Reminder Methods Research Articles

The Strategy to Internalize Social Care and Leadership Values for Early Childhood in Inclusive Schools in Bengkulu

Early childhood education is an effort to stimulate and provide learning activities that will later produce children's abilities and skills. Early childhood education is carried out with the aim of helping early childhood in the aspect of development, with the existence of early childhood education children can express ideas through playing while learning. In addition, in early childhood education it is important to internalize character education, because character education is one of the efforts that can be made to help children's development involving knowledge, feelings, and actions. The purpose of this study is to determine the strategy of instilling character values of social care and leadership for early childhood students in inclusive schools in Bengkulu. The research method used in this study is mixed method or combined method with data collection through questionnaires and interviews. The sample in this study was TK B which amounted to 71 respondents and the subjects of the study were 5 kindergarten B teachers. The results showed that the categorization of social care and early childhood leadership profiles consisted of three categories, namely high, medium, and low. For social care profiles of 71 respondents, there were 32 people or around 45.1% in the high category, 33 people or 45.5% in the medium category, and 6 people or 8.5% in the low category. As for the leadership profile of 71 respondents, there were 21 people or 29.6% in the high category, 44 people or 62% in the medium category, and 6 people or 8.5% in the low category. Furthermore, the strategy carried out by teachers in instilling the value of social care and leadership using the method of telling stories, listening to speech, habituation, direct practice, and reminder methods. Keywords: Early childhood education, Social care and leadership values, inclusive schools

Evaluating Impacts of Bus Route Map Design and Dynamic Real-Time Information Presentation on Bus Route Map Search Efficiency and Cognitive Load

The purpose of this study was to explore the impact of different design methods of bus route maps and dynamic real-time information on the bus route map search efficiency and cognitive load. A total of 32 participants were tested through an experiment of destination bus route searching, and the NASA-TLX scale was used to measure their cognitive load. Two route map schemes were designed according to the research purposes and application status. One was a collinear bus route map with geographic location information based on a realistic map, the other was a highly symmetric straight-line collinear bus route map without map information, and two different types of dynamic real-time information reminder methods were designed (the dynamic flashing of the number of the bus entering the stop, and the dynamic animated flash of the route of the bus entering the stop). Then, four different combinations of the bus route maps were used for testing through the search task of bus routes available for bus destinations. The results indicated no significant difference in the search efficiency between the map-based bus route map and the linear bus route map, but the cognitive load of the map-based bus route map was higher than that of the linear route map. In the presentation of dynamic real-time information, neither the search performance nor the cognitive load of the dynamic flashing of the route of the bus entering the stop was as good as those of the flashing of the number only of the bus entering the stop. In addition, it was found that, compared with men, the cognitive load for women was more affected by geographic information. The optimization strategies of the bus route map information design were proposed by the comprehensive consideration of the feedback of route maps and real-time information.

Increasing Fecal Immunochemical Test Return Rates by Implementing Effective "Reminder to Complete Kit" Communication With Participants: A Quality Improvement Study.

