scholarly journals Assessing the Impact of Patient-Facing Mobile Health Technology on Patient Outcomes: Retrospective Observational Cohort Study

10.2196/19333 ◽  
2020 ◽  
Vol 8 (6) ◽  
pp. e19333 ◽  
Author(s):  
Courtenay R Bruce ◽  
Patricia Harrison ◽  
Tariq Nisar ◽  
Charlie Giammattei ◽  
Neema M Tan ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Patient Outcomes ◽  
Mobile Health ◽  
Text Messages ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Readmission Rates ◽  
Orthopedic Surgeons ◽  
Mhealth Technology ◽  
The Impact

Background Despite the growth of and media hype about mobile health (mHealth), there is a paucity of literature supporting the effectiveness of widespread implementation of mHealth technologies. Objective This study aimed to assess whether an innovative mHealth technology system with several overlapping purposes can impact (1) clinical outcomes (ie, readmission rates, revisit rates, and length of stay) and (2) patient-centered care outcomes (ie, patient engagement, patient experience, and patient satisfaction). Methods We compared all patients (2059 patients) of participating orthopedic surgeons using mHealth technology with all patients of nonparticipating orthopedic surgeons (2554 patients). The analyses included Wilcoxon rank-sum tests, Kruskal-Wallis tests for continuous variables, and chi-square tests for categorical variables. Logistic regression models were performed on categorical outcomes and a gamma-distributed model for continuous variables. All models were adjusted for patient demographics and comorbidities. Results The inpatient readmission rates for the nonparticipating group when compared with the participating group were higher and demonstrated higher odds ratios (ORs) for 30-day inpatient readmissions (nonparticipating group 106/2636, 4.02% and participating group 54/2048, 2.64%; OR 1.48, 95% CI 1.03 to 2.13; P=.04), 60-day inpatient readmissions (nonparticipating group 194/2636, 7.36% and participating group 85/2048, 4.15%; OR 1.79, 95% CI 1.32 to 2.39; P<.001), and 90-day inpatient readmissions (nonparticipating group 261/2636, 9.90% and participating group 115/2048, 5.62%; OR 1.81, 95% CI 1.40 to 2.34; P<.001). The length of stay for the nonparticipating cohort was longer at 1.90 days, whereas the length of stay for the participating cohort was 1.50 days (mean 1.87, SD 2 vs mean 1.50, SD 1.37; P<.001). Patients treated by participating surgeons received and read text messages using mHealth 83% of the time and read emails 84% of the time. Patients responded to 60% of the text messages and 53% of the email surveys. Patients were least responsive to digital monitoring questions when the hospital asked them to do something, and they were most engaged with emails that did not require action, including informational content. A total of 96% (558/580) of patients indicated high satisfaction with using mHealth technology to support their care. Only 0.40% (75/2059) patients opted-out of the mHealth technology program after enrollment. Conclusions A novel, multicomponent, pathway-driven, patient-facing mHealth technology can positively impact patient outcomes and patient-reported experiences. These technologies can empower patients to play a more active and meaningful role in improving their outcomes. There is a deep need, however, for a better understanding of the interactions between patients, technology, and health care providers. Future research is needed to (1) help identify, address, and improve technology usability and effectiveness; (2) understand patient and provider attributes that support adoption, uptake, and sustainability; and (3) understand the factors that contribute to barriers of technology adoption and how best to overcome them.

scholarly journals Assessing the Impact of Patient-Facing Mobile Health Technology on Patient Outcomes: Retrospective Observational Cohort Study (Preprint)

2020 ◽  
Author(s):  
Courtenay R Bruce ◽  
Patricia Harrison ◽  
Tariq Nisar ◽  
Charlie Giammattei ◽  
Neema M Tan ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Patient Outcomes ◽  
Mobile Health ◽  
Text Messages ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Readmission Rates ◽  
Orthopedic Surgeons ◽  
Mhealth Technology ◽  
The Impact

