scholarly journals Exploring the Specific Needs of Persons with Multiple Sclerosis for mHealth Solutions for Physical Activity: Mixed-Methods Study (Preprint)

2017 ◽  
Author(s):  
Guido Giunti ◽  
Jan Kool ◽  
Octavio Rivera Romero ◽  
Enrique Dorronzoro Zubiete

BACKGROUND Multiple sclerosis (MS) is one of the world’s most common neurologic disorders, with symptoms such as fatigue, cognitive problems, and issues with mobility. Evidence suggests that physical activity (PA) helps people with MS reduce fatigue and improve quality of life. The use of mobile technologies for health has grown in recent years with little involvement from relevant stakeholders. User-centered design (UCD) is a design philosophy with the goal of creating solutions specific to the needs and tasks of the intended users. UCD involves stakeholders early and often in the design process. In a preliminary study, we assessed the landscape of commercially available MS mobile health (mHealth) apps; to our knowledge, no study has explored what persons with MS and their formal care providers think of mHealth solutions for PA. OBJECTIVE The aim of this study was to (1) explore MS-specific needs for MS mHealth solutions for PA, (2) detect perceived obstacles and facilitators for mHealth solutions from persons with MS and health care professionals, and (3) understand the motivational aspects behind adoption of mHealth solutions for MS. METHODS A mixed-methods design study was conducted in Kliniken Valens, Switzerland, a clinic specializing in neurological rehabilitation. We explored persons with MS and health care professionals who work with them separately. The study had a qualitative part comprising focus groups and interviews, and a quantitative part with standardized tools such as satisfaction with life scale and electronic health (eHealth) literacy. RESULTS A total of 12 persons with relapsing-remitting MS and 12 health care professionals from different backgrounds participated in the study. Participants were well-educated with an even distribution between genders. Themes identified during analysis were MS-related barriers and facilitators, mHealth design considerations, and general motivational aspects. The insights generated were used to create MS personas for design purposes. Desired mHealth features were as follows: (1) activity tracking, (2) incentives for completing tasks and objectives, (3) customizable goal setting, (4) optional sociability, and (5) game-like attitude among others. Potential barriers to mHealth apps adoption were as follows: (1) rough on-boarding experiences, (2) lack of clear use benefits, and (3) disruption of the health care provider-patient relationship. Potential facilitators were identified: (1) endorsements from experts, (2) playfulness, and (3) tailored to specific persons with MS needs. A total of 4 MS personas were developed to provide designers and computer scientists means to help in the creation of future mHealth solutions for MS. CONCLUSIONS mHealth solutions for increasing PA in persons with MS hold promise. Allowing for realistic goal setting and positive feedback, while minimizing usability burdens, seems to be critical for the adoption of such apps. Fatigue management is especially important in this population; more attention should be brought to this area.

2016 ◽  
Vol 12 (4) ◽  
pp. 302-310 ◽  
Author(s):  
Denise Mitten ◽  
Jillisa R. Overholt ◽  
Francis I. Haynes ◽  
Chiara C. D’Amore ◽  
Janet C. Ady

Research has connected sedentary lifestyles with numerous negative health outcomes, including a significant increased risk for mortality. Many health care professionals seek ways to help clients meet physical activity guidelines recommended by the Office of Disease Prevention and Health Promotion, the World Health Organization, and the American College of Sports Medicine in order to promote active lifestyles and improve overall wellness. Hiking is a cost-effective intervention that encourages people to be physically active while spending time in nature. Time in nature can lead to health benefits through contact with the natural elements, participation in physical activity, restoration of mental and emotional health, and time with social contacts. Benefits may be immediate, such as decreased blood pressure, decreased stress levels, enhanced immune system functioning, and restored attention, or transpire over time, such as weight loss, decreased depression, and overall wellness. Health care providers are ideally positioned to recommend and prescribe hiking to clients. Federal, state, and local natural resource agencies are beginning to partner with health care professionals to promote outdoor nature-related activities. Examples of successful doctor and other health care practitioner partnership programs are described, along with tips for getting started.


