1,010 research outputs found

    The Efficacy of the Persian Version of the Mindfulness-Based Stress Management App (Aramgar) for College’s Mindfulness Skills and Perceived Stress

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    Functional mobile applications are regarded as one of the brand-new approaches to psychological interventions in different areas, including stress. The study aims to analyze a mobile application for Persian users on perceived stress and improve mindful skills. This study was a one-group pretest-posttest design with a quasi-experimental research design. Three instruments were used in this study: the Five Factor Mindfulness Questionnaire (FFMQ), the Perceived Stress Scale (PSS-10), and the Mobile App Rating Scale (MARS). Eighty-five students participated in an 8-week mindfulness mobile app (Aramgar) for at least 10 minutes per day  intervention. They responded to validated outcome measures of stress and mindfulness at baseline after the 8-week continued access period. The mobile application, Aramgar, was designed based on Mindfulness-based stress reduction. Paired t-tests showed significant differences in general perceived stress (P = 0.03) and total score of mindfulness (P = 0.002) before and after Aramgar. The results of analyzing the quality of Aramgar in terms of engagement, functionality, aesthetics, and information quality showed that specialists assessed the quality of the application appropriately. Using functional mobile apps provides ease of use for mental health services. Therefore, to strengthen and develop the mentioned services, it is recommended that the necessary information technology infrastructures be provided and the existing limitations for designing and running mental health mobile apps be removed

    Development and Content Validation of Scoresheet and User Manual to Assess the Quality of Health Apps

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    There has been a continuous growth of health application programs (apps) both in web-based and mobile platforms in recent years. However, there has been no instrument available to assess the degree of quality of these apps in Finland during the time this study has been initiated. The aim of this study was to develop an easy-to-use and practical scoresheet and user manual to assess the degree of quality of health apps as well as validate its contents using an expert panel. The design of the study adopted a two-stage process. The first stage entails designing the instrument in which the identification of conceptual framework, item generation and determining the structure of the instrument were performed. A comprehensive literature review was undertaken as well as the examination of applicable legislations, policies and guidelines pertaining to mHealth and digital health devices. The second stage entailed judgement wherein the scoresheet was tested for face validity with a small representative sample (n=6) of intended users and two rounds of content validation using an expert panel (n=19). The Content Validity Index (CVI) both in item and scale-levels were computed. The result of the study yielded a total of 34 content validated items categorized into five distinctive domains – Basic Details, Health Content, Technical Properties, User-orientation, Privacy and Safety. The CVIs on item-level for all items reached a favorable score of > 0,78 on the assertions of relevance and clarity. Whilst it garnered > 0,90 on scale level based on universal agreement and average. This study paved ways for the scoresheet and user manual to proceed with further psychometric measurement procedures such as reliability, feasibility and acceptability.Terveydenhuollon ei-lääkinnällisten sovellusten (apps) määrä on kasvanut jatkuvasti viime vuosina sekä verkko- että mobiilialustoilla. Tämän tutkimuksen aloittamisen aikana ei Suomessa kuitenkaan ollut saatavilla instrumenttia näiden sovellusten laadun arvioimiseksi. Tämän tutkimuksen tarkoituksena oli kehittää helppokäyttöinen ja käytännöllinen mittari ja käyttöopas terveyssovellusten laadun arvioimiseksi ja validoida sen sisältö asiantuntijapaneelin avulla. Tutkimus toteutettiin kaksivaiheisena. Ensimmäisessä vaiheessa kehitettiin mittari eli määritettiin teoreettinen viitekehys, ja muodostettiin sen perusteella mittarin osiot ja rakenne. Vaiheessa yksi toteutettiin kattava kirjallisuuskatsaus sekä koottiin yhteen terveyssovelluksia koskeva lainsäädäntö ja viralliset ohjeistukset. Tutkimuksen toisessa vaiheessa arvioitiin kehitetyn mittarin ilmivaliditeettia (face validity) tavoiteltua käyttäjäjoukkoa edustavalla tarkoituksenmukaisella otoksella (n=6). Sisältövaliditeetin (content validity) testaamiseen rekrytoitiin asiantuntijapaneeli (n=19) ja he toteuttivat mittarille kaksi validointikierrosta. Vastauksista laskettiin Content Validity Index (CVI) sekä osioiden että mittarin tasolla (item and scale levels). Tutkimuksen tuloksena syntyi 34 kohdan asiantuntijapaneelin validoima mittari terveyssovellusten laadun arvioimiseen. Mittarin kohdat on luokiteltu aihealueittain viiteen osa-alueeseen: perustiedot, terveyteen liittyvä sisältö, tekniset ominaisuudet, käyttäjälähtöisyys, sekä yksityisyys ja turvallisuus. Kaikkien osioiden CVI pisteet saavuttivat suotuisat lukemat > 0,78 relevanssiuden ja selkeyden osalta. Lisäksi mittari sai > 0,90 pisteet koko mittarin tasolla (universal agreement and average). Tämä tutkimus tuotti uuden tavan arvioida terveyssovellusten laatua. Jatkossa mittarin ja sen käyttöoppaan psykometrisiä ominaisuuksia kuten reliabiliteettia sekä käyttökelpoisuutta ja hyväksyttävyyttä tulee edelleen testata

