Mobile Health Services Research Articles

Relationship Between The Use of National Health Insurance Mobile Application and Health Services

Background: Advances in science and technology continue to develop rapidly, including in the use of the National Health Insurance (JKN) Mobile application. Mobile JKN is a digital innovation developed by BPJS Kesehatan. With this application, people can easily access comprehensive health services. Mobile JKN is a progressive step in ensuring equal access for everyone. In addition, users of this application can be more practical when forgetting to bring a physical card; Just open the application, the officer can view the card online. Objective: This study aims to explain the relationship between the use of the Mobile JKN application and the quality of health services. Research method: This study uses a quantitative method with an analytical survey approach and a cross-sectional design. The population in this study is all BPJS participants in the working area of the Pagar Merbau Health Center, Deli Serdang Regency. Samples were taken purposively, and primary and secondary data were collected for analysis. Results: The results showed that the majority of respondents (64.7%) used the Mobile JKN application, and the majority of respondents (70.4%) stated that the quality of health services they received was good. There was a significant relationship between the use of Mobile JKN and the quality of health services in the working area of the Pagar Merbau Health Center, Deli Serdang Regency (p=0.002). It is hoped that people in the Pagar Merbau Health Center area will make more use of the Mobile JKN application to get more effective and efficient services when receiving treatment. In addition, health workers are expected to continue to socialize about Mobile JKN on a regular basis, so that the public always remembers the importance of using this application to get optimal service.

Structural barriers and facilitators to accessing HIV services for marginalized working populations: Insights from farm workers in South Africa.

Farm workers are a vulnerable working population that face significant inequalities in accessing health services, including those for HIV prevention, treatment, and care. This descriptive phenomenological study aimed to explore farm workers' experiences when accessing HIV services, and was conducted in Limpopo province, South Africa. Eighteen in-depth interviews (IDIs) were conducted in four health facilities from two districts, and two focus group discussions (FDGs) were conducted in one of the farms within the province. Purposive and systematic random sampling were used to select study participants. A deductive thematic approach was used to analyze data, informed by the social-ecological model of health. The results reveal that farm workers perceive multiple interdependent factors that inhibit or enable their access to HIV healthcare services. Key barriers to HIV healthcare were transport affordability, health worker attitudes, stigma and discrimination, models of HIV healthcare delivery, geographic location of health facilities, and difficult working conditions. Key facilitators to HIV healthcare included the availability of mobile health services, the presence of community health workers, and a supportive work environment. The findings suggest disparities in farm workers' access to HIV services, with work being the main determinant of access. We, therefore, recommend a review of HIV policies and programs for the agricultural sector, and models of HIV healthcare delivery that address the unique needs of farm workers.

Examination of Health Data of Elderly Individuals Registered with Family Medicine: A Retrospective Study

Objective: The research aims to determine the utilization of health services by elderly individuals registered in family medicine according to their sociodemographic characteristics and mobile service usage. Methods: The population of the research consists of 417 individuals aged 65 and over who are registered with a family health center in the west of Türkiye. The retrospective research method was used in this research. In the study, the information of elderly people aged 65 and over registered with family medicine was used. Results: In the study, it was determined that there was a statistically significant relationship between old age and gender, educational status, place of residence, and mobile service availability. It has been determined that mobile services are the most used in middle age (55.2%). Additionally, it was determined that 97.8% of mobile service users had not been vaccinated (Influenza Vaccine, Hepatitis B Vaccine, Tetanus-Diphtheria Vaccine). Conclusion: The results revealed that mobile health services are inadequate for elderly individuals. As a solution, it is recommended to increase the number of days of mobile health service for rural areas or to establish a family medicine unit in these villages.

MHealth Service Effects for Negative Emotions Among Parents of Preterm Infants: A Systematic Review and Meta-Analysis.

