scholarly journals 3MD for Chronic Conditions, a Model for Motivational mHealth Design: Embedded Case Study (Preprint)

2018 ◽  
Author(s):  
Guido Giunti
Keyword(s):  
Mobile Health ◽  
Health Care Professionals ◽  
Behavioral Change ◽  
Chronic Conditions ◽  
Mobile Technologies ◽  
Chronic Patients ◽  
Change Models ◽  
Research Through Design ◽  
Embedded Case Study

BACKGROUND Chronic conditions are the leading cause of death in the world. Major improvements in acute care and diagnostics have created a tendency toward the chronification of formerly terminal conditions, requiring people with these conditions to learn how to self-manage. Mobile technologies hold promise as self-management tools due to their ubiquity and cost-effectiveness. The delivery of health-related services through mobile technologies (mobile health, mHealth) has grown exponentially in recent years. However, only a fraction of these solutions take into consideration the views of relevant stakeholders such as health care professionals or even patients. The use of behavioral change models (BCMs) has proven important in developing successful health solutions, yet engaging patients remains a challenge. There is a trend in mHealth solutions called gamification that attempts to use game elements to drive user behavior and increase engagement. As it stands, designers of mHealth solutions for behavioral change in chronic conditions have no clear way of deciding what factors are relevant to consider. OBJECTIVE The goal of this work is to discover factors for the design of mHealth solutions for chronic patients using negotiations between medical knowledge, BCMs, and gamification. METHODS This study uses an embedded case study research methodology consisting of 4 embedded units: 1) cross-sectional studies of mHealth applications; 2) statistical analysis of gamification presence; 3) focus groups and interviews to relevant stakeholders; and 4) research through design of an mHealth solution. The data obtained was thematically analyzed to create a conceptual model for the design of mHealth solutions. RESULTS The Model for Motivational Mobile-health Design (3MD) for chronic conditions guides the design of condition-oriented gamified behavioral change mHealth solutions. The main components are (1) condition specific, which describe factors that need to be adjusted and adapted for each particular chronic condition; (2) motivation related, which are factors that address how to influence behaviors in an engaging manner; and (3) technology based, which are factors that are directly connected to the technical capabilities of mobile technologies. The 3MD also provides a series of high-level illustrative design questions for designers to use and consider during the design process. CONCLUSIONS This work addresses a recognized gap in research and practice, and proposes a unique model that could be of use in the generation of new solutions to help chronic patients.

scholarly journals More Stamina, a Gamified mHealth Solution for Persons with Multiple Sclerosis: Research Through Design (Preprint)

2017 ◽  
Author(s):  
Guido Giunti ◽  
Vasiliki Mylonopoulou ◽  
Octavio Rivera Romero
Keyword(s):  
Multiple Sclerosis ◽  
Design Process ◽  
Behavioral Change ◽  
Heuristic Evaluation ◽  
Change Models ◽  
Usability Problems ◽  
Research Through Design ◽  
The Impact ◽  
Mhealth Apps ◽  
A Current

BACKGROUND Multiple sclerosis (MS) is one of the world’s most common neurologic disorders. Fatigue is one of most common symptoms that persons with MS experience, having significant impact on their quality of life and limiting their activity levels. Self-management strategies are used to support them in the care of their health. Mobile health (mHealth) solutions are a way to offer persons with chronic conditions tools to successfully manage their symptoms and problems. Gamification is a current trend among mHealth apps used to create engaging user experiences and is suggested to be effective for behavioral change. To be effective, mHealth solutions need to be designed to specifically meet the intended audience needs. User-centered design (UCD) is a design philosophy that proposes placing end users’ needs and characteristics in the center of design and development, involving users early in the different phases of the software life cycle. There is a current gap in mHealth apps for persons with MS, which presents an interesting area to explore. OBJECTIVE The purpose of this study was to describe the design and evaluation process of a gamified mHealth solution for behavioral change in persons with MS using UCD. METHODS Building on previous work of our team where we identified needs, barriers, and facilitators for mHealth apps for persons with MS, we followed UCD to design and evaluate a mobile app prototype aimed to help persons with MS self-manage their fatigue. Design decisions were evidence-driven and guided by behavioral change models (BCM). Usability was assessed through inspection methods using Nielsen’s heuristic evaluation. RESULTS The mHealth solution More Stamina was designed. It is a task organization tool designed to help persons with MS manage their energy to minimize the impact of fatigue in their day-to-day life. The tool acts as a to-do list where users can input tasks in a simple manner and assign Stamina Credits, a representation of perceived effort, to the task to help energy management and energy profiling. The app also features personalization and positive feedback. The design process gave way to relevant lessons to the design of a gamified behavioral change mHealth app such as the importance of metaphors in concept design, negotiate requirements with the BCM constructs, and tailoring of gamified experiences among others. Several usability problems were discovered during heuristic evaluation and guided the iterative design of our solution. CONCLUSIONS In this paper, we designed an app targeted for helping persons with MS in their fatigue management needs. We illustrate how UCD can help in designing mHealth apps and the benefits and challenges that designers might face when using this approach. This paper provides insight into the design process of gamified behavioral change mHealth apps and the negotiation process implied in it.

