scholarly journals An Adaptive Mobile Health System to Support Self-Management for Persons With Chronic Conditions and Disabilities: Usability and Feasibility Studies

10.2196/12982 ◽  
2019 ◽  
Vol 3 (2) ◽  
pp. e12982 ◽  
Author(s):  
I Made Agus Setiawan ◽  
Leming Zhou ◽  
Zakiy Alfikri ◽  
Andi Saptono ◽  
Andrea D Fairman ◽  
...  
Keyword(s):  
Health System ◽  
Mobile Health ◽  
Chronic Conditions ◽  
Feasibility Studies ◽  
Self Management

User-Centered Design Enhances Usability of an mHealth System for Users with Dexterity Impairments (Preprint)

2020 ◽  
Author(s):  
Kuntal Chowdhary ◽  
Daihua Xie Yu ◽  
Gede Pramana ◽  
Andrea Fairman ◽  
Brad Edward Dicianno ◽  
...  
Keyword(s):  
User Interface ◽  
Mobile Health ◽  
Chronic Conditions ◽  
Independent Living ◽  
Health Interventions ◽  
Self Management ◽  
User Centered Design ◽  
Entire Study ◽  
Efficiency And Effectiveness ◽  
User Centered

BACKGROUND Mobile health (mHealth) systems have been shown to be useful in supporting self-management by promoting adherence to schedules and longitudinal health interventions, especially in people with disabilities (PwD). The Interactive Mobile Health and Rehabilitation (iMHere) System was developed to empower PwD and those with chronic conditions with supports needed for self-management and independent living. Since the first iteration of the iMHere 1.0 app, several studies have evaluated accessibility and usability of the system. Potential opportunities to improve and simplify the user interface (UI) were identified, and the iMHere modules were redesigned accordingly. OBJECTIVE The aim of this study was to evaluate the usability of the redesigned modules within iMHere 1.0. METHODS This study evaluated the original and redesigned MyMeds and SkinCare modules. To assess the participants’ dexterity levels, the Purdue Pegboard Test (PPBT) was administered. Participants were then asked to perform a set of tasks using both the original and redesigned MyMeds and SkinCare modules to assess efficiency and effectiveness. Usability was measured using the Telehealth Usability Questionnaire (TUQ) to evaluate 10 new accessibility features that were added to the redesigned app. Participants were also asked which version they preferred. RESULTS Twenty-four participants with disabilities and varied degrees of dexterity impairments completed the entire study protocol. Participants displayed improved efficiency and effectiveness of use when using the redesigned modules, as compared to the original modules. Participants also reported improved usability and preferred the redesigned modules. CONCLUSIONS This study demonstrated that the iMHere System became more efficient, effective, and usable for individuals with dexterity impairments after redesigning it according to user-centered principles.

scholarly journals A Patient-Centered Mobile Health System That Supports Asthma Self-Management (breathe): Design, Development, and Utilization (Preprint)

2018 ◽  
Author(s):  
Plinio Pelegrini Morita ◽  
Melanie S Yeung ◽  
Madonna Ferrone ◽  
Ann K Taite ◽  
Carole Madeley ◽  
...  
Keyword(s):  
Health System ◽  
Real Time ◽  
Asthma Control ◽  
Mobile Health ◽  
Peak Flow ◽  
Action Plan ◽  
Self Management ◽  
Evidence Based ◽  
Web Based ◽  
Physician Visits

BACKGROUND Uncontrolled asthma poses substantial negative personal and health system impacts. Web-based technologies, including smartphones, are novel means to enable evidence-based care and improve patient outcomes. OBJECTIVE The aim of this study was to design, develop, and assess the utilization of an asthma collaborative self-management (CSM) platform (breathe) using content based on international evidence-based clinical guidelines. METHODS We designed and developed breathe as a Web-based mobile health (mHealth) platform accessible on smartphones, tablets, or desktop with user-centered design methods and International Organization for Standardization–certified quality development processes. Moreover, breathe was envisioned as a multifunctional, CSM mHealth platform, with content based on international clinical practice guidelines and compliant with national privacy and security specifications. The system enabled CSM (patient, provider, and breathe) and self-monitoring of asthma patients through (1) assessment of asthma control, (2) real-time access to a dynamic asthma action plan, (3) access to real-time environmental conditions, and (4) risk-reduction messaging. The data collection protocol collected user data for 12 months, with clinic visits at baseline and 6 and 12 months. Utilization outcomes included user interactions with the platform, user impressions, self-reported medication use, asthma symptom profile, reported peak flow measurement, and the delivery and impact of email reminders. RESULTS We enrolled 138 patients with a mean age of 45.3 years to receive the breathe intervention. Majority were female (100/138, 72.5%), had a smartphone (92/138, 66.7%), and had a mean Asthma Control Test score of 18.3 (SD 4.9). A majority reported that breathe helped in the management of their asthma. Moreover, breathe scored 71.1 (SD 18.9) on the System Usability Scale. Overall, 123 patients had complete usage analytics datasets. The platform sent 7.96 reminder emails per patient per week (pppw), patients accessed breathe 3.08 times, journaled symptoms 2.56 times, reported medication usage 0.30 times, and reported peak flow measurements 0.92 times pppw. Furthermore, breathe calculated patients’ action plan zone of control 2.72 times pppw, with patients being in the green (well-controlled) zone in 47.71% (8300/17,396) of the total calculations. Usage analysis showed that 67.5% (83/123) of the participants used the app at week 4 and only 57.7% (71/123) by week 45. Physician visits, email reminders, and aged 50 years and above were associated with higher utilization. CONCLUSIONS Individuals with asthma reported good usability and high satisfaction levels, reacted to breathe notifications, and had confidence in the platform’s assessment of asthma control. Strong utilization was seen at the intervention’s initiation, followed by a rapid reduction in use. Patient reminders, physician visits, and being aged 50 years and above were associated with higher utilization. CLINICALTRIAL ClinicalTrials.gov NCT01964469; https://clinicaltrials.gov/ct2/show/NCT01964469

