PTSD Coach Version 3.1: A closer look at the reach, use, and potential impact of this updated mobile health app in the general public (Preprint)

2021 ◽  
Author(s):  
Haijing Wu Hallenbeck ◽  
Beth K Jaworski ◽  
Joseph Wielgosz ◽  
Eric Kuhn ◽  
Kelly M Ramsey ◽  
...  
Keyword(s):  
Public Health ◽  
Mobile Health ◽  
General Public ◽  
Large Population ◽  
Full Potential ◽  
Ptsd Symptoms ◽  
Content Areas ◽  
Potential Impact ◽  
Mhealth Apps ◽  
Observation Period

BACKGROUND With widespread smartphone ownership, mobile health (mHealth) apps can expand access to evidence-based interventions for mental health conditions, including posttraumatic stress disorder (PTSD). Research to evaluate new features and capabilities in these apps is critical but lags behind app development. The initial release of PTSD Coach, a free self-management app developed by the U.S. Departments of Veterans Affairs (VA) and Defense (DoD), was found to have a positive public health impact. However, major stakeholder-driven updates to the app have yet to be evaluated. OBJECTIVE We sought to characterize the reach, use, and potential impact of PTSD Coach Version 3.1 in the general public. As part of characterizing use, we investigated the use of specific app features, which extended prior work on PTSD Coach. METHODS We examined naturalistic usage of PTSD Coach during a one-year observation period between April 20, 2020 and April 19, 2021, using anonymous in-app event data to generate summary metrics for users. RESULTS During the observation period, PTSD Coach was broadly disseminated to the public, reaching approximately 150,000 total users and 20,000 users per month. On average, users used the app three times across three separate days for 18 minutes total, with steep drop-offs in use over time; a subset of users, however, demonstrated high or sustained engagement. Over 60% of users accessed one or more main content areas of the app (i.e., Manage Symptoms, Track Progress, Learn, or Get Support). Among content areas, features under Manage Symptoms (including coping tools) were accessed most frequently, by over 40% of users. Users who provided initial distress ratings (44.3% of users, n = 56,971) endorsed relatively high momentary distress (M = 6.03, SD = 2.52, on a 0-10 scale), and use of coping tool modestly improved momentary distress (M = -1.38, SD = 1.70). Among users who completed at least one PTSD Checklist for DSM-5 (PCL-5; 13.7% of users, n = 17,589), PTSD symptoms were largely above clinical threshold (M = 49.80, SD = 16.36). Among users who completed at least two PCL-5s (3.9% of users, n = 4,989), PTSD symptoms decreased from the first to last assessment (M = -4.35, SD = 15.29), with approximately a third of these users (n = 1,585) experiencing clinically significant improvements. CONCLUSIONS PTSD Coach continues to fulfill its mission as a public health resource. Version 3.1 compares favorably with Version 1 on most metrics related to reach, use, and potential impact. Although benefits appear modest on an individual basis, the app provides these benefits to a large population. For mHealth apps to reach their full potential in supporting trauma recovery, future research should aim to understand the utility of individual app features and identify strategies to maximize overall effectiveness and engagement.

EFFECTIVNESS OF SPECIFIC MOBILE HEALTH APPLICATIONS (mHEALTH-APPS)in GESTATIONAL DIABTETES MELLITUS: A SYSTEMATIC REVIEW (Preprint)

2020 ◽  
Author(s):  
Claudia Eberle ◽  
Maxine Löhnert
Keyword(s):  
Mobile Health ◽  
Cochrane Library ◽  
Clinical Parameters ◽  
Control Groups ◽  
Manual Search ◽  
Mobile Health Applications ◽  
Short And Long Term ◽  
Mhealth Apps ◽  
Health Applications

