Exploration of user�s perspectives and needs and design of a type 1 diabetes management mobile app: mixed-methods study (Preprint)

10.2196/preprints.11393 ◽

2018 ◽

Author(s):

Yiyu Zhang ◽

Xia Li ◽

Shuoming Luo ◽

Chaoyuan Liu ◽

Fang Liu ◽

...

Keyword(s):

Mixed Methods ◽

Health Care Professionals ◽

Diabetes Management ◽

Mobile Apps ◽

Diabetes Education ◽

Qualitative Interviews ◽

Mobile App ◽

Patient Questionnaires ◽

App Design ◽

Doctor Communication

BACKGROUND With the popularity of smart phones, mobile apps have great potential for the management of diabetes, but the effectiveness of current diabetes apps for T1DM is poor. No study has explored the reasons from the user’s perspective. OBJECTIVE To explore the perspectives and needs of T1DM patients and diabetes experts concerning diabetes app and to design a new T1DM management mobile app. METHODS A mixed methods design combining quantitative surveys and qualitative interviews was used to explore user needs and perspectives. Experts were surveyed at two diabetes conferences using paper questionnaires. T1DM patients were surveyed using Sojump on a network. We conducted semi-structured in-depth interviews with adult T1DM patients or parents of child patients who had ever used diabetes apps. The interviews were audio-recorded, transcribed and coded for theme identification. RESULTS The expert response rate was 63.5% (127/200). They thought that the reasons for app invalidity were that patients did not stick to using the app (76.4%, 97/127), little guidance was received from health care professionals (HCPs) (73.2%, 93/127), diabetes education knowledge was unsystematic (52.8% 67/127) and the app functions were incomplete (44.1%, 56/127). A total of 245 T1DM patient questionnaires were collected, of which 21.2% (52/245) of the respondents had used diabetes apps. The reasons for their reluctance to use an app were limited time (39%, 20/52), complicated operations (25%, 13/52), uselessness (25%, 13/52) and cost (25%, 13/52). Both the experts and patients thought that the most important functions of the app were patient-doctor communication and diabetes diary. Two themes that were useful for app design were identified from the interviews: (1) problems with patients’ diabetes self-management and (2) problems with current apps. Additionally, needs and suggestions for a diabetes app were obtained. CONCLUSIONS Patient-doctor communication is the most important function of a diabetes app. Apps should be integrated with HCPs rather than stand alone. We advocate that doctors follow up with their patients using diabetes app. Our user-centered method explored comprehensively and deeply why the effectiveness of current diabetes apps for T1DM was poor and what T1DM patients needed for a diabetes app, and provided meaningful guidance for app design.

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Seeing Things Differently: The use of mobile app interpretation and its effect on visitor experience at two heritage sites in Aotearoa New Zealand

10.26686/wgtn.17061977 ◽

2021 ◽

Author(s):

◽

Jessica Aitken

Keyword(s):

New Zealand ◽

Case Studies ◽

Mobile Applications ◽

Mobile Apps ◽

Qualitative Interviews ◽

Mobile App ◽

Research Approach ◽

Visitor Experience ◽

Heritage Sites ◽

High Street

The practice of contemporary heritage interpretation has seen increased investment in digital technologies and more recently in mobile applications. However, few empirical studies assess how effective mobile apps are to the visitor experience of heritage sites. What kind of visitor experience do mobile apps provide? How do mobile apps deliver on the aims of interpretation for heritage sites? What types of apps work best? What are the challenges for developers and heritage professionals? A qualitative research approach is used to examine two case studies; High Street Stories: the life and times of Christchurch’s High Street Precinct and IPENZ Engineering Tours: Wellington Heritage Walking Tour. These case studies ask what kind of experience mobile apps offer as an interpretation tool at these heritage sites. To investigate the topic, email interviews were carried out with heritage professionals and digital developers; together with qualitative interviews with visitors recruited to visit the case study sites using the mobile applications. This study explores two current examples of mobile app technology in the heritage sector in a New Zealand context. The results of this study aim to augment current literature on the topic of digital interpretation. This study seeks to offer heritage managers and interpreters some key factors to consider when making decisions regarding the methods used to present and interpret heritage sites to visitors and in developing new interpretation and digital strategies that include mobile applications. Although each scenario presents its particular set of considerations and all heritage sites are different, it is hoped these recommendations can be applied and offer working models and strategies.

