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In recent years, increasing attention has been paid to identifying new approaches to improve workplace well-being and manage stress with the help of m-health solutions. The primary purpose of this review is to provide an overview of the current use of smartphone applications integrated with wearable technologies in stress management and the promotion of well-being in the workplace. A key terms literature search was performed using multiple electronic databases. The review process followed the international PRISMA statement guidelines. A quality assessment was conducted using the Mixed Methods Appraisal Tool. A total of 25 eligible papers published between 2016 and 2023 were included. Interventions proposed were heterogeneous and primarily based on smartphone applications (72%). 84% of the interventions had background theories, with a high preference for Mindfulness. Interventions were reported as generally significant, and the combined use of smartphone applications and wearable technologies increased awareness at the individual and collective levels. In conclusion, the review demonstrates how the interventions developed through the synergy of technologies can effectively promote well-being and reduce stress in the workplace context, decreasing the stigma still related to mental health and increasing peer support strategies. This work opens the doors to several possibilities for future research. It could be interesting to indagate more in-depth the value of integration between technologies and, eventually, the integration with more traditional type of interventions, e.g., face-to-face activities, evaluating if this synergy can amplify and strengthen the results. Protocol registration: The review protocol was registered with PROSPERO: CRD42023423126 (May 2nd, 2023).

Electronic health, or e-Health, can revolutionize the clinical management of tuberculosis (TB) through enhanced treatment efficiency and effectiveness, among other benefits. Regarding TB, this may entail teleconsultation, which allows medical professionals to speak with TB specialists remotely, or telemonitoring, which allows patients to be remotely monitored using digital technology. This paper aims to determine the effectiveness of tele-counselling in enhancing adherence to patient tuberculosis. We used the Scopus database, Science Direct, Ebsco Host, and PubMed for English published between 2018 and 2023: the Joanna Briggs Institute guidelines assessed eligibility, PRISMA quality, and a checklist to guide this review. The articles have case-control, quasi-experimental, mixed method studies, and randomized control trials (RCT). E-counseling was included in the analysis if they focused on tuberculosis and were excluded if unrelated to other disease areas. Fifteen articles that could be used in this review were found. The majority of the population were adults. Results of the review showed that most m-Health apps support tuberculosis treatment. There are numerous ways that electronic counseling, or “e-counseling,” may improve adherence to TB treatment. This study illustrated how m-health might improve patient comprehension and adherence. The five goals of the World Health Organization (WHO) e-Health framework are being met using more e-Health treatments to treat TB. Among the technology interventions demonstrated to have a significant, positive effect on disease outcomes are smartphone apps, mobile voice conversations, SMS, and instructive films. Keywords: E-counselling; m-Health; tuberculosis; patient adherence

Electronic health, or e-Health, can revolutionize the clinical management of tuberculosis (TB) through enhanced treatment efficiency and effectiveness, among other benefits. Regarding TB, this may entail teleconsultation, which allows medical professionals to speak with TB specialists remotely, or telemonitoring, which allows patients to be remotely monitored using digital technology. This paper aims to determine the effectiveness of tele-counselling in enhancing adherence to patient tuberculosis. We used the Scopus database, Science Direct, Ebsco Host, and PubMed for English published between 2018 and 2023: the Joanna Briggs Institute guidelines assessed eligibility, PRISMA quality, and a checklist to guide this review. The articles have case-control, quasi-experimental, mixed method studies, and randomized control trials (RCT). E-counseling was included in the analysis if they focused on tuberculosis and were excluded if unrelated to other disease areas. Fifteen articles that could be used in this review were found. The majority of the population were adults. Results of the review showed that most m-Health apps support tuberculosis treatment. There are numerous ways that electronic counseling, or “e-counseling,” may improve adherence to TB treatment. This study illustrated how m-health might improve patient comprehension and adherence. The five goals of the World Health Organization (WHO) e-Health framework are being met using more e-Health treatments to treat TB. Among the technology interventions demonstrated to have a significant, positive effect on disease outcomes are smartphone apps, mobile voice conversations, SMS, and instructive films. Keywords: E-counselling; m-Health; tuberculosis; patient adherence

Introduction: The increase in the use of mobile apps since the COVID-19 pandemic, even among people with multiple sclerosis (PwMS) and health care providers (HCPs), has enabled access to reliable information, symptoms monitoring and management, and social connections. The pandemic has undoubtedly contributed to the acceleration of the "digital revolution." But how far has it progressed for the MS communities?Methods: Italian Google Play and App Store were queried, selecting MS-specific apps in English or Italian language and usable by a wide public.Results: Fifty-four (n = 54) MS-specific apps were identified; most were PwMS-oriented (83%), free of charge (94%), and in English language (76%). The 45 PwMS-oriented apps focused on increasing MS knowledge (71%), tracking symptoms (33%), and promoting networking with peers or HCPs (38%). The 13 HCPs-oriented tools addressed education and updates on MS (62%), disease assessment and management (54%), and research (15%). Google Search tool was also queried to find non-MS-specific apps to fulfill some unmet domains (as sleep, pain, sexual or mental health). Twenty-four additional apps were listed to provide a valuable contribution.Conclusion: The "digital revolution" led to increasingly customized tools for PwMS, especially as m-health or social-networking apps. However, apps to support other specific MS-relevant domains, appealing HCPs-oriented apps, and specific mobile tools for MS caregivers are still lacking. The absence of data assessing the usability and quality of MS apps in ecologically contexts leads to not reliable conclusions about potential benefits. A strong dialogue between MS communities and the digital industry is encouraged to fill this gap.

Background Diabetes type 2 is a metabolic disease in which insulin production is either completely absent or too small in relation to the body's needs and/or the body's ability to assimilate the insulin is reduced. Untreated, the disease leads to harmfully high blood sugar levels and subsequent complications such as damage to vital organs and death. The incidence has increased significantly globally during the last thirty years, especially within the group of young adults. Reduced physical activity, overweight and obesity, and increased longevity are the driving factors behind the increased incidence in Sweden. Self-care is an important part of treating the disease and new technological innovations have paved the way for a new type of digital support for patients in their self-care. Aim The aim was to describe patients' experience of self-care with the help of m-health in diabetes type 2. Method The study was done with a non-systematic literature review which included 15 scientific articles from two databases (PubMed and CINAHL). Of the included articles, 13 had a qualitative approach and 2 had a quantitative approach, all of which have undergone a quality review. The result was iterated through integrated data analysis. Results The result generated 3 main themes: perceived enablers for the use of m-health, perceived barriers to the use of m-health, and the experience of interaction and information sharing. The results showed that most participants experienced positive effects from the use such as strengthened self-confidence, increased knowledge, and increased self-care skills. Some of the participants, however, experienced obstacles before use, in the form of prejudices, but also obstacles during use which was identified as a barrier to integrating the application into everyday life. Conclusions The experience of using a mobile application for self-care support largely depends on the individual's personal characteristics, life situation, and possible co-morbiditie, Bakgrund Diabetes typ 2 är en metabol sjukdom där insulinproduktionen antingen helt saknas eller är för liten i relation till kroppens behov och/eller att kroppens förmåga att tillgodogöra sig insulinet är nedsatt. Obehandlat leder sjukdomen till skadligt höga blodsockernivåer och följdkomplikationer som skador på vitala organ och dödsfall. Förekomsten har ökat kraftigt globalt under de senaste trettio åren, speciellt inom gruppen unga vuxna. Minskad fysisk aktivitet, övervikt och fetma samt ökad livslängd pekas ut som de drivande faktorerna bakom den ökade förekomsten i Sverige. Egenvård är en viktig del av behandling av sjukdomen och nya tekniska innovationer har banat väg för en ny typ av digitalt stöd för egenvård. Syfte Syftet var att beskriva patienters upplevelser av m-hälsa som stöd för egenvård vid diabetes typ 2. Metod Studien gjordes som en icke-systematisk litteraturöversikt vilken inkluderade 15 vetenskapliga artiklar från 2 databaser (PubMed och CINAHL). Av de inkluderade artiklarna hade 13 av dem kvalitativ ansats och 2 kvantitativ ansats, samtliga har genomgått en kvalitetsgranskning. Resultatet arbetades fram genom en integrerad dataanalys. Resultat Resultatet genererade 3 huvudteman: upplevda möjliggörare för användandet av m-hälsa, upplevda hinder för användandet av m-hälsa och upplevelsen av interaktion och informationsdelande. Resultatet visade att majoriteten av deltagarna upplevde positiva effekter av användandet såsom stärkt självförtroende, ökad kunskap och ökad egenvårdsförmåga. En del av deltagarna upplevde dock hinder inför användandet i form av fördomar, men även hinder under användandet som gav svårigheter att integrera applikationen i vardagen. Slutsats Upplevelsen av användandet beror till stor del på individens personliga egenskaper, livssituation och eventuell samsjuklighet. I litteraturstudien dras slutsatsen att dessa insikter är viktig kunskap för sjuksköterskan för att ge adekvat stöd i egenvården till varje patient.

