Randomized trial of a phone- and web-based weight loss program for women at elevated breast cancer risk: the HELP study

Excess weight and physical inactivity are modifiable risk factors for breast cancer. Behavioral intervention is particularly important among women with an elevated risk profile. This trial tested an intervention that trained women to use a self-monitoring website to increase activity and lose weight. Women with BMI≥27.5 kg/m(2) at elevated breast cancer risk were randomized to the intervention (N=71) or usual care (N=34). The intervention group received telephone-based coaching and used web-based self-monitoring tools. At 6 months, significant weight loss was observed in the intervention group (4.7% loss from starting weight; SD=4.7%) relative to usual care (0.4% gain; SD=3.0%) (p<.0001). By 12 months, the intervention group had lost 3.7% of weight (SD=5.4%), compared to 1.3% (SD=4.2) for usual care (p=.003). At 12 months, accelerometer-measured moderate-to-vigorous physical activity increased by 12 min/day (SD=24) compared to no change in usual care (p=.04. In summary, this web- and phone-based approach produced modest but significant improvements in weight and physical activity for women at elevated breast cancer risk

Telehealth Palliative Care Needs Rounds During a Pandemic

Older people living in care homes deserve access to specialist palliative care in their last months of life, and this has never been more important than during a global pandemic. Palliative Care Needs Rounds facilitated by nurse practitioners are cost-effective, reduce avoidable hospital transfers, improve quality of death and dying, and increase the capacity of staff to recognize and plan for care for dying residents in care homes. Conducting Palliative Care Needs Rounds via telehealth increases access to specialist palliative care while reducing the risk of coronavirus disease 2019 transmission

Opportunities for technology use for self-management in chronic kidney disease: The TELI-CKD study

Background Australians are considered early adopts of technology with over 80% using the internet and over 90% having a mobile phone. In healthcare, technology can be used to support self-education, improve communication, and enhance clinician-patient relationships. However, current technology use amongst our Australian CKD population is unknown. Aim To investigate the use of technology in people with CKD. Methods A 38-item self-report survey was distributed to consenting CKD stage 1 to 5 (dialysis) patients across five health districts. Demographics, current technology use (internet and mobile phone), reported barriers and opportunities to support CKD self-management. Results Of the 619 (n= 244 dialysis) participants, 48% were >60 years; mostly male (54%), not on dialysis (59%), and had more than 10 years of schooling (52%). The vast majority had access to a computer (90%) and used the internet at home (77%). Only 25% were aware of websites to get information about renal healthcare. Overall 85% reported owning a mobile phone; of these, 66% were smartphones. Mobile phones were mostly used for making calls (86%) and sending/receiving SMS (81%). In those with smartphones only 38% used apps. About half (51%) indicated a willingness to use technology for their renal healthcare. Barriers were did not know how to use (16%) and did not like to use (13%). Conclusion Those with CKD are using the internet and mobile phone mostly for communication. The wide-spread introduction of technology to support self-management may be justifiable, however in the non-dialysis group in-person education and support is still required

Evaluating the prevalence and opportunity for technology use in chronic kidney disease patients: a cross-sectional study

Background Chronic kidney disease (CKD) is increasing worldwide and early education to improve adherence to self-management is a key strategy to slow CKD progression. The use of the internet and mobile phone technologies (mHealth) to support patients is considered an effective tool in many other chronic disease populations. While a number of mHealth platforms for CKD exist, few studies have investigated if and how this population use technology to engage in self-management. Methods Using a cross-sectional design across five health districts in Queensland (Australia), a 38-item self-report survey was distributed to adults with CKD attending outpatient clinics or dialysis units to measure current use and type of engagement with mHealth, perceived barriers to use, and opportunities to support CKD self-management. Odds ratio (OR) were calculated to identify associations between demographic characteristic and mHealth use. Results Of the 708 participants surveyed, the majority had computer access (89.2%) and owned a mobile phone (83.5%). The most likely users of the internet were those aged ≤60 years (OR: 7.35, 95% confidence interval [CI]: 4.25-12.75, p<0.001), employed (OR: 7.67, 95% CI: 2.58-22.78, p<0.001), from non-indigenous background (OR: 6.98, 95% CI: 3.50-13.93, p<0.001), or having completed higher levels of education (OR: 3.69, CI: 2.38-5.73, p<0.001). Those using a mobile phone for complex communication were also younger (OR: 6.01, 95% CI: 3.55-10.19, p<0.001), more educated (OR: 1.99, 95% CI: 1.29-3.18, p<0.01), or from non-indigenous background (OR: 3.22, 95% CI: 1.58-6.55, p<0.001). Overall, less than 25% were aware of websites to obtain information about renal healthcare. The mHealth technologies most preferred for communication with their renal healthcare teams were by telephone (56.5%), internet (50%), email (48.3%) and text messages (46%). Conclusion In the CKD cohort, younger patients are more likely than older patients to use mHealth intensively and interactively although all patients’ technology literacy ought to be thoroughly assessed by renal teams before implementing in practice. Further research testing mHealth interventions to improve self-management in a range of patient cohorts is warranted

