Auditing for Score Inflation Using Self-Monitoring Assessments: Findings From Three Pilot Studies

BACKGROUND Reviews of weight loss mobile apps have revealed they include very few evidence-based features, relying mostly on self-monitoring. Unfortunately, adherence to self-monitoring is often low, especially among patients with motivational challenges. One behavioral strategy that is leveraged in virtually every visit of behavioral weight loss interventions and is specifically used to deal with adherence and motivational issues is problem solving. Problem solving has been successfully implemented in depression mobile apps, but not yet in weight loss apps. OBJECTIVE This study describes the development and feasibility testing of the Habit app, which was designed to automate problem-solving therapy for weight loss. METHODS Two iterative single-arm pilot studies were conducted to evaluate the feasibility and acceptability of the Habit app. In each pilot study, adults who were overweight or obese were enrolled in an 8-week intervention that included the Habit app plus support via a private Facebook group. Feasibility outcomes included retention, app usage, usability, and acceptability. Changes in problem-solving skills and weight over 8 weeks are described, as well as app usage and weight change at 16 weeks. RESULTS Results from both pilots show acceptable use of the Habit app over 8 weeks with on average two to three uses per week, the recommended rate of use. Acceptability ratings were mixed such that 54% (13/24) and 73% (11/15) of participants found the diet solutions helpful and 71% (17/24) and 80% (12/15) found setting reminders for habits helpful in pilots 1 and 2, respectively. In both pilots, participants lost significant weight (P=.005 and P=.03, respectively). In neither pilot was an effect on problem-solving skills observed (P=.62 and P=.27, respectively). CONCLUSIONS Problem-solving therapy for weight loss is feasible to implement in a mobile app environment; however, automated delivery may not impact problem-solving skills as has been observed previously via human delivery. CLINICALTRIAL ClinicalTrials.gov NCT02192905; https://clinicaltrials.gov/ct2/show/NCT02192905 (Archived by WebCite at http://www.webcitation.org/6zPQmvOF2)

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Personal Digital Assistant-Based Self-Monitoring Adherence Rates in 2 Dialysis Dietary Intervention Pilot Studies: BalanceWise-HD and BalanceWise-PD

Journal of Renal Nutrition ◽

10.1053/j.jrn.2010.10.026 ◽

2011 ◽

Vol 21 (6) ◽

pp. 492-498 ◽

Cited By ~ 13

Author(s):

Susan Stark ◽

Linda Snetselaar ◽

Beth Piraino ◽

Roslyn A. Stone ◽

Sunghee Kim ◽

...

Keyword(s):

Dietary Intervention ◽

Personal Digital Assistant ◽

Pilot Studies ◽

Self Monitoring

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Feasibility of Self-Monitoring Rheumatoid Arthritis With a Smartphone App: Results of Two Mixed-Methods Pilot Studies

JMIR Formative Research ◽

10.2196/20165 ◽

2020 ◽

Vol 4 (9) ◽

pp. e20165 ◽

Cited By ~ 1

Author(s):

Bart F Seppen ◽

Jimmy Wiegel ◽

Merel J L'ami ◽

Sharon Duarte dos Santos Rico ◽

Fabio S Catarinella ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Pilot Study ◽

