An mHealth Intervention to Support Parenting Self-efficacy in the NICU from Admission to Home

2022 ◽  
Author(s):  
Craig F. Garfield ◽  
Elizabeth Kerrigan ◽  
Rebecca Christie ◽  
Kathryn L. Jackson ◽  
Young S. Lee
Keyword(s):  
Self Efficacy ◽  
Mhealth Intervention

scholarly journals Integration of Mobile Health Into Sickle Cell Disease Care to Increase Hydroxyurea Utilization: Protocol for an Efficacy and Implementation Study

10.2196/16319 ◽  
2020 ◽  
Vol 9 (7) ◽  
pp. e16319
Author(s):  
Jane S Hankins ◽  
Nirmish Shah ◽  
Lisa DiMartino ◽  
Donald Brambilla ◽  
Maria E Fernandez ◽  
...  
Keyword(s):  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Mobile Health ◽  
Self Efficacy ◽  
Large Scale ◽  
Cell Disease ◽  
Prescribing Behavior ◽  
Blood Institute ◽  
Mhealth Intervention ◽  
Knowledge Barriers

Background Hydroxyurea prevents disease complications among patients with sickle cell disease (SCD). Although its efficacy has been endorsed by the National Health Lung and Blood Institute evidence-based guidelines, its adoption is low, both by patients with SCD and providers. Mobile health (mHealth) apps provide benefits in improving medication adherence and self-efficacy among patients with chronic diseases and have facilitated prescription among medical providers. However, mHealth has not been systematically tested as a tool to increase hydroxyurea adherence nor has the combination of mHealth been assessed at both patient and provider levels to increase hydroxyurea utilization. Objective This study aims to increase hydroxyurea utilization through a combined two-level mHealth intervention for both patients with SCD and their providers with the goals of increasing adherence to hydroxyurea among patients and improve hydroxyurea prescribing behavior among providers. Methods We will test the efficacy of 2 mHealth interventions to increase both patient and provider utilization and knowledge of hydroxyurea in 8 clinical sites of the NHLBI-funded Sickle Cell Disease Implementation Consortium (SCDIC). The patient mHealth intervention, InCharge Health, includes multiple components that address memory, motivation, and knowledge barriers to hydroxyurea use. The provider mHealth intervention, Hydroxyurea Toolbox (HU Toolbox), addresses the clinical knowledge barriers in prescribing and monitoring hydroxyurea. The primary hypothesis is that among adolescents and adults with SCD, adherence to hydroxyurea, as measured by the proportion of days covered (the ratio of the number of days the patient is covered by the medication to the number of days in the treatment period), will increase by at least 20% after 24 weeks of receiving the InCharge Health app, compared with their adherence at baseline. As secondary objectives, we will (1) examine the change in health-related quality of life, acute disease complications, perceived health literacy, and perceived self-efficacy in taking hydroxyurea among patients who use InCharge Health and (2) examine potential increases in the awareness of hydroxyurea benefits and risks, appropriate prescribing, and perceived self-efficacy to correctly administer hydroxyurea therapy among SCD providers between baseline and 9 months of using the HU Toolbox app. We will measure the reach, adoption, implementation, and maintenance of both the InCharge Health and the HU Toolbox apps using the reach, effectiveness, adoption, implementation, and maintenance framework and qualitatively evaluate the implementation of both mHealth interventions. Results The study is currently enrolling study participants. Recruitment is anticipated to be completed by mid-2021. Conclusions If this two-level intervention, that is, the combined use of InCharge Health and HU Toolbox apps, demonstrates efficacy in increasing adherence to hydroxyurea and prescribing behavior in patients with SCD and their providers, respectively, both apps will be offered to other institutions outside the SCDIC through a future large-scale implementation-effectiveness study. Trial Registration ClinicalTrials.gov NCT04080167; https://clinicaltrials.gov/ct2/show/NCT04080167 International Registered Report Identifier (IRRID) DERR1-10.2196/16319

scholarly journals Community Health Worker Evaluation of Implementing an mHealth Application to Support Maternal Health Care in Rural India

