mHealth Technology Research Articles

Users' Acceptability and Perceived Efficacy of mHealth for Opioid Use Disorder: Scoping Review.

The opioid crisis continues to pose significant challenges to global public health, necessitating the development of novel interventions to support individuals in managing their substance use and preventing overdose-related deaths. Mobile health (mHealth), as a promising platform for addressing opioid use disorder, requires a comprehensive understanding of user perspectives to minimize barriers to care and optimize the benefits of mHealth interventions. This study aims to synthesize qualitative insights into opioid users' acceptability and perceived efficacy of mHealth and wearable technologies for opioid use disorder. A scoping review of PubMed (MEDLINE) and Google Scholar databases was conducted to identify research on opioid user perspectives concerning mHealth-assisted interventions, including wearable sensors, SMS text messaging, and app-based technology. Overall, users demonstrate a high willingness to engage with mHealth interventions to prevent overdose-related deaths and manage opioid use. Users perceive mHealth as an opportunity to access care and desire the involvement of trusted health care professionals in these technologies. User comfort with wearing opioid sensors emerged as a significant factor. Personally tailored content, social support, and encouragement are preferred by users. Privacy concerns and limited access to technology pose barriers to care. To maximize benefits and minimize risks for users, it is crucial to implement robust privacy measures, provide comprehensive user training, integrate behavior change techniques, offer professional and peer support, deliver tailored messages, incorporate behavior change theories, assess readiness for change, design stigma-reducing apps, use visual elements, and conduct user-focused research for effective opioid management in mHealth interventions. mHealth demonstrates considerable potential as a tool for addressing opioid use disorder and preventing overdose-related deaths, given the high acceptability and perceived benefits reported by users.

Feasibility and acceptability of measuring prenatal stress in daily life using smartphone-based ecological momentary assessment and wearable physiological monitors.

High levels of stress during pregnancy can have lasting effects on maternal and offspring health, which disproportionately impacts families facing financial strain, systemic racism, and other forms of social oppression. Developing ways to monitor daily life stress during pregnancy is important for reducing stress-related health disparities. We evaluated the feasibility and acceptability of using mobile health (mHealth) technology (i.e., wearable biosensors, smartphone-based ecological momentary assessment) to measure prenatal stress in daily life. Fifty pregnant women (67% receiving public assistance; 70% Black, 6% Multiracial, 24% White) completed 10 days of ambulatory assessment, in which they answered smartphone-based surveys six times a day and wore a chest-band device (movisens EcgMove4) to monitor their heart rate, heart rate variability, and activity level. Feasibility and acceptability were evaluated using behavioral meta-data and participant feedback. Findings supported the feasibility and acceptability of mHealth methods: Participants answered approximately 75% of the surveys per day and wore the device for approximately 10hours per day. Perceived burden was low. Notably, participants with higher reported stressors and financial strain reported lower burden associated with the protocol than participants with fewer life stressors, highlighting the feasibility of mHealth technology for monitoring prenatal stress among pregnant populations living with higher levels of contextual stressors. Findings support the use of mHealth technology to measure prenatal stress in real-world, daily life settings, which shows promise for informing scalable, technology-assisted interventions that may help to reduce health disparities by enabling more accessible and comprehensive care during pregnancy.

Evaluating Experts’ Perspectives on Utilizing mHealth for Data Services in HIV Program Implementation in Cameroon

<i>Introduction</i>: The widespread adoption of mobile health (mHealth) technology has become a crucial aspect of healthcare delivery, particularly in regions with limited access to traditional healthcare systems. Cameroon, a Central African nation grappling with a high prevalence of HIV/AIDS, presents a suitable context for mHealth interventions. This study aims to assess expert opinions on the application of mHealth for data services in implementing HIV programs in Cameroon. <i>Methods</i>: Employing a mixed-methods approach, we utilized a quantitative cross-sectional design (via a survey questionnaire) and a qualitative design (through in-depth interviews). The purposive sample technique was employed to recruit health specialists from diverse organizations and healthcare facilities across the country. <i>Results</i>: Analysis of responses from mHealth experts revealed that 76% held a positive perspective on using mHealth for data services in HIV program implementation in Cameroon, while 24% expressed a negative opinion. Statistical analysis did not reveal a significant association (p = 0.265) between qualifications and perspectives on mHealth. Monitoring and Evaluation (M&E) experts exhibited a notable association (94.1%) with positive perspectives on mHealth utilization. In contrast, IT specialists and public health experts demonstrated slightly lower percentages (78.6% and 60%, respectively). <i>Conclusion</i>: Experts in mHealth conveyed optimism about using mHealth to provide data services for implementing HIV programs in Cameroon. The study discovered that mHealth users' perceptions were positively correlated with age group and work position. However, there was no discernible relationship between the attitudes of mHealth users and gender or educational attainment.

