App Functionality Research Articles

A qualitative study of patients’ perceptions of DASH diet apps for dietary self- management of hypertension in Saudi Arabia

Nutrition smartphone apps have become a popular and readily accessible approach to improving dietary behaviour. Hypertension is often associated with a poor diet, and its prevalence is increasing in Saudi Arabia(1). The Dietary Approaches to Stop Hypertension (DASH) eating plan has been shown to reduce blood pressure in people with hypertension(2). A previous study identified two high-quality, safe, and potentially effective smartphone apps for managing hypertension: NOOM and DASH To TEN(3). This study aimed to explore the potential of these two DASH diet self- management apps for controlling blood pressure in the Saudi Arabian context.Fifteen patients were recruited at King Abdullah bin Abdulaziz University Hospital in Riyadh, Saudi Arabia. Ten patients had hypertension, and five had prehypertension (mean age = 45). Patients were given the two apps and asked to try each for one week. Focus groups (n=4) were held at the end of the trial to understand the patient perceptions of the apps. Discussions were recorded, and the transcriptions were analysed using a thematic framework analysis(4).The following four themes emerged:1.Managing hypertension through diet was perceived as important. Most patients reported thatadhering to the DASH diet was challenging due to a lack of motivation and willpower,inadequate support from household members, and high prices for healthy food.2.The potential and current reach of dietary apps emerged as a main theme, and manycomments related to patients’ belief that dietary apps could increase their motivation and awareness about the DASH diet. Barriers to the use of apps were also identified including their difficulty of use, a preference for dietetic monitoring, and cost.3.Interactive app functionality was identified as a key theme, as evidenced by comments about a straightforward sign-up process, an extensive food database for dietary self-monitoring, feedback, goal setting, and reminders, considered essential for diet adherence.4.A preference for the NOOM app emerged. Patients perceived the NOOM app more suitable in the Saudi context. Noom was deemed to support DASH self-management because it supports weight reduction, which helps lower blood pressure. NOOM was perceived as highly interactive, offering motivational reminders, feedback, realistic dietary plans, and a comprehensive food database. Patients made several recommendations for app improvement; these included Arabic language support, automatic calculation of sodium and potassium consumption, and lower cost. Patients also expressed a desire for training in the use of the app.This qualitative analysis suggests that the NOOM app could be suitable for use with hypertensive patients in Saudi Arabia. Further research is needed to determine the feasibility and efficacy of long- term use of the NOOM app with a Saudi Arabia population.

How do mobile app users react to embedded advertising? A perspective from psychological reactance theory

ABSTRACT This study investigated the effects of in-app advertisements (in-app ads) on user responses based on psychological reactance theory. Three types of in-app ads were categorised: banners, pop-up graphics and pop-up video clips. The study also examined the moderating effect of prior negative experiences on the relationship between in-app ad appearance and advertising clutter and in-app ad appearance and advertising scepticism. A total of 1,343 valid questionnaires were collected for each type of in-app ad. Structural equation modelling (SEM) analysis revealed that the duration and frequency of different ads had distinct effects on users' negative psychological reactance, leading to behaviours of ignoring and resisting the ads. Moreover, advertising clutter not only positively influenced advertising scepticism but also increased advertising avoidance, subsequently impacting both the tendency to ignore and resist the advertised content. Prior negative experiences played a moderating role in the banner and pop-up graphic ad models. In conclusion, this study recommends that app developers avoid overwhelming sensory stimulation when displaying ads to reduce the complexity of visual perception. Improving content innovation can help minimise users perceiving the ads as obtrusive. Furthermore, emphasising the relevance of advertisements by integrating them effectively with app functions can increase user ad acceptance.

Functionality of Fitness Applications and the Physical Activity of College Students

The study determined whether the functionality of fitness applications predicts the level of physical activity of Chinese college students. In the process, the study assessed the level of physical activity and functionality of fitness apps in terms of exercise, recreation, and sports. Data were gathered through online survey with the use of a researcher made questionnaire. The study showed that the respondents were engaged in light physical activity only. This is true in all the sub-variables of physical activity which are exercise, recreation, and sports. The study also showed that the respondents rated their fitness apps as slightly functional only in exercise, recreation, and sports. Simple linear regression was used in determining whether the functionality of fitness apps significantly predict physical activity.