BackgroundThe incidence of colorectal cancer (CRC) in the United States is increasing. It remains the second leading cause of cancer death in the United States for men and women combined, mainly due to underutilization of screening methods. The American Cancer Society now recommends that adults aged 45 years and older with an average risk of CRC undergo regular screening with either a high-sensitivity stool-based test or structural (visual) examination, depending on patient preference and test availability. The primary objective of this quality improvement project was to determine if reminder methods, such as telephone or letter reminders, increased the return rate of fecal immunochemical tests (FIT) for CRC screening.MethodologyAt public outreach events and daily clinics in the West Texas Panhandle area, participants in the GET FIT program were provided with FIT kits after completing the education on CRC. Participants who fit the inclusion criteria and had received a FIT kit from the program were included. They were instructed on how to perform the test and mail it back. Participants who did not return the completed kits within two weeks were reminded either through (1) a reminder letter, (2) telephone, or (3) a combination of letter reminder and telephone call every two weeks (±three days) for 60 days or five attempts to contact. We de-identified and analyzed the FIT kit return data from April-September 2019 before analyzing these reminder methods. We then calculated the change in return rates from October 2019 to March 2020. Our goal was to increase the FIT return rates by 25% compared to the baseline return rate.ResultsThe pre-intervention return rate of kits for April-September 2019 was 61.52%, and the post-intervention return rate for October 2019-March 2020 was 71.85%. This rate was equal to an approximately 16.79% increase in return rates that was statistically significant (p < 0.01). There was a significant difference in the method of reminder between the two groups, but no significant differences in gender and race/ethnicity between the two groups. There was a significant difference in return rates between race/ethnicities in the October-March cohort with black and Hispanic participants having the highest return rates of 82.3% and 77.25%, respectively.ConclusionsFIT remains one of the primary options for CRC screening. Due to its lower cost and noninvasiveness, FIT was offered to patients at average risk. We demonstrated an increase in return rates, although we did not meet our target return rate goal for this project. This study was limited due to a gradual increase in coronavirus disease 2019 (COVID-19) cases and a subsequent shift and conversation of ongoing research into COVID-19.

The role of health facility and individual level characteristics on medication adherence among PLHIV on second-line antiretroviral therapy in Northeast Ethiopia: use of multi-level model

BackgroundMedication adherence plays a pivotal role in achieving the desired treatment outcomes. The proportion of HIV patients on second-line antiretroviral therapy is becoming a growing public health concern. However, to date, little attention has been given to second-line antiretroviral medication adherence. Moreover, the association between health facility characteristics and medication adherence has yet not been tested. Thus, this research was conducted to determine the magnitude of medication adherence and examine the role of facility-level determinants among HIV patients on second-line ART.MethodsA cross-sectional study was conducted on 714 HIV patients on second-line therapy who were selected via systematic random sampling in twenty public health facilities. Medication adherence was measured using the six-item Simplified Medication Adherence Questionnaire (SMAQ) tool. Data were collected in a personal interview as well as document reviews. A multi-level binary logistic regression was used to uncover individual and facility-level determinants. The effect size was presented using an adjusted odds ratio (AOR), and statistical significance was declared at a P value less than 0.05.ResultsThe magnitude of optimal medication adherence among HIV patients on second-line antiretroviral therapy was 69.5% (65.9–72.7%). Medication adherence was positively associated with the use of adherence reminder methods [AOR = 3.37, (95% CI 2.03–5.62)], having social support [AOR = 1.11, (95% CI 1.02–1.23)], and not having clinical depression [AOR = 3.19, (95% CI 1.93–5.27). The number of adherence counselors [AOR = 1.20, (95% CI 1.04–1.40)], teamwork for enhanced adherence support [AOR = 1.82, (95% CI 1.01–3.42)], and caseloads at ART clinics were all significantly correlated with ARV medication adherence at the facility level.ConclusionsA large proportion of HIV patients on second-line antiretroviral therapy had adherence problems. Both facility-level and individual-level were linked with patient medication adherence. Thus, based on the identified factors, individual and system-level interventions should be targeted.

Human papillomavirus dose reminder preferences among parents from a diverse clinical sample: a qualitative study

ABSTRACT Reminders are an important method for encouraging patients to return for follow-up visits, such as for successive doses of the human papillomavirus (HPV) vaccine. However, patients may have preferences for different types of reminders. This study examined which reminder methods parents of pediatric patients found most useful and their thoughts on how the reminders helped them to complete their children’s HPV vaccine series. This qualitative study was conducted on a purposively sampled group of parents who participated in a multi-level intervention intended to improve uptake and completion of the HPV vaccine series. Parents who agreed to participate were interviewed by phone using semi-structured interviews about their satisfaction with different program components, including reminders they received. Interviews were conducted between May 26, 2016 and October 18, 2017. Thematic analyses of data were conducted using NVivo software. Among 269 program participants invited to participate in the interviews, 157 agreed (58.4%) and 89 were successfully interviewed (33.1%). Participants thought that reminders were effective at helping them return for follow-up visits to ensure their children received all recommended HPV vaccine doses. Although most parents preferred texts, many also favored other reminder methods by themselves or in combination with texts. Parents suggested that the reminders indicate the purpose of the appointment and for which child. Reminders are an important part of a multi-component intervention that aims to increase completion of the HPV vaccine series. Program enrollees prefer different types of reminders, so offering several options may improve returns for follow-up doses.

