Use Of Mobile Health Apps Research Articles

Quality factors affecting the continued use of mobile health apps in ethnic minority regions of Southwest China using PLS-SEM and ANN

Mobile technology has significantly accelerated the rapid development of healthcare services. Despite the convenience brought by the proliferation of mobile health (mHealth) apps, the challenge of promoting their continued use among patients has garnered attention from many scholars and administrators. Based on the Expectation Confirmation Model (ECM), this study explores the impact of quality elements on the continuance intention of mHealth apps in Southwest China’s ethnic minority regions. Researchers conducted a structured questionnaire survey on 337 users of mHealth apps in these regions to measure their self-reported responses to seven constructs: information quality, system quality, service quality, perceived usefulness, confirmation, satisfaction, and continuance intention. The study uses the structural equation model-artificial neural network (SEM-ANN) approach to interpret the compensatory and non-linear relationships between predictors and continuance intention. The findings reveal that user satisfaction and perceived usefulness significantly predict the continuance intention to use mHealth apps. All other relationships were confirmed except for the non-significant relationships between service quality and confirmation, service quality and perceived usefulness, and system quality and perceived usefulness. Furthermore, based on the normalized importance obtained from the multilayer perceptron, the most critical predictors identified were satisfaction (100%), followed by information quality (70.2%), perceived usefulness (43.2%), system quality (25.1%), and confirmation (17.6%). Finally, this study presents theoretical and practical implications for the continuance intention towards mHealth apps in Southwest China’s ethnic minority regions.

Progress Achieved, Landmarks, and Future Concerns in Biomedical and Health Informatics.

The biomedical and health informatics (BMHI) fields have been advancing rapidly, a trend particularly emphasised during the recent COVID-19 pandemic, introducing innovations in BMHI. Over nearly 50 years since its establishment as a scientific discipline, BMHI has encountered several challenges, such as mishaps, delays, failures, and moments of enthusiastic expectations and notable successes. This paper focuses on reviewing the progress made in the BMHI discipline, evaluating key milestones, and discussing future challenges. To, Structured, step-by-step qualitative methodology was developed and applied, centred on gathering expert opinions and analysing trends from the literature to provide a comprehensive assessment. Experts and pioneers in the BMHI field were assigned thematic tasks based on the research question, providing critical inputs for the thematic analysis. This led to the identification of five key dimensions used to present the findings in the paper: informatics in biomedicine and healthcare, health data in Informatics, nurses in informatics, education and accreditation in health informatics, and ethical, legal, social, and security issues. Each dimension is examined through recently emerging innovations, linking them directly to the future of healthcare, like the role of artificial intelligence, innovative digital health tools, the expansion of telemedicine, and the use of mobile health apps and wearable devices. The new approach of BMHI covers newly introduced clinical needs and approaches like patient-centric, remote monitoring, and precision medicine clinical approaches. These insights offer clear recommendations for improving education and developing experts to advance future innovations. Notably, this narrative review presents a body of knowledge essential for a deep understanding of the BMHI field from a human-centric perspective and, as such, could serve as a reference point for prospective analysis and innovation development.

Patients’ experience using an app for home remote monitoring of heart failure for a university hospital in Quebec, Canada

BackgroundThe use of mobile health apps for remote monitoring has considerable potential for patient care. However, more research is needed to gather patients’ experience with their use. This study evaluates heart failure patients’ experience of the effects of remote monitoring on the management of heart failure (HF) using a smartphone app, the challenges faced in such use, and patients’ suggestions for improving the efficacy of this device.MethodA qualitative study was conducted with all patients who had used the TakeCare™ app for at least three months during the exploratory phase of the Continuum project. Patients were recruited before COVID-19 began, and they used the app during this period. The app allows patients to submit their daily vital signs and answer questions about their symptoms to help the clinical professionals adjust their treatment plan as needed. Individual interviews were conducted by telephone or videoconference using a semi-structured individual interview guide. All interviews were recorded, transcribed and analyzed using the thematic analysis method.ResultsOf the 29 patients invited, 5 had since died, 10 did not respond, two gave positive feedback on the app but declined the interview, and 12 patients agreed to participate in an individual interview. The participants all liked the app’s ease of use. They particularly praised the contribution it made to monitoring their disease, both by themselves and by clinicians. The app also allowed them to stay connected to their clinical team and have better access to healthcare professionals. Patients suggested, as an improvement, that the feedback and communication features should be personalized to make them more individualized and interactive.ConclusionThe TakeCare™ smartphone app was well received by patients with heart failure. Its use could facilitate better remote monitoring of heart conditions in the home as well as improve access to clinical teams.