BACKGROUND Despite the growth of and media hype about mobile health (mHealth), there is a paucity of literature supporting the effectiveness of widespread implementation of mHealth technologies. OBJECTIVE This study aimed to assess whether an innovative mHealth technology system with several overlapping purposes can impact (1) clinical outcomes (ie, readmission rates, revisit rates, and length of stay) and (2) patient-centered care outcomes (ie, patient engagement, patient experience, and patient satisfaction). METHODS We compared all patients (2059 patients) of participating orthopedic surgeons using mHealth technology with all patients of nonparticipating orthopedic surgeons (2554 patients). The analyses included Wilcoxon rank-sum tests, Kruskal-Wallis tests for continuous variables, and chi-square tests for categorical variables. Logistic regression models were performed on categorical outcomes and a gamma-distributed model for continuous variables. All models were adjusted for patient demographics and comorbidities. RESULTS The inpatient readmission rates for the nonparticipating group when compared with the participating group were higher and demonstrated higher odds ratios (ORs) for 30-day inpatient readmissions (nonparticipating group 106/2636, 4.02% and participating group 54/2048, 2.64%; OR 1.48, 95% CI 1.03 to 2.13; <i>P</i>=.04), 60-day inpatient readmissions (nonparticipating group 194/2636, 7.36% and participating group 85/2048, 4.15%; OR 1.79, 95% CI 1.32 to 2.39; <i>P</i>&lt;.001), and 90-day inpatient readmissions (nonparticipating group 261/2636, 9.90% and participating group 115/2048, 5.62%; OR 1.81, 95% CI 1.40 to 2.34; <i>P</i>&lt;.001). The length of stay for the nonparticipating cohort was longer at 1.90 days, whereas the length of stay for the participating cohort was 1.50 days (mean 1.87, SD 2 vs mean 1.50, SD 1.37; <i>P</i>&lt;.001). Patients treated by participating surgeons received and read text messages using mHealth 83% of the time and read emails 84% of the time. Patients responded to 60% of the text messages and 53% of the email surveys. Patients were least responsive to digital monitoring questions when the hospital asked them to <i>do</i> something, and they were most engaged with emails that <i>did not</i> require action, including informational content. A total of 96% (558/580) of patients indicated high satisfaction with using mHealth technology to support their care. Only 0.40% (75/2059) patients <i>opted-out</i> of the mHealth technology program after enrollment. CONCLUSIONS A novel, multicomponent, pathway-driven, patient-facing mHealth technology can positively impact patient outcomes and patient-reported experiences. These technologies can empower patients to play a more active and meaningful role in improving their outcomes. There is a deep need, however, for a better understanding of the interactions between patients, technology, and health care providers. Future research is needed to (1) help identify, address, and improve technology usability and effectiveness; (2) understand patient and provider attributes that support adoption, uptake, and sustainability; and (3) understand the factors that contribute to barriers of technology adoption and how best to overcome them.

scholarly journals 108. Impact of Accelerate Pheno System in the Management of Gram-Negative Rod Bacteremia

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S69-S69
Author(s):  
Iaswarya Ganapathiraju ◽  
Amanda Bushman ◽  
Rossana Rosa Espinoza
Keyword(s):  
Length Of Stay ◽  
Blood Culture ◽  
Hospital Mortality ◽  
Culture Collection ◽  
Categorical Variables ◽  
Fisher Exact Test ◽  
Continuous Variables ◽  
Gram Negative ◽  
Stewardship Program ◽  
The Impact

