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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]

Purpose: Patient-reported outcomes (PROs) are essential to evaluate inguinal hernia surgery. There is a need for digital and disease-specific PRO measurement. Current measuring instruments (PROMs) have several disadvantages, for example, fixed measuring moments with a chance of recall bias. The Q1.6 Inguinal Hernia application has been developed to overcome these challenges. This pilot study reports the first clinical feasibility results. Methods: All surgically treated inguinal hernia patients were eligible for inclusion. The application uses "twitch crowdsourcing"; after unlocking a smartphone or tablet, a single short question is asked. This can easily be repeated multiple times a day/week/month. Questions from validated questionnaires were implemented. The adaptive question engine generates an individualised set of questions. Alerts are generated when a complication is suspected. Results: A total of 229 patients were given over 50.000 questions of which 92% were answered. Pre- and postoperative patient characteristics and their reported clinical outcomes confirmed a standard inguinal hernia population. Compliance with the application was 91.7% after 14 days, 69.0% after 3 months and 28.8% after one year. After months 3, 6 and 11, respectively, 3.0%, 4.4% and 4.5% of patients reported inguinal pain or discomfort (NRS ≥ 4). Patients were highly satisfied (92.8% preferred the app over standard care). Conclusions: This smartphone application shows promising results for clinical practice. It might allow for continuous digital patient-reported outcome measurement using non-intrusive, concise questions. Remote monitoring may become standard postoperative care after (inguinal hernia) surgery. The current application will be further improved and evaluated for cost-effectiveness, safety and validity. [ABSTRACT FROM AUTHOR]

Mobile health (m-health) is considered an undeniable part of health service delivery, planning, and marketing, which has dramatically changed due to the unique situation caused by the COVID-19 pandemic. The Forth International Congress of Mobile Health, from February 14th to 16th, 2021, in Shiraz, Iran, aimed to provide a venue to exchange ideas, techniques, relevant experiments, and applications with a particular focus on the COVID-19 pandemic impacts. More than 70 experts from different countries in engineering, biomedical sciences, and humanities presented their recent experiences in m-health advancements, particularly in response to the COVID-19 outbreak. In this article, highlights of the most valuable ideas presented at the congress are concisely summarized to give scientists, entrepreneurs, policymakers, and other stakeholders a better understanding of the growing opportunities, and challenges toward the development of m-health. [ABSTRACT FROM AUTHOR]

Background: Intrinsic features of COVID-19 disease, including the severity of the virus transmission and mortality rates, make it difficult to provide obstetric care to pregnant women. In this regard, telemedicine can provide comprehensive midwifery care relying on new technologies, such as virtual clinic, telehealth, tele-monitoring, m-Health, wearable sensors, and the internet of medical things. The objective of this study is to identify the application and requirements of a telehealth system for midwifery care. Methods: We conducted a literature search from 2019/12/1 to 2022/10/1 using the following electronic scientific databases: Web of Science, Scopus, PubMed, Science Direct, and Google Scholar. We carried out hand searches from the reference lists of retrieved studies of journals. Results: We showed that, during COVID-19 pandemic, prenatal care via telehealth increased and telehealth is a good strategy for prenatal and post-partum disease managements. Mental health services are also feasible via telehealth. These new technologies also reduce the risks associated with interpersonal contacts in COVID-19 pandemic. Conclusion: With the COVID-19 pandemic, telehealth became the norm. The future of medical services will be built around this technology and that is a great opportunity to move toward a great evolution. [ABSTRACT FROM AUTHOR]

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 were common factors that led to dropouts. We also proposed a taxonomy based on diverse theoretical foundations of mHealth interventions, delivery methods, psycho-educational programs, and social platforms. We suggest that future research should investigate, improve, and verify this taxonomy classification to enhance the design and efficacy of mHealth interventions. [ABSTRACT FROM AUTHOR]

Background: Although it is well known that regular physical activity and exercise, as well as maintaining adequate nutritional status is important to delaying symptom development and maintaining physical capacity and function in people with Parkinson's Disease (PD), many are unable to follow self-management recommendations. Active interventions have shown short-term effects, but there is a need for interventions that facilitate self-management over the course of the disease. Until now, no studies have combined exercise and nutritional interventions with an individual self-management approach in PD. Thus, we aim to examine the effect of a six-month mobile health technology(m-health)-based follow-up programme, focusing on self-management in exercise and nutrition, after an in-service interdisciplinary rehabilitation programme. Methods: A single-blinded, two-group randomised controlled trial. Participants are Adults aged 40 or older, with idiopathic PD, Hoehn and Yahr 1–3, living at home. The intervention group receives a monthly, individualized, digital conversation with a PT, combined with use of an activity tracker. People at nutritional risk get additional digital-follow-up from a nutritional specialist. The control group receives usual care. The primary outcome is physical capacity, measured by 6-min walk test (6MWT). Secondary outcomes are nutritional status, Health related quality of life (HRQOL), physical function and exercise adherence. All measurements are performed at baseline, after 3 months and after 6 months. Sample size, based on primary outcome, is set at 100 participants randomized into the two arms, including an estimated 20% drop out. Discussion: The increasing prevalence of PD globally makes it even more important to develop evidence-based interventions that can increase motivation to stay active, promote adequate nutritional status and improve self-management in people with PD. The individually tailored digital follow-up programme, based on evidence-based practice, has the potential to promote evidence-based decision-making and to empower people with PD to implement exercise and optimal nutrition in their daily lives and, hopefully, increase adherence to exercise and nutritional recommendations. Trial registration: ClinicalTrials.gov (NCT04945876). First registration 01.03.2021. [ABSTRACT FROM AUTHOR]