Analisis Keamanan Data Pelanggan dalam Menghadapi Tantangan Penggunaan Marketplace

The advent of the digital economy makes commerce more accessible to everyone. Example: an online marketplace app that simplifies buying and selling. The marketplace app's useful features and ease of use attract many users. The marketplace app's functionality and convenience have been enhanced to meet consumer expectations and prioritize consumer data protection. This study investigates how customers protect their data when shopping online and utilizing marketplace apps. Environmental and social influences, personal data security facilities, the goal of utilizing the marketplace, and awareness of customer data security when using the marketplace application were asked of 70 random sample participants. The questionnaires had 16 Guttman scale questions. According to the report, 81.42% of customers trust the marketplace app to protect their data. Likewise, 88.57% of customers strongly believe that the marketplace application they use secures their personal information, indicating that this is related to their marketplace service needs.

Mobile Health Apps, Family Caregivers, and Care Planning: Scoping Review.

People living with multiple chronic conditions (MCCs) face substantial challenges in planning and coordinating increasingly complex care. Family caregivers provide important assistance for people with MCCs but lack sufficient support. Caregiver apps have the potential to help by enhancing care coordination and planning among the health care team, including patients, caregivers, and clinicians. We aim to conduct a scoping review to assess the evidence on the development and use of caregiver apps that support care planning and coordination, as well as to identify key factors (ie, needs, barriers, and facilitators) related to their use and desired caregiver app functionalities. Papers intersecting 2 major domains, mobile health (mHealth) apps and caregivers, that were in English and published from 2015 to 2021 were included in the initial search from 6 databases and gray literature and ancestry searches. As per JBI (Joanna Briggs Institute) Scoping Review guidelines and PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews), 2 authors independently screened full texts with disagreements resolved by a third author. Working in pairs, the authors extracted data using a pilot-tested JBI extraction table and compared results for consensus. We identified 34 papers representing 25 individual studies, including 18 (53%) pilot and feasibility studies, 13 (38%) qualitative studies, and 2 experimental or quasi-experimental studies. None of the identified studies assessed an intervention of a caregiver app for care planning and coordination for people with MCCs. We identified important caregiver needs in terms of information, support, and care coordination related to both caregiving and self-care. We compiled desired functionalities and features enabling apps to meet the care planning and care coordination needs of caregivers, in particular, the integration of caregiver roles into the electronic health record. Caregiver needs identified through this study can inform developers and researchers in the design and implementation of mHealth apps that integrate with the electronic health record to link caregivers, patients, and clinicians to support coordinated care for people with MCCs. In addition, this study highlights the need for more rigorous research on the use of mHealth apps to support caregivers in care planning and coordination.

“I think it was helpful but not as helpful as it could have been” - a qualitative study of the experiences and perspectives of using fitness apps among manual wheelchair users with spinal cord injury

Purpose To gain knowledge of the experiences and perceptions of using fitness apps by full-time wheelchair users with spinal cord injury (SCI) and to explore experiences and perceptions of using these apps in relation to barriers to and facilitators of physical activity (PA). Materials and Methods A qualitative design was employed. Semi-structured interviews were conducted with ten manual wheelchair users with SCI. Data were analysed using reflexive thematic analysis. Results Four themes were developed: 1) App functionality and experience, 2) Enhancing motivation, 3) Precursors to engagement and 4) Knowledge gaps. Experience and perception were strongly influenced by app design, particularly the presence or absence of features tailored for wheelchair users. Many apps incorporated the use wearable or mountable sensors. Fitness apps were perceived to increase motivation, although, this had its limitations. Conversely, apps were reported to have limited influence on commonly reported barriers to PA. Furthermore, the data highlighted gaps in knowledge which created barriers to effective app use. Conclusions Fitness apps were perceived to increase motivation to engage in PA in manual wheelchair users with SCI. However, more needs to be done to further develop app features for wheelchair users with SCI and to address remaining barriers to engagement.

App-based interventions to improve cancer outcomes rely on informational support from professionals: a systematic review.