Influence of pharmaceutical representatives on prescription decisions by physicians in Qassim province.

Pharmaceutical representatives are an important part of the marketing of pharmaceutical products and an important source of prescribing information for common practitioners. Thus, this study aims to identify factors that affect physicians' drug selection decisions, determine the main source of information for physicians about new drugs, and the most effective reminder methods used by pharmaceutical representatives. This study is a cross-sectional study that was distributed to doctors in different health specialties and different clinics and hospitals in the Qassim region from February to March 2020. The data collected were analyzed using Microsoft Excel. The Internet is the most considered main source of new drug information. Moreover, hospital policy is the most common factor that affects physicians' drug selection decisions. Finally, leaflets and pharmaceutical sales representatives' (PRs') frequent visits are the most effective reminder methods. This study showed the main source of new drug information was the Internet. In comparison, the factor that affects the physician's drug selection decision in this study was hospital policy. Finally, the most effective reminder methods were PRs' frequent visits and also an equal percentage leaflet.

S250 Increasing Fecal Immunochemical Test Return Rates by Patient Reminders: A Quality Improvement Study

Introduction: The incidence of colorectal cancer (CRC) in the United States is increasing, and it remains the second leading cause of cancer death in the United States for men and women combined. The American Cancer Society now recommends that adults aged 45 years and older with an average risk of CRC undergo regular screening with either a high sensitivity stool-based test or structural (visual) examination, depending on patient preference and test availability. The primary objective of this quality improvement project was to determine if reminder methods, such as telephone or letter reminders, increased the return rate of fecal immunochemical tests (FIT) for colorectal cancer screening. Methods: At public outreach events and daily clinics in the West Texas Panhandle area, participants in the GET FIT program were provided with FIT kits after completing the education on colorectal cancer. Participants who fit the inclusion criteria and had received a FIT kit from the program were included. They were instructed on how to perform the test and mail it back. Participants that did not return the completed kits within two weeks were reminded either by 1) through a reminder letter or 2) by telephone every 2 weeks (+/- 3 days) for 60 days or 5 attempts to contact. We de-identified and analyzed the FIT kit return data from June-November 2019 before instituting these reminder methods. We then calculated the change in return rates from December 2019 to February 2020. Our goal was to increase the FIT return rates by 25% over the baseline return rate. Results: The pre-intervention return rate of kits for June-November 2019 was 67.58%, and the postintervention return rate for December 2019-February 2020 was 81.87%. This rate was equal to an approximately 21% increase in return rates. The average return rate of FIT kits overall was 72.34%. The average rate of returned new patient kits was 69%, and the average % of new patient return kits was 68.51%. We also noticed a significant increase in return of FIT tests after a community cancer screening in October 2019. Conclusion: Fecal immunohistochemical test (FIT) remains one of the primary options for colorectal cancer screening. Due to its lower cost and noninvasiveness, FIT was offered to patients at average risk.We did achieve a significant increase in return rates, although we did not meet our target goal for this project. Our project was limited to studying 3 months post-intervention due to the COVID pandemic and barrier in returning tests. (Table Presented).

