Exploring the Category and Use Cases on Digital Therapeutic Methodologies

OBJECTIVES

As the Fourth Industrial Revolution advances, there is a growing interest in digital technology. In particular, the use of digital therapeutics (DTx) in healthcare is anticipated to reduce medical expenses. However, analytical research on DTx is still insufficient to fuel momentum for future DTx development. The purpose of this article is to analyze representative cases of different types of DTx from around the world and to propose a classification system.

METHODS

In this exploratory study examining DTx interaction types and representative cases, we conducted a literature review and selected seven interaction types that were utilized in a large number of cases. Then, we evaluated the specific characteristics of each DTx mechanism by reviewing the relevant literature, analyzing their indications and treatment components. A representative case for each mechanism was provided.

RESULTS

Cognitive behavioral therapy, distraction therapy, graded exposure therapy, reminiscence therapy, art therapy, therapeutic exercise, and gamification are the seven categories of DTx interaction types. Illustrative examples of each variety are provided.

CONCLUSIONS

Efforts from both the government and private sector are crucial for success, as standardization can decrease both the expense and the time required for government-led DTx development. The private sector should partner with medical facilities to stimulate potential demand, carry out clinical research, and produce scholarly evidence.

Characteristics and related factors of family functioning in Chinese families during early pregnancy

Introduction

Family functioning has been found to significantly impact each family member's health mentally, physically, and socially. A number of the research has focused on the impact of impaired family functioning in general, but limited studies explore family functioning in the vulnerable period, early pregnancy. Therefore, the study aimed to investigate the characteristics and related factors in Chinese females and partners during early pregnancy.

Methods

The cross-sectional study enrolled 226 pregnant women and 166 partners. Assessment tools included the McMaster Family Assessment Device (FAD), Edinburgh Postnatal Depression Scale, Patient Health Questionnaire-9, Generalized Anxiety Disorder 7-Item, Social Support Rating Scale, and Quality of Life Enjoyment and Satisfaction Questionnaire, Short Form. Correlation analysis was applied to investigate the related factors.

Results

In the present study, FAD-Behavior Control (BC) was the only dysfunctional dimension and had the highest dysfunctional rates than other dimensions. Length of time living with a partner, depressive and anxious symptoms, and quality of life were all associated with the dysfunctional family functioning of BC.

Conclusions

The study reinforced the important clues of family functioning during early pregnancy. Also, it provided new entry points for the general population and healthcare providers to minimize the negative impact that impaired family function might bring to a family.

Use of Behavior Change Techniques Alongside Exercise in the Management of Rotator Cuff-Related Shoulder Pain: A Scoping Review

OBJECTIVES

The aims of this scoping review were to: (1) determine the frequency and types of behavior change techniques (BCTs) and education utilized in trials investigating exercise interventions for rotator cuff related shoulder pain (RCRSP); (2) subcategorize the BCTs and education found in the trials to summarize all behavior change approaches reported by trials; and (3) compare the frequency, types, and subcategories of BCTs and education utilized in the clinical guidelines for managing RCRSP between the trials.

METHODS

Data sources included Cochrane Central Register of Controlled Trials, Ovid MEDLINE, Ovid EMBASE, CINAHL Plus, Google Scholar and PubMed, which were searched from inception to June 2020. Trials assessing exercise interventions for RCRSP were included. Three authors independently determined eligibility and extracted data. The frequency and types of BCTs and education in the trials and clinical practice guidelines were reported and compared descriptively. Two authors assessed the content of the BCTs to develop subcategories.

RESULTS

Most trials reported including at least 1 type of BCT (89.2%), which was most commonly feedback and monitoring (78.5%). There were many different approaches to the BCTs and education; for example, feedback and monitoring was subcategorized into supervised exercise, exercise monitoring, and feedback through external aids, such as mirrors. Clinical guidelines recommend supervision, goal setting, activity modification, pain management recommendations, information about the condition, and exercise education.

CONCLUSION

Although over two-thirds of trials reported including a BCT alongside exercise interventions for RCRSP, the breadth of these interventions is limited (supervision is the only common one). Future trialists should consider using any type of BCT that may improve exercise adherence and outcomes.

IMPACT

The findings of this review have: (1) identified gaps in the literature; and (2) contributed to the design of future exercise interventions for RCRSP.

Effects of a Theory Based Intervention on Physical Activity Among Female Employees: A Quasi-Experimental Study

Background

Regular physical activity has been highlighted as an important factor in decreasing about 25 factors harmful to health, such as obesity, diabetes, heart failure, depression and osteoporosis. Female office workers, because of the long hours they stay seated in their workplace, are seriously threatened by immobility. The Theory of Planned Behavior has been successfully used several times to predict PA behaviorphysical activity (PA). The TPB studies also have identified perceived behavioral control as the key determinant of walking intentions.

Objectives

The present study aims to assess the effectiveness of an intervention based on TPB to improve attitude, perceived behavioral control, Subjective norms, behavioral intention and PA behavior among female office workers.

Materials and Methods

The present study is an interventional, quasi-experimental study. Participants were 95 female office workers of the Tehran University that divided randomly in two case and control groups. Using the theory of planned behavior questionnaire and the International physical activity questionnaire, the participants were evaluated before the training and three months after that. The training was provided in the form of four 90-minute training sessions and some electronic messages sent through office automation system once every two weeks.

Results

The intervention increased PBC, attitudes, intentions and objectively measured PA behavior. The effects of the intervention on intentions and behavior were mediated by PBC.

Conclusions

The present study has provided some of the data toward understanding determinants of physical activity behavior in female office workers. Specifically, the results suggest that interventions designed to promote physical activity in this population should focus on the development of PBC as well as positive attitude toward PA.

Treatment Programs for Students With Attention Deficit Hyperactivity Disorder: A Meta-Analysis Study

Context:

The aim of this study was to determine the experimental evidence of treatment/intervention programs for deficits in social skills, attention, and behavioral disorder in children and adolescents with attention deficit hyperactivity disorder (ADHD).

Evidence Acquisition:

Meta-analysis procedures were employed to investigate whether children and adolescents with ADHD exhibit deficits in attention and social skills. A total of 17 empirical research studies published between 2000 and 2013 met our inclusion criteria. Attention and social skills measures were categorized according to both modality and type of processing required.

Results:

Children with ADHD exhibited deficits in multiple components of attention and social skills that were not related to language-learning disorders and weaknesses in general intellectual abilities. The overall percentage effect for attention and social skills in students with ADHD was calculated (effect size = 0. 79, confidence interval = 0.57 - 1.08). This meta-analysis study showed that treatment programs reduced attention deficit and social skills in ADHD children and adolescents.

Conclusions:

The evidence of attention and social skills deficits in children with ADHD supports recent studies in ADHD deficits. Further research is required to explain in detail the nature, severity, and specificity of the deficits in individuals with ADHD.