The importance of social support for cancer patients is well-established, and mobile applications hold promise for implementation. This systematic review examines app-based interventions with social support components for cancer patients, investigating the use of different support functions from different sources and the impact on cancer-related symptoms and psychological outcomes. A systematic search across five databases (EMBASE, Scopus, PsycINFO, PubMed, Web of Science) yielded 449 records, of which 17 studies (12 controlled designs) were included. Two independent reviewers extracted data and assessed study quality, revealing a high risk of bias across studies. Social support was implemented through different app functions, including contact/chat functions (n = 9), automatic alerts based on app input (n = 6) and discussion forums (n = 5). Social support predominantly focused on informational support (n = 17), mostly from healthcare professionals. Emotional support was less common (n = 7). Results indicated some promising intervention effects for pain, fatigue, nausea/vomiting, insomnia, constipation and overall symptom distress, but heterogeneous effects for health-related quality of life. Overall, results were mixed, but indicate that mobile apps incorporating social support may hold promise for cancer patients. However, future studies should focus on measuring and reporting social support as an intervention mechanism to systematically investigate its specific impact and improve effectiveness.HighlightsApps for cancer patients predominantly include informational social supportEmotional social support is substantially less frequently includedApps focus on formal support sources like healthcare professionalsFirst results are somewhat promising for improving cancer-related symptoms.

Which Educational Topics and Smartphone App Functions Are Prioritized by US Patients With Rheumatic and Musculoskeletal Diseases? A Mixed-Methods Study.

We sought to identify (1) what types of information US adults with rheumatic and musculoskeletal diseases (RMD) perceive as most important to know about their disease, and (2) what functions they would use in an RMD-specific smartphone app. Nominal groups with patients with RMD were conducted using online tools to generate a list of needed educational topics. Based on nominal group results, a survey with final educational items was administered online, along with questions about desired functions of a smartphone app for RMD and wearable use, to patients within a large community rheumatology practice-based research network and the PatientSpot registry. Chi-square tests and multivariate regression models were used to determine differences in priorities between groups of respondents with rheumatic inflammatory conditions (RICs) and osteoarthritis (OA), and possible associations. At least 80% of respondents considered finding a rheumatologist, understanding tests and medications, and quickly recognizing and communicating symptoms to doctors as extremely important educational topics. The highest-ranked topic for both RIC and OA groups was "knowing when the medication is not working." The app functions that most respondents considered useful were viewing laboratory results, recording symptoms to share with their rheumatology provider, and recording symptoms (eg, pain, fatigue) or disease flares for health tracking over time. Approximately one-third of respondents owned and regularly used a wearable activity tracker. People with RMD prioritized information about laboratory test results, medications, and disease and symptom monitoring, which can be used to create educational and digital tools that support patients during their disease journey.

The Ashwell Project: creating an online geospatial community

As the world increasingly embraces digital platforms, archaeologists are adapting their methods of public engagement accordingly. This was particularly evident during the COVID-19 pandemic, when many outreach and engagement efforts moved online. One such project was The Ashwell Project (TAP), which combined aspects of participatory Geographical Information Systems (GIS) and crowdsourcing of datasets, with Progressive Web App functionality of geolocation and navigation to disseminate community-collected photographs and narratives. The project's primary focus was two-fold: to disseminate anecdotal datasets within local heritage initiatives, and how to facilitate the involvement of users with limited technical proficiency innavigating complex digital systems. This paper highlights the opportunities and valuable lessons regarding digital engagement in communities. It considers strategies to promote the adoption of participatory GIS and crowdsourcing datasets, as well as how users' own devices can be utilised to increase engagement with tangible and intangible heritage. I argue that such approaches merit broader consideration, encouraging communities to actively engage with such platforms. The project underscores the importance of design thinking, emphasising empathy and iterative testing, in crafting effective heritage assets. Furthermore, it demonstrates the feasibility of engaging the public with archaeology even amidst a global pandemic.

