Mobile Phone Health Research Articles

Hypertensive Pregnant Women’s Experience Regarding the Use of Mobile Health Application: A Phenomenological Study

Background: Considering the popularity of mobile health applications among people in the community and the positive results of studies, these applications can be helpful in improving and better controlling blood pressure in patients. Examining users' experiences using these technologies can enhance their effectiveness. Objectives: The current study aimed to investigate the experiences of pregnant mothers with high blood pressure using a mobile phone health application with a phenomenological approach in Kermanshah, Iran. Methods: This qualitative and phenomenological study was conducted in 2023. For this purpose, 17 pregnant mothers with high blood pressure were included in the study. Data were collected through semi-structured interviews and analyzed using the "Van Manen" method. Results: Four main themes and 12 sub-themes were identified from the interviews. Based on this, reliability (quality of content, educational method, and feedback), waiting time (no need to refer to different sources and speed of response), motivation (achievable goals, structure and order, encouragement and diversity in content), and facilities (interface easy to use, interactive activities and the ability to receive advice from an expert) were the themes and sub-themes extracted from the interviews. Conclusions: This study's findings shed light on the potential of mobile health applications for hypertensive pregnant women. They underscore the importance of user-centered design and the potential of mobile health applications to empower and support pregnant women with hypertension. Future research and innovation can lead to developing more appropriate and effective mobile health applications for individuals, thereby fostering a more optimistic outlook for healthcare by incorporating users' perspectives and needs.

Opportunities for improving hypertension control in sub-Saharan Africa.

Hypertension is currently one of the most common risk factors for the development of cardiovascular disease. An estimated 46% of the adult population in sub-Saharan Africa (SSA) has hypertension and its increasing prevalence is associated with factors such as urbanization and adverse lifestyle behavior. The process of managing hypertension in SSA includes increasing screening and diagnosis, and treatment of diagnosed patients. In addition to this process, community-based interventions have also highlighted promotion of educating healthcare providers and building capacity within the health system. Although there seems to be a process in place to control blood pressure of hypertensive individuals in SSA, optimal management of hypertension in this region remains a challenge, and the need for implementation of innovative strategies to achieve optimal BP control in hypertensive individuals remains critical. Various hypertension guidelines recommend the use of out-of-office blood pressure monitoring as a technique to control hypertension. Thus far, several publications have highlighted the potential of implementing the use of home blood pressure telemonitoring (HTM) in general practice, globally. HTM is a telemedicine strategy that is implemented to remotely transmit blood pressure data and additional health information of patients from the comfort of their home to the health practitioner. To date, there is evidence from various controlled trials reporting that prolonged and regular use of HTM is associated with a significant reduction of blood pressure in hypertensive patients compared with usual care. Despite HTM being reported as a potential measure for control of hypertension, there are no known estimates of hypertensive patients being managed using HTM in SSA and there have been few successful HTM programs implemented in SSA. HTM activity is reported in only 4 out of 46 countries in SSA using telephone calls, text messages and mobile phone health applications. In these HTM programs, significant reduction in blood pressure of patients was reported showing the great potential that HTM has in controlling blood pressure of hypertensive patients in SSA.

Abstract 12491: Use of a Self-Care Mobile Phone Application Can Improve Patient Education and Medication Adherence in Patients With Acute Decompensated Heart Failure

Introduction: The use of digital health technologies using mobile phone health applications has increased over the last few years. We developed a mobile phone application (APP) (Aintree Heart Failure Passport APP) for heart failure (HF) patient self-education and improved medication adherence. The APP consisted of a Traffic Light System for education self-care advice, prompt for medications, reminder of appointments, educational videos as well as a mood check questionnaire. Methods: This was a pilot feasibility study in a British university hospital conducted in 2019 and 2020. We assessed self-care behaviour following the use of the Aintree Heart Failure Passport Mobile APP in a cohort of patients with acute decompensated HF. We employed the use of European Heart Failure Self-care Behaviour scale (EHFSBs), medication adherence using the Medication Adherence Report Scale (MARS-5) at 2 weeks and compared 30-day HF readmissions with annual hospital HF data. Descriptive statistics were represented as continuous variables as means with standard deviations. Categorical variables were represented with percentages and analysed using Chi-squared test. Results: 102 patients with acute decompensated HF were recruited to this pilot feasibility study. 57% were men and mean age 56 years±5.1. 55% patients had HF with reduced ejection fraction (HFrEF), 34% had HF with preserved EF (HFpEF) and 11% had HF with mid-range EF. Mean EHFSBs was 19.7±6.1and mean MARS-5 score was 23.5±1. 10/102 (10%) patients were re-hospitalised with HF compared to the annual hospital HF rehospitalisation incidence which was 19% (95/393); p=0.04. Conclusions: Results from our pilot feasibility study suggest that use of a HF self care mobile phone APP (Aintree Heart Failure Passport App) in patients with acute decompensated HF, leads to high quality self care behaviour, high levels of medication adherence and lower levels of 30-day HF re-hospitalisation. These results will need to be validated in a randomised controlled trial.