Disease Activity ◽

Pilot Studies ◽

Self Monitoring ◽

System Usability Scale ◽

Semistructured Interviews ◽

System Usability ◽

Over Time ◽

Clinic Visits

Background Several mobile apps that monitor symptoms of rheumatoid arthritis (RA) exist, but a recent systematic review indicated that high-quality apps are lacking. When patients self-monitor their own disease with patient-reported outcomes (PROs) and self-initiate care at the right moment, it may be possible to reduce the frequency of their clinic visits, which would reduce health care burden and costs. We developed an app, that is, the MijnReuma Reade app, for this purpose and performed 2 pilot tests with weekly self-monitoring. Objective The primary objective of this study was to design, develop, and evaluate the usability, satisfaction, and usage of the MijnReuma Reade app—an app that allows patients with RA to monitor their own disease. The secondary objective was to review the patients’ perspectives on app usage and its intended purpose. Methods This app was designed in collaboration with patients with RA, rheumatologists, and information technology experts. Two 1-month pilot studies were performed, after which satisfaction (0-10 scale), usability (system usability scale, 0-100), and usage (proportion of completed questionnaires) of this app were assessed. After the second pilot study, semistructured interviews were performed to determine patients’ perspectives and the promoters and barriers of app usage. Results In the first and second pilot study, 42 and 27 patients were included, respectively. Overall, the patients were satisfied (medians, 8 and 7) and found the app usable (mean system usability scores, 76 and 71) in pilot studies 1 and 2, respectively. App usage declined over time in both the pilot studies; 61% (17/28) and 37% (10/27) of the patients who disclosed their usage statistics completed the final weekly questionnaire in pilot study 1 and pilot study 2, respectively. Approximately 81% (25/31) of the patients indicated they would like to skip hospital visits if the self-monitored disease activity is low. In the semistructured interviews, technical problems, internal resistance (respondent fatigue, the app reminded them of their disease), and a lack of symptoms were identified as barriers for usage. Patients reported that “experiencing more grip on their disease” and “improved communication with their physician” were promoters for usage. Patients reported that pain positively mediated usage, that is, more pain promoted and less pain discouraged app usage. Conclusions This study illustrates the feasibility of the MijnReuma Reade app that enables self-monitoring of the disease activity in patients with RA with the overarching aim to allocate clinical consultations according to need. Satisfaction with the app and usability of the app were found to be high; however, app usage declined over time. Patients acknowledged the potential of the app to self-monitor their own disease and would like to be able to skip clinic visits if the monitored disease activity is low. To evaluate this strategy, a randomized controlled trial is underway.

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Feasibility of Self-Monitoring Rheumatoid Arthritis With a Smartphone App: Results of Two Mixed-Methods Pilot Studies (Preprint)

10.2196/preprints.20165 ◽

2020 ◽

Author(s):

Bart F Seppen ◽

Jimmy Wiegel ◽

Merel J L'ami ◽

Sharon Duarte dos Santos Rico ◽

Fabio S Catarinella ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Pilot Study ◽

Disease Activity ◽

Pilot Studies ◽

Self Monitoring ◽

System Usability Scale ◽

Semistructured Interviews ◽

System Usability ◽

Over Time ◽

Clinic Visits

BACKGROUND Several mobile apps that monitor symptoms of rheumatoid arthritis (RA) exist, but a recent systematic review indicated that high-quality apps are lacking. When patients self-monitor their own disease with patient-reported outcomes (PROs) and self-initiate care at the right moment, it may be possible to reduce the frequency of their clinic visits, which would reduce health care burden and costs. We developed an app, that is, the MijnReuma Reade app, for this purpose and performed 2 pilot tests with weekly self-monitoring. OBJECTIVE The primary objective of this study was to design, develop, and evaluate the usability, satisfaction, and usage of the MijnReuma Reade app—an app that allows patients with RA to monitor their own disease. The secondary objective was to review the patients’ perspectives on app usage and its intended purpose. METHODS This app was designed in collaboration with patients with RA, rheumatologists, and information technology experts. Two 1-month pilot studies were performed, after which satisfaction (0-10 scale), usability (system usability scale, 0-100), and usage (proportion of completed questionnaires) of this app were assessed. After the second pilot study, semistructured interviews were performed to determine patients’ perspectives and the promoters and barriers of app usage. RESULTS In the first and second pilot study, 42 and 27 patients were included, respectively. Overall, the patients were satisfied (medians, 8 and 7) and found the app usable (mean system usability scores, 76 and 71) in pilot studies 1 and 2, respectively. App usage declined over time in both the pilot studies; 61% (17/28) and 37% (10/27) of the patients who disclosed their usage statistics completed the final weekly questionnaire in pilot study 1 and pilot study 2, respectively. Approximately 81% (25/31) of the patients indicated they would like to skip hospital visits if the self-monitored disease activity is low. In the semistructured interviews, technical problems, internal resistance (respondent fatigue, the app reminded them of their disease), and a lack of symptoms were identified as barriers for usage. Patients reported that “experiencing more grip on their disease” and “improved communication with their physician” were promoters for usage. Patients reported that pain positively mediated usage, that is, more pain promoted and less pain discouraged app usage. CONCLUSIONS This study illustrates the feasibility of the MijnReuma Reade app that enables self-monitoring of the disease activity in patients with RA with the overarching aim to allocate clinical consultations according to need. Satisfaction with the app and usability of the app were found to be high; however, app usage declined over time. Patients acknowledged the potential of the app to self-monitor their own disease and would like to be able to skip clinic visits if the monitored disease activity is low. To evaluate this strategy, a randomized controlled trial is underway.

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Brazilian adaptation of the Hotel Task: a tool for the ecological assessment of executive functions

Dementia & Neuropsychologia ◽

10.1590/1980-57642015dn92000010 ◽

2015 ◽

Vol 9 (2) ◽

pp. 156-164 ◽

Cited By ~ 3

Author(s):

Caroline de Oliveira Cardoso ◽

Nicolle Zimmermann ◽

Camila Borges Paraná ◽

Gigiane Gindri ◽

Ana Paula Almeida de Pereira ◽

...

Keyword(s):

Executive Functions ◽

Cognitive Flexibility ◽

Brain Injuries ◽

Ecological Assessment ◽

Business Administration ◽

Adaptation Process ◽

Hotel Management ◽

Pilot Studies ◽

Self Monitoring ◽

Patient Functioning

Over recent years, neuropsychological research has been increasingly concerned with the need to develop more ecologically valid instruments for the assessment of executive functions. The Hotel Task is one of the most widely used ecological measures of executive functioning, and provides an assessment of planning, organization, self-monitoring and cognitive flexibility. OBJECTIVE: The goal of this study was to adapt the Hotel Task for use in the Brazilian population. METHODS: The sample comprised 27 participants (three translators, six expert judges, seven healthy adults, ten patients with traumatic brain injuries and one hotel manager). The adaptation process consisted of five steps, which were repeated until a satisfactory version of the task was produced. The steps were as follows: (1) Translation; (2) Development of new stimuli and brainstorming among the authors; (3) Analysis by expert judges; (4) Pilot studies; (5) Assessment by an expert in business administration and hotel management. RESULTS: The adapted version proved adequate and valid for the assessment of executive functions. However, further research must be conducted to obtain evidence of the reliability, as well as the construct and criterion validity, sensitivity and specificity, of the Hotel Task. CONCLUSION: Many neurological and/or psychiatric populations may benefit from the adapted task, since it may make significant contributions to the assessment of dysexecutive syndromes and their impact on patient functioning.

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Pilot Studies to Evaluate Feasibility of a Physical Activity Intervention for Persons With Depression

Journal of Sport and Exercise Psychology ◽

10.1123/jsep.2019-0248 ◽

2020 ◽

Vol 42 (6) ◽

pp. 443-451

Author(s):

Kendall J. Sharp ◽

Charles C. South ◽

Cherise Chin Fatt ◽

Madhukar H. Trivedi ◽

Chad D. Rethorst

Keyword(s):

Physical Activity ◽

Depressive Symptoms ◽

Breast Cancer Survivors ◽

Physical Activity Intervention ◽

Intervention Group ◽

Activity Levels ◽

Pilot Studies ◽

Self Monitoring ◽

Multicomponent Intervention ◽

Exercise Facilities

Exercise reduces depressive symptoms and improves physical health in persons with depression. However, the interventions implemented in research studies require significant resources, limiting adoption into clinical practice and suggesting the need for more efficient interventions. In two nonrandomized pilot studies, the authors evaluated the feasibility of a multicomponent intervention (group educational sessions, Fitbit, and access to exercise facility) in adult persons with depression and breast cancer survivors with depression. The participants in both pilot studies completed 12 weeks of group educational sessions to increase physical activity levels, were provided with self-monitoring devices, and were provided access to on-site exercise facilities. Depressive symptoms significantly decreased postintervention, and over 90% of the participants reported that they had benefited from the intervention. These results indicate that implementing a multicomponent intervention is feasible and may reduce depressive symptoms and improve other psychosocial outcomes.

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Development and Evaluation of a Smartphone Application for Self-Monitoring of Rheumatoid Arthritis Disease Activity: Results of Two Pilot Studies and Design of a Randomized Controlled Trial (Preprint)

10.2196/preprints.15105 ◽

2019 ◽

Author(s):

Bart Seppen ◽

Merel J L'ami ◽

Sharon Rico ◽

Marieke ter Wee ◽

Franktien Turkstra ◽

...

Keyword(s):

Health Care ◽

Randomized Controlled Trial ◽

Disease Activity ◽

Health Care System ◽

Controlled Trial ◽

Smartphone Application ◽

Pilot Studies ◽

Self Monitoring ◽

Randomized Controlled ◽

Care System

BACKGROUND Rising health care costs, an increasing elderly population and shortage of (medical) personnel force us to think about alternative ways to organize our health care system. Telemedicine, based on self-measurement of disease activity, could be one of the key ingredients to create the health care system of the future. Previous publications in various fields have shown that it is possible to safely telemonitor patients whilst reducing the number of outpatient clinic visits. However, evidence for patients with RA is lacking. OBJECTIVE (1) To provide an extensive description of the development and evaluation of a smartphone application (app) for self-monitoring of rheumatoid arthritis (RA) disease activity. (2) To present the study design in order to measure the safety and efficacy of self-initiated care supported with an app. METHODS Following the Medical Research Council (MRC) guidance for developing and evaluating complex interventions, the development and evaluation of the app was carried out in three distinct phases. In the first phase design requirements were set by a team of patient representatives, health care professionals and software developers, the prototype app was developed and tested in a first pilot study. The second phase consisted of building a digital care platform, through which the app was integrated with the electronic medical record, other app-improvements and a second pilot study. The third phase comprises further improvements to achieve the set design requirements and a randomized controlled trial to evaluate the efficacy of self-management supported by the developed smartphone tool. RESULTS Two pilot studies evaluated the patient satisfaction, usability and adherence to the app. The studies were performed with 42 and 24 RA patients. In the initial pilot, the app was graded with an overall score of 8.0 (IQR 7.0-9.0). The mean system usability score was 76 (SD 15) and adherence was 60%. Consequently, improvements were made, integration to the EMR was completed and the second pilot showed similar (promising) results in terms of patient satisfaction, usability and adherence. In the planned assessor blind-pragmatic randomized controlled trial, 176 RA will be randomized to self-initiated care assisted by the app with only one scheduled follow-up consultation or to usual care. The co-primary outcome measures are the number of outpatient clinic consultations with a rheumatologist that took place during the 12 months trial period and the mean disease activity score as measured by the disease activity score 28 (DAS 28) at 12 months. Secondary outcomes include patient and physician satisfaction with care, patient empowerment, patient-physician interaction and therapeutic adherence. CONCLUSIONS We have developed an app that RA patients find satisfactory and usable for self-monitoring of disease activity. If proven safe and effective with the planned randomized controlled trial, our aim is to implement this telemonitoring strategy in the Dutch health care system. CLINICALTRIAL Trial ID: NL7715 (https://www.trialregister.nl/trial/7715)

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Low-voltage field-emission SEM of polymeric membranes for glucose biosensors

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100161862 ◽

1990 ◽

Vol 48 (3) ◽

pp. 860-861

Author(s):

Lorna K. Mayo ◽

Kenneth C. Moore ◽

Mark A. Arnold

Keyword(s):

Glucose Sensor ◽

Low Voltage ◽

Glucose Sensors ◽

Polymeric Membranes ◽

Artificial Endocrine Pancreas ◽

Self Monitoring ◽

Conducting Materials ◽

Insulin Dependent ◽

Living Tissues ◽

Voltage Scanning

An implantable artificial endocrine pancreas consisting of a glucose sensor and a closed-loop insulin delivery system could potentially replace the need for glucose self-monitoring and regulation among insulin dependent diabetics. Achieving such a break through largely depends on the development of an appropriate, biocompatible membrane for the sensor. Biocompatibility is crucial since changes in the glucose sensors membrane resulting from attack by orinter action with living tissues can interfere with sensor reliability and accuracy. If such interactions can be understood, however, compensations can be made for their effects. Current polymer technology offers several possible membranes that meet the unique chemical dynamics required of a glucose sensor. Two of the most promising polymer membranes are polytetrafluoroethylene (PTFE) and silicone (Si). Low-voltage scanning electron microscopy, which is an excellent technique for characterizing a variety of polymeric and non-conducting materials, 27 was applied to the examination of experimental sensor membranes.

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Using Popular Mobile Devices in Voice Therapy

Perspectives on Voice and Voice Disorders ◽

10.1044/vvd23.3.82 ◽

2013 ◽

Vol 23 (3) ◽

pp. 82-87 ◽

Cited By ~ 1

Author(s):

Eva van Leer

Keyword(s):

Exercise Behavior ◽

Voice Therapy ◽

Pure Oxygen ◽

Mobile Platforms ◽

Self Monitoring ◽

Web Based ◽

Motivational Messages ◽

Related Information ◽

Health Related ◽

Tailored Approach

Mobile tools are increasingly available to help individuals monitor their progress toward health behavior goals. Commonly known commercial products for health and fitness self-monitoring include wearable devices such as the Fitbit© and Nike + Pedometer© that work independently or in conjunction with mobile platforms (e.g., smartphones, media players) as well as web-based interfaces. These tools track and graph exercise behavior, provide motivational messages, offer health-related information, and allow users to share their accomplishments via social media. Approximately 2 million software programs or “apps” have been designed for mobile platforms (Pure Oxygen Mobile, 2013), many of which are health-related. The development of mobile health devices and applications is advancing so quickly that the Food and Drug Administration issued a Guidance statement with the purpose of defining mobile medical applications and describing a tailored approach to their regulation.

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Persönlichkeitspsychologie in interaktionistischer Sicht* * Ich bedanke mich bei Jens B. Asendorpf, Peter Bokenau, Karl-Heinz Reimer, Harald Schaub, Astrid Schütz und Caroline Spielhagen für die wertvollen Anregungen, die sich aus ihrer Durchsicht des Manuskripts ergaben.

Zeitschrift für Psychologie / Journal of Psychology ◽

10.1026//0044-3409.208.12.242 ◽

2000 ◽

Vol 208 (1-2) ◽

pp. 242-266 ◽

Cited By ~ 7

Author(s):

Lothar Laux

Keyword(s):

Big Five ◽

Self Monitoring

Zusammenfassung: Hauptziel des Beitrags ist es, zwei persönlichkeitspsychologische Grundpositionen, den Eigenschaftsansatz und den dynamisch-interaktionistischen Ansatz, aufeinander zu beziehen. Als Beispiel für die dominierende Eigenschaftsorientierung der deutschsprachigen Persönlichkeitspsychologie wird im ersten Abschnitt das Fünf-Faktoren Modell dargestellt und mit alternativen Ansätzen verglichen. Im zweiten Abschnitt wird die Position vertreten, daß Eigenschaftsmodelle mit der Konzeption des dynamischen Interaktionismus vereinbar sind. Dies wird am Beispiel der Selbstdarstellungsforschung, die sich auf Müller-Freienfels zurückführen läßt, veranschaulicht. Eigenschaften können nicht nur (1) als Prädiktoren von Selbstdarstellung, sondern auch (2) als Produkte von Selbstdarstellung aufgefaßt werden: Als Beispiel für den ersten Fall bietet sich die Persönlichkeitsdimension “Self-Monitoring” an. Außerdem wird “Persönlichkeitsdarstellung” als neuer Selbstdarstellungsstil eingeführt. Als Beispiele für Eigenschaften als Selbstdarstellungsprodukte dienen “situative Identitäten” sowie die “Big Five”, die als Stile der Selbstdarstellung interpretiert werden. Im dritten Abschnitt geht es um eine kritische Einschätzung des “Selbst als Beziehung” von Gergen . Seine Auffassung, daß grundlegende Annahmen von Eigenschaftsmodellen nicht länger gültig sind, konnte in einer explorativen Untersuchung nicht bestätigt werden. Um zu einer Lösung des Problems der Einheit in der Vielheit des Selbst beizutragen, wird schließlich das Sternsche Konzept einer zielbezogenen “unitas multiplex” vorgestellt.

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