mHealth最新文献

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.

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.

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.

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.

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.

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.

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.