Background Diabetes type 2 is a metabolic disease in which insulin production is either completely absent or too small in relation to the body's needs and/or the body's ability to assimilate the insulin is reduced. Untreated, the disease leads to harmfully high blood sugar levels and subsequent complications such as damage to vital organs and death. The incidence has increased significantly globally during the last thirty years, especially within the group of young adults. Reduced physical activity, overweight and obesity, and increased longevity are the driving factors behind the increased incidence in Sweden. Self-care is an important part of treating the disease and new technological innovations have paved the way for a new type of digital support for patients in their self-care. Aim The aim was to describe patients' experience of self-care with the help of m-health in diabetes type 2. Method The study was done with a non-systematic literature review which included 15 scientific articles from two databases (PubMed and CINAHL). Of the included articles, 13 had a qualitative approach and 2 had a quantitative approach, all of which have undergone a quality review. The result was iterated through integrated data analysis. Results The result generated 3 main themes: perceived enablers for the use of m-health, perceived barriers to the use of m-health, and the experience of interaction and information sharing. The results showed that most participants experienced positive effects from the use such as strengthened self-confidence, increased knowledge, and increased self-care skills. Some of the participants, however, experienced obstacles before use, in the form of prejudices, but also obstacles during use which was identified as a barrier to integrating the application into everyday life. Conclusions The experience of using a mobile application for self-care support largely depends on the individual's personal characteristics, life situation, and possible co-morbiditie, Bakgrund Diabetes typ 2 är en metabol sjukdom där insulinproduktionen antingen helt saknas eller är för liten i relation till kroppens behov och/eller att kroppens förmåga att tillgodogöra sig insulinet är nedsatt. Obehandlat leder sjukdomen till skadligt höga blodsockernivåer och följdkomplikationer som skador på vitala organ och dödsfall. Förekomsten har ökat kraftigt globalt under de senaste trettio åren, speciellt inom gruppen unga vuxna. Minskad fysisk aktivitet, övervikt och fetma samt ökad livslängd pekas ut som de drivande faktorerna bakom den ökade förekomsten i Sverige. Egenvård är en viktig del av behandling av sjukdomen och nya tekniska innovationer har banat väg för en ny typ av digitalt stöd för egenvård. Syfte Syftet var att beskriva patienters upplevelser av m-hälsa som stöd för egenvård vid diabetes typ 2. Metod Studien gjordes som en icke-systematisk litteraturöversikt vilken inkluderade 15 vetenskapliga artiklar från 2 databaser (PubMed och CINAHL). Av de inkluderade artiklarna hade 13 av dem kvalitativ ansats och 2 kvantitativ ansats, samtliga har genomgått en kvalitetsgranskning. Resultatet arbetades fram genom en integrerad dataanalys. Resultat Resultatet genererade 3 huvudteman: upplevda möjliggörare för användandet av m-hälsa, upplevda hinder för användandet av m-hälsa och upplevelsen av interaktion och informationsdelande. Resultatet visade att majoriteten av deltagarna upplevde positiva effekter av användandet såsom stärkt självförtroende, ökad kunskap och ökad egenvårdsförmåga. En del av deltagarna upplevde dock hinder inför användandet i form av fördomar, men även hinder under användandet som gav svårigheter att integrera applikationen i vardagen. Slutsats Upplevelsen av användandet beror till stor del på individens personliga egenskaper, livssituation och eventuell samsjuklighet. I litteraturstudien dras slutsatsen att dessa insikter är viktig kunskap för sjuksköterskan för att ge adekvat stöd i egenvården till varje patient.

Background: Suicide is a major global public health issue that is becoming increasingly common despite preventive efforts. Though current methods for predicting suicide risk are not sufficiently accurate, technological advances provide invaluable tools with which we may evolve toward a personalized, predictive approach. Objective: We aim to predict the short-term (1-week) risk of suicide by identifying changes in behavioral patterns characterized through real-time smartphone monitoring in a cohort of patients with suicidal ideation. Methods: We recruited 225 patients between February 2018 and March 2020 with a history of suicidal thoughts and behavior as part of the multicenter SmartCrisis study. Throughout 6 months of follow-up, we collected information on the risk of suicide or mental health crises. All participants underwent voluntary passive monitoring using data generated by their own smartphones, including distance walked and steps taken, time spent at home, and app usage. The algorithm constructs daily activity profiles for each patient according to these data and detects changes in the distribution of these profiles over time. Such changes are considered critical periods, and their relationship with suicide-risk events was tested. Results: During follow-up, 18 (8%) participants attempted suicide, and 14 (6.2%) presented to the emergency department for psychiatric care. The behavioral changes identified by the algorithm predicted suicide risk in a time frame of 1 week with an area under the curve of 0.78, indicating good accuracy. Conclusions: We describe an innovative method to identify mental health crises based on passively collected information from patients' smartphones. This technology could be applied to homogeneous groups of patients to identify different types of crises.

El alcohol es la sustancia psicoactiva más consumida a nivel global. Su uso tiene consecuencias negativas para la salud física y psicológica, suponiendo su consumo excesivo un importante problema de salud pública. El uso de herramientas digitales para llevar a cabo intervenciones psicológicas dirigidas al abordaje del consumo de sustancias ha experimentado un notable crecimiento en los últimos años. El objetivo del presente trabajo es revisar la literatura científica que examina los resultados de las intervenciones de salud móvil destinadas a la prevención e intervención del consumo de alcohol. Los resultados de la revisión apoyan la efectividad de las herramientas digitales, tanto web como aplicaciones móviles, para prevenir y abordar el consumo, a pesar de que algunos de los trabajos no encontraron efectos significativos. Además, una limitación presente en todos los estudios fue la alta tasa de abandono de los programas, siendo necesario potenciar la adherencia al tratamiento de los participantes. Finalmente, se ha diseñado una propuesta de intervención basada en una aplicación móvil y dirigida a la población joven universitaria, con el objetivo de abordar el consumo de riesgo de alcohol, Alcohol is the most widely consumed psychoactive substance worldwide. Its use has negative consequences for physical and psychological health, and its excessive consumption is a major public health problem. The use of digital tools to carry out psychological interventions aimed at addressing substance use has experienced a remarkable growth in recent years. The aim of this paper is to review the scientific literature examining the outcomes of mobile health interventions aimed at alcohol prevention and intervention. The results of the review support the effectiveness of digital tools, both web and mobile applications, to prevent and address consumption, despite the fact that some of the papers found no significant effects. In addition, a limitation present in all the studies was the high dropout rate of the programs, being necessary to enhance adherence to treatment of the participants. Finally, an intervention proposal has been designed based on a mobile application and aimed at the young university population, with the objective of addressing the risk consumption of alcohol

Background: Dengue fever is the most common viral infection transmitted by Aedes mosquitoes. This disease puts more than 3.9 billion people from 129 countries at risk of contracting dengue fever and causes 40,000 deaths each year. This study aims to analyze the effectiveness of SI-DBD applications for finding, recording, and reporting suspected cases of dengue. Methods: This type of research is a quasi-experiment with The Nonrandomized Control Group Pretest Posttest Design, namely there were two treatment groups (SI-DBD application users) at RT 02 and (a control group) at RT. 01, with a sample of 112 households (1:1 ratio). Data was collected through interviews and reports of suspected dengue fever. Results: There was an increase in reporting of suspected dengue after using the Application of the Dengue Hemorrhagic Fever Information System (SI-DBD) (233.33%). Statistical test results in the intervention group's simplicity, acceptability, data quality, and timeliness had p < 0.000, meaning that there were significant differences in all variables studied in the reporting system using the SI-DBD application. In the control group, statistical tests showed that the acceptability variable had a p < 0.0001, meaning that there were significant differences in the acceptability variable in the use of the manual system before and during the study while the variables were for simplicity, data quality, and timeliness had a p > 0.1797, 0.0833, 0.5567 means that there is no significant difference in these variables in the manual reporting system. Conclusion: SI-DBD application is effective for recording and reporting suspected dengue.

