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Fajardo MA, Batcup C, Ayre J, McKinn S, Knight J, Raffoul N, Brims K, Nelson AJ, Bonner C. Could nudges reduce health literacy disparities in CVD prevention? An experiment using alternative messages for CVD risk assessment screening. Patient Educ Couns 2024; 123:108192. [PMID: 38377707 DOI: 10.1016/j.pec.2024.108192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 01/23/2024] [Accepted: 02/03/2024] [Indexed: 02/22/2024]
Abstract
OBJECTIVE To explore the effect of SMS nudge messages amongst people with varying health literacy on their intention to get a Heart Health Check. METHODS A 3 (Initial SMS: scarcity, regret, or control nudge) x 2 (Reminder SMS: social norm or control nudge) factorial design was used in a hypothetical online experiment. 705 participants eligible for Heart Health Checks were recruited. Outcomes included intention to attend a Heart Health Check and psychological responses. RESULTS In the control condition, people with lower health literacy had lower behavioural intentions compared to those with higher health literacy (p = .011). Scarcity and regret nudges closed this gap, resulting in similar intention levels for lower and higher health literacy. There was no interactive effect of the reminder nudge and health literacy (p = .724). CONCLUSION Scarcity and regret nudge messages closed the health literacy gap in behavioural intentions compared to a control message, while a reminder nudge had limited additional benefit. Health literacy should be considered in behavioural intervention evaluations to ensure health equity is addressed. PRACTICE IMPLICATIONS Results informed a national screening program using a universal precautions approach, where messages with higher engagement for lower health literacy groups were used in clinical practice.
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Affiliation(s)
- Michael Anthony Fajardo
- Sydney Health Literacy Lab, School of Public Health, Faculty of Medicine & Health, University of Sydney, NSW, Australia
| | - Carys Batcup
- Sydney Health Literacy Lab, School of Public Health, Faculty of Medicine & Health, University of Sydney, NSW, Australia
| | - Julie Ayre
- Sydney Health Literacy Lab, School of Public Health, Faculty of Medicine & Health, University of Sydney, NSW, Australia
| | - Shannon McKinn
- Sydney Health Literacy Lab, School of Public Health, Faculty of Medicine & Health, University of Sydney, NSW, Australia
| | - Joshua Knight
- National Heart Foundation of Australia, Sydney, NSW, Australia
| | - Natalie Raffoul
- National Heart Foundation of Australia, Sydney, NSW, Australia
| | - Kerryn Brims
- National Heart Foundation of Australia, Sydney, NSW, Australia
| | | | - Carissa Bonner
- Sydney Health Literacy Lab, School of Public Health, Faculty of Medicine & Health, University of Sydney, NSW, Australia; Menzies Centre for Health Policy and Economics, Faculty of Medicine & Health, University of Sydney, NSW, Australia.
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Fletcher R, Regan C, May C, Rennie A, Ludski K, George JS. Developing text-messaging support for fathers after perinatal loss. Women Birth 2024; 37:101594. [PMID: 38508068 DOI: 10.1016/j.wombi.2024.101594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 01/24/2024] [Accepted: 02/27/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND Perinatal loss is a devastating occurrence for expecting parents. Although both parents are affected, research on fathers' grief has not resulted in effective support services for fathers. AIM To describe a multi-stage co-design process for developing text messaging support for fathers experiencing perinatal loss. METHODS Co-designed text messages were developed in collaboration with a perinatal bereavement organisation, mothers and fathers with lived experience of perinatal loss, and clinicians working with bereaved parents. Bereaved parents responded to a survey about bereaved fathers' information needs (stage 1). A qualitative descriptive data analysis created topics for the generation of text messages (stage 2). Parents with lived experience and clinicians evaluated the messages on importance and clinical fit (stage 3). Messages were revised (stage 4), followed by parent and clinician evaluation and final message revision (stage 5). FINDINGS There were 959 survey respondents; the majority agreed that support for fathers would have been useful; 539 provided comments. Qualitative analysis created twelve topics within three themes, leading to the generation of 64 text messages. Messages were evaluated by 27 lived experience parents and 19 clinicians as important (91.6%) and understandable (91.3%), and 92.5% of clinicians agreed the messages fitted clinical guidelines. Message revision resulted in 59 messages across three themes. The final evaluation by 12 parents and 14 clinicians led to a final revised set of 52 messages. CONCLUSION Text-based support for bereaved fathers can be developed in a co-design process to accord with clinical practice, from topics suggested parents with lived experience.
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Affiliation(s)
- Richard Fletcher
- School of Health Sciences, The University of Newcastle, Callaghan, NSW, Australia.
| | - Casey Regan
- School of Health Sciences, The University of Newcastle, Callaghan, NSW, Australia
| | - Chris May
- School of Health Sciences, The University of Newcastle, Callaghan, NSW, Australia
| | | | | | - Jennifer St George
- School of Health Sciences, The University of Newcastle, Callaghan, NSW, Australia
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Lyzwinski LN, Elgendi M, Menon C. Users' Acceptability and Perceived Efficacy of mHealth for Opioid Use Disorder: Scoping Review. JMIR Mhealth Uhealth 2024; 12:e49751. [PMID: 38602751 PMCID: PMC11046395 DOI: 10.2196/49751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 11/14/2023] [Accepted: 11/29/2023] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND The opioid crisis continues to pose significant challenges to global public health, necessitating the development of novel interventions to support individuals in managing their substance use and preventing overdose-related deaths. Mobile health (mHealth), as a promising platform for addressing opioid use disorder, requires a comprehensive understanding of user perspectives to minimize barriers to care and optimize the benefits of mHealth interventions. OBJECTIVE This study aims to synthesize qualitative insights into opioid users' acceptability and perceived efficacy of mHealth and wearable technologies for opioid use disorder. METHODS A scoping review of PubMed (MEDLINE) and Google Scholar databases was conducted to identify research on opioid user perspectives concerning mHealth-assisted interventions, including wearable sensors, SMS text messaging, and app-based technology. RESULTS Overall, users demonstrate a high willingness to engage with mHealth interventions to prevent overdose-related deaths and manage opioid use. Users perceive mHealth as an opportunity to access care and desire the involvement of trusted health care professionals in these technologies. User comfort with wearing opioid sensors emerged as a significant factor. Personally tailored content, social support, and encouragement are preferred by users. Privacy concerns and limited access to technology pose barriers to care. CONCLUSIONS To maximize benefits and minimize risks for users, it is crucial to implement robust privacy measures, provide comprehensive user training, integrate behavior change techniques, offer professional and peer support, deliver tailored messages, incorporate behavior change theories, assess readiness for change, design stigma-reducing apps, use visual elements, and conduct user-focused research for effective opioid management in mHealth interventions. mHealth demonstrates considerable potential as a tool for addressing opioid use disorder and preventing overdose-related deaths, given the high acceptability and perceived benefits reported by users.
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Affiliation(s)
- Lynnette Nathalie Lyzwinski
- Menrva Research Group, School of Mechatronics Systems Engineering and Engineering Science, Simon Fraser University, Vancouver, BC, Canada
| | - Mohamed Elgendi
- ETH Biomedical and Mobile Health Technology Lab, Zurich, Switzerland
| | - Carlo Menon
- Menrva Research Group, School of Mechatronics Systems Engineering and Engineering Science, Simon Fraser University, Vancouver, BC, Canada
- ETH Biomedical and Mobile Health Technology Lab, Zurich, Switzerland
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Wray TB, Chan PA, Kahler CW, Ocean EMS, Nittas V. Pilot Randomized Controlled Trial of Game Plan for PrEP: A Brief, Web and Text Message Intervention to Help Sexual Minority Men Adhere to PrEP and Reduce Their Alcohol Use. AIDS Behav 2024; 28:1356-1369. [PMID: 37971613 PMCID: PMC10947926 DOI: 10.1007/s10461-023-04223-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2023] [Indexed: 11/19/2023]
Abstract
Suboptimal adherence to oral PrEP medications, particularly among younger sexual minority men (SMM), continues to be a key barrier to achieving more substantial declines in new HIV infections. Although variety of interventions, including web and text-message-based applications, have successfully addressed PrEP adherence, very few have addressed the potential influence of alcohol. This pilot study explored whether the Game Plan for PrEP, a brief, web-based and text messaging intervention, helped promote PrEP persistence and adherence and reduced condomless sex and alcohol use. Seventy-three heavy-drinking SMM on PrEP were recruited online from states with Ending the HIV Epidemic jurisdictions and randomly assigned 1:1 to receive either the Game Plan for PrEP intervention or an attention-matched control. We collected online surveys assessing primary outcomes at one, three, and six months post-enrollment. As secondary outcomes, we also collected dried blood spot samples at baseline, three, and six months to analyze for biomarkers of PrEP and alcohol use. Our results showed that the odds of stopping PrEP or experiencing a clinically meaningful lapse in PrEP adherence (≥ 4 consecutive missed doses) were not different across the two conditions. We also did not find evidence of any differences in condomless sex or drinking outcomes across conditions, although participants in both conditions reported drinking less often over time. These findings were consistent across both self-reported outcomes and biomarkers. Overall, we did not find evidence that our brief, web and text messaging intervention encouraged more optimal PrEP coverage or moderate their alcohol use.
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Affiliation(s)
- Tyler B Wray
- Center for Alcohol and Addictions Studies, Brown University School of Public Health, 121 South Main Street, Providence, RI, 02912, USA.
| | - Philip A Chan
- Department of Medicine, Brown University, Providence, RI, USA
| | - Christopher W Kahler
- Center for Alcohol and Addictions Studies, Brown University School of Public Health, 121 South Main Street, Providence, RI, 02912, USA
| | - Erik M S Ocean
- Center for Alcohol and Addictions Studies, Brown University School of Public Health, 121 South Main Street, Providence, RI, 02912, USA
| | - Vasileios Nittas
- Center for Alcohol and Addictions Studies, Brown University School of Public Health, 121 South Main Street, Providence, RI, 02912, USA
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Liu AY, Alleyne CD, Doblecki-Lewis S, Koester KA, Gonzalez R, Vinson J, Scott H, Buchbinder S, Torres TS. Adapting mHealth Interventions (PrEPmate and DOT Diary) to Support PrEP Retention in Care and Adherence Among English and Spanish-Speaking Men Who Have Sex With Men and Transgender Women in the United States: Formative Work and Pilot Randomized Trial. JMIR Form Res 2024; 8:e54073. [PMID: 38536232 PMCID: PMC11007601 DOI: 10.2196/54073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 01/30/2024] [Accepted: 01/31/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND A growing number of mobile health (mHealth) technologies are being developed to support HIV preexposure prophylaxis (PrEP) adherence and persistence; however, most tools have focused on men who have sex with men (MSM), and few are available in Spanish. To maximize the potential impact of these tools in reducing gender and racial/ethnic disparities and promoting health equity, mHealth tools tailored to Spanish-speaking people and transgender women are critically needed. OBJECTIVE The aim of this study is to adapt and tailor 2 mHealth technologies, PrEPmate and DOT Diary, to support daily PrEP adherence and persistence among Spanish-speaking MSM and English- and Spanish-speaking transgender women and to evaluate the feasibility and acceptability of these tools. METHODS PrEPmate, an interactive, bidirectional, text messaging intervention that promotes personalized communication between PrEP users and providers, and DOT Diary, a mobile app that promotes self-management of PrEP use and sexual health through an integrated electronic pill-taking and sexual activity diary, were previously developed for English-speaking MSM. We conducted 3 focus groups with 15 English- and Spanish-speaking transgender women and MSM in San Francisco and Miami to culturally tailor these tools for these priority populations. We then conducted a 1-month technical pilot among 21 participants to assess the usability and acceptability of the adapted interventions and optimize the functionality of these tools. RESULTS Participants in focus groups liked the "human touch" of text messages in PrEPmate and thought it would be helpful for scheduling appointments and asking questions. They liked the daily reminder messages, especially the fun facts, gender affirmations, and transgender history topics. Participants recommended changes to tailor the language and messages for Spanish-speaking and transgender populations. For DOT Diary, participants liked the adherence tracking and protection level feedback and thought the calendar functions were easy to use. Based on participant recommendations, we tailored language within the app for Spanish-speaking MSM and transgender women, simplified the sexual diary, and added motivational badges. In the technical pilot of the refined tools, mean System Usability Scale scores were 81.2/100 for PrEPmate and 76.4/100 for DOT Diary (P=.48), falling in the "good" to "excellent" range, and mean Client Satisfaction Questionnaire scores were 28.6 and 28.3 for PrEPmate and DOT Diary, respectively (maximum possible score=32). Use of both tools was high over the 1-month pilot (average of 10.5 messages received from each participant for PrEPmate; average of 17.6 times accessing the DOT Diary app), indicating good feasibility for both tools. CONCLUSIONS Using a user-centered design approach, we culturally tailored PrEPmate and DOT Diary to support daily PrEP use among Spanish-speaking MSM and English- and Spanish-speaking transgender women. Our positive findings in a technical pilot support further testing of these mHealth interventions in an upcoming comparative effectiveness trial.
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Affiliation(s)
- Albert Y Liu
- Bridge HIV, San Francisco Department of Public Health, San Francisco, CA, United States
- Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Cat-Dancing Alleyne
- Bridge HIV, San Francisco Department of Public Health, San Francisco, CA, United States
| | - Susanne Doblecki-Lewis
- Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Kimberly A Koester
- Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Rafael Gonzalez
- Bridge HIV, San Francisco Department of Public Health, San Francisco, CA, United States
| | - Janie Vinson
- Bridge HIV, San Francisco Department of Public Health, San Francisco, CA, United States
| | - Hyman Scott
- Bridge HIV, San Francisco Department of Public Health, San Francisco, CA, United States
- Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Susan Buchbinder
- Bridge HIV, San Francisco Department of Public Health, San Francisco, CA, United States
- Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Thiago S Torres
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
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Aycock CA, Mallawaarachchi I, Wang XQ, Cassidy DG, Ellis JM, Klesges RC, Talcott GW, Wiseman K. Developing a Text Messaging Intervention to Prevent Binge and Heavy Drinking in a Military Population: Mixed Methods Development Study. JMIR Form Res 2024; 8:e55041. [PMID: 38502165 PMCID: PMC10988383 DOI: 10.2196/55041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 02/09/2024] [Accepted: 02/13/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Alcohol misuse is the fourth leading cause of death in the United States and a significant problem in the US military. Brief alcohol interventions can reduce negative alcohol outcomes in civilian and military populations, but additional scalable interventions are needed to reduce binge and heavy drinking. SMS text messaging interventions could address this need, but to date, no programs exist for military populations. OBJECTIVE We aimed to develop an SMS text messaging intervention to address binge and heavy drinking among Airmen in Technical Training in the US Air Force. METHODS We implemented a 2-phase, mixed methods study to develop the SMS text messaging intervention. In phase 1, a total of 149 respondents provided feedback about the persuasiveness of 49 expert-developed messages, preferences regarding message frequency, timing and days to receive messages, and suggested messages, which were qualitatively coded. In phase 2, a total of 283 respondents provided feedback about the persuasiveness of 77 new messages, including those developed through the refinement of messages from phase 1, which were coded and assessed based on the Behavior Change Technique Taxonomy (BCTT). For both phases, mean persuasiveness scores (range 1-5) were calculated and compared according to age (aged <21 or ≥21 years) and gender. Top-ranking messages from phase 2 were considered for inclusion in the final message library. RESULTS In phase 1, top-rated message themes were about warnings about adverse outcomes (eg, impaired judgment and financial costs), recommendations to reduce drinking, and invoking values and goals. Through qualitative coding of suggested messages, we identified themes related to warnings about adverse outcomes, recommendations, prioritizing long-term goals, team and belonging, and invoking values and goals. Respondents preferred to receive 1 to 3 messages per week (124/137, 90.5%) and to be sent messages on Friday, Saturday, and Sunday (65/142, 45.8%). In phase 2, mean scores for messages in the final message library ranged from 3.31 (SD 1.29) to 4.21 (SD 0.90). Of the top 5 highest-rated messages, 4 were categorized into 2 behavior change techniques (BCTs): valued self-identity and information about health consequences. The final message library includes 28 BCTT-informed messages across 13 BCTs, with messages having similar scores across genders. More than one-fourth (8/28, 29%) of the final messages were informed by the suggested messages from phase 1. As Airmen aged <21 years face harsher disciplinary action for alcohol consumption, the program is tailored based on the US legal drinking age. CONCLUSIONS This study involved members from the target population throughout 2 formative stages of intervention development to design a BCTT-informed SMS text messaging intervention to reduce binge and heavy drinking, which is now being tested in an efficacy trial. The results will determine the impact of the intervention on binge drinking and alcohol consumption in the US Air Force.
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Affiliation(s)
- Chase A Aycock
- United States Air Force, 37th Human Performance Squadron, Joint Base San Antonio-Lackland Air Force Base, San Antonio, TX, United States
| | - Indika Mallawaarachchi
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, United States
| | - Xin-Qun Wang
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, United States
| | - Daniel G Cassidy
- United States Air Force, 37th Training Wing, Joint Base San Antonio-Lackland Air Force Base, San Antonio, TX, United States
| | - Jordan M Ellis
- United States Air Force, Wilford Hall Ambulatory Surgical Center, 59th Medical Wing, Joint Base San Antonio-Lackland Air Force Base, San Antonio, TX, United States
| | - Robert C Klesges
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, United States
| | - G Wayne Talcott
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, United States
| | - Kara Wiseman
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, United States
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Tong HL, Alnasser A, Alshahrani NZ, Bawaked RA, AlAhmed R, Alsukait RF, Rakic S, Cetinkaya V, Al-Hazzaa HM, Alqahtani SA. The Use of Mobile Technologies to Promote Physical Activity and Reduce Sedentary Behaviors in the Middle East and North Africa Region: Systematic Review and Meta-Analysis. J Med Internet Res 2024; 26:e53651. [PMID: 38502160 PMCID: PMC10988381 DOI: 10.2196/53651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 12/01/2023] [Accepted: 02/12/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND The Middle East and North Africa (MENA) region faces unique challenges in promoting physical activity and reducing sedentary behaviors, as the prevalence of insufficient physical activity is higher than the global average. Mobile technologies present a promising approach to delivering behavioral interventions; however, little is known about the effectiveness and user perspectives on these technologies in the MENA region. OBJECTIVE This study aims to evaluate the effectiveness of mobile interventions targeting physical activity and sedentary behaviors in the MENA region and explore users' perspectives on these interventions as well as any other outcomes that might influence users' adoption and use of mobile technologies (eg, appropriateness and cultural fit). METHODS A systematic search of 5 databases (MEDLINE, Embase, CINAHL, Scopus, and Global Index Medicus) was performed. Any primary studies (participants of all ages regardless of medical condition) conducted in the MENA region that investigated the use of mobile technologies and reported any measures of physical activity, sedentary behaviors, or user perceptions were included. We conducted a narrative synthesis of all studies and a meta-analysis of randomized controlled trials (RCTs). The Cochrane risk-of-bias tool was used to assess the quality of the included RCTs; quality assessment of the rest of the included studies was completed using the relevant Joanna Briggs Institute critical appraisal tools. RESULTS In total, 27 articles describing 22 interventions (n=10, 37% RCTs) and 4 (15%) nonexperimental studies were included (n=6141, 46% women). Half (11/22, 50%) of the interventions included mobile apps, whereas the other half examined SMS. The main app functions were goal setting and self-monitoring of activity, whereas SMS interventions were primarily used to deliver educational content. Users in experimental studies described several benefits of the interventions (eg, gaining knowledge and receiving reminders to be active). Engagement with the interventions was poorly reported; few studies (8/27, 30%) examined users' perspectives on the appropriateness or cultural fit of the interventions. Nonexperimental studies examined users' perspectives on mobile apps and fitness trackers, reporting several barriers to their use, such as perceived lack of usefulness, loss of interest, and technical issues. The meta-analysis of RCTs showed a positive effect of mobile interventions on physical activity outcomes (standardized mean difference=0.45, 95% CI 0.17-0.73); several sensitivity analyses showed similar results. The trim-and-fill method showed possible publication bias. Only 20% (2/10) of the RCTs measured sedentary behaviors; both reported positive changes. CONCLUSIONS The use of mobile interventions for physical activity and sedentary behaviors in the MENA region is in its early stages, with preliminary evidence of effectiveness. Policy makers and researchers should invest in high-quality studies to evaluate long-term effectiveness, intervention engagement, and implementation outcomes, which can inform the design of culturally and socially appropriate interventions for countries in the MENA region. TRIAL REGISTRATION PROSPERO CRD42023392699; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=392699.
