Self-monitoring Features Research Articles

Full-scale testing and multiphysics modeling of a reinforced shot-earth concrete vault with self-sensing properties

Abstract Civil constructions significantly contribute to greenhouse gas emissions and entail extensive energy and resource consumption, leading to a substantial ecological footprint. Research into eco-friendly engineering solutions is therefore currently imperative, particularly to mitigate the impact of concrete technology. Among potential alternatives, shot-earth-concrete, which combines cement and earth as a binder matrix and is applied via spraying, emerges as a promising option. Furthermore, this composite material allows for the incorporation of nano and micro-fillers, thereby providing room for enhancing mechanical properties and providing multifunctional capabilities. This paper investigates the damage detection capabilities of a novel smart shot-earth concrete with carbon microfibers, by investigating the strain sensing performance of a full-scale vault with a span of 4 m, mechanically tested until failure. The material’s strain and damage sensing capabilities involve its capacity to produce an electrical response (manifested as a relative change in resistance) corresponding to the applied strain in its uncracked state, as well as to exhibit a significant alteration in electrical resistance upon cracking. A detailed multiphysics numerical (i.e. mechanical and electrical) model is also developed to aid the interpretation of the experimental results. The experimental test was conducted by the application of an increasing vertical load at a quarter of the span, while modelling of the element was carried out by considering a piezoresistive material, with coupled mechanical and electrical constitutive properties, including a new law to reproduce the degradation of the electrical conductivity with tensile cracking. Another notable aspect of the simulation was the consideration of the effects of the electrical conduction through the rebars, which was found critical to accurately reproduce the full-scale electromechanical response of the vault. By correlating the outcomes from external displacement transducers with the self-monitoring features inherent in the proposed material, significant insights were gleaned. The findings indicated that the proposed smart-earth composite, besides being well suited for structural applications, also exhibits a distinctive electromechanical behavior that enables the early detection of damage initiation. The results of the paper represent an important step toward the real application of smart earth-concrete in the construction field, demonstrating the effectiveness and feasibility of full-scale strain and damage monitoring even in the presence of steel reinforcement.

Mobile Apps for Common Noncommunicable Disease Management: Systematic Search in App Stores and Evaluation Using the Mobile App Rating Scale.

The success of mobile apps in improving the lifestyle of patients with noncommunicable diseases through self-management interventions is contingent upon the emerging growth in this field. While users of mobile health (mHealth) apps continue to grow in number, little is known about the quality of available apps that provide self-management for common noncommunicable diseases such as diabetes, hypertension, and obesity. We aimed to investigate the availability, characteristics, and quality of mHealth apps for common noncommunicable disease health management that included dietary aspects (based on the developer's description), as well as their features for promoting health outcomes and self-monitoring. A systematic search of English-language apps on the Google Play Store (Google LLC) and Apple App Store (Apple Inc) was conducted between August 7, 2022, and September 13, 2022. The search terms used included weight management, obesity, diabetes, hypertension, cardiovascular diseases, stroke, and diet. The selected mHealth apps' titles and content were screened based on the description that was provided. Apps that were not designed with self-management features were excluded. We analyzed the mHealth apps by category and whether they involved health care professionals, were based on scientific testing, and had self-monitoring features. A validated and multidimensional tool, the Mobile App Rating Scale (MARS), was used to evaluate each mHealth app's quality based on a 5-point Likert scale from 1 (inadequate) to 5 (excellent). Overall, 42 apps were identified. Diabetes-specific mHealth apps accounted for 7% (n=3) of the market, hypertension apps for 12% (n=5), and general noncommunicable disease management apps for 21% (n=9). About 38% (n=16) of the apps were for managing chronic diseases, while 74% (n=31) were for weight management. Self-management features such as weight tracking, BMI calculators, diet tracking, and fluid intake tracking were seen in 86% (n=36) of the apps. Most mHealth apps (n=37, 88%) did not indicate whether there was involvement of health professionals in app development. Additionally, none of the apps reported scientific evidence demonstrating their efficacy in managing health. The overall mean MARS score was 3.2 of 5, with a range of 2.0 to 4.1. Functionality was the best-rated category (mean score 3.9, SD 0.5), followed by aesthetics (mean score 3.2, SD 0.9), information (mean score 3.1, SD 0.7), and engagement (mean score 2.9, SD 0.6). The quality of mHealth apps for managing chronic diseases was heterogeneous, with roughly half of them falling short of acceptable standards for both quality and content. The majority of apps contained scant information about scientific evidence and the developer's history. To increase user confidence and accomplish desired health outcomes, mHealth apps should be optimized with the help of health care professionals. Future studies on mHealth content analysis should focus on other diseases as well.

