000港元或以上、受教育程度较低(文凭以下)、曾经使用过健康app、曾经购买过健康app与购买健康app的意愿较高相关。结论:确定了影响消费者购买应用意愿的健康应用属性和不太愿意购买健康应用的人群。应努力改善健康应用的属性,并在这些服务不足的人群中加强健康应用的推广。
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引用次数: 0
Overview of telehealth in the United States since the COVID-19 public health emergency: a narrative review. 自COVID-19突发公共卫生事件以来美国远程医疗概况:叙述性回顾
Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-01-01 DOI: 10.21037/mhealth-23-15
Juan J Andino, Nicholas W Eyrich, Richard J Boxer

Background and objective: The coronavirus disease 2019 (COVID-19) public health emergency (PHE) resulted in rapid expansion and use of telehealth services. Regulatory and reimbursement flexibilities were put in place to ensure patients had continued access to care while the health system was overwhelmed by COVID-19 cases. These changes have allowed clinicians to use and researchers to evaluate telehealth in new ways.

Methods: This narrative review focuses on highlighting telehealth research and evaluation that took place from March 2020 to February 2023 in the outpatient setting of the United States healthcare system.

Key content and findings: The research conducted during the COVID-19 PHE shows that telehealth was primarily used as a substitute for in-person care, to maintain continuity of care for established patients, and has not had a negative impact on clinical outcomes or resulted in increasing healthcare costs.

Conclusions: Studies show high patient and physician satisfaction, similar clinical outcomes and suggest that telehealth is used as a substitute for in-person care. The findings of this narrative review have direct implications for key stakeholders using telehealth now and beyond the COVID-19 pandemic. Patients, physicians and providers, healthcare leaders and administrators, as well as policymakers should consider how telehealth should continue to be reimbursed and regulated even as the COVID-19 PHE expired in May 2023.

背景与目的:2019冠状病毒病(COVID-19)突发公共卫生事件(PHE)导致远程医疗服务的迅速扩展和使用。实施了灵活的监管和报销措施,以确保患者在卫生系统因COVID-19病例而不堪重负时继续获得医疗服务。这些变化使临床医生和研究人员能够以新的方式使用和评估远程医疗。方法:这篇叙述性综述的重点是强调从2020年3月到2023年2月在美国医疗保健系统门诊环境中进行的远程医疗研究和评估。关键内容和发现:在2019冠状病毒病PHE期间进行的研究表明,远程医疗主要被用作面对面护理的替代品,以保持对既定患者护理的连续性,并且没有对临床结果产生负面影响,也没有导致医疗成本增加。结论:研究表明,患者和医生满意度高,临床结果相似,并表明远程保健可作为面对面护理的替代品。本次叙述性审查的结果对当前和今后使用远程医疗的主要利益攸关方具有直接影响。患者、医生和提供者、医疗保健领导者和管理人员以及政策制定者应该考虑,即使2019冠状病毒病PHE于2023年5月到期,远程医疗应该如何继续得到报销和监管。
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引用次数: 1
How a digital patient experience can lead to future outcome driven healthcare: thoughts for executive teams. 数字化患者体验如何引领未来以结果为导向的医疗保健:对执行团队的思考。
Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-01-01 DOI: 10.21037/mhealth-23-2
L Albert Villarin, John R Patrick
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引用次数: 0
Co-design, co-learning, and co-production of an app for pancreatic cancer patients-the "Pancreas Plus" study protocol. 共同设计,共同学习和共同制作胰腺癌患者应用程序-“胰腺Plus”研究方案。
Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-01-01 DOI: 10.21037/mhealth-22-48
Lorenzo Cobianchi, Francesca Dal Mas, Erica Pizzocaro, Marzia Tripepi, Giovanni Butturini

Background: Pancreatic cancer is a malignant and complex tumor that often leads to an adverse prognosis. Patients need to face a challenging treatment path, which involves highly-specialized multidisciplinary professionals. The complexity of the disease requires the development of dedicated tools to support patients in their care journey. Co-production stands as a valuable strategy in oncological care to engage patients in understanding their care journey and behaving accordingly to get the best possible clinical outcome.