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Affiliation(s)
- Huong Ly Tong
- Cultural and Indigenous Research Centre Australia, Redfern, Australia
- The World Bank Group, Washington, DC, United States
| | - Aroub Alnasser
- Department of Food Science and Nutrition, King Saud University, Riyadh, Saudi Arabia
| | - Najim Z Alshahrani
- Department of Family and Community Medicine, Faculty of Medicine, University of Jeddah, Jeddah, Saudi Arabia
| | - Rowaedh A Bawaked
- Department of Public Health, Saudi Electronic University, Riyadh, Saudi Arabia
| | - Reem AlAhmed
- Department of Biostatistics, Epidemiology and Scientific Computing, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | | | | | | | - Hazzaa M Al-Hazzaa
- Health Sciences Research Center, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Saleh A Alqahtani
- Organ Transplant Center of Excellence, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
- Division of Gastroenterology & Hepatology, Johns Hopkins University, Baltimore, MD, United States
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Willoughby JF, King RL, Adams PM. Development of an mHealth text message intervention to promote adherence to COVID-19 isolation recommendations for college students. J Am Coll Health 2024; 72:335-339. [PMID: 35259081 DOI: 10.1080/07448481.2022.2037615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 01/13/2022] [Accepted: 01/30/2022] [Indexed: 06/14/2023]
Abstract
Background: Important tools in preventing the spread of COVID-19 include contract tracing and adherence to isolation guidelines after a positive diagnosis of COVID-19. This is especially relevant among college students who are often away from support systems at home, living in high-density housing, and may not experience serious symptoms from COVID-19 while still contagious. Objective: As text message-based interventions have been found effective in addressing health behaviors among young adults, we conducted formative research to explore how text messaging could support students in adhering to isolation guidelines. Participants: A convenience sample of college students (n = 104) at one university. Methods: An online survey gathered students' perceptions of helpful components to include in a text message-based intervention. Results: Students expressed interest in receiving text messages with support, encouragement, and resources during their time in isolation following a COVID-19 diagnosis. Conclusions: Based on the results, we developed a text message-based intervention designed to provide motivation, support, distraction, and information on resources.
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Affiliation(s)
- Jessica Fitts Willoughby
- The Edward R. Murrow College of Communication, Washington State University, Pullman, Washington, USA
| | - Rebekah L King
- Cougar Health Services, Washington State University, Pullman, Washington, USA
| | - Paula M Adams
- Cougar Health Services, Washington State University, Pullman, Washington, USA
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9
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Hall K, Barry F, Thompson LR, Ravandi B, Hall JE, Chang TP, Halterman JS, Szilagyi PG, Okelo SO. Feasibility of text message follow-up for pediatric asthma care after an emergency department visit. J Asthma 2024; 61:140-147. [PMID: 37610221 DOI: 10.1080/02770903.2023.2248507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 08/03/2023] [Accepted: 08/11/2023] [Indexed: 08/24/2023]
Abstract
Background: Many children seen in the Emergency Department (ED) for asthma do not follow-up with their primary care provider. Text messaging via short message service (SMS) is a ubiquitous, but untested means of providing post-ED asthma follow-up care.Objective: To evaluate responses to an asthma assessment survey via SMS following an ED visit and estimate the likelihood of response by sociodemographic and clinical characteristics. Methods: We recruited 173 parents of children 2-17 years-old presenting for ED asthma care to receive a follow-up text (participation rate: 85%). One month later, parents received via SMS a 22-item survey that assessed asthma morbidity. We assessed response rates overall and by various sociodemographic and clinical characteristics, including age, parental education, and indicators of asthma severity.Results: Overall, 55% of parents (n = 95) responded to the SMS survey. In multivariable logistic regression (MLR), parents who graduated high school had a four-fold higher response rate compared to parents with less than a high school degree (OR: 4.05 (1.62, 10.13)). More parents of children with oral steroid use in the prior 12 months responded to survey items (OR: 2.53 (1.2, 5.31)). Reported asthma characteristics included: 48% uncontrolled, 22% unimproved/worse, 21% with sleep disruption, and 10% who were hospitalized for asthma.Conclusions: Text messaging may be a viable strategy to improve post-ED asthma assessment and to identify children with persistent symptoms in need of enhanced care or modification of care plans.
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Affiliation(s)
- Kaitlin Hall
- Department of Pediatrics, UCLA David Geffen School of Medicine, Los Angeles, CA, USA
| | - Frances Barry
- Frances Barry Psychotherapy Practice, Santa Monica, CA, USA
| | - Lindsey R Thompson
- Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA
| | - Bahareh Ravandi
- Division of Emergency and Transport Medicine, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern CA, Los Angeles, CA, USA
| | - Jeanine E Hall
- Division of Emergency and Transport Medicine, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern CA, Los Angeles, CA, USA
| | - Todd P Chang
- Division of Emergency and Transport Medicine, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern CA, Los Angeles, CA, USA
| | - Jill S Halterman
- Department of Pediatrics, University of Rochester School of Medicine, Rochester, NY, USA
| | - Peter G Szilagyi
- Department of Pediatrics, UCLA David Geffen School of Medicine, Los Angeles, CA, USA
| | - Sande O Okelo
- Department of Pediatrics, UCLA David Geffen School of Medicine, Los Angeles, CA, USA
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10
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Nelson LA, Spieker AJ, LeStourgeon LM, Greevy Jr RA, Molli S, Roddy MK, Mayberry LS. The Goldilocks Dilemma on Balancing User Response and Reflection in mHealth Interventions: Observational Study. JMIR Mhealth Uhealth 2024; 12:e47632. [PMID: 38297891 PMCID: PMC10850735 DOI: 10.2196/47632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 11/29/2023] [Accepted: 11/30/2023] [Indexed: 02/02/2024] Open
Abstract
Background Mobile health (mHealth) has the potential to radically improve health behaviors and quality of life; however, there are still key gaps in understanding how to optimize mHealth engagement. Most engagement research reports only on system use without consideration of whether the user is reflecting on the content cognitively. Although interactions with mHealth are critical, cognitive investment may also be important for meaningful behavior change. Notably, content that is designed to request too much reflection could result in users' disengagement. Understanding how to strike the balance between response burden and reflection burden has critical implications for achieving effective engagement to impact intended outcomes. Objective In this observational study, we sought to understand the interplay between response burden and reflection burden and how they impact mHealth engagement. Specifically, we explored how varying the response and reflection burdens of mHealth content would impact users' text message response rates in an mHealth intervention. Methods We recruited support persons of people with diabetes for a randomized controlled trial that evaluated an mHealth intervention for diabetes management. Support person participants assigned to the intervention (n=148) completed a survey and received text messages for 9 months. During the 2-year randomized controlled trial, we sent 4 versions of a weekly, two-way text message that varied in both reflection burden (level of cognitive reflection requested relative to that of other messages) and response burden (level of information requested for the response relative to that of other messages). We quantified engagement by using participant-level response rates. We compared the odds of responding to each text and used Poisson regression to estimate associations between participant characteristics and response rates. Results The texts requesting the most reflection had the lowest response rates regardless of response burden (high reflection and low response burdens: median 10%, IQR 0%-40%; high reflection and high response burdens: median 23%, IQR 0%-51%). The response rate was highest for the text requesting the least reflection (low reflection and low response burdens: median 90%, IQR 61%-100%) yet still relatively high for the text requesting medium reflection (medium reflection and low response burdens: median 75%, IQR 38%-96%). Lower odds of responding were associated with higher reflection burden (P<.001). Younger participants and participants who had a lower socioeconomic status had lower response rates to texts with more reflection burden, relative to those of their counterparts (all P values were <.05). Conclusions As reflection burden increased, engagement decreased, and we found more disparities in engagement across participants' characteristics. Content encouraging moderate levels of reflection may be ideal for achieving both cognitive investment and system use. Our findings provide insights into mHealth design and the optimization of both engagement and effectiveness.
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Affiliation(s)
- Lyndsay A Nelson
- Department of Medicine, Vanderbilt University Medical Center, NashvilleTN, United States
- Center for Health Behavior and Health Education, Vanderbilt University Medical Center, NashvilleTN, United States
| | - Andrew J Spieker
- Department of Biostatistics, Vanderbilt University Medical Center, NashvilleTN, United States
| | - Lauren M LeStourgeon
- Department of Medicine, Vanderbilt University Medical Center, NashvilleTN, United States
- Center for Health Behavior and Health Education, Vanderbilt University Medical Center, NashvilleTN, United States
| | - Robert A Greevy Jr
- Department of Biostatistics, Vanderbilt University Medical Center, NashvilleTN, United States
| | - Samuel Molli
- Department of Medicine, Vanderbilt University Medical Center, NashvilleTN, United States
- Center for Health Behavior and Health Education, Vanderbilt University Medical Center, NashvilleTN, United States
| | - McKenzie K Roddy
- Department of Medicine, Vanderbilt University Medical Center, NashvilleTN, United States
- Center for Health Behavior and Health Education, Vanderbilt University Medical Center, NashvilleTN, United States
| | - Lindsay S Mayberry
- Department of Medicine, Vanderbilt University Medical Center, NashvilleTN, United States
- Center for Health Behavior and Health Education, Vanderbilt University Medical Center, NashvilleTN, United States
- Department of Biomedical Informatics, Vanderbilt University Medical Center, NashvilleTN, United States
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Vasudevan L, Ostermann J, Thielman N, Baumgartner JN, Solomon D, Mosses A, Hobbie A, Hair NL, Liang C, van Zwetselaar M, Mfinanga S, Ngadaya E. Leveraging Community Health Workers and a Responsive Digital Health System to Improve Vaccination Coverage and Timeliness in Resource-Limited Settings: Protocol for a Cluster Randomized Type 1 Effectiveness-Implementation Hybrid Study. JMIR Res Protoc 2024; 13:e52523. [PMID: 38214956 PMCID: PMC10818232 DOI: 10.2196/52523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 10/26/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND Tanzania is 1 of 20 countries where the majority of unvaccinated and undervaccinated children reside. Prior research identified substantial rural-urban disparities in the coverage and timeliness of childhood vaccinations in Tanzania, with children in rural settings being more likely to receive delayed or no vaccinations. Further research is necessary to identify effective and scalable interventions that can bridge rural-urban gaps in childhood vaccination while accounting for multifaceted barriers to vaccination. OBJECTIVE This protocol describes a type 1 effectiveness-implementation hybrid study to evaluate Chanjo Kwa Wakati (timely vaccination in Kiswahili), a community-based digital health intervention to improve vaccination timeliness. The intervention combines human resources (community health workers), low-cost digital strategies (electronic communication, digital case management, and task automation), a vaccination knowledge intervention, and insights from behavioral economics (reminders and incentives) to promote timely childhood vaccinations. METHODS The study will be conducted in 2 predominantly rural regions in Tanzania with large numbers of unvaccinated or undervaccinated children: Shinyanga and Mwanza. Forty rural health facilities and their catchment areas (clusters) will be randomized to an early or delayed onset study arm. From each cluster, 3 cohorts of mother-child dyads (1 retrospective cohort and 2 prospective cohorts) will be enrolled in the study. The timeliness and coverage of all vaccinations recommended during the first year of life will be observed for 1200 children (n=600, 50% intervention group children and n=600, 50% nonintervention group children). The primary effectiveness outcome will be the timeliness of the third dose of the pentavalent vaccine (Penta3). Quantitative surveys, vaccination records, study logs, fidelity checklists, and qualitative interviews with mothers and key informants will inform the 5 constructs of the reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) framework. The results will be used to develop an implementation blueprint to guide future adaptations and scale-up of Chanjo Kwa Wakati. RESULTS The study was funded in August 2022. Data collection is expected to last from February 2024 to July 2027. CONCLUSIONS This study will address the lack of rigorous evidence on the effectiveness of community-based digital health interventions for promoting vaccination coverage and timeliness among children from sub-Saharan Africa and identify potential implementation strategies to facilitate the deployment of vaccination promotion interventions in low- and middle-income countries. TRIAL REGISTRATION ClinicalTrials.gov NCT06024317; https://www.clinicaltrials.gov/study/NCT06024317. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/52523.
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Affiliation(s)
- Lavanya Vasudevan
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States
- Duke Global Health Institute, Duke University, Durham, NC, United States
| | - Jan Ostermann
- Duke Global Health Institute, Duke University, Durham, NC, United States
- Department of Health Services Policy & Management, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Nathan Thielman
- Duke Global Health Institute, Duke University, Durham, NC, United States
- Department of Medicine, Duke University, Durham, NC, United States
| | - Joy Noel Baumgartner
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - David Solomon
- National Institute for Medical Research, Muhimbili Research Centre, Dar es Salaam, United Republic of Tanzania
| | - Anna Mosses
- National Institute for Medical Research, Muhimbili Research Centre, Dar es Salaam, United Republic of Tanzania
| | - Amy Hobbie
- Duke Global Health Institute, Duke University, Durham, NC, United States
| | - Nicole L Hair
- Department of Health Services Policy & Management, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Chen Liang
- Department of Health Services Policy & Management, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | | | - Sayoki Mfinanga
- National Institute for Medical Research, Muhimbili Research Centre, Dar es Salaam, United Republic of Tanzania
| | - Esther Ngadaya
- National Institute for Medical Research, Muhimbili Research Centre, Dar es Salaam, United Republic of Tanzania
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12
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Addo-Lartey AA, Bonful HA, Sefenu RS, Abagre TA, Asamoah A, Bandoh DA, Awua AK, Adu-Aryee NA, Dedey F, Adanu RMK, Okuyemi KS. Effectiveness of a culturally tailored text messaging program for promoting cervical cancer screening in accra, Ghana: a quasi-experimental trial. BMC Womens Health 2024; 24:22. [PMID: 38172883 PMCID: PMC10765844 DOI: 10.1186/s12905-023-02867-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 12/25/2023] [Indexed: 01/05/2024] Open
Abstract
INTRODUCTION Despite breakthroughs in cervical cancer detection, resource-constrained countries continue to have a disproportionately high incidence and death rate. Mhealth has been identified as an important tool for increasing cervical cancer screening rates in Sub-Saharan Africa. We determined whether sending Ghanaian women culturally tailored one-way mobile phone SMS text messages about cervical cancer would encourage the uptake of the human papillomavirus (HPV) test. METHODS From August to November 2016, 88 women aged 18 to 39 living or working in an urban community (Accra, Ghana) participated in a quasi-experimental study. For 8 weeks, 32 SMS messages regarding cervical cancer were developed and sent to the personal phones of intervention arm participants (n = 42). Women in the control group (n = 46) received SMS texts with general health and lifestyle advice. Fischer's exact tests were performed to assess cervical cancer screening uptake and associated reasons for non-uptake between the intervention and control groups (p < 0.05). RESULTS At the baseline, women differed in terms of ethnicity and wealth. After the intervention, participants' self-reported risk factors for cervical cancer, such as early menarche, usual source of medical treatment, family history of cancer, smoking, and alcohol history, changed. None of the women in the intervention group sought cervical cancer screening after the intervention, but only one (2.2%) of the control arm participants did. Almost all the women (> 95%) agreed that an HPV test was essential and that regular healthcare check-ups could help prevent cervical cancer. Some women believed that avoiding particular foods could help prevent cervical cancer (23.8% intervention vs. 58.7% control, p < 0.001). Time constraints and out-of-pocket expenses were significant barriers to cervical cancer screening. CONCLUSION A one-way SMS delivered to urban women did not increase cervical cancer screening attendance. The time spent in screening facilities and the lack of coverage by the National Health Insurance Scheme limited screening uptake. We urge for the establishment of screening centers in all healthcare facilities, as well as the inclusion of cervical cancer screening in healthcare programs through cost-sharing.
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Affiliation(s)
| | - Harriet Affran Bonful
- Department of Epidemiology and Disease Control, University of Ghana School of Public Health, Accra, Ghana.
| | - Ransford Selasi Sefenu
- Department of Epidemiology and Disease Control, University of Ghana School of Public Health, Accra, Ghana
| | - Timothy Agandah Abagre
- Department of Epidemiology and Disease Control, University of Ghana School of Public Health, Accra, Ghana
| | - Alexander Asamoah
- Department of Epidemiology and Disease Control, University of Ghana School of Public Health, Accra, Ghana
| | - Delia Akosua Bandoh
- Department of Epidemiology and Disease Control, University of Ghana School of Public Health, Accra, Ghana
| | - Adolf Kofi Awua
- Cellular and Clinical Research Center, Radiological and Medical Sciences Research Institute, Ghana Atomic Energy Commission. Kwabenya, Accra, Ghana
| | - Nii Armah Adu-Aryee
- Department of Surgery, School of Medicine and Dentistry, University of Ghana, Accra, Ghana
| | - Florence Dedey
- Department of Surgery, School of Medicine and Dentistry, University of Ghana, Accra, Ghana
| | - Richard Mawuena Kofi Adanu
- Department of Population and Family Health, University of Ghana School of Public Health to Ghana College of Physicians and Surgeons, Accra, Ghana
| | - Kolawole Stephen Okuyemi
- Department of Family and Preventive Medicine, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, USA
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Zamanillo-Campos R, Fiol-DeRoque MA, Serrano-Ripoll MJ, Mira-Martínez S, Llobera-Canaves J, Taltavull-Aparicio JM, Leiva-Rus A, Ripoll-Amengual J, Angullo-Martínez E, Socias-Buades IM, Masmiquel-Comas L, Konieczna J, Zaforteza-Dezcallar M, Boronat-Moreiro MA, Gervilla-García E, Ricci-Cabello I. DiabeText, a mobile health intervention to support medication taking and healthy lifestyle in adults with type 2 diabetes: Study protocol for a randomized controlled trial. Contemp Clin Trials 2024; 136:107399. [PMID: 37995967 DOI: 10.1016/j.cct.2023.107399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 10/31/2023] [Accepted: 11/18/2023] [Indexed: 11/25/2023]
Abstract
AIM To evaluate the effectiveness of DiabeText, a low-intensity, multifaceted, mobile health (mHealth) intervention to support medication taking and lifestyle change targeted to people with type 2 diabetes (T2D). DESIGN Phase III, 12-months, two-arm (1:1 allocation ratio), randomized parallel-group trial. METHODS We will recruit 740 adults with glycated hemoglobin (A1c) >8% (>64 mmol/mol) and with at least one prescription of a non-insulin antidiabetic drug. They will be allocated to a control (usual care) group or an intervention (DiabeText messaging intervention) group. The primary outcome measure will be A1c at 12 months follow-up. Secondary outcomes will include medication possession ratio and behavioral and psychological outcomes. DISCUSSION Recent trials suggest that digital health interventions can effectively support diabetes self-management improving T2D control and reducing important T2D complications. In Spain this type of interventions is understudied. IMPACT This trial will strengthen the evidence base of the impact of mHealth interventions to support diabetes self-management. If effective, DiabeText may offer a low-cost and highly scalable strategy to improve health at the population level in a sustainable way. TRIAL REGISTRATION ClinicalTrials.gov identifier NCT05006872; Official Title: Supporting People with Type 2 Diabetes in Effective Use of their Medicine Through a System Comprising Mobile Health Technology Integrated with Clinical Care.
