Development of the mHealth App Trustworthiness checklist

Background Mobile health applications (mHealth apps) currently lack a consensus on substantial quality and safety standards. As such, the number of individuals engaging with untrustworthy mHealth apps continues to grow at a steady pace. Objective The purpose of this study was to investigate end-users’ opinions on the features or actions necessary for trustworthy mHealth apps; and to convey this information to app developers via a succinct but informative checklist: the mHealth app trustworthiness checklist. Methods The checklist was formulated in three stages: (a) a literature review of studies identified the desirable features of the most prolific mHealth apps (health and fitness apps); (b) four focus group sessions with past or current users of these apps ( n = 20); and (c) expert feedback on whether the checklist items are conceivable in a real-life setting ( n = 6). Results Five major themes emerged from the focus group discussions: informational content, organizational attributes, societal influence, technology-related features, and user control factors. The mHealth app trustworthiness checklist was developed to incorporate these five themes and subsequently modified following expert consultation. In addition to the trustworthiness themes, we identified features that lie between trust and mistrust (limited digital literacy and indifference) as well as 10 features and actions that cause end-users to mistrust mHealth apps. Conclusion This study contributes to the evidence base on the attributes of trustworthy mHealth apps. The mHealth app trustworthiness checklist is a useful tool in advancing continued efforts to ensure that health technologies are trustworthy.

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EFFECTIVNESS OF SPECIFIC MOBILE HEALTH APPLICATIONS (mHEALTH-APPS)in GESTATIONAL DIABTETES MELLITUS: A SYSTEMATIC REVIEW (Preprint)

10.2196/preprints.23016 ◽

2020 ◽

Author(s):

Claudia Eberle ◽

Maxine Löhnert

Keyword(s):

Mobile Health ◽

Cochrane Library ◽

Clinical Parameters ◽

Control Groups ◽

Manual Search ◽

Mobile Health Applications ◽

Short And Long Term ◽

Mhealth Apps ◽

Health Applications

BACKGROUND Gestational diabetes mellitus (GDM) emerges worldwide and is closely associated with short- and long-term health issues in women and their offspring, such as pregnancy and birth complications respectively comorbidities, Type 2 Diabetes (T2D), Metabolic Syndrome (MetS) as well as cardiovascular disease (CD). Against this background mobile health applications (mHealth-Apps) do open up new possibilities to improve the management of GDM clearly. OBJECTIVE Since there is – to our knowledge – no systematic literature review published, which focusses on the effectiveness of specific mHealth-Apps on clinical health-related short and long-term outcomes of mother and child, we conducted these much-needed analyses. METHODS Data sources: A systematic literature search in Medline (Pubmed), Cochrane Library, Embase, CINAHL and Web of Science was performed including full text publications since 2008 up to date. An additional manual search in references and Google Scholar was conducted subsequently. Study Eligibility Criteria: Women diagnosed with GDM using specific mHealth-Apps during pregnancy compared to control groups, which met main clinical parameters and outcomes in GDM management as well as maternity and offspring care. Study appraisal and synthesis methods: Study quality was assessed and rated “strong”, “moderate” or “weak” by using the Effective Public Health Practice Project (EPHPP) tool. Study results were strongly categorized by outcomes; an additional qualitative summary was assessed. Study selection: Overall, n= 114 studies were analyzed, n= 46 duplicates were removed, n=5 studies met the eligible criteria and n=1 study was assessed by manual search subsequently. In total, n=6 publications, analyzing n=408 GDM patients in the interventional and n=405 women diagnosed with GDM in the control groups, were included. These studies were divided into n=5 two-arm randomized controlled trials (RCT) and n=1 controlled clinical trial (CCT). RESULTS Distinct improvements in clinical parameters and outcomes, such as fasting blood glucoses (FBG), 2-hour postprandial blood glucoses (PBG), off target blood glucose measurements (OTBG), delivery modes and patient compliance were analyzed in GDM patients using specific mHealth-Apps compared to matched control groups. CONCLUSIONS mHealth-Apps clearly improve clinical outcomes in management of GDM effectively. More studies need to be done more in detail.

