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The purpose of this study was to evaluate the effectiveness of the Fun For Wellness (FFW) online intervention to increase well-being actions in adults with obesity in the United States in relatively uncontrolled settings. The FFW intervention is guided by self-efficacy theory. The study design was a large-scale, prospective, double-blind, and parallel-group randomized controlled trial. Data collection occurred at baseline, 30 days after baseline, and 60 days after baseline. Participants (N = 667) who were assigned to the FFW group (nFFW = 331) were provided with 30 days of 24-hr access to FFW. Supportive evidence was provided for the effectiveness of FFW in real-world settings to promote, either directly or indirectly, three dimensions of well-being actions: community, occupational, and psychological. This study shows that theory-based intervention may be effective in promoting well-being actions in adults with obesity in the United States. [ABSTRACT FROM AUTHOR]

The objective of this study was to provide initial validity evidence for responses to the newly developed Well-Being Actions Self-Efficacy (WBASE) scale from adults with obesity under an exploratory latent variable approach. Longitudinal data (Nbaseline = 667 and N30 days post-baseline = 550) from the Well-Being and Physical Activity study (ClinicalTrials.gov, identifier: NCT03194854), which deployed the Fun For Wellness (FFW) intervention, were analyzed. The a priori measurement model exhibited close fit to baseline data within an exploratory framework. Similarly, there was strong evidence for at least partial temporal measurement invariance for the a priori WBASE scale measurement model. Convergent (and divergent) correlations between concordant (and discordant) pairs of well-being actions scores at baseline and latent well-being actions self-efficacy factors at 30 days post-baseline were observed. There was mixed evidence for the effectiveness of the FFW intervention to exert a direct effect on latent well-being actions self-efficacy at 30 days post-baseline. [ABSTRACT FROM AUTHOR]

Fun For Wellness is a self-efficacy theory-based online behavioral intervention developed to promote growth in well-being and physical activity by providing capability-enhancing opportunities to participants. Evidence has been provided for the efficacy of Fun For Wellness to promote subjective well-being in adults in a relatively controlled setting. The objective of this study was to evaluate the effectiveness of Fun For Wellness to increase subjective well-being in adults with obesity in the United States of America in a relatively uncontrolled setting. The data described in this manuscript were collected within a more broadly focused trial: the Well-Being and Physical Activity Study (ClinicalTrials.gov, identifier: NCT03194854, https://clinicaltrials.gov/ct2/show/NCT03194854). The study design was a large-scale, prospective, double-blind, parallel group randomized controlled trial. Participants were recruited through an online panel recruitment company. Data collection occurred at three time points: baseline, 30 days and 60 days after baseline. Participants (N = 667) who were assigned to the Fun For Wellness group (nFFW = 331) were provided with 30 days of 24 h access to the online intervention (i.e., from baseline to 30 days after baseline). Participants assigned to the usual care group (nusual care = 336) were asked to conduct their lives as usual. There was evidence for a positive indirect effect of Fun For Wellness on both occupational and psychological subjective well-being at 60 days after baseline through occupational and psychological well-being self-efficacy at 30 days after baseline, respectively. There was evidence for a positive direct effect of Fun For Wellness on both community (d = 0.33) and physical (d = 0.26) subjective well-being at 60 days after baseline. Results from this study provided some initial evidence for both the effectiveness (e.g., promoting community, occupational, physical, and psychological subjective well-being), and the ineffectiveness (e.g., failing to promote interpersonal, economic, and overall subjective well-being), of the Fun For Wellness intervention for increasing subjective well-being in adults with obesity in the United States of America. [ABSTRACT FROM AUTHOR]

