Mobile learning for delivering health professional education (protocol)

© 2015 The Cochrane Collaboration.This is the protocol for a review and there is no abstract. The objectives are as follows: The objective of this review is to evaluate the effectiveness of mLearning educational interventions for delivering pre-registration and post-registration healthcare professional education. We will primarily assess the impact of these interventions on students knowledge, skills, professional attitudes and satisfaction

The Feasibility of a Using a Smart Button Mobile Health System to Self-Track Medication Adherence and Deliver Tailored Short Message Service Text Message Feedback

BACKGROUND: As many as 50% of people experience medication nonadherence, yet studies for detecting nonadherence and delivering real-time interventions to improve adherence are lacking. Mobile health (mHealth) technologies show promise to track and support medication adherence. OBJECTIVE: The study aimed to evaluate the feasibility and acceptability of using an mHealth system for medication adherence tracking and intervention delivery. The mHealth system comprises a smart button device to self-track medication taking, a companion smartphone app, a computer algorithm used to determine adherence and then deliver a standard or tailored SMS (short message service) text message on the basis of timing of medication taking. Standard SMS text messages indicated that the smartphone app registered the button press, whereas tailored SMS text messages encouraged habit formation and systems thinking on the basis of the timing the medications were taken. METHODS: A convenience sample of 5 adults with chronic kidney disease (CKD), who were prescribed antihypertensive medication, participated in a 52-day longitudinal study. The study was conducted in 3 phases, with a standard SMS text message sent in phases 1 (study days 1-14) and 3 (study days 46-52) and tailored SMS text messages sent during phase 2 (study days 15-45) in response to participant medication self-tracking. Medication adherence was measured using: (1) the smart button and (2) electronic medication monitoring caps. Concordance between these 2 methods was evaluated using percentage of measurements made on the same day and occurring within ±5 min of one another. Acceptability was evaluated using qualitative feedback from participants. RESULTS: A total of 5 patients with CKD, stages 1-4, were enrolled in the study, with the majority being men (60%), white (80%), and Hispanic/Latino (40%) of middle age (52.6 years, SD 22.49; range 20-70). The mHealth system was successfully initiated in the clinic setting for all enrolled participants. Of the expected 260 data points, 36.5% (n=95) were recorded with the smart button and 76.2% (n=198) with electronic monitoring. Concordant events (n=94), in which events were recorded with both the smart button and electronic monitoring, occurred 47% of the time and 58% of these events occurred within ±5 min of one another. Participant comments suggested SMS text messages were encouraging. CONCLUSIONS: It was feasible to recruit participants in the clinic setting for an mHealth study, and our system was successfully initiated for all enrolled participants. The smart button is an innovative way to self-report adherence data, including date and timing of medication taking, which were not previously available from measures that rely on recall of adherence. Although the selected smart button had poor concordance with electronic monitoring caps, participants were willing to use it to self-track medication adherence, and they found the mHealth system acceptable to use in most cases

Piloting Multimodal Learning Analytics using Mobile Mixed Reality in Health Education

© 2019 IEEE. Mobile mixed reality has been shown to increase higher achievement and lower cognitive load within spatial disciplines. However, traditional methods of assessment restrict examiners ability to holistically assess spatial understanding. Multimodal learning analytics seeks to investigate how combinations of data types such as spatial data and traditional assessment can be combined to better understand both the learner and learning environment. This paper explores the pedagogical possibilities of a smartphone enabled mixed reality multimodal learning analytics case study for health education, focused on learning the anatomy of the heart. The context for this study is the first loop of a design based research study exploring the acquisition and retention of knowledge by piloting the proposed system with practicing health experts. Outcomes from the pilot study showed engagement and enthusiasm of the method among the experts, but also demonstrated problems to overcome in the pedagogical method before deployment with learners

Exploring Challenges in Conducting E-Mental Health Research Among Asian American Women