278 Accelerating the Practice of Human-Centered Design in Translational Research

OBJECTIVES/GOALS: Human-centered design (HCD) provides a practical, collaborative approach to integrating diverse perspectives throughout the translational research process. We highlight two CTSAs with established HCD teams who are utilizing varied approaches to accelerate the use of HCD in health intervention design and community engagement. METHODS/STUDY POPULATION: The CTSAs at the University of Michigan (MICHR) and the University of Pittsburgh (Pitt CTSI) have dedicated teams of human-centered designers that assist investigators with the application of HCD in their studies. MICHR’s service approach utilizes facilitated Design Sprints with study teams, guiding them from early conception of a research question through the co-design of interventions and innovations with end-users. Pitt CTSI’s training and consultation approach employs a two-day intensive training with group coaching sessions that provide investigators and research staff with skills and knowledge needed to implement HCD within translational research projects. Both hubs offer consultations on methodology for investigators interested in pursuing funding for studies utilizing HCD. RESULTS/ANTICIPATED RESULTS: Research teams at both hubs are pursuing HCD to co-design health research interventions and mHealth technologies with end-users locally and internationally, to facilitate meaningful engagement within advisory boards and collaboratives, and to enhance team science. To date, MICHR has conducted 13 research study-focused Design Sprints with 73 participants, as well as providing consultations to 26 research teams. Pitt CTSI has trained 164 investigators and staff and provided 146 consultations with research teams. Requests for HCD training have increased at MICHR while requests for HCD service provision have increased at Pitt CTSI. Both hubs are now building capacity to enact a more holistic approach to HCD that combines service delivery and training approaches to better meet the needs of investigators. DISCUSSION/SIGNIFICANCE: Increasing CTSA hub capacity to support the use of HCD in translational research by offering service and training opportunities can position investigators to conduct high impact health research that elevates the voices of those most likely to benefit from interventions, treatments, and innovations.

Evaluation of an mHealth App on Self-Management of Osteoporosis: Prospective Survey Study.

Mobile health (mHealth) technologies can be used for disease-specific self-management, and these technologies are experiencing rapid growth in the health care industry. They use mobile devices, specifically smartphone apps, to enhance and support medical and public health practices. In chronic disease management, the use of apps in the realm of mHealth holds the potential to improve health outcomes. This is also true for mHealth apps on osteoporosis, but the usage and patients' experiences with these apps are underexplored. This prospective survey study aimed to investigate the eHealth literacy of Danish patients with osteoporosis, as well as the usability and acceptability of the app "My Bones." Data on patient characteristics, disease knowledge, eHealth literacy, usability, and acceptability were collected using self-administered questionnaires at baseline, 2 months, and 6 months. The following validated questionnaires were used: eHealth Literacy Questionnaire, System Usability Scale, and Service User Technology Acceptability Questionnaire. Mean scores for eHealth literacy ranged from 2.6 to 3.1, with SD ranging from 0.5 to 0.6 across the 7 domains. The mean (SD) System Usability Scale score was 74.7 (14.4), and the mean (SD) scores for domains 1, 2, and 6 of the Service User Technology Acceptability Questionnaire were 3.4 (1.2), 4.5 (1.1), 4.1 (1.2), respectively. Danish patients with osteoporosis are both motivated and capable of using digital health services. The app's usability was acceptable, and it has the potential to reduce visits to general practitioner clinics, enhance health outcomes, and serve as a valuable addition to regular health or social care services.

Women’s health and digitalization in forced migration: Review of existing digital tools, challenges and opportunities

Forced migration is a significant global challenge affecting millions of people worldwide. Women and girls, in particular, face unique health risks during forced migration, including sexual and gender-based violence, pregnancy complications and limited access to healthcare services. This article examines the role of digital technologies in promoting health equity among female refugees and asylum seekers. It shows the potential of digitalization to address the unique health needs of women in forced migration contexts. Digitalization, including mobile health (mHealth) technologies and online platforms, can potentially improve women’s health outcomes in forced migration contexts. The article draws on extant literature, and digitalization was shown to improve health literacy among women forced to migrate; and also make access to health information and services easier. From the literature, themes, which include access to health information and inclusive design methodologies, were discussed in the context of the digitalization of women’s health in forced migration. Recommendations for interventions in this area were also proffered.