Abstract Background Early pathogen identification and initiation of appropriate antimicrobial therapy is key in the management of Gram-negative rods (GNR) bloodstream infection (BSI). The Accelerate Pheno System (ACC) has been shown to reduce time to GNR identification compared to traditional culture-based methods. We aimed to determine the impact of ACC on the management of GNR BSI in the setting of a well-established antimicrobial stewardship program (ASP). Table 1 Methods ACC was introduced in our institution on February 2019. Due to issues incorporating ACC, of patients with GNR BSI, 74% had ACC done and 26% had reporting through traditional methods. This allowed for the design of a retrospective cohort study (instead of a pre-post analysis) to evaluate the association of interest. We included adult patients admitted to three affiliated hospitals in Des Moines, Iowa with BSI due to Enterobacteriales from February 2019 to February 2020. Exclusion criteria were Emergency Department visit only and death within 48 hours of blood culture collection. Primary outcomes were length of hospital stay, days to therapy optimization and in-hospital mortality. Continuous variables were compared by non-parametric methods and categorical variables were compared by Chi-square and Fisher-exact test. Logistic regression models were used to calculate odds ratio for the impact of the intervention on therapy optimization. Results A total of 268 patients were analyzed. The median length of stay among patients who had ACC done was 5.2 days (IQR 3.6–8.7) and in those on who ACC was not done it was 5.5 (IQR 3.8–8.9) (p=0.54). No differences in in-hospital mortality were found (p=0.942). Changes in therapy and missed opportunities for optimization according to whether ACC was done are shown in Table 1. Patients who had ACC done had 99% higher odds of de-escalation within 48 hours of blood culture collection compared to patients who did not have it done (95% CI 1.01–3.92; p=0.044). Conclusion In the context of hospitals with baseline short length of stay and a well-established ASP, performing ACC was associated with higher odds of de-escalation within 48 hours of blood culture collection but did not impact length of stay or mortality among patients hospitalized with GNR BSI. Disclosures All Authors: No reported disclosures

617 Who Benefits the Most from Burn Camps?

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S162-S163
Author(s):  
Jennifer B Radics-Johnson ◽  
Daniel W Chacon ◽  
Li Zhang
Keyword(s):  
Retrospective Review ◽  
Burn Injury ◽  
Statistical Significance ◽  
Categorical Variables ◽  
P Value ◽  
Continuous Variables ◽  
Self Evaluation ◽  
Significant Difference ◽  
Return Home ◽  
The Impact

Abstract Introduction Burn camps provide a unique environment and activities for children that have experienced a burn-injury. Positive outcomes from attending burn camp include increased self-esteem, decreased feelings of isolation and a greater sense of self-confidence. In a 3-year retrospective review of camper evaluations from one of the largest and longest running week-long burn camps in the nation for ages 5–17, we aimed to assess if a child’s gender, age, TBSA or ethnicity affected the impact that burn camp had on a child. Methods A 3-year retrospective review of a Burn Camp’s camper evaluation forms was conducted for campers that attended burn camp between 2017–2019. Camp rosters were reviewed to determine the camper gender, age, TBSA and ethnicity. Camper self-evaluation forms completed at the end of each camp session were reviewed to record camper responses to questions regarding their opinions on the impact camp had on them as well as how camp will impact their lives once they return home. Categorical variables were summarized as frequency and percentage, and continuous variables were described as median and range. To check the relationship between two categorical variables, Chi-square test was used. To compare the continuous variable among groups, Kruskal-Wallis ANOVA was used. Statistical significance was declared based on a p value&lt; 0.5. Results Within 2017–2019, there were 413 camper records. Participants’ demographic characteristics are summarized in Table 1. There were 208 males (50.3%) and 205 females (49.6%). The median age of campers were 11.86, 12.44 and 12.45 for 2017–2019, with the range from 5.16 years to 17.96 years. The median TBSA were 20, 20 and 18 for 2017–2019, with the range from 0.08 to 90. Collectively there were 47.7% Hispanic (n= 197); 24.2% Whites (n=100); 13.1% Black (n= 54); 4.6% Asian (n=19) and 7.7% Other (n=32). There were 395 camper self-evaluation forms submitted. Results of three questions there we were interested in are summarized collectively in Table 2. 57% of campers responded, “Yes, Definitely” to the question “After going to this event, will you feel more comfortable being around your classmates or friends?” 54% responded, “ Yes, Definitely” to the question “Do you feel more confidents in sharing your burn story with others when returning home?” and 51% responded “Yes, Definitely” to “Did you learn anything that will help you when you return home?” Conclusions In analyzing the camper responses, there was no statistically significant difference in responses comparing gender, age, TBSA or ethnicity.