A cost study for mobile phone health surveys using interactive voice response for assessing risk factors of noncommunicable diseases

BackgroundThis is the first study to examine the costs of conducting a mobile phone survey (MPS) through interactive voice response (IVR) to collect information on risk factors for noncommunicable diseases (NCD) in three low- and middle-income countries (LMIC); Bangladesh, Colombia, and Uganda.MethodsThis is a micro-costing study conducted from the perspective of the payer/funder with a 1-year horizon. The study evaluates the fixed costs and variable costs of implementing one nationally representative MPS for NCD risk factors of the adult population. In this costing study, we estimated the sample size of calls required to achieve a population-representative survey and associated incentives. Cost inputs were obtained from direct economic costs incurred by a central study team, from country-specific collaborators, and from platform developers who participated in the deployment of these MPS during 2017. Costs were reported in US dollars (USD). A sensitivity analysis was conducted assessing different scenarios of pricing and incentive strategies. Also, costs were calculated for a survey deployed targeting only adults younger than 45 years.ResultsWe estimated the fixed costs ranging between $47,000 USD and $74,000 USD. Variable costs were found to be between $32,000 USD and $129,000 USD per nationally representative survey. The main cost driver was the number of calls required to meet the sample size, and its variability largely depends on the extent of mobile phone coverage and access in the country. Therefore, a larger number of calls were estimated to survey specific harder-to-reach sub-populations.ConclusionMobile phone surveys have the potential to be a relatively less expensive and timely method of collecting survey information than face-to-face surveys, allowing decision-makers to deploy survey-based monitoring or evaluation programs more frequently than it would be possible having only face-to-face contact. The main driver of variable costs is survey time, and most of the variability across countries is attributable to the sampling differences associated to reaching out to population subgroups with low mobile phone ownership or access.

Impact of mhealth messages and environmental cues on hand hygiene practice among healthcare workers in the greater Kampala metropolitan area, Uganda: study protocol for a cluster randomized trial

BackgroundHand hygiene (HH) among healthcare workers (HCWs) is critical for infection prevention and control (IPC) in healthcare facilities (HCFs). Nonetheless, it remains a challenge in HCFs, largely due to lack of high-impact and efficacious interventions. Environmental cues and mobile phone health messaging (mhealth) have the potential to improve HH compliance among HCWs, however, these remain under-studied. Our study will determine the impact of mhealth hygiene messages and environmental cues on HH practice among HCWs in the Greater Kampala Metropolitan Area (GKMA).MethodsThe study is a cluster-randomized trial, which will be guided by the behaviour centred design model and theory for behaviour change. During the formative phase, we shall conduct 30 key informants’ interviews and 30 semi-structured interviews to explore the barriers and facilitators to HCWs’ HH practice. Besides, observations of HH facilities in 100 HCFs will be conducted. Findings from the formative phase will guide the intervention design during a stakeholders’ insight workshop.The intervention will be implemented for a period of 4 months in 30 HCFs, with a sample of 450 HCWs who work in maternity and children’s wards. HCFs in the control arm will receive innovatively designed HH facilities and supplies. HCWs in the intervention arm, in addition to the HH facilities and supplies, will receive environmental cues and mhealth messages. The main outcome will be the proportion of utilized HH opportunities out of the 9000 HH opportunities to be observed. The secondary outcome will be E. coli concentration levels in 100mls of hand rinsates from HCWs, an indicator of recent fecal contamination and HH failure. We shall run multivariable logistic regression under the generalized estimating equations (GEE) framework to account for the dependence of HH on the intervention.DiscussionThe study will provide critical findings on barriers and facilitators to HH practice among HCWs, and the impact of environmental cues and mhealth messages on HCWs’ HH practice.Trial registrationISRCTN Registry with number ISRCTN98148144. The trial was registered on 23/11/2020.