scholarly journals An Adaptive Mobile Health System to Support Self-Management for Persons With Chronic Conditions and Disabilities: Usability and Feasibility Studies (Preprint)

2018 ◽  
Author(s):  
I Made Agus Setiawan ◽  
Leming Zhou ◽  
Zakiy Alfikri ◽  
Andi Saptono ◽  
Andrea D Fairman ◽  
...  
Keyword(s):  
Mobile Health ◽  
Chronic Conditions ◽  
Self Management ◽  
Management Support ◽  
Secondary Complications ◽  
Change Over Time ◽  
Adaptive Architecture ◽  
Persuasive Technologies ◽  
Over Time

BACKGROUND Persons with chronic conditions and disabilities (PwCCDs) are vulnerable to secondary complications. Many of these secondary complications are preventable with proactive self-management and proper support. To enhance PwCCDs' self-management skills and conveniently receive desired support, we have developed a mobile health (mHealth) system called iMHere. In 2 previous clinical trials, iMHere was successfully used to improve health outcomes of adult participants with spina bifida and spinal cord injury. To further expand use of iMHere among people with various types of disabilities and chronic diseases, the system needs to be more adaptive to address 3 unique challenges: 1) PwCCDs have very diverse needs with regards to self-management support, 2) PwCCDs’ self-management needs may change over time, and 3) it is a challenge to keep PwCCDs engaged and interested in long-term self-management. OBJECTIVE The aim of this study was to develop an adaptive mHealth system capable of supporting long-term self-management and adapting to the various needs and conditions of PwCCDs. METHODS A scalable and adaptive architecture was designed and implemented for the new version, iMHere 2.0. In this scalable architecture, a set of mobile app modules was created to provide various types of self-management support to PwCCDs with the ability to add more as needed. The adaptive architecture empowers PwCCDs with personally relevant app modules and allows clinicians to adapt these modules in response to PwCCDs’ evolving needs and conditions over time. Persuasive technologies, social support, and personalization features were integrated into iMHere 2.0 to engage and motivate PwCCDs and support long-term usage. Two initial studies were performed to evaluate the usability and feasibility of the iMHere 2.0 system. RESULTS The iMHere 2.0 system consists of cross-platform client and caregiver apps, a Web-based clinician portal, and a secure 2-way communication protocol for providing interactions among these 3 front-end components, all supported by a back-end server. The client and caregiver apps have 12 adaptive app modules to support various types of self-management tasks. The adaptive architecture makes it possible for PwCCDs to receive personalized app modules relevant to their conditions with or without support from various types of caregivers. The personalization and persuasive technologies in the architecture can be used to engage PwCCDs for long-term usage of the iMHere 2.0 system. Participants of the usability study were satisfied with the iMHere 2.0 client app. The feasibility evaluation revealed several practical issues to consider when implementing the system on a large scale. CONCLUSIONS We developed an adaptive mHealth system as a novel method to support diverse needs in self-management for PwCCDs that can dynamically change over time. The usability of the client app is high, and it was feasible for PwCCDs to use in supporting personalized and evolving self-care needs.

scholarly journals Development and pilot testing of a mobile health solution for asthma self-management: Asthma action plan smartphone application pilot study

2013 ◽  
Vol 20 (4) ◽  
pp. 301-306 ◽  
Author(s):  
Christopher J Licskai ◽  
Todd W Sands ◽  
Madonna Ferrone
Keyword(s):  
Knowledge Translation ◽  
Health System ◽  
Mobile Health ◽  
Action Plan ◽  
Smartphone Application ◽  
Ease Of Use ◽  
Self Management ◽  
Life Questionnaire ◽  
Health Technologies ◽  
Asthma Action Plan

