Usability and Effectiveness of eHealth and mHealth Interventions That Support Self-Management and Health Care Transition in Adolescents and Young Adults With Chronic Disease: Systematic Review

mHealth Applications for Childhood Anxiety Disorders: Current Landscape, Challenges, and Future Directions

Purpose of Review

We review the literature on mHealth applications for childhood anxiety disorders, highlighting current use, limitations, and future directions.

Recent Findings

Although mHealth apps targeting childhood anxiety disorders have recently increased, most have not been evaluated for clinical effectiveness, data security, or quality standards. Many apps do not contain scientifically based content and do not adequately incorporate the principles of exposure-based cognitive behavioral therapy. In addition, many apps have significant deficiencies in age-appropriateness, data security, privacy, cultural sensitivity, and accessibility. Limitations remain in terms of the standards for evaluating apps in pediatric populations.

Summary

While interest in mHealth applications for childhood anxiety disorders is increasing, more research is needed to develop effective, safe, and age-appropriate digital interventions. Priorities include scientific grounding, privacy, equitable access, gamification, and parental involvement. Studies in this direction will increase the quality of applications and strengthen equality in access to mental health services.

mHealth Applications for Childhood Anxiety Disorders: Current Landscape, Challenges, and Future Directions

PURPOSE OF REVIEW

We review the literature on mHealth applications for childhood anxiety disorders, highlighting current use, limitations, and future directions.

RECENT FINDINGS

Although mHealth apps targeting childhood anxiety disorders have recently increased, most have not been evaluated for clinical effectiveness, data security, or quality standards. Many apps do not contain scientifically based content and do not adequately incorporate the principles of exposure-based cognitive behavioral therapy. In addition, many apps have significant deficiencies in age-appropriateness, data security, privacy, cultural sensitivity, and accessibility. Limitations remain in terms of the standards for evaluating apps in pediatric populations. While interest in mHealth applications for childhood anxiety disorders is increasing, more research is needed to develop effective, safe, and age-appropriate digital interventions. Priorities include scientific grounding, privacy, equitable access, gamification, and parental involvement. Studies in this direction will increase the quality of applications and strengthen equality in access to mental health services.

User Perceptions of a Multilevel mHealth Intervention to Boost Adherence to Hydroxyurea in Sickle Cell Disease

BACKGROUND

Adherence to hydroxyurea has been low historically. The InCharge Health app demonstrates increased adherence with hydroxyurea, but engagement has not been fully investigated. This study investigated the association between InCharge Health app perceptions and app engagement among adolescents and young adults with sickle cell disease (SCD).

METHODS

We obtained user perceptions of InCharge with the Mobile App Rating Scale (MARS) among participants of the "Integration of mHealth into Sickle Cell Disease Care to Increase Hydroxyurea Utilization" study. Days of app use were correlated with reported patient-reported outcomes of interest, ease of use, the utility of features, and importance of features.

RESULTS

Of 293 enrolled participants, 284 remained active in the study, and 206 (72.5%) completed the 24-week MARS survey. App Interest was positively correlated with app use (p = 0.01) and self-reported days of app use (p = 0.0008). Perceived ease of use trended toward significance with greater app use (p = 0.06). Most individuals (72.0%, 144/200) agreed the app helped them remember to take hydroxyurea, with trends toward higher days of app use (p = 0.07). Those who used the app more agreed they would continue to use it after the study (p = 0.04). Most individuals (54.3%) reported that reminders to take their hydroxyurea were the most important app feature.

CONCLUSIONS

In this study, positive perceptions toward the application features influenced app use and intention to continue using the application. Determining features that drive application utilization can have a positive impact when an app, such as the InCharge app, is demonstrated to improve adherence with proven therapy.

Knowledge comparison amongst telehealth service utilized and never-utilized adults in Bangladesh: a cross-sectional study

Background

Telehealth service is an approach to health care delivery that uses various telecommunication technologies, where the knowledge of the patient plays an important role in its acceptance, preference, and utilization. This study compared telehealth service knowledge among adults who utilized and never-utilized telehealth services and explored factors associated with telehealth knowledge.