In this discussion paper, we explore the challenges of conducting e-mental health intervention research among Asian American women and propose a model for addressing these barriers. Based on an extensive literature review, we identify two main types of barriers to conducting e-mental health intervention research among Asian American women: recruitment barriers and adherence barriers. Recruitment barriers are further subcategorized into those related to (1) stigmatized cultural beliefs about mental illness and mental health services; (2) lack of awareness about mental health services; and (3) language barrier. As to adherence barriers, the two identified subtypes concern (1) acuity and severity of mental health condition; and (2) lack of time. In order to enhance recruitment and adherence in e-mental health intervention research among the studied population, we formulate the following three main research strategies, namely: (1) considering the cultural and social contexts of Asian American women in the development of e-mental health interventions; (2) determining appropriate program length; and (3) conducting feasibility studies to test e-mental health interventions. We suggest that nurse researchers integrate our proposed model in conducting e-mental health interventions among Asian American women. Our proposed model also implies that nurses play an important role in encouraging Asian American women’s acceptance of and adherence to e-mental health interventions. In order to overcome the obstacles to conducting e-mental health research among Asian American women, we recommend that nurses familiarize themselves with credible, relevant, and evidence-based e-mental health resources and integrate online mental health services and information within their nursing practice

Increasing the Capacity of Primary Care Through Enabling Technology.

Primary care is the foundation of effective and high-quality health care. The role of primary care clinicians has expanded to encompass coordination of care across multiple providers and management of more patients with complex conditions. Enabling technology has the potential to expand the capacity for primary care clinicians to provide integrated, accessible care that channels expertise to the patient and brings specialty consultations into the primary care clinic. Furthermore, technology offers opportunities to engage patients in advancing their health through improved communication and enhanced self-management of chronic conditions. This paper describes enabling technologies in four domains (the body, the home, the community, and the primary care clinic) that can support the critical role primary care clinicians play in the health care system. It also identifies challenges to incorporating these technologies into primary care clinics, care processes, and workflow

Digital technologies to support mental health among young people

The aim of this study was to describe how digital technologies can support young people in mental health services. An explorative mixed methods study was conducted in three phases. First, a systematic literature review was carried out between 2011 and 2013, followed by a meta-analysis of three studies to examine the effectiveness of a virtual reality intervention used in specialized psychiatric care. Second, the use of an electronic diary (e-diary) was explored among young people (n=89) who were clients of adolescent psychiatric outpatient clinics between 2008 and 2010 due to depressive symptoms. Third, the use of web-based community services aimed at young people (n=2,193) in 2018 was explored. In the second and third stages, quantitative data were analyzed with descriptive analysis and qualitative data with inductive thematic analysis. No quality evidence for or against virtual reality usage among people with serious mental health problems was found in the systematic review and meta- analysis. The young people’s long-term use of the e-diary was low, and nearly half of the participants did not use it at all. Those who did use the e-diary had previous experiences in mental health services and had more severe symptoms of depression than those who did not use it. Most of the young people who used digital technologies during treatment at the adolescent psychiatric outpatient clinics and in the community were females. According to the study results, digital technologies were most often used in the evenings and during the school year. Young people openly discussed their mental health and their personal issues such as relationships, identity, social life, health and illnesses, and self-perception. Digital technologies have the potential to help young people monitor their behavior, symptoms, and experiences and get support when they need it. When developing and implementing mental health support based on digital technologies, it is important to consider the different mental health and gender-specific needs of young people, as well as their readiness to use digital technologies to support their own mental health and well-being.Digitaaliset teknologiat nuorten mielenterveyden tukena Tämän tutkimuksen tavoitteena oli kuvata, miten digitaalisia teknologioita voidaan käyttää nuorten mielenterveyden tukena mielenterveyspalveluissa. Tutkimus toteutettiin kolmessa vaiheessa. Ensimmäisessä vaiheessa systemaattinen kirjallisuuskatsaus tehtiin vuosina 2011–2013, jonka jälkeen tehtiin meta-analyysi kolmesta tutkimuksesta, joissa tutkittiin virtuaalitodellisuusintervention tehokkuutta psykiatrian erityispalveluissa. Toisessa vaiheessa sähköisen päiväkirjan (e-päiväkirjan) käyttöä tutkittiin nuorisopsykiatrian poliklinikoilla masennusoireiden takia vuosina 2008–2010 asiakkaina olleiden nuorten (n=89) keskuudessa. Kolmannessa vaiheessa tutkittiin vuonna 2018 nuorille (n=2,193) suunnattujen verkkopohjaisten palvelujen käyttöä. Toisessa ja kolmannessa vaiheessa kvantitatiivisia tietoja analysoitiin kuvailevalla analyysillä ja kvalitatiivisia tietoja induktiivisella temaattisella analyysillä. Systemaattisen katsauksen ja meta-analyysin perusteella virtuaalitodellisuus-interventioiden hyödyistä tai haitoista vakavien mielenterveysongelmien hoidossa ei löytynyt laadukasta näyttöä. Nuorten pitkäaikainen e-päiväkirjan käyttö oli vähäistä ja lähes puolet osallistujista eivät käyttäneet sitä lainkaan. E-päiväkirjaa käyttäneillä oli aiempaa kokemusta mielenterveyspalveluista ja heillä oli vakavampia masennusoireita kuin heillä, jotka eivät sitä käyttäneet. Nuoret, jotka käyttivät digitaalisia teknologioita nuorisopsykiatrisen polikliinisen hoidon aikana tai verkkopohjaisissa palveluissa, olivat pääasiassa naispuolisia. Tämän tutkimuksen tulosten mukaan digitaalisia teknologioita käytettiin useimmiten iltaisin ja kouluvuoden aikana. Nuoret keskustelivat avoimesti mielenterveydestään ja henkilökohtaisista asioistaan, kuten ihmissuhteistaan, identiteetistään, sosiaalisesta elämästään, terveydestään ja sairauksistaan sekä miten he näkivät ja kokivat itsensä. Digitaaliset teknologiat luovat mahdollisuuksia auttaa nuoria seuraamaan käyttäytymistään, oireitaan tai kokemuksiaan sekä saamaan tukea, silloin kun he sitä tarvitsevat. Digitaaliseen teknologiaan perustuvaa tukea kehitettäessä ja toteutettaessa on tärkeää ottaa huomioon nuorten erilaiset mielenterveys- ja sukupuolikohtaiset tarpeet sekä heidän valmiutensa käyttää digitaalista teknologiaa oman mielenterveyden ja hyvinvoinnin tukemiseen

