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Schroeder T, Kamalakkannan A, Seaman K, Nguyen A, Siette J, Gewald H, Georgiou A. Perception of middle-aged and older adults towards mHealth apps: A comparative factor analysis between Australia and Germany. Int J Med Inform 2024; 189:105502. [PMID: 38815317 DOI: 10.1016/j.ijmedinf.2024.105502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 02/23/2024] [Accepted: 05/24/2024] [Indexed: 06/01/2024]
Abstract
OBJECTIVE Although evidence of the global effectiveness and usability of mobile health (mHealth) apps as non-drug interventions is growing, older adults often demonstrate low adoption rates of these apps. This study aims to identify the perspectives of older adults on introducing and adopting mHealth apps in Australia and Germany. MATERIALS AND METHODS We conducted two online cross-sectional surveys to examine factors from contextual, technological and personal perspectives that influence older adults in mHealth app adoption. Using descriptive statistics, chi-square tests and exploratory factor analysis, we identified the differences and similarities between respondents' perspectives across two countries. RESULTS A total of 290 respondents (149, Australia; 141, Germany) completed the survey. Older adults' ability to use a mHealth app, the user-friendliness of the app, their positive self-efficacy regarding their health and resource availability for using mHealth apps were related to intended adoption. Differences between Germany and Australia were found in issues concerned with data sharing and empowerment by the doctor, while similarities were related to trust in the doctor and their treatment approaches. DISCUSSION AND CONCLUSION This study highlights participants' perspectives and attitudes towards mHealth app use, unmet needs and barriers, and the facilitating influences in the two countries. These insights can be used to inform the development and implementation of mHealth apps and to construct tailored strategies to increase the adoption rates of mHealth apps among older adults and to maximise their potential benefits.
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Affiliation(s)
- Tanja Schroeder
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Australia.
| | - Abbish Kamalakkannan
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Australia
| | - Karla Seaman
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Australia
| | - Amy Nguyen
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Australia
| | - Joyce Siette
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Australia; MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Australia
| | - Heiko Gewald
- Institute for Digital Innovation (IDI), University of Applied Sciences Neu-Ulm, Germany
| | - Andrew Georgiou
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Australia
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Giansanti D. Joint Expedition: Exploring Telehealth and the Digital Healthcare Landscape as a Team Integration. Healthcare (Basel) 2024; 12:585. [PMID: 38470696 PMCID: PMC10931385 DOI: 10.3390/healthcare12050585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 02/29/2024] [Indexed: 03/14/2024] Open
Abstract
The TeleHealth and digital healthcare domains have witnessed remarkable advancements in recent years (Contribution 1), propelled by the evolution of digitization processes, both in mobile [...].
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Schroeder T, Seaman K, Nguyen A, Siette J, Gewald H, Georgiou A. What would it take to improve the uptake and utilisation of mHealth applications among older Australians? A qualitative study. AUST HEALTH REV 2024; 48:28-33. [PMID: 38266308 DOI: 10.1071/ah23119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 01/10/2024] [Indexed: 01/26/2024]
Abstract
Objective Health-related apps on mobile devices (mHealth apps) have become an effective self-management tool and treatment support for patients. There is limited research, however, on how older people (50 and over) perceive the opportunity of using mHealth apps. Our aim was to investigate the perceptions of older people in Australia regarding the opportunity of using prescribed or doctor-recommended mHealth apps and provide insights which can enhance their uptake of mHealth. Methods This was a qualitative study using semi-structured interviews involving 21 participants aged 51-82 years. Qualitative thematic analysis was used to categorise the factors that influence the adoption of mHealth apps by older adults. Results We show that beyond the prominent influencing factors from technology adoption research (such as performance and effort expectancy, social influence and facilitating conditions), health-specific factors such as a trusting doctor-patient relationship and strong health self-efficacy positively influence the intended adoption of mHealth apps among older adults. In addition, the IT security and accurate interpretation of participants' input in an mHealth app can present barriers to mHealth app adoption. Conclusion Our analyses provide additional insights complementing existing technology adoption research. Their successful adoption and utilisation require further empirical evidence on its effectiveness along with attention to the voices of those who are meant to use them. To address potential barriers, improve the quality and security of mHealth apps, and thus achieve greater patient safety, the involvement of consumers, regulators and health professionals is necessary.
