App Utilization Research Articles

Acceptability and Scalability of a Meditation App Among Adolescents With Type 1 Diabetes Mellitus.

Background Adolescents with type 1 diabetes mellitus (T1DM) experience stress from general life stressors and diabetes-specific stressors. This stress manifests in a range of ways, such as mood swings, heightened frustration, strained familial relationships, and difficulties in T1DM self-management, which then leads to worse health outcomes. There is small to moderate evidence that frequent use of mental health applications (MHapps) improves mental and physical health outcomes. Meditation apps may help reduce some of the stress associated with living with T1DM. This study explores the acceptability and scalability of a self-guided, smartphone-based meditation app, the Healthy Minds Program (HMP) app, among adolescents with T1DM using the Unified Theory of Acceptance and Use of Technology. Methods Eight adolescents ages 15-19 were recruited from a pediatric clinic in a Midwestern state and introduced to the HMP app. After using the HMP app for one week, they were invited to participate in three successive focus group meetings. During the meetings, they shared their perspectives on the content, navigation, and acceptability of the HMP app and strategies to introduce and scale app utilization among adolescents with T1DM. Researchers conducted conventional content analysis using a hybrid coding approach. Data was managed and analyzed using NVivo 10 (Lumivero, Denver, Colorado, USA). Findings Participants believed that the HMP app has the potential to enhance their stress management, mood, and coping abilities when dealing with the challenges of T1DM management. They found the app enjoyable and easy to use but expressed concerns about time constraints as a potential barrier. To address this, they shared recommendations for facilitating app uptake and usage. Conclusions This study's results provide an in-depth understanding of how positively this subset of adolescents with T1DM viewed the HMP app. The participants also offered valuable suggestions that can promote the adoption and sustained use of MHapps by adolescents living with T1DM.

Expanding oncology navigation capacity through digital and in-person volunteer support: ACS Community Access to Resources, Education, and Support (ACS CARES).

205 Background: The American Cancer Society (ACS) CARES (Community Access to Resources, Education, and Support) is a novel nationwide non-clinical navigation program for people with cancer and caregivers. ACS CARES includes a multi-channel approach providing direct, individualized, non-clinical assistance through a native app, telephonic, and in-person support. This study examines the feasibility of leveraging non-clinical virtual and in-person volunteers to expand navigation capacity. Methods: This pragmatic study evaluates the implementation of volunteer navigation of patients and caregivers accessing virtual navigation via the ACS CARES app and in-person/telephonic navigation for patients at 3 pilot cancer centers. Virtual and in-person volunteers aim to deliver timely information and support for health-related social needs (HRSNs) identified using a HRSN assessment, which was adapted from the NCCN distress thermometer and problem list. Initial process measures include number and demographics of patients served, HRSNs, and time spent by volunteers. Results: In the first year, 4,673 individuals utilized the ACS CARES app (54% people with cancer, 31% caregivers, 15% supporters). Since launching the virtual connection feature on 11/30/2023, we have trained 122 virtual volunteers (20% Black, 78% female, 8% Hispanic) who have made 182 connections with app users. App users prioritized matches based on shared cancer experience (47.7%), caregiving for an adult with cancer (28.8%), need for help finding information (12.4%), desire for a Spanish-speaking volunteer (3%), other (8.1%, geographic location, caring for a child with cancer volunteers averaged). Community volunteers averaged 11 messages per connection over 35 days. From 10/23/2023 to 4/30/2024, 31 volunteers at 3 cancer centers navigated 195 patients who were 55% female, 22% Black, with an average age of 53.02. The most common HRSNs were finances and transportation. Volunteers spent an average of 105 min per patient per in-person meeting, 35 min per patient per follow-up call, 38 min per patient coordinating care and sending encrypted messages, and 75 min per patient identifying and providing resources to address barriers to care. Conclusions: Preliminary data indicates feasibility of leveraging the multi-channel approach of CARES to address gaps in access to navigation. App utilization data analysis is ongoing. In-person support will be expanded to 9 additional cancer centers in September.

