Evaluation of Two Mobile Health Apps in the Context of Smoking Cessation: Qualitative Study of Cognitive Behavioral Therapy (CBT) Versus Non-CBT-Based Digital Solutions (Preprint)

Mapping Intimacies ◽

10.2196/preprints.9405 ◽

2017 ◽

Author(s):

Carina Tudor-Sfetea ◽

Riham Rabee ◽

Muhammad Najim ◽

Nima Amin ◽

Mehak Chadha ◽

...

Keyword(s):

Mental Health ◽

Smoking Cessation ◽

Health Behavior ◽

Mobile Health ◽

Thematic Analysis ◽

Behavioral Change ◽

Behavioral Therapy ◽

Health Behavior Change ◽

Evidence Base ◽

Mhealth Apps

BACKGROUND Mobile health (mHealth) apps can offer users numerous benefits, representing a feasible and acceptable means of administering health interventions such as cognitive behavioral therapy (CBT). CBT is commonly used in the treatment of mental health conditions, where it has a strong evidence base, suggesting that it represents an effective method to elicit health behavior change. More importantly, CBT has proved to be effective in smoking cessation, in the context of smoking-related costs to the National Health Service (NHS) having been estimated to be as high as £2.6bn in 2015. Although the evidence base for computerized CBT in mental health is strong, there is limited literature on its use in smoking cessation. This, combined with the cost-effectiveness of mHealth interventions, advocates a need for research into the effectiveness of CBT-based smoking cessation apps. OBJECTIVE The objective of this study was, first, to explore participants’ perceptions of 2 mHealth apps, a CBT-based app, Quit Genius, and a non-CBT-based app, NHS Smokefree, over a variety of themes. Second, the study aimed to investigate the perceptions and health behavior of users of each app with respect to smoking cessation. METHODS A qualitative short-term longitudinal study was conducted, using a sample of 29 smokers allocated to one of the 2 apps, Quit Genius or Smokefree. Each user underwent 2 one-to-one semistructured interviews, 1 week apart. Thematic analysis was carried out, and important themes were identified. Descriptive statistics regarding participants’ perceptions and health behavior in relation to smoking cessation are also provided. RESULTS The thematic analysis resulted in five higher themes and several subthemes. Participants were generally more positive about Quit Genius’s features, as well as about its design and information engagement and quality. Quit Genius users reported increased motivation to quit smoking, as well as greater willingness to continue using their allocated app after 1 week. Moreover, these participants demonstrated preliminary changes in their smoking behavior, although this was in the context of our limited sample, not yet allowing for the finding to be generalizable. CONCLUSIONS Our findings underscore the use of CBT in the context of mHealth apps as a feasible and potentially effective smoking cessation tool. mHealth apps must be well developed, preferably with an underlying behavioral change mechanism, to promote positive health behavior change. Digital CBT has the potential to become a powerful tool in overcoming current health care challenges. The present results should be replicated in a wider sample using the apps for a longer period so as to allow for generalizability. Further research is also needed to focus on the effect of greater personalization on behavioral change and on understanding the psychological barriers to the adoption of new mHealth solutions.

Assessing the Efficacy of Mobile Health Apps Using the Basic Principles of Cognitive Behavioral Therapy: Systematic Review (Preprint)

10.2196/preprints.8598 ◽

2017 ◽

Author(s):

Amy Leigh Rathbone ◽

Laura Clarry ◽

Julie Prescott

Keyword(s):

