Use Of Mobile Health Applications Research Articles

Abstract 245: Smartwomantm: Feasibility of a Mobile Application to Improve Cardiovascular Risk Factors in Indigent Diabetic Women

Introduction: Cardiovascular disease disparately affects women with diabetes mellitus. Among women with diabetes, cardiovascular disease prevention, including risk factor monitoring and lifestyle modification is important but underutilized. Mobile health strategies are emerging communication technologies to improve self management and health behaviours. However, the feasibility of mobile health technology (m-health) to enhance health behaviors in an indigent population is unknown. We developed and examined the feasibility of m-health to improve health behaviors and self-management regarding coronary risk factors in indigent women with diabetes. Methods: We developed a smartphone application based on the AHA’s “Life’s Simple 7” prevention module. Mobile technology was integrated into the overall program, with communication enabled devices (weight scales, glucometers, and sphygmomanometers) synchronized to the smartphone. FitBit was used to monitor activity level. We tested the feasibility of the mobile application in the SMARTWOMANTM project which enrolled women with diabetes, without known CVD at an inner city hospital;,these women had suboptimal access to care, limited transportation and resources, and limited health literacy. Results: Fourteen women, all African-American were enrolled in SMARTWOMANTM (mean age 52 yrs, 86% with hypertension, hypercholesterolemia and obesity). The overall weekly mobile-application reporting was 85% for blood glucose, 83% for daily steps, and 77% for systolic blood pressure. The majority reported the text messages to be useful (92%) and appropriate in frequency (92%). Participants found positive text messages as a strong reinforcement to healthy behaviors. They indicated that study participation increased their motivation in taking charge of their health, and increased understanding of their health condition and self-management. Conclusions: Among indigent African-American women with diabetes and no known CVD, the development and use of mobile health application was feasible and resulted in increased patient satisfaction and positive reinforcement to healthy behaviors.

Extending FDA guidance to include consumer medication information (CMI) delivery on mobile devices.

This paper describes the current state of consumer-focused mobile health application use and the current U.S. Food and Drug Administration (FDA) guidance on the distribution of consumer medication information (CMI), and discusses recommendations and considerations for the FDA to expand CMI guidance to include CMI in mobile applications. Smartphone-based health interventions have been linked to increased medication adherence and improved health outcomes. Trends in smartphone ownership present opportunities to more effectively communicate and disseminate medication information; however, current FDA guidance for CMI does not outline how to effectively communicate CMI on a mobile platform, particularly in regards to user-centered design and information sourcing. As evidence supporting the potential effectiveness of mobile communication in health care continues to increase, CMI developers, regulating entities, and researchers should take note. Although mobile-based CMI offers an innovative mechanism to deliver medication information, caution should be exercised. Specifically, considerations for developing mobile CMI include consumers' digital literacy, user experience (e.g., usability), and the quality and accuracy of new widely used sources of information (e.g., crowd-sourced reviews and ratings). Recommended changes to FDA guidance for CMI include altering the language about scientific accuracy to address more novel methods of information gathering (e.g., anecdotal experiences and Google Consumer Surveys) and including guidance for usability testing of mobile health applications.

Electronic diagnostic algorithms to assist mid-level health care workers in Nepal: A mixed-method exploratory study

IntroductionThe use of mobile health applications for data collection and disease management by rural health care workers in developing countries has been shown to be accepted by patients and health care workers. However, the acceptances of diagnostic decision applications have not been studied. Moreover, verbal acceptance of these tools has not been shown to equate with actual usage by the health care workers when use is not compulsory. ObjectiveTo measure the acceptance, usage and reasons for use or non-use of electronic diagnostic applications by health care workers to aid in clinical diagnosis. MethodsEleven health care workers (HCW) from rural facilities were asked to use the e-algo application on an electronic tablet with patients over the age of five presenting with acute complaints. Use was compulsory for the first 30 working days and after that optional. Patients were asked by questionnaire about their preference and confidence between the traditional approach and that of the e-algo. HCW acceptance was measured by focus group discussions after the compulsory period. The HCW was then told to use the application as they desired. After two months of non-compulsory usage, reasons were explored for use or non-use through a focus group discussion and interviews. ResultsA total of 1410 out-patient encounters occurred in the first phase. Of this, the e-algo was used with 1177 encounters (83%). 496 patients were asked about their preference and confidence in the use of the e-algo. 325 preferred the e-algo over the traditional visit 65.8–25.1%. Patient confidence was higher in the e-algo 72.2–17.4%.In the second phase, three of the nine HCWs did not use the e-algo at all, the remaining six HCWs reported e-algo use dropped to approximately 15% of total OPD visits. E-algos were reported to be used primarily with more complicated or confusing cases. Reasons for non-use was primarily time related. ConclusionsWe concluded that patients had confidence in and preferred the HCW using the e-algo in their patient care. The HCW users were also positive about the e-algo application, seeing its primary benefit as assisting them in more difficult cases through the use of a differential diagnosis and focused questions. HCWs also reported that the e-algo functioned as a learning tool as well as a diagnostic tool. However, actual usage of the application dropped off significantly when its use was not mandatory. The primary reason was that they did not feel the time required to use the application was warranted in the vast majority of their cases which they perceived as being simple and easily diagnose without the assistance of the application. Unless the HCW perceives the decision-support application to be valid, time-saving and easy to use, they will not use them.