    a randomized controlled trial

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    학위논문(박사) -- 서울대학교대학원 : 의과대학 의과학과, 2021.8. 최형진.Background - Since lifestyle modification is the cornerstone of the obesity treatment, digital therapeutics (DTx) became one of the compelling and easily accessible treatment modalities. Objective - This research proposes to validate the treatment efficacy, understand behavioral changes by eating behavioral analysis, identify the predictive digital phenotypes for engagement and clinical outcomes, and examine genetic precision medicine of a novel digital therapeutic for obesity (dCBT-O). Method – This was an open-label, active-comparator, randomized controlled trial. Seventy female participants with body mass index (BMI) scores above 24kg/m² and no clinical problems besides obesity were randomized into experimental and control groups. The experimental group (dCBT-O group; 45 participants) was connected with a therapist intervention using a digital healthcare service that provided daily feedback and assignments for 8 weeks. The control group (25 participants) also used the digital healthcare service but practiced self-care without therapist intervention. Regarding the validating treatment efficacy, the primary outcomes of this study were objectively measured: weight in kg as well as other body compositions at 0, 8, and 24 weeks. Also, several eating behavioral phenotypes were assessed by buffet test-meal and food diary in app to examine the healthy behavioral change. Regarding the predictors for treatment efficacy, multidimensional digital phenotypes within time-series data were analyzed by elastic net regression method and obesity-related SNPs were genotyped from dCBT-O group. Result – Both weight (–3.1%, SD 4.5, vs –0.7%, SD 3.4; p = 0.036) and fat mass (–6.3%, SD 8.8, vs –0.8%, SD 8.1; p = 0.021) reduction at 8 weeks in the dCBT-O group were significantly higher than in the control group. Applying the machine learning approach, sixteen types of digital phenotypes (i.e., lower intake of high calorie food and evening snack, higher interaction frequency with mentors) predicted engagement rates, thirteen different digital phenotypes (i.e., lower intake of high calorie food and carb, higher intake of low calorie food) predicted the short-term weight change, and eight measures of digital phenotypes (i.e., lower intake of carb and evening snack, higher motivation) predicted the long-term weight change. The dCBT-O was also successful in promoting healthy eating behaviors that led to physiological and psychological adjustment for the metabolic mechanisms and consequences of healthy eating behavior. Lastly, CETP and APOA2 SNPs were significantly associated with the change in BMI (p = 0.028 and