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A Human Machine Hybrid Approach for Systematic Reviews and Maps in International Development and Social Impact Sectors

Forests ◽

10.3390/f12081027 ◽

2021 ◽

Vol 12 (8) ◽

pp. 1027

Author(s):

Murat Sartas ◽

Sarah Cummings ◽

Alessandra Garbero ◽

Akmal Akramkhanov

Keyword(s):

International Development ◽

Systematic Reviews ◽

Digital Literacy ◽

Social Impact ◽

Semantic Analysis ◽

Hybrid Approach ◽

Evidence Base ◽

Societal Relevance ◽

Lexical Databases ◽

Very High

The international development and social impact evidence community is divided about the use of machine-centered approaches in carrying out systematic reviews and maps. While some researchers argue that machine-centered approaches such as machine learning, artificial intelligence, text mining, automated semantic analysis, and translation bots are superior to human-centered ones, others claim the opposite. We argue that a hybrid approach combining machine and human-centered elements can have higher effectiveness, efficiency, and societal relevance than either approach can achieve alone. We present how combining lexical databases with dictionaries from crowdsourced literature, using full texts instead of titles, abstracts, and keywords. Using metadata sets can significantly improve the current practices of systematic reviews and maps. Since the use of machine-centered approaches in forestry and forestry-related reviews and maps are rare, the gains in effectiveness, efficiency, and relevance can be very high for the evidence base in forestry. We also argue that the benefits from our hybrid approach will increase in time as digital literacy and better ontologies improve globally.

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Behavioral engagement with mHealth for improved well-being among chronically ill patients: the role of human-related and app-related factors (Preprint)

10.2196/preprints.33772 ◽

2021 ◽

Author(s):

Freek Van Baelen ◽

Melissa De Regge ◽

Bart Larivière ◽

Katrien Verleye ◽

Sam Schelfout ◽

...

Keyword(s):

Chronic Condition ◽

Chronically Ill ◽

Well Being ◽

Behavioral Engagement ◽

Related Factors ◽

Design Factor ◽

Mobile Health Applications ◽

Chronically Ill Patients ◽

The Relationship ◽

Mhealth Apps

BACKGROUND Last decade has shown a considerable increase in the amount of mobile health applications (mHealth apps) in everyday life. These mHealth apps have the potential to significantly improve well-being for chronically ill patients. However, behavioral engagement with mHealth apps remains low. OBJECTIVE The aim of this study is to provide insight into the behavioral engagement of adults with chronic conditions with mHealth apps by investigating (1) how it is affected by human-related factors (here, physician motivation) and app-related factors (here, app integration) and (2) how it affects their well-being. Supplementary, this study considers the moderating effect of preference for traditional visits to the physician (habit) and experience in app use (app experience) by the patients. METHODS A scenario based experiment among patients with a chronic condition (n= 521) was carried out. A Bayesian SEM model with mediation and moderation analysis was conducted in MPlus. RESULTS Both physician motivation for mHealth app use and mHealth app integration have a positive effect on the behavioral engagement of chronically ill patients towards mHealth apps. Higher behavioral engagement positively influences the hedonic and eudaimonic well-being of chronically ill patients. App experience positively moderates the relationship between app integration and behavioral engagement. A patients’ habit with receiving traditional care does not moderate the relationship between physician motivation and behavioral engagement. CONCLUSIONS The human and design factor play a key role in behavioral engagement and well-being among patients with a chronic condition. During and after the development of a mHealth app, app integration and physician motivation should be a point of attention.

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How Happy Are Equine Athletes? Stakeholder Perceptions of Equine Welfare Issues Associated with Equestrian Sport

Animals ◽

10.3390/ani11113228 ◽

2021 ◽

Vol 11 (11) ◽

pp. 3228

Author(s):

Tamzin Furtado ◽

Liane Preshaw ◽

Jo Hockenhull ◽

Jennifer Wathan ◽

Janet Douglas ◽

...

