Phone-based Interventions Research Articles

Can adopting skin cancer preventive behaviors among seafarers be increased via a theory-based mobile phone-based text message intervention? A randomized clinical trial

BackgroundOne of the main occupational hazards for seafarers is the long exposure to sunlight. This study aimed to determine the efficacy of a mobile phone-based text message intervention in adopting skin cancer preventive behaviors among a sample of seafarers in Genaveh port located in Bushehr province, Iran.MethodsIn this randomized controlled trial, 136 seafarers were randomly selected and assigned to the intervention (n = 68) or a control groups (n = 68). As a theoretical basis, we followed the Protection Motivation Theory (PMT) variables to develop the text messages. The data related to PMT variables and skin cancer preventive behaviors were collected through a questionnaire. Forty-five text messages were designed, pre-tested and sent to the seafarers’ phones in the intervention group in 45 days. Both groups were followed up 1 month after the intervention. Data collected in the two stages were analyzed using paired-samples t-test, ANCOVA, and Chi-square tests.ResultsFollowing the intervention, the mean scores of adopting skin cancer preventive behaviors (p = 0.001), perceived self-efficacy (p = 0.01), protection motivation (p = 0.02), and fear (p = 0.001) were significantly higher in the intervention group than the control group. There was significant reduction in the response costs (p = 0.05) and perceived rewards (p = 0.01) scores in the intervention group compared with the control group after the intervention. However, there were no significant differences in the perceived vulnerability (p = 0.14), perceived severity (p = 0.09), and response efficacy (p = 0.64) between the two groups after the intervention.ConclusionsThe results of the study indicated the effectiveness of mobile phone-based text message intervention for increasing skin cancer preventive behaviors in Iranian seafarers.Trial registrationIranian Registry for Clinical Trial (the link to trial: https://www.irct.ir/trial/7572). Registered 16 July, 2016. Prospectively registered.

Lifestyle intervention using mobile technology and smart devices in patients with high cardiovascular risk: A pragmatic randomised clinical trial

Background and aimsMobile technology-based solutions present promising effects against cardiovascular diseases. Long-term follow-up in mobile phone-based interventions has not yet been elucidated as a primary prevention technique for cardiovascular diseases. The objective of the present trial is to evaluate the effectiveness of lifestyle intervention on the change in the atherosclerotic cardiovascular disease (ASCVD) risk score in a 1-year follow-up using smart phone technology in patients with high cardiovascular risk. MethodsThis prospective, randomised, single-centre clinical investigation enrolled 242 and 241 patients to the intervention plus usual care and usual care arms, respectively. The primary outcome of this study was the 1-year ASCVD risk score adjusted to baseline ASCVD risk score. ASCVD risk scores were calculated for every study participant at the randomisation and final stages. ResultsAfter a 1-year follow-up, the intervention plus usual care reduced the ASCVD score by 2.7% (adjusted treatment effect −2.7, 95% confidence interval (CI): -2.2,-3.3, p<0.0001). An improvement was observed in favour of the intervention plus usual care arm in the majority of the pre-specified secondary endpoints. The high sensitive troponin and high sensitive C-reactive protein levels at 1 year were similar between the two arms. The treatment effect was homogenous for diabetes mellitus, gender, systolic blood pressure, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides and body mass index; however, heterogeneity in the treatment effect was observed for age. ConclusionsThe lifestyle intervention using smart phone technology compared to usual care alone in patients with high cardiovascular risk reduced the ASCVD score at 1-year follow-up.

A mobile phone-based multimedia intervention to support maternal health is acceptable and feasible among illiterate pregnant women in Uganda: Qualitative findings from a pilot randomized controlled trial.

