Observational study of UK mobile health apps for COVID-19

A comprehensive survey on exploring and analyzing COVID-19 mobile apps: Meta and exploratory analysis

During the current COVID-19 pandemic, many digital solutions around the world have been proposed to cope with the deadly virus but the role of mobile-based applications is dominant one. In Pakistan, during the current COVID-19 pandemic, an array of mobile health applications (apps) and platforms have been launched to grapple with the impacts of the COVID-19 situation. In this survey, our major focus is to explore and analyze the starring role of mobile apps based on the features and functionalities to tackle the COVID-19 disease, particularly in Pakistan. In this study, over fifty (50) mobile apps have been scrapped from the well-known three different sources i.e. Google Play Store, iOS Play Store, and web source. We developed our own data set after searching through the different play stores. We have designed two criteria such that the first criteria are known as eligibility criteria, while the second one is known as assessment criteria. The features and functions of each mobile app are pinpointed and discussed against the parameters of the assessment criteria. The major parameters of assessment criteria are: (i) Home monitoring; (ii) COVID-19 awareness; (iii) contact tracing; (iv) telemedicine; (v) health education; (vi) COVID-19 surveillance; (vii) self-assessment; (viii) security; and (ix) accessibility. This study conducted exploratory analysis and quantitative meta-data analysis by adopting PRISMA guidelines. This survey article is not only discussing the function and features of each COVID-19-centered app in Pakistan, but it also sheds light on the limitations of every mobile app as well. The results of this survey might be helpful for the mobile developers to review the current app products and enhance the existing mobile platforms targeted towards the COVID-19 pandemic. This is the first attempt of its kind to present a state-of-the-art survey of the COVID-19-centered mobile health apps in Pakistan.

The impact of mobile health interventions on service users' health outcomes and the role of health professions: a systematic review of systematic reviews-protocol

BACKGROUND

Mobile health tools have gained prominence in global health care in recent years. Mobile health (mHealth) interventions have demonstrated their impact on managing healthcare service users' health. A pilot search revealed many systematic reviews on the effectiveness of mobile health tools on service users' health outcomes. However, how the role of healthcare professionals in promoting the adoption of mobile health may lead to improved outcomes needs to be clarified. Therefore, this systematic review aims to synthesise existing systematic reviews that examine both the impact of mobile health interventions on service users' outcomes and the role of healthcare professionals in facilitating the adoption of mobile health solutions.

METHODS

Five electronic databases will be searched: EMBASE, CINHAL Plus, MEDLINE, Web of Science, and the Cochrane Library for systematic reviews exploring the impact of mobile health interventions on service users' outcomes and the role of healthcare professionals in facilitating the adoption of mobile health solutions. Systematic reviews published in English dated from January 2015 to June 2024 will be included. Screening and selection of the reviews against inclusion and exclusion criteria will be performed by three independent reviewers, as well as data extraction and quality assessment.

DISCUSSION

Current systematic reviews in mHealth have primarily focused on assessing the effectiveness of mHealth interventions for managing a range of conditions. While these reviews provide valuable input into the outcomes for mHealth, more is needed to know about the impact of the involvement of health professions on service users' outcomes when adopting mHealth. This systematic review of systematic reviews aims to bridge this critical gap in the literature by critically appraising and synthesising the evidence of mHealth interventions' impact on service user outcomes and the level of involvement of health professionals.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD 42023414435.

The resistance toward COVID-19 contact tracing apps: A study of psychological reactance among young adults in Italy

Western governments' attempts to encourage young adults to adopt COVID-19 contact tracing apps (CTAs) have been unsuccessful. Drawing on psychological reactance theory, we propose that government-imposed containment measures (e.g., lockdowns, curfews) may cause young adults to resist CTAs. We investigate how and when threats to freedom posed by government-imposed containment measures to young adults reduce their CTA adoption intentions. We conducted a survey of young adults during the second general lockdown (March‒April 2021) in Italy. The results show that when young Italian adults focus on the restrictive nature of government-imposed containment measures, their sense of freedom is threatened. Threats to freedom produce psychological states of either helplessness or reactance, depending on if young Italian adults think they can recover their freedom. Helpless young adults are motivated to adopt CTAs because they seek guidance from containment measures. Reactant young adults resist CTAs because they exhibit aversive psychological states toward containment measures. These results offer relevant insights for policymakers. They shed light on young Italian adults' resistance toward CTAs. They also inform governments on how to interact more efficiently with young adults if a novel pandemic should occur.

