Mobile Text Research Articles

Prevalence of De-Quervain’s Tenosynovitis and Its Association with Text Messaging in Collegiate Girl Students of Amritsar

Purpose: The purpose of the present study was to search the prevalence of De-Quervain’s tenosynovitis in collegiate girl students of Amritsar and its association with mobile size and text messaging per day by the students. Materials and methods: To fulfill the purpose, randomly selected 201 girl students those who used their smart phones of different sizes and for texting varied number of SMS every day, aged 18-26 years, were selected from Guru Nanak Dev University, Amritsar. The Visual Analogue Scale (VAS) was used to measure the pain in wrist. The Finkelstein test was conducted on the subjects to ascertain their De-Quervain’s tenosynovitis status. Chi-square test was applied to search any association of De-Quervain’s tenosynovitis and mobile size and SMS messaging by the students. Results: It was observed that, out of 201 girl students, 20.89% were reported Finkelstein test positive. Statistically, highly significant (p<0.001) association was found between positive Finkelstein status and the mobile size and SMS messaging per day by the collegiate girl students. Conclusion: It might be concluded that 20.89% of the girl students had De-Quervain’s tenosynovitis. Statistically highly significant association was found between positive Finkelstein status and the mobile size and SMS messaging per day by the collegiate girl students.

Cancer Survivor Perspectives on Text Messages in a Technology-Based Physical Activity Intervention

Messaging through mobile apps and texts are a common feature of technology-based physical activity interventions. We aimed to examine perspectives of mid-life and older cancer survivors on message content, timing, and two-way communication. We conducted qualitative interviews with 14 participants (Mean 59.9 years, Range 52-79) who completed a remotely delivered intervention that included text messages to support physical activity. After transcription, the interviews were coded and analyzed thematically using inductive, directed content analysis. Themes related to content preferences included personalization, accountability, perspective on the ‘bigger picture,’ and acknowledgement of PA-related achievements. Random timing for receipt was considered acceptable whereas interest in responding to messages was highly variable. Older cancer survivors’ preferences for highly personalized messages are an important consideration in designing technology-based physical activity interventions. A combination of accountability, relation to personal factors, and acknowledgement of goal attainment need to be considered in efforts to scale interventions. Part of a symposium sponsored by the Cancer and Aging Interest Group.

Awareness Development and Usage of Mobile Health Technology Among Individuals With Hypertension in a Rural Community of Bangladesh: Randomized Controlled Trial.

BackgroundHypertension (HTN) is a major modifiable risk factor and the leading cause of premature deaths globally. The lack of awareness and knowledge have been identified as risk factors in low- and middle-income countries including Bangladesh. Recently, the use of mobile phone SMS text messaging is found to have an important positive impact on HTN management.ObjectiveThe study aimed to develop awareness and knowledge in order to enhance lifestyle behavior changes among individuals with HTN in a rural community of Bangladesh by using health education and mobile health (mHealth) technology (SMS text messaging).MethodsA prospective randomized 5-month intervention, open-label (1:1), parallel-group trial was implemented among the individuals with HTN aged 35 years or older. Both men and women were included. Between August 2018 and July 2019, we enrolled 420 participants, selected from a tertiary level health facility and through door-to-door visits by community health workers. After block randomization, they were assigned to either the intervention group (received SMS text messaging and health education; n=209) or the control group (received only health education; n=211). The primary outcome was the evaluation of self-reported behavior changes (salt intake, fruits and vegetables intake, physical activity, and blood pressure [BP], and body weight monitoring behaviors). The secondary outcomes were measurements of actual salt intake and dietary salt excretion, blood glucose level, BP values, and quality of life (QOL).ResultsDuring the study period, a total of 8 participants were dropped, and the completion rate was 98.0% (412/420). The adherence rates were significantly higher (9%) among the control group regarding salt intake (P=.04) and physical activity behaviors (P<.03), and little differences were observed in other behaviors. In primary outcome, the focused behavior, salt intake less than 6 g/day, showed significant chronological improvement in both groups (P<.001). The fruits intake behavior steadily improved in both groups (P<.001). Participants in both groups had a custom of vegetables intake everyday/week. Physical activity suddenly increased and continued until the study end (P<.001 in both groups). Both BP and body weight monitoring status increased from baseline to 1 month but decreased afterward (P<.001). In case of secondary outcomes, significant chronological changes were observed in food salt concentration and urinary salinity between the groups (P=.01). The mean systolic BP and diastolic BP significantly chronologically decreased in both groups (systolic BP, P=.04; diastolic BP, P=.02.P<.05). All of these supported self-reported behavior changes. For the QOL, both groups showed significant improvement over the study periods (P<.001).ConclusionsBased on these results, we suggest that face-to-face health education requires integration of home health care provision and more relevant and timely interactive SMS text messages to increase the effectiveness of the intervention. Besides, community awareness can be created to encourage “low-salt culture” and educate family members.Trial RegistrationBangladesh Medical Research Council (BMRC) 06025072017; ClinicalTrials.gov NCT03614104; https://clinicaltrials.gov/ct2/show/NCT03614104 and UMIN-CTR R000033736; https://tinyurl.com/y48yfcooInternational Registered Report Identifier (IRRID)RR2-10.2196/15523

