scholarly journals An Adaptive Mobile Health System to Support Self-Management for Persons With Chronic Conditions and Disabilities: Usability and Feasibility Studies (Preprint)

2018 ◽  
Author(s):  
I Made Agus Setiawan ◽  
Leming Zhou ◽  
Zakiy Alfikri ◽  
Andi Saptono ◽  
Andrea D Fairman ◽  
...  
Keyword(s):  
Mobile Health ◽  
Chronic Conditions ◽  
Self Management ◽  
Management Support ◽  
Secondary Complications ◽  
Change Over Time ◽  
Adaptive Architecture ◽  
Persuasive Technologies ◽  
Over Time

BACKGROUND Persons with chronic conditions and disabilities (PwCCDs) are vulnerable to secondary complications. Many of these secondary complications are preventable with proactive self-management and proper support. To enhance PwCCDs' self-management skills and conveniently receive desired support, we have developed a mobile health (mHealth) system called iMHere. In 2 previous clinical trials, iMHere was successfully used to improve health outcomes of adult participants with spina bifida and spinal cord injury. To further expand use of iMHere among people with various types of disabilities and chronic diseases, the system needs to be more adaptive to address 3 unique challenges: 1) PwCCDs have very diverse needs with regards to self-management support, 2) PwCCDs’ self-management needs may change over time, and 3) it is a challenge to keep PwCCDs engaged and interested in long-term self-management. OBJECTIVE The aim of this study was to develop an adaptive mHealth system capable of supporting long-term self-management and adapting to the various needs and conditions of PwCCDs. METHODS A scalable and adaptive architecture was designed and implemented for the new version, iMHere 2.0. In this scalable architecture, a set of mobile app modules was created to provide various types of self-management support to PwCCDs with the ability to add more as needed. The adaptive architecture empowers PwCCDs with personally relevant app modules and allows clinicians to adapt these modules in response to PwCCDs’ evolving needs and conditions over time. Persuasive technologies, social support, and personalization features were integrated into iMHere 2.0 to engage and motivate PwCCDs and support long-term usage. Two initial studies were performed to evaluate the usability and feasibility of the iMHere 2.0 system. RESULTS The iMHere 2.0 system consists of cross-platform client and caregiver apps, a Web-based clinician portal, and a secure 2-way communication protocol for providing interactions among these 3 front-end components, all supported by a back-end server. The client and caregiver apps have 12 adaptive app modules to support various types of self-management tasks. The adaptive architecture makes it possible for PwCCDs to receive personalized app modules relevant to their conditions with or without support from various types of caregivers. The personalization and persuasive technologies in the architecture can be used to engage PwCCDs for long-term usage of the iMHere 2.0 system. Participants of the usability study were satisfied with the iMHere 2.0 client app. The feasibility evaluation revealed several practical issues to consider when implementing the system on a large scale. CONCLUSIONS We developed an adaptive mHealth system as a novel method to support diverse needs in self-management for PwCCDs that can dynamically change over time. The usability of the client app is high, and it was feasible for PwCCDs to use in supporting personalized and evolving self-care needs.

The Nexus of M-Health and Self-Care

2019 ◽  
pp. 235-259
Author(s):  
Anastasius S. Moumtzoglou
Keyword(s):  
Mobile Health ◽  
Self Care ◽  
Normal Activity ◽  
Models Of Care ◽  
Self Management ◽  
Management Support ◽  
Long Term Conditions ◽  
Concept Of Health ◽  
Health Related

Self-care emerged from the concept of health promotion in the 1970s while from 2000 onwards the term self-management gained popularity, with a greater focus on long-term conditions and the trend towards more holistic models of care. Although self-management and self-care are often used interchangeably, a distinction between the two concepts can be made. Both can be considered in terms of a continuum, with self-care at one end as “normal activity” and self-management an extension of this. Self-management support is the assistance given to patients in order to encourage daily decisions that improve health-related behaviors and clinical outcomes. The chapter envisions these concepts on a continuum with one pole representing mobile health and the other self-care. It concludes that self-management support is the nexus of mobile health and self-care.

scholarly journals Critical moments in long-term condition management: A longitudinal qualitative social network study

2017 ◽  
Vol 14 (2) ◽  
pp. 119-134 ◽  
Author(s):  
Rebecca L Morris ◽  
Caroline Sanders
Keyword(s):  
Social Networks ◽  
Health Management ◽  
Self Management ◽  
Long Term Conditions ◽  
Change Over Time ◽  
Face To Face ◽  
Term Condition ◽  
Over Time ◽  
Critical Moments

