scholarly journals Identifying Mobile Health Technology Experiences and Preferences of Low-Income Pregnant Women with Diabetes

2021 ◽  
pp. 193229682199317
Author(s):  
Karolina Leziak ◽  
Eleanor Birch ◽  
Jenise Jackson ◽  
Angelina Strohbach ◽  
Charlotte Niznik ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Mobile Health ◽  
Low Income ◽  
Self Regulation ◽  
Health Inequities ◽  
Comparison Method ◽  
Rapid Expansion ◽  
Self Management ◽  
Postpartum Women ◽  
Design Elements

Background: Rapid expansion of mobile technology has resulted in the development of many mobile health (“mHealth”) platforms for health monitoring and support. However, applicability, desirability, and extent of tailoring of these platforms for pregnant women, particularly in populations who experience the greatest health inequities—such as women with diabetes mellitus (DM) and/or those with greater socioeconomic barriers—remains unknown. The objective is to understand low-income pregnant women’s experiences and preferences for mHealth tools to support DM health and improve DM self-management during pregnancy. Methods: Low-income pregnant and postpartum women were included in individual interviews or focus groups; women with type 2 DM, gestational DM, or no DM were included. Analysis was performed with the constant comparison method. Results: In this population of 45 ( N=37 with DM) low-income, largely minority, pregnant and postpartum women, 100% reported access to smartphones and prior experience with apps. Interest in mHealth to support health and engagement during pregnancy was high. Preferences for general mHealth features included education that reduces uncertainty, support communities, visualizing progress, convenient access to information, and support for better management of pregnancy-related tasks. Preferred design elements included personalization, interactive features, and integrated graphics. Women with DM expressed multiple additional DM-specific needs, including support tools for DM self-management and self-regulation tasks. Conclusion: Pregnant and postpartum women, especially those with DM, desire mHealth technology to support engagement and to adapt lifestyle guidelines and treatment requirements for a healthy pregnancy. Further work to develop mHealth interventions tailored for target populations remains a key step in reducing health inequities and promoting access to evidence-based perinatal health interventions.

scholarly journals A comprehensive 6A framework for improving patient self-management of hypertension using mobile health services: A qualitative thematic analysis (Preprint)

2020 ◽  
Author(s):  
Ting Song ◽  
Fang Liu ◽  
Ning Deng ◽  
Siyu Qian ◽  
Tingru Cui ◽  
...  
Keyword(s):  
Mobile Health ◽  
Health Assessment ◽  
Vital Signs ◽  
Comparison Method ◽  
Community Dwelling ◽  
Self Management ◽  
Easy Access ◽  
Global Public Health ◽  
Lifestyle Modifications ◽  
Assessment Results

BACKGROUND Hypertension affects over 15% of the world's population and is a significant global public health and socioeconomic challenge. Mobile health (mHealth) services have been increasingly introduced to support hypertensive patients to improve self-management behaviours, i.e. adherence to pharmacotherapy and lifestyle modifications. OBJECTIVE This study aims to explore patient perceptions of the most valuable characteristics of such services to support patients' self-management of hypertension. METHODS A semi-structured, in-depth interview study was conducted with 22 outpatients of the General Hospital of Ningxia Medical University from March to May 2019. The hospital had introduced a mHealth service to support community-dwelling, outpatients with self-management of hypertension since 2015. The data were analysed using the constant comparison method of grounded theory. Each sentence of the transcripts was split into atomic units with a unique meaning and coded. The codes were then reassembled into higher-level content categories. RESULTS The patient-perceived mechanism of the mHealth service for supporting their self-management of hypertension can be summarised as six 'A's: access, assessment, assistance, awareness, ability, and activation. With the portability of mobile phones and digitisation of information, the mHealth service provided the outpatients with easy access to assess their vital signs and self-management behaviours. The assessment results gave the patients real-time awareness of their health conditions and self-management performance, activating their self-management behaviours. The mHealth service also gave the outpatients access to assistance which included health education and self-management reminders. Both types of assistance could also be activated by abnormal assessment results, i.e. uncontrolled or deteriorating BP value, discomfort symptoms, or not using the system for a long period. With its scalable usage to handle any possible information and services, the mHealth service provided the outpatients with educational materials to learn at their own pace. This led to an improvement in self-management awareness and ability, again activating their self-management behaviours. CONCLUSIONS The mHealth service extended the traditional hypertension care model beyond the hospital and clinician's office. It provided the outpatients with easy access to otherwise inaccessible hypertension management services. This led to process improvement for outpatients to access health assessment and healthcare assistance and improved their awareness and self-management ability, which activated their hypertension self-management behaviours.