2021 ◽  
Vol 2 ◽  
Author(s):  
Umesh Charanthimath ◽  
Geetanjali Katageri ◽  
Mai-Lei Woo Kinshella ◽  
Ashalata Mallapur ◽  
Shivaprasad Goudar ◽  
...  
Keyword(s):  
Qualitative Analysis ◽  
Community Health ◽  
Community Health Workers ◽  
Self Efficacy ◽  
Health Workers ◽  
Adverse Outcomes ◽  
Ease Of Use ◽  
Rural India ◽  
Mhealth Intervention ◽  
Auxiliary Nurse

Introduction: PIERS on the Move (POM) is a mobile health (mHealth) application developed for a smartphone to support community health workers (CHWs) for identification and management of women at risk of adverse outcomes from pre-eclampsia. POM was implemented as an addition to routine antenatal care by accredited social health activists (ASHAs) and auxiliary nurse midwives (ANMs) during the community level intervention for pre-eclampsia (CLIP) Trial in Karnataka state, India (NCT01911494). The objective of this study was to evaluate the experiences of CHWs of using POM in rural India and their perceptions of acceptability and feasibility of this mHealth intervention.Methods: A posttrial mixed-methods evaluation was designed to measure CHW knowledge and self-efficacy regarding the care of women with pre-eclampsia and perceptions of CHWs on the ease of use and usefulness of POM. A structured survey with open-ended questions was conducted between October and November 2017. The median values on a 5-point Likert scale for knowledge and self-efficacy questions were compared between trial arms by Mann–Whitney U test (p < 0.05 significant). Qualitative analysis was undertaken on NVivo 12 (QSR International, Melbourne, Australia).Results: A total of 48 ASHAs and ANMs were interviewed, including 24 who used POM (intervention arm) and 24 who did not (control arm). Self-reported knowledge and self-efficacy for the care of women with pre-eclampsia did not differ between groups. The qualitative analysis highlighted that health workers who used POM reported improved interactions with women and families in their communities. POM strengthened the role of ASHA as a CHW beyond a “link-worker” accompanying women to health services. With training, the mHealth application was easy to use even for CHWs who did not have much experience with smartphones.Conclusions: Community health workers found the POM app easy to use, useful, and well-received by women and their families. POM did not improve care through increased knowledge but built capacity by increasing the recognition of the ASHA and ANM as critical members of the continuum of antenatal healthcare within their communities. These findings support the important role that mHealth technologies can play in strengthening health systems to reach rural, remote, and marginalized populations to reduce disparities in health.

scholarly journals Usage and Weekly Attrition in a Smartphone-Based Health Behavior Intervention for Adolescents: Pilot Randomized Controlled Trial

10.2196/21432 ◽  
2021 ◽  
Vol 5 (2) ◽  
pp. e21432
Author(s):  
Erlendur Egilsson ◽  
Ragnar Bjarnason ◽  
Urdur Njardvik
Keyword(s):  
Mental Health ◽  
Health Behavior ◽  
Outcome Measures ◽  
Self Efficacy ◽  
Secondary Outcome ◽  
Specific Information ◽  
Attrition Rates ◽  
Mhealth Intervention ◽  
Randomized Controlled ◽  
Time Specific

Background The majority of adolescents own smartphones, although only 8% of them use health apps. Attrition rates from adolescent mobile health (mHealth) interventions for treating mental health problems such as anxiety and depression are an issue with a high degree of variation. Attrition in mHealth interventions targeting adolescent populations is frequently presented in a two-point fashion, from initiation of the intervention to the end of treatment, lacking more time-specific information on usage and times of attrition. Self-efficacy could provide an avenue to lower attrition rates, although a better understanding of the relationship between mental health factors and time-specific attrition rates is needed. Objective The aims of this study were to obtain time-specific attrition rates among adolescents in an mHealth intervention, and to describe the intervention’s usage and feasibility in relation to adolescent self-efficacy levels, and emotional and physical health. Methods A single-center randomized controlled public school pilot trial was undertaken with 41 adolescents. Outcome measures were assessed at baseline and after 6 weeks, while in-app activity and attrition rates were continually assessed throughout the intervention period. The primary outcome was attrition based on time and type of in-app health behavior usage, and feasibility of the mHealth app. Secondary outcome measures were self-efficacy levels, depressive and anxiety symptoms, as well as standardized BMI and sleep. Analyses of group mean variances with adjusted α levels through Bonferroni corrections were used to assess main outcome effects. Results The attrition from initiation of the intervention to 6-week follow up was 35%. Attrition started in the third week of the intervention and was related to daily time of app usage (Rt=0.43, P<.001). The number of average weekly in-app health exercises completed decreased significantly from the first week of the intervention (mean 55.25, SD 10.96) to the next week (mean 13.63, SD 2.94). However, usage increased by 22% between week 2 and the last week of the intervention (mean 16.69, SD 8.37). Usability measures revealed satisfactory scores (mean 78.09, SD 9.82) without gender differences (P=.85). Self-reported daily physical activity increased by 19.61% in the intervention group but dropped by 26.21% among controls. Self-efficacy levels increased by 8.23% in the invention arm compared to a 3.03% decrease in the control group. Conclusions This pilot study demonstrated the feasibility and usability of an mHealth intervention among adolescent participants. Indications were toward beneficial effects on physical and mental health that warrant further research. Focus on time-specific attrition measures alongside daily times of usage and ways to increase participants’ self-efficacy levels appear to be a promising avenue for research on mHealth interventions for adolescent populations with the aim to ultimately lower attrition rates.