Factors associated with nonadherence to antiretroviral therapy among children with HIV/AIDS in Ahmadu Bello University Teaching Hospital, Zaria, Nigeria

Background: The advent of antiretroviral (ARV) treatment in combined therapy has transformed HIV/AIDS into a chronic treatable condition and significantly improved the prognosis and quality of life of patients with HIV/AIDS. However, to achieve this, patients have to maintain strict adherence which has been shown to be affected by several factors. This study, therefore, aimed to estimate and identify factors associated with adherence to ARV drugs among children attending Paediatric ARV Clinic at Ahmadu Bello University Teaching Hospital, Zaria. Subjects and Methods: Sociodemographic and clinical information of the children and their caregivers was collected using a semi-structured questionnaire. Bivariate and multivariate analyses were done to examine the odds of adherence and nonadherence to ARV therapy with respect to the various factors. P = 0.05 was considered statistically significant. Results: A total of 167 children and their caregivers were studied. The children were aged between 2 and 17 years with a mean age of 9.1 ± 3.4 years, while the caregivers were aged between 20 and 70 years with a mean age of 37.6 ± 10.7 years. The estimated adherence in the past 30 days was found to be 76.6%. Caregivers' forgetfulness and traveling were reported as the major reasons for missing medications. Caregivers' age <35 years was significantly associated with poor adherence (odds ratio = 2.35 [95% confidence interval: 1.09–5.06]). Conclusion: Caregiver factors were the main factors associated with poor adherence in children with HIV. We recommend regular adherence counseling at every visit with emphasis on the use of reminder methods to improve adherence.

Clinic-Level Factors Associated With Retention in Care Among People Living With Human Immunodeficiency Virus in a Multisite US Cohort, 2010-2016.

Retention in care (RIC) leads to reduced HIV transmission and mortality. Few studies have investigated clinic services and RIC among people living with HIV (PLWH) in the United States. We conducted a multisite retrospective cohort study to identify clinic services associated with RIC from 2010-2016 in the United States. PLWH with ≥1 HIV primary care visit from 2010-2016 at 7 sites in the Centers for AIDS Research Network of Integrated Clinical Systems (CNICS) were included. Clinic-level factors evaluated via site survey included patients per provider/trainee, navigation, RIC posters/brochures, laboratory test timing, flexible scheduling, appointment reminder methods, and stigma support services. RIC was defined as ≥2 encounters per year, ≥90 days apart, observed until death, administrative censoring (31 December 2016), or loss to follow-up (censoring at first 12-month interval without a visit with no future visits). Poisson regression with robust error variance, clustered by site adjusting for calendar year, age, sex, race/ethnicity, and HIV transmission risk factor, estimated risk ratios (RRs) and 95% confidence intervals (CIs) for RIC. Among 21 046 PLWH contributing 103 348 person-years, 67% of person-years were retained. Availability of text appointment reminders (RR, 1.13; 95% CI, 1.03-1.24) and stigma support services (RR, 1.11; 95% CI, 1.04-1.19) were associated with better RIC. Disparities persisted for age, sex, and race. Availability of text appointment reminders and stigma support services was associated with higher rates of RIC, indicating that these may be feasible and effective approaches for improving RIC.

A systematic review on reminder systems in physical therapy.

Background:The main goal of physical therapy is to help the patient gain a better health status. Several studies have investigated the use of reminders to prevent such failures on the patients’ side. This article presents a systematic review of the literature concerning reminders in physical therapy.Methods:Databases were searched until May 2017 and literatures were found from April 1992 until 2017. The literature recruitment strategy was based on applying several keywords and Medical Subject Heading (MeSH) combination running against title and abstract, including concepts such as reminder, physical therapy. The finally selected articles were categorized through reminder aspects such as how, who feedback. Data were extracted according to PRISMA guidelines.Results: In 47% of studies, the reminder was sent to the patients, 29% to the physical therapists and 12% to the caretaker team. In 24% of the studies, paper-based letters were main medium for reminders while the rest were various types of media like emails and SMS mobile text messages. 35% of the articles showed positive effects of the reminders.Conclusions:Many reminder methods consisted of SMS, phone calls, letters, emails and notices on the wall were used in physical therapy. Reminders may be used to improve patients' adherence to exercise programs.