The ChAMP App: A Scalable mHealth Technology for Detecting Digital Phenotypes of Early Childhood Mental Health.

Childhood mental health problems are common, impairing, and can become chronic if left untreated. Children are not reliable reporters of their emotional and behavioral health, and caregivers often unintentionally under- or over-report child symptoms, making assessment challenging. Objective physiological and behavioral measures of emotional and behavioral health are emerging. However, these methods typically require specialized equipment and expertise in data and sensor engineering to administer and analyze. To address this challenge, we have developed the ChAMP (Childhood Assessment and Management of digital Phenotypes) System, which includes a mobile application for collecting movement and audio data during a battery of mood induction tasks and an open-source platform for extracting digital biomarkers. As proof of principle, we present ChAMP System data from 101 children 4-8 years old, with and without diagnosed mental health disorders. Machine learning models trained on these data detect the presence of specific disorders with 70-73% balanced accuracy, with similar results to clinical thresholds on established parent-report measures (63-82% balanced accuracy). Features favored in model architectures are described using Shapley Additive Explanations (SHAP). Canonical Correlation Analysis reveals moderate to strong associations between predictors of each disorder and associated symptom severity (r = .51-.83). The open-source ChAMP System provides clinically-relevant digital biomarkers that may later complement parent-report measures of emotional and behavioral health for detecting kids with underlying mental health conditions and lowers the barrier to entry for researchers interested in exploring digital phenotyping of childhood mental health.

Utilising resistance feedback for software implementation in healthcare

The COVID-19 pandemic has caused a rapid transformation in the healthcare industry. Telemedicine, mHealth, and artificial intelligence technologies have become integral components of healthcare delivery, enabling remote consultations, symptom tracking, medication reminders, diagnosis, and treatment. However, the adoption of these technologies in healthcare organisations is often met with resistance from shareholders. The most frequent reasons are fear of technology, uncertainty about the impact of technology solutions on patient care, ethical and regulatory concerns, skepticism about the effectiveness of remote medical consultations, concerns about data privacy and security, reluctance to change workflows, risk of job losses due to automation of certain processes, and possible conflicts of interest. This article explores the complex landscape of shareholder resistance during software implementation projects, the origins of this problem, its manifestations, advantages, disadvantages, and consequences. The article also examines this issue through the prism of the Lewin’s Change Model and the Transtheoretical Model of Change, and demonstrates it on the examples of Information Technology Company and Microsoft. The article offers strategic recommendations for healthcare organisations to effectively manage and mitigate these challenges, facilitating a successful transition to the healthcare technology landscape. Among the main problems, the article discusses the following things: creating open and transparent communication channels for shareholders; joint problem-solving sessions with all stakeholders; an iterative approach to implementing IT projects in healthcare facilities, which allows reviewing, adjusting, and agreeing on solutions at each iteration; involving shareholders in decision-making at the early stages of the software implementation process; comprehensive programs to improve shareholder competencies; targeting opinion leaders who are supporters of changes in the organisation; maintaining continuous feedback, etc.

Efektivitas Penggunaan Teknologi Mobile Health dalam Peningkatan Self Management Pasien Diabetes Mellitus Tipe-2

This review aim to evaluate effectiveness of mobile health (mHealth) technology on self management of Type 2 Diabetes Mellitus (T2DM) patients based on evidence from various studies. The method employed in this review included a systematic search of articles from PubMed, Scopus, and Embased databases using the keywords “mobile health and diabetic”, mobile health and diabetes”, dan “mobile health and diabetes mellitus”. The analysis was conducted on 1,479 articles, from which 12 met the inclusion criteria. The findings of this review reveal that the utilization of mHealth whether in the form of application or text messages, has the potential to enhance self-management, particularly in diet regulation, physical activity, blood glucoseoo monitoring, medication adherence, and doctoro visits among T2DM patients. mHealth technolgy has proven effective in improving self-management T2DM patients. Keywords : Diabetes Mellitus, Mobile Health, Self Management, Smartphone.