This review aims to ascertain the effects of mHealth on negative emotions among parents of preterm infants and analyze the current state of mHealth services in this context. Caring for preterm infants often engenders negative emotions in parents, such as anxiety, depression, and stress. Mobile Health (mHealth) services offer potential benefits for preterm infant care. However, there are several uncertainties regarding the impact of mHealth services on parental emotions. Randomized controlled trial (RCT) and quasi-RCT were published in English and Chinese until 2023 and are available in the electronic databases of MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINHAHL), Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Wanfang Database, and China Science and Technology Journal Database were reviewed. Review Manager 5.4 was employed for random-effects meta-analysis. Seven RCTs and 6 quasi-RCTs with high risks were included, most of them were based on small sample size and single-centered. Meta-analysis demonstrated that mHealth interventions mitigated negative emotions, including anxiety (standard mean difference [SMD]=-1.07; 95% confidence interval [CI], -1.47 to -0.66; P<0.0001), depression (SMD=-1.94; 95% CI, -3.01 to -0.86; P<0.0001), and stress (SMD=-1.24; 95% CI, -2.07 to -0.40; P<0.0001), among parents of preterm infants. It is recommended to develop independent specialized software for mHealth, enhance theoretical underpinnings, and standardize practical protocols. Incorporating early recognition and screening of negative emotions within mHealth could offer comprehensive support for the mental health of parents with preterm infants. The mHealth-based interventions are needed to focus on the parents' emotional needs and minimize the impacts associated with mental stress.

Digital Health: The Critical Value of Mobile Technology for the Health Sector, Different Application Examples from the World and Current Trends

The internet technology, which began to integrate into our lives rapidly by the end of the 1990s, underwent significant transformations with the advent of mobile technology in the 2000s. Initially accessible through desktop or notebook computers, the internet has evolved to become an integral part of virtually every aspect of our lives as mobile technology advanced throughout the 2000s. The purpose of this study is to examine the role of mobile technologies within current health technologies, investigate the necessary competencies, evaluate mobile technology developments both in Türkiye and globally, and assess the information technology infrastructure, competencies, and skills required by the sector. Our research details various and specific mobile applications from numerous countries. Findings indicate that mobile technology has established itself much more rapidly and effectively in countries with strong internet infrastructure. Mobile health services are perceived as highly valuable by citizens. The real quality and effectiveness of mobile technology depend on its acceptance and swift implementation by users. Gamification is an important tool in the adoption of mobile health applications. These applications can enhance motivation by enabling both doctors to monitor patient care services and patients to track their own health. A good mobile health system should be accepted by both patients and doctors. In countries like Türkiye, where the health system is largely supported by the state, it is seen as necessary for the Ministry of Health to prioritize mobile services to establish a robust mobile health system. Furthermore, to effectively structure mobile services, it is essential to focus on the right problems and identify issues in order of priority. Literature review reveals that various mobile applications have been implemented in fields such as dermatology, orthopedics, ophthalmology, neurosurgery, and clinical pathology. Mobile technologies offer significant cost advantages in the delivery of health services. As the population ages in European Union countries, national governments are seeking ways to reduce healthcare costs. Mobile health is considered a solution to transform the delivery of health services and reduce costs through viable new care models for both industrialized and developing countries. Moreover, it has been observed that mobile applications provide significant benefits for the elderly, particularly in developed countries such as Germany and Sweden. Our study provides a comprehensive assessment of mobile technology in the healthcare sector, highlights prominent applications from Türkiye and around the world, and offers an extensive evaluation for field readers.

Mobile Health Service Adoption: Reducing the Digital Gap and Age's Moderating Influence

Mobile Health Service Adoption: Reducing the Digital Gap and Age's Moderating Influence

Air Pollution, Physical Exercise, and Physical Health: An Analysis Based on Data from the China General Social Survey

This study aims to investigate the influence of air pollution and physical exercise on residents’ health using data from the Chinese General Social Survey (CGSS) 2018. The research is based on the Grossman Health Production Function and employs the ordered logit model to analyze the relationship between air pollution, physical exercise, and residents’ health. We find that among the Chinese population aged 18 and above, air pollution negatively affects residents’ physical health, whereas physical exercise has a significantly positive effect. Introducing gender-stratified and urban–rural stratified models, the research reveals that the negative effects of air pollution on residents’ health vary among different groups. On one hand, men and residents living in urban areas will bear heavier health damages due to air pollution. On the other hand, physical exercise positively affect the health of both men and women, whether in rural or urban areas. Additionally, age and higher income are associated with better physical health, whereas education does not show a significant impact. Based on these findings, a series of policy recommendations have been proposed to comprehensively and systematically promote ecological governance and sustainable development. The government should strengthen environmental regulations, reduce residents’ exposure to air pollution risks, improve the equality of basic public services, invest in rural sports infrastructure, promote healthy lifestyles, and provide personalized health guidance through health education and mobile health services. Moreover, when formulating policies, the government should consider the specific needs of different groups to ensure the fairness and sustainability of the policies.

