scholarly journals Development and Local Contextualization of Mobile Health Messages for Enhancing Disease Management Among Community-Dwelling Stroke Patients in Rural China: Multimethod Study

10.2196/15758 ◽  
2019 ◽  
Vol 7 (12) ◽  
pp. e15758
Author(s):  
Enying Gong ◽  
Wanbing Gu ◽  
Erdan Luo ◽  
Liwei Tan ◽  
Julian Donovan ◽  
...  
Keyword(s):  
Pilot Study ◽  
Secondary Prevention ◽  
Mobile Phone ◽  
Rural China ◽  
Text Messages ◽  
Community Dwelling ◽  
Self Management ◽  
Stroke Patients ◽  
Dispatching Algorithm ◽  
Depth Interviews

Background Rural China has experienced an increasing health burden because of stroke. Stroke patients in rural communities have relatively poor awareness of and adherence to evidence-based secondary prevention and self-management of stroke. Mobile technology represents an innovative way to influence patient behaviors and improve their self-management. Objective This study is part of the System-Integrated Technology-Enabled Model of Care (the SINEMA trial) to improve the health of stroke patients in resource-poor settings in China. This study aimed to develop and pilot-test a mobile phone message–based package, as a component of the SINEMA intervention. Methods The SINEMA trial was conducted in Nanhe County, Hebei Province, China. A total of 4 villages were selected for pretrial contextual research and pilot study. The 5 stages for developing the mobile phone messages were as follows: (1) conducting literature review on existing message banks and analyzing the characteristics of these banks; (2) interviewing stroke patients and caregivers to identify their needs; (3) drafting message contents and designing dispatching algorithms for a 3-month pilot testing; (4) collecting feedback from pilot participants through questionnaire survey and in-depth interviews on facilitators and barriers related to their acceptance and understanding of messages; and (5) finalizing the message-based intervention based on participants’ feedback for the SINEMA trial. Results On the basis of 5 existing message banks screened out of 120 papers and patients’ needs identified from 32 in-depth interviews among stroke patients and caregivers, we developed a message bank containing 224 messages for a pilot study among 54 community-dwelling stroke patients from 4 villages. Of 54 participants, 51 (response rate: 94.4%) completed the feedback survey after receiving daily messages for 3 months. Participants’ mean age was 68 years (SD 9.2), and about half had never been to school. We observed a higher proportion of participants who were in favor of voice messages (23/42, 54%) than text messages (14/40, 35%). Among participants who received voice messages (n=43) and text messages (n=40), 41 and 30, respectively, self-reported a full or partial understanding of the contents, and 39 (39/43, 91%) and 32 (32/40, 80%), respectively, rated the messages as helpful. Analyses of the 32 interviews further revealed that voice messages containing simple and single-theme content, in plain language, with a repeated structure, a slow playback speed, and recorded in local dialect, were preferred by rural stroke patients. In addition, the dispatching algorithm and tools may also influence the acceptance of message-based interventions. Conclusions By applying multiple methodologies and conducting a pilot study, we designed and fine-tuned a voice message–based intervention package for promoting secondary prevention among community-dwelling stroke patients in rural China. Design of the content and dispatching algorithm should engage both experts and end users and adequately consider the needs and preferences of recipients.

scholarly journals Effects of Customized Long-Message Service and Phone-Based Health-Coaching on Elderly People with Hypertension

2019 ◽  
Author(s):  
Myoungsuk KIM
Keyword(s):  
Medication Adherence ◽  
Self Efficacy ◽  
Pragmatic Trial ◽  
Health Coaching ◽  
Text Messages ◽  
Community Dwelling ◽  
Self Management ◽  
Control Group ◽  
Management Behavior ◽  
Phone Calls