Simple Summary Mobile applications in clinical treatment are becoming increasingly popular among cancer patients and survivors. The COVID-19 pandemic demonstrated the importance of digital interventions in patient monitoring. We conducted a scoping review and classified Mobile Health (mHealth) trials into sub-groups based on intervention methodologies, lifestyle variables, and their effectiveness on cancer health outcomes. Our study identified the key elements of the mHealth approach for cancer care, including interactive support, personalized suggestions, active participation of users, wearable technology and rigorous theory-based solutions. We also established a taxonomy that can be employed by application developers and medical specialists in developing future mHealth cancer care solutions. Mobile Health (mHealth) has a great potential to enhance the self-management of cancer patients and survivors. Our study aimed to perform a scoping review to evaluate the impact and trends of mobile application-based interventions on adherence and their effects on health outcomes among the cancer population. In addition, we aimed to develop a taxonomy of mobile-app-based interventions to assist app developers and healthcare researchers in creating future mHealth cancer care solutions. Relevant articles were screened from the online databases PubMed, EMBASE, and Scopus, spanning the time period from 1 January 2016 to 31 December 2022. Of the 4135 articles initially identified, 55 were finally selected for the review. In the selected studies, breast cancer was the focus of 20 studies (36%), while mixed cancers were the subject of 23 studies (42%). The studies revealed that the usage rate of mHealth was over 80% in 41 of the 55 studies, with factors such as guided supervision, personalized suggestions, theoretical intervention foundations, and wearable technology enhancing adherence and efficacy. However, cancer progression, technical challenges, and unfamiliarity with devices we

Cardiovascular diseases are one of the leading causes of death in the world and in Cuba. Hypertension has a very considerable prevalence in the Cuban population, being the risk factor with the highest occurrence. As part of the process of computerization and distribution of knowledge, the objective of the work is to present an application for the Android operating system to contribute to the diagnosis, evaluation and treatment of Hypertension in a more accessible way to the population and medical staff, including other tools for the best hypertension control. This tool is targeted to, fundamentally, to primary health care and focuses on the Patient Pathway. The application contains a guiding text, calculators of medical interest, pharmacological and non-pharmacological recommendations depending on the clinical evaluation. In addition, it includes the strategy of hypertension treatment in Cuba according to the individual clinical evaluation, clarifying the drugs to be used. It also includes an interface for the acquisition of data from individuals. The application obtained an average SUS score of 93.61, after being evaluated by cardiology specialists and non-specialists., Las enfermedades cardiovasculares son una de las principales causas de muerte en el mundo y en Cuba. La hipertensión arterial tiene una prevalencia muy considerable en la población cubana, siendo el factor de riesgo de mayor ocurrencia. Como parte del proceso de informatización y difusión del conocimiento, el objetivo del trabajo es presentar una aplicación para el sistema operativo Android que contribuya al diagnóstico, evaluación y tratamiento de la Hipertensión Arterial de una manera más accesible a la población y personal médico. incluyendo otras herramientas para el mejor control de la hipertensión. Esta herramienta está dirigida, fundamentalmente, a la atención primaria de salud y se centra en la Ruta del Paciente. La aplicación contiene un texto guía, calculadoras de interés médico, recomendaciones farmacológicas y no farmacológicas según la evaluación clínica. Además, incluye la estrategia de tratamiento de la hipertensión en Cuba según la evaluación clínica individual, aclarando los fármacos a utilizar. También incluye una interfaz para la adquisición de datos de personas. La aplicación obtuvo un puntaje SUS promedio de 93,61, luego de ser evaluada por especialistas y no especialistas en cardiología.

Introduction: Pelvic floor exercises are effective in the treatment of urinary incontinence (UI) and are routinely prescribed, along with bladder training, by primary healthcare providers as first line conservative management. Mobile phone applications are increasingly popular within the healthcare setting and can provide opportunities for patients to complete treatments at home. To date, there has not been a systematic review examining outcomes from randomised controlled trials on the effectiveness of mobile applications to improve UI. Methods: A systematic review of randomized controlled trials evaluating the effectiveness of mobile applications to improve UI was carried out according to the PRISMA reporting guidelines. The online databases MEDLINE, Embase, PsychINFO, CINAHL, Web of Science, Scopus, The Cochrane Library, Joanna Briggs Institute (JBI), Google Scholar were searched for papers published between 2007 to 2020. Keywords and MeSH terms were used to identify relevant English language studies. The quality and risk of bias within included studies was assessed by two independent reviewers, RCT JBI critical appraisal tool. Due to heterogeneity in the outcome of studies, a meta-analysis of the data could not be conducted. Findings: Four studies reported an improvement in the outcome assessed post-intervention, suggesting that using mobile phone applications for pelvic floor muscle training (PFMT) was an acceptable and valid intervention to improve UI. Conclusion: Mobile applications for PFMT indicated that increase adherence to treatment and decrease UI. The integration of this treatment modality into current practice is recommended. Mobile phone applications for PFMT show promise in the conservative management of UI. Further research is required to support the use of this technology in the conservative management of UI.

[EN] Objective: The main objective is to transfer to clinical practice a new smoking cessation appli- M-health; cation ("Vive sin Tabaco" a) in all health centers of the public Basque Health Service. Design: An implementation study of a smoking cessation program previously validated. After implementation, a retrospective study has been carried out to evaluate its use under normal conditions. Site: The process of transfer to clinical practice has been held in several phases; first a pilotage in four health centers of Alava and subsequently, when all reported incidents were resolved, it was extended to all health centers of the Basque Health Service. Intervention and main measurement: Development of "Vive sin Tabaco"; a corporate toot for smoking cessation, and its transfer to clinical practice. All interested health care workers received training on how to use the application. User manuals for both patients and professionals were developed. Smoking cessation rates at 12 months during implementation were also collected. Results: The percentage of patients of post pilot phase who quit smoking at 12 months was 14.1%. Conclusions: The conception of "Vive sin tabaco" as a corporate tool for smoking cessation, available in all health centers of Basque Health Service, has been long and arduous, and has required the participation of health professionals and patients as end-users in order to obtain a toot that adapts to their expectations and guarantees greater usability and satisfaction. This application is being effective as an adjuvant tool to health advice.

Background: Chronic pain is a prolonged condition that deteriorates one’s quality of life. Treating chronic pain requires a multicomponent approach, and in many cases, there are no “silver bullet” solutions. Mobile health (mHealth) is a rapidly expanding category of solutions in digital health with proven potential in chronic pain management. Objective: This study aims to contrast the viewpoints of 2 groups of people with chronic pain concerning mHealth: people who have adopted the use of mHealth and those who have not. We highlight the benefits of mHealth solutions for people with chronic pain and the perceived obstacles to their increased adoption. We also provide recommendations to encourage people to try mHealth solutions as part of their self-care. Methods: The Prolific crowdsourcing platform was used to collect crowdsourced data. A prescreening questionnaire was released to determine what type of pain potential participants have and whether they are currently using mHealth solutions for chronic pain. The participants were invited based on their experience using mHealth to manage their pain. Similar questions were presented to mHealth users and nonusers. Qualitative and quantitative analyses were performed to determine the outcomes of this study. Results: In total, 31 responses were collected from people (aged 19–63 years, mean 31.4, SD 12.1) with chronic pain who use mHealth solutions. Two-thirds (n=20, 65%) of the users identified as female and 11 (35%) as male. We matched these mHealth users with an equal number of nonusers: 31 responses from the pool of 361 participants in the prescreening questionnaire. The nonusers’ ages ranged from 18 to 58 years (mean 30.8, SD 11.09), with 15 (50%) identifying as female and 15 (50%) as male. Likert-scale questions were analyzed using the Mann-Whitney-Wilcoxon (MWW) test. Results showed that the 2 groups differed significantly on 10 (43%) of 23 questions and shared similar views in the remaining 13 (57%). The mo