Keyword(s):

Focus Group ◽

Real Life ◽

Psychological Needs ◽

Stakeholder Perceptions ◽

General Management ◽

Equestrian Sport ◽

Group Sessions ◽

Equine Welfare ◽

And Training

The international governing body for equestrian sports, the Fédération Equestre Internationale (FEI), states that the welfare of the horse must be paramount and never subordinated to competitive or commercial influences. However, there is growing unease about welfare issues from both within and outside the sport. The aim of this study was to understand stakeholder perceptions of current welfare issues within equestrian sport, determine whether there is scope for change, and explore attitudes towards welfare assessment. Participants (n = 48) from equestrian sport (n = 38) and animal welfare research (n = 10) attended a workshop that included welfare-related presentations and focus group sessions. The focus group sessions were recorded, anonymised and analysed using thematic analysis. Conflict between the demands of competition and the needs of the horse was identified as a key welfare challenge. Although the physical health of equine athletes is closely monitored, horses’ psychological needs are sometimes overlooked. Participants recognised that improving competition practices may not be as impactful as improving the general management and training of horses. The term “quality of life” was considered preferable to “welfare”, which had negative connotations. Participants appreciated the idea of incorporating formal welfare assessments into their training and competition plans but stated that existing tools are rarely used and are not deemed feasible for real-life conditions.

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Methods Used to Evaluate mHealth Applications for Cardiovascular Disease: A Quasi-Systematic Scoping Review

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182312315 ◽

2021 ◽

Vol 18 (23) ◽

pp. 12315

Author(s):

Felix Holl ◽

Jennifer Kircher ◽

Walter J. Swoboda ◽

Johannes Schobel

Keyword(s):

Cardiovascular Disease ◽

Health Care ◽

Scoping Review ◽

Evaluation Framework ◽

Future Research ◽

Laboratory Diagnostics ◽

The Face ◽

Mobile Health Applications ◽

Study Designs ◽

Mhealth Apps

In the face of demographic change and constantly increasing health care costs, health care system decision-makers face ever greater challenges. Mobile health applications (mHealth apps) have the potential to combat this trend. However, in order to integrate mHealth apps into care structures, an evaluation of such apps is needed. In this paper, we focus on the criteria and methods of evaluating mHealth apps for cardiovascular disease and the implications for developing a widely applicable evaluation framework for mHealth interventions. Our aim is to derive substantiated patterns and starting points for future research by conducting a quasi-systematic scoping review of relevant peer-reviewed literature published in English or German between 2000 and 2021. We screened 4066 articles and identified n = 38 studies that met our inclusion criteria. The results of the data derived from these studies show that usability, motivation, and user experience were evaluated primarily using standardized questionnaires. Usage protocols and clinical outcomes were assessed primarily via laboratory diagnostics and quality-of-life questionnaires, and cost effectiveness was tested primarily based on economic measures. Based on these findings, we propose important considerations and elements for the development of a common evaluation framework for professional mHealth apps, including study designs, data collection tools, and perspectives.

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Mobile Apps for Oral Health Promotion: Content Review and Heuristic Usability Analysis (Preprint)

10.2196/preprints.11432 ◽

2018 ◽

Author(s):

Brooks Tiffany ◽

Paula Blasi ◽

Sheryl L Catz ◽

Jennifer B McClure

Keyword(s):