Mental Health ◽

Cognitive Behavioral Therapy ◽

Mobile Health ◽

Behavioral Therapy ◽

Cognitive Behavioral ◽

Control Group ◽

Health Issues ◽

Web Based ◽

Mental Health Issues ◽

Mhealth Apps

BACKGROUND Cognitive behavioral therapy (CBT) in its basic principle has developed itself as a stand-alone, substantial method of therapy. With effective application in therapy for a range of mental health issues, the spread of CBT methods to Web-based therapy sources is evident. The development of mobile phone apps using CBT principles is increasing within the research area. Despite the move to Web-based methods of therapy, it is argued that these methods lack the same efficacy of face-to-face therapy sessions. OBJECTIVE The aim of this review was to assess extent research findings with regard to the effectiveness of CBT-related mobile health (mHealth) apps. By assessing only studies employing a randomized controlled trial design, the review aimed to determine app efficacy within the highly regarded method of investigation. METHODS A comprehensive literature search was conducted across several databases. Search results were filtered, and results were subject to strict inclusion and exclusion criteria because of the nature of the review. Where possible, analysis of effect size was calculated and results reported. RESULTS A total of 8 studies investigating the effectiveness of mHealth CBT-related apps across a range of mental health issues were reviewed. Three studies used the app against a control group, and 5 studies used the app intervention against another form of treatment or intervention. A range of effect sizes were seen across all included studies (d=−0.13 to 1.83; 0.03-1.44), with the largest effects often being seen when comparing the data from pre- to posttest for the app engaged group. CONCLUSIONS The studies reviewed support the use of mHealth apps containing CBT principles for a range of mental health issues. However, the effectiveness over longer time periods should be assessed. Researchers and professionals should seek to collaborate effectively when creating new apps to enhance their effectiveness as a treatment for the general public.

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)

10.2196/preprints.26453 ◽

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

Smokers' Engagement Behavior on Facebook regarding to Smoking Cessation Verbalization and Facebook Reaction Usage: Content Analysis (Preprint)

10.2196/preprints.36219 ◽

2022 ◽

Author(s):

Jezdancher Watti ◽

Máté Millner ◽

Kata Siklósi ◽

Hedvig Kiss ◽

Oguz Kelemen ◽

...

Keyword(s):

Smoking Cessation ◽

Health Behavior ◽

Behavior Change ◽

Language Change ◽

Health Behavior Change ◽

Processes Of Change ◽

Change Talk ◽

Significant Difference ◽

Linguistic Categories ◽

The Relationship

BACKGROUND The Transtheoretical Model recommends "processes of change", while the Motivational Interviewing approach offers “motivational language” as indicators of health behavior change. The relationship between these indicators and the usage of Facebook reaction buttons is little known. However, this relationship may highlight how to evaluate one of the most popular engagement indicators (Facebook reactions) in online health behavior change interventions. OBJECTIVE The study aim was to understand the relationship between processes of change, motivational language, Facebook users’ gender, and the Facebook reaction buttons. METHODS A total of 821 comments were analyzed in the current study (N=821), which came from different Facebook users, and responded to image-based, smoking cessation support contents. The processes of change (experiential and behavioral processes) and the motivational language (change talk and sustain talk) in the investigated comments were identified. The presence, the number, and the proportion of these linguistic categories were compared with the Facebook users’ gender and the usage of reaction buttons. RESULTS The Facebook users who used the “Haha” reaction button wrote significantly higher proportion of sustain talk than those who used the “Like” or “Love” reaction (P=.011). No significant difference in the number or proportion of linguistic categories was found between those who used the "Like" reaction button, and those who did not use reaction buttons. The Facebook users who combined the comment and “Love” reaction wrote significantly more change talk than those who used the “Haha” and “Like” reactions, or those who did not utilize these buttons (P<.001). Significant female dominance was observed in the presence, the number, and the proportion of experiential processes and change talk (P<.05). In addition, significant male predominance was found in the presence, the number, and the proportion of sustain talk (P<.05). CONCLUSIONS The "Haha" reaction may be a negative engagement indicator, the "Like" reaction may be a neutral engagement indicator, and the "Love" reaction may be a positive engagement indicator in terms of the smoking cessation during Facebook-based interventions. Furthermore, female engagement may be characterized by utilizing the terms of experiential processes and change talk, while the usage of sustain talk can be typical for male engagement. We recommend the evaluation of processes of change and motivational utterances in participants' comments during online public health interventions.

Using the multi-theory model of health behavior change to identify correlates of change in substance use behavior in a mental health clinic-based sample

Journal of Substance Use ◽

10.1080/14659891.2020.1745309 ◽

2020 ◽

Vol 25 (5) ◽

pp. 555-560

Author(s):

Edith Claros ◽

Vinayak K. Nahar ◽

Milad Mafi ◽

Carol Eliadi ◽

Sherief Abu-Moustafa ◽

...