Effectiveness of Mobile-assisted Language Learning in Developing Oral English in Higher Education: A Comparative Systematic Review

English is a globally prominent language, and oral English proficiency is both crucial and challenging. Mobile technology offers a promising avenue for language enhancement, but research on the role of Mobile-Assisted Language Learning (MALL) in English-speaking skills is relatively scarce. Literature reviews on this topic are even rarer, particularly those that provide comparative analyses between China and other nations. This study addresses this gap through a comparative systematic literature review of 30 relevant studies from 2019 to 2023. The findings reveal similarities between Chinese and global studies, with only slight differences in sample size and oral English proficiency assessment methods. The preferences for mixed research methods, tests, questionnaires, and interviews were found. Additionally, this review identifies limitations in previous research, including a lack of theoretical frameworks, limited large-scale studies, and a need for deeper exploration of mobile app utilization. This comparative analysis provides valuable insights that can guide future studies and foster a more comprehensive understanding of MALL’s effectiveness in enhancing oral English proficiency, both in China and globally.

Factors associated with dating app use for sexual "hookups" in the United States: insights from the National Survey of Family Growth.

The use of dating applications for matchmaking and sexual exploits ("hookups") has increased, and this modern phenomenon has supplanted traditional socialization and relationship formation. To date, sociodemographic data on the use of dating apps has been limited. In this study, we sought to identify predictors associated with the use of dating apps in the United States. Using cross-sectional data from the 2017-2019 National Survey of Family Growth, we examined sociodemographic determinants influencing the use of dating apps to find partners for sexual intercourse. We constructed survey-weighted regression models to study these associations, with additional sensitivity analyses performed within specific subgroups. Furthermore, this study investigated the correlation of app use with sexual frequency. Study outcomes were participant data regarding reported use of dating apps for sexual intercourse in the 2017-2019 National Survey of Family Growth. A total of 11,225 respondents were examined, representing a survey-weighted total of approximately 143,201, 286 Americans. Among them, 757 respondents (6.7%), equating to approximately 8, 818, 743 individuals, reported dating app use for sexual hookups. Regression analysis revealed that factors such as male sex, White race, previous sexual experience, substance/alcohol use, history of sexually transmitted infections, same-sex attraction, and bisexuality increased the likelihood of dating app usage. Conversely, reduced odds of dating app use were observed among Catholics, Protestants, married/widowed individuals, and older respondents. Stratified analyses across various demographics, including male and female individuals aged 20 to 40years, heterosexual, and lesbian, gay, and bisexual respondents, generally supported these trends. Notably, dating app use did not correlate with increased sexual frequency (adjusted incidence rate ratio: 1.10; 95% CI: 0.96-1.26; P = .16). Dating app use is prevalent among male patients and White individuals and correlates with increased sexually transmitted infection risk, alcohol/illicit substance use, past sexual experience, and popularity within the lesbian, gay, and bisexual community, all important considerations for public health interventions. Dating app use, however, was not associated with increased sexual encounters. Strengths of our study were the utilization of a national survey of individuals of reproductive age in the United States and focus on a clearly defined outcome of dating app utilization for the purposes of sexual intercourse. Limitations include self-reported survey responses and insufficient detail on the types and duration of dating app platforms and their use. Many sociodemographic factors, including male sex, White race, history of STIs, substance and alcohol use, and same-sex and bisexual attraction, were linked with dating app use. However, there was no increase in sexual frequency associated with dating app utilization. Further research is essential for integrating these technologies into the relational and sexual dynamics of individuals.

Mobile Application to Improve Just-in-Time 2-Way Formative Feedback in Graduate Medical Education.

