scholarly journals Using Mobile Health to Improve Social Support for Low-Income Latino Patients with Diabetes: A Mixed-Methods Analysis of the Feasibility Trial of TExT-MED + FANS

2018 ◽  
Vol 20 (1) ◽  
pp. 39-48 ◽  
Author(s):  
Elizabeth Burner ◽  
Chun Nok Lam ◽  
Rebecca DeRoss ◽  
Marjorie Kagawa-Singer ◽  
Michael Menchine ◽  
...  
Keyword(s):  
Social Support ◽  
Mixed Methods ◽  
Mobile Health ◽  
Low Income ◽  
Feasibility Trial ◽  
Patients With Diabetes

scholarly journals Perceptions of Family Among Low-Income Patients With Diabetes in a Text-Based Mobile Health Intervention

2018 ◽  
Vol 12 (6) ◽  
pp. 1203-1210
Author(s):  
Elizabeth R. E. Burner ◽  
Michael D. Menchine ◽  
Katrina Kubicek ◽  
Marisela Robles ◽  
Marjorie Kagawa Singer ◽  
...  
Keyword(s):  
Social Support ◽  
Mobile Health ◽  
Low Income ◽  
Diabetes Management ◽  
Cultural Practices ◽  
Self Care ◽  
Careful Study ◽  
Family Responsibilities ◽  
Effective Interventions ◽  
Patients With Diabetes

Background: Diabetes disproportionately affects the US Latino population, due to socioeconomic pressures, genetics, reduced access to care and cultural practices. While efforts to improve self-care through interventions incorporating family are highly rated by Latinos, family can be both supportive and obstructive. To develop effective interventions, this role needs clarification. Methods: We conducted group interviews in Spanish and English with 24 participants with diabetes from a mobile health diabetes self-care intervention. We imported transcripts into Dedoose, a qualitative computer analysis program and analyzed them with a modified grounded theory technique. Utilizing an iterative process, we reexamined transcripts with new codes derived in each round of analysis until saturation was reached. We employed techniques to improve trustworthiness (co-coding, member checking). Broad categorical themes arose from the initial codes and were developed into a conceptual model of barriers to and strategies for diabetes management. Results: Family and family responsibilities emerged as both a supportive and obstructive force for diabetes self-care. While the desire to care for family motivated patients, food at family gatherings and pressure from managing multiple family responsibilities contributed to poor diet choices. Yet, some patients believed their diabetes caused their immediate family to make healthier choices. Conclusions: Among these predominantly Latino patients, family and family responsibilities were key motivators as well as obstacles to self-care, particularly regarding nutrition. Finding the ideal design for social support mHealth-based interventions will require careful study and creation of culturally based programs to match the needs of specific populations, and may require educating family members to provide effective social support.

scholarly journals Self-monitoring diabetes with multiple mobile health devices

2020 ◽  
Vol 27 (5) ◽  
pp. 667-676 ◽  
Author(s):  
Ryan J Shaw ◽  
Q Yang ◽  
A Barnes ◽  
D Hatch ◽  
M J Crowley ◽  
...  
Keyword(s):  
Mobile Health ◽  
Care Delivery ◽  
Text Message ◽  
Patient Characteristics ◽  
Models Of Care ◽  
Feasibility Trial ◽  
Self Monitoring ◽  
Health Technologies ◽  
Related Data ◽  
Patients With Diabetes