User engagement in relation to effectiveness of a digital lifestyle intervention (the HealthyMoms app) in pregnancy

Although user engagement is generally considered important for the effectiveness of digital behavior change interventions, there is a lack of such data in pregnancy. The aim of this study was therefore to examine the associations of user engagement with the HealthyMoms app with gestational weight gain, diet quality and physical activity in pregnancy. The study involved secondary analyses of participant data from the intervention group (n = 134) in a randomized controlled trial to determine the effectiveness of a 6-month mHealth intervention (the HealthyMoms app) on gestational weight gain, diet quality and physical activity. In adjusted regression models, the total number of registrations from three self-monitoring features (i.e., for weight-, diet- and physical activity) was associated with lower gestational weight gain (β = − 0.18, P = 0.043) and improved diet quality (β = 0.17, P = 0.019). These findings were mainly attributable to the associations of physical activity registrations with lower gestational weight gain (β = − 0.20, P = 0.026) and improved diet quality (β = 0.20, P = 0.006). However, the number of app sessions and page views were not associated with any of the outcomes. Our results may motivate efforts to increase user engagement in digital lifestyle interventions in pregnancy. However, additional studies are needed to further elucidate the influence of different types of user engagement in digital pregnancy interventions on their effectiveness.Trial registration: ClinicalTrials.gov (NCT03298555); https://clinicaltrials.gov/ct2/show/NCT03298555 (date of registration: October 2, 2017; date of first enrolled participant: October 24, 2017).

Abstract P074: A Cluster Randomized Trial Of An Mhealth Intervention To Promote Cardiovascular Health In Emerging Adults: Results Of The Nuyou Study

Background: Cardiovascular disease (CVD) persists as the leading preventable cause of death in the US and worldwide. The American Heart Association (AHA) defines ideal cardiovascular health as the presence of: non-smoking, normal weight, adequate physical activity, healthy diet, normal blood pressure, normal fasting plasma glucose, and normal cholesterol. Only 45% of youth under 20 years old in the US exhibit five of the seven factors at ideal levels and that proportion plummets to 10% by age 40. Thus, novel strategies are needed to support primordial prevention of CVD via promotion of the seven health factors. Targeting young adults could stave off the alarming drop in cardiovascular health and contribute to healthier longevity. Objective: The NUYou trial was a two arm prospective cluster randomized trial to evaluate whether an mHealth intervention focused on cardiovascular health promotion improved cardiovascular health more than an active comparator in college students. Methods: Northwestern University Freshmen were cluster randomized by dormitory into two mHealth intervention groups: 1) Cardiovascular Health (CVH), addressing behaviors related to CVD risk; or 2) Whole Health (WH), addressing behaviors unrelated to CVD. Both groups received smartphone applications, co-designed with students to help them manage time, connect via social media, and report health behaviors weekly. The CVH group also received tailored self-monitoring features to track their risk behaviors. Cardiovascular health was assessed at the beginning of freshman, sophomore, and junior years. Health questionnaires, blood pressure, height, weight, glucose, and cholesterol were used to calculate the AHA’s Life’s Simple Seven (LSS) composite score (0-14, 14 being ideal health). Linear mixed models were used to compare CVD vs WH on LSS score. Results: Over 2 years, we recruited 302 participants (60% female). Participants were an average age of 18.1 (1.2) years and had a mean LSS score of 11.3 (1.4). Participant race was reported as, 28% Asian, 10% Black, 12% other/unknown/unreported, and 50% White. Ethnicity was reported as 12% Hispanic, 79% Non-Hispanic, and 9% unknown or unreported. There were no group, time, or group by time differences in LSS over 2-years. However, cholesterol increased as a function of time, by 7.39 mg/dL from Freshmen to Junior year and was not different by group. Conclusion: Despite using evidence-based behavior change techniques and employing a co-development approach with students, the groups did not differ on LSS over the 2-year intervention. The non-significant effects could be explained by high baseline LSS scores, the relatively short follow up time where a drop in LSS score would not be evident, or the absence of a human contact in the intervention. More research over a longer time span is needed to identify opportunistic time frames and strategies to intervene during young adulthood.

