mHealth Apps Research Articles

What would it take to improve the uptake and utilisation of mHealth applications among older Australians? A qualitative study.

Objective Health-related apps on mobile devices (mHealth apps) have become an effective self-management tool and treatment support for patients. There is limited research, however, on how older people (50 and over) perceive the opportunity of using mHealth apps. Our aim was to investigate the perceptions of older people in Australia regarding the opportunity of using prescribed or doctor-recommended mHealth apps and provide insights which can enhance their uptake of mHealth. Methods This was a qualitative study using semi-structured interviews involving 21 participants aged 51-82 years. Qualitative thematic analysis was used to categorise the factors that influence the adoption of mHealth apps by older adults. Results We show that beyond the prominent influencing factors from technology adoption research (such as performance and effort expectancy, social influence and facilitating conditions), health-specific factors such as a trusting doctor-patient relationship and strong health self-efficacy positively influence the intended adoption of mHealth apps among older adults. In addition, the IT security and accurate interpretation of participants' input in an mHealth app can present barriers to mHealth app adoption. Conclusion Our analyses provide additional insights complementing existing technology adoption research. Their successful adoption and utilisation require further empirical evidence on its effectiveness along with attention to the voices of those who are meant to use them. To address potential barriers, improve the quality and security of mHealth apps, and thus achieve greater patient safety, the involvement of consumers, regulators and health professionals is necessary.

Use of Mobile Health Applications by Lay Users in Kuwait

Aim/Purpose: This study aims to explore the use of mobile health applications (mHealth apps) by lay users in Kuwait. Specifically, it seeks to: (i) identify and highlight the impact of factors that contribute to their use of mHealth apps and (ii) validate a model of these users’ usage of mHealth apps. Background: The advancement of information technologies has paved the way for efficiency and effectiveness in healthcare sectors in developed countries. Kuwait has attempted to revolutionise healthcare systems through mobile applications of information technology solutions to educate users on better methods of receiving customised health services. However, end-user usage of mHealth apps remains in the infancy in developing countries, including Kuwait. Lay users are often vulnerable and frequently overlooked by researchers and health technology providers. Methodology: A cross-sectional study was conducted among 225 lay users of mHealth apps in Kuwait using an online questionnaire to achieve the study objectives. A purposive sampling method utilising convenience and snowballing sampling techniques was used in which all the respondents were lay users. Descriptive statistics, Pearson correlation, and regression analyses were employed to analyse the collected data. Contribution: The study contributes to the extant literature on health informatics and mHealth by providing a comprehensive understanding of how technological, social, and functional factors are related to mHealth apps in the context of developing countries. It identifies key drivers of mHealth app use, suggests expanding the TAM model, and facilitates comparisons with developed countries, addressing gaps in mHealth research. Findings: Four factors (i.e., perceived trust (PT), perceived ease of use (PEU) and behaviour control (PBC), perceived usefulness (PU), and subjective norms (SN)) were identified that influence the use of mHealth apps. These four identified factors also contributed to lay users’ use of these mHealth apps. Among these four factors, perceived trust (PT) was the main contributor to lay users’ use of these mHealth apps. Recommendations for Practitioners: Based on the empirical results, this study provides feasible recommendations for the government, healthcare providers, and developers of mHealth apps. The findings urge developers to enhance app functionality by prioritising privacy and security to build user trust while outlining guidelines for future development focused on user-centric design and compliance with data privacy regulations. Additionally, the government should establish supportive policies and funding, ensure regulatory oversight, and promote public awareness to foster trust. Healthcare providers should integrate mHealth apps into their services, train staff for practical use, gather users’ feedback, and collaborate with developers to create tailored healthcare solutions. Future Research: Additional research is required to apply probability sampling techniques and increase the sample size to generate more reliable and generalisable findings. Additionally, the young age segment must be considered here, and research must be extended to consider the moderating role of demographic factors like age, gender, and educational levels to better understand the adoption of mHealth apps.

A mHealth application for the training of caregivers of children with developmental disorders in South Africa: rationale and initial piloting.

