Opportunities for Mobile App–Based Adherence Support for Children With Tuberculosis in South Africa (Preprint)

UNSTRUCTURED Tuberculosis is the number one infectious cause of death globally. Young children, generally those younger than 5 years, are at the highest risk of progressing from tuberculosis infection to tuberculosis disease and of developing the most severe forms of tuberculosis. Most current tuberculosis drug formulations have poor acceptability among children and require consistent adherence for prolonged periods of time. These challenges complicate children’s adherence to treatment and caregivers’ daily administration of the drugs. Rapid developments in mobile technologies and apps present opportunities for using widely available technology to support national tuberculosis programs and patient treatment adherence. Pilot studies have demonstrated that mobile apps are a feasible and acceptable means of enhancing children’s treatment adherence for other chronic conditions. Despite this, no mobile apps that aim to promote adherence to tuberculosis treatment have been developed for children. In this paper, we draw on our experiences carrying out research in clinical pediatric tuberculosis studies in South Africa. We present hypothetical scenarios of children’s adherence to tuberculosis medication to suggest priorities for behavioral and educational strategies that a mobile app could incorporate to address some of the adherence support gaps faced by children diagnosed with tuberculosis. We argue that a mobile app has the potential to lessen some of the negative experiences that children associate with taking tuberculosis treatment and to facilitate a more positive treatment adherence experience for children and their caregivers.

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Opportunities for Mobile App–Based Adherence Support for Children With Tuberculosis in South Africa

JMIR mhealth and uhealth ◽

10.2196/19154 ◽

2020 ◽

Vol 8 (11) ◽

pp. e19154

Author(s):

Rachel M Morse ◽

Hanlie Myburgh ◽

David Reubi ◽

Ava E Archey ◽

Leletu Busakwe ◽

...

Keyword(s):

South Africa ◽

Treatment Adherence ◽

Mobile Apps ◽

Mobile App ◽

Tuberculosis Treatment ◽

Mobile Technologies ◽

Patient Treatment ◽

Pilot Studies ◽

Adherence Support ◽

Positive Treatment

Tuberculosis is the number one infectious cause of death globally. Young children, generally those younger than 5 years, are at the highest risk of progressing from tuberculosis infection to tuberculosis disease and of developing the most severe forms of tuberculosis. Most current tuberculosis drug formulations have poor acceptability among children and require consistent adherence for prolonged periods of time. These challenges complicate children’s adherence to treatment and caregivers’ daily administration of the drugs. Rapid developments in mobile technologies and apps present opportunities for using widely available technology to support national tuberculosis programs and patient treatment adherence. Pilot studies have demonstrated that mobile apps are a feasible and acceptable means of enhancing children’s treatment adherence for other chronic conditions. Despite this, no mobile apps that aim to promote adherence to tuberculosis treatment have been developed for children. In this paper, we draw on our experiences carrying out research in clinical pediatric tuberculosis studies in South Africa. We present hypothetical scenarios of children’s adherence to tuberculosis medication to suggest priorities for behavioral and educational strategies that a mobile app could incorporate to address some of the adherence support gaps faced by children diagnosed with tuberculosis. We argue that a mobile app has the potential to lessen some of the negative experiences that children associate with taking tuberculosis treatment and to facilitate a more positive treatment adherence experience for children and their caregivers.

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Using the Habit App for Weight Loss Problem Solving: Development and Feasibility Study (Preprint)

10.2196/preprints.9801 ◽

2018 ◽

Author(s):

Sherry Pagoto ◽

Bengisu Tulu ◽

Emmanuel Agu ◽

Molly E Waring ◽

Jessica L Oleski ◽

...