An evaluation of the impact of social and structural determinants of health on forgone care during the COVID-19 pandemic in Baltimore, Maryland.

Evidence suggests that reductions in healthcare utilization, including forgone care, during the COVID-19 pandemic may be contributing towards excess morbidity and mortality. The objective of this study was to describe individual and community-level correlates of forgone care during the COVID-19 pandemic. We conducted a cross-sectional, secondary data analysis of participants (n = 2,003) who reported needing healthcare in two population-representative surveys conducted in Baltimore, MD in 2021 and 2021-2022. Abstracted data included the experience of forgone care, socio-demographic data, comorbidities, financial strain, and community of residence. Participant's community of residence were linked with data acquired from the Baltimore Neighborhood Indicators Alliance relevant to healthcare access and utilization, including walkability and internet access, among others. The data were analyzed using weighted random effects logistic regression. Individual-level factors found to be associated with increased odds for forgone care included individuals age 35-49 (compared to 18-34), female sex, experiencing housing insecurity during the pandemic, and the presence of functional limitations and mental illness. Black/African American individuals were found to have reduced odds of forgone care, compared to any other race. No community-level factors were significant in the multilevel analyses. Moving forward, it will be critical that health systems identify ways to address any barriers to care that populations might be experiencing, such as the use of mobile health services or telemedicine platforms. Additionally, public health emergency preparedness planning efforts must account for the unique needs of communities during future crises, to ensure that their health needs can continue to be met. Finally, additional research is needed to better understand how healthcare access and utilization practices have changed during versus before the pandemic.

Contribution of mobile health technologies to public health in rural areas: Accessibility and education methods

In today's rapidly advancing world, mobile health services have become influential in various aspects of our lives. It is anticipated that mobile applications, especially in rural areas, can play a significant role in the delivery of healthcare services. In this context, it is essential to examine the applications of mobile health services in rural areas and the education methods employed in these applications. The main objective of this study is to explore the contributions of mobile health services applications in rural areas to public health and to examine the education methods used in these services in light of current literature. The focus of this study is on how mobile health applications can be utilized in rural areas, the impact of this usage on public health, and the effectiveness of the education methods employed. The research was conducted through searches using key terms such as "mobile health" and "public health nursing" or "mobile health technologies" and "nursing" or "telehealth" on important academic databases like Google Scholar, PubMed free fulltext, Science Direct, Ebscohost, Sage, Scopus, and CINAHL. The information obtained from literature searches was analyzed to understand the impact of mobile health applications on public health in rural areas and the education methods employed. The study results indicate that the use of mobile health applications in rural areas can contribute significantly to public health. Advantages such as rapid diagnosis and treatment, effective monitoring of chronic diseases, and quick access to emergency services stand out among the potential impacts of mobile health applications. Mobile health applications can contribute significantly to public health in rural areas and increase their usage, particularly in primary healthcare services.

A fusion architecture to deliver multipurpose mobile health services

Mobile Health (mHealth) services typically make use of customized software architectures, leading to development-dependent fragmentation. Nevertheless, irrespective of their specific purpose, most mHealth services share common functionalities, where standard pieces could be reused or adapted to expedite service deployment and even extend the follow-up of appearing conditions under the same service. To harness compatibility and reuse, this article presents a data fusion architecture proposing a common design framework for mHealth services. An exhaustive mapping of mHealth functionalities identified in the literature serves as starting point. The architecture is then conceptualized making use of the Joint Directors of Laboratories (JDL) data fusion model. The aim of the architecture is to exploit the multi-source data acquisition capabilities supported by smartphones and Internet of Things devices, and artificial intelligence-enabled feature fusion. A series of interconnected fusion layers ensure streamlined data management; each layer is composed of microservices which may be implemented or omitted depending on the specific goals of the healthcare service. Moreover, the architecture considers essential features related to authentication mechanisms, data sharing protocols, practitioner-patient communication, context-based notifications and tailored visualization interfaces. The effectiveness of the architecture is underscored by its instantiation for four real cases, encompassing risk assessment for youth with mental health issues, remote monitoring for SARS-CoV-2 patients, liquid intake control for kidney disease patients, and peritoneal dialysis treatment support. This breadth of applications exemplifies how the architecture can effectively serve as a guidance framework to accelerate the design of mHealth services.

