Challenges & solutions in a hybrid mHealth mobile app

The paper describes the various problems and challenges encountered during the development and remote data collection in a cross-platform hybrid application developed for remote monitoring of participants and what solutions were implemented to mitigate them. These problems and challenges are universal for hybrid applications and this paper digs deep into these in the domain of large-scale, long-duration mHealth research studies. From technical issues to issues with user compliance, this paper discusses the core problems inherent to these types of studies and technologies, and how to mitigate them

Mobile health data: investigating the data used by an mHealth app using different mobile app architectures

Mobile Health (mHealth) has come a long way in the last forty years and is still rapidly evolving and presenting many opportunities. The advancements in mobile technology and wireless mobile communication technology contributed to the rapid evolution and development of mHealth. Consequently, this evolution has led to mHealth solutions that are now capable of generating large amounts of data that is synchronised and stored on remote cloud and central servers, ensuring that the data is distributable to healthcare providers and available for analysis and decision making. However, the amount of data used by mHealth apps can contribute significantly to the overall cost of implementing a new or upscaling an existing mHealth solution. The purpose of this research was to determine if the amount of data used by mHealth apps would differ significantly if they were to be implemented using different mobile app architectures. Three mHealth apps using different mobile app architectures were developed and evaluated. The first app was a native app, the second was a standard mobile Web app and the third was a mobile Web app that used Asynchronous JavaScript and XML (AJAX). Experiments using the same data inputs were conducted on the three mHealth apps. The primary objective of the experiments was to determine if there was a significant difference in the amount of data used by different versions of an mHealth app when implemented using different mobile app architectures. The experiment results demonstrated that native apps that are installed and executed on local mobile devices used the least amount of data and were more data efficient than mobile Web apps that executed on mobile Web browsers. It also demonstrated that mobile apps implemented using different mobile app architectures will demonstrate a significant difference in the amount of data used during normal mobile app usage

Visions and Challenges in Managing and Preserving Data to Measure Quality of Life

Health-related data analysis plays an important role in self-knowledge, disease prevention, diagnosis, and quality of life assessment. With the advent of data-driven solutions, a myriad of apps and Internet of Things (IoT) devices (wearables, home-medical sensors, etc) facilitates data collection and provide cloud storage with a central administration. More recently, blockchain and other distributed ledgers became available as alternative storage options based on decentralised organisation systems. We bring attention to the human data bleeding problem and argue that neither centralised nor decentralised system organisations are a magic bullet for data-driven innovation if individual, community and societal values are ignored. The motivation for this position paper is to elaborate on strategies to protect privacy as well as to encourage data sharing and support open data without requiring a complex access protocol for researchers. Our main contribution is to outline the design of a self-regulated Open Health Archive (OHA) system with focus on quality of life (QoL) data.Comment: DSS 2018: Data-Driven Self-Regulating System

Designing a Multimedia Intervention for Illiterate and Semi-Illiterate Pregnant Women in Developing Countries: A Case of Uganda