aime Perales,2 Lisa Sanderson Cox,2 Edward F Ellerbeck,2 Delwyn Catley,3 Ana Paula Cupertino11Department of Cancer Prevention and Control, Hackensack University Medical Center, Hackensack, NJ, USA; 2Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, KS, USA; 3Center for Children's Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, Kansas City, MO, USA Introduction: Mobile health interventions are a promising mode to address tobacco-related disparities among Latinos, the largest minority group and the highest users of text messaging technology. The purpose of this pilot study was to assess engagement in a smoking cessation intervention delivered via text message (Kick Buts) among Latino smokers. Methods: We relied on a community-based recruitment strategy to enroll 20 Latino smokers in Kick Buts. Outcome measures included biochemically verified abstinence at 12 weeks, participant text messaging interactivity with the program, and satisfaction. Results: Participants' mean age was 40.7 years old (SD=14.6). Most of the participants were male (70%), did not have health insurance (75%), and reported low nicotine-dependence (60%). The majority of participants (75%) sent at least one text message to the program. On average, participants who interacted with the program sent 31.8 (SD=39.7) text messages. Eight themes were identified in participants' messages (eg, well-being, self-efficacy, strategies to quit, extra-treatment social support, etc). At 12 weeks, 30% of the participants were biochemically verified as abstinent. Conclusion: A smoking cessation text message intervention generated high engagement among Latinos and resulted in noteworthy cessation rates. Future studies should assess the relationship of text messaging interactions with psychological effects (eg, intra-treatment social support, therapeutic alliance, and perceived autonomy support). [ABSTRACT FROM AUTHOR]

Background:The increasing number of diabetes mellitus (DM)m-health applications (apps) reveals a panorama of different approaches to the subject, demonstrating dynamism and heterogeneity. Available applications have various functions, capabilities, and data collection techniques. Objective:We systematically reviewed the literature to identify and analyze studies regarding the diversity of applications aimed at DM monitoring and treatment. We aimed to investigateapp functionalities, the basis for their design, and how they were tested. Materials and Methods:We conducted a systematic literature review in Association for Computing Machinery (ACM), Institute of Electrical and Electronics Engineers (IEEE), ScienceDirect, Springer, and Medical Literature Analysis and Retrieval System Online (MEDLINE) databases. The search considered studies published until April 2017, without language restrictions. Results:After removal of duplicates, 679 studies were screened and assessed for eligibility, when 39 studies met the inclusion criteria. We present tables summarizing the functionalities, features, fundamental techniques, and methods. Conclusions:There is a variety of approaches used in the DM apps, with comprehensive, customizable, and adjusted functionalities for different purposes. Most apps are digital logbooks for collecting data on various daily tasks from DM treatment. The researchers are interested in guidelines of medical organizations, evaluations from health professionals and patients, and other methods to verify accuracy and reliability. [ABSTRACT FROM AUTHOR]

Autism is a complex developmental disorder that affects approximately 1 in 68 children (according to the recent survey conducted by the Centers for Disease Control and Prevention--CDC) in the U.S., and has become the fastest growing category of special education. Each student with autism comes with her or his own unique needs and an array of behaviors and habits that can be severe and which interfere with everyday tasks. Autism is associated with intellectual disability, impairments in social skills, and physical health issues such as sleep and abdominal disturbances. We have designed an Internet-of-Things (IoT) framework named Wear Sense that leverages the sensing capabilities of modern smartwatches to detect stereotypic behaviors in children with autism. In this work, we present a study that used the inbuilt accelerometer of a smartwatch to detect three behaviors, including hand flapping, painting, and sibbing that are commonly observed in children with autism. In this feasibility study, we recruited 14 subjects to record the accelerometer data from the smartwatch worn on the wrist. The processing part extracts 34 different features in each dimension of the three-axis accelerometer, resulting in 102 features. Using and comparing various classification techniques revealed that an ensemble of 40 decision trees has the best accuracy of around 94.6%. This accuracy shows the quality of the data collected from the smartwatch and feature extraction methods used in this study. The recognition of these behaviors by using a smartwatch would be helpful in monitoring individuals with autistic behaviors, since the smartwatch can send the data to the cloud for comprehensive analysis and also to help parents, caregivers, and clinicians make informed decisions. [ABSTRACT FROM AUTHOR]