The Nigerian Health System and mHealth Philosophy: Weighing the Balance

The appalling state of the Nigerian healthcare system has drawn a lot of attention from scholars, medical experts, and free thinkers. To these people, it is baffling why despite Nigeria’s political and economic relevance in Africa; the country suffers a great deal of health insecurity. It is against this backdrop that this paper sought to examine and ascertain the balance between the Nigerian healthcare system and the mobile health philosophy (the process whereby mobile health devices and applications are used to carry out healthcare services delivery). Relying on the descriptive survey research design and method of analysis, the study examined healthcare procedures that provide prompt mobile health services to Nigerians. It finds that although the concept of mHealth is new to Nigerians, nonetheless, both medical experts and end users have taken advantage of it to maintain good health by seeking and providing solutions to health concerns and challenges. Other outstanding challenges that hamper the mHealth philosophy in Nigeria are epileptic power supply, poor internet coverage, lack of finance to acquire mobile health devices, security of peoples’ private information and many others. The paper condemned the lack of sustainable government (Federal, State and Local) support for primary, secondary and tertiary healthcare systems in the country. It is the conclusion of the paper that despite these challenges, the benefits of mHealth remain overwhelming especially as it makes healthcare service delivery proactive and easily accessible by everyone anywhere and anytime. Therefore, it should be integrated into the policy and health care delivery system in Nigeria.

SNS 기반 모바일 정신건강서비스 플랫폼 이용경험에 관한 현상학적 연구

This study is a phenomenological study on the experience of using a mobile mental health service platform developed and provided by mental health social welfare experts, and was conducted to provide practical policy and practical suggestions for the necessity of a mobile mental health service platform and the use of a professional mobile mental health service platform in Korea's mental health service delivery system. To this study, data were collected from 12 research participants who have been continuously using the platform for more than a year, and the data were analyzed by applying Giorgi's phenomenological perspective to deeply analyze the nature and meaning of the experience of the phenomenon. As a result of the analysis, 7 components and 20 sub-components were derived, and the components were found to struggle in the beginning and despair of the problem, mental health services I used and negative memories, various mental health services experienced in accidental spaces, reasons for continuing to find the mobile mental health service platform, psychological stability and practical change and recovery, limitations of personal mobile mental health service platforms, and partnerships with public mental health services. Based on these analysis results, the conclusions of this study and practical suggestions were presented.

The acceptability, usability, engagement and optimisation of a mHealth service promoting healthy lifestyle behaviours: A mixed method feasibility study.

Mobile health (mHealth) services suffer from high attrition rates yet represent a viable strategy for adults to improve their health. There is a need to develop evidence-based mHealth services and to constantly evaluate their feasibility. This study explored the acceptability, usability, engagement and optimisation of a co-developed mHealth service, aiming to promote healthy lifestyle behaviours. The service LongLife Active® (LLA) is a mobile app with coaching. Adults were recruited from the general population. Quantitative results and qualitative findings guided the reasoning for the acceptability, usability, engagement and optimisation of LLA. Data from: questionnaires, log data, eight semi-structured interviews with users, feedback comments from users and two focus groups with product developers and coaches were collected. Inductive content analysis was used to analyse the qualitative data. A mixed method approach was used to interpret the findings. The final sample was 55 users (82% female), who signed up to use the service for 12 weeks. Engagement data was available for 43 (78%). The action plan was the most popular function engaged with by users. The mean scores for acceptability and usability were 3.3/5.0 and 50/100, respectively, rated by 15 users. Users expressed that the service's health focus was unique, and the service gave them a 'kickstart' in their behaviour change. Many ways to optimise the service were identified, including to increase personalisation, promote motivation and improve usability. By incorporating suggestions for optimisation, this service has the potential to support peoples' healthy lifestyle behaviours.