Formalising ‘informal’ mHealth in Ghana: Opportunities and challenges for Universal Health Coverage (UHC)

ABSTRACT While mobile phones promise to be an important tool for bridging the healthcare gaps in resource-poor areas in developing countries, scalability and sustainability of mobile phones for health (mhealth) interventions still remain a major challenge. Meanwhile, health workers are already using their own mobile phones (referred to as ‘informal mhealth’) to facilitate healthcare delivery in diverse ways. Therefore, this paper explores some strategies for integrating ‘informal mHealth’ in the healthcare delivery of Ghana, by highlighting some opportunities and challenges. The study mainly employed a combination of literature review, focus group discussions and key informant interviews with community health nurses (CHNs) and other stakeholders, who were purposively selected from the three ecological zones in Ghana. The study found that, while scale-up of ‘formal mhealth’ remains challenging in Ghana, almost all CHNs in our study are using their personal mobile phones ‘informally’ to bridge healthcare gaps, thereby promoting universal health coverage. This provides opportunities for promoting (or formalising) ‘informal’ mhealth in Ghana, in spite of some practical challenges in the use of personal mobile phones that need to be addressed to ensure sustainable healthcare delivery in the country.

Effectiveness of a mobile phone text messaging intervention on dietary behaviour in patients with type 2 diabetes: a post-hoc analysis of a randomised controlled trial.

Evidence suggests that mobile phone health (mHealth) programs may improve healthy behaviours and clinical outcomes in patients with type 2 diabetes mellitus (T2DM). However, data on mHealth dietary behaviour is scarce in low-and-middle-income countries. This study aims to determine the effectiveness of a text messaging program on dietary habits in patients with T2DM. We performed a post-hoc analysis of a randomised controlled trial of text messaging intervention in 236 patients with T2DM recruited from a tertiary hospital. Data were collected on socio-demographics, mobile phone use, family and medical history, self-reported diseases, medication use, health-seeking behaviour, diet and physical activity. Dietary behaviour was assessed using a modified version of WHO STEPS and the Indian Migration Study Food Frequency Questionnaire. Intervention participants received one message/day over six months focusing on lifestyle modification. Dietary intake of fruits, vegetables, sugar beverages and teaspoons of sugar in tea/coffee were determined in serves-per-week and were analysed using Chi-square tests. Poisson regression models, adjusted for age, sex and baseline values following an intention-to-treat approach were performed and expressed as an estimate of effect size. At 6 months, the adjusted difference in vegetable consumption was -0.02 serves/week [95% confidence interval (CI): -0.11-0.06, P>0.05] and fruit intake was 0.02 serves/week (95% CI: -0.15-0.21, P>0.05). Consumption of sugar beverages reduced in both groups at 6 months with an adjusted difference of -0.34 serves/week (95% CI: -1.10-0.42, P>0.05). Teaspoons of sugar in tea reduced to 0.1±0.3 teaspoons/week in the control group, however, remained the same at 0.2±0.6 teaspoons/week in the intervention group with an adjusted difference of 0.94 teaspoons/week (95% CI: 0.04-1.84, P<0.05). Our results suggest that a text messaging program did not significantly improve dietary behaviour in patients with T2DM. Further studies are warranted to explore the effectiveness of text messaging on dietary behaviour in adults with T2DM. German Clinical Trials Register DRKS00005188, http://www.drks.de.

Effectiveness of a mobile phone text messaging intervention on dietary behaviour in patients with type 2 diabetes: a post-hoc analysis of a randomised controlled trial

Background: Evidence suggests that mobile phone health (mHealth) programs may improve healthy behaviours and clinical outcomes in patients with type 2 diabetes mellitus (T2DM). However, data on mHealth dietary behaviour is scarce in low-and-middle-income countries. This study aims to determine the effectiveness of a text messaging program on dietary habits in patients with T2DM.