Background: Congestion is the hallmark clinical manifestation of heart failure (HF) syndrome and a strong predictor of poor outcomes. Despite rapid improvements in volume status during the hospital course, about half of all patients are discharged with residual congestion, which significantly increases the risk of readmission and affects survival. Although nurse-led disease management programs (DMP) improve outcomes, patients may not be offered this level of support, often because of limited resources. Risk stratification to target DMP to high risk patients is essential; nevertheless, despite DMP and risk assessment, readmission due to re-congestion remains frequent, possibly linked to insufficient decongestion at index discharge. Thus, there is an imperative to ensure euvolemia pre-discharge and monitor post-discharge for early detection of re-congestion. To date, pre-discharge euvolemia is usually based on subjective clinical assessment, which is sometimes inaccurate. Therefore, applying sensitive congestion assessments pre-discharge may help to detect residual congestion and guide the administration of diuretic treatment before and after hospital discharge, during DMP home visits – we call this strategy “DMP-plus”. The primary focus of this thesis was guided decongestion and early detection of deterioration. Hypothesis It is hypothesised that targeting high risk patients (i.e., 33% risk or more) at an enhanced post-discharge, nurse-led DMP, comprised of ultrasound-guided decongestion and constant patient monitoring using mobile health (m-Health), will improve short-term adverse outcomes in patients admitted for ADHF. Objectives: i. To evaluate novel non-invasive congestion assessments and establish the most practical that can be applied to all patients by any health practitioner. ii. To use technological advances to: a) detect, track and eliminate congestion with a portable, non-invasive assessment and b) enhance patient monitoring with an m-Health digital HF ava

Denna studie syftar till att bidra med en djupare förståelse kring hur användarupplevelsen av spelifierade m-hälsoapplikationer för kroniskt sjuka påverkas av icke-monetära belöningar. För att kunna göra detta har centrala områden gällande m-hälsa, spelifiering, spelelementet icke-monetära belöningar och användarupplevelse behandlats. Studiens empiri består av kvalitativ data vilket samlats in genom intervjuer med användare av m-hälsoapplikationer för kroniskt sjuka med spelelementet icke-monetära belöningar. Resultatet av studien visar på att det finns en bredd i hur användare uppfattar de icke-monetära belöningarna. Hälften av användarna uppvisade tendenser till att icke-monetära belöningar i m-hälsoapplikationer för kroniskt sjuka bidrar till en positiv påverkan på användarupplevelsen. Det finns dock fall där icke-monetära belöningar riskerar att påverka användarupplevelsen negativt.

Introduction: Pelvic floor exercises are effective in the treatment of urinary incontinence (UI) and are routinely prescribed, along with bladder training, by primary healthcare providers as first line conservative management. Mobile phone applications are increasingly popular within the healthcare setting and can provide opportunities for patients to complete treatments at home. To date, there has not been a systematic review examining outcomes from randomised controlled trials on the effectiveness of mobile applications to improve UI. Methods: A systematic review of randomized controlled trials evaluating the effectiveness of mobile applications to improve UI was carried out according to the PRISMA reporting guidelines. The online databases MEDLINE, Embase, PsychINFO, CINAHL, Web of Science, Scopus, The Cochrane Library, Joanna Briggs Institute (JBI), Google Scholar were searched for papers published between 2007 to 2020. Keywords and MeSH terms were used to identify relevant English language studies. The quality and risk of bias within included studies was assessed by two independent reviewers, RCT JBI critical appraisal tool. Due to heterogeneity in the outcome of studies, a meta-analysis of the data could not be conducted. Findings: Four studies reported an improvement in the outcome assessed post-intervention, suggesting that using mobile phone applications for pelvic floor muscle training (PFMT) was an acceptable and valid intervention to improve UI. Conclusion: Mobile applications for PFMT indicated that increase adherence to treatment and decrease UI. The integration of this treatment modality into current practice is recommended. Mobile phone applications for PFMT show promise in the conservative management of UI. Further research is required to support the use of this technology in the conservative management of UI.

[EN] Objective: The main objective is to transfer to clinical practice a new smoking cessation appli- M-health; cation ("Vive sin Tabaco" a) in all health centers of the public Basque Health Service. Design: An implementation study of a smoking cessation program previously validated. After implementation, a retrospective study has been carried out to evaluate its use under normal conditions. Site: The process of transfer to clinical practice has been held in several phases; first a pilotage in four health centers of Alava and subsequently, when all reported incidents were resolved, it was extended to all health centers of the Basque Health Service. Intervention and main measurement: Development of "Vive sin Tabaco"; a corporate toot for smoking cessation, and its transfer to clinical practice. All interested health care workers received training on how to use the application. User manuals for both patients and professionals were developed. Smoking cessation rates at 12 months during implementation were also collected. Results: The percentage of patients of post pilot phase who quit smoking at 12 months was 14.1%. Conclusions: The conception of "Vive sin tabaco" as a corporate tool for smoking cessation, available in all health centers of Basque Health Service, has been long and arduous, and has required the participation of health professionals and patients as end-users in order to obtain a toot that adapts to their expectations and guarantees greater usability and satisfaction. This application is being effective as an adjuvant tool to health advice.

The rapid advancements in technology have brought benefits to many sectors, including the health sector. Popular technologies related to e-health and m-health have transformed traditional healthcare and are getting more popular among physicians and patients. Since these technologies, like any other, are constantly changing and improving, some groups of people who are not digitally literate enough to use them are getting neglected. One of those groups is elderly people, who are known for struggling with the use of technology. Considering that m-health applications have proven to be of big essence for elders, this raises a big issue. Therefore, this study aims to further explore the accessibility of m-health applications for elderly people. For this to be done, existing literature about this topic has been compared with empirical findings derived from conducting interviews. The research is based on the Senior Technology Acceptance Model (STAM) which helped us understand elders’ adoption of technology. The study concludes that m-health applications are not accessible enough for elders. Therefore, we proposed the accessibility guidelines for the design of m-health applications which will help improve their accessibility. Along with providing these guidelines, we emphasized the importance of including elders at every stage of m-health development and testing processes and raising awareness about this issue among everyone involved in m-health development.

Denna studie syftar till att bidra med en djupare förståelse kring hur användarupplevelsen av spelifierade m-hälsoapplikationer för kroniskt sjuka påverkas av icke-monetära belöningar. För att kunna göra detta har centrala områden gällande m-hälsa, spelifiering, spelelementet icke-monetära belöningar och användarupplevelse behandlats. Studiens empiri består av kvalitativ data vilket samlats in genom intervjuer med användare av m-hälsoapplikationer för kroniskt sjuka med spelelementet icke-monetära belöningar. Resultatet av studien visar på att det finns en bredd i hur användare uppfattar de icke-monetära belöningarna. Hälften av användarna uppvisade tendenser till att icke-monetära belöningar i m-hälsoapplikationer för kroniskt sjuka bidrar till en positiv påverkan på användarupplevelsen. Det finns dock fall där icke-monetära belöningar riskerar att påverka användarupplevelsen negativt.

Breastfeeding is an unquestionable right of mothers and their children; however, it is not a one-womanjob. For breastfeeding to succeed, women must have access to appropriate support and guidance. The COVID-19 pandemic and subsequent restriction measures and lockdown to reduce community spread of the disease have negatively impacted breastfeeding support from health services and thus, in mothers’ breastfeeding experiences., Peer Reviewed, Postprint (published version)

Objective: Fundamental movement skills (FMS) are the foundational building blocks for lifetime participation in physical activity (PA). Programmes to promote FMS development have been primarily delivered in childcare settings. No studies have evaluated the effectiveness of an interactive digital application, designed to be co-used by parent and child, to increase FMS proficiency in preschool-aged children. Therefore, the purpose of this study was to evaluate the effectiveness of the Moovosity™ programme, a novel digital application to increase FMS proficiency in 3- to 6-year-old children. Methods: A randomized controlled trial (RCT) was conducted involving 34 parent-child dyads randomly assigned to either the 8-week intervention (n = 17) or wait-list control (n = 17) condition. FMS proficiency, PA, and parental support for PA was assessed at baseline and 8-weeks. Intervention participants were given free access to the app over a period of 8 weeks. Wait-listed controls were given access after the 8-week period. Group differences for pre to post changes in outcomes were tested for significance using general linear mixed models. Results: There was a significant group by time interaction for object control skills (F1,32 = 10.81, P = 0.003). Intervention children exhibited significant improvements in object control skills, while children in the wait-list control group exhibited a modest decline. Intervention children also exhibited improvements in locomotor skills, while wait-listed controls exhibited minimal change; however, the group by time interaction fell outside the 0.05 level of significance (F1,32 = 3.15, P = 0.09). There were no significant intervention effects observed for child PA (F1,32 = 0.03, P = 0.86) and parental support for PA (F1,32 = 0.84, P = 0.37). Conclusions: An 8-week exposure to a digital application to promote motor