Methods: The non-profit association Unipancreas, active in promoting the latest advances in pancreatic cancer care and in supporting pancreatic cancer patients, has partnered with a multidisciplinary group of professionals to conceive the brand new program "Pancreas Plus" to employ a co-design, co-learning, and co-production path to design an app devoted to pancreatic cancer patients to assist them during their treatment and follow-up journey. The app, which is the outcome of a multi-stakeholder engagement project, offers health information and medical advice specifically tailored on the pancreatic cancer disease. The article reports the research protocol, which may be replicated for the design of other e-health tools focusing on different conditions.

Discussion: The study's output will be an app that sees the pancreatic cancer patient as the main beneficiary but which can gather and address the interests and needs of all meaningful stakeholders, including clinicians, researchers, healthcare and educational institutions, and non-profit associations.

Registration: Given the type of study, no registration is required.

背景:胰腺癌是一种复杂的恶性肿瘤,常导致不良预后。患者需要面对一个具有挑战性的治疗路径,这涉及到高度专业化的多学科专业人员。这种疾病的复杂性要求开发专用工具来支持患者的护理过程。在肿瘤治疗中,联合生产是一种有价值的策略,可以让患者了解他们的治疗过程,并采取相应的行动,以获得最佳的临床结果。方法:非营利组织uni胰腺积极推动胰腺癌治疗的最新进展,支持胰腺癌患者,与多学科专业人员合作,构思了一个全新的项目“胰腺+”,采用共同设计、共同学习和共同制作的路径,设计一个专门为胰腺癌患者设计的应用程序,以帮助他们在治疗和随访过程中。该应用程序是多方利益相关者参与项目的成果,提供专门针对胰腺癌疾病的健康信息和医疗建议。本文报告了研究方案,可用于针对不同条件的其他电子卫生工具的设计。讨论:该研究的成果将是一个应用程序,该应用程序将胰腺癌患者视为主要受益者,但可以收集并解决所有有意义的利益相关者的利益和需求,包括临床医生、研究人员、医疗保健和教育机构以及非营利协会。注册:考虑到学习类型,不需要注册。
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引用次数: 2
Mobile applications to support parents in the transition from neonatal intensive care unit to home: a narrative review. 移动应用程序支持父母从新生儿重症监护病房到家庭的过渡:叙述性审查。
Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-01-01 DOI: 10.21037/mhealth-23-10
Isabel L Sunshine, Lynn Kysh, Ashwini Lakshmanan

Background and objective: Among the unique challenges for parents in the transition of infant care from neonatal intensive care unit (NICU) to home are the medical complexity of their babies and the psychological burden of caring for this special patient population. Despite the increased use and accessibility of smartphones, mobile applications (apps) intended for use by families during this transition remain underdeveloped and understudied. Apps to support parents of infants in the NICU represent an accessible potential solution to mitigate existing disparities in follow up. Through this Narrative Review, we intend to describe the characteristics of and development process for apps intended to address the challenges parents with NICU babies may face, and to provide recommendations for further development of apps for this purpose.

Methods: We conducted a review of articles published between November 2012 to November 2022. This search spanned three major databases, PubMed, Embase, and CINAHL, using a controlled vocabulary and keywords for mobile apps and the NICU. These three databases generated 473 articles for review. Utilizing the online primary screening and data extraction tool Covidence, we ultimately included eight articles in this narrative review.

Key content and findings: There are few existing mobile apps intended to ease the transition home for parents of babies in the NICU. There are even fewer apps that have been critically evaluated using acceptable methods and produced with contribution from healthcare practitioners. Among the existing articles on app solutions to benefit education and socioemotional support for parents, many emphasized the importance of including key stakeholders during the app development process and highlighted both qualitative and quantitative measures for assessing relative success of these apps in a clinical setting.

