mHealth Technology Research Articles

Patient-Centered mHealth Intervention to Improve Self-Care in Patients With Chronic Heart Failure: Phase 1 Randomized Controlled Trial

Background Heart failure (HF) is one of the most common causes of hospital readmission in the United States. These hospitalizations are often driven by insufficient self-care. Commercial mobile health (mHealth) technologies, such as consumer-grade apps and wearable devices, offer opportunities for improving HF self-care, but their efficacy remains largely underexplored. Objective The objective of this study was to examine the feasibility, acceptability, safety, and preliminary efficacy of a patient-centered mHealth intervention (iCardia4HF) that integrates 3 consumer mHealth apps and devices (Heart Failure Health Storylines, Fitbit, and Withings) with a program of individually tailored SMS text messages to improve HF self-care. Methods We conducted a phase 1 randomized controlled trial. Eligible patients had stage C HF, were aged ≥40 years, and had New York Heart Association (NYHA) class I, II, or III HF. Patients were randomly assigned to either iCardia4HF plus usual care or to usual care only and were observed for 8 weeks. Key feasibility measures were recruitment and retention rates. The primary efficacy outcome was change in HF self-care subscale scores (maintenance, symptom perception, and self-care management) at 8 weeks, assessed with the Self-Care Heart Failure Index (SCHFI; version 7.2). Key secondary outcomes were modifiable behaviors targeted by the intervention (health beliefs, self-efficacy, and HF knowledge), health status, and adherence to daily self-monitoring of 2 core vital signs (body weight and blood pressure). Results A total of 27 patients were enrolled in the study and randomly assigned to iCardia4HF (n=13, 48%) or usual care (n=14, 52%). Of these 27 patients, 11 (41%) in the intervention group (iCardia4HF) and 14 (52%) in the usual care group started their assigned care and were included in the full analysis. Patients’ mean age was 56 (SD 8.3) years, 44% (11/25) were female, 92% (23/25) self-reported race as Black, 76% (19/25) had NYHA class II or III HF, and 60% (15/25) had HF with reduced left ventricular ejection fraction. Participant retention, completion of study visits, and adherence to using the mHealth apps and devices for daily self-monitoring were high (>80%). At 8 weeks, the mean group differences in changes in the SCHFI subscale scores favored the intervention over the control group: maintenance (Cohen d=0.19, 95% CI –0.65 to 1.02), symptom perception (Cohen d=0.33, 95% CI –0.51 to 1.17), and self-care management (Cohen d=0.25, 95% CI –0.55 to 1.04). The greatest improvements in terms of effect size were observed in self-efficacy (Cohen d=0.68) and health beliefs about medication adherence (Cohen d=0.63) and self-monitoring adherence (Cohen d=0.94). There were no adverse events due to the intervention. Conclusions iCardia4HF was found to be feasible, acceptable, and safe. A larger trial with a longer follow-up duration is warranted to examine its efficacy among patients with HF. Trial Registration ClinicalTrials.gov NCT03642275; https://clinicaltrials.gov/study/NCT03642275

Effectiveness of Mobile Health Applications for Cardiometabolic Risk Reduction in Urban and Rural India: A Pilot, Randomized Controlled Study.