Telemedicine can be considered as an evolution of the provision of telecommunication-oriented health services remotely. According to the definitions given for Colombia on this issue, they are regulated by Law 1419 of 2010, where the term “telemedicine” would be closely related to that of m-health. The objective of this research work is to identify trends, regulations and guidelines for the design of Smart m-health systems for monitoring biological signals, under an IoT scheme, especially aimed at patients with diseases that require monitoring of vital signs permanently like Cancer. It is sought that the prototype can be compatible with a Web environment under client / server architecture, using low-cost devices such as Raspberry Pi for the processing, monitoring, transmission and acquisition of biological signals, with the ability to establish wired and wireless communication processes and articulating special functions such as: GPS location, RFID identification, medication supply management and specialized alarm system, articulating Artificial Intelligence mechanisms in its management and monitoring processes, among others. The development of solutions supported in the concepts of e-health and m-health represent a great opportunity to overcome the great limitations of coverage, equity and quality of health services in countries such as Colombia, especially in analyzing new strategies that allow overcoming limitations established by the norm given in Resolution 1448 of 2006, in the incorporation of services supported in telemedicine technologies, according to which, telemedicine services can only be enabled within an IPS, in charge of a health professional. Therefore, it is necessary to direct this type of research to an application within IPS senders, or eventually to ambulance applications, since they are legally considered as entities providing health services., La telemedicina puede considerarse como una evolución de la provisión de servicios de salud orientados a las telecomunicaciones en forma remota. De acuerdo con las definiciones dadas para Colombia en este tema, están reglamentadas por la Ley 1419 de 2010, en donde el término “telemedicina” estaría estrechamente relacionado con el de m-health. El objetivo del presente trabajo de investigación consiste en identificar las tendencias, normativas y lineamientos para el diseño de sistemas Smart m-health para el monitoreo de señales biológicas, bajo un esquema de IoT, orientado especialmente a pacientes con enfermedades que requieran supervisión de signos vitales de manera permanente como el Cáncer. Se busca que el prototipo pueda ser compatible con un entorno Web bajo arquitectura cliente / servidor, utilizando dispositivos de bajo costo como Raspberry Pi para el procesamiento, monitoreo, transmisión y adquisición de señales biológicas, con capacidad de establecer procesos de comunicación cableada e inalámbrica y articulando funciones especiales tales como: ubicación por GPS, Identificación RFID, gestión de suministro de medicamentos y sistema de alarmas especializadas, articulando mecanismos de Inteligencia Artificial en sus procesos de gestión y monitoreo, entre otras. El desarrollo de soluciones soportadas en los conceptos de e-health y m-health representan una gran oportunidad para superar las grandes limitaciones de cobertura, equidad y calidad de los servicios de salud de países como Colombia, especialmente en analizar nuevas estrategias que permitan superar las limitaciones establecidas por la norma dada en la Resolución 1448 de 2006, en la incorporación de servicios soportados en tecnologías de telemedicina, según la cual, sólo se pueden habilitar servicios de telemedicina al interior de una IPS, a cargo de un profesional de la salud. Por lo tanto, es necesario orientar este tipo de investigaciones a una aplicación dentro de IPS remisoras, o eventualmente a aplica

Telemedicine can be considered as an evolution of the provision of telecommunication-oriented health services remotely. According to the definitions given for Colombia on this issue, they are regulated by Law 1419 of 2010, where the term “telemedicine” would be closely related to that of m-health. The objective of this research work is to identify trends, regulations and guidelines for the design of Smart m-health systems for monitoring biological signals, under an IoT scheme, especially aimed at patients with diseases that require monitoring of vital signs permanently like Cancer. It is sought that the prototype can be compatible with a Web environment under client / server architecture, using low-cost devices such as Raspberry Pi for the processing, monitoring, transmission and acquisition of biological signals, with the ability to establish wired and wireless communication processes and articulating special functions such as: GPS location, RFID identification, medication supply management and specialized alarm system, articulating Artificial Intelligence mechanisms in its management and monitoring processes, among others. The development of solutions supported in the concepts of e-health and m-health represent a great opportunity to overcome the great limitations of coverage, equity and quality of health services in countries such as Colombia, especially in analyzing new strategies that allow overcoming limitations established by the norm given in Resolution 1448 of 2006, in the incorporation of services supported in telemedicine technologies, according to which, telemedicine services can only be enabled within an IPS, in charge of a health professional. Therefore, it is necessary to direct this type of research to an application within IPS senders, or eventually to ambulance applications, since they are legally considered as entities providing health services., La telemedicina puede considerarse como una evolución de la provisión de servicios de salud orientados a las telecomunicaciones en forma remota. De acuerdo con las definiciones dadas para Colombia en este tema, están reglamentadas por la Ley 1419 de 2010, en donde el término “telemedicina” estaría estrechamente relacionado con el de m-health. El objetivo del presente trabajo de investigación consiste en identificar las tendencias, normativas y lineamientos para el diseño de sistemas Smart m-health para el monitoreo de señales biológicas, bajo un esquema de IoT, orientado especialmente a pacientes con enfermedades que requieran supervisión de signos vitales de manera permanente como el Cáncer. Se busca que el prototipo pueda ser compatible con un entorno Web bajo arquitectura cliente / servidor, utilizando dispositivos de bajo costo como Raspberry Pi para el procesamiento, monitoreo, transmisión y adquisición de señales biológicas, con capacidad de establecer procesos de comunicación cableada e inalámbrica y articulando funciones especiales tales como: ubicación por GPS, Identificación RFID, gestión de suministro de medicamentos y sistema de alarmas especializadas, articulando mecanismos de Inteligencia Artificial en sus procesos de gestión y monitoreo, entre otras. El desarrollo de soluciones soportadas en los conceptos de e-health y m-health representan una gran oportunidad para superar las grandes limitaciones de cobertura, equidad y calidad de los servicios de salud de países como Colombia, especialmente en analizar nuevas estrategias que permitan superar las limitaciones establecidas por la norma dada en la Resolución 1448 de 2006, en la incorporación de servicios soportados en tecnologías de telemedicina, según la cual, sólo se pueden habilitar servicios de telemedicina al interior de una IPS, a cargo de un profesional de la salud. Por lo tanto, es necesario orientar este tipo de investigaciones a una aplicación dentro de IPS remisoras, o eventualmente a aplica

This study is a literature review designed to investigate the use of monitoring and screening instruments for child developmental delay using mobile technology. In addition, the aim was to characterize the methodologies used, samples of participants, whether clinical or not, the research context and the purpose of the instrument use. Articles were searched by three judges in the databases indexed in the BVS, PUBMED/MEDLINE and APA PsyNET. The PRISMA recommendations were used for this review. After applying the inclusion/exclusion criteria, five articles were retrieved and analyzed. The two types of instruments: monitoring and screening, were presented in three study categories: 1. descriptive; 2. viability/usability and 3. validity. Further studies are needed to assess the impact and effectiveness of the use of mobile format instruments for the monitoring and screening for childhood developmental delays., Este estudo é uma revisão de literatura desenvolvida para investigar o uso de instrumentos de vigilância e rastreio para atraso do desenvolvimento infantil por meio de tecnologia móvel. Além disso, objetivou-se caracterizar as metodologias utilizadas, amostras de participantes, se clínicas ou não, contexto de pesquisa, bem como a finalidade do uso instrumento. Foi realizada a busca de artigos, por três juízes, nas bases de dados indexadas na BVS, PUBMED/MEDLINE e APA PsyNET. Utilizaram-se as recomendações do PRISMA para essa revisão. A partir de critérios de inclusão/exclusão, foram recuperados e analisados cinco artigos. As duas modalidades de instrumentos: vigilância e rastreio, apresentaram-se em três categorias de estudo: 1. descritivo; 2. viabilidade/usabilidade e 3. validade. Conclui-se que mais estudos sejam necessários, especialmente para avaliar o impacto e eficácia do uso de instrumentos de vigilância e rastreio para atraso no desenvolvimento infantil em formato de tecnologia móvel., Este estudio es una revisión de la literatura desarrollada para investigar el uso de instrumentos de vigilancia y rastreo del retraso del desarrollo infantil a través de la tecnología móvil. Asimismo, el objetivo fue caracterizar las metodologías utilizadas, muestras de participantes, ya sean clínicas o no; además del contexto de investigación y la finalidad del uso del instrumento. Tres jueces realizaron una búsqueda de artículos en las bases de datos indexadas en la BVS, PUBMED/MEDLINE y APA PsyNET. Las recomendaciones de PRISMA se utilizaron para esta revisión. Según los criterios de inclusión/exclusión, cinco artículos fueron recuperados y analizados. Los dos tipos de instrumentos fueron: vigilancia y detección, se presentaron en tres categorías de estudio: 1. descriptivo; 2. viabilidad/ usabilidad y 3. validez. Se concluyó que son necesarios más estudios, especialmente para evaluar el impacto y la efectividad del uso de instrumentos de vigilancia y rastreo del retraso en el desarrollo infantil en formato de tecnología móvil.