Mobile Texting and Lay Health Supporters to Improve Schizophrenia Care in a Resource-Poor Community in Rural China (LEAN Trial): Randomized Controlled Trial Extended Implementation.

BackgroundSchizophrenia is a severe and disabling condition that presents a dire health equity challenge. Our initial 6-month trial (previously reported) using mobile texting and lay health supporters, called LEAN, significantly improved medication adherence from 0.48 to 0.61 (adjusted mean 0.11, 95% CI 0.03 to 0.20, P=.007) for adults with schizophrenia living in a resource-poor village in rural China.ObjectiveWe explored the effectiveness of our texting program in improving participants’ medication adherence, functioning, and symptoms in an extended implementation of the intervention after its initial phase.MethodsIn an approximated stepped-wedge wait-list design randomized controlled trial, 277 community-dwelling villagers with schizophrenia were assigned 1:1 in phase 1 into intervention and wait-list control groups. The intervention group received (1) lay health supporters (medication or care supervisors), (2) e-platform (mobile-texting reminders and education message) access, (3) a token gift for positive behavioral changes, and (4) integration with the existing government community-mental health program (the 686 Program) while the wait-listed control group initially only received the 686 Program. Subsequently (in the extended period), both groups received the LEAN intervention plus the 686 Program. The primary outcome was antipsychotic medication adherence (percentage of dosages taken over the past month assessed by unannounced home-based pill counts). The secondary outcomes were symptoms measured during visits to 686 Program psychiatrists using the Clinical Global Impression scale for schizophrenia and functioning measured by trained student assessors using the World Health Organization Disability Assessment Schedule 2.0. Other outcomes included data routinely collected in the 686 Program system (refill records, rehospitalization due to schizophrenia, death for any reason, suicide, wandering, and violent behaviors). We used intention-to-treat analysis and missing data were imputed. A generalized estimating equation model was used to assess program effects on antipsychotics medication adherence, symptoms, and functioning.ResultsAntipsychotics medication adherence improved from 0.48 in the control period to 0.58 in the extended intervention period (adjusted mean difference 0.11, 95% CI 0.04 to 0.19; P=.004). We also noted an improvement in symptoms (adjusted mean difference –0.26, 95% CI –0.50 to –0.02; P=.04; Cohen d effect size 0.20) and a reduction in rehospitalization (0.37, 95% CI 0.18 to 0.76; P=.007; number-needed-to-treat 8.05, 95% CI 4.61 to 21.41). There was no improvement in functioning (adjusted mean difference 0.02, 95% CI –0.01 to 0.06; P=.18; Cohen d effect size 0.04).ConclusionsIn an extended implementation, our intervention featuring mobile texting messages and lay health workers in a resource-poor community setting was more effective than the 686 Program alone in improving medication adherence, improving symptoms, and reducing rehospitalization.Trial RegistrationChinese Clinical Trial Registry; ChiCTR-ICR-15006053 https://tinyurl.com/y5hk8vng

The Impact of Text Messaging as an Instructional Tool to Enhance Learner Autonomy and Perception

This paper investigates the efficiency of text messaging as an English as a Foreign Language (EFL) instructional tool to enhance learner autonomy and perception at the Islamic Azad University-South Tehran Branch, Iran. The study considers seventy-four learners to participate in the study after the administration of an Oxford Placement Test to measure their proficiency level. Participants are randomly assigned in experimental and control groups, including 37 participants each. A questionnaire is used as a pretest and posttest to measure learners` autonomy. Participants from the experimental group use text messaging (the treatment) to receive instructions, whereas those from the control group receive traditional classroom instructions in a face-to-face channel. A semi-structured interview is also used to collect date on experimental group participants` perception in using MALL in classrooms. The results reveal remarkable differences between the experimental and control groups’ means on their learner autonomy scores. However, the impact of the independent samples t-test has shown that there is no statistically meaningful gender difference among the learners regarding their autonomy scores. The findings based on the semi-structured interview showed complimentary views on MALL. The current study is beneficial since its outcomes could be relevant for EFL curriculum developers and English language teachers in the use of mobile learning and text messaging in the English classroom.

Abstract PO-008: mHealth for smoking cessation: Development of a bilingual messenger chat to engage young adult smokers

Abstract Background: Quitxt is an evidence-based mobile text messaging service for smoking cessation promoted in South Texas via social media advertising. A group analysis of 798 Quitxt participants with a mean age of 29.3 found that 21% of the enrollees reported abstinence at 7 months. This confirmed that a text and mobile media service specifically designed for young adults provides a feasible, potentially cost- effective approach to promoting cessation. Quitxt is tailored to reach Latino, non- Latino white and African American young smokers. Objective: We present the design, development process and preliminary results of a theory-based, bilingual, interactive Facebook Messenger Chat to promote smoking cessation among young adults in Texas. Methods: We conducted focus groups (2) and an online survey (200) with young adult smokers aged 18-30 to assess images, video testimonials, and messages for social media and updated webpages linked to in Quitxt text messages. Feedback from focus group and online survey participants informed the development of the Facebook Messenger Chat prototype. The Chat was pretested multiple times to identify and fix technical issues and improve its functionality. Results: Formative research participants positively reviewed the images, messages, and videos within the Quitxt mobile program, with the suggested addition of more information on negative consequences of smoking. Participants listed Facebook as the most popular social media platform, adding credibility to the conversion of the Quitxt text messaging program into a Facebook Messenger Chat version. This platform also enabled additional graphic content to make the messages more appealing to young adults. After beta-testing, we refined the Messenger Chat prototype and resolved technical issues. The Quitxt communication team designed Facebook ads with a “quit smoking for a New Year’s resolution” theme and began enrollment in late December 2019. Based on past social media recruitment, we expected to recruit up to 300 participants during the 2-week campaign, but we exceeded expectations and enrolled 2,347 in the Messenger Chat version of Quitxt. Additional promotional campaigns in 2020 for Valentine’s Day, St. Patrick’s Day, and as a preventive health measure amid the rise of COVID-19 produced a total of 5,344 enrollments. 73.8% were Spanish speakers, 55.2% were aged 18-29; 74% were males, 81.7% self- identified as Hispanic/Latino, most were light/medium smokers (mean 11.8 cig/day), and 51% were ready to quit the next day. About 14% reported cessation at 1 month. Conclusions: We followed an iterative design process to develop a bilingual, culturally tailored and interactive Facebook Messenger Chat prototype to deliver our Quitxt smoking cessation program. Preliminary results showed that the Facebook Messenger Chat version may be a successful strategy to deliver smoking cessation services to young adult smokers. The anticipated outcome is a scalable, evidence- based, easily disseminated smoking cessation intervention. Citation Format: Alfred L. McAlister, Edgar Muñoz, Cliff Despres, Pramod Sukumaran, Illeana Tiemann, Bianca Gutierrez, Sahak Kaghyan, Rahul Mundlamuri, David Akopian, Amelie G. Ramirez, Patricia Chalela. mHealth for smoking cessation: Development of a bilingual messenger chat to engage young adult smokers [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-008.

The Effects of Predictive Features of Mobile Keyboards on Text Entry Speed and Errors

Mobile users rely on typing assistant mechanisms such as prediction and autocorrect. Previous studies on mobile keyboards showed decreased performance for heavy use of word prediction, which identifies a need for more research to better understand the effectiveness of predictive features for different users. Our work aims at such a better understanding of user interaction with autocorrections and the prediction panel while entering text, in particular when these approaches fail. We present a crowd-sourced mobile text entry study with 170 participants. Our mobile web application simulates autocorrection and word prediction to capture user behaviours around these features. We found that using word prediction saves an average of 3.43 characters per phrase but also adds an average of two seconds compared to actually typing the word, resulting in a negative effect on text entry speed. We also identified that the time to fix wrong autocorrections is on average 5.5 seconds but that autocorrection does not have a significant effect on typing speed.

An economic evaluation of a mobile text messaging intervention to improve mental health care in resource-poor communities in China: a cost-effectiveness study

BackgroundSevere mental disorders, a leading cause of disability has become a major public health problem. In order to promote mental health, a series of programs have been promulgated by the Chinese government. However, economic evaluations of such programs are lacking. The purpose of this study is to develop and validate an economic model to assess the cost and health outcomes of the LEAN (Lay health supporters, E-platform, Award, and iNtegration) program, and to perform an economic evaluation of LEAN versus the nationwide community-based mental health program that provides free antipsychotic medications.MethodsA cost-effectiveness and cost-utility analysis of the LEAN intervention will be performed. A Markov model will be developed, validated and used to assess and compare the costs and outcomes for the LEAN intervention versus nationwide community-based mental health program. The calculated sample size is 258 participants for the analysis. A societal perspective will be applied with the time horizon of 1-year after the termination of the LEAN program. The cost-utility will be measured primarily using Quality Adjusted Life Years and the cost-effectiveness will be measured using number of relapses and number of re-hospitalizations avoided 6-month after the intervention. Univariate and probabilistic sensitivity analysis will be conducted for the analysis of uncertainty.DiscussionIf proven cost-effective, this study will contribute to the nationwide implementation of the program, not only for schizophrenia but for all kind of severe mental disorders. Markov model developed as part of the study will benefit potential researchers in analyzing cost-effectiveness of other programs. The Chinese context of the study may limit the generalizability of the study results to some extent.Trial registrationThis study was registered in a Chinese Clinical Trial Registry (ChiCTR2000034962) on 25 July 2020.

Test@Work Texts: Mobile Phone Messaging to Increase Awareness of HIV and HIV Testing in UK Construction Employees during the COVID-19 Pandemic.

Background: HIV poses a threat to global health. With effective treatment options available, education and testing strategies are essential in preventing transmission. Text messaging is an effective tool for health promotion and can be used to target higher risk populations. This study reports on the design, delivery and testing of a mobile text messaging SMS intervention for HIV prevention and awareness, aimed at adults in the construction industry and delivered during the COVID-19 pandemic. Method: Participants were recruited at Test@Work workplace health promotion events (21 sites, n = 464 employees), including health checks with HIV testing. Message development was based on a participatory design and included a focus group (n = 9) and message fidelity testing (n = 291) with assessment of intervention uptake, reach, acceptability, and engagement. Barriers to HIV testing were identified and mapped to the COM-B behavioural model. 23 one-way push SMS messages (19 included short web links) were generated and fidelity tested, then sent via automated SMS to two employee cohorts over a 10-week period during the COVID-19 pandemic. Engagement metrics measured were: opt-outs, SMS delivered/read, number of clicks per web link, four two-way pull messages exploring repeat HIV testing, learning new information, perceived usefulness and behaviour change. Results: 291 people participated (68.3% of eligible attendees). A total of 7726 messages were sent between March and June 2020, with 91.6% successfully delivered (100% read). 12.4% of participants opted out over 10 weeks. Of delivered messages, links were clicked an average of 14.4% times, max 24.1% for HIV related links. The number of clicks on web links declined over time (r = −6.24, p = 0.01). Response rate for two-way pull messages was 13.7% of participants. Since the workplace HIV test offer at recruitment, 21.6% reported having taken a further HIV test. Qualitative replies indicated behavioural influence of messaging on exercise, lifestyle behaviours and intention to HIV test. Conclusions: SMS messaging for HIV prevention and awareness is acceptable to adults in the construction industry, has high uptake, low attrition and good engagement with message content, when delivered during a global pandemic. Data collection methods may need refinement for audience, and effect of COVID-19 on results is yet to be understood.

My deal expires soon: Can time restriction and exclusivity induce clickthrough in hospitality promotional offers?

Abstract The high penetration level of information and communication technology presents challenges for hospitality marketers in designing a promotional offer that stands out from the plethora of social media posts and mobile text messages received by potential customers. Without users’ clickthrough on the posts or hyperlinks, purchases will not occur. This study explored time restriction as a determinant and offer exclusivity as a moderator of clickthrough. Drawing from a scenario-based experiment, the results showed that a time-restricted offer, but not an exclusive offer, induced clickthrough intention through positive offer evaluation. A convergent result was revealed in the field experiment that examined actual clickthrough. Moreover, the time restriction effect was contingent on offer exclusivity. Their dynamics add knowledge to the advertising and hospitality marketing literature. It is recommended that hospitality marketers impose time restrictions to increase clickthrough rate and it is not advisable to incorporate exclusivity messages in their promotional offers.

Effects on walking performance and lower body strength by short message service guided training after stroke or transient ischemic attack (The STROKEWALK Study): a randomized controlled trial

Objective: To evaluate whetherdaily mobile-phone delivered messages with training instructions during three months increase physical activity and overall mobility in patients soon after stroke or transient ischemic attack. Design: Randomised controlled trial with intention-to-treat analyses. Setting: University hospital. Data collection from November 2016 until December2018. Subjects: Seventy-nine patients (mean (SD) age 63.9 (10.4) years, 29 were women) were allocated to either intervention (n = 40) or control group (n = 39). Participants had to be independent (modified Ranking Scale ⩽2) and able to perform the six-minute walking test at discharge from the hospital. Interventions: The intervention group received standard care and daily mobile phone instructional text messages to perform regular outdoor walking and functional leg exercises. The control group received standard care; that is, primary care follow-up. Main measures: Walking performance by six-minute walking test (m), lower body strength by five times chair-stand test (s), the short physical performance battery (0–12 points) and 10-metres walk test (m/s) were assessed at baseline and after three months. Results: The estimated median difference in the six-minute walking test was in favour of the intervention group by 30 metres (95% CI, 55 to 1; effect size 0.64; P = 0.037) and in the chair-stand test by 0.88 seconds (95% CI, 0.02 to 1.72; effect size 0.64; P = 0.034). There were no differences between groups on the short physical performance battery or in 10-metres walking time. Conclusions: Three months of daily mobile phone text messages with guided training instructions improved composite mobility measures; that is, walking performanceand lower body strength. Clinical Trial Registry: The study is registered with ClinicalTrials.gov, number NCT02902367.

Use of Eye-tracking in Artworks to Understand Information Needs of Visitors

ABSTRACT This study examined which accompanying information elements were noticed by visitors while they were looking at artworks, using eye-tracking experiments. First, we conducted an online survey to grasp the types of information that visitors wanted to know, and five elements were obtained. Second, we collected information on these five elements through interviews with one artist. Third, eye-tracking experiments were performed with semi-structured interviews. We set the information delivery media as follows: wall and mobile texts as commonly used in art museums. The results showed that patterns of eye movement of visitors were different according to the information delivery media. Also, we found that there was a correlation between the results of the eye-tracking experiment and visitor interest. This study has limitations in that it is an experiment limited to small sample size and artwork genre; however, it is meaningful in that it was able to grasp the information needs of visitors through eye-tracking.

The Effects of Mobile Texting and Walking Speed on Gait Characteristics of Normal Weight and Obese Adults.

The aim of this study was to examine how usage of mobile devices while simultaneously walking affects walking characteristics and texting performance of normal weight (NW) and obese (OB) individuals. Thirty-two OB (body mass index [BMI] = 34.4) and NW (BMI = 22.7) adults performed two 60-s walking trials at three-step frequencies along a rectangular walkway in two conditions (No Texting and Texting). Dual-task cost as well as unadjusted spatial and temporal gait characteristics were measured. Dual-task costs for the gait parameters as well as texting performance were not different between the groups, except for the lateral step variability showing a larger variability at the preferred frequency in OB individuals. For the unadjusted variables, OB exhibited longer double support, longer stance time, and lower turn velocity compared with NW. Overall, the results highlight a similar dual-task cost for the OB individuals compared with the NW individuals, in spite of underlying differences in gait mechanics.

Does personalised text messaging influence patients' caries risk?

Design A single-blinded, randomised controlled trial. The experimental group received 24 personalised text messages each week, disseminating tailored preventive advice using the multifactorial model for individual caries risk assessment: Cariogram. The same frequency of text messaging was delivered to the control group; however, these were non-personalised messages and did not factor the Cariogram.Sample selection One hundred and ninety-one participants were assessed for eligibility by eight calibrated, volunteer dental practitioners in County Cork, Ireland. Six different inclusion criteria were detailed, including the requirement for medical card holders, serving as an indicator for economically underprivileged status. Other criteria included: aged between 19-70 years; competent with text messaging services; have a minimum of 20 teeth present; not pregnant; and prepared to give consent. Failure to return a baseline food diary or possess a mobile phone saw the exclusion of 20 participants. Following stratified and blocked randomisation, 85 and 86 participants were allocated in the test and control group, respectively. The study received ethical approval by the Clinical Research Ethics Committee of the Cork Teaching Hospitals.Data analysis One hundred and eleven participants attended the follow-up examination, 26 weeks after randomisation, where the 'chance of avoiding new cavities' was determined as a numerical index for caries risk. The secondary aim was to measure individual changes to seven Cariogram risk factors between the baseline assessment and the re-examination. The ANCOVA intention-to-threat (ITT) protocol and the per-protocol method were adhered to for analyses of outcome measures. Statistical analysis was performed using SAS 9.4, in adherence to a pre-defined significance level of 5% (two-sided).Results Both analytic techniques confirmed no statistically significant difference (p >0.05) between the groups regarding the 'chance of avoiding new cavities'. Of the risk parameters assessed, only saliva secretion demonstrated a positive effect in the intervention group (p = 0.036, OR = 0.3, 95% CI = 0.1, 0.9). Predictive modelling techniques were not reliable due to the limited sample size of per-protocol analysis.Conclusions The failure to conclude statistical significance between the groups validates the null hypothesis. Accordingly, no difference can be established between the personalised nor non-personalised mobile text messaging intervention on the caries risk of underprivileged adults in Ireland. The authors address the value of further studies exploring the potential for caries risk reduction through mobile phone communications.

#wordswewear: mobile texts, expressive persons, and conviviality in urban spaces

ABSTRACT In this programmatic paper, we approach #wordswewear, referring to the wide range of linguistic inscriptions on clothing and accessories, as part of the embodied, mobile semiotic landscape of the city. Our main objective is to reflect on (1) the conditions that gave rise to the apparent pervasiveness of #wordswewear in urban spaces, and (2) the extent to which they constitute a form of public, urban discourse. Drawing on an emergent collection of over 500 images photographed in situ, mainly in three global cities – Hong Kong, London, and Shanghai – the paper situates #wordswewear in everyday mobilities and moorings and considers their wearers as expressive persons. We contend that #wordswewear encapsulate the contemporary, paradoxical urban condition among city dwellers, whereby they seek a sense of involvement with one another while being “on the move” and maintaining their respective, individual comfort zones. Fleeting and ephemeral as they may be, such acts of momentary engagement (or avoidance thereof) are some of the most minimal, analyzable acts of performing identities in public discourse. Finally, we suggest that #wordswewear can be considered as manifestations of urban conviviality understood as a space for the negotiation of diversity, inclusion and exclusion.

Parental-oriented educational mobile messages to aid in the control of early childhood caries in low socioeconomic children: A randomized controlled trial

ObjectivesTo evaluate the effectiveness of educational messages as an aid in the control of early childhood caries (ECC) in low socioeconomic children. MethodsA single-blinded, randomized, and parallel-group study was conducted with 104 dyads of parents and children aged between 36–60 months, recruited in preschools from Bauru, Brazil. The participants were randomly allocated into control and intervention groups (1:1), stratified by parental eHealth literacy scores (eHEALS) and children's caries experience. Every 2 weeks, text messages were sent to parents of intervention group via WhatsApp. Visible plaque index (VPI) and the International Caries Detection and Assessment System (ICDAS) were assessed at baseline, 3- and 6-month follow-ups, while eHEALS and dietary habits were determined at baseline and 6-month follow-up. Statistical analysis was performed to intra and intergroup comparisons through Fischer’s exact and McNemar tests, and Mann-Whitney U and Friedman tests, respectively (P < 0.05). ResultsDespite similarities between groups, intervention increased parental eHEALS scores, influencing the reports about the children’s consumption of sugar-free sweets and controlling the severity of ECC. ConclusionTherefore, mobile text messages were effective to control the severity of ECC in low socioeconomic preschoolers, improving parental eHealth literacy and changing children’s dietary patterns. Clinical significanceThese findings demonstrate that parental-oriented WhatsApp messages can contribute to oral health education of socioeconomic vulnerable parents towards risk behavior changes to control ECC.

Shortcut Gestures for Mobile Text Editing on Fully Touch Sensitive Smartphones

While advances in mobile text entry enable smartphone users to type almost as fast as on hardware keyboards, text-heavy activities are still not widely adopted. One reason is the lack of shortcut mechanisms. In this article, we determine shortcuts for text-heavy activities, elicit shortcut gestures, implement them for a fully touch-sensitive smartphone, and conduct an evaluation with potential users. We found that experts perform around 800 keyboard shortcuts per day, which are not available on smartphones. Interviews revealed the lack of shortcuts as a major limitation that prevents mobile text editing. Therefore, we elicited gestures for the 22 most important shortcuts for smartphones that are touch-sensitive on the whole device surface. We implemented the gestures for a fully touch-sensitive smartphone using deep learning and evaluated them in realistic scenarios to gather feedback. We show that the developed prototype is perceived as intuitive and faster than recent commercial approaches.

Patient and Provider Cocreation of Mobile Texting Apps to Support Behavioral Health: Usability Study.

BackgroundMobile technologies hold potential for improving the quality of care and engagement of patients. However, there are considerable challenges in ensuring that technologies are relevant, useful, and engaging. While end users such as patients and providers are increasingly involved in the design of health technologies, there are limited examples of their involvement in directly creating technologies for their personal use.ObjectiveWe aim to evaluate the feasibility and acceptability of patients and providers creating mobile texting apps to support treatment goals.MethodsIn an 11-month usability study, we enrolled 4 providers and 28 patients in an intensive outpatient program for obsessive-compulsive disorder. Patients and providers created their own mobile texting apps using a visual app development platform. A subsample of 10 patients and 4 providers completed a usability measure.ResultsParticipants created a total of 360 unique mobile text messages (1787 total messages sent). There were 4 types of messages identified, including personalized reminders, clinical exposures, interactive prompts, and encouraging/informational messages. A total of 9 out of 10 (90%) patients agreed that the messages were relevant to their recovery, and 8 out of 10 (80%) agreed that the messages were effective at helping complete treatment plans.ConclusionsEnabling patients and providers to cocreate apps for their own use by using a visual application platform is feasible and holds potential for increasing the relevance, sustainability, and effectiveness of digital health technologies.

Effects of Female Community Health Volunteer Capacity Building and Text Messaging Intervention on Gestational Weight Gain and Hemoglobin Change Among Pregnant Women in Southern Nepal: A Cluster Randomized Controlled Trial.

Introduction: Public health interventions such as text messaging are commonly evaluated in high-income countries and that the evaluation reports of the effectiveness of community health volunteers in low-income countries like Nepal is scarce. This study aimed to determine whether female community health volunteer (FCHV) capacity building and text messaging to expectant mother increases gestational weights and hemoglobin levels of pregnant women living in southern Nepal.Methods: A cluster randomized control trial was carried out in 52 clusters of 6 Village Development Committees in southern Nepal between July 2015 and March 2016. A total of 413 pregnant mothers of gestation age between 13 and 28 weeks (214 in the intervention group and 199 in the control group) were included in the analysis. Intervention consisted of FCHV capacity building followed by regular supervision and monitoring and mobile phone text messaging to expectant mothers. Regression analysis, controlled for confounders, was conducted to assess gestational weight gains and changes in hemoglobin levels.Results: At the end of the pregnancy, the mean weight gain difference between the intervention and control groups was 1.1 kg (95% CI: 1.0, 1.9). Rates of weight increases in the intervention and control groups were 0.504 kg/week (95% CI: 0.371, 0.528), and 0.399 kg/week (95% CI: 0.362, 0.465), respectively. Similarly, the mean inter group difference in hemoglobin levels was 0.11 gm/dl (95% CI: 0.09, 0.15), and rates of hemoglobin increases (gm/dl/week) in the intervention and control groups were 0.02 gm/dl (95% CI: 0.01, 0.09) and 0.004 gm/dl (95% CI: 0.02, 0.12), respectively.Conclusions: The study shows that FCHV capacity building and mobile text messaging have a positive effect on the gestational weights and hemoglobin levels of expectant mothers. Our findings suggest that mobile text messaging coupled with FCHV capacity building services should be supported and would usefully expand in resource poor settings.Trial registration: ISRCTN60684155.

Engaging Children and Young People in Digital Mental Health Interventions: Systematic Review of Modes of Delivery, Facilitators, and Barriers.

BackgroundThere is a high prevalence of children and young people (CYP) experiencing mental health (MH) problems. Owing to accessibility, affordability, and scalability, an increasing number of digital health interventions (DHIs) have been developed and incorporated into MH treatment. Studies have shown the potential of DHIs to improve MH outcomes. However, the modes of delivery used to engage CYP in digital MH interventions may differ, with implications for the extent to which findings pertain to the level of engagement with the DHI. Knowledge of the various modalities could aid in the development of interventions that are acceptable and feasible.ObjectiveThis review aimed to (1) identify modes of delivery used in CYP digital MH interventions, (2) explore influencing factors to usage and implementation, and (3) investigate ways in which the interventions have been evaluated and whether CYP engage in DHIs.MethodsA literature search was performed in the Cochrane Library, Excerpta Medica dataBASE (EMBASE), Medical Literature Analysis and Retrieval System Online (MEDLINE), and PsycINFO databases using 3 key concepts “child and adolescent mental health,” “digital intervention,” and “engagement.” Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed using rigorous inclusion criteria and screening by at least two reviewers. The selected articles were assessed for quality using the mixed methods appraisal tool, and data were extracted to address the review aims. Data aggregation and synthesis were conducted and presented as descriptive numerical summaries and a narrative synthesis, respectively.ResultsThis study identified 6 modes of delivery from 83 articles and 71 interventions for engaging CYP: (1) websites, (2) games and computer-assisted programs, (3) apps, (4) robots and digital devices, (5) virtual reality, and (6) mobile text messaging. Overall, 2 themes emerged highlighting intervention-specific and person-specific barriers and facilitators to CYP’s engagement. These themes encompassed factors such as suitability, usability, and acceptability of the DHIs and motivation, capability, and opportunity for the CYP using DHIs. The literature highlighted that CYP prefer DHIs with features such as videos, limited text, ability to personalize, ability to connect with others, and options to receive text message reminders. The findings of this review suggest a high average retention rate of 79% in studies involving various DHIs.ConclusionsThe development of DHIs is increasing and may be of interest to CYP, particularly in the area of MH treatment. With continuous technological advancements, it is important to know which modalities may increase engagement and help CYP who are facing MH problems. This review identified the existing modalities and highlighted the influencing factors from the perspective of CYP. This knowledge provides information that can be used to design and evaluate new interventions and offers important theoretical insights into how and why CYP engage in DHIs.