Maternal health includes health during pregnancy and childbirth. Each stage during pregnancy should be a positive experience, ensuring that women and their babies reach their full potential in health and well-being. However, this cannot always be achieved. According to UNFPA (United Nations Population Fund), approximately 800 women die every day from avoidable causes related to pregnancy and childbirth, so it is important to monitor mother and fetal health throughout the pregnancy. Many wearable sensors and devices have been developed to monitor both fetal and the mother's health and physical activities and reduce risk during pregnancy. Some wearables monitor fetal ECG or heart rate and movement, while others focus on the mother's health and physical activities. This study presents a systematic review of these analyses. Twelve scientific articles were reviewed to address three research questions oriented to (1) sensors and method of data acquisition; (2) processing methods of the acquired data; and (3) detection of the activities or movements of the fetus or the mother. Based on these findings, we discuss how sensors can help effectively monitor maternal and fetal health during pregnancy. We have observed that most of the wearable sensors were used in a controlled environment. These sensors need more testing in free-living conditions and to be employed for continuous monitoring before being recommended for mass implementation. [ABSTRACT FROM AUTHOR]

Transgender women (TGW) in India, especially those who engage in sex work, are at high risk for HIV. Guided by the information-motivation-behavioral skills model and qualitative formative research findings, Sakhi (girlfriend), a 3-week smartphone-based pilot intervention consisting of short videos (one/week) and text messages (two/week), was implemented using a one-group pre- and post-test design to test its efficacy in promoting condom use and HIV testing among TGW (n = 50) who engage in sex work in Chennai. Changes in outcomes were assessed by conducting multivariable analyses using generalized estimating equations. Participants' mean age was 26 years, and the mean monthly income was INR 21700 (USD 292). About one-third completed college, and 96% were HIV-negative. Significant changes in the desired direction were observed in the primary outcomes: condom use – decrease in the engagement of condomless anal sex with male partners (12% to 2%, p < 0.05) and HIV testing – increase in intentions to undergo HIV testing every 6 months (34% to 86%, p < 0.001); and in some of the secondary outcomes: decrease in alcohol use before sex, increase in intentions to use condoms consistently and increase in the well-being score. This study demonstrated the feasibility, acceptability, and preliminary efficacy of the Sakhi intervention and warrants a larger randomized trial among diverse subgroups in diverse settings. [ABSTRACT FROM AUTHOR]

Copyright of Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Fun For Wellness (FFW) is a self-efficacy theory-based online behavioral intervention that aims to promote growth in physical activity and well-being. The FFW conceptual model for the promotion of subjective well-being posits that FFW exerts both a positive direct effect, and a positive indirect effect through well-being self-efficacy, on subjective well-being. Subjective well-being is defined in FFW as an individual's satisfaction with their status in seven key domains of their life. Well-being self-efficacy is defined in FFW as the degree to which an individual perceives that they have the capability to attain a positive status in seven key domains of their life. The objective of this study was to use baseline target moderation to assess variation in the impact of FFW on subjective well-being dimensions in adults with obesity. Data (N = 667) from the Well-Being and Physical Activity Study (ClinicalTrials.gov, identifier: NCT03194854) were reanalyzed. There was evidence that well-being self-efficacy at baseline moderated the direct effect of FFW on well-being self-efficacy at 30 days post-baseline for the occupational and psychological dimensions. Both of these findings suggest a "compensatory" effect. Similarly, there was evidence that well-being self-efficacy at baseline moderated the indirect effect of FFW on subjective well-being at 60 days post-baseline through well-being self-efficacy at 30 days post-baseline for the occupational and psychological dimensions. Both of these findings suggest a "compensatory" effect. Finally, there was evidence that well-being self-efficacy at baseline moderated the direct effect of FFW on subjective well-being at 60 days post-baseline for the community, occupational, and physical dimensions. Each of these three findings suggests some version of a "rich-get-richer" effect. In summary, results provide both supportive and unsupportive (i.e., interpersonal, economic, and overall dimensions) evidence regarding variation in the impact of the FFW intervention and should impact the design of future FFW trials. [ABSTRACT FROM AUTHOR]

Background: World Health Organization, through a partnership with European Union, encourages the implementation e-health systems. E-health is a relatively old concept that is upgraded with new technologies and is directed toward monitoring different health conditions with the help of technology.