2019 ◽  
Vol 22 (4) ◽  
pp. 178-186
Author(s):  
Sarah J. Donkers ◽  
Sarah Oosman ◽  
Stephan Milosavljevic ◽  
Kristin E. Musselman

Abstract Background: Although physical activity (PA) is considered the most important nonpharmaceutical intervention for persons with multiple sclerosis (MS), less than 20% of people with MS are engaging in sufficient amounts to accrue benefits. Promotion of PA is most effective when combined with additional behavior change strategies, but this is not routinely done in clinical practice. This study aimed to increase our understanding of current practice and perspectives of health care providers (HCPs) in Canada regarding their use of interventions to address PA behavior in MS management. Investigating HCPs’ perspectives on implementing PA behavior change with persons with MS will provide insight into this knowledge-to-practice gap. Methods: Semistructured focus groups were conducted with 31 HCPs working with persons with MS in Saskatchewan, Canada. Based on interpretive description, data were coded individually by three researchers, who then collaboratively developed themes. Analysis was inductive and iterative; triangulation and member reflections were used. Results: Five themes were established: 1) prescribing, promoting, and impacting wellness with PA; 2) coordinating communication and continuity in practice; 3) timely access to relevant care: being proactive rather than reactive; 4) enhancing programming and community-based resources; and 5) reconciling the value of PA with clinical practice. Conclusions: The HCPs value PA and want more support with application of behavior change strategies to deliver PA behavioral interventions, but due to the acute and reactive nature of health care systems they feel this cannot be prioritized in practice. Individual- and system-level changes are needed to support consistent and effective use of PA behavioral interventions in MS.


Author(s):  
Teresia Mbogori

Background: Hypertension is one of the main modifiable risk factors for cardiovascular disease morbidity and mortality. Pharmacological and lifestyle modification approaches are used in the treatment and management of hypertension. The purpose of this study was to identify lifestyle modification advice provided to the general population and to those diagnosed with hypertension by health care providers (HCP) in Kenya.Methods: A secondary data analysis of cross-sectional data collected among 4500 Kenyans participating in the 2015 Kenya stepwise approach to surveillance study was conducted. Questions related to the consumption of salt, sugar, fat, fruits and vegetables as well as physical activity and weight management were evaluated.Results: Among all the participants, only 12.5%, 20.7%, 12.2%, 10.7%, 10.3% and 11.6% were advised to either reduce salt intake, eat 5 or more servings of fruits and vegetables, reduce fat intake, reduce intake of sugary beverages, lose or maintain weight and start or do more physical activity respectively.  Of those diagnosed with HTN, 37% were advised to increase intake fruits and vegetables, 37%, 27% and 25% were advised to reduce, salt, fat and sugary beverages intake respectively, 21% and 22% were advised to start or do more physical activity and maintain a healthy body weight or lose weight respectively.Conclusions: Majority of Kenyans had not received dietary modification advice from HCP despite this being a policy recommendation in Kenya. Policy makers need to work closely with HCP to develop appropriate policy implementation strategies. 


2019 ◽  
Author(s):  
Sheikh Mohammed Shariful Islam ◽  
Susie Cartledge ◽  
Chandan Karmakar ◽  
Jonathan Charles Rawstorn ◽  
Steve F Fraser ◽  
...  

BACKGROUND Blood pressure (BP) is an important modifiable cardiovascular risk factor, yet its long-term monitoring remains problematic. Wearable cuffless devices enable the capture of multiple BP measures during everyday activities and could improve BP monitoring, but little is known about their validity or acceptability. OBJECTIVE This study aimed to validate a wrist-worn cuffless wearable BP device and assess its acceptability among users and health care professionals. METHODS A mixed methods study was conducted to examine the validity and comparability of a wearable cuffless BP device against ambulatory and home devices. BP was measured simultaneously over 24 hours using wearable and ambulatory devices and over 7 days using wearable and home devices. Pearson correlation coefficients compared the degree of association between the measures, and limits of agreement (LOA; Bland-Altman plots) were generated to assess measurement bias. Semistructured interviews were conducted with users and 10 health care professionals to assess acceptability, facilitators, and barriers to using the wearable device. Interviews were audio recorded, transcribed, and analyzed. RESULTS A total of 9090 BP measurements were collected from 20 healthy volunteers (mean 20.3 years, SD 5.4; N=10 females). Mean (SD) systolic BP (SBP)/diastolic BP (DBP) measured using the ambulatory (24 hours), home (7 days), and wearable (7 days) devices were 126 (SD 10)/75 (SD 6) mm Hg, 112 (SD 10)/71 (SD 9) mm Hg and 125 (SD 4)/77 (SD 3) mm Hg, respectively. Mean (LOA) biases and precision between the wearable and ambulatory devices over 24 hours were 0.5 (−10.1 to 11.1) mm Hg for SBP and 2.24 (−17.6 to 13.1) mm Hg for DBP. The mean biases (LOA) and precision between the wearable and home device over 7 days were −12.7 (−28.7 to 3.4) mm Hg for SBP and −5.6 (−20.5 to 9.2) mm Hg for DBP. The wearable BP device was well accepted by participants who found the device easy to wear and use. Both participants and health care providers agreed that the wearable cuffless devices were easy to use and that they could be used to improve BP monitoring. CONCLUSