Search

Background: Financial incentives delivered via apps appear to be effective in encouraging physical activity. However, the literature on different incentive strategies is limited, and the question remains whether financial incentives offer a cost-effective intervention that could be funded at the population level., Objective: This study aimed to explore patterns of tracked physical activity by users of an incentive-based app before and after a change in incentive strategy. A business decision to alter the incentives in a commercially available app offered a natural experiment to explore GPS-tracked data in a retrospective, quasi-experimental study. The purpose of this exploratory analysis was to inform the design of future controlled trials of incentives delivered via an app to optimize their usability and cost-effectiveness., Methods: Weekly minutes of tracked physical activity were explored among a sample of 1666 participants. A Friedman test was used to determine differences in physical activity before and after the change in incentive strategies. Post hoc Wilcoxon tests were used to assess minutes of physical activity in the 2 weeks before and after the change. A secondary analysis explored longitudinal patterns of physical activity by plotting the mean and median minutes of physical activity from 17 weeks before and 13 weeks after the change in incentive strategy. CIs were calculated using bias-corrected bootstraps. Demographics were also explored in this way., Results: There were significant differences in the weekly minutes of activity before and after the change in incentive strategy (Friedman χ 2 2 =42, P<.001). However, a longitudinal view of the data showed a more complex and marked variation in activity over time that undermined the conclusions of the before/after analysis., Conclusions: Short-term before-and-after observational studies of app-tracked physical activity may result in misleading conclusions about the effectiveness of incentive strategies. Longitudinal views of the data show that important fluctuations are occurring over time. Future studies of app-tracked physical activity should explore such variations by using longitudinal analyses and accounting for possible moderating variables to better understand what an effective incentive might be, for whom, and at what cost., (©Hannah McCarthy, Henry W W Potts, Abigail Fisher. Originally published in JMIR Formative Research (https://formative.jmir.org), 10.12.2024.)

The aim of the present study was to explore perceptions of the Digital Twin (a three-dimensional digital representation of an anatomical body) on a mobile health application, and the potential mechanisms that are important for behaviour change, with a focus on health and weight management. An explorative and participant-led approach was taken using semi-structured online interviews to explore the experiences of people, in this case non-users and users wanting to independently manage their health. An opportunity sample of forty participants from the United Kingdom (20 who had not used digitally assistive technology and 20 who had) were recruited from social media platforms (22 females and 18 males; mean age was 30). The interviews were transcribed verbatim and analysed using Thematic Analysis. Two main themes were elicited: Initiators of behaviour change (i.e., autonomous choices, social influences, and personalisation) and Barriers to behaviour change (i.e., adverse reactions, weight management norms and negative attitudes). Overall, it was suggested that the Digital Twin should be representative of a user's personalised health information and BMI. These results can inform an intervention designed to use the Digital Twin to initiate and maintain lifestyle behaviour change. It can also develop our understanding of how such technology can be applied as a tool for health management. [ABSTRACT FROM AUTHOR]

Background and Purpose: The use of smartphone applications is ubiquitous within healthcare. Over recent years there have been multiple applications developed within the field of plastic surgery. In the UK, applications with a medical purpose should be registered with the Medicines and Healthcare products Regulatory Authority (MHRA) as a medical device. The aim of this study was to evaluate plastic surgery specific smartphone applications designed for healthcare professional usage, and determine what proportion meet the criteria of a medical device and are suitably certified.Methods: A systematic review of the Apple and Google Play App stores was carried out using search terms relevant to plastic surgery. Data was extracted from the app store listing, developer website and the contents of each application. Each application was evaluated against the criteria given by the MHRA to determine whether it constituted a medical device.Results: 215 applications for plastic surgery healthcare professionals were identified, of which 22 met the definition of a medical device. Only 14% (n = 3) of these applications were appropriately certified, 14% (n = 3) were validated in peer-reviewed literature and 45% (n = 10) had documented medical professional involvement.Conclusion: Most applications with a medical purpose were not certified as a medical device, had not been validated in any peer-reviewed research, and did not have any documented involvement of medical professionals. The potential consequences of such applications operating incorrectly are stark and represent a risk to patient safety. Usage of multiple applications in a single patient encounter may compound error and safety of clinical care. [ABSTRACT FROM AUTHOR]