Using panel data on immigrant populations from European, Asian and African countries the study estimates positive associations between the number of mobile applications in use aiming to facilitate immigrants' societal integration (m-Integration) and increased level of integration (Ethnosizer), good overall health (EQ-VAS) and mental health (CESD-20). It is estimated that the patterns are gender sensitive. In addition, it is found that m-Integration applications in relation to translation and voice assistants, public services, and medical services provide the highest returns on immigrants' level of integration, health/mental health status. For instance, translation and voice assistant applications are associated with a 4% increase in integration and a 0.8% increase in good overall health. Moreover, m-Integration applications aided by artificial intelligence (AI) are associated with increased health/mental health and integration levels among immigrants. We indicate that AI by providing customized search results, peer reviewed e-learning, professional coaching on pronunciation, real-time translations, and virtual communication for finding possible explanations for health conditions might bring better quality services facilitating immigrants' needs. This is the first known study to introduce the term 'm-Integration', quantify associations between applications, health/mental health and integration for immigrants, and assess AI's role in enhancing the aforementioned outcomes. • m-Integration applications are a vector of applications facilitating immigrants' integration. • m-Integration applications are associated with enhanced integration (Ethnosizer). • m-Integration applications are associated with better health status (EQ-VAS). • m-Integration applications are associated with good mental health (CESD-20). • m-Integration applications aided by AI boost integration and health/mental health status. [ABSTRACT FROM AUTHOR]

Objective: Assess the feasibility and acceptability of a culturally- and linguistically-adapted smoking cessation text messaging intervention for Latino smokers. Methods: Using a community-based strategy, 50 Latino smokers were recruited to participate in a smoking cessation pilot study. Participants received a 12-week text messaging intervention and were offered Nicotine Replacement Therapy (NRT) at no cost. We assessed biochemically verified abstinence at 12 weeks, text messaging interactivity with the program, NRT utilization, self-efficacy, therapeutic alliance, and satisfaction. Results: Participants were 44.8 years old on average (SD 9.80), and they were primarily male (66%) and had no health insurance (78%). Most of the participants were born in Mexico (82%) and were light smokers (1-10 CPD) (68%). All participants requested the first order of NRT, and 66% requested a refill. Participants sent an average of 39.7 text messages during the 12-week intervention (SD 82.70). At 12 weeks, 30% of participants were biochemically verified abstinent (88% follow-up rate) and working alliance mean value was 79.2 (SD 9.04). Self-efficacy mean score increased from 33.98 (SD 10.36) at baseline to 40.05 (SD 17.65) at follow-up ( p = 0.04). The majority of participants (90.9%, 40/44) reported being very or extremely satisfied with the program. Conclusion: A culturally- and linguistically-adapted smoking cessation text messaging intervention for Latinos offers a promising strategy to increase the use of NRT, generated high satisfaction and frequent interactivity, significantly increased self-efficacy, produced high therapeutic alliance, and resulted in noteworthy cessation rates at the end of treatment. Additional testing as a formal randomized clinical trial is warranted., (Copyright © 2020 Cartujano-Barrera, Sanderson Cox, Arana-Chicas, Ramírez, Perales-Puchalt, Valera, Díaz, Catley, Ellerbeck and Cupertino.)

Background: Fun For Wellness (FFW) is an online behavioral intervention developed to encourage growth in well-being by providing capability-enhancing learning opportunities to participants. Self-efficacy theory guides the conceptual model underlying the FFW intervention. Some initial evidence has been provided for the efficacy of FFW to promote: well-being self-efficacy; interpersonal, community, psychological and economic subjective well-being; and, interpersonal and physical well-being actions. The purpose of this paper is to describe the protocol for a new randomized controlled trial (RCT) designed to provide the first investigation of the effectiveness of FFW to increase well-being and physical activity in adults with obesity in the United States of America.Methods: The study design is a large-scale, prospective, parallel group RCT. Approximately 9 hundred participants will be randomly assigned to the FFW or Usual Care (UC) group to achieve a 1:1 group (i.e., Ffw: UC) assignment. Participants will be recruited through an online panel recruitment company. Data collection, including determination of eligibility, will be conducted online and enrollment is scheduled to begin on 8 August 2018. Data collection will occur at baseline, 30 days and 60 days after baseline. Instruments to measure demographic information, anthropometric characteristics, self-efficacy, physical activity and well-being will be included in the battery. Data will be modeled under an intent to treat approach and/or a complier average causal effect approach depending on the level of observed engagement with the intervention.Discussion: The effectiveness trial described in this paper builds upon the 2015 FFW efficacy trial and has the potential to be important for at least three reasons. The first reason is based upon a general scientific approach that the potential utility of interventions should be evaluated under both ideal (e.g., more controlled) and real-world (e.g., less controlled) conditions. The second reason is based upon the global need for readily scalable online behavioral interventions that effectively promote physical activity in adults. The third reason is based upon the troubling global trend toward obesity along with evidence for obesity as a risk factor for several major non-communicable diseases.Trial Registration: ClinicalTrials.gov, identifier: NCT03194854 , registered 21 June 2017. [ABSTRACT FROM AUTHOR]