Conclusions: Although the experiences of parents with infants admitted to the NICU have been well-studied, there remain relatively few existing apps to provide educational and socioemotional support to this population. Future studies should focus on an iterative process of app development whereby both parents and providers are closely involved, in combination with critical appraisal of the app to assess for appropriate support and education of caregivers.

背景和目的:在新生儿重症监护病房(NICU)到家庭的婴儿护理过渡中,父母面临的独特挑战是婴儿的医疗复杂性和照顾这一特殊患者群体的心理负担。尽管智能手机的使用和可访问性越来越高,但在这一过渡时期,面向家庭使用的移动应用程序(app)仍然不发达,研究不足。支持新生儿重症监护室婴儿父母的应用程序是缓解现有随访差异的一种可行的潜在解决方案。通过这篇叙述性综述,我们打算描述旨在解决NICU婴儿父母可能面临的挑战的应用程序的特点和开发过程,并为进一步开发这方面的应用程序提供建议。方法:我们对2012年11月至2022年11月发表的文章进行了综述。这个搜索跨越了三个主要的数据库,PubMed, Embase和CINAHL,使用了一个受控的词汇表和移动应用程序和新生儿重症监护病房的关键字。这三个数据库生成了473篇文章。利用在线初级筛选和数据提取工具Covidence,我们最终在这篇叙述性综述中纳入了8篇文章。主要内容和发现:很少有现有的移动应用程序旨在缓解新生儿重症监护室婴儿父母的过渡家庭。使用可接受的方法进行严格评估的应用程序甚至更少,并且由医疗保健从业者贡献。在现有的应用程序解决方案中,许多文章都强调了在应用程序开发过程中包括关键利益相关者的重要性,并强调了在临床环境中评估这些应用程序相对成功的定性和定量措施。结论:尽管对新生儿重症监护病房收治婴儿的父母的经历进行了充分的研究,但为这一人群提供教育和社会情感支持的现有应用程序仍然相对较少。未来的研究应侧重于应用程序开发的迭代过程,在此过程中,父母和提供者都密切参与,并结合对应用程序的批判性评估,以评估对护理人员的适当支持和教育。
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引用次数: 0
Development and validation of a prototype multimedia application to enhance health education on the pelvic floor muscles among pregnant and puerperal women in Brazil. 开发和验证一个原型多媒体应用程序,以加强对巴西孕妇和产妇盆底肌肉的健康教育。
Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-01-01 DOI: 10.21037/mhealth-22-40
Ana Jéssica Dos Santos Sousa, Jessica Gabriela de Godoi Fernandes, Carolina Angélico, Patricia Driusso

Background: Women are interested in and need to receive more information about pelvic floor muscles (PFMs), its functions, and dysfunctions. The aim of this study is to develop and validate a multimedia application (app) aimed to enhance health education on PFM among pregnant and postpartum women in Brazil.

Methods: This is a descriptive, transversal study in the modality of technological production, consisting of three stages, namely, bibliographic review, development of the multimedia app prototype, and validation of the multimedia app by specialists in the fields of health and technology as well as pregnant and postpartum women. The validation specialists answered an instrument that evaluated several skills including functioning, content, language, illustrations, general aspects, innovation and design, and level of satisfaction. The data obtained were tabulated and analyzed using Microsoft Excel for Windows® 2010. Analysis of the validation of the app prototype and its content was performed using the Content Validity Index (CVI) and by calculating the percentage of absolute agreement.

Results: The app presented a CVI of 0.89 by experts and 0.93 by the participating pregnant and postpartum women, with a global CVI of 0.91. The level of agreement between professionals and the participating pregnant and postpartum women was 93.7% and 95.8%, respectively, resulting in an overall level of agreement of 94.8%.

Conclusions: The educational material in the app format was evaluated based on its functionality, content, language, illustrations, design, and innovation. Furthermore, the content has been validated for pregnant and postpartum women. Thus, this content will contribute to the promotion of health education and dissemination of information regarding PFM, its functions, and dysfunctions.

