Mobile Survey Research Articles

A Decision Support Tool for Allogeneic Hematopoietic Stem Cell Transplantation for Children With Sickle Cell Disease: Acceptability and Usability Study.

BackgroundIndividuals living with sickle cell disease (SCD) may benefit from a variety of disease-modifying therapies, including hydroxyurea, voxelotor, crizanlizumab, L-glutamine, and chronic blood transfusions. However, allogeneic hematopoietic stem cell transplantation (HCT) remains the only nonexperimental treatment with curative intent. As HCT outcomes can be influenced by the complex interaction of several risk factors, HCT can be a difficult decision for health care providers to make for their patients with SCD.ObjectiveThe aim of this study is to determine the acceptability and usability of a prototype decision support tool for health care providers in decision-making about HCT for SCD, together with patients and their families.MethodsOn the basis of published transplant registry data, we developed the Sickle Options Decision Support Tool for Children, which provides health care providers with personalized transplant survival and risk estimates for their patients to help them make informed decisions regarding their patients’ management of SCD. To evaluate the tool for its acceptability and usability, we conducted beta tests of the tool and surveys with physicians using the Ottawa Decision Support Framework and mobile health app usability questionnaire, respectively.ResultsAccording to the mobile health app usability questionnaire survey findings, the overall usability of the tool was high (mean 6.15, SD 0.79; range 4.2-7). According to the Ottawa Decision Support Framework survey findings, acceptability of the presentation of information on the decision support tool was also high (mean 2.94, SD 0.63; range 2-4), but the acceptability regarding the amount of information was mixed (mean 2.59, SD 0.5; range 2-3). Most participants expressed that they would use the tool in their own patient consults (13/15, 87%) and suggested that the tool would ease the decision-making process regarding HCT (8/9, 89%). The 4 major emergent themes from the qualitative analysis of participant beta tests include user interface, data content, usefulness during a patient consult, and potential for a patient-focused decision aid. Most participants supported the idea of a patient-focused decision aid but recommended that it should include more background on HCT and a simplification of medical terminology.ConclusionsWe report the development, acceptability, and usability of a prototype decision support tool app to provide individualized risk and survival estimates to patients interested in HCT in a patient consultation setting. We propose to finalize the tool by validating predictive analytics using a large data set of patients with SCD who have undergone HCT. Such a tool may be useful in promoting physician-patient collaboration in making shared decisions regarding HCT for SCD. Further incorporation of patient-specific measures, including the HCT comorbidity index and the quality of life after transplant, may improve the applicability of the decision support tool in a health care setting.

Factors associated with access to condoms and sources of condoms during the COVID-19 pandemic in South Africa

BackgroundEvidence has shown that the prescribed lockdown and physical distancing due to the novel coronavirus disease 2019 (COVID-19) have made accessing essential health care services much more difficult in low-and middle-income countries. Access to contraception is an essential service and should not be denied, even in a global crisis, because of its associated health benefits. Therefore, it is important to maintain timely access to contraception without unnecessary barriers. Hence, this study examines the factors contributing to limited access to condoms and sources of condoms during the COVID-19 pandemic in South Africa.MethodsThis study used the National Income Dynamics Study-Coronavirus Rapid Mobile Survey (NIDS-CRAM) wave 1 survey dataset. The NIDS-CRAM is a nationally representative survey of the National Income Dynamics Survey (NIDS) conducted via telephone interview during COVID-19 in the year 2020. This is the first secondary dataset on COVID-19 conducted by NIDS during pandemic. A total of 5304 respondents were included in the study. Data were analysed using frequencies distribution percentages, chi-square test and multivariable logistic regression analysis.ResultsAlmost one-quarter (22.40%) of South Africans could not access condoms, and every 7 in 10 South Africans preferred public source of condoms during the COVID-19 pandemic. Those who were from other population groups [AOR = 0.37; 95% CI = 0.19–0.74] and those who were in the third wealth quintile [AOR = 0.60; 95% CI = 0.38–0.93] had lower odds of having access to condoms while those respondents who were aged 25–34 [AOR = 0.48; 95% CI = 0.27–0.83] and those with a secondary level of education and above [AOR = 0.24; 95% CI = 0.08–0.71] were less likely to prefer public source of condom.ConclusionsThis study concludes that there was limited access to condoms during the COVID-19 pandemic and that the preferred source of condoms was very skewed to public sources in South Africa. Strategic interventions such as community distribution of free condoms to avert obstruction of condom access during the COVID-19 pandemic or any future pandemics should be adopted.