Vaccination adherence: Review and proposed model.

The prevalence of childhood vaccine-preventable diseases can be significantly reduced through adherence to confirmed vaccination schedules. However, many barriers to vaccination compliance exist, including a lack of awareness regarding the importance of vaccines, missing due dates, and fear of complications from vaccinations. The aim of this study is to review the existing tools and publications regarding vaccination adherence, and to propose a design for a vaccination adherence application (app) for smartphones. Android and iOS apps designed for vaccination reminders have been reviewed to examine six elements: educational factor; customizing features; reminder tools; peer education facilitations; feedback, and the language of apps' interface and content. The literature from PubMed has been reviewed for studies addressing reminder systems or tools including apps. The study has revealed insufficient (n=6) technology-based interventions for increasing childhood vaccination rates by reminding parents in comparison to the fast growth in technology, out of which are two publications discussed mobile apps. Ten apps have been found in apps stores; only one out of them was designed for the Saudi vaccination schedule in Arabic language with some weaknesses. The study proposed a design for a vaccination reminder app that includes a number of features in order to overcome the limitations discussed in the studied reminders, apps, and systems. The design supports the Arabic language and the Saudi vaccination schedule; parental education including peer education; a variety of reminder methods, and the capability to track vaccinations and refer to the app as a personal health record. The study discussed a design for a vaccination reminder app that satisfies the specific requirements for better compliance to children's immunization schedules based on reviewing the existing apps and publications. The proposed design includes element to educate parents and answer their concerns about vaccines. It involves their peers and can encourage the exchange of experiences and overcome vaccine fears. In addition, it could form a convenient child personal health record.

Public Relations as Part of Integrated Communication of an Enterprise-Consumer Oriented On

Pharmaceutical Representatives and Prescription Decisions by Physicians in Saudi Arabia Ishak Abubakar Y. Ibrahim, Charles H. Bélanger Abstract Purpose: This research aims to identify key factors that influence physicians’ drug selection decisions as well as the main sources of information for physicians about new drugs and the most effective “reminder methods” used by pharmaceutical sales representatives. This study fills a gap within the existing literature by identifying the most important factors that affect physicians’ drug selection decisions in Saudi Arabia Design/methodology/approach: A survey was conducted in the Western region of Saudi Arabia using a convenience sample. A total of 106 physicians who met with pharmaceutical sales representatives filled out a questionnaire identifying the factors that influenced their prescribing decisions, as well as determining their main sources of information about new drugs, and the most effective “reminder methods” used by pharmaceutical representatives. Data were analyzed using SPSS. Findings: The results indicate that pharmaceutical sales representatives are the most commonly mentioned main source of new drugs information. Moreover, the factors identified as most impacting physicians’ drug selection decisions include in order, the patient’s financial situation and prevailing hospital policies, followed by media advertising and frequent visits from pharmaceutical sales representatives. Finally, leaflets were identified as the most effective ‘reminder method’ used by pharmaceutical sales representatives. Originality/value: The study findings are relevant because they can help pharmaceutical sales representatives to focus their efforts on the most effective marketing methods to boost their sales revenue, increase their market share, reduce marketing expenses, and potentially pass on the savings to patients. Full Text: PDF DOI: 10.15640/jmm.v3n2a7

Sensory discrimination by consumers of multiple stimuli from a reference: Stimulus configuration in A-Not AR and constant-ref. duo-trio superior to triangle and unspecified tetrad?

