Self-management Application Research Articles

Effects of the transtheoretical model-based self-management program on behavioral change in persons with epilepsy: Study protocol for a randomized controlled trial.

Self-management applications are cost-effective and scalable for epilepsy treatment. However, there is a limited long-term quantitative evidence regarding their effectiveness. The Transtheoretical Model (TTM) offers a psychological framework that tailors self-management plans to the individual's stage of behavioral change. This approach aims to address utilization needs, reduce information overload, minimize the adverse effects of self-management, and enhance the overall effectiveness of interventions for individuals with epilepsy. This will be a randomized, double-blind, the clinical trial involving two groups of adults diagnosed with epilepsy. In addition to treatment as usual (TAU), the intervention group will receive an intervention program constructed from TTM combined with self-management as part of the treatment plan. The control group will receive TAU only. Prior to the intervention, the participants will undergo an initial assessment to determine their current stage of behavioral change to facilitate the implementation of targeted behavior support strategies. Additionally, participants will receive weekly 30-minute educational videos on epilepsy. The goal is to enroll 160 adults who have been diagnosed with epilepsy for at least six months and are receiving medication. Data collection will encompass an assessment of C-ESMS, HADS, QOLIE-31, and LSSS. These parameters will be evaluated at baseline, as well as during follow-up periods at 1, 3, and 6 months post-intervention. Existing self-management interventions for people with epilepsy primarily focus on knowledge and psychological factors. Discrepancies in research design, intervention plans, and patient characteristics have contributed to inconsistent outcomes in previous studies. This study seeks to advance the field by integrating the TTM with empirically supported self-management practices. The delineation of behavioral change stages within the TTM framework is expected to form a structured intervention protocol. This study will inform standardized, evidence-based epilepsy care practices.

양극성 장애 환자의 자가관리 모바일 애플리케이션의 개발 및 효과

Objectives This study aimed to develop a mobile application for self-management by community-dwelling patients with bipolar disorder and to test its effects. Methods The development of a self-management mobile application for patients with bipolar disorder was developed according to the modified five stages of the mobile application development life cycle model. The effectiveness of the developed self-management mobile application for bipolar disorder patients was verified through a non-equivalent control group pre-post design on self-management performance, mental symptoms, level of Insigh, and quality of life in 47 bipolar disorder patients. Data analysis was performed using independent t-test and Mann-Whitney U test. Results The mobile application for self-management of bipolar disorder patients was confirmed to be effective in improving self-management performance(Z=-5.61, p<.001), Insigh(t=4.58, p<.001), and quality of life(Z=-3.68, p<.000) of patients with bipolar disorder. Conclusions Bipolar disorder patients living in the community-dwelling will be able to receive help in self-management more easily and conveniently through the use of self-management mobile applications.

Public mobile chronic obstructive pulmonary disease applications for self-management: Patients and healthcare professionals' perspectives.

Poorly controlled chronic obstructive pulmonary disease (COPD) can negatively impact quality of life but mobile applications (apps) are popular digital tools that may mitigate these support needs. However, it is unclear if public mobile COPD apps are acceptable to healthcare professionals and patients, people living with COPD. Objectives: The primary objective is to determine people with COPD and healthcare professionals' perspectives on the appropriateness of public mobile COPD apps for supporting individuals' needs. The secondary objectives were to identify the ideal features and styles of mobile COPD apps for COPD self-management; and to identify the facilitators, barriers and needs for future COPD app research and development. Methods: Public mobile COPD apps were rated by questionnaires administered before and after focus group meetings. Ratings were reported as medians with interquartile ranges and median scores were categorized into three levels of appropriateness: 1-3 for inappropriate; 4-6 for uncertain; and 7-9 for appropriate. Results: A total of 6 people with COPD (mean age 68.2 ± 4.8years) and 22 healthcare professionals (mean age 45 ± 8.3years) completed this study. People with COPD identified one and healthcare professionals identified three public mobile COPD apps to be appropriate. They had different preferences for features and engagement styles but similar preferences for facilitators and barriers to use. Stakeholders mutually rated one public mobile COPD app as appropriate for self-management and emphasized the need for apps to be supplementary and customizable, rather than replacements for clinical management.