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Affiliation(s)
- Rocío Zamanillo-Campos
- Research Group on Primary Care and Promotion of the Balearic Islands Community (GRAPP-caIB), Health Research Institute of the Balearic Islands (IdISBa), Carretera de Valldemossa, 79, University Hospital Son Espases (HUSE), Palma, Spain; Primary Care Research Unit of Mallorca, Balearic Islands Health Service, Carrer de l'Escola Graduada, n° 3, 07002 Palma, Spain
| | - Maria Antonia Fiol-DeRoque
- Research Group on Primary Care and Promotion of the Balearic Islands Community (GRAPP-caIB), Health Research Institute of the Balearic Islands (IdISBa), Carretera de Valldemossa, 79, University Hospital Son Espases (HUSE), Palma, Spain; Primary Care Research Unit of Mallorca, Balearic Islands Health Service, Carrer de l'Escola Graduada, n° 3, 07002 Palma, Spain.
| | - Maria Jesús Serrano-Ripoll
- Research Group on Primary Care and Promotion of the Balearic Islands Community (GRAPP-caIB), Health Research Institute of the Balearic Islands (IdISBa), Carretera de Valldemossa, 79, University Hospital Son Espases (HUSE), Palma, Spain; Primary Care Research Unit of Mallorca, Balearic Islands Health Service, Carrer de l'Escola Graduada, n° 3, 07002 Palma, Spain; Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS, RD21/0016/0005), Gran Via de les Corts Catalanes, 587, 08007 Barcelona, Spain
| | - Sofía Mira-Martínez
- Research Group on Primary Care and Promotion of the Balearic Islands Community (GRAPP-caIB), Health Research Institute of the Balearic Islands (IdISBa), Carretera de Valldemossa, 79, University Hospital Son Espases (HUSE), Palma, Spain; Primary Care Research Unit of Mallorca, Balearic Islands Health Service, Carrer de l'Escola Graduada, n° 3, 07002 Palma, Spain
| | - Joan Llobera-Canaves
- Research Group on Primary Care and Promotion of the Balearic Islands Community (GRAPP-caIB), Health Research Institute of the Balearic Islands (IdISBa), Carretera de Valldemossa, 79, University Hospital Son Espases (HUSE), Palma, Spain; Primary Care Research Unit of Mallorca, Balearic Islands Health Service, Carrer de l'Escola Graduada, n° 3, 07002 Palma, Spain; Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS, RD21/0016/0005), Gran Via de les Corts Catalanes, 587, 08007 Barcelona, Spain
| | - Joana María Taltavull-Aparicio
- Research Group on Primary Care and Promotion of the Balearic Islands Community (GRAPP-caIB), Health Research Institute of the Balearic Islands (IdISBa), Carretera de Valldemossa, 79, University Hospital Son Espases (HUSE), Palma, Spain; Primary Care Research Unit of Mallorca, Balearic Islands Health Service, Carrer de l'Escola Graduada, n° 3, 07002 Palma, Spain
| | - Alfonso Leiva-Rus
- Research Group on Primary Care and Promotion of the Balearic Islands Community (GRAPP-caIB), Health Research Institute of the Balearic Islands (IdISBa), Carretera de Valldemossa, 79, University Hospital Son Espases (HUSE), Palma, Spain; Primary Care Research Unit of Mallorca, Balearic Islands Health Service, Carrer de l'Escola Graduada, n° 3, 07002 Palma, Spain; Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS, RD21/0016/0005), Gran Via de les Corts Catalanes, 587, 08007 Barcelona, Spain
| | - Joana Ripoll-Amengual
- Research Group on Primary Care and Promotion of the Balearic Islands Community (GRAPP-caIB), Health Research Institute of the Balearic Islands (IdISBa), Carretera de Valldemossa, 79, University Hospital Son Espases (HUSE), Palma, Spain; Primary Care Research Unit of Mallorca, Balearic Islands Health Service, Carrer de l'Escola Graduada, n° 3, 07002 Palma, Spain
| | - Escarlata Angullo-Martínez
- Primary Care Research Unit of Mallorca, Balearic Islands Health Service, Carrer de l'Escola Graduada, n° 3, 07002 Palma, Spain
| | - Isabel Maria Socias-Buades
- Primary Care Research Unit of Mallorca, Balearic Islands Health Service, Carrer de l'Escola Graduada, n° 3, 07002 Palma, Spain
| | - Luis Masmiquel-Comas
- Primary Care Research Unit of Mallorca, Balearic Islands Health Service, Carrer de l'Escola Graduada, n° 3, 07002 Palma, Spain
| | - Jadwiga Konieczna
- Research Group on Nutritional Epidemiology & Cardiovascular Physiopathology (NUTRECOR), Health Research Institute of the Balearic Islands (IdISBa), Carretera de Valldemossa, 79, University Hospital Son Espases (HUSE), Palma, Spain; CIBER de Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Av. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
| | - María Zaforteza-Dezcallar
- Pharmacy Service, Balearic Islands Health Service, Carrer Reina Esclaramunda n° 9, 07003 Palma, Spain
| | | | - Elena Gervilla-García
- Psychology Department, University of the Balearic Islands (UIB), Palma de Mallorca, Spain; Statistical and Psychometric Procedures Applied in Health Science, University of the Balearic Islands (UIB), Palma de Mallorca, Spain
| | - Ignacio Ricci-Cabello
- Research Group on Primary Care and Promotion of the Balearic Islands Community (GRAPP-caIB), Health Research Institute of the Balearic Islands (IdISBa), Carretera de Valldemossa, 79, University Hospital Son Espases (HUSE), Palma, Spain; Primary Care Research Unit of Mallorca, Balearic Islands Health Service, Carrer de l'Escola Graduada, n° 3, 07002 Palma, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Av. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
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Turvey C, Fuhrmeister L, Klein D, McCoy K, Moeckli J, Stewart Steffensmeier KR, Suiter N, Van Tiem J. Secure Messaging Intervention in Patients Starting New Antidepressant to Promote Adherence: Pilot Randomized Controlled Trial. JMIR Form Res 2023; 7:e51277. [PMID: 38064267 PMCID: PMC10746966 DOI: 10.2196/51277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 10/17/2023] [Accepted: 10/19/2023] [Indexed: 12/25/2023] Open
Abstract
BACKGROUND There are a range of effective pharmacological and behavioral treatments for depression. However, approximately one-third of patients discontinue antidepressants within the first month of treatment and 44% discontinue them by the third month of treatment. The major reasons reported for discontinuation were side effect burden, patients experiencing that the medications were not working, and patients wanting to resolve their depression without using medication. OBJECTIVE This study tested the acceptability, feasibility, and preliminary effectiveness of an SMS messaging intervention designed to improve antidepressant adherence and depression outcomes in veterans. The intervention specifically targeted the key reasons for antidepressant discontinuation. For example, the secure message included reminders that it can take up to 6 weeks for an antidepressant to work, or prompts to call their provider should the side effect burden become significant. METHODS This pilot was a 3-armed randomized controlled trial of 53 veterans undergoing depression treatment at the Iowa City Veterans Affairs Health Care System. Veterans starting a new antidepressant were randomized to secure messaging only (SM-Only), secure messaging with coaching (SM+Coach), or attention control (AC) groups. The intervention lasted 12 weeks with follow-up assessments of key outcomes at 6 and 12-weeks. This included a measure of antidepressant adherence, depressive symptom severity, and side effect burden. RESULTS The 2 active interventions (SM-Only and SM+Coach) demonstrated small to moderate effect sizes (ESs) in improving antidepressant adherence and reducing side effect burden. They did not appear to reduce the depressive symptom burden any more than in the AC arm. Veteran participants in the SM arms demonstrated improved medication adherence from baseline to 12 weeks on the Medication Adherence Rating Scale compared with those in the AC arm, who had a decline in adherence (SM-Only: ES=0.09; P=.19; SM+Coach: ES=0.85; P=.002). Depression scores on the 9-Item Patient Health Questionnaire decreased for all 3 treatment arms, although the decline was slightly larger for the SM-Only (ES=0.32) and the SM+Coach (ES=0.24) arms when compared with the AC arm. The 2 intervention arms indicated a decrease in side effects on the Frequency, Intensity, and Burden of Side Effects Ratings, whereas the side effect burden for the AC arm increased. These differences indicated moderate ES (SM-Only vs AC: ES=0.40; P=.07; SM+Coach: ES=0.54; P=.07). CONCLUSIONS A secure messaging program targeting specific reasons for antidepressant discontinuation had small-to-moderate ES in improving medication adherence. Consistent with prior research, the intervention that included brief synchronic meetings with a coach appeared to have a greater benefit than the SMS-alone intervention. Veterans consistently engaged with the SMS messaging in both treatment arms throughout the study period. They additionally provided feedback on which texts were most helpful, tending to prefer messages providing overall encouragement rather than specific wellness recommendations. TRIAL REGISTRATION ClinicalTrials.gov NCT03930849; https://clinicaltrials.gov/study/NCT03930849.
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Affiliation(s)
- Carolyn Turvey
- Center for Access and Delivery Research and Evaluation, Iowa City VA Health Care System, Iowa City, IA, United States
- Office Rural Health Veterans Rural Health Resource Center, Iowa City, IA, United States
- Department of Psychiatry, Carver College of Medicine, University of Iowa, Iowa City, IA, United States
| | - Lindsey Fuhrmeister
- Center for Access and Delivery Research and Evaluation, Iowa City VA Health Care System, Iowa City, IA, United States
- Department of Psychiatry, Carver College of Medicine, University of Iowa, Iowa City, IA, United States
| | | | - Kimberly McCoy
- Center for Access and Delivery Research and Evaluation, Iowa City VA Health Care System, Iowa City, IA, United States
- Office Rural Health Veterans Rural Health Resource Center, Iowa City, IA, United States
| | - Jane Moeckli
- Center for Access and Delivery Research and Evaluation, Iowa City VA Health Care System, Iowa City, IA, United States
- Office Rural Health Veterans Rural Health Resource Center, Iowa City, IA, United States
| | - Kenda R Stewart Steffensmeier
- Center for Access and Delivery Research and Evaluation, Iowa City VA Health Care System, Iowa City, IA, United States
- Office Rural Health Veterans Rural Health Resource Center, Iowa City, IA, United States
| | - Natalie Suiter
- Center for Access and Delivery Research and Evaluation, Iowa City VA Health Care System, Iowa City, IA, United States
- Office Rural Health Veterans Rural Health Resource Center, Iowa City, IA, United States
| | - Jen Van Tiem
- Center for Access and Delivery Research and Evaluation, Iowa City VA Health Care System, Iowa City, IA, United States
- Office Rural Health Veterans Rural Health Resource Center, Iowa City, IA, United States
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Choi SK, Bauermeister J, Tingler RC, Johnson S, Macagna N, Ho K, Hoesley C, Liu A, Kayange N, Palanee-Phillips T, Chariyalertsak S, Gonzales P, Piper JM. A latent trajectory analysis of young sexual and gender minorities' adherence to three rectal microbicide placebo formulations (MTN-035; a randomized crossover trial). BMC Public Health 2023; 23:2464. [PMID: 38066471 PMCID: PMC10709877 DOI: 10.1186/s12889-023-17368-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 11/28/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Rectal microbicides (RM) are biomedical HIV prevention products that aim to prevent or reduce the transmission of HIV and other sexually transmitted infections (STIs). RM modalities may be beneficial for populations who have complex lifestyles, difficulties adhering to pre-exposure prophylaxis (PrEP) regimens, and/or have limited access to care. MTN-035 (DESIRE; Developing and Evaluating Short-Acting Innovations for Rectal Use), a randomized crossover trial, aimed to evaluate the safety and acceptability of, and adherence to, three placebo RM modalities (douche, insert, and suppository) prior to receptive anal intercourse. METHODS We conducted latent trajectory analysis to identify clusters of individuals who shared similar trajectories in acceptability and adherence for each product (douche, insert, and suppository) over time. We analyzed weekly short messaging service (SMS) use reports for each modality as reported by enrolled sexual and gender minority (SGM) participants. RESULTS Two trajectories for each product were identified: a "protocol compliant" trajectory (i.e., at least one product use occasion per week) and "high use" trajectory (i.e., more than three product use occasions per week). Participants with high use were more likely to lack access to PrEP and have higher intentions to utilize RM modalities compared to those who were protocol compliant. CONCLUSIONS This study highlighted high adherence to RM modalities among SGM. As research into viable HIV prevention modalities continues to evolve, tailored intervention strategies are needed to support the uptake of and adherence to alternative prevention modalities that are behaviorally congruent with targeted users. TRIAL REGISTRATION NCT03671239 (14/09/2018).
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Affiliation(s)
- Seul Ki Choi
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, 418 Curie Blvd, Room 235L, Philadelphia, PA, 19104, USA.
| | - José Bauermeister
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, 418 Curie Blvd, Room 235L, Philadelphia, PA, 19104, USA
| | - Ryan C Tingler
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, 418 Curie Blvd, Room 235L, Philadelphia, PA, 19104, USA
| | | | | | - Ken Ho
- Magee-Women's Research Institute, Pittsburgh, PA, USA
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Craig Hoesley
- University of Alabama at Birmingham, Birmingham, AL, USA
| | - Albert Liu
- San Francisco Department of Public Health, San Francisco, CA, USA
| | - Noel Kayange
- Johns Hopkins University Research Project, Blantyre, Malawi
| | - Thesla Palanee-Phillips
- Faculty of Health Sciences, School of Public Health, Wits Reproductive Health and HIV Institute, University of the Witwatersrand, Johannesburg, South Africa
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, USA
| | - Suwat Chariyalertsak
- Faculty of Public Health, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
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Noronha JA, Lewis MS, Phagdol T, Nayak BS, D A, Shetty J, N R, Nair S. Efficacy of mHealth Interventions for Improving Maternal and Neonatal Outcomes Among Pregnant Women With Hypertensive Disorders: Protocol for a Systematic Review. JMIR Res Protoc 2023; 12:e51792. [PMID: 38015596 DOI: 10.2196/51792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 09/20/2023] [Accepted: 09/21/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Hypertension is one of the most prevalent medical conditions that arise during pregnancy, resulting in maternal and neonatal complications. Mobile health (mHealth) has emerged as an innovative intervention for delivering maternal and child health care services. The evidence on the effectiveness of mHealth interventions in improving the health outcomes of pregnant women with hypertensive disorders is lacking. Therefore, there is a need for evidence synthesis using systematic review methods to address this evidence gap. OBJECTIVE This review aims to determine the efficacy of mHealth interventions in improving maternal and neonatal outcomes among pregnant women with hypertensive disorders. The review will answer the following research questions: (1) What are the types of mHealth interventions used in pregnant women with hypertensive disorders? (2) Are the various mHealth interventions effective in improving maternal and neonatal health outcomes, health behaviors, and their knowledge of the disease? and (3) Are mHealth interventions effective in supporting health care providers to make health care decisions for pregnant women with hypertensive disorders? METHODS This review will include randomized controlled trials, nonrandomized controlled trials, and cohort studies focusing on mHealth interventions for pregnant women with hypertensive disorders. Studies reporting health care providers use of mHealth interventions in caring for pregnant women with hypertensive disorders will be included. The search strategy will be tailored to each database using database-specific search terms. The search will be conducted in PubMed-MEDLINE, ProQuest, CINAHL, Scopus, Web of Science, and CENTRAL. Other literature sources, such as trial registries and bibliographies of relevant studies, will be additionally searched. Studies published in English from January 2000 to January 2023 will be included. A total of 2 review authors will independently perform the data extraction and the quality appraisal. For quality appraisal of randomized controlled trials, the Cochrane Risk of Bias 2 tool will be used. The Risk of Bias in Nonrandomized Studies of Interventions (ROBINS-1) tool will be used for nonrandomized controlled trials, and the Critical Appraisal Skills Programme checklist for cohort studies will be used. Any disagreements between the 2 reviewers will be resolved through discussion and a third reviewer if required. A meta-analysis will be performed based on the availability of the data. RESULTS As per the protocol, the study methodology was followed, and 2 independent reviewers conducted the search in 6 databases and clinical registries. Currently, the review is in the full-text screening stage. The review will publish the results in the first quarter of 2024. CONCLUSIONS The evidence synthesized from this systematic review will help guide future research, support health care decisions, and inform policy makers on the effectiveness of mHealth interventions in improving the maternal and neonatal outcomes of pregnant women with hypertensive disorders. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/51792.
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Affiliation(s)
- Judith Angelitta Noronha
- Department of Obstetrics and Gynecological Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Udupi, India
| | - Mitchelle S Lewis
- Department of Fundamentals of Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, India
| | - Tenzin Phagdol
- Department of Child Health Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, India
| | - Baby S Nayak
- Department of Child Health Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, India
| | - Anupama D
- Department of Global Health, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India
| | - Jyothi Shetty
- Department of Obstetrics and Gynecology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Ravishankar N
- Department of Biostatistics, Vallabhai Patel Chest Institute, University of Delhi, New Delhi, India
| | - Sreekumaran Nair
- Medical Biometrics & Informatics (Biostatistics), JIPMER, Pondicherry, India
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Kılınç T, Karaman Özlü Z, İlgin VE, Yayla A, Dişçi E. The Effect of Informing Patients Who Will Undergo a Colonoscopy via Short Messaging Service on the Procedure Quality and Satisfaction: An Endoscopist-Blinded, Randomized Controlled Trial. J Perianesth Nurs 2023:S1089-9472(23)00973-5. [PMID: 37999686 DOI: 10.1016/j.jopan.2023.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 08/24/2023] [Accepted: 09/14/2023] [Indexed: 11/25/2023]
Abstract
PURPOSE The present research was carried out to determine the impact of informing patients who would undergo a colonoscopy via short messaging service (SMS) on the procedure quality and satisfaction. DESIGN The study was designed as a randomized controlled experimental and single-blind. METHODS The study was completed with 170 patients (87 in the control group and 83 in the intervention group). Verbal and written information about bowel preparation was provided to all patients at the first appointment. Additionally, a total of nine informative SMS, including the time of colonoscopy, dietary restrictions to be followed, purgative drugs to be used, and the time of taking the drugs, were sent to the patients in the intervention group starting 2 days before the procedure. Data were collected using a patient questionnaire, Boston Bowel Preparation Scale (BBPS), and postcolonoscopy follow-up form. FINDINGS The mean score of each colon segment and the total BBPS mean score of the patients in the intervention group were higher compared to the control group, and the difference between them was statistically significant. The percentage of patients with adequate bowel preparation was significantly higher in the intervention group (84.3%) in comparison with the control group (71.3%). The intervention group had high compliance with a clear diet, enema application, and oral medication intake (P < .05). The cecum was reached in 85.5% of the intervention group. The majority of the patients (89.2%) in the intervention group reported that the information provided via SMS was adequate, and 91.6% were satisfied with the information provided by SMS. CONCLUSIONS The study shows that, in addition to written and verbal information provided before colonoscopy, SMS information positively impacts the quality of patients' bowel preparation, increases their compliance with the preparation instructions, the rate of reaching the cecum, and their satisfaction. Patient education with this practice can help ensure adequate bowel preparation quality and increase patient comfort in the colonoscopy procedure.