Utilizing a Mobile Health Intervention to Manage Hypertension in an Underserved Community

2019 ◽  
Vol 42 (3) ◽  
pp. 201-209
Author(s):  
Peijia Zha ◽  
Rubab Qureshi ◽  
Sallie Porter ◽  
Ying-Yu Chao ◽  
Dula Pacquiao ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Urban Communities ◽  
Mobile Health ◽  
Self Efficacy ◽  
Controlled Trial ◽  
Self Monitoring ◽  
Mhealth Intervention ◽  
Related Quality ◽  
Health Related

This 6-month pilot randomized controlled trial examined the effectiveness of a Mobile Health (mHealth) intervention for hypertension self-monitoring and management in an underserved urban community. The four health outcomes measured included changes in systolic and diastolic blood pressure (BP), BP monitoring adherence, perceived medication adherence self-efficacy, and health-related quality of life. Thirty participants were randomly assigned to the mHealth group or a standard follow-up group; 25 participants completed the study. The mHealth group had statistically significant improvement in systolic BP decrease ( p = .01). The mHealth group had better adherence to BP monitoring and improved perceived medication adherence self-efficacy at 6 months, compared with the standard follow-up group. The results suggest that an mHealth intervention has the potential to facilitate hypertension management in underserved urban communities.

scholarly journals Integration of Mobile Health Into Sickle Cell Disease Care to Increase Hydroxyurea Utilization: Protocol for an Efficacy and Implementation Study (Preprint)

2019 ◽  
Author(s):  
Jane S Hankins ◽  
Nirmish Shah ◽  
Lisa DiMartino ◽  
Donald Brambilla ◽  
Maria E Fernandez ◽  
...  
Keyword(s):  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Mobile Health ◽  
Self Efficacy ◽  
Large Scale ◽  
Cell Disease ◽  
Prescribing Behavior ◽  
Blood Institute ◽  
Mhealth Intervention ◽  
Knowledge Barriers