Background: Fun For Wellness (FFW) is an online behavioral intervention designed to promote growth in well-being and physical activity by providing capability-enhancing learning opportunities to participants. The conceptual framework for the FFW intervention is guided by self-efficacy theory. Evidence has been provided for the efficacy of FFW to promote self-reported free-living physical well-being actions in adults who comply with the intervention. The objective of this manuscript is to describe the protocol for a feasibility study designed to address uncertainties regarding the inclusion of accelerometer-based assessment of free-living physical activity within the FFW online intervention among adults with obesity in the United States of America (USA). Method: The study design is a prospective, double-blind, parallel group randomized pilot trial. Thirty participants will be randomly assigned to the FFW or usual care (UC) group to achieve a 1:1 group (i.e., FFW:UC) assignment. Recruitment of participants is scheduled to begin on 29 April 2019 at a local bariatric services center within a major healthcare organization in the Midwest of the USA. There are five eligibility criteria for participation in this study: (1) between 18 and 64 years old, (2) a body mass index ≥ 25.00 kg/m2, (3) ability to access the online intervention, (4) the absence of simultaneous enrollment in another intervention program promoting physical activity, and (5) willingness to comply with instructions for physical activity monitoring. Eligibility verification and data collection will be conducted online. Three waves of data will be collected over a 13-week period. Instruments designed to measure demographic information, anthropometric characteristics, acceptability and feasibility of accelerometer-based assessment of physical activity, self-efficacy, and well-being will be included in the study. Data will be analyzed using descriptive statistics (e.g., recruitment rates), Pearson's correlation coefficient, Bland-Altman analyses, and inferential statistical models under both an intent to treat approach and a complier average causal effect approach. Discussion: Results are intended to inform the preparation of a future definitive randomized controlled trial. Trial registration: ClinicalTrials.gov, NCT03906942, registered 8 April 2019. Trial funding: The Erwin and Barbara Mautner Charitable Foundation and the Michigan State University College of Education. [ABSTRACT FROM AUTHOR]

Background: Communication with orthopedic trauma patients is traditionally problematic with low response rates (RRs). The purpose of this investigation was to (1) evaluate the feasibility of communicating with orthopedic trauma patients postoperatively, utilizing an automated mobile phone messaging platform; and (2) assess the first 2 weeks of postoperative patient-reported pain and opioid use after lower extremity orthopedic trauma procedures., Materials and Methods: This was a prospective investigation at a Level 1 trauma center in the United States. Adult patients who were capable of mobile phone messaging and were undergoing common, lower extremity orthopedic trauma procedures were enrolled in the study. Patients received a daily mobile phone message protocol inquiring about their current pain level and amount of opioid medication they had taken in the past 24 h starting on postoperative day (POD) 3 and continuing through POD 17. Our analysis considered (1) Patient completion rate of mobile phone questions, (2) Patient-reported pain level (0-10 scale), and (3) Number and percentage of daily prescribed opioid medication patients reported taking., Results: Twenty-five patients were enrolled in this investigation. Patients responded to 87.5% of the pain and opioid medication inquiries they received over the 2-week study period. There were no differences in RRs by patient age, sex, or educational attainment. Patient-reported pain decreased over the initial 2-week study period from an average of 4.9 ± 1.7 on POD 3 to 3 ± 2.2 on POD 16-17. Patients took an average of 68% of their maximum daily narcotic prescription on POD 3 compared with 35% of their prescribed pain medication on POD 16-17., Conclusions: We found that in orthopedic trauma patients, an automated mobile phone messaging platform elicited a high patient RR that improved upon prior methods in the literature. This method may be used to reliably obtain pain and medication utilization data after trauma procedures.