Boosting app-based mobile financial services engagement in B2B subsistence marketplaces: The roles of marketing strategy and app design

Subsistence marketplaces generate over US$4 trillion annual spend and host fifty million B2B subsistence micro-enterprises, globally. These enterprises are increasingly adopting technology-driven service innovations, including app-based mobile financial services, to boost retail supply value chain efficiency. However, fostering users' continued engagement post-adoption in these markets remains challenging. Addressing this issue, in Study 1, we gather insights into theories-in-use held by app-based service providers, subsistence micro-suppliers, and -retailers. This led to a conceptual model grounded on the stimuli-organism-response (S-O-R) framework and SD logic. In Study 2 we empirically test this model through a field study with a dyadic sample of 253 micro-suppliers and micro-retailers. The findings reveal that relationship-building marketing strategies increase engagement, while transaction-focused strategies hinder it. App functionality (vs. aesthetics), likewise, represents a key customer engagement driver. Increased app-based services engagement positively impacts on non-coercive power and relationship satisfaction. These findings offer actionable implications for policymakers and marketers, emphasizing technology's role in fostering financial and digital inclusivity and efficiency in traditionally underserved B2B subsistence marketplaces.

The influence of app function evolution on transport SuperApp use behaviour over time

AbstractIn the past few decades, there has been a significant increase in smartphone apps that are designed to help users optimise their daily activities. As a result, there has been a noticeable impact on travel demand. Some of these apps have evolved with the incorporation of additional functions in a gradual transformation into multi-function apps or SuperApps, thereby providing users with more integrated and personalised services for a wider range of activities. Focusing on Transport SuperApps (TSA) in Indonesia, this study aims to investigate how app usage behaviour interacts with the evolving functions of these apps over time. The study further examines the influence of personality traits, socio-demographic factors, and residential location on app usage patterns. In this study, longitudinal data on TSA usage from 2015–2022 was collected from users in four Indonesian cities. The Latent Markov (LMM) and Negative Binomial (NBM) Models were used to analyse the transition of behaviours, app types, and the number of apps used. The findings reveal that transport and shopping services are the most popular and consistently utilised services by users. The results suggest that the introduction of new services has a positive impact on the number of TSA services used. However, some services were found to be used only temporarily, primarily serving as alternatives to support users’ daily needs and desires. Initial higher service usage was observed among educated users with sociable and disorganised personalities, while discontinuation of usage is associated with older users and affluent households. Higher transition and continuation to use more services are also observed in larger cities like Jakarta compared to smaller cities like Cianjur.

Big Data-driven Decision Support: Enhancing Information Integration and User Experience with Mobile Integrated Technology

This study examines how big data-driven decision support and mobile technology interact to improve information integration and user experience. The research studies big data for digital decision-making and provides theoretical and practical suggestions to assist organizations in overcoming its challenges. This study used mixed method analysis to find the relationship between big data-driven user experience and mobile-integrated technology. Businesses require sophisticated decision support tools to navigate the digital landscape of massive data. Big data-driven decision support is examined to determine how information integration and user experience affect mobile-integrated technologies. A rigorous quantitative technique examines data volume and decision precision. Although big data volumes may have diminishing returns, decision-making generally improves. The study emphasizes the delicate balance between data volume, quality, velocity, diversity, and governance. Beyond quantitative analysis, the study examines complex decision-making. Information integration methods and user experience affect decision-making time, with more data offering strategic options. Agile integration and user-centric design boost efficiency and decision-making. The research highlights the change in mobile integrated technology. The title fits the research since mobile technology increases information integration and user experience. According to the study, mobile technology's user-friendly gadgets, quick internet connectivity, security safeguards, and app functionality boost user contentment, productivity, and decision-making accuracy. The report also emphasizes big data governance in decision quality. Decision support systems need big data governance for data access, accuracy, security, and compliance. Finally, this study provides theoretical insights into big data-driven decision support and practical suggestions for organizations navigating it. The study uses data, technology, user experience, and governance to improve business decision-making. This provides them with digital-era precision, agility, and strategic edge.

Development of a Management App for Postviral Fibromyalgia-Like Symptoms: Patient Preference-Guided Approach.

Persistent fibromyalgia-like symptoms have been increasingly reported following viral infections, including SARS-CoV-2. About 30% of patients with post-COVID-19 syndrome fulfill the fibromyalgia criteria. This complex condition presents significant challenges in terms of self-management. Digital health interventions offer a viable means to assist patients in managing their health conditions. However, the challenge of ensuring their widespread adoption and adherence persists. This study responds to this need by developing a patient-centered digital health management app, incorporating patient preferences to enhance usability and effectiveness, ultimately aiming to improve patient outcomes and quality of life. This research aims to develop a digital health self-management app specifically for patients experiencing postviral fibromyalgia-like symptoms. By prioritizing patient preferences and engagement through the app's design and functionality, the study intends to facilitate better self-management practices and improve adherence. Using an exploratory study design, the research used patient preference surveys and usability testing as primary tools to inform the development process of the digital health solution. We gathered and analyzed patients' expectations regarding design features, content, and usability to steer the iterative app development. The study uncovered crucial insights from patient surveys and usability testing, which influenced the app's design and functionality. Key findings included a preference for a symptom list over an automated chatbot, a desire to report on a moderate range of symptoms and activities, and the importance of an intuitive onboarding process. While usability testing identified some challenges in the onboarding process, it also confirmed the importance of aligning the app with patient needs to enhance engagement and satisfaction. Incorporating patient feedback has been a significant factor in the development of the digital health app. Challenges encountered with user onboarding during usability testing have highlighted the importance of this process for user adoption. The study acknowledges the role of patient input in developing digital health technologies and suggests further research to improve onboarding procedures, aiming to enhance patient engagement and their ability to manage digital health resources effectively. RR2-10.2196/32193.

What Functions of Smartphone Apps and Wearable Devices Promote Physical Activity?: Six-Month Longitudinal Study on Japanese-Speaking Adults (Preprint)

What Functions of Smartphone Apps and Wearable Devices Promote Physical Activity?: Six-Month Longitudinal Study on Japanese-Speaking Adults (Preprint)

Detecting your depression with your smartphone? – An ethical analysis of epistemic injustice in passive self-tracking apps

Smartphone apps might offer a low-threshold approach to the detection of mental health conditions, such as depression. Based on the gathering of ‘passive data,’ some apps generate a user’s ‘digital phenotype,’ compare it to those of users with clinically confirmed depression and issue a warning if a depressive episode is likely. These apps can, thus, serve as epistemic tools for affected users. From an ethical perspective, it is crucial to consider epistemic injustice to promote socially responsible innovations within digital mental healthcare. In cases of epistemic injustice, people are wronged specifically as epistemic agents, i.e., agents of the production and distribution of knowledge. We suggest that epistemic agency relies on different resource- and uptake-related preconditions which can be impacted by the functionality of passive self-tracking apps. We consider how this can lead to different forms of epistemic injustice (testimonial, hermeneutical, and contributory injustice) and analyze the influence of the apps’ use on epistemic practices on an individual level, in mental healthcare settings, and on the structural level.

Redesigning Android Development: Using Reactive Programming to Retrofit REST APIs and Concurrency

In this paper the current techniques and tools used by developers to create applications are described in detail and the use of REST APIs in Android applications as a case study. The first component is the installation of the APIs, which we will focus on the Retrofit library for network management, and the API Clients to manage requests. This study evaluates the nuances of JSON parsing, serialization, and deserialization through the Retrofit API client. We study the technique of data searching, the introduction of Tap Drawer using Firebase to improve the app functionality, and the string transformation method of Scalar with JSON Converter Factory.The tutorial explains how to set up an API, design an interface for Product ID query, use a Binding Adaptor for handling images and a Glide dependency to load images. As well, we consider how to create a Product Adaptor for a Recycler View which leverages Fragments to implement complex user interfaces. According to the plan of Android development, we absorb width, wrap content and verticality alignment as layout factors.The building of the “Adapter List” based on the “Create View Holder” function and the creation of Product Model class — which consists of fields for ratings and product details — as well as the JSON integration are presented in the article. Asynchronous processes are applied in the application as well as the `enqueue` technique has been used to provide effective network connection.We intend to acquire an experimental data by app scanning on the Android platform, by referring to Stack Overflow's most favourite pages and through a survey of mobile application developers in order to build a code collection associated with REST mobile client technologies. From our findings it follows that application communicating through the Internet phenomenon associated with JSON syntax implementation in comparison to XML data processing execution rather widespread and acceptable in terms of Android developers. We include the HTTP libraries standardized by third-party organizations in the paper which also explains how to use the practices.In unity, we discuss the perks of Android system uniqueness which facilitates the application customization, suppliers and the consumers, in terms of security, usability, and usefulness. Our app framework for Android offers coronary adjust to existing apps through behaviour simply without accessing or modifying app source code but sticks to the universal app-agnostic transformation objectives. This architecture is thus designed to allow the modified software version to function without any hindrance on any normal Android device. Keywords- REST API, Android, Retrofit, Firebase, Gson, Recycler View, JSON parsing, HTTP libraries, refactoring, Android programming principles.