Stakeholder-led understanding of the implementation of digital technologies within heart disease diagnosis: a qualitative study protocol

INTRODUCTION

Cardiovascular diseases are highly prevalent among the UK population, and the quality of care is being reduced due to accessibility and resource issues. Increased implementation of digital technologies into the cardiovascular care pathway has enormous potential to lighten the load on the National Health Service (NHS), however, it is not possible to adopt this shift without embedding the perspectives of service users and clinicians.

METHODS AND ANALYSIS

A series of qualitative studies will be carried out with the aim of developing a stakeholder-led perspective on the implementation of digital technologies to improve holistic diagnosis of heart disease. This will be a decentralised study with all data collection being carried out online with a nationwide cohort. Four focus groups, each with 5-6 participants, will be carried out with people with lived experience of heart disease, and 10 one-to-one interviews will be carried out with clinicians with experience of diagnosing heart diseases. The data will be analysed using an inductive thematic analysis approach.

ETHICS AND DISSEMINATION

This study received ethical approval from the Sciences and Technology Cross Research Council at the University of Sussex (reference ER/FM409/1). Participants will be required to provide informed consent via a Qualtrics survey before being accepted into the online interview or focus group. The findings will be disseminated through conference presentations, peer-reviewed publications and to the study participants.

Conducting a systematic review and evaluation of commercially available mobile applications (apps) on a health-related topic: the TECH approach and a step-by-step methodological guide

OBJECTIVES

To provide an overview of the methodological considerations for conducting commercial smartphone health app reviews (mHealth reviews), with the aim of systematising the process and supporting high-quality evaluations of mHealth apps.

DESIGN

Synthesis of our research team's experiences of conducting and publishing various reviews of mHealth apps available on app stores and hand-searching the top medical informatics journals (eg, The Lancet Digital Health, npj Digital Medicine, Journal of Biomedical Informatics and the Journal of the American Medical Informatics Association) over the last five years (2018-2022) to identify other app reviews to contribute to the discussion of this method and supporting framework for developing a research (review) question and determining the eligibility criteria.

RESULTS

We present seven steps to support rigour in conducting reviews of health apps available on the app market: (1) writing a research question or aims, (2) conducting scoping searches and developing the protocol, (3) determining the eligibility criteria using the TECH framework, (4) conducting the final search and screening of health apps, (5) data extraction, (6) quality, functionality and other assessments and (7) analysis and synthesis of findings. We introduce the novel TECH approach to developing review questions and the eligibility criteria, which considers the Target user, Evaluation focus, Connectedness and the Health domain. Patient and public involvement and engagement opportunities are acknowledged, including co-developing the protocol and undertaking quality or usability assessments.

CONCLUSION

Commercial mHealth app reviews can provide important insights into the health app market, including the availability of apps and their quality and functionality. We have outlined seven key steps for conducting rigorous health app reviews in addition to the TECH acronym, which can support researchers in writing research questions and determining the eligibility criteria. Future work will include a collaborative effort to develop reporting guidelines and a quality appraisal tool to ensure transparency and quality in systematic app reviews.

Country- and app-level factors affecting the adoption and evaluation of COVID-19 mobile apps

BACKGROUND

Countries across the globe have released many COVID-19 mobile apps. However, there is a lack of systematic empirical investigation into the factors affecting the adoption and evaluation of COVID-related apps. This study explores what factors at the country level and the app levels would influence the adoption and evaluation of COVID-19 apps.