Evidence-based mobile health (mHealth) interventions have been successful for an array of physical and mental health conditions. Children with developmental disorders (DD) often have secondary speech and language disorders. The lack of high-quality medical and educational services in low- and middle-income countries limits the opportunities for children with DD to succeed in life. South Africa currently offers limited access to education, social, and health services. Twelve caregivers of twelve children with DD between the ages of 3 and 6 years who already received monthly early childhood therapy participated in this study. A mHealth app, called Nna'Le'wena, a Setswana phrase meaning "Me and You", was designed, developed, installed, and tested on tablets. The app provided a systematic framework and guidance to the caregivers in order to use evidence-based communication interaction strategies with the children over a twelve-week period. The app could be used offline and provided audio instructions in English and Setswana, two dominant languages in South Africa. The app automatically generated log files and collected answers to weekly surveys. At the end of the study, caregivers were asked to evaluate the app by using relevant portions of the Mobile App Rating Scale (MARS). Caregivers were able to successfully interact and use the app. The app was well-received and liked by the caregivers. Caregivers listened to the instructional audios in English and Setswana during the 12-week period. They were able to provide communication opportunities to their children during daily living activities, especially during play- and mealtime activities. The Nna'Le'wena app was successfully deployed and used by caregivers of children with DD. mHealth solutions can be effective and are relatively affordable solutions that can enhance health care and educational delivery in different settings, including in low-and middle-income countries with limited Internet capabilities.

Exploring Family Caregivers' Likelihood of Adopting a Novel App That Connects Care Teams of Persons Living With Dementia: A Mixed-Methods Study.

Family caregivers of persons living with dementia (PLWD) are often expected to coordinate and manage all aspects of a loved one's day-to-day care across settings with limited modern, user-friendly resources to support them. We developed CareMOBI, a mHealth app prototype that aims to support improved care coordination and communication between care team members. A concurrent mixed-methods triangulation design was used to assess the acceptability and likelihood of adopting CareMOBI among family caregivers of PLWD. Caregivers (n = 13) completed the Technology Acceptance Model questionnaire (quantitative) and semi-structured interviews (qualitative). Integration occurred using the four themes of the Technology Acceptance Model. There was strong agreement among family caregivers that CareMOBI had a high perceived value for care (M = 6.23/7), was easy to use (M = 6.20/7), and enhanced current workflows (M = 5.86/7). However, training in utilizing mHealth apps and the need for a Spanish-language version were cited as necessary enhancements to increase the widespread adoption of CareMOBI.

MHealth App to improve medication adherence among older adult stroke survivors: Development and usability study.

Effective medication adherence is vital for older adult stroke survivors, yet 20-33% cease treatment within a year post-discharge, increasing risks of recurrent strokes and mortality. A mobile health (mHealth) app could be a novel tool to improve medication adherence among stroke survivors because of its potential to increase patient empowerment. A few stroke-related apps provide information and support to stroke survivors. However, none have focused on medication adherence and documented their development and evaluation process, particularly those focused on this older population. This study aims to design and develop a smartphone app called OASapp to improve medication adherence among older adult stroke survivors and evaluate its usability. OASapp was developed in a three-phase development process. Phase 1 is the exploration phase (including a cross-sectional survey, a systematic review, a search for stroke apps on the app stores of Apple App Store and Google Play Store, and a nominal group technique). In phase 2, a prototype was designed based on the Health Belief Model and Technology Acceptance Model. In phase 3, Alpha and Beta testing was conducted to validate the app. Twenty-five features for inclusion in the app were collected in round one, and 14 features remained and were ranked by the participants during nominal group technique. OASapp included five core components (medication management, risk factor management, health information, communication, and stroke map). Users of OASapp were satisfied based on reports from Alpha and Beta testing. The mean Usability Metric for User Experience (UMUX) score was 71.4 points (SD 14.6 points). OASapp was successfully developed using comprehensive, robust, and theory-based methods and was found to be highly accepted by users. Further research is needed to establish the clinical efficacy of the app so that it can be utilized to improve clinically relevant outcomes.

Development of an epilepsy self-management mobile health app framework: Content validity study results.