mHealth technology has the potential to deliver personalized health care; however, data on cardiometabolic risk factors are limited. This study aims to assess the effectiveness of mobile health applications (apps) on cardiometabolic risk factor reduction in adults aged 25 to 60 years in urban and rural India. The study design was a pilot randomized controlled trial conducted in Tamil Nadu, India. Smartphone users (25-60 years) with basic literacy and at high risk of developing diabetes (Indian Diabetes Risk Score ≥30 and/or fasting blood sugar [FBS] 100-125 mg/dL) were recruited. Four mobile apps (two commercially available, two novel) for cardiometabolic risk reduction were evaluated. Primary outcome (weight loss) was analyzed using intention-to-treat analysis with post hoc analysis and logistic regression models adjusted for confounders. A total of 5264 participants were screened, and 610 were recruited into the study. Participants (7%) dropped out largely due to the COVID-19 pandemic. Data from 567 participants were used for the final analysis. In the intention-to-treat analysis, a significant reduction in body weight was observed in the intervention group as compared with control, more so in the urban (-2.40 kg, 95% confidence interval [CI] = [-3.10, -1.69], P < .001) compared with rural population (-1.19 kg, 95% CI = [-1.55, -0.82], P < .001). Intervention group participants showed significant reductions in body mass index, waist circumference, blood pressure, FBS, total serum cholesterol, and a positive effect on dietary and physical activity behaviors compared with controls. mHealth interventions can reduce diabetes risk, improve cardiometabolic health, and improve lifestyle behaviors in South Asian populations. The trial is registered with the Central Trials Registry, India (CTRI/2020/03/024327).

Mobile health in communication disorders: willingness to use, attitude, advantages, and challenges from the perspective of patients

IntroductionCommunication disorders are one of the most common disorders that, if not treated in childhood, can cause many social, educational, and psychological problems in adulthood. One of the technologies that can be helpful in these disorders is mobile health (m-Health) technology. This study aims to examine the attitude and willingness to use this technology and compare the advantages and challenges of this technology and face-to-face treatment from the perspective of patients.MethodsThis descriptive study was conducted with a researcher-made questionnaire and investigated the willingness and attitude of patients with communication disorders to use mobile health technology. The face and content validity of the questionnaire were examined with the help of experts in speech therapy, health information management, and medical informatics. Chi-square, Fisher's exact test, and the Kruskal–Wallis test were used to analyze the relationship between variables. Also, the challenges and advantages of mobile health technology and face-to-face treatment were extracted from the patient's answers and presented in the form of main themes and sub-themes.ResultsOne hundred seventy patients participated in this study. The results of this study showed that 57 (33.5%) participants preferred face-to-face visits, 11 (6.5%) preferred m-Health, and 102 (60.0%) preferred the combination of mobile applications and the face-to-face visits method. The results showed a statistically significant relationship between "Residence (rural or urban)", "Having trouble traveling to speech therapy centers", and "Delaying treatment due to lack of access to speech therapists" with treatment methods (face-to-face, mobile health, face to face and mobile health). Accessibility and convenience, treatment efficacy and variety, patient empowerment and confidence, family involvement and support, cost and time efficiency, treatment adherence and completion, and comfort and lifestyle compatibility were six categories related to the advantages of mobile health technology from the point of view of patients with communication disorders. Also, technological challenges, effectiveness and quality concerns, patient experience and engagement, and trust and confidence issues were mobile health challenges from the patients' point of view.ConclusionThe results of this study showed that patients tend to use both face-to-face interactions and mobile health. Integrating both m-Health and traditional methods can optimize speech therapy outcomes. Addressing challenges such as inadequate technological infrastructure and data security is crucial for successful implementation.

Health-promoting lifestyle mediates the relationship between mHealth technology acceptance and cognitive function in older adults with chronic diseases.

This study used a cross-sectional design to investigate the mediating role of a health-promoting lifestyle on mobile health technology acceptance and cognitive function. A total of 219 older adults, age 65 years or older, with diagnosed chronic diseases, were recruited from a northern Taiwan community. Participants completed questionnaires including demographic characteristics, the Senior Technology Acceptance Scale, the Health Promoting Lifestyle Profile Scale, and the Montreal Cognitive Assessment. Mediation analysis was conducted using the PROCESS macro. After controlling for demographic factors, health-promoting lifestyle proved to be a full mediator of mobile health technology acceptance and cognitive function. The results indicate that interventions to maintain or improve cognitive function in older adults with chronic diseases who are living in the community should also encourage the acceptance of mobile health technology and adoption of health-promoting lifestyle.

Self-Management Support Apps for Spinal Cord Injury: Results of a Systematic Search in App Stores and Mobile App Rating Scale Evaluation.