p = 0.005, respectively) at 24 weeks and eating behavioral phenotypes (p = 0.007 for healthy diet diversity and p = 0.036 for healthy diet proportion, respectively), the clinical efficacy markers of this study. Conclusion – These findings confirm that the multidisciplinary approach via digital modalities enhances the clinical efficacy of digital-based interventions for obesity. Moreover, it contributes to better understand the mechanisms of human eating behavior related to weight control. This line of research may shed light on the development of advanced prevention and personalized digital therapeutics.비만은 대표적인 생활습관 질병으로 알려져 있다. 따라서, 효과적인 비만 치료를 위해서는 다차원적인 치료적 접근이 중요시되는데, 디지털 치료제(Digital Therapeutics; DTx)는 이러한 접근에 최적화 되어있다. 본 연구의 목적은 새로 개발한 비만 디지털 치료제의 효과를 임상적 지표들과 섭식 행동 표현형들의 변화를 기반으로 검증하며, 치료적 순응도와 효과성을 예측할 수 있는 디지털 표현형들과 유전형들을 탐색하는 것이다. 본 연구에서는 BMI 24 이상, 기타 임상적인 증상을 보이지 않는 70명의 2-30대 여성들을 대상으로 대조군 대비 비만 디지털 치료제군(Digital Therapeutic for Obesity; dCBT-O군)에 1:2 비율의 무작위배정 임상시험을 시행하였다. dCBT-O군의 비만 치료는 임상심리학 전공 및 디지털 헬스케어 전문가가 8주 동안 진행하였으며, 24주차에는 치료 후 경과에 대한 평가를 실시하였다. 비만 디지털 치료제 효과 검증의 주요 지표는 체중을 비롯한 다양한 신체 계측 지표들의 변화이다. 이차 지표는 뷔폐실험과 모바일 어플리케이션 내 식단기록에서 수집된 섭식행동 표현형들을 기반으로 건강한 섭식행동 변화이다. 치료 순응도 및 효과 예측 인자들을 발굴하기 위해서는 다차원적인 시계열 디지털 표현형들을 머신러닝 기법으로 분석하였다. 그리고, 치료 반응 수준을 예측하는 유전형들을 찾기 위해 단일염기다형(Single Nucleotide Polymorphisms; SNP) 분석을 시행하였다. 본 연구의 주요 결과로 첫째, 8주간 치료 직후 dCBT-O군의 체중 변화가 대조군의 체중 변화에 비해 유의미하게 감량하였으며, 치료 종료 후 24주차도 체중이 감량 및 유지되었다. 둘째, dCBT-O군의 섭식행동이 대조군의 섭식행동에 비해 유의미하게 건강한 섭식행동으로 증진되었다. 셋째, 머신러닝 분석의 결과 16가지 디지털 표현형들이 치료적 순응도를 예측하고, 13가지 디지털 표현형들이 단기적인 치료효과를 예측하며, 8가지 디지털 표현형들이 장기적인 치료효과를 예측하였다. 마지막으로, CETP와 APOA2 SNP 유전형들이 신체계측 변화와 섭식행동변화와 유의미한 상관을 보였다. 본 연구는 디지털 기술을 활용한 다학제적인 접근이 비만 디지털 치료제의 임상 효과를 향상시킨다는 것을 보여준다. 또한 다차원적인 분석을 통해 체중 조절과 관련된 인간의 섭식 행동의 메커니즘을 더 잘 이해하는 데 기여한다. 본 연구는 첨단 예방의학과 정밀의학을 위한 디지털 치료제 개발에 중요한 패러다임을 제시할 것이다.Chapter 1. Introduction 1 Part I. Validating the treatment efficacy and finding its predictive markers: development of a dCBT-O 6 Part II. Eating behavioral analysis using buffet test-meal and food diary in app: understanding human eating behavior change by dCBT-O 8 Part III. Digital phenotyping using machine-learning analysis: identifying a predictive model for engagement in application and clinical outcomes of dCBT-O 11 Part IV. Genetic analysis for predicting the clinical responses: genetic precision medicine of dCBT-O 14 Chapter 2. Method 19 Chapter 3. Results 40 Chapter 4. Discussion 75 Perspectives A. Main issues related to DTx for obesity and eating behavior problems 91 Perspectives B. Limitations of DTx being applied in the clinics 96 Perspectives C. Future perspectives and recommendations 96 Chapter 5. Conclusion 99 Bibliography 100 Abstract in Korean 118 Acknowledgement 120박