Background: We aimed to develop long-message services (LMS) and phone-based health-coaching for community-dwelling seniors diagnosed with hypertension and assess the effects of the programs implemented both separately and together. These programs are easily applicable to seniors diagnosed with hypertension and will help control their blood pressure (BP) in a practical manner. Methods: We conducted a single-blinded, randomized, controlled pragmatic trial. Individuals aged 65 years or older with hypertension at two senior welfare centers in Seoul, South Korea, who were able to take phone calls and check text messages were enrolled. The study included 124 participants: 31 in the control group, 30 in the health-coaching group, 32 in the LMS group, and 31 in the health-coaching-with-LMS group. Results: Phone-based health-coaching with LMS was effective in improving medication adherence, hypertension self-efficacy, and self-management behavior and decreasing systolic BP as compared to LMS only. There were also improvements in medication adherence, hypertension-related knowledge, hypertension self-efficacy, self-management behavior, and systolic BP in the LMS group as compared to the control group. Conclusion: Using phone-based health-coaching with LMS was effective for managing hypertension in community-dwelling seniors diagnosed with hypertension and could become a useful intervention method.

scholarly journals Supporting people with type 2 diabetes in effective use of their medicine through mobile health technology integrated with clinical care (SuMMiT-D Feasibility): a randomised feasibility trial protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e033504
Author(s):  
Andrew Farmer ◽  
Julie Allen ◽  
Kiera Bartlett ◽  
Peter Bower ◽  
Yuan Chi ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Mobile Phone ◽  
Health Technology ◽  
Text Messages ◽  
Feasibility Trial ◽  
Self Management ◽  
Link Type ◽  
Patient Reported

IntroductionType 2 diabetes is common, affecting over 400 million people worldwide. Risk of serious complications can be reduced through use of effective treatments and active self-management. However, people are often concerned about starting new medicines and face difficulties in taking them regularly. Use of brief messages to provide education and support self-management, delivered through mobile phone-based text messages, can be an effective tool for some long-term conditions. We have developed messages aiming to support patients’ self-management of type 2 diabetes in the use of medications and other aspects of self-management, underpinned by theory and evidence. The aim of this trial is to determine the feasibility of a large-scale clinical trial to test the effectiveness and cost-effectiveness of the intervention, compared with usual care.Methods and analysisThe feasibility trial will be a multicentre individually randomised, controlled trial in primary care recruiting adults (≥35 years) with type 2 diabetes in England. Consenting participants will be randomised to receive short text messages three times a week with messages designed to produce change in medication adherence or non-health-related messages for 6 months. The aims are to test recruitment methods, retention to the study, the feasibility of data collection and the mobile phone and web-based processes of a proposed definitive trial and to refine the text messaging intervention. The primary outcome is the rate of recruitment to randomisation of participants to the trial. Data, including patient reported measures, will be collected online at baseline and the end of the 6-month follow-up period. With 200 participants (100 in each group), this trial is powered to estimate 80% follow-up within 95% CIs of 73.8% to 85.3%. The analysis will follow a prespecified plan.Ethics and disseminationEthics approval was obtained from the West of Scotland Research Ethics Committee 05. The results will be disseminated through conference presentations, peer-reviewed journals and will be published on the trial website: www.summit-d.org (SuMMiT-D (SUpport through Mobile Messaging and digital health Technology for Diabetes)).Trial registration numberISRCTN13404264.

scholarly journals mHealth Tools for the Self-Management of Patients With Multimorbidity in Primary Care Settings: Pilot Study to Explore User Experience (Preprint)

2017 ◽  
Author(s):  
Anum Irfan Khan ◽  
Ashlinder Gill ◽  
Cheryl Cott ◽  
Parminder Kaur Hans ◽  
Carolyn Steele Gray
Keyword(s):  
Primary Care ◽  
Pilot Study ◽  
Community Dwelling ◽  
The Self ◽  
Self Management ◽  
Management Approach ◽  
Multiple Chronic Conditions ◽  
Primary Care Settings ◽  
Patient Reported ◽  
Explicit Recognition