Abstract Objective The purpose of this study was to examine the use of multiple mobile health technologies to generate and transmit data from diverse patients with type 2 diabetes mellitus (T2DM) in between clinic visits. We examined the data to identify patterns that describe characteristics of patients for clinical insights. Methods We enrolled 60 adults with T2DM from a US healthcare system to participate in a 6-month longitudinal feasibility trial. Patient weight, physical activity, and blood glucose were self-monitored via devices provided at baseline. Patients also responded to biweekly medication adherence text message surveys. Data were aggregated in near real-time. Measures of feasibility assessing total engagement in device submissions and survey completion over the 6 months of observation were calculated. Results It was feasible for participants from different socioeconomic, educational, and racial backgrounds to use and track relevant diabetes-related data from multiple mobile health devices for at least 6 months. Both the transmission and engagement of the data revealed notable patterns and varied by patient characteristics. Discussion Using multiple mobile health tools allowed us to derive clinical insights from diverse patients with diabetes. The ubiquitous adoption of smartphones across racial, educational, and socioeconomic populations and the integration of data from mobile health devices into electronic health records present an opportunity to develop new models of care delivery for patients with T2DM that may promote equity as well.

scholarly journals Acceptability, Adherence and Retention of a Feasibility Randomised Trial on Periodontal Treatment and Vitamin D/ Calcium Milk Fortification among Pregnant Women: A Mixed-Methods Evaluation

2020 ◽  
Author(s):  
Amanda Rodrigues Amorim Adegboye ◽  
Danilo Dias Santana ◽  
Paula Guedes Cocate ◽  
Camila Benaim ◽  
Pedro Paulo Teixeira dos Santos ◽  
...  
Keyword(s):  
Vitamin D ◽  
Mixed Methods ◽  
Pregnant Women ◽  
Low Income ◽  
Retention Rate ◽  
Randomised Trial ◽  
Feasibility Trial ◽  
Random Allocation ◽  
Treatment Groups ◽  
Mixed Methods Evaluation

This study aims to assess the acceptability, adherence, and retention of a feasibility trial on milk fortification with calcium and vitamin D (Ca+VitD) and periodontal therapy (PT) among low income Brazilian pregnant women with periodontitis (IMPROVE trial). This 2x2 factorial feasibility trial used a mixed-methods evaluation. 69 pregnant women were randomly allocated to four groups: 1.fortified sachet with Ca+VitD and milk plus early PT (throughout gestation); 2.placebo and milk plus early PT; 3.fortified sachet with Ca+VitD and milk plus late PT after childbirth; 4.placebo and milk plus late PT. Data were collected via questionnaires, field notes, participant flow logs, treatment diary, and focal group discussions. Quantitative and qualitative data were analysed using appropriate descriptive statistics and content analysis, respectively. Eligibility rate (12%) was below the target of 15%, but participation (76.1%) and recruitment rate (2 women/week) exceeded the targets. Retention rate (78.6%) was slightly below the target (80%). Adherence to the PT was significantly higher in the early treatment groups (98.8%) compared to the late treatment groups (29%). All women accepted the random allocation and baseline groups were balanced. There was no report of adverse events. This multi-component intervention is acceptable, well-tolerated, and feasible among low-risk pregnant women in Brazil.

scholarly journals Feasibility and Acceptability of Using Smartphone Apps in Diabetes Self-Management in an Underserved Population: Qualitative Study (Preprint)

2018 ◽  
Author(s):  
Jenny Luo ◽  
Shelley White-Means
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Mobile Health ◽  
Low Income ◽  
Underserved Populations ◽  
Low Cost ◽  
Self Management ◽  
Care Providers ◽  
Health Apps ◽  
Patients With Diabetes