Background An easy-to-use application to facilitate direct observation and allow for 2-way feedback between residents and faculty is needed. Objective To develop a mobile-based application (app) with the goals of (1) providing just-in-time feedback to residents; (2) improving timeliness of feedback by faculty; and (3) allowing residents to comment on the value of faculty feedback. Methods Fifty-one of 69 (74%) internal medicine (IM) residents and 20 of 25 (80%) IM core faculty participated in the study from July 1, 2020, to December 31, 2021. An iOS app was designed by authors with expertise in medical education and application development to capture entrustable professional activities (EPAs)-based feedback (eg, informed consent) based on direct observation of residents' skills in the workplace. App utilization and narrative feedback characteristics of faculty comments were examined by exporting the data from the database server. The end user satisfaction was examined using a survey instrument. Results Eighty-seven percent of assessments (117 of 134) initiated were fully completed by residents and faculty. Faculty narrative comments were noted in 97% (114 of 117) of completed assessments and 64% (75 of 117) of residents' feedback to the faculty contained narrative comments. Eighty-three percent (97 of 117) of comments were behaviorally specific and 71% (83 of 117) contained an actionable item. Eighty-six percent (18 of 21) of residents and 90% (9 of 10) of core faculty stated that this application promoted an educational interaction between them. Conclusions This app facilitates the efficient completion of EPA-based formative assessments and captures bidirectional feedback in the workplace setting.

Enhancing tuberculosis treatment adherence and motivation through gamified real-time mobile app utilization: a single-arm intervention study

BackgroundFinding innovative methods to enhance Tuberculosis treatment adherence in Malaysia is imperative, given the rising trend of non-adhere TB patients. Direct Observed Therapy (DOTS) has been used to ensure Tuberculosis (TB) drug compliance worldwide. However, due to its inconvenience, digitalizing this system into a virtual monitoring system via a mobile app can help deliver a more efficient tuberculosis management system. A gamified video-observed therapy is developed that connects three users the patient, supervisor, and administrator, allowing drug monitoring and patient loss to follow up with the patient tracking system. Thus, the objective of this study is to determine the impact of Gamified Real-time Video Observed Therapy (GRVOTS) mobile apps on patient medication adherence rates and motivation.Methods71 patients from 18 facilities participated in the 8-week single-arm intervention study. GRVOTS mobile apps were installed in their mobile apps, and patients were expected to fulfill tasks such as providing Video Direct Observe Therapy (VDOTS) daily as well as side effect reporting. At 3-time intervals of baseline,1-month, and 2-month intervals, the number of VDOT taken, the Malaysian Medication Adherence Assessment Tool (MyMAAT), and the Intrinsic Motivation Inventory (IMI) questionnaire were collected. One-sample t-test was conducted comparing the VDOT video adherence to the standard rate of 80%. RM ANOVA was used to analyze any significant differences in MyMAAT and IMI scores across three-time intervals.ResultsThis study involved 71 numbers of patients from 18 healthcare facilities who showed a significantly higher treatment adherence score of 90.87% than a standard score of 80% with a mean difference of 10.87(95% CI: 7.29,14.46; p < 0.001). The participants’ MyMAAT and IMI scores significantly increased over 3-time intervals with the IMI Interest domain showing the highest mean difference 19.76 (95% CI: 16.37, 21.152: p < 0.001).ConclusionsBy utilizing GRVOTS, a mobile application based on gamification and real-time features, we can enhance motivation and medication adherence among TB patients, while also addressing the limitations of physical DOTS.Trial registrationIRCT20230308057657N1, Registered on (15/03/23).

Gaming the System: A Fun Continuous Glucose Monitor Interface Improves Glycemic Outcomes for Children.

Achieving optimal glycemic control in children with type 1 diabetes (T1D) is challenging even when wearing a continuous glucose monitor (CGM). We measured the impact of eddii, a gamified real-time app connected to a CGM, on glycemic control. An open label, eight-week randomized controlled trial (RCT) compared glycemic control utilizing the gamified CGM app connected to Dexcom G6 with only Dexcom G6 usage. Children with T1D using Dexcom G6 were enrolled (N=92, ages 5-12 years). Time-in-range (TIR) data were collected four weeks prior to and during the study period. The gamified CGM app utilization effect was measured by difference-in-difference (D-I-D) models. The TIR and time-above-range (TAR) improved among users of the gamified CGM app; 5.38% higher and 5.80% lower than controls (P = .001 and P = .019, respectively).