scholarly journals Understanding Determinants of Health Care Professionals’ Perspectives on Mobile Health Continuance and Performance (Preprint)

2018 ◽  
Author(s):  
Ju-Ling Hsiao ◽  
Rai-Fu Chen
Keyword(s):  
Health Care ◽  
Mobile Health ◽  
Health Care Professionals ◽  
User Satisfaction ◽  
Individual Performance ◽  
Perceived Usefulness ◽  
Mobile Technologies ◽  
Sufficient Evidence ◽  
Critical Factors ◽  
And Performance

BACKGROUND With the widespread use of mobile technologies, mobile information systems have become crucial tools in health care operations. Although the appropriate use of mobile health (mHealth) may result in major advances in expanding health care coverage (increasing decision-making speeds, managing chronic conditions, and providing suitable health care in emergencies), previous studies have argued that current mHealth research does not adequately evaluate mHealth interventions, and it does not provide sufficient evidence regarding the effects on health. OBJECTIVE The aim of this study was to facilitate the widespread use of mHealth systems; an accurate evaluation of the systems from the users’ perspective is essential after the implementation and use of the system in daily health care practices. This study extends the expectation-confirmation model by using characteristics of individuals, technology, and tasks to identify critical factors affecting mHealth continuance and performance from the perspective of health care professionals (HCPs). METHODS A questionnaire survey was used to collect data from HCPs who were experienced in using mHealth systems of a Taiwanese teaching hospital. In total, 282 questionnaires were distributed, and 201 complete and valid questionnaires were returned, thus indicating a valid response rate of 71.3% (201/282). The collected data were analyzed using WarpPLS version 5.0 (ScriptWarp Systems). RESULTS The results revealed that mHealth continuance (R2=0.522) was mainly affected by perceived usefulness, technology maturity, individual habits, task mobility, and user satisfaction, whereas individual performance (R2=0.492) was affected by mHealth continuance. In addition, user satisfaction (R2=0.548) was affected by confirmation and perceived usefulness of mHealth, whereas perceived usefulness (R2=0.521) was affected by confirmation. This implied that confirmation played a key role in affecting perceived usefulness and user satisfaction. Furthermore, the results showed that mHealth continuance positively affected individual performance. CONCLUSIONS The identified critical factors influencing mHealth continuance and performance can be used as a useful assessment tool by hospitals that have implemented mHealth systems to facilitate the use and infusion of the systems. Furthermore, the results can help health care institutions that intend to introduce or develop mHealth applications to identify critical issues and effectively allocate limited resources to mHealth systems.

scholarly journals Implementing Mobile Health–Enabled Integrated Care for Complex Chronic Patients: Patients and Professionals’ Acceptability Study

10.2196/22136 ◽  
2020 ◽  
Vol 8 (11) ◽  
pp. e22136
Author(s):  
Jordi de Batlle ◽  
Mireia Massip ◽  
Eloisa Vargiu ◽  
Nuria Nadal ◽  
Araceli Fuentes ◽  
...  
Keyword(s):  
Usual Care ◽  
Integrated Care ◽  
Continuity Of Care ◽  
Mobile Health ◽  
Health Care Professionals ◽  
Lessons Learned ◽  
Assessment Process ◽  
Chronic Patients ◽  
Health And Social Care ◽  
System Usability Scale