BACKGROUND The successful management of diabetes is a chronic endeavor. It involves a whole host of factors ranging from a consistent patient-provider relationship to regular physical activity. Not all patients with diabetes, however, have access to the resources needed for effective disease management. Health disparities contribute to a higher frequency of diabetes development in poor and minority populations. Moreover, health care disparities limit the care these patient populations receive. Because underserved populations have little to no access to traditional means of health care, providers must explore other avenues to reach this patient group. Mobile health (mHealth) has grown significantly in the last decade. With the fast-paced adoption of cell phones across all socioeconomic groups, mobile health presents the opportunity to offer patients a low-cost way to receive health information, to communicate with providers, and to self-manage chronic conditions. It has been well established that low-income, minority populations experience several barriers to receiving basic health care including uninsurance, limited transportation, and high out-of-pocket costs. The provision of health care via mobile devices may have the potential to address such health disparities. Little is known about the effectiveness of using mobile health and smartphone applications (apps) in underserved populations to help with diabetes management. Knowledge of these patients’ interest in using mobile apps to augment their home self-management may have use in future implementations. OBJECTIVE The objective of this study is to examine the perception of and willingness to use diabetes mobile health apps on smartphones in patients with limited access to primary care providers. METHODS This study used purposive sampling to select patients for personal interviews. The study was conducted at a general hospital located in a part of town with predominate minority and low-income residency, as well as the highest diabetes prevalence rates. Semi-structured interviews were conducted according to McNamara’s interview staging. A total of 15 interviews were collected and coded by the researcher according to the interpretative phenomenological analysis framework. An independent committee reviewed all interview transcripts and coding to verify trustworthiness of collection and analysis. RESULTS The data produced 7 clusters related to smartphone app use and mHealth, each highlighting a component of the patient experience, which supported 3 overarching themes. The themes are as follows: despite limited knowledge about health apps and varying phone use patterns, patients were all willing to try at least one diabetes-related app; apps functions should be individualized to meet each patient’s needs for maximum benefit; and barriers to app use were varied but commonly included knowledge and technological challenges and security issues. CONCLUSIONS Personal interviews of this underserved patient population demonstrated an interest in and willingness to try mobile health apps, despite limited knowledge about the technology. Responses indicate that tailoring app choices to individual needs, instead of choosing a multi-functional one-size-fits-all app, would provide the most benefit for at-home diabetes self-management. Smartphone apps may serve as a viable low-cost resource for patients with diabetes who have limited access to traditional health care providers.

A Theoretical Framework for Mixed Methods Research with Canadian Families Living with Low Income

2019 ◽  
Vol 11 (3) ◽  
pp. 255-276 ◽  
Author(s):  
Carla Ginn ◽  
◽  
Karen Benzies ◽  
Leslie-Anne Keown ◽  
Shelley Raffin Bouchal ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Low Income ◽  
Mixed Methods Research ◽  
Theoretical Framework

Mixed-Methods Evaluation as Scaffold to the Development of a Mobile Health Application to Support the Prescription of Wheelchairs and Postural Support Devices (Preprint)

2020 ◽  
Author(s):  
Adriana Klein ◽  
Roseli de Deus Lopes ◽  
Rodrigo Suigh
Keyword(s):  
Mixed Methods ◽  
Mobile Health ◽  
Second Phase ◽  
The Third ◽  
Evaluation Approach ◽  
Mixed Methods Evaluation ◽  
Usability Tests ◽  
Third Phase ◽  
Postural Support ◽  
Support Devices