Perceptions of Factors Influencing Engagement With Health and Well-being Apps in the United Kingdom: Qualitative Interview Study.

BackgroundDigital health devices, such as health and well-being smartphone apps, could offer an accessible and cost-effective way to deliver health and well-being interventions. A key component of the effectiveness of health and well-being apps is user engagement. However, engagement with health and well-being apps is typically poor. Previous studies have identified a list of factors that could influence engagement; however, most of these studies were conducted on a particular population or for an app targeting a particular behavior. An understanding of the factors that influence engagement with a wide range of health and well-being apps can inform the design and the development of more engaging apps in general.ObjectiveThe aim of this study is to explore user experiences of and reasons for engaging and not engaging with a wide range of health and well-being apps.MethodsA sample of adults in the United Kingdom (N=17) interested in using a health or well-being app participated in a semistructured interview to explore experiences of engaging and not engaging with these apps. Participants were recruited via social media platforms. Data were analyzed with the framework approach, informed by the Capability, Opportunity, Motivation–Behaviour (COM-B) model and the Theoretical Domains Framework, which are 2 widely used frameworks that incorporate a comprehensive set of behavioral influences.ResultsFactors that influence the capability of participants included available user guidance, statistical and health information, reduced cognitive load, well-designed reminders, self-monitoring features, features that help establish a routine, features that offer a safety net, and stepping-stone app characteristics. Tailoring, peer support, and embedded professional support were identified as important factors that enhance user opportunities for engagement with health and well-being apps. Feedback, rewards, encouragement, goal setting, action planning, self-confidence, and commitment were judged to be the motivation factors that affect engagement with health and well-being apps.ConclusionsMultiple factors were identified across all components of the COM-B model that may be valuable for the development of more engaging health and well-being apps. Engagement appears to be influenced primarily by features that provide user guidance, promote minimal cognitive load, support self-monitoring (capability), provide embedded social support (opportunity), and provide goal setting with action planning (motivation). This research provides recommendations for policy makers, industry, health care providers, and app developers for increasing effective engagement.

Revealing University Students’ Attitudes toward Online Extensive Reading in Thailand

This study explores undergraduates’ attitudes toward extensive reading (ER) and reading graded readers online via Xreading.com in a large-scale ER program (ERP) involving over 5,000 students. Data were obtained from 356 students via an online questionnaire and 13 students in three focus groups. The quantitative findings showed that the students had positive attitudes toward ER. The top three reasons included (1) reading graded readers made them enjoy reading in English more than before, (2) they were more motivated to read graded readers because the stories were simple, and (3) they preferred to read shorter texts because they were simpler. Additionally, the qualitative findings revealed that all 13 students enjoyed freedom of choice in which they could choose their own graded readers that matched their interests and proficiency. Also, students had positive attitudes toward online ER through Xreading due to a variety of graded readers, an opportunity for students to practice their English and reading skills, enjoyment from reading, convenience and ease of use, and self-monitoring features. However, two difficulties were reported, including not knowing which graded readers to choose and eyestrain when reading online. Finally, pedagogical implications are discussed to guide ERP coordinators and teachers.

A Cardiovascular Health and Wellness Mobile Health Intervention Among Church-Going African Americans: Formative Evaluation of the FAITH! App.

