scholarly journals Behavior Change Content, Understandability, and Actionability of Chronic Condition Self-Management Apps Available in France: Systematic Search and Evaluation

10.2196/13494 ◽  
2019 ◽  
Vol 7 (8) ◽  
pp. e13494 ◽  
Author(s):  
Luiza Siqueira do Prado ◽  
Camille Carpentier ◽  
Marie Preau ◽  
Anne-Marie Schott ◽  
Alexandra Lelia Dima
Keyword(s):  
Behavior Change ◽  
Chronic Conditions ◽  
Chronic Condition ◽  
Respiratory Diseases ◽  
Literature Search ◽  
The Self ◽  
Self Management ◽  
Target Behaviors ◽  
And Behavior ◽  
Google Play

Background The quality of life of people living with chronic conditions is highly dependent on self-management behaviors. Mobile health (mHealth) apps could facilitate self-management and thus help improve population health. To achieve their potential, apps need to target specific behaviors with appropriate techniques that support change and do so in a way that allows users to understand and act upon the content with which they interact. Objective Our objective was to identify apps targeted toward the self-management of chronic conditions and that are available in France. We aimed to examine what target behaviors and behavior change techniques (BCTs) they include, their level of understandability and actionability, and the associations between these characteristics. Methods We extracted data from the Google Play store on apps labelled as Top in the Medicine category. We also extracted data on apps that were found through 12 popular terms (ie, keywords) for the four most common chronic condition groups—cardiovascular diseases, cancers, respiratory diseases, and diabetes—along with apps identified through a literature search. We selected and downloaded native Android apps available in French for the self-management of any chronic condition in one of the four groups and extracted background characteristics (eg, stars and number of ratings), coded the presence of target behaviors and BCTs using the BCT taxonomy, and coded the understandability and actionability of apps using the Patient Education Material Assessment Tool for audiovisual materials (PEMAT-A/V). We performed descriptive statistics and bivariate statistical tests. Results A total of 44 distinct native apps were available for download in France and in French: 39 (89%) were found via the Google Play store and 5 (11%) were found via literature search. A total of 19 (43%) apps were for diabetes, 10 for cardiovascular diseases (23%), 8 for more than one condition in the four groups (18%), 6 for respiratory diseases (14%), and 1 for cancer (2%). The median number of target behaviors per app was 2 (range 0-7) and of BCTs per app was 3 (range 0-12). The most common BCT was self-monitoring of outcome(s) of behavior (31 apps), while the most common target behavior was tracking symptoms (30 apps). The median level of understandability was 42% and of actionability was 0%. Apps with more target behaviors and more BCTs were also more understandable (ρ=.31, P=.04 and ρ=.35, P=.02, respectively), but were not significantly more actionable (ρ=.24, P=.12 and ρ=.29, P=.054, respectively). Conclusions These apps target few behaviors and include few BCTs, limiting their potential for behavior change. While content is moderately understandable, clear instructions on when and how to act are uncommon. Developers need to work closely with health professionals, users, and behavior change experts to improve content and format so apps can better support patients in coping with chronic conditions. Developers may use these criteria for assessing content and format to guide app development and evaluation of app performance. Trial Registration PROSPERO CRD42018094012; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=94012

scholarly journals Behavior Change Content, Understandability, and Actionability of Chronic Condition Self-Management Apps Available in France: Systematic Search and Evaluation (Preprint)

2019 ◽  
Author(s):  
Luiza Siqueira do Prado ◽  
Camille Carpentier ◽  
Marie Preau ◽  
Anne-Marie Schott ◽  
Alexandra Lelia Dima
Keyword(s):  
Behavior Change ◽  
Chronic Conditions ◽  
Chronic Condition ◽  
Respiratory Diseases ◽  
Literature Search ◽  
The Self ◽  
Self Management ◽  
Target Behaviors ◽  
And Behavior ◽  
Google Play

