scholarly journals Designing a Cancer Prevention Collaborative Goal Setting Mobile App for Non-Hispanic Black Primary Care Patients: An Iterative, Qualitative Patient-led Process (Preprint)

10.2196/28157 ◽  
2021 ◽  
Author(s):  
Daniel Resnick ◽  
Matthew D Kearney ◽  
Jazmine M Smith ◽  
Allison Bautista ◽  
Liz Jones ◽  
...  
Keyword(s):  
Primary Care ◽  
Cancer Prevention ◽  
Goal Setting ◽  
Mobile App ◽  
Primary Care Patients

scholarly journals Promoting Collaborative Goal Setting for Cancer Prevention Among Primary Care Patients: Pilot Testing a New Application (Preprint)

2020 ◽  
Author(s):  
Daniel Resnick ◽  
Marilyn M. Schapira ◽  
Jazmine M. Smith ◽  
Allison Bautista ◽  
Chang Xu ◽  
...  
Keyword(s):  
Primary Care ◽  
Cancer Prevention ◽  
Goal Setting ◽  
Behavioral Change ◽  
Mobile Application ◽  
Primary Care Providers ◽  
Care Providers ◽  
System Usability Scale ◽  
Primary Care Patients ◽  
The Mean

BACKGROUND Many newly diagnosed cancers are associated with modifiable lifestyle behaviors, such as diet, exercise, smoking cessation, and maintaining a healthy weight. Despite this, primary care providers rarely discuss cancer prevention behaviors with their patients. OBJECTIVE To assess the usability, acceptability and engagement of the Healthier Together mobile application, which is designed to promote cancer prevention behaviors among Non-Hispanic Black primary care patients, utilizing social network and goal setting theories of behavior change. METHODS In an eight-week pilot study, we enrolled primary care patients (n=41) and provided these participants with a cancer prevention mobile application that allowed them to select, track, and share progress on cancer prevention goals with other users. We assessed application usability with the System Usability Scale (SUS). We assessed app acceptability by qualitatively analyzing open-ended responses about participants’ overall experience with the app. We assessed participant engagement by analyzing the built-in data capture, including how many times participants checked in (out of a maximum of eight) during the study. RESULTS Of 41 participants, the mean age was 51 (SD: 12) and 31 (76%) were women. App use data was captured for all participants and 34 (83%) completed the exit survey and interview. The mean SUS score was 87 (SD ±12; median 90; IQR 78-95). Analysis of open-ended responses revealed several key themes, with participants complementing the application’s ease of use and health behavior promoting features, while also commenting on the need for more feedback and social interactions through the application. On average, participants checked in 5.7 times (SD: 2.7) out of eight possible opportunities. Thirty-one participants (76%) checked in during at least 4 of the 8 weeks. Secondary analyses revealed that participants often accomplished their set goal (mean: 5.1, SD: 2.7) for each week. Qualitative analysis of comments participants left within the app after each weekly check-in revealed several themes on how the app assisted participants in behavioral change, highlighting that some participants built up exercise programs, ate healthier foods, lost a significant amount of weight, and stopped smoking during the study. CONCLUSIONS The implementation of a mobile cancer prevention goal setting application in a primary care setting was feasible with high usability, acceptability, and engagement from participants. User feedback revealed an influence on health behaviors. These findings suggest the promise of the HT application to facilitate behavioral change to reduce cancer risk among Non-Hispanic Black primary care patients.

Designing a Cancer Prevention Collaborative Goal Setting Application for Primary Care Patients: An Iterative, Patient-led Process (Preprint)

2021 ◽  
Author(s):  
Daniel Resnick ◽  
Matthew D Kearney ◽  
Jazmine M Smith ◽  
Allison Bautista ◽  
Liz Jones ◽  
...  
Keyword(s):  
Primary Care ◽  
Cancer Prevention ◽  
Goal Setting ◽  
Mobile Application ◽  
Primary Care Physicians ◽  
Structured Interviews ◽  
Health Goals ◽  
System Usability Scale ◽  
Primary Care Patients ◽  
Beta Version