Understanding Adolescents' Experiences With Menstrual Pain to Inform the User-Centered Design of a Mindfulness-Based App: Mixed Methods Investigation Study.

Digital interventions are increasingly popular for the provision of nonpharmacological pain interventions, but few exist for adolescents with menstrual pain. User-centered design involves incorporating users across phases of digital health intervention design, development, and implementation and leads to improved user engagement and outcomes. A needs assessment is the first step of this approach. The goal of this study was to conduct a needs assessment to understand menstrual pain management needs and preferences and mindfulness experiences, preferences, and knowledge of adolescents with menstrual pain to inform the future development of an app for managing menstrual pain. We used an explanatory sequential mixed method design that included a survey followed by focus groups. Adolescents aged 13-17 years completed a survey (n=111) and participated in focus groups (n=16). Data were analyzed using descriptive statistics and thematic content analysis and synthesized to provide specific recommendations based on adolescent responses. Adolescents (n=111) who completed the survey reported a moderate understanding of mindfulness and menstrual pain. Over three-quarters (n=87, 78%) of participants practiced some form of mindfulness and 87% (n=97) of survey participants used nonpharmacological pain management strategies. Teens had a moderate perception that mindfulness could help their menstrual pain (mean 4.51/10, SD 2.45, with higher scores suggesting more interest). Themes were generated related to mindfulness experiences, menstrual pain knowledge and experiences, and app functionality. These themes underscored adolescents' need for continued support and flexible access to mindfulness activities; their awareness of multiple influences to pain, with potential for further education in this area; and the need for menstrual pain-specific content, along with content relevant to typical day-to-day experiences of adolescents. Adolescents with menstrual pain have an interest in using a mindfulness app for pain but have unique needs that need to be addressed to ensure app engagement and relevance for this population. Concrete recommendations for future app development are provided.

APP antisense oligonucleotides reduce amyloid-β aggregation and rescue endolysosomal dysfunction in Alzheimer's disease.

APP gene dosage is strongly associated with Alzheimer's disease (AD) pathogenesis. Genomic duplication of the APP locus leads to autosomal dominant early-onset AD. Individuals with Down syndrome (trisomy of chromosome 21) harbour three copies of the APP gene and invariably develop progressive AD with highly characteristic neuropathological features. Restoring expression of APP to the equivalent of that of two gene copies, or lower, is a rational therapeutic strategy, as it would restore physiological levels of neuronal APP protein without the potentially deleterious consequences of inadvertently inducing loss of APP function. Here we find that antisense oligonucleotides (ASOs) targeting APP are an effective approach to reduce APP protein levels and rescue endolysosome and autophagy dysfunction in APP duplication and Trisomy 21 human induced pluripotent stem cell (hiPSC)-derived cortical neurons. Importantly, using ultrasensitive single-aggregate imaging techniques, we show that APP targeting ASOs significantly reduce both intracellular and extracellular amyloid-β-containing aggregates. Our results highlight the potential of APP ASOs as a therapeutic approach for forms of AD caused by duplication of the APP gene, including monogenic AD and AD related to Down syndrome.