The use of mobile technology to meet health needs, widely referred to as mobile health (mHealth), has played a critical role in providing self-management support for chronic health conditions. However, despite its potential benefits, mHealth technologies such as self-management support apps for spinal cord injury (SCI) have received little research attention, and an understanding of their public availability is lacking. Therefore, an overview of these apps is needed to complement findings from the literature for a complete understanding of mHealth self-management support tools for SCI to support the selection and improvement of existing apps and the development of new ones. This study aimed to identify and describe quantity, quality, focus, strengths, and weaknesses of self-management support apps for SCI available on major mobile app digital distribution platforms. A systematic search of the Google Play Store and Apple App Store was conducted to identify and summarize apps for SCI that have been updated since 2017. A supplementary systematic literature review was conducted across 11 bibliographic databases to identify publications that provided more detailed descriptions of the identified apps than what is typically available in app stores. The data synthesis was guided by self-management tasks and skills taxonomies. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines informed the reporting. The 13 apps included in the final synthesis were launched between 2013 and 2021, mostly originating in the United States, with availability in 72 countries and support for 14 languages. Most apps used the Android operating system (10/13, 77%), while 31% (4/13) used iOS. The identified apps mainly focused on activities of daily living, physical activity promotion, health literacy, and therapeutic exercise. All 3 self-management tasks (medical, role, and emotional management) and most self-management skills and support activities were supported by the apps. The mean Mobile App Rating Scale score was 3.86 (SD 0.54), indicating good overall quality. No publications were found describing these apps. Despite their good overall quality, as measured by the Mobile App Rating Scale assessment, the 13 identified apps, alone or combined, do not appear to offer a comprehensive self-management approach that incorporates theory-based strategies. Besides working to improve comprehensiveness, future research and practice should consider adopting new technologies, such as artificial intelligence, to enhance future self-management support apps for SCI. Furthermore, adopting new app development methods, such as low-code development platforms, could help reduce barriers to development, such as time, cost, and securing scarce expertise.

Effectiveness of Self-Care Teaching Media for Pregnant Women and Pregnant Women with Hypertension

Complications that occur during pregnancy are one of the causes of high maternal mortality, but these complications can be treated and prevented. Proper care before giving birth and adequate antenatal care can be supported by the presence of teaching media for pregnant women, including pregnant women with hypertension. Teaching media is effective in improving knowledge and self-care skills and helping understand pregnant women and pregnant women with hypertension. The small number of study articles on teaching media for self-care for pregnant women and pregnant women with hypertension made researchers interested in conducting a literature review on this topic. This study aims to determine the effectiveness of teaching media for self-care for pregnant women and pregnant women with hypertension. This research method is a literature review with a narrative review design. A comprehensive literature search was conducted using electronic databases, namely Pubmed, CINAHL, and Google Scholar. The author obtained 24 articles that were based on the research objectives. The results of the study, the teaching media used in self-care for pregnant women and pregnant women with hypertension are educational modules, power points, booklets, videos, animated videos, pamphlets, m-Health technology, mobile applications, social networks such as WhatsApp, Telegram, and Instagram. In conclusion, self-care teaching media can improve self-care in pregnant women, including pregnant women with hypertension because the teaching media is adjusted to the needs of pregnant women, the material is for self-care, the language is easy to understand, and the media used is interesting.

Training and Support Practices and Insights in the Sustainability of mHealth Implementations in Sub-Saharan Africa

We conducted an interview-based study to understand the training and support practices and insights that influence sustainable implementations of mHealth projects of varying mHealth technologies. The qualitative assessment was inspired by the Consolidated Framework for Implementation Research adapted with the recommended questions for guiding the implementation of training programs. Participants in the study (N=16) were both international and in-country researchers managing projects in Sub-Saharan Africa. We chose to focus on training and support as it is often the interface between international and in-country components of these projects. Participants agreed on the central role of training in the implementation of mHealth projects and are following best practices. There was often a division in the responsibility of training between international and in-country researchers reflecting the distinction between project management and local implementation adaptions. One of the main findings is the importance of individualized continuous retraining to make deployments robust with respect to changing conditions with technology and personnel, an aspect that has been managed a bit differently with varying mHealth technologies as we present.