Purpose: To examine interest and concerns among those who fund and operate state-run smoking cessation helplines (quitlines) about the concept of creating a centralized smokers' registry that could be used to reengage smokers after they receive initial quitline support services., Design: We conducted 3, hour-long focus groups with stakeholders, covering the perceived benefits and barriers to creating a smokers' registry., Setting: The focus groups were conducted via telephone., Participants: Three groups participated: quitline service providers (n = 14), quitline funders (n = 9), and national quitline partners (n = 8)., Method: Data collection: Focus groups were recorded, transcribed, and coded for major relevant themes. Analysis Strategies: We used a grounded theory approach., Results: Stakeholders were generally positive about the concept of a centralized smokers' registry (ie, QuitConnect), especially with its potential to link relapsed smokers to ongoing research studies designed to help smokers achieve abstinence from tobacco. However, stakeholders expressed concern about QuitConnect duplicating services already offered by state quitlines., Conclusion: Despite a common goal, many state quitline stakeholders had strong reservations about the creation of a centralized smokers' registry unless they could see clear evidence that the registry added value and was not duplicative of their existing services.

Background: Technology access and use are increasing worldwide. Adults can potentially use technology to assist with health promotion and medical care., Introduction: The purpose of this study was to compare the prevalence of participation in online health-related activities between different genders of U.S. adults aged 18-90 years., Methods: Primary data collected through a survey panel were used to examine associations between gender and technology ownership, Internet health-seeking behaviors and online behaviors related to health, having an app, and preferences for health information. Data were collected through an online survey panel of U.S. adults (n = 400) in March 2017. Results and Materials: Almost 75% had ever looked for health information and 56.8% had searched for information in the past month. About one-third of both genders (34.1%) reported tracking any health indicator regularly, and 24% had a health app. Compared with males, females were more likely to have ever sought health information online and to have a mobile app for health. No significant differences were observed between gender and individual or total e-health literacy scores. The top three preferences for health sources were Web sites (81.3%), in person (72.0%), and then print materials (72.0%)., Conclusions: This study illustrates that U.S. adults are using the Internet for health activities; however, females are more likely to engage in different e-health behaviors than males. Additional research could determine the causal factors behind these group differences in the use of online healthcare and health implications in public health practice for each group.

Background: The Office of Public Health Preparedness and Response (OPHPR) in the Centers for Disease Control and Prevention conducts outreach for public preparedness for natural and manmade incidents. In 2011, OPHPR conducted a nationwide mobile public health (m-Health) campaign that pushed brief videos on preparing for severe winter weather onto cell phones, with the objective of evaluating the interoperability of multimedia m-Health outreach with diverse cell phones (including handsets without Internet capability), carriers, and user preferences., Methods: Existing OPHPR outreach material on winter weather preparedness was converted into mobile-ready multimedia using mobile marketing best practices to improve audiovisual quality and relevance. Middleware complying with opt-in requirements was developed to push nine bi-weekly multimedia broadcasts onto subscribers' cell phones, and OPHPR promoted the campaign on its web site and to subscribers on its govdelivery.com notification platform. Multimedia, text, and voice messaging activity to/from the middleware was logged and analyzed., Results: Adapting existing media into mobile video was straightforward using open source and commercial software, including web pages, PDF documents, and public service announcements. The middleware successfully delivered all outreach videos to all participants (a total of 504 videos) regardless of the participant's device. 54 % of videos were viewed on cell phones, 32 % on computers, and 14 % were retrieved by search engine web crawlers. 21 % of participating cell phones did not have Internet access, yet still received and displayed all videos. The time from media push to media viewing on cell phones was half that of push to viewing on computers., Conclusions: Video delivered through multimedia messaging can be as interoperable as text messages, while providing much richer information. This may be the only multimedia mechanism available to outreach campaigns targeting vulnerable populations impacted by the digital divide. Anti-spam laws preserve the integrity of mobile messaging, but complicate campaign promotion. Person-to-person messages may boost enrollment.