Background: The utility of long-term intermittent heart rhythm monitoring after atrial fibrillation (AF) ablation remains unclear. Therefore, we compared the efficacy and usability of long-term intermittent (AliveCor Kardia® (ACK)) versus short continuous (Holter) heart rhythm monitoring for the detection of AF recurrences after AF ablation and evaluated ACK accuracy to detect AF. Methods: Patients were provided with Holter (for ≥24 h) simultaneously with an ACK (4 weeks) used three times a day and in case of symptoms. The primary endpoint was the difference in proportion of patients diagnosed with recurrent AF by ACK as compared to Holter monitoring. Secondary endpoints were the usability (System Usability Scale and a four-item questionnaire) of ACK and Holter monitoring; and the accuracy of the ACK algorithm for AF detection. Results: Out of 126 post-ablation patients, 115 (91.3%; 35 females, median age 64.0 [58.0–68.0] years) transmitted overall 7838 ACK ECG recordings. ACK and Holter monitoring detected 29 (25.2%) and 17 (14.8%) patients with AF recurrences, respectively (p < 0.001). More than 2 weeks of ACK monitoring did not have additional diagnostic yield for detection of AF recurrences. Patients graded ACK higher than Holter monitoring and found ACK more convenient in daily usage than Holter (p < 0.001). Sensitivity and specificity of ACK for AF detection were 95.3% and 97.5%, respectively. Conclusions: Long-term intermittent monitoring by ACK more effectively detects AF recurrences after AF ablation and has a higher patients' usability than short continuous Holter monitoring. ACK showed a high accuracy to detect AF.

BACKGROUND AND OBJECTIVE: Anxiety is a common emotion that people often feel in certain situations. But when the feeling of anxiety is persistent and interferes with a person's day to day life then this may likely be an anxiety disorder. Anxiety disorders are a common issue worldwide and can fall under general anxiety, panic attacks, and social anxiety among others. They can be disabling and can impact all aspects of an individual's life, including work, education, and personal relationships. It is important that people with anxiety receive appropriate care, which in some cases may prove difficult due to mental health care delivery barriers such as cost, stigma, or distance from mental health services. A potential solution to this could be mobile mental health applications. These can serve as effective and promising tools to assist in the management of anxiety and to overcome some of the aforementioned barriers. The objective of this study is to provide an analysis of treatment and management-related functionality and characteristics of high-rated mobile applications (apps) for anxiety, which are available for Android and iOS systems. METHOD: A broad search was performed in the Google Play Store and App Store following the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) protocol to identify existing apps for anxiety. A set of free and highly rated apps for anxiety were identified and the selected apps were then installed and analyzed according to a predefined data extraction strategy. RESULTS: A total of 167 anxiety apps were selected (123 Android apps and 44 iOS apps). Besides anxiety, the selected apps addressed several health issues including stress, depression, sleep issues, and eating disorders. The apps adopted various treatment and management approaches such as meditation, breathing exercises, mindfulness and cognitive behavioral therapy. Results also showed that 51% of the selected apps used various gamification features to motiva

BACKGROUND: The COVID-19 outbreak was first reported to the World Health Organization on December 31, 2019, and it was officially declared a public health emergency of international concern on January 30, 2020. The COVID-19 outbreak and the safety measures taken to control it caused many psychological issues in populations worldwide, such as depression, anxiety, and stress. OBJECTIVE: The objectives of this study were to assess the psychological effects of the lockdown due to the COVID-19 outbreak on university students in the United Arab Emirates (UAE) and to investigate the students' awareness of mobile mental health care apps as well as their attitudes toward the use of these apps. METHODS: A two-part self-administered web-based questionnaire was delivered to students at United Arab Emirates University. The first part of the questionnaire assessed the mental state of the participants using the 12-item General Health Questionnaire (GHQ-12), while the second part contained questions investigating the participants' awareness of and attitudes toward mental health care apps. Students were invited to fill out the web-based questionnaire via social media and mailing lists. RESULTS: A total of 154 students participated in the survey, and the majority were female. The results of the GHQ-12 analysis showed that the students were experiencing psychological issues related to depression and anxiety as well as social dysfunction. The results also revealed a lack of awareness of mental health care apps and uncertainty regarding the use of such apps. Approximately one-third of the participants (44/154, 28.6%) suggested preferred functionalities and characteristics of mobile mental health care apps, such as affordable price, simple design, ease of use, web-based therapy, communication with others experiencing the same issues, and tracking of mental status. CONCLUSIONS: Like many groups of people worldwide, university students in the UAE were psychologically affected by the lockdo

Introduction: The rapid adoption of smartphones, especially in low- and middle-income countries, has opened up novel ways to deliver health care, including diagnosis and management of burns. This study was conducted to measure acceptability and to identify factors that influence health care provider's attitudes toward m-health technology for emergency care of burn patients. Methods: An extended version of the technology acceptance model (TAM) was used to assess the acceptability toward using m-health for burns. A questionnaire was distributed to health professionals at four hospitals in Dar Es Salaam, Tanzania. The questionnaire was based on several validated instruments and has previously been adopted for the sub-Saharan context. It measured constructs, including acceptability, usefulness, ease of use, social influences, and voluntariness. Univariate analysis was used to test our proposed hypotheses, and structural equation modeling was used to test the extended version of TAM. Results: In our proposed test-model based on TAM, we found a significant relationship between compatibility-usefulness and usefulness-attitudes. The univariate analysis further revealed some differences between subgroups. Almost all health professionals in our sample already use smartphones for work purposes and were positive about using smartphones for burn consultations. Despite participants perceiving the application to be easy to use, they suggested that training and ongoing support should be available. Barriers mentioned include access to wireless internet and access to hospital-provided smartphones.

Mobile phones, wearable trackers and Internet of Things devices continuously produce data about our health and lifestyle that can be used for medical research. However, how data is accessed, by whom and for what purpose is not always understood. This lack of transparency undermines citizens trust in the use of such technologies for research purposes. This paper proposes a set of 6 use cases and related mock-up interfaces for citizen science, mobile-based health research: “Curated information about the institution”, “Sequential consent of shared data”, “Updates from the institution”, “Privacy notifications”, “Overview of donated data” and “Personal impact in medical research”. Interviews and Kano analysis of the interfaces with 6 prospective users show that all except “Privacy notifications” are perceived as important and beneficial for increasing users’ trust. The defined use cases can guide the development of future data collection platforms.

Introduction: The rapid adoption of smartphones, especially in low- and middle-income countries, has opened up novel ways to deliver health care, including diagnosis and management of burns. This study was conducted to measure acceptability and to identify factors that influence health care provider's attitudes toward m-health technology for emergency care of burn patients. Methods: An extended version of the technology acceptance model (TAM) was used to assess the acceptability toward using m-health for burns. A questionnaire was distributed to health professionals at four hospitals in Dar Es Salaam, Tanzania. The questionnaire was based on several validated instruments and has previously been adopted for the sub-Saharan context. It measured constructs, including acceptability, usefulness, ease of use, social influences, and voluntariness. Univariate analysis was used to test our proposed hypotheses, and structural equation modeling was used to test the extended version of TAM. Results: In our proposed test-model based on TAM, we found a significant relationship between compatibility-usefulness and usefulness-attitudes. The univariate analysis further revealed some differences between subgroups. Almost all health professionals in our sample already use smartphones for work purposes and were positive about using smartphones for burn consultations. Despite participants perceiving the application to be easy to use, they suggested that training and ongoing support should be available. Barriers mentioned include access to wireless internet and access to hospital-provided smartphones.