Risk Factors ◽

Health Promotion ◽

Oral Health ◽

Theoretical Basis ◽

Mobile Apps ◽

Oral Disease ◽

Oral Health Promotion ◽

Health Technologies ◽

Mhealth Apps

BACKGROUND There has been an increase in consumer-facing mobile health (mHealth) apps in recent years. Prior reviews have characterized the availability, usability, or quality of popular mHealth apps targeting a range of health behaviors, but none has examined apps that promote better oral health care. Oral disease affects billions of people worldwide and mobile phone use is on the rise, so the market for well-designed and effective oral health apps is substantial. OBJECTIVE We examined the content and usability of popular oral health promotion apps to better understand the current state of these self-help interventions and inform the need and opportunity for future app development. METHODS Between February and March 2018, we identified oral health-focused apps that were designed for Android or iOS, available in English, and targeted adult consumers (as opposed to children or dental health professionals). The sample was limited to the most popular and highly rated apps on each platform. For each app reviewed, we assessed its basic descriptive characteristics (eg, platform, cost), evidence of a theoretical basis or empirical validation, key program functionality, and the extent to which the app addressed diet and tobacco and alcohol use as risk factors for oral disease. We characterized the framing (ie, gain vs loss) of all persuasive messaging and conducted a heuristic analysis to assess each app’s usability as a persuasive health technology. RESULTS Thirty-three apps were eligible for review based on the selection criteria. Two-thirds (22/33, 67%) were geared toward the general public as opposed to dental clinic patients, insurance plan members, or owners of specific electric toothbrushes. Most (31/33, 94%) were free to download, and a majority (19/33, 58%) were sponsored by software developers as opposed to oral health experts. None offered any theoretical basis for the content or had been empirically validated. Common program features included tools for tracking or reminding one to brush their teeth and assistance scheduling dental appointments. Nineteen apps (58%) included educational or persuasive content intended to influence oral health behavior. Only 32% (6/19) of these included a larger proportion of gain-framed than loss-framed messaging. Most of the apps did not mention diet, alcohol or tobacco—important risk factors for oral disease. Overall, the apps performed poorly on standard usability heuristics recommended for persuasive health technologies. CONCLUSIONS The quality of the reviewed apps was generally poor. Important opportunities exist to develop oral health promotion apps that have theoretically grounded content, are empirically validated, and adhere to good design principles for persuasive health technologies.

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Student Writen Conversation In The Midst Of Social Media Era

Jurnal Gentala Pendidikan Dasar ◽

10.22437/gentala.v5i1.9336 ◽

2020 ◽

Vol 5 (1) ◽

pp. 12-18

Author(s):

Eko Kuntarto

Keyword(s):

Social Media ◽

Focus Group ◽

Positive Attitude ◽

Negative Impact ◽

Group Discussion ◽

Real Life ◽

Real Relationship ◽

The Social ◽

Data Source ◽

Oral Interaction

This research aimed to explain the model of writen conversationin the social media era, such presence of WhatsApp (WA) as well as to explore some of the positive contributions of WA used in building the Real Life Communication. By applying the Exploratory design, this research involved 4 participants as a purposively selected data source with indicators as WA users. Data were collected through Focus Group Discussion, Interview, and Observation and analyzed by several stages i.e. data reduction, displaying data, categorizing, and verifying and concluding. The results showed that Indonesia writen conversationcan decrease as the dominant use of WA was not wise. Nevertheless, the use of WA applications also had some positive contributions in building a real relationship. Finally, the assumption that the negative impact of using the WA application should be able to change the mindset and positive attitude in initiating and defending an oral interaction.

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Digital Health Platforms in Saudi Arabia: Determinants from the COVID-19 Pandemic Experience

Healthcare ◽

10.3390/healthcare9111517 ◽

2021 ◽

Vol 9 (11) ◽

pp. 1517

Author(s):

Saeed M. Alghamdi ◽

Abdullah S. Alsulayyim ◽

Jaber S. Alqahtani ◽

Abdulelah M. Aldhahir

Keyword(s):

Saudi Arabia ◽

Digital Health ◽

Digital Technologies ◽

Vital Role ◽

Future Research ◽

Narrative Form ◽

Published Data ◽

Health Technologies ◽

Significant Burden ◽

Mobile Health Applications

COVID-19 poses a significant burden to healthcare systems. Healthcare organisations with better health innovation infrastructures have faced a reduced burden and achieved success in curbing COVID-19. In Saudi Arabia, digital technologies have played a vital role in fighting SARS-CoV-2 transmission. In this paper, we aimed to summarise the experience of optimising digital health technologies in Saudi Arabia as well as to discuss capabilities and opportunities during and beyond the COVID-19 pandemic. A literature search was conducted up to September 2021 to document the experience of using DHTPs in Saudi Arabia in response to the COVID-19 outbreak. We also considered any published data, press briefings, and announcements by the MOH in Saudi Arabia. The findings were synthesised in narrative form. Health officials succeeded in optimising and maintaining a strategy to mitigate the spread of the virus via different digital technologies, such as mobile health applications, artificial intelligence, and machine learning. The quick digital response in Saudi Arabia was facilitated by governmental support and by considering users and technology determinants. Future research must concentrate on establishing and updating the guidelines for using DHTPs.