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Affiliation(s)
- Tanja Schroeder
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia; and In-sti-tute for Di-gital In-nov-a-tion (IDI), Neu-Ulm University of Applied Sciences, Neu-Ulm, Germany
| | - Karla Seaman
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Amy Nguyen
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Joyce Siette
- MARCS Institute for Brain, Behaviour and Development, School of Computer, Data and Mathematical Science, Western Sydney University, Westmead, NSW, Australia
| | - Heiko Gewald
- In-sti-tute for Di-gital In-nov-a-tion (IDI), Neu-Ulm University of Applied Sciences, Neu-Ulm, Germany
| | - Andrew Georgiou
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
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Walsh EA, Safren SA, Penedo FJ, Antoni MH. If we build it, will they come? A scoping review of objective engagement metrics in asynchronous psychosocial telehealth interventions for breast cancer survivors. Clin Psychol Rev 2024; 107:102374. [PMID: 38171138 DOI: 10.1016/j.cpr.2023.102374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 12/11/2023] [Accepted: 12/21/2023] [Indexed: 01/05/2024]
Abstract
Burgeoning technologies and the COVID-19 pandemic resulted in a boom of telehealth for immunocompromised patients, such as those with cancer. Telehealth modalities overcome barriers and promote accessibility to care. Currently, efficacious psychosocial interventions exist to address negative aftereffects of a cancer diagnosis and treatment. Many of these interventions often incorporate asynchronous telehealth (e.g., web-based, smartphone mobile app) features. However, asynchronous platforms are limited by suboptimal engagement. Subjective indicators of perceived engagement in the forms of acceptability, feasibility, and adherence are often captured, yet prior research has found discrepancies between perceived and actual engagement. The FITT (frequency, intensity, time/duration, type of engagement) model, originally developed for use to quantify engagement within exercise trials, provides a framework to assess objective engagement of psychosocial interventions for breast cancer. Using 14 keywords and searching six databases through 11/2023, 56 studies that used asynchronous telehealth interventions in breast cancer were identified. All FITT domains were reported at least once across studies with intensity metrics most commonly reported. Nine metrics were described across FITT domains. Human-centered design principles to guide telehealth development and privacy considerations are discussed. Findings offer suggestions for how to represent and optimize objective engagement in asynchronous telehealth cancer care.
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Affiliation(s)
- Emily A Walsh
- Department of Psychology, University of Miami, Coral Gables, FL, USA.
| | - Steven A Safren
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Frank J Penedo
- Department of Psychology, University of Miami, Coral Gables, FL, USA; Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA
| | - Michael H Antoni
- Department of Psychology, University of Miami, Coral Gables, FL, USA; Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA
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McCarthy B, Sabharwal JK, Chawla S. Old age or cognitive decline? Examining the usability of a mobile health app for older Australians. Inform Health Soc Care 2024; 49:83-97. [PMID: 38529731 DOI: 10.1080/17538157.2024.2332691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
There is a growing literature on the role of mobile health applications (mHealth apps) in supporting older adults and the self-management of personal health. The purpose of this pilot study is to assess the usability of a government-funded mobile health app amongst older Australians and to evaluate whether cognitive function and demographic characteristics (i.e. age, gender, education) are associated with usability. A total of 28 older adults living in a regional city in Australia took part in the study. The participants were recruited using purposive sampling. Data collection instruments consisted of validated cognitive tests, task-based usability tests, and a questionnaire. The data was analyzed using non-parametric strategies. The findings of this study demonstrated that a government-funded, mHealth app was usable by older adults. Users were able to perform basic tasks in an effective and efficient manner. The hypothesis that elderly age would be significantly associated with performance on cognitive tests, as well as usability, was not supported. Performance on some cognitive tests was significantly and positively related to usability. Education and gender were not related to usability. The results suggest that traditional stereotypes surrounding aging and cognitive decline need to be reexamined.