METHODS

We collected data on 267 COVID-19 apps in App Store and Google Play. The number of installs, ratings, reviews and rating scores were used as indicators of adoption and evaluation. Country-level predictors include the number of infected cases and the political system (i.e., democratic vs. non-democratic). App-level predictors include developer (i.e., government vs. non-government) and functions. Four app functions were coded for analysis: providing health information, contact tracing, home monitoring, and consultation. Negative binomial regression and OLS (Ordinary Least Square) regression were used to analyze the data.

RESULTS

Our analyses show that apps developed by countries with more infected cases (B = 0.079, CI (Confidence Interval) = 0.000, 0.158; P = .049) and by non-governmental institutions (B=-0.369, CI=-0.653, -0.083; P = .01) received more positive rating scores. Apps with home monitoring function received lower rating scores (B=-0.550, CI=-0.971, -0.129; P = .01). Regarding adoption, apps developed by governments were more likely to be installed (IRR (Incident Rate Ratio) = 8.156, CI = 3.389, 19.626; P < .001), to be rated (IRR = 26.036, CI = 7.331, 92.468; P < .001), and to receive user comments (IRR = 12.080, CI = 3.954, 37.568; p < .001). Apps with functions of contact tracing or consultation were more likely to be installed (IRR = 4.533, CI = 2.072, 9.918; p < .001; IRR = 4.885, CI = 1.970, 12.111; p < .001), to be rated (IRR = 11.634, CI = 3.486, 38.827; p < .001; IRR = 17.194, CI = 5.309, 55.680; p < .001), and to receive user comments (IRR = 5.688, CI = 2.052, 5.770; p < .001; IRR = 16.718, CI = 5.363, 52.113; p < .001). Apps with home monitoring functions were less likely to be rated (IRR = 0.206, CI = 0.047, 0.896; P = .04) but more likely to receive user comments (IRR = 3.874, CI = 1.044, 14.349; P = .04). Further analysis shows that apps developed in democratic countries (OR (Odd Ratio) = 3.650, CI = 1.238, 10.758; P = .02) or by governments (OR = 7.987, CI = 4.106, 15.534, P < .001) were more likely to include the function of contact tracing.

CONCLUSION

This study systematically investigates factors affecting the adoption and evaluation of COVID-19 apps. Evidence shows that government-developed apps and the inclusion of contact tracing and consultation app functions strongly predict app adoption.

Efficiency of the EmERGE Pathway of Care in Five European HIV Centres

OBJECTIVE

We aimed to calculate the efficiency of the EmERGE Pathway of Care in five European HIV clinics, developed and implemented for medically stable people living with HIV.

METHODS

Participants were followed up for 1 year before and after implementation of EmERGE, between April 2016 and October 2019. Micro-costing studies were performed in the outpatient services of the clinics. Unit costs for outpatient services were calculated in national currencies and converted to US$ 2018 OECD purchasing parity prices to enable between clinic comparisons in terms of outcomes and costs. Unit costs were linked to the mean use of services for medically stable people living with HIV,  before and after implementation of EmERGE. Primary outcome measures were CD4 count and viral load; secondary outcomes were patient activation (PAM13) and quality of life (PROQOL-HIV). Out-of-pocket expenditure data were collected.

RESULTS

There were 2251 participants: 87-93% were male, mean age at entry was 41-47 years. Medically stable people living with HIV had outpatient visits in four sites which decreased by 9-31% and costs by 5-33%; visits and costs increased by 8% in one site, which had to revert back to face-to-face visits. Antiretroviral drugs comprised 83-91% of annual costs: the Portuguese site had the highest antiretroviral drug costs in US$ purchasing parity prices. Primary and secondary outcome measures of participants did not change during the study.

