Use Of Mobile Health Applications Research Articles

Contribution of mobile health technologies to public health in rural areas: Accessibility and education methods

In today's rapidly advancing world, mobile health services have become influential in various aspects of our lives. It is anticipated that mobile applications, especially in rural areas, can play a significant role in the delivery of healthcare services. In this context, it is essential to examine the applications of mobile health services in rural areas and the education methods employed in these applications. The main objective of this study is to explore the contributions of mobile health services applications in rural areas to public health and to examine the education methods used in these services in light of current literature. The focus of this study is on how mobile health applications can be utilized in rural areas, the impact of this usage on public health, and the effectiveness of the education methods employed. The research was conducted through searches using key terms such as "mobile health" and "public health nursing" or "mobile health technologies" and "nursing" or "telehealth" on important academic databases like Google Scholar, PubMed free fulltext, Science Direct, Ebscohost, Sage, Scopus, and CINAHL. The information obtained from literature searches was analyzed to understand the impact of mobile health applications on public health in rural areas and the education methods employed. The study results indicate that the use of mobile health applications in rural areas can contribute significantly to public health. Advantages such as rapid diagnosis and treatment, effective monitoring of chronic diseases, and quick access to emergency services stand out among the potential impacts of mobile health applications. Mobile health applications can contribute significantly to public health in rural areas and increase their usage, particularly in primary healthcare services.

Access and use of mobile health applications among Medicaid-insured pregnant and postpartum individuals

Mobile health applications can address health disparities in prenatal care due to adverse social determinants of health. We assessed the uptake and use of, preferences for, and barriers to mobile health applications among Medicaid-insured pregnant and postpartum individuals enrolled in prenatal care from March to May 2021. Medicaid-insured pregnant and postpartum individuals frequently used (56 %) and were potentially interested in using (90 %) mobile health applications for health-related tasks and had reliable internet access to do so (94 %). Over two fifths (44 %) reported barriers to using mobile health applications. Further research is needed to understand whether using mobile health applications to address social needs in the peripartum period can affect prenatal care utilization and decrease health disparities.

EHealth tools use and mental health: a cross-sectional network analysis in a representative sample

eHealth tools usage is vital for health care systems and increased significantly after the COVID-19 pandemic, which aggravated mental health issues. This cross-sectional study explored whether sociodemographic characteristics and mental health indices (stress and symptoms of anxiety and depression) were linked to the behavioral intention to use eHealth tools and eHealth tools usage in a representative sample from Poland using a network approach. Measurements were conducted in March 2023 among 1000 participants with a mean age of 42.98 (18–87) years, with 51.50% women. The measures included the behavioral intention to use eHealth tools (BI) based on the UTUAT2; eHealth tool use frequency (use behavior) including ePrescription, eSick leave, eReferral, electronic medical documentation (EMD), Internet Patient Account (IKP), telephone consultation, video consultation, mobile health applications, and private and public health care use; and the PSS-4, GAD-2, and PHQ-2. Furthermore, sociodemographic factors (sex, age, children, relationship status, education, and employment) were included in the research model. Network analysis revealed that mental health indices were weakly related to eHealth tools use. Higher stress was positively linked with mobile health application use but negatively linked to video consultation use. Use of various eHealth tools was intercorrelated. Sociodemographic factors were differentially related to the use of the eight specific eHealth tools. Although mental health indices did not have strong associations in the eHealth tools use network, attention should be given to anxiety levels as the factor with the high expected influence.

Heuristics used for evaluating the usability of mobile health applications: A systematic literature review.