Applications for data collection: AppDatCol

Health surveillance or routine health surveys are the main sources of health-related information in developing countries. The need to support the paper process and the recent advanced popularity of mobile devices fortified the development and use of electronic data collection methods in community health and clinical research works. Data collection apps are mobile applications that make it possible to collect data from a smartphone, tablet, or iPad. The main objective of this article is to explore different type of applications easily available for using as a tool for data collection purpose. This article will brief about software’s that are easily available to be customized and can be used for data collection. Mobile data collection apps are becoming integral to secure, reliable, and scalable research. The efficiency and dependability of these mobile survey apps, even in offline settings, open doors to new research possibilities. It begins with the freedom and adaptability of designing research-specific forms that work even in the most challenging environments. Sharing experiences of the barriers and distinct benefits of this technology will help future users to be better informed and allow for the swifter adoption of these and similar technologies. Although any digital form may suffice for the purpose of data gathering, not every data collection system may be used for sensitive, clinical or research data. We believe that Teamscope and CSPro stands out in the mobile data collection landscape and is the best choice for research purposes. No other application combines data encryption, passcode lock, cross-device compatibility with iOS and android, support for both cross sectional and longitudinal studies, like these applications does.

Personalized Remote Mobile Surveys of Adult ADHD Symptoms and Function: A Pilot Study of Usability and Utility for Pharmacology Monitoring

Objective: Validate the usability and treatment-sensitivity of a remote SMS-based ADHD monitoring method. Method: 206 adults taking stimulants for ADHD participated. Participants selected ADHD symptoms and functional impairments that they anticipated to be stimulant-sensitive, which were rated via mobile messages up to 20 times over 10 days. Results: A majority of participants found it only somewhat or not at all difficult to identify an ADHD symptom sensitive to presence of stimulant medication, and 79% responded to at least one survey message. As expected, a majority of participants endorsed it was “easy” to participate, and less burdensome than a paper diary. Surveys significantly discriminated between on and off medication states, both between days, and within the same day. Conclusion: Our findings suggest SMS-based monitoring of patient-selected ADHD-related challenges is both feasible and sensitive to stimulant treatment. This remote assay method may be a meaningful adjunct to in-visit treatment monitoring

Japanese translation and linguistic validation of the Prosthetic Limb Users Survey of Mobility (PLUS-M).

Self-report survey instruments can be used to improve clinical care for lower-limb prosthesis users on a global scale by pooling comparable health outcomes data from multiple countries. The language translation process is critical to the quality and comparability of a translated survey instrument. The goals of this research were to translate the Prosthetic Limb Users Survey of Mobility (PLUS-M) item bank from English to Japanese using established guidelines, and linguistically validate the translated instrument by assessing its clarity, comprehension, and cultural applicability with Japanese prosthesis users. Instrument translation and qualitative interviews. The translation process included two forward translations, reconciliation, backward translation, and review by clinical experts in Japan. Adult lower-limb prosthesis users participated in a linguistic validation study by responding to translated survey items and providing item-by-item feedback through cognitive interviews. Following expert reviews, translated items were classified as grammatically and contextually unchanged (n = 21), minor revision required (n = 19), major revision required (n = 3), or removed (n = 1). Cognitive interviews with 10 participants indicated that additional revisions were required (n = 4). Items were revised and retested until it was determined that they were clear, well understood, and culturally applicable. Use of a multistep translation and linguistic validation processes resulted in a linguistically comparable Japanese translation of the PLUS-M item bank. Japanese translations of the PLUS-M 7- and 12-item short forms were created for use in clinical practice and research. Availability of these linguistically comparable instruments is expected to facilitate opportunities for international comparison of prosthetic mobility data.