From Gaps to Solutions: Semi-Structured Interviews to Identify Care Gaps in Breast Cancer Care and How to Solve Them with Digital Solutions.

Standardized treatment pathways should make it easier for medical staff and patients to achieve the best possible individual treatment outcome by making sure all relevant information are taken into consideration. The aim of this paper is to identify gaps in care along the treatment pathway through semi-structured patient interviews. Subsequently, it will be discussed if mobile health applications can close these identified gaps in care. Nine semi-structured interviews of patients with invasive lobular breast cancer were conducted in March 2023 in German at the breast cancer center at Charité Universitätsmedizin Berlin, which were subsequently transcribed word for word and processed using a thematic analysis approach. Eight recurring themes are identified in the patient interviews: 1. Limited capacity to absorb information, 2. Discrepancy between information needs and information provision, 3. Need for individual initiative, 4. Uncertainty, 5. not being seen and heard, 6. Patient's desires and suggestions for improvement, 7. Use of mobile health apps, 8. Support through an app for patients. The identified gaps in care of breast cancer patients can be largely addressed through the use of digital health solutions after the establishment of regulatory frameworks, thus improving care for patients with early breast cancer. The interviews were done within a registry for which ethical approval was obtained by the Ethics Committee of Charité Universitätsmedizin Berlin EA4/180/17.

Fostering Continued Use of Mobile Health Apps: An Integrated Socio-Technical and S-O-R Approach

Fostering Continued Use of Mobile Health Apps: An Integrated Socio-Technical and S-O-R Approach

Health Technology Access and Peer Support Among Digitally Engaged People Experiencing Homelessness: Qualitative Study.

Although the effects of digital health are receiving wide scientific attention, very little is known about the characteristics of digitally engaged people experiencing homelessness, especially in Central and Eastern Europe. Our previous research revealed a considerable level of internet use in the homeless population of Budapest, Hungary, for general purposes (350/662, 52.9%) and medical purposes (229/664, 34.6%). Moreover, a digitally engaged subgroup was identified (129/662, 19.5%). The aim of this exploratory study was to map out the resources, attitudes, and behaviors of digitally engaged homeless individuals in relation to digital technology to set the basis for potential health policy interventions, which will enable better access to health services through strengthening of the digital components of the existing health care system. Between August 18, 2022, and October 27, 2022, a total of 12 in-depth semistructured interviews were conducted in 4 homeless shelters in Budapest, Hungary. Upon analysis by 3 independent evaluators, 2 interviews were excluded. The interviewees were chosen based on purposive sampling with predefined inclusion criteria. Thematic analysis of the transcripts was conducted. In the thematic analysis, 4 main themes (attitude, access, usage patterns, and solutions for usage problems) emerged. Health-related technology use mostly appeared in health information-seeking behavior. Online search for prescribed medications (5 interviews), active ingredients of medications (4 interviews), medicinal herbs believed to replace certain pills (2 interviews) or foods, and natural materials (1 interview) were mentioned. Moreover, mobile health app use (3 interviews) was reported. The intention to circumvent or check on mainstream health care solutions was mainly associated with previous negative experiences in the health care system. Several gaps in the daily use of technology were identified by the interviewees; however, more than half of the interviewees (6/10) turned out to be contact points for their peers for digital problem-solving or basic digital literacy skill enhancement in the homeless shelters. Furthermore, a lack of institutional support or special programs targeting senior clients was noted. Digitally engaged homeless individuals might become mediators between their peers and comprehensive digital health programs. They have the trust of their peers, can recognize and harness the benefits of digital technology, and are able to provide meaningful help in technology- and usage-related issues through experience. Digital health services have great promise in community shelters for managing and preventing health issues, and digitally engaged individuals might be important for the success of such services.