Mobile health applications hold immense potential for enhancing health outcomes. Usability is one of the main factors for the adoption and use of mobile health applications. However, despite the growing importance of mHealth applications, clear standards for their evaluation remain elusive. The present study aimed to determine heuristics for the usability evaluation of health-related applications. We systematically searched multiple databases for relevant papers published between January 2008 and April 2021. Articles were reviewed, and data were extracted and categorized from those meeting inclusion criteria by two authors independently. Heuristics were identified based on statements, words, and concepts expressed in the studies. These heuristics were first mapped to Nielsen's heuristics based on their differences or similarities. The remaining heuristics that were very important for mobile applications were categorized into new heuristics. Seventeen studies met the eligibility criteria. Seventy-nine heuristics were extracted from the papers. After combining the items with the same concepts and removing irrelevant items based on the exclusion criteria, 20 heuristics remained. Common heuristics such as "Visibility of system status" and "Flexibility and efficiency of use" were categorized into 10 previously established heuristics and new heuristics like "Navigation" and "User engagement" were recognized as new ones. In our study, we have meticulously identified 20 heuristics that hold promise for evaluating and designing mHealth applications. These heuristics can be used by the researchers for the development of robust tools for heuristic evaluation. These tools, when adapted or tailored for health domain applications, have the potential to significantly enhance the quality of mHealth applications. Ultimately, this improvement in quality translates to enhanced patient safety. (10.17605/OSF.IO/PZJ7H).

The Effectiveness of Mobile Health Utilization to Prevent Non-Communicable Diseases at the Group of Majlis Taklim

Background: Mobile health application is a technological innovation that has proven effective use for the prevention and management of NCDs in other countries. However, there has been no test on the use of mobile health applications that have been launched in Indonesia, including the Halodoc application. The majlis taklim group is a target group in increasing community empowerment in the family order. Aims: This study was to examine Halodoc application in preventing noncommunicable diseases. Methods: The population is the member of the majlis taklim who was active in the last three months. The sample was respondents who were identified as having knowledge and bad behavior in NCD prevention efforts, 45 people. Descriptive analysis on respondents' characteristics and level of knowledge. While analytical analysis consists of dependent T tests to determine the difference in effectiveness before and after utilizing the application, the next test is the CBAM-Stage of Concern test, which is to assess respondents' perceptions through the level of respondents' concern for halodoc innovation. Results: Univariate analysis found that most respondents were poorly educated, namely 35 respondents (78%), as IRT 30 respondents (67%), family history of NCD disease 30 respondents (67%), and history of NCD disease in themselves 10 respondents (22%). The level of knowledge on the pretest was low at 23 respondents (51%), and the knowledge on the posttest was mostly high at 31 respondents (69%). Conclusion: The result of the dependent T test obtained a value of 0.000 means that statistically there is a significant difference in knowledge before and after the use of Halodoc for the prevention and management of NCDs. The test results with the Stage of Use Consern Questionnaire (SoC) analysis, obtained information on the percentage of respondents' perception of the highest acceptance of innovation before being given the Halodoc intervention (pretest) at the personal level, which is 60%. However, after utilizing Halodoc, most respondents' perceptions were at the level of unconcern, which was 81%.

Sağlık Bilimleri Öğrencilerinin Sağlık Okuryazarlık, Etik Duyarlılık Düzeylerinin ve Bilgi Güvenliği Farkındalıklarının Mobil Sağlık Uygulamaları (Aplikasyonları) Kullanımları Bağlamında Değerlendirilmesi

