scholarly journals Feasibility and Acceptability of Using Mobile Health Apps in Underserved Patients with Diabetes

2021 ◽  
Author(s):  
◽  
Jieyu Luo ◽  
Keyword(s):  
Health Care ◽  
Mobile Health ◽  
Diabetes Management ◽  
Low Cost ◽  
Self Management ◽  
Smartphone Apps ◽  
Health Apps ◽  
Underserved Patients ◽  
Mobile Health Apps ◽  
At Home

Introduction. Diabetes mellitus is a condition with a growing morbidity and mortality burden. An estimated 30 million adults currently live with diabetes, with each individual spending over $9500 annually on medical care. The successful management of diabetes is a lifelong endeavor. This involves balancing a variety of factors including diet, medications, and glucose monitoring. It has been well established that successful control of diabetes depends largely upon patients’ daily lifestyle habits and activities. Not all patients, however, have the resources necessary for effective diabetes management. Health disparities lead to a higher rate of diabetes development in minority and poor populations. Since underserved patients have limited access to traditional healthcare avenues, providers should explore other means, like mobile health (mHealth), to help such patients. The rapid adoption of smartphones within the last decade has allowed an opportunity for patients to use mHealth and smartphone applications (apps) as a low-cost way to get health information and services. mHealth has the potential to address such disparities in access to health care. Little is known about the effectiveness of using apps to help underserved patients with their diabetes management. Assessing these patients’ current self-management practices and their interest in using smartphone apps for their diabetes management is the first step in determining how mHealth may benefit this patient population. Purpose. The purpose of this study was to assess how underserved patients with limited access to primary care physicians handled their diabetes on their own at home, to determine what challenges they faced with their self-management, and to examine their willingness to use diabetes mHealth apps on their smartphones to assist with their diabetes management. Methods. This study employed purposive sampling to select patients for individual interviews. Participant selection occurred at a Memphis hospital located in an area of town with predominately low-income and minority residents, as well as a high prevalence of diabetes. Semi-structured interviews were conducted on-site at the hospital based on McNamara’s interview staging. In all, 15 interviews were recorded, transcribed, and coded according to the interpretative phenomenological analysis framework. Results. The data produced 5 topic clusters related to at-home diabetes management, which supported 2 overarching themes, and 7 clusters related to mHealth smartphone app use, which supported 3 overarching themes. The themes related to self-management are as follows: 1. Patients are aware that successful diabetes control requires active engagement on their part but voiced struggles related to balancing limited income and a healthy diet, how to manage fluctuating glucose readings throughout the day, and affording medications; and 2. Lacking a traditional relationship with a primary care doctor, these underserved patients turn to friends and family, written materials, and the internet as health care resources. The themes related to smartphone mHealth are as follows: 1. Despite limited knowledge about health apps and varying phone use patterns, patients were all willing to try at least one diabetes-related app; 2. App functions should be individualized to meet each patient’s needs for maximum benefit; and 3. Barriers to app use were varied but commonly included knowledge and technological challenges and security issues. Conclusion. Interviews from this vulnerable population demonstrated that individuals understood the importance of their own active involvement in controlling their diabetes. Yet, because of limited economic and health care resources, these patients struggle with the implementation of effective lifestyle choices in their daily routine. Furthermore, interviewees expressed interest in trying mobile health apps for diabetes management, despite minimal knowledge about the technology. Responses showed that selecting apps tailored to each individual’s needs, instead of offering one blanket multifunctional app, would provide patients with the greatest benefit. Smartphone apps may be a low-cost health resource that patients without regular access to physicians can use for their at-home diabetes management.

scholarly journals Evaluating the Potential Use of Smartphone Apps for Diabetes Self-Management in an Underserved Population: A Qualitative Approach

2021 ◽  
Vol 18 (18) ◽  
pp. 9886
Author(s):  
Jenny Luo ◽  
Shelley White-Means
Keyword(s):  
Diabetes Management ◽  
Low Cost ◽  
Primary Care Providers ◽  
The United States ◽  
Smartphone Apps ◽  
Care Providers ◽  
Limited Access ◽  
Health Apps ◽  
Underserved Patients ◽  
Patients With Diabetes

