scholarly journals Using Goal-Directed Design to Create a Mobile Health App to Improve Patient Compliance With Hypertension Self-Management: Development and Deployment

10.2196/14466 ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. e14466 ◽  
Author(s):  
Huilong Duan ◽  
Zheyu Wang ◽  
Yumeng Ji ◽  
Li Ma ◽  
Fang Liu ◽  
...  
Keyword(s):  
Patient Compliance ◽  
Mobile Health ◽  
Design Method ◽  
Qualitative Interviews ◽  
Self Management ◽  
Functional Modules ◽  
Stage 4 ◽  
Directed Design ◽  
Stage 1 ◽  
Improve Patient

Background Hypertension is a lifestyle-induced chronic disease that threatens the lives of patients. Control of hypertension requires patients to follow self-management regimes; unfortunately, however, patient compliance with hypertension self-management is low, especially in developing countries. Improvement of patient compliance is premised on meeting patient needs. Mobile health apps are becoming increasingly popular for self-management of chronic diseases. However, few mobile apps have been designed to meet patient needs for hypertension self-management. Objective The goal of this study was to develop a mobile health app to improve patient compliance with hypertension self-management and evaluate the effectiveness of the app in terms of patient compliance. Methods The goal-directed design method was applied to guide study design. We divided the study into 4 stages. Stages 1 to 3 comprised the development process. To improve the applicability of the goal-directed design method to chronic disease management, we extracted elements of user models concerned with patient compliance and defined a concrete process for user modeling. In stage 1, personas of hypertensive patients were built using qualitative and quantitative methods. Clustering methods based on questionnaire responses were used to group patients. Qualitative interviews were conducted to identify the needs of different groups. In stage 2, several functional modules were designed to meet the needs of different groups based on the results from stage 1. In stage 3, prototypes of functional modules were designed and implemented as a real app. Stage 4 was the deployment process, in which we conducted a pilot study to investigate patient compliance after using the app. Patient compliance was calculated through the frequency with which they took blood pressure measurements. In addition, qualitative interviews were conducted to learn the underlying reasons for the compliance results. Results In stage 1, patients were divided into 3 groups based on 82 valid questionnaire responses. Eighteen patients from the different groups (7, 5, and 6 patients) were interviewed, and the needs of the groups were summarized as follows: improve self-management ability, enhance self-management motivation, and receive self-management support. In stages 2 and 3, 6 functional modules were designed and implemented based on specified needs, and the usability of the app was improved through usability tests. In stage 4, 143 patients were recruited to use different versions of the app for 2 months. Results show that patient compliance improved as functional modules were added (P<.001) and was maintained at a high level (rate of 0.73). Interview results from 32 patients show that the design of the app met different needs; thus, patients were more compliant with it. Conclusions This study developed a mobile health app for hypertension self-management using the goal-directed design method. The app proved to be effective for improving patient compliance with hypertension self-management.

Using Goal-directed Design to Create a Mobile Health App for Improving Patient Compliance with Hypertension Self-management: Development and Deployment (Preprint)

2019 ◽  
Author(s):  
Huilong Duan ◽  
Zheyu Wang ◽  
Yumeng Ji ◽  
Li Ma ◽  
Mingwei Chi ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Patient Compliance ◽  
Mobile Health ◽  
Design Method ◽  
Qualitative Interviews ◽  
Self Management ◽  
Functional Modules ◽  
Stage 4 ◽  
Directed Design ◽  
Stage 1

BACKGROUND Hypertension is a lifestyle-induced chronic disease threatening lives of patients. The control of hypertension requires patients’ long-term self-management. Unfortunately, compliance with hypertension self-management is low, especially in developing countries. Improvement of patient compliance is premised on meeting their needs. Meanwhile, the use of mobile health is becoming popular in the self-management of chronic diseases. However, few mobile apps were specially designed to meet patients’ needs in hypertension self-management. OBJECTIVE The aim of this study was to develop a mobile health app for improving patient compliance with hypertension self-management and evaluate the effectiveness of the app in terms of patient compliance. METHODS The study contained 4 stages. Stage 1 to 3 was the development process. Goal-directed Design method was applied to guide the development. In order to improve the applicability of Goal-directed Design method in chronic disease management, we extracted elements of user models concerned with patient compliance and defined the concrete process for user modeling. In stage 1, personas of hypertensive patients were built using qualitative and quantitative methods. Clustering method based on questionnaires were used to divide patients into different groups. Qualitative interviews were conducted to identify the needs of different groups. In stage 2, several functional modules were defined based on the results from stage 1, in order to meet different groups’ needs. In stage 3, prototypes of functional modules were designed and implemented as a real app. Stage 4 was the deployment process, in which we conducted a pilot study to investigate patient compliance after using the app. Patient compliance was calculated through the number of blood pressure measurement. Besides, qualitative interviews were conducted to learn reasons for the compliance results. RESULTS In stage 1, patients were divided into 3 groups based on 82 valid questionnaires. 18 patients from different groups (7, 5 and 6) were interviewed and the needs of the groups were summarized as: to improve self-management ability, to enhance self-management motivation and to receive self-management support. In stage 2 and 3, 6 functional modules were designed and implemented based on the personas, and the usability of the app was improved through usability tests. In stage 4, 143 patients were recruited to use different versions of the app for 2 months, the results showed that patient compliance improved as functional modules were added, and finally maintained at a high level (the rate of 0.73). Interview results from 32 patients showed that the design of the app met different needs of patients so that patients were more complied with it. CONCLUSIONS This study developed a mobile health app for hypertension self-management using Goal-directed Design method. The app proved to be effective in improving patient compliance with hypertension self-management.