Design and Development of an Interactive Assessment Application for the Observation of Heart Failure Self-Health Management.

Heart disease can lead to physical disability and mortality, ranking second among the top 10 causes of death according to the Ministry of Health and Welfare. This study aims to examine the impact of the interactive assessment application on patients' public health knowledge. In this study, a single-group pretest and posttest experimental design was adopted. Thirty-six hospitalized patients diagnosed with heart failure participated in the pretest and posttest assessments. The findings demonstrate that the developed application led to an increase in the number of recorded physiological measurements, effectively enabling patients to manage their blood pressure. The heart failure self-management application was observed to improve patients' understanding and awareness of heart failure disease, improving their self-management skills.

Experience of integrating mobile applications in the self-management of patients with heart failure

Abstract Background Self-management in patients with heart failure is important in terms of their prognosis and quality of life. The use of mobile applications in the self-management of patients with heart failure has been suggested to improve their knowledge of the disease and quality of life. However, there are limited data on the experiences of patients with heart failure when mobile applications are integrated into their routine as a self-management intervention. Purpose We aimed to determine the experiences of patients with heart failure who incorporated the use of mobile applications as a self-management intervention. Methods In this qualitative cross-sectional study, participants were purposive-sampled at a university hospital, and semi-structured interviews were conducted with both male and female patients, aged 40–70 years, with a diagnosis of chronic heart failure (ACCF/AHA stage C). Data were collected between December 2022 and April 2023. All interviews were audio-recorded and transcribed verbatim, followed by content analyses. The mobile application used in this study recorded and managed patients’ subjective symptoms and daily life as cloud data and allowed healthcare professionals to access the data using a dedicated terminal. Results Four themes were identified from the data: 1) patients used the mobile application in their own way through trial and error; 2) the support of healthcare professionals through the mobile application increased patients’ sense of self-efficacy; 3) using the mobile application made them feel secure as they always felt connected; and 4) some patients struggled to incorporate new technology into their self-management. Most participants in this study had a positive experience of using the mobile application for self-management in their own way with the support of healthcare professionals, including gaining a sense of self-efficacy and security. On the other hand, some patients had a negative experience, such as not looking at the mobile application for a while or discontinuing self-management because they felt burdened by the introduction of this new self-management method. Conclusions Both positive and negative aspects of the experiences of patients with heart failure with adopting a mobile application for self-management were identified. Psychological support is essential when patients incorporate mobile applications into their routine as a self-management intervention.

Improving the management of type 2 diabetes in China using a multifaceted digital health intervention in primary health care: the SMARTDiabetes cluster randomised controlled trial

There is limited evidence, mainly from high-income countries, that digital health interventions improve type 2 diabetes (T2DM) care. Large-scale implementation studies are lacking. A multifaceted digital health intervention comprising: (1) a self-management application ('app') for patients and lay 'family health promotors' (FHPs); and (2) clinical decision support for primary care doctors was evaluated in an open-label, parallel, cluster randomized controlled trial in 80 communities (serviced by a primary care facility for >1000 residents) in Hebei Province, China. People >40 years with T2DM and a glycated haemoglobin (HbA1c) ≥7% were recruited (∼25/community). After baseline assessment, community clusters were randomly assigned to intervention or control groups (1:1) via a web-based system, stratified by locality (rural/urban). Control arm clusters received usual care without access to the digital health application or family health promoters. The primary outcome was at the participant level defined as the proportion with ≥2 "ABC" risk factor targets achieved (HbA1c<7.0%, blood pressure < 140/80mmHg and LDL-cholesterol < 2.6mmol/L) at 24 months. A total of 2072 people were recruited from the 80 community clusters (40 urban and 40 rural), with 1872 (90.3%) assessed at 24 months. In the intervention arm, patients used FHPs for support more in rural than urban communities (252 (48.6%) rural vs 92 (21.5%) urban, p<0.0001). The mean monthly proportion of active app users was 46.4% (SD 7.8%) with no significant difference between urban and rural usage rates. The intervention was associated with improved ABC control rates (339 [35.9%] intervention vs 276 [29.9%] usual care; RR 1.20, 95% CI 1.02-1.40; p=0.025), with significant heterogeneity by geography (rural 220 [42.6%] vs 158 [31.0%]; urban 119 [27.9%] vs 118 [28.6%]; p=0.022 for interaction). Risk factor reductions were mainly driven by improved glycaemic control (mean HbA1C difference-0.33%, 95% CI-0.48 to-0.17; p=0.00025 and mean fasting plasma glucose difference-0.58mmol, 95% CI-0.89 to-0.27; p=0.00013). There were no changes in blood pressure and LDL-cholesterol levels. A multifaceted digital health intervention improved T2DM risk factor control rates, particularly in rural communities where there may be stronger relationships between patients and doctors and greater family member support. National Health and Medical Research CouncilGlobal Alliance for Chronic Diseases (ID 1094712).

Effect of a gamified mobile-based self-management application on disease activity index, quality of life, and mental health in adults with inflammatory bowel disease: A protocol of a randomized controlled trial study.

Inflammatory bowel disease (IBD) is a chronic inflammatory gastrointestinal tract disease subdivided into Crohn's disease (CD) and ulcerative colitis (UC). There is currently no cure for IBD, and individuals with IBD frequently experience a lower health-related quality of life (HRQOL) than the general population. Gamification has become an increasingly popular topic in recent years. Adapting game design concepts to nongaming contexts represents a novel and potential approach to changing user engagement. This study will be conducted with the aim of evaluating the effect of a gamified mobile-based self-management application on disease activity index, quality of life, and mental health in adults with IBD. A multicenter, parallel, two-arm, exploratory randomized controlled trial with a 6-month follow-up per patient will be designed to compare the impact of the gamified mobile-based tele-management system on primary and secondary health outcomes and outpatient visits in 210 patients with all types of IBD which are divided equally into a control group with standard care and an intervention group which will use the developed mobile application named MY IBD BUDDY. All patients will attend study visits at baseline, 12 and 24 weeks, and routine IBD clinic visits or telephone consultations based on randomization group assignment. Disease activity or disease activity index, mental health (anxiety and depression) symptoms, quality of life, self-efficacy, and IBD-specific knowledge will be measured at baseline with two follow-ups at 12 and 24 weeks. In sum, the outcomes of our trial will demonstrate the impact of the gamified mobile-based self-management system on disease activity, quality of life, and anxiety and depression by means of interactive care and patient empowerment. IRCT: IRCT20200613047757N1. Registered November 16, 2021. Prospectively registered and visible at OSF (https://doi.org/10.17605/OSF.IO/AWFY9).

Co-creation of a self-management application for asthma: A citizen science protocol

Digital health can effectively engage patients in the self-management of their asthma. Still, it will only reach its full potential when apps are aligned with patients’ needs and are integrated into clinical practice. We aim to test a framework for the involvement of patients/carers in all phases of developing and implementing an app for asthma. This protocol was co-designed with six asthma patients/carers and includes 5 tasks. Regular interactions among patients, developers and healthcare professionals will be a priority for user requirements definition (task 1) and iterative development and testing until the app’s initial version (tasks 2-3). Patients/carers and healthcare professionals will be fully engaged in the real-life feasibility study (task 4) and management and dissemination activities (task 5). The eligibility criteria to participate in tasks 2-4 are 1) diagnosis of asthma or carer of a person with asthma; 2) ≥18 years; 3) ability to use apps and access a mobile device with Internet. We anticipate applying questionnaires such as the User Experience Questionnaire and the System Usability Scale in all app testing tasks. We expect to have a final version of the asthma app that meets patients’/carers’ needs and experiences and healthcare professionals’ concerns. This will be an attractive app to support patients in self-management of their disease, keeping their asthma in control, having fewer asthma symptoms, and enjoying life. This study will be a framework for fully involving patients, carers and citizens in the iterative co-production development and implementation of an asthma app.

Feasibility of a wearable self-management application for patients with COPD at home: a pilot study

BackgroundAmong people with COPD, smartphone and wearable technology may provide an effective method to improve care at home by supporting, encouraging, and sustaining self-management. The current study was conducted to determine if patients with COPD will use a dedicated smartphone and smartwatch app to help manage their COPD and to determine the effects on their self-management.MethodsWe developed a COPD self-management application for smartphones and smartwatches. Participants were provided with the app on a smartphone and a smartwatch, as well as a cellular data plan and followed for 6 months. We measured usage of the different smartphone app functions. For the primary outcome, we examined the change in self-management from baseline to the end of follow up. Secondary outcomes include changes in self-efficacy, quality of life, and COPD disease control.ResultsThirty-four patients were enrolled and followed. Mean age was 69.8 years, and half of the participants were women. The most used functions were recording steps through the smartwatch, entering a daily symptom questionnaire, checking oxygen saturation, and performing breathing exercises. There was no significant difference in the primary outcome of change in self-management after use of the app or in overall total scores of health-related quality of life, disease control or self-efficacy.ConclusionWe found older patients with COPD would engage with a COPD smartphone and smartwatch application, but this did not result in improved self-management. More research is needed to determine if a smartphone and smartwatch application can improve self-management in people with COPD.Trial registrationClinicalTrials.Gov NCT03857061, First Posted February 27, 2019.

The Effect of Self-Management Application on Academic Procrastination in Nursing Students at STIKep PPNI West Java

Aims: To determine the effect of self-management applications on academic procrastination in nursing students at STIKep PPNI West Java. Methods: This study used a quantitative quasi-experimental method with a two-group pretest-posttest design. The number of respondents was 60 with sampling using a proportionate stratified random sampling technique consisting of 30 intervention groups and 30 control groups, with inclusion criteria for undergraduate nursing students. The instrument used was the Tuckman Procrastination Scale. Univariate analysis used mean, SD, min, max and bivariate analysis using paired sample t test and independent sample t test. Results: Based on the results of the paired sample t-test, the p-value is 0.000 (p &lt;0.05) and the independent sample t-test has a p-value of 0.000 (p &lt;0.05), which means that there is a significant differences in value between the intervention groups and the control group so that Ha is accepted and H0 is rejected. Conclusions: The study found a significant reduction in academic procrastination in the intervention group compared to the control group, due to structured self-management. The intervention group experienced better behavioral changes, while the control group experienced a decrease. The study also found significant differences in self-management implementation through four stages: self-monitoring, self-contracting, stimulus control, and self-reinforcement.

Mobile and Computer-Based Applications for Rehabilitation Monitoring and Self-Management After Knee Arthroplasty: Scoping Review.

Successful post-knee replacement rehabilitation requires adequate access to health information, social support, and periodic monitoring by a health professional. Mobile health (mHealth) and computer-based technologies are used for rehabilitation and remote monitoring. The extent of technology use and its function in post-knee replacement rehabilitation care in low and middle-income settings are unknown. To inform future mHealth intervention development, we conducted a scoping review to map the features and functionality of existing technologies and determine users' perspectives on telerehabilitation and technology for self-management. We followed the Joanna Briggs Institute methodology for scoping reviews. We searched the Embase, Medline, PsycINFO via OVID, and Cochrane Central Register of Controlled Trials databases for manuscripts published from 2001 onward. We included original research articles reporting the use of mobile or computer-based technologies by patients, health care providers, researchers, or family members. Studies were divided into the following 3 categories based on the purpose: validation studies, clinical evaluation, and end user feedback. We extracted general information on study design, technology features, proposed function, and perspectives of health care providers and patients. The protocol for this review is accessible in the Open Science Framework. Of the 5960 articles, 158 that reported from high-income settings contributed to the qualitative summary (64 studies on mHealth or telerehabilitation programs, 28 validation studies, 38 studies describing users' perceptions). The highest numbers of studies were from Europe or the United Kingdom and North America regarding the use of a mobile app with or without wearables and reported mainly in the last decade. No studies were from low and middle-income settings. The primary functions of technology for remote rehabilitation were education to aid recovery and enable regular, appropriate exercises; monitoring progress of pain (n=19), activity (n=20), and exercise adherence (n=30); 1 or 2-way communication with health care professionals to facilitate the continuum of care (n=51); and goal setting (n=23). Assessment of range of motion (n=16) and gait analysis (n=10) were the commonly validated technologies developed to incorporate into a future rehabilitation program. Few studies (n=14) reported end user involvement during the development stage. We summarized the reasons for satisfaction and dissatisfaction among users across various technologies. Several existing mobile and computer-based technologies facilitate post-knee replacement rehabilitation care for patients and health care providers. However, they are limited to high-income settings and may not be extrapolated to low-income settings. A systematic needs assessment of patients undergoing knee replacement and health care providers involved in rehabilitation, involving end users at all stages of development and evaluation, with clear reporting of the development and clinical evaluation can make post-knee replacement rehabilitation care in resource-poor settings accessible and cost-effective.

Epilepsy self–management mobile health application: A needs assessment in people with epilepsy and caregivers in Viet Nam

ObjectivesThis study aimed to determine (1) the needsof Vietnamese people with epilepsy (PWE) and their caregivers for self-management mobile health applications and (2) the self-management features expected to be included in an application. MethodsThe survey consisted of an anonymous self-administered questionnaire that was distributed to PWE and caregivers from the age of 18 in Vietnam through online platforms and onsite at Nguyen Tri Phuong Hospital and University Medical Center, Ho Chi Minh City, from February 2022 to May 2022. The questionnaire assessed the participants’ attitudes toward epilepsy self-management mobile applications, their willingness to use applications, and their expectations of the contents of an application. ResultsResponses from 103 participants were submitted. Eighty-one participants (78.6%) reported using a smartphone, but only 50.6% of those claimed to know about self-management applications. Most respondents (70.9%) thought the applications would be useful for disease self-management, and 68.9% were willing to use epilepsy self-management applications. In addition, the most expected features to be included in self-management applications were epilepsy information, seizure first aid, connecting with medical professionals, and a seizure diary. ConclusionMost Vietnamese PWE and caregivers had a willingness to use epilepsy self-management applications.The expected features are related to all aspects of self-management, including information, seizure, medication, and safety management.

Development of the iManage SCD mobile health application for transition

ObjectiveThis paper outlines the design and implementation of iManage SCD, a self-management mobile health application for adolescents and young adults (AYA) with sickle cell disease (SCD) during transition from pediatric to adult health care. MethodsThe Integrate, Design, Assess, Share (IDEAS) framework, emphasizing user insights, iterative design, rigorous assessment, and knowledge sharing, guided the development process. The design team consisted of researchers, psychologists, physicians, social workers, AYA with SCD, and parents of AYA with SCD (n = 16) across three states. Qualitative focus groups and interviews were conducted and analyzed using thematic analysis across the integrate and design phases. Point of use feedback from AYA with SCD was used to assess feasibility and acceptability. ResultsThe development process was centered around tenants of the Social-ecological Model of Adolescent and Young Adult Readiness to Transition. Development integrated multidisciplinary perspectives, fostering a person-centered approach. The iterative design process involved collaboration with a digital health firm, Agency39A. Health equity and implementation considerations were addressed at individual, community, and healthcare system levels. Themes that emerged from focus groups with AYA, clinicians, and researchers in the integrate and design phases of development included recommendations for content and user experience features. ConclusionsiManage SCD emerges as a comprehensive, user-friendly mobile health application, incorporating theoretical principles and direct user input. The development process demonstrated feasibility and acceptability, and the paper discusses dissemination strategies for the Community Health Workers and Mobile Health Programs to Help Young Adults with SCD Transition to Using Adult Healthcare Services (COMETS) study.

Community-based intervention for promoting healthy habits through MAHA mobile application in Basque elderly population.

Background: Population over 65 years of age in EU is increasing, rising costs in health and social care systems and making changes in biological, physiological, and psychosocial field. Promoting healthy ageing has become a key to improve the lifelong health and wellbeing of ageing population. Health technologies and eHealth tools can be an effective instrument to address the challenge of ageing. They provide an opportunity to improve the health and well-being of older people, and to prevent, treat and ensure the sustainability of health systems.&#x0D; Digital technologies aimed at promoting active ageing enable access to greater knowledge, better communication and a better relationship with people's environment, if they are designed in a person-centred way. They open up a range of new possibilities and resources that represent a way to reduce the generation gap and bring older people closer to the rest of the community.&#x0D; Methods: The Basque Country region has implemented a community-based intervention to promote active and healthy ageing through the use of a self-managed mobile MAHA App within Gatekeeper European project (H2020, nº857223). MAHA app developed in a co-creation process involving end-users and professionals from community settings is available in Google Play and App Store for iOS. The tool offers activities and materials to reinforce socialization and, promote healthy, meaningful, creative and fulfilling lives among elderly people.&#x0D; This quasi-experimental and longitudinal study is targeted at 10,000 older people and/or their caregivers from the Basque Country (Spain). The community-based intervention in the Basque Country has been designed to involve Primary Health Care services and key agents from different sectors at the community level that can influence the well-being and health of the elderly population. The Support Network created for the intervention has the participation of 39 community organisations and entities belonging to the Basque Health Ecosystem.&#x0D; Results: A mixed methods approach to evaluation will be carried out, using quantitative techniques, through validated questionnaires and usage metrics to assess effectiveness; and qualitative techniques, to collect user experience. An analysis of the implementation process has been executed, to identify the determinants, factors, and aspects that impact the intervention, and the commitment, adherence and dropout rate towards user engagement. The intermediate data shows that the actions implemented are effective, as the intervention has been widely disseminated and many people have been contacted. Although more than half have accepted to participate in the intervention, only 3% finally registered in the application. This intervention also shows low adherence to the intervention and a high level of dropout, as it is understood that once the user accepted to participate, they do not follow the study protocol. &#x0D; Discussion and Conclusions: The community-based intervention implemented will contribute to generating awareness and new data on research into the intention-to-treat, adherence and attrition rate of the use of self-managed eHealth applications by the elderly. Likewise, a tool with these characteristics can be considered an effective health asset for improving elderly people's health, making healthy options more accessible and incorporating new habits in this population.&#x0D; &#x0D;

EXPLORATION OF SELF MANAGEMENT OF HYPERTENSION PATIENTS IN THE CITY OF JAYAPURA

Abstract&#x0D; Introductions : Hypertension is an asymptomatic chronic disease that can lead to complications and death. To control hypertension, patients can do pharmacological or non-pharmacological treatment. In non-pharmacological treatment, patients can make lifestyle changes in daily behavior, so that patients are responsible for themselves, which is called self management. The application of self management can reduce the risk of complications in patients. Aims : This study aims to identify Self Management in patients with hypertension. Methode : The research method is an analytic survey with a cross sectional study design. Identification of self management of hypertension patients using the Hypertension Self Management Behavior Questionaire (HSMBQ). The research sample was hypertension patients at Jayapura City Hospital selected by simple random sampling. The results of this study indicate that self management of hypertension patients is in the good category. Good self management can help patients manage their disease and improve their quality of life.&#x0D; Keywords: Hypertension, Self Management.

Factors influencing patients' adoption and use of mobile health applications for diabetes self-management: a systematic review

Mobile health (mHealth) apps can facilitate diabetes self-management (DSM) and assist in reducing the risk of complications, enhancing diabetes control and improving patient outcomes. The objectives of this systematic review were to (1) determine the adoption level of DSM apps among diabetes patients, (2) identify the factors associated with the adoption and use of DSM apps, and (3) explore patients’ perspectives of DSM apps and the predominant preferred features. A comprehensive literature search was performed in four electronic databases: PubMed, Scopus, PsychNet, and IEEE Xplore digital library using the PRISMA guidelines. Relevant data and information were collected from studies published between 2016 and 2023, fulfilling the inclusion criteria (n = 26), and thematic analysis was performed. The adoption level of mHealth apps for DSM among diabetic patients ranged from 7.0% to 47.0%, and diverse factors relating to patients’ demographics, preferences and experiences were identified. Overall, older, male and less educated patients were less likely to adopt DSM apps, while the intention to use these apps was influenced by patients’ perceived benefits, recommendations by patients and healthcare professionals, and ease of use. Given that most of the reviewed studies were conducted in developed countries, the present patients’ adoption level of mHealth apps for DSM is relatively low, thereby highlighting the need for improvement. The factors identified in this study may be considered when attempting to encourage patients to use these apps. More research is needed to elucidate how mobile health apps can be effectively integrated into diabetes care and management pathways.

Development and assessment of a self-management intervention for urinary incontinence among patients with prostate cancer: protocol for a randomized feasibility study

BackgroundUrinary incontinence is a common complication among patients with prostate cancer who have undergone radical prostatectomy. Guided by social cognitive theory and a framework for the recovery of health and well-being, we propose to develop and test a self-management intervention for patients with prostate cancer who experience urinary incontinence after undergoing radical prostatectomy.MethodsIn this study, a self-management intervention for urinary incontinence (SMI-UI) is developed, comprising a mobile self-management application, a self-management handbook, and professional support. The feasibility, acceptability, and effectiveness of this intervention will be assessed. Patient data from the urology departments of two hospitals will be collected through convenience sampling by adopting an experimental, parallel, and random assignment research design. Patients experiencing urinary incontinence after undergoing radical prostatectomy will be invited to participate. After completing the pretest questionnaire, patients will be randomly divided into the experimental and attention control groups. The experimental group will undergo a 12-week SMI-UI, whereas the attention control group will receive an intervention consisting of a single dietetic education information package. The two groups will be tested 12 and 16 weeks after the pretest. In this study, we recorded the sociodemographic and clinical variables; recruitment rate; retention rate; satisfaction with the intervention; cancer-related self-efficacy; urination symptoms and disturbance; social participation and satisfaction; resilience; and demoralization.Trial RegistrationClinicalTrials.gov ID: NCT05335967 [date of registration 04-04-2022].

Long-Term Efficacy of primary care combining a mobile healthcare application with human coaching

Abstract Background Chronic diseases have become a global burden, and digital self-healthcare using mobile devices has gained importance in managing these conditions. However, barriers to implementing mobile self-management healthcare applications in current primary care system, and previous research has focused on short-term effects. This study aims to evaluate the long-lasting effect of combining human coaching with mobile self-management healthcare applications for chronic disease patients in primary healthcare services. Methods The study recruited 178 patients with chronic diseases from participating primary care clinics. The intervention group (N = 128) received a 12-week mobile self-management healthcare application service combined with traditional primary care, while the control group (N = 50) received only traditional healthcare. The Noom application was used, with two weekly human coaching sessions by a nutritionist. A telephone survey on weight changes was conducted one year after the intervention. Results The intervention group showed a greater weight loss compared to the control group during the intervention period (Intervention: -1.29 ± 2.94 vs Control: -0.38 ± 1.72, P-value 0.002). Although there was no statistically significant difference in additional weight change between the two groups during the follow-up period, the difference in weight loss during the intervention period was maintained (Intervention: -2.16 ± 5.54 vs Control: -1.06 ± 3.24, P-value: 0.008). Additionally, among the intervention group continuously for 1 year using the health management application, the average weight loss was higher than the other groups. Conclusions Combining a mobile self-management healthcare application with human coaching has long-lasting effects and can be effective in primary healthcare services. This suggests that such an approach has the potential to be a treatment option in current primary healthcare systems, but further large-scale long-term studies are needed. Key messages • This study suggests that using mobile self-management healthcare apps with human coaching can be an effective long-term treatment option for chronic disease patients in primary healthcare services. • The combination of the two methods may provide better outcomes than traditional healthcare services alone.

Overcoming the Digital Divide for Older Patients With Respiratory Disease: Focus Group Study.

The need for and adoption of eHealth programs are growing worldwide. However, access can be limited among patients with low socioeconomic backgrounds, often resulting in a so-called "digital divide" due to a mismatch between eHealth and target populations that can gain benefit. This digital divide can result in unsuccessful eHealth implementations, which is of critical importance to health care. This study evaluated the opinions of elderly patients with asthma and chronic obstructive pulmonary disease (COPD) about an existing pharmacy-based personalized patient web portal that provides medication overview and information on associated diagnoses. The aim was to obtain insights on the common barriers of elderly people when using health-related websites, which can help to improve accessibility. This was a cross-sectional qualitative study of a patient panel of the Groningen Research Institute for Asthma and COPD in primary care. Participants were required to be older than 55 years, be Dutch speaking, have no prior experience with the study website, and be diagnosed with a chronic respiratory illness. Two focus groups were created, and they completed a 45-minute session for testing the website and a 120-minute session for semistructured interviews. The focus group sessions were recorded, transcribed verbatim, and analyzed by content analysis. We enrolled 11 patients (9 women) with a mean age of 66 (SD 9) years. Of these, 5 had asthma, 3 had COPD, 2 had asthma-COPD overlap syndrome, and 1 had bronchiectasis. Participants were generally positive about the website, especially the areas providing disease-related information and the medication overview. They appreciated that the website would enable them to share this information with other health care providers. However, some difficulties were reported with navigation, such as opening a new tab, and others reported that the layout of the website was difficult either because of visual impairments or problems with navigation. It was also felt that monitoring would only be relevant if it is also checked by health care professionals as part of a treatment plan. Participants mentioned few privacy or safety concerns. It is feasible to develop websites for elderly patients; however, developers must take the specific needs and limitations of elderly people into account (eg, navigation problems, poor vision, or poor hand-eye coordination). The provision of information appears to be the most important aspect of the website, and as such, we should endeavor to ensure that the layout and navigation remain basic and accessible. Patients are only motivated to use self-management applications if they are an integrated part of their treatment. The usability of the website can be improved by including older people during development and by implementing design features that can improve accessibility in this group.

Identification and Evaluation of Mobile Applications for Self-Management of Diet and Lifestyle for Patients with Inflammatory Bowel Disease.

Mobile health applications (apps) providing diet and lifestyle self-management programs to patients with inflammatory bowel disease (IBD) are emerging. The objective of this study was to evaluate current apps available in the US and Canada based on app quality, perceived impact on diet and mental health and comprehensiveness to support self-management. The Apple iOS and Google Play app stores were searched for terms related to IBD. Apps were included if they targeted diet and lifestyle behaviours for patients living with IBD and were available to the general public. Apps were excluded if they were not specific to IBD, not available in English, did not target diet or lifestyle therapy, were not available in the US and Canada, or did not offer stand-alone self-management programs. The Mobile App Rating Scale was used to assess mobile app quality. A total of 1,512 apps were identified through the app stores. Six apps met inclusion criteria. My IBD Care: Crohn's and Colitis received the highest quality rating and LyfeMD received the highest overall app rating. Only these two apps provided behaviour tracking over time, and three (50 percent) apps provided good-quality information. While many IBD-related apps exist, few support self-management of diet and lifestyle behaviours. The My IBD Care and LyfeMD apps had the highest ratings and can be used to track lifestyle behaviours. The effectiveness of these apps to improve behaviours, and subsequently impact the disease course and quality of life, should be explored in future studies.