BACKGROUND Gestational diabetes mellitus (GDM) emerges worldwide and is closely associated with short- and long-term health issues in women and their offspring, such as pregnancy and birth complications respectively comorbidities, Type 2 Diabetes (T2D), Metabolic Syndrome (MetS) as well as cardiovascular disease (CD). Against this background mobile health applications (mHealth-Apps) do open up new possibilities to improve the management of GDM clearly. OBJECTIVE Since there is – to our knowledge – no systematic literature review published, which focusses on the effectiveness of specific mHealth-Apps on clinical health-related short and long-term outcomes of mother and child, we conducted these much-needed analyses. METHODS Data sources: A systematic literature search in Medline (Pubmed), Cochrane Library, Embase, CINAHL and Web of Science was performed including full text publications since 2008 up to date. An additional manual search in references and Google Scholar was conducted subsequently. Study Eligibility Criteria: Women diagnosed with GDM using specific mHealth-Apps during pregnancy compared to control groups, which met main clinical parameters and outcomes in GDM management as well as maternity and offspring care. Study appraisal and synthesis methods: Study quality was assessed and rated “strong”, “moderate” or “weak” by using the Effective Public Health Practice Project (EPHPP) tool. Study results were strongly categorized by outcomes; an additional qualitative summary was assessed. Study selection: Overall, n= 114 studies were analyzed, n= 46 duplicates were removed, n=5 studies met the eligible criteria and n=1 study was assessed by manual search subsequently. In total, n=6 publications, analyzing n=408 GDM patients in the interventional and n=405 women diagnosed with GDM in the control groups, were included. These studies were divided into n=5 two-arm randomized controlled trials (RCT) and n=1 controlled clinical trial (CCT). RESULTS Distinct improvements in clinical parameters and outcomes, such as fasting blood glucoses (FBG), 2-hour postprandial blood glucoses (PBG), off target blood glucose measurements (OTBG), delivery modes and patient compliance were analyzed in GDM patients using specific mHealth-Apps compared to matched control groups. CONCLUSIONS mHealth-Apps clearly improve clinical outcomes in management of GDM effectively. More studies need to be done more in detail.

MODELING ANTIBIOTIC RESISTANCE IN PREGNANT WOMAN AND FETUS

2011 ◽  
Vol 19 (03) ◽  
pp. 505-520
Author(s):  
HAI-FENG HUO ◽  
JUN LI ◽  
YU-NING LI
Keyword(s):  
Public Health ◽  
Pregnant Woman ◽  
Transmission Dynamics ◽  
Resistant Bacteria ◽  
Uniform Persistence ◽  
Antibiotic Residues ◽  
Global Public Health ◽  
Antibiotic Resistant ◽  
Gestational Period ◽  
Potential Impact

Infection caused by antibiotic-resistant pathogens is one of global public health problems. Many factors contribute to the emergence and spread of these pathogens. A model which describes the transmission dynamics of susceptible and resistant bacteria in a pregnant woman and the fetus is presented. Detailed qualitative analysis about positivity, boundedness, global stability and uniform persistence of the model is carried out. Numerical simulation and sensitivity analysis show that antibiotic input has potential impact for neonatal drug resistance. Our results show that the resistant bacteria in baby mainly come from antibiotics which are wrongly-used during gestational period, or foods containing antibiotic residues.

Will Routine Annual Influenza Prevention and Control Systems Serve the United States Well in a Pandemic?

2009 ◽  
Vol 3 (S2) ◽  
pp. S160-S165 ◽  
Author(s):  
Jeanne S. Ringel ◽  
Melinda Moore ◽  
John Zambrano ◽  
Nicole Lurie
Keyword(s):  
Public Health ◽  
United States ◽  
Prevention And Control ◽  
The United States ◽  
Qualitative Assessment ◽  
Full Potential ◽  
Pandemic Preparedness ◽  
The Public ◽  
Influenza Prevention ◽  
And Control

ABSTRACTObjective: To assess the extent to which the systems in place for prevention and control of routine annual influenza could provide the information and experience needed to manage a pandemic.Methods: The authors conducted a qualitative assessment based on key informant interviews and the review of relevant documents.Results: Although there are a number of systems in place that would likely serve the United States well in a pandemic, much of the information and experience needed to manage a pandemic optimally is not available.Conclusions: Systems in place for routine annual influenza prevention and control are necessary but not sufficient for managing a pandemic, nor are they used to their full potential for pandemic preparedness. Pandemic preparedness can be strengthened by building more explicitly upon routine influenza activities and the public health system’s response to the unique challenges that arise each influenza season (eg, vaccine supply issues, higher than normal rates of influenza-related deaths). (Disaster Med Public Health Preparedness. 2009;3(Suppl 2):S160–S165)

31.E. Workshop: Food processing in the modern era: implication for public health

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  
Keyword(s):  
Public Health ◽  
Dietary Supplements ◽  
Dietary Patterns ◽  
General Public ◽  
Communicable Diseases ◽  
Current Evidence ◽  
Processed Foods ◽  
Healthy Weight ◽  
Traditional Foods ◽  
Non Communicable Diseases

