scholarly journals Usability and Acceptability of a Mobile App for the Self-Management of Alcohol Misuse Among Veterans (Step Away): Pilot Cohort Study

10.2196/25927 ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. e25927
Author(s):  
Carol A Malte ◽  
Patrick L Dulin ◽  
John S Baer ◽  
John C Fortney ◽  
Anissa N Danner ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Alcohol Misuse ◽  
Heavy Drinking ◽  
Operation Iraqi Freedom ◽  
Mobile App ◽  
Operation Enduring Freedom ◽  
System Usability Scale ◽  
Inventory Of Problems ◽  
Iraqi Freedom

Background Alcohol misuse is common among Operation Enduring Freedom and Operation Iraqi Freedom veterans, yet barriers limit treatment participation. Mobile apps hold promise as means to deliver alcohol interventions to veterans who prefer to remain anonymous, have little time for conventional treatments, or live too far away to attend treatment in person. Objective This pilot study evaluated the usability and acceptability of Step Away, a mobile app designed to reduce alcohol-related risks, and explored pre-post changes on alcohol use, psychological distress, and quality of life. Methods This single-arm pilot study recruited Operation Enduring Freedom and Operation Iraqi Freedom veterans aged 18 to 55 years who exceeded National Institute on Alcohol Abuse and Alcoholism drinking guidelines and owned an iPhone. Enrolled veterans (N=55) completed baseline and 1-, 3-, and 6-month assessments. The System Usability Scale (scaled 1-100, ≥70 indicating acceptable usability) assessed the effectiveness, efficiency, and satisfaction dimensions of usability, while a single item (scaled 1-9) measured the attractiveness of 10 screenshots. Learnability was assessed by app use during week 1. App engagement (proportion of participants using Step Away, episodes of use, and minutes per episode per week) over 6 months measured acceptability. Secondary outcomes included pre-post change on heavy drinking days (men: ≥5 drinks per day; women: ≥4 drinks per day) and Short Inventory of Problems–Revised, Kessler-10, and brief World Health Organization Quality of Life Questionnaire scores. Results Among the 55 veterans enrolled in the study, the mean age was 37.4 (SD 7.6), 16% (9/55) were women, 82% (45/55) were White, and 82% (45/55) had an alcohol use disorder. Step Away was used by 96% (53/55) of participants in week 1, 55% (30/55) in week 4, and 36% (20/55) in week 24. Step Away use averaged 55.1 minutes (SD 57.6) in week 1 and <15 minutes per week in weeks 2 through 24. Mean System Usability Scale scores were 69.3 (SD 19.7) and 71.9 (SD 15.8) at 1 and 3 months, respectively. Median attractiveness scores ranged from 5 to 8, with lower ratings for text-laden screens. Heavy drinking days decreased from 29.4% (95% CI 23.4%-35.4%) at baseline to 16.2% (95% CI 9.9%-22.4%) at 6 months (P<.001). Likewise, over 6 months, Short Inventory of Problems–Revised scores decreased from 6.3 (95% CI 5.1-7.5) to 3.6 (95% CI 2.4-4.9) (P<.001) and Kessler-10 scores decreased from 18.8 (95% CI 17.4-20.1) to 17.3 (95% CI 15.8-18.7) (P=.046). Changes were not detected on quality of life scores. Conclusions Operation Enduring Freedom and Operation Iraqi Freedom veterans found the usability of Step Away to be acceptable and engaged in the app over the 6-month study. Reductions were seen in heavy drinking days, alcohol-related problems, and Kessler-10 scores. A larger randomized trial is warranted to confirm our findings.

scholarly journals Usability and Acceptability of a Mobile App for the Self-Management of Alcohol Misuse Among Veterans (Step Away): Pilot Cohort Study (Preprint)

2020 ◽  
Author(s):  
Carol A Malte ◽  
Patrick L Dulin ◽  
John S Baer ◽  
John C Fortney ◽  
Anissa N Danner ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Alcohol Misuse ◽  
Heavy Drinking ◽  
Operation Iraqi Freedom ◽  
Mobile App ◽  
Operation Enduring Freedom ◽  
System Usability Scale ◽  
Inventory Of Problems ◽  
Iraqi Freedom