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Affiliation(s)
- Tülay Kılınç
- Faculty of Nursing, Department of Surgical Nursing, Atatürk University, Erzurum, Turkey.
| | - Zeynep Karaman Özlü
- Faculty of Nursing, Department of Surgical Nursing, Anesthesiology Clinical Research Office, Ataturk University, Erzurum, Turkey
| | - Vesile Eskici İlgin
- Faculty of Nursing, Department of Surgical Nursing, Atatürk University, Erzurum, Turkey
| | - Ayşegül Yayla
- Faculty of Nursing, Department of Surgical Nursing, Atatürk University, Erzurum, Turkey
| | - Esra Dişçi
- Faculty of Medicine, Department of General Surgery, Atatürk University, Erzurum, Turkey
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Ross E, Al Ozairi E, Al Qabandi N, Jamison R. Optimizing an mHealth Program to Promote Type 2 Diabetes Prevention in High-Risk Individuals: Cross-Sectional Questionnaire Study. JMIR Form Res 2023; 7:e45977. [PMID: 37843911 PMCID: PMC10616742 DOI: 10.2196/45977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 08/18/2023] [Accepted: 09/11/2023] [Indexed: 10/17/2023] Open
Abstract
BACKGROUND We evaluated the outcomes of a pilot SMS text messaging-based public health campaign that identified social networking nodes and variations of response rates to develop a list of variables that could be used to analyze and develop an outreach strategy that would maximize the impact of future public health campaigns planned for Kuwait. Computational analysis of connections has been used to analyze the spread of infectious diseases, dissemination of new thoughts and ideas, efficiency of logistics networks, and even public health care campaigns. Percolation theory network analysis provides a mathematical alternative to more established heuristic approaches that have been used to optimize network development. We report on a pilot study designed to identify and treat subjects at high risk of developing type 2 diabetes mellitus in Kuwait. OBJECTIVE The aim of this study was to identify ways to optimize efficient deployment of resources and improve response rates in a public health campaign by using variables identified in this secondary analysis of our previously published data (Alqabandi et al, 2020). This analysis identified key variables that could be used in a computational analysis to plan for future public health campaigns. METHODS SMS text message screening posts were sent inviting recipients to answer 6 questions to determine their risk of developing type 2 diabetes mellitus. If subjects agreed to participate, a link to the Centers for Disease Control and Prevention prediabetes screening test was automatically transmitted to their mobile devices. The phone numbers used in this campaign were recorded and compared to the responses received through SMS text messaging and social media forwarding. RESULTS A total of 180,000 SMS text messages through 5 different campaigns were sent to 6% of the adult population in Kuwait. A total of 260 individuals agreed to participate, of which 153 (58.8%) completed the screening. Remarkably, 367 additional surveys were received from individuals who were not invited by the original circulated SMS text messages. These individuals were invited through forwarded surveys from the original recipients after authentication with the study center. The original SMS text messages were found to successfully identify influencers in existing social networks to improve the efficacy of the public health campaign. CONCLUSIONS SMS text messaging-based health care screening campaigns were found to have limited effectiveness alone; however, the increased reach through shared second-party forwarding suggests the potential of exponentially expanding the reach of the study and identifying a higher percentage of eligible candidates through the use of percolation theory. Future research should be directed toward designing SMS text messaging campaigns that support a combination of SMS text message invitations and social networks along with identification of influential nodes and key variables, which are likely unique to the environment and cultural background of the population, using percolation theory modeling and chatbots.
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Affiliation(s)
- Edgar Ross
- Atrius Healthcare, Harvard Medical School, Burlington, MA, United States
| | | | | | - Robert Jamison
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
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Kazi S, Truesdale C, Ryan P, Wiesner G, Jennings G, Chow C. Initial Implementation of the My Heart, My Life Program by the National Heart Foundation of Australia: Pilot Mixed Methods Evaluation Study. JMIR Cardio 2023; 7:e43889. [PMID: 37796544 PMCID: PMC10587802 DOI: 10.2196/43889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 02/28/2023] [Accepted: 05/18/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Coronary heart disease (CHD) remains the leading cause of death in Australia, with a high residual risk of repeat events in survivors. Secondary prevention therapy is crucial for reducing the risk of both death and other major adverse cardiac events. The National Heart Foundation of Australia has developed a consumer-facing support program called My Heart, My Life (MHML) to address the gap in the secondary prevention of CHD in Australia. The MHML pilot program supplies advice and support for both patients and their caregivers, and it was conducted over 8 months from November 2019 to June 2020. OBJECTIVE This study aims to describe and examine the implementation of a novel multimodality secondary CHD prevention pilot program called MHML, which was delivered through booklets, text messages, emails, and telephone calls. METHODS This pilot study consists of a mixed methods evaluation involving surveys of participants (patients and caregivers) and health professionals, in-depth interviews, and digital communication (SMS text message, electronic direct mail, and call record analytics). This study was performed in people older than 18 years with acute coronary syndrome or angina and their caregivers in 38 Australian hospitals from November 2019 to June 2020 through the National Heart Foundation of Australia web page. The main outcome measures were reach, accessibility, feasibility, barriers, and enablers to implementation of this program. RESULTS Of the 1004 participants (838 patients and 164 caregivers; 2 missing), 60.9% (608/1001) were males, 50.7% (491/967) were aged between 45 and 64 years, 27.4% (276/1004) were from disadvantaged areas, 2.5% (24/946) were from Aboriginal or Torres Strait Islander background, and 16.9% (170/1004) reported English as their second language. The participants (patients and their caregivers) and health professionals reported high satisfaction with the MHML program (55/62, 88.7% and 33/38, 87%, respectively). Of the 62 participants who took the survey, 88% (55/62) used the text messaging service and reported a very high level of satisfaction. Approximately 94% (58/62) and 89% (55/62) of the participants were satisfied with the quick guide booklets 1 and 2, respectively; 79% (49/62) were satisfied with the monthly email journey and 71% (44/62) were satisfied with the helpline calls. Most participants reported that the MHML program improved preventive behaviors, that is, 73% (45/62) of them reported that they maintained increased physical activity and 84% (52/62) reported that they maintained a healthy diet even after the MHML program. CONCLUSIONS The findings of our pilot study suggest that a multimodal support program, including digital, print, phone, and web-based media, for the secondary prevention of CHD is useful and could be a potential means of providing customized at-scale secondary prevention support for survivors of acute coronary syndrome.
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Affiliation(s)
- Samia Kazi
- The University of Sydney, Sydney, Australia
- Westmead Applied Research Centre, Westmead, Australia
| | | | - Pauline Ryan
- The National Heart Foundation, Melbourne, Australia
| | - Glen Wiesner
- The National Heart Foundation, Melbourne, Australia
| | - Garry Jennings
- The University of Sydney, Sydney, Australia
- The National Heart Foundation, Melbourne, Australia
| | - Clara Chow
- The University of Sydney, Sydney, Australia
- Westmead Applied Research Centre, Westmead, Australia
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Krasuska M, Davidson EM, Beune E, Jenum AK, Gill JM, Stronks K, van Valkengoed IG, Diaz E, Sheikh A. A Culturally Adapted Diet and Physical Activity Text Message Intervention to Prevent Type 2 Diabetes Mellitus for Women of Pakistani Origin Living in Scotland: Formative Study. JMIR Form Res 2023; 7:e33810. [PMID: 37713245 PMCID: PMC10541642 DOI: 10.2196/33810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 12/20/2022] [Accepted: 01/31/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND Individuals of South Asian origin are at an increased risk of developing type 2 diabetes mellitus (T2DM) compared with other ethnic minority groups. Therefore, there is a need to develop interventions to address, and reduce, this heightened risk. OBJECTIVE We undertook formative work to develop a culturally adapted diet and physical activity text message intervention to prevent T2DM for women of Pakistani origin living in Scotland. METHODS We used a stepwise approach that was informed by the Six Steps in Quality Intervention Development framework, which consisted of gathering evidence through literature review and focus groups (step 1), developing a program theory for the intervention (step 2), and finally developing the content of the text messages and an accompanying delivery plan (step 3). RESULTS In step 1, we reviewed 12 articles and identified 3 key themes describing factors impacting on diet and physical activity in the context of T2DM prevention: knowledge on ways to prevent T2DM through diet and physical activity; cultural, social, and gender norms; and perceived level of control and sense of inevitability over developing T2DM. The key themes that emerged from the 3 focus groups with a total of 25 women were the need for interventions to provide "friendly encouragement," "companionship," and a "focus on the individual" and also for the text messages to "set achievable goals" and include "information on cooking healthy meals." We combined the findings of the focus groups and literature review to create 13 guiding principles for culturally adapting the text messages. In step 2, we developed a program theory, which specified the main determinants of change that our text messages should aim to enhance: knowledge and skills, sense of control, goal setting and planning behavior, peer support, and norms and beliefs guiding behavior. In step 3, we used both the intervention program theory and guiding principles to develop a set of 73 text messages aimed at supporting a healthy diet and 65 text messages supporting increasing physical activity. CONCLUSIONS We present a theory-based approach to develop a culturally adapted diet and physical activity text message intervention to prevent T2DM for women of Pakistani origin living in Scotland. This study outlines an approach that may also be applicable to the development of interventions for other ethnic minority populations in diverse settings. There is now a need to build on this formative work and undertake a feasibility trial of a text message-based diet and physical activity intervention to prevent T2DM for women of Pakistani origin living in Scotland.
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Affiliation(s)
- Marta Krasuska
- Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Emma M Davidson
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Erik Beune
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, Netherlands
| | - Anne Karen Jenum
- General Practice Research Unit (AFE), Department of General Practice, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Jason Mr Gill
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Karien Stronks
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, Netherlands
| | - Irene Gm van Valkengoed
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, Netherlands
| | - Esperanza Diaz
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Aziz Sheikh
- Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
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21
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Ma Y, Liu L, Zhou X, Tian T, Xu S, Li D, Li C, Li Y. Optimizing Straw-Rotting Cultivation for Sustainable Edible Mushroom Production: Composting Spent Mushroom Substrate with Straw Additions. J Fungi (Basel) 2023; 9:925. [PMID: 37755033 PMCID: PMC10532571 DOI: 10.3390/jof9090925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 09/03/2023] [Accepted: 09/09/2023] [Indexed: 09/28/2023] Open
Abstract
In recent years, the optimization of straw-rotting formulations for cultivating edible mushrooms and the management of the resulting spent mushroom substrate have emerged as new challenges. This study aimed to investigate the composting of spent mushroom substrate produced from mushroom cultivation with various straw additions, under conditions where chicken manure was also used. Parameters measured during the composting process included temperature, pH, electrical conductivity (EC), germination index (GI), moisture, and total nitrogen content. Additionally, changes in nutrient content within the compost piles before and after composting were determined, and the variations in bacterial and fungal communities across different treatments before and after composting were analyzed using 16S rRNA and ITS sequencing. The results indicated that the spent mushroom substrate produced by adding 20% straw during mushroom cultivation was more suitable for composting treatment. The findings suggest that incorporating an appropriate amount of straw in mushroom cultivation can facilitate subsequent composting of spent mushroom substrate, providing an effective strategy for both environmental protection and cost reduction.
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Affiliation(s)
- Yongsheng Ma
- Engineering Research Center of Edible and Medicinal Fungi, Ministry of Education, Jilin Agricultural University, Changchun 130118, China; (Y.M.); (L.L.); (X.Z.); (T.T.); (S.X.); (D.L.); (Y.L.)
| | - Lingyun Liu
- Engineering Research Center of Edible and Medicinal Fungi, Ministry of Education, Jilin Agricultural University, Changchun 130118, China; (Y.M.); (L.L.); (X.Z.); (T.T.); (S.X.); (D.L.); (Y.L.)
| | - Xiaoyan Zhou
- Engineering Research Center of Edible and Medicinal Fungi, Ministry of Education, Jilin Agricultural University, Changchun 130118, China; (Y.M.); (L.L.); (X.Z.); (T.T.); (S.X.); (D.L.); (Y.L.)
| | - Tian Tian
- Engineering Research Center of Edible and Medicinal Fungi, Ministry of Education, Jilin Agricultural University, Changchun 130118, China; (Y.M.); (L.L.); (X.Z.); (T.T.); (S.X.); (D.L.); (Y.L.)
| | - Shuai Xu
- Engineering Research Center of Edible and Medicinal Fungi, Ministry of Education, Jilin Agricultural University, Changchun 130118, China; (Y.M.); (L.L.); (X.Z.); (T.T.); (S.X.); (D.L.); (Y.L.)
| | - Dan Li
- Engineering Research Center of Edible and Medicinal Fungi, Ministry of Education, Jilin Agricultural University, Changchun 130118, China; (Y.M.); (L.L.); (X.Z.); (T.T.); (S.X.); (D.L.); (Y.L.)
| | - Changtian Li
- Engineering Research Center of Edible and Medicinal Fungi, Ministry of Education, Jilin Agricultural University, Changchun 130118, China; (Y.M.); (L.L.); (X.Z.); (T.T.); (S.X.); (D.L.); (Y.L.)
- International Joint Research Center for the Creation of New Edible Mushroom Germplasm Resources, Ministry of Science and Technology, Jilin Agricultural University, Changchun 130118, China
| | - Yu Li
- Engineering Research Center of Edible and Medicinal Fungi, Ministry of Education, Jilin Agricultural University, Changchun 130118, China; (Y.M.); (L.L.); (X.Z.); (T.T.); (S.X.); (D.L.); (Y.L.)
- International Joint Research Center for the Creation of New Edible Mushroom Germplasm Resources, Ministry of Science and Technology, Jilin Agricultural University, Changchun 130118, China
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Thijsen A, Gemelli CN, Davison TE, Masser B. A randomized controlled trial of post-donation communication materials to increase donor return following a vasovagal reaction. Transfusion 2023; 63:1701-1709. [PMID: 37493388 DOI: 10.1111/trf.17494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 06/29/2023] [Accepted: 06/29/2023] [Indexed: 07/27/2023]
Abstract
BACKGROUND Vasovagal reactions (VVRs) are one of the primary reasons for people to stop donating blood. The aim of this study was to evaluate the impact of newly developed online communications on the rate of return of whole-blood (WB) and plasma donors who experienced a VVR. STUDY DESIGN AND METHODS First-time and experienced WB and plasma donors who had a VVR without a loss of consciousness in the previous 3 days were randomly allocated to receive (a) an SMS sent 1-4 days post-VVR (n = 2303), (b) an email sent 6-10 days post-VVR (n = 2360), (c) both the SMS and the email (n = 2248), or (d) business-as-usual donor retention communications (control; n = 2557). Donation data were extracted to determine subsequent donation attempts. RESULTS For return within 3 months, WB donors in the Email Only condition had significantly increased odds of returning (OR: 1.26, 95%CI: 1.01-1.56). Subgroup analysis within WB donors showed increased odds of return for women sent the SMS and Email (OR: 1.50, 95%CI: 1.14-1.96) or the Email Only (OR: 1.44, 95%CI: 1.10-1.89), and for first-time donors sent the Email Only (OR: 1.48, 95%CI: 1.07-2.05). At 6 months, only first-time WB donors in the Email Only condition had significantly increased odds of returning (OR: 1.30, 95%CI: 1.01-1.69). No significant effects of the intervention were found for immediate or intermediate return for plasma donors. DISCUSSION Sending an email addressing common donor concerns regarding VVRs increases WB donor retention, but additional strategies are needed for the effects to last and to retain plasma donors.
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Affiliation(s)
- Amanda Thijsen
- Clinical Services and Research, Australian Red Cross Lifeblood, Sydney, New South Wales, Australia
| | - Carley N Gemelli
- Clinical Services and Research, Australian Red Cross Lifeblood, Melbourne, Victoria, Australia
| | - Tanya E Davison
- Monash Art, Design and Architecture, Monash University, Melbourne, Victoria, Australia
- Research & Innovation, Silverchain, Melbourne, Victoria, Australia
| | - Barbara Masser
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
- Clinical Services and Research, Australian Red Cross Lifeblood, Brisbane, Queensland, Australia
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Materia FT, Smyth JM, Puoane T, Tsolekile L, Goggin K, Kodish SR, Fox AT, Resnicow K, Werntz S, Catley D. Implementing text-messaging to support and enhance delivery of health behavior change interventions in low- to middle-income countries: case study of the Lifestyle Africa intervention. BMC Public Health 2023; 23:1526. [PMID: 37563595 PMCID: PMC10416414 DOI: 10.1186/s12889-023-16388-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 07/25/2023] [Indexed: 08/12/2023] Open
Abstract
The prevalence of non-communicable diseases, such as diabetes and cardiovascular disease, is rising in low- and middle-income countries (LMICs). Health behavior change (HBC) interventions such as the widely used Diabetes Prevention Program (DPP) are effective at reducing chronic disease risk, but have not been adapted for LMICs. Leveraging mobile health (mHealth) technology such as text messaging (SMS) to enhance reach and participant engagement with these interventions has great promise, yet we lack evidence-informed approaches to guide the integration of SMS specifically to support HBC interventions in LMIC contexts. To address this gap, we integrated guidance from the mHealth literature with expertise and first-hand experience to establish specific development steps for building and implementing SMS systems to support HBC programming in LMICs. Specifically, we provide real-world examples of each development step by describing our experience in designing and delivering an SMS system to support a culturally-adapted DPP designed for delivery in South Africa. We outline eight key SMS development steps, including: 1) determining if SMS is appropriate; 2) developing system architecture and programming; 3) developing theory-based messages; 4) developing SMS technology; 5) addressing international SMS delivery; 6) testing; 7) system training and technical support; and 8) cost considerations. We discuss lessons learned and extractable principles that may be of use to other mHealth and HBC researchers working in similar LMIC contexts.Trial registration Clinicaltrials.gov, NCT03342274 . Registered 10 November 2017.
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Affiliation(s)
- Frank T Materia
- Division of Health Services and Outcomes Research, Children's Mercy Kansas City, 2401 Gillham Road, Kansas City, MO, 64108, USA.
| | - Joshua M Smyth
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, USA
- Penn State College of Medicine, Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Thandi Puoane
- School of Public Health, University of the Western Cape, Cape Town, South Africa
| | - Lungiswa Tsolekile
- School of Public Health, University of the Western Cape, Cape Town, South Africa
| | - Kathy Goggin
- Division of Health Services and Outcomes Research, Children's Mercy Kansas City, 2401 Gillham Road, Kansas City, MO, 64108, USA
- School of Medicine, University of Missouri - Kansas City, Kansas City, MO, USA
- School of Pharmacy, University of Missouri - Kansas City, Kansas City, MO, USA
| | - Stephen R Kodish
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, USA
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA
| | - Andrew T Fox
- Division of Health Services and Outcomes Research, Children's Mercy Kansas City, 2401 Gillham Road, Kansas City, MO, 64108, USA
| | - Ken Resnicow
- School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | | | - Delwyn Catley
- School of Medicine, University of Missouri - Kansas City, Kansas City, MO, USA
- Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Kansas City, Kansas City, MO, USA
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24
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Rodríguez-Rodríguez WE, Puente-Sujo JA, Rodríguez-Rodríguez AJ, Matias IR, Vargas-Requena DT, García-Garza LA. Low-Cost Online Monitoring System for the Etching Process in Fiber Optic Sensors by Computer Vision. Sensors (Basel) 2023; 23:5951. [PMID: 37447798 DOI: 10.3390/s23135951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 06/04/2023] [Accepted: 06/20/2023] [Indexed: 07/15/2023]
Abstract
The present research exposes a novel methodology to manufacture fiber optic sensors following the etching process by Hydrofluoric Acid deposition through a real-time monitoring diameter measurement by computer vision. This is based on virtual instrumentation developed with the National Instruments® technology and a conventional digital microscope. Here, the system has been tested proving its feasibility by the SMS structure diameter reduction from its original diameter of 125 μ until approximately 42.5 μm. The results obtained have allowed us to demonstrate a stable state behavior of the developed system during the etching process through diameter measurement at three different structure sections. Therefore, this proposal will contribute to the etched fiber optic sensor development that requires reaching an enhanced sensitivity. Finally, to demonstrate the previously mentioned SMS without chemical corrosion, and the etched manufactured SMS, both have been applied as glucose concentration sensors.