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Appscapes in everyday life

MedieKultur Journal of media and communication research ◽

10.7146/mediekultur.v36i69.121018 ◽

2020 ◽

Vol 36 (69) ◽

pp. 029-051

Author(s):

Signe Sophus Lai ◽

Sofie Flensburg

Keyword(s):

Everyday Life ◽

Mobile Apps ◽

Empirical Studies ◽

Qualitative Interviews ◽

Mobile App ◽

Trade Off ◽

Online Tracking ◽

Material Conditions ◽

Infrastructure Studies ◽

App Economy

It has long been acknowledged that the use of ‘free’ mobile apps comes at a price,but few empirical studies have looked into this supposed trade-off. This articlecombines qualitative interviews with mappings of infrastructures for dataficationin order to study the implications of mobile app usage from the perspectiveof individual users. It analyses users’ understanding of online tracking, maps theinfrastructural tenets of mobile datafication, and finds a disconnect between whatusers believe happens to their data and the actual data harvesting and distributionmechanisms of their apps. We thereby argue that users’ resigned attitudes shouldbe understood in light of the material conditions of the app economy and, as such,that user and infrastructure studies should join forces in exploring and enhancingusers’ agency, empowerment and emancipation.

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Development and evaluation of a culturally tailored education module for type 1 diabetes in a resource-constrained setting: protocol for a mixed-methods study

International Journal of Clinical Trials ◽

10.18203/2349-3259.ijct20212847 ◽

2021 ◽

Vol 8 (3) ◽

pp. 244

Author(s):

Latika Rohilla ◽

Devi Dayal ◽

Prahbhjot Malhi ◽

Bhavneet Bharti ◽

Sukhpal Kaur ◽

...

Keyword(s):

Type 1 Diabetes ◽

Mixed Methods ◽

Diabetes Management ◽

Resource Constraints ◽

Diabetes Education ◽

Mixed Methods Study ◽

Trial Registration ◽

Second Phase ◽

Culturally Tailored

Background: Diabetes education is the key to successful diabetes management. There is a need for an education module for type 1 diabetes (T1D) that is culture-specific and suited to resource constraints.Methods: A mixed-methods study will be conducted, in three phases, to develop and evaluate a culturally tailored diabetes education module for Indian children with T1D and their families. During the first phase, a qualitative study among health professionals and families of children with T1D for need assessment will be conducted. During the second phase, based on the themes from the last phase, an educational module will be developed. The third phase will involve an evaluation of the content, feasibility and effectiveness of the proposed module. The content evaluation will be done using the standardized 'suitability assessment of materials' checklist. For feasibility, a mixed-method approach will be used with iterative cycles of satisfaction scale, semi-structured interview and feasibility and observation checklist. The module will be revised after each cycle till no new changes are suggested. The effectiveness will be assessed by a quasi-experimental controlled trial assessing glycemic control, health-related quality of life, clinically important events and self-management practices in T1D children at baseline and three and six months.Conclusions: This study aims at development and validation of a novel culturally tailored diabetes education module for children with T1D, suited to their resource constraints. A module designed with the inputs from all stakeholders, and evaluated using iterative cycles, has the potential to suit the dynamic nature of diabetes management in children.Trial registration: Trial registration number is CTRI/2021/04/032739.

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Carbohydrate Counting App Using Image Recognition for Youth With Type 1 Diabetes: Pilot Randomized Control Trial

JMIR mhealth and uhealth ◽

10.2196/22074 ◽

2020 ◽

Vol 8 (10) ◽

pp. e22074

Author(s):

Jeffrey E Alfonsi ◽

Elizabeth E Y Choi ◽

Taha Arshad ◽

Stacie-Ann S Sammott ◽

Vanita Pais ◽

...

Keyword(s):