BACKGROUND: Collaborative self-management is a core recommendation of national asthma guidelines; the written action plan is the knowledge tool that supports this objective. Mobile health technologies have the potential to enhance the effectiveness of the action plan as a knowledge translation tool.OBJECTIVE: To design, develop and pilot a mobile health system to support asthma self-management.METHODS: The present study was a prospective, single-centre, nonrandomized, pilot preintervention-postintervention analysis. System design and development were guided by an expert steering committee. The network included an agnostic web browser-based asthma action plan smart-phone application (SPA). Subjects securely transmitted symptoms and peak flow data daily, and received automated control assessment, treatment advice and environmental alerts.RESULTS: Twenty-two adult subjects (mean age 47 years, 82% women) completed the study. Biophysical data were received on 84% of subject days (subject day = 1 subject × 1 day). Subjects viewed their action plan current zone of control on 54% and current air quality on 61% of subject days, 86% followed self-management advice and 50% acted to reduce exposure risks. A large majority affirmed ease of use, clarity and timeliness, and 95% desired SPA use after the study. At baseline, 91% had at least one symptom criterion for uncontrolled asthma and 64% had ≥2, compared with 45% (P=0.006) and 27% (P=0.022) at study close. Mean Asthma Quality of Life Questionnaire score improved from 4.3 to 4.8 (P=0.047).CONCLUSIONS: A dynamic, real-time, interactive, mobile health system with an integrated asthma action plan SPA can support knowledge translation at the patient and provider levels.

scholarly journals An mHealth App for Users with Dexterity Impairments: Accessibility Study (Preprint)

2018 ◽  
Author(s):  
Daihua Yu ◽  
Bambang Parmanto ◽  
Brad Dicianno
Keyword(s):  
Mobile Health ◽  
Chronic Conditions ◽  
Lower Number ◽  
Ease Of Use ◽  
Self Management ◽  
Usability Study ◽  
Interface Quality ◽  
App Development ◽  
Lower Error Rate ◽  
Insight Into

BACKGROUND A mobile health (mHealth) system called iMHere (interactive mobile health and rehabilitation) was developed to support individuals with chronic conditions and disability in their self-management regimens. The initial design of iMHere, however, lacked sufficient accessibility for users with a myriad of dexterity impairments. The accessibility of self-management apps is essential in ensuring usability. OBJECTIVE This study aims to increase the usability of the iMHere system for users with dexterity impairments by increasing the app’s accessibility. METHODS We targeted the accessibility redesign by focusing on the physical presentation and the navigability of the iMHere apps. Six participants presenting with dexterity impairments were included in the usability study of the original and redesigned apps. RESULTS We observed a lower number of touches needed to complete tasks (P=.09) and time to complete individual tasks (P=.06) with the redesigned app than with the original app; a significantly lower time for users to complete all tasks (P=.006); and a significantly lower error rate (P=.01) with the redesigned app than with the original app. In fact, no errors occurred with use of the redesigned app. Participant-reported overall average usability of the redesigned app (P=.007) and usability of individual modules (P<.001) were significantly higher than that of the original app due mostly to better ease of use and learnability, interface quality, and reliability. CONCLUSIONS Improved usability was achieved using a redesigned app. This study offers insight into the importance of personalization in enhancing the accessibility and also identifies strategies for improving usability in app development.

scholarly journals Mobile Health Technology for Hypertension Management: A Systematic Review

2020 ◽  
Author(s):  
Sohrab Almasi ◽  
Azamossadat Hosseini ◽  
Hassan Emami ◽  
Azam Sabahi
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Mobile Health ◽  
Chronic Conditions ◽  
Web Of Science ◽  
Pressure Control ◽  
Self Management ◽  
Hypertension Control ◽  
Mhealth Technology ◽  
Present Systematic Review

Hypertension is a chronic condition, and a major risk factor for other chronic conditions requires management. Considering the growth and extensive use of mobile health (mHealth) technologies and their capabilities, it is essential to examine the effects of these technologies on hypertension control and self-management. The present systematic review examined the effect of using mHealth technologies in controlling blood pressure and investigated the functionalities of mHealth technology on self-management aspects of patients with hypertension. A systematic search was conducted on PubMed, Web of Science, Embase, and Scopus databases. Clinical trials in English investigating the use of mHealth technologies for blood pressure control published from 2005 to 2018 were included in this study. The functionalities of these technologies were also investigated. These functionalities were divided into five categories of monitoring, alarms, feedbacks, education, and communication. The most frequently used technology for hypertension control was smartphones in the 15 articles examined. Moreover, the most frequent functionalities used for self-management of hypertension were communications and reminders, education, monitoring, and feedback, respectively. In the majority of the studies, these functionalities were employed in combination with mHealth technologies, a feature that affects hypertension control and self-management. The use of mHealth technologies, such as smartphones, positively affects hypertension self-management and reduces blood pressure. Functionalities such as communication and reminders, education, monitoring, and feedback are effective in hypertension self-management programs. The simultaneous use of these functionalities combined will be more effective in hypertension self-management programs.