Keyword(s):

Weight Loss ◽

Problem Solving ◽

Mobile Apps ◽

Mobile App ◽

Behavioral Weight Loss ◽

Problem Solving Therapy ◽

Pilot Studies ◽

Self Monitoring ◽

Problem Solving Skills ◽

Automated Delivery

BACKGROUND Reviews of weight loss mobile apps have revealed they include very few evidence-based features, relying mostly on self-monitoring. Unfortunately, adherence to self-monitoring is often low, especially among patients with motivational challenges. One behavioral strategy that is leveraged in virtually every visit of behavioral weight loss interventions and is specifically used to deal with adherence and motivational issues is problem solving. Problem solving has been successfully implemented in depression mobile apps, but not yet in weight loss apps. OBJECTIVE This study describes the development and feasibility testing of the Habit app, which was designed to automate problem-solving therapy for weight loss. METHODS Two iterative single-arm pilot studies were conducted to evaluate the feasibility and acceptability of the Habit app. In each pilot study, adults who were overweight or obese were enrolled in an 8-week intervention that included the Habit app plus support via a private Facebook group. Feasibility outcomes included retention, app usage, usability, and acceptability. Changes in problem-solving skills and weight over 8 weeks are described, as well as app usage and weight change at 16 weeks. RESULTS Results from both pilots show acceptable use of the Habit app over 8 weeks with on average two to three uses per week, the recommended rate of use. Acceptability ratings were mixed such that 54% (13/24) and 73% (11/15) of participants found the diet solutions helpful and 71% (17/24) and 80% (12/15) found setting reminders for habits helpful in pilots 1 and 2, respectively. In both pilots, participants lost significant weight (P=.005 and P=.03, respectively). In neither pilot was an effect on problem-solving skills observed (P=.62 and P=.27, respectively). CONCLUSIONS Problem-solving therapy for weight loss is feasible to implement in a mobile app environment; however, automated delivery may not impact problem-solving skills as has been observed previously via human delivery. CLINICALTRIAL ClinicalTrials.gov NCT02192905; https://clinicaltrials.gov/ct2/show/NCT02192905 (Archived by WebCite at http://www.webcitation.org/6zPQmvOF2)

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Young People�s, Parents�, and Professionals� Views on Required Components of Mobile Apps to Support Self-Management of Juvenile Arthritis: Qualitative Study (Preprint)

10.2196/preprints.9179 ◽

2017 ◽

Author(s):

Jennifer M Waite-Jones ◽

Rabiya Majeed-Ariss ◽

Joanna Smith ◽

Simon R Stones ◽

Vanessa Van Rooyen ◽

...

Keyword(s):

Social Support ◽

Young People ◽

Health Care Professionals ◽

Mobile Apps ◽

Developmentally Appropriate ◽

Mobile App ◽

Juvenile Arthritis ◽

Mobile Technologies ◽

Self Management ◽

Framework Approach

BACKGROUND There is growing evidence that supporting self-management of Juvenile Arthritis can benefit both patients and professionals. Young people with Juvenile Arthritis and their healthy peers increasingly use mobile technologies to access information and support in day-to-day life. Therefore, a user-led, rigorously developed and evaluated mobile app could be valuable for facilitating young people’s self-management of Juvenile Arthritis. OBJECTIVE The objective of this study was to seek the views of young people with Juvenile Arthritis, their parents or carers, and health care professionals (HCPs) as to what should be included in a mobile app to facilitate young people’s self-management of chronic Juvenile Arthritis. METHODS A qualitative approach was adopted with a purposeful sample of 9 young people aged 10-18 years with Juvenile Arthritis, 8 parents or carers, and 8 HCPs involved in their care. Data were gathered through semi-structured focus group and individual interviews with young people and their parents or carers and HCPs. Interview discussion was facilitated through demonstration of four existing health apps to explore participants’ views on strengths and limitations of these, barriers and facilitators to mobile app use, preferred designs, functionality, levels of interaction, and data sharing arrangements. Data were analyzed using the framework approach. RESULTS Analysis revealed three interlinked, overarching themes: (1) purpose, (2) components and content, and (3) social support. Despite some differences in emphasis on essential content, general agreement was found between young people with Juvenile Arthritis their parents or carers, and professionals that a mobile app to aid self-management would be useful. Underpinning the themes was a prerequisite that young people are enabled to feel a sense of ownership and control of the app, and that it be an interactive, engaging resource that offers developmentally appropriate information and reminders, as well as enabling them to monitor their symptoms and access social support. CONCLUSIONS Findings justify and pave the way for a future feasibility study into the production and preliminary testing of such an app. This would consider issues such as compatibility with existing technologies, costs, age, and cross-gender appeal as well as resource implications.