BackgroundIn light of the scarcity of culturally tailored mobile health (mHealth) lifestyle interventions for African Americans, we designed and pilot tested the Fostering African-American Improvement in Total Health (FAITH!) App in a community-based participatory research partnership with African American churches to promote cardiovascular health and wellness in this population.ObjectiveThis report presents the results of a formative evaluation of the FAITH! App from participants in an intervention pilot study.MethodsWe included 2 semistructured focus groups (n=4 and n=5) to explore participants’ views on app functionality, utility, and satisfaction as well as its impact on healthy lifestyle change. Sessions were audio-recorded and transcribed verbatim, and qualitative data were analyzed by using general inductive analysis to generate themes.ResultsIn total, 6 overarching themes emerged among the 9 participants: overall impression, content usefulness, formatting, implementation, impact, and suggestions for improvement. Underpinning the themes was a high level of agreement that the intervention facilitated healthy behavioral change through cultural tailoring, multimedia education modules, and social networking. Suggestions for improvement were streamlining the app self-monitoring features, prompts to encourage app use, and personalization based on individuals’ cardiovascular risk.ConclusionsThis formative evaluation found that the FAITH! App had high reported satisfaction and impact on the health-promoting behaviors of African Americans, thereby improving their overall cardiovascular health. Further development and testing of the app among African Americans is warranted.Trial RegistrationClinicalTrials.gov NCT03084822; https://clinicaltrials.gov/ct2/show/NCT03084822.

A mHealth intervention to preserve and promote ideal cardiovascular health in college students: Design and protocol of a cluster randomized controlled trial

BackgroundCardiovascular disease (CVD) remains the leading cause of death globally. Seven health factors are associated with ideal cardiovascular health: being a non-smoker; not overweight; physically active; having a healthy diet; and normal blood pressure; fasting plasma glucose and cholesterol. Whereas approximately half of U.S. youth have ideal levels in at least 5 of the 7 components of cardiovascular health, this proportion falls to 16% by adulthood. ObjectiveWe will evaluate whether the NUYou cardiovascular mHealth intervention is more effective than an active comparator to promote cardiovascular health during the transition to young adulthood. Methods302 incoming freshmen at a midwest university will be cluster randomized by dormitory into one of two mHealth intervention groups: 1) Cardiovascular Health (CVH), addressing behaviors related to CVD risk; or 2) Whole Health (WH), addressing behaviors unrelated to CVD. Both groups will receive smartphone applications, co-designed with students to help them manage time, interact with other participants via social media, and report health behaviors weekly. The CVH group will also have self-monitoring features to track their risk behaviors. Cardiovascular health will be assessed at the beginning of freshman year and the end of freshman and sophomore years. Linear mixed models will be used to compare groups on a composite of the seven cardiovascular-related health factors. SignificanceThis is the first entirely technology-mediated multiple health behavior change intervention delivered to college students to promote cardiovascular health. Findings will inform the potential for primordial prevention in young adulthood.Trial Registration Number: clinicaltrials.gov #NCT02496728

Efficacy of a Smartphone App Intervention for Reducing Caregiver Stress: Randomized Controlled Trial.

BackgroundCaregivers play a pivotal role in maintaining an economically viable health care system, yet they are characterized by low levels of psychological well-being and consistently report unmet needs for psychological support. Mobile app–based (mobile health [mHealth]) interventions present a novel approach to both reducing stress and improving well-being.ObjectiveThis study aims to evaluate the effectiveness of a self-guided mobile app–based psychological intervention for people providing care to family or friends with a physical or mental disability.MethodsIn a randomized, single-blind, controlled trial, 183 caregivers recruited through the web were randomly allocated to either an intervention (n=73) or active control (n=110) condition. The intervention app contained treatment modules combining daily self-monitoring with third-wave (mindfulness-based) cognitive-behavioral therapies, whereas the active control app contained only self-monitoring features. Both programs were completed over a 5-week period. It was hypothesized that intervention app exposure would be associated with decreases in depression, anxiety, and stress, and increases in well-being, self-esteem, optimism, primary and secondary control, and social support. Outcomes were assessed at baseline, postintervention, and 3-4 months postintervention. App quality was also assessed.ResultsIn total, 25% (18/73) of the intervention participants were lost to follow-up at 3 months, and 30.9% (34/110) of the participants from the wait-list control group dropped out before the postintervention survey. The intervention group experienced reductions in stress (b=−2.07; P=.04) and depressive symptoms (b=−1.36; P=.05) from baseline to postintervention. These changes were further enhanced from postintervention to follow-up, with the intervention group continuing to report lower levels of depression (b=−1.82; P=.03) and higher levels of emotional well-being (b=6.13; P<.001), optimism (b=0.78; P=.007), self-esteem (b=−0.84; P=.005), support from family (b=2.15; P=.001), support from significant others (b=2.66; P<.001), and subjective well-being (b=4.82; P<.001). On average, participants completed 2.5 (SD 1.05) out of 5 treatment modules. The overall quality of the app was also rated highly, with a mean score of 3.94 out of a maximum score of 5 (SD 0.58).ConclusionsThis study demonstrates that mHealth psychological interventions are an effective treatment option for caregivers experiencing high levels of stress. Recommendations for improving mHealth interventions for caregivers include offering flexibility and customization in the treatment design.Trial RegistrationAustralian New Zealand Clinical Trial Registry ACTRN12616000996460; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=371170