Informed Consent for Mobile Phone Health Surveys in Colombia: A Qualitative Study.

Public health surveys deployed through automated mobile phone calls raise a set of ethical challenges, including succinctly communicating information necessary to obtain respondent informed consent. This study aimed to capture the perspectives of key stakeholders, both experts and community members, on consent processes and preferences for participation in automated mobile phone surveys (MPS) of non-communicable disease risk factors in Colombia. We conducted semi-structured interviews with ethics and digital health experts and focus group discussions with community representatives. There was meaningful disagreement within both groups regarding the necessity of consent, when the purpose of a survey is to contribute to the formulation of public policies. Respondents who favored consent emphasized that consent communications ought to promote understanding and voluntariness, and implicitly suggested that information disclosure conform to a reasonable person standard. Given the automated and unsolicited nature of the phone calls and concerns regarding fraud, trust building was emphasized as important, especially for national MPS deployment. Community sensitization campaigns that provide relevant contextual information (such as the name of the administering institution) were thought to support trust-building. Additional ways to achieve the goals of consent while building trust in automated MPS for disease surveillance should be evaluated in order to inform ethical and effective practice.

Adaptation of a mobile phone health survey for risk factors for noncommunicable diseases in Colombia: a qualitative study

ABSTRACT Background Data collection on noncommunicable disease (NCD) behavioral risk factors has traditionally been carried out through face-to-face surveys. However, its high costs and logistical difficulties can lead to lack of timely statistics for planning, particularly in low and middle-income countries. Mobile phone surveys (MPS) have the potential to fill these gaps. Objective This study explores perceptions, feasibility and strategies to increase the acceptability and response rate of health surveys administered through MPS using interactive voice response in Colombia. Method A sequential multimodal exploratory design was used. We conducted key informant interviews (KII) with stakeholders from government and academia; focus group discussions (FGDs) and user-group tests (UGTs) with young adults and elderly people living in rural and urban settings (men and women). The KII and FGDs explored perceptions of using mobile phones for NCD surveys. In the UGTs, participants were administered an IVR survey, and they provided feedback on its usability and potential improvement. Results Between February and November 2017, we conducted 7 KII, 6 FGDs (n = 54) and 4 UGTs (n = 34). Most participants consider MPS is a novel way to explore risk factors in NCDs. They also recognize challenges for their implementation including security issues, technological literacy and telecommunications coverage, especially in rural areas. It was recommended to promote the survey using mass media before its deployment and stressing its objectives, responsible institution and data privacy safeguards. The preferences in the survey administration relate to factors such as skills in the use of mobile phones, age, availability of time and educational level. The participants recommend questionnaires shorter than 10 minutes. Conclusions The possibility of obtaining data through MPS at a population level represents an opportunity to improve the availability of risk-factor data. Steps towards increasing the acceptability and overcoming technological and methodological challenges need to be taken.

The Cedar Project - Mobile Phone Use and Acceptability of Mobile Health Among Young Indigenous People Who Have Used Drugs in British Columbia, Canada: Mixed Methods Exploratory Study.