Health disparities cause a higher rate of diabetes development in poor and minority groups and also limit the care these people receive. Smartphone applications (apps) may be a low-cost, accessible resource to patients with diabetes who experience barriers to traditional health care. Currently, little is known about using health apps to help underserved patients in the United States. This study aimed to investigate the willingness to use diabetes apps in patients with limited access to primary care providers. Fifteen personal interviews were collected and analyzed according to the interpretative phenomenological analysis framework. The interviews produced three overall themes: (1) Despite having little previous knowledge about health apps, patients were all willing to try at least one diabetes-related app; (2) app functions should be individualized to each patient’s needs for maximum benefit; and (3) barriers to app use were varied but commonly included knowledge and technological challenges and security issues. Underserved patients with diabetes expressed a willingness to try health apps, despite limited experience with the technology. Choosing apps individualized to each patient’s needs, instead of a blanket multifunctional app, would provide the greatest benefit for patient-driven diabetes management. Smartphone apps may be a feasible, low-cost resource for patients with limited access to traditional healthcare.

scholarly journals Development of Smartphone Apps for Skin Cancer Risk Assessment: Progress and Promise (Preprint)

2019 ◽  
Author(s):  
Tiago M de Carvalho ◽  
Eline Noels ◽  
Marlies Wakkee ◽  
Andreea Udrea ◽  
Tamar Nijsten
Keyword(s):  
Health Care ◽  
Skin Cancer ◽  
Diagnostic Accuracy ◽  
General Practitioners ◽  
Mobile Health ◽  
Smartphone Apps ◽  
Screening Programs ◽  
Cancer Management ◽  
Health Apps ◽  
Mobile Health Apps

UNSTRUCTURED Skin cancer is a growing public health problem. Early and accurate detection is important, since prognosis and cost of treatment are highly dependent on cancer stage at detection. However, access to specialized health care professionals is not always straightforward, and population screening programs are unlikely to become implemented. Furthermore, there is a wide margin for improving the efficiency of skin cancer diagnostics. Specifically, the diagnostic accuracy of general practitioners and family physicians in differentiating benign and malignant skin tumors is relatively low. Both access to care and diagnostic accuracy fuel interest in developing smartphone apps equipped with algorithms for image analyses of suspicious lesions to detect skin cancer. Based on a recent review, seven smartphone apps claim to perform image analysis for skin cancer detection, but as of October 2018, only three seemed to be active. These apps have been criticized in the past due to their lack of diagnostic accuracy. Here, we review the development of the SkinVision smartphone app, which has more than 900,000 users worldwide. The latest version of the SkinVision app (October 2018) has a 95% sensitivity (78% specificity) for detection of skin cancer. The current accuracy of the algorithm may warrant the use of this app as an aid by lay users or general practitioners. Nonetheless, for mobile health apps to become broadly accepted, further research is needed on their health impact on the health system and the user population. Ultimately, mobile health apps could become a powerful tool to reduce health care costs related to skin cancer management and minimize the morbidity of skin cancer in the population.

scholarly journals Mobile Health to Maintain Continuity of Patient-Centered Care for Chronic Kidney Disease: Content Analysis of Apps (Preprint)

2018 ◽  
Author(s):  
Ying-Li Lee ◽  
Yan-Yan Cui ◽  
Ming-Hsiang Tu ◽  
Yu-Chi Chen ◽  
Polun Chang
Keyword(s):  
Health Care ◽  
Kidney Disease ◽  
Mobile Health ◽  
Health Care Professionals ◽  
Patient Centered Care ◽  
Self Management ◽  
Patient Centered ◽  
Health Apps ◽  
Centered Care ◽  
Mobile Health Apps