A SCOPING REVIEW OF MHEALTH TECHNOLOGIES FOR PATIENTS UNDERGOING HAEMODIALYSIS

Background: The prevalence of patients requiring haemodialysis increases annually, highlighting the need for improved quality of care. Haemodialysis care involves several key aspects, including monitoring, education, and patient connectivity. The availability of mobile health (mHealth) technology enhances the effectiveness and efficiency of patient monitoring compared to conventional methods, ultimately improving patients’ quality of life. Aims: To map the development, types, and impact of mHealth technologies on patients undergoing haemodialysis. Methods: We conducted a scoping review following the Arksey and O’Malley methodological framework. We searched PubMed, Scopus, ScienceDirect, Google Scholar, CINAHL, and Sage Journals to identify relevant studies describing integrated mobile health applications for monitoring patients with CKD undergoing haemodialysis. Two independent reviewers screened and categorised findings based on predefined synthesis questions. Eleven studies representing various mHealth technologies were included. The PRISMA-ScR guidelines for scoping reviews were followed to ensure comprehensive reporting of results. Results: Out of 1,200 papers, 11 studies representing mHealth technologies were included. Most respondents were patients, though several articles also involved healthcare providers. We map our findings into three themes: the functionality of the applications, the types and features of mHealth technologies, and their impact. Conclusion: mHealth can be implemented as web-based or application-based platforms, offering innovative solutions for monitoring, education, and enhanced connectivity between patients and healthcare providers. Keywords: mHealth, haemodialysis, quality of life, monitoring, CKD

Views and experiences of young people on using mHealth platforms for sexual and reproductive health services in rural low-and middle-income countries: A qualitative systematic review.

In low- and middle-income countries (LMICs), reproductive health programs use mobile health (mHealth) platforms to deliver a broad range of SRH information and services to young people in rural areas. However, young people's experiences of using mobile phone platforms for SRH services in the rural contexts of LMICs remains unexplored. This review qualitatively explored the experiences and perceptions of young people's use of mobile phone platforms for SRH information and services. This qualitative evidence synthesis was conducted through a systematic search of online databases: Medline, Embase, CINAHL, PsycInfo and Scopus. We included peer reviewed articles that were conducted between 2000 to 2023 and used qualitative methods. The methodological quality of papers was assessed by two authors using Grading of Recommendations, Assessment, Development and Evaluation (GRADE) and Confidence in Evidence from Reviews of Qualitative research (CERQual) approach with the identified papers synthesized using a narrative thematic analysis approach. The 26 studies included in the review were conducted in a wide range of LMIC rural settings. The studies used seven different types of mHealth platforms in providing access to SRH information and services on contraception, family planning, sexually transmitted infections (STIs) and human immunodeficiency virus (HIV) education. Participant preferences for use of SRH service platforms centred on convenience, privacy and confidentiality, as well as ease and affordability. High confidence was found in the studies preferencing text messaging, voice messaging, and interactive voice response services while moderate confidence was found in studies focused on phone calls. The overall constraint for platforms services included poor and limited network and electricity connectivity (high confidence in the study findings), limited access to mobile phones and mobile credit due to cost, influence from socio-cultural norms and beliefs and community members (moderate confidence in the study findings), language and literacy skills constraints (high confidence in the study findings). The findings provide valuable information on the preferences of mHealth platforms for accessing SRH services among young people in rural settings in LMICs and the quality of available evidence on the topic. As such, the findings have important implications for health policy makers and implementers and mHealth technology platform developers on improving services for sustainable adoption and integration in LMIC rural health system.

The impact of digital health technologies on moral responsibility: a scoping review.