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Affiliation(s)
- Wenceslao Eduardo Rodríguez-Rodríguez
- Reynosa Rodhe Multidisciplinary Academic Unit, Department of Computational Sciences and Technologies, Computational Systems Academy, Autonomous University of Tamaulipas (UAT), Reynosa-San Fernando Highway, Reynosa 88779, Tamaulipas, Mexico
| | - Jesús Abraham Puente-Sujo
- Reynosa Rodhe Multidisciplinary Academic Unit, Department of Computational Sciences and Technologies, Computational Systems Academy, Autonomous University of Tamaulipas (UAT), Reynosa-San Fernando Highway, Reynosa 88779, Tamaulipas, Mexico
| | - Adolfo Josué Rodríguez-Rodríguez
- Reynosa Rodhe Multidisciplinary Academic Unit, Department of Computational Sciences and Technologies, Computational Systems Academy, Autonomous University of Tamaulipas (UAT), Reynosa-San Fernando Highway, Reynosa 88779, Tamaulipas, Mexico
| | - Ignacio R Matias
- Department of Electrical, Electronic and Communications Engineering, Institute of Smart Cities (ISC), Public University of Navarre (UPNA), Campus de Arrosadia, 31006 Pamplona, Spain
| | - David Tomás Vargas-Requena
- Reynosa Rodhe Multidisciplinary Academic Unit, Department of Computational Sciences and Technologies, Computational Systems Academy, Autonomous University of Tamaulipas (UAT), Reynosa-San Fernando Highway, Reynosa 88779, Tamaulipas, Mexico
| | - Luis Antonio García-Garza
- Reynosa Rodhe Multidisciplinary Academic Unit, Department of Computational Sciences and Technologies, Computational Systems Academy, Autonomous University of Tamaulipas (UAT), Reynosa-San Fernando Highway, Reynosa 88779, Tamaulipas, Mexico
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Acharya A, Judah G, Ashrafian H, Sounderajah V, Johnstone-Waddell N, Harris M, Stevenson A, Darzi A. Investigating the national implementation of SMS and mobile messaging in population screening (The SIPS study). EBioMedicine 2023; 93:104685. [PMID: 37384997 DOI: 10.1016/j.ebiom.2023.104685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 05/25/2023] [Accepted: 06/14/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND The increasing use of mobile messaging within healthcare, poses challenges for screening programmes, which involve communicating with large, diverse populations. This modified Delphi study aimed to create guidance regarding the use of mobile messaging for screening programmes, to facilitate greater, and equitable screening uptake. METHODS Initial recommendations were derived from a literature review, expert scoping questionnaire, public consultation, and discussion with relevant national organisations. Experts from the fields of public health, screening commissioning, industry and academia voted upon the importance and feasibility of these recommendations across two consensus rounds, using a 5-point Likert scale. Items reaching consensus, defined a priori at 70%, on importance and feasibility formed 'core' recommendations. Those reaching this threshold on importance only, were labelled 'desirable'. All items were subsequently discussed at an expert meeting to confirm suitability. FINDINGS Of the initial 101 items, 23 reached consensus regarding importance and feasibility. These 'core' items were divided across six domains: message content, timing, delivery, evaluation, security, and research considerations. 'Core' items such as explicitly specifying the sender and the role of patient involvement in development of screening message research had the highest agreement. A further 17 'desirable' items reached consensus regarding importance, but not feasibility, including the integration into GP services to enable telephone verification. INTERPRETATION These findings forming national guidance for services, will enable programmes to overcome implementation challenges and facilitate uptake of screening invitations. By providing a list of desirable items, this study provides areas for future consideration, as technological innovation in messaging continues to grow. FUNDING NIHR Imperial Patient Safety Translational Research Centre.
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Affiliation(s)
- Amish Acharya
- Institute of Global Health Innovation, Imperial College London, London, W2 1NY, United Kingdom.
| | - Gaby Judah
- Institute of Global Health Innovation, Imperial College London, London, W2 1NY, United Kingdom
| | - Hutan Ashrafian
- Institute of Global Health Innovation, Imperial College London, London, W2 1NY, United Kingdom
| | - Viknesh Sounderajah
- Institute of Global Health Innovation, Imperial College London, London, W2 1NY, United Kingdom
| | | | - Mike Harris
- Department of Health and Social Care, London, SW1H 0EU, United Kingdom; Public Health England, London, United Kingdom
| | - Anne Stevenson
- Department of Health and Social Care, London, SW1H 0EU, United Kingdom; Public Health England, London, United Kingdom
| | - Ara Darzi
- Institute of Global Health Innovation, Imperial College London, London, W2 1NY, United Kingdom
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Chuchu VM, Mutono N, Bichanga P, Kitala PM, Ksee D, Muturi M, Mwatondo A, Nasimiyu C, Akunga L, Amiche A, Hampson K, Thumbi SM. Effect of Phone Text Message Reminders on Compliance with Rabies Post-Exposure Prophylaxis following Dog Bites in Rural Kenya. Vaccines (Basel) 2023; 11:1112. [PMID: 37376501 DOI: 10.3390/vaccines11061112] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 05/29/2023] [Accepted: 06/08/2023] [Indexed: 06/29/2023] Open
Abstract
The prompt administration of post-exposure prophylaxis (PEP) is one of the key strategies for ending human deaths from rabies. A delay in seeking the first dose of rabies PEP, or failure to complete the recommended dosage, may result in clinical rabies and death. We assessed the efficacy of short message system (SMS) phone texts in improving the adherence to scheduled PEP doses among bite patients in rural eastern Kenya. We conducted a single-arm, before-after field trial that compared adherence among bite patients presenting at Makueni Referral Hospital between October and December 2018 (control) and between January and March 2019 (intervention). Data on their demographics, socio-economic status, circumstances surrounding the bite, and expenditures related to the bite were collected. A total of 186 bite patients were enrolled, with 82 (44%) in the intervention group, and 104 (56%) in the control group. The odds of PEP completion were three times (OR 3.37, 95% CI 1.28, 10.20) more likely among patients who received the SMS reminder, compared to the control. The intervention group had better compliance on the scheduled doses 2 to 5, with a mean deviation of 0.18 days compared to 0.79 days for the control group (p = 0.004). The main reasons for non-compliance included lack of funds (30%), and forgetfulness (23%) on days for follow-up treatment, among others. Nearly all (96%, n = 179) the bite patients incurred indirect transport costs, at an average of USD 4 (USD 0-45) per visit. This study suggests that the integration of SMS reminders into healthcare service delivery increases compliance with PEP, and may strengthen rabies control and elimination strategies.
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Affiliation(s)
- Veronicah M Chuchu
- Centre for Global Health Research, Kenya Medical Research Institute, Kisumu 1578-40100, Kenya
- Department of Public Health, Pharmacology and Toxicology, University of Nairobi, Nairobi 29053-00625, Kenya
- Paul G. Allen School for Global Health, Washington State University, Pullman, WA 99164-7090, USA
| | - Nyamai Mutono
- Paul G. Allen School for Global Health, Washington State University, Pullman, WA 99164-7090, USA
- Centre for Epidemiological Modelling and Analysis, University of Nairobi, Nairobi 19676-00202, Kenya
| | - Philet Bichanga
- Department of Health Services, Government of Makueni County, Makueni 95-90300, Kenya
| | - Philip M Kitala
- Department of Public Health, Pharmacology and Toxicology, University of Nairobi, Nairobi 29053-00625, Kenya
| | - Daniel Ksee
- Department of Agriculture, Irrigation, Livestock and Fisheries Development, Government of Makueni County, Makueni 78-90300, Kenya
| | - Mathew Muturi
- Zoonotic Disease Unit, Joint One Health Office of the Ministry of Health and the Ministry of Agriculture, Livestock and Fisheries, Government of Kenya, Nairobi 20811-00202, Kenya
| | - Athman Mwatondo
- Zoonotic Disease Unit, Joint One Health Office of the Ministry of Health and the Ministry of Agriculture, Livestock and Fisheries, Government of Kenya, Nairobi 20811-00202, Kenya
| | - Carolyne Nasimiyu
- Paul G. Allen School for Global Health, Washington State University, Pullman, WA 99164-7090, USA
| | | | | | - Katie Hampson
- Institute of Biodiversity, Animal Health & Comparative Medicine, Graham Kerr Building, University of Glasgow, Glasgow G12 8QQ, UK
| | - Samuel M Thumbi
- Centre for Global Health Research, Kenya Medical Research Institute, Kisumu 1578-40100, Kenya
- Paul G. Allen School for Global Health, Washington State University, Pullman, WA 99164-7090, USA
- Centre for Epidemiological Modelling and Analysis, University of Nairobi, Nairobi 19676-00202, Kenya
- Institute of Immunology and Infection Research, School of Biological Sciences, University of Edinburgh, Edinburgh EH8 9YL, UK
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Braddock WRT, Ocasio MA, Comulada WS, Mandani J, Fernandez MI. Increasing Participation in a TelePrEP Program for Sexual and Gender Minority Adolescents and Young Adults in Louisiana: Protocol for an SMS Text Messaging-Based Chatbot. JMIR Res Protoc 2023; 12:e42983. [PMID: 37256669 PMCID: PMC10267782 DOI: 10.2196/42983] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 01/13/2023] [Accepted: 03/23/2023] [Indexed: 06/01/2023] Open
Abstract
BACKGROUND Sexual and gender minority (SGM) adolescents and young adults (AYAs) are at increased risk of HIV infection, particularly in the Southern United States. Despite the availability of effective biomedical prevention strategies, such as pre-exposure prophylaxis (PrEP), access and uptake remain low among SGM AYAs. In response, the Louisiana Department of Health initiated the LA TelePrEP Program, which leverages the power of telemedicine to connect Louisiana residents to PrEP. A virtual TelePrEP Navigator guides users through the enrollment process, answers questions, schedules appointments, and facilitates lab testing and medication delivery. To increase the participation of SGM AYAs in the program, the TelePrEP program partnered with researchers to develop a chatbot that would facilitate access to the program and support navigator functions. Chatbots are capable of carrying out many functions that reduce employee workload, and despite their successful use in health care and public health, they are relatively new to HIV prevention. OBJECTIVE In this paper, we describe the iterative and community-engaged process that we used to develop an SMS text messaging-based chatbot tailored to SGM AYAs that would support navigator functions and disseminate PrEP-related information. METHODS Our process was comprised of 2 phases: conceptualization and development. In the conceptualization phase, aspects of navigator responsibilities, program logistics, and user interactions to prioritize in chatbot programming (eg, scheduling appointments and answering questions) were identified. We also selected a commercially available chatbot platform that could execute these functions and could be programmed with minimal coding experience. In the development phase, we engaged Department of Health staff and SGM AYAs within our professional and personal networks. Five different rounds of testing were conducted with various groups to evaluate each iteration of the chatbot. After each iteration of the testing process, the research team met to discuss feedback, guide the programmer on incorporating modifications, and re-evaluate the chatbot's functionality. RESULTS Through our highly collaborative and community-engaged process, a rule-based chatbot with artificial intelligence components was successfully created. We gained important knowledge that could advance future chatbot development efforts for HIV prevention. Key to the PrEPBot's success was resolving issues that hampered the user experience, like asking unnecessary questions, responding too quickly, and misunderstanding user input. CONCLUSIONS HIV prevention researchers can feasibly and efficiently program a rule-based chatbot with the assistance of commercially available tools. Our iterative process of engaging researchers, program personnel, and different subgroups of SGM AYAs to obtain input was key to successful chatbot development. If the results of this pilot trial show that the chatbot is feasible and acceptable to SGM AYAs, future HIV researchers and practitioners could consider incorporating chatbots as part of their programs. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/42983.
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Affiliation(s)
| | - Manuel A Ocasio
- Department of Pediatrics, School of Medicine, Tulane University, New Orleans, LA, United States
| | - W Scott Comulada
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Jan Mandani
- Office of Public Health, Louisiana Department of Health, New Orleans, LA, United States
| | - M Isabel Fernandez
- College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL, United States
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Zamanillo-Campos R, Fiol-deRoque MA, Serrano-Ripoll MJ, Mira-Martínez S, Ricci-Cabello I. Development and evaluation of DiabeText, a personalized mHealth intervention to support medication adherence and lifestyle change behaviour in patients with type 2 diabetes in Spain: A mixed-methods phase II pragmatic randomized controlled clinical trial. Int J Med Inform 2023; 176:105103. [PMID: 37267809 DOI: 10.1016/j.ijmedinf.2023.105103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 05/16/2023] [Accepted: 05/18/2023] [Indexed: 06/04/2023]
Abstract
BACKGROUND Despite the increasing interest in text-messaging interventions to support healthcare delivery, the available evidence about their effectiveness is still limited. OBJECTIVES 1) to develop DiabeText, an intervention delivering automated, tailored brief text messages to support diabetes self-management; 2) to explore the potential impact of DiabeText on self-management behavior and glycaemic control, and; 3) to examine the feasibility of conducting a future phase III randomized clinical trial to evaluate the effectiveness of DiabeText. METHODS 3-month, two-arm, randomized feasibility trial (ClinicalTrials.gov: NCT04738591) with patients with type 2 diabetes (HbA1c > 8%). Participants were allocated to the control (usual care) or DiabeText group (usual care + five text messages per week). Outcomes were: recruitment rate; follow-up rate, missing data; medication adherence; adherence to Mediterranean diet; physical activity; and HbA1c. In addition, after delivering the intervention, we conducted a qualitative study involving 14 semi-structured interviews with participants allocated to the DiabeText group, to understand their views about the intervention. RESULTS From 444 screened people, we recruited 207 participants (recruitment rate = 47%), of which 179 completed the post-intervention interview (follow-up rate = 86%). We sent 7,355 SMS during the intervention period, of which 99% successfully reached the participants. At post-intervention, DiabeText was associated with non-statistically significant (p > 0.05) improvements in adherence to medication (OR = 2.0; 95%CI 1.0 to 4.2), Mediterranean diet (1.7; 0.9 to 3.2), and physical activity (1.7; 0.9 to 3.1). No between-group differences were observed in mean HbA1c (p = 0.670). The qualitative study indicated that participants perceived DiabeText as a helpful resource because it increased their awareness about the importance of adequate self-management and the sense of being cared for. CONCLUSIONS DiabeText is the first system in Spain to integrate patient-generated and routinely collected clinical data to deliver tailored text messages to support diabetes self-management. More robust trials are needed to determine its effectiveness and cost-efficacy.
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Affiliation(s)
- Rocío Zamanillo-Campos
- Balearic Islands Health Research Institute (IdISBa) Carretera de Valldemossa, 79, Hospital Universitari Son Espases. Edifici S, 07120 Palma, Spain; Primary Care Research Unit of Mallorca, Balearic Islands Health Service, Carrer de l'Escola Graduada, n° 3, 07002 Palma, Spain
| | - Maria Antonia Fiol-deRoque
- Balearic Islands Health Research Institute (IdISBa) Carretera de Valldemossa, 79, Hospital Universitari Son Espases. Edifici S, 07120 Palma, Spain; Primary Care Research Unit of Mallorca, Balearic Islands Health Service, Carrer de l'Escola Graduada, n° 3, 07002 Palma, Spain.
| | - Maria Jesús Serrano-Ripoll
- Balearic Islands Health Research Institute (IdISBa) Carretera de Valldemossa, 79, Hospital Universitari Son Espases. Edifici S, 07120 Palma, Spain; Primary Care Research Unit of Mallorca, Balearic Islands Health Service, Carrer de l'Escola Graduada, n° 3, 07002 Palma, Spain; Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS, RD21/0016/0005), Gran Via de les Corts Catalanes, 587, 08007 Barcelona, Spain
| | - Sofía Mira-Martínez
- Balearic Islands Health Research Institute (IdISBa) Carretera de Valldemossa, 79, Hospital Universitari Son Espases. Edifici S, 07120 Palma, Spain; Primary Care Research Unit of Mallorca, Balearic Islands Health Service, Carrer de l'Escola Graduada, n° 3, 07002 Palma, Spain
| | - Ignacio Ricci-Cabello
- Balearic Islands Health Research Institute (IdISBa) Carretera de Valldemossa, 79, Hospital Universitari Son Espases. Edifici S, 07120 Palma, Spain; Primary Care Research Unit of Mallorca, Balearic Islands Health Service, Carrer de l'Escola Graduada, n° 3, 07002 Palma, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0, 28029 Madrid, Spain
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Campbell JI, Aturinda I, Mwesigwa E, Habinka A, Kanyesigye M, Holden RJ, Siedner MJ, Kraemer JD. Behavioral Predictors of Intention to Use a Text Messaging Reminder System Among People Living With HIV in Rural Uganda: Survey Study. JMIR Hum Factors 2023; 10:e42952. [PMID: 37145834 DOI: 10.2196/42952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 01/27/2023] [Accepted: 01/29/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND The expansion of cellular phones in sub-Saharan Africa spurred the development of SMS text message-based mobile health (mHealth) technology. Numerous SMS text message-based interventions have attempted to increase retention in care for people living with HIV in sub-Saharan Africa. Many of these interventions have failed to scale. Understanding theory-grounded factors leading to mHealth acceptability is needed to create scalable, contextually appropriate, and user-focused interventions to improve longitudinal HIV care for people living with HIV in sub-Saharan Africa. OBJECTIVE In this study, we aimed to understand the relationship between constructs from the Unified Theory of Acceptance and Use of Technology (UTAUT), constructs identified in previous qualitative research, and behavioral intention to use a novel SMS text message-based mHealth intervention designed to improve care retention among people living with HIV initiating treatment in rural Uganda. METHODS We conducted a survey of people living with HIV who were newly initiating HIV care in Mbarara, Uganda, and had agreed to use a novel SMS text message-based system that notified them of abnormal laboratory results and reminded them to return to the clinic. Survey items assessed behavioral intention to use the SMS text messaging system; constructs from UTAUT; and demographics, literacy, SMS text messaging experience, HIV status disclosure, and social support. We used factor analysis and logistic regression to estimate the relationships between UTAUT constructs and the behavioral intention to use the SMS text messaging system. RESULTS A total of 249 participants completed the surveys, of whom 115 (46.2%) expressed high behavioral intention to use the SMS text messaging intervention. In a multivariable analysis, we found that performance expectancy (adjusted odds ratio [aOR] of the scaled factor score 5.69, 95% CI 2.64-12.25; P<.001), effort expectancy (aOR of the scaled factor score 4.87, 95% CI 1.75-13.51; P=.002), and social influence (measured as a 1-unit Likert score increase in the perception that clinical staff have been helpful in the use of the SMS text messaging program; aOR 3.03, 95% CI 1.21-7.54; P=.02) were significantly associated with high behavioral intention to use the SMS text messaging program. SMS text messaging experience (aOR/1-unit increase 1.48, 95% CI 1.11-1.96; P=.008) and age (aOR/1-year increase 1.07, 95% CI 1.03-1.13; P=.003) were also significantly associated with increased odds of high intention to use the system. CONCLUSIONS Performance expectancy, effort expectancy, and social influence, as well as age and SMS experience, were drivers of high behavioral intention to use an SMS text messaging reminder system among people living with HIV initiating treatment in rural Uganda. These findings highlight salient factors associated with SMS intervention acceptability in this population and indicate attributes that are likely to be key to the successful development and scaling of novel mHealth interventions.