Amaç: Doğu Anadolu Bölgesi’ndeki üniversitelerde örgün eğitim-öğretim gören lisans sağlık bilimleri öğrencilerinin sağlık okuryazarlık, etik duyarlılık düzeylerinin ve bilgi güvenliği farkındalıklarının mobil sağlık uygulamaları kullanımları bağlamında değerlendirilmesi amaçlanmıştır. Yöntem: Çalışma kesitsel tanımlayıcı araştırmadır. 2020-2021 Bahar ve Yaz Eğitim-Öğretim Dönemleri’nde Doğu Anadolu Bölgesi’ndeki araştırma iznini onaylayan 7 üniversitenin 324 (18 yaş üstü) örgün eğitim-öğretim gören lisans öğrencisi örneklemi oluşturmuştur. Veriler Tanıtıcı Bilgi Formu, Bilgi Güvenliği Farkındalık Ölçeği, Sağlık Okuryazarlığı Ölçeği, Etik Duyarlılık Ölçeği kullanılarak çevrimiçi ölçek aracılığıyla kartopu yöntemiyle toplanmıştır. Bulgular: Öğrencilerin %79’u 18-22 yaş aralığında, %75,9’u kadın, %57,1’i hemşirelik öğrencisidir. Öğrenciler sağlık okuryazarlığı eğitimi (%23,8), mobil sağlık uygulamaları eğitimi (%18,2), hasta güvenliği eğitimi (%60,2) almışlardır. Öğrencilerin bilgi güvenliği açısından saldırı ve tehditlere yönelik farkındalıklarının orta düzey, sağlık okuryazarlıklarının yüksek düzey, etik ikilem deneyimleme puanının orta düzey olduğu saptanmıştır. Eğitim alınan bölüm etik ikilem deneyimlemenin %2’sini, saldırı ve tehditlere yönelik farkındalığın %2’sini ve sağlık okuryazarlığın %2’sini açıklamaktadır. Sağlık okuryazarlık, etik ikilem deneyimlemenin %3’ünü açıklamaktadır. Sonuç: Sağlık bilimleri öğrencilerinin başarılı mobil sağlık uygulamaları kullanımları, çalışma yaşamlarında kendilerinin ve toplumun akıllı sağlık hizmetlerini etkin ve güvenli bir şekilde kullanabilmelerini, sağlık hizmetlerinin ve lisans eğitimlerinin kalitelerinin artmasını sağlayacaktır.

The use of mobile health applications in empowering self-management of type 2 diabetes: a literature review

The use of mobile health applications is vital for achieving glycemic control, promoting lifestyle changes, and empowering self-management in individuals with type 2 diabetes. This literature review aims to assess the effectiveness of mobile health applications in empowering self-management among type 2 diabetes patients. A thorough search was conducted in databases like PubMed, CINAHL, Web of Science, Cochrane Library, Scopus, ULAKBIM National Database, and Medline between January 2020 and March 2023, using keywords such as "mobile health, mobile applications, type 2 diabetes, diabetes self-management, nursing." The search yielded 525 articles, out of which 34 studies in Turkish or English that evaluated the effectiveness of mobile health applications in individuals aged 18 years and above with type 2 diabetes were included in the review. Recent studies demonstrate a growing utilization of mobile health applications for the management of treatment and care in individuals with type 2 diabetes. These applications have been shown to empower self-management by promoting dietary adherence, regular blood sugar monitoring, regular physical activity, reduced medication requirements, and decreased HbA1c levels. Additionally, mobile health applications have been found to reduce face-to-face counseling time and healthcare costs. In conclusion, mobile health applications offer promising solutions for improving self-management and healthcare outcomes for individuals with type 2 diabetes. Further research and continued integration of these applications into clinical practice are essential to optimize their benefits and address the challenges faced by diabetes patients worldwide.

Factors influencing patients' adoption and use of mobile health applications for diabetes self-management: a systematic review

Mobile health (mHealth) apps can facilitate diabetes self-management (DSM) and assist in reducing the risk of complications, enhancing diabetes control and improving patient outcomes. The objectives of this systematic review were to (1) determine the adoption level of DSM apps among diabetes patients, (2) identify the factors associated with the adoption and use of DSM apps, and (3) explore patients’ perspectives of DSM apps and the predominant preferred features. A comprehensive literature search was performed in four electronic databases: PubMed, Scopus, PsychNet, and IEEE Xplore digital library using the PRISMA guidelines. Relevant data and information were collected from studies published between 2016 and 2023, fulfilling the inclusion criteria (n = 26), and thematic analysis was performed. The adoption level of mHealth apps for DSM among diabetic patients ranged from 7.0% to 47.0%, and diverse factors relating to patients’ demographics, preferences and experiences were identified. Overall, older, male and less educated patients were less likely to adopt DSM apps, while the intention to use these apps was influenced by patients’ perceived benefits, recommendations by patients and healthcare professionals, and ease of use. Given that most of the reviewed studies were conducted in developed countries, the present patients’ adoption level of mHealth apps for DSM is relatively low, thereby highlighting the need for improvement. The factors identified in this study may be considered when attempting to encourage patients to use these apps. More research is needed to elucidate how mobile health apps can be effectively integrated into diabetes care and management pathways.