BackgroundIndigenous leaders continue to be concerned about high rates of HIV and barriers to HIV treatment among young Indigenous people involved in substance use. Growing evidence suggests that using mobile phones for health (mHealth) may be a powerful way to support connection with health services, including HIV prevention and treatment.ObjectiveThis study examined the patterns of mobile phone ownership and use among young Indigenous people who have used drugs living with or vulnerable to HIV and explored the acceptability of mHealth to support access to health care in this population.MethodsThe Cedar Project is a cohort study involving young Indigenous people who have used drugs in Vancouver and Prince George, British Columbia. This mixed methods exploratory study involved 131 Cedar Project participants enrolled in our WelTel mHealth program. At enrollment, participants completed a questionnaire related to mobile phone use and interest in mHealth. Data were linked to Cedar Project questionnaires and serodata. We present comparative statistics (quantitative) and results of a rapid thematic analysis (qualitative) related to mobile phone patterns and interest in receiving mHealth.ResultsLess than half of the participants (59/130; 45.4%) reported owning a phone. Among those with a phone, the majority owned a smartphone (46/59; 78%). Most participants with a phone reported having an unlimited texting plan (39/55; 71%), using the internet on their phone (44/59; 75%), and texting daily (44/55; 80%). A majority reported that using a mobile phone for health would be invaluable (120/130; 92.3%). There were no differences in mHealth acceptance between participants who owned a phone and those who did not (P>.99). All but one participant living with HIV felt using a mobile phone would be helpful for their health, while a small proportion of HIV-negative participants remained unsure (1.9% vs 11.7%; P=.047). In response to open-ended questions asking why using a mobile phone may be helpful for health, participants identified a diverse set of anticipated benefits: (1) connection for emotional, mental, and spiritual support, (2) connection to family, (3) staying in touch and/or being reachable, (4) overcoming current barriers to phone use, (5) convenience, privacy, and safety, and (6) access to health care and emergency services.ConclusionsWe observed high acceptance and interest in using mobile phone technology for health despite low rates of personal mobile phone connectivity among young Indigenous people who have used drugs living with and vulnerable to HIV in British Columbia, Canada. Mobile phones were viewed as a way to support connections and relationships that are seen as critical to health and well-being among young Indigenous people in this study. Findings may be useful for health care providers preparing to scale up mHealth programs to support HIV prevention and treatment in this population.

Continuity of health service delivery during the COVID-19 pandemic: the role of digital health technologies in Uganda.

In response to coronavirus disease-2019 pandemic (COVID-19), the government of Uganda instituted movement restrictions to curb disease spread. However, this affected accessibility to medical services in a setting where the healthcare system is not equipped to handle most healthcare needs of the populace outside hospital premises. This gap led to the prominence and unprecedented rise in the use of digital health technologies to deliver health information and services at a distance (telehealth) during the COVID-19 outbreak. The use of telehealth modalities including tele-consultation, tele-psychiatry, call centers and mobile phone health information dissemination increased. The COVID-19 pandemic augmented the rising role of digital health technologies as a much needed aspect of medical service delivery in our times. However, the efficacy and impact on clinical outcomes across various healthcare thematic areas need to be explored further and more evidence generated.

Evaluation of a Mobile Phone App for Patients With Pollen-Related Allergic Rhinitis: Prospective Longitudinal Field Study

BackgroundMobile health apps have great potential to support the self-management of chronic conditions such as allergic diseases, which constitute significant challenges in health care. However, the health app market is confusing for users, as it is vast, dynamic, and lacks scientific evidence regarding the effectiveness of the apps on offer. To our knowledge, no health app for pollen-related allergic rhinitis has been evaluated.ObjectiveThe aim of our study was to evaluate the Husteblume mobile phone health app, developed in Germany to facilitate the self-management of pollen-related allergic rhinitis.MethodsWe evaluated usability and changes in quality of life, health literacy, and self-efficacy for managing one’s chronic disease. We conducted 2 online surveys of registered users of the app, 1 before and 1 after the 2017 pollen season, allowing for the analysis of both cross-sectional and longitudinal data in a field setting.ResultsThe sample comprised 661 app users at the first measurement point and 143 users at follow-up. The subgroup of study participants at follow-up rated the usability of the app as good or very good. There were no significant changes in patient-reported outcomes such as quality of life, health literacy, and self-efficacy between the 2 measurement points (P>.05). However, those reached at follow-up perceived subjective improvements due to the app: 55.9% (80/143) reported being subjectively better informed about their allergy, 27.3% (39/143) noted improved quality of life, 33.6% (48/143) reported subjectively better coping with their allergy, and 28.0% (40/143) felt better prepared for the consultation with their physician. Finally, 90.9% (130/143) users did not identify any adverse effects of the app.ConclusionsDespite some methodological caveats, the results of the evaluation of the Husteblume app are encouraging for the subgroup using the app in the long term. However, further studies evaluating the effectiveness of the app are needed.Trial RegistrationGerman Clinical Trials Register DRKS00011897; https://tinyurl.com/yxxrg9av

Oral cancer screening using mobile phone-based(mHealth) approach versus conventional oral examination approach, protocol of a cluster randomized study with cost-effectiveness analysis