Content comparison of four commonly used amputee mobility assessment scales in the literature by linking to the International Classification of Functioning, Disability, and Health.

Despite the fact that there are a number of studies revealing the linkage of scales with the World Health Organization's international classification of functioning, disability, and health (ICF), there is a need for comprehensive studies examining the relationship between amputee mobility scales and ICF. To analyze the content of four amputee mobility scales at the item level using the ICF. The Locomotor Capacity Index, Rivermead Mobility Index, Amputee Mobility Predictor, and Prosthetic Limb Users Survey of Mobility were analyzed by two health professionals for content comparison according to the ICF categories. Kappa statistic was used to calculate the degree of agreement between the two investigators. A total of 62 items in the scales were analyzed and linked with ICF codes. The scale questions were linked with 27 different ICF codes as follows: 1 (3.7%) "body function", 23 (85.1%) "activity and participation", 2 (7.5%) "environmental factors," and 1 (3.7%) "not definable. The estimated kappa values ranged from 0.83 to 0.90 for ICF codes. As a result of the study, the ICF is a highly effective resource that can be used in the analysis of amputee mobility scales. Because the scale items are more concentrated on the mobility chapter, it was seen that the scales generally served their purposes. In the light of the findings obtained, it is thought that the diversity of the scales in the concept distribution will guide clinicians and researchers in choosing scales according to their target groups.

Development and uptake of the National Heart Foundation of Australia Smart Heart Guideline App

Abstract Background Many organisations have developed Smartphone mobile applications (apps) to improve access and uptake of clinical guidelines, including the European Society of Cardiology and the American Heart Foundation. The National Heart Foundation of Australia publish clinical guidelines in collaboration with the Cardiac Society of Australia and New Zealand. We aimed to develop an app for three national guidelines: 1) the Australian clinical guidelines for the prevention and detection of atrial fibrillation 2018; 2) the Australian clinical guidelines for the detection and management of heart failure in Australia 2018; and 3) the Australian clinical guidelines for the management of acute coronary syndromes 2016. Purpose To develop a mobile app for Australian health professionals to improve access and uptake of national cardiac clinical guidelines. Methods A national health professional mobile app online survey was developed and distributed in 2017. Survey items included the frequency of searching for information about the prevention or management of cardiovascular disease, the methods of searching, and the likelihood of using an Australian-specific mobile app to access clinical guidelines. Following analysis of survey responses, a software developer was contracted to develop the app, which included user-testing. The Smart Heart Guidelines App was registered with the regulatory body in Australia, the Therapeutic Goods Administration, and made freely available from October 2019 on iOS and Android operating systems. The app was promoted using electronic direct mail, social media techniques (Twitter and LinkedIn), on our organisation's website and via printed flyers and materials at regional and national event stands at conferences. Data from the Apple App Store was analysed between 1 October 2019 – 1 October 2020 to evaluate app use. Results The health professional survey (respondents n=504; nurses 39%, allied health professionals 26%; GP/cardiologist 9%; researcher 8%; other 18%) showed most (n=447; 89%) reported accessing the Heart Foundation's resources electronically. The majority (n=355; 70%) reported they would be likely to use an Australian-specific app. Data from the Apple App Store indicated over 30,300 impressions (the number of times the Smart Heart App appeared in an App Store search) during the first year the app was available. This resulted in approximately 4,400 app downloads, with consistent “search-to-download rates” throughout the year (monthly average rate 22%). Of the downloads, 3,200 (82%) were a direct result of searching for the Smart Heart App, indicating promotional activities were effective. Conclusion Development of the Smart Heart Guideline App in Australia was indicated by health professionals to improve access to national cardiac clinical guidelines. Consistent app downloads and use during the first-year support further research, development, promotion, and evaluation of the app. Funding Acknowledgement Type of funding sources: Foundation. Main funding source(s): The National Heart Foundation of Australia

Digital Strategies to Improve Food Assistance in Disasters: A Scoping Review.