CONCLUSIONS

EmERGE is acceptable and provided cost savings in different socio-economic settings. Antiretroviral drug costs remain the main cost drivers in medically stable people living with HIV. While antiretroviral drug prices in local currencies did not differ that much between countries, conversion to US$ purchasing parity prices revealed antiretroviral drugs were more expensive in the least wealthy countries. This needs to be taken into consideration when countries negotiate drug prices with pharmaceutical vendors. Greater efficiencies can be anticipated by extending the use of the EmERGE Pathway to people with complex HIV infection or other chronic diseases. Extending such use should be systematically monitored, implementation should be evaluated and funding should be provided to monitor and evaluate future changes in service provision.

Designing evaluation framework for the empirical assessment of COVID-19 mobile apps in Pakistan

The significant proliferation in the mobile health applications (Apps) amidst Coronaviruses disease 2019 (COVID-19) resulted in decision making problems for healthcare professionals, decision makers and mobile users in Pakistan. This decision making process is also hampered by mobile app trade-offs, multiple features support, evolving healthcare needs and varying vendors. In this regard, evaluation model for mobile apps is presented which completes in three different phases. In first phase, features-based criteria is designed by leveraging Delphi method, and twenty (20) mobile apps are selected from app stores. In second stage, empirical evaluation is performed by using hybrid multi criteria decision approaches like CRiteria Importance Through Inter-criteria Correlation (CRITIC) method has been used for assigning weights to criteria features; and Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) method has been used for assessment of mobile app alternatives. In last step, decision making is performed to select the best mobile app for COVID-19 situations. The results suggest that proposed model can be adopted as a guideline by mobile app subscribers, patients and healthcare professionals.

Factors Affecting the Perceived Usability of the COVID-19 Contact-Tracing Application "Thai Chana" during the Early COVID-19 Omicron Period

Thai Chana is one of the mobile applications for COVID-19 disease-control tracking, especially among the Thais. The purpose of this study was to determine factors affecting the perceived usability of Thai Chana by integrating protection motivation theory, the extended technology acceptance model, and the system usability scale. In all, 800 Thais participated and filled an online questionnaire with 56 questions during the early COVID-19 omicron period (15 December 2021 to 14 January 2022). Structural equation modeling (SEM) showed that the understanding of COVID-19 has significant effects on perceived severity and perceived vulnerability, which subsequently leads to perceived usefulness. In addition, perceived usefulness and perceived ease of use have significant direct effects on attitude, which subsequently leads to the intention to use, actual use, and perceived usability. This study is one of the first studies that have analyzed the mobile application for COVID-19 disease-control tracking. The significant and substantial findings can be used for a theoretical foundation, particularly in designing a new mobile application for disease-control tracking worldwide. Finally, protection motivation theory, the extended technology acceptance model, and the system usability scale can be used for evaluating other disease-control tracking mobile applications worldwide.

The efficiency of the EmERGE pathway of care for people living with HIV in England

This study estimated the efficiency of implementing the EmERGE Pathway of Care for people living with medically stable HIV in Brighton, UK; an App enables individuals to communicate with caregivers via their smart-phone. Individual data on the use of HIV outpatient services were collected one-year pre- and post-implementation of EmERGE. Unit costs of HIV outpatient services were calculated and linked with mean use of services per patient year. Primary outcomes were CD4 count and viral load; patient activation and quality-of-life measures were secondary outcomes. 565 participants were followed up April 2017 - October 2018: 93% men, mean age at recruitment 47.0 years (95%CI:46.2-47.8). Outpatient visits decreased by 9% from 5.6 (95%CI:5.4-5.8) to 5.1 (95%CI:4.9-5.3). Face-to-face visits decreased and virtual visits increased. Annual costs decreased by 9% from £751 (95%CI: £722-£780) to £678 (95%CI: £653-£705). Including anti-retroviral drugs, total annual cost decreased from £7,343 (95%CI: £7,314-7,372) to £7,270 (95%CI: £7,245-7,297): ARVs costs comprised 90%. EmERGE was a cost-saving intervention, patients remained engaged and clinically stable. Annual costs were reduced, but ARVs continue to dominate costs. Extension of EmERGE to other people with chronic conditions, could produce greater efficiencies but these needs to be evaluated and monitored over time.