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Affiliation(s)
| | - Isaac Aturinda
- Mbarara University of Science and Technology, Mbarara, Uganda
| | - Evans Mwesigwa
- Mbarara University of Science and Technology, Mbarara, Uganda
| | | | | | - Richard J Holden
- School of Public Health, Indiana University, Bloomington, IN, United States
| | - Mark J Siedner
- Massachusetts General Hospital, Massachusetts, MA, United States
| | - John D Kraemer
- Department of Health Management and Policy, Georgetown University School of Health, Washington, DC, United States
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Finsterbusch J, Chu Y. Simultaneous multislice imaging with slice-specific z-shim. Magn Reson Med 2023; 90:633-642. [PMID: 37093986 DOI: 10.1002/mrm.29673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/29/2023] [Accepted: 03/30/2023] [Indexed: 04/26/2023]
Abstract
PURPOSE To implement slice-specific z-shim in simultaneous multislice (SMS) imaging in order to minimize signal losses in slice-accelerated T2 *-weighted acquisitions, such as for spinal cord functional neuroimaging. METHODS The RF envelopes of the individual slice bands are temporally shifted on the plateau of the slice-selection gradient pulse before being combined to the multiband RF envelope. Thus, optimum z-shims can be realized for each slice of an SMS excitation, which is in contrast to conventional z-shimming. EPI with 2-fold SMS acceleration was performed on a 3T whole-body MR system in phantoms and the cervical spinal cord of healthy volunteers (i) without z-shim, (ii) with conventional z-shim using the average value of the slices of the SMS excitation, and (iii) with optimal, slice-specific z-shims for each slice using envelope shifts. RESULTS Phantom experiments demonstrate the equivalence of the envelope shift and conventional z-shimming for non-SMS excitations. With SMS, the best image quality is obtained with "mixed" z-shim, where only the z-shim differences of the slices of an SMS excitation are implemented by an envelope shift while their mean z-shim is applied conventionally with a gradient pulse after the echoes acquired for N/2 ghost correction. In phantoms and in vivo, this setup outperforms the approaches without slice-specific z-shim with respect to signal amplitude and temporal SNR at the expense of slight TE differences (<1 ms) between the slices. CONCLUSION With RF envelope shifts, slice-specific z-shims can be combined with SMS imaging, which could improve slice-accelerated functional neuroimaging in the spinal cord.
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Affiliation(s)
- Jürgen Finsterbusch
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ying Chu
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Cen J, Wang L, Zhang H, Guo Y. Analysis of the prognostic significance and potential mechani sms of lncRNAs related to m6A methylation in laryngeal cancer. Biotechnol Genet Eng Rev 2023:1-26. [PMID: 37053494 DOI: 10.1080/02648725.2023.2198630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/15/2023]
Abstract
Objective to investigate the prognostic significance and potential mechanism analysis of m6A methylation-associated lncRNAs in laryngeal cancer. Methods based on the expression of m6A-associated lncRNAs, the samples were divided into two clusters and least absolute value and selection operator (LASSO) regression analysis was performed to build and validate prognostic models. In addition, the relationships between risk scores, clusters, arginine synthase (SMS), tumor microenvironment, clinicopathological features, immune infiltration, immune checkpoints, and tumor mutation burden were analyzed. Finally, the relationship between SMS and m6A-associated IncRNAs was analyzed and SMS-associated pathways were enriched by gene set enrichment analysis (GSEA). Results a total of 95 lncRNAs were associated with the expression of 22 m6A methylation regulators in laryngeal cancer, 14 of which were prognostic lncRNAs. These lncRNAs were divided into two clusters and evaluated. Clinicopathological features did not show significant differences. However, the two clusters differed significantly in terms of naive B cells, memory B cells, naive CD4 T cells, T helper cells and immune score. lASSO regression analysis showed that risk score was a significant predictor of progression-free survival. Conclusion low expression of m6A-related lncRNAs involved in laryngeal cancer development in laryngeal cancer tissues can be used as an indicator to diagnose patients with laryngeal cancer, reduce patient prognosis, be an independent risk factor affecting patient prognosis and be able to assess patient prognosis.
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Affiliation(s)
- Jingtu Cen
- Shanghai Municipal Hospital of Traditional Chinese Medicine,ear-nose-throat department, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Lihua Wang
- Shanghai Municipal Hospital of Traditional Chinese Medicine,ear-nose-throat department, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Haopeng Zhang
- Shanghai Municipal Hospital of Traditional Chinese Medicine,ear-nose-throat department, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yu Guo
- Shanghai Municipal Hospital of Traditional Chinese Medicine,ear-nose-throat department, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Srinivasarao U, Sharaff A. SMS sentiment classification using an evolutionary optimization based fuzzy recurrent neural network. Multimed Tools Appl 2023:1-32. [PMID: 37362691 PMCID: PMC10107590 DOI: 10.1007/s11042-023-15206-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 09/13/2022] [Accepted: 03/30/2023] [Indexed: 06/28/2023]
Abstract
Sentiment analysis using the inbox message polarity is a challenging task in text mining, this analysis is used to differentiate spam and ham messages in mail. Polarity estimation is mandatory for spam and ham identification, whereas developing a perfect architecture for such classification is the hot demanding topic. To fulfill that, fuzzy based Recurrent Neural network-based Harris Hawk optimization (FRNN-HHO) is introduced, which performs post-classification over the classified messages (spam and ham). Previously the authors tried to classify the spam and ham messages from the collection of SMSs. But sometimes, the spam messages may incorrectly be classified within the ham classes. This misclassification may reduce the accuracy. The sentiment analysis process is performed over the classified messages to improve such classification accuracy. The spam and ham messages from the available data are classified using a Kernel Extreme Learning Machine (KELM) classifier. The sentiment analysis and classification based experimental evaluation is carried out using accuracy, recall, f-measure, precision, RMSE, and MAE. The performance of the proposed architecture is evaluated using threedifferent datasets: SMS, Email, and spam-assassin. The Area under the curve (AUC) of the proposed approach is found to be 0.9699 (SMS dataset), 0.958 (Email dataset), and 0.95 (spam assassin).
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Affiliation(s)
- Ulligaddala Srinivasarao
- Department of Computer Science and Engineering, National Institute of Technology Raipur, Chhattisgarh, 492010 India
| | - Aakanksha Sharaff
- Department of Computer Science and Engineering, National Institute of Technology Raipur, Chhattisgarh, 492010 India
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Asgary R, Beideck E, Naderi R, Schoenthaler A. SMS texting for uncontrolled diabetes among persons experiencing homelessness: Study protocol for a randomized trial. Contemp Clin Trials 2023; 128:107149. [PMID: 36918092 DOI: 10.1016/j.cct.2023.107149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 02/20/2023] [Accepted: 03/09/2023] [Indexed: 03/13/2023]
Abstract
BACKGROUND Diabetes mellitus (DM) is common among persons experiencing homelessness (PEH), often inadequately managed, and carries significant costs. mHealth strategies including short messaging service (SMS) texting have been feasible and acceptable, and improved control of chronic diseases including DM. SMS strategies for DM have not been tested among PEH despite the accessibility of mobile phones. We propose an SMS strategy could offer better communication, education, and information management; improve outreach; facilitate care coordination; explore barriers to care; and support behavior changes. METHODS AND ANALYSIS This mixed-methods (RCT and qualitative) study will be implemented in shelter-clinics in New York City in collaboration with community organizations, allowing for sustainability and scalability. Aim 1 will evaluate the efficacy of a 6-month SMS program for DM management versus an attention control on changes in HbA1c and adherence to DM self-care activities, medications, and appointments at 9 months in adult PEH with uncontrolled DM (n = 100). Outcomes will be measured at 0, 3, 6, &9 months. AIM 2 will assess patients' and providers' attitudes, acceptability, and experience of the program through semi-structured interviews with PEH (n = 20) and providers (n = 10). DISCUSSION DM is not well-addressed among PEH. SMS strategies for DM have never been tested in PEH despite evidence of their effectiveness and access to mobile phones among PEH. Results from this study will provide important empirical data to inform evidence-based strategies to avert personal suffering and significant costs. It will have broader policy implications in control of DM and other chronic diseases.
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Lee WG, Gosnell JE, Shen WT, Duh QY, Suh I, Chen Y. Recovery After Thyroid and Parathyroid Surgery: How Do Our Patients Really Feel? J Surg Res 2023; 283:764-770. [PMID: 36470201 DOI: 10.1016/j.jss.2022.11.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 11/10/2022] [Accepted: 11/16/2022] [Indexed: 12/05/2022]
Abstract
INTRODUCTION Counseling on the immediate postoperative experience for outpatient procedures is largely based on anecdotal experience. We devised a short messaging service (SMS) survey using mobile phone text messages to evaluate real-time patient recovery following outpatient thyroid or parathyroid surgery. MATERIALS AND METHODS Daily automated SMS surveys were sent the evening of the operation until postoperative day 10. Pain, opioid use, voice quality, and energy levels were assessed. Impaired voice and energy was defined as a score < 2/3 of normal. RESULTS One hundred fifty five patients were enrolled with an overall response rate of 81.6%. One hundred thirty three patients had an individual response rate > 50% and were included in the final analysis. Median patient age was 60 y with 102 females (76.7%). Seventy patients (52.6%) underwent parathyroidectomy and 66 (49.6%) thyroidectomy and 10 (7.5%) neck dissection. Forty eight patients (36.1%) did not use any opioids postoperatively. Independent risk factors for higher total pain scores included thyroidectomy and patients with preoperative opioid or tobacco use, while increased opioid use was associated with age < 60 y, body mass index > 30 kg/m2, preoperative opioid or tobacco use, and history of anxiety or depression. Patients with loss of intraoperative recurrent laryngeal nerve signaling had a significantly worse overall voice score (54.65 versus 92.67, P < 0.001). Up to 10% of patients were still using opioids and/or reported impaired voice and energy levels beyond 1 wk postoperatively. CONCLUSIONS Real-time SMS survey is an effective and potentially valuable way to monitor patient recovery following surgery. A subset of patients reported impaired voice and energy and was still using opioids beyond 1 wk after thyroid and parathyroid surgery and these patients may benefit from closer follow-up and earlier intervention.
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Affiliation(s)
- William G Lee
- Cedars-Sinai Medical Center, Department of Surgery, Los Angeles, California
| | - Jessica E Gosnell
- University of San Francisco, Section of Endocrine Surgery, San Francisco, California
| | - Wen T Shen
- University of San Francisco, Section of Endocrine Surgery, San Francisco, California
| | - Quan-Yang Duh
- University of San Francisco, Section of Endocrine Surgery, San Francisco, California
| | - Insoo Suh
- NYU Langone Health, Division of Endocrine Surgery, New York, New York
| | - Yufei Chen
- Cedars-Sinai Medical Center, Department of Surgery, Los Angeles, California.
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Currie GE, Totterdell J, Bowland G, Leeb A, Peters I, Blyth CC, Waddington C, Marsh JA, Snelling TL. The AuTOMATIC trial: a study protocol for a multi-arm Bayesian adaptive randomised controlled trial of text messaging to improve childhood immunisation coverage. Trials 2023; 24:97. [PMID: 36750833 PMCID: PMC9904255 DOI: 10.1186/s13063-023-07097-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 01/17/2023] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND While most Australian children are vaccinated, delays in vaccination can put them at risk from preventable infections. Widespread mobile phone ownership in Australia could allow automated short message service (SMS) reminders to be used as a low-cost strategy to effectively 'nudge' parents towards vaccinating their children on time. METHODS AuTOMATIC is an adaptive randomised trial which aims to both evaluate and optimise the use of SMS reminders for improving the timely vaccination of children at primary care clinics across Australia. The trial will utilise high levels of digital automation to effect, including eligibility assessment, randomisation, delivery of intervention, data extraction and analysis, thereby allowing healthcare-embedded trial delivery. Up to 10,000 parents attending participating primary care clinics will be randomised to one of 12 different active SMS vaccine reminder content and timing arms or usual practice only (no SMS reminder). The primary outcome is vaccine receipt within 28 days of the scheduled date for the index vaccine (the first scheduled vaccine after randomisation). Secondary analyses will assess receipt and timeliness for all vaccine occasions in all children. Regular scheduled analyses will be performed using Bayesian inference and pre-specified trial decision rules, enabling response adaptive randomisation, suspension of any poorly performing arms and early stopping if a single best message is identified. DISCUSSION This study will aim to optimise SMS reminders for childhood vaccination in primary care clinics, directly comparing alternative message framing and message timing. We anticipate that the trial will be an exemplar in using Bayesian adaptive methodology to assess a readily implementable strategy in a wide population, capable of delivery due to the levels of digital automation. Methods and findings from this study will help to inform strategies for implementing reminders and embedding analytics in primary health care settings. TRIAL REGISTRATION ANZCTR: ACTRN12618000789268 .
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Affiliation(s)
- Grace E. Currie
- grid.414659.b0000 0000 8828 1230Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA Australia ,grid.1013.30000 0004 1936 834XSchool of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006 Australia
| | - James Totterdell
- grid.414659.b0000 0000 8828 1230Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA Australia ,grid.1013.30000 0004 1936 834XSchool of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006 Australia
| | - Grahame Bowland
- grid.414659.b0000 0000 8828 1230Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA Australia
| | - Alan Leeb
- SmartVax, c/o Illawarra Medical Centre, Perth, WA Australia
| | - Ian Peters
- SmartVax, c/o Illawarra Medical Centre, Perth, WA Australia
| | - Chris C. Blyth
- grid.414659.b0000 0000 8828 1230Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA Australia ,grid.410667.20000 0004 0625 8600Department of Infectious Diseases, Perth Children’s Hospital, Perth, WA Australia ,grid.1012.20000 0004 1936 7910School of Medicine, University of Western Australia, Perth, WA Australia
| | - Claire Waddington
- grid.5335.00000000121885934Department of Medicine, University of Cambridge, Cambridge, UK
| | - Julie A. Marsh
- grid.414659.b0000 0000 8828 1230Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA Australia
| | - Thomas L. Snelling
- grid.414659.b0000 0000 8828 1230Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA Australia ,grid.1013.30000 0004 1936 834XSchool of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006 Australia ,grid.410667.20000 0004 0625 8600Department of Infectious Diseases, Perth Children’s Hospital, Perth, WA Australia ,grid.1032.00000 0004 0375 4078School of Public Health, Curtin University, Perth, WA Australia ,Menzies School of Public Health, Darwin, NT Australia
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Lang M, Cartmell S, Tabari A, Briggs D, Pianykh O, Kirsch J, Cauley S, Lo WC, Risacher S, Filho AG, Succi MD, Rapalino O, Schaefer P, Conklin J, Huang SY. Evaluation of the Aggregated Time Savings in Adopting Fast Brain MRI Techniques for Outpatient Brain MRI. Acad Radiol 2023; 30:341-348. [PMID: 34635436 PMCID: PMC8989721 DOI: 10.1016/j.acra.2021.07.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 06/29/2021] [Accepted: 07/02/2021] [Indexed: 01/11/2023]
Abstract
INTRODUCTION Clinical validation studies have demonstrated the ability of accelerated MRI sequences to decrease acquisition time and motion artifact while preserving image quality. The operational benefits, however, have been less explored. Here, we report our initial clinical experience in implementing fast MRI techniques for outpatient brain imaging during the COVID-19 pandemic. METHODS Aggregate acquisition times were extracted from the medical record on consecutive imaging examinations performed during matched pre-implementation (7/1/2019-12/31/2019) and post-implementation periods (7/1/2020-12/31/2020). Expected acquisition time reduction for each MRI protocol was calculated through manual collection of acquisition times for the conventional and accelerated sequences performed during the pre- and post-implementation periods. Aggregate and expected acquisition times were compared for the five most frequently performed brain MRI protocols: brain without contrast (BR-), brain with and without contrast (BR+), multiple sclerosis (MS), memory loss (MML), and epilepsy (EPL). RESULTS The expected time reductions for BR-, BR+, MS, MML, and EPL protocols were 6.6 min, 11.9 min, 14 min, 10.8 min, and 14.1 min, respectively. The overall median aggregate acquisition time was 31 [25, 36] min for the pre-implementation period and 18 [15, 22] min for the post-implementation period, with a difference of 13 min (42%). The median acquisition time was reduced by 4 min (25%) for BR-, 14.0 min (44%) for BR+, 14 min (38%) for MS, 11 min (52%) for MML, and 16 min (35%) for EPL. CONCLUSION The implementation of fast brain MRI sequences significantly reduced the acquisition times for the most commonly performed outpatient brain MRI protocols.
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Affiliation(s)
- Min Lang
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street Boston, Boston, Massachusetts; Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, Massachusetts
| | - Samuel Cartmell
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street Boston, Boston, Massachusetts
| | - Azadeh Tabari
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street Boston, Boston, Massachusetts
| | - Daniel Briggs
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street Boston, Boston, Massachusetts
| | - Oleg Pianykh
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street Boston, Boston, Massachusetts
| | - John Kirsch
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street Boston, Boston, Massachusetts; Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts
| | - Stephen Cauley
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street Boston, Boston, Massachusetts; Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts
| | - Wei-Ching Lo
- Siemens Medical Solutions, Boston, Massachusetts
| | - Seretha Risacher
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street Boston, Boston, Massachusetts
| | - Augusto Goncalves Filho
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street Boston, Boston, Massachusetts; Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts
| | - Marc D Succi
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street Boston, Boston, Massachusetts; Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, Massachusetts
| | - Otto Rapalino
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street Boston, Boston, Massachusetts
| | - Pamela Schaefer
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street Boston, Boston, Massachusetts
| | - John Conklin
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street Boston, Boston, Massachusetts
| | - Susie Y Huang
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street Boston, Boston, Massachusetts; Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts.