BACKGROUND The quality of life of people living with chronic conditions is highly dependent on self-management behaviors. Mobile health (mHealth) apps could facilitate self-management and thus help improve population health. To achieve their potential, apps need to target specific behaviors with appropriate techniques that support change and do so in a way that allows users to understand and act upon the content with which they interact. OBJECTIVE Our objective was to identify apps targeted toward the self-management of chronic conditions and that are available in France. We aimed to examine what target behaviors and behavior change techniques (BCTs) they include, their level of understandability and actionability, and the associations between these characteristics. METHODS We extracted data from the Google Play store on apps labelled as Top in the Medicine category. We also extracted data on apps that were found through 12 popular terms (ie, keywords) for the four most common chronic condition groups—cardiovascular diseases, cancers, respiratory diseases, and diabetes—along with apps identified through a literature search. We selected and downloaded native Android apps available in French for the self-management of any chronic condition in one of the four groups and extracted background characteristics (eg, stars and number of ratings), coded the presence of target behaviors and BCTs using the BCT taxonomy, and coded the understandability and actionability of apps using the Patient Education Material Assessment Tool for audiovisual materials (PEMAT-A/V). We performed descriptive statistics and bivariate statistical tests. RESULTS A total of 44 distinct native apps were available for download in France and in French: 39 (89%) were found via the Google Play store and 5 (11%) were found via literature search. A total of 19 (43%) apps were for diabetes, 10 for cardiovascular diseases (23%), 8 for more than one condition in the four groups (18%), 6 for respiratory diseases (14%), and 1 for cancer (2%). The median number of target behaviors per app was 2 (range 0-7) and of BCTs per app was 3 (range 0-12). The most common BCT was self-monitoring of outcome(s) of behavior (31 apps), while the most common target behavior was tracking symptoms (30 apps). The median level of understandability was 42% and of actionability was 0%. Apps with more target behaviors and more BCTs were also more understandable (ρ=.31, P=.04 and ρ=.35, P=.02, respectively), but were not significantly more actionable (ρ=.24, P=.12 and ρ=.29, P=.054, respectively). CONCLUSIONS These apps target few behaviors and include few BCTs, limiting their potential for behavior change. While content is moderately understandable, clear instructions on when and how to act are uncommon. Developers need to work closely with health professionals, users, and behavior change experts to improve content and format so apps can better support patients in coping with chronic conditions. Developers may use these criteria for assessing content and format to guide app development and evaluation of app performance. CLINICALTRIAL PROSPERO CRD42018094012; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=94012

A review of mHealth depression apps: Assessing app functions for the Self-Determination Theory (Preprint)

2020 ◽  
Author(s):  
Luke Brownlow
Keyword(s):  
Health Behavior ◽  
Behavior Change ◽  
Basic Needs ◽  
Health Behavior Change ◽  
Self Determination Theory ◽  
Healthcare Research ◽  
The Self ◽  
Self Determination ◽  
Ideal Tool ◽  
Google Play

BACKGROUND Smartphone applications (apps) are an ideal tool that is highly accessible to people who wish to begin self-treatment for depression. While many studies have performed content analyses on healthcare apps, few studies have reviewed these apps for adherence to behavior theory. Furthermore, apps for depression management are underrepresented in healthcare research. OBJECTIVE The objective of this study is to assess mHealth depression apps using SDT as a theoretical framework for meeting needs of autonomy, competence and, relatedness METHODS All depression healthcare apps available in Australia from the iTunes and Google Play app stores that met the inclusion criteria were analyzed. Each app was reviewed based on price options, store availability, download rates, and how in-app functions met the three basic needs for motivation towards health behavior change outlined in the Self-Determination Theory (SDT). RESULTS The analysis of the apps showed that most apps were free to download (69.9%) and addressed at least one of the three needs (81.4%) of SDT. However, few apps addressed all three of the basic needs through their functions (7.7%), and no apps hosted all functions expected to stimulate motivation for health behavior change. Furthermore, neither store availability, price option nor download rate were accurate predictors that apps hosted in-app functions expected to meet the basic needs. CONCLUSIONS The results suggest that some depression healthcare apps that meet the basic needs would effectively stimulate motivation (i.e., autonomy, competence, and relatedness). However, each individual app is limited in its number of functions that meet the basic needs. People who want access to more functions would need to download a suite of apps.

scholarly journals Standardising the Lay: Logics of Change in Programs of Disease Self-management

2012 ◽  
Vol 4 (3) ◽  
pp. 425-442 ◽  
Author(s):  
Annegrete Juul Nielsen ◽  
Lone Grøn
Keyword(s):  
Chronic Disease ◽  
Role Models ◽  
Chronic Condition ◽  
Expert Knowledge ◽  
Management Program ◽  
The Self ◽  
Self Management ◽  
Social Settings ◽  
Patient Centric ◽  
Forms Of Knowledge