Maintaining healthy lifestyle through fitness app use: A parallel mediation model from a nationwide survey.

Adolescents face various health challenges due to academic pressures and sedentary lifestyles. Establishing healthy habits during this critical period is essential for long-term well-being. With the widespread use of fitness apps, understanding their impact on adolescent health behaviors and the underlying mechanisms is crucial. Guided by social support theory and social comparison theory, this study examined the influence of WeRun, a fitness app within WeChat, on adolescents' adoption of healthy lifestyles. It investigated the correlation between WeRun usage and healthy behaviors, as well as the underlying mechanisms driving this relationship. A cross-sectional survey was conducted across 31 provinces and metropolitans in China, utilizing a random cluster sampling approach targeting high school and freshman students aged 15-24 (N = 1312). A parallel mediation model was employed to test the hypotheses. The analysis showed that WeRun use positively predicted both social support and social comparison. Meanwhile, both social support and social comparison were positively associated with healthy lifestyles. Additionally, WeRun use could not directly predict healthy lifestyles. However, WeRun use indirectly predicted healthy lifestyles via social support and social comparison. The study's findings revealed the pivotal roles of social support and social comparison as mediating variables in the relationship between adolescents' WeRun usage and adoption of healthy lifestyles. The results contributed to the current comprehension of the mechanisms linking app utilization to health-promoting behaviors. Furthermore, it provided valuable insights for promoting adolescent health and informed improved design strategies for fitness apps.

해외거주 유아를 위한 스마트폰 앱 활용 가정 연계 한국어교육 실행연구

Objectives The purpose was to explore the changes experienced by parents and young children residing overseas through examining the execution process of Korean language education with a focus on smartphone app uti-lization and fostering home-school connections.&#x0D; Methods Following Elliot's (1991) action research model, a 15-week Korean language education program was conducted for ten preschoolers and their parents at a Korean school in City B, State A, USA. Data were collected through observations of children's behavior and language during class, parent-child interactions, teacher-parent conferences, peer teacher workshops, and Korean language proficiency assessments.&#x0D; Results In the first implementation, ‘Korean language education centered daily routines for young children’ and ‘home-school linked education encouraging parental participation through smartphone apps’ were conducted. The second implementation focused on ‘one-on-one support-based Korean language instruction’ and ‘intensive home-school linked education using portfolios’. Through these processes, the children progressed from ‘increased interest in Korean’ to ‘formation of confidence and improvement in Korean language ability’, while parents devel-oped ‘trust in Korean language schools’ and eventually ‘experienced the benefits of active participation in Korean language education’.&#x0D; Conclusions Korean language education for overseas-residing young children can facilitate emotional develop-ment, including improved self-confidence and self-identity formation, not only enhancing Korean language profi-ciency but also when communication and participation frequency with parents through home-school collabo-rations are increased.

OP112 Evaluation Of A Self-Administered Smart Phone-Based Application As A Wellness Measure In A Clinical Trial Of Zanubrutinib

IntroductionAssessments self-administered via smart phone-based apps can gather patient wellness data; however, data regarding app utilization in clinical trials are limited. This study evaluated engagement with a self-administered wellness app as a supplemental tool to assess quality-of-life (QoL) in study BGB-3111-215 (NCT04116437), which included patients with B-cell malignancies treated daily with oral zanubrutinib.MethodsThis exploratory analysis evaluated the feasibility of using a voluntary device-based, self-administered activity and QoL questionnaire app (Medable, California, USA) in clinical trial patients. Feasibility was measured by rates of consent, utilization, and compliance. Consent was assessed by the percentage of patients who agreed to use the app. Utilization was assessed by the percentage of patients who engaged with the app. Compliance was assessed by actual versus scheduled engagements. The app also included passive activity tracking and a six-minute walk test.ResultsAs of 1 September 2022, 78 patients had enrolled in the study (median age 71 years) and 20 had consented to participate (26% consent rate). Eleven patients (median age 65 years) engaged with the app at least once (14% utilization rate; n=11 for the questionnaire; n=7 for the walk test). Engagement occurred a median two times (range 1 to 17) for the questionnaire and a median seven times (range 1 to 15) for the walk test. Four patients engaged with the questionnaire and six patients engaged in the walk test beyond week 12. Passive activity was collected for eight patients beyond week 12. Among patients who engaged with the QoL questionnaire and walk test, compliance rates were 18 and 21 percent, respectively.ConclusionsThis initial study showed that a subset of patients was willing to participate in the self-administered QoL questionnaire and activity tracker. Further comparison of app results and clinical trial findings are ongoing to explore factors affecting utilization and compliance rates.