In the food industry, overall discrimination tests are used with untrained/naïve consumer subjects to compare multiple test stimuli against a fixed reference, such as a company’s gold standard or a stimulus familiar to the consumer. Such tests are used for various objectives, including reformulation and cost reduction. Yet, studies on relative discrimination power and efficiency have been limited to experimental designs with a fixed pair of stimuli and method comparisons based on the same numbers of tests. In the present study, two reminder methods, A-Not A with Reminder (A-Not AR) and 2-AFC with Reminder (2-AFCR), were investigated as potentially better methods for experimental designs including comparisons of multiple pairs of stimuli for consumer discrimination. 2-AFCR is procedurally equivalent to a constant-reference duo-trio test with the reference presented first (DTF) and thus this test is referred to as the constant-ref. DTF/2-AFCR test in this paper. The practical efficiency of these two reminder methods, attributed to their effective stimulus configurations in replicated tests (i.e. using a fixed reference and lower number of different stimuli required in a test), was tested in comparison with the two most commonly used balanced reference classification methods, the triangle test and the unspecified tetrad test, by equalizing the number of stimuli required for the different methods. Namely the relative operational discrimination power was studied based on the same number of stimuli rather than the same number of tests. 180 naïve consumers performed a set of 12 replicated triangle tests and, based on the results, were divided into one of three equally-performing groups. A related-samples design was implemented for comparison between the triangle and the other three methods. An independent-samples design was implemented across the three groups to compare the A-Not AR, constant-ref. DTF/2-AFCR, and unspecified tetrad methods. Statistical ratio comparisons of d′ estimates obtained from different methods revealed that discrimination performance in the reminder methods was better than in both the tetrad and triangle methods. No discrimination difference was found between the triangle and tetrad tests having all possible test sequences, although the triangle test considering only the optimal test sequences, which were the same as those in the constant-ref. DTF/2-AFCR, resulted in superior discrimination than the tetrad test. Collectively, these results suggest that when assessing the discriminability of multiple stimuli from a fixed reference, the reminder scheme is the superior research design.

Comparison of Reminder Methods in Selected Adolescents With Records in an Immunization Registry

PurposeThe aim of this study was to assess the effectiveness and cost efficiency of three reminder/recall methods for improving adolescent vaccination rates using the San Diego Immunization Registry. MethodsParents of 5,050 adolescents whose records indicated they lacked one or more adolescent vaccines were identified from the San Diego Immunization Registry and contacted by telephone. Based on their preference, consenting participants were enrolled to receive either postal mail (n = 282), e-mail (n = 963), or text (n = 552) reminders for vaccination. The intervention groups were sent a series of up to three reminders. The vaccination completion rate was compared between the intervention groups and two control groups—the enrollment phone call–only group who declined to participate and a no contact group—using logistic regression. ResultsThe participants who received any reminder were more likely (24.6% vs. 12.4%; p < .001) to become up-to-date (UTD) than those in the enrollment phone call–only group. At the conclusion of the study observation, UTD status was reached by 32.1% of text message recipients, 23.0% of postcard recipients, and 20.8% of e-mail recipients compared to 12.4% for the enrollment phone call recipients. Only 9.7% of nonintervention adolescents became UTD. ConclusionsAll three reminder interventions were effective in improving adolescent vaccination rates. Although postal mail reminders were preferred by most participants, text messaging and e-mail were the more effective reminder methods. Text messaging and e-mail as reminder methods for receiving vaccinations should be considered for use to boost vaccination completion among adolescents.

Improving attendance in psychiatric outpatient clinics by using reminders

We compared non-attendance rates at follow-up appointments in an adult psychiatry outpatient clinic using three different reminder methods: letters, telephone prompts and text message reminders. Two of the three strategies resulted in a significant increase in the rate of attendance. Reminder letters increased attendance from 62% to 85% (P < 0.001) and text messaging increased attendance from 72% to 80% (P < 0.002). The attendance rate was not significantly different between the two groups when telephone reminders were used (P = 0.068). However, telephone prompts resulted in an 8% higher cancellation rate compared to controls. When all factors were taken into consideration, no method demonstrated clear superiority. Efforts should be made to reduce patient non-attendance, as this is a predictor of patients being unwell and at higher risk of relapse. Text messages are an inexpensive method of reminding patients, although appropriate safeguards for patient confidentiality are required.

A systematic review of the implementation and impact of asthma protocols.