The health political discourse on self-care is dominated by the view that the selfmanaging patient represents a more democratic and patient-centric perspective, as he or she is believed to renegotiate the terms on which patient participation in health care has hitherto taken place. The self-managing patient is intended as a challenge to traditional medical authority by introducing lay methods of knowing disease. Rather than a meeting between authoritative professionals and vulnerable patients, the self-managing patient seeks to open up new spaces for a meeting between experts. The present paper questions these assumptions through an ethnographic exploration of a patient-led self-management program called the Chronic Disease Self-Management Program. The program is concerned with what its developers call the social and mental aspects of living with a chronic disease and uses trained patients as role models and program leaders. Drawing inspiration from Annemarie Mol’s term ’logic’, we explore the rationale of ’situations of selfmanagement’ and identify what we call a ’logic of change’, which involves very specific ideas on how life with a chronic condition should be dealt with and directs attention towards particular manageable aspects of life with a chronic condition. This logic of change entails, we argue, a clash not between ’medical’ and ’lay’ forms of knowledge but between different logics or perceptions of how transformation can be achieved: through open-ended and ongoing reflection and experimentation in social settings or through standardised trajectories of change. Returning to the literature on lay forms of knowledge and illness perspectives, we question whether programs such as the Chronic Disease Self-Management Program – despite its apparent patient-centric perspective – reproduces classical hierarchical relations between lay and expert knowledge, albeit in new forms.

The Effectiveness of a Healthcare Application and Human Coaching Program in Primary Care Clinics: A Non-randomized Controlled Trial (Preprint)

2021 ◽  
Author(s):  
HyoRim Ju ◽  
EunKyo Kang ◽  
YoungIn Kim ◽  
HyunYoung Ko ◽  
Belong Cho
Keyword(s):  
Primary Care ◽  
Weight Loss ◽  
Sleep Quality ◽  
Chronic Conditions ◽  
Chronic Condition ◽  
Intervention Group ◽  
Self Management ◽  
Control Group ◽  
Primary Care Clinics ◽  
Healthcare Application

BACKGROUND As the global burden of chronic conditions increases, effective management for these are a concern. There is an increasing need for chronic condition management using mobile self-management healthcare applications. OBJECTIVE This study evaluated the effectiveness of a mobile self-management healthcare application combined with human coaching for primary care services in patients with chronic conditions. METHODS A total of 110 patients with hypertension, diabetes, dyslipidemia, and/or metabolic syndrome who visited one of 17 participating primary care clinics from September 2020 to November 2020 were included in this study. Data regarding changes in body weight, sleep conditions, quality of life, depression, anxiety, stress, body mass index, waist circumference, blood sugar levels, blood pressure, and blood lipids levels were recorded. The intervention group (N=65) used a mobile self-management healthcare application with human coaching for 12 weeks, and the control group (N=45) underwent conventional, self-managed health care. RESULTS Patients in the intervention group reported significantly more weight loss than those in the control group (P=.002). The weight loss was markedly greater after using application for nine weeks than using it for four weeks or five to eight weeks (P=.002). Patients in the intervention group reported better sleep quality (P=.04) and duration (P=.004) than those in the control group. CONCLUSIONS The combination of a mobile self-management healthcare application and human coaching in primary care clinics results in better management of chronic conditions. The observed weight loss was greater and sleep quality improved than conventional primary care for patients with at least one chronic condition.

scholarly journals Managing chronic conditions care across primary care and hospital systems: lessons from an Australian Hospital Avoidance Risk Program using the Flinders Chronic Condition Management Program

2018 ◽  
Vol 42 (5) ◽  
pp. 542 ◽  
Author(s):  
Sharon Lawn ◽  
Sara Zabeen ◽  
David Smith ◽  
Ellen Wilson ◽  
Cathie Miller ◽  
...  
Keyword(s):  
Emergency Department ◽  
Heart Disease ◽  
Length Of Stay ◽  
Chronic Conditions ◽  
Chronic Condition ◽  
Hospital Admissions ◽  
Self Management ◽  
Psychosocial Needs ◽  
Post Discharge ◽  
The Impact