4044 A Cardiovascular Health and Wellness Mobile Health Intervention Among Church-going African-Americans: Formative Evaluation of the FAITH! App

OBJECTIVES/GOALS: To evaluate the FAITH! (Fostering African-American Improvement in Total Health) App mHealth lifestyle intervention by using post-intervention feedback obtained from participants in our intervention pilot study. METHODS/STUDY POPULATION: We used qualitative methods (focus groups) to elicit post-intervention feedback. Participants who completed the pilot study were recruited to one of two focus groups. Semi-structured focus groups were conducted to explore participants’ views on the app functionality, utility and satisfaction as well as its impact on healthy lifestyle change. Sessions were audio-recorded, transcribed verbatim and qualitative data were analyzed by systematic text condensation thematic analysis. RESULTS/ANTICIPATED RESULTS: Nine individuals participated (N = 4 and N = 5) in each of the two focus groups. Their mean age was 47.9 years (SD 12.1), 67% were women, and all had at least an education level of some college. Six overarching themes emerged from the data: (1) overall impression, (2) content usefulness (3) formatting, (4) implementation, (5) impact and (6) suggestions for improvement. Underpinning the themes was a high level of agreement that the intervention facilitated healthy behavioral change through cultural tailoring, multimedia education modules and social networking. Among the suggestions for improvement were streamlining of app self-monitoring features, personalization based on individual’s cardiovascular risk and attentiveness to nuanced cultural perspectives. DISCUSSION/SIGNIFICANCE OF IMPACT: This formative evaluation found the FAITH! App mHealth lifestyle intervention had high reported satisfaction and impact on the health-promoting behaviors of African-Americans, thereby improving their overall cardiovascular health. The findings provide further support for the acceptability of mHealth interventions among African-Americans. CONFLICT OF INTEREST DESCRIPTION: None.

Influences on the Uptake of and Engagement With Health and Well-Being Smartphone Apps: Systematic Review.

BackgroundThe public health impact of health and well-being digital interventions is dependent upon sufficient real-world uptake and engagement. Uptake is currently largely dependent on popularity indicators (eg, ranking and user ratings on app stores), which may not correspond with effectiveness, and rapid disengagement is common. Therefore, there is an urgent need to identify factors that influence uptake and engagement with health and well-being apps to inform new approaches that promote the effective use of such tools.ObjectiveThis review aimed to understand what is known about influences on the uptake of and engagement with health and well-being smartphone apps among adults.MethodsWe conducted a systematic review of quantitative, qualitative, and mixed methods studies. Studies conducted on adults were included if they focused on health and well-being smartphone apps reporting on uptake and engagement behavior. Studies identified through a systematic search in Medical Literature Analysis and Retrieval System Online, or MEDLARS Online (MEDLINE), EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsychINFO, Scopus, Cochrane library databases, DataBase systems and Logic Programming (DBLP), and Association for Computing Machinery (ACM) Digital library were screened, with a proportion screened independently by 2 authors. Data synthesis and interpretation were undertaken using a deductive iterative process. External validity checking was undertaken by an independent researcher. A narrative synthesis of the findings was structured around the components of the capability, opportunity, motivation, behavior change model and the theoretical domains framework (TDF).ResultsOf the 7640 identified studies, 41 were included in the review. Factors related to uptake (U), engagement (E), or both (B) were identified. Under capability, the main factors identified were app literacy skills (B), app awareness (U), available user guidance (B), health information (E), statistical information on progress (E), well-designed reminders (E), features to reduce cognitive load (E), and self-monitoring features (E). Availability at low cost (U), positive tone, and personalization (E) were identified as physical opportunity factors, whereas recommendations for health and well-being apps (U), embedded health professional support (E), and social networking (E) possibilities were social opportunity factors. Finally, the motivation factors included positive feedback (E), available rewards (E), goal setting (E), and the perceived utility of the app (E).ConclusionsAcross a wide range of populations and behaviors, 26 factors relating to capability, opportunity, and motivation appear to influence the uptake of and engagement with health and well-being smartphone apps. Our recommendations may help app developers, health app portal developers, and policy makers in the optimization of health and well-being apps.