Childhood obesity is a complex disease with multiple biological and psychosocial risk factors. Recently, novel digital programs were developed with growing evidence for their effectiveness in pediatric weight management studies. The ENDORSE platform consists of mobile applications, wearables, and serious games for the remote management of childhood obesity. The pilot studies included 50 mothers and their children aged 6–14 years and resulted in a clinically significant BMI z-score reduction over 4 to 5 months. This secondary analysis of the ENDORSE study focuses on parenting styles and psychosocial factors. Methodology: Semi-structured clinical interviews were conducted with all participating mothers pre-and post-intervention. The Parenting Styles and Dimensions Questionnaire (PSDQ) evaluated the mothers’ parenting styles. The psychosocial functioning of the participating children was assessed with the parental version of the Strengths and Difficulties Questionnaire (SDQ). The relationship between parenting styles, psychosocial parameters, and weight outcomes was investigated using a linear regression analysis. Results: Weight-related stigma at school (56%), body image concerns (66%), and difficulties in family relationships (48%) were the main concerns documented during the initial psychological interviews. According to the SDQ, there was a significant decrease in children’s conduct problems during the study’s initial phase (pre-pilot group). A decrease in maternal demandingness (i.e., strict parenting style) was associated with a decrease in BMI z-score (beta coefficient = 0.314, p-value = 0.003). Conclusion: Decreasing parental demandingness was associated with better weight outcomes, highlighting the importance of assessing parenting factors in pediatric weight management programs.

This paper proposes a new system based on the Industrial Internet of Things (IIoT) for the monitoring of Mobile Health (m-Health) of workers in the underground mining industry. The proposed architecture uses a hybrid model in data transmission. Visible Light Communication (VLC) is used for downlink because of its narrow coverage, which aids in worker positioning. Radio frequency (RF) communication technology is used to send data for primary vital signs in the uplink, which is more efficient in transmission and is a viable solution according to the problem raised. The results obtained in terms of coverage and transmission for the downlink and uplink links show the feasibility of implementing the proposed system.

The Internet of Things (IoT) has positioned itself globally as a dominant force in the technology sector. IoT, a technology based on interconnected devices, has found applications in various research areas, including healthcare. Embedded devices and wearable technologies powered by IoT have been shown to be effective in patient monitoring and management systems, with a particular focus on pregnant women. This study provides a comprehensive systematic review of the literature on IoT architectures, systems, models and devices used to monitor and manage complications during pregnancy, postpartum and neonatal care. The study identifies emerging research trends and highlights existing research challenges and gaps, offering insights to improve the well-being of pregnant women at a critical moment in their lives. The literature review and discussions presented here serve as valuable resources for stakeholders in this field and pave the way for new and effective paradigms. Additionally, we outline a future research scope discussion for the benefit of researchers and healthcare professionals.

Home health monitoring can facilitate patient monitoring remotely for diabetes and blood pressure patients. Early detection of hypertension and diabetes is extremely important, as these chronic diseases often result in life-threatening complications when found at a later stage. This work proposes a smart home health monitoring system that helps to analyze the patient’s blood pressure and glucose readings at home and notifies the healthcare provider in case of any abnormality detected. A combination of conditional decision-making and machine-learning approaches is used to predict hypertension and diabetes status, respectively. The goal is to predict the hypertension and diabetes status using the patient’s glucose and blood pressure readings. Using supervised machine learning classification algorithms, herein a system is trained to predict the patient’s diabetes and hypertension status. After analyzing all the classification algorithms, support vector machine classification algorithm was found to be most accurate and thus chosen to train the model. This proposed work develops an application for a home health monitoring system with a user-friendly easy-to-use graphical user interface to diagnose blood pressure and diabetes status of patients along with sending categorized alerts and real-time notifications to their registered physician or clinic all from home.

Adherence to treatment regimens is a significant challenge faced by patients with chronic illnesses and healthy individuals, including through m-Health—a new model of remote health delivery via mobile phones. Middle-aged adults often need more internet skills, especially concerning internet self-efficacy and online trust behavior in health services. This study aims to elucidate the relationship between internet self-efficacy and adherence to medical advice among middle-aged m-Health users, mediated by online trust behavior. A cross-sectional study was conducted from 4 July to 4 September 2022, involving 214 respondents selected through convenient sampling from various cities and regencies in Indonesia. Data were collected using online forms distributed to the participants. The statistical analysis employed a structural equation model (SEM) with the LISREL version 8.7. The results showed a chi-square value of 438.61, df=187, p=0.00000, RMSEA=0.079, NFI=0.93, NNFI=0.95, CFI=0.95, and IFI=0.95. These findings indicate that online trust behavior successfully mediates the relationship between internet self-efficacy and adherence. However, internet self-efficacy does not directly affect adherence. This means that adherence will increase when trust in health services.