Engagement with Incharge App - a Mobile Health Intervention to Improve Adherence to Hydroxyurea Among Individuals with Sickle Cell Disease

Introduction: Sickle cell disease (SCD) affects around 100,000 people in the United States, causing acute vaso-occlusive events and chronic end-organ damage. Hydroxyurea (HU) is a proven treatment for SCD that reduces acute and chronic complications. Despite extensive evidence and guideline recommendations, many people with SCD do not receive optimal HU therapy. Our group has shown that using the InCharge Health app, a SCD-specific app co-developed with patients (Alberts et al, JMIR mHealth uHealth, 2020), for at least 24 weeks, increases adherence to HU up to 29%, but engagement with the app varied among users. This study reports user's perceptions of the app relative to their degree of app utilization, thus informing future app adaptations to optimize app engagement and potentiate its effect. Methods: The InCharge Health app features included daily reminders, adherence and pain progress tracking, communication with providers and other patients, hospital mode deactivation, educational resources, and an accountability partner. Participants used the InCharge Health app and completed the validated Mobile Application Rating Scale (MARS, Stoyanov SR, JMIR mHealth uHealth, 2015) after 24 weeks of app use. The MARS evaluates the quality of mobile health apps by eliciting users' perceptions of engagement, functionality, aesthetics, and information quality. App utilization data (% of the study days) were obtained from the backend of the app and defined as low (&amp;lt;25%), medium low (25-50%), medium high (50-75%), and high (&amp;gt;75%). HU percentage of days covered (PDC), the percentage of days covered by filled HU prescriptions during the study period, was used as a proxy for medication adherence. Baseline pain frequency 12 months before study enrollment was obtained using the Adult Sickle Cell Quality of Life Measurement Information System. After 24 weeks, the ease of use, importance, and helpfulness of app features were evaluated and stratified based on the level of app usage. Results: A total of 208 participants enrolled, median age 26.3 years (range, 15 to 45), 52% (108/208) females, 87% (181/208) with HbSS/Sβ 0-thalassemia. Fifty-eight percent (121/208) of participants were low app utilizers, 19.2% (40/208) medium low, 15.9% (33/208) medium high, and 6.7% (14/208) high app utilizers (Table 1). As app usage increased, users reported lower pain frequency and pain severity. After 24 weeks, all groups increased PDC, which sustained post-study, and the magnitude of an increase was proportional to the amount of app use (Table 1). The mean (SD) daily use was 2.3 (4.8) minutes/day, and daily duration of app use increased with the total app use. Conversely, the interval between app usage decreased with total app use (Table 2). The most used app features included pain tracking (56.2%, 117/208) and weekly progress report (20.7%, 43/117). The least used features were connecting to educational resources (7.2%, 15/208) and communicating with treating providers (6.3%, 13/208, Table 2). Overall, 57.7% (120/208) rated the app moderately or very interesting, 63.0% (131/208) reported using it daily to 2 to 3 days/week, 83.2% (173/208) found the app easy to learn, simple, or intuitive. Low users found the app less interesting and had more concerns of the time and effort it took to use the app (Table 2). Across all groups, daily reminders were considered the most important and useful feature. Fewer high users considered daily reminders the most important feature, however high users more often deemed other features as most important. HU information was found to be the most important by high users, but this varied between the other user levels. High users also found adherence tracking most important with more users valuing it as app usage increased. Adherence and pain progress tracking were found helpful in all groups except the medium-high users. Importantly, more than 50% of all groups intended to continue using the app beyond the study period. Conclusions: The InCharge Health app promoted increased HU adherence proportional to its engagement. All users considered daily reminders the most beneficial and crucial feature, while pain tracking was widely utilized. Distinct app consumption and preference patterns were observed according to app usage level. Plans are underway to improve the app functionality and interface to allow real-time customization to boost app engagement and further adherence enhancement among individuals with SCD.