Recent publications on digital health technologies highlight the importance of 'responsible' use. References to the concept of responsibility are, however, frequently made without providing clear definitions of responsibility, thus leaving room for ambiguities. Addressing these uncertainties is critical since they might lead to misunderstandings, impacting the quality and safety of healthcare delivery. Therefore, this study investigates how responsibility is interpreted in the context of using digital health technologies, including artificial intelligence (AI), telemonitoring, wearables and mobile apps. We conducted a scoping review with a systematic search in PubMed, Web of Science, Embase, CINAHL and Philosopher's Index. A total of 34 articles were included and categorized using a theoretical framework of responsibility aspects, and revealed two main findings. First, we found that digital health technologies can expand and shift existing 'role responsibilities' among caregivers, patients and technology. Second, moral responsibility is often equated with liability or accountability, without clear justification. Articles describe new ways in which physicians can be held accountable, particularly in the context of AI, and discuss the emergence of a 'responsibility gap' where no-one can be fully responsible for AI-generated outcomes. The literature also shows that m-Health technologies can increase patients' accountability for their own health. However, there was limited discussion in the reviewed literature on whether these attributions of accountability are appropriate. We conclude with implications for practice and suggestions for expanding the theoretical framework of moral responsibility, recommending further study on responsibility of collectives and artificial entities, and on the role of virtue in digital health.

Mobile Health Technologies and Their Features Affecting Medication Adherence Among Cancer Patients: A Scoping Review.

This scoping review explores mobile health (mHealth) technologies and their features affecting medication adherence in cancer patients. Among 11 selected studies, predominantly from the USA, mHealth tools, particularly smartphone apps, were examined for their features in managing cancer patient's medication adherence. The studies highlighted the importance of adherence in continuous cancer therapy, with mHealth tools offering reminders and interactive features, that aim to enhance patient engagement. However, the review identified research gaps, emphasizing the need for broader investigations into diverse mHealth tools beyond apps, including electronic capsules and smart pill dispensers. Additionally, it underscored the absence of information on costs, user input, integration with electronic health records, and data management. While acknowledging potential positive impacts on adherence, the review calls for more comprehensive research to substantiate these findings in clinical oncology.

Protocol for a co-design study for the development of a chronotherapeutic mobile health behaviour change intervention targeting light exposure among older adults

Through its wide-ranging effects on human physiology and behaviour, daily light exposure is an important environmental modulator of healthy ageing. Integrating mobile health (mHealth) technology with behaviour change strategies offers a promising approach to optimise light exposure and positively impact sleep, rest-wake cycles, cognitive function, and mood at scale. This study aims to develop the LightSPAN mHealth behaviour change intervention to optimise light exposure across the lifespan. Employing a co-design methodology, the study comprises two distinct workstreams. The first focuses on conceptualising the theoretical framework and implementation strategies through a comprehensive review of light exposure interventions, behaviour change theories, mHealth user personas, and recommendations for designing mHealth interventions for older adults. The second workstream centres on co-designing the intervention, involving consultation with community service providers and engagement with older adults at ageing community centres (≥60 years of age). Community service providers will be consulted through open-ended discussions (target n=5). Older adult participants (n=20) will engage in telephone interviews, focus group discussions and prototyping workshops to explore older adult participants’ characteristics, needs, preferences, and mHealth intervention design elements and co-design the LightSPAN mHealth behaviour change intervention. The insights generated in these co-design components will ensure that the intervention addresses the needs of its future users.