Introduction: The rapid adoption of smartphones, especially in low- and middle-income countries, has opened up novel ways to deliver health care, including diagnosis and management of burns. This study was conducted to measure acceptability and to identify factors that influence health care provider's attitudes toward m-health technology for emergency care of burn patients. Methods: An extended version of the technology acceptance model (TAM) was used to assess the acceptability toward using m-health for burns. A questionnaire was distributed to health professionals at four hospitals in Dar Es Salaam, Tanzania. The questionnaire was based on several validated instruments and has previously been adopted for the sub-Saharan context. It measured constructs, including acceptability, usefulness, ease of use, social influences, and voluntariness. Univariate analysis was used to test our proposed hypotheses, and structural equation modeling was used to test the extended version of TAM. Results: In our proposed test-model based on TAM, we found a significant relationship between compatibility-usefulness and usefulness-attitudes. The univariate analysis further revealed some differences between subgroups. Almost all health professionals in our sample already use smartphones for work purposes and were positive about using smartphones for burn consultations. Despite participants perceiving the application to be easy to use, they suggested that training and ongoing support should be available. Barriers mentioned include access to wireless internet and access to hospital-provided smartphones.

ObjectivesIndividuals with serious mental illnesses such as bipolar disorder (BD) are at an increased risk for poor medication adherence compared to the general population. Individuals with BD also have high rates of chronic comorbid medical conditions like hypertension (HTN), diabetes, and cardiovascular disease. Cognitive-behavioral therapies often integrate strategies to improve medication adherence by targeting medication attitudes and self-efficacy, but the pathway toward behavior change needs further investigation.MethodsThis 3-month prospective, single-arm cohort study tested an automated SMS intervention entitled Individualized Texting for Adherence Building- Cardiovascular (iTAB-CV) in 38 participants with BD and HTN. The Tablets Routine Questionnaire (TRQ) measures the percentage of BD and HTN non-adherence over the past week and the past month. Attitudinal and habit measures including the Brief Illness Perception Questionnaire (Brief IPQ), the Medication Adherence Self-Efficacy Scale-Revised (MASES-R), the Self-Report Habit Index (SRHI), the Beliefs about Medicines Questionnaire (BMQ), and the Attitudes toward Mood Stabilizers Questionnaire (AMSQ) were given for BD and HTN medications. Correlational analyses were run to determine the associations between BD and HTN attitudinal and habit indices. Additionally, longitudinal analyses were conducted to determine if attitudes changed over time as a function of a 2-month mobile-health intervention.ResultsIllness attitudes towards BD were worse than towards HTN at the start of the study. Attitudes toward BD and towards mood-stabilizing drugs as well as antihypertensives improved following a mHealth intervention aimed at improving adherence. Furthermore, self-efficacy and habit strength for both BD and HTN drugs were correlated and were responsive to the intervention, with most of the change occurring after the first month of the intervention and not requiring the addition of the explicit reminders.ConclusionPart

ObjectivesIndividuals with serious mental illnesses such as bipolar disorder (BD) are at an increased risk for poor medication adherence compared to the general population. Individuals with BD also have high rates of chronic comorbid medical conditions like hypertension (HTN), diabetes, and cardiovascular disease. Cognitive-behavioral therapies often integrate strategies to improve medication adherence by targeting medication attitudes and self-efficacy, but the pathway toward behavior change needs further investigation.MethodsThis 3-month prospective, single-arm cohort study tested an automated SMS intervention entitled Individualized Texting for Adherence Building- Cardiovascular (iTAB-CV) in 38 participants with BD and HTN. The Tablets Routine Questionnaire (TRQ) measures the percentage of BD and HTN non-adherence over the past week and the past month. Attitudinal and habit measures including the Brief Illness Perception Questionnaire (Brief IPQ), the Medication Adherence Self-Efficacy Scale-Revised (MASES-R), the Self-Report Habit Index (SRHI), the Beliefs about Medicines Questionnaire (BMQ), and the Attitudes toward Mood Stabilizers Questionnaire (AMSQ) were given for BD and HTN medications. Correlational analyses were run to determine the associations between BD and HTN attitudinal and habit indices. Additionally, longitudinal analyses were conducted to determine if attitudes changed over time as a function of a 2-month mobile-health intervention.ResultsIllness attitudes towards BD were worse than towards HTN at the start of the study. Attitudes toward BD and towards mood-stabilizing drugs as well as antihypertensives improved following a mHealth intervention aimed at improving adherence. Furthermore, self-efficacy and habit strength for both BD and HTN drugs were correlated and were responsive to the intervention, with most of the change occurring after the first month of the intervention and not requiring the addition of the explicit reminders.ConclusionPart

Introduction: The rapid adoption of smartphones, especially in low- and middle-income countries, has opened up novel ways to deliver health care, including diagnosis and management of burns. This study was conducted to measure acceptability and to identify factors that influence health care provider's attitudes toward m-health technology for emergency care of burn patients. Methods: An extended version of the technology acceptance model (TAM) was used to assess the acceptability toward using m-health for burns. A questionnaire was distributed to health professionals at four hospitals in Dar Es Salaam, Tanzania. The questionnaire was based on several validated instruments and has previously been adopted for the sub-Saharan context. It measured constructs, including acceptability, usefulness, ease of use, social influences, and voluntariness. Univariate analysis was used to test our proposed hypotheses, and structural equation modeling was used to test the extended version of TAM. Results: In our proposed test-model based on TAM, we found a significant relationship between compatibility-usefulness and usefulness-attitudes. The univariate analysis further revealed some differences between subgroups. Almost all health professionals in our sample already use smartphones for work purposes and were positive about using smartphones for burn consultations. Despite participants perceiving the application to be easy to use, they suggested that training and ongoing support should be available. Barriers mentioned include access to wireless internet and access to hospital-provided smartphones.

The past 10 years have seen the development and maturation of several digital technologies that can have a critical role to enhancement of happiness and psychological well-being. In particular, the past decade has seen the emergence of a new paradigm: "Positive Technology," the scientific and applied approach to the use of technology for improving the quality of our personal experience. In this article we discussed the potential of Positive Technology to augment and enhance the existing strategies for generating psychological well-being during the COVID-19 pandemic. In particular different positive technologies-m-Health and smartphone apps, stand-alone and social virtual reality, video games, exergames, and social technologies-have the potential of enhancing different critical features of our personal experience-affective quality, engagement/actualization, and connectedness-that are challenged by the pandemic and its social and economic effects. In conclusion, although the focus of tackling the direct impact of COVID-19 is important, positive technologies can be extremely useful to reduce the psychological burden of the pandemic and to help individuals in flourishing even during difficult and complex times.

The past 10 years have seen the development and maturation of several digital technologies that can have a critical role to enhancement of happiness and psychological well-being. In particular, the past decade has seen the emergence of a new paradigm: "Positive Technology,"the scientific and applied approach to the use of technology for improving the quality of our personal experience. In this article we discussed the potential of Positive Technology to augment and enhance the existing strategies for generating psychological well-being during the COVID-19 pandemic. In particular different positive technologies - m-Health and smartphone apps, stand-alone and social virtual reality, video games, exergames, and social technologies - have the potential of enhancing different critical features of our personal experience - affective quality, engagement/actualization, and connectedness - that are challenged by the pandemic and its social and economic effects. In conclusion, although the focus of tackling the direct impact of COVID-19 is important, positive technologies can be extremely useful to reduce the psychological burden of the pandemic and to help individuals in flourishing even during difficult and complex times.

Introduction: The rapid adoption of smartphones, especially in low- and middle-income countries, has opened up novel ways to deliver health care, including diagnosis and management of burns. This study was conducted to measure acceptability and to identify factors that influence health care provider's attitudes toward m-health technology for emergency care of burn patients. Methods: An extended version of the technology acceptance model (TAM) was used to assess the acceptability toward using m-health for burns. A questionnaire was distributed to health professionals at four hospitals in Dar Es Salaam, Tanzania. The questionnaire was based on several validated instruments and has previously been adopted for the sub-Saharan context. It measured constructs, including acceptability, usefulness, ease of use, social influences, and voluntariness. Univariate analysis was used to test our proposed hypotheses, and structural equation modeling was used to test the extended version of TAM. Results: In our proposed test-model based on TAM, we found a significant relationship between compatibility-usefulness and usefulness-attitudes. The univariate analysis further revealed some differences between subgroups. Almost all health professionals in our sample already use smartphones for work purposes and were positive about using smartphones for burn consultations. Despite participants perceiving the application to be easy to use, they suggested that training and ongoing support should be available. Barriers mentioned include access to wireless internet and access to hospital-provided smartphones.