Methods

This comparative cross-sectional study recruited 1252 adults from Bangladesh. The outcome variable of the study was the knowledge of telehealth services. We used convenience sampling approaches to recruit participants. The online questionnaire was distributed via Google Forms through Facebook, Messenger, and WhatsApp. The independent variables of the study were sociodemographic factors and the perceived health status of the participants. The bivariate logistic regression model was used to investigate the association between study variables and the level of knowledge among those who utilized and never-utilized the telehealth service. The data analysis was done using STATA version 16.

Results

In the never-utilized group, 54.41% of participants were male, with an average age of 28.89 years. In the utilized group, 55.77% of the participants were male, with an average age of 30 years. Age, marital status, educational level, student status, and perceived health status were significantly associated with good telehealth knowledge among those who never-utilized the telehealth service. Among the utilized groups, we found that age, marital status, and perceived health status were significantly associated with good knowledge of telehealth services.

Conclusions

This study emphasizes the importance of addressing the associated factors to improve telehealth knowledge, considering existing variations among adults who utilized and who never-utilize telehealth services.

Mobile Health App for Adolescent Asthma Self-Management: Development and Usability Study of the Pulmonary Education and Knowledge Mobile Asthma Action Plan

Background

Adolescents with asthma are vulnerable to poor asthma outcomes due to inadequate self-management skills and nonadherence to medications. Mobile health (mHealth) apps have shown promise in improving asthma control, medication adherence, and self-efficacy. However, existing mHealth asthma apps lack personalization and real-time feedback and are not tailored for at-risk adolescents.

Objective

This study aimed to design, develop, and test a smartphone-based mHealth Asthma Action Plan for adolescents, called Pulmonary Education and Knowledge Mobile Asthma Action Plan (PEAK-mAAP), in preparation for a large-scale randomized controlled trial.

Methods

We employed user-centered design principles to develop our app, leveraging our previous work and following guidelines from the National Heart, Lung, and Blood Institute. The app consists of a patient-facing mobile app and a provider-facing portal. A convenience sample of 13 adolescents (aged 12-20 years) was recruited from the Arkansas Children's Research Institute database or direct health care provider referrals. Participants underwent a task-based usability assessment followed by the System Usability Scale assessment to measure user satisfaction, interface effectiveness, and overall system usability.

Results

PEAK-mAAP integrates 7 core modules supporting personalized asthma self-management, symptom monitoring, medication tracking, and real-time feedback. The mean System Usability Scale score was 83/100 (SD 5.54), indicating high user satisfaction and system usability. Notably, older adolescents (>17 years) reported higher usability scores (87.5) than younger users (77.5), suggesting potential age-related differences in app navigation and engagement.

Conclusions

The results demonstrate that PEAK-mAAP is a feasible and user-friendly mHealth intervention for adolescent asthma self-management. While the high usability score reflects a positive user experience, some participants encountered initial usability challenges, highlighting the need for minor refinements and user training materials. The integration of personalized self-management tools and real-time feedback distinguishes PEAK-mAAP from existing asthma apps, addressing key barriers to adherence and engagement. Moving forward, an ongoing randomized controlled trial will assess its clinical effectiveness, long-term engagement, and impact on asthma outcomes, providing further insights into its potential as a scalable solution for adolescent asthma care.

Mapping the research landscape of mHealth and technology in pediatric chronic illness: a bibliometric study

Introduction

The presence of a chronic disease during adolescence has been linked to an increased risk of developing psychosocial problems and a greater likelihood of experiencing difficulties during the transition to adulthood. In this regard, research has been conducted on the development of applications or programs based on new technologies to address the potential complications associated with self-management and coping with chronic diseases in adolescents.

Method

The objective of the present study was to conduct a bibliometric analysis of the existing literature on the use of new technologies to enhance self-management and coping with chronic diseases during adolescence. This four-staged bibliometric analysis was conducted using the following software programs: HisCite, Bibexcel, Pajek, and VOSviewer. The programs were utilized for the extraction of data and the subsequent construction of graphs, which facilitate the visualization of existing networks between disparate authors, institutions, and terms.

Results

The screening results shortlisted a total of 157 articles from an initial 207. The further analysis of these records indicated that the United States was the most prominent nation in terms of scientific output in the domain of digital applications designed to enhance self-management and coping in chronic diseases during adolescence.

Discussion

The digital intervention in this specific population is primarily associated with the development of the mHealth app, along with the physical and psychological consequences that illness can entail. This research can serve as a reference for future bibliometric studies or scientific investigations in this field.