Type 1 Diabetes ◽

Diabetes Management ◽

Digital Health ◽

Controlled Trial ◽

Qualitative Interviews ◽

Mobile App ◽

Thinking Aloud ◽

Carbohydrate Counting ◽

Scale Scores

Background Carbohydrate counting is an important component of diabetes management, but it is challenging, often performed inaccurately, and can be a barrier to optimal diabetes management. iSpy is a novel mobile app that leverages machine learning to allow food identification through images and that was designed to assist youth with type 1 diabetes in counting carbohydrates. Objective Our objective was to test the app's usability and potential impact on carbohydrate counting accuracy. Methods Iterative usability testing (3 cycles) was conducted involving a total of 16 individuals aged 8.5-17.0 years with type 1 diabetes. Participants were provided a mobile device and asked to complete tasks using iSpy app features while thinking aloud. Errors were noted, acceptability was assessed, and refinement and retesting were performed across cycles. Subsequently, iSpy was evaluated in a pilot randomized controlled trial with 22 iSpy users and 22 usual care controls aged 10-17 years. Primary outcome was change in carbohydrate counting ability over 3 months. Secondary outcomes included levels of engagement and acceptability. Change in HbA1c level was also assessed. Results Use of iSpy was associated with improved carbohydrate counting accuracy (total grams per meal, P=.008), reduced frequency of individual counting errors greater than 10 g (P=.047), and lower HbA1c levels (P=.03). Qualitative interviews and acceptability scale scores were positive. No major technical challenges were identified. Moreover, 43% (9/21) of iSpy participants were still engaged, with usage at least once every 2 weeks, at the end of the study. Conclusions Our results provide evidence of efficacy and high acceptability of a novel carbohydrate counting app, supporting the advancement of digital health apps for diabetes care among youth with type 1 diabetes. Further testing is needed, but iSpy may be a useful adjunct to traditional diabetes management. Trial Registration ClinicalTrials.gov NCT04354142; https://clinicaltrials.gov/ct2/show/NCT04354142

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Impact of a Mobilized Stress Management Program (Pep-Pal) for Caregivers of Oncology Patients: Mixed-Methods Study (Preprint)

10.2196/preprints.11406 ◽

2018 ◽

Author(s):

Alaina L Carr ◽

Jacqueline Jones ◽

Susan Mikulich Gilbertson ◽

Mark L Laudenslager ◽

Jean S Kutner ◽

...

Keyword(s):

Mixed Methods ◽

Psychosocial Support ◽

Qualitative Interviews ◽

Management Program ◽

Mobile App ◽

Advanced Illness ◽

Web Based ◽

Individual Interviews ◽

Independent Review ◽

Evidenced Based

BACKGROUND Caregivers of patients with advanced diseases are known to have high levels of distress, including depression and anxiety. Recent research has focused on recognizing caregivers in need of psychosocial support to help them manage their distress. Evidenced-based technological interventions have the potential to aid caregivers in managing distress. OBJECTIVE The objective of our study was to describe caregiver perceptions of the usability and acceptability, and their suggestions for future adaptations, of a mobilized psychoeducation and skills-based intervention. METHODS This study was a part of a larger trial of a mobilized psychoeducation and skills-based intervention (Psychoeducation and Skills-Based Mobilized Intervention [Pep-Pal]) for caregivers of patients with advanced illness. This substudy used a mixed-methods analysis of quantitative data from all 26 intervention participants and qualitative data from 14 intervention caregivers who completed the Pep-Pal intervention. The qualitative semistructured individual interviews, which we conducted within the first 4 weeks after participants completed the intervention, assessed the acceptability and usability of Pep-Pal. Additionally, the qualitative interviews provided contextual evidence of how the intervention was helpful to interviewees in unanticipated ways. We conducted applied thematic analysis via independent review of transcripts to extract salient themes. RESULTS Overall, caregivers of patients with advanced cancer deemed Pep-Pal to be acceptable in all Web-based sessions except for Improving Intimacy. Caregivers perceived the program to be of use across the areas they needed and in others that they had not anticipated. Caregiver recommendations of key changes for the program were to include more variety in caregiver actors in sessions, change the title of Improving Intimacy to Improving Relationships, provide an audio-only option in addition to video, and change the format of the mobilized website program to a stand-alone mobile app. CONCLUSIONS The valuable feedback in key areas from individual interviews will be integrated into the final version of Pep-Pal that will be tested in a fully powered randomized clinical trial. CLINICALTRIAL ClinicalTrials.gov NCT03002896; https://clinicaltrials.gov/ct2/show/NCT03002896 (Archived by WebCite at http://www.webcitation.org/76eThwaei)

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Mobile Health Apps on COVID-19 Launched in the Early Days of the Pandemic: Content Analysis and Review

JMIR mhealth and uhealth ◽

10.2196/19796 ◽

2020 ◽

Vol 8 (9) ◽

pp. e19796 ◽

Cited By ~ 7

Author(s):

Long Chiau Ming ◽

Noorazrina Untong ◽

Nur Amalina Aliudin ◽

Norliza Osili ◽

Nurolaini Kifli ◽

...