Modern digital strategies, including Internet of Things, machine learning, and mobile applications, have revolutionized situational awareness during disaster management. Despite their importance, no review of digital strategies to support emergency food security efforts has been conducted. This scoping review fills that gap. Keywords were defined within the concepts of food assistance, digital technology, and disasters. After the database searches, PRISMA guidelines were followed to perform a partnered, 2-round scoping literature review. The search identified 3201 articles, and 26 articles met criteria and were included in the analysis. The data types used to describe the tools were text/opinion (42.3%), qualitative (23.1%), system architecture (19.2%), quantitative and qualitative (11.5 %), and quantitative (3.8%). The tools' main functions were Resource Allocation (41.7%), Data Collection and Management (33%), Interagency Communications (15.4 %), Beneficiary Communications (11.5%), and Fundraising (7.7%). The platforms used to achieve these goals were Mobile Application (36%), Internet of Things (20%), Website (20%), and Mobile Survey (8%); 92% covered the disaster response phase. Digital tools for planning, situational awareness, client choice, and recovery are needed to support emergency food assistance, but there is a lack of these tools and research on their effectiveness across all disaster phases.

Remote Assessment of Lung Disease and Impact on Physical and Mental Health (RALPMH): Protocol for a Prospective Observational Study.

BackgroundChronic lung disorders like chronic obstructive pulmonary disease (COPD) and idiopathic pulmonary fibrosis (IPF) are characterized by exacerbations. They are unpleasant for patients and sometimes severe enough to cause hospital admission and death. Moreover, due to the COVID-19 pandemic, vulnerable populations with these disorders are at high risk, and their routine care cannot be done properly. Remote monitoring offers a low cost and safe solution for gaining visibility into the health of people in their daily lives, making it useful for vulnerable populations.ObjectiveThe primary objective is to assess the feasibility and acceptability of remote monitoring using wearables and mobile phones in patients with pulmonary diseases. The secondary objective is to provide power calculations for future studies centered around understanding the number of exacerbations according to sample size and duration.MethodsTwenty participants will be recruited in each of three cohorts (COPD, IPF, and posthospitalization COVID). Data collection will be done remotely using the RADAR-Base (Remote Assessment of Disease And Relapse) mobile health (mHealth) platform for different devices, including Garmin wearable devices and smart spirometers, mobile app questionnaires, surveys, and finger pulse oximeters. Passive data include wearable-derived continuous heart rate, oxygen saturation, respiration rate, activity, and sleep. Active data include disease-specific patient-reported outcome measures, mental health questionnaires, and symptom tracking to track disease trajectory. Analyses will assess the feasibility of lung disorder remote monitoring (including data quality, data completeness, system usability, and system acceptability). We will attempt to explore disease trajectory, patient stratification, and identification of acute clinical events such as exacerbations. A key aspect is understanding the potential of real-time data collection. We will simulate an intervention to acquire responses at the time of the event to assess model performance for exacerbation identification.ResultsThe Remote Assessment of Lung Disease and Impact on Physical and Mental Health (RALPMH) study provides a unique opportunity to assess the use of remote monitoring in the evaluation of lung disorders. The study started in the middle of June 2021. The data collection apparatus, questionnaires, and wearable integrations were setup and tested by the clinical teams prior to the start of recruitment. While recruitment is ongoing, real-time exacerbation identification models are currently being constructed. The models will be pretrained daily on data of previous days, but the inference will be run in real time.ConclusionsThe RALPMH study will provide a reference infrastructure for remote monitoring of lung diseases. It specifically involves information regarding the feasibility and acceptability of remote monitoring and the potential of real-time data collection and analysis in the context of chronic lung disorders. It will help plan and inform decisions in future studies in the area of respiratory health.Trial RegistrationISRCTN Registry ISRCTN16275601; https://www.isrctn.com/ISRCTN16275601International Registered Report Identifier (IRRID)PRR1-10.2196/28873