BACKGROUND Chronic kidney disease (CKD) is a global health problem with a high economic burden, which is particularly prevalent in Taiwan. Mobile health apps have been widely used to maintain continuity of patient care for various chronic diseases. To slow the progression of CKD, continuity of care is vital for patients’ self-management and cooperation with health care professionals. However, the literature provides a limited understanding of the use of mobile health apps to maintain continuity of patient-centered care for CKD. OBJECTIVE This study identified apps related to the continuity of patient-centered care for CKD on the App Store, Google Play, and 360 Mobile Assistant, and explored the information and frequency of changes in these apps available to the public on different platforms. App functionalities, like patient self-management and patient management support for health care professionals, were also examined. METHODS We used the CKD-related keywords “kidney,” “renal,” “nephro,” “chronic kidney disease,” “CKD,” and “kidney disease” in traditional Chinese, simplified Chinese, and English to search 3 app platforms: App Store, Google Play, and 360 Mobile Assistant. A total of 2 reviewers reached consensus on coding guidelines and coded the contents and functionalities of the apps through content analysis. After coding, Microsoft Office Excel 2016 was used to calculate Cohen kappa coefficients and analyze the contents and functionalities of the apps. RESULTS A total of 177 apps related to patient-centered care for CKD in any language were included. On the basis of their functionality and content, 67 apps were recommended for patients. Among them, the most common functionalities were CKD information and CKD self-management (38/67, 57%), e-consultation (17/67, 25%), CKD nutrition education (16/67, 24%), and estimated glomerular filtration rate (eGFR) calculators (13/67, 19%). In addition, 67 apps were recommended for health care professionals. The most common functionalities of these apps were comprehensive clinical calculators (including eGFR; 30/67; 45%), CKD medical professional information (16/67, 24%), stand-alone eGFR calculators (14/67, 21%), and CKD clinical decision support (14/67, 21%). A total of 43 apps with single- or multiple-indicator calculators were found to be suitable for health care professionals and patients. The aspects of patient care apps intended to support self-management of CKD patients were encouraging patients to actively participate in health care (92/110, 83.6%), recognizing and effectively responding to symptoms (56/110, 50.9%), and disease-specific knowledge (53/110, 48.2%). Only 13 apps contained consulting management functions, patient management functions or teleconsultation functions designed to support health care professionals in CKD patient management. CONCLUSIONS This study revealed that the continuity of patient-centered care for CKD provided by mobile health apps is inadequate for both CKD self-management by patients and patient care support for health care professionals. More comprehensive solutions are required to enhance the continuity of patient-centered care for CKD.

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 Mobile Health Apps for Medical Emergencies: Systematic Review

10.2196/18513 ◽  
2020 ◽  
Vol 8 (12) ◽  
pp. e18513
Author(s):  
Alejandro Plaza Roncero ◽  
Gonçalo Marques ◽  
Beatriz Sainz-De-Abajo ◽  
Francisco Martín-Rodríguez ◽  
Carlos del Pozo Vegas ◽  
...  
Keyword(s):  
Health Care ◽  
Mobile Health ◽  
Mobile Apps ◽  
Current Status ◽  
Health Technologies ◽  
Health Apps ◽  
App Store ◽  
Mobile Health Apps ◽  
Medical Emergencies ◽  
Google Play

Background Mobile health apps are used to improve the quality of health care. These apps are changing the current scenario in health care, and their numbers are increasing. Objective We wanted to perform an analysis of the current status of mobile health technologies and apps for medical emergencies. We aimed to synthesize the existing body of knowledge to provide relevant insights for this topic. Moreover, we wanted to identify common threads and gaps to support new challenging, interesting, and relevant research directions. Methods We reviewed the main relevant papers and apps available in the literature. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology was used in this review. The search criteria were adopted using systematic methods to select papers and apps. On one hand, a bibliographic review was carried out in different search databases to collect papers related to each application in the health emergency field using defined criteria. On the other hand, a review of mobile apps in two virtual storage platforms (Google Play Store and Apple App Store) was carried out. The Google Play Store and Apple App Store are related to the Android and iOS operating systems, respectively. Results In the literature review, 28 papers in the field of medical emergency were included. These studies were collected and selected according to established criteria. Moreover, we proposed a taxonomy using six groups of applications. In total, 324 mobile apps were found, with 192 identified in the Google Play Store and 132 identified in the Apple App Store. Conclusions We found that all apps in the Google Play Store were free, and 73 apps in the Apple App Store were paid, with the price ranging from US $0.89 to US $5.99. Moreover, 39% (11/28) of the included studies were related to warning systems for emergency services and 21% (6/28) were associated with disaster management apps.

scholarly journals Development of a Personalized Apps to Inculcate Dietary Self-Management for Maintenance Hemodialysis Patients: A Need Analysis