The effect of mHealth program on behavior modification and health outcomes among patients with diabetes: A randomized controlled trial study.

Mobile health presents a promising alternative in the digital era. Mobile health apps (mHealth), when combined with the concept of self-management, are considered one of the methods for incorporating technology-based interventions into the healthcare system. This study aimed to determine the effect of mHealth (specifically, the Diabetic Care App) on foot care behavior, dietary behavior, foot condition, and fasting blood glucose levels among patients with uncontrolled diabetes mellitus. A single randomized controlled trial was conducted at a government-run primary clinic in Northern Malaysia, involving 58 patients with uncontrolled diabetes who were assigned to two groups. The intervention group received the Diabetic Care App, attended a 2-hour face-to-face session, and was included in a WhatsApp group, while the control group received standard care. Relevant assessments were conducted for both groups in Week 1 and Week 5. The study was conducted from February 2020 to November 2020, and parametric and non-parametric statistics were used for data analysis. Pretest-posttest comparisons in both groups revealed significant findings for foot care behavior (p <0.01), dietary behavior (p <0.01), and foot condition (p <0.01), except for fasting blood glucose levels. In inter-group comparisons, a significant difference was observed only in foot care behavior (p <0.01) and dietary behavior (p <0.01). The results indicate that technology-based interventions are beneficial for modifying behavior, specifically in terms of foot care and dietary behavior, in this study. The study highlights the applicability of mHealth for nurses in patient education and self-management of chronic conditions. Future research should explore app utilization among patients with chronic conditions. NCT04260100 (registered at https://clinicaltrials.gov/ct2/show/NCT04260100).

Can self-set goals encourage resource conservation? Field experimental evidence from a smartphone app

This study leverages a large RCT to examine the potential of goal-setting nudges to encourage resource conservation at scale. We randomize a feature that allows subjects to set themselves energy consumption targets in a popular smartphone app. We document negative effects of the nudge on app utilization and estimate null effects on energy consumption with confidence intervals that rule out estimates from observational studies. A complementary survey identifies the mechanisms underlying these behavioral responses. Using a structural model and random variation of the app’s price, we estimate that the average user is willing to pay 7.41 EUR to avoid the nudge.

User experiences of college students using mental health applications to improve self-care: Implications for improving engagement

The purpose of this study is to evaluate themes on ‘user experiences’ among college students (N = 265) enrolled in an upper-division Psychopathology course who were assigned a project in which they were instructed to identify a self-care goal, choose from a list of six mental health-focused mobile applications (apps) provided by the instructor, and use the app over the course of three weeks to support progress towards their goal. Prior literature on user experiences typically evaluates user reviews, or asks participants to reflect on past app use or anticipate future use. Students reported their experiences using the app during key decision points: app selection, while using the app, and at the conclusion of the assignment. Using thematic analysis, results identified seven central themes and eight subthemes pertaining to the content of the app (e.g., app features) and the context of using the app (e.g., classroom assignment). Content-wise students liked: 1) features with a strong evidence base, namely, thought diaries and guided meditations; 2) progress tracking, because it increased awareness of mood/stressors, motivated students to see improvement, and helped them stay on track. Students appreciated having 3) crisis support resources; 4) app interfaces that allowed for customization (poor app interfaces were sometimes cited as the reason for disengagement); and 5) apps that included varied, comprehensive resources such that it felt like a one-stop shop. In addition to the content of features and design interface, the context in which mental health apps are introduced and used is important. The remaining themes related to the context in which the app was used, including 6) preparation for app usage, such as reviewing scholarly/credible sources, and 7) social support from fellow students completing the same assignment. Future research should evaluate the ‘who, what, when, why, where, and how’ of app utilization during key decision points, such as initial app selection or subscription renewal, to better understand the impact of user experience on engagement.