BACKGROUND Hydroxyurea prevents disease complications among patients with sickle cell disease (SCD). Although its efficacy has been endorsed by the National Health Lung and Blood Institute evidence-based guidelines, its adoption is low, both by patients with SCD and providers. Mobile health (mHealth) apps provide benefits in improving medication adherence and self-efficacy among patients with chronic diseases and have facilitated prescription among medical providers. However, mHealth has not been systematically tested as a tool to increase hydroxyurea adherence nor has the combination of mHealth been assessed at both patient and provider levels to increase hydroxyurea utilization. OBJECTIVE This study aims to increase hydroxyurea utilization through a combined two-level mHealth intervention for both patients with SCD and their providers with the goals of increasing adherence to hydroxyurea among patients and improve hydroxyurea prescribing behavior among providers. METHODS We will test the efficacy of 2 mHealth interventions to increase both patient and provider utilization and knowledge of hydroxyurea in 8 clinical sites of the NHLBI-funded Sickle Cell Disease Implementation Consortium (SCDIC). The patient mHealth intervention, <i>InCharge Health,</i> includes multiple components that address memory, motivation, and knowledge barriers to hydroxyurea use. The provider mHealth intervention, <i>Hydroxyurea Toolbox</i> (<i>HU Toolbox</i>), addresses the clinical knowledge barriers in prescribing and monitoring hydroxyurea. The primary hypothesis is that among adolescents and adults with SCD, adherence to hydroxyurea, as measured by the proportion of days covered (the ratio of the number of days the patient is covered by the medication to the number of days in the treatment period), will increase by at least 20% after 24 weeks of receiving the <i>InCharge Health</i> app, compared with their adherence at baseline. As secondary objectives, we will (1) examine the change in health-related quality of life, acute disease complications, perceived health literacy, and perceived self-efficacy in taking hydroxyurea among patients who use <i>InCharge Health</i> and (2) examine potential increases in the awareness of hydroxyurea benefits and risks, appropriate prescribing, and perceived self-efficacy to correctly administer hydroxyurea therapy among SCD providers between baseline and 9 months of using the <i>HU Toolbox</i> app. We will measure the reach, adoption, implementation, and maintenance of both the <i>InCharge Health</i> and the <i>HU Toolbox</i> apps using the reach, effectiveness, adoption, implementation, and maintenance framework and qualitatively evaluate the implementation of both mHealth interventions. RESULTS The study is currently enrolling study participants. Recruitment is anticipated to be completed by mid-2021. CONCLUSIONS If this two-level intervention, that is, the combined use of InCharge Health and HU Toolbox apps, demonstrates efficacy in increasing adherence to hydroxyurea and prescribing behavior in patients with SCD and their providers, respectively, both apps will be offered to other institutions outside the SCDIC through a future large-scale implementation-effectiveness study. CLINICALTRIAL ClinicalTrials.gov NCT04080167; https://clinicaltrials.gov/ct2/show/NCT04080167 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/16319

scholarly journals Usage and weekly attrition from a smartphone based health behaviour intervention for adolescents: Pilot study (Preprint)

2020 ◽  
Author(s):  
Erlendur Egilsson ◽  
Ragnar Bjarnason ◽  
Urdur Njardvik
Keyword(s):  
Mental Health ◽  
Pilot Study ◽  
Outcome Measures ◽  
Health Behaviour ◽  
Self Efficacy ◽  
Secondary Outcome ◽  
Specific Information ◽  
Attrition Rates ◽  
Mhealth Intervention ◽  
Time Specific

BACKGROUND Majority of adolescents own smartphones though only 8% of them use health apps. Attrition rates from adolescent mHealth interventions treating mental health problems, such as anxiety and depression, are an issue with high degree of variation and attrition rates. Attrition in mHealth interventions targeting adolescent populations is frequently presented in two-point fashion, from initiation of intervention to end of treatment, lacking more time-specific information on usage and times of attrition. Self-efficacy could provide avenue to lower attrition rates though a better understanding of the relationship between mental health factors and time specific attrition rates is needed. OBJECTIVE The study aimed at obtaining time-specific attrition rates among adolescents in an mHealth intervention and describe the intervention’s usage and feasibility in relation to adolescent self-efficacy levels, emotional- and physical health. METHODS A single-centre, randomized controlled elementary school pilot trial was undertaken with 41 adolescents. Outcome measures were assessed at baseline and after 6-weeks while in-app activity and attrition rates were continually assessed throughout intervention period. Primary outcome was attrition based on time and type of in-app health behaviour usage and feasibility of mHealth app. Secondary outcome measures were self-efficacy levels, depressive- and anxiety symptoms as well as BMI-SDS and sleep. Analyses of group mean variances with adjusted alpha levels through Bonferroni corrections were used to assess main outcome effects. RESULTS Attrition from initiation of intervention to 6-weeks follow-up was 35%. Attrition started in 3rd week of intervention and was related to daily time of app usage (Rt = 0.43, p <.05.). Average weekly in-app health exercises decreased significantly from 1st week of intervention (M = 55.25, SD = 10.96) to the next (M = 13.63, SD = 2.94). However, usage increased by 22% between week 2 and last week of intervention (M = 16.69, SD = 8.37). Usability measures revealed satisfactory scores or 78.09 (SD = 9.82) without gender differences (P=.85). Self-reported daily physical activity increased by 19.61% in intervention group while dropping by 26.21% among controls. Self-efficacy levels were increased by 8.23% in invention arm compared to 3.03% decrease in control group. CONCLUSIONS This pilot study demonstrated the feasibility and usability of a mHealth intervention among adolescent participants. Indications were towards beneficial effects on physical and mental health that warrant further research. Focus on time-specific attrition measures alongside daily times of usage and ways to increase participants’ self-efficacy levels appear to be a promising avenue for research on mHealth interventions for adolescent populations with the aim to ultimately lower attrition rates. CLINICALTRIAL