BACKGROUND Alcohol misuse is common among Operation Enduring Freedom and Operation Iraqi Freedom veterans, yet barriers limit treatment participation. Mobile apps hold promise as means to deliver alcohol interventions to veterans who prefer to remain anonymous, have little time for conventional treatments, or live too far away to attend treatment in person. OBJECTIVE This pilot study evaluated the usability and acceptability of Step Away, a mobile app designed to reduce alcohol-related risks, and explored pre-post changes on alcohol use, psychological distress, and quality of life. METHODS This single-arm pilot study recruited Operation Enduring Freedom and Operation Iraqi Freedom veterans aged 18 to 55 years who exceeded National Institute on Alcohol Abuse and Alcoholism drinking guidelines and owned an iPhone. Enrolled veterans (N=55) completed baseline and 1-, 3-, and 6-month assessments. The System Usability Scale (scaled 1-100, ≥70 indicating acceptable usability) assessed the effectiveness, efficiency, and satisfaction dimensions of usability, while a single item (scaled 1-9) measured the attractiveness of 10 screenshots. Learnability was assessed by app use during week 1. App engagement (proportion of participants using Step Away, episodes of use, and minutes per episode per week) over 6 months measured acceptability. Secondary outcomes included pre-post change on heavy drinking days (men: ≥5 drinks per day; women: ≥4 drinks per day) and Short Inventory of Problems–Revised, Kessler-10, and brief World Health Organization Quality of Life Questionnaire scores. RESULTS Among the 55 veterans enrolled in the study, the mean age was 37.4 (SD 7.6), 16% (9/55) were women, 82% (45/55) were White, and 82% (45/55) had an alcohol use disorder. Step Away was used by 96% (53/55) of participants in week 1, 55% (30/55) in week 4, and 36% (20/55) in week 24. Step Away use averaged 55.1 minutes (SD 57.6) in week 1 and &lt;15 minutes per week in weeks 2 through 24. Mean System Usability Scale scores were 69.3 (SD 19.7) and 71.9 (SD 15.8) at 1 and 3 months, respectively. Median attractiveness scores ranged from 5 to 8, with lower ratings for text-laden screens. Heavy drinking days decreased from 29.4% (95% CI 23.4%-35.4%) at baseline to 16.2% (95% CI 9.9%-22.4%) at 6 months (<i>P&lt;.</i>001). Likewise, over 6 months, Short Inventory of Problems–Revised scores decreased from 6.3 (95% CI 5.1-7.5) to 3.6 (95% CI 2.4-4.9) (<i>P&lt;.</i>001) and Kessler-10 scores decreased from 18.8 (95% CI 17.4-20.1) to 17.3 (95% CI 15.8-18.7) (<i>P</i>=.046). Changes were not detected on quality of life scores. CONCLUSIONS Operation Enduring Freedom and Operation Iraqi Freedom veterans found the usability of Step Away to be acceptable and engaged in the app over the 6-month study. Reductions were seen in heavy drinking days, alcohol-related problems, and Kessler-10 scores. A larger randomized trial is warranted to confirm our findings.

Family Caregivers of Veterans: A Critical Review of the Empirical Literature and Recommendations for Future Research

2014 ◽  
Vol 32 (1) ◽  
pp. 155-202 ◽  
Author(s):  
Constance R. Uphold ◽  
Meggan Jordan ◽  
Magaly Freytes
Keyword(s):  
Family Caregivers ◽  
Family Caregiving ◽  
Operation Iraqi Freedom ◽  
Operation Enduring Freedom ◽  
Empirical Literature ◽  
Substantial Contribution ◽  
Future Research ◽  
Iraqi Freedom ◽  
Two Populations

In recent years, research on caregiving has grown in both quality and quantity. Caregivers play an important role in supporting and promoting the health and recovery of injured, disabled, and ill family members in their care. Although researchers have made a substantial contribution to our understanding of family caregiving, less is known about family caregivers of U.S. Veterans. The purpose of this review is to identify and evaluate the research surrounding caregivers of U.S. Veterans, particularly two populations of Veterans: those who returned from the wars in Iraq and Afghanistan and those who had suffered a stroke. A search of the available literature from 1987 to present day resulted in a review of 18 publications on Operation Enduring Freedom/Operation Iraqi Freedom caregivers and 19 publications on caregivers of Veterans with stroke. We summarize empirical findings, critique the study methods, and provide our recommendations to improve the quality of care of Veterans and their caregivers.