BackgroundUganda’s maternal mortality rate remains unacceptably high. Mobile phones can potentially provide affordable means of accessing maternal health services even among the otherwise hard-to-reach populations. Evidence about the acceptability and feasibility of mobile phone-based interventions targeting illiterate women, however, is limited.ObjectiveTo assess the acceptability and feasibility of a mobile phone-based multimedia application (MatHealth app) to support maternal health amongst illiterate pregnant women in rural southwestern Uganda.Methods80 pregnant women initiating antenatal care from Mbarara regional referral hospital were enrolled in a pilot randomized controlled trial and followed until six weeks after delivery. The 40 women in the intervention group received a MatHealth app composed of educational videos/audios, clinic appointment reminders, and the calling function. Qualitative interviews on acceptability of this technology were carried out with 30 of the intervention participants. An inductive, content analytic approach was used to analyze qualitative data. Quantitative feasibility data were recorded and summarized descriptively.ResultsParticipants reported that the intervention is acceptable as it enabled them adopt good maternal health practices, enhanced social support from spouses, provided clinic appointment reminders, and facilitated communication with healthcare providers. Challenges included: phone sharing (74%), accidental deletion of the application 15 (43%), lack of electricity 15 (43%), and inability to set up a reminder function 20 (57%).ConclusionThe MatHealth app is an acceptable and feasible intervention among illiterate women, in a resource limited setting. Future efforts should focus on optimized application design, spouse orientation, and incorporating economic support to overcome the challenges we encountered.

Pragmatic randomized trial of a pre-visit intervention to improve the quality of telemedicine visits for vulnerable patients living with HIV

Introduction The COVID-19 pandemic has required a shift of many routine primary care visits to telemedicine, potentially widening disparities in care access among vulnerable populations. In a publicly-funded HIV clinic, we aimed to evaluate a pre-visit phone-based planning intervention to address anticipated barriers to telemedicine. Methods We conducted a pragmatic randomized controlled trial of patients scheduled for a phone-based HIV primary care visit at the Ward 86 HIV clinic in San Francisco from 15 April to 15 May 2020. Once reached by phone, patients were randomized to either have a structured pre-visit planning intervention to address barriers to an upcoming telemedicine visit versus a standard reminder call. The primary outcome was telemedicine visit attendance. Results Of 476 scheduled telemedicine visits, 280 patients were reached by a pre-visit call to offer enrollment. Patients were less likely to be reached if virally unsuppressed (odds ratio (OR) 0.11, 95% confidence intervals (CI) 0.03–0.48), CD4 < 200 (OR 0.24, 95% CI 0.07–0.85), or were homeless (OR 0.24, 95% CI 0.07–0.87). There was no difference between intervention and control in scheduled visit attendance (83% v. 78%, OR 1.38, 95% CI 0.67–2.81). Conclusions A structured phone-based planning call to address barriers to telemedicine in a public HIV clinic was less likely to reach patients with poorly-controlled HIV and patients experiencing homelessness, suggesting additional interventions may be needed in this population to ensure access to telemedicine-based care. Among patients reachable by phone, telemedicine visit attendance was high and not improved with a structured pre-visit intervention, suggesting that standard reminders may be adequate in this population.

Effectiveness of Mobile Phone-Based Support on Exclusive Breastfeeding and Infant Growth in Nigeria: A Randomized Controlled Trial

This study examined whether mobile phone-based support improve the rates, duration of exclusive breastfeeding (EBF) as well as infant growth patterns in Nigeria. A 6-month prospective randomized controlled trial with 75 participants assigned to receive 'usual care' or 'mobile phone-based support in addition to usual care' EBF rates and duration as well as anthropometric measurements of infants before and after intervention were compared using proportions and mean differences. Attrition rates of 10.7% and 14.7% were observed in the intervention and control groups, respectively. Treatment groups were identical in all baseline characteristics and participants in the intervention group showed a slower rate of decline in the practice of EBF. The mean difference of 0.6 months (95% confidence interval: -0.22, 1.42) in EBF duration between intervention and control groups was not statistically significant (t = 1.45; p = 0.149). Similarly, the difference in the EBF rates at the 6th month for the intervention (55.2%) and control (46.8%) groups was not statistically significant (χ2 = 0.623; p = 0.430). Although the intervention group had significantly higher mean weight (p = 0.030) and length (p = 0.044) at the 6th month, the difference in the gain in weight and length of these infants over the period was only significant for the weight (p = 0.044). Although the incidence of adverse clinical nutritional status was more in the control group, these differences were not statistically significant. Mobile phone-based intervention has positive effects on the rate and duration of EBF as well as the growth of young infants. Sustaining this simple and cheap technology will improve infant wellbeing especially in resource-constrained settings.

Do mobile phone-based interventions improve the use of contraception?

Do mobile phone-based interventions improve the use of contraception?

MHealth interventions in the management of heart failure, ischaemic heart disease and hypertension: a systematic review and meta-analysis of randomised controlled trials

Abstract Introduction Cardiovascular disease (CVD) remains the leading cause of death in the world. Mobile phones have become ubiquitous in most developed societies. Smartphone applications, telemonitoring and clinician-driven short message service (SMS) allow for novel methods in managing chronic cardiovascular conditions such as ischaemic heart disease, heart failure and hypertension. Purpose To evaluate the impact of mobile phone-based interventions (MPIs) on mortality, hospitalisations and blood pressure and body mass index (BMI) in patients diagnosed with either acute coronary syndrome, heart failure or hypertension. Methods A systematic review was conducted using seven electronic databases, identifying all randomised control trials (RCTs) featuring an MPI in the management of these conditions. Meta-analysis was performed by using standard analytical techniques. The odds ratio (OR) was used as a summary statistic. Results Twenty-six RCTs including 6,713 patients were identified. Of these 26 studies, 13 examined text messaging intereventions, 10 studied telemonitoring interventions and three described smartphone applications with other functions. Twelve studies were included for meta-analysis. In patients with heart failure (n=1683), MPIs were associated with a significantly lower rate of all-cause hospital admissions at six months (31% vs. 36%, OR 0.77, 95% CI 0.62–0.97, p=0.03, I2 = 0). A significant difference was also demonstrated for heart-failure admissions (14.0% vs. 18.5%, OR 0.69, 95% CI 0.48 to 0.98, p=0.04, I2 = 26%). There was no difference in mortality (10.4% vs. 11.6% p=0.45). In patients with hypertension, the difference in systolic BP was 4.3mmHg less in the intervention group (95% CI: −7.8 to −0.78 mmHg, p=0.02). Four studies examined medication compliance as an endpoint in patients with ischaemic heart disease, and all four demonstrated a significant difference favouring the MPI group (see table 1). However, due to variable quantification of compliance, meta-analysis was not possible. There was no significant difference in the change in BMI from four studies after six or more months (mean difference −0.46, 95% CI: −1.44 to 0.52, P=0.36). Conclusions The available data suggests MPIs may have a role as valuable adjuncts in the management of chronic CVD. Figure 1 Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): National Health and Medical Research Council (NHMRC)

Assessing telehealth interventions for physical activity and sedentary behavior self-management in adults with type 2 diabetes mellitus: An integrative review.

Type 2 diabetes is a chronic disease, requiring lifestyle management to prevent chronic complications. Increasing physical activity and reducing sedentary behavior are integral to maintaining glycemic control. The purpose of this study was to (1) appraise and synthesize the literature about physical activity and sedentary behavior intervention delivery via telehealth strategies in adults with type 2 diabetes mellitus and (2) to evaluate what is known about the effectiveness of such interventions on physical activity, sedentary behavior, and glycemic control. An integrative literature review was carried out, including the electronic databases PubMed, CINAHL, and PsychInfo, searching for articles published within the past 10 years, meeting specified inclusion and exclusion criteria, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidelines. Seventeen studies were included. Significant improvements in physical activity and sedentary behavior were identified in web and mobile phone-based interventions. Modest improvements in glycemic control were reported. Theoretical framework use and integration was limited, and intervention length and follow-up varied greatly in the studies reviewed. Outcomes were measured using both self-report and objective measures, but objective measures were used less frequently. Further, few studies have been conducted in the United States or in rural populations. Web and mobile phone-based telehealth interventions to increase physical activity, reduce sedentary behaviors, and improve glycemic control have been supported by the literature. A need exists for future studies that are theory-driven, include dose-specific measures, self-report and objective measures, and long-term follow-up. Examining intervention effects in rural populations is needed.

A qualitative study on the use of mobile-based intervention for perinatal depression among perinatal mothers in rural Bihar, India.