Keyword(s):

Health Care ◽

Health Care Professionals ◽

Mobile Apps ◽

Home Monitoring ◽

Mobile App ◽

Inclusion Criteria ◽

Self Monitoring ◽

App Store ◽

Online Consultation ◽

Basic Features

Background Mobile health (mHealth) app use is a major concern because of the possible dissemination of misinformation that could harm the users. Particularly, it can be difficult for health care professionals to recommend a suitable app for coronavirus disease (COVID-19) education and self-monitoring purposes. Objective This study aims to analyze and evaluate the contents as well as features of COVID-19 mobile apps. The findings are instrumental in helping health care professionals to identify suitable mobile apps for COVID-19 self-monitoring and education. The results of the mobile apps’ assessment could potentially help mobile app developers improve or modify their existing mobile app designs to achieve optimal outcomes. Methods The search for the mHealth apps available in the android-based Play Store and the iOS-based App Store was conducted between April 18 and May 5, 2020. The region of the App Store where we performed the search was the United States, and a virtual private network app was used to locate and access COVID-19 mobile apps from all countries on the Google Play Store. The inclusion criteria were apps that are related to COVID-19 with no restriction in language type. The basic features assessment criteria used for comparison were the requirement for free subscription, internet connection, education or advisory content, size of the app, ability to export data, and automated data entry. The functionality of the apps was assessed according to knowledge (information on COVID-19), tracing or mapping of COVID-19 cases, home monitoring surveillance, online consultation with a health authority, and official apps run by health authorities. Results Of the 223 COVID-19–related mobile apps, only 30 (19.9%) found in the App Store and 28 (44.4%) in the Play Store matched the inclusion criteria. In the basic features assessment, most App Store (10/30, 33.3%) and Play Store (10/28, 35.7%) apps scored 4 out of 7 points. Meanwhile, the outcome of the functionality assessment for most App Store apps (13/30, 43.3%) was a score of 3 compared to android-based apps (10/28, 35.7%), which scored 2 (out of the maximum 5 points). Evaluation of the basic functions showed that 75.0% (n=36) of the 48 included mobile apps do not require a subscription, 56.3% (n=27) provide symptom advice, and 41.7% (n=20) have educational content. In terms of the specific functions, more than half of the included mobile apps are official mobile apps maintained by a health authority for COVID-19 information provision. Around 37.5% (n=18) and 31.3% (n=15) of the mobile apps have tracing or mapping and home monitoring surveillance functions, respectively, with only 17% (n=8) of the mobile apps equipped with an online consultation function. Conclusions Most iOS-based apps incorporate infographic mapping of COVID-19 cases, while most android-based apps incorporate home monitoring surveillance features instead of providing focused educational content on COVID-19. It is important to evaluate the contents and features of COVID-19 mobile apps to guide users in choosing a suitable mobile app based on their requirements.

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Losing Control to Data-Hungry Apps: A Mixed-Methods Approach to Mobile App Privacy

Social Science Computer Review ◽

10.1177/0894439318777706 ◽

2018 ◽

Vol 37 (4) ◽

pp. 466-488 ◽

Cited By ~ 8

Author(s):

Petter Bae Brandtzaeg ◽

Antoine Pultier ◽

Gro Mette Moen

Keyword(s):

Mixed Methods ◽

Data Sharing ◽

Mobile Apps ◽

Personal Data ◽

The United States ◽

Mobile App ◽

Third Party ◽

User Survey ◽

Privacy Policies ◽

Mixed Methods Approach

Personal data from mobile apps are increasingly impacting users’ lives and privacy perceptions. However, there is a scarcity of research addressing the combination of (1) individual perceptions of mobile app privacy, (2) actual dataflows in apps, and (3) how such perceptions and dataflows relate to actual privacy policies and terms of use in mobile apps. To address these limitations, we conducted an innovative mixed-methods study including a representative user survey in Norway, an analysis of personal dataflows in apps, and content analysis of privacy policies of 21 popular, free Android mobile apps. Our findings show that more than half the respondents in the user survey repeatedly had refrained from downloading or using apps to avoid sharing personal data. Our analysis of dataflows applied a novel methodology measuring activity in the apps over time (48 hr). The investigation showed that 19 of the 21 apps investigated transmitted personal data to a total of approximately 600 different primary and third-party domains. From an European perspective, it is particularly noteworthy that most of these domains were associated with tech companies in the United States, where privacy laws are less strict than companies operating from Europe. The investigation further revealed that some apps by default track and share user data continuously, even when the app is not in use. For some of these, the terms of use provided with the apps did not inform the users about the actual tracking practice. A comparison of terms of use as provided in the studied apps with actual person dataflows as identified in the analysis disclosed that three of the apps shared data in violation with their provided terms of use. A possible solution for the mobile app industry, to strengthen user trust, is privacy by design through opt-in data sharing with the service and third parties and more granular information on personal data sharing practices. Also, based on the findings from this study, we suggest specific visualizations to enhance transparency of personal dataflows in mobile apps. A methodological contribution is that a mixed-methods approach strengthens our understanding of the complexity of privacy issues in mobile apps.