The Compliance of Prescribed Activity Restriction in Women at High Risk for Preterm Birth

2020 ◽  
Author(s):  
Ghamar Bitar ◽  
Anthony Sciscione
Keyword(s):  
Preterm Birth ◽  
High Risk ◽  
Medical Center ◽  
Compliance Rate ◽  
Tertiary Care ◽  
Prescribing Patterns ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Activity Restriction ◽  
The Impact

Objective Despite lack of evidence to support efficacy, activity restriction is one of the most commonly prescribed interventions used for the prevention of preterm birth. We have a departmental policy against the use of activity restriction but many practitioners still prescribe it in an effort to prevent preterm birth. We sought to evaluate the rate and compliance of women who are prescribed activity restriction during pregnancy to prevent preterm birth. Study Design This was a single-site retrospective questionnaire study at a tertiary care, academic affiliated medical center. Women with a history of preterm delivery or short cervix were included. Once patients were identified, each patient was contacted and administered a questionnaire. We assessed the rates of activity restriction prescription and compliance. Secondary outcomes included details regarding activity restriction and treatment in pregnancy. Continuous variables were compared with t-test and categorical variables with Chi-square test. The value p < 0.05 was considered significant. Results Among the 52 women who responded to the questionnaire, 18 reported being placed on activity restriction by a physician, with 1 self-prescribing activity restriction, giving a rate of our primary outcome of 19 of 52 (36.5%). All women reported compliance with prescribed activity restriction (100%). Gestational age at delivery was not different in women placed on activity restriction. Conclusion This questionnaire suggests that approximately one in three high-risk women were placed on activity restriction during their pregnancy despite a departmental policy against its use. The 100% compliance rate in patients placed on activity restriction is a strong reminder of the impact prescribing patterns of physicians can have on patients. Key Points

Evaluation of Targeted Pharmacist Interventions to Reduce Length of Stay in an Acute Care Practice Model

2018 ◽  
Vol 53 (5) ◽  
pp. 471-477 ◽  
Author(s):  
Mary-Haston Leary ◽  
Kathryn Morbitzer ◽  
Bobbi Jo Walston ◽  
Stephen Clark ◽  
Jenna Kaplan ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Acute Care ◽  
Positive Impact ◽  
Pharmacy Practice ◽  
Care Practice ◽  
Readmission Rates ◽  
A Value ◽  
Pharmacist Interventions ◽  
Semistructured Interviews ◽  
The Impact

Background: Despite widespread recognition of the need for innovative pharmacy practice approaches, the development and implementation of value-based outcomes remains difficult to achieve. Furthermore, gaps in the literature persist because the majority of available literature is retrospective in nature and describes only the clinical impact of pharmacists’ interventions. Objective: Length of stay (LOS) is a clinical outcome metric used to represent efficiency in health care. The objective of this study was to evaluate the impact of pharmacist-driven interventions on LOS in the acute care setting. Methods: A separate samples pretest-posttest design was utilized to compare the effect of pharmacist interventions across 3 practice areas (medicine, hematology/oncology, and pediatrics). Two time periods were evaluated: preimplementation (PRE) and a pilot period, postimplementation of interventions (POST). Interventions included targeted discharge services, such as discharge prescription writing (with provider cosignature). Participating pharmacists completed semistructured interviews following the pilot. Results: A total of 924 patients (466 PRE and 458 POST) were included in the analysis. The median LOS decreased from 4.95 (interquartile range = 3.24-8.5) to 4.12 (2.21-7.96) days from the PRE versus POST groups, respectively ( P < 0.011). There was no difference in readmission rates between groups (21% vs 19.1%, P = 0.7). Interviews revealed several themes, including positive impact on professional development. Conclusion and Relevance: This pilot study demonstrated the ability of pharmacist interventions to reduce LOS. Pharmacists identified time as the primary barrier and acknowledged the importance of leaders prioritizing pharmacists’ responsibilities. This study is novel in targeting LOS, providing a value-based outcome for clinical pharmacy services.

scholarly journals Incorporating Behavioral Trigger Messages Into a Mobile Health App for Chronic Disease Management: Randomized Clinical Feasibility Trial in Diabetes

10.2196/15927 ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. e15927
Author(s):  
Scott Sittig ◽  
Jing Wang ◽  
Sriram Iyengar ◽  
Sahiti Myneni ◽  
Amy Franklin
Keyword(s):  
Chronic Disease ◽  
Disease Management ◽  
Mobile Health ◽  
Self Efficacy ◽  
Chronic Disease Management ◽  
Text Messages ◽  
Feasibility Trial ◽  
Significant Difference ◽  
Within Subjects ◽  
The Impact