Perinatal depression (PND) is one of the most common psychiatric illnesses in women, with a prevalence around 22% in India. Leveraging mobile-based technologies could help in the prevention and treatment of perinatal depression even in remote places. Understanding the experiences and barriers of using such technology interventions by perinatal mothers could help in the better design and in delivery of these interventions. We aimed to study the experiences of the perinatal women using a mobile phone-based intervention, Interactive Voice Response System (IVRS), for the prevention and management of perinatal depression in a rural district of Bihar, India. A total of 12 in-depth interviews (IDIs) and one focus group discussion (FGD) with eight participants were conducted with perinatal mothers using the mobile-based IVRS to explore the experiences and perspectives of women receiving mobile phone-based interventions for the treatment of PND. Thematic analysis was done to identify major themes. Five major themes emerged from the study around accessibility, usability, community participation, cost and preference to either intervention. Women found the mobile-based intervention useful as it made them feel lighter. They considered mental health as a health issue and wanted help to address their problems. They became familiar with terms like anxiety, depression, helplessness and burden and bean using them in their conversations. The patients used therapeutic strategies such as breathing, coping and relaxation. They even agreed to take up sessions for their peer group. Women in rural Bihar seemed satisfied with the technology-based intervention. It has made mental health issues more visible and acceptable even in the rural hinterlands of Bihar.

Lifestyle Intervention Using Mobile Technology in Patients with High Cardiovascular Risk: A Pragmatic Randomized Clinical Trial

Aims: Mobile technology-based solutions present promising effects against cardiovascular diseases. Long-term follow-up in mobile phone-based interventions has not yet been elucidated as a primary prevention technique for cardiovascular diseases. The objective of the present trial is to evaluate the effectiveness of lifestyle intervention on the change in the atherosclerotic cardiovascular disease (ASCVD) risk score in a 1-year follow-up using smartphone technology in patients with high cardiovascular risk. Methods and Results: This prospective, randomised and single-centre clinical investigation enrolled 242 and 241 patients to the intervention plus usual care and usual care arms, respectively. After a follow-up of 1-year, the intervention plus usual care reduced the ASCVD score by 2.7% (adjusted treatment effect -2.7, 95% confidence interval (CI): -2.2, -3.3, p<0.0001). An improvement was observed in favour of the intervention plus usual care arm in the majority of the pre-specified secondary end points. The high sensitive-troponin and high sensitive-C reactive protein levels at 1 year were similar between the two arms. The treatment effect was homogenous for diabetes mellitus, gender, systolic blood pressure, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides and body mass index; however, heterogeneity in the treatment effect was observed for age. Conclusion: The lifestyle intervention using smartphone technology compared to usual care alone in patients with high cardiovascular risk reduced the ASCVD score at 1-year follow-up. Clinical Trial Registration: The trial was registered at www.clinicaltrials.gov (NCT03397849). Funding Statement: TThis work was supported by Turk Telekomunikasyon A.S. The study was performed at Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Turkey. Declaration of Interests: None declared. Ethics Approval Statement: The study protocol complies with the Declaration of Helsinki and it was approved by the local ethics committee of the Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey (approval no. 2017/78). All the participants provided written informed consent.

Developing and evaluating the effectiveness of mobile phone-based career intervention for career competencies of Malaysian public managers: Protocol for a mixed method study

BackgroundThis study presents a protocol for a mixed method study on the development and evaluation of the effectiveness of mobile phone-based intervention for enhancing career competencies of managers in the Malaysian public service. Career competencies, being central to the self-management and development of one's career, are necessary for proactive management of careers; they help to guide the individuals towards subjective career success which subsequently leads to organization success. However, there is a lack of career competencies intervention practices in the Malaysian public service. Therefore, this study aims to develop and evaluate the effectiveness of a user and expert centric mobile phone-based career intervention program of career competencies among Malaysian public managers. In this study, the Social Cognitive Career Theory (SCCT) is adopted as the framework to develop mobile phone-based intervention for career competencies. MethodThis is a sequential exploratory mixed method study which involves, in Phase 1, a qualitative approach: reviewing of literature and interviewing experts and public servants who are users of mobile phones so as to obtain their perspectives regarding the components in the career intervention module and mobile phone application features. A quantitative approach is implemented in Phase 2 that evaluates the mobile phone-based career intervention program. Validation will be conducted to meet the objectives of (i) the usability of the mobile communication career intervention application (survey), and (ii) evaluation of the effectiveness of the intervention program for career competencies delivered through mobile phone application (randomized controlled trial). The career intervention program consists of five modules through which development is based on reflective, communicative and behavioral dimensions. OutcomeThe primary outcome of this study is career competencies. The career competencies score will be compared between participants in the intervention and control group at the baseline, and follow-ups at week four and week 12 respectively, using mixed design ANOVA. DiscussionThe results from this study will indicate the effectiveness of the career intervention program for career competencies in the reformation of public services management. The intervention can serve as a new modality to enhance career competencies among public managers in Malaysia if its effectiveness is proven.