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Affiliation(s)
- Breda McCarthy
- Psychology, School of Social and Health Sciences, James Cook University, Townsville, Singapore
- Information Technology, James Cook University, Singapore, Singapore
| | - Jagdeep Kaur Sabharwal
- Psychology, School of Social and Health Sciences, James Cook University, Townsville, Singapore
| | - Shailey Chawla
- Information Technology, James Cook University, Singapore, Singapore
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Savoy A, Holden RJ, de Groot M, Clark DO, Sachs GA, Klonoff D, Weiner M. Improving Care for People Living With Dementia and Diabetes: Applying the Human-Centered Design Process to Continuous Glucose Monitoring. J Diabetes Sci Technol 2024; 18:201-206. [PMID: 36384313 PMCID: PMC10899847 DOI: 10.1177/19322968221137907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
People with Alzheimer's disease or related dementias and diabetes mellitus (ADRD-DM) are at high risk for hypoglycemic events. Their cognitive impairment and psychosocial situation often hinder detection of hypoglycemia. Extending use and benefits of continuous glucose monitoring (CGM) to people with ADRD-DM could improve hypoglycemia detection, inform care, and reduce adverse events. However, cognitive impairment associated with ADRD presents unique challenges for CGM use. This commentary proposes applying the human-centered design process to CGM, investigating design solutions or interventions needed to integrate CGM into the health care of patients with ADRD-DM. With this process, we can identify and inform CGM designs for people with ADRD-DM, broadening CGM access, increasing detection and treatment of the silent threat posed by hypoglycemia.
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Affiliation(s)
- April Savoy
- Purdue School of Engineering & Technology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
- Regenstrief Institute, Inc., Indianapolis, IN, USA
- Center for Health Information and Communication, Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service CIN 13-416, Richard L. Roudebush VA Medical Center, Indianapolis, IN, USA
| | - Richard J. Holden
- Regenstrief Institute, Inc., Indianapolis, IN, USA
- Indiana University School of Public Health-Bloomington, Bloomington, IN, USA
- Indiana University School of Medicine, Indianapolis, IN, USA
| | - Mary de Groot
- Indiana University School of Medicine, Indianapolis, IN, USA
| | - Daniel O. Clark
- Regenstrief Institute, Inc., Indianapolis, IN, USA
- Indiana University School of Medicine, Indianapolis, IN, USA
| | - Greg A. Sachs
- Regenstrief Institute, Inc., Indianapolis, IN, USA
- Indiana University School of Medicine, Indianapolis, IN, USA
- Eskenazi Health, Indianapolis, IN, USA
| | - David Klonoff
- School of Medicine, University of California San Francisco, San Francisco, CA, USA
- Dorothy L. and James E. Frank Diabetes Research Institute, Mills-Peninsula Medical Center, San Mateo, CA, USA
| | - Michael Weiner
- Regenstrief Institute, Inc., Indianapolis, IN, USA
- Center for Health Information and Communication, Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service CIN 13-416, Richard L. Roudebush VA Medical Center, Indianapolis, IN, USA
- Indiana University School of Medicine, Indianapolis, IN, USA
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Gui F, Yang J, Wu Q, Liu Y, Zhou J, An N. Enhancing Caregiver Empowerment Through the Story Mosaic System: Human-Centered Design Approach for Visualizing Older Adult Life Stories. JMIR Aging 2023; 6:e50037. [PMID: 37962517 PMCID: PMC10662670 DOI: 10.2196/50037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 09/07/2023] [Accepted: 09/22/2023] [Indexed: 11/15/2023] Open
Abstract
Background Various older adult care settings have embraced the use of the life story approach to enhance the development of comprehensive care plans. However, organizing life stories and extracting useful information is labor-intensive, primarily due to the repetitive, fragmented, and redundant nature of life stories gathered from everyday communication scenarios. Existing life story systems, while available, do not adequately fulfill the requirements of users, especially in the application of care services. Objective The objective of this study is to design, develop, and evaluate a digital system that provides caregivers with the necessary tools to view and manage the life stories of older adults, enabling expedited access to pertinent information effectively and visually. Methods This study used a multidisciplinary, user-centered design approach across 