BackgroundHigh-salt diet is an important risk factor for several non-communicable diseases. School-based health education has been found effective in reducing salt intake among children and their families in China. However, no such interventions have been scaled up in the real world. For this purpose, a study was launched to support the development and scale-up of an mHealth-based system (EduSaltS) that integrated routine health education and salt reduction and was delivered through primary schools. This study aims to elaborate the framework, development process, features, and preliminary scaling-up of the EduSaltS system.MethodsThe EduSaltS system evolved from previously successfully tested interventions to reduce family salt intake by empowering schoolchildren through school health education. EduSaltS was designed by following the WHO’s conceptual framework for developing a scaling-up strategy which accounted for the nature of the innovation, the capacity of the implementing organizations, the characteristics of the environment, the resources available, and type of scaling up. The system was then developed step by step from determination of online platform architecture, definition of component interventions and activities, development of specific educational materials and tools, to the development of the online/offline hybridized system. The system was tested and refined by a pilot in two schools and a preliminary scale-up in two cities in China.ResultsEduSaltS was developed as an innovative health education system, including an online WeChat-based education platform, a set of offline activities, and an actual administrative website showing the progress and setting the system. The WeChat platform could be installed on users’ smartphones to automatically deliver 20 sessions of five-minute well-structured cartoon video classes, followed by other online interactive activities. It also helps support project implementation and real-time performance evaluation. As a first-stage roll-out, a one-year course has been successfully implemented among 54,538 children and their families from 209 schools in two cities, and the average course completion rate was 89.1%.ConclusionAs an innovative mHealth-based health education system, EduSaltS was developed based on successfully tested interventions and an appropriate framework for scaling up. The early-stage roll-out has shown its preliminary scalability, and further evaluation is ongoing.

In Saudi Arabia, several mitigating measures were implemented in response to the COVID-19 pandemic, including the creation of COVID-19 mobile applications (apps) for public use. The Saudi government has made the use of these apps mandatory for its citizens and residents. However, it is essential to explore the perception that common users have regarding using these apps in terms of usability and user experience. Therefore, this paper assesses user experience in terms of effectiveness, efficiency, and user satisfaction with the usability of the Saudi COVID-19 apps. The reviews of five mobile apps launched by the Saudi Data and AI Authority (SDAIA) and the Ministry of Health in the Apple Store were extracted using an online tool and analyzed using the content analysis method. The number of collected reviews was 29 for Sehha, 406 for Sehhaty, 442 for Mawid, 107 for Tabaud, and 1338 for Tawakkalna. The results of the study showed that Mawid (82%) and Tabaud (81%) had the highest usability of all the apps studied. Sehha (− 138%) and Sehhaty (−107%) received the lowest usability scores, followed by Tawakkalna (− 22%). Based on these results, we identified several usability issues with each app. Some of the main problems reported by users were increased battery drain, lack of privacy, and technical issues. [ABSTRACT FROM AUTHOR]

While an increasing number of Informal CareGivers (ICGs) are assisting their dependent loved ones with the daily living tasks and medical care, they are rarely considered in the medical devices design process. The objective of this study is to identify the characteristics of ICGs impacting the use of the iHealth® Sense BP7 medical device, namely a connected wrist blood pressure monitor. For this purpose, user tests were conducted with 29 potential or actual ICGs. First, the participants filled out a socio-demographic questionnaire and then handled the blood pressure monitor. Finally, they completed the System Usability Scale questionnaire. The results revealed an impact of technophilia and age on usability dimensions. To conclude, the consideration of the ICG population in the design process of connected medical devices is discussed, particularly the age and level of technophilia. [ABSTRACT FROM AUTHOR]

Background This research aims to assess the users' perceptions of usability and quality of mobile health applications used for promoting physical activity in Saudi Arabia. Methods This was a quantitative cross-sectional study. A survey was developed based on the Technology Acceptance Model (TAM) and the Mobile Application Rating Scale (MARS) and distributed among the Saudi population through social media to assess the users' perceptions of using mobile applications to enhance physical activity. The survey questionnaire consisted of 27 questions in six sections, including demographics (nine items), perceived usefulness (three items), perceived ease of use (three items), attitudes (three items), user experience (six items) and subjective quality (three items). All the participants were in Saudi Arabia and >15 y of age. Results A total of 195 m-Health users participated in the survey. Of the total participants, 25.1% were overweight and 21.0% were obese. The workout frequency of most users was rarely (32.3%) and three to four times a week (29.2%). In addition, 55.9% of the users agreed that the application they use served all fitness levels and >80% either agreed or strongly agreed that it was easy for them to learn how to use the application. More than 70% of users agreed or strongly agreed that the application enhanced their knowledge of workouts and physical activity and >90% would recommend the application to others. There were no differences identified between the male and female participants and younger (<40 y) and older (>40 y) participants with respect to perceived usefulness and ease of use, attitudes, experiences and subjective quality. However, significant differences were observed between participants <40 y and >40 y of age in terms of perceived ease of use of mHealth applications. Conclusion mHealth users across Saudi Arabia believe that the mHealth applications have good usability and quality factors. As a result, they can motivate people and help them achieve their goals in relation to physical activities. [ABSTRACT FROM AUTHOR]