Feasibility, usability and acceptability of a lifestyle-integrated multicomponent exercise delivered via a mobile health platform in community-dwelling pre-frail older adults: a short-term, mixed-methods, prospective pilot study

BackgroundPre-frailty is a window of opportunity for frailty reversal and can be enhanced by multicomponent exercise. The Lifestyle-integrated Functional Exercise (LiFE) program may be a promising alternative to overcome traditional exercise barriers. The latest advancements in mobile health (mHealth) technology have enabled individuals to retain the advantages of supervised exercise training within group settings while providing exercise programs that can be accessed and completed at home. This study aims to assess the feasibility, acceptability, and primary efficacy of the PF-Life program, which is the Lifestyle-Integrated Functional Exercise program for Pre-Frail supported by an mHealth platform.MethodsSixteen pre-frail adults aged ≥ 65 years were recruited from five community health centers in Fuzhou, China. All participants were prescribed the PF-Life program by geriatricians using the mhealth platform (web-based portal). Participants engaged in the customized exercises program following in-app video instructions and feedback on the mhealth platform (smartphone application). Physical activity (PA) and sedentary behavior (SB) were registered daily through wearable devices. Study endpoints were feasibility (retention rate, compliance rate, adverse events), usability (system usability scale), acceptability (qualitative interviews), changes in physical function (timed up and go (TUG), handgrip strength (HGS), and 30-second chair rise tests), PA and SB.ResultsThe intervention was feasible, 88% of participants adhered completely to the study protocol, and 95% had completed at least 75% of the prescribed experimental duration. System usability was high (85 out of 100 best imaginable). Changes were observed from baseline to follow-up for total HGS (21.41 ± 6.38 vs. 24.12 ± 6.62 kg, P < 0.05, d = 0.714), TUG (8.23 ± 1.33 vs. 7.48 ± 2.01 s, P < 0.01, d = 1.647) and 30-second chair rise test (17.13 ± 4.3 vs. 20.04 ± 4.54 repetitions, P < 0.01, d = 0.94). In addition, SB decreased by a mean of 33 min/day (P < 0.01), and low physical activity increased by 31 min/day (P < 0.01). No adverse events occurred. The majority of participants found the PF-Life program to be straightforward, adaptable, and easily integrable into their daily routines.ConclusionsPreliminary studies have demonstrated that the PF-life program exhibits good compliance, safety, and usability for the pre-frail elderly population. Large-scale randomized controlled trials are required to ascertain its long-term effectiveness.

Rural-Urban Disparities in Mobile Health Application Ownership and Utilization Among Cancer Survivors.

Mobile health applications (mHealth apps) can provide health care and health-promoting information while contributing to improving cancer survivors' quality of life and health outcomes. However, little is known about the rural-urban distribution of mHealth app ownership and utilization. In this study, we explore the characteristics of cancer survivors who own and use mHealth apps and examine rural-urban disparities in mHealth app ownership and utilization among cancer survivors. We utilized data from the "Health Information National Trends Survey-Surveillance, Epidemiology, and End Results" pilot study, fielded among cancer survivors from 3 U.S. cancer registries (Iowa, New Mexico, and California) in 2021. Our sample included 942 cancer survivors who reported owning a smart device (a smartphone and/or a tablet computer). The analyses included computing weighted proportions and fitting a multivariable regression model. Overall, 60.3% of cancer survivors reported using mHealth apps, and 16.9% resided in rural areas. Approximately 45.0% of rural cancer survivors reported utilizing mHealth apps (vs 63.5% of urban survivors). Regression analysis revealed that rural cancer survivors had 46.0% lower odds of owning and using mHealth apps compared with their urban counterparts (adjusted odds ratio = 0.54; 95% CI: 0.36, 0.80). Rural cancer survivors were less likely to own and use mHealth apps compared with urban survivors. Rural cancer survivors usually face structural and health care system-related barriers to health care access and affordability. Leveraging mHealth technology as a tool could potentially contribute to improving health care delivery for rural cancer survivors, and help address existing structural and informational barriers to access.

Exploring the Needs of People With Chronic Low Back Pain and Health Care Professionals for mHealth Devices to Support Self-Managed Physical Activity and Pain: User-Centered Design Approach.