Challenges for modelling interventions for future pandemics

Mathematical modelling and statistical inference provide a framework to evaluate different non-pharmaceutical and pharmaceutical interventions for the control of epidemics that has been widely used during the COVID-19 pandemic. In this paper, lessons learned from this and previous epidemics are used to highlight the challenges for future pandemic control. We consider the availability and use of data, as well as the need for correct parameterisation and calibration for different model frameworks. We discuss challenges that arise in describing and distinguishing between different interventions, within different modelling structures, and allowing both within and between host dynamics. We also highlight challenges in modelling the health economic and political aspects of interventions. Given the diversity of these challenges, a broad variety of interdisciplinary expertise is needed to address them, combining mathematical knowledge with biological and social insights, and including health economics and communication skills. Addressing these challenges for the future requires strong cross-disciplinary collaboration together with close communication between scientists and policy makers.

Communication in Healthcare: Global challenges in the 21st Century

This article explores the communication challenges brought about by the digital revolution in the 21st century for healthcare professionals internationally. It particularly focuses on the use of content-generating and sharing platforms like social media. Globally, healthcare has been irrevocably altered by digital innovation and health professionals deploy an extensive range of social media and web-based tools on a daily basis. However, many healthcare professionals use these platforms in a regulatory vacuum-where there may not be specific legal or ethical guidance-and without an appreciation of the associated risks. Given the special protections afforded to the practitioner-patient relationship, and the importance of a health practitioners' reputation, it is vital that we understand how to traverse the many ethical and legal challenges of the digital interaction. A comprehensive set of recommendations (see "Guidelines for Good Digital Citizenship in the Health Professions" on page 5 ff.) to keep practitioners out of trouble is provided. These hinge on the notion of being a "good person and a good doctor" as a formative maxim for ethical and legal safety. The constituents of publication, and the consequences of falling foul of acceptable publication standards on social media, are specifically discussed. "Publication" involves sharing content with a third party, or a group of people, and social media refers to platforms on which content can be shared with more than one person. Hence, most information that we post on social media can be considered as "published," and as such may attach liability for health professionals who do not use these platforms with requisite care and sufficient forethought.

Contact tracing apps for the COVID-19 pandemic: a systematic literature review of challenges and future directions for neo-liberal societies

PURPOSE

The COVID-19 pandemic has spread with increased fatalities around the world and has become an international public health crisis. Public health authorities in many countries have introduced contact tracing apps to track and trace infected persons as part of measures to contain the spread of the Severe Acute Respiratory Syndrome-Coronavirus 2. However, there are major concerns about its efficacy and privacy which affects mass acceptance amongst a population. This systematic literature review encompasses the current challenges facing this technology and recommendations to address such challenges in the fight against the COVID-19 pandemic in neo-liberal societies.

METHODS

The systematic literature review was conducted by searching databases of Google Scholar, Web of Science, PubMed, IEEE Xplore Digital Library, PsycInfo and ScienceDirect using the search terms ("Contact Tracing" OR "Contact Tracing apps") AND ("COVID-19" OR "Coronavirus") to identify relevant literature. The searches were run against the title, keywords, or abstract, depending on the search platforms. The searches were conducted between January 1, 2020, through 31st January 2021. Further inputs were also taken from preprints, published government and technical reports. We explore and discuss from the selected literature, the key challenges and issues that influence unwillingness to use these contact tracing apps in neo-liberal societies which include the plausibility of abuse of user privacy rights and lack of trust in the government and public health authorities by their citizens. Other challenges identified and discussed include ethical issues, security vulnerabilities, user behaviour and participation, and technical constraints.

RESULTS AND CONCLUSION

Finally, in the analysis of this systematic literature review, recommendations to address these challenges, future directions, and considerations in the use of digital contact tracing apps and related technologies to contain the spread of future pandemic outbreaks are presented. For policy makers in neo-liberal societies, this study provides an in-depth review of issues that must be addressed. We highlight recommendations to improve the willingness to use such digital technologies and could facilitate mass acceptance amongst users.