4 phases: initial design requirements, prototyping, prototype refinement workshops, and usability testing. During the initial phase, we conducted field research in the Hefei Tianyu Senior Living Service Nursing Home, China, to discover how caregivers currently store and use life stories and their needs, challenges, and obstacles in organizing and retrieving information. Subsequently, we designed a low-fidelity prototype according to the users' requirements. A prototyping workshop involving 6 participants was held to collaboratively design and discuss the prototype's function and interaction. User feedback from the workshops was used to optimize the prototype, leading to the development of the system. We then designed 2 rounds of usability testing with 7 caregivers to evaluate the system's usability and effectiveness. Results We identified 3 categories of functionalities that are necessary to include in the design of our initial low-fidelity prototype of life story visualizations: life story input, life story organization, and timeline generation. Subsequently, through the workshops, we identified 3 categories for functional optimization: feedback on user interface and usability, optimization suggestions for existing features, and the request for additional functionalities. Next, we designed a medium-fidelity prototype based on human-centered design. The Story Mosaic system underwent usability testing in the Hefei Tianyu Senior Living Service Nursing Home. Overall, 7 users recorded and organized 1123 life stories of 16 older adults. The usability testing results indicated that the system was accessible and easy to use for caregivers. Based on the feedback from the usability testing, we finalized the high-fidelity prototype. Conclusions We designed, developed, and evaluated the Story Mosaic system to support the visual management of older adults' life stories. This system empowers caregivers through digital technology and innovative design, pioneering personal narrative integration in caregiving. This system can expand to include informal caregivers and family members for continued adaptability and empathy.
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Affiliation(s)
- Fang Gui
- Key Laboratory of Knowledge Engineering with Big Data, Ministry of Education, Hefei, China
- School of Computer Science and Information Engineering, Hefei University of Technology, Hefei, China
| | - Jiaoyun Yang
- Key Laboratory of Knowledge Engineering with Big Data, Ministry of Education, Hefei, China
- School of Computer Science and Information Engineering, Hefei University of Technology, Hefei, China
| | - Qilin Wu
- School of Computer Science and Artificial Intelligence, Chaohu University, Hefei, China
| | - Yang Liu
- Key Laboratory of Knowledge Engineering with Big Data, Ministry of Education, Hefei, China
- School of Computer Science and Information Engineering, Hefei University of Technology, Hefei, China
| | - Jia Zhou
- Department of Industrial Engineering, Chongqing University, Chongqing, China
| | - Ning An
- Key Laboratory of Knowledge Engineering with Big Data, Ministry of Education, Hefei, China
- School of Computer Science and Information Engineering, Hefei University of Technology, Hefei, China
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Gomez-Hernandez M, Ferre X, Moral C, Villalba-Mora E. Design Guidelines of Mobile Apps for Older Adults: Systematic Review and Thematic Analysis. JMIR Mhealth Uhealth 2023; 11:e43186. [PMID: 37733401 PMCID: PMC10557006 DOI: 10.2196/43186] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 06/20/2023] [Accepted: 07/11/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Mobile apps are fundamental tools in today's society for practical and social endeavors. However, these technologies are often not usable for older users. Given the increased use of mobile apps by this group of users and the impact that certain services may have on their quality of life, such as mobile health, personal finance, or online administrative procedures, a clear set of guidelines for mobile app designers is needed. Existing recommendations for older adults focus on investigations with certain groups of older adults or have not been extracted from experimental results. OBJECTIVE In this research work, we systematically reviewed the scientific literature that provided recommendations for the design of mobile apps based on usability testing with older adults and organized such recommendations into a meaningful set of design guidelines. METHODS We conducted a systematic literature review of journal and conference articles from 