Acceptability and usability of a WeChat-based intervention for depression in China: A mixed-methods study.

As research on the use of mobile technology to deliver mental health support grows, the research from China is still very limited. How to design an acceptable and usable mobile mental health service model suitable for China's social and cultural environment remains to be studied. To understand the acceptability and usability of a WeChat-based intervention among Chinese patients with depression, and to provide insights to promote future development of user-centered mobile mental health services design. The research team developed a multi-theoretical intervention that includes seven modules: recovery lessons, recovery journal, coaching sessions, mindfulness, personalized support, regular assessments and feedback collection. Forty-two patients diagnosed with depressive disorder were recruited, with a mixed sample of patients who were using an antidepressant medication (n = 29) and patients who were not using an antidepressant medication (n = 13). A single-arm mixed-methods study was conducted to understand engagement, satisfaction, usability and potential clinical effectiveness of the intervention. There was a retention rate of 83.33% - 22 participants who used an antidepressant medication and 13 participants who did not use an antidepressant medication completed the final assessments. The median (upper quartile-lower quartile) of the completed 60 recovery journals and 7 coaching sessions was 56 (59-46) and 6 (7-4) times, respectively. Participants' satisfaction regarding their recovery progress, and on perceived helpfulness on different modules were high. The overall score of the user version of the Mobile Application Rating Scale was 4.23 (SD 0.44, range 1-5), indicating high acceptability and usability. Qualitative feedback identified three key themes: an efficient access to professional help, a personalized source of social support, and a facilitator of cognitive and behavioral change. This study demonstrated that a WeChat-based intervention for depression was acceptable, and has the potential to promote personal recovery. More studies are needed to understand the efficacy and implementation of this model in real world.

Acceptance of mobile health services in emerging markets: a study of Egyptian consumers

Acceptance of mobile health services in emerging markets: a study of Egyptian consumers

Exploring sources of patient dissatisfaction in mobile health communication: A text analysis based on structural topic model.

Understanding online patient dissatisfaction is essential for improving the quality of healthcare services, patient satisfaction, and physician career development. This study is the first to apply the structural topic model to patient satisfaction research based on patient online reviews from a mobile health communication platform, revealing eight negative topics of patient concerns. These topics include under-explored areas such as "go to the hospital for check-ups," "incomplete counseling," and "language expression." Additionally, we incorporated the doctor's title as a covariate in the model to examine how specific topics varied across different conditions. The results indicated that higher-titled doctors were more likely to receive complaints about the cost of treatment and whether the question was answered, whereas lower-titled doctors were more likely to receive complaints related to physician's knowledge, incomplete counseling, and response speed. This study not only enhances our understanding of mobile health services but also provides targeted insights for healthcare providers to improve their services, thereby contributing to the advancement of patient-centered care.

Exploring User Requirements for Mobile Health Service Systems

This study investigates the evolving role of mHealth services, emphasizing their potential to enhance well-being and promote a healthy lifestyle. The widespread adoption of mobile devices has led to a surge in mHealth services and a growing user base, creating the challenge of developing services that meet diverse needs. This research explores the requirements of different user segments for mHealth services, using health motivation and control beliefs as the basis for segmentation. The study categorizes mHealth services into eight distinct categories based on user perceptions and assesses how different segments prioritize and value these services. The findings offer insights into the characteristics and preferences of various mHealth user segments, guiding the development of targeted mHealth services that enhance engagement and overall well-being. Ultimately, this study contributes to innovation and development within the mHealth industry, providing a pathway for creating more effective and comprehensive service systems that address the varied needs of the population, fostering a more personalized approach to healthcare delivery.