Background Although there is a rise in the use of mobile health (mHealth) tools to support chronic disease management, evidence derived from theory-driven design is lacking. Objective The objective of this study was to determine the impact of an mHealth app that incorporated theory-driven trigger messages. These messages took different forms following the Fogg behavior model (FBM) and targeted self-efficacy, knowledge, and self-care. We assess the feasibility of our app in modifying these behaviors in a pilot study involving individuals with diabetes. Methods The pilot randomized unblinded study comprised two cohorts recruited as employees from within a health care system. In total, 20 patients with type 2 diabetes were recruited for the study and a within-subjects design was utilized. Each participant interacted with an app called capABILITY. capABILITY and its affiliated trigger (text) messages integrate components from social cognitive theory (SCT), FBM, and persuasive technology into the interactive health communications framework. In this within-subjects design, participants interacted with the capABILITY app and received (or did not receive) text messages in alternative blocks. The capABILITY app alone was the control condition along with trigger messages including spark and facilitator messages. A repeated-measures analysis of variance (ANOVA) was used to compare adherence with behavioral measures and engagement with the mobile app across conditions. A paired sample t test was utilized on each health outcome to determine changes related to capABILITY intervention, as well as participants’ classified usage of capABILITY. Results Pre- and postintervention results indicated statistical significance on 3 of the 7 health survey measures (general diet: P=.03; exercise: P=.005; and blood glucose: P=.02). When only analyzing the high and midusers (n=14) of capABILITY, we found a statistically significant difference in both self-efficacy (P=.008) and exercise (P=.01). Although the ANOVA did not reveal any statistically significant differences across groups, there is a trend among spark conditions to respond more quickly (ie, shorter log-in lag) following the receipt of the message. Conclusions Our theory-driven mHealth app appears to be a feasible means of improving self-efficacy and health-related behaviors. Although our sample size is too small to draw conclusions about the differential impact of specific forms of trigger messages, our findings suggest that spark triggers may have the ability to cue engagement in mobile tools. This was demonstrated with the increased use of capABILITY at the beginning and conclusion of the study depending on spark timing. Our results suggest that theory-driven personalization of mobile tools is a viable form of intervention. Trial Registration ClinicalTrials.gov NCT04132089; http://clinicaltrials.gov/ct2/show/NCT004122089

Perianal disease remains an understudied and difficult complication in leukemia patients.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e19016-e19016
Author(s):  
Shreya Gupta ◽  
Nirav Patil ◽  
Emily Steinhagen-Golbig ◽  
Benjamin Kent Tomlinson ◽  
Sharon Stein ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Hospital Mortality ◽  
Hospital Cost ◽  
Hospital Costs ◽  
Perianal Abscess ◽  
Lymphocytic Leukemia ◽  
Operative Intervention ◽  
Perianal Disease ◽  
Categorical Variables ◽  
Continuous Variables