Mobile phones, wearable trackers and Internet of Things devices continuously produce data about our health and lifestyle that can be used for medical research. However, how data is accessed, by whom and for what purpose is not always understood. This lack of transparency undermines citizens trust in the use of such technologies for research purposes. This paper proposes a set of 6 use cases and related mock-up interfaces for citizen science, mobile-based health research: “Curated information about the institution”, “Sequential consent of shared data”, “Updates from the institution”, “Privacy notifications”, “Overview of donated data” and “Personal impact in medical research”. Interviews and Kano analysis of the interfaces with 6 prospective users show that all except “Privacy notifications” are perceived as important and beneficial for increasing users’ trust. The defined use cases can guide the development of future data collection platforms.

Overconsumption of alcohol, from hazardous to excessive, heavy, and harmful levels, is common among university students. Consenting Swedish students were assigned to one of two smartphone apps offering feedback on estimated blood alcohol concentration (eBAC; Promillekoll/PartyPlanner) or assessment only (n = 2166; 1:1:1 ratio). App participants with excessive drinking according to public health criteria (>9/>14 drinks/week for women/men, respectively) at a 7 week follow-up were additionally assigned to the skills-based TeleCoach app or waitlist (n = 186; 1:1 ratio). All participants were followed at 14 and 20 weeks. At 7 weeks, Promillekoll users showed higher risk of excessive drinking (odds ratio (OR) = 1.83; p

Overconsumption of alcohol, from hazardous to excessive, heavy, and harmful levels, is common among university students. Consenting Swedish students were assigned to one of two smartphone apps offering feedback on estimated blood alcohol concentration (eBAC; Promillekoll/PartyPlanner) or assessment only (n = 2166; 1:1:1 ratio). App participants with excessive drinking according to public health criteria (>9/>14 drinks/week for women/men, respectively) at a 7 week follow-up were additionally assigned to the skills-based TeleCoach app or waitlist (n = 186; 1:1 ratio). All participants were followed at 14 and 20 weeks. At 7 weeks, Promillekoll users showed higher risk of excessive drinking (odds ratio (OR) = 1.83; p

Privacy is a major concern for breast cancer patients. When patients use mobile health applications (mHealth apps), many sensitive data are handled by the application developers. General Data Protection Regulation (GDPR) arises as a solution to privacy issues. In this paper, we analyze the privacy policy of a sample of mHealth apps for breast cancer patients, developing a scale to check if GDPR is complied. Despite privacy is a key factor in the adoption of the use of mHealth apps, the low level of compliance with the GDPR of the analyzed applications was quite surprising. Thus, application developers must be concerned about this matter.

Privacy is a major concern for breast cancer patients. When patients use mobile health applications (mHealth apps), many sensitive data are handled by the application developers. General Data Protection Regulation (GDPR) arises as a solution to privacy issues. In this paper, we analyze the privacy policy of a sample of mHealth apps for breast cancer patients, developing a scale to check if GDPR is complied. Despite privacy is a key factor in the adoption of the use of mHealth apps, the low level of compliance with the GDPR of the analyzed applications was quite surprising. Thus, application developers must be concerned about this matter.

There is a growing body of literature highlighting the role that wearable and mobile remote measurement technology (RMT) can play in measuring symptoms of major depressive disorder (MDD). Outcomes assessment typically relies on self-report, which can be biased by dysfunctional perceptions and current symptom severity. Predictors of depressive relapse include disrupted sleep, reduced sociability, physical activity, changes in mood, prosody and cognitive function, which are all amenable to measurement via RMT. This study aims to: 1) determine the usability, feasibility and acceptability of RMT; 2) improve and refine clinical outcome measurement using RMT to identify current clinical state; 3) determine whether RMT can provide information predictive of depressive relapse and other critical outcomes.

Much of the developed world is experiencing an aging population. This requires society to adapt to take care of a growing elderly population and improve their quality of life. Today, mobile systems are available that makes it possible to monitor and improve health (m-health). Even though these systems could be immensely helpful for the elderly population, this has not been the primary demographic for the current m-health systems. This case study aimed at examining how persuasive technology (technology for changing behavior and/or attitude) can be used to promote usage of m-health applications by the elderly. For this purpose, a theoretical framework for supporting m-health systems is proposed. This framework consist of persuasive technology (for motivation and support for fulfillment of human needs), knowledge of elderly issues in interacting with mobile interfaces, smartphone usability heuristics and the Plan-Do-Study-Act (PDSA) cycle (to support goalsetting and incremental progress). To determine how persuasive technology can be used to motivate elderly and find effective strategies for this purpose, the case study examined health behavior, motivations for healthy behavior, attitude to health, general goal setting behavior, needs, preferences, technological experience and self-efficacy, as well as usage of m-health systems using qualitative and participatory methods. Methods used included semi-structured interviews, future workshop, revolutionary rapid prototyping and usability evaluation. The findings of the interviews and the future workshop suggested the primary motivation for healthy behavior was derived from social aspects. Thus, the most effective persuasive strategies for the elderly likely target their need for social belonging and socialization. Based on the findings, an interactive prototype was developed. The prototype proposed an m-health application with self-monitoring that implemented an elderly community around healthy behavior, with opportunities

Recent advances in wearable sensor technology and smartphones enable simple and affordable collection of personal analytics. This paper reflects on the lessons learned in the SWELL project that addressed the design of user-centered ICT applications for self-management of vitality in the domain of knowledge workers. These workers often have a sedentary lifestyle and are susceptible to mental health effects due to a high workload. We present the sense–reason–act framework that is the basis of the SWELL approach and we provide an overview of the individual studies carried out in SWELL. In this paper, we revisit our work on reasoning: interpreting raw heterogeneous sensor data, and acting: providing personalized feedback to support behavioural change. We conclude that simple affordable sensors can be used to classify user behaviour and heath status in a physically non-intrusive way. The interpreted data can be used to inform personalized feedback strategies. Further longitudinal studies can now be initiated to assess the effectiveness of m-Health interventions using the SWELL methods., Applied Ergonomics and Design, Interactive Intelligence

Objective: Integrating mobile phone-based health (m-health) interventions into healthcare systems is one solution to improve access to services for the growing number of patients with chronic illness. Practical challenges such as poor recruitment and inadequate resource allocation can hamper the assessment of such interventions with clinical trial methodology. This paper highlights the challenges encountered during a pilot randomized controlled trial of an m-health medication adherence intervention and offers recommendations for future multi-site, non-drug clinical trials. Results: Eighteen patients were recruited to the study; eight were randomly allocated to the intervention arm. Intervention participants responded to their daily medication-reminder text messages, indicating that medication had been taken or not, and nurses were able to organize their calls around their workload. The trial closed prematurely primarily due to inadequate numbers of eligible patients; however, other potentially resolvable feasibility issues were identified. These included lack of infrastructure at study sites, poor screening data acquisition and management processes, and inexperience in conducting supportive care trials at participating sites. M-health intervention trials are designed to inform implementation of best supportive care practice. Adequate skills and infrastructure are research prerequisites that require careful consideration and sufficient investment for the successful execution of multi-site supportive care trials.

Privacy is a major concern for breast cancer patients. When patients use mobile health applications (mHealth apps), many sensitive data are handled by the application developers. General Data Protection Regulation (GDPR) arises as a solution to privacy issues. In this paper, we analyze the privacy policy of a sample of mHealth apps for breast cancer patients, developing a scale to check if GDPR is complied. Despite privacy is a key factor in the adoption of the use of mHealth apps, the low level of compliance with the GDPR of the analyzed applications was quite surprising. Thus, application developers must be concerned about this matter.

Privacy is a major concern for breast cancer patients. When patients use mobile health applications (mHealth apps), many sensitive data are handled by the application developers. General Data Protection Regulation (GDPR) arises as a solution to privacy issues. In this paper, we analyze the privacy policy of a sample of mHealth apps for breast cancer patients, developing a scale to check if GDPR is complied. Despite privacy is a key factor in the adoption of the use of mHealth apps, the low level of compliance with the GDPR of the analyzed applications was quite surprising. Thus, application developers must be concerned about this matter.