Objectives Recent literature has demonstrated the nature and importance of social networks. This study aimed to understand how support needs of people with long-term conditions change over time and how this influences their ability to self-manage. Methods A longitudinal qualitative design was used to explore changes in individual’s social networks over a period of year. Thirty participants were recruited and completed initial in-depth face-to-face interviews, telephone follow-ups, and final face-to-face interviews. Results Findings illuminated that changes in health and changes in social networks can influence each other. The social networks implicated in the management of long-term conditions change over time at critical moments and can range between positive and negative reciprocal influences with self-management. Network changes, such as the breaking or reconnecting of ties influenced the context of health management and the degree of engagement with self-management activities. Discussion By examining the specific processes of support and resource provision, this study highlights how overtime the variety of relationships and support available implicated in long-term condition management changes. This has implications for the provision of formal support services and the need for a wider range of support to be identified that recognises change in support requirements as self-management strategies evolve.

scholarly journals How Online Communities of People With Long-Term Conditions Function and Evolve: Network Analysis of the Structure and Dynamics of the Asthma UK and British Lung Foundation Online Communities (Preprint)

2018 ◽  
Author(s):  
Sagar Joglekar ◽  
Nishanth Sastry ◽  
Neil S Coulson ◽  
Stephanie JC Taylor ◽  
Anita Patel ◽  
...  
Keyword(s):  
Health Care ◽  
Network Analysis ◽  
Online Communities ◽  
Self Management ◽  
Management Support ◽  
Long Term Conditions ◽  
Research Attention ◽  
Structure And Dynamics ◽  
Over Time

BACKGROUND Self-management support can improve health and reduce health care utilization by people with long-term conditions. Online communities for people with long-term conditions have the potential to influence health, usage of health care resources, and facilitate illness self-management. Only recently, however, has evidence been reported on how such communities function and evolve, and how they support self-management of long-term conditions in practice. OBJECTIVE The aim of this study is to gain a better understanding of the mechanisms underlying online self-management support systems by analyzing the structure and dynamics of the networks connecting users who write posts over time. METHODS We conducted a longitudinal network analysis of anonymized data from 2 patients’ online communities from the United Kingdom: the Asthma UK and the British Lung Foundation (BLF) communities in 2006-2016 and 2012-2016, respectively. RESULTS The number of users and activity grew steadily over time, reaching 3345 users and 32,780 posts in the Asthma UK community, and 19,837 users and 875,151 posts in the BLF community. People who wrote posts in the Asthma UK forum tended to write at an interval of 1-20 days and six months, while those in the BLF community wrote at an interval of two days. In both communities, most pairs of users could reach one another either directly or indirectly through other users. Those who wrote a disproportionally large number of posts (the superusers) represented 1% of the overall population of both Asthma UK and BLF communities and accounted for 32% and 49% of the posts, respectively. Sensitivity analysis showed that the removal of superusers would cause the communities to collapse. Thus, interactions were held together by very few superusers, who posted frequently and regularly, 65% of them at least every 1.7 days in the BLF community and 70% every 3.1 days in the Asthma UK community. Their posting activity indirectly facilitated tie formation between other users. Superusers were a constantly available resource, with a mean of 80 and 20 superusers active at any one time in the BLF and Asthma UK communities, respectively. Over time, the more active users became, the more likely they were to reply to other users’ posts rather than to write new ones, shifting from a help-seeking to a help-giving role. This might suggest that superusers were more likely to provide than to seek advice. CONCLUSIONS In this study, we uncover key structural properties related to the way users interact and sustain online health communities. Superusers’ engagement plays a fundamental sustaining role and deserves research attention. Further studies are needed to explore network determinants of the effectiveness of online engagement concerning health-related outcomes. In resource-constrained health care systems, scaling up online communities may offer a potentially accessible, wide-reaching and cost-effective intervention facilitating greater levels of self-management.

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.

Gender, mobility and contact

2021 ◽  
Vol 7 (2) ◽  
pp. 142-167
Author(s):  
Catherine E. Travis ◽  
Inas Ghina
Keyword(s):  
Older Women ◽  
High Mobility ◽  
Spontaneous Speech ◽  
Social Changes ◽  
Change Over Time ◽  
Aceh Province ◽  
Rural Variety ◽  
The Impact ◽  
Over Time

Abstract We examine variation in a rural variety of Acehnese spoken in Aceh Province, to better understand the impact of long-term contact with Indonesian and increasing urbanization. The Great Aceh variety is characterized by variable realization of word-final (t) as a dental vs. glottal stop. Analyses of over 2,000 tokens of this variable from a corpus of spontaneous speech from 35 speakers indicate that the variability is relatively stable among men, and among women of high mobility, measured in terms of education, occupation, and time spent outside Great Aceh. Women with low mobility produce the lowest rates of [t̪], and in this group we observe a higher rate of [t̪] by younger than older women, suggesting change over time. We thus find both stability – among those who have long enjoyed high levels of mobility – and change – among those most affected by recent social changes, namely low-mobility women.