2010 to 2021. We included articles that carried out usability tests with populations aged >60 years and presented transferable guidelines on mobile software design, resulting in a final set of 40 articles. We then carried out a thematic analysis with 3 rounds of analysis to provide meaning to an otherwise diverse set of recommendations. At this stage, we discarded recommendations that were made by just 1 article, were based on a specific mobile app and were therefore nontransferrable, were based on other authors' literature (as opposed to recommendations based on the results of usability tests), or were not sufficiently argued. With the remaining recommendations, we identified commonalities, wrote a faithful statement for each guideline, used a common language for the entire set, and organized the guidelines into categories, thereby giving shape to an otherwise diverse set of recommendations. RESULTS Among the 27 resulting guidelines, the rules Simplify and Increase the size and distance between interactive controls were transversal and of the greatest significance. The rest of the guidelines were divided into 5 categories (Help & Training, Navigation, Visual Design, Cognitive Load, and Interaction) and consequent subcategories in Visual Design (Layout, Icons, and Appearance) and Interaction (Input and Output). The recommendations were structured, explained in detail, and illustrated with applied examples extracted from the selected studies, where appropriate. We discussed the design implications of applying these guidelines, contextualized with relevant studies. We also discussed the limitations of the approach followed, stressing the need for further experimentation to gain a better understanding of how older adults use mobile apps and how to better design such apps with these users in mind. CONCLUSIONS The compiled guidelines support the design of mobile apps that cater to the needs of older adults because they are based on the results of actual usability tests with users aged >60 years.
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Affiliation(s)
- Miguel Gomez-Hernandez
- Center for Biomedical Technology, Universidad Politécnica de Madrid, Pozuelo de Alarcón, Spain
- Emerging Technologies Research Lab, Department of Human-Centred Computing, Monash University, Melbourne, Australia
| | - Xavier Ferre
- Center for Biomedical Technology, Universidad Politécnica de Madrid, Pozuelo de Alarcón, Spain
- School of Software Engineering, Tongji University, Shanghai, China
| | - Cristian Moral
- Center for Biomedical Technology, Universidad Politécnica de Madrid, Pozuelo de Alarcón, Spain
| | - Elena Villalba-Mora
- Center for Biomedical Technology, Universidad Politécnica de Madrid, Pozuelo de Alarcón, Spain
- Biomedical Research Networking Center in Bioengineering Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
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An Q, Kelley MM, Hanners A, Yen PY. Sustainable Development for Mobile Health Apps Using the Human-Centered Design Process. JMIR Form Res 2023; 7:e45694. [PMID: 37624639 PMCID: PMC10492175 DOI: 10.2196/45694] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 05/31/2023] [Accepted: 06/28/2023] [Indexed: 08/26/2023] Open
Abstract
Well-documented scientific evidence indicates that mobile health (mHealth) apps can improve the quality of life, relieve symptoms, and restore health for patients. In addition to improving patients' health outcomes, mHealth apps reduce health care use and the cost burdens associated with disease management. Currently, patients and health care providers have a wide variety of choices among commercially available mHealth apps. However, due to the high resource costs and low user adoption of mHealth apps, the cost-benefit relationship remains controversial. When compared to traditional expert-driven approaches, applying human-centered design (HCD) may result in more useable, acceptable, and effective mHealth apps. In this paper, we summarize current HCD practices in mHealth development studies and make recommendations to improve the sustainability of mHealth. These recommendations include consideration of factors regarding culture norms, iterative evaluations on HCD practice, use of novelty in mHealth app, and consideration of privacy and reliability across the entire HCD process. Additionally, we suggest a sociotechnical lens toward HCD practices to promote the sustainability of mHealth apps. Future research should consider standardizing the HCD practice to help mHealth researchers and developers avoid barriers associated with inadequate HCD practices.