How does information technology affect individuals’ health behavior in a pandemic? Insights from mobile health application use during COVID-19

The COVID-19 crisis has affected human mental health and health behavior. This was not the first pandemic in the world and will not be the last. Pandemics affect health behavior regarding prevention, avoidance, and management of illness. This study applies literature from Information Systems (IS) success, pandemic behavior, unified theory of acceptance and use of technology (UTAUT), and mobile technology identity (MTI) to investigate the effects of information technology (IT) attributes on health behavior during a pandemic. It is based on data from 232 patients of Arabic ethnic origin who visited a primary care clinic in Shefar'am. Results, based on structural equation modeling, indicate that perceived usefulness of mobile technology increases satisfaction with health reporting. Moreover, anxiety increases disclosure effort in using mobile technology, both directly and through a path mediated by MTI. Finally, disclosure effort reduces change in health behavior and satisfaction with self-reporting. Previous studies on health behavior during a pandemic and the role of IT in health behavior do not consider the role of IT in people's heath behavior, such as how IT can enable them to more frequently check their health during the pandemic. This study contributes to the literature by addressing this gap and providing insights into the role of IT in health behavior change during a pandemic. It also offers insights for clinics regarding the usefulness of mobile health (m-health) applications for patients so that they can to help patients change their health behavior towards using these applications.

Leveraging Digital Health to Improve the Cardiovascular Health of Women.

In this review, we present a comprehensive discussion on the population-level implications of digital health interventions (DHIs) to improve cardiovascular health (CVH) through sex- and gender-specific prevention strategies among women. Over the past 30 years, there have been significant advancements in the diagnosis and treatment of cardiovascular diseases, a leading cause of morbidity and mortality among men and women worldwide. However, women are often underdiagnosed, undertreated, and underrepresented in cardiovascular clinical trials, which all contribute to disparities within this population. One approach to address this is through DHIs, particularly among racial and ethnic minoritized groups. Implementation of telemedicine has shown promise in increasing adherence to healthcare visits, improving BP monitoring, weight control, physical activity, and the adoption of healthy behaviors. Furthermore, the use of mobile health applications facilitated by smart devices, wearables, and other eHealth (defined as electronically delivered health services) modalities has also promoted CVH among women in general, as well as during pregnancy and the postpartum period. Overall, utilizing a digital health approach for healthcare delivery, decentralized clinical trials, and incorporation into daily lifestyle activities has the potential to improve CVH among women by mitigating geographical, structural, and financial barriers to care. Leveraging digital technologies and strategies introduces novel methods to address sex- and gender-specific health and healthcare disparities and improve the quality of care provided to women. However, it is imperative to be mindful of the digital divide in specific populations, which may hinder accessibility to these novel technologies and inadvertently widen preexisting inequities.

A Mobile Health Information Behavior Model: Theoretical Development and Mixed-Method Testing in the Context of Mobile Apps on Child Poisoning Prevention

While several studies have explored the use of mobile health applications, few have observed determinants of mobile health information behavior. To develop a model explaining parents’ mobile information behavior on child poisoning prevention, we first explored relevant theories to suggest a theoretical model. In that, we combine existing models on risk and health information seeking, such as the Planned Risk Information Seeking Model, with models on the acceptance of mobile technologies, such as the Unified Theory of Acceptance and Use of Technologies. Thereafter, we employed a sequential mixed-method design with an initial qualitative study (four online focus groups with n = 25 parents in total) and a standardized online survey of n = 1,013 parents to evaluate our research model. Results confirm that both, determinants of information seeking and determinants of technology acceptance, contribute to the explanation of mobile information behavior. App use intention was mainly related to the performance expectancy of app use, the subjective information norm, and social influence on app use. To increase the usage of prevention apps and contribute to the reduction of child injuries, communication on poisoning apps should address subdimensions of the performance expectancy, such as their utility and peoples’ trust in app providers. Moreover, physicians are important multipliers for these messages.

