Implementation of a distributed guideline-based decision support model within a patient-guidance framework

We report on new projection engine which was developed in order to implement a distributed guideline-based decision support system (DSS) within the European project MobiGuide.In this model, small portions of the guideline knowledge are projected, i.e. 'downloaded', from a central DSS server to a local DSS in the patient's mobile device, which then applies that knowledge using the mobile device’s local resources. Furthermore, the projection engine generates guideline projections which are adapted to the patient’s previously defined preferences and, implicitly, to the patient’s current context, which is embodied in the projected knowledge. We evaluated this distributed guideline application model for two complex guidelines: one for Gestational Diabetes Mellitus, and one for Atrial Fibrillation. We found that the initial specification of what we refer to as the customized guideline should be in the terms of the distributed DSS, i.e., include two levels: one for the central DSS, and one for the local DSS. In addition, we found significant differences between the customized, distributed versions of the two guidelines, indicating further research directions and possibly additional ways to analyze and characterize guidelines

Social media for health promotion in diabetes: study protocol for a participatory public health intervention design

BACKGROUND: Participatory health approaches are increasingly drawing attention among the scientific community, and could be used for health promotion programmes on diabetes through social media. The main aim of this project is to research how to best use social media to promote healthy lifestyles with and within the Norwegian population. METHODS: The design of the health promotion intervention (HPI) will be participatory, and will involve both a panel of healthcare experts and social media users following the Norwegian Diabetes Association. The panel of experts will agree on the contents by following the Delphi method, and social media users will participate in the definition of the HPI by expressing their opinions through an adhoc online questionnaire. The agreed contents between both parties to be used in the HPI will be posted on three social media channels (Facebook, Twitter and Instagram) along 24 months. The 3 months before starting the HPI, and the 3 months after the HPI will be used as control data. The effect of the HPI will be assessed by comparing formats, frequency, and reactions to the published HPI messages, as well as comparing potential changes in five support-intended communication behaviours expressed on social media, and variations in sentiment analysis before vs during and after the HPI. The HPI's effect on social media users' health-related lifestyles, online health behaviours, and satisfaction with the intervention will be assessed every 6 months through online questionnaires. A separate questionnaire will be used to assess the panel of experts' satisfaction and perceptions of the benefits for health professionals of a HPI as this one. DISCUSSION: The time constraints of today's medical practice combined with the piling demand of chronic conditions such as diabetes make any additional request of extra time used by health care professionals a challenge. Social media channels provide efficient, ubiquitous and user-friendly platforms that can encourage participation, engagement and action necessary from both those who receive and provide care to make health promotion interventions successful

Evaluation of breastfeeding mobile health applications based on the persuasive system design model

The rapid and ongoing growth in information technology has created many applications for health and wellbeing, including breastfeeding. However, due to a lack of rigorous evaluation of these applications, midwives and other health professionals are unable to recommend any specific breastfeeding application in supporting women towards long-term breastfeeding as a global challenge. Only half of women in developed countries continue any form of breastfeeding for six months. The aim of this study was to evaluate the existing breastfeeding applications based on the Persuasive System Design model. An online search was conducted of the Apple Store in May 2017. The search strategy included the following keywords: breastfeeding, lactation and breast milk. After being checked against the inclusion criteria, each application was assessed based on the four Persuasive System Design Principles. Data from each application was then compared for each element of the design model. Eleven applications met the inclusion criteria and were included in the review. Primary task support and system credibility support principles were addressed at acceptable level in all of the included apps. However, dialogue support and social support principles and their features like praise, reward and social networking were not identified in many of the applications. This review demonstrates the lack of dialogue support and social support principles that could augment human to computer dialogue. There is a need for designing a breastfeeding app that can persuade women to engage and continue breastfeeding based on a full Persuasive System Design model, thus promoting long term breastfeeding