Background: Apps have been shown to be an effective tool in changing patients' behaviours in orthodontics and can be used to improve their compliance with treatment. The Behaviour Change Techniques (BCTs) and quality (using MARS) within these apps have previously not been published. Objectives: To evaluate the quality of these apps aiming to change behaviour. To assess BCTs used in patient focused orthodontic apps. Methods: The UK Google Play and Apple App Stores were searched to identify all orthodontic apps and 305 apps were identified. All 305 apps were assessed for the presence of BCTs using an accepted taxonomy of BCTs (Behaviour Change Wheel (BCW)), widely utilised in healthcare. Of those containing BCTs, the quality was assessed using the Mobile App Rating Scale (MARS), a validated and multi-dimensional tool which rates apps according to 19 objective criteria. Data collection was carried out by two calibrated, independent assessors and repeated after 6 weeks for 25% of the apps by both assessors. Results: BCTs were found in 31 apps, although only 18 of them were analysed for quality and 13 apps were excluded. Six different BCTs were identified: these were most commonly 'prompts/cues', and 'information about health consequences'. All apps were shown to be of moderate quality (range 3.1–3.7/5). Inter-rater and intra-rater reliability for BCT and quality assessment were excellent. Conclusions: The current availability of orthodontic apps of sufficient quality to recommend to patients is very limited. There is therefore a need for high-quality orthodontic apps with appropriate BCTs to be created, which may be utilised to improve patients' compliance with treatment. [ABSTRACT FROM AUTHOR]

There has been a recent explosion in development of image recognition technology and its application to automated plant identification, so it is timely to consider its potential for field botany. Nine free apps or websites for automated plant identification and suitable for use on mobile phones or tablet computers in the field were tested on a disparate set of 38 images of plants or parts of plants chosen from the higher plant flora of Britain and Ireland. There were large differences in performance with the best apps identifying >50 % of samples tested to genus or better. Although the accuracy is good for some of the top-rated apps, for any quantitative biodiversity study or for ecological surveys, there remains a need for validation by experts or against conventional floras. Nevertheless, the better-performing apps should be of great value to beginners and amateurs and may usefully stimulate interest in plant identification and nature. Potential uses of automated image recognition plant identification apps are discussed and recommendations made for their future use. [ABSTRACT FROM AUTHOR]

Virtual reality environments presented on tablets and smartphones have potential to aid the early diagnosis of conditions such as Alzheimer’s dementia by quantifying impairments in navigation performance. However, it is unclear whether performance on mobile devices can predict navigation errors in the real world. We compared the performance of 49 participants (25 females, 18-35 years old) at wayfinding and path integration tasks designed in our mobile app ‘Sea Hero Quest’ with their performance at similar tasks in a real-world environment. We first performed this experiment in the streets of London (UK) and replicated it in Paris (France). In both cities, we found a significant correlation between virtual and real-world wayfinding performance and a male advantage in both environments, although smaller in the real world (Cohen’s d in the game = 0.89, in the real world = 0.59). Results in London and Paris were highly similar, and controlling for familiarity with video games did not change the results. The strength of the correlation between real world and virtual environment increased with the difficulty of the virtual wayfinding task, indicating that Sea Hero Quest does not merely capture video gaming skills. The fact that the Sea Hero Quest wayfinding task has real-world ecological validity constitutes a step toward controllable, sensitive, safe, low-cost, and easy to administer digital cognitive assessment of navigation ability. [ABSTRACT FROM AUTHOR]