Mobile health (mHealth) applications (apps) show promise in supporting epilepsy self-management (eSM). To delve deeper into this potential, we conducted a systematic review of epilepsy mHealth apps available on both iOS and Android platforms, examining articles related to eSM. This review allowed us to identify important domains related to eSM. Furthermore, based on the findings, we developed an epilepsy mHealth app framework that aims to improve self-management for the local population. This study aims to assess the practicality and usability of the proposed mHealth app framework designed to improve eSM. We will conduct an expert panel review to evaluate the effectiveness and feasibility of the framework. Content validity was assessed by an expert panel comprising epileptologists and pharmacists. The validation process involved scoring the items within each domain of the framework to evaluate their practicality and usability (quantitative component). In addition, a panel discussion was conducted to further explore and discuss the qualitative aspects of the items. A total of 4 domains with 15 items were highly rated for their practicality and usefulness in eSM. The locally validated framework will be useful for developing eSM mobile apps. Seizure Tracking, Medication Adherence, Treatment Management, and Healthcare Communication emerged as the most crucial domains for enhancing eSM.

Naturalistic Evaluation of HeadGear: A Smartphone App to Reduce Depressive Symptoms in Workers

Mobile health (mHealth) apps have the potential to expand access to evidence-based interventions for mental health conditions, including depression. HeadGear was developed to prevent depression and improve well-being among the working population and was associated with significant positive effects in an efficacy trial. This study presents the results from a naturalistic trial intended to evaluate real-world usage of the app. We examined the naturalistic use of HeadGear between March 2019 and March 2022, using app analytic data, in-app event data, and surveys assessing depressive symptoms, well-being, and work performance repeated at 30-day intervals over 5-month app usage. During the observation period, HeadGear was widely disseminated to the public, and downloaded 26,455 times. Of those who downloaded the app, 12,995 completed baseline. The mean age of users was 38.23 (SD = 12.39) and 60% were women. Approximately one in four met criteria for probable depression at baseline. Depressive symptoms showed consistent improvement at all time points (Cohen’s d ranging from 0.24 at 1 month to 0.13 at 5 months). A similar pattern emerged for well-being. Work performance showed improvement to 2-month follow-up only. The strongest change was found for those with greater symptom severity at baseline, and those with high app engagement. Attrition at follow-up points was high. Findings regarding the real-world use of HeadGear are promising and highlight the use of such apps among those with higher symptom severity (despite the intended use of the app as a prevention tool). Further work is required to tailor mHealth apps to reach their full potential through an enhanced understanding of the utility of individual features for effectiveness and engagement.

Embedding artificial intelligence in healthcare: An ethnographic exploration of an AI-based mHealth app through the lens of legitimacy

Purpose Skin cancer, a significant global health problem, imposes financial and workload burdens on the Dutch healthcare system. Artificial intelligence (AI) for diagnostic augmentation has gained momentum in dermatology, but despite significant research on adoption, acceptance, and implementation, we lack a holistic understanding of why technologies (do not) become embedded in the healthcare system. This study utilizes the concept of legitimacy, omnipresent but underexplored in health technology studies, to examine assumptions guiding the integration of an AI mHealth app for skin lesion cancer risk assessment in the Dutch healthcare system. Methods We conducted a 3-year ethnographic case study, using participant observation, interviews, focus groups, and document analysis to explore app integration within the Dutch healthcare system. Participants included doctors, policymakers, app users, developers, insurers, and researchers. Our analysis focused on moments of legitimacy breakdown, contrasting company narratives and healthcare-based assumptions with practices and affectively-charged experiences of professionals and app users. Results Three major kinds of legitimacy breakdowns impacted the embedding of this app: first, lack of institutional legitimacy led to informal workarounds by the company at the institutional level; second, quantification privilege impacted app influence in interactions with doctors; and third, interactive limits between users and the app contradicted expectations around ease of use and work burden alleviation. Conclusions Our results demonstrate that legitimacy is a useful lens for understanding the embedding of health technology while taking into account institutional complexity. A legitimacy lens is helpful for decision-makers and researchers because it can clarify and anticipate pain points for the integration of AI into healthcare systems.