Evaluating the prevalence and opportunity for technology use in chronic kidney disease patients: a cross-sectional study

Background Chronic kidney disease (CKD) is increasing worldwide and early education to improve adherence to self-management is a key strategy to slow CKD progression. The use of the internet and mobile phone technologies (mHealth) to support patients is considered an effective tool in many other chronic disease populations. While a number of mHealth platforms for CKD exist, few studies have investigated if and how this population use technology to engage in self-management. Methods Using a cross-sectional design across five health districts in Queensland (Australia), a 38-item self-report survey was distributed to adults with CKD attending outpatient clinics or dialysis units to measure current use and type of engagement with mHealth, perceived barriers to use, and opportunities to support CKD self-management. Odds ratio (OR) were calculated to identify associations between demographic characteristic and mHealth use. Results Of the 708 participants surveyed, the majority had computer access (89.2%) and owned a mobile phone (83.5%). The most likely users of the internet were those aged ≤60 years (OR: 7.35, 95% confidence interval [CI]: 4.25-12.75, p<0.001), employed (OR: 7.67, 95% CI: 2.58-22.78, p<0.001), from non-indigenous background (OR: 6.98, 95% CI: 3.50-13.93, p<0.001), or having completed higher levels of education (OR: 3.69, CI: 2.38-5.73, p<0.001). Those using a mobile phone for complex communication were also younger (OR: 6.01, 95% CI: 3.55-10.19, p<0.001), more educated (OR: 1.99, 95% CI: 1.29-3.18, p<0.01), or from non-indigenous background (OR: 3.22, 95% CI: 1.58-6.55, p<0.001). Overall, less than 25% were aware of websites to obtain information about renal healthcare. The mHealth technologies most preferred for communication with their renal healthcare teams were by telephone (56.5%), internet (50%), email (48.3%) and text messages (46%). Conclusion In the CKD cohort, younger patients are more likely than older patients to use mHealth intensively and interactively although all patients’ technology literacy ought to be thoroughly assessed by renal teams before implementing in practice. Further research testing mHealth interventions to improve self-management in a range of patient cohorts is warranted

Evaluating the prevalence and opportunity for technology use in chronic kidney disease patients: a cross-sectional study

Abstract Background Chronic kidney disease (CKD) is increasing worldwide and early education to improve adherence to self-management is a key strategy to slow CKD progression. The use of the internet and mobile phone technologies (mHealth) to support patients is considered an effective tool in many other chronic disease populations. While a number of mHealth platforms for CKD exist, few studies have investigated if and how this population use technology to engage in self-management. Methods Using a cross-sectional design across five health districts in Queensland (Australia), a 38-item self-report survey was distributed to adults with CKD attending outpatient clinics or dialysis units to measure current use and type of engagement with mHealth, perceived barriers to use, and opportunities to support CKD self-management. Odds ratio (OR) were calculated to identify associations between demographic characteristic and mHealth use. Results Of the 708 participants surveyed, the majority had computer access (89.2%) and owned a mobile phone (83.5%). The most likely users of the internet were those aged ≤ 60 years (OR: 7.35, 95% confidence interval [CI]: 4.25–12.75, p < 0.001), employed (OR: 7.67, 95% CI: 2.58–22.78, p < 0.001), from non-indigenous background (OR: 6.98, 95% CI: 3.50–13.93, p < 0.001), or having completed higher levels of education (OR: 3.69, CI: 2.38–5.73, p < 0.001). Those using a mobile phone for complex communication were also younger (OR: 6.01, 95% CI: 3.55–10.19, p < 0.001), more educated (OR: 1.99, 95% CI: 1.29–3.18, p < 0.01), or from non-indigenous background (OR: 3.22, 95% CI: 1.58–6.55, p < 0.001). Overall, less than 25% were aware of websites to obtain information about renal healthcare. The mHealth technologies most preferred for communication with their renal healthcare teams were by telephone (56.5%), internet (50%), email (48.3%) and text messages (46%). Conclusion In the CKD cohort, younger patients are more likely than older patients to use mHealth intensively and interactively although all patients’ technology literacy ought to be thoroughly assessed by renal teams before implementing in practice. Further research testing mHealth interventions to improve self-management in a range of patient cohorts is warranted

Additional file 1: of Evaluating the prevalence and opportunity for technology use in chronic kidney disease patients: a cross-sectional study

Telehealth survey instrument. (PDF 162 kb