Mobile health application can add our insight into caring for children: The benefit and future usage of the Chemo Assist for Children

Background: The ease of use of mobile health applications felt by users is essential to ensure the sustainability of digital-based intervention programs. The mHealth Chemo Assist for Children (CAC) application has been used by parents with children with acute lymphoblastic leukemia (ALL) who are undergoing chemotherapy in usability tests and positive benefits felt by users have been reported. A deeper understanding of the barriers and factors supporting implementing the CAC mHealth application can help guide strategies to overcome these challenges. Purpose: This study aims to evaluate the obstacles and factors supporting implementing mHealth CAC application in a natural setting. Methods: Qualitative research was conducted at two government hospitals in Indonesia. Focus group discussions were conducted with nine parents of children with ALL following chemotherapy. The interview was transcribed verbatim and analyzed using qualitative content analysis. Results: This research produced three main themes, namely the use of CAC and additional usage expectations, application quality, and current and future application usage. Conclusions: It is necessary to improve the benefit, ease of use of application features and overcome the obstacles experienced in using the CAC application.

Trends and Innovations in Health Behavior Change Interventions

This review article provides a comprehensive examination of the evolving landscape of health behavior change interventions from 2000 to 2023. It synthesizes key trends, innovations, and theoretical advancements in the field, highlighting the shift towards technology-enabled interventions and personalized approaches. The methodology involved a systematic literature search across major databases, focusing on peer-reviewed articles and systematic reviews that met specific inclusion criteria. The review identifies significant developments in digital health interventions, such as the use of mobile health applications, wearables, and artificial intelligence, and discusses how these technologies integrate with traditional behavior change theories. It also explores interdisciplinary approaches combining psychology, technology, and medicine, offering insights into their effectiveness and challenges. The article further addresses the barriers to implementation, ethical considerations, and the future trajectory of health behavior change interventions, emphasizing the need for scalable, evidence-based strategies. This review aims to inform practitioners, policymakers, and researchers about the current state and future potential of interventions in health behavior modification, underlining the importance of innovation in public health strategies.

Treating and Managing Urinary Incontinence: Evolving and Potential Multicomponent Medical and Lifestyle Interventions.

Incontinence is defined by either ICS 2002 or IUGA/ICS 2010 as the involuntary loss of urine and includes urgency urinary incontinence (UUI), stress urinary incontinence (SUI) or mixed urinary incontinence (MUI). It has a high worldwide prevalence with an associated impact on quality of life. Despite existing management options for the management of urinary incontinence, patients continue to be troubled by symptoms or side effects of existing treatment. There is therefore a requirement for ongoing research into treatment options for the management of UUI and SUI, that are more effective and tolerable to patients. Advances in treatment of UUI include a more selective beta 3 agonist, Vibegron, which has less impact on cardiac function than Mirabegron. Hormonal treatment, including Ospemifene and Prasterone, may improve GSM and in turn symptoms of UUI. There are advances in the types of neuromodulators available, including those that are rechargeable at home and are MRI safe. Laser has shown promising initial results. There is developing interest in the microbiome, and how this may impact future treatment modalities. Advances in treatment of SUI include the use of mobile health applications to support delivery of pelvic floor muscle training. Litoxetine, a selective serotonin reuptake inhibitor, has shown promising results at phase III trials. Functional magnetic stimulation is being developed to improve contractility of pelvic floor muscles. We also discuss interventions that improve tissue elasticity and regeneration, such as platelet rich plasma, autologous stem cell transplantation, laser therapy and radiofrequency treatment, which show short term benefits.

Analysis the Critical Factors of M-government Service Acceptance: An Integrating Theoretical Model between TAM and ECM

The development of smartphones has an essential role in digital services, which have the advantage of access to health services that can be performed anywhere and anytime. Unfortunately, the diffusion process of smartphone technology in the provision of health services faces the problem of decreasing the actual use of mobile health applications. Previous studies on m-government health services have also focused on using TAM and UTAUT to predict individual user behavior. A gap in the literature has been identified in previous studies. This study investigates the critical factors for the individual acceptance of m-government health services, especially the Peduli Lindungi mobile health service. The two theoretical models, TAM and ECM, were integrated to enhance the body of knowledge in predicting individual behavior in the m-government healthcare context. A quantitative method was used to analyse a total of 200 data. PLS-SEM was used to analyze the outer and inner models. The findings of this study support all hypotheses. The study's findings show that Perceived Usefulness, Perceived Easy to Use, and Satisfaction significantly affect on Intention Use; Perceived Usefulness, Perceived Easy to Use, and Expectation Confirmatory significantly affect on Satisfaction, Perceived Easy to Use has a significant effect on Perceived Usefulness. Expectation confirmation significantly affected Perceived Usefulness and perceived ease of use. The proposed model is successfully validated. Future research could consider integrating these theoretical models to assess the critical factors influencing the acceptance and use of digital services in other contexts.