scholarly journals Patient and Provider Perspectives on a Novel Mobile Health Intervention for Low-Income Pregnant Women With Gestational or Type 2 Diabetes Mellitus

2020 ◽  
pp. 193229682093734
Author(s):  
Lynn M. Yee ◽  
Karolina Leziak ◽  
Jenise Jackson ◽  
Angelina Strohbach ◽  
Rana Saber ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Pregnant Women ◽  
Mobile Health ◽  
Negative Feedback ◽  
Low Income ◽  
Positive Feedback ◽  
Qualitative Assessment ◽  
Provider Perspectives ◽  
Functional Features

Background: Management of diabetes mellitus (DM) during pregnancy is burdensome given the intensity of required patient engagement and skills, especially for women with greater social disadvantage. Mobile health (mHealth) technology is a promising avenue for DM health promotion, but few evidence-based mHealth tools exist for pregnancy. Thus, we designed a theory-driven mHealth tool called SweetMama, and planned a priori to gather usability and acceptability feedback from patients and providers to ensure a user-centered design. Methods: In this qualitative assessment, we solicited patient and provider feedback on this novel educational and motivational mobile application for low-income pregnant women with type 2 or gestational DM. Patients and providers participated in separate focus groups. Participants shared feedback regarding SweetMama’s visual appeal, architecture, and content. SweetMama modifications were made in an iterative manner. Transcripts were analyzed using the constant comparative technique. Results: Patient ( N = 16) and provider ( N = 29) feedback was organized as positive feedback, negative feedback, or additional desired features. Within each category, themes addressed SweetMama visual features, information, or functional features. The majority of negative feedback was addressed and multiple desired features were implemented via iterative application development, resulting in a user-friendly, efficient, and potentially impactful mHealth app designed to support the unique needs of this population. Conclusions: SweetMama users had largely positive feedback about the mHealth tool’s appeal, content, and functionality. Suggested improvements were incorporated in preparation for further evaluation steps, which include longitudinal usability testing, feasibility trials, and larger trials to determine the efficacy of SweetMama use for improving perinatal outcomes.

scholarly journals Evaluation of a Text Messaging Intervention to Support Self-Management of Diabetes During Pregnancy Among Low-Income, Minority Women: Qualitative Study

JMIR Diabetes ◽  
10.2196/17794 ◽  
2020 ◽  
Vol 5 (3) ◽  
pp. e17794
Author(s):  
Lynn Yee ◽  
Shaneah Taylor ◽  
Maria Young ◽  
Makayla Williams ◽  
Charlotte Niznik ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Low Income ◽  
Text Messaging ◽  
Self Care ◽  
Perinatal Outcomes ◽  
Health Care Team ◽  
Text Messages ◽  
Self Management ◽  
Text Messaging Intervention ◽  
Sms Text Messaging