Oh, Won’t You Stay with Me? A Literature Review on Motivational Features in MHealth Apps

Mobile apps have become a go-to solution for interventions in many health areas that aim to influence user behavior, such as physical activity or nutrition. However, many apps still fail to bind users long-term. Although research has been conducted on individual mechanisms aiming to improve long-term user adoption, such as gamification, we lack an understanding of different approaches at the time of this research. Thus, in this research, we investigate different approaches and persuasive technology that aim to keep the users’ engagement with the app in use. Therefore, this study reviews existing literature and tries to identify how motivational mechanisms can be successfully implemented. In the course of this, identify 14 major motivational mechanisms to increase long-term user adoption of mobile apps. Based on these insights, we want to give advice on how to improve their impact through combination as well as give advice on future implementation.

Preferences, Acceptability and Usage of Mobile Health Applications Among Undergraduate Nursing Students: A Multisite, Cross-Sectional Survey.

Mobile health applications (mHealth) can bring revolutionary changes to health care by making it more accessible, cost-effective, and efficient. The successful adoption of mHealth is largely determined by its acceptance by providers and end users. The acceptance of mHealth among nursing students, who are the future nurses, needs to be understood. This study aimed to determine the preferences, acceptability, and usage of mHealth applications among undergraduate nursing students. A descriptive cross-sectional study was conducted in two selected universities in southern and northern India. A convenience sample of 567 undergraduate nursing students was recruited for the study. The data were collected using a structured questionnaire via Google Forms. mHealth applications were presently used by 32.9% of the students. The most common types of mHealth applications used were diet related (27.6%) and lifestyle related (23.4%). The majority of nursing students were willing to use mobile phones for consulting health professionals (78.8%) for prevention and management of health and disease. (83.1%), and for emergencies (73.3%). While more than half of the students were willing to recommend mHealth applications for patients, those students who were using two or more mHealth apps were more likely to recommend the same for the patients. The results of the study highlight about the usage of mobile health applications among the nursing students. The students consider mHealth applications to be useful for delivering health-related services to end users. The study underscores the need to sensitize students about the possible usage of mHealth in healthcare delivery.

An Integrated Framework for Regulating OCD using Holistic Therapy in Indian Youth

This paper aims to propose a conceptual regulation system for Obsessive-compulsive Disorder (OCD) plaguing the younger generation, especially women. Two percent people are affected by OCD globally, while 0.8% people are affected in India. The symptoms can manifest in different forms and can be categorised into four main clusters, namely, a) Checking, b) Mental Contamination, c) Symmetry and order, and d) Obsessions. An OCD diagnostic quiz is conducted for 38 patients of age group 21-25, and the results are analysed. Based on these surveys and four interviews, a framework for OCD regulation is proposed. To deploy this framework, a conceptual solution comprising a mHealth application and a smart health tracker is developed. The mHealth app features e-diagnostics, gamification, AI-based personalisation, and support groups. The smart health tracker has multiple sensors including heartrate sensor, blood pulse monitor, skin temperature sensor, moisture sensor, and so on. This system also focuses on implementing key aspects of Exposure and response prevention therapy (ERP), Cognitive behavioural therapy (CBT) and music therapy. The goal is to reduce the dependence on Selective serotonin reuptake inhibitors (SSRI) by providing holistic and behavioural therapy. In the future, metaverse based games, and AR/VR could also be integrated in the proposed framework, to provide deeper insights and more personalised sustainable solutions.

Factors associated with usability of the EMPOWER-SUSTAIN Self-management mobile app© among individuals with cardiovascular risk factors in primary care.