Abstract Current scientific evidence and reports from governmental organizations agree that healthy nutrition represents a key factor to prevent death and disability from major nutrition-related chronic diseases. For many years, the essential goal of healthy dietary recommendations included eating nutrient dense foods and limiting consumption of foods high in energy (sugar, starch and/or fat) to maintain a healthy weight. However, the scientific community abandoned the more simplistic approach of energy balance between calorie in and out, shifting into investigation of the whole diet quality as main determinant of health. With development of new technologies and globalization of the markets, the food availability improved worldwide, often in spite of (nutritional) quality and loss of local products production/consumption. As a result, there is an industry-supported wide spread of “non-traditional” foods, including processed foods characterized by various ingredients, added sugars, and additives that are highly influencing consumers' behaviors and, only recently, questioned for their role on general public health. This workshop aims to provide insights on consumption of ultra-processed foods up to the extreme processing of dietary supplements and their use and misuse, emphasizing on their potential impact on traditional dietary patterns. The objectives of the present workshop are the following: To provide a science-based definition of processed and ultra-processed foods; To explore current evidence of the association between ultra-processed foods and risk of chronic non-communicable diseases and mortality; To explore current evidence of the association between dietary supplements and human health; To discuss whether introduction of non-traditional foods may affect the relation between traditional dietary patterns and health. Given the novelty of the topic, it is crucial to summarize current evidence from lead experts on this field of research and sharing opinions with the audience in light of the presented results. The conclusions might have crucial implications for potential policy and research outcomes. Key messages Uncontrolled consumption of ultra-processed foods and dietary supplements represent a potential threat for general public health. The inclusion of ultra-processed foods into traditional healthy dietary patterns may affect their efficacy in preventing chronic non-communicable diseases.

scholarly journals No-jab, no-job clause: ethical issues and legal impediments

2021 ◽  
Author(s):  
Jeff Clyde G Corpuz
Keyword(s):  
Public Health ◽  
20Th Century ◽  
Vaccination Programme ◽  
General Public ◽  
Ethical Issues

Abstract Vaccination is considered to be one of the greatest public health achievements in the 20th century. The coronavirus disease 2019 (COVID-19) has triggered a worldwide debate and legal exemption of vaccination and its possible consequences. Now that COVID-19 vaccination programme has started, there is immense pressure from the general public. Following the recent correspondence where the authors have rightly stated the need to take seriously the ethical issues under the COVID-19 vaccination, this paper highlights the ethical and legal impediments of ‘no-jab, no-job clause’ arising in many countries.

Efficacy, effectiveness, and quality of resilience-building mobile health apps for military, veteran and public safety personnel populations: a scoping literature review and app evaluation (Preprint)

2021 ◽  
Author(s):  
Melissa Voth ◽  
Shannon Chisholm ◽  
Hannah Sollid ◽  
Chelsea Jones ◽  
Lorraine Smith-MacDonald ◽  
...  
Keyword(s):  
Mental Health ◽  
Literature Review ◽  
Mobile Health ◽  
Public Safety ◽  
Evidence Based ◽  
Inclusion Criteria ◽  
Public Safety Personnel ◽  
Scoping Literature Review ◽  
Mhealth Apps ◽  
Safety Personnel