COVID-19 Contact Tracing and Detection-Based on Blockchain Technology

The fight against the COVID-19 pandemic still involves many struggles and challenges. The greatest challenge that most governments are currently facing is the lack of a precise, accurate, and automated mechanism for detecting and tracking new COVID-19 cases. In response to this challenge, this study proposes the first blockchain-based system, called the COVID-19 contact tracing system (CCTS), to verify, track, and detect new cases of COVID-19. The proposed system consists of four integrated components: an infection verifier subsystem, a mass surveillance subsystem, a P2P mobile application, and a blockchain platform for managing all transactions between the three subsystem models. To investigate the performance of the proposed system, CCTS has been simulated and tested against a created dataset consisting of 300 confirmed cases and 2539 contacts. Based on the metrics of the confusion matrix (i.e., recall, precision, accuracy, and F1 Score), the detection evaluation results proved that the proposed blockchain-based system achieved an average of accuracy of 75.79% and a false discovery rate (FDR) of 0.004 in recognizing persons in contact with COVID-19 patients within two different areas of infection covered by GPS. Moreover, the simulation results also demonstrated the success of the proposed system in performing self-estimation of infection probabilities and sending and receiving infection alerts in P2P communications in crowds of people by users. The infection probability results have been calculated using the binomial distribution function technique. This result can be considered unique compared with other similar systems in the literature. The new system could support governments, health authorities, and citizens in making critical decisions regarding infection detection, prediction, tracking, and avoiding the COVID-19 outbreak. Moreover, the functionality of the proposed CCTS can be adapted to work against any other similar pandemics in the future.

BJS commission on surgery and perioperative care post-COVID-19

BACKGROUND

Coronavirus disease 2019 (COVID-19) was declared a pandemic by the WHO on 11 March 2020 and global surgical practice was compromised. This Commission aimed to document and reflect on the changes seen in the surgical environment during the pandemic, by reviewing colleagues' experiences and published evidence.

METHODS

In late 2020, BJS contacted colleagues across the global surgical community and asked them to describe how severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) had affected their practice. In addition to this, the Commission undertook a literature review on the impact of COVID-19 on surgery and perioperative care. A thematic analysis was performed to identify the issues most frequently encountered by the correspondents, as well as the solutions and ideas suggested to address them.

RESULTS

BJS received communications for this Commission from leading clinicians and academics across a variety of surgical specialties in every inhabited continent. The responses from all over the world provided insights into multiple facets of surgical practice from a governmental level to individual clinical practice and training.

CONCLUSION

The COVID-19 pandemic has uncovered a variety of problems in healthcare systems, including negative impacts on surgical practice. Global surgical multidisciplinary teams are working collaboratively to address research questions about the future of surgery in the post-COVID-19 era. The COVID-19 pandemic is severely damaging surgical training. The establishment of a multidisciplinary ethics committee should be encouraged at all surgical oncology centres. Innovative leadership and collaboration is vital in the post-COVID-19 era.

A survey of Egyptian physicians’ awareness and use of coronavirus-related mHealth applications

The key purpose of this study is to look into Egyptian physicians' knowledge and use of coronavirus-related mHealth apps. The study used a quantitative approach in the form of a self-administered questionnaire in January 2021.The population of the study included 203 Egyptian physicians, 56% of whom were males and 43.8% of whom were females, ranging in age from 36 to 55 years and with work experience ranging from 11 to 25 years. Many Egyptian physicians were described as advanced mobile phone users who were aware of the use of coronavirus-related mHealth apps and had used them for one to two hours per day for seven to twelve months. Many physicians first learned about these apps through social media, family, and the media. Physicians' homes were discovered to be the most popular location for accessing these apps. The most popular platforms for physicians were those based on Android. According to many physicians, the most frequently recommended apps are “coronavirus symptoms apps” and “coronavirus health monitoring apps”. Accessing coronavirus-related services, communicating with peers, and sharing data were among the most important tasks for physicians. Many physicians agreed that these apps provide a lot of information about the coronavirus, increase access to information, and allow them to communicate with one another, but they also agreed that they take a long time, violate privacy, and may even lead to social isolation. Many physicians have expressed trust in these applications. More than half of the physicians stated that they “usually” recommend these apps to their patients. The most significant barriers to using coronavirus-related mHealth apps identified by Egyptian physicians surveyed in this study are a lack of time and concerns about personal data privacy and security.