Harnessing Phones to Target Pediatric Populations with Socially Complex Needs: Systematic Review.

BackgroundMobile and smartphones are owned and accessed by many, making them a potentially optimal delivery mechanism to reach pediatric patients with socially complex needs (ie, pediatric populations who face overlapping adversities).ObjectiveTo address the specialized needs of youth from such groups, this review synthesized the literature exploring the use of phone-based delivery to access pediatric populations with socially complex needs, targeting mental and behavioral health outcomes. The purpose of this synthesis was to provide recommendations for future research developing phone-based interventions for youth with socially complex needs.MethodsA trained medical librarian conducted the search strategy in the following databases: PubMed, Scopus, CINAHL, PsycINFO, Cochrane CENTRAL Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Google Scholar. Studies targeting youth with socially complex needs were defined by recruiting samples that were primarily from traditionally underserved populations (ie, sex/gender minorities, racial/ethnic background, low socioeconomic status, rural/remote location, and sexual orientation). A systematic narrative framework was utilized and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed (registration number CRD42020141212).ResultsA total of 14 studies met the inclusion criteria, with 3 depicting the use of phones to complete assessment and tracking goals and 11 to intervene on mental and behavioral health targets.ConclusionsThe literature indicates important directions for future research, including (1) involving diverse and representative teens (ie, the likely users of the interventions), stakeholders, and clinical/research staff; (2) integrating evidence-based therapies with minority-focused theories; (3) harnessing mobile device capabilities; and (4) considering and assessing for potential costs in phones as delivery mechanisms.Trial RegistrationPROSPERO CRD42020141212; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=141212

Racial Differences in the Effectiveness of a Multifactorial Telehealth Intervention to Slow Diabetic Kidney Disease.

African Americans are significantly more likely than non-African Americans to have diabetes, chronic kidney disease, and uncontrolled hypertension, increasing their risk for kidney function decline. The objective of this study was to compare how African Americans and non-African Americans with diabetes responded to a multifactorial telehealth intervention designed to slow kidney function decline. Secondary analysis of a randomized trial. Primary care patients (N=281, 56% African American) were allocated to either: (1) a multifactorial, pharmacist-delivered phone-based telehealth intervention focused on behavioral and medication management of diabetic kidney disease; or (2) an education control. The primary study outcome was change in estimated glomerular filtration rate (eGFR). Linear mixed models were used to explore the moderating effect of race on the relationship between study arm and eGFR decline over time; the mean annual rate of eGFR decline was estimated by race and study arm. Findings demonstrated a differential intervention effect on kidney function over time by race (Pinteraction=0.005). Among African Americans, the intervention arm had significantly greater preservation of eGFR over time than the control arm (difference in the annual rate of eGFR decline=1.5 mL/min/1.73 m; 95% confidence interval: 0.04, 3.02). For non-African Americans, the intervention arm had a faster decline in eGFR over time than the control arm (difference in the annual rate of eGFR decline=-1.7 mL/min/1.73 m; 95% confidence interval: -3.3, -0.02). A multifactorial, pharmacist-delivered telehealth intervention for diabetic kidney disease may be more effective for slowing eGFR decline among African Americans than non-African Americans.

A Pilot Study and Ecological Model of Smoking Cues to Inform Mobile Health Strategies for Quitting Among Low-Income Smokers.

One crucial factor that leads to disparities in smoking cessation between groups with higher and lower socioeconomic status is more prevalent socioenvironmental smoking cues in low-income communities. Little is known about how these cues influence socioeconomically disadvantaged smokers in real-world scenarios and how to design interventions, especially mobile phone-based interventions, to counteract the impacts of various types of smoking cues. We interviewed 15 current smokers living in low-income communities and scanned their neighborhoods to explore smoking-related experiences and identify multilevel cues that may trigger them to smoke. Findings suggest four major types of smoking cues influence low-income smokers-internal, habitual, social, and environmental. We propose an ecological model of smoking cues to inform the design of mobile health (mHealth) interventions for smoking cessation. We suggest that user-triggered strategies will be most useful to address internal cues; server-triggered strategies will be most suitable in changing perceived social norms of smoking and routine smoking activities to address social and habitual cues; and context-triggered strategies will be most effective for counteracting environmental cues. The pros and cons of each approach are discussed regarding their cost-effectiveness, the potential to provide personalized assistance, and scale.