HEALTHCARE ON WHEELS: SOCIAL AND ECONOMIC OUTCOMES OF THE MOBILE DISPENSARY INITIATIVE BY TATA POWER DDL

This paper focuses on the social and economic impacts of Mobile Dispensary Initiative of Tata Power DDL in the JJ colony of North and West Delhi. Using an ethnographic research approach, based on their perceptions of the mobile health care services. The results show positive changes in health literacy concerning the availability of primary healthcare services to disenfranchised populations. Participants expressed the fact that they were experiencing low healthcare bills as well as the efficient delivery of services therefore the key role of the initiative to the improvement of economic stability was evident. Also, quantitative data collected through interviews, surveys, and direct observations gave a more social aspect of the social relations and community mobilization supported by the mobile dispensaries. This study emphasizes the need to come up with new solutions to some of the health issues affecting the urban dwellers and supports the incorporation of corporate social responsibility programs into the public health framework. Finally, the research provides policy implications for the extension of mobile health service and the exploration of the effects on the well-being of a community.

The Effect of "Offline-to-Online" Trust Transfer on the Utilization of Online Medical Consultation Among Chinese Rural Residents: Experimental Study.

Online medical consultation can serve as a valuable means for rural residents to access high-quality health care resources, thereby mitigating the geographic and economic disadvantages prevalent in rural areas. Nevertheless, due to lower cognitive abilities, rural residents often face challenges in trusting and making effective use of online medical consultations. More likely, adopting a bounded rational decision-making model that facilitates the "offline-to-online" trust transfer could prove to be a potentially effective approach. This strategy aims to encourage less technologically experienced rural residents to trust and make use of online medical consultations. This study aims to characterize the status of "offline-to-online" trust transfer among rural residents in the context of internet health care, and analyze its direct impact on facilitating the utilization of online medical consultation. Additionally, we investigate the family spillover effect of "offline-to-online" trust transfer in promoting the use of online medical consultation among rural family members, considering its distributional effect across various education levels of the population. A multistage stratified random sampling method was used to survey participants in rural areas of China from July to September 2021, encompassing a total of 2597 rural residents from 960 rural households. Propensity score values were estimated using logit regression, and the propensity score matching method, using the K-nearest neighbor matching, radius matching, and kernel matching methods, was applied to create matched treatment and control samples of rural residents based on their experience of "offline-to-online" trust transfer. Subsequently, we calculated average treatment effect scores to compare the differences in utilizing online medical consultation between the treatment and control rural samples. As many as 551/960 (57.4%) rural residents experienced an "offline-to-online" trust transfer, with a higher likelihood observed in the older population with lower levels of education and higher satisfaction with local health care services. Furthermore, rural residents who underwent "offline-to-online" trust transfer were 37%-40% more likely to utilize online medical consultation compared with those who did not experience this trust transfer. Additionally, family members of householders who underwent "offline-to-online" trust transfer were 25%-28% more likely to utilize online medical consultation than those whose householders did not experience this trust transfer. Notably, when compared with populations with high-level education, the "offline-to-online" trust transfer had more significant direct and spillover effects on the utilization of online medical consultation services among rural residents with low-level education. To enhance the "offline-to-online" trust transfer among rural residents and its facilitation in their utilization of online medical consultation, as well as other mobile health (mHealth) and ubiquitous health (uHealth) services, we recommend that online health care providers adopt a "patient-oriented" service model. This approach aims to elevate rural residents' satisfaction with local health care services and harness the trust-building functions inherent in physician-patient relationships and among family members.

DIGITAL MARKETING IN HEALTHCARE AND ITS APPLICATIONS IN THE WORLD AND TURKEY

Developing technologies and changing consumer attitudes and demands have caused major changes in many sectors. Some of these have disappeared and new sectors that were previously unknown or unheard of have emerged in their place. Digital technologies play the leading role in this change. While digital technologies are accepted in many sectors, it is unthinkable for the healthcare sector to stay away from this. Digital technology has caused radical changes in marketing in healthcare. The type of marketing that aims to provide services by taking advantage of all the opportunities of digitalization via the internet in order to effectively communicate the products or services of businesses and service providers to large communities is called digital marketing. All actions taken to perceive the problems related to the physical and mental health of the target community, to find solutions to these problems, and to influence the target community by explaining how benefits can be provided are called healthcare marketing. E-health or digital health is used as a generalizing term for the use of information communication technologies in health-related services and processes. The scope of digital health technologies used in digital health services is wide. In this context, digital technologies such as digital health records, mobile health services, artificial intelligence applications, wearable technologies and telemedicine can be considered.