scholarly journals Measuring Success of Patients' Continuous Use of Mobile Health Services for Self-Management of Chronic Conditions: A Theoretical Model and Empirical Test with Hypertensive Patients (Preprint)

2020 ◽  
Author(s):  
Ting Song ◽  
Ning Deng ◽  
Tingru Cui ◽  
Siyu Qian ◽  
Fang Liu ◽  
...  
Keyword(s):  
Health Status ◽  
Theoretical Model ◽  
Health Services ◽  
Mobile Health ◽  
User Satisfaction ◽  
Chronic Conditions ◽  
Perceived Usefulness ◽  
Self Management ◽  
Perceived Health Status ◽  
Continuous Use

BACKGROUND Mobile health services are gradually being introduced to support patients' self-management of chronic conditions. The success of these services is contingent upon patients' continuous use of them. OBJECTIVE This study aims to develop a model to measure the success of patients' continuous use of mobile health services for self-management of chronic conditions. METHODS The proposed model was derived from the Information Systems Continuance Model and Information Systems Success Model. The model contained seven theoretical constructs: information quality, system quality, service quality, perceived usefulness, user satisfaction, perceived health status, and continuous use intention. An online questionnaire survey instrument was developed to test the model. The survey was conducted to collect data from 129 patients who used a mobile health app for hypertension management from 2017 to 2019. The questionnaire items were derived from the validated instruments and were measured by a five-point Likert Scale. The partial least square modelling method was used to test the theoretical model. RESULTS The model accounted for 58.5% of the variance in perceived usefulness (R2=.585), 52.3% of the variance in user satisfaction (R2=.523), and 41.4% of the variance in patients' intention to make continuous use of mobile health services (R2=.414). The continuous use intention was significantly influenced by their perceived health status (β=.195, P=.034), the perceived usefulness (β=.307, P=.004) and user satisfaction (β=.254, P=.037) with the mobile health service. Information quality (β=.235, P=.005), system quality (β=.192, P=.022) and service quality (β=.494, P<.001) had a significant positive influence on perceived usefulness, but not on user satisfaction. Perceived usefulness had a significant positive influence on user satisfaction (β=.664, P<.001). In a result opposite to the original hypothesis, perceived health status did not negatively influence patients' intention to continue using the mobile health service but showed a significant, positive correlation. CONCLUSIONS This study developed a theoretical model to predict and explain patients' continuous use of mobile health services for self-management of chronic conditions and empirically tested the model. Perceived usefulness, user satisfaction and health status contributed to patients' intention to make continuous use of mobile health services for self-managing their chronic conditions.

scholarly journals Gamification Concepts to Promote and Maintain Therapy Adherence in Children with Growth Hormone Deficiency

2018 ◽  
Author(s):  
Sally Radovick ◽  
Eli Hershkovitz ◽  
Aline Kalisvaart ◽  
Marco Koning ◽  
Kristine Paridaens ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Mobile Health ◽  
Chronic Conditions ◽  
Gh Deficiency ◽  
Smart Phone ◽  
Hormone Deficiency ◽  
Self Management ◽  
Target Height ◽  
Management Behaviour ◽  
Adherence To Therapy

Growth hormone (GH) deficiency affects up to 1 in 4,000 children and is usually treated with daily injections of GH whilst the child is still growing. With children typically diagnosed around 5 years old, this can mean over 10 years of therapy, which can place a considerable burden on the child and parent. Over three-quarters of children are estimated to be not fully compliant with therapy, which can compromise their chances of attaining their target height. In recent years, interactive mobile health (smart phone or tablet) interventions using game-like concepts, so called &lsquo;gamification&rsquo;, have increased in popularity and have demonstrated success in promoting positive self-management behaviour in children with chronic conditions, such as diabetes. The application of gamified interventions has the potential to support adherence to therapy and positive behaviour in children with GH deficiency in a number of ways: 1) By providing education in a format that the child understands and accepts (e.g. using behavioural constructs to facilitate explaining why adherence is important); 2) By providing a mechanism to reduce the anxiety and stress associated with administering the injection (e.g. diversion with a virtual pet); and 3) By providing feedback to encourage on-going engagement (e.g. rewards, progression through levels).

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