Abstract P317: Patient Perceptions and Satisfactions of a Remote Blood Pressure Monitoring Program in an Integrated Healthcare System

Background: Uncontrolled high blood pressure (BP) is a leading contributor to cardiovascular disease. Remote BP monitoring (RBPM) can empower patients to participate in their healthcare which may be important for improving BP control. The aim of this study was to understand patients’ attitudes toward and satisfaction with a RBPM program. Methods: We identified Kaiser Permanente (KP) Southern California members aged 18 years and older enrolled in a RBPM program. Eligibility criteria include having uncontrolled BP (≥140/90 mmHg), a smartphone, and an email address. Between July 27 and August 17, 2023, we emailed a letter of invitation and link to an online survey to 716 eligible members followed by 2 reminder emails. The survey consisted of 5 domains to assess patients’ experiences with a BP monitor and the KP Health Ally app: ease of use, trust, perceived benefits, privacy and overall satisfaction. Responses to each question were rated on a scale from 1 (disagree) to 7 (agree). The average score for each domain was calculated as the weighted sum of the questions. Antihypertensive medication adherence was reported on a scale ranging from “all of the time” to “less than half the time”. Results: A total of 71 patients (9.9%) responded to the survey with 60 (8.4%) completing all questions. Respondents had a mean age of 60.4 (SD 13.1) years, with 70.4% being female and 50.5% African American. Overall satisfaction and perceived benefits were the highest scoring domains followed by ease of use and trust in the monitor and app (Figure). Privacy concerns were minimal. The overwhelming majority of respondents (89.7%) reported taking their BP medications all or nearly all of the time. Conclusion: Most respondents rated the RBPM program with a high level of satisfaction, perceived benefits and had limited concern about privacy with the potential opportunity to improve patients’ trust in the BP monitor and app functionality. This high level of patient satisfaction and acceptability should lead to increased implementation and scaling of the RBPM program.

The Use of Mobile Technologies to Promote Physical Activity and Reduce Sedentary Behaviors in the Middle East and North Africa Region: Systematic Review and Meta-Analysis.

The Middle East and North Africa (MENA) region faces unique challenges in promoting physical activity and reducing sedentary behaviors, as the prevalence of insufficient physical activity is higher than the global average. Mobile technologies present a promising approach to delivering behavioral interventions; however, little is known about the effectiveness and user perspectives on these technologies in the MENA region. This study aims to evaluate the effectiveness of mobile interventions targeting physical activity and sedentary behaviors in the MENA region and explore users' perspectives on these interventions as well as any other outcomes that might influence users' adoption and use of mobile technologies (eg, appropriateness and cultural fit). A systematic search of 5 databases (MEDLINE, Embase, CINAHL, Scopus, and Global Index Medicus) was performed. Any primary studies (participants of all ages regardless of medical condition) conducted in the MENA region that investigated the use of mobile technologies and reported any measures of physical activity, sedentary behaviors, or user perceptions were included. We conducted a narrative synthesis of all studies and a meta-analysis of randomized controlled trials (RCTs). The Cochrane risk-of-bias tool was used to assess the quality of the included RCTs; quality assessment of the rest of the included studies was completed using the relevant Joanna Briggs Institute critical appraisal tools. In total, 27 articles describing 22 interventions (n=10, 37% RCTs) and 4 (15%) nonexperimental studies were included (n=6141, 46% women). Half (11/22, 50%) of the interventions included mobile apps, whereas the other half examined SMS. The main app functions were goal setting and self-monitoring of activity, whereas SMS interventions were primarily used to deliver educational content. Users in experimental studies described several benefits of the interventions (eg, gaining knowledge and receiving reminders to be active). Engagement with the interventions was poorly reported; few studies (8/27, 30%) examined users' perspectives on the appropriateness or cultural fit of the interventions. Nonexperimental studies examined users' perspectives on mobile apps and fitness trackers, reporting several barriers to their use, such as perceived lack of usefulness, loss of interest, and technical issues. The meta-analysis of RCTs showed a positive effect of mobile interventions on physical activity outcomes (standardized mean difference=0.45, 95% CI 0.17-0.73); several sensitivity analyses showed similar results. The trim-and-fill method showed possible publication bias. Only 20% (2/10) of the RCTs measured sedentary behaviors; both reported positive changes. The use of mobile interventions for physical activity and sedentary behaviors in the MENA region is in its early stages, with preliminary evidence of effectiveness. Policy makers and researchers should invest in high-quality studies to evaluate long-term effectiveness, intervention engagement, and implementation outcomes, which can inform the design of culturally and socially appropriate interventions for countries in the MENA region. PROSPERO CRD42023392699; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=392699.