Chronic low back pain (CLBP) is a major economic and social problem worldwide. Despite the variety of recommended treatments, long-term self-management of this condition is complex and requires the development of innovative interventions. Mobile health (mHealth) technologies hold great promise for the management of chronic pain, particularly to support physical activity. However, their implementation is challenged by a lack of user compliance and limited engagement, which may be due to insufficient consideration of the needs of potential users during development. This study aims to explore the needs of people with CLBP and health care professionals regarding mHealth technologies to support self-managed physical activity, and to delineate design recommendations based on identified needs. A participatory study was conducted using a 3-phase, user-centered design approach: needs investigation with a group of experts in a workshop (phase 1), needs exploration with end users in focus groups (phase 2), and validation of needs using Delphi questionnaires followed by the development of a set of recommendations (phase 3). A total of 121 people with CLBP, expert patients, health care professionals, rehabilitation researchers, and biomechanical engineers participated in this study. The results indicated how technology could help people with CLBP overcome their difficulties with managing physical activity. Specific needs were formulated concerning device objectives, expected strategies, functionalities, technical features, conditions of use, and potential facilitators and barriers to use. These needs were validated by consensus from the potential end users and translated into design recommendations. This study provides design recommendations for the development of an mHealth device specifically adapted for people with CLBP.

Evaluating mobile health interventions for HIV patients in Nigeria: Healthcare policy implications from a simulation study

ObjectivesPeople living with HIV/AIDS (PLWHA) benefit from mobile health (mHealth) technologies through self-managing and monitoring their disease with enhanced patient experience and health outcomes. However, the efficiency and cost-effectiveness of these interventions are yet to be studied. The study aims to assess the impact of mHealth on operational and cost metrics relevant to PLWHA and HIV service delivery. Data SourcesData were a mixture of primary and secondary data from the hospital setting, experts’ opinions, reports, and the literature. MethodUsing a web-based simulation platform, SmartHIV Manager™, for the management of HIV services, we tested scenarios based on four possible reductions in the number of clinic visits and four groups of PLWHA who can be offered a mobile device free of charge (16 scenarios in total). The study was conducted in collaboration with Faith Alive Foundation Hospital (Nigeria) using a mHealth app (BSmart Chart). ResultsIn the worst-case scenario, the hospital anticipates a 14 % decrease in the number of visits from stable patients, nine fewer doctors to operate their service, and a 3 % savings in total cost after accounting for mHealth intervention expenses and mobile phone acquisition. With the service currently running at 161 % doctor capacity, this intervention alleviates staff pressure and ensures quality care. ConclusionThe study shows significant system efficiency gains, fewer visits, better health outcomes, economic benefits for stable patients, and increased capacity. These findings apply to most HIV services worldwide, especially in times of limited resources. Public Interest SummaryMobile health (mHealth) technologies support people living with HIV/AIDS by helping them manage their health and receive remote monitoring. This study examines the impact of mHealth apps on the costs and operations of HIV services. Conducted in a rural HIV setting in Nigeria, where many patients face financial challenges, the research used a simulation-based decision support tool (known as SmartHIV Manager) to test the scenario of providing free mobile devices and reducing clinic visits for stable patients. Results indicated that this approach could reduce patient visits and healthcare costs while easing the workload of overburdened doctors. Globally, introducing mHealth apps could be impactful, given the constraints of limited healthcare staff and budgets.

Remote Patient Monitoring Using Mobile Health Technology in Cancer Care and Research: Patients' Views and Preferences.

There is an increasing interest in studying the potential of mobile health (mHealth) technologies, such as smartphone apps and wearables, as monitoring tools for patients with cancer during or after their treatment. However, little research is dedicated to exploring the opinions and concerns of patients regarding the adoption of these technologies. This study aimed to gain insight into patients' perspectives and preferences for participating in mHealth-based monitoring in cancer care. A qualitative study comprising semistructured interviews was conducted in the Netherlands between April and June 2023. Participants were eligible if they were 18 years or older with a current or past diagnosis of cancer. The interview guide was developed on the basis of the technology acceptance model, with main themes being use, communication, trust, privacy, and expectations. Thirteen participants with urologic primary cancer were interviewed. Most patients had already some familiarity with the use of digital monitoring devices or wearables. Main barriers included persistent reminders of the illness, receiving notifications deemed unnecessary or unwanted, and the acknowledgment that mHealth technology does not serve as a substitute for human doctors. Conversely, patients recognized the potential for time-savings through the utilization of mHealth, viewed active monitoring as nonburdensome, considered mHealth a tool for reducing the communication threshold with their doctor, and expressed willingness to adopt such a platform if they perceived personal or societal relevance. This study has elucidated which factors are important for successful development of mHealth for patients with cancer. While both barriers and facilitators play a role, patients' attitudes were positive toward the implementation of remote digital monitoring, showing promising prospects for future research of mHealth in oncology.