Patients' needs and perspectives for using mobile phone interventions to improve heart failure self-care: A qualitative study.

To explore heart failure patients' needs and perspectives for using mobile health technology at home before developing a mobile phone-based heart failure self-care intervention. A qualitative interview study. Purposive sampling was used to conduct semi-structured individual interviews with patients diagnosed with chronic heart failure (N=20). Data were collected from November 2018 - May 2019. All interviews were audio-recorded and transcribed verbatim and data were analysed using qualitative content analysis. The four themes that emerged from the interviews were as follows: 'The demand for reliable and customized health information', 'Valuable features of mobile phone applications', 'Barriers to adopting mobile health service', and 'Expected benefits of using mobile health technology'. Participants in this study required personalized health-related information and reminders for improving their self-care behaviours. However, while difficulties in using mobile phone applications posed the main obstacle, users expected mobile health services to improve their overall quality of life. Despite mobile phone technology's potential benefits for effective self-care strategies at home, there were some obstacles such as security issues, application costs, and the need for user friendly designs and reliable information for patients' optimal use. This study highlights that healthcare professionals should consider patients' needs and preferences to promote the acceptability of mobile health technology. This study's findings can guide the future design and implementation of mobile health interventions for improving self-care among patients with heart failure.

The influence of mobile phone-based health reminders on patient adherence to medications and healthy lifestyle recommendations for effective management of diabetes type 2: a randomized control trial in Dhaka, Bangladesh

BackgroundIn 2017, 80% of 425 million adults with diabetes worldwide were living in low and middle-income countries. Diabetes affected 6.9 million adults in Bangladesh and accounted for 3% of the country’s total mortality. Proper management of diabetes is the key to positive health outcomes. This study investigated how mobile phone-based health intervention could increase patient adherence and thereby improve the disease outcomes for diabetes type 2 in Bangladesh.MethodsA mobile phone-based health project (including mobile phone reminders and 24/7 call center) was implemented in Dhaka District, Bangladesh from January to December 2014. A randomized control trial was carried out, recruiting randomly in intervention and control groups among the patients receiving treatment for type 2 diabetes at the Bangladesh Institute of Health Sciences Hospital, Dhaka, Bangladesh. A total of 320 patients from both groups at baseline and 273 at endline were interviewed.ResultsA significant improvement in patient adherence to diet, physical exercise, the cessation of use of tobacco and betel nut, and blood glycaemic control was found in the intervention group, whereas no such significant improvement was found in the control group. Cost and other co-morbidities were found to be the main reasons for non-adherence.ConclusionA mobile-health intervention should be considered as an additional option for non-communicable disease programs.

4135 Digital Mental Health Interventions for PTSD &amp; Resilience: A Systematic Review

OBJECTIVES/GOALS: 1) In this literature review we want to explore the literature on DMHI (Interventions delivered via digital technologies, such as smartphones, websites, or text messaging), specifically designed to treat Posttraumatic Stress Disorder (PTSD), and/or to promote positive change &amp; resilience after trauma. 2) We also want to evaluate the literature in terms of the theoretical model used in each DMHI, engagement, effectiveness, &amp; potential harms/challenges. METHODS/STUDY POPULATION: We will review the literature that describes DMHI for PTSD, resilience, &amp; positive change in persons exposed to psychological trauma (Exposure to actual or threatened death, serious injury, or sexual violence, as defined by the fifth edition of the Diagnostic &amp; Statistical Manual of Mental Disorders). We will review the following databases: PsychINFO, EBSCOhost, PubMed, &amp; PsychiatryOnline. The following inclusion criteria will be used: 1) Interventions delivered by computer, smartphones, or online, 2) studies published between 1999-2019. Exclusion criteria will include reviews, opinion, or discussion articles, &amp; unpublished works. RESULTS/ANTICIPATED RESULTS: We expect to find that the most popular therapeutic model for DMHI is cognitive behavioral therapy. We also expect to find a higher number of web-based interventions, as opposed to phone-based interventions, or other types of DMHI. We also expect to find variable drop-out rates, low engagement, &amp; small to moderate effect sizes. DISCUSSION/SIGNIFICANCE OF IMPACT: We expect our contribution to center on evaluating available DMHI for psychological trauma. This systematic literature review is expected to provide scientific justification for the development (or validation), &amp; implementation of a DMHI that takes into account the results of previous studies. This contribution is expected to be significant because it will help in choosing, or developing an effective future intervention with DMHI. CONFLICT OF INTEREST DESCRIPTION: There is no conflict of interest in this study.