The use of eHealth and health coaching in postnatal diabetes prevention, in women with history of gestational diabetes

This literature review explores the role of eHealth and health coaching in assisting prevention of type 2 diabetes in women with history of gestational diabetes mellitus (GDM). The integration of electronic health (eHealth) and mobile health (mHealth) technologies, including telemedicine, smartphone apps, and mixed-method approaches, has emerged as a crucial strategy in healthcare delivery. These technologies address postnatal barriers such as lack of support, time constraints, and childcare issues, enhancing accessibility to diabetes prevention interventions. The review presents evidence from various studies, including randomized controlled trials and ongoing research projects, indicating positive impacts on engagement, adherence, and follow-up rates when utilizing remote interventions through smartphone apps and health coaching. Notably, the use of telemedicine during the COVID-19 pandemic has further underscored the potential benefits of delivering care remotely. The focus on postnatal diabetes prevention in women with a history of GDM is particularly pertinent, given the increased risk of developing type 2 diabetes. The inclusion of partners and families in interventions, highlights a holistic approach to promoting a healthy lifestyle. While the results are promising, the review acknowledges the inconclusive nature of current evidence, emphasizing the need for further research to establish the long-term efficacy and acceptance of these interventions. Continued efforts to refine these strategies and expand research will contribute to a better understanding of their impact, ultimately paving the way for targeted and effective diabetes prevention in this high-risk population of women with a history of GDM.

Adapting mHealth Interventions (PrEPmate and DOT Diary) to Support PrEP Retention in Care and Adherence Among English and Spanish-Speaking Men Who Have Sex With Men and Transgender Women in the United States: Formative Work and Pilot Randomized Trial.

A growing number of mobile health (mHealth) technologies are being developed to support HIV preexposure prophylaxis (PrEP) adherence and persistence; however, most tools have focused on men who have sex with men (MSM), and few are available in Spanish. To maximize the potential impact of these tools in reducing gender and racial/ethnic disparities and promoting health equity, mHealth tools tailored to Spanish-speaking people and transgender women are critically needed. The aim of this study is to adapt and tailor 2 mHealth technologies, PrEPmate and DOT Diary, to support daily PrEP adherence and persistence among Spanish-speaking MSM and English- and Spanish-speaking transgender women and to evaluate the feasibility and acceptability of these tools. PrEPmate, an interactive, bidirectional, text messaging intervention that promotes personalized communication between PrEP users and providers, and DOT Diary, a mobile app that promotes self-management of PrEP use and sexual health through an integrated electronic pill-taking and sexual activity diary, were previously developed for English-speaking MSM. We conducted 3 focus groups with 15 English- and Spanish-speaking transgender women and MSM in San Francisco and Miami to culturally tailor these tools for these priority populations. We then conducted a 1-month technical pilot among 21 participants to assess the usability and acceptability of the adapted interventions and optimize the functionality of these tools. Participants in focus groups liked the "human touch" of text messages in PrEPmate and thought it would be helpful for scheduling appointments and asking questions. They liked the daily reminder messages, especially the fun facts, gender affirmations, and transgender history topics. Participants recommended changes to tailor the language and messages for Spanish-speaking and transgender populations. For DOT Diary, participants liked the adherence tracking and protection level feedback and thought the calendar functions were easy to use. Based on participant recommendations, we tailored language within the app for Spanish-speaking MSM and transgender women, simplified the sexual diary, and added motivational badges. In the technical pilot of the refined tools, mean System Usability Scale scores were 81.2/100 for PrEPmate and 76.4/100 for DOT Diary (P=.48), falling in the "good" to "excellent" range, and mean Client Satisfaction Questionnaire scores were 28.6 and 28.3 for PrEPmate and DOT Diary, respectively (maximum possible score=32). Use of both tools was high over the 1-month pilot (average of 10.5 messages received from each participant for PrEPmate; average of 17.6 times accessing the DOT Diary app), indicating good feasibility for both tools. Using a user-centered design approach, we culturally tailored PrEPmate and DOT Diary to support daily PrEP use among Spanish-speaking MSM and English- and Spanish-speaking transgender women. Our positive findings in a technical pilot support further testing of these mHealth interventions in an upcoming comparative effectiveness trial.

Assessment of the Barriers and Enablers of the Use of mHealth Systems in Sub-Saharan Africa According to the Perceptions of Patients, Physicians, and Health Care Executives in Ethiopia: Qualitative Study.