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Mogaka JN, Otieno FA, Akim E, Beima-Sofie K, Dettinger J, Gomez L, Marwa M, Odhiambo B, Ngure K, Ronen K, Sharma M, John-Stewart G, Richardson B, Stern J, Unger J, Udren J, Watoyi S, Pintye J, Kinuthia J. A Text Messaging-Based Support Intervention to Enhance Pre-exposure Prophylaxis for HIV Prevention Adherence During Pregnancy and Breastfeeding: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e41170. [PMID: 36716092 PMCID: PMC9926344 DOI: 10.2196/41170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 11/22/2022] [Accepted: 12/06/2022] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Cisgender women in Kenya are at elevated risk of HIV acquisition during pregnancy and post partum. Acute HIV infection during pregnancy and breastfeeding accounts for approximately one-third of all vertical HIV transmissions. The World Health Organization recommends offering oral tenofovir-based pre-exposure prophylaxis (PrEP) to pregnant and postpartum women who are HIV negative but at substantial and ongoing risk for HIV acquisition. PrEP delivery for pregnant and postpartum women is expanding within routine maternal child health clinics in Kenya. However, approximately half of pregnant women discontinue PrEP within 30 days of initiation. Therefore, it is crucial to develop PrEP adherence strategies that enhance support for adherence when peripartum events and health issues pose challenges to sustaining PrEP adherence. OBJECTIVE We are conducting a randomized controlled trial to determine the effect of a bidirectional communication platform named Mobile Solutions for Women's and Children's Health (mWACh), which utilizes two-way SMS text messaging between patients and remote nurses to support PrEP adherence and address maternal health concerns in real time during the peripartum period. METHODS The mWACh-PrEP study is a randomized trial designed to support PrEP adherence during the peripartum period by comparing mWACh-PrEP to the standard of care (ie, in-clinic adherence counseling) among women who are HIV negative and initiating PrEP. Purposive sampling was used to select 5 facilities offering PrEP in antenatal clinics in Kisumu and Siaya Counties, and block randomization will be used to divide participants into groups. Participants in the intervention arm will receive a customized messaging curriculum via SMS text messages targeted toward their particular perinatal stage. The primary outcome, PrEP adherence at 6 months post partum, will be evaluated using a log-binomial regression model, adjusting for imbalanced baseline characteristics. Based on a previous study of directly observed dosing conditions, we will use a hair tenofovir concentration cutoff of 0.038 ng/mg (corresponding to 7 doses/week) as the primary adherence outcome measured at 6 months post partum (binary outcome). Qualitative interviews and cost-effective analyses will be conducted to understand the feasibility, acceptability, and economic impact of the intervention. RESULTS Enrollment began in March 2022 and is projected to continue until July 2023, with follow-up through March 2024. The study results are expected to be reported in 2025. CONCLUSIONS This trial will provide insights into using mobile health to enhance PrEP adherence among pregnant and postpartum mothers. Additionally, the findings will have implications for the use of mobile health technology to improve adherence to other daily medications during the peripartum period. TRIAL REGISTRATION ClinicalTrials.gov NCT04472884; https://clinicaltrials.gov/ct2/show/NCT04472884. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/41170.
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Affiliation(s)
| | | | | | - Kristin Beima-Sofie
- Department of Global Health, University of Washington, Seattle, WA, United States
| | - Julia Dettinger
- Department of Global Health, University of Washington, Seattle, WA, United States
| | - Lauren Gomez
- Department of Global Health, University of Washington, Seattle, WA, United States
| | - Mary Marwa
- Kenyatta National Hospital, Nairobi, Kenya
| | | | - Kenneth Ngure
- Department of Global Health, University of Washington, Seattle, WA, United States
- School of Public Health, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
| | - Keshet Ronen
- Department of Global Health, University of Washington, Seattle, WA, United States
| | - Monisha Sharma
- Department of Global Health, University of Washington, Seattle, WA, United States
| | - Grace John-Stewart
- Department of Global Health, University of Washington, Seattle, WA, United States
| | - Barbra Richardson
- Department of Global Health, University of Washington, Seattle, WA, United States
- Department of Biostatistics, University of Washington, Seattle, WA, United States
| | - Joshua Stern
- Department of Biostatistics, University of Washington, Seattle, WA, United States
| | - Jennifer Unger
- Department of Global Health, University of Washington, Seattle, WA, United States
- Women and Infants Hospital, Providence, RI, United States
| | - Jenna Udren
- Department of Global Health, University of Washington, Seattle, WA, United States
| | | | - Jillian Pintye
- School of Nursing, University of Washington, Seattle, WA, United States
- Department of Global Health, University of Washington, Seattle, WA, United States
| | - John Kinuthia
- Kenyatta National Hospital, Nairobi, Kenya
- Department of Global Health, University of Washington, Seattle, WA, United States
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Korsah KA, Abdulai E, Dzansi G, Gamor N. Perception of nurses on the use of mobile phone text messaging for the management of diabetes mellitus in rural Ghana. Nurs Open 2023; 10:3415-3423. [PMID: 36611225 PMCID: PMC10077418 DOI: 10.1002/nop2.1596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 11/12/2022] [Accepted: 12/23/2022] [Indexed: 01/09/2023] Open
Abstract
AIM This study aims to explore the perception of nurses on the use of mobile phone SMS for managing diabetes in rural Ghana. DESIGN Exploratory Descriptive Qualitative Design. METHODS Purposive sampling was used to recruit (13) participants relative to data saturation after ethical clearance (REDACTED); using a semi-structured interview guide. All interviews were transcribed verbatim and analysed using thematic content analysis. RESULTS Participants believe SMS was useful in facilitating interaction between nurses, clients, family and statistically significant others; improving medication adherence and supporting blood glucose monitoring. The use of infographics was preferred to traditional SMS among digitally literate patients and voice calls for those who were illiterate. Participants had limited knowledge of downloadable diabetic applications. Participants were willing to accept and use SMS for the management of diabetes mellitus. PATIENT OR PUBLIC CONTRIBUTION Thirteen nurses actively participated in the study.
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Affiliation(s)
| | - Eliasu Abdulai
- School of Nursing and Midwifery, College of Health SciencesUniversity of GhanaLegonGhana
| | - Gladys Dzansi
- School of Nursing and MidwiferyUniversity of GhanaLegonGhana
| | - Nathan Gamor
- Catholic Hospital BattorUniversity of GhanaLegonGhana
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Mavragani A, Pehlivan MJ, Singleton A, Hawkey A, Redfern J, Armour M, Dear B, Duckworth TJ, Ciccia D, Cooper M, Parry KA, Gandhi E, Imani SA. Co-design and Development of Endo SMS, a Supportive Text Message Intervention for Individuals Living With Endometriosis: Mixed Methods Study. JMIR Form Res 2022; 6:e40837. [PMID: 36485029 PMCID: PMC9789499 DOI: 10.2196/40837] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 10/17/2022] [Accepted: 11/01/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Endometriosis, which affects 1 in 10 people assigned female at birth, is a chronic systemic inflammatory disease with a high symptom burden and adverse socioemotional impacts. There is a need for an accessible, cost-effective, and low-burden intervention to support individuals in managing their endometriosis condition. OBJECTIVE This study aimed to co-design and evaluate the acceptability, readability, and quality of a bank of supportive SMS text messages (EndoSMS) for individuals with endometriosis. METHODS In phase 1 of this mixed method design, 17 consumer representatives (individuals with endometriosis) participated across three 3-hour web-based (Zoom, Zoom Video Communications, Inc) focus groups. The transcripts were encoded and analyzed thematically. In phase 2, consumer representatives (n=14) and health care professionals (n=9) quantitatively rated the acceptability, readability, and appropriateness of the developed text messages in a web-based survey. All the participants initially completed a background survey assessing sociodemographic and medical factors. RESULTS Consumer representatives demonstrated diverse sociodemographic characteristics (Mage=33.29), varying in location (metropolitan vs rural or regional), employment, and relationship and educational statuses. Participants reached a consensus regarding the delivery of 4 SMS text messages per week, delivered randomly throughout the week and in one direction (ie, no reply), with customization for the time of day and use of personal names. Seven main areas of unmet need for which participants required assistance were identified, which subsequently became the topic areas for the developed SMS text messages: emotional health, social support, looking after and caring for your body, patient empowerment, interpersonal issues, general endometriosis information, and physical health. Through a web-based survey, 371 co-designed SMS text messages were highly rated by consumers and health care professionals as clear, useful, and appropriate for individuals with endometriosis. Readability indices (Flesch-Kincaid scale) indicated that the SMS text messages were accessible to individuals with a minimum of 7th grade high school education. CONCLUSIONS On the basis of the needs and preferences of a diverse consumer representative group, we co-designed EndoSMS, a supportive SMS text message program for individuals with endometriosis. The initial evaluation of the SMS text messages by consumer representatives and health professionals suggested the high acceptability and suitability of the developed SMS text messages. Future studies should further evaluate the acceptability and effectiveness of EndoSMS in a broader population of individuals with endometriosis.
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Affiliation(s)
| | - Melissa Jade Pehlivan
- Centre for Emotional Health, School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Anna Singleton
- School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Alexandra Hawkey
- Translational Health Research Institute (THRI), Western Sydney University, Sydney, Australia
| | - Julie Redfern
- School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Mike Armour
- Translational Health Research Institute (THRI), Western Sydney University, Sydney, Australia.,NICM Health Research Institute, Western Sydney University, Sydney, Australia
| | - Blake Dear
- School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Tanya Jane Duckworth
- School of Psychology, Faculty of Medical and Health Sciences, University of Adelaide, Adelaide, Australia
| | | | | | | | - Esther Gandhi
- School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Sara A Imani
- School of Psychological Sciences, Macquarie University, Sydney, Australia
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Côté LP, Mishara BL. Effect of helping suicidal people using text messaging: An evaluation of effects and best practices of the Canadian suicide prevention Service's text helpline. Suicide Life Threat Behav 2022; 52:1140-1148. [PMID: 35946317 DOI: 10.1111/sltb.12908] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 04/11/2022] [Accepted: 08/01/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Empirical research on best practices in suicide prevention text intervention is scarce. We present analyses of exchanges concerning suicide on the Canadian Suicide Prevention Service (CSPS) text helpline. OBJECTIVE To describe the users of the CSPS text service, explore the perceived impact of the service, and identify intervention characteristics associated with a greater likelihood of positive or negative effects of the exchanges. METHODS We analyzed data from 112 transcripts using quantitative content analysis, counselor assessments of the calls, and responses by callers to pre-call questionnaires. RESULTS Counselors infrequently conducted a complete suicide risk assessment, but almost always thoroughly explored resources and discussed possible solutions to callers' problems. An operational action plan was rarely developed. Only one technique, reinforcing a strength or a positive action of the caller, was a significant predictor of positive effects of the call. The number of words exchanged during the intervention was positively correlated with the completeness of explorations of resources and solutions and the development of an action plan. CONCLUSIONS High-quality effective interventions can be delivered via text messages. Using reinforcement of strengths and encouraging longer calls is recommended. Intervention effects were comparable to those reported in studies of telephone and chat services.
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Affiliation(s)
- Louis-Philippe Côté
- Centre for Research and Intervention on Suicide, Ethical Issues and End of Life Practices (CRISE), Université du Québec à Montréal, Montréal, Québec, Canada
| | - Brian L Mishara
- Ethical Issues and End of Life Practices (CRISE), Psychology Department, Université du Québec à Montréal, Montréal, Québec, Canada
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Lanning P, Rawlinson C, Hoehn E, De Young A, StGeorge J, Fletcher R. Primary mental health prevention in partners of mothers with a major mental illness: SMS4Dads. J Reprod Infant Psychol 2022; 40:623-632. [PMID: 33956538 DOI: 10.1080/02646838.2021.1921715] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Mental health promotion and prevention with expecting and new fathers has historically been challenging. Approximately 10% of this population report experiencing depression in the post-partum period and 18% report experiencing anxiety. This population may be further at risk if their partner has a mental illness. OBJECTIVE To assess if information provided by SMS may be a way to reach a vulnerable population of new fathers with partners who have a mental illness. METHOD Twenty-three new and expecting fathers who have partners with a mental illness were engaged in a qualitative assessment of their experience with the SMS4Dads programme. RESULTS This analysis showed that at risk new fathers appreciated the information received during the programme and reported acting on this, making changes in the way they interact with their children. CONCLUSION The combination of timely, accurate and practical information delivered in a novel way, likely contributed to the reports of improved interactions within the family unit.
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Affiliation(s)
- Paul Lanning
- Queensland Centre for Infant and Perinatal Mental Health, Queensland Children's Hospital, Brisbane, Australia
| | - Catherine Rawlinson
- Queensland Centre for Infant and Perinatal Mental Health, Queensland Children's Hospital, Brisbane, Australia
| | - Elisabeth Hoehn
- Queensland Centre for Infant and Perinatal Mental Health, Queensland Children's Hospital, Brisbane, Australia
| | - Alex De Young
- Queensland Centre for Infant and Perinatal Mental Health, Queensland Children's Hospital, Brisbane, Australia
| | - Jennifer StGeorge
- School of Health Sciences, Faculty of Health & Medicine, University of Newcastle, Callaghan, Australia
| | - Richard Fletcher
- School of Health Sciences, Faculty of Health & Medicine, University of Newcastle, Callaghan, Australia
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MacDonald SE, Marfo E, Sell H, Assi A, Frank-Wilson A, Atkinson K, Kellner JD, McNeil D, Klein K, Svenson LW. Text Message Reminders to Improve Immunization Appointment Attendance in Alberta, Canada: The Childhood Immunization Reminder Project Pilot Study. JMIR Mhealth Uhealth 2022; 10:e37579. [PMID: 36346666 PMCID: PMC9682453 DOI: 10.2196/37579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 09/15/2022] [Accepted: 10/06/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Vaccine coverage for 18-month-old children in Canada is often below the recommended level, which may be partially because of parental forgetfulness. SMS text message reminders have been shown to potentially improve childhood immunization uptake but have not been widely used in Alberta, Canada. In addition, it has been noted that language barriers may impede immunization service delivery but continue to remain unaddressed in many existing reminder and recall systems. OBJECTIVE This study aimed to assess the effectiveness and acceptability of using SMS text messages containing a link to web-based immunization information in different languages to remind parents of their child's 18-month immunization appointment. METHODS The Childhood Immunization Reminder Project was a pilot intervention at 2 public health centers, one each in Lethbridge and Edmonton, Alberta, Canada. Two SMS text message reminders were sent to parents: a booking reminder 3 months before their child turned 18 months old and an appointment reminder 3 days before their scheduled appointment. Booking reminders included a link to the study website hosting immunization information in 9 languages. To evaluate intervention effectiveness, we compared the absolute attendance no-show rates before the intervention and after the intervention. The acceptability of the intervention was evaluated through web-based surveys completed by parents and public health center staff. Google Analytics was used to determine how often web-based immunization information was accessed, from where, and in which languages. RESULTS Following the intervention, the health center in Edmonton had a reduction of 6.4% (95% CI 3%-9.8%) in appointment no-shows, with no change at the Lethbridge Health Center (0.8%, 95% CI -1.4% to 3%). The acceptability surveys were completed by 222 parents (response rate: 23.9%) and 22 staff members. Almost all (>95%) respondents indicated that the reminders were helpful and provided useful suggestions for improvement. All surveyed parents (222/222, 100%) found it helpful to read web-based immunization information in their language of choice. Google Analytics data showed that immunization information was most often read in English (118/207, 57%), Punjabi (52/207, 25.1%), Arabic (13/207, 6.3%), Spanish (12/207, 5.8%), Italian (4/207, 1.9%), Chinese (4/207, 1.9%), French (2/207, 0.9%), Tagalog (1/207, 0.5%), and Vietnamese (1/207, 0.5%). CONCLUSIONS The study's findings support the use of SMS text message reminders as a convenient and acceptable method to minimize parental forgetfulness and potentially reduce appointment no-shows. The diverse languages accessed in web-based immunization information suggest the need to provide appropriate translated immunization information. Further research is needed to evaluate the impact of SMS text message reminders on childhood immunization coverage in different settings.
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Affiliation(s)
- Shannon E MacDonald
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Emmanuel Marfo
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Hannah Sell
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Ali Assi
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Andrew Frank-Wilson
- South Zone Data & Analytics, Alberta Health Services, Lethbridge, AB, Canada
- Faculty of Health Sciences, University of Lethbridge, Lethbridge, AB, Canada
| | - Katherine Atkinson
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - James D Kellner
- Department of Pediatrics, University of Calgary, Calgary, AB, Canada
- Alberta Health Services, Calgary, AB, Canada
| | - Deborah McNeil
- Strategic Clinical Networks, Alberta Health Services, Calgary, AB, Canada
| | - Kristin Klein
- Communicable Disease Control, Provincial Population & Public Health, Alberta Health Services, Edmonton, AB, Canada
- Division of Preventive Medicine, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Lawrence W Svenson
- School of Public Health, University of Alberta, Edmonton, AB, Canada
- Division of Preventive Medicine, Department of Medicine, University of Alberta, Edmonton, AB, Canada
- Analytics and Performance Reporting, Alberta Health, Edmonton, AB, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
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Hermes D, Wu H, Kerr AB, Wandell BA. Measuring brain beats: Cardiac-aligned fast functional magnetic resonance imaging signals. Hum Brain Mapp 2022; 44:280-294. [PMID: 36308417 PMCID: PMC9783469 DOI: 10.1002/hbm.26128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 09/17/2022] [Accepted: 09/26/2022] [Indexed: 02/05/2023] Open
Abstract
Blood and cerebrospinal fluid (CSF) pulse and flow throughout the brain, driven by the cardiac cycle. These fluid dynamics, which are essential to healthy brain function, are characterized by several noninvasive magnetic resonance imaging (MRI) methods. Recent developments in fast MRI, specifically simultaneous multislice acquisition methods, provide a new opportunity to rapidly and broadly assess cardiac-driven flow, including CSF spaces, surface vessels and parenchymal vessels. We use these techniques to assess blood and CSF flow dynamics in brief (3.5 min) scans on a conventional 3 T MRI scanner in five subjects. Cardiac pulses are measured with a photoplethysmography (PPG) on the index finger, along with functional MRI (fMRI) signals in the brain. We, retrospectively, align the fMRI signals to the heartbeat. Highly reliable cardiac-gated fMRI temporal signals are observed in CSF and blood on the timescale of one heartbeat (test-retest reliability within subjects R2 > 50%). In blood vessels, a local minimum is observed following systole. In CSF spaces, the ventricles and subarachnoid spaces have a local maximum following systole instead. Slower resting-state scans with slice timing, retrospectively, aligned to the cardiac pulse, reveal similar cardiac-gated responses. The cardiac-gated measurements estimate the amplitude and phase of fMRI pulsations in the CSF relative to those in the arteries, an estimate of the local intracranial impedance. Cardiac aligned fMRI signals can provide new insights about fluid dynamics or diagnostics for diseases where these dynamics are important.
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Affiliation(s)
- Dora Hermes
- Department of Physiology and Biomedical EngineeringMayo ClinicRochesterMinnesotaUSA,Department of PsychologyStanford UniversityStanfordCaliforniaUSA
| | - Hua Wu
- Center for Cognitive and Neurobiological ImagingStanford UniversityStanfordCaliforniaUSA
| | - Adam B. Kerr
- Center for Cognitive and Neurobiological ImagingStanford UniversityStanfordCaliforniaUSA,Department of Electrical EngineeringStanford UniversityStanfordCaliforniaUSA
| | - Brian A. Wandell
- Department of PsychologyStanford UniversityStanfordCaliforniaUSA
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Stockwell MS, Reed C, Vargas CY, Wang L, Alba LR, Jia H, LaRussa P, Larson EL, Saiman L. Five-Year Community Surveillance Study for Acute Respiratory Infections Using Text Messaging: Findings From the MoSAIC Study. Clin Infect Dis 2022; 75:987-995. [PMID: 35037056 PMCID: PMC9383201 DOI: 10.1093/cid/ciac027] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Acute respiratory infections (ARI) are the most common infectious diseases globally. Community surveillance may provide a more comprehensive picture of disease burden than medically attended illness alone. METHODS In this longitudinal study conducted from 2012 to 2017 in the Washington Heights/Inwood area of New York City, we enrolled 405 households with 1915 individuals. Households were sent research text messages twice weekly inquiring about ARI symptoms. Research staff confirmed symptoms by follow-up call. If ≥2 criteria for ARI were met (fever/feverish, cough, congestion, pharyngitis, myalgias), staff obtained a mid-turbinate nasal swab in participants' homes. Swabs were tested using the FilmArray reverse transcription polymerase chain reaction (RT-PCR) respiratory panel. RESULTS Among participants, 43.9% were children, and 12.8% had a chronic respiratory condition. During the 5 years, 114 724 text messages were sent; the average response rate was 78.8% ± 6.8%. Swabs were collected for 91.4% (2756/3016) of confirmed ARI; 58.7% had a pathogen detected. Rhino/enteroviruses (51.9%), human coronaviruses (13.9%), and influenza (13.2%) were most commonly detected. The overall incidence was 0.62 ARI/person-year, highest (1.73) in <2 year-olds and lowest (0.46) in 18-49 year-olds. Approximately one-fourth of those with ARI sought healthcare; percents differed by pathogen, demographic factors, and presence of a chronic respiratory condition. CONCLUSIONS Text messaging is a novel method for community-based surveillance that could be used both seasonally as well as during outbreaks, epidemics and pandemics. The importance of community surveillance to accurately estimate disease burden is underscored by the findings of low rates of care-seeking that varied by demographic factors and pathogens.