    360 Quantified Self

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    Wearable devices with a wide range of sensors have contributed to the rise of the Quantified Self movement, where individuals log everything ranging from the number of steps they have taken, to their heart rate, to their sleeping patterns. Sensors do not, however, typically sense the social and ambient environment of the users, such as general life style attributes or information about their social network. This means that the users themselves, and the medical practitioners, privy to the wearable sensor data, only have a narrow view of the individual, limited mainly to certain aspects of their physical condition. In this paper we describe a number of use cases for how social media can be used to complement the check-up data and those from sensors to gain a more holistic view on individuals' health, a perspective we call the 360 Quantified Self. Health-related information can be obtained from sources as diverse as food photo sharing, location check-ins, or profile pictures. Additionally, information from a person's ego network can shed light on the social dimension of wellbeing which is widely acknowledged to be of utmost importance, even though they are currently rarely used for medical diagnosis. We articulate a long-term vision describing the desirable list of technical advances and variety of data to achieve an integrated system encompassing Electronic Health Records (EHR), data from wearable devices, alongside information derived from social media data.Comment: QCRI Technical Repor

    Testing the Feasibility of a Positive Psychology Mobile Health App for College Electronic Cigarette Users

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    Electronic cigarette (EC) use is common among college students, with over 50% endorsing lifetime use. Recent research shows Mobile Health (mHealth) technology is a promising tool to help address EC use in young adults. Yet only 3% of cessation apps were designed to facilitate quitting ECs and the majority lack empirical support of their effectiveness. The Smiling Instead of Smoking (SiS) app is a positive psychology-based smartphone app for nondaily smokers. Due to previous success with brief, self-administered positive psychology exercises for cigarette cessation, this study examined the SiS App’s feasibility and effectiveness for EC cessation. Sixteen undergraduates used the SiS app for 3 weeks: one week before their quit date and 2 weeks after. As hypothesized, participants had significant declines in their craving and maintained pre-cessation levels of positive affect. There were no significant changes in dependency or self-efficacy. At the one-month follow-up survey, 38% of participants reported being abstinent. The app had an almost 4-star rating for its features (e.g., functionality, aesthetics, information, etc.) and participants reported moderate satisfaction with its use. Participants used the app, on average, 10 out of the 21 days of the prescribed app use. This study highlights the promise of mHealth support and positive psychology for EC cessation, adding to the understanding of possible ways to support EC quit attempts

    Monitoring and Improving User Compliance and Data Quality For Long and Repetitive Self-Reporting MHealth Surveys

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    abstract: For the past decade, mobile health applications are seeing greater acceptance due to their potential to remotely monitor and increase patient engagement, particularly for chronic disease. Sickle Cell Disease is an inherited chronic disorder of red blood cells requiring careful pain management. A significant number of mHealth applications have been developed in the market to help clinicians collect and monitor information of SCD patients. Surveys are the most common way to self-report patient conditions. These are non-engaging and suffer from poor compliance. The quality of data gathered from survey instruments while using technology can be questioned as patients may be motivated to complete a task but not motivated to do it well. A compromise in quality and quantity of the collected patient data hinders the clinicians' effort to be able to monitor patient's health on a regular basis and derive effective treatment measures. This research study has two goals. The first is to monitor user compliance and data quality in mHealth apps with long and repetitive surveys delivered. The second is to identify possible motivational interventions to help improve compliance and data quality. As a form of intervention, will introduce intrinsic and extrinsic motivational factors within the application and test it on a small target population. I will validate the impact of these motivational factors by performing a comparative analysis on the test results to determine improvements in user performance. This study is relevant, as it will help analyze user behavior in long and repetitive self-reporting tasks and derive measures to improve user performance. The results will assist software engineers working with doctors in designing and developing improved self-reporting mHealth applications for collecting better quality data and enhance user compliance.Dissertation/ThesisMasters Thesis Computer Science 201

    START adolescents: study protocol of a randomised controlled trial to investigate the efficacy of a low-threshold group treatment programme in traumatised adolescent refugees