Evaluation of the Effectiveness of Mobile Health Apps in Improving Public Health Awareness in Indonesia

This study investigates the effectiveness of mobile health apps in enhancing public health awareness in Indonesia through a quantitative analysis. Using 170 participants, data was collected through surveys to assess mobile health app usage patterns and public health awareness levels. Results indicate that frequent use of mobile health apps is positively associated with higher public health awareness scores. Specifically, fitness tracking and nutrition apps were found to be significantly correlated with increased public health awareness. These findings highlight the potential of mobile health apps as tools for disseminating health information and empowering individuals to make informed decisions about their health. The study contributes to understanding the role of mobile technology in promoting public health awareness in Indonesia and underscores the importance of targeted interventions tailored to specific health needs and preferences.

Investigation of Young People’s Use of Mobile Health Apps, and Their Physical Activity and Health Perception Levels

Objectives: The interest in mobile health apps is increasing day by day. This study aimed to examine young people’s preferences for mobile health apps, their physical activity levels, and health perceptions. Materials and Methods: The study was conducted with 283 students from two vocational schools of higher education. Participants were asked to complete the International Physical Activity Questionnaire Short Form and the Perception of Health Scale, as well as questions about their mobile health application preferences. The data were evaluated at p<0.05 significance level. Results: The study was conducted with 283 participants with a mean age of 20.6±2 years. The number of participants using health-related apps on their smartphones was 179 (63.3%). Of the 104 participants who did not use mobile health apps, 71.1% reported that they did not prefer them because they thought they would not use them regularly. 11 participants did not know about mobile apps. 41.9% had been using mobile health apps for about one year, and the most used app was pedometers (n=147). Both health perceptions and physical activity scores of individuals who used mobile health apps were higher than those who did not (respectively; p=0.003, p<0.001), and the health perception of physically active individuals was higher than the others (p=0.044). Conclusion: Currently, the use of mobile health applications is associated with both health perception and physical activity. However, constant use of the apps cannot be ensured. Therefore, it is important to provide the necessary promotion and motivation to people.

Health perceptions and attitudes on mobile health apps in China.

Since the COVID-19 pandemic, the use of mobile health apps has been increasing significantly. Many have started using mobile health apps to manage their health and well-being. People need to develop healthy habits that will increase their job productivity, life expectancy and improve their social relationships. This study tests the Health Belief Model with adults in China in influencing health motivation and in turn improving their health behavior. A mobile and online survey was developed, and 120 usable responses were collected. A structural equation modeling was used to test the relationships between perceived benefits, perceived susceptibility, perceived barriers, health motivation, and health behavior. We found perceived self-efficacy, perceived benefits, and perceived susceptibility predicts health motivation, and health motivation predicts health behavior. We did not find that perceived barrier is a predictor for health motivation. We conclude that to encourage behavioral change, it is important to enhance self-efficacy and address the benefits; in the meantime, educating people on susceptibility is also important.

'You have to put a lot of trust in me': autonomy, trust, and trustworthiness in the context of mobile apps for mental health

Trust and trustworthiness are essential for good healthcare, especially in mental healthcare. New technologies, such as mobile health apps, can affect trust relationships. In mental health, some apps need the trust of their users for therapeutic efficacy and explicitly ask for it, for example, through an avatar. Suppose an artificial character in an app delivers healthcare. In that case, the following questions arise: Whom does the user direct their trust to? Whether and when can an avatar be considered trustworthy? Our study aims to analyze different dimensions of trustworthiness in the context of mobile health app use. We integrate O'Neill's account of autonomy, trust, and trustworthiness into a model of trustworthiness as a relational concept with four relata: B is trustworthy with respect to A regarding the performance of Z because of C. Together with O'Neill's criteria of trustworthiness (honesty, competence, and reliability), this four-sided model is used to analyze different dimensions of trustworthiness in an exemplary case of mobile health app use. Our example focuses on an app that uses an avatar and is intended to treat sleep difficulties. The conceptual analysis shows that interpreting trust and trustworthiness in health app use is multi-layered and involves a net of interwoven universal obligations. At the same time, O'Neill's approach to autonomy, trust, and trustworthiness offers a normative account to structure and analyze these complex relations of trust and trustworthiness using mobile health apps.