A digital health application for managing pediatric asthma: Use and benefits

ABSTRACTChildhood asthma is a common and serious chronic lung disease. Mobile health (mHealth) technologies may assist clinical providers, caregivers, and children in managing pediatric asthma. This study evaluated the Nemours app, an mHealth application. We examined: a) frequency of data access by providers and feature use by caregivers (parents/legal guardians) of 5–11-year-old children diagnosed with asthma and b) whether utilization was related to benefits. Nine providers (allergists/pulmonologists) and 80 patient-families (caregiver/child dyads) participated. Two-years of retrospective data were obtained for asthma control, in-person urgent healthcare utilization, and app utilization. Six-months of prospective data included asthma control, in-person urgent healthcare utilization, app utilization, surveys, and health literacy screeners. Providers (56%) accessed app data and caregivers (61%) utilized the app. Caregiver use of messaging feature predicted gains in health literacy scores (b = .44, p = .041), suggesting app use may offer some educational benefits. Implementation of strategies that support app engagement and utilization may help to maximize intended benefits.

An ehealth intervention during radical radiotherapy: Patient-Reported Outcome Side effects (PROSE) study—An emerging approach from sub-Saharan Africa.

6628 Background: PROSE is an electronic patient-reported outcome tool for real-time, remote monitoring of treatment related side-effects. It enables a two way communication between the patient and clinicians. Remote monitoring of treatment related toxicities can eliminate underreporting of side effects (SE), facilitate timely symptom assessment, and improve management of SE. These will thereby reduce morbidity and hospitalization and improve treatment outcomes and quality of life of affected patients. The overarching goal of the study is to enhance the efficiency of the conventional weekly SE clinic using an emerging technology and thereby create evidence for a personalized digital health interventions for cancer patients in Africa. Methods: A prospective study among adult cancer patients receiving radical radiotherapy for head and neck, pelvic, and breast cancers at NSIA-LUTH Cancer Centre in Nigeria between March and October 2022. Eligible (≥18 years, KPS≥75%) and consenting participants were trained on to report their SE daily and receive remote clinical advice on prosecare.com . The PROSE tool was built as an adapted version of the Patient Reported Outcome version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE). The study participants were monitored throughout their radiotherapy sessions and two weeks thereafter. The cancer care team can review the Patients Reported Outcome (PRO) data through a dedicated log-in portal during the SE clinic. Participants scored their SE daily and EORTC QLQ-30 quality of life surveys were administered thrice during the study and 2 weeks thereafter. SE reports were chosen according to the site of disease; 12 items for head and neck tumors, 9 items for breast tumors, 14 items for female pelvic and 18 items for male pelvic tumors. Patient’s PROSE tool application utilization was defined as &gt;50% daily reporting during study period. Results: A total of 137 participants were screened, of which 120 met the eligibility criteria. Of the 120 patients eligible, 23 had technical issues with the use of the PROSE tool application and 1 died during the study; thus, 96 participants data were analyzed. More than 40,000 SE reports were generated during the study. SE with highest symptom burden include urinary frequency in male pelvic cancers (n=17), radiation dermatitis in breast cancer (n=40), diarrhea in female pelvic cancer (n=19) and xerostomia in head/neck cancers (n=20). The app utilization rate was 58%. Conclusions: There was a moderate utilization (58%) of the PROSE tool application. The PROSE pilot study demonstrated the potential utility of the PROSE application as a promising tool and data resource that offers a great opportunity to improve cancer care and the development of predictive clinical algorithms by engaging patients in their own care and increased SE reporting of acute radiation toxicities.