scholarly journals Understanding and Addressing Vaccine Hesitancy in the Context of COVID-19: Development of a Digital intervention

2021 ◽  
Author(s):  
Holly Knight ◽  
Ru Jia ◽  
Kieran Ayling ◽  
Katherine Bradbury ◽  
Katherine Baker ◽  
...  
Keyword(s):  
Qualitative Interviews ◽  
Population Level ◽  
Vaccine Hesitancy ◽  
Evidence Based ◽  
The Public ◽  
Digital Intervention ◽  
Digital Format ◽  
Stage 4 ◽  
Stage 1 ◽  
Respiratory Coronavirus

AbstractBackgroundSevere Acute Respiratory Coronavirus 2 (SARS-CoV-2) was identified in late 2019, spreading to over 200 countries and resulting in almost two million deaths worldwide. The emergence of safe and effective vaccines provides a route out of the pandemic, with vaccination uptake of 75-90% needed to achieve population protection. Vaccine hesitancy is problematic for vaccine rollout; global reports suggest only 73% of the population may agree to being vaccinated. As a result, there is an urgent need to develop equitable and accessible interventions to address vaccine hesitancy at the population level.MethodWe report the development of a scalable digital intervention seeking to address COVID-19 vaccine hesitancy and enhance uptake of COVID-19 vaccines. Guided by motivational interviewing (MI) principles, the intervention includes a series of therapeutic dialogues addressing 10 key concerns of vaccine hesitant individuals. Development of the intervention occurred linearly across four stages. During stage 1, we identified common reasons for COVID-19 vaccine hesitancy through analysis of existing survey data, a rapid systematic literature review, and public engagement workshops. Stage 2 comprised qualitative interviews with medical, immunological, and public health experts. Rapid content and thematic analysis of the data provided evidence-based responses to common vaccine concerns. Stage 3 involved the development of therapeutic dialogues through workshops with psychological and digital behaviour change experts. Dialogues were developed to address concerns using MI principles, including embracing resistance and supporting self-efficacy.Finally, stage 4 involved digitisation of the dialogues and pilot testing with members of the public.DiscussionThe digital intervention provides an evidence-based approach to addressing vaccine hesitancy through MI principles. The dialogues are user-selected, allowing exploration of relevant issues associated with hesitancy in a non-judgmental context. The text-based content and digital format allow for rapid modification to changing information and scalability for wider dissemination.

Alterations in the number of motoneurons containing immunoreactive calcitonin gene-related peptide(CGRP)& choline acetyltransferase(ChAT) in the cervical spinal cord of the wobbler mouse during the development of the motoneuron disease

1995 ◽  
Vol 53 ◽  
pp. 970-971
Author(s):  
L. Vacca-Galloway ◽  
Y.Q. Zhang ◽  
P. Bose ◽  
S.H. Zhang
Keyword(s):  
Spinal Cord ◽  
Early Stage ◽  
Cervical Spinal Cord ◽  
Wild Type Mouse ◽  
Reflex Response ◽  
Mouse Strains ◽  
Behavioral Tests ◽  
Wobbler Mouse ◽  
Stage 4 ◽  
Stage 1

The Wobbler mouse (wr) has been studied as a model for inherited human motoneuron diseases (MNDs). Using behavioral tests for forelimb power, walking, climbing, and the “clasp-like reflex” response, the progress of the MND can be categorized into early (Stage 1, age 21 days) and late (Stage 4, age 3 months) stages. Age-and sex-matched normal phenotype littermates (NFR/wr) were used as controls (Stage 0), as well as mice from two related wild-type mouse strains: NFR/N and a C57BI/6N. Using behavioral tests, we also detected pre-symptomatic Wobblers at postnatal ages 7 and 14 days. The mice were anesthetized and perfusion-fixed for immunocytochemical (ICC) of CGRP and ChAT in the spinal cord (C3 to C5).Using computerized morphomety (Vidas, Zeiss), the numbers of IR-CGRP labelled motoneurons were significantly lower in 14 day old Wobbler specimens compared with the controls (Fig. 1). The same trend was observed at 21 days (Stage 1) and 3 months (Stage 4). The IR-CGRP-containing motoneurons in the Wobbler specimens declined progressively with age.