Digital technologies are increasingly being used to deliver health care services and promote public health. Mobile wireless technologies or mobile health (mHealth) technologies are particularly relevant owing to their ease of use, broad reach, and wide acceptance. Unlike developed countries, Sub-Saharan Africa experiences more challenges and obstacles when it comes to deploying, using, and expanding mHealth systems. In addition to barriers, there are enabling factors that could be exploited for the design, implementation, and scaling up of mHealth systems. Sub-Saharan Africa may require tailored solutions that address the specific challenges facing the region. The overall aim of this study was to identify the barriers and enablers for using mHealth systems in Sub-Saharan Africa from the perspectives of patients, physicians, and health care executives. Multi-level and multi-actor in-depth semistructured interviews were employed to qualitatively explore the barriers and enablers of the use of mHealth systems. Data were collected from patients, physicians, and health care executives. The interviews were audio recorded, transcribed verbatim, translated, and coded. Thematic analysis methodology was adopted, and NVivo software was used for the data analysis. Through this rigorous study, a total of 137 determinants were identified. Of these determinants, 68 were identified as barriers and 69 were identified as enablers. Perceived barriers in patients included lack of awareness about mHealth systems and language barriers. Perceived enablers in patients included need for automated tools for health monitoring and an increasing literacy level of the society. According to physicians, barriers included lack of available digital health systems in the local context and concern about patients' mHealth capabilities, while enablers included the perceived usefulness in reducing workload and improving health care service quality, as well as the availability of mobile devices and the internet. As perceived by health care executives, barriers included competing priorities alongside digitalization in the health sector and lack of interoperability and complete digitalization of implemented digital health systems, while enablers included the perceived usefulness of digitalization for the survival of the highly overloaded health care system and the abundance of educated manpower specializing in technology. mHealth systems in Sub-Saharan Africa are hindered and facilitated by various factors. Common barriers and enablers were identified by patients, physicians, and health care executives. To promote uptake, all relevant stakeholders must actively mitigate the barriers. This study identified a promising outlook for mHealth in Sub-Saharan Africa, despite the present barriers. Opportunities exist for successful integration into health care systems, and a user-centered design is crucial for maximum uptake.

Combining mHealth Technology and Pharmacotherapy to Improve Mental Health Outcomes and Reduce Human Rights Abuses in West Africa: Intervention Field Trial.

In West Africa, healers greatly outnumber trained mental health professionals. People with serious mental illness (SMI) are often seen by healers in "prayer camps" where they may also experience human rights abuses. We developed "M&M," an 8-week-long dual-pronged intervention involving (1) a smartphone-delivered toolkit designed to expose healers to brief psychosocial interventions and encourage them to preserve human rights (M-Healer app), and (2) a visiting nurse who provides medications to their patients (Mobile Nurse). We examined the feasibility, acceptability, safety, and preliminary effectiveness of the M&M intervention in real-world prayer camp settings. We conducted a single-arm field trial of M&M with people with SMI and healers at a prayer camp in Ghana. Healers were provided smartphones with M-Healer installed and were trained by practice facilitators to use the digital toolkit. In parallel, a study nurse visited their prayer camp to administer medications to their patients. Clinical assessors administered study measures to participants with SMI at pretreatment (baseline), midtreatment (4 weeks) and post treatment (8 weeks). Seventeen participants were enrolled and most (n=15, 88.3%) were retained. Participants had an average age of 44.3 (SD 13.9) years and 59% (n=10) of them were male. Fourteen (82%) participants had a diagnosis of schizophrenia and 2 (18%) were diagnosed with bipolar disorder. Four healers were trained to use M-Healer. On average, they self-initiated app use 31.9 (SD 28.9) times per week. Healers watched an average of 19.1 (SD 21.2) videos, responded to 1.5 (SD 2.4) prompts, and used the app for 5.3 (SD 2.7) days weekly. Pre-post analyses revealed a significant and clinically meaningful reduction in psychiatric symptom severity (Brief Psychiatric Rating Scale score range 52.3 to 30.9; Brief Symptom Inventory score range 76.4 to 27.9), psychological distress (Talbieh Brief Distress Inventory score range 37.7 to 16.9), shame (Other as Shamer Scale score range 41.9 to 28.5), and stigma (Brief Internalized Stigma of Mental Illness Scale score range 11.8 to 10.3). We recorded a significant reduction in days chained (1.6 to 0.5) and a promising trend for reduction in the days of forced fasting (2.6 to 0.0, P=.06). We did not identify significant pre-post changes in patient-reported working alliance with healers (Working Alliance Inventory), depressive symptom severity (Patient Health Questionnaire-9), quality of life (Lehman Quality of Life Interview for the Mentally Ill), beliefs about medication (Beliefs about Medications Questionnaire-General Harm subscale), or other human rights abuses. No major side effects, health and safety violations, or serious adverse events occurred over the course of the trial. The M&M intervention proved to be feasible, acceptable, safe, and clinically promising. Preliminary findings suggest that the M-Healer toolkit may have shifted healers' behaviors at the prayer camp so that they commit fewer human rights abuses.