BACKGROUND EasySeating is a mobile health (mHealth) app that supports the prescription of wheelchair and postural support devices (WPSD). It can be used by occupational therapists (OT) and physiotherapists (PT) who prescribe WPSD. The app offers a standardization of the prescription procedure, showing images, metrics and details that guide the prescriber to decide on the best equipment. It was developed with an iterative mixed-methods evaluation approach. Objective: The aim of this study was to investigate the processes involved in the prescription of WPSD and to propose, develop and evaluate a mHealth to support OT and PT prescribers. OBJECTIVE The aim of this study was to investigate the processes involved in the prescription of WPSD and to propose, develop and evaluate a mHealth to support OT and PT prescribers. METHODS This study was divided into three phases and was carried out as an iterative process composed of user consulting/testing (using a mixed-methods evaluation approach), system (re)design and software development. The first phase consisted of the collection of qualitative and quantitative data to map and understand the users requirements and of the development of the first prototype (v1) of the app. This data collection was performed through semi-structured interviews with 14 OT and PT prescribers, 5 specialized technicians and 5 WPSD users. The second phase aimed at improving the overall functionality of the app and consisted in the development, test and evaluation of the prototypes v1, v2, v3 and v4. A total of 59 prescribers tested and evaluated these prototypes by means of open interviews, semi-structured questionnaires and focus groups. The third phase focused in the usability aspects of the app. It consisted in the development and test of the prototype v5. Eight technology specialists assessed its usability through heuristics evaluation. RESULTS Data collected in phase one indicated there is a lack of standardization on the prescription of postural support devices (PSD). A divergent nomenclature for the PSDs was also found and classified in eight categories. These information guided the development of the first prototype of the EasySeating app. Phase two results pointed that the prescribers value the insertion of the app into their clinical practice, as it accelerates and increases the quality of the evaluation process and improves the organization of the prescription information. Significant suggestions for the improvement of the app were given during the users tests, including the use of images to represent the PSDs. The usability tests from the third phase revealed two strong issues that must be solved: the need of greater feedback and failures in the persistence of the input data. CONCLUSIONS This study demonstrated that there is a lack of systematization of the WPSD prescription process. The evaluation of the developed EasySeating app demonstrated that there is a potential to standardize, integrate and organize the WPSD prescription information, supporting and facilitating the decision making process of the prescribers. CLINICALTRIAL This study was approved by the Research Ethics Board of the Universidade de São Paulo (registered protocol n°53929516.6.0000.0065) URL - http://plataformabrasil.saude.gov.br/login.jsf

Empathy not quarantined: Association between people’s empathy to others and the COVID-19 pandemic situations based on a national survey study (Preprint)

2020 ◽  
Author(s):  
Zhibin Jiang ◽  
Fan Yang ◽  
Bu Zhong ◽  
Xuebing Qin
Keyword(s):  
Social Support ◽  
Social Media ◽  
National Survey ◽  
Low Income ◽  
Rural Areas ◽  
Critical Role ◽  
Affective Response ◽  
Survey Study ◽  
Income Levels ◽  
The Social

BACKGROUND The Covid-19 pandemic had turned the world upside down, but not much is known about how people’s empathy might be affected by the pandemic. OBJECTIVE This study examined 1) how empathy towards others might be influenced by the social support people obtained by using social media; and 2) how the individual demographics (e.g., age, income) may affect empathy. METHODS A national survey (N = 943) was conducted in China in February 2020, in which the participants read three real scenarios about low-income urban workers (Scenario I), small business owners in cities (Scenario II), and farmers in rural areas (Scenario III) who underwent hardship due to COVID-19. After exposure to others’ difficulties in the scenarios, the participants’ empathy and anxiety levels were measured. We also measured the social support they had by using social media. RESULTS Results show that social support not only positively impacted empathy, β = .30, P < .001 for Scenario I, β = .30, P < .001 for Scenario II, and β = .29, P < .001 for Scenario III, but also interacted with anxiety in influencing the degree to which participants could maintain empathy towards others, β = .08, P = .010 for Scenario I, and β = .07, P = .033 for scenario II. Age negatively predicted empathy for Scenario I, β = -.08, P = .018 and Scenario III, β = -.08, P = .009, but not for Scenario II, β = -.03, P = .40. Income levels – low, medium, high – positively predicted empathy for Scenario III, F (2, 940) = 8.10, P < .001, but not for Scenario I, F (2, 940) = 2.14, P = .12, or Scenario II, F (2, 940) = 2.93, P = .06. Participants living in big cities expressed greater empathy towards others for Scenario III, F (2, 940) = 4.03, P =.018, but not for Scenario I, F (2, 940) = .81, P = .45, or Scenario II, F (2, 940) = 1.46, P =.23. CONCLUSIONS This study contributes to the literature by discovering the critical role empathy plays in people’s affective response to others during the pandemic. Anxiety did not decrease empathy. However, those gaining more social support on social media showed more empathy for others. Those who resided in cities with higher income levels were more empathetic during the COVID-19 outbreak. This study reveals that the social support people obtained helped maintain empathy to others, making them resilient in challenging times.

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