BackgroundAsthma is one of the most common childhood illnesses. Guideline-driven clinical care positively affects patient outcomes for care. There are several asthma guidelines and reminder methods for implementation to help integrate them into clinical workflow. Our goal is to determine the most prevalent method of guideline implementation; establish which methods significantly improved clinical care; and identify the factors most commonly associated with a successful and sustainable implementation.MethodsPUBMED (MEDLINE), OVID CINAHL, ISI Web of Science, and EMBASE.Study Selection: Studies were included if they evaluated an asthma protocol or prompt, evaluated an intervention, a clinical trial of a protocol implementation, and qualitative studies as part of a protocol intervention. Studies were excluded if they had non-human subjects, were studies on efficacy and effectiveness of drugs, did not include an evaluation component, studied an educational intervention only, or were a case report, survey, editorial, letter to the editor.ResultsFrom 14,478 abstracts, we included 101 full-text articles in the analysis. The most frequent study design was pre-post, followed by prospective, population based case series or consecutive case series, and randomized trials. Paper-based reminders were the most frequent with fully computerized, then computer generated, and other modalities. No study reported a decrease in health care practitioner performance or declining patient outcomes. The most common primary outcome measure was compliance with provided or prescribing guidelines, key clinical indicators such as patient outcomes or quality of life, and length of stay.ConclusionsPaper-based implementations are by far the most popular approach to implement a guideline or protocol. The number of publications on asthma protocol reminder systems is increasing. The number of computerized and computer-generated studies is also increasing. Asthma guidelines generally improved patient care and practitioner performance regardless of the implementation method.

A Systematic Review of Smartphone Oral Contraceptive Reminder Applications

INTRODUCTION: The purpose of this study was to systematically evaluate English-language Smartphone applications currently available to promote consistent oral contraceptive use. METHODS: Official mobile application platforms were searched using terms birth control the and contraception. For each application we collected: health care professionals involvement in application development download (purchase) cost average user rating reminder method(s) used safeguards in place to minimize chance of a user missing an alarm and whether reminder application worked as advertised. RESULTS: Thirty-nine oral contraceptive reminder applications were identified. Three applications (7.7%) documented a health care professionals involvement in application development. The download cost ranged from free to $3.99. The average user rating was 3.4 out of 5. The methods of reminder included: sound (n=31 [79%]) vibration (n=25 [64%]) popup (n=19 [49%]) and/or light-emitting diode notification (n=20 [51%]). Additional features to prevent missing a pill were: snooze reminders (n=16 [41%]) required acknowledgment before notice would clear from display (n=26 [67%]); and audio alarm that permitted reminder notice to override phones silent mode setting (n=20 [65%]). Eleven applications (28%) contained all of these safeguards. Seven of applications (18%) did not function when installed. CONCLUSIONS: Smartphone reminder applications may be useful as backup oral contraceptive reminder methods. As a result of potential to miss an alarm and lack of appropriate safeguards Smartphone applications should not be relied on as sole reminder to take a daily oral contraceptive. Oral contraceptive users could benefit from recommendations from health care professionals about highest performing applications.

Evaluating user perceptions of mobile medication management applications with older adults: a usability study.