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    Introduction No evaluated therapeutic approaches, that can efficiently be established in routine mental healthcare, are currently available for traumatised adolescent refugees in Germany. This study evaluates the efficacy of the Stress-Traumasymptoms-Arousal-Regulation-Treatment (START) programme to reduce trauma-related symptoms and psychological distress in traumatised adolescent refugees based in Germany. Methods and analysis This randomised, waiting-list-controlled, multicentre trial with a 12-week follow-up will include 174 refugee minors with partial or full post-traumatic stress disorder who are fluent in either Arabic, Dari, English, German or Somali. Eligible refugee minors will be randomised to the START or waiting-list control groups. The manualised 8-week START programme is based on techniques of dialectical behaviour therapy (DBT), fosters adaptive coping with emotional distress and traumatic symptoms and comprises eight therapy modules and a booster session. Study assessments are planned at baseline, post-treatment (ie, after programme participation or waiting time), booster session at week 12 or 12-week waiting time, and at the 12-week follow-up. Primary and coprimary outcomes are changes in psychological distress and traumatic symptoms at post-treatment and will be analysed as response variables in linear mixed regression models. Secondary outcomes are changes in further trauma-related and other psychopathological symptoms, emotion regulation and intermediate effects of the programme at follow-up. We will also assess effects of the programme with ecological momentary assessments and on neuroendocrine stress parameters using hair cortisol. Ethics and dissemination This study has been approved by the lead ethics committee of Rhineland-Palatinate and the ethics committees of participating sites. The study results will be disseminated through peer-reviewed publications and scientific conferences

    Babies and Babble : parents’ experiences of the neonatal unit and the role of the Babble app : a thesis presented in partial fulfilment of the requirements for the degree Doctor of Clinical Psychology at Massey University, Auckland, New Zealand

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    Neonatal unit admission is commonly a highly distressing and difficult time for new parents, impacting their confidence in their parenting abilities and predisposing them to significant mental health difficulties (Ballantyne et al., 2017; Holditch-Davis & Miles, 2000). In response to admission, parents commonly report a need for clear, concise information and inclusion in neonatal care (Cleveland, 2008). Alongside the rise of technology and the prevalence of smartphones across the world, mobile health applications have been theorised as an effective method of delivering rapid, consistent and accessible information to health consumer populations. Within the neonatal sphere, such approaches have been growing in popularity, however, little research has focused on the development and efficacy of mobile health applications dedicated to needs of parents with an infant admitted to a neonatal unit. In response, MidCentral District Health Board has developed an informational mobile health application, Babble, for use in conjunction with traditional care formats and with the hopes of providing greater support to parents in neonatal units (Spargo & de Vries, 2018). Although utilised by parents, the Babble app is yet to be empirically evaluated and the impacts of its use are not well understood. In this thesis, an exploration as to parents’ experiences of the neonatal unit and the role of the Babble app is conducted in two parts. Study One explores the experiences of 449 parents with an infant admitted to a neonatal unit in New Zealand, across measures of distress, self-efficacy, how informed they felt during their infant’s admission, and their Babble app use. Study Two involved in-depth qualitative interviews with eight mothers from the Palmerston North neonatal unit, (where the Babble app originated), exploring their perspectives of their infant’s hospitalisation, and the Babble app itself. Study One showed that parents experienced moderate distress, felt reasonably informed and considered themselves to be somewhat confident in their parental role during their infant’s neonatal admission. The Babble app did not demonstrate any significant effect on any of the variables of interest. However, results indicated that the more informed parents felt, the less distress they experienced. This relationship was partially mediated by enhanced self-efficacy, suggesting the importance of information in supporting parental self-efficacy and reducing distress. Study Two expanded on these findings, identifying several key themes present in the experiences of mothers with infants admitted to a Level II+ neonatal unit. Firstly, findings indicated there were various ways in which mothers struggled with their parental role within a neonatal context, experiencing challenges related to managing their own expectations of the experience and asserting their role within the unit. Consistent and supportive relationships with staff, family, friends, and their partners, were seen as influential in the maternal experience. Most significantly, good communication and strong relationships with staff were seen to improve maternal confidence. Information was highly valued by mothers, with some variation in their interactions with information, depending on individual needs and styles. The Babble app was considered a useful adjunct to traditional care formats by mothers who identified that they were able to adapt and integrate its use in alignment with their individual preferences and needs. Taken together, these findings suggest that for families, neonatal admission is a challenging and diverse experience. Staff are essential, not only as sources of information, but as part of a supportive relationship with families. The importance of informational support cannot be understated and its value in building parental self-efficacy and reducing parental distress was evidenced across both studies. Ultimately, the findings presented here suggest that informational resources, such as Babble, can act supportively for parents and therefore, are worthy of further development and exploration
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