The effectiveness of green heart application to manage modifiable risk factors of coronary artery disease in Tehran Heart Center: Study protocol for a randomized controlled trial

The burden of cardiovascular disease (CVD) is diminishing in developed countries. However, in middle- and low-income countries the CVD death rates are growing. CVD is the most common cause of death and disability in Iran and accounts for nearly half of all mortalities in Iranians. Therefore, preventive strategies by risk factor modification are a top priority in the country.Recently, Mobile-Health (mHealth) technology has been the focus of increasing interest in improving the delivery of cardiovascular prevention, targeting a combination of modifiable risk factors.This parallel-group single-blinded randomized controlled trial study has been designed to evaluate the impact of using a mHealth application on risk factors control. Individuals aged between 25 and 75 years who have documented CVD by coronary angiography in Tehran Heart Center and have at least one uncontrolled risk factor from the three including hypertension, dyslipidemia, and current cigarette smoking will be included. We are going to randomize 1544 patients into two study arms as follows: 1- Intervention: usual care + mHealth 2- Control: usual care + paper-based recommendations and educational materials. After 3 and 6 months of follow-up, the status of risk factors will be determined through outpatient visits and face-to-face interviews for both arms. Outcome: Successful risk factor control will be measured after 3 and 6 months.Nowadays, mHealth is becoming increasingly popular, providing a good opportunity for constant monitoring of risk factors and changing health behavior in a target population. Meanwhile, providing evidence for the effectiveness of health intervention delivery using mobile technologies could help health providers encourage their at-risk population to stop smoking, control blood pressure and blood cholesterol, and participate in regular physical activity. While the burden of CVD is growing in developing countries, this type of intervention can be a cost-effective way to reduce it in these countries.

Peers plus mobile app for treatment in HIV (PATH): protocol for a randomized controlled trial to test a community-based integrated peer support and mHealth intervention to improve viral suppression among Hispanic and Black people living with HIV

BackgroundSignificant disparities continue to exist in the HIV care continuum, whereby Hispanic and Black people living with HIV (PLWH) are less likely to achieve viral suppression compared to their White counterparts. Studies have shown that intervention approaches that involve peer navigation may play an important role in supporting patients to stay engaged in HIV care. However, implementation may be challenging in real-world settings where there are limited resources to support peer navigators. Combining a peer navigation approach with scalable mobile health (mHealth) technology may improve impact and implementation outcomes.MethodsWe combined a peer navigation intervention with a mHealth application and are conducting a randomized controlled trial (RCT) to test the efficacy of this integrated “Peers plus mobile App for Treatment in HIV” (PATH) intervention to improve HIV care engagement, and ultimately sustained viral suppression, among Hispanic and Black PLWH. We will enroll up to 375 PLWH into a two-arm prospective RCT, conducting follow-up assessments every 3 months up to 12 months post-baseline. Participants randomized to the control arm will continue to receive usual care Ryan White Program case management services. Individuals randomized to receive the PATH intervention will receive usual care plus access to two main intervention components: (1) a peer navigation program and (2) a mHealth web application. The primary outcome is sustained HIV viral suppression (undetectable viral load observed at 6- and 12-month follow-up). Secondary outcomes are retention in HIV care, gaps in HIV medical visits, and self-reported ART adherence. Recruitment for the RCT began in November 2021 and will continue until June 2024. Follow-up assessments and medical chart abstractions will be conducted to collect measurements of outcome variables.DiscussionThe efficacy trial of PATH will help to fill gaps in our scientific understanding of how a combined peer navigation and mHealth approach may produce effects on HIV care outcomes while addressing potential implementation challenges of peer navigation in Ryan White-funded clinics.Trial registrationThe PATH trial is registered at the United States National Institutes of Health National Library of Medicine (ClinicalTrials.gov) under ID # NCT05427318. Registered on 22 June 2022.