Background Integrated care (IC) can promote health and social care efficiency through prioritization of preventive patient-centered models and defragmentation of care and collaboration across health tiers, and mobile health (mHealth) can be the cornerstone allowing for the adoption of IC. Objective This study aims to assess the acceptability, usability, and satisfaction of an mHealth-enabled IC model for complex chronic patients in both patients and health professionals. Methods As part of the CONNECARE Horizon 2020 project, a prospective, pragmatic, 2-arm, parallel, hybrid effectiveness-implementation trial was conducted from July 2018 to August 2019 in a rural region of Catalonia, Spain. Home-dwelling patients 55 years and older with chronic conditions and a history of hospitalizations for chronic obstructive pulmonary disease or heart failure (use case [UC] 1), or a scheduled major elective hip or knee arthroplasty (UC2) were recruited. During the 3 months, patients experienced an mHealth-enabled IC model, including a self-management app for patients, a set of integrated sensors, and a web-based platform connecting professionals from different settings or usual care. The Person-Centered Coordinated Care Experience Questionnaire (P3CEQ) and the Nijmegen Continuity Questionnaire (NCQ) assessed person-centeredness and continuity of care. Acceptability was assessed for IC arm patients and staff with the Net Promoter Score (NPS) and the System Usability Scale (SUS). Results The analyses included 77 IC patients, 58 controls who completed the follow-up, and 30 health care professionals. The mean age was 78 (SD 9) years in both study arms. Perception of patient-centeredness was similarly high in both arms (usual care: mean P3CEQ score 16.1, SD 3.3; IC: mean P3CEQ score 16.3, SD 2.4). IC patients reported better continuity of care than controls (usual care: mean NCQ score 3.7, SD 0.9; IC: mean NCQ score 4.0, SD 1; P=.04). The scores for patient acceptability (UC1: NPS +67%; UC2: NPS +45%) and usability (UC1: mean SUS score 79, SD 14; UC2: mean SUS score 68, SD 24) were outstanding. Professionals’ acceptability was low (UC1: NPS −25%; UC2: NPS −35%), whereas usability was average (UC1: mean SUS score 63, SD 20; UC2: mean SUS score 62, SD 19). The actual use of technology was high; 77% (58/75) of patients reported physical activity for at least 60 days, and the ratio of times reported over times prescribed for other sensors ranged from 37% for oxygen saturation to 67% for weight. Conclusions The mHealth-enabled IC model showed outstanding results from the patients’ perspective in 2 different UCs but lacked maturity and integration with legacy systems to be fully accepted by professionals. This paper provides useful lessons learned through the development and assessment process and may be of use to organizations willing to develop or implement mHealth-enabled IC for older adults.

scholarly journals Implementing Mobile Health–Enabled Integrated Care for Complex Chronic Patients: Patients and Professionals’ Acceptability Study (Preprint)

2020 ◽  
Author(s):  
Jordi de Batlle ◽  
Mireia Massip ◽  
Eloisa Vargiu ◽  
Nuria Nadal ◽  
Araceli Fuentes ◽  
...  
Keyword(s):  
Usual Care ◽  
Integrated Care ◽  
Continuity Of Care ◽  
Mobile Health ◽  
Health Care Professionals ◽  
Lessons Learned ◽  
Assessment Process ◽  
Chronic Patients ◽  
Health And Social Care ◽  
System Usability Scale