Research on the Recommendation of Exercise Recovery Duration of Mobile Health APP

With the further deepening of people's demand for health, the use of mobile health apps has become more popular. The recovery duration suggestion function of the mobile health App can provide more scientific exercise guidance and good exercise experience, but there are still some shortcomings, such as low data utilization, and the suggestion is difficult to be accurate to individuals. In this paper, questionnaire survey is used to collect data, and a hidden Markov prediction model based on K-means clustering analysis is established. Through training the collected data, a more scientific analysis of the recovery time after exercise can be finally given. Finally, we give some suggestions on the future development of sports bracelets.

Evaluation of Pedometer Interfaces for Mobile Apps.

The use of mobile health apps has been on the rise, as they allow people to get their health information more conveniently. Many people are using their mobile health apps to track their health status (KC et al., 2021), but there are known issues with people being unable to use their health apps effectively due to poor design. According to Wildebos et al. (2019), if users are continuously failing to get the information they need, they could develop feelings of insecurity and stop using the app. To mitigate these negative interface design impacts, Universal Design Principles (Story, 1998) and Gestalt's Principle of Perceptual Grouping (Smith-Gratto & Fisher, 1999) could be used to improve the interfaces. In the present study, we evaluated several interfaces of pedometer apps that varied in terms of flexibility (low and high) and three levels of simplicity (simple, intermediate, and complex). Ninety six participants were recruited from MTurk. The participants responded to questions on a survey that require them to extract information from a pedometer interface. After answering the comprehension questions for the specific interface, participants were asked to indicate their perceived ease of use (Brooke, 1996) and the likelihood of utilizing the pedometer app (Pasha & Indrawati, 2020). We found that participants had higher accuracy scores with the interface that was intermediate in terms of simplicity, but they preferred the simple or complex interface design. Results of this study suggest that users may not prefer designs that lead to better task performance and designers will need to balance features that enhance performance versus those that users find to be more attractive or desirable for continued use.

The Role of Access Type and Age Group in the Breadth of Use of Patient Portals: Observational Study

Health care delivery and patient satisfaction are improved when patients engage with their medical information through patient portals. Despite their wide availability and multiple functionalities, patient portals and their functionalities are still underused. We seek to understand factors that lead to patient engagement through multiple portal functionalities. We provide recommendations that could lead to higher patients' usage of their portals. Using data from the Health Information National Trends Survey 5, Cycle 3 (N=2093), we performed descriptive statistics and used a chi-square test to analyze the association between the demographic variables and the use of mobile health apps for accessing medical records. We further fitted a generalized linear model to examine the association between access type and the use of portal functionalities. We further examined the moderation effects of age groups on the impact of access type on portal usage. Our results show that accessing personal health records using a mobile health app is positively associated with greater patient usage of access capabilities (β=.52; P<.001), patient-provider interaction capabilities (β=.24, P=.006), and patient-personal health information interaction capabilities (β=.23, P=.009). Patients are more likely to interact with their records and their providers when accessing their electronic medical records using a mobile health app. The impacts of mobile health app usage fade with age for tasks consisting of viewing, downloading, and transmitting medical results to a third party (β=-.43, P=.005), but not for those involving patient-provider interaction (β=.05, P=.76) or patient-personal health information interaction (β=-.15, P=.19). These findings provide insights on how to increase engagement with diverse portal functionalities for different age groups and thus improve health care delivery and patient satisfaction.

Parents' mHealth App for Promoting Healthy Eating Behaviors in Children: Feasibility, Acceptability, and Pilot Study.

The use of mobile health apps to improve diet and nutrition behaviors has increased in recent years. Several studies have described the benefits and advantages of this technology as a complement to interventions for improving nutrition behaviors and nutrition-related health outcomes, including obesity indices and clinical parameters. Few of these works have developed clinical mobile health apps for children, and although parents play a critical role in children's nutrition behaviors, work targeting parents is scarce. The work presented in this paper describes the development of the PersuHabit app, a stand-alone mobile health app targeting parents to promote the intake of fruits and vegetables (FVs) and reduce the intake of ultra-processed foods (UPF) in children aged 6 to 10years. The paper also presents the execution of an exploratory pilot study to assess the feasibility, acceptability, and preliminary effects of the PersuHabit app. The results are presented and discussed, and actions for further improvement of the PersuHabit app are identified.

Mobile Health Use by Older Individuals at Risk of Cardiovascular Disease and Type 2 Diabetes Mellitus in an Australian Cohort: Cross-sectional Survey Study.