Perceptions of Mobile Health Apps and Features to Support Psychosocial Well-being Among Frontline Health Care Workers Involved in the COVID-19 Pandemic Response: Qualitative Study

BACKGROUND

Frontline health care workers are experiencing a myriad of physical and psychosocial challenges amid the COVID-19 pandemic. There is growing recognition that digital technologies have the potential to improve the well-being of frontline workers. However, there has been limited development of wellness interventions using mobile health (mHealth) technology. More importantly, little research has been conducted on how frontline workers perceive mHealth-based support to promote their well-being.

OBJECTIVE

This study aimed to explore frontline workers' experience of conventional psychological wellness programs and their perceptions of the usefulness of mHealth apps and features for promoting well-being. It also sought to identify factors that could potentially influence uptake and retention of an mHealth-based wellness program.

METHODS

We conducted semistructured interviews using purposive sampling with frontline workers involved in the COVID-19 response. Various visual materials, collated from existing mHealth app features, were presented to facilitate discussion. Interviews were audio-recorded and transcribed verbatim. Thematic analysis based on grounded theory was undertaken. Themes were subsequently mapped to key nudge strategies-those commonly used for mHealth development-to assess participants' preferences for particular features and their reasoning.

RESULTS

A total of 42 frontline workers participated in 12 one-on-one interviews or focus group discussions. Frontline workers generally had a limited ability to identify their own psychological problems and liked the reminders functionality of the app to track their mood over time. A personalized goal-setting feature (ie, tailoring) and in-app resources were generally valued, while frequent coaching and messages (ie, framing) were seen as a distraction. The majority of participants desired a built-in chat function with a counselor (ie, guidance) for reasons of accessibility and protection of privacy. Very few participants appreciated a gamification function. Frontline workers commonly reported the need for ongoing social support and desired access to an in-app peer support community (ie, social influence). There were, however, concerns regarding potential risks from virtual peer interactions. Intrinsic motivational factors, mHealth app technicality, and tangible rewards were identified as critical for uptake and retention.

CONCLUSIONS

Our study highlights the potential of mHealth apps with relevant features to be used as wellness tools by frontline health care workers. Future work should focus on developing a nonintrusive and personalized mHealth app with in-app counseling, peer support to improve well-being, and tangible and extrinsic rewards to foster continued use.

Savitzky-Golay filter energy features-based approach to face recognition using symbolic modeling

Face recognition is a well-researched domain however many issues for instance expression changes, illumination variations, and presence of occlusion in the face images seriously affect the performance of such systems. A recent survey shows that COVID-19 will also have a considerable and long-term impact on biometric face recognition systems. The work has presented two novel Savitzky-Golay differentiator (SGD) and gradient-based Savitzky-Golay differentiator (GSGD) feature extraction techniques to elevate issues related to face recognition systems. The SGD and GSGD feature descriptors are able to extract discriminative information present in different parts of the face image. In this paper, an efficient and robust person identification using symbolic data modeling approach and similarity analysis measure is devised and employed for feature representation and classification tasks to address the aforementioned issues of face recognition. Extensive experiments and comparisons of the proposed descriptors experimental results indicated that the proposed approaches can achieve optimal performance of 96-97, 92-96, 100, 84-93, and 87-96% on LFW, ORL, AR, IJB-A datasets, and newly devised VISA database, respectively.