This article interrogates the concept of technical memory in relation to smart city systems. Using the example of the UK air pollution monitoring system Automatic Urban and Rural Network (AURN) and how information from this system is displayed in smartphone air monitoring apps, the article theorizes the memory of smart systems. Developing the work of Garcia, the article rethinks Stiegler's retentional accounts of technical memory, which suggest that memory is held or inscribed on or within a particular technical object. To do this it argues that technical memory can be productively considered as a form of artificial comprehension. Here, the memory of smart systems is analyzed through a variety of logics that disclose particular qualities of objects for particular purposes, which shapes how people make sense of and respond to their environment. Through the example of AURN, the article suggests that the concept of artificial comprehension is useful for geographers studying a range of smart and nonsmart technical systems. [ABSTRACT FROM AUTHOR]

Studies into the use of mobile applications (apps) for language learning have found positive results on language improvement and learner engagement, but they have mostly focused on small samples of learners using apps that were selected by a researcher/educator rather than on learners using apps of their own choice. This article presents the results of a large-scale survey (n = 4095) into the use of one of the most popular language learning apps in the market: the busuu mobile app (over 60 million registered users). Data were collected through an online questionnaire with 30 items. The survey was distributed both in English and in Spanish. The results provide a profile of busuu app users, show patterns of use, and what app features learners find most valuable for language learning. Most users are at beginner level and learn for personal interest. They find the app has helped them improve their knowledge of the language they are learning, with vocabulary as the main area of improvement. The high expectations from users and the fact that a third of respondents use busuu as their only language learning source suggest that a large proportion of users consider apps a reliable tool for language learning. [ABSTRACT FROM AUTHOR]

Smartphones with their rising popularity and versatile software ‘apps’ have great potential for revolutionising healthcare services. However, this was soon overshadowed by concerns highlighted by many studies over quality. These were subject and/or discipline specific and mostly evaluated compliance with a limited number of information portrayal standards originally devised for health websites. Hence, this study aimed to take a broader approach by evaluating the most popular apps categorised as medical in the United Kingdom for compliance with all of those standards systematically using the Health On the Net (HON) Foundation principles.The study evaluated top 50 free and paid apps of the ‘medical’ category on both iTunes and Google stores for evidence of compliance with an app-adapted version of the HON Foundation code of conduct. The sample included 64 apps, 34/64 (53%) were on Google Play and 36/64 (56%) were free. None of the apps managed to comply with the entire eight principles. Compliance with seven principles was achieved by only one app (1.6%), and the rest were compliant with three, two, and one (14.7%, 27%, and 38%, respectively).In conclusion, this study demonstrated that most popular apps on the medical category that are available in the United Kingdom do not meet the standards for presenting health information to the public, and this is consistent with earlier studies. Improving the situation would require raising the public awareness, providing tools that would assist in quality evaluation, encouraging developers to use robust development process, and facilitating collaboration and engagement among the stakeholders. [ABSTRACT FROM AUTHOR]

Background: Street imagery is a promising and growing big data source providing current and historical images in more than 100 countries. Studies have reported using this data to audit road infrastructure and other built environment features. Here we explore a novel application, using Google Street View (GSV) to predict travel patterns at the city level. Methods: We sampled 34 cities in Great Britain. In each city, we accessed 2000 GSV images from 1000 random locations. We selected archived images from time periods overlapping with the 2011 Census and the 2011–2013 Active People Survey (APS). We manually annotated the images into seven categories of road users. We developed regression models with the counts of images of road users as predictors. The outcomes included Census-reported commute shares of four modes (combined walking plus public transport, cycling, motorcycle, and car), as well as APS-reported past-month participation in walking and cycling. Results: We found high correlations between GSV counts of cyclists (‘GSV-cyclists’) and cycle commute mode share (r = 0.92)/past-month cycling (r = 0.90). Likewise, GSV-pedestrians was moderately correlated with past-month walking for transport (r = 0.46), GSV-motorcycles was moderately correlated with commute share of motorcycles (r = 0.44), and GSV-buses was highly correlated with commute share of walking plus public transport (r = 0.81). GSV-car was not correlated with car commute mode share (r = –0.12). However, in multivariable regression models, all outcomes were predicted well, except past-month walking. The prediction performance was measured using cross-validation analyses. GSV-buses and GSV-cyclists are the strongest predictors for most outcomes. Conclusions: GSV images are a promising new big data source to predict urban mobility patterns. Predictive power was the greatest for those modes that varied the most (cycle and bus). With its ability to identify mode of travel and capture street activity often excluded in routinely carried out surveys, GSV has the potential to be complementary to new and traditional data. With half the world’s population covered by street imagery, and with up to 10 years historical data available in GSV, further testing across multiple settings is warranted both for cross-sectional and longitudinal assessments. [ABSTRACT FROM AUTHOR]