The burden of the informal caregiver role poses a significant threat to the caregiver's physical and psychological health, with repercussions on their general well-being. It becomes necessary to identify their needs, and for that, a study was developed to assess the needs and characterize the psychosocial profile of the informal caregiver "Cuidar Maior". Most caregivers reported not having access to any type of resource in the community, including not receiving training to provide care, technical help, or having access to support groups, health measures, or social support. All caregivers reported having access to a health professional but not a social worker. In view of the lack of support in care and the requirement to provide it, and the absence of timely responses in the community, the construction and development of m-health tools that facilitate the provision of care by caregivers, which do not necessarily require a move to an institution, and which allow innovative, quick, and practical responses are necessary. It is evident that social services must intervene in the community and supervise these caregivers, allowing them to guide them towards the social resources available and informing them of their rights in this vulnerable situation. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Care coordination is critical for the management of health care needs of children with Down syndrome by encompassing management of health information and linking of providers. This study was designed to identify caregiver and health care provider experiences of care coordination to inform the development of an m-health application. In this mixed methods study, caregivers completed survey materials addressing the child's health care needs, m-health use, and care coordination experiences. A sample of caregivers and health care providers were interviewed to further understanding. Most caregivers reported having a primary health care provider but wanted increased communication and help with care coordination. Interview data identified themes related to care coordination challenges, including information management, information sharing, use of health care guidelines, tracking health data, resources, technology use, previous application use, and coordination of schedules. Qualitative themes were linked to desired features of an m-health application to aid in development. [ABSTRACT FROM AUTHOR]

Background: Occupational health nurses in workplaces aim to offer evidence-based interventions to increase physical activity among employees to promote health. Mobile health (m-health) interventions have demonstrated effectiveness in increasing physical activity, and the application of m-health solutions in workplaces warrants investigation. We examined the effectiveness of a cell phone/smart device and web-based (m-health) intervention in motivating the employees at financial enterprise firms to increase physical activity. Methods: This study included employees from 16 banks (n = 194) who were randomly assigned to either (a) an experimental group (6 banks, n = 89), which received an intervention that integrated the Theory of Planned Behavior (TPB)-based tailored Short Message Service (SMS) with web-based knowledge or (b) a comparison group (10 banks, n = 105), which received web-based messages alone. Outcomes included psychosocial variables (attitude toward physical activity, normative beliefs, and control beliefs) and the level of physical activity. Data were collected at baseline, immediately after the intervention, and 3 months after the intervention. Findings: The level of physical activity significantly increased in the experimental group (p <.05). TPB variables such as perceived social norms (p <.01) and behavioral control (p <.05) also significantly improved in the experimental group. However, all the effects had a small size (=.05) and diminished in 12 weeks. Conclusions: In addition to internet-based information, the use of mobile phones/smart devices to encourage employees to exercise for 8 weeks effectively increased employees' physical activity level. More research, specifically addressing workplace culture, is warranted to establish methods for sustaining healthy behaviors to increase physical activity. [ABSTRACT FROM AUTHOR]

Along with social development and the improvement of living standards, individuals have begun focusing more on health and disease prevention. Therefore, the demand for health care services is also increasing. Thus, mobile health services have originated. Mobile Health (M-Health) has evolved as one of the most direct tools for public health management. There is enhanced research on the factors influencing users' acceptance and M-Health service use, which provide a basis to improve M-Health services. In this study, the latest research progress of M-Health service acceptance is reviewed, and the future development and direction of M-Health services are suggested. [ABSTRACT FROM AUTHOR]

Copyright of Marketing & Menedzsment is the property of University of Pecs and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Diabetes represents an important public health challenge in India and globally. It affects the quality of life and is one of the leading causes of death and disability. The burden on global health is huge, and about 463 million adults are currently living with diabetes. 77 million people in India in the age group of 20-79 years are affected by this pandemic, and the total cost of health expenditure is 8 billion US dollars. This is a huge burden and a great economic cost to public health. The research aims to explore the concept of diabetes self-management and major research questions would comprise asking what affects self-management in people with diabetes and how mhealth applications and interventions can impact the self-management behaviors in development and the utility of the m-health apps in self-management of people with diabetes. Objective: To design, develop, and assess the impact of an m-health-enabled nutrition informatics intervention for home-based type 2 diabetes self-management in an Indian setting. Methods: The study is divided into three phases, in the first phase a systematic literature review of global and Indian literature using Scoping review method using PRISMA-SCR tool to report on various m-health interventions on Self-care management regimes on type 2 diabetes and Nutrition informatics will evaluate the effectiveness and utility of m-health application developed on Selfcare management with nutrition informatics will be reported. In the second phase m-health application on Selfcare management and nutrition informatics regime will be built in the third phase of the study evaluation of the m-health application will be done using System Usability Scale (SUS) usability and mixed research evaluation with end-users using Diabetes based management system (DBMS)questionnaire. A mixed research study between January 2023 and April 2023. A sample of approximately 250 individuals to be recruited online, enrolled in the m-health application using a nonprobability complete enumeration sampling method from selected urban settings in Delhi & all over India. The inclusion and exclusion criteria for males and females aged 20-79 years old with Type 2 diabetes and access to a smartphone. Results: A sample of 250 individuals will go through a pretested DBMS questionnaire. The data collection will be initiated in June 2022, and the initial results are planned for publication by July 2023. Out of n=250 individuals, at least 120 individuals will be retained in the study. A qualitative study using descriptive analysis of the gathered data will be performed using SPSS V11, and reporting of the results will be done at 95% CIs and P=.0.05. Conclusions: The findings of the study using scoping review would inform the elements essential for the development of m-health to improve self-care management of diabetes at home settings in India and its wider application in the global framework. [ABSTRACT FROM AUTHOR]