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1325-1325
Author(s):  
Jun Hao Lim ◽  
Cordelia Kheng May Lim ◽  
Imliya Ibrahim ◽  
Jazlina Shahrul ◽  
Mohd Hazli Mohd Zabil ◽  
...  
Keyword(s):  
Mobile Health ◽  
Online Survey ◽  
Self Management ◽  
Maintenance Hemodialysis ◽  
Health Apps ◽  
Funding Sources ◽  
Need Analysis ◽  
Renal Diet ◽  
Poor Treatment ◽  
Mobile Health Apps

Abstract Objectives Dietary non-adherence is highly prevalent among maintenance hemodialysis (HD) patients resulting in multitudes health complications and poor treatment outcomes. Given high penetration of smartphone, well-designed mobile health apps emerged as a potential tool to empower HD patients with dietary self-management skills. This need analysis study determined the perception and expectation of patients and dietitians on the features and the use of apps in dialysis care to foster development of evidence-based renal diet apps. Methods This was a mixed-method study with concurrent triangulation design. The quantitative arm involved HD patients (n = 184) through face-to-face interview and dietitians (n = 120) via anonymous online survey. While the qualitative arm consisted of 10 in-depth interviews (HD patients) and 8 email interviews (dietitians). Descriptive and thematic analyses were used, and the results were compared. Results A total of 69.6% of HD patients owned a smartphone. More than half (53.9%) of the smartphone users had the experience of searching health information especially nutrition-related topics (91.3%). Majority of them (78.9%) perceived renal diet apps as very important and were willing to use (80.5%). They agreed that renal diet apps can help them in preventing nutrition complications (82.0%), planning menu (78.9%) and monitoring nutrient intakes (82.8%). In the context of practising dietitians, 60.8% aware of the existence of renal diet apps but only 38.3% of them would recommend existing renal diet apps to their patients due to lack of local content (42.5%) and unsure credibility (37.5%). Most of them (88.3%) perceived that local-based renal diet app is needed and agreed that it can enhance dietetics care in HD population (90.8%). Top features anticipated by both patients and dietitians included plan or order, tailored assistance, usability and tracker. Conclusions Dietary self-management via mobile health apps seems to be feasible in the dialysis population given the high smartphone penetration, strong desire to use and positive perceptions from patients and dietitians. Features valued by patients and dietitians will be integrated into the design of the apps to promote acceptance and usage. Funding Sources This project is funded by the internal grant of Universiti Putra Malaysia (Inisiatif Putra Muda).

scholarly journals The Mobile App Development and Assessment Guide (MAG): Delphi-Based Validity Study (Preprint)

2020 ◽  
Author(s):  
Pere Llorens-Vernet ◽  
Jordi Miró
Keyword(s):  
Health Care ◽  
Mobile Health ◽  
Health Care Professionals ◽  
Online Survey ◽  
End Users ◽  
Mobile App ◽  
Health Apps ◽  
App Development ◽  
Mobile Health Apps

BACKGROUND In recent years, there has been an exponential growth of mobile health (mHealth)–related apps. This has occurred in a somewhat unsupervised manner. Therefore, having a set of criteria that could be used by all stakeholders to guide the development process and the assessment of the quality of the apps is of most importance. OBJECTIVE The aim of this paper is to study the validity of the Mobile App Development and Assessment Guide (MAG), a guide recently created to help stakeholders develop and assess mobile health apps. METHODS To conduct a validation process of the MAG, we used the Delphi method to reach a consensus among participating stakeholders. We identified 158 potential participants: 45 patients as potential end users, 41 health care professionals, and 72 developers. We sent participants an online survey and asked them to rate how important they considered each item in the guide to be on a scale from 0 to 10. Two rounds were enough to reach consensus. RESULTS In the first round, almost one-third (n=42) of those invited participated, and half of those (n=24) also participated in the second round. Most items in the guide were found to be important to a quality mHealth-related app; a total of 48 criteria were established as important. “Privacy,” “security,” and “usability” were the categories that included most of the important criteria. CONCLUSIONS The data supports the validity of the MAG. In addition, the findings identified the criteria that stakeholders consider to be most important. The MAG will help advance the field by providing developers, health care professionals, and end users with a valid guide so that they can develop and identify mHealth-related apps that are of quality.

scholarly journals The Mobile App Development and Assessment Guide (MAG): Delphi-Based Validity Study