Attitudes toward and the Current Adoption and Future Expectations of Working from Home in Hong Kong during the COVID-19 Pandemic

This study employs a dataset from the Hong Kong Mobility Survey to investigate attitudes towards working from home (WFH) among 901 workers in Hong Kong. A latent-class cluster analysis identified three clusters, each of which displays distinctive attitudes towards WFH. Those with positive attitudes tend to have a higher frequency of WFH while those with negative attitudes tend to have a lower frequency. Near-future expectations, however, do not appear to be affected by differences in attitudes toward WFH.

HIV-1 Nucleic Acids Identify Rectal HIV Exposures in Self-Collected Rectal Swabs, Whereas Y-Chromosome Single Tandem Repeat Mixtures Are Not Reliable Biomarkers of Condomless Receptive Anal Intercourse.

To focus interventions, biomarkers of HIV-1 exposure could help in identifying subpopulations at highest risk of acquisition. We assessed whether Y-chromosome single tandem repeat (YSTR) mixtures obtained from rectal swabs could serve as a biomarker of condomless receptive anal intercourse (CRAI) among men who have sex with men and transgender women and evaluated the feasibility of detecting HIV-1 virions to assess exposures. Twenty-nine sexually active HIV-seronegative men who have sex with men and one transgender woman from New York City answered on-site and mobile app sexual behavior questionnaires. They were randomized to collecting self-administered rectal swabs every morning or after receptive anal intercourse (RAI). YSTR profiles were assessed from blood sample and swabs; HIV-1 exposure was measured by conducting quantitative polymerase chain reaction in swabs. After 2 months, the daily mobile survey had 135%-201% more instances of anal sex acts and 170%-193% more RAI than on-site surveys. Daily mobile reporting had 11%-35% less CRAI events than those reported on-site (Pdaily = 0.001; Pper-sex = 0.047). The daily swabbing arm reported less RAI (P < 0.001) and CRAI (P < 0.038) and had 2.95 lower odds of detecting YSTR mixtures (P = 0.021) than the per-sex-event arm. Surprisingly, YSTR detection was not significantly modified by report of bowel movements and lubricant, enema, or condom use. No participant became HIV-1 infected, yet HIV-1 total nucleic acids were detected in 6 independent episodes of CRAI in 2 participants taking pre-exposure prophylaxis. YSTR mixtures demonstrated 80% specificity but only 30% sensitivity as a biomarker of CRAI in self-collected rectal swabs. However, detection of HIV-1 exposures in self-collected swabs may help in identifying those needing further HIV risk reduction strategies.

Residential Charging Scheduling of Electric Vehicles in Brazilian Context

This paper presents a methodology to schedule the charging of Electric Vehicles (EVs) in order to maintain the loading of distribution transformer under the nameplate load while reducing charging costs. Brazilian consumption characteristics, mobility pattern and tariff structure are considered to design an optimization algorithm. While the demand of dwellings are estimated from typical load curves of a distribution utility located in the South of Brazil, the demand of EVs are estimated from mobility survey data. Adopting the current Brazilian tariff structure, coefficients of the objective function are formulated in order to schedule the charging of EVs to satisfy the following goals: limit the power demand requested to the distribution transformer, cope the demand of EVs with lower demand of dwellings and reduce the charging costs. The results shows that, in addition to prevent the overloading of distribution transformer, the charging only occurs in periods of higher tariff when necessary, whereas most of it occurs during late night and early morning, corresponding to cost reduction by purchasing energy during lower tariff prices