A self‐management support program for older Australians with multiple chronic conditions: a randomised controlled trial

2018 ◽  
Vol 208 (2) ◽  
pp. 69-74 ◽  
Author(s):  
Richard L Reed ◽  
Leigh Roeger ◽  
Sara Howard ◽  
Jodie M Oliver‐Baxter ◽  
Malcolm W Battersby ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Chronic Conditions ◽  
Controlled Trial ◽  
Support Program ◽  
Self Management ◽  
Multiple Chronic Conditions ◽  
Management Support ◽  
Randomised Controlled

Transitions in Technology Mediated Cardiac Rehabilitation and Self-management: A Qualitative Study using the Theoretical Domains Framework (Preprint)

2021 ◽  
Author(s):  
Shreya Tadas ◽  
Claudette Pretorius ◽  
Emma J. Foster ◽  
Trish Gorely ◽  
Stephen J. Leslie ◽  
...  
Keyword(s):  
Cardiac Rehabilitation ◽  
Behaviour Change ◽  
Theoretical Domains Framework ◽  
Self Management ◽  
Normal Life ◽  
Use Of Technology ◽  
Holistic Understanding ◽  
The Impact ◽  
Over Time

BACKGROUND An acute cardiac incident is a life changing event, often necessitating surgery. While surgery has high success rates, rehabilitation, behaviour change, and self-care are critical to long-term health. Recent systematic reviews highlight the potential of technology in this area, but significant shortcomings are also identified, particularly in regard to patient experience. OBJECTIVE To improve future systems this paper explores the experiences of cardiac patients during key phases post-hospitalisation: recuperation, initial rehabilitation and long term self-management. The key objective is to provide a holistic understanding of behavioural factors that impact people across these phases, understand how experiences evolve over time, and provide user-centred recommendations to improve the design of cardiac rehabilitation and self-management technologies. METHODS Semi-structured interviews were conducted with people who attended rehabilitation programs following hospitalisation for an acute cardiac event. Interviews were developed and data is analysed via the Theoretical Domains Framework (TDF), a pragmatic framework that synthesizes prior theories of behaviour change. RESULTS Three phases that arise post-hospitalisation are examined: recuperation, rehabilitation, and long-term self-management. Through these phases we describe the impact of key factors and important changes that occur in patients’ experiences over time, including: a desire for and redefinition of normal life; the need for different types of formal and informal knowledge; the benefits of safe-zoning and connectedness; and the need to recognise capability. The use of the TDF allows us to show how factors that influence behaviour evolve over time and identify potential sources of tension. CONCLUSIONS The paper provides empirically grounded recommendations for the design of technology-mediated cardiac rehabilitation and self-management systems. Key recommendations include the use of technology to support a normal life; leveraging social influences to extend participants’ sense of normality; the use of technology to provide a safe zone; the need to support both emotional and physical wellbeing; and a focus on recognizing capability and providing recommendations that are positive and reinforce this capability.

Raptor Prey Remains

2020 ◽  
Author(s):  
Ed Drewitt
Keyword(s):  
Feeding Ecology ◽  
Prey Species ◽  
Local Level ◽  
Body Parts ◽  
Change Over Time ◽  
The Common ◽  
Prey Remains ◽  
Over Time ◽  
Prey Populations

Are you curious about the remains of an animal you have found? This compilation of the most likely found body parts of animals eaten by raptors will help you identify your discovery. Including over 100 species of bird and mammal prey of raptors such as sparrowhawks, peregrines and hen harriers, this photographic guide highlights the common feathers, fur and other body parts found at raptor nests, roosts, plucking posts and other opportunistic spots. Discovering what raptors eat is an important part of confirming their feeding ecology and how this might change over time, vary on a local level or in response to changing prey populations, as well as dispelling myths and assumptions about what certain raptor species eat. Diet studies are vital for the conservation of raptor species; the more we know about what they need for survival the more we can predict and plan long-term for the protection and survival of raptors that may be vulnerable and in decline. This is the first book to show in detail the actual parts of a bird, mammal or other animal that you are likely to find in a garden, woodland or beneath a raptor roost. As more people take an interest in raptors and watch species such as peregrines via webcams and through watch groups, there is greater opportunity for finding prey remains. This book provides the first and most important step in identifying a prey species.

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