Lifestyle intervention in children with obesity and nonalcoholic fatty liver disease (NAFLD): study protocol for a randomized controlled trial in Ningbo city (the SCIENT study)

BackgroundThe increasing prevalence of childhood obesity has become an urgent public health problem, evidence showed that intervention for childhood obesity bring enormous health benefits. However, an effective individualized intervention strategy remains to be developed, and the accompanying remission of related complications, such as nonalcoholic fatty liver disease (NAFLD), needs to be assessed. This study aimed to develop an m-Health-assisted lifestyle intervention program targeting overweight/obese children and assess its effectiveness on indicators of adiposity and NAFLD.MethodsThis is a cluster-randomized controlled trial that conducted in children with overweight/obesity in Ningbo city, Zhejiang Province, China. Students in Grade 3 (8–10 years old) were recruited from six primary schools, with three be randomized to intervention group and three to usual practice group. The intervention program will last for one academic year and consists of health education, dietary guidance, and physical activity reinforcement. This program is characterized by encouraging four stakeholders, including School, Clinic, famIly, and studENT (SCIENT), to participate in controlling childhood obesity, assisted by m-Health technology. Assessments will be conducted at baseline and 3 months, 9 months, 24 months, and 36 months after baseline. The primary outcome will be the differences between the two groups in students’ body mass index and fatty liver index at the end of the intervention (9 months after baseline). During the implementation process, quality control methods will be adopted.DiscussionThe program will test the effectiveness of the m-Health-assisted lifestyle intervention on children with obesity and NAFLD. The results of this study will provide evidence for establishing effective lifestyle intervention strategy aimed at childhood obesity and NAFLD and may help develop guidelines for the treatment of obesity and NAFLD in Chinese children.Trial registrationClinicaltrials.gov NCT05482191. Registered on July 2022.

MOBILE HEALTH (MHEALTH) INNOVATIONS FOR PUBLIC HEALTH FEEDBACK: A GLOBAL PERSPECTIVE

In recent years, Mobile Health (mHealth) innovations have emerged as a transformative force in the realm of public health, revolutionizing the way healthcare is delivered and monitored worldwide. This review presents a comprehensive overview of the latest advancements in mHealth technologies, focusing particularly on their role in soliciting and utilizing public health feedback on a global scale. The proliferation of smartphones and mobile applications has paved the way for novel approaches to healthcare delivery, monitoring, and data collection. Through leveraging the ubiquity and connectivity of mobile devices, mHealth initiatives have facilitated enhanced communication between healthcare providers and patients, enabling real-time monitoring of health metrics, adherence to treatment regimens, and timely interventions. One of the key aspects of mHealth innovations is their capacity to engage diverse populations and solicit feedback regarding various aspects of public health, ranging from disease outbreaks to healthcare service quality. Through interactive platforms and user-friendly interfaces, individuals can provide valuable insights, report symptoms, and participate in surveys, thereby contributing to the generation of actionable data for public health interventions. Furthermore, mHealth solutions have demonstrated significant promise in overcoming barriers to healthcare access, particularly in underserved and remote communities. By delivering health information, diagnostic tools, and remote consultations via mobile platforms, these innovations have expanded the reach of essential healthcare services, thereby bridging gaps in healthcare delivery and improving health outcomes on a global scale. However, challenges such as privacy concerns, technological literacy, and disparities in digital access persist, underscoring the importance of equitable deployment and user-centered design in mHealth initiatives. Moreover, the integration of mHealth solutions into existing healthcare infrastructure requires careful coordination among stakeholders, including policymakers, healthcare providers, and technology developers. Mobile Health (mHealth) innovations hold immense potential to revolutionize public health feedback mechanisms on a global scale. By harnessing the power of mobile technologies, these initiatives can empower individuals, enhance healthcare delivery, and inform evidence-based public health policies for a healthier future.
 Keywords: Mobile Health, mHealth, Public Health, Healthcare, Innovation, Review.

Development of the intelligent knee osteoarthritis lifestyle app: a person-based approach

BackgroundKnee osteoarthritis is one of the most prevalent long term health conditions globally. Exercise and physical activity are now widely recognised to significantly reduce joint pain, improve physical function and quality of life in patients with knee osteoarthritis. However, prescribed exercise without regular contact with a healthcare professional often results in lower adherence and poorer health outcomes. Digital mobile health (mHealth) technologies offer great potential to support people with long-term conditions such as knee osteoarthritis more efficiently and effectively and with relatively lower cost than existing interventions. However, there are currently very few mHealth interventions for the self-management of knee osteoarthritis. The aim of the present study was to describe the development process of a mHealth app to extend the support for physical activity and musculoskeletal health beyond short-term, structured rehabilitation through self-management, personalised physical activity, education, and social support.MethodsThe development of the intelligent knee osteoarthritis lifestyle application intervention involved an iterative and interconnected process comprising intervention ‘planning’ and ‘optimisation’ informed by the person-based approach framework for the development of digital health interventions. The planning phase involved a literature review and collection of qualitative data obtained from focus groups with individuals with knee osteoarthritis (n = 26) and interviews with relevant physiotherapists (n = 5) to generate ‘guiding principles’ for the intervention. The optimisation phase involved usability testing (n = 7) and qualitative ‘think aloud’ sessions (n = 6) with potential beneficiaries to refine the development of the intervention.ResultsKey themes that emerged from the qualitative data included the need for educational material, modifying activities to suit individual abilities and preferences as well as the inclusion of key features such as rehabilitation exercises. Following a user-trial further changes were made to improve the usability of the application.ConclusionsUsing a systematic person-based, development approach, we have developed the intelligent knee osteoarthritis lifestyle application to help people maintain physical activity behaviour. The app extends the support for physical activity and musculoskeletal health beyond short-term, structured rehabilitation through personalised physical activity guidance, education, and social support.