Background Given the growing burden of diabetes in underserved communities and the complexity of diabetes self-management during pregnancy, the development of interventions to support low-income pregnant women with diabetes is urgently needed. Objective This study aims to develop and pilot test a theory-driven curriculum of SMS text messaging for diabetes support and education during pregnancy. Methods This was a prospective pilot investigation of a novel SMS text messaging intervention offered to pregnant women with pregestational or gestational diabetes mellitus and publicly funded prenatal care. Prior work yielded a conceptual model of diabetes self-management barriers and support factors in this population, which was used to guide curriculum development along with health behavior theories. Participants received three supportive or educational one-way text messages per week during pregnancy. In-depth semistructured interviews were performed at study exit to solicit feedback on the program. Narrative data were analyzed using the constant comparative technique to identify themes and subthemes. Results Participants (N=31 enrolled and n=26 completed both interviews) consistently reported that SMS text messaging provided enhanced motivation for diabetes self-care, reduced diabetes-related social isolation, increased perceived diabetes-associated knowledge, enhanced comfort with the health care team, and reduced logistical burdens of diabetes during pregnancy. Participants requested enhanced interactive and customizable features in future intervention iterations. Conclusions Pregnant women with diabetes who were enrolled in this pilot study of an SMS text messaging curriculum for diabetes support described enhanced motivation, knowledge, and comfort with diabetes self-care activities as a result of the health education intervention. The next steps include enriching the interactive features of the intervention and investigating the effect of the intervention on perinatal outcomes.

scholarly journals Evaluation of a Text Messaging Intervention to Support Self-Management of Diabetes During Pregnancy Among Low-Income, Minority Women: Qualitative Study (Preprint)

2020 ◽  
Author(s):  
Lynn Yee ◽  
Shaneah Taylor ◽  
Maria Young ◽  
Makayla Williams ◽  
Charlotte Niznik ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Low Income ◽  
Text Messaging ◽  
Self Care ◽  
Perinatal Outcomes ◽  
Health Care Team ◽  
Text Messages ◽  
Self Management ◽  
Text Messaging Intervention ◽  
Sms Text Messaging

BACKGROUND Given the growing burden of diabetes in underserved communities and the complexity of diabetes self-management during pregnancy, the development of interventions to support low-income pregnant women with diabetes is urgently needed. OBJECTIVE This study aims to develop and pilot test a theory-driven curriculum of SMS text messaging for diabetes support and education during pregnancy. METHODS This was a prospective pilot investigation of a novel SMS text messaging intervention offered to pregnant women with pregestational or gestational diabetes mellitus and publicly funded prenatal care. Prior work yielded a conceptual model of diabetes self-management barriers and support factors in this population, which was used to guide curriculum development along with health behavior theories. Participants received three supportive or educational one-way text messages per week during pregnancy. In-depth semistructured interviews were performed at study exit to solicit feedback on the program. Narrative data were analyzed using the constant comparative technique to identify themes and subthemes. RESULTS Participants (N=31 enrolled and n=26 completed both interviews) consistently reported that SMS text messaging provided enhanced motivation for diabetes self-care, reduced diabetes-related social isolation, increased perceived diabetes-associated knowledge, enhanced comfort with the health care team, and reduced logistical burdens of diabetes during pregnancy. Participants requested enhanced interactive and customizable features in future intervention iterations. CONCLUSIONS Pregnant women with diabetes who were enrolled in this pilot study of an SMS text messaging curriculum for diabetes support described enhanced motivation, knowledge, and comfort with diabetes self-care activities as a result of the health education intervention. The next steps include enriching the interactive features of the intervention and investigating the effect of the intervention on perinatal outcomes.

Process evaluation of a mobile health intervention for people with diabetes in low income countries – the implementation of the TEXT4DSM study

2016 ◽  
Vol 23 (1) ◽  
pp. 96-105 ◽  
Author(s):  
Josefien Van Olmen ◽  
Maurits Van Pelt ◽  
Billy Malombo ◽  
Grace M Ku ◽  
Dominique Kanda ◽  
...  
Keyword(s):  
Process Evaluation ◽  
Mobile Health ◽  
Low Income ◽  
Democratic Republic Of Congo ◽  
Intervention Group ◽  
The Philippines ◽  
Text Messages ◽  
Low Income Countries ◽  
Self Management ◽  
Management Support

Introduction Evidence about mobile health (mHealth) approaches to manage diabetes shows modest effects on outcomes, but little is known about implementation variability. This is a process evaluation of an mHealth intervention to improve diabetes self-management through Short Message Service (SMS) provision in three diabetes care programmes in the Democratic Republic of Congo (DRC), Cambodia and the Philippines. Methods The intervention involved Diabetes Self-Management Support via text messages. The content and process of the intervention is based upon the core principles of diabetes self-management and behaviour theory. In each country, messages were sent by project managers to 240 participants in each country, who were randomly assigned to the intervention group. Contracts were negotiated with national phone providers and open access software was used to send the messages. Participants received a mobile phone and SIM card. We analysed data about the implementation process over a one year period. Results The mean monthly number of messages delivered to recipients’ phones was 67.7% of the planned number in DRC, 92.3% in Cambodia and 83.9% in the Philippines. A telephone check revealed problems with one-third of the phones, including breakage, loss and cancelled subscriptions. The number of people reached at least once was 177 (70.0%) in DRC; 147 (60.7%) in Cambodia; five in the Philippines (2.0%). Those reached each time was 144 in DRC (56.9%), 28 (9.9%) in Cambodia, none in the Philippines. People used their phone more frequently than before the intervention. Discussion Implementation of the intervention meets constraints at every step in the process. Barriers relate to the technology, the context and the participants.

scholarly journals Mobile Health Applications for Rehabilitation of Musculoskeletal Diseases of the Shoulder: A Systematic Analysis

2021 ◽  
Author(s):  
Bianca Steiner ◽  
Isabel Richter ◽  
Lena Elgert ◽  
Reinhold Haux ◽  
Klaus-Hendrik Wolf
Keyword(s):  
Mobile Health ◽  
Game Design ◽  
Musculoskeletal Diseases ◽  
Self Management ◽  
Management Skills ◽  
Eligibility Criteria ◽  
Systematic Analysis ◽  
Design Elements ◽  
Mobile Health Applications ◽  
Health Applications

Rehabilitation of musculoskeletal diseases (MSD) of the shoulder is a multifaceted long-term process, which is often not transparent to affected patients. Mobile health applications (apps) have the potential to support this complex process by improving patients’ self-management skills. However, there seems to be a lack of apps providing a holistic approach to motivate and guide patients during the whole rehabilitation process. Therefore, a systematic analysis of apps on Google Play Store was conducted by two independent reviewers. A total of 3227 apps were identified, of which 64 met the eligibility criteria for the qualitative analysis. The majority of analyzed apps were developed generally for patients with MSD of the shoulder, rarely for specific diseases (individual needs of patients). The majority of apps focus on the provision of information, exercise training, and alternative medicine. Apps for diagnostics, inpatient treatment, and self-management, especially for multiple rehabilitation phases, are rare or even not existent. Game design elements are seldom used. If there are any, then simple to implement ones, e.g. messages and progress bars. The (psychological) effects of individual game design elements on patients seem to be neglected, when selecting and implementing game-components.

scholarly journals Feasibility and Acceptability of Using Smartphone Apps in Diabetes Self-Management in an Underserved Population: Qualitative Study (Preprint)

2018 ◽  
Author(s):  
Jenny Luo ◽  
Shelley White-Means
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Mobile Health ◽  
Low Income ◽  
Underserved Populations ◽  
Low Cost ◽  
Self Management ◽  
Care Providers ◽  
Health Apps ◽  
Patients With Diabetes