Background: Multiple sclerosis (MS) is one of the most common neurological disorders worldwide, and self-management is considered an essential dimension in its control. This study aimed to develop an evidence-based mobile application for MS self-management and evaluate it. Methods: This study was undertaken in three phases: content preparation, design, and evaluation. In the content preparation phase, the researchers extracted MS self-management needs based on related guidelines and guides, existing apps on the self-management of MS, and the field experts' views and confirmation. The design phase was conducted in five steps: defining app functionalities, depicting the wireframe, preparing the media, coding the app, and testing the app's performance. The app was developed using the Android Studio environment and Java programming language for the Android operating system. The performance of the developed app was tested separately in several turns, and existing defects were corrected in each turn. Finally, after using the app for three weeks, the app was evaluated for its short-term impact on MS management and user-friendliness using a researcher-constructed questionnaire from participants' (N = 20) perspectives. Results: The IDoThis app is an offline app for people with MS that includes five main modules: three modules for training or informing users about different aspects of MS, one module for monitoring the user's MS condition, and a reporting module. In the initial evaluation of the app, 75% (n = 15) of participants mentioned that using this app improved MS self-management status at intermediate and higher levels, but 25% (n = 5) of the participants mentioned that the effect of using the app on the self-management tasks was low or was very low. The majority of users rated the user-friendliness of the app as high. The users found the sections "exercises in MS" and "monitoring of MS status" beneficial to their self-management. Still, the fatigue and sleep management sections are needed to meet users' expectations. Conclusion: Using IDoThis app as a self-management tool for individuals with MS appears feasible, that can meet the need for a free and accessible self-management tool for individuals with MS. Future directions should consider the users' fatigue and sleep management expectations. [ABSTRACT FROM AUTHOR]

Studies show positive affect buffers against stress for people living with HIV, however, limited research has examined its potential health benefits for sexual minority men living with HIV (SMM-LHIV). In our proof-of-concept pilot, we adapted a Positive Affect intervention for mobile app delivery. The Positively Healthy app was designed as an ecological momentary intervention using a just-in-time adaptive intervention (JITAI) delivery format. Participants were 22 SMM-LHIV (Mage = 37.82; SD = 10.52), who completed a 90-day ecological momentary assessment (EMA). JITAI activities were triggered based on reported stress in the EMA survey. Participants completed a post-intervention assessment assessing usability, feasibility, and acceptability. On average, participants reported stress in 58.21% of the EMAs and responded to 82.1% of the intervention activities. Qualitative interview data indicated that app-based delivery was acceptable and feasible. Participant feedback also revealed our intervention would benefit from further adaptation to enhance system usability and tailored content to optimize acceptability for SMM-LWH. [ABSTRACT FROM AUTHOR]

Supervised exercise therapy is recommended as first line in the management of intermittent claudication. Its use is often limited by accessibility, compliance and cost. Home-based exercise therapy (HBET) programs emerged as an alternative solution, but have shown inferior results. The use of structured monitoring with the use of external wearable activity monitors (WAM) has been shown to improve outcomes. Mobile applications (apps) can make use of built-in accelerometers of modern smartphones and become an alternative solution for monitoring patients during HBET, potentially providing wider accessibility. This review aims to assess current use of smartphone technology (ie, mobile apps) for monitoring or tracking patients' activity in exercise therapy for peripheral arterial disease (PAD). The PubMed database was searched from January 2011 to September 2021. Eligible articles had to include a population of patients with PAD, conduct a mobile-health exercise intervention and use smartphone technology for monitoring or tracking patients' activity. Randomized controlled trials, prospective studies, and study protocols were included. A total of seven articles met the selection criteria. These articles described six different studies and five different mobile apps. Three were fitness apps (FitBit, Nike+ FuelBand, and Garmin Connect) that synchronized with commercially available WAMs to provide users with feedback. Two were PAD-specific apps (TrackPAD and Movn) developed specifically to assess patients' activity during exercise therapy. PAD-specific apps also incorporated coaching and educational elements such as weekly goal setting, claudication reminders, messaging, gamification, training advice, and PAD education. Current HBET programs use smartphone apps mainly via commercially available fitness apps that synchronize with WAM devices to register and access data. PAD-specific apps are scarce, but show promising features that can be used to monitor, train, coach, and educate patients during HBET programs. Larger studies combining these elements into HBET programs should provide future direction. [ABSTRACT FROM AUTHOR]

