Utility Of mHealth Research Articles

Applying Interactive Mobile health to Asthma Care in Teens (AIM2ACT): Development and design of a randomized controlled trial

Early adolescents have difficulties performing asthma self-management behaviors, placing them at-risk for poor asthma control and reduced quality of life. This paper describes the development and plans for testing an interactive mobile health (mHealth) tool for early adolescents, ages 12–15years, and their caregivers to help improve asthma management. Applying Interactive Mobile health to Asthma Care in Teens (AIM2ACT) is informed by the Pediatric Self-management model, which posits that helpful caregiver support is facilitated by elucidating disease management behaviors and allocating treatment responsibility in the family system, and subsequently engaging in collaborative caregiver-adolescent asthma management. The AIM2ACT intervention was developed through iterative feedback from an advisory board composed of adolescent-caregiver dyads. A pilot randomized controlled trial of AIM2ACT will be conducted with 50 early adolescents with poorly controlled asthma and a caregiver. Adolescent-caregiver dyads will be randomized to receive the AIM2ACT smartphone application (AIM2ACT app) or a self-guided asthma control condition for a 4-month period. Feasibility and acceptability data will be collected throughout the trial. Efficacy outcomes, including family asthma management, lung function, adolescent asthma control, asthma-related quality of life, and self-efficacy for asthma management, will be collected at baseline, post-treatment, and 4-month follow-up. Results from the current study will inform the utility of mHealth to foster the development of asthma self-management skills among early adolescents.

Systematic Review and Meta-Analysis Examining the Effectiveness of Mobile Health Technologies in Using Self-Monitoring for Pediatric Weight Management.

Pediatric obesity is a public health concern related to multiple negative physical and psychosocial problems. While behavioral weight control (BWC) interventions are generally effective in decreasing pediatric weight status, these interventions are not able to reach the third of U.S. children currently classified as overweight or obese. This review and meta-analysis examined the overall effectiveness of mobile health (mHealth) technologies employing self-monitoring, a central component of change within BWC, to decrease pediatric weight status. Overall, a small, but significant overall effect size (d = 0.42) was found with the inclusion of nine eligible studies examining the effect on weight status. However, the quality of studies included within this weight status meta-analysis was weak, therefore limiting the interpretability of results. Analyses were also conducted examining the effect of mHealth technologies employing self-monitoring on secondary behavioral outcomes of physical activity and diet. Results indicated a small to medium, but nonsignificant effect (d = 0.41; four samples) on physical activity and a small, but significant effect on diet (d = 0.10; eight samples). Overall, the articles included in behavioral outcomes were of generally moderate quality. More work is needed to better identify the utility of mHealth and specific treatment components (such as self-monitoring), for pediatric weight management.

Using mHealth for HIV/TB Treatment Support in Lesotho: Enhancing Patient-Provider Communication in the START Study.

Background:mHealth is a promising means of supporting adherence to treatment. The Start TB patients on ART and Retain on Treatment (START) study included real-time adherence support using short-text messaging service (SMS) text messaging and trained village health workers (VHWs). We describe the use and acceptability of mHealth by patients with HIV/tuberculosis and health care providers.Methods:Patients and treatment supporters received automated, coded medication and appointment reminders at their preferred time and frequency, using their own phones, and $3.70 in monthly airtime. Facility-based VHWs were trained to log patient information and text message preferences into a mobile application and were given a password-protected mobile phone and airtime to communicate with community-based VHWs. The use of mHealth tools was analyzed from process data over the study course. Acceptability was evaluated during monthly follow-up interviews with all participants and during qualitative interviews with a subset of 30 patients and 30 health care providers at intervention sites. Use and acceptability were contextualized by monthly adherence data.Findings:From April 2013 to August 2015, the automated SMS system successfully delivered 39,528 messages to 835 individuals, including 633 patients and 202 treatment supporters. Uptake of the SMS intervention was high, with 92.1% of 713 eligible patients choosing to receive SMS messages. Patient and provider interviews yielded insight into barriers and facilitators to mHealth utilization. The intervention improved the quality of health communication between patients, treatment supporters, and providers. HIV-related stigma and technical challenges were identified as potential barriers.Conclusions:The mHealth intervention for HIV/tuberculosis treatment support in Lesotho was found to be a low-tech, user-friendly intervention, which was acceptable to patients and health care providers.

Health Worker mHealth Utilization: A Systematic Review.

Health Worker mHealth Utilization: A Systematic Review.

Health Worker mHealth Utilization: A Systematic Review.

This systematic review describes mHealth interventions directed at healthcare workers in low-resource settings from the PubMed database from March 2009 to May 2015. Thirty-one articles were selected for final review. Four categories emerged from the reviewed articles: data collection during patient visits, communication between health workers and patients, communication between health workers, and public health surveillance. Most studies used a combination of quantitative and qualitative methods to assess acceptability of use, barriers to use, changes in healthcare delivery, and improved health outcomes. Few papers included theory explicitly to guide development and evaluation of their mHealth programs. Overall, evidence indicated that mobile technology tools, such as smartphones and tablets, substantially benefit healthcare workers, their patients, and healthcare delivery. Limitations to mHealth tools included insufficient program use and sustainability, unreliable Internet and electricity, and security issues. Despite these limitations, this systematic review demonstrates the utility of using mHealth in low-resource settings and the potential for widespread health system improvements using technology.