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National strategy for palliative care of severely ill and dying people and their relatives in pandemics (PallPan) in Germany - study protocol of a mixed-methods project

BMC Palliative Care ◽

10.1186/s12904-021-00898-w ◽

2022 ◽

Vol 21 (1) ◽

Author(s):

C. Bausewein ◽

F. Hodiamont ◽

N. Berges ◽

A. Ullrich ◽

C. Gerlach ◽

...

Keyword(s):

Health Care ◽

Palliative Care ◽

Mixed Methods ◽

Health Care Professionals ◽

Qualitative Interviews ◽

Symptom Control ◽

Relevant Literature ◽

Inpatient Setting ◽

Specialist Palliative Care ◽

Seriously Ill

Abstract Background In the SARS-CoV-2 pandemic, general and specialist Palliative Care (PC) plays an essential role in health care, contributing to symptom control, psycho-social support, and providing support in complex decision making. Numbers of COVID-19 related deaths have recently increased demanding more palliative care input. Also, the pandemic impacts on palliative care for non-COVID-19 patients. Strategies on the care for seriously ill and dying people in pandemic times are lacking. Therefore, the program ‘Palliative care in Pandemics’ (PallPan) aims to develop and consent a national pandemic plan for the care of seriously ill and dying adults and their informal carers in pandemics including (a) guidance for generalist and specialist palliative care of patients with and without SARS-CoV-2 infections on the micro, meso and macro level, (b) collection and development of information material for an online platform, and (c) identification of variables and research questions on palliative care in pandemics for the national pandemic cohort network (NAPKON). Methods Mixed-methods project including ten work packages conducting (online) surveys and qualitative interviews to explore and describe i) experiences and burden of patients (with/without SARS-CoV-2 infection) and their relatives, ii) experiences, challenges and potential solutions of health care professionals, stakeholders and decision makers during the SARS-CoV-2 pandemic. The work package results inform the development of a consensus-based guidance. In addition, best practice examples and relevant literature will be collected and variables for data collection identified. Discussion For a future “pandemic preparedness” national and international recommendations and concepts for the care of severely ill and dying people are necessary considering both generalist and specialist palliative care in the home care and inpatient setting.

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Young People�s, Parents�, and Professionals� Views on Required Components of Mobile Apps to Support Self-Management of Juvenile Arthritis: Qualitative Study (Preprint)

10.2196/preprints.9179 ◽

2017 ◽

Author(s):

Jennifer M Waite-Jones ◽

Rabiya Majeed-Ariss ◽

Joanna Smith ◽

Simon R Stones ◽

Vanessa Van Rooyen ◽

...

Keyword(s):

Social Support ◽

Young People ◽

Health Care Professionals ◽

Mobile Apps ◽

Developmentally Appropriate ◽

Mobile App ◽

Juvenile Arthritis ◽

Mobile Technologies ◽

Self Management ◽

Framework Approach

BACKGROUND There is growing evidence that supporting self-management of Juvenile Arthritis can benefit both patients and professionals. Young people with Juvenile Arthritis and their healthy peers increasingly use mobile technologies to access information and support in day-to-day life. Therefore, a user-led, rigorously developed and evaluated mobile app could be valuable for facilitating young people’s self-management of Juvenile Arthritis. OBJECTIVE The objective of this study was to seek the views of young people with Juvenile Arthritis, their parents or carers, and health care professionals (HCPs) as to what should be included in a mobile app to facilitate young people’s self-management of chronic Juvenile Arthritis. METHODS A qualitative approach was adopted with a purposeful sample of 9 young people aged 10-18 years with Juvenile Arthritis, 8 parents or carers, and 8 HCPs involved in their care. Data were gathered through semi-structured focus group and individual interviews with young people and their parents or carers and HCPs. Interview discussion was facilitated through demonstration of four existing health apps to explore participants’ views on strengths and limitations of these, barriers and facilitators to mobile app use, preferred designs, functionality, levels of interaction, and data sharing arrangements. Data were analyzed using the framework approach. RESULTS Analysis revealed three interlinked, overarching themes: (1) purpose, (2) components and content, and (3) social support. Despite some differences in emphasis on essential content, general agreement was found between young people with Juvenile Arthritis their parents or carers, and professionals that a mobile app to aid self-management would be useful. Underpinning the themes was a prerequisite that young people are enabled to feel a sense of ownership and control of the app, and that it be an interactive, engaging resource that offers developmentally appropriate information and reminders, as well as enabling them to monitor their symptoms and access social support. CONCLUSIONS Findings justify and pave the way for a future feasibility study into the production and preliminary testing of such an app. This would consider issues such as compatibility with existing technologies, costs, age, and cross-gender appeal as well as resource implications.

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