MOBILE HEALTH: ECG MONITORING FOR ATRIAL FIBRILLATION DETECTION

This systematic review examines the use of mobile health (mHealth) technologies, such as smartphone apps and wearable devices, for detecting atrial fibrillation (AF). The review includes studies assessing the quality and performance of mobile apps and smartwatch algorithms, as well as the clinical validity of ECG measurement and photoplethysmography technology. Findings suggest diverse results, with some studies indicating promising sensitivity and specificity for AF detection. However, there is a need for further research to develop reliable algorithms for diagnosing and managing cardiovascular conditions using mHealth technologies.

Perspectives on barriers to traditional sources of sexual and reproductive health information and services: Are mHealth technologies the answer?

In Ghana, several qualitative studies have explored users' perspectives on conventional sources of sexual and reproductive health (SRH) information and factors which influence provision of and access in rural settings. However, there is a dearth of qualitative studies on healthcare provider (HCP) perspectives on factors that deter access to conventional sources of SRH information among young people in rural Ghana and innovative ways for addressing barriers. This study explored perspectives on barriers to traditional sources of SRH information and services and innovative ways of using mHealth technologies for addressing provision and access challenges among young people in rural Ghana. This study used a qualitative approach using in-depth interviews. Semi-structured in-depth interviews were conducted with HCPs in rural areas in three regions of Ghana between May and August 2021. Participants were selected from rural communities using the convenience snowball sampling and were interviewed via Zoom. The interviews explored the experiences and perceptions of HCPs on conventional SRH information and services and young people's access to this information and services. The interviews were audio recorded and transcribed verbatim. Data were analysed thematically using NVivo software version 12, following the approach outlined by Braun and Clarke. Twenty HCPs were interviewed for this study. The participants identified different sources of SRH information and services used by rural young people. Peers or friends, health facilities, health providers, and community settings were reported as the main services and sources of SRH information. Participants reported several barriers and challenges to the provision of and access to SRH information to young people, including socio-cultural norms, religious beliefs, unfriendly health facility environments, negative health providers' attitudes, lack of privacy and confidentiality resulting in unfriendly youth SRH services, distance, and financial challenges due to costs of transportation which limits rural young people's access to, and use of, SRH services. All the participants indicated that in addressing provision and access barriers, the use of mobile phones could be beneficial. This study highlights several barriers and challenges that deter provision of, and access to, SRH information and services for young people in rural Ghana. The findings indicate the use of innovative mobile health (mHealth) technologies may be one solution to some of the barriers and challenges.

2SpamH: A Two-Stage Pre-Processing Algorithm for Passively Sensed mHealth Data.

Recent advancements in mobile health (mHealth) technology and the ubiquity of wearable devices and smartphones have expanded a market for digital health and have emerged as innovative tools for data collection on individualized behavior. Heterogeneous levels of device usage across users and across days within a single user may result in different degrees of underestimation in passive sensing data, subsequently introducing biases if analyzed without addressing this issue. In this work, we propose an unsupervised 2-Stage Pre-processing Algorithm for Passively Sensed mHealth Data (2SpamH) algorithm that uses device usage variables to infer the quality of passive sensing data from mobile devices. This article provides a series of simulation studies to show the utility of the proposed algorithm compared to existing methods. Application to a real clinical dataset is also illustrated.