Background: Poor information privacy practices have been identified in health apps. Medical app accreditation programs offer a mechanism for assuring the quality of apps; however, little is known about their ability to control information privacy risks. We aimed to assess the extent to which already-certified apps complied with data protection principles mandated by the largest national accreditation program.Methods: Cross-sectional, systematic, 6-month assessment of 79 apps certified as clinically safe and trustworthy by the UK NHS Health Apps Library. Protocol-based testing was used to characterize personal information collection, local-device storage and information transmission. Observed information handling practices were compared against privacy policy commitments.Results: The study revealed that 89% (n = 70/79) of apps transmitted information to online services. No app encrypted personal information stored locally. Furthermore, 66% (23/35) of apps sending identifying information over the Internet did not use encryption and 20% (7/35) did not have a privacy policy. Overall, 67% (53/79) of apps had some form of privacy policy. No app collected or transmitted information that a policy explicitly stated it would not; however, 78% (38/49) of information-transmitting apps with a policy did not describe the nature of personal information included in transmissions. Four apps sent both identifying and health information without encryption. Although the study was not designed to examine data handling after transmission to online services, security problems appeared to place users at risk of data theft in two cases.Conclusions: Systematic gaps in compliance with data protection principles in accredited health apps question whether certification programs relying substantially on developer disclosures can provide a trusted resource for patients and clinicians. Accreditation programs should, as a minimum, provide consistent and reliable warnings about possible threats and, ideally, require publishers to rectify vulnerabilities before apps are released. [ABSTRACT FROM AUTHOR]

The participatory turn, fuelled by discourses and rhetoric regarding social media, and in the aftermath of the dot.com crash of the early 2000s, enrols to some extent an idea of being able to deploy networks to achieve institutional aims. The arts and cultural sector in the UK, in the face of funding cuts, has been keen to engage with such ideas in order to demonstrate value for money; by improving the efficiency of their operations, improving their respective audience experience and ultimately increasing audience size and engagement. Drawing on a case study compiled via a collaborative research project with a UK-based symphony orchestra (UKSO) we interrogate the potentials of social media engagement for audience development work through participatory media and networked publics. We argue that the literature related to mobile phones and applications (‘apps’) has focused primarily on marketing for engagement where institutional contexts are concerned. In contrast, our analysis elucidates the broader potentials and limitations of social-media-enabled apps for audience development and engagement beyond a marketing paradigm. In the case of UKSO, it appears that the technologically deterministic discourses often associated with institutional enrolment of participatory media and networked publics may not necessarily apply due to classical music culture. More generally, this work raises the contradictory nature of networked publics and argues for increased critical engagement with the concept. [ABSTRACT FROM PUBLISHER]

Aim The increased utilization of smartphones within the clinical environment together with connected applications (apps) provides opportunity for doctors, including coloproctologists, to integrate such technology into clinical practice. However, the reliability of unregulated medical apps has recently been called into question. Here, we review contemporary medical apps specifically themed towards colorectal diseases and assess levels of medical professional involvement in their design and content. Method The most popular smartphone app stores (iPhone, Android, Blackberry, Nokia, Windows and Samsung) were searched for colorectal disease themed apps, using the disease terms colorectal cancer, Crohn's disease, ulcerative colitis, diverticulitis, haemorrhoids, anal fissure, bowel incontinence and irritable bowel syndrome. Results A total of 68 individual colorectal themed apps were identified, amongst which there were five duplicates. Only 29% of colorectal apps had had customer satisfaction ratings and 32% had named medical professional involvement in their development or content. Conclusion The benefits of apps are offset by lack of colorectal specification. There is little medical professional involvement in their design. Increased regulation is required to improve accountability of app content. [ABSTRACT FROM AUTHOR]