BACKGROUND Integrated care (IC) can promote health and social care efficiency through prioritization of preventive patient-centered models and defragmentation of care and collaboration across health tiers, and mobile health (mHealth) can be the cornerstone allowing for the adoption of IC. OBJECTIVE This study aims to assess the acceptability, usability, and satisfaction of an mHealth-enabled IC model for complex chronic patients in both patients and health professionals. METHODS As part of the CONNECARE Horizon 2020 project, a prospective, pragmatic, 2-arm, parallel, hybrid effectiveness-implementation trial was conducted from July 2018 to August 2019 in a rural region of Catalonia, Spain. Home-dwelling patients 55 years and older with chronic conditions and a history of hospitalizations for chronic obstructive pulmonary disease or heart failure (use case [UC] 1), or a scheduled major elective hip or knee arthroplasty (UC2) were recruited. During the 3 months, patients experienced an mHealth-enabled IC model, including a self-management app for patients, a set of integrated sensors, and a web-based platform connecting professionals from different settings or usual care. The Person-Centered Coordinated Care Experience Questionnaire (P3CEQ) and the Nijmegen Continuity Questionnaire (NCQ) assessed person-centeredness and continuity of care. Acceptability was assessed for IC arm patients and staff with the Net Promoter Score (NPS) and the System Usability Scale (SUS). RESULTS The analyses included 77 IC patients, 58 controls who completed the follow-up, and 30 health care professionals. The mean age was 78 (SD 9) years in both study arms. Perception of patient-centeredness was similarly high in both arms (usual care: mean P3CEQ score 16.1, SD 3.3; IC: mean P3CEQ score 16.3, SD 2.4). IC patients reported better continuity of care than controls (usual care: mean NCQ score 3.7, SD 0.9; IC: mean NCQ score 4.0, SD 1; <i>P</i>=.04). The scores for patient acceptability (UC1: NPS +67%; UC2: NPS +45%) and usability (UC1: mean SUS score 79, SD 14; UC2: mean SUS score 68, SD 24) were outstanding. Professionals’ acceptability was low (UC1: NPS −25%; UC2: NPS −35%), whereas usability was average (UC1: mean SUS score 63, SD 20; UC2: mean SUS score 62, SD 19). The actual use of technology was high; 77% (58/75) of patients reported physical activity for at least 60 days, and the ratio of times reported over times prescribed for other sensors ranged from 37% for oxygen saturation to 67% for weight. CONCLUSIONS The mHealth-enabled IC model showed outstanding results from the patients’ perspective in 2 different UCs but lacked maturity and integration with legacy systems to be fully accepted by professionals. This paper provides useful lessons learned through the development and assessment process and may be of use to organizations willing to develop or implement mHealth-enabled IC for older adults.

Ties to the outside: An exploration of faculty interactions with external organizations

2018 ◽  
Vol 4 (1) ◽  
pp. 295-313 ◽  
Author(s):  
Karley A Riffe
Keyword(s):  
Study Design ◽  
Financial Constraints ◽  
Academic Discipline ◽  
Faculty Members ◽  
Faculty Work ◽  
Case Study Design ◽  
Low Resource ◽  
Faculty Interactions ◽  
Embedded Case Study

Faculty work now includes market-like behaviors that create research, teaching, and service opportunities. This study employs an embedded case study design to evaluate the extent to which faculty members interact with external organizations to mitigate financial constraints and how those relationships vary by academic discipline. The findings show a similar number of ties among faculty members in high- and low-resource disciplines, reciprocity between faculty members and external organizations, and an expanded conceptualization of faculty work.

Kajian Sosiolinguistik Penggunaan Alih Kode di Media Sosioal

2020 ◽  
Author(s):  
Iftitahul Kamaliyah
Keyword(s):  
Embedded Case Study

Kajian mengenai Soisolinguistik memang sangat menarik untuk dibahas. Dengan beraneka ragam suku, bahasa, dan budaya mengakibatkan munculnya masyarakat Indonesia yang kedwibahasaan. Sebagai objek dari sosiolinguistik, bahasa tidak dipandang sebagai bahasa, melainkan dilihat dipandang sebagai sarana interaksi atau komunikasi di dalam masyarakat (Chaer dan Agustina,2010:3). Sebagai sarana komunikasi di dalam masyarakat, bahasa menitik beratkan pada penggunanan yang bertujuan membuat komunikasi antara penutur dan lawan tutur dapat berkomunikasi dengan baik walaupun dilakukan secara kedwibahasaan. Penelitian ini bertujuan untuk mengetahui serta mendeskripsikan penggunaan alih kode di media sosial Instagram dan Twitter. Serta untuk mengetahui alasan munculnya alih kode pada media sosial. Penelitian ini menggunakan metode kualititatif deskriptif, dikarenakan memiliki tujuan untuk mendeskripsikan, menjelasakan serta memaparkan data dengan sedetail mungkin. Penelitian berfokus pada penggunaan alih kode di media sosial. Apabila ditinjau berdasarkan sifat kasusnya, termasuk dalam studi kasus tunggal terpancang (embedded case study). Sumber data penelitian ini didapatkan melalui dokumen-dokumen tertulis yang diunggah di berbagai media sosial seperti Instagram dan twitter. Dalam teknik pengumpuan data, menggunakan metode observasi dan studi dokumen.