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

Background: The 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. Objective: This review aimed to understand what is known about influences on the uptake of and engagement with health and well-being smartphone apps among adults. Methods: We 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). Results: Of 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). Conclusions: Across 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

Using Smartphone Technology to Enhance Self-Management Support in Adults with Type 2 Diabetes in Primary Care

Background: Self-care is a crucial component in the management of Type 2 Diabetes Mellitus (T2DM). The literature shows that frequent feedback on blood sugar recordings together with reminders can lead to improvements in patient’s glucose control and diabetic self-care. The Chronic Care Model developed by Wagner emphasizes the importance of patient participation in the management of their chronic diseases. Purpose: To explore the possibility of using smartphone technology to help adults with T2DM better manage this chronic disease in a primary care clinic in New England. Methods: A smartphone application (App) OnTrack Diabetes (OnTrack) and text messaging were used to enhance communication between the patient and the provider. After receiving facility and IRB waivers, participants were recruited and trained on the downloaded App. Data was generated through text messages, the App and DNP student journaling, which was evaluated for patient and provider satisfaction with the App. Results: This project lasted about five months with five out of the seven participants recruited actually completing the project. Many (60%) of the participants found the App useful, 80% followed through with the instructions in the text messages and 60% intend to continue to use the App. Three out of five providers liked the App and intend to continue to use it. Most (80%) of the participants noticed a decrease in blood sugar, hemoglobin A1C and weight. Conclusion: This project confirms that an App and text messaging may be a useful tool for primary care providers to enhance self management in patients with T2DM and that frequent communication with the patient in between face to face office visits keeps them engaged and more compliant with diabetes management

Fall prevention intervention technologies: A conceptual framework and survey of the state of the art

In recent years, an ever increasing range of technology-based applications have been developed with the goal of assisting in the delivery of more effective and efficient fall prevention interventions. Whilst there have been a number of studies that have surveyed technologies for a particular sub-domain of fall prevention, there is no existing research which surveys the full spectrum of falls prevention interventions and characterises the range of technologies that have augmented this landscape. This study presents a conceptual framework and survey of the state of the art of technology-based fall prevention systems which is derived from a systematic template analysis of studies presented in contemporary research literature. The framework proposes four broad categories of fall prevention intervention system: Pre-fall prevention; Post-fall prevention; Fall injury prevention; Cross-fall prevention. Other categories include, Application type, Technology deployment platform, Information sources, Deployment environment, User interface type, and Collaborative function. After presenting the conceptual framework, a detailed survey of the state of the art is presented as a function of the proposed framework. A number of research challenges emerge as a result of surveying the research literature, which include a need for: new systems that focus on overcoming extrinsic falls risk factors; systems that support the environmental risk assessment process; systems that enable patients and practitioners to develop more collaborative relationships and engage in shared decision making during falls risk assessment and prevention activities. In response to these challenges, recommendations and future research directions are proposed to overcome each respective challenge.The Royal Society, grant Ref: RG13082