背景:女性对骨盆底肌肉(PFMs)及其功能和功能障碍有兴趣并需要获得更多的信息。本研究的目的是开发和验证一个多媒体应用程序(app),旨在加强巴西孕妇和产后妇女对PFM的健康教育。方法:这是一项描述性的、横向的技术生产模态研究,包括三个阶段,即文献综述、多媒体应用原型的开发、卫生和技术领域的专家以及孕妇和产后妇女对多媒体应用的验证。验证专家回答了一个评估几种技能的工具,包括功能、内容、语言、插图、一般方面、创新和设计以及满意度。使用Microsoft Excel for Windows®2010将获得的数据制成表格并进行分析。使用内容有效性指数(content Validity Index, CVI)和计算绝对一致性百分比,对应用原型及其内容的验证性进行分析。结果:该应用程序的专家CVI为0.89,参与的孕妇和产后妇女的CVI为0.93,全球CVI为0.91。专业人员与参与调查的孕妇和产后妇女的一致程度分别为93.7%和95.8%,总体一致程度为94.8%。结论:应用程序格式的教材根据其功能、内容、语言、插图、设计和创新进行评估。此外,该内容已对孕妇和产后妇女进行了验证。因此,这一内容将有助于促进健康教育和传播有关生殖器官及其功能和功能障碍的信息。
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引用次数: 0
Applying the behaviour change wheel to assess the theoretical underpinning of a novel smartphone application to increase physical activity in adults with spinal cord injuries. 应用行为改变轮来评估一种新的智能手机应用程序的理论基础,以增加脊髓损伤成人的身体活动。
Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-01-01 DOI: 10.21037/mhealth-22-52
James A Haley, Daniel J A Rhind, David W Maidment

Background: People with spinal cord injuries (SCI) are physically inactive. Smartphone applications (or apps) may prove as one strategy to overcome this. This study examines the theoretical underpinning of a novel mHealth intervention that aims to improve physical activity in people with SCI, namely, the Accessercise smartphone app, using the behaviour change wheel (BCW).

Methods: Accessercise was evaluated using the BCW in eight steps across the following three stages: (I) understanding the behaviour, (II) identifying intervention options, and (III) identifying content and implementation options.

Results: Thirteen target behaviours were identified to improve physical activity and reduce sedentary behaviours in adults with SCI, including goal setting and monitoring, increasing self-confidence, interest and motivation for undertaking physical activity, improving the knowledge/awareness of available physical activity opportunities and resources, and reducing stigma and negative attitudes associated with physical activity. Accessercise incorporates the necessary components for adults with SCI to be physically and psychologically capable of undertaking physical activity, offering social and physical opportunities to reduce sedentary behaviours, and supports automatic and reflective motivation.

Conclusions: This systematic approach of assessing the theoretical underpinning of Accessercise in the context of the BCW has revealed potential mechanisms of action for improving physical activity in adults with SCI. This serves as a blueprint to inform further intervention development, as well as high-quality effectiveness studies, namely, randomised controlled trials, assessing whether fitness apps can improve physical and psychological health outcomes in individuals with SCI.