IntroductionOral cancer is a significant health problem in India. Diagnosis is often delayed. The effectiveness of conventional oral screening has been shown in the Trivandrum oral cancer screening study. The present study will be a step forward to test a mobile phone-based (the mHealth approach) comparing it with the conventional approach. The purpose of this paper is to report the protocol for this study. The primary objective will be to compare both methods in diagnosing oral potentially malignant disorders and cancers. The secondary objective would be to study the cost-effectiveness. Methods and analysisThis will be a cluster-randomized clinical trial of the population in Ernakulam district of Kerala state in India. They will undergo oral cancer screening by community health workers, who will be pre-assigned to the randomly allotted intervention (mHealth) or control (conventional method) clusters. We will enrol a minimum of 9696 subjects from all 6 clusters over 18 months. The cost-effectiveness of the two strategies for oral screening will be determined using data from this randomized controlled trial. The incremental cost per oral cancer/high-risk dysplasia detected, and the incremental cost per life saved will be reported. We will conduct sensitivity and scenario analysis to evaluate the robustness of the findings. Ethics and disseminationWhen completed, this will be the first cluster randomized population-based study to test the technology-based approach in India. The knowledge from this study will indicate whether specialists can make a remote diagnosis of oral lesions accurately based on the information gathered using a mobile phone health application and whether the mHealth strategy will be cost-effective in Oral cancer screening. The study will follow the ethical guidelines and will be published in an indexed journal.

Potential Use of Mobile Phone Applications for Self-Monitoring and Increasing Daily Fruit and Vegetable Consumption: A Systematized Review.

A wide range of chronic diseases could be prevented through healthy lifestyle choices, such as consuming five portions of fruits and vegetables daily, although the majority of the adult population does not meet this recommendation. The use of mobile phone applications for health purposes has greatly increased; these applications guide users in real time through various phases of behavioural change. This review aimed to assess the potential of self-monitoring mobile phone health (mHealth) applications to increase fruit and vegetable intake. PubMed and Web of Science were used to conduct this systematized review, and the inclusion criteria were: randomized controlled trials evaluating mobile phone applications focused on increasing fruit and/or vegetable intake as a primary or secondary outcome performed from 2008 to 2018. Eight studies were included in the final assessment. The interventions described in six of these studies were effective in increasing fruit and/or vegetable intake. Targeting stratified populations and using long-lasting interventions were identified as key aspects that could influence the effectiveness of these interventions. In conclusion, evidence shows the effectiveness of mHealth application interventions to increase fruit and vegetable consumption. Further research is needed to design effective interventions and to determine their efficacy over the long term.

Evaluating Mobile Health Apps for Customized Dietary Recording for Young Adults and Seniors: Randomized Controlled Trial.

BackgroundThe role of individual-tailored dietary recording in mobile phone health apps has become increasingly important in management of self-health care and population-based preventive service. The development of such mobile apps for user-centered designing is still challengeable and requires further scientific evidence.ObjectiveThis study aims to conduct a randomized trial to assess the accuracy and time efficiency of two prototypes for dietary recoding utilization related to the input method of food intake.MethodsWe first present an innovative combinatorial concept for dietary recording to account for dish variation. One prototype was a self-chosen tab app that featured choosing each food ingredient to synthesize an individual dish, whereas the other was an autonomous exhaustive list app that provided one selection from a comprehensive list of dish items. The concept included commercially available choices that allowed users to more accurately account for their individual food selection. The two mobile apps were compared in a head-to-head parallel randomized trial evaluation. Young adults (n=70, aged 18-29) and older adults (n=35, aged 55-73) were recruited and randomized into two groups for accuracy and response time evaluation based on 12 types of food items in use of the developed self-chosen tab and autonomous exhaustive list apps, respectively.ResultsFor the trials based on the self-chosen tab (53 participants) and autonomous exhaustive list groups (52 participants), the two prototypes were found to be highly accurate (>98%). The self-chosen tab app was found to be more efficient, requiring significantly less time for input of 11 of 12 items (P<.05). The self-chosen tab users occasionally neglected to select food attributes, an issue which did not occur in the autonomous exhaustive list group.ConclusionsOur study contributes through the scientific evaluation of the transformation step into prototype development to demonstrate that a self-chosen tab app has potentially better opportunity in effectiveness and efficiency. The combinatorial concept offers potential for dietary recording and planning which can account for high food item variability. Our findings on prototype development of diversified dietary recordings provide design consideration and user interaction for related further app development and improvement.Trial RegistrationISRCTN Registry ISRCTN86142301; http://www.isrctn.com/ ISRCTN86142301 (Archived by WebCite at http://www.webcitation.org/74YLEPYnS)

Mobile Phone Apps for Quality of Life and Well-Being Assessment in Breast and Prostate Cancer Patients: Systematic Review.