Keyword(s):

Mental Health ◽

Substance Use ◽

Health Behavior ◽

Behavior Change ◽

Health Behavior Change ◽

Theory Model ◽

Health Clinic ◽

Mental Health Clinic ◽

Use Behavior

Cancer patient interest and perceptions of health behavior change programs.

Journal of Clinical Oncology ◽

10.1200/jco.2018.36.7_suppl.98 ◽

2018 ◽

Vol 36 (7_suppl) ◽

pp. 98-98

Author(s):

Lawson Eng ◽

Sophia Yijia Liu ◽

Qihuang Zhang ◽

Delaram Farzanfar ◽

Sabrina Yeung ◽

...

Keyword(s):

Smoking Cessation ◽

Health Behavior ◽

Behavior Change ◽

Health Behavior Change ◽

Routine Care ◽

Second Hand Smoke ◽

Drinking Alcohol ◽

Logistic Regression Models ◽

Survey Results

98 Background: Health behavior change including smoking cessation, physical activity (PA) and alcohol moderation are important aspects of cancer survivorship. We assessed cancer pt interest and perceptions of programs for these behaviours. Methods: 501 cancer pts were surveyed on their smoking, PA and alcohol use along with their interest and perceptions for programs for these behaviors. Multivariate logistic regression models identified factors associated with pt interest and perceptions. Results: At diagnosis, 115 pts smoked; 184 were exposed to second hand smoke (SHS); 313 did not meet PA guidelines; 238 were drinking alcohol. At risk pts’ (e.g, smokers for smoking cessation, SHS exposed for household smoking cessation) survey results are shown in the table. Most pts perceived smoking (90%), SHS (83%) and alcohol (56%) to be harmful on quality of life, survival and fatigue while PA (77%) was felt to improve these outcomes. These perceptions were not associated with program interest ( P> 0.05). However, pts perceiving that alcohol worsened and PA improved these outcomes were more to likely believe associated programs are beneficial (alcohol aORs = 2.1-2.2 P< 0.03; PA aORs = 1.9-3.2 P< 0.02) and should be routine care (alcohol aORs = 1.9-3.5 P< 0.03; PA aORs = 1.7-2.4 P< 0.1). Pts with more pack-yrs smoked less likely perceived a benefit in a household smoking cessation program (aOR = 1.02 P< 0.007). Pts preferred discussing programs with doctors ( > 35%) or counsellors ( > 42%). Conclusions: About half of pts feel that health behavior change programs would be beneficial and should be part of routine care. These factors were more important than perception of the behaviors on outcomes in influencing pt interest. Initial discussions with pts should focus on discussing benefits of these programs. [Table: see text]

Self-administered programs for health behavior change: Smoking cessation and weight reduction by mail

Addictive Behaviors ◽

10.1016/0306-4603(82)90025-9 ◽

1982 ◽

Vol 7 (1) ◽

pp. 57-63 ◽

Cited By ~ 41

Author(s):

Robert W. Jeffery ◽

Brian G. Danaher ◽

John Killen ◽

John W. Farquhar ◽

Richard Kinnier

Keyword(s):

Smoking Cessation ◽

Health Behavior ◽

Behavior Change ◽

Weight Reduction ◽

Health Behavior Change

Examining the Impact of a Mobile Health Behavior Change Intervention with a brief in-person component for Cancer Survivors with Overweight/Obesity: Randomized Controlled Trial (Preprint)

JMIR mhealth and uhealth ◽

10.2196/24915 ◽

2020 ◽

Author(s):

Jane C Walsh ◽

Janice Richmond ◽

Jenny McSharry ◽

AnnMarie Groarke ◽

Liam Glynn ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Health Behavior ◽

Behavior Change ◽

Cancer Survivors ◽

Mobile Health ◽

Controlled Trial ◽

Health Behavior Change ◽

Behavior Change Intervention ◽

Randomized Controlled ◽

The Impact

Methods and Measures Used to Evaluate Patient-Operated Mobile Health Interventions: Scoping Literature Review (Preprint)

10.2196/preprints.16814 ◽

2019 ◽

Author(s):

Meghan Bradway ◽

Elia Gabarron ◽

Monika Johansen ◽

Paolo Zanaboni ◽

Patricia Jardim ◽

...