BackgroundThe digital transformation has the potential to change health care toward more consumers’ involvement, for example, in the form of health-related apps which are already widely available through app stores. These could be useful in helping people understand their risk of chronic conditions and helping them to live more healthily.ObjectiveWith this study, we assessed mobile health app use among older Australians in general and among those who were at risk of cardiovascular disease or type 2 diabetes mellitus.MethodsIn this cross-sectional analysis, we used data from the second follow-up wave of the 45 and Up Study. It is a cohort study from New South Wales, Australia, with 267,153 participants aged 45 years and older that is based on a random sample from the Services Australia (formerly the Australian Government Department of Human Services) Medicare enrollment database. The 2019 follow-up questionnaire contained questions about technology and mobile health use. We further used data on prescribed drugs and hospitalizations to identify participants who already had cardiovascular disease or diabetes or who were at risk of these conditions. Our primary outcome measure was mobile health use, defined as having used a mobile health app before. We used descriptive statistics and multivariate logistic regression to answer the research questions.ResultsOverall, 31,946 individuals with a median age of 69 (IQR 63-76) years had completed the follow-up questionnaire in 2019. We classified half (16,422/31,946, 51.41%) of these as being at risk of cardiovascular disease or type 2 diabetes mellitus and 38.04% (12,152/31,946) as having cardiovascular disease or type 1 or type 2 diabetes mellitus. The proportion of mobile health app users among the at-risk group was 31.46% (5166/16,422) compared to 29.16% (9314/31,946) in the total sample. Those who used mobile health apps were more likely to be female, younger, without physical disability, and with a higher income. People at risk of cardiovascular disease or type 2 diabetes mellitus were not statistically significantly more likely to use mobile health than were people without risk (odds ratio 1.06, 95% CI 0.97-1.16; P=.18; adjusted for age, sex, income, and physical disability).ConclusionsPeople at risk of cardiovascular disease or type 2 diabetes mellitus were not more likely to use mobile health apps than were people without risk. Those who used mobile health apps were less likely to be male, older, with a physical disability, and with a lower income. From the results, we concluded that aspects of equity must be considered when implementing a mobile health intervention to reach all those that can potentially benefit from it.

Older cancer survivors' perspectives and use of telehealth in their cancer survivorship care in the United States: A ResearchMatch® sample

IntroductionCOVID-19 has resulted in reliance on telecommunication technologies for the provision of supportive cancer care. However, research on the use of these resources among older adults, who are the majority of cancer survivors, is limited. The objective of this study was to gather information on older cancer survivors' perspectives and use of telehealth their cancer survivorship care in the United States. Materials and MethodsPotential participants were recruited through ResearchMatch® from December 2020–January 2021. Online semi-structured interviews were conducted. Descriptive statistics were used to analyze the participants' demographic and health characteristics. Content analysis were conducted by two independent coders for identification of common themes. Coding agreement was reached through consensus, and count comparisons of participant responses were made. ResultsThe majority of respondents (n = 21; mean age = 73.5 ± 4.9) were female (57%), White (90%), and had a variety of cancer diagnoses. Participants reported using a variety of technology devices and telehealth products. Older cancer survivors (n = 10) endorsed telehealth video use for physical health concerns and basic check-ups, but some (n = 4) preferred in-person visits for major concerns and sensitive issues (e.g., mental health). Half of participants reported mobile health app use; however, ten participants did not use these apps as they felt the technology was not useful. Barriers to health technology use included missing face-to-face connections with providers, lack of familiarity with the technology, and perceived lack of utility and personalized telehealth platforms. Lastly, video-based conferencing and social media site use among seventeen participants was reported for social interaction during the COVID-19 pandemic. DiscussionThese findings suggest that older cancer survivors utilize online platforms for their general health; however, they prefer in-person visits for serious issues and value personalization with telehealth. Despite from a highly educated sample of ResearchMatch® participants, these results can be used to inform clinicians and researchers about the appropriateness and provision of telehealth-based supportive care among older cancer survivors.

The Use of Mobile Health Apps in Clinical Practice Remains Challenging.