BackgroundMedication nonadherence has a significant impact on the health and wellbeing of individuals with chronic disease. Several mobile medication management applications are available to help users track, remember, and read about their medication therapy.ObjectiveThe objective of this study was to explore the usability and usefulness of existing medication management applications for older adults.MethodsWe recruited 35 participants aged 50 and over to participate in a 2-hour usability session. The average age ranged from 52-78 years (mean 67 years) and 71% (25/35) of participants were female. Each participant was provided with an iPad loaded with four medication management applications: MyMedRec, DrugHub, Pillboxie, and PocketPharmacist. These applications were evaluated using the 10 item System Usability Scale (SUS) and visual analog scale. An investigator-moderated 30-minute discussion followed, and was recorded. We used a grounded theory (GT) approach to analyze qualitative data.ResultsWhen assessing mobile medication management applications, participants struggled to think of a need for the applications in their own lives. Many were satisfied with their current management system and proposed future use only if cognition and health declined. Most participants felt capable of using the applications after a period of time and training, but were frustrated by their initial experiences with the applications. The early experiences of participants highlighted the benefits of linear navigation and clear wording (eg, “undo” vs “cancel”) when designing for older users. While there was no order effect, participants attributed their poor performance to the order in which they tried the applications. They also described being a part of a technology generation that did not encounter the computer until adulthood. Of the four applications, PocketPharmacist was found to be the least usable with a score of 42/100 (P<.0001) though it offered a drug interaction feature that was among the favorite features of participants. The usability scores for MyMedRec (56/100), DrugHub (57/100), and Pillboxie (52/100) were not significantly different and participants preferred MyMedRec and DrugHub for their simple, linear interfaces.ConclusionsWith training, adults aged 50 and over can be capable and interested in using mHealth applications for their medication management. However, in order to adopt such technology, they must find a need that their current medication management system cannot fill. Interface diversity and multimodal reminder methods should be considered to increase usability for older adults. Lastly, regulation or the involvement of older adults in development may help to alleviate generation bias and mistrust for applications.

Implementing Self-Collection of Biological Specimens with a Diverse Sample

Collecting saliva is the most noninvasive way to detect changing levels of cortisol (Adam & Kumari, 2009; Soo-Quee Koh & Choon-Huat Koh, 2007), a stress hormone of interest to behavioral and health scientists, where there are benefits from multiple samples taken over a period of days. Various self-collection strategies have been employed, ranging from treated cards to cotton swabs and passive drool methods. The current study investigates the effectiveness of a variety of reminder techniques in encouraging adherence with procedures requiring 4 samples per day on 3 separate days of passive drool collection among African American and European American young adults. The findings suggest that direct texts were associated with the greatest level of adherence, while phone reminders were most effective when controlling for total number of contacts. Results indicate that both traditional and novel reminder methods can positively influence adherence, even with challenging populations.

Trends and determining factors associated with adherence to antiretroviral therapy (ART) in Cameroon: a systematic review and analysis of the CAMPS trial.

BackgroundThe benefits of antiretroviral therapy (ART) cannot be experienced if they are not taken as prescribed. Yet, not all causes of non-adherence are dependent on the patient. Having to pay for medication reduces adherence rates. Non- adherence has severe public health implications which must be addressed locally and globally. This paper seeks to describe the trends in adherence rates reported in Cameroon and to investigate the determinants of adherence to ART in the Cameroon Mobile Phone SMS (CAMPS) trial.MethodsWe conducted a systematic review of electronic databases (PubMed, Google Scholar, Web of Science, CINAHL, EMBASE and PSYCINFO) for publications on adherence to ART in Cameroon (from January 1999 to May 2012) and described the trend in reported adherence rates and the factors associated with adherence. Data were extracted in duplicate. We used multivariable analyses on the baseline data for 200 participants in the CAMPS trial to determine the factors associated with adherence in four models using different measures of adherence (more than 90% or 95% on the visual analogue scale, no missed doses and a composite measure: 100% on the visual analogue scale, no missed doses and all pills taken on time).ResultsWe identified nine studies meeting our inclusion criteria. Adherence to ART in Cameroon has risen steadily between 2000 and 2010, corresponding to reductions in the cost of medication. The factors associated with adherence to ART in Cameroon are grouped into patient, medication and disease related factors. We also identified factors related to the health system and the patient-provider relationship. In the CAMPS trial, education, side effects experienced and number of reminder methods were found to improve adherence, but only using multiple reminder methods was associated with better adherence in all the regression models (Adjusted Odds Ratio [AOR] 4.11, 95% Confidence Interval [CI] 1.89, 8.93; p<0.001; model IV).ConclusionsReducing the cost of ART is an important aspect of ensuring adequate adherence rates. Using multiple reminder methods may have a cumulative effect on adherence to ART, but should be investigated further.