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Cloud computing becomes an important application development platform for processing user data with high security. Service providers are accustomed to providing storage centers outside the trusted location preferred by the data owner. Thus, ensuring the security and confidentiality of the data while processing in the centralized network is very difficult. The secured key transmission between the sender and the receiver in the network is a huge challenge in managing most of the sensitive data transmission among the cloud network. Intruders are very active over the network like real authenticated user to hack the personal sensitive data, such as bank balance, health data, personal data, and confidential documents over the cloud network. In this research, a secured key agreement between the sender and the receiver using Kerberos authentication protocol with fingerprint is proposed to ensure security in M-Healthcare. Conditions of patients are monitored using wireless sensor devices and are then transferred to the server. Kerberos protocol helps in avoiding unnecessary communication of authenticated data over the cloud network. Biometric security process is a procedure with the best security in most of the authentication field. Trust node is responsible in carrying data packets from the sender to the receiver in the cloud network. The Kerberos protocol is used in trust node to ensure security. Secured communication between the local health center and the healthcare server is ensured by using a fingerprint feature called minutiae form, which refers to the fingerprint image of both sender and receiver. The computational and communicational cost of the proposed system is lesser when compared with other existing authentication methods. [ABSTRACT FROM AUTHOR]

Aim: To study the feasibility and effectiveness of a m‐Health app in improving the management of rheumatoid arthritis. Design: Randomized controlled trial. Methods: Sixty rheumatoid arthritis participants will be recruited for a 6‐month feasibility study. Patients meeting the inclusion criteria will be randomly allocated to receive standard care or standard care plus the m‐Health intervention. The primary outcome is the feasibility of a randomized controlled trial. In addition, we will investigate patient satisfaction in using the "Rheumatism Center" app in the intervention group. The secondary outcomes include the scores for the simplified disease activity index, clinical disease activity index, disease activity score 28, health assessment questionnaire and 6‐item self‐efficacy scale for chronic diseases. The assessments will be performed at baseline and at 4 weeks, 3 months and 6 months after the study is initiated. At the end of the study, we will also collect user views of the app through qualitative interviews. Results: This study is ongoing. The findings of this study will determine the feasibility and effectiveness of m‐Health intervention in the management of rheumatoid arthritis, hoping to enhance the awareness of disease management and quality of life for rheumatoid arthritis patients. [ABSTRACT FROM AUTHOR]

Information provision for social welfare via cheap technological media is now a widely available tool used by policymakers. Often, however, an ample supply of information does not translate into high consumption of information due to various frictions in demand, possibly stemming from the pecuniary and non‐pecuniary cost of engagement, along with institutional factors. We test this hypothesis in the Indian context using a unique data set comprising 2 million call records of enrolled users of ARMMAN, a Mumbai‐based nongovernmental organization that sends timely informational calls to mobile phones of less‐privileged pregnant women. The strict lockdown induced by COVID‐19 in India was an unexpected shock on engagement with m‐Health technology, in terms of both reductions in market wages and increased time availability at home. Using a difference‐in‐differences design on unique calls tracked at the user‐time level with fine‐grained time‐stamps on calls, we find that during the lockdown period, the call durations increased by 1.53 percentage points. However, technology engagement behavior exhibited demographic heterogeneity increasing relatively after the lockdown for women who had to borrow the phones vis‐à‐vis phone owners, for those enrolled in direct outreach programs vis‐à‐vis self‐registered women, and for those who belonged to the low‐income group vis‐à‐vis high‐income group. These findings are robust with coarsened exact matching and with a placebo test for a 2017–2018 sample. Our results have policy implications around demand‐side frictions for technology engagement in developing economies and maternal health. [ABSTRACT FROM AUTHOR]

Introduction: Digital health technologies have been enhancing the capacity of healthcare providers and, thereby, the delivery of targeted health services. The Southeast Asia Region (SEAR) has invested in strengthening digital public health. Many digital health interventions have been implemented in public health settings but are rarely assessed using the holistic health technology assessment (HTA) approach., Methods: A systematic literature review was performed to provide an overview of evaluations of digital public health interventions in the World Health Organization (WHO) SEAR. Searches were conducted on four electronic databases. Screening title abstracts and full texts was independently conducted by two reviewers, followed by data extraction. Dimensions of HTA were analyzed against the EUnetHTA Core Model 3.0. Quality assessment of included articles was conducted using the JBI Checklist for Economic Evaluation and Consolidated Health Economic Evaluation Reporting Standards 2022 checklist to assess the reporting quality. The findings are presented using systematic evidence tables and bar charts., Results: Of the forty-three studies screened at the full-text stage, thirteen studies conducted across six countries were included in the analysis. Telemedicine and m-health interventions were assessed in ten studies. Nine studies conducted cost-effectiveness analysis, and five assessments were conducted from a societal perspective. Four studies utilized more than one perspective for the assessment. Health problem definition and current use of technology, description and technical characteristics of the technology, clinical effectiveness, costs, economic evaluation, and organizational aspects were assessed by all the studies, whereas legal aspects were least assessed., Conclusion: The lack of HTAs on digital public health interventions in the region highlights the need for capacity-building efforts.