A Strategic Consideration on Chronic Disease Prevention and Management through mHealth Utilization

A Strategic Consideration on Chronic Disease Prevention and Management through mHealth Utilization

Perceptions and knowledge toward mobile-health among the college going students in Coastal South India.

Background:Among the manifold uses of mobile phones, mobile-health (mHealth) has been an important one, which is the practice of public health initiatives by awareness raising and communication campaigns. Optimum utilization of mHealth is possible only through adequate awareness. Hence, we aimed to study the perceptions and knowledge about mHealth among college going students in Mangalore, India.Materials and Methods:A cross-sectional study was conducted in March 2014 among 627 students in selected engineering (302 students) and medical colleges (325 students) in Mangalore, India. Colleges were selected using convenience sampling (nonrandom) method. Data were collected using semi-structured self-administered questionnaire and analyzed.Results:Overall, 48.9% were males, 61.4% belonged to 18-20 years age group. The awareness about mobile phone health utilities among medical and engineering students was found to be similar. Among those who were aware of the concept of mHealth (74 [11.2%]), 40 (54.1%) were medical students. Marginally higher proportion of medical students felt mHealth could be helpful in protecting the patients’ confidentiality and would help in better communication with the patients.Conclusion:There was high level of general awareness about mHealth among the subjects. However, many specific areas had limited knowledge among both the streams of students, hence highlighting the need for increasing awareness and sensitization.

Conceptual Model for M-Health Utilization: A Nigerian Adaptation

Background: Compliance with Antenatal Care (ANC) and Postnatal Care (PNC) regimen is a known determinant of pregnancy outcomes. In most developing countries, access to Skilled Birth Delivery (SBD) and Childhood Immunization (CIm), socio-cultural beliefs, physical and financial barriers significantly influence perinatal health outcome. Mobile health (M-Health) is an emerging strategy for improving healthcare utilization and compliance but the extent to which it may influence uptake of available maternal and infant welfare services in Nigeria is not documented in literature. Nurses are the fulcrum for maternal healthcare but their knowledge and roles in the use of M-Health are not known in Nigeria.

Text message interventions for follow up of infants born to mothers positive for Chagas disease in Tucumán, Argentina: a feasibility study.

BackgroundDiagnosis of congenital Chagas disease occurs at 9 months of age, making effective treatment challenging due to loss to follow-up. Mobile health (mHealth) has been utilized to improve communication and treatment adherence in many chronic diseases, although no studies of mHealth in Trypanosoma cruzi-infected individuals have been conducted. Text message interventions, a subset of mHealth, has shown to improve appointment attendance and is relatively simple to set up, thus making it an ideal mechanism to facilitate communication with individuals in low-resource settings.ObjectiveThe aim of this study is to understand the acceptability, utilization, and barriers of an SMS-based appointment reminder to confirm a post-partum home visit to women in Tucumán, Argentina and whether these factors differ in urban and rural populations.MethodsWomen that tested positive for Chagas disease were invited to receive SMS reminders of their follow-up 4-week postpartum home visit. Demographic information and SMS contact preferences were collected at hospital discharge, and variables on mHealth utilization and barriers were recorded at follow-up.Results77 (70.6 %) of women possessed a cell phone for personal use. All eligible women owned phones compatible with SMS messages. The appointment reminder SMS was widely accepted with 64/72 (88.9 %) enrolled women receiving the SMS message and 58/64 (90.6 %) replying. Ninety-two percent of women stated that the text message was a useful reminder for the follow-up home visit. Women living in rural areas were less likely to own a cell phone for personal use and were significantly less likely to have internet access on their phone than women living in urban areas (RR 0.30, 95 % CI 0.10–0.89). Furthermore, women from rural areas faced barriers to mHealth uptake such as change of phone number and response to messages from the hospital team at higher rates than women from urban areas, although these differences were not statistically significant.ConclusionsThere is generally widespread acceptance and utilization of mHealth among this group of women with access to cell phones. However, there are still many barriers to overcome before mHealth interventions attain complete penetration in a population, most notably the issue of cell phone for personal use.

M-Health adoption by healthcare professionals: a systematic review.