Die hohe Müttersterblichkeit in Entwicklungsländern ist zum Teil auf indirekte Faktoren wie Analphabetismus und eingeschränkten Zugang zu Gesundheitsinformationen für Mütter zurückzuführen. Während gebildete Frauen auf Gesundheitsinformationen über Online-Plattformen und mHealth-Apps zugreifen können, müssen Analphabetinnen diese in Gesundheitseinrichtungen abrufen, was aufgrund der Transportkosten oft nicht möglich ist. Mobilfunktechnologie hat in der Gesundheitsversorgung Chancen für ressourcenarme Gemeinschaften eröffnet, die sonst nicht von den digitalen Technologien profitiert hätten. Obwohl Mobilfunktechnologie in der Müttergesundheit eingesetzt wird, können die meisten Maßnahmen nicht von Analphabeten genutzt werden, verwenden Sicherheitsmodelle die nicht auf den Kontext von Entwicklungsländern zugeschnitten sind, und wurden nicht auf ihre Auswirkungen auf die Müttergesundheit hin evaluiert. In dieser Arbeit wurden zwei (Web und Mobile) Apps entwickelt, die die Übermittlung von multimedialen Nachrichten zur Müttergesundheit, Terminerinnerungen und Anrufe/Chats erleichtern. Um die Anforderungen der Nutzer zu erfassen, wurde eine Feldstudie mit halbstrukturierten Interviews und Fokusgruppendiskussionen mit schwangeren Analphabetinnen, Gesundheitsexperten und Entwicklern durchgeführt. Es folgte die Entwicklung eines Sicherheitsmodells (T2RoL) zur Sicherung der Gesundheitsinformationen in den Apps, die dann nach einem nutzerzentrierten Designansatz entwickelt wurden. Eine zweite Feldstudie in Form von halbstrukturierten Interviews und Umfragen wurde durchgeführt, um die mobile App in einer randomisierten kontrollierten Studie mit 80 schwangeren Analphabetinnen über 9 Monate zu evaluieren. Die Auswertung zeigte, dass die App akzeptiert wurde sowie einfach zu erlernen und zu benutzen war. Das Wissen über Müttergesundheit in der Interventionsgruppe verbesserte sich, was sich positiv auf gesundheitsbezogene Entscheidungen und Gesundheitsmaßnahmen auswirkte.Maternal mortality is high in developing countries partly due to indirect factors such as illiteracy and limited access to maternal health information. While literate women can access health information from online platforms, and mHealth apps, illiterate women must get it from health facilities which is often not possible due to lack of transport fees. Mobile technology has opened opportunities in maternal health care for low resource communities that would otherwise not have benefited from digital technologies. Although used in maternal health, most interventions are not usable by the illiterate, use security models that are not tailored to the developing countries’ context, and have not been evaluated to assess their impact on maternal health care. In this thesis, two (web and mobile) apps that facilitate delivery of multimedia-based maternal health messages, appointment reminders, and calls/ chats were developed. To gather user requirements, a field study in form of semi-structured interviews and focus group discussions was conducted with illiterate pregnant women, health practitioners and developers. Development of a security model (T2RoL) to secure the health information in the apps followed. The apps were then developed following a user-centered design approach. A second field study in form of semi-structured interviews and surveys was conducted to evaluate the mobile app through a randomized controlled trial with 80 illiterate pregnant women that were followed for 9 months. Overall, results show that the app was acceptable, easy to learn and use. There was improved maternal health knowledge among the intervention group which positively influenced health related decision making and health practices

schema: An open-source, distributed mobile platform for deploying mHealth research tools and interventions

Background: Mobile applications for health, also known as \u27mHealth apps\u27, have experienced increasing popularity over the past ten years. However, most publicly available mHealth apps are not clinically validated, and many do not utilise evidence-based strategies. Health researchers wishing to develop and evaluate mHealth apps may be impeded by cost and technical skillset barriers. As traditionally lab-based methods are translated onto mobile platforms, robust and accessible tools are needed to enable the development of quality, evidence-based programs by clinical experts. Results: This paper introduces schema, an open-source, distributed, app-based platform for researchers to deploy behavior monitoring and health interventions onto mobile devices. The architecture and design features of the platform are discussed, including flexible scheduling, randomisation, a wide variety of survey and media elements, and distributed storage of data. The platform supports a range of research designs, including cross-sectional surveys, ecological momentary assessment, randomised controlled trials, and micro-randomised just-in-time adaptive interventions. Use cases for both researchers and participants are considered to demonstrate the flexibility and usefulness of the platform for mHealth research. Conclusions: The paper concludes by considering the strengths and limitations of the platform, and a call for support from the research community in areas of technical development and evaluation. To get started with schema, please visit the GitHub repository: Https://github.com/schema-app/schema

Microlearning mApp to Improve Long Term Health Behaviours: Design and Test of Multi-Channel Service Mix

Work place health support interventions are relevant: to support our aging work force and to help reduce the private and social burdens of preventable disease. Moreover, healthy living has become a priority in Dutch society. Previous research showed that health apps should offer enough newness and relevance each time they are used. Otherwise the ‘eHealth law of attrition’ applies: 90% of users are lost prematurely. We developed a hybrid health support solution that uses a mix of electronic and physical support services for improving health behaviours, including a mobile microlearning health quiz. This solution was tested in a multiple-case study at three work sites. The research question was whether a mobile health quiz can provide added value for users within a hybrid service mix and whether it promotes long term health readiness (awareness, motivation, plans and behaviours)? We found that both the mobile health quiz and the overall hybrid solution contributed to health readiness and health behaviour improvements. Users indicated that the microlearning health quiz courses provided new and relevant information. We also observed relatively high utilization rates of the health quiz. Participants indicated that health behaviour insights were given that were directly applicable and that fitted well within the overall service mix. Moreover, even after 10 months they indicated to still have increased health awareness, -motivation and -behaviours (food, physical activity, mental recuperation). A design analysis is conducted regarding service mix efficacy; the mobile microlearning health quiz helped fulfil key requirements for designing ICT-enabled lifestyle interventions, largely in the way it was anticipated