BACKGROUND Given the complex and evolving needs of individuals with multimorbidity, the adoption of mHealth tools to support self-management efforts is increasingly being explored, particularly in primary care settings. The electronic patient-reported outcomes (ePRO) tool was codeveloped with patients and providers in an interdisciplinary primary care team in Toronto, Canada, to help facilitate self-management in community-dwelling adults with multiple chronic conditions. OBJECTIVE The objective of study is to explore the experience and expectations of patients with multimorbidity and their providers around the use of the ePRO tool in supporting self-management efforts. METHODS We conducted a 4-week pilot study of the ePRO tool. Patients’ and providers’ experiences and expectations were explored through focus groups that were conducted at the end of the study. In addition, thematic analyses were used to assess the shared and contrasting perspectives of patients and providers on the role of the ePRO tool in facilitating self-management. Coded data were then mapped onto the Individual and Family Self-Management Theory using the framework method. RESULTS In this pilot study, 12 patients and 6 providers participated. Both patients and providers emphasized the need for a more explicit recognition of self-management context, including greater customizability of content to better adapt to the complexity and fluidity of self-management in this particular patient population. Patients and providers highlighted gaps in the extent to which the tool enables self-management processes, including how limited progress toward self-management goals and the absence of direct provider engagement through the ePRO tool inhibited patients from meeting their self-management goals. Providers highlighted proximal outcomes based on their experience of the tool and specifically, they indicated that the tool offered valuable insights into the broader patient context, which helps to inform the self-management approach and activities they recommend to patients, whereas patients recognized the tool’s potential in helping to improve access to different providers in a team-based primary care setting. CONCLUSIONS This study identifies a more explicit recognition of the contextual factors that influence patients’ ability to self-manage and greater adaptability to accommodate patient complexity and provider workflow as next steps in refining the ePRO tool to better support self-management efforts in primary care ahead of its application in a full-scale randomized pragmatic trial.

scholarly journals Intervention through Short Messaging System (SMS) and phone call alerts reduced HbA1C levels in ~47% type-2 diabetics–results of a pilot study

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0241830
Author(s):  
Kanakavalli K. Kundury ◽  
Basavanagowdappa Hathur
Keyword(s):  
Pilot Study ◽  
Mobile Phone ◽  
World Health ◽  
Phone Call ◽  
Self Management ◽  
Base Line ◽  
Management Tools ◽  
Phone Calls ◽  
Number Of Individuals ◽  
Hba1c Levels

Purpose Despite extensive research and newer methods of interventions, the incidence and prevalence of diabetes is increasing at an alarming rate. Currently, according to world health organization (WHO) statistics, 422 million individuals are suffering from diabetes worldwide. In India, recent estimates have reported a significant increase in the number of diabetics in the last decade. Poor dietary habits, minimal adherence to treatment regimens, lack of timely education are some of the contributing factors for increasing incidence and huge economic burden; which can be handled by life style behavior modifications backed up by hand holding through continuous education. Prior studies have demonstrated the efficacy of various self-management tools and educational programs in better disease management behaviors among individuals with diabetes. Among various self-management tools, educating the individuals and alerting them using mobile phone calls and short messaging system (SMS) are widely accepted due to (a) the increasing mobile phone users and (b) availability of short messaging systems in local languages in the recent years. Therefore, a pilot study was conducted to determine the benefit of educating patients through phone calls and SMS in the self-management of diabetes. Objectives The objective of the study is to determine the feasibility and utility of SMS and phone call-based interventions in the management of diabetes by comparing the HbA1c values. Methodology The study was conducted for a period of 14 months from December 2017 till Feb 2019. Out of 380 individuals initially enrolled into the study, 120 had completed the 14-months period. Diabetes education through SMS and phone calls was provided on regular basis, and HbA1C levels at baseline, 8-months and 14-months quantified. In addition, feedback on patients’ satisfaction and utility of the SMS / Phone calls was collected using questionnaires. Results Data from our study demonstrated that after 8-months of intervention through phone calls, a significant increase in the number of individuals with HbA1c in the range of 5.1 to 7.0 was observed (from 27 individuals at base line to 37 individuals after 8-months intervention). Much more significant improvement in the number of individuals with lower HbA1c was observed at 14-months of intervention, indicating the benefit of regular phone call-based system in managing diabetes. A Chi square (χ2) test was performed to examine if the frequencies in the cells varied at baseline and at 8 and 14 months. Conclusion Chronic diseases like diabetes needs awareness and education to patients in adopting disease self-management practices. As mobile phone users are increasing in number, providing diabetes management education through mobile phone intervention could be a viable strategy for controlling diabetes.