BackgroundMobile phone health apps are increasingly gaining attention in oncological care as potential tools for supporting cancer patients. Although the number of publications and health apps focusing on cancer is increasing, there are still few specifically designed for the most prevalent cancers diagnosed: breast and prostate cancers. There is a need to review the effect of these apps on breast and prostate cancer patients’ quality of life (QoL) and well-being.ObjectiveThe purposes of this study were to review the scientific literature on mobile phone apps targeting breast or prostate cancer patients and involving QoL and well-being (anxiety and depression symptoms) and analyze the clinical and technological characteristics, strengths, and weaknesses of these apps, as well as patients’ user experience with them.MethodsWe conducted a systematic review of peer-reviewed literature from The Cochrane Library, Excerpta Medica Database, PsycINFO, PubMed, Scopus, and MEDLINE to identify studies involving apps focused on breast and/or prostate cancer patients and QoL and/or well-being published between January 1, 2000, and July 12, 2017. Only trial studies which met the inclusion criteria were selected. The systematic review was completed with a critical analysis of the apps previously identified in the health literature research that were available from the official app stores.ResultsThe systematic review of the literature yielded 3862 articles. After removal of duplicates, 3229 remained and were evaluated on the basis of title and abstract. Of these, 3211 were discarded as not meeting the inclusion criteria, and 18 records were selected for full text screening. Finally, 5 citations were included in this review, with a total of 644 patients, mean age 52.16 years. Four studies targeted breast cancer patients and 1 focused on prostate cancer patients. Four studies referred to apps that assessed QoL. Only 1 among the 5 analyzed apps was available from the official app store. In 3 studies, an app-related intervention was carried out, and 2 of them reported an improvement on QoL. The lengths of the app-related interventions varied from 4 to 12 weeks. Because 2 of the studies only tracked use of the app, no effect on QoL or well-being was found.ConclusionsDespite the existence of hundreds of studies involving cancer-focused mobile phone apps, there is a lack of rigorous trials regarding the QoL and/or well-being assessment in breast and/or prostate cancer patients. A strong and collective effort should be made by all health care providers to determine those cancer-focused apps that effectively represent useful, accurate, and reliable tools for cancer patients’ disease management.Trial RegistrationPROSPERO CRD42017073069; https://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID= CRD42017073069 (Archived by WebCite at http://www.webcitation.org/6v38Clb9T)

A systematic review of smartphone applications for smoking cessation.

Tobacco use is the leading cause of preventable disease and death in the USA. However, limited data exists regarding smoking cessation mobile app quality and intervention effectiveness. Innovative and scalable interventions are needed to further alleviate the public health implications of tobacco addiction. The proliferation of the smartphone and the advent of mobile phone health interventions have made treatment more accessible than ever. The purpose of this review was to examine the relation between published scientific literature and available commercial smartphone health apps for smoking cessation to identify the percentage of scientifically supported apps that were commercially available to consumers and to determine how many of the top commercially available apps for smoking cessation were supported by the published scientific literature. Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, apps were reviewed in four phases: (1) identified apps from the scientific literature, (2) searched app stores for apps identified in the literature, (3) identified top apps available in leading app stores, and (4) determined which top apps available in stores had scientific support. Seven articles identified six apps with some level of scientific support, three (50%) were available in at least one app store. Conversely, among the top 50 apps suggested by each of the leading app stores, only two (4%) had any scientific support. While half of the scientifically vetted apps remain available to consumers, they are difficult to find among the many apps that are identified through app store searches.

Who Uses Mobile Phone Health Apps and Does Use Matter? A Secondary Data Analytics Approach.