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.

scholarly journals How medical dominance and interprofessional conflicts undermine patient-centred care in hospitals: historical analysis and multiple embedded case study in Morocco

2021 ◽  
Vol 6 (7) ◽  
pp. e006140
Author(s):  
Zakaria Belrhiti ◽  
Sara Van Belle ◽  
Bart Criel
Keyword(s):  
Soft Power ◽  
Health Workers ◽  
Interprofessional Collaboration ◽  
Historical Analysis ◽  
Best Interests ◽  
Group Discussions ◽  
Power Struggles ◽  
Embedded Case Study ◽  
Health Managers

BackgroundIn Morocco’s health systems, reforms were accompanied by increased tensions among doctors, nurses and health managers, poor interprofessional collaboration and counterproductive power struggles. However, little attention has focused on the processes underlying these interprofessional conflicts and their nature. Here, we explored the perspective of health workers and managers in four Moroccan hospitals.MethodsWe adopted a multiple embedded case study design and conducted 68 interviews, 8 focus group discussions and 11 group discussions with doctors, nurses, administrators and health managers at different organisational levels. We analysed what health workers (doctors and nurses) and health managers said about their sources of power, perceived roles and relationships with other healthcare professions. For our iterative qualitative data analysis, we coded all data sources using NVivo V.11 software and carried out thematic analysis using the concepts of ‘negotiated order’ and the four worldviews. For context, we used historical analysis to trace the development of medical and nursing professions during the colonial and postcolonial eras in Morocco.ResultsOur findings highlight professional hierarchies that counterbalance the power of formal hierarchies. Interprofessional interactions in Moroccan hospitals are marked by conflicts, power struggles and daily negotiated orders that may not serve the best interests of patients. The results confirm the dominance of medical specialists occupying the top of the professional hierarchy pyramid, as perceived at all levels in the four hospitals. In addition, health managers, lacking institutional backing, resources and decision spaces, often must rely on soft power when dealing with health workers to ensure smooth collaboration in care.ConclusionThe stratified order of care professions creates hierarchical professional boundaries in Moroccan hospitals, leading to partitioning of care and poor interprofessional collaboration. More attention should be placed on empowering health workers in delivering quality care by ensuring smooth interprofessional collaboration.

Entrepreneurship and self-employment for mature-aged people

2021 ◽  
Vol 30 (1) ◽  
pp. 3-14
Author(s):  
Alex Maritz ◽  
Bronwyn Eager ◽  
Saskia De Klerk
Keyword(s):  
Social Health ◽  
Active Ageing ◽  
Entrepreneurial Ecosystem ◽  
Aged People ◽  
Self Employment ◽  
Australian Economy ◽  
Embedded Case Study ◽  
Theoretical Foundations ◽  
Research Recommendations

Not only do Australian mature-aged entrepreneurs contribute $11.9 billion per annum to the Australian economy in over 379,000 businesses, they launch approximately 14,000 new businesses each year and actively contribute to fiscal, social, health, and active ageing outcomes in their communities. Thirty-four per cent of all young businesses in Australia are now led by mature-aged entrepreneurs, identifying mature-aged entrepreneurship as the fastest growing sector of entrepreneurship. This study is the first of its kind to examine mature-aged entrepreneurship in Australia using five pragmatic and embedded case-study examples. Aligning to Cartensen's sociomotional selection theory, we adopted an interpretivist philosphical framework of emergent enquiry action research. The paper includes benefits and challenges associated with mature-aged entrepreneurship, including contextual and theoretical foundations. We provide policy and research recommendations to enhance the development of a dedicated entrepreneurial ecosystem for mature-aged people.

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