Purpose of the Review: Psychotherapy remains a fundamental component of mental health treatment, yet it encounters significant barriers to accessibility and efficacy. The integration of digital therapies, encompassing e-Health, m-Health, and artificial intelligence (AI) offers the transformative potential to enhance therapeutic processes through automated systems that improve access and personalize treatment. This integration, however, involves complex considerations, including health-related quality of life (HRQoL) and the dynamics of the therapeutic alliance. This narrative review synthesizes current literature on the application of digital therapies in psychotherapy, with a focus on attention-deficit/hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), schizophrenia, and substance use disorders (SUDs). The review evaluates the effectiveness of these interventions, their impact on HRQoL, therapeutic relationships, and the associated ethical considerations., Collection and Analysis of Data: Following Green's checklist for narrative reviews, a systematic literature review was conducted on studies published from January 2009 to May 2024. Inclusion criteria centered on digital therapies, including AI-based, Internet-based, and mobile-based interventions in psychotherapy. A total of 23 studies were analyzed., Conclusions: The findings indicate that digital therapies hold substantial promise for enhancing therapeutic interventions across various mental health disorders, particularly through chatbots and Internet-based psychotherapy. However, successful integration requires careful attention to the therapeutic alliance, HRQoL, and ethical implications. This review highlights the significant potential of digital therapies, including AI-driven psychotherapy, in managing diverse mental health disorders. A balanced approach to integration, prioritizing patient well-being and addressing ethical complexities, is essential for optimizing treatment outcomes., Competing Interests: The authors declared no conflicts of interest regarding the research, authorship and/or publication of this article., (© 2023 The Author(s).)

Background and Objective: In this systematic review and meta-analysis, we compared the effectiveness of the combined m-health and a cardiac rehabilitation program (CRP) and of CRP alone on functional capacity, adherence to CRP, and management of cardiovascular risk factors in cardiac patients., Methods: Medline, EMBASE, Central, PEDro, and SPORTDiscus were searched, from inception until July 2020, for randomized controlled trials (RCTs) comparing the m-health with CRP combination with CRP alone for adults with heart disease. The PEDro scale and GRADE approach was used to assess methodological and overall quality, respectively. Pooled estimates were calculated using a random-effects model to obtain the mean difference (MD) or standardized mean difference (SMD), and their respective 95 % confidence intervals (95 %CIs)., Results: Twenty-two RCTs were eligible. The median risk-of-bias was 6.5/10. CRP with the m-Health intervention was more effective than CRP alone in improving VO 2 peak (MD: 1.02 95 %CI 0.50 -1.54) at short-term, and at medium-term follow-up (MD: 0.97, 95 %CI: 0.04 - 1.90. Similarly, CRP and m-Health were superior to CRP alone in increasing self-reported physical activity at short-term (SMD: 0.98, 95 %CI: 0.65 - 1.32] but not at medium-term follow-up (SMD: 0.18, 95 %CI:0.01 to 0.36). Furthermore, supervision of CRP with the m-Health intervention at short-term follow-up and M-Health and semi-supervised CRP - medium-term were more effective in improving VO 2 peak respectively (MD: 1.01, 95 %CI: 0.38‒1.64), (MD: 1.49, 95 %CI: 0.09, 2.89), and self-reported physical activity than supervised CRP at short-term (SMD: 0.98, 95 %CI: 0.65‒1.32) medium-term follow-ups (MD: 0.29 95 %CI: 0.12, 0.45]., Conclusion: Our review found high-quality evidence that m-health interventions combined with CRP was more effective than CRP alone in improving cardiorespiratory fitness, at the short and medium terms follow-up., Competing Interests: Declaration of competing interest The authors declare no conflicts of interest for submission of this article and this article adheres to the terms of ethical research. And, the Authors warrants that the Manuscript is an original work not published elsewhere in whole or in part except in abstract form, that he has full power to make this grant, and that the Manuscript contains no matter libelous or otherwise unlawful or which invades the right of privacy or which infringes any proprietary right., (Copyright © 2024. Published by Elsevier B.V.)

Background: The COVID-19 pandemic has highlighted the critical role of mobile health applications in the management of health crises. Despite the promising outcomes of these technologies, however, their acceptance and use among physicians in the developing world such as Saudi Arabia are notably low. Objective: The study aimed to explore the factors influencing the acceptance and adoption of mobile health applications by physicians in Saudi Arabia during the COVID-19 pandemic. Method: The study employed a qualitative research method, guided by the Unified Theory of Acceptance and Use of Technology (UTAUT). The study collected data through semi-structured interviews with 16 physicians to delve into the determinants of their readiness to adopt m-health technologies. Data were analysed using template analysis to identify key themes and patterns. Results: In line with the UTAUT, the study identified performance expectancy, effort expectancy, social influence and facilitating conditions as significant influencing factors of the acceptance and adoption of mobile health applications by physicians in Saudi Arabia during the pandemic. This study also inquired into context-specific determinants, such as data privacy concerns, patient engagement, organisational support and compatibility with religious and cultural norms, which are especially relevant in Saudi Arabia and similar developing countries, where these factors, alongside the exigencies arising from the COVID-19 pandemic, have shaped the landscape of mobile health applications utilisation. Conclusions: This study enriches the literature by expanding the UTAUT model to include context-specific drivers of acceptance and adoption. It highlights the need for tailored adoption frameworks to fit local contexts for successful m-health integration. Implications: This research broadens the UTAUT model by including cultural compatibility and data privacy concerns, offering deeper insights into mHealth adoption during crises. It highlights the need for policies and practices that support culturally sensitive app design, strengthen data privacy measures and provide improved training and patient engagement to enhance mHealth adoption., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Abstract 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.