背景:脊髓损伤(SCI)患者身体活动较少。智能手机应用程序(或应用程序)可能被证明是克服这一问题的一种策略。本研究探讨了一种新型移动健康干预的理论基础,该干预旨在改善脊髓损伤患者的身体活动,即使用行为改变轮(BCW)的Accessercise智能手机应用程序。方法:使用BCW在以下三个阶段中分八个步骤对Accessercise进行评估:(I)理解行为,(II)确定干预方案,(III)确定内容和实施方案。结果:我们确定了13种目标行为,以改善脊髓损伤成人的身体活动和减少久坐行为,包括目标设定和监测,增加进行身体活动的自信、兴趣和动机,提高对现有身体活动机会和资源的知识/意识,减少与身体活动相关的耻辱感和消极态度。Accessercise结合了脊髓损伤成人进行身体和心理活动的必要组成部分,提供了减少久坐行为的社交和身体机会,并支持自动和反思动机。结论:在BCW背景下,这种评估无障碍运动理论基础的系统方法揭示了改善脊髓损伤成人身体活动的潜在作用机制。这可以作为进一步干预开发的蓝图,以及高质量的有效性研究,即随机对照试验,评估健身应用程序是否可以改善脊髓损伤患者的身心健康结果。
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引用次数: 2
mHealth for transgender and gender-expansive youth: an update on COVID, venture capital, and the cultural in/congruence of revenue-driven sustainability models. 变性和性别扩张青年的移动保健:关于 COVID、风险投资和收入驱动型可持续发展模式的文化内涵/一致性的最新情况。
IF 2.2 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2022-07-20 eCollection Date: 2022-01-01 DOI: 10.21037/mhealth-22-10
Simone J Skeen, Demetria Cain
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引用次数: 0
Key observations in terms of management of electronic health records from a mHealth perspective. 从mHealth的角度来看电子健康记录管理方面的主要观察结果。
IF 2.2 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2022-04-20 eCollection Date: 2022-01-01 DOI: 10.21037/mhealth-21-39
Varadraj P Gurupur

The article is a narrative review that briefly describes some of the recent advances in healthcare data management that will have positive effect on mHealth. The advances described in this article are in fact innovation introduced by the author to the field of data management with respect to electronic health records. The research delineated is transdisciplinary in nature and will potentially have positive impact on healthcare outcomes. Also, the article illustrates the necessity for an out of the box thinking approach to improve mHealth while discussing the current impending issues related to data incompleteness of electronic health records and the much-needed decision support systems for mHealth. It is to be noted that most of the electronic health records are now accessed by patients through mobile devices. These mobile devices will run as clients while much of the heavy computing is performed using servers. Here it is important to discuss some of the important technologies and methods used for decision making. The article attempts to present a discussion on how this myriad of intertwining technologies support this decision making with respect to electronic health records. More importantly it is these processes that assist in decision making and efficiency for both mHealth users and providers. In this respect, the article first provides insights on the complexities of decision making involved with electronic health records. This is followed by a discussion on the problem of data incompleteness of electronic health records. Finally, the author provides some insights into the gravity of the problem of data incompleteness in terms of revenue loss/gain for healthcare providers.

这篇文章是一篇叙述性综述,简要描述了医疗保健数据管理的一些最新进展,这些进展将对mHealth产生积极影响。这篇文章中描述的进展实际上是作者在电子健康记录的数据管理领域引入的创新。所描述的研究具有跨学科性质,可能对医疗保健结果产生积极影响。此外,文章阐述了采用开箱即用的思维方法来改善mHealth的必要性,同时讨论了当前即将出现的与电子健康记录的数据不完整性相关的问题,以及mHealth急需的决策支持系统。需要注意的是,大多数电子健康记录现在都由患者通过移动设备访问。这些移动设备将作为客户端运行,而大部分繁重的计算都是使用服务器执行的。在这里,讨论一些用于决策的重要技术和方法是很重要的。这篇文章试图讨论这些错综复杂的技术如何支持电子健康记录的决策。更重要的是,正是这些流程有助于mHealth用户和提供者的决策和效率。在这方面,本文首先提供了有关电子健康记录决策复杂性的见解。接着讨论了电子健康档案数据不完整的问题。最后,作者对医疗保健提供者收入损失/收益方面的数据不完整问题的严重性提供了一些见解。
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引用次数: 0
Approaches for text mining of mHealth literature. 移动医疗文献的文本挖掘方法。
IF 2.2 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2022-04-20 eCollection Date: 2022-01-01 DOI: 10.21037/mhealth-22-1
Bunyamin Ozaydin, Ferhat Zengul, Nurettin Oner, Dursun Delen
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引用次数: 0
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