Application of Smart Device App Utilization for Cervical Pain and Postural Improvement: A Systematic Review

Application of Smart Device App Utilization for Cervical Pain and Postural Improvement: A Systematic Review

Passive Mobile Self-tracking of Mental Health by Veterans With Serious Mental Illness: Protocol for a User-Centered Design and Prospective Cohort Study.

BackgroundSerious mental illnesses (SMI) are common, disabling, and challenging to treat, requiring years of monitoring and treatment adjustments. Stress or reduced medication adherence can lead to rapid worsening of symptoms and behaviors. Illness exacerbations and relapses generally occur with little or no clinician awareness in real time, leaving limited opportunity to modify treatments. Previous research suggests that passive mobile sensing may be beneficial for individuals with SMI by helping them monitor mental health status and behaviors, and quickly detect worsening mental health for prompt assessment and intervention. However, there is too little research on its feasibility and acceptability and the extent to which passive data can predict changes in behaviors or symptoms.ObjectiveThe aim of this research is to study the feasibility, acceptability, and safety of passive mobile sensing for tracking behaviors and symptoms of patients in treatment for SMI, as well as developing analytics that use passive data to predict changes in behaviors and symptoms.MethodsA mobile app monitors and transmits passive mobile sensor and phone utilization data, which is used to track activity, sociability, and sleep in patients with SMI. The study consists of a user-centered design phase and a mobile sensing phase. In the design phase, focus groups, interviews, and usability testing inform further app development. In the mobile sensing phase, passive mobile sensing occurs with participants engaging in weekly assessments for 9 months. Three- and nine-month interviews study the perceptions of passive mobile sensing and ease of app use. Clinician interviews before and after the mobile sensing phase study the usefulness and feasibility of app utilization in clinical care. Predictive analytic models are built, trained, and selected, and make use of machine learning methods. Models use sensor and phone utilization data to predict behavioral changes and symptoms.ResultsThe study started in October 2020. It has received institutional review board approval. The user-centered design phase, consisting of focus groups, usability testing, and preintervention clinician interviews, was completed in June 2021. Recruitment and enrollment for the mobile sensing phase began in October 2021.ConclusionsFindings may inform the development of passive sensing apps and self-tracking in patients with SMI, and integration into care to improve assessment, treatment, and patient outcomes.Trial RegistrationClinicalTrials.gov NCT05023252; https://clinicaltrials.gov/ct2/show/NCT05023252International Registered Report Identifier (IRRID)DERR1-10.2196/39010

Using CDS Hooks to increase SMART on FHIR app utilization: a cluster-randomized trial.

HL7 SMART on FHIR apps have the potential to improve healthcare delivery and EHR usability, but providers must be aware of the apps and use them for these potential benefits to be realized. The HL7 CDS Hooks standard was developed in part for this purpose. The objective of this study was to determine if contextually relevant CDS Hooks prompts can increase utilization of a SMART on FHIR medical reference app (MDCalc for EHR). We conducted a 7-month, provider-randomized trial with 70 providers in a single emergency department. The intervention was a collection of CDS Hooks prompts suggesting the use of 6 medical calculators in a SMART on FHIR medical reference app. The primary outcome was the percentage of provider-patient interactions in which the app was used to view a recommended calculator. Secondary outcomes were app usage stratified by individual calculators. Intervention group providers viewed a study calculator in the app in 6.0% of interactions compared to 2.6% in the control group (odds ratio = 2.45, 95% CI, 1.2-5.2, P value .02), an increase of 130%. App use was significantly greater for 2 of 6 calculators. Contextually relevant CDS Hooks prompts led to a significant increase in SMART on FHIR app utilization. This demonstrates the potential of using CDS Hooks to guide appropriate use of SMART on FHIR apps and was a primary motivation for the development of the standard. Future research may evaluate potential impacts on clinical care decisions and outcomes.

Abstract No. 585 2nd annual interventional radiology benchmarking survey: variation in APP utilization among academic and private interventional radiology practices

Abstract No. 585 2nd annual interventional radiology benchmarking survey: variation in APP utilization among academic and private interventional radiology practices