The Development of Solar-Powered Gas Metering Units Equipped with Radio or 3G Based Telemetry Systems

In this article we have described the development of solar-powered gas metering units including modern ultrasonic and vortex flowmeters for volume and mass measurement of natural gas, associated petroleum gases, inert gases, oxygen, hydrogen, air, nitrogen, carbon dioxide and any other single and multicomponent gases that are not aggressive to the flowmeter materials. We have shown implementation of such units in the existing gas producing stations in the desert of Kara-Kum. Confirmed was the ability of our gas metering units to operate more than a year without network power supply and staff intervention. Also pictured was creation of telemetry system for collecting and transmitting metrological information, including gas flow rate, temperature, pressure, humidity to the central terminal. Different physical layers have been used to transfer data from the metering units, including radio channels at 433 MHz frequency between units and central station. This telemetry system implemented selfmaintenance and self-monitoring features, facilitating remote control of metering unit, so important in rigid conditions of solar-rich deserts and semi-deserts.

A Web-Based Intervention for Social Media Addiction Disorder Management in Higher Education: Quantitative Survey Study.

BackgroundSocial media addiction disorder has recently become a major concern and has been reported to have negative impacts on postgraduate studies, particularly addiction to Facebook. Although previous studies have investigated the effects of Facebook addiction disorder in learning settings, there still has been a lack of studies investigating the relationship between online intervention features for Facebook addiction focusing on postgraduate studies.ObjectiveIn an attempt to understand this relationship, this study aimed to carry out an investigation on online intervention features for effective management of Facebook addiction in higher education.MethodsThis study was conducted quantitatively using surveys and partial least square-structural equational modeling. The study involved 200 postgraduates in a Facebook support group for postgraduates. The Bergen Facebook Addiction test was used to assess postgraduates’ Facebook addiction level, whereas online intervention features were used to assess postgraduates’ perceptions of online intervention features for Facebook addiction, which are as follows: (1) self-monitoring features, (2) manual control features, (3) notification features, (4) automatic control features, and (5) reward features.ResultsThe study discovered six Facebook addiction factors (relapse, conflict, salience, tolerance, withdrawal, and mood modification) and five intervention features (notification, auto-control, reward, manual control, and self-monitoring) that could be used in the management of Facebook addiction in postgraduate education. The study also revealed that relapse is the most important factor and mood modification is the least important factor. Furthermore, findings indicated that notification was the most important intervention feature, whereas self-monitoring was the least important feature.ConclusionsThe study’s findings (addiction factors and intervention features) could assist future developers and educators in the development of online intervention tools for Facebook addiction management in postgraduate education.

Dietary Application for the Management of Patients with Hemodialysis: A Formative Development Study.

ObjectivesTo describe the step-by-step person-centered, theory-based development of the KELA.AE app for Arabic speaking hemodialysis patients.MethodsA step-by-step person-driven theory-based approach was conducted to develop a self-monitoring and educational dietary app for hemodialysis patients. The development follows the Integration, Design, Assessment, and Sharing (IDEAS) framework. Qualitative, semi-structured interviews with 6 hemodialysis patients and 6 healthcare practitioners (dietitians and nephrologists) were performed to assess the need for an app, the willingness to use an app, and features desired in an app.ResultsThe KELA.AE app, which includes a self-monitoring feature, CKD-friendly recipes, and a theory-based, evidence-based educational feature was developed. Qualitative analysis of interviews revealed two predominant themes from patient interviews ‘Experience with the diet’, ‘App evaluation’, and one theme from interviews with healthcare practitioners ‘App evaluation’. Patients expressed frustration with current accessibility of dietary information along with the need for educational materials in the app. The review of the KELA.AE prototype was positive overall, and patients reported a willingness to use the app. Healthcare practitioners considered the app accurate, simple, and culturally sensitive but expressed concerns about app misuse and the replacement of healthcare practitioners.ConclusionsThe KELA.AE app was found to be satisfactory and supportive of the participants' needs. Changes were made to the app as suggested during the interviews.