The aim of this systematic review was to synthesize current knowledge of the factors influencing healthcare professional adoption of mobile health (m-health) applications. Covering a period from 2000 to 2014, we conducted a systematic literature search on four electronic databases (PubMed, EMBASE, CINAHL, PsychInfo). We also consulted references from included studies. We included studies if they reported the perceptions of healthcare professionals regarding barriers and facilitators to m-health utilization, if they were published in English, Spanish, or French and if they presented an empirical study design (qualitative, quantitative, or mixed methods). Two authors independently assessed study quality and performed content analysis using a validated extraction grid with pre-established categorization of barriers and facilitators. The search strategy led to a total of 4223 potentially relevant papers, of which 33 met the inclusion criteria. Main perceived adoption factors to m-health at the individual, organizational, and contextual levels were the following: perceived usefulness and ease of use, design and technical concerns, cost, time, privacy and security issues, familiarity with the technology, risk-benefit assessment, and interaction with others (colleagues, patients, and management). This systematic review provides a set of key elements making it possible to understand the challenges and opportunities for m-health utilization by healthcare providers.

Human Factors and Usability in Mobile Health Design – Factors for Sustained Patient Engagement in Diabetes Care

The degree of health care resource consumption within the United States is significant, even with the passage of the Patient Protection and Affordable Care Act (PPACA), with annual expenditures expected to reach 14% of the US gross domestic product by 2016. This suggests the need for population-level solutions that cover the spectrum of both clinical and non-clinical care for the primary prevention of chronic disease, in particular diabetes, which affects over eight percent of the population and costs over $100 billion annually. Over the past decade, there have been an abundance of technological solutions that provide the potential of mitigating the risk issues associated with diabetes and improving self-management practices. One such technology in particular is emerging that may become very important to the delivery of health care: mobile phones. In 2012, a study undertook a comprehensive assessment of the use of mobile health (mHealth) in the management and treatment of diabetes. This study encompassed the review of over 514 articles, as well as series of key informant interviews and site visits, to determine the effectiveness and utility of mHealth in managing and treating diabetes. The research suggested that the usability of mHealth applications could be understood and assessed according to four major factors: user-friendliness, user design, user satisfaction and user confidence. The first two primarily deal with the type of technology and the design of the interface. The last two concern user perception and are crucial in appropriately evaluating how well the application meets a patient’s expectations, which is a critical component of both quality of care and patient outcomes.

Bridging the Human Resource Gap in Primary Health Care Delivery Systems of Developing Countries With mHealth: Narrative Literature Review.

BackgroundMobile health (mHealth) has the potential to solve human resource issues in the health care sector. mHealth is of particular interest in developing countries, where widespread mobile networks and access to devices are connecting people like never before.ObjectiveThe aim of this paper was to review published and unpublished literature, field projects, and pilot studies on mHealth usage in overcoming shortage of human health resources in developing countries.MethodsA narrative literature review was undertaken using an iterative approach in extracting literature focused on mHealth and human health resources of low-income countries, especially India. The present review has undertaken comprehensive coverage of the work on related field projects that have been either published, accepted for publication, or pilot tested.ResultsThis review presented the use of mHealth across various dimensions of primary health care, including data collection, disease surveillance, health education, supervision, monitoring, and feedback. Field studies of fast, error-free data collection and transmission using mHealth were also documented. New apps for supervision, monitoring, and utilization of innovative health education tools were documented in the current review. Practical limitations of mHealth and challenges set forth in developing countries included issues of data security, cost constraints, health provider privacy, and technical barriers.ConclusionsIn the present review, we have documented a few mHealth projects that contribute to the proficient use of human resources. These projects pave the path for the efficient utilization of mHealth, offering solutions to emerging human resource challenges and simultaneously revamping the health care delivery in resource-limited settings.

The utility of mHealth in Medical Imaging

Current Evidence The role of mobile devices in medical imaging has broaden to encompass a broad range of functions including diagnostic purposes, facilitating triage of emergent conditions, improving communication between health care providers to expedite patient care, and providing a feasible system for patient follow-up and self monitoring. The ever increasing capabilities of mobile technologies have also enabled their purpose to expand beyond simply an image capturing tool. This has been reflected in a spectrum of basic sciences, medical and surgical specialties, and public health that are using the imaging capabilities of mHealth to improve access and delivery of patient care.

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The successful control of chronic diseases mainly depends on how well patients manage their disease conditions with the aid of healthcare providers. Mobile health technology—also known as mHealth—supports healthcare practice by means of mobile devices such as smartphone applications, web-based technologies, telecommunications services, social media, and wearable technology, and is becoming increasingly popular. Many studies have evaluated the utility of mHealth as a tool to improve chronic disease management through monitoring and feedback, educational and lifestyle interventions, clinical decision support, medication adherence, risk screening, and rehabilitation support. The aim of this article is to summarize systematic reviews addressing the effect of mHealth on the outcome of patients with chronic diseases. We describe the current applications of various mHealth approaches, evaluate their effectiveness as well as limitations, and discuss potential challenges in their future development. The evidence to date indicates that none of the existing mHealth technologies are inferior to traditional care. Telehealth and web-based technologies are the most frequently reported interventions, with promising results ranging from alleviation of disease-related symptoms, improvement in medication adherence, and decreased rates of rehospitalization and mortality. The new generation of mHealth devices based on various technologies are likely to provide more efficient and personalized healthcare programs for patients.