BACKGROUND Globally, military members (MM) and public safety personnel (PSP) are vulnerable to occupational stress injuries (OSIs) due to their job demands. Consequently, when MM and PSP transition out of these professions, they may continue to experience mental health challenges. In response to this, resilience building programs are being developed and implemented with the goal of promoting empowerment and primary stress regulation. The development of mobile health (mHealth) applications (apps) as an emergent mental health intervention platform has allowed for targeted, cost effective, and easily accessible treatment when in-person therapy may be limited or unavailable. However, current mHealth app development is not regulated, and often lacks both clear evidence-based research and the input of healthcare professionals. OBJECTIVE The purpose of this manuscript is to evaluate the evidence-based quality, efficacy, and effectiveness of resilience building mobile apps targeted towards MM, PSP, and veteran populations via: (1) a scoping literature review of the current evidence-base regarding resilience apps for these populations, and; (2) evaluation of free resilience apps designed for use amongst these populations. METHODS Studies were selected using a comprehensive search of MEDLINE, CINAHL Plus, PsycINFO, SocINDEX, Academic Search Complete, Embase, and Google and was guided by Preferred Reporting Items for Systematic Reviews and Meta-Analysis for scoping reviews (PRISMA-ScR). The Alberta Rating Index for Apps (ARIA) was utilized to conduct a review of each of the identified apps. Inclusion criteria consisted of apps: 1) free to download in either Google Play or the App Store; 2) updated within the last 3 years; 3) available in English and in Canada; and 4) intended for use by MM and/or PSP. RESULTS Twenty-two apps met the inclusion criteria for evaluation. The resilience strategies offered by the majority of apps included psychoeducation, mindfulness, Cognitive Behavioural Therapy (CBT), and Acceptance and Commitment Therapy (ACT). Eleven apps (50%) had been tested with randomized controlled trials, seven (31.8%) were evaluated using other research methods, and five (22.7%) had not been researched. Using the ARIA, apps scores ranged from 37 to 56 out of 72 with higher rated apps demonstrating increased useability and security features. CONCLUSIONS The mHealth apps reviewed are well suited to providing resilience strategies for MMs, PSP and veterans. They offer easy accessibility to evidence-based tools while working to encourage the use of emotional and professional support with safety in mind. While not intended to function as a substitute for professional services, research has demonstrated that mHealth apps have the potential to foster a significant reduction in symptom severity for PTSD, depression, anxiety, and other stress-induced concerns. Within clinical practice, apps can be utilized to supplement treatment as well as provide clients with population-specific, confidential tools to increase engagement in the treatment process. CLINICALTRIAL N/A

scholarly journals Risks to Children under-five in India from COVID-19

2020 ◽  
Author(s):  
Isabel Frost ◽  
Katie Tseng ◽  
Stephanie Hauck ◽  
Geetanjali Kappor ◽  
Aditi Sriram ◽  
...  
Keyword(s):  
Indoor Air Pollution ◽  
Large Population ◽  
Household Survey ◽  
Access To Health Services ◽  
Indian States ◽  
Worst Case ◽  
Global Pandemic ◽  
Potential Impact ◽  
Access To Medical Care ◽  
Novel Coronavirus

Objective: The novel coronavirus, COVID-19, has rapidly emerged to become a global pandemic and is known to cause a high risk to patients over the age of 70 and those with co-morbidities, such as hypertension and diabetes. Though children are at comparatively lower risk compared to adults, the Indian population has a large young demographic that is likely to be at higher risk due to exposure to pollution, malnutrition and poor access to medical care. We aimed to quantify the potential impact of COVID-19 on Indias child population. Methods: We combined district family household survey data with data from the COVID-19 outbreak in China to analyze the potential impact of COVID-19 on children under the age of 5, under three different scenarios; each of which assumed the prevalence of infection to be 0.5%, 1%, or 5%. Results: We find that in the lowest prevalence scenario, across the most populous 18 Indian states, asymptomatic, non-hospitalized symptomatic and hospitalized symptomatic cases could reach 87,200, 412,900 and 31,900, respectively. In a moderate prevalence scenario, these figures reach 174,500, 825,800, and 63,800, and in the worst case, high prevalence scenario these cases could climb as high as 872,200, 4,128,900 and 319,700. Conclusion: These estimates show COVID-19 has the potential to pose a substantial threat to Indias large population of children, particularly those suffering from malnutrition and exposure to indoor air pollution, who may have limited access to health services.

scholarly journals A Men Who Have Sex With Men–Friendly Doctor Finder Hackathon in Guangzhou, China: Development of a Mobile Health Intervention to Enhance Health Care Utilization (Preprint)

2019 ◽  
Author(s):  
Chunyan Li ◽  
Yuan Xiong ◽  
Hao Fong Sit ◽  
Weiming Tang ◽  
Brian J Hall ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Social Media ◽  
Social Networking ◽  
Computer Science ◽  
Mobile Health ◽  
Clinical Medicine ◽  
Web Based ◽  
Mhealth Intervention ◽  
Sex With Men