User-Centered Design Enhances Usability of an mHealth System for Users with Dexterity Impairments (Preprint)

2020 ◽  
Author(s):  
Kuntal Chowdhary ◽  
Daihua Xie Yu ◽  
Gede Pramana ◽  
Andrea Fairman ◽  
Brad Edward Dicianno ◽  
...  
Keyword(s):  
User Interface ◽  
Mobile Health ◽  
Chronic Conditions ◽  
Independent Living ◽  
Health Interventions ◽  
Self Management ◽  
User Centered Design ◽  
Entire Study ◽  
Efficiency And Effectiveness ◽  
User Centered

BACKGROUND Mobile health (mHealth) systems have been shown to be useful in supporting self-management by promoting adherence to schedules and longitudinal health interventions, especially in people with disabilities (PwD). The Interactive Mobile Health and Rehabilitation (iMHere) System was developed to empower PwD and those with chronic conditions with supports needed for self-management and independent living. Since the first iteration of the iMHere 1.0 app, several studies have evaluated accessibility and usability of the system. Potential opportunities to improve and simplify the user interface (UI) were identified, and the iMHere modules were redesigned accordingly. OBJECTIVE The aim of this study was to evaluate the usability of the redesigned modules within iMHere 1.0. METHODS This study evaluated the original and redesigned MyMeds and SkinCare modules. To assess the participants’ dexterity levels, the Purdue Pegboard Test (PPBT) was administered. Participants were then asked to perform a set of tasks using both the original and redesigned MyMeds and SkinCare modules to assess efficiency and effectiveness. Usability was measured using the Telehealth Usability Questionnaire (TUQ) to evaluate 10 new accessibility features that were added to the redesigned app. Participants were also asked which version they preferred. RESULTS Twenty-four participants with disabilities and varied degrees of dexterity impairments completed the entire study protocol. Participants displayed improved efficiency and effectiveness of use when using the redesigned modules, as compared to the original modules. Participants also reported improved usability and preferred the redesigned modules. CONCLUSIONS This study demonstrated that the iMHere System became more efficient, effective, and usable for individuals with dexterity impairments after redesigning it according to user-centered principles.

Novel staging classification of primary mitral regurgitation based on the presence of cardiac damage

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A.L Van Wijngaarden ◽  
Y.L Hiemstra ◽  
P Van Der Bijl ◽  
V Delgado ◽  
N Ajmone Marsan ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Kidney Function ◽  
Left Ventricular ◽  
Prognostic Impact ◽  
Cardiac Damage ◽  
Stage 4 ◽  
All Cause Mortality ◽  
Primary Mitral Regurgitation ◽  
Stage 1 ◽  
Staging Classification

Abstract Background The indication for surgery in patients with severe primary mitral regurgitation (MR) is currently based on the presence of symptoms, left ventricular (LV) dilatation and dysfunction, atrial fibrillation and pulmonary hypertension. The aim of this study was to evaluate the prognostic impact of a new staging classification based on cardiac damage including the known risk factors but also including global longitudinal strain (GLS), severe left atrial (LA) dilatation and right ventricular (RV) dysfunction. Methods In total 614 patients who underwent surgery for severe primary MR with available baseline transthoracic echocardiograms were included. Patients were classified according to the extent of cardiac damage (Figure): Stage 0-no cardiac damage, Stage 1-LV damage, Stage 2-LA damage, Stage 3-pulmonary vasculature or tricuspid valve damage and Stage 4-RV damage. Patients were followed for all-cause mortality. Results Based on the proposed classification, 172 (28%) patients were classified as Stage 0, 102 (17%) as Stage 1, 134 (21%) as Stage 2, 135 (22%) as Stage 3 and 71 (11%) as Stage 4. The more advanced the stage, the older the patients were with worse kidney function, more symptoms and higher EuroScore. Kaplan-Meier curve analysis revealed that patients with more advanced stages of cardiac damage had a significantly worse survival (log-rank chi-square 35.2; p&lt;0.001) (Figure). On multivariable analysis, age, male, chronic obstructive pulmonary disease, kidney function, and stage of cardiac damage were independently associated with all-cause mortality. For each stage increase, a 22% higher risk for all-cause mortality was observed (95% CI: 1.064–1.395; p=0.004). Conclusion In patients with severe primary MR, a novel staging classification based on the extent of cardiac damage, may help refining risk stratification, particularly including also GLS, LA dilatation and RV dysfunction in the assessment. Funding Acknowledgement Type of funding source: None

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.

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