10.2196/17760 ◽  
2020 ◽  
Vol 8 (7) ◽  
pp. e17760 ◽  
Author(s):  
Pere Llorens-Vernet ◽  
Jordi Miró
Keyword(s):  
Health Care ◽  
Mobile Health ◽  
Health Care Professionals ◽  
Online Survey ◽  
End Users ◽  
Mobile App ◽  
Health Apps ◽  
App Development ◽  
Mobile Health Apps

Background In recent years, there has been an exponential growth of mobile health (mHealth)–related apps. This has occurred in a somewhat unsupervised manner. Therefore, having a set of criteria that could be used by all stakeholders to guide the development process and the assessment of the quality of the apps is of most importance. Objective The aim of this paper is to study the validity of the Mobile App Development and Assessment Guide (MAG), a guide recently created to help stakeholders develop and assess mobile health apps. Methods To conduct a validation process of the MAG, we used the Delphi method to reach a consensus among participating stakeholders. We identified 158 potential participants: 45 patients as potential end users, 41 health care professionals, and 72 developers. We sent participants an online survey and asked them to rate how important they considered each item in the guide to be on a scale from 0 to 10. Two rounds were enough to reach consensus. Results In the first round, almost one-third (n=42) of those invited participated, and half of those (n=24) also participated in the second round. Most items in the guide were found to be important to a quality mHealth-related app; a total of 48 criteria were established as important. “Privacy,” “security,” and “usability” were the categories that included most of the important criteria. Conclusions The data supports the validity of the MAG. In addition, the findings identified the criteria that stakeholders consider to be most important. The MAG will help advance the field by providing developers, health care professionals, and end users with a valid guide so that they can develop and identify mHealth-related apps that are of quality.

scholarly journals Mobile apps for real-world evidence in health care

2020 ◽  
Vol 27 (6) ◽  
pp. 976-980
Author(s):  
Madison Milne-Ives ◽  
Michelle Helena van Velthoven ◽  
Edward Meinert
Keyword(s):  
Health Care ◽  
Mobile Health ◽  
Real World ◽  
Patient Empowerment ◽  
Real World Data ◽  
Privacy And Security ◽  
World Data ◽  
Health Apps ◽  
Real World Evidence ◽  
Mobile Health Apps

Abstract The use of real-world evidence for health care research and evaluation is growing. Mobile health apps have often-overlooked potential to contribute valuable real-world data that are not captured by other sources and could provide data that are more cost-effective and generalizable than can randomized controlled trials. However, there are several challenges that must be overcome to realize the potential value of patient-used mobile health app real-world data, including data quality, motivation for long-term use, privacy and security, methods of analysis, and standardization and integration. Addressing these challenges will increase the value of data from mobile health apps to inform real-world evidence and improve patient empowerment, clinical management, disease research, and treatment development.

scholarly journals Mind the App: Considerations for the Future of Mobile Health in Canada

10.2196/15301 ◽  
2019 ◽  
Vol 7 (11) ◽  
pp. e15301
Author(s):  
Ma'n H Zawati ◽  
Michael Lang
Keyword(s):  
Health Care ◽  
Mobile Health ◽  
Health Apps ◽  
The Past ◽  
Health Care Context ◽  
Mobile Health Apps ◽  
Smartphone Technology ◽  
Smartphone Use ◽  
User Friendly ◽  
Health Canada

Over the past decade, smartphone technology has become increasingly sophisticated and ubiquitous. Modern smartphones, now owned by more than three quarters of Canadians and 94% of millennials, perform an array of functions that are potentially useful in the health care context, such as tracking fitness data, enabling health record sharing, and providing user-friendly platforms for disease management. Approximately half of smartphone users have downloaded at least one health app, and clinicians are increasingly using them in their practice. However, despite widespread use, there is little evidence that supports their safety and efficacy. Few apps have been independently evaluated and many lack basic patient protections such as privacy policies. In this context, the demand for the regulation of mobile health apps has increased. Against this backdrop, regulators, including Health Canada, have begun to propose regulating the use of smartphones in health care. In this viewpoint, we respond to Health Canada’s recent proposal to regulate smartphone use in Canada according to a risk-based model. We argue that although Health Canada’s recent proposed approach is promising, it may require complementary regulation and oversight.

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