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Affiliation(s)
- Qingfan An
- Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
| | - Marjorie M Kelley
- College of Nursing, The Ohio State University, Columbus, OH, United States
| | - Audra Hanners
- College of Nursing, The Ohio State University, Columbus, OH, United States
| | - Po-Yin Yen
- Institute for Informatics, Washington University School of Medicine in St Louis, St Louis, MO, United States
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He Y, Liu D, Guo R, Guo S. Information Cocoons on Short Video Platforms and Its Influence on Depression Among the Elderly: A Moderated Mediation Model. Psychol Res Behav Manag 2023; 16:2469-2480. [PMID: 37426388 PMCID: PMC10327920 DOI: 10.2147/prbm.s415832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 06/19/2023] [Indexed: 07/11/2023] Open
Abstract
Background As the elderly increasingly engage with new media, particularly short video platforms, concerns are arising about the formation of "information cocoons" that limit exposure to diverse perspectives. While the impact of these cocoons on society has been investigated, their effects on the mental well-being of the elderly remain understudied. Given the prevalence of depression among the elderly, it is crucial to understand the potential link between information cocoons and depression among older adults. Methods The study examined the relationships between information cocoons and depression, loneliness, and family emotional support among 400 Chinese elderly people. The statistical software package SPSS was used to establish a moderated mediation model between information cocoons and depression. Results Information cocoons directly predicted depression among the elderly participants. Family emotional support moderated the first half and the second half of the mediation process, whereby information cocoons affected the depression of the elderly through loneliness. Specifically, in the first half of the mediation process, when the level of information cocoons was lower, the role of family emotional support was more prominent. In the second half of the process, when the level of family emotional support was higher, such support played a more protective role in the impact of loneliness on depression. Discussion The findings of this study have practical implications for addressing depression among the elderly population. Understanding the influence of information cocoons on depression can inform interventions aimed at promoting diverse information access and reducing social isolation. These results will contribute to the development of targeted strategies to improve the mental well-being of older adults in the context of evolving media landscapes.
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Affiliation(s)
- Yiqing He
- School of Education, Guangzhou University, Guangzhou, People’s Republic of China
| | - Darong Liu
- Department of Artificial Intelligence, Faculty of Computer Science and Information Technology, University of Malaya, Kuala Lumpur, Malaysia
| | - Ruitong Guo
- School of Education, Yunnan Minzu University, Kunming, People’s Republic of China
| | - Siping Guo
- School of Education, Guangzhou University, Guangzhou, People’s Republic of China
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Wang Q, Liu J, Zhou L, Tian J, Chen X, Zhang W, Wang H, Zhou W, Gao Y. Usability evaluation of mHealth apps for elderly individuals: a scoping review. BMC Med Inform Decis Mak 2022; 22:317. [PMID: 36461017 PMCID: PMC9717549 DOI: 10.1186/s12911-022-02064-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 11/23/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Usability is a key factor affecting the acceptance of mobile health applications (mHealth apps) for elderly individuals, but traditional usability evaluation methods may not be suitable for use in this population because of aging barriers. The objectives of this study were to identify, explore, and summarize the current state of the literature on the usability evaluation of mHealth apps for older adults and to incorporate these methods into the appropriate evaluation stage. METHODS Electronic searches were conducted in 10 databases. Inclusion criteria were articles focused on the usability evaluation of mHealth apps designed for older adults. The included studies were classified according to the mHealth app usability evaluation framework, and