BACKGROUND There remains a need to engage at-risk primary care populations in cancer prevention behaviors, yet primary care physicians often lack the time or resources to discuss these behaviors with their patients. OBJECTIVE The objective of the study was to evaluate the content, usability, and acceptability of a mobile application that leverages insights from goal-setting and social networks literature to facilitate cancer prevention goal setting, tracking, and sharing between Non-Hispanic Black primary care patients and their social ties. METHODS We recruited participants from two primary care clinics in Philadelphia using non-probabilistic purposive sampling. We conducted semi-structured interviews with 5 to 7 participants over three weeks to solicit feedback on paper mock-ups of the application, iteratively adapting these mock-ups after each set of interviews. Thereafter, and informed by initial feedback, we created an electronic beta-version of the application and sought acceptability and usability feedback from a different set of participants. Then we conducted content analysis of all user responses to search for unifying themes on acceptability and usability of both the initial mock-ups and beta-version of the application. We further assessed application usability using questions derived from the System Usability Scale (SUS). RESULTS Thirty-three Non-Hispanic Black primary care patients participated in the study. The mean age was 49 (SD ± 13) and 79% identified as female. Semi-structured interviews revealed three primary generalizable insights from our target population: 1) the framing of each goal and its relevance to cancer impacted the likelihood the goal would be chosen; 2) participants thought that sharing health goals with others facilitates health behaviors; and 3) most participants found it motivating to see other users’ goal progress, while still collaborating with these users on their health goals. An overarching insight that permeated across each theme was the participants’ desire to customize and personalize the app. Usability testing revealed that 100% of participants found the application easy to use and 76% of participants reported they would like to use this application frequently. CONCLUSIONS Cancer prevention in the modern era must include options that are accessible to all, but this does not mean that all options must be universal. This study’s iterative process led to the development of a cancer prevention mobile application that Non-Hispanic Black primary care patients deemed usable and acceptable and yielded a number of noteworthy insights about what intended end-users value in setting and accomplishing health goals.

scholarly journals Uses of Mobile Device Digital Photography of Dermatologic Conditions in Primary Care (Preprint)

2017 ◽  
Author(s):  
Jennifer L Pecina ◽  
Kirk D Wyatt ◽  
Nneka I Comfere ◽  
Matthew E Bernard ◽  
Frederick North
Keyword(s):  
Primary Care ◽  
Nurse Practitioners ◽  
Physician Assistants ◽  
Mobile App ◽  
Usage Patterns ◽  
Primary Care Patients ◽  
Primary Care Clinicians ◽  
Curbside Consultation ◽  
Record Review ◽  
And Training

BACKGROUND PhotoExam is a mobile app that incorporates digital photographs into the electronic health record (EHR) using iPhone operating system (iOS, Apple Inc)–based mobile devices. OBJECTIVE The aim of this study was to describe usage patterns of PhotoExam in primary care and to assess clinician-level factors that influence the use of the PhotoExam app for teledermatology (TD) purposes. METHODS Retrospective record review of primary care patients who had one or more photos taken with the PhotoExam app between February 16, 2015 to February 29, 2016 were reviewed for 30-day outcomes for rates of dermatology consult request, mode of dermatology consultation (curbside phone consult, eConsult, and in-person consult), specialty and training level of clinician using the app, performance of skin biopsy, and final pathological diagnosis (benign vs malignant). RESULTS During the study period, there were 1139 photo sessions on 1059 unique patients. Of the 1139 sessions, 395 (34.68%) sessions documented dermatologist input in the EHR via dermatology curbside consultation, eConsult, and in-person dermatology consult. Clinicians utilized curbside phone consults preferentially over eConsults for TD. By clinician type, nurse practitioners (NPs) and physician assistants (PAs) were more likely to utilize the PhotoExam for TD as compared with physicians. By specialty type, pediatric clinicians were more likely to utilize the PhotoExam for TD as compared with family medicine and internal medicine clinicians. A total of 108 (9.5%) photo sessions had a biopsy performed of the photographed site. Of these, 46 biopsies (42.6%) were performed by a primary care clinician, and 27 (25.0%) biopsies were interpreted as a malignancy. Of the 27 biopsies that revealed malignant findings, 6 (22%) had a TD consultation before biopsy, and 10 (37%) of these biopsies were obtained by primary care clinicians. CONCLUSIONS Clinicians primarily used the PhotoExam for non-TD purposes. Nurse practitioners and PAs utilized the app for TD purposes more than physicians. Primary care clinicians requested curbside dermatology consults more frequently than dermatology eConsults.