This study aimed to determine the usability of the EMPOWER-SUSTAIN Self-Management Mobile App© and evaluate the factors associated with its usability among patients with cardiovascular risk factors in primary care. This was a cross-sectional study, conducted among patients aged ≥ 18 years with cardiovascular risk factors attending a university primary care clinic. Patients were given the app to use for at least three months. Those who fulfilled the eligibility criteria were recruited. Data gathered were on sociodemographic, clinical characteristics, self-management support by doctors, utilisation of the app at home and social support in using the app. The previously translated and validated Malay version of the mHealth App Usability Questionnaire was used to measure usability. The mean usability score was calculated and linear regressions analysis was conducted to determine the factors associated with the usability of the app. A total of 247 patients with at least one cardiovascular risk factor(s) were recruited. The mean age was 60.2 (±8.2). The majority were Malays (86.2%) and half of them were males (52.2%). The total mean (±SD) usability score was 5.26 (±0.67) indicating a high usability of the app. Usability of the app declined with increasing age in the simple linear regressions analysis. The multiple linear regressions yielded that being Malay (b = 0.31, 95% CI 0.08,0.54), using the app at home to understand their medications (b = 0.33, 95% CI 0.12,0.53) and having social support from family members and friends (b = 0.28, 95% CI 0.07,0.49) were significantly associated with higher usability of the app. The usability of the EMPOWER-SUSTAIN Self-Management Mobile App© was high among patients with cardiovascular risk factors in our primary care clinic. This finding supports the widespread use of this app among our patients. Involvement of family members and friends should be encouraged to improve the usability of the app.

A mixed-methods examination of the acceptability of, CareMOBI, a dementia-focused mhealth app, among primary care providers.

CareMOBI (mhealth for Organization to Bolster Interconnectedness) is a user-centered mobile application that supports secure communication between adult day health centers, primary care providers, and family caregivers. The aim of this study was to examine the acceptability of CareMOBI in the primary care setting and identify factors contributing to the likelihood of adoption among primary care providers. We used a mixed-methods concurrent triangulation design. We, first, collected quantitative data using the Technology Acceptance Model questionnaire. Follow-up interview questions allowed participants to elaborate on their experience interacting with CareMOBI. We developed an informational matrix based on major themes within the Technology Acceptance Model (ease of use, value in clinical care, fit within existing workflows, and likelihood of adoption) in which qualitative data were embedded and compared. Our sample included 10 primary care providers. Participants rated CareMOBI high in ease of use (M = 6.71 out of 7), value in clinical care (M = 6.79), and likelihood of adoption (M = 6.71). They found specific functions of CareMOBI helpful, including the summary of health progress and the patient profile. In contrast, participants reported the lowest score for the fit of CareMOBI within existing workflows (M = 5.52). Qualitative feedback attributed this score to concerns over the lack of interoperability between CareMOBI in its current form and electronic health record systems used in the primary care setting. Providers found CareMOBI valuable and easy to use, and there was a high likelihood of eventual adoption. However, apprehensions regarding workflow and electronic health records integration arose, which the team will have to consider as they move forward to the next phase of the application's development.

Ni-kshay SETU, a Digital Health Intervention for Capacity Building in Tuberculosis under the National TB Elimination Program in India: A comprehensive mHealth app review

This mHealth application review explores the evolution, design, and impact of Ni-kshay SETU, a digital health intervention tailored for India's National Tuberculosis Elimination Program (NTEP). Faced with escalating TB incidences, the NTEP prioritized capacity-building, leading to the conception of Ni-kshay SETU. This review describes the narrative of Ni-kshay SETU's concept from the beginning to the present day. It starts with the National Strategic Plan 2017–25, which says that capacity building of health care workers is important for reduction of tuberculosis morbidity and mortality by 2025. The digital platform materialized as a web app with Android and iOS versions, constituting a user-friendly interface. The app, embodying a ready reckoner and decision-making tool, offers cadre-specific modules in local languages, promoting ease of comprehension and applicability. The app's development, rooted in a consultative process, aligns with the nuanced needs of healthcare personnel across various geographies and cadres. With more than 40,400 subscribers and 1,450,000 visits, Ni-kshay SETU serves as a notable example of digital health intervention, providing a comprehensive and context-aware approach to TB care. However, it's important to acknowledge the limitations of Ni-kshay SETU. While the app aims to address various challenges in TB care, its effectiveness is contingent on factors such as digital literacy and access to smartphones. Additionally, the app's success relies on consistent updates and continuous user engagement for its usage, posing potential challenges in sustaining the momentum. In summary, Ni-kshay SETU is not just a tool for building capacity but also acts as a driver for affordable digital solutions in areas with limited resources, aiming to strengthen healthcare systems on the path to eliminating TB.

Preferences in the Willingness to Download an mHealth App: Discrete Choice Experimental Study in Spain, Germany, and the Netherlands.