Health Apps for Combating COVID-19: Descriptive Review and Taxonomy

BACKGROUND

Mobile phone apps have been leveraged to combat the spread of COVID-19. However, little is known about these technologies' characteristics, technical features, and various applications in health care when responding to this public health crisis. The lack of understanding has led developers and governments to make poor choices about apps' designs, which resulted in creating less useful apps that are overall less appealing to consumers due to their technical flaws.

OBJECTIVE

This review aims to identify, analyze, and categorize health apps related to COVID-19 that are currently available for consumers in app stores; in particular, it focuses on exploring their key technical features and classifying the purposes that these apps were designed to serve.

METHODS

A review of health apps was conducted using the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. The Apple Store and Google Play were searched between April 20 and September 11, 2020. An app was included if it was dedicated for this disease and was listed under the health and medical categories in these app stores. The descriptions of these apps were extracted from the apps' web pages and thematically analyzed via open coding to identify both their key technical features and overall purpose. The characteristics of the included apps were summarized and presented with descriptive statistics.

RESULTS

Of the 298 health apps that were initially retrieved, 115 met the inclusion criteria. A total of 29 technical features were found in our sample of apps, which were then categorized into five key purposes of apps related to COVID-19. A total of 77 (67%) apps were developed by governments or national authorities and for the purpose of promoting users to track their personal health (9/29, 31%). Other purposes included raising awareness on how to combat COVID-19 (8/29, 27%), managing exposure to COVID-19 (6/29, 20%), monitoring health by health care professionals (5/29, 17%), and conducting research studies (1/29, 3.5%).

CONCLUSIONS

This study provides an overview and taxonomy of the health apps currently available in the market to combat COVID-19 based on their differences in basic technical features and purpose. As most of the apps were provided by governments or national authorities, it indicates the essential role these apps have as tools in public health crisis management. By involving most of the population in self-tracking their personal health and providing them with the technology to self-assess, the role of these apps is deemed to be a key driver for a participatory approach to curtail the spread of COVID-19. Further effort is required from researchers to evaluate these apps' effectiveness and from governmental organizations to increase public awareness of these digital solutions.

COVID-19 Mobile Apps: A Systematic Review of the Literature

Background

A vast amount of mobile apps have been developed during the past few months in an attempt to “flatten the curve” of the increasing number of COVID-19 cases.

Objective

This systematic review aims to shed light into studies found in the scientific literature that have used and evaluated mobile apps for the prevention, management, treatment, or follow-up of COVID-19.

Methods

We searched the bibliographic databases Global Literature on Coronavirus Disease, PubMed, and Scopus to identify papers focusing on mobile apps for COVID-19 that show evidence of their real-life use and have been developed involving clinical professionals in their design or validation.

Results

Mobile apps have been implemented for training, information sharing, risk assessment, self-management of symptoms, contact tracing, home monitoring, and decision making, rapidly offering effective and usable tools for managing the COVID-19 pandemic.

Conclusions

Mobile apps are considered to be a valuable tool for citizens, health professionals, and decision makers in facing critical challenges imposed by the pandemic, such as reducing the burden on hospitals, providing access to credible information, tracking the symptoms and mental health of individuals, and discovering new predictors.

COVID-19 Contact Tracing Apps: A Technologic Tower of Babel and the Gap for International Pandemic Control

As the world struggles with the new COVID-19 pandemic, contact tracing apps of various types have been adopted in many jurisdictions for combating the spread of the SARS-CoV-2 virus. However, even if they are successful in containing the virus within national borders, these apps are becoming ineffective as international travel is gradually resumed. The problem rests in the plurality of apps and their inability to operate in a synchronized manner, as well as the absence of an international entity with the power to coordinate and analyze the information collected by the disparate apps. The risk of creating a useless Tower of Babel of COVID-19 contact tracing apps is very real, endangering global health. This paper analyzes legal barriers for realizing the interoperability of contact tracing apps and emphasizes the need for developing coordinated solutions to promote safe international travel and global pandemic control.