BackgroundMobile phone use and the adoption of healthy lifestyle software apps (“health apps”) are rapidly proliferating. There is limited information on the users of health apps in terms of their social demographic and health characteristics, intentions to change, and actual health behaviors.ObjectiveThe objectives of our study were to (1) to describe the sociodemographic characteristics associated with health app use in a recent US nationally representative sample; (2) to assess the attitudinal and behavioral predictors of the use of health apps for health promotion; and (3) to examine the association between the use of health-related apps and meeting the recommended guidelines for fruit and vegetable intake and physical activity.MethodsData on users of mobile devices and health apps were analyzed from the National Cancer Institute’s 2015 Health Information National Trends Survey (HINTS), which was designed to provide nationally representative estimates for health information in the United States and is publicly available on the Internet. We used multivariable logistic regression models to assess sociodemographic predictors of mobile device and health app use and examine the associations between app use, intentions to change behavior, and actual behavioral change for fruit and vegetable consumption, physical activity, and weight loss.ResultsFrom the 3677 total HINTS respondents, older individuals (45-64 years, odds ratio, OR 0.56, 95% CI 0.47-68; 65+ years, OR 0.19, 95% CI 0.14-0.24), males (OR 0.80, 95% CI 0.66-0.94), and having degree (OR 2.83, 95% CI 2.18-3.70) or less than high school education (OR 0.43, 95% CI 0.24-0.72) were all significantly associated with a reduced likelihood of having adopted health apps. Similarly, both age and education were significant variables for predicting whether a person had adopted a mobile device, especially if that person was a college graduate (OR 3.30). Individuals with apps were significantly more likely to report intentions to improve fruit (63.8% with apps vs 58.5% without apps, P=.01) and vegetable (74.9% vs 64.3%, P<.01) consumption, physical activity (83.0% vs 65.4%, P<.01), and weight loss (83.4% vs 71.8%, P<.01). Individuals with apps were also more likely to meet recommendations for physical activity compared with those without a device or health apps (56.2% with apps vs 47.8% without apps, P<.01).ConclusionsThe main users of health apps were individuals who were younger, had more education, reported excellent health, and had a higher income. Although differences persist for gender, age, and educational attainment, many individual sociodemographic factors are becoming less potent in influencing engagement with mobile devices and health app use. App use was associated with intentions to change diet and physical activity and meeting physical activity recommendations.

Evidence-based adaptation and scale-up of a mobile phone health information service.

The research base recommending the use of mobile phone interventions for health improvement is growing at a rapid pace. The use of mobile phones to deliver health behavior change and maintenance interventions in particular is gaining a robust evidence base across geographies, populations, and health topics. However, research on best practices for successfully scaling mHealth interventions is not keeping pace, despite the availability of frameworks for adapting and scaling health programs. m4RH-Mobile for Reproductive Health-is an SMS, or text message-based, health information service that began in two countries and over a period of 7 years has been adapted and scaled to new population groups and new countries. Success can be attributed to following key principles for scaling up health programs, including continuous stakeholder engagement; ongoing monitoring, evaluation, and research including extensive content and usability testing with the target audience; strategic dissemination of results; and use of marketing and sustainability principles for social initiatives. This article investigates how these factors contributed to vertical, horizontal, and global scale-up of the m4RH program. Vertical scale of m4RH is demonstrated in Tanzania, where the early engagement of stakeholders including the Ministry of Health catalyzed expansion of m4RH content and national-level program reach. Ongoing data collection has provided real-time data for decision-making, information about the user base, and peer-reviewed publications, yielding government endorsement and partner hand-off for sustainability of the m4RH platform. Horizontal scale-up and adaptation of m4RH has occurred through expansion to new populations in Rwanda, Uganda, and Tanzania, where best practices for design and implementation of mHealth programs were followed to ensure the platform meets the needs of target populations. m4RH also has been modified and packaged for global scale-up through licensing and toolkit development, research into new business/distribution models, and serving as the foundation for derivative NGO and quasi-governmental mHealth platforms. The m4RH platform provides an excellent case study of how to apply best practices to successfully scale up mobile phone interventions for health improvement. Applying principles of scale can inform the successful scale-up, sustainability, and potential impact of mHealth programs across health topics and settings.