Keyword(s):

Mental Health ◽

Mobile Health ◽

Self Efficacy ◽

Health Intervention ◽

Noncommunicable Disease ◽

Health Conditions ◽

Self Management ◽

Qualitative And Quantitative ◽

Mental Health Conditions ◽

Mhealth Apps

BACKGROUND Despite the prevalence of mobile health (mHealth) technologies and observations of their impacts on patients’ health, there is still no consensus on how best to evaluate these tools for patient self-management of chronic conditions. Researchers currently do not have guidelines on which qualitative or quantitative factors to measure or how to gather these reliable data. OBJECTIVE This study aimed to document the methods and both qualitative and quantitative measures used to assess mHealth apps and systems intended for use by patients for the self-management of chronic noncommunicable diseases. METHODS A scoping review was performed, and PubMed, MEDLINE, Google Scholar, and ProQuest Research Library were searched for literature published in English between January 1, 2015, and January 18, 2019. Search terms included combinations of the description of the intention of the intervention (eg, self-efficacy and self-management) and description of the intervention platform (eg, mobile app and sensor). Article selection was based on whether the intervention described a patient with a chronic noncommunicable disease as the primary user of a tool or system that would always be available for self-management. The extracted data included study design, health conditions, participants, intervention type (app or system), methods used, and measured qualitative and quantitative data. RESULTS A total of 31 studies met the eligibility criteria. Studies were classified as either those that evaluated mHealth apps (ie, single devices; n=15) or mHealth systems (ie, more than one tool; n=17), and one study evaluated both apps and systems. App interventions mainly targeted mental health conditions (including Post-Traumatic Stress Disorder), followed by diabetes and cardiovascular and heart diseases; among the 17 studies that described mHealth systems, most involved patients diagnosed with cardiovascular and heart disease, followed by diabetes, respiratory disease, mental health conditions, cancer, and multiple illnesses. The most common evaluation method was collection of usage logs (n=21), followed by standardized questionnaires (n=18) and ad-hoc questionnaires (n=13). The most common measure was app interaction (n=19), followed by usability/feasibility (n=17) and patient-reported health data via the app (n=15). CONCLUSIONS This review demonstrates that health intervention studies are taking advantage of the additional resources that mHealth technologies provide. As mHealth technologies become more prevalent, the call for evidence includes the impacts on patients’ self-efficacy and engagement, in addition to traditional measures. However, considering the unstructured data forms, diverse use, and various platforms of mHealth, it can be challenging to select the right methods and measures to evaluate mHealth technologies. The inclusion of app usage logs, patient-involved methods, and other approaches to determine the impact of mHealth is an important step forward in health intervention research. We hope that this overview will become a catalogue of the possible ways in which mHealth has been and can be integrated into research practice.

VA Peer Providers Supporting Physical Health and Wellness Among Aging Veterans With Mental Health Conditions

Innovation in Aging ◽

10.1093/geroni/igaa057.2155 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 631-631

Author(s):

Anjana Muralidharan ◽

Amanda Peeples ◽

Alicia Lucksted ◽

Richard Goldberg

Keyword(s):

Mental Illness ◽

Health Behavior ◽

Behavior Change ◽

Physical Health ◽

Lived Experience ◽

Group Intervention ◽

Qualitative Interviews ◽

Health Behavior Change ◽

Evidence Base ◽

Self Disclosure

Abstract There is a growing evidence base for the utility of peers in supporting physical health outcomes among aging Veterans with mental illness. This talk will consider two questions: (1) what does it mean to be a “peer” when the focus is improving physical health, and (2) how does peer support promote health behavior change? In considering these questions, select peer-delivered interventions recently or currently being tested in the VA will be discussed. Data from qualitative interviews (N=16; ages 47-75) from a recent RCT of Living Well, a peer co-facilitated group intervention promoting illness self-management, will be presented. These data shed light on the peer role, especially the role of peer self-disclosure in promoting group cohesion, social learning, self-efficacy, and health behavior change. Notably, when physical health is the focus, participants relate to peer providers across diverse characteristics, and not necessarily based on a shared lived experience of mental illness.