Self-Management Capacity in Adults with Type 2 Diabetes Using Educational Interventions: A Pilot Study

2021 ◽  
Author(s):  
Maricarmen Moreno-Tochihuitl ◽  
Erika Lozada-Perezmitre ◽  
Carmen Cruz-Rivera ◽  
Rayo Cruz-Rivera ◽  
Lizamar-Lorena Ramos-Sánchez ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Pilot Study ◽  
Self Care ◽  
Educational Interventions ◽  
Text Messages ◽  
The Self ◽  
Self Management ◽  
Control Actions ◽  
Management Capacity

Type 2 Diabetes (T2D) has been increasing in prevalence over the last decade in Mexico. The glycemic control actions can help to prevent complications. The aimed is to pilot an educational intervention in self- management of adults with T2D through using text messages. Findings show the respondents reported a low level of self-care skills of T2D and there was an increase in the self-care skills after it.

scholarly journals A Smart and Multifaceted Mobile Health System for Delivering Evidence-Based Secondary Prevention of Stroke in Rural China: Design, Development, and Feasibility Study (Preprint)

2019 ◽  
Author(s):  
Na Wu ◽  
Enying Gong ◽  
Bo Wang ◽  
Wanbing Gu ◽  
Nan Ding ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Secondary Prevention ◽  
Health Care Providers ◽  
Rural China ◽  
Care Providers ◽  
Stroke Patients ◽  
Village Doctors ◽  
Primary Health ◽  
Resource Limited

BACKGROUND Mobile health (mHealth) technologies hold great promise in improving the delivery of high-quality health care services. Yet, there has been little research so far applying mHealth technologies in the context of delivering stroke care in resource-limited rural regions. OBJECTIVE This study aimed to introduce the design and development of an mHealth system targeting primary health care providers and to ascertain its feasibility in supporting the delivery of a System-Integrated techNology-Enabled Model of cAre (SINEMA) service for strengthening secondary prevention of stroke in rural China. METHODS The SINEMA mHealth system was designed by a multidisciplinary team comprising public health researchers, neurologists, and information and communication technology experts. The iterative co-design and development of the mHealth system involved the following 5 steps: (1) assessing the needs of relevant end users through in-depth interviews of stakeholders, (2) designing the functional modules and evidence-based care content, (3) designing and building the system and user interface, (4) improving and enhancing the system through a 3-month pilot test in 4 villages, and (5) finalizing the system and deploying it in field trial, and finally, evaluating its feasibility through a survey of the dominant user group. RESULTS From the in-depth interviews of 49 relevant stakeholders, we found that village doctors had limited capacity in caring for village-dwelling stroke patients in rural areas. Primary health care workers demonstrated real needs in receiving appropriate training and support from the mHealth system as well as great interests in using the mHealth technologies and tools. Using these findings, we designed a multifaceted mHealth system with 7 functional modules by following the iterative user-centered design and software development approach. The mHealth system, aimed at 3 different types of users (village doctors, town physicians, and county managers), was developed and utilized in a cluster-randomized controlled trial by 25 village doctors in a resource-limited county in rural China to manage 637 stroke patients between July 2017 and July 2018. In the end, a survey on the usability and functions of the mHealth system among village doctors (the dominant group of users, response rate=96%, 24/25) revealed that most of them were satisfied with the essential functions provided (71%) and were keen to continue using it (92%) after the study. CONCLUSIONS The mHealth system was feasible for assisting primary health care providers in rural China in delivering the SINEMA service on the secondary prevention of stroke. Further research and initiatives in scaling up the SINEMA approach and this mHealth system to other resource-limited regions in China and beyond will likely enhance the quality and accessibility of essential secondary prevention among stroke patients. CLINICALTRIAL ClinicalTrials.gov NCT03185858; https://clinicaltrials.gov/ct2/show/NCT03185858 INTERNATIONAL REGISTERED REPOR RR2-10.1016/j.ahj.2018.08.015

Mobile Phone Text Messages and Effect on Treatment Adherence in Patients Taking Methotrexate for Rheumatoid Arthritis: A Randomized Pilot Study

2019 ◽  
Vol 71 (10) ◽  
pp. 1344-1352 ◽  
Author(s):  
Aurélien Mary ◽  
Amélie Boursier ◽  
Isabelle Desailly Henry ◽  
Franck Grados ◽  
Alice Séjourné ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Pilot Study ◽  
Mobile Phone ◽  
Treatment Adherence ◽  
Text Messages
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