scholarly journals Coached Mobile App Platform for the Treatment of Depression and Anxiety Among Primary Care Patients

2020 ◽  
Vol 77 (9) ◽  
pp. 906 ◽  
Author(s):  
Andrea K. Graham ◽  
Carolyn J. Greene ◽  
Mary J. Kwasny ◽  
Susan M. Kaiser ◽  
Paul Lieponis ◽  
...  
Keyword(s):  
Primary Care ◽  
Mobile App ◽  
Depression And Anxiety ◽  
Treatment Of Depression ◽  
Primary Care Patients

A Mobile App to Prevent Depression Among Low-Income Primary Care Patients in the Dominican Republic: Sociocultural Adaptations

2020 ◽  
Vol 31 (4) ◽  
pp. 413-424
Author(s):  
Susan Caplan ◽  
Angelina Sosa Lovera ◽  
Esther Veloz Comas ◽  
Jonas Attilus
Keyword(s):  
Primary Care ◽  
Dominican Republic ◽  
Low Income ◽  
Mobile Apps ◽  
Detailed Examination ◽  
Mobile App ◽  
User Preferences ◽  
Individual Interviews ◽  
Culturally Congruent ◽  
Primary Care Patients

Introduction: Mental health mobile apps (MHapps) can provide depression treatment to people worldwide who do not have access to care, but few apps are culturally targeted to the population. In this series of studies, we described sociocultural considerations of MHapp development, and we explored participants’ perceptions of acceptability, usability, and cultural relevance of the MHapp. Method: Individual interviews were conducted in three separate primary care sites in the Dominican Republic among convenience samples of staff and patients ( n = 23, 18, and 21, respectively), using mixed methods of data collection. Results: Modifications were made during the iterative design process to reflect user preferences, which included a female gendered voice, the addition of animations, and changes to the psychoeducational content. Discussion: Primary care patients reported strong interest in MHapps due to its convenience, privacy, and affordability. Our findings support the necessity of detailed examination of user preferences to develop culturally congruent MHapp psychoeducation.

scholarly journals Mobile Apps Use by Primary Care Patients to Manage Their Depressive Symptoms: A Qualitative Study (Preprint)

2018 ◽  
Author(s):  
Alison Pung ◽  
Susan Louise Fletcher ◽  
Jane Maree Gunn
Keyword(s):  
Primary Care ◽  
Depressive Symptoms ◽  
Skill Acquisition ◽  
Mobile Apps ◽  
Controlled Trial ◽  
Management Strategies ◽  
Health Sector ◽  
Mobile App ◽  
Primary Care Patients ◽  
Depression Management

BACKGROUND Mobile applications (apps) are emerging as tools with the potential to revolutionise the treatment of mental health conditions such as depression. At the forefront of community health sector, general practitioners (GPs) are in a unique position to guide the integration of technology and depression management, however little is currently known about how primary care patients with depressive symptoms are currently using apps. OBJECTIVE The aim of this study was to explore the natural patterns of mobile app use amongst patients with depressive symptoms, in order to facilitate understanding of the potential role for mobile apps in managing depressive symptoms in the community. METHODS Semi-structured phone interviews were conducted with primary care patients in Victoria, Australia, who reported symptoms of depression and were enrolled in a larger randomized controlled trial of depression care. Interviews explored current depression management strategies and the use of mobile apps (if any). Interviews were audio-recorded and transcribed verbatim. Inductive thematic analysis was iteratively conducted using QSR NVivo 11 Pro to identify emergent themes. RESULTS A total of 16 participants aged between 20 to 58 years took part in the interviews, with 11 reporting the use of at least one mobile app to manage depressive symptoms and 5 reporting no app use. A variety of apps were described including relaxation, mindfulness, cognitive, exercise, gaming, social media and wellbeing apps to aid with depressive symptoms. Amongst users, there were four main patterns of app use: skill acquisition, social connectedness, inquisitive trial, and safety netting. Factors that influenced app use included accessibility, perceptions of technology and personal compatibility. Healthcare providers also had a role in initiating app use. CONCLUSIONS Mobile apps are being utilised for self-management of depressive symptoms by primary care patients. This study provided insight into the natural patterns and perspectives of app use, which enhances understanding of how this technology may be integrated into the toolbox for the management of depression.

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