Examination of the Factors Impacting the Interest of Residents in Semarang City in Mobile Health Applications: An UTAUT Analysis

Purpose: The study aims is to examine the determinants that impact the level of public interest in utilizing mobile health (m-health) applications in Semarang City, Indonesia. Our specific objective is to identify the critical factors that facilitate or impede the public's adoption of these applications.Methods: This study objective was pursued using a comprehensive approach. A study model was developed utilizing the Unified Theory of Acceptance and Use of Technology (UTAUT) as its foundation. This model encompasses essential variables including performance expectancy, effort expectancy, social influence, facilitating conditions, price value, and perceived trust. The process of data collecting was carried out by means of a survey that was disseminated across widely used social media channels. The study was conducted using a sample size of 257 participants who are residents of Semarang City. The data that was collected underwent a thorough analysis utilizing the Partial Least Squares - Structural Equation Model (PLS-SEM) approach.Results: The research conducted in our study resulted in several significant findings. The study revealed that several factors, namely performance expectancy, social influence, price value, and perceived trust, had a notable and beneficial impact on users' inclination towards using m-health applications. On the other hand, the variables of effort expectancy and facilitating conditions did not exhibit a statistically significant influence on the level of public interest in these applications. Furthermore, a substantial correlation was found between the behavioral intention and the actual usage behavior of inhabitants of Semarang City in their adoption of m-health applications.Novelty: The research presented in this study is distinguished by its comprehensive analysis of the various factors that impact the adoption of mobile health (m-health) applications in Semarang City. Through the incorporation and expansion of variables such as price value and perceived trust, our study provides a comprehensive and nuanced comprehension of this particular occurrence by adapting and extending the UTAUT model. Our work emphasizes the importance of performance expectancy and social influence, while also suggesting the need for additional investigation into the roles of effort expectancy and facilitating conditions. Additionally, our study offers valuable information regarding the influence of age and gender as moderators in these associations. The results of this study have significant practical implications for healthcare professionals and policymakers who are interested in promoting the use of mobile health (m-health) technologies among the public. Additionally, these findings can serve as a valuable guide for future research endeavors in this particular area of study.

Mobile Technologies for Monitoring Sleep Time: A Systematic Search of App Stores in Brazil

Abstract Introduction Decreased sleep time is detrimental to physical and mental health, exerting negative impacts on daily functioning and quality of life. Mobile health (mHealth) applications can be useful for improving sleep quality. Objective To perform a systematic search of mHealth applications for monitoring sleep time at Brazilian online stores and evaluate the selected applications in terms of engagement, functionality, aesthetics, and quality of information. Methods A systematic search was performed at the Google Play Store and the App Store developed or updated between 2020 and 2022. The mobile app rating scale (MARS) was used to assess their quality. The characteristics and information of these applications were presented. Data were analyzed descriptively. Results Among the 2,264 relevant mHealth apps identified, 11 were eligible for inclusion. There was one app that offered only sleep time recordings, three offered sleep recordings and educational content, three monitored sleep time with audiovisual resources, two offered sleep time recordings with a focus on monitoring snoring, and two offered sleep time monitoring with individual content customizations. The apps scored fair on MARS, with a mean of 3.5 points (standard deviation: 0.8) on a scale of 1 to 5. Most apps scored low due to poor evidence-based information, aesthetics, and engagement. Conclusion Although the use of mHealth technologies for monitoring sleep time has considerable potential for investigation, it is a relatively new, underexplored topic. Collaboration between researchers, clinical professionals, patients, and application developers is necessary for the creation of new evidence-based mHealth applications focused on Brazilian users.