A Mobile App-Based Intervention for Depression: End-User and Expert Usability Testing Study.

BackgroundDespite the growing number of mental health apps available for smartphones, the perceived usability of these apps from the perspectives of end users or health care experts has rarely been reported. This information is vital, particularly for self-guided mHealth interventions, as perceptions of navigability and quality of content are likely to impact participant engagement and treatment compliance.ObjectiveThe aim of this study was to conduct a usability evaluation of a personalized, self-guided, app-based intervention for depression.MethodsParticipants were administered the System Usability Scale and open-ended questions as part of a semistructured interview. There were 15 participants equally divided into 3 groups: (1) individuals with clinical depression who were the target audience for the app, (2) mental health professionals, and (3) researchers who specialize in the area of eHealth interventions and/or depression research.ResultsThe end-user group rated the app highly, both in quantitative and qualitative assessments. The 2 expert groups highlighted the self-monitoring features and range of established psychological treatment options (such as behavioral activation and cognitive restructuring) but had concerns that the amount and layout of content may be difficult for end users to navigate in a self-directed fashion. The end-user data did not confirm these concerns.ConclusionsEncouraging participant engagement via self-monitoring and feedback, as well as personalized messaging, may be a viable way to maintain participation in self-guided interventions. Further evaluation is necessary to determine whether levels of engagement with these features enhance treatment effects.

Development and Validation of a Multidisciplinary Mobile Care System for Patients With Advanced Gastrointestinal Cancer: Interventional Observation Study.

BackgroundMobile health apps have emerged as supportive tools in the management of advanced cancers. However, only a few apps have self-monitoring features, and they are not standardized and validated.ObjectiveThis study aimed to develop and validate a multidisciplinary mobile care system with self-monitoring features that can be useful for patients with advanced gastrointestinal cancer.MethodsThe development of the multidisciplinary mobile health management system was divided into 3 steps. First, the service scope was set up, and the measurement tools were standardized. Second, the service flow of the mobile care system was organized. Third, the mobile app (Life Manager) was developed. The app was developed to achieve 3 major clinical goals: support for quality of life, nutrition, and rehabilitation. Three main functional themes were developed to achieve clinical goals: a to-do list, health education, and in-app chat. Thirteen clinically oriented measures were included: the modified Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events questionnaire, Scored Patient-Generated Subjective Global Assessment (PG-SGA), distress, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, International Physical Activity Questionnaire–Short Form, Low anterior resection syndrome score, satisfaction rate, etc. To validate the system, a prospective observational study was conducted. Patients with gastric cancer or colon cancer undergoing chemotherapy were recruited. We followed the subjects for 12 weeks, and selected clinical measures were taken online and offline.ResultsAfter the development process, a multidisciplinary app, the Life Manager, was launched. For evaluation, 203 patients were recruited for the study, of whom 101 (49.8%) had gastric cancer, and 102 (50.2%) were receiving palliative care. Most patients were in their fifties (35.5%), and 128 (63.1%) were male. Overall, 176 subjects (86.7%) completed the study. Among subjects who dropped out, the most common reason was the change of patient’s clinical condition (51.9%). During the study period, subjects received multiple health education sessions. For the gastric cancer group, the “general gastric cancer education” was most frequently viewed (322 times), and for the colon cancer group, the “warming-up exercise” was most viewed (340 times). Of 13 measurements taken from subjects, 9 were taken offline (response rate: 52.0% to 90.1%), and 3 were taken online (response rate: 17.6% to 57.4%). The overall satisfaction rate among subjects was favorable and ranged from 3.93 (SD 0.88) to 4.01 (SD 0.87) on the 5-point Likert scale.ConclusionsA multidisciplinary mobile care system for patients with advanced gastrointestinal cancer was developed with clinically oriented measures. A prospective study was performed for its evaluation, which showed favorable satisfaction.

A Web-Based, Social Networking Physical Activity Intervention for Insufficiently Active Adults Delivered via Facebook App: Randomized Controlled Trial.