Despite the worldwide growth in mobile health (mHealth) tools and the possible benefits for both patients and health care providers, the adoption of mHealth is low, and only a limited number of studies have examined the intention to download mHealth apps. In this study, we investigated individuals' preferences in the adoption of a health app. We conducted a discrete choice experimental study in 3 countries (Spain: n=800, Germany: n=800, and the Netherlands: n=416) with 4 different attributes and levels (ie, price: €1.99 vs €4.99 [a currency exchange rate of €1=US $1.09 is applicable] vs for free, data protection: data protection vs no information, recommendation: patients' association vs doctors, and manufacturer: medical association vs pharmaceutical company). Participants were randomly assigned. For the analyses, we used the conditional logistic model separately for each country. The results showed that price and data protection were considered important factors that significantly increased the probability to download an mHealth app. In general, the source of the recommendation and the manufacturer affected the probability to download the mHealth app less. However, in Germany and the Netherlands, we found that if the app was manufactured by a pharmaceutical company, the probability to download the mHealth app decreased. mHealth tools are highly promising to reduce health care costs and increase the effectiveness of traditional health interventions and therapies. Improving data protection, reducing costs, and creating sound business models are the major driving forces to increase the adoption of mHealth apps in the future. It is thereby essential to create trustworthy standards for mobile apps, whereby prices, legislation concerning data protection, and health professionals can have a leading role to inform the potential consumers.

MHealth Technology Experiences of Middle-Aged and Older Individuals With Visual Impairments: Cross-Sectional Interview Study.

Current mobile health (mHealth) technology is predominantly designed with a visual orientation, often resulting in user interfaces that are inaccessible to visually impaired users. While mHealth technology offers potential for facilitating chronic illness management and enhancing health behaviors among visually impaired older populations, understanding its usage remains limited. This qualitative research aimed to explore the mHealth technology experiences of middle-aged and older individuals with visual impairments including the accessibility and usability issues they faced. The qualitative exploration was structured using the mHealth for Older Users framework. Cross-sectional interviews were conducted via Zoom between June 1 and July 31, 2023, using an interview protocol for data collection. A thematic analysis approach was employed to analyze the transcribed interview scripts. Of the 7 participants who took part in the Zoom interviews, 3 were men and 4 were women, with ages ranging from 53 to 70 years. Most participants adopted mHealth apps and wearable devices for promoting health. They exhibited 3 distinct adoption patterns. Seven themes were emerged from the perceived challenges in using mHealth technologies: (1) a scarcity of accessible user manuals, (2) user interfaces that are not visually impaired-friendly, (3) health data visualizations that are not accessible, (4) unintuitive arrangement of app content, (5) health information that is challenging to comprehend, (6) cognitive overload caused by an excess of audible information, and (7) skepticism regarding the accuracy of health records. mHealth technologies seem to positively affect the health and health management of participants. Design considerations for mHealth technologies should consider individuals' disabilities and chronic conditions and should emphasize the importance of providing accessible manuals and training opportunities when introducing new mHealth solutions.

Decolonizing mHealth Technology for User Empowerment and Persuasion in the Global South Healthcare Context: A Case Study

ABSTRACT This article explores the extent to which Global North mHealth apps are designed for user empowerment and persuasion in the Global South healthcare context. Findings from a case study underscore the need for decolonizing digital technology to promote more inclusive and equitable access to the digital ecosystem. The article suggests that deploying rhetorically nuanced, justice-driven decolonial design approaches can help stamp out digital colonialism and build a just future by bridging the North-South divide.

A Novel Smartphone App for Self-Monitoring of Neonatal Jaundice Among Postpartum Mothers: Qualitative Research Study.