Mobile phone applications or 'apps' are increasingly becoming an integral part of our daily lives, with the number of mobile app users in the UK predicted to exceed 43 million by 2016 (The Statistics Portal, 2015). The App and Play stores are saturated with thousands of apps that claim to cater for all elements of our lives: healthy living, education, entertainment and more. Undoubtedly apps can be a convenient way of accessing information; however, in relation to pregnancy and childbirth, how do women know whether the app they are downloading is providing high-quality, evidence-based information? This short article outlines the history of apps, discusses potential quality and credibility issues and provides suggestions for how to navigate the apps minefield to ensure the apps you download or recommend to others are credible and trusted. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic led to the implementation of worldwide restrictive measures to reduce social contact and viral spread. These measures have been reported to have a negative effect on physical activity (PA). Studies of PA during the pandemic have primarily used self-reported data. The single academic study that used tracked data did not report on demographics. Objective: This study aimed to explore patterns of smartphone-tracked activity before, during, and immediately after lockdown in the United Kingdom, and examine differences by sociodemographic characteristics and prior levels of PA. Methods: Tracked longitudinal weekly minutes of PA were captured using the BetterPoints smartphone app between January and June 2020. Data were plotted by week, demographics, and activity levels at baseline. Nonparametric tests of difference were used to assess mean and median weekly minutes of activity at significant points before and during the lockdown, and as the lockdown was eased. Changes over time by demographics (age, gender, Index of Multiple Deprivation, baseline activity levels) were examined using generalized estimating equations (GEEs). Results: There were 5395 users with a mean age of 41 years (SD 12) and 61% (n=3274) were female. At baseline, 26% (n=1422) of users were inactive, 23% (n=1240) were fairly active, and 51% (n=2733) were active. There was a relatively even spread across deprivation deciles (31% [n=1693] in the least deprived deciles and 23% in the most [n=1261]). We found significant changes in PA from the week before the first case of COVID-19 was announced (baseline) to the week that social distancing restrictions were relaxed (Friedman test: χ22=2331, P <.001). By the first full week of lockdown, the median change in PA was 57 minutes less than baseline. This represents a 37% reduction in weekly minutes of PA. Overall, 63% of people decreased their level of activity between baseline and the first week of COVID-19 restrictions. Younger people showed more PA before lockdown but the least PA after lockdown. In contrast, those aged >65 years appeared to remain more active throughout and increased their activity levels as soon as lockdown was eased. Levels of PA among those classed as active at baseline showed a larger drop compared with those considered to be fairly active or inactive. Socioeconomic group and gender did not appear to be associated with changes in PA. Conclusions: Our tracked PA data suggests a significant drop in PA during the United Kingdom's COVID-19 lockdown. Significant differences by age group and prior PA levels suggests that the government's response to COVID-19 needs to be sensitive to these individual differences and the government should react accordingly. Specifically, it should consider the impact on younger age groups, encourage everyone to increase their PA, and not assume that people will recover prior levels of PA on their own. [ABSTRACT FROM AUTHOR]

The integration of patient/person generated health data into clinical applications is a key strategic priority internationally. However, despite agreement on the overall direction of travel, there are still a range of challenges that inhibit progress in this area. These include technology-related factors (such as interoperability), use-related factors (such as data overload) and characteristics of the strategic environment (such as existing standards). Building on important policy deliberations from the United States that aim to navigate these challenges, we here apply emerging policy frameworks to the United Kingdom and outline five key priority areas that are intended to help policy makers make important strategic decisions in attempting to integrate patient/person generated data into electronic health records.