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Mobile Learning for Social Change

Advances in Mobile and Distance Learning - Handbook of Research on Mobile Learning in Contemporary Classrooms ◽

10.4018/978-1-5225-0251-7.ch018 ◽

2016 ◽

pp. 363-377 ◽

Cited By ~ 1

Author(s):

Tseday Alehegn ◽

Dominic Mentor

Keyword(s):

Social Change ◽

Civic Engagement ◽

Democratic Education ◽

Mobile Apps ◽

Classroom Community ◽

After School Programs ◽

Mobile App ◽

Mobile Technologies ◽

After School ◽

School Learning

This chapter focuses on how mobile apps and smartphones can be used to enhance democratic education in schools and society at large, why such opportunities need to be more seriously considered as integral to the school learning environment, and how it can empower citizens for civic engagement. Using Dewey's philosophy of democratic education this chapter provides examples of mobile apps designed through classroom, community-based or after school programs that provide youth with coding training opportunities as well as macro-level highlights of civic engagement for social change. Reviewing theories of technology – from determinism to social embeddedness – this chapter reflects on the inherent “democratic” design of mobile technologies, as well as the challenge to embrace the interest that youth and society in general have for mobile app use. It is a call to promote mobile-driven democratic education in an environment encouraging continuous learning as well as cultivating and leveraging mobile technologies to develop an informed public voice and participatory agency.

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Patients’ experiences of an intervention to support tuberculosis treatment adherence in South Africa

Journal of Health Services Research & Policy ◽

10.1258/jhsrp.2010.009111 ◽

2010 ◽

Vol 15 (3) ◽

pp. 163-170 ◽

Cited By ~ 5

Author(s):

Salla Atkins ◽

David Biles ◽

Simon Lewin ◽

Karin Ringsberg ◽

Anna Thorson

Keyword(s):

South Africa ◽

Treatment Adherence ◽

Tuberculosis Treatment

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Improving treatment adherence for blood pressure lowering via mobile phone SMS-messages in South Africa: a qualitative evaluation of the SMS-text Adherence SuppoRt (StAR) trial

BMC Family Practice ◽

10.1186/s12875-015-0289-7 ◽

2015 ◽

Vol 16 (1) ◽

Cited By ~ 47

Author(s):

Natalie Leon ◽

Rebecca Surender ◽

Kirsty Bobrow ◽

Jocelyn Muller ◽

Andrew Farmer

Keyword(s):

South Africa ◽

Blood Pressure ◽

Mobile Phone ◽

Treatment Adherence ◽

Qualitative Evaluation ◽

Blood Pressure Lowering ◽

Adherence Support ◽

Pressure Lowering ◽

Star Trial

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Mobile Apps Based on Keller Personalized System of Instruction to Promote English Vocabulary Acquisition

International Journal of Interactive Mobile Technologies (iJIM) ◽

10.3991/ijim.v15i23.27227 ◽

2021 ◽

Vol 15 (23) ◽

pp. 4-17

Author(s):

Rooban Arumugam ◽

Norah Md Noor

Keyword(s):

Vocabulary Acquisition ◽

Electronic Device ◽

Mobile Apps ◽

Mobile App ◽

Mobile Technologies ◽

Control Group ◽

Personalized System Of Instruction ◽

Significant Difference ◽

Quasi Experimental ◽

Personalized System

Mobile learning (or m-learning) is the ability to learn anywhere and at any time using a portable electronic device. Mobile technologies gradually integrate into learnedness. Mobile devices and apps are changing the way learners acquires English. This study aims to develop a mobile Apps based on the Keller Plan Personalized system of instruction (PSI) theory called JuJu English Vocabulary to improve learners’ vocabulary acquisition. The mobile Apps was developed using ADDIE instructional design model. The developed Apps was investigated using a quasi-experimental research design among 60 students separated into two(2) groups: control and experimental groups. Data were analysed using SPSS software. The outcome shows a significant difference between Post-test experimental (using the mobile app) and the control group (traditional learning). This Mobile Apps design allows personalised growth among the experimental group of students in terms of their vocabulary acquisition. The design mimicking a game strategy did help increase their interest to enjoy the learning process.