Neonatal jaundice (NNJ) or hyperbilirubinemia is a ubiquitous condition in newborn infants. Currently, the transcutaneous bilirubinometer is used to screen for NNJ in health care facilities, where neonates need to be physically present (ie, a centralized model of care for NNJ screening). Mobile health (mHealth) apps present a low-cost, home-based, and noninvasive system that could facilitate self-monitoring of NNJ and could allow mothers the convenience of screening for NNJ remotely. However, end users' acceptability of such mHealth apps is of fundamental importance before the incorporation of such apps into clinical practice. The study aimed to explore the perception of postpartum mothers toward self-monitoring of NNJ using a novel mHealth app. Mothers attending video consultations for early postpartum care at 2 Singapore primary care clinics watched an instructional video for a hyperbilirubinemia-screening mHealth app (HSMA). An independent researcher used a semistructured topic guide to conduct in-depth interviews with 25 mothers, assessing their views on HSMAs. All interviews were audio recorded, transcribed verbatim, and checked for accuracy before data analysis. Two researchers independently analyzed the transcripts via thematic analysis. Data were managed using NVivo qualitative data management software. The identified themes were grouped under perceived usability and utility. Mothers valued the convenience and utility of HSMAs for remote monitoring of NNJ. They appreciated the objectivity the app readings provided compared to visual inspection. However, they perceived that the app's applicability would be restricted to severe jaundice, were concerned about its accuracy and restriction to the English language, and lacked confidence in using it. Nevertheless, they were willing to use it once its accuracy was proven and when they received adequate guidance from health care professionals. They also suggested including an action plan for the measured readings and clinical signs within the app. Mothers proposed pairing teleconsultations with HSMAs to boost their confidence and enhance adoption. Mothers were receptive to using HSMAs but had concerns. Multiple languages, proof of accuracy, and resources to guide users should be incorporated into the app in the next phase to increase its successful adoption. Complementing such apps with a teleconsultation service presents a plausible and pragmatic NNJ care delivery model in general practice.

Enhancing Cognitive Performance and Monitoring through a Mobile App: Insights from the Rodi Study

The prevalence of neurocognitive disorders has led to increased interest in mobile health applications (mHealth apps) for detection and training. However, there’s a need for apps that integrate comprehensive cognitive training, assessment, and monitoring in personalized contexts. The RODI app was meticulously developed with the objective of catering to individuals with deficits as well as healthy adults. In this study, 11 participants without diagnosed impairments used the app twice weekly for eight weeks. Results show a consistent enhancement in cognitive performance within the app over time. Notably, a discernible divergence is observed, with the rate of improvement appearing to be comparatively slower in the younger age group in contrast to their older counterparts. Furthermore, the study assesses the reliability of the application using the intraclass correlation coefficient (ICC), confirming its consistent performance across repeated administrations. Finally, the app’s capacity to monitor participants’ cognitive status across various domains is investigated, unveiling controlled variations that indicate foreseeable outcomes within defined parameters. These findings underscore RODI’s potential for cognitive enhancement and monitoring, offering insights into user needs and the broader significance of mobile app interventions for cognitive well-being and future research in this field.

EVALUATING MHEALTH APPLICATIONS FOR OLDER ADULTS WITH DIABETES: SYSTEMATIC META-ANALYSIS OF CLINICAL TRIALS

Abstract Diabetes is a common chronic condition among older adults and health technology interventions for diabetes management have the potential to support their self-management. However there is no systematic review and meta-analysis of the effects of mobile health applications (mHealth apps) for older adults. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to examine the effectiveness of mHealth apps for improving older adults’ diabetes outcomes. We searched the EBSCO, Clinical Trials, Cochrane Library, ProQuest, PubMed, ScienceDirect, Scopus, and Web of Science databases for relevant studies. We retrieved 4247 papers and two reviewers completed a full screen review of 257. We excluded papers if the study was not a RCT, did not examine the effect of mHealth apps, or was not conducted with older adults, resulting in 7 papers included in the final analysis. Our results indicate that mHealth apps can be effective for older adults managing diabetes, with significant reductions in glycated hemoglobin (HbA1C) (Hedge’s g: -0.40, 95% CI [-0.75 to -0.06]), and fasting blood sugar (FBS) levels (g: -0.29, 95% CI [-1.52 to 0.42]), as well as improvements in medication adherence (g: 0.93, 95% CI [0.53 to 1.28]). These effect sizes are comparable with other meta-analysis conducted across different aging groups. We describe each intervention and evaluate the risk of bias and the app components that could relate to effectiveness to inform the design of other diabetes management RCTs, and more broadly, the design of other mHealth tools for older adults. Pre-registration: http://doi.org/10.17605/OSF.IO/AWVCX