BackgroundOnline social networks offer considerable potential for delivery of socially influential health behavior change interventions.ObjectiveTo determine the efficacy, engagement, and feasibility of an online social networking physical activity intervention with pedometers delivered via Facebook app.MethodsA total of 110 adults with a mean age of 35.6 years (SD 12.4) were recruited online in teams of 3 to 8 friends. Teams were randomly allocated to receive access to a 50-day online social networking physical activity intervention which included self-monitoring, social elements, and pedometers (“Active Team” Facebook app; n=51 individuals, 12 teams) or a wait-listed control condition (n=59 individuals, 13 teams). Assessments were undertaken online at baseline, 8 weeks, and 20 weeks. The primary outcome measure was self-reported weekly moderate-to-vigorous physical activity (MVPA). Secondary outcomes were weekly walking, vigorous physical activity time, moderate physical activity time, overall quality of life, and mental health quality of life. Analyses were undertaken using random-effects mixed modeling, accounting for potential clustering at the team level. Usage statistics were reported descriptively to determine engagement and feasibility.ResultsAt the 8-week follow-up, the intervention participants had significantly increased their total weekly MVPA by 135 minutes relative to the control group (P=.03), due primarily to increases in walking time (155 min/week increase relative to controls, P<.001). However, statistical differences between groups for total weekly MVPA and walking time were lost at the 20-week follow-up. There were no significant changes in vigorous physical activity, nor overall quality of life or mental health quality of life at either time point. High levels of engagement with the intervention, and particularly the self-monitoring features, were observed.ConclusionsAn online, social networking physical activity intervention with pedometers can produce sizable short-term physical activity changes. Future work is needed to determine how to maintain behavior change in the longer term, how to reach at-need populations, and how to disseminate such interventions on a mass scale.Trial RegistrationAustralian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12614000488606; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=366239 (Archived by WebCite at http://www.webcitation.org/6ZVtu6TMz).

Brain Extraction Using Label Propagation and Group Agreement: Pincram.

Accurately delineating the brain on magnetic resonance (MR) images of the head is a prerequisite for many neuroimaging methods. Most existing methods exhibit disadvantages in that they are laborious, yield inconsistent results, and/or require training data to closely match the data to be processed. Here, we present pincram, an automatic, versatile method for accurately labelling the adult brain on T1-weighted 3D MR head images. The method uses an iterative refinement approach to propagate labels from multiple atlases to a given target image using image registration. At each refinement level, a consensus label is generated. At the subsequent level, the search for the brain boundary is constrained to the neighbourhood of the boundary of this consensus label. The method achieves high accuracy (Jaccard coefficient > 0.95 on typical data, corresponding to a Dice similarity coefficient of > 0.97) and performs better than many state-of-the-art methods as evidenced by independent evaluation on the Segmentation Validation Engine. Via a novel self-monitoring feature, the program generates the "success index," a scalar metadatum indicative of the accuracy of the output label. Pincram is available as open source software.

User attitudes towards physical activity websites in a randomized controlled trial

Objective To better understand the mixed findings regarding the efficacy of Internet-based physical activity interventions, we examined the use and usefulness of particular website components that may lead to improvements in intervention efficacy. Method Participants were sedentary individuals from a 12-month randomized controlled physical activity trial conducted in Providence, Rhode Island and Pittsburgh, Pennsylvania from 2003–2006. The present study included participants from the Tailored Internet arm ( n = 81; instantaneous web-based tailored feedback to participants) or the Standard Internet arm ( n = 82; websites currently available to the public). We obtained objective data via the intervention websites and subjective usefulness data via questionnaires. Results The Tailored Internet arm logged onto their website significantly more times than the Standard Internet arm (median 50 vs. 38; p < .05). Among participants in the Tailored Internet arm, the self-monitoring feature (i.e., logging) followed by goal setting were rated as the most useful website components. Conclusion Logins in the current study were substantially higher compared to previous studies. Participants endorsed goal setting and self-monitoring as being most useful, which are critical components for health behavior change. Future studies should continue to examine these features and improve the perceived usefulness of other theory-based strategies.

A Compact Modular High Voltage System for Phototube and MWPC Applications

This high voltage system consists of a 64 channel CAMAC control module and various power modules which can optionally be located in CAMAC crates. Power is generated by VMOS transistors in a high frequency, high efficiency circuit. A table driven processor in the control module provides a variety of self-monitoring features without the software complexity of a microprocessor.