Modelling the impact of the COVID-19 pandemic on South African livelihoods

PurposeThe coronavirus disease 2019 (COVID-19)-induced declining economic prospects and accompanying economic shocks present socioeconomic vulnerabilities for developing economies at the tranches of poverty, unemployment and minimal social security. South Africa is one of the countries that have the most precarious societies in developing nations due to the triple challenges of unemployment, poverty and inequality. As such, this paper investigates the impact of the pandemic on South African livelihoods.Design/methodology/approachThis paper uses secondary data obtained from the National Income Dynamics Study – Coronavirus Rapid Mobile Survey (NIDS-CRAM) Wave 1 dataset to analyse the impact of COVID-19 on South African livelihoods.FindingsThe findings reveal that COVID-19 amplified the country's poor and vulnerable population's socioeconomic conditions because of the stringent Level 5 lockdown regulations that barred low-income households from making a livelihood. It further revealed that low-income households, who are the least educated, Black African, female and marginalized, were disproportionally socioeconomically affected by losing the main household income.Research limitations/implicationsThe research is limited in that it used secondary quantitative data that relied on a telephonic survey during the COVID-19 lockdown period.Practical implicationsThis study offers a policy suggestion that increasing social grants during the pandemic will not have any significant impact on the livelihoods of many South Africans unless distributional inequalities are reduced.Social implicationsThe government needs to develop welfarist policies to protect the most vulnerable in society to limit the socioeconomic impact of pandemics and take proactive policy measures to reduce unemployment and income inequalities in the country.Originality/valueThe paper contributes to understanding the precarious nature of low-income households.

Regular employment and intergenerational income mobility in Japan

Using 1995 and 2005 Survey of Social Stratification and Mobility (SSM), this paper analyzes the effect of being regularly employed on intergenerational income mobility (IGM) from fathers to sons in Japan. Using Two Sample Two Stage Least Square (TS2SLS) method by which fathers’ income is imputed by their characteristics since it is unobservable, intergenerational income elasticity (IGE) between fathers and sons who are employees is estimated, and IGE is decomposed following a well-established framework. Focusing on sons born from 1935 to 1976, this paper finds that IGE increased from 1995 to 2005. The contribution rate of whether being regular employees in current job or not to IGE increased from less than 2% in 1995 to over 9% in 2005, and the increasing in IGE explained by regular employment status accounts for around 30% of increasing in IGE between father and sons who are employees from 1995 to 2005. The dominating reason for this pattern is that it had become difficult for sons from less prosperous families to find regular positions after the collapse of traditional employment structure since late 1990s. This study indicates that “how are people employed” had impeded equality of opportunities for youth and had exacerbated intergenerational transmission of income inequality in Japan.

Effects of Coronavirus Pandemic on Young Adults’ Ability to Access Health Services and Practice Recommended Preventive Measures

Given the limited attention to young adults as key contributors to the spread of COVID-19 in Uganda, this study examines the effects of the outbreak on the ability of young adults aged 18-29 to access health services and practice preventive measures. A national population-based mobile phone survey was conducted in December 2020. Multivariable regression analyses were used to explore the effect of the COVID-19 pandemic on access to health care services. Control variables included region, education level, parity, and source of health information. The majority (98%) perceived COVID-19 as a serious threat to Ugandans. Although the majority reported handwashing (97%) and masking (92%), fewer respondents avoided shaking hands (39%), ensured physical distancing (57%), avoided groups of more than four people (43%), stayed home most days (30%), avoided touching eyes, nose, and mouth (14%), and practiced sneezing/coughing into their elbow (7%). Participants noted that the COVID-19 pandemic affected their ability to access family planning (40%), HIV (49%), maternal health (55%), child health (56%), and malaria (63%) services. The perceived effect of the COVID-19 pandemic on services was higher for those in the Northern region (OR= 2.00, 95% CI 1.00-4.02), those with higher education OR= 2.26, 95% CI 1.28-3.99), those with five plus children (OR= 2.05, 95% CI 0.92-4.56), and those who trust radio for COVID-19 information (OR= 1.65, 95% CI 1.01-2.67). The findings show the pragmatic importance of understanding the dynamic characteristics and behavioral patterns of young adults in the context of COVID-19 to inform targeted programming.

Investigating the Influence of Personalised Gamification on Mobile Survey User Experience

Gamification in healthcare has shown to increase user motivation and treatment adherence. Personalisation strategies have the potential to create sustainable health change and user motivation. In striving for personalisation, surveys are often used as an easy tool to collect information about the user. But lengthy surveys are often tedious and demotivating, provoking bad respondent behaviour which results in a loss of data quality. Gamified surveys can enhance respondent behaviour but are labour-intensive to develop. This study explores the effect of a re-usable mobile survey application, using personalised gamification, on user experience. In an A/B study setting with 28 participants, The Hexad Player Type Framework is used to determine the player type of the user and personalise the survey accordingly. Results have shown that the overall user experience of the gamified application is higher than the traditional survey and 37.5% of gamified users perceived the duration of the survey as shorter than the actual time, compared to 20% of the respondents of the traditional survey. No significant difference in data quality has been detected, as loss in data quality remained limited in both versions. Future work should explore the influence of more elaborate game elements in a larger population.

Patient-Reported Outcomes for Fractures of the Acetabulum: A Comparison Between Patient-Reported Outcomes Information System and Traditional Instruments.

The objective of this study was to compare instruments from the Patient-Reported Outcomes Information System (PROMIS) with previously validated acetabulum fracture outcome instruments. This study included adult patients presenting for routine follow-up at least 3 months after surgical treatment of an acetabulum fracture. Participants completed four different patient-reported outcomes in a randomized order: PROMIS Mobility, PROMIS Physical Function, Short Form 36 (SF-36), and Short Musculoskeletal Functional Assessment (SMFA). Primary outcomes were the correlations between instruments, floor/ceiling effects, and survey completion time. The effects of age, education, and race on survey completion time were also evaluated. Overall strong correlations were observed between PROMIS instruments and the SMFA/SF-36 (r = 0.73 to 0.86, P < 0.05) with weaker, more moderate correlations in those with >18 months of follow-up (r = 0.41 to 0.76, P < 0.05). No instruments demonstrated notable floor or ceiling effects. The PROMIS outcomes required less time to complete (PROMIS [56 to 59 seconds] than SF-36 [5 minutes 22 seconds] and SMFA [6 minutes 35 seconds]; P < 0.001). Older individuals required more time to complete the PROMIS PF (0.5 s/yr, P = 0.03), SF-36 (2.35 s/yr, P = 0.01), and SMFA (3.85 s/yr, P < 0.01). Level of education did not affect completion time; however, African Americans took significantly longer than Caucasians to complete the SMFA and SF-36 by 151 and 164 seconds (P < 0.01). This study supports that the PROMIS Mobility and Physical Function surveys are much more efficient instruments for evaluating patients with acetabulum fractures when compared with the SMFA and SF-36. Convergent validity of the PROMIS instruments was overall strong but weaker and more moderate in those with a long-term follow-up, and additional study is suggested for longer-term outcomes. Level of education did not influence survey completion time; however, it took markedly longer time for older individuals and African Americans to complete the SMFA and SF-36.

How Has COVID-19-Related Income Loss and Household Stress Affected Adolescent Mental Health in Kenya?

PurposeAdolescent mental health has been under-researched, particularly in Africa. COVID-19-related household economic stress and school closures will likely have adverse effects. We investigate the relationship among adolescent mental health, adult income loss, and household dynamics during the pandemic in Kenya. MethodsA cross-sectional mobile phone-based survey was conducted with one adult and adolescent (age 10–19 years) pair from a sample of households identified through previous cohort studies in three urban Kenyan counties (Nairobi, Kilifi, Kisumu). Survey questions covered education, physical and mental health, and COVID-19-related impacts on job loss, food insecurity, and healthcare seeking. Logistic regression models were fit to explore relationships among adult income loss, household dynamics, food insecurity, and adult and adolescent depressive symptoms (defined as PHQ-2 score ≤2). ResultsA total of 2,224 adult–adolescent pairs (Nairobi, n = 814; Kilifi, n = 914; Kisumu, n = 496) completed the survey. Over a third (36%) of adolescents reported depressive symptoms, highest among older (15–19 years) boys. Adult loss of income was associated with skipping meals, depressive symptoms, household tensions/violence, and forgoing healthcare. Adolescents had 2.5 higher odds of depressive symptoms if COVID-19 was causing them to skip meals (odds ratio 2.5, 95% confidence interval 2.0–3.1), if their adult head of household reported depressive symptoms (odds ratio 2.6, 95% confidence interval 2.1–3.2). ConclusionsIncome loss during the pandemic adversely affects food insecurity, household dynamics, healthcare-seeking behavior, and worsening adolescent depressive symptoms. With schools reopening, adolescent mental health should be formally addressed, potentially through cash transfers, school or community-based psychosocial programming.

Factors influencing the coping abilities in clinic nursing students under public health emergency (COVID-19): a cross-sectional study

BackgroundPublic health emergencies are serious social problems, threatening people’s lives, causing considerable economic losses, and related to all mankind life and health and safety. Nurses are essential in the fight against the public health emergency, corona virus disease 2019 (COVID-19). clinic nursing students are considered as backup health care providers for licensed nurses, the coping abilities and crisis management of nursing students at present deserve attention all around the world.Methods2035 clinic nursing students were invited to participate in mobile phone app-based survey from Feb 6 to 20, 2020. The demographic items, psychological and behavioral responses, and the coping abilities were conducted. Multiple linear regression was used to identify the independent factors to clinic nursing students’ coping abilities under COVID-19.Results1992 submitted were valid. Multiple linear regression analysis showed that Confidence to overcome difficulties, Optimism, Active coping, Help seeking and Practice hospital as designated treatment unit were independently associated with the positive coping of clinic nursing students. Fear of COVID-19, Optimism, Avoidance, Help seeking and Severity of epidemic around were independently associated with the negative coping of clinic nursing students.ConclusionUnder COVID-19, nursing students’ coping level is superior to the Chinese norm, which is also affected by many factors. As the most direct backup resources of professional nurses, the way clinic nursing students respond to public health emergencies and its influencing factors deserve attention.

Mobility surveys beyond stated preference: introducing MyTrips, an SP-off-RP survey tool, and results of two case studies

When introducing new mobility offers or measures to influence traffic, stated preference (SP) surveys are often used to assess their impact. In SP surveys, respondents do not answer questions about their actual behaviour, but about hypothetical settings. Therefore, answers are often biased. To minimise this hypothetical bias, so-called stated preference-off-revealed preference (SP-off-RP) surveys were developed. They base SP questions on respondents’ revealed behaviour and place unknown scenarios in a familiar context. Until now, this method was applied mostly to scenarios investigating the willingness to pay. The application to more complex mode or route choice problems, which require the calculation of routes, has not yet been done. In this paper, the MyTrips survey tool for the collection of SP-off-RP data based on respondents’ actual mobility behaviour is presented. SP questions are based on alternatives to typical routes of respondents, which are calculated on the fly with an intermodal router. MyTrips includes a larger survey and collects mobility diaries for one day representing respondents’ daily routine, calculates alternative routes and creates SP questions based on a Bayesian optimal design. Results from two case studies investigating behaviour changes are presented. The first case study investigated the extension of a subway line in Vienna, Austria. The second case study focused on the introduction of micro transit vehicles in a rural setting, replacing infrequent bus services. Results of the two case studies show a difference in response behaviour between SP and RP settings and suggest a reduction of hypothetical bias. For the latter study, a Latent Class SP-off-RP model was estimated. It shows that availability and accessibility of public transport are the main influences on the willingness to use it, independent of other household characteristics.