e19016 Background: Perianal infection is a rare and poorly understood complication of patients with acute myeloid/lymphocytic leukemia (AML/ALL). With the advancements in oncology, patients are living longer in an immunocompromised state and thus bearing the inherent problems such as infections that arise with it. Perianal infection and its management impacts patients' quality of life as well as interrupts their ongoing oncologic treatment. The optimal treatment strategy for perianal infections in this highly immunocompromised group remains unclear, as does the selection and outcomes of patients for operative intervention. The aim of this study is to identify patient characteristics associated with perianal infection and to delineate outcomes in patients that undergo operative intervention. Methods: The National Inpatient Sample (NIS) database was used to identify hospitalized patients with diagnoses of perianal abscess and AML/ALL between 2007 and 2015. Patient data were weighted to obtain national estimates. Demographics and clinical characteristics were compared between patients with and without perianal disease using Rao-Scott Chi-square test for categorical variables, and weighted simple linear regression for continuous variables. Characteristics and outcomes were compared between patients who underwent operative or non-operative management. Results: There were 12,626 (0.7%) patients with perianal disease among 1,782,778 AML/ALL patient admissions. Patients with perianal disease were more likely to be younger (43.9 (42.5 – 45.3) years, p < 0.001), male (67.4% vs 32.6%, p < 0.001) and white (65.8% vs 54.8%, p < 0.001). Length of stay (18.4 days vs 9 days, p < 0.001) and hospital cost ($54K vs $25K, p < 0.001) were higher in those with perianal disease, but there was no difference in in-hospital mortality (5.5% in those with perianal diseases vs 6.2% in those without, p = 0.150). Greater proportion of patients without perianal disease were discharged to hospice (12.6% patients without perianal disease vs 5.1% patients with perianal disease, p < 0.001). Receiving a surgical intervention did not improve outcomes with respect to in-hospital mortality (5.9% operative vs 5.4 non-operative, p = 0.596), length of stay (20.2 days vs 18.2 days, p = 0.582) or hospital cost ($67K vs $53K, p = 0.525). Conclusions: Perianal disease is a rare but distressing complication in AML/ALL patients associated with longer hospital stays and higher hospital costs. Operative intervention for perianal disease did not reduce rates of in-hospital mortality, length of stay or hospital cost but it does impact the probability of discharge to hospice. Non-operative and operative intervention both remain equivocal in changing the outcomes these patients. Further studies are required to examine these associations and determine best practices for treatment of this condition in this complex patient population.

Misunderstanding immunotherapy: An analysis of provider-patient conversations.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18638-e18638
Author(s):  
Shannon M. Blee ◽  
Bari Rosenberg ◽  
Jeffrey M. Switchenko ◽  
Rachel Hianik ◽  
Mary Catherine Thomson ◽  
...  
Keyword(s):  
Immune System ◽  
Informed Consent ◽  
Family Member ◽  
Patient Outcomes ◽  
College Education ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Patient Centered ◽  
Patient Understanding ◽  
Technical Terms

e18638 Background: Immunotherapy terminology is often complex and can be difficult for patients to understand, threatening both informed consent and patient-centered communication. Improving patient-centered communication is fundamental to fostering a quality provider-patient relationship and has been shown to positively impact the length of time to initiating treatment and to optimize patient outcomes. The aim of this study is to determine whether patients understand basic immunotherapy terminology and if a provider defining the term improves patient understanding. Methods: Conversations between oncology providers and patients discussing immunotherapy for the first time, either as standard of care or as part of a clinical trial, were observed, audio recorded and transcribed (n = 39). Technical terms used in the conversation were noted by the research assistant. With consent, patients were interviewed post-conversation to assess their understanding of these technical terms used by the provider (n = 39). Comparisons of the terms (correct vs. incorrect) were conducted using chi-square tests or Fisher’s exact tests, where appropriate, for categorical variables, and using ANOVA for continuous variables. Results: Participants were mostly white (79.5%), had some college education (55.3%), had a personal income of > = $50k (56.7%), and had a family member with cancer (54.1%). The term ‘immunotherapy’ was the most difficult term for participants to understand with less than half (19/39; 48.7%) correctly defining it. The only demographic characteristic that was significantly correlated with understanding ‘immunotherapy’ was having a family member with cancer (p = 0.031). Immunotherapy agents, such as Pembro and Nivolumab, were defined correctly by patients 65% (19/29) of time). Interestingly ‘immune system’ was well understood (23/26; 88.5%). Providers defined immunotherapy in 97.4% of conversations. However, there was no correlation between having a provider define immunotherapy in the conversation, and the likelihood of participants correctly defining the term in the post-conversation interview (p = 0.487).The immune system was defined in 92.3% of conversations (n = 26), and defining immune system in the conversation was correlated with increased patient understanding (p = 0.009). Conclusions: Analysis of patient-provider conversations shows that patients have difficulty understanding some immunotherapy terminology. Since immunotherapy is a relatively new therapy, it may be more difficult for providers to translate it into lay language, which could be why patients lack understanding of ’immunotherapy’, even when provided with a definition. Since patient understanding of key terminology is essential for not only enhancing patient-centered communication, but for improving informed consent and optimizing patient outcomes, educational interventions should be developed to improve understanding.