Objective The study aimed to determine the impact of the Flinders Chronic Condition Management Program for chronic condition self-management care planning and how to improve its use with Bendigo Health’s Hospital Admission Risk Program (HARP). Methods A retrospective analysis of hospital admission data collected by Bendigo Health from July 2012 to September 2013 was undertaken. Length of stay during admission and total contacts post-discharge by hospital staff for 253 patients with 644 admissions were considered as outcome variables. For statistical modelling we used the generalised linear model. Results The combination of the HARP and Flinders Program was able to achieve significant reductions in hospital admissions and non-significant reduction in emergency department presentations and length of stay. The generalised linear model predicted that vulnerable patient groups such as those with heart disease (P = 0.037) and complex needs (P < 0.001) received more post-discharge contacts by HARP staff than those suffering from diabetes, renal conditions and psychosocial needs when they lived alone. Similarly, respiratory (P < 0.001), heart disease (P = 0.015) and complex needs (P = 0.050) patients had more contacts, with an increased number of episodes than those suffering from diabetes, renal conditions and psychosocial needs. Conclusion The Flinders Program appeared to have significant positive impacts on HARP patients that could be more effective if high-risk groups, such as respiratory patients with no carers and respiratory and heart disease patients aged 0–65, had received more targeted care. What is known about the topic? Chronic conditions are common causes of premature death and disability in Australia. Besides mental and physical impacts at the individual level, chronic conditions are strongly linked to high costs and health service utilisation. Hospital avoidance programs such as HARP can better manage chronic conditions through a greater focus on coordination and integration of care across primary care and hospital systems. In support of HARP, self-management interventions such as the Flinders Program aim to help individuals better manage their medical treatment and cope with the impact of the condition on their physical and mental wellbeing and thus reduce health services utilisation. What does this paper add? This paper sheds light on which patients might be more or less likely to benefit from the combination of the HARP and Flinders Program, with regard to their impact on reductions in hospital admissions, emergency department presentations and length of stay. This study also sheds light on how the Flinders Program could be better targeted towards and implemented among high-need and high-cost patients to lessen chronic disease burden on Australia’s health system. What are the implications for practitioners? Programs targeting vulnerable populations and applying evidence-based chronic condition management and self-management support achieve significant reductions in potentially avoidable hospitalisation and emergency department presentation rates, though sex, type of chronic condition and living situation appear to matter. Benefits might also accrue from the combination of contextual factors (such as the Flinders Program, supportive service management, clinical champions in the team) that work synergistically.

Recreation and collaboration within the Expanded Chronic Care Model: working towards social transformation

2020 ◽  
Vol 35 (6) ◽  
pp. 1531-1542
Author(s):  
Susan L Hutchinson ◽  
Heidi Lauckner
Keyword(s):  
Social Change ◽  
Chronic Care Model ◽  
Social Transformation ◽  
Chronic Conditions ◽  
Chronic Condition ◽  
Chronic Care ◽  
Self Management ◽  
Care Model ◽  
Community Based ◽  
Community Recreation

Abstract Assisting people to live well with a chronic physical or mental health condition requires the creation of intersectoral community-based supports for chronic condition self-management. One important but underutilized resource for supporting chronic condition self-management in the community is recreation, which refers to relatively self-determined and enjoyable physical, social or expressive everyday activities. The Expanded Chronic Care Model (ECCM) provides a framework for identifying systems-level strategies to support self-management through increased access to community recreation opportunities. In this article, an occupation-based social transformation approach, which involves examining assumptions, considering contexts of daily activities and partnering to create meaningful social change, is used to examine the ECCM. Recommendations related to strengthening social change with a specific focus on collaborations and networks through recreation are provided. Through such collaborations, self-management of chronic conditions in community recreation contexts is advanced. Health providers and community-based recreation services providers are invited to be part of these intersectoral changes that will promote health amongst those living with chronic conditions.

Concurrent validity of the Partners in Health scale against general self-rated health in chronic conditions: A short report

2017 ◽  
Vol 15 (1) ◽  
pp. 74-77 ◽  
Author(s):  
David Smith ◽  
Sharon Lawn ◽  
Peter Harvey ◽  
Malcolm Battersby
Keyword(s):  
Construct Validity ◽  
Representative Sample ◽  
Chronic Conditions ◽  
Concurrent Validity ◽  
Chronic Condition ◽  
Self Management ◽  
Short Report ◽  
Valid Measure ◽  
Single Item ◽  
Self Rated Health

The Partners in Health scale is a structurally valid measure of chronic condition self-management behaviours. This report describes a study that further evaluated construct validity of Partners in Health scale by assessing its relationship with a single-item measure of general self-rated health. The concurrent validity of the scale was demonstrated by a statistically significant association with general self-rated health in a population representative sample of people with chronic conditions.

scholarly journals The organization of the self: An alternative focus for psychopathology and behavior change.

1994 ◽  
Vol 4 (4) ◽  
pp. 317-353 ◽  
Author(s):  
Karen Farchaus Stein ◽  
Hazel Rose Markus
Keyword(s):  
Behavior Change ◽  
The Self ◽  
And Behavior
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