A training curriculum for an mHealth supported peer counseling program to promote exclusive breastfeeding in rural India

BackgroundDespite strong evidence about the benefits of exclusive breastfeeding, that is the baby receiving only breast milk, no other foods or liquids, rates have remained relatively unchanged over the past two decades in low- and middle-income countries. One strategy for increasing exclusive breastfeeding is through community-based programs that use peer counselors for education and support. The use of mobile health applications is also gaining increasing applicability in these countries. Minimal information is available about training peer counselors in the use of mobile technologies to support exclusive breastfeeding. The present article describes our curriculum in the state of Karnataka, India for supporting new mothers to exclusively breastfeed using a mobile health application in rural India.MethodsTwenty-five women from the community surrounding the city of Belgavi, Karnataka, India were trained to be peer counselors and to use a mobile health application to conduct a structured curriculum to support new mothers in exclusive breastfeeding. The three-day interactive training, conducted in March 2018, was based on the WHO breastfeeding course, translated, and adapted to the local culture The curriculum, which included information collected during a formative research process, consisted of eight visits, two during the antenatal period and continuing for six months postpartum. Twelve nursing and obstetric experts validated curriculum content. Pre-post-evaluation of the training focused on breastfeeding knowledge, self-efficacy, skills, and app usability.ResultsWe observed a significant increase in the mean scores for knowledge (P < 0.0001) and skills (P = 0.0006) from pre- to post-training. Age of the peer counselors and their own breastfeeding experience correlated significantly with the acquisition of knowledge and skills. The mobile health app showed high usability scores.ConclusionsThe culturally adapted curriculum presented here, combined with an mHealth app, can be an important educational strategy for training rural women in the acquisition of exclusive breastfeeding knowledge and skills.

Designing an acceptance model and using public health apps by Iranian users.

Nowadays, there are hundreds of mobile applications related to sports, health and fitness. The benefits of using mobile phones in physical activity can be seen in the increasing use of mobile health applications. The purpose of this study was to design a behavioral model of acceptance and use of public health apps by Iranian users. The present study was a qualitative and exploratory approach that was conducted based on the theme analysis method (team). The statistical population included programmers and designers of sports programs and academic specialists in the field of sports and computers. Data collection was performed through review of documents, backgrounds and semi-structured interviews. The interviews were conducted in person or by telephone and each interview lasted about 20 to 40 minutes. In total, 249 key points with marker codes were extracted from 14 interviews which were classified into 21 sub-themes and 6 main themes (app quality, digital literacy, social influences, facilitating conditions, intention to use, trust and accept the app. Finally, the pattern of acceptance and use of health apps by Iranian users were presented in accordance with UTAUT theory. The results of this study can help the officials of the federation, public sports boards and clubs to use information and communication technology as a media in their strategies and programs to develop sports and health at the community level. It also contributes to social vitality and improves the quality of life of individuals.

Predictors of sustained use of mobile health applications: Content analysis of user perspectives from a fever management app.