BACKGROUND The successful management of diabetes is a chronic endeavor. It involves a whole host of factors ranging from a consistent patient-provider relationship to regular physical activity. Not all patients with diabetes, however, have access to the resources needed for effective disease management. Health disparities contribute to a higher frequency of diabetes development in poor and minority populations. Moreover, health care disparities limit the care these patient populations receive. Because underserved populations have little to no access to traditional means of health care, providers must explore other avenues to reach this patient group. Mobile health (mHealth) has grown significantly in the last decade. With the fast-paced adoption of cell phones across all socioeconomic groups, mobile health presents the opportunity to offer patients a low-cost way to receive health information, to communicate with providers, and to self-manage chronic conditions. It has been well established that low-income, minority populations experience several barriers to receiving basic health care including uninsurance, limited transportation, and high out-of-pocket costs. The provision of health care via mobile devices may have the potential to address such health disparities. Little is known about the effectiveness of using mobile health and smartphone applications (apps) in underserved populations to help with diabetes management. Knowledge of these patients’ interest in using mobile apps to augment their home self-management may have use in future implementations. OBJECTIVE The objective of this study is to examine the perception of and willingness to use diabetes mobile health apps on smartphones in patients with limited access to primary care providers. METHODS This study used purposive sampling to select patients for personal interviews. The study was conducted at a general hospital located in a part of town with predominate minority and low-income residency, as well as the highest diabetes prevalence rates. Semi-structured interviews were conducted according to McNamara’s interview staging. A total of 15 interviews were collected and coded by the researcher according to the interpretative phenomenological analysis framework. An independent committee reviewed all interview transcripts and coding to verify trustworthiness of collection and analysis. RESULTS The data produced 7 clusters related to smartphone app use and mHealth, each highlighting a component of the patient experience, which supported 3 overarching themes. The themes are as follows: despite limited knowledge about health apps and varying phone use patterns, patients were all willing to try at least one diabetes-related app; apps functions should be individualized to meet each patient’s needs for maximum benefit; and barriers to app use were varied but commonly included knowledge and technological challenges and security issues. CONCLUSIONS Personal interviews of this underserved patient population demonstrated an interest in and willingness to try mobile health apps, despite limited knowledge about the technology. Responses indicate that tailoring app choices to individual needs, instead of choosing a multi-functional one-size-fits-all app, would provide the most benefit for at-home diabetes self-management. Smartphone apps may serve as a viable low-cost resource for patients with diabetes who have limited access to traditional health care providers.

scholarly journals Responsive Asthma Care for Teens (ReACT): development protocol for an adaptive mobile health intervention for adolescents with asthma

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e030029 ◽  
Author(s):  
Christopher C Cushing ◽  
David A Fedele ◽  
Susana R Patton ◽  
Elizabeth L McQuaid ◽  
Joshua M Smyth ◽  
...  
Keyword(s):  
Mobile Health ◽  
Inhaled Corticosteroids ◽  
Self Regulation ◽  
Self Management ◽  
Asthma Care ◽  
Allied Health Professionals ◽  
Intervention Delivery ◽  
Mhealth Intervention ◽  
Behavioural Health ◽  
The University

IntroductionAsthma is a leading cause of youth morbidity in the USA, affecting >8% of youth. Adherence to inhaled corticosteroids (ICS) can prevent asthma-related morbidity; however, the typical adolescent with asthma takes fewer than 50% of their prescribed doses. Adolescents are uniquely vulnerable to suboptimal asthma self-management due to still-developing executive functioning capabilities that may impede consistent self-regulation and weaken attempts to use problem solving to overcome barriers to ICS adherence.Methods and analysisThe aims of this project are to improve adherence to ICS as an important step towards better self-management among adolescents aged 13–17 years diagnosed with asthma by merging the efficacious behaviour change strategies found in behavioural health interventions with scalable, adaptive mobile health (mHealth) technologies to create the Responsive Asthma Care for Teens programme (ReACT). ReACT intervention content will be developed through an iterative user-centred design process that includes conducting (1) one-on-one interviews with 20 teens with asthma; (2) crowdsourced feedback from a nationally representative panel of 100 adolescents with asthma and (3) an advisory board of youth with asthma, a paediatric pulmonologist and a behavioural health expert. In tandem, we will work with an existing technology vendor to programme ReACT algorithms to allow for tailored intervention delivery. We will conduct usability testing of an alpha version of ReACT with a sample of 20 target users to assess acceptability and usability of our mHealth intervention. Participants will complete a 4-week run-in period to monitor their adherence with all ReACT features turned off. Subsequently, participants will complete a 4-week intervention period with all ReACT features activated. The study started in October 2018 and is scheduled to conclude in late 2019.Ethics and disseminationInstitutional review board approval was obtained at the University of Kansas and the University of Florida. We will submit study findings for presentation at national research conferences that are well attended by a mix of psychologists, allied health professionals and physicians. We will publish study findings in peer-reviewed journals read by members of the psychology, nursing and pulmonary communities.

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