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Mobile Apps for Increasing Treatment Adherence: Systematic Review (Preprint)

10.2196/preprints.12505 ◽

2018 ◽

Author(s):

Virtudes Pérez-Jover ◽

Marina Sala-González ◽

Mercedes Guilabert ◽

José Joaquín Mira

Keyword(s):

Systematic Review ◽

Treatment Adherence ◽

Mobile Apps ◽

Mobile App ◽

Perceived Usefulness ◽

Cochrane Library ◽

Average Score ◽

Percentage Increase ◽

Therapeutic Adherence ◽

At Home

BACKGROUND It is estimated that 20% to 50% of patients do not take their medication correctly, and this leads to increased morbidity and inefficacy of therapeutic approaches. Fostering treatment adherence is a priority objective for all health systems. The growth of mobile apps to facilitate therapeutic adherence has significantly increased in recent years. However, the effectiveness of the apps for this purpose has not been evaluated. OBJECTIVE This study aimed to analyze whether mobile apps are perceived as useful for managing medication at home and if they actually contribute to increasing treatment adherence in patients. METHODS We carried out a systematic review of research published using Scopus, Cochrane Library, ProQuest, and MEDLINE databases and analyzed the information about their contribution to increasing therapeutic adherence and the perceived usefulness of mobile apps. This review examined studies published between 2000 and 2017. RESULTS Overall, 11 studies fulfilled the inclusion criteria. The sample sizes of these studies varied between 16 and 99 participants. In addition, 7 studies confirmed that the mobile app increased treatment adherence. In 5 of them, the before and after adherence measures suggested significant statistical improvements, when comparing self-reported adherence and missed dose with a percentage increase ranging between 7% and 40%. The users found mobile apps easy to use and useful for managing their medication. The patients were mostly satisfied with their use, with an average score of 8.1 out of 10. CONCLUSIONS The use of mobile apps helps increase treatment adherence, and they are an appropriate method for managing medication at home.

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Clinician Perspectives on Unmet Needs for Mobile Technology Among Hospitalists: Workflow Analysis Based on Semistructured Interviews (Preprint)

10.2196/preprints.28783 ◽

2021 ◽

Author(s):

April Savoy ◽

Jason J Saleem ◽

Barry C Barker ◽

Himalaya Patel ◽

Areeba Kara

Keyword(s):

Health Information ◽

Mobile Technology ◽

Nurse Practitioners ◽

Mobile Apps ◽

Medical Center ◽

Mobile App ◽

Mobile Technologies ◽

Contributing Factors ◽

Workflow Analysis ◽

Semistructured Interviews

BACKGROUND The hospitalist workday is cognitively demanding and dominated by activities away from patients’ bedsides. Although mobile technologies are offered as solutions, clinicians report lower expectations of mobile technology after actual use. OBJECTIVE The purpose of this study is to better understand opportunities for integrating mobile technology and apps into hospitalists’ workflows. We aim to identify difficult tasks and contextual factors that introduce inefficiencies and characterize hospitalists’ perspectives on mobile technology and apps. METHODS We conducted a workflow analysis based on semistructured interviews. At a Midwestern US medical center, we recruited physicians and nurse practitioners from hospitalist and inpatient teaching teams and internal medicine residents. Interviews focused on tasks perceived as frequent, redundant, and difficult. Additionally, participants were asked to describe opportunities for mobile technology interventions. We analyzed contributing factors, impacted workflows, and mobile app ideas. RESULTS Over 3 months, we interviewed 12 hospitalists. Participants collectively identified chart reviews, orders, and documentation as the most frequent, redundant, and difficult tasks. Based on those tasks, the intake, discharge, and rounding workflows were characterized as difficult and inefficient. The difficulty was associated with a lack of access to electronic health records at the bedside. Contributing factors for inefficiencies were poor usability and inconsistent availability of health information technology combined with organizational policies. Participants thought mobile apps designed to improve team communications would be most beneficial. Based on our analysis, mobile apps focused on data entry and presentation supporting specific tasks should also be prioritized. CONCLUSIONS Based on our results, there are prioritized opportunities for mobile technology to decrease difficulty and increase the efficiency of hospitalists’ workflows. Mobile technology and task-specific mobile apps with enhanced usability could decrease overreliance on hospitalists’ memory and fragmentation of clinical tasks across locations. This study informs the design and implementation processes of future health information technologies to improve continuity in hospital-based medicine.

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