Mobile health applications could be means of educating and changing behaviours of their users. Their features and qualities determine the sustainability of use. The FeverApp with two main features of information and documentation is a research-based app. In this observational cohort study, to evaluate the influential predictors of use, users' feedback on the FeverApp, were analyzed. Feedback is given using a structured questionnaire, four Likert items and two open questions regarding positive and negative impressions, available via app menu. Conventional content analysis (inductive approach) on the two open questions was performed. Comments were grouped into 12 codes. These codes were grouped hierarchically in an iterative process into nine subcategories and lastly into two main categories 'format' and 'content'. Descriptive and quantitative analysis were performed. Out of 8243 users, 1804 of them answered the feedback questionnaire. The features of the app (N = 344), followed by the information aspect (N = 330) were most frequently mentioned. Documentation process (N = 226), request for new features or improvement of the current ones (N = 193), and functioning (N = 132) were also highlighted in users' feedback. App's ease of use, design and being informative were important for the users. The first impression of the app seems important as the majority of feedback were given during the first month of using the app. In-app feedback function could highlight shortcomings and strengths of mobile health apps. Taking users' feedback into consideration could increase the chance of sustained use. Besides ease of use and clear, likeable designs, users want apps that serve their needs while saving time.

Assessing the digital literacy levels of the community pharmacy workforce using a survey tool.

To investigate the digital literacy of staff in London, UK, community pharmacies and to explore their perceptions about the use of eHealth tools. The study population was community pharmacy staff (N = 21,346) in Greater London. A survey tool was divided into six sections: Use of the internet; Use of social media; Use of mobile health applications (MHAs); Perception of and practical use of digital health tools; Scenario-based questions and demographics. Responses were analysed in SPSS. Following data collection, Health Education England's (HEE's) Digital Capabilities Framework (DCF) was published. The authors mapped the survey tool retrospectively to the framework. Almost all respondents (98.0%, n = 551/562) used eHealth tools at work, mainly to access medicine information (89.8%, n = 495/551). Almost one-third (31.7%, N = 178/562) used social media regularly, while many (79.4%, N = 446/562) were aware of MHAs. Self-perceived digital literacy indicated that 63.3% (n = 356/562) deemed themselves to be above average. Under 35s rated their digital literacy more highly than over 35s (P < 0.001). HEE's DCF indicated that actual digital literacy was lower than that of self-perceived. Despite the high use of eHealth tools, respondents were reluctant to recommend these to the public for health advice. Community pharmacy staff self-report their digital literacy to be high yet do not use these skills for public health purposes. Furthermore, these self-reported skills appear to be over-estimated. Despite high levels of use of digital tools at work, staff do not use them for public health, therefore, further training to build confidence to better utilise them is recommended.

Perceptions on a mobile health intervention to improve maternal child health for Syrian refugees in Turkey: Opportunities and challenges for end-user acceptability.

Mobile health (mhealth) technology presents an opportunity to address many unique challenges refugee populations face when accessing healthcare. A robust body of evidence supports the use of mobile phone-based reminder platforms to increase timely and comprehensive access to health services. Yet, there is a dearth of research in their development for displaced populations, as well as refugee perspectives in design processes to improve effective adoptions of mhealth interventions. This study aimed to explore healthcare barriers faced by Syrian refugee women in Turkey, and their perceptions of a maternal-child health mobile application designed to provide antenatal care and vaccine services. These findings guided development of a framework for enhancing acceptability of mobile health applications specific to refugee end-users. Syrian refugee women who were pregnant or had at least one child under the age of 2 years old at the time of recruitment (n = 14) participated in semi-structured in-depth interviews. Participants had the opportunity to directly interact with an operational maternal-child health mobile application during the interview. Using a grounded theory approach, we identified critical factors and qualities mhealth developers should consider when developing user-friendly applications for refugees. It was observed that a refugee's perception of the mobile health application's usability was heavily influenced by past healthcare experiences and the contextual challenges they face while accessing healthcare. The in-depth interviews with refugee end-users identified that data security, offline capability, clear-user directions, and data retrievability were critical qualities to build into mobile health applications. Among the features included in the maternal-child health application, participants most valued the childhood vaccination reminder and health information features. Furthermore, the application's multi-lingual modes (Arabic, Turkish, and English) strengthened the application's usability among Syrian refugee populations living in Turkey. The inclusion of refugee perceptions in mhealth applications offers unique developer insights for building more inclusive and effective tools for vulnerable populations. Basic upfront discussions of the mobile application's health goals and its personal value to the user may improve their long-term use. Further prospective research is needed on retention and use of mobile health applications for refugee women and other displaced populations.