An mHealth intervention to prevent postnatal smoking relapse: The RESPREMO study protocol.

Up to 70% of women who quit smoking relapse after birth, usually within 3 months postpartum. The wide adoption of mobile technologies, especially smartphones, in recent years in low- and middle-income countries (LMICs) offers the possibility of low-cost, novel, and innovative mobile phone-based interventions for smoking relapse prevention. This study presents the protocol of the RESPREMO clinical trial for postnatal smoking relapse prevention for enrolled women, who recently gave birth and quit tobacco smoking before or during pregnancy, and their life partners.This work relies on data collected in two of the largest government-owned obstetrics and gynecology clinics in Cluj-Napoca, Romania. Seventy-five couples were randomized into one of three groups: a) 24 couples were allocated to the first intervention group and asked to install and use the xSmoker app; b) 26 couples were randomized to the second intervention group, who, in addition to the use of the xSmoker app, received text messages with content focused on motivation, problem solving, and dyadic efficacy; and c) 25 couples were randomized into a control group.Several measures of engagement with the xSmoker app were assessed, including duration of app use, the frequency of utilizing the tool to calculate savings from quitting, number of app-delivered challenges accepted by users, and number of app-delivered cessation and abstinence tips.If effective, RESPREMO is expected to have a sustainable impact on the prevention of postnatal relapse tobacco smoking with positive effects for both the mother and the newborn. The implications are beyond tobacco control, and relevant to the design and implementation of other mHealth behavioral interventions focused on the pregnancy and reproductive years in general.

A Survey of the Mobile Phone-Based Interventions for Violence Prevention Among Women

Information Communication Technologies (ICT), particularly mobile phone technology, has increased the propinquity between individuals by enhancing their ability to frequently communicate with one another through different mediums, like text, audio, video, and emojis. Cell phone technology is being used to combat various social issues, including several public health-related problems such as violence against women. Over the past two decades several cellphone-based apps, including Circle of 6, MyPlan, Panic Button, and Aspire News have been developed in several countries to prevent violence against women. Anecdotal evidence suggests that these apps are effective both as violence prevention and as an intervention tool in public as well as private spaces. However, very little awareness exists among social workers about these mobile phone applications (apps), particularly the capabilities and limitations of these apps. Based on a brief survey and classification of the existing mobile phone apps designed to prevent violence against women, this paper aims to explain how these apps work, and point out their capabilities and limitations so that social workers and public health professionals can better guide their clients in using these technology-based services. It is highly recommended that social workers evaluate how their clients are affected by the use or non-use of violence prevention apps and advocate for their client’s right to digital literacy and internet access.

Effectiveness of Mobile Phone-Based Interventions for Improving Health Outcomes in Patients with Chronic Heart Failure: A Systematic Review and Meta-Analysis.

Mobile phone-based interventions are increasingly used to prevent adverse health outcomes in heart failure patients. However, the effects of mobile phone-based interventions on the health outcomes of heart failure patients remain unclear. Our review aims to synthesize the randomized controlled trials (RCT) of mobile phone-based interventions for heart failure patients and identify the intervention features that are most effective. Electronic searches of RCTs published from January 2000 to July 2019 were conducted. Primary outcomes included all-cause mortality, readmission, emergency department visits, length of hospital stays, and quality of life. Secondary outcomes were self-care behaviors, including medication adherence and other clinical outcomes. A total of eight studies with varying methodological quality met the inclusion criteria and were analyzed. Voice call intervention was more frequently used compared with telemonitoring and short message services. Our meta-analysis showed that voice call interventions had significant effects on the length of hospital stays. However, no significant effects on all-cause mortality, readmission, emergency department visits, or quality of life were found. Compared to other mobile phone-based interventions, voice calls were more effective in reducing the length of hospital stay. Future studies are needed to identify which features of mobile phone-based intervention most effectively improve health outcomes.