Social Media in Clinical Practice

discussed since Health 2.0 appeared in the mid-2000s [1], and it has received ongoing attention ever since. Social media are weband mobile-based digital communication tools used for interactive dialogues, forming communities, and supporting user-generated content [2]. In an article on the effects of social media on the healthcare field, Honigman [3] reported statistics and figures to describe the findings of the impact of social media on healthcare. The article reported that YouTube traffic to hospital sites has increased 119% year-over-year; this includes people communicating information with friends, family, or colleagues about the hospital and sharing videos. Thirty percent of patients who watched a video made an appointment with that hospital [4]. Although the report was based on the United States alone, this example clearly shows that social media play a role in the provision of health information and are increasingly being used as a marketing tool for the healthcare industry. A review article examining the benefits and challenges regarding patients’ use of social media tools reported an increased use of social media by patients in healthcare with benefits and promises; at the same time, it also described some limitations regarding social media’s effectiveness [5]. Additionally, the availability of people’s experiences and reviews of the care they have received on blogs, social networks, and microblogs, enables the novel possibility of analyzing these reviews via techniques such as natural language processing and sentiment analysis to detect quality of care [6]. Several articles have been published in Healthcare Informatics Research (HIR) regarding the development and use of mobile health applications for a variety of conditions, such as diabetes, coronary heart disease, and obesity [7-10]. Social Media in Clinical Practice

Mobile Health Applications in Workplace Health Promotion: An Integrated Conceptual Adoption Framework

Mobile health applications have proved very useful in preventive healthcare. Yet, neither theorists nor practitioners have considered mobile health applications in the context of workplace health promotion. This paper aims to fill this gap by discussing the suitability of mobile health applications as a measure of workplace health promotion and the underlying motivations that drive employees to adopt the use of mobile health applications in the workplace. Drawing on the technology acceptance model, health belief model, and the theory of planned behavior, constructs affecting adoption behavior are identified, relevant propositions are arrived at, and managerial implications are discussed.

Abstract TP317: Mobile Technology Profile of Stroke Survivors and Caregivers: Preliminary Results from a National Survey

Background: Recent estimates are that approximately 110 million Americans have access to nearly 14,000 health-related apps. There is a paucity in applications specific for stroke, either survivors or caregivers. Objective: Qualitative survey of stroke survivors and caregivers’ needs, attitudes, knowledge, and behaviors concerning mobile technology (m-TECH) was assessed through an online medium. Methods: National Stroke Association (NSA) elicited responses from a random, national sample of 601 stroke survivors and caregivers. The 25-question survey asked about how stroke survivors and caregivers track their health information, use smartphones and available health-related applications, and their perceived needs and preferences for a potential smartphone application. Data were collected on demographics, health tracking behavior, smartphone and mobile health application use, and interest in health management applications. Responses were collected through open source online survey application, LimeSurvey. Results: Thirty-five (6%) individuals (range 18-91+ years; 55% female) completed the survey, evenly split between: stroke survivors and caregivers; 41% completed some college. The majority of respondents (73%) tracked their health information to manage risk factors to prevent stroke: medication tracking (82%), monitoring blood pressure and cholesterol (77%), and managing medical appointments (73%). The greatest barrier to tracking health information was forgetfulness (41%). Half owned smartphones, with 27% Android users and 14% iPhone users, with almost half (45%) reporting to have downloaded applications on their smartphones that they used (41%), including multiple times a day (32%). Additionally, 23% of the smartphone users reported using their phones to track health information. Majority (60%) of respondents expressed interest in smartphone apps that can help managing health information and half (50%) were interested in helping with the application development. Conclusions: Recognizing concern over generalizability, these preliminary results suggest a clear need for patient-centered mobile health applications in personal health management tailored specifically for stroke survivors and caregivers.