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A Multicentre Observational Psoriatic Arthritis Cohort Study Addressing Real-life Outcomes of a Treat to Target Approach in Routine Clinical Practice.

10.21203/rs.3.rs-136883/v1 ◽

2021 ◽

Author(s):

Laura Coates ◽

William Tillett ◽

Deepak Jadon ◽

Ines Rombach ◽

Laura Tucker ◽

...

Keyword(s):

Psoriatic Arthritis ◽

Real Life ◽

Clinical Effectiveness ◽

Evidence Base ◽

Routine Care ◽

Treat To Target ◽

Life Outcomes ◽

Disease Modifying Therapy ◽

Remission Criteria ◽

Monitoring Treatment

Abstract BackgroundThe Tight Control of psoriatic arthritis (TICOPA) trial confirmed improved clinical outcomes with a treat to target (T2T) strategy in PsA. This consisted of 4-weekly review and escalation of ‘step up’ therapy (single disease modifying therapy (DMARD), combination DMARDs and then biologics) based on remission criteria. Based on this, a T2T approach is supported by European PsA treatment recommendations. However, it is not commonly implemented in routine care primarily due to feasibility and cost concerns. In the TICOPA trial, the same treatment regime was used for all participants regardless of their disease profile. Despite the recognition of PsA as a highly heterogenous condition no studies have tailored which drugs are used depending on disease severity. The cohort will establish real world outcomes for the T2T approach in PsA and also form the basis of a trials within cohorts (TWiCs) design to test alternative therapeutic approaches within embedded clinical trials providing an evidence base for treatment strategy in PsA.MethodsThe Multicentre Observational Initiative in Treat to target Outcomes in Psoriatic Arthritis (MONITOR-PsA) cohort will apply a T2T approach within routine care. It will recruit newly diagnosed adult patients with PsA starting systemic therapies. The cohort is observational allowing routine therapeutic care within NHS clinics but a T2T approach will be supported when monitoring treatment within the cohort. Eligible participants will be adults (≥18 years) with active PsA with ≥1 tender or swollen joints or enthesis who have not previously had treatment with DMARDs for articular disease.DiscussionThis study is the first TWiC designed to support a fully powered randomized drug trial. The results from the observational cohort will be compared with those observed in the TICOPA trial investigating the clinical effectiveness and health care costs of the pragmatic T2T approach. Nested trials will provide definitive RCT evidence establishing the optimal management of PsA within the T2T approach. The TWiCs design allows robust generalizability to routine healthcare, avoids disappointment bias, aids recruitment and in future will allow assessment of longer term outcomes.Trial registrationNCT03531073, retrospectively registered 21 May 2018

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Quality and Safety in eHealth: The Need to Build the Evidence Base (Preprint)

10.2196/preprints.16689 ◽

2019 ◽

Author(s):

Elizabeth Borycki

Keyword(s):

Health Informatics ◽

Improve Patient Safety ◽

Health Technology ◽

Evidence Base ◽

Evidence Based ◽

Quality And Safety ◽

Design Development ◽

Health Technologies ◽

Safety Science ◽

Improve Patient

UNSTRUCTURED Research in the area of health technology safety has demonstrated that technology may both improve patient safety and introduce new types of technology-induced errors. Thus, there is a need to publish safety science literature to develop an evidence-based research base, on which we can continually develop new, safe technologies and improve patient safety. The aim of this viewpoint is to argue for the need to advance evidence-based research in health informatics, so that new technologies can be designed, developed, and implemented for their safety prior to their use in health care. This viewpoint offers a historical perspective on the development of health informatics and safety literature in the area of health technology. I argue for the need to conduct safety studies of technologies used by health professionals and consumers to develop an evidence base in this area. Ongoing research is necessary to improve the quality and safety of health technologies. Over the past several decades, we have seen health informatics emerge as a discipline, with growing research in the field examining the design, development, and implementation of different health technologies and new challenges such as those associated with the quality and safety of technology use. Future research will need to focus on how we can continually extend safety science in this area. There is a need to integrate evidence-based research into the design, development, and implementation of health technologies to improve their safety and reduce technology-induced errors.

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