BACKGROUND Mobile health (mHeath)–based HIV and sexual health promotion among men who have sex with men (MSM) is feasible in low- and middle-income settings. However, many currently available mHealth tools on the market were developed by the private sector for profit and have limited input from MSM communities. OBJECTIVE A health hackathon is an intensive contest that brings together participants from multidisciplinary backgrounds to develop a proposed solution for a specific health issue within a short period. The purpose of this paper was to describe a hackathon event that aimed to develop an mHealth tool to enhance health care (specifically HIV prevention) utilization among Chinese MSM, summarize characteristics of the final prototypes, and discuss implications for future mHealth intervention development. METHODS The hackathon took place in Guangzhou, China. An open call for hackathon participants was advertised on 3 Chinese social media platforms, including Blued, a popular social networking app among MSM. All applicants completed a Web-based survey and were then scored. The top scoring applicants were grouped into teams based on their skills and content area expertise. Each team was allowed 1 month to prepare for the hackathon. The teams then came together in person with on-site expert mentorship for a 72-hour hackathon contest to develop and present mHealth prototype solutions. The judging panel included experts in psychology, public health, computer science, social media, clinical medicine, and MSM advocacy. The final prototypes were evaluated based on innovation, usability, and feasibility. RESULTS We received 92 applicants, and 38 of them were selected to attend the April 2019 hackathon. A total of 8 teams were formed, including expertise in computer science, user interface design, business or marketing, clinical medicine, and public health. Moreover, 24 participants self-identified as gay, and 3 participants self-identified as bisexual. All teams successfully developed a prototype tool. A total of 4 prototypes were designed as a mini program that could be embedded within a popular Chinese social networking app, and 3 prototypes were designed as stand-alone apps. Common prototype functions included Web-based physician searching based on one’s location (8 prototypes), health education (4 prototypes), Web-based health counseling with providers or lay health volunteers (6 prototypes), appointment scheduling (8 prototypes), and between-user communication (2 prototypes). All prototypes included strategies to ensure privacy protection for MSM users, and some prototypes offered strategies to ensure privacy of physicians. The selected prototypes are undergoing pilot testing. CONCLUSIONS This study demonstrated the feasibility and acceptability of using a hackathon to create mHealth intervention tools. This suggests a different pathway to developing mHealth interventions and could be relevant in other settings.

scholarly journals Making Self-Management Mobile Health Apps Accessible to People With Disabilities: Qualitative Single-Subject Study

10.2196/15060 ◽  
2020 ◽  
Vol 8 (1) ◽  
pp. e15060 ◽  
Author(s):  
Leming Zhou ◽  
Andi Saptono ◽  
I Made Agus Setiawan ◽  
Bambang Parmanto
Keyword(s):  
Mobile Health ◽  
Motor Impairment ◽  
People With Disabilities ◽  
Self Management ◽  
Fine Motor ◽  
Single Subject ◽  
Study Results ◽  
Cord Injury ◽  
Study Participants ◽  
Mhealth Apps

Background Over the past decade, a large number of mobile health (mHealth) apps have been created to help individuals to better manage their own health. However, very few of these mHealth apps were specifically designed for people with disabilities, and only a few of them have been assessed for accessibility for people with disabilities. As a result, people with disabilities have difficulties using many of these mHealth apps. Objective The objective of this study was to identify an approach that can be generally applied to improve the accessibility of mHealth apps. Methods We recruited 5 study participants with a primary diagnosis of cerebral palsy or spinal cord injury. All the participants had fine motor impairment or lack of dexterity, and hence, they had difficulties using some mHealth apps. These 5 study participants were first asked to use multiple modules in the client app of a novel mHealth system (iMHere 2.0), during which their performance was observed. Interviews were conducted post use to collect study participants’ desired accessibility features. These accessibility features were then implemented into the iMHere 2.0 client app as customizable options. The 5 participants were asked to use the same modules in the app again, and their performance was compared with that in the first round. A brief interview and a questionnaire were then performed at the end of the study to collect the 5 participants’ comments and impression of the iMHere 2.0 app in general and of the customizable accessibility features. Results Study results indicate that the study participants on their first use of the iMHere 2.0 client app experienced various levels of difficulty consistent with the severity of their lack of dexterity. Their performance was improved after their desired accessibility features were added into the app, and they liked the customizable accessibility features. These participants also expressed an interest in using this mHealth system for their health self-management tasks. Conclusions The accessibility features identified in this study improved the accessibility of the mHealth app for people with dexterity issues. Our approach for improving mHealth app accessibility may also be applied to other mHealth apps to make those apps accessible to people with disabilities.

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