the suitability of evaluation methods for use among the elderly was analyzed. RESULTS Ninety-six articles met the inclusion criteria. Research activity increased steeply after 2013 (n = 92). Satisfaction (n = 74) and learnability (n = 60) were the most frequently evaluated critical measures, while memorability (n = 13) was the least evaluated. The ratios of satisfaction, learnability, operability, and understandability measures were significantly related to the different stages of evaluation (P < 0.05). The methods used for usability evaluation were questionnaire (n = 68), interview (n = 36), concurrent thinking aloud (n = 25), performance metrics (n = 25), behavioral observation log (n = 14), screen recording (n = 3), eye tracking (n = 1), retrospective thinking aloud (n = 1), and feedback log (n = 1). Thirty-two studies developed their own evaluation tool to assess unique design features for elderly individuals. CONCLUSION In the past five years, the number of studies in the field of usability evaluation of mHealth apps for the elderly has increased rapidly. The mHealth apps are often used as an auxiliary means of self-management to help the elderly manage their wellness and disease. According to the three stages of the mHealth app usability evaluation framework, the critical measures and evaluation methods are inconsistent. Future research should focus on selecting specific critical measures relevant to aging characteristics and adapting usability evaluation methods to elderly individuals by improving traditional tools, introducing automated evaluation tools and optimizing evaluation processes.
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Affiliation(s)
- Qiuyi Wang
- grid.73113.370000 0004 0369 1660Clinical Nursing Department, Naval Medical University, 800 Xiang Yin Road, Yangpu District, Shanghai, 200433 China
| | - Jing Liu
- grid.73113.370000 0004 0369 1660Clinical Nursing Department, Naval Medical University, 800 Xiang Yin Road, Yangpu District, Shanghai, 200433 China
| | - Lanshu Zhou
- grid.73113.370000 0004 0369 1660Clinical Nursing Department, Naval Medical University, 800 Xiang Yin Road, Yangpu District, Shanghai, 200433 China
| | - Jing Tian
- grid.73113.370000 0004 0369 1660Clinical Nursing Department, Naval Medical University, 800 Xiang Yin Road, Yangpu District, Shanghai, 200433 China
| | - Xuemei Chen
- grid.73113.370000 0004 0369 1660Clinical Nursing Department, Naval Medical University, 800 Xiang Yin Road, Yangpu District, Shanghai, 200433 China
| | - Wei Zhang
- grid.73113.370000 0004 0369 1660Clinical Nursing Department, Naval Medical University, 800 Xiang Yin Road, Yangpu District, Shanghai, 200433 China
| | - He Wang
- grid.73113.370000 0004 0369 1660Clinical Nursing Department, Naval Medical University, 800 Xiang Yin Road, Yangpu District, Shanghai, 200433 China
| | - Wanqiong Zhou
- grid.73113.370000 0004 0369 1660Clinical Nursing Department, Naval Medical University, 800 Xiang Yin Road, Yangpu District, Shanghai, 200433 China
| | - Yitian Gao
- grid.73113.370000 0004 0369 1660Clinical Nursing Department, Naval Medical University, 800 Xiang Yin Road, Yangpu District, Shanghai, 200433 China
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Schweiger A, Rodebaugh TL, Lenze EJ, Keenoy K, Hassenstab J, Kloeckner J, Gettinger TR, Nicol GE. Mindfulness Training for Depressed Older Adults Using Smartphone Technology: Protocol for a Fully Remote Precision Clinical Trial. JMIR Res Protoc 2022; 11:e39233. [PMID: 36301604 PMCID: PMC9650569 DOI: 10.2196/39233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 09/29/2022] [Accepted: 09/30/2022] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Precision medicine, optimized interventions, and access to care are catchphrases for the future of behavioral treatments. Progress has been slow due to the dearth of clinical trials that optimize interventions' benefits, individually tailor interventions to meet individual needs and preferences, and lead to rapid implementation after effectiveness is demonstrated. Two innovations have emerged to meet these challenges: fully remote trials and precision clinical trials. OBJECTIVE This paper provides a detailed description of Mindful MyWay, a study designed to test online mindfulness training in older adults with depression. Consistent with the concept of fully remote trials using a smartphone app, the study requires no in-person contact and