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Affiliation(s)
- Melissa S Stockwell
- Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
- Mailman School of Public Health, Columbia University Irving Medical Center, New York, New York, USA
- NewYork-Presbyterian Hospital, New York, New York, USA
| | - Carrie Reed
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Celibell Y Vargas
- Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
| | - Liqun Wang
- Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
| | - Luis R Alba
- Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
| | - Haomiao Jia
- Mailman School of Public Health, Columbia University Irving Medical Center, New York, New York, USA
- School of Nursing, Columbia University Irving Medical Center, New York, New York, USA
| | - Philip LaRussa
- Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
| | - Elaine L Larson
- Mailman School of Public Health, Columbia University Irving Medical Center, New York, New York, USA
- School of Nursing, Columbia University Irving Medical Center, New York, New York, USA
| | - Lisa Saiman
- Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
- NewYork-Presbyterian Hospital, New York, New York, USA
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Irgens P, Myhrvold BL, Kongsted A, Natvig B, Vøllestad NK, Robinson HS. Exploring visual pain trajectories in neck pain patients, using clinical course, SMS-based patterns, and patient characteristics: a cohort study. Chiropr Man Therap 2022; 30:37. [PMID: 36076234 PMCID: PMC9454174 DOI: 10.1186/s12998-022-00443-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 07/06/2022] [Indexed: 11/10/2022] Open
Abstract
Background The dynamic nature of neck pain has so far been identified through longitudinal studies with frequent measures, a method which is time-consuming and impractical. Pictures illustrating different courses of pain may be an alternative solution, usable in both clinical work and research, but it is unknown how well they capture the clinical course. The aim of this study was to explore and describe self-reported visual trajectories in terms of details of patients’ prospectively reported clinical course, their SMS-based pattern classification of neck pain, and patient’s characteristics. Methods Prospective cohort study including 888 neck pain patients from chiropractic practice, responding to weekly SMS-questions about pain intensity for 1 year from 2015 to 2017. Patients were classified into one of three clinical course patterns using definitions based on previously published descriptors. At 1-year follow-up, patients selected a visual trajectory that best represented their retrospective 1-year course of pain: single episode, episodic, mild ongoing, fluctuating and severe ongoing. Results The visual trajectories generally resembled the 1-year clinical course characteristics on group level, but there were large individual variations. Patients selecting Episodic and Mild ongoing visual trajectories were similar on most parameters. The visual trajectories generally resembled more the clinical course of the last quarter. Discussion The visual trajectories reflected the descriptors of the clinical course of pain captured by weekly SMS measures on a group level and formed groups of patients that differed on symptoms and characteristics. However, there were large variations in symptoms and characteristics within, as well as overlap between, each visual trajectory. In particular, patients with mild pain seemed predisposed to recall bias. Although the visual trajectories and SMS-based classifications appear related, visual trajectories likely capture more elements of the pain experience than just the course of pain. Therefore, they cannot be seen as a proxy for SMS-tracking of pain over 1 year. Supplementary Information The online version contains supplementary material available at 10.1186/s12998-022-00443-3.
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Affiliation(s)
- Pernille Irgens
- Department of Interdisciplinary Health Sciences, Institute of Health and Society, University of Oslo, Blindern, P.O. Box 1089, 0317, Oslo, Norway.
| | - Birgitte Lawaetz Myhrvold
- Department of Interdisciplinary Health Sciences, Institute of Health and Society, University of Oslo, Blindern, P.O. Box 1089, 0317, Oslo, Norway
| | - Alice Kongsted
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,Chiropractic Knowledge Hub, Odense M, Denmark
| | - Bård Natvig
- Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Nina Køpke Vøllestad
- Department of Interdisciplinary Health Sciences, Institute of Health and Society, University of Oslo, Blindern, P.O. Box 1089, 0317, Oslo, Norway
| | - Hilde Stendal Robinson
- Department of Interdisciplinary Health Sciences, Institute of Health and Society, University of Oslo, Blindern, P.O. Box 1089, 0317, Oslo, Norway
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Mohammed A, Desu AP, Acheampong PR, Mensah KA, Osei FA, Yeboah EO, Amanor E, Owusu-Dabo E. Effect of fear appeal mobile phone messaging on health behaviors of caregivers with children under-five in Ghana. Health Promot Int 2022; 37:6671813. [PMID: 35984339 DOI: 10.1093/heapro/daac098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Social and Behavior Change Communication is a vital strategy in the control of malaria. However, the effectiveness of fear appeal tactic as a preventive strategy remains uncertain. This study examined the influence of a fear appeal mobile phone-based intervention, guided by Witte's Extended Parallel Process model, on malaria prevention among caregivers with children under-five. We conducted a quasi-experimental study of a 12-month intervention using a sample of 324 caregivers from two rural districts, assigned to either an intervention or control group. The intervention group received fear appeal voice Short Message Service (SMS), once a week for twelve (12) months, while caregivers in the control group received none. The results showed that exposure to the messages was associated with an increased odds of positive attitude [adjusted Odds ratio (aOR) = 2.58; 95% CI 1.61-4.15] and behavioral changes (aOR = 2.03, 95% CI 1.29-3.19). The intervention group exhibited lower odds of defensive avoidance (aOR = 0.44, 95% CI 0.29-0.68) and message minimization (aOR = 0.51, 95% CI 0.33-0.78) compared with the control group. These findings highlight the importance of communicating health messages via mobile phones using fear appeal for improving the health behaviors of caregivers. This strategy, however, may not be useful for influencing the intention of caregivers to engage in positive health practices to protect their children from malaria.
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Affiliation(s)
- Aliyu Mohammed
- School of Public Health, Kwame Nkrumah University of Science and Technology, School of Public Health, Kumasi, Ghana
| | - Adwoa Pinamang Desu
- School of Public Health, Kwame Nkrumah University of Science and Technology, School of Public Health, Kumasi, Ghana
| | - Princess Ruhama Acheampong
- School of Public Health, Kwame Nkrumah University of Science and Technology, School of Public Health, Kumasi, Ghana
| | - Kofi Akohene Mensah
- School of Public Health, Kwame Nkrumah University of Science and Technology, School of Public Health, Kumasi, Ghana
| | - Francis Adjei Osei
- School of Public Health, Kwame Nkrumah University of Science and Technology, School of Public Health, Kumasi, Ghana.,Public Health Unit, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Eugene Osei Yeboah
- Upper East Regional Health Directorate, Ghana Health Service, Bolgatanga, Ghana
| | - Ernest Amanor
- School of Public Health, Kwame Nkrumah University of Science and Technology, School of Public Health, Kumasi, Ghana
| | - Ellis Owusu-Dabo
- School of Public Health, Kwame Nkrumah University of Science and Technology, School of Public Health, Kumasi, Ghana
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47
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Shamasunder B, Chan M, Navarro S, Eckel S, Johnston JE. Mobile daily diaries to characterize stressors and acute health symptoms in an environmental justice neighborhood. Health Place 2022; 76:102849. [PMID: 35780656 DOI: 10.1016/j.healthplace.2022.102849] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 06/01/2022] [Accepted: 06/14/2022] [Indexed: 11/16/2022]
Abstract
Low-income communities and communities of color face multiple, cumulative environmental and social burdens. Methods development in environmental justice research has largely focused on spatial and quantitative approaches. Less attention has been paid to developing methodologies that help collect information on everyday stressors and quality of life experiences for residents in overburdened communities. Mixed methods approaches can be one way to structure study designs that help consider how residents experience environmental and socioeconomic impacts in a localized community context. In neighborhoods burdened by cumulative stressors, traditional cross-sectional epidemiological research designs can also be challenging, as well as limited or narrow in their application. However, repeat sampling of measures within a vulnerable population can approach a quasi-experimental design and help consider variations within residents in a single neighborhood as well as better parse relationships between exposures and outcomes. Through a community-academic partnership with university partners, local community partners, and a local promotores de salud (community health workers) network, we pilot tested a novel mobile daily diary approach in both English and Spanish in an urban, predominantly immigrant community in South Los Angeles as a potential method to collect information on daily stress, environmental quality, and health status/symptoms. We collected resident responses via a once per day 7-day SMS/text messaging survey. We sought to gather granular data on daily resident experiences of air pollution and environmental hazards. Residents reported acute health symptoms and stressors, with repeat measures demonstrating how residents might rank, categorize, or cope with stressors. We find that residents in environmental justice communities record variation in their daily diary responses and document changes in environmental quality, stressors, and odors. Refining this type of method could enable a more rigorous examination of co-occurrences of environmental quality and acute health symptoms. This approach supports the inclusion of residents in the research process and helps more systematically integrate open-ended environmental health relevant data in environmental justice efforts. Used with measured data such as air monitoring or health measures, mixed methods generated data can help support efforts that aim to alleviate sources of daily stress, alongside efforts to reduce overall pollution burdens. Mobile daily diaries can be one way to capture variable responses to environmental quality, acute health symptoms, and stressors.
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Affiliation(s)
- Bhavna Shamasunder
- Urban & Environmental Policy Department and Public Health Program, Occidental College, Los Angeles, CA, USA.
| | - Marissa Chan
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 665 Huntington Ave., Bldg. 1, 14th Floor, Boston, MA, 02115, USA.
| | | | - Sandrah Eckel
- Division of Biostatistics, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
| | - Jill E Johnston
- Division of Environmental Health, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
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48
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Cardoso VHR, Caldas P, Giraldi MTR, Fernandes CS, Frazão O, Costa JCWA, Santos JL. A Simple Optical Sensor Based on Multimodal Interference Superimposed on Additive Manufacturing for Diameter Measurement. Sensors (Basel) 2022; 22:s22124560. [PMID: 35746342 PMCID: PMC9227895 DOI: 10.3390/s22124560] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/08/2022] [Accepted: 06/14/2022] [Indexed: 12/30/2022]
Abstract
In many areas, the analysis of a cylindrical structure is necessary, and a form to analyze it is by evaluating the diameter changes. Some areas can be cited: pipelines for oil or gas distribution and radial growth of trees whose diameter changes are directly related to irrigation and the radial expansion since it depends on the water soil deficit. For some species, these radial variations can change in around 5 mm. This paper proposes and experimentally investigates a sensor based on a core diameter mismatch technique for diameter changes measurement. The sensor structure is a combination of a cylindrical piece developed using a 3D printer and a Mach-Zehnder interferometer. The pieces were developed to assist in monitoring the diameter variation. It is formed by splicing an uncoated short section of MMF (Multimode Fiber) between two standard SMFs (Singlemode Fibers) called SMF-MMF-SMF (SMS), where the MMF length is 15 mm. The work is divided into two main parts. Firstly, the sensor was fixed at two points on the first developed piece, and the diameter reduction caused dips or peaks shift of the transmittance spectrum due to curvature and strain influence. The fixation point (FP) distances used are: 5 mm, 10 mm, and 15 mm. Finally, the setup with the best sensitivity was chosen, from first results, to develop another test with an optimization. This optimization is performed in the printed piece where two supports are created so that only the strain influences the sensor. The results showed good sensitivity, reasonable dynamic range, and easy setup reproduction. Therefore, the sensor could be used for diameter variation measurement for proposed applications.
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Affiliation(s)
- Victor H. R. Cardoso
- Applied Electromagnetism Laboratory, Federal University of Pará, Rua Augusto Corrêa, 01, Belém 66075-110, Brazil;
- Institute for Systems and Computer Engineering, Technology and Science, Rua do Campo Alegre, 687, 4169-007 Porto, Portugal; (O.F.); (J.L.S.)
- Correspondence: (V.H.R.C.); (P.C.)
| | - Paulo Caldas
- Institute for Systems and Computer Engineering, Technology and Science, Rua do Campo Alegre, 687, 4169-007 Porto, Portugal; (O.F.); (J.L.S.)
- Polytechnic Institute of Viana do Castelo, Rua Escola Industrial e Comercial de Nun’Álvares, 4900-347 Viana do Castelo, Portugal
- Correspondence: (V.H.R.C.); (P.C.)
| | - Maria Thereza R. Giraldi
- Laboratory of Photonics, Military Institute of Engineering, Praça Gen. Tibúrcio, 80, Rio de Janeiro 22290-270, Brazil;
| | - Cindy Stella Fernandes
- Faculty of Computing and Electrical Engineering, Federal University of South and Southeast of Pará, Marabá 68507-590, Brazil;
| | - Orlando Frazão
- Institute for Systems and Computer Engineering, Technology and Science, Rua do Campo Alegre, 687, 4169-007 Porto, Portugal; (O.F.); (J.L.S.)
- Department of Physics and Astronomy, Faculty of Sciences of University of Porto, Rua do Campo Alegre, 687, 4169-007 Porto, Portugal
| | - João C. W. Albuquerque Costa
- Applied Electromagnetism Laboratory, Federal University of Pará, Rua Augusto Corrêa, 01, Belém 66075-110, Brazil;
| | - José Luís Santos
- Institute for Systems and Computer Engineering, Technology and Science, Rua do Campo Alegre, 687, 4169-007 Porto, Portugal; (O.F.); (J.L.S.)
- Department of Physics and Astronomy, Faculty of Sciences of University of Porto, Rua do Campo Alegre, 687, 4169-007 Porto, Portugal
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Nordby ES, Gjestad R, Kenter RMF, Guribye F, Mukhiya SK, Lundervold AJ, Nordgreen T. The Effect of SMS Reminders on Adherence in a Self-Guided Internet-Delivered Intervention for Adults With ADHD. Front Digit Health 2022; 4:821031. [PMID: 35651537 PMCID: PMC9149073 DOI: 10.3389/fdgth.2022.821031] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 04/04/2022] [Indexed: 11/13/2022] Open
Abstract
Background Self-guided Internet-delivered interventions may serve as an accessible and flexible non-pharmacological treatment supplement for adults with ADHD. However, these interventions are challenged by low adherence. Objective To examine whether weekly SMS reminders improve adherence to a self-guided Internet-delivered intervention for adults with ADHD. Method The study used a multiple randomized trial design where the participants who had not completed their weekly module within 2 days were randomized to either receive or not receive an SMS reminder. The primary outcome was adherence, defined as module completion, logins, time spent on intervention, and self-reported practice of coping strategies. Results A total of 109 adults with a self-reported ADHD diagnosis were included in the study. The results showed that SMS reminders were associated with an increased likelihood of login within 48 h during the second module of the intervention, but not for the remaining modules. Moreover, receiving an SMS reminder was associated spending more time on the modules and faster login time in module three and five, specifically. However, the overall results did not show an effect of SMS reminders on module completion, number of logins or practice of coping strategies. Conclusion The results showed that SMS reminders do not improve number of logins, module completion rates or practice of coping strategies, but they may lead to faster login time and more time spent on the modules. To utilize the potential of self-guided Internet-delivered intervention in making non-pharmacological accessible for adults with ADHD, new methods to facilitate meaningful engagement should be developed and tested. Trial Registration ClinicalTrials.gov NCT04511169.
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Affiliation(s)
- Emilie S. Nordby
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
- Department of Biological and Medical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Rolf Gjestad
- Center for Crisis Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
- Research Department, Division of Mental Health, Haukeland University Hospital, Bergen, Norway
- Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Robin M. F. Kenter
- Department of Clinical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Frode Guribye
- Department of Information Science and Media Studies, University of Bergen, Bergen, Norway
| | - Suresh K. Mukhiya
- Department of Computer Science, Electrical Engineering, and Mathematical Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Astri J. Lundervold
- Department of Biological and Medical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Tine Nordgreen
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
- Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
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50
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King SL, Lebert J, Karpisek LA, Phillips A, Neal T, Kosyluk K. Characterizing User Experiences With an SMS Text Messaging-Based mHealth Intervention: Mixed Methods Study. JMIR Form Res 2022; 6:e35699. [PMID: 35503524 PMCID: PMC9115655 DOI: 10.2196/35699] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 03/22/2022] [Accepted: 03/30/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Limited access to mental health care services due to provider shortages, geographic limitations, and cost has driven the area of mobile health (mHealth) care to address these access gaps. Reports from the Cohen Veterans Network and National Council for Behavioral Health show that in states where mental health care is more accessible, 38% of people still do not receive the care they need. mHealth strategies help to provide care to individuals experiencing these barriers at lower cost and greater convenience, making mHealth a great resource to bridge the gaps. OBJECTIVE We present a mixed methods study to evaluate user experiences with the mental mHealth service, Cope Notes. Specifically, we aimed to investigate the following research questions: How do users perceive the service in relation to stigma, impact of the intervention, and perceived usefulness? How do users rate the Cope Notes service and SMS text messaging along various dimensions of acceptability? What is the relationship between Cope Notes SMS text message ratings, user personality, and coping strategies? What are user perspectives of leveraging ubiquitous sensing technologies to improve delivery and provide tailored content? METHODS We performed qualitative interviews with Cope Notes users (N=14) who have used the service for at least 30 days to evaluate their experiences and usefulness of the service. These interviews were coded by 2 raters (SLK and JL), and the interrater reliability was calculated with SPSS (IBM Corp) at 61.8%. In addition, participants completed quantitative measures, including a user experiences survey, personality inventory (Big Five Inventory-10), and coping assessment (Brief Coping Orientation to Problems Experienced). RESULTS We derived 7 themes from our qualitative interviews: Likes or Perceived Benefits, Dislikes or Limitations, Suggested Changes, Stigma or Help Seeking, Perceptions of Ubiquitous Sensing, Cultural Sensitivity, and Alternative mHealth Resources. Exploratory analyses between acceptability ratings of Cope Notes and personality factors showed statistically significant positive relationships between seeing oneself as someone who is generally trusting and acceptability items, the most significant being item 7 (I fully understood the sentiment behind Cope Notes Messages) with (rs(10)=0.82, P=.001). We also found statistically significant relationships between acceptability and Brief Coping Orientation to Problems Experienced items, with the strongest positive correlation between participants strongly endorsing coping by accepting the reality that an event has happened and acceptability item 7 (rs(8)=0.86, P=.001). CONCLUSIONS Our study found that Cope Notes subscribers appreciate the service for reframing their mental wellness with statistically significant correlations between personality and acceptability of the service. We found that some users prefer a more personalized experience with neutral to positive reactions to a potential companion app that continuously monitors user behavior via smartphone sensors to provide just-in-time interventions when users need it most.
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Affiliation(s)
- Sayde Leya King
- Department of Computer Science and Engineering, College of Engineering, University of South Florida, Tampa, FL, United States
| | - Jana Lebert
- Department of Mental Health Law and Policy, Louis de la Parte Florida Mental Health Institute, University of South Florida, Tampa, FL, United States
| | - Lacey Anne Karpisek
- Department of Child and Family Studies, College of Behavioral and Community Sciences, University of South Florida, Tampa, FL, United States
| | - Amelia Phillips
- Department of Medical Education, Morsani College of Medicine, University of South Florida, Tampa, FL, United States
| | - Tempestt Neal
- Department of Computer Science and Engineering, College of Engineering, University of South Florida, Tampa, FL, United States
| | - Kristin Kosyluk
- Department of Mental Health Law and Policy, Louis de la Parte Florida Mental Health Institute, University of South Florida, Tampa, FL, United States
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