Evidence for feasibility of mobile health and social media-based interventions for early psychosis and clinical high risk (Preprint)

2021 ◽  
Author(s):  
Olivia H. Franco ◽  
Monica E. Calkins ◽  
Salvatore Giorgi ◽  
Lyle H. Ungar ◽  
Raquel E. Gur ◽  
...  
Keyword(s):  
Social Media ◽  
Mobile Health ◽  
Mental Health Treatment ◽  
Negative Symptoms ◽  
Psychotic Disorders ◽  
Early Psychosis ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Care Clinic ◽  
Access To Technology

BACKGROUND Digital technology, the internet and social media are increasingly investigated as a promising means for monitoring symptoms and delivering mental health treatment. These apps and interventions have demonstrated preliminary acceptability and feasibility, but previous reports suggests that access to technology may still be limited among individuals with psychotic disorders relative to the general population. OBJECTIVE We evaluated and compared access and use of technology and social media in young adults with psychotic disorders (PD), clinical risk for psychosis (CR), and psychosis-free youths (PF). METHODS Participants were recruited through a coordinated specialty care clinic dedicated towards early psychosis as well as ongoing studies. We surveyed 21 PD, 23 CR, and 15 PF participants regarding access to technology and use of social media, specifically Facebook and Twitter. Statistical analyses were conducted in R. Categorical variables were compared among groups Fisher’s exact test, continuous variables were compared using one-way ANOVA, and multiple linear regressions were used to evaluate for covariates. RESULTS Access to technology and social media were similar among PD, CR and PF. Individuals with PD, but not CR, were less likely to post at a weekly or higher frequency compared to psychosis-free individuals. We found that decreased active social media posting was unique to psychotic disorders and did not occur with other psychiatric diagnoses or demographic variables. Additionally, variation in age, sex, Caucasian vs. non-Caucasian race did not affect posting frequency. CONCLUSIONS For young people with psychosis spectrum disorders, there appears to be no “technology gap” limiting the implementation of digital and mobile health interventions. Active posting to social media was reduced for individuals with psychosis, which may be related to negative symptoms or impairment in social functioning.

scholarly journals FEASIBILITY OF MOBILE HEALTH FOR LOW-INCOME MINORITY HISPANIC PATIENTS WITH A STROKE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S334-S334
Author(s):  
Stuti Dang ◽  
Kasra Sarhadi ◽  
Sonjia Kenya ◽  
Chuanhui Dong ◽  
Natalie Ferras ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Patient Education ◽  
Mobile Health ◽  
Low Income ◽  
Health Knowledge ◽  
Randomized Study ◽  
Response Rates ◽  
Text Messages ◽  
Stroke Patients ◽  
The Impact

Abstract Stroke is a leading cause of death and functional impairment that disproportionately impacts Hispanics. Several studies have supported the feasibility of mobile health interventions (mHealth) to provide health monitoring and patient education for improving chronic disease management, but none have focused on Latino stroke patients. The Hispanic Secondary Stroke Prevention Initiative is a randomized study of 200 stroke patients designed to evaluate the impact of a 12-month multi-modal Community Health Worker (CHW) and mHealth intervention on blood pressure control. Eligible participants were Latinos who experienced a mild-moderate stroke within the last five years. The CHW component included home visits, telephone calls, and daily text messages to obtain home blood pressure readings and provide patient navigation and health education. Feasibility was defined as the proportion of patients that responded to at least half the messages. Pre-post paired t-tests assessed improvements in question accuracy while correlation coefficients highlighted improvements in response rates. Among the 65 participants randomized to the intervention, the response rate was as follows: 37% - &gt;50% response, 21% - 25-50%, 19% - 10-25%, and 23% - &lt;10%, This finding suggests that mHealth interventions may be challenging in this population. However, the proportion of questions answered correctly increased from 63% to 84% in the intervention period’s last two months (p&lt;0.05). There was a positive correlation between increased response rates and response accuracy to patient education assessments (r=0.82, p&lt;0.05). These improvements in health knowledge suggest that a subset of patients may benefit from mHealth interventions, and the benefit correlates with use.

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