can be conducted with participants anywhere in the United States. Based upon the precision medicine framework, the study assesses participants using high-frequency assessments of symptoms, cognitive performance, and patient preferences to both understand the individualized nature of treatment response and help individually tailor the intervention. METHODS Mindful MyWay is an open-label early-phase clinical trial for individuals 65 years and older with current depression. A smartphone app was developed to help coordinate the study, deliver the intervention, and evaluate the acceptability of the intervention, as well as predictors and outcomes of it. The curriculum for the fully remote intervention parallels the mindfulness-based stress reduction curriculum, a protocolized group-based mindfulness training that is typically provided in person. After consent and screening, participants download The Healthy Mind Lab mobile health smartphone app from the Apple App Store, allowing them to complete brief smartphone-based assessments of depressive symptoms and cognitive performance 4 times each day for 4 weeks prior to and after completing the intervention. The intervention consists of an introduction video and 10 weekly mindfulness training sessions, with the expectation to practice mindfulness at home daily. The app collects participant preference data throughout the 10-week intervention period; these high-frequency assessments identify participants' individually dynamic preferences toward the goal of optimizing the intervention in future iterations. RESULTS Participant recruitment and data collection began in March 2019. Final end point assessments will be collected in May 2022. The paper describes lessons learned regarding the critical role of early-phase testing prior to moving to a randomized trial. CONCLUSIONS The Mindful MyWay study is an exemplar of innovative clinical trial designs that use smartphone technology in behavioral and neuropsychiatric conditions. These include fully remote studies that can recruit throughout the United States, including hard-to-access areas, and collect high-frequency data, which is ideal for idiographic assessment and individualized intervention optimization. Our findings will be used to modify our methods and inform future randomized controlled trials within a precision medicine framework. TRIAL REGISTRATION ClinicalTrials.gov NCT03922217; https://clinicaltrials.gov/ct2/show/NCT03922217. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/39233.
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Affiliation(s)
- Abigail Schweiger
- Healthy Mind Lab, Department of Psychiatry, Washington University School of Medicine, Saint Louis, MO, United States
- School of Social Work, Saint Louis University, Saint Louis, MO, United States
| | - Thomas L Rodebaugh
- Department of Psychological and Brain Sciences, Washington University in Saint Louis, Saint Louis, MO, United States
| | - Eric J Lenze
- Healthy Mind Lab, Department of Psychiatry, Washington University School of Medicine, Saint Louis, MO, United States
- mHealth Research Core, Washington University School of Medicine, Saint Louis, MO, United States
| | - Katie Keenoy
- mHealth Research Core, Washington University School of Medicine, Saint Louis, MO, United States
- Trial Care Unit, Center for Clinical Studies, Washington University School of Medicine, Saint Louis, MO, United States
| | - Jason Hassenstab
- Department of Psychological and Brain Sciences, Washington University in Saint Louis, Saint Louis, MO, United States
- Department of Neurology, Washington University School of Medicine, Saint Louis, MO, United States
| | - Jeanne Kloeckner
- Healthy Mind Lab, Department of Psychiatry, Washington University School of Medicine, Saint Louis, MO, United States
| | - Torie R Gettinger
- Healthy Mind Lab, Department of Psychiatry, Washington University School of Medicine, Saint Louis, MO, United States
- School of Social Work, Saint Louis University, Saint Louis, MO, United States
| | - Ginger E Nicol
- Healthy Mind Lab, Department of Psychiatry, Washington University School of Medicine, Saint Louis, MO, United States
- mHealth Research Core, Washington University School of Medicine, Saint Louis, MO, United States
- Division of Child and Adolescent Psychiatry, Washington University School of Medicine, Saint Louis, MO, United States
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