According to several international recommendations, disease activity should be regularly monitored with validated outcome measures in patients with axial spondyloarthritis (axSpA), and therapy should be adapted accordingly.1-3 Increasingly, healthcare providers are encouraged to also use patient-reported outcomes (PROs) for this purpose, to capture valuable data from the patient's perspective.

The Sociodemographic Digital Divide in Mobile Health App Use Among Clients at Outpatient Departments in Inner Mongolia, China: Cross-sectional Survey Study.

BackgroundMobile health (mHealth) apps have become part of the infrastructure for access to health care in hospitals, especially during the COVID-19 pandemic. However, little is known about the effects of sociodemographic characteristics on the digital divide regarding the use of hospital-based mHealth apps and their benefits to patients and caregivers.ObjectiveThe aim of this study was to document the cascade of potential influences from digital access to digital use and then to mHealth use, as well as the potential influence of sociodemographic variables on elements of the cascade.MethodsA cross-sectional survey was conducted from January to February 2021 among adult clients at outpatient departments in 12 tertiary hospitals of Inner Mongolia, China. Structural equation modeling was conducted after the construct comprising digital access, digital use, and mHealth use was validated.ResultsOf 2115 participants, the β coefficients (95% CI) of potential influence of digital access on digital use, and potential influence of digital use on mHealth use, were 0.28 (95% CI 0.22-0.34) and 0.51 (95% CI 0.38-0.64), respectively. Older adults were disadvantaged with regard to mHealth access and use (β=–0.38 and β=–0.41), as were less educated subgroups (β=–0.24 and β=–0.27), and these two factors had nonsignificant direct effects on mHealth use.ConclusionsTo overcome the mHealth use divide, it is important to improve digital access and digital use among older adults and less educated groups.

COVID-19 Mobile Apps in Saudi Arabia: Systematic Identification, Evaluation, and Features Assessment.

BackgroundThe coronavirus disease 2019 (COVID-19) pandemic is the greatest global health threat in our century at the moment, and the use of mobile health apps has been one digital healthcare strategy adopted for coping with this outbreak.ObjectiveThis study aims to identify and explore the mobile applications that are currently being utilized for dealing with COVID-19 in Saudi Arabia.MethodsThe applications were selected based on the (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) PRISMA guidelines, then the functionalities were extracted based on the COVID-19 application mind map. Finally, the quality of the apps was assessed using the Mobile Application Rating Scale (MARS) for overall quality, satisfaction, engagement, functionality, aesthetics, and information.ResultsThe search identified six applications that were currently being used for COVID-19 which provided the following functionalities: self-assessment, self-isolation, permit for car mobility, prevention guidelines, COVID-19 lab results, call support, identifying nearby facilities, reporting suspected cases, and booking clinic appointments and the COVID-19 test. The findings showed that while most of these features were provided by multiple apps, on the MARS, the overall scores ranged from 3.26 to 3.69 with the apps scoring lower in the areas of satisfaction and engagement and higher in functionalities.ConclusionFurther steps are needed to unify all these functions in one health app to enhance the users' experience.

Expectations of a Health-Related Mobile Self-Management App Intervention Among Individuals With Spinal Cord Injury.

Our research team developed a mobile application (app) to facilitate health-related self-management behaviors for secondary conditions among individuals with spinal cord injury (SCI). To facilitate mobile app adoption and ongoing use into the community, it is important to understand potential users' expectations and needs. The primary objective of this study was to explore user expectations of a mobile app intervention designed to facilitate self-management behavior among individuals with SCI. Data were collected via one-on-one, semi-structured interviews with a subsample of 20 community-dwelling participants enrolled in a larger, clinical trial. Analysis of the transcripts was undertaken using a six-phase process of thematic analysis. Our analysis identified three main themes for expectations of the mobile app intervention. The first theme, desiring better health outcomes, identified participants' expectation of being able to improve their psychological, behavioral, and physical health outcomes and reduce associated secondary conditions. The second theme, wanting to learn about the mobile app's potential, identified participants' interest in exploring the functionality of the app and its ability to promote new experiences in health management. The third theme, desiring greater personal autonomy and social participation, identified participants' desire to improve their understanding of their health and the expectation for the app to facilitate social engagement with others in the community. By exploring end-users' expectations, these findings may have short-term effects on improving continued mobile health app use among SCI populations and long-term effects on informing future development of mobile app interventions among chronic disease populations.