The Quality of Mental Health Care for Veterans of Operation Enduring Freedom/Operation Iraqi Freedom

Medical Care ◽  
2013 ◽  
Vol 51 (1) ◽  
pp. 84-89 ◽  
Author(s):  
Susan M. Paddock ◽  
Abigail Woodroffe ◽  
Katherine E. Watkins ◽  
Melony E. Sorbero ◽  
Brad Smith ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Operation Iraqi Freedom ◽  
Operation Enduring Freedom ◽  
Iraqi Freedom

Co-Design and Open Trial of Starship Rescue, a Cognitive Behavior Therapy, Biofeedback, and Game-Based eHealth Intervention to Treat Anxiety in Children and Young People with Long-Term Physical Conditions (Preprint)

2020 ◽  
Author(s):  
Hiran Thabrew ◽  
Karolina Stasiak ◽  
Harshali Kumar ◽  
Tarique Naseem ◽  
Christopher Frampton ◽  
...  
Keyword(s):  
Quality Of Life ◽  
New Zealand ◽  
Young People ◽  
Preliminary Evidence ◽  
Children And Young People ◽  
Physical Conditions ◽  
System Usability Scale ◽  
Ehealth Intervention

BACKGROUND Approximately 10% to 12% of New Zealand children and young people have long-term physical conditions (also known as chronic illnesses) and are more likely to develop psychological problems, particularly anxiety and depression. Delayed treatment leads to worse physical and mental healthcare, school absence, and poorer long-term outcomes. Recently, electronic health (eHealth) interventions, especially those based on the principles of Cognitive Behavior Therapy (CBT), have been shown to be as good as face-to-face therapy. Biofeedback techniques have also been shown to enhance relaxation during the treatment of anxiety. However, these modalities have rarely been combined. Young people with long-term physical conditions have expressed a preference for well-designed and technologically-based support to deal with psychological issues, especially anxiety. OBJECTIVE This study aimed to co-design and evaluate the (i) acceptability and (ii) usability of a CBT and biofeedback-based, 5-module eHealth game called ‘Starship Rescue’ and (iii) to provide preliminary evidence regarding its effectiveness in addressing anxiety and quality of life in young people with long-term physical conditions. METHODS Starship Rescue was co-designed with children and young people from a tertiary hospital in Auckland, New Zealand. Following this, 24 young people aged 10 to 17 years were enrolled in an open trial, during which they were asked to use the game for an 8-week period. Acceptability of the game to all participants was assessed using a brief, open-ended questionnaire, and more detailed feedback was obtained from a subset of 10 participants via semi-structured interviews. Usability was evaluated via the System Usability Scale (SUS) and device-recorded frequency and duration of access on completion of the game. Anxiety levels were measured prior to commencement, on completion of the game, and 3 months later using the Generalized Anxiety Disorder 7-item scale (GAD-7) and Spence Child Anxiety Scales (SCAS), and at the start of each module and at the end of the game using an embedded Likert/visual analog scale. Quality of life was measured prior to commencement and on completion of the game using the Pediatric Quality of Life Scale (PEDS-QL). RESULTS Users gave Starship Rescue an overall rating of 5.9 out of 10 (range 3-10 and a mean score of 71 out of 100 (SD 11.7; min 47.5; max 90) on the System Usability Scale (SUS). The mean time period for use of the game was just over 11-weeks (78.8 days, 13.5 hours, 40 minutes). Significant reductions in anxiety were noted between the start and end of the game on the GAD-7 (-4.6 (p=0.000)), SCAS (-9.6 (p=0.005)), and the Likert/visual analogue scales (-2.4 (p=0.001)). Quality of life also improved on the PedsQL scale (+4.3 (p=0.042)). All changes were sustained at 3-month follow-up. CONCLUSIONS This study provides preliminary evidence for Starship Rescue being an acceptable, usable and effective eHealth intervention for addressing anxiety in young people with long-term physical conditions. Further evaluation is planned via a more formal randomized controlled trial. CLINICALTRIAL Australian New Zealand Clinical Trials Network Registry (ANZCTR): ACTRN12616001253493p;https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=371443 (Archived by WebCite at http://www.webcitation.org/6sYB716lf)

scholarly journals Semen Quality Parameters Among U.S. Veterans of Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn

2017 ◽  
Vol 182 (5) ◽  
pp. e1775-e1781
Author(s):  
Luke A. Lindaman ◽  
J. Richard Pilsner ◽  
Aimee R. Kroll-Desrosiers ◽  
Sally Haskell ◽  
Cynthia A. Brandt ◽  
...  
Keyword(s):  
Semen Quality ◽  
Operation Iraqi Freedom ◽  
Quality Parameters ◽  
Operation Enduring Freedom ◽  
Iraqi Freedom
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