Auditory Training to Improve Speech Perception and Self-Efficacy in Aging Adults

2020 ◽  
Vol 63 (4) ◽  
pp. 1270-1281
Author(s):  
Leah Fostick ◽  
Riki Taitelbaum-Swead ◽  
Shulamith Kreitler ◽  
Shelly Zokraut ◽  
Miriam Billig
Keyword(s):  
Speech Perception ◽  
Self Efficacy ◽  
Temporal Order Judgment ◽  
Auditory Training ◽  
Intensity Discrimination ◽  
Training Design ◽  
Auditory Temporal Processing ◽  
Temporal Properties ◽  
Computer Based ◽  
Aging Adults

Purpose Difficulty in understanding spoken speech is a common complaint among aging adults, even when hearing impairment is absent. Correlational studies point to a relationship between age, auditory temporal processing (ATP), and speech perception but cannot demonstrate causality unlike training studies. In the current study, we test (a) the causal relationship between a spatial–temporal ATP task (temporal order judgment [TOJ]) and speech perception among aging adults using a training design and (b) whether improvement in aging adult speech perception is accompanied by improved self-efficacy. Method Eighty-two participants aged 60–83 years were randomly assigned to a group receiving (a) ATP training (TOJ) over 14 days, (b) non-ATP training (intensity discrimination) over 14 days, or (c) no training. Results The data showed that TOJ training elicited improvement in all speech perception tests, which was accompanied by increased self-efficacy. Neither improvement in speech perception nor self-efficacy was evident following non-ATP training or no training. Conclusions There was no generalization of the improvement resulting from TOJ training to intensity discrimination or generalization of improvement resulting from intensity discrimination training to speech perception. These findings imply that the effect of TOJ training on speech perception is specific and such improvement is not simply the product of generally improved auditory perception. It provides support for the idea that temporal properties of speech are indeed crucial for speech perception. Clinically, the findings suggest that aging adults can be trained to improve their speech perception, specifically through computer-based auditory training, and this may improve perceived self-efficacy.

Effects of Using Mixed Reality With Coaching on the Interprofessional Communication Skills of Speech-Language Pathology Graduate Students

2021 ◽  
pp. 1-21
Author(s):  
Jacqueline A. Towson ◽  
Matthew S. Taylor ◽  
Diana L. Abarca ◽  
Claire Donehower Paul ◽  
Faith Ezekiel-Wilder
Keyword(s):  
Graduate Students ◽  
Self Efficacy ◽  
Mixed Reality ◽  
Role Play ◽  
Speech Language Pathology ◽  
Traditional Role ◽  
Allied Health Professionals ◽  
Interprofessional Communication ◽  
Language Pathology ◽  
The Individual

Purpose Communication between allied health professionals, teachers, and family members is a critical skill when addressing and providing for the individual needs of patients. Graduate students in speech-language pathology programs often have limited opportunities to practice these skills prior to or during externship placements. The purpose of this study was to research a mixed reality simulator as a viable option for speech-language pathology graduate students to practice interprofessional communication (IPC) skills delivering diagnostic information to different stakeholders compared to traditional role-play scenarios. Method Eighty graduate students ( N = 80) completing their third semester in one speech-language pathology program were randomly assigned to one of four conditions: mixed-reality simulation with and without coaching or role play with and without coaching. Data were collected on students' self-efficacy, IPC skills pre- and postintervention, and perceptions of the intervention. Results The students in the two coaching groups scored significantly higher than the students in the noncoaching groups on observed IPC skills. There were no significant differences in students' self-efficacy. Students' responses on social validity measures showed both interventions, including coaching, were acceptable and feasible. Conclusions Findings indicated that coaching paired with either mixed-reality simulation or role play are viable methods to target improvement of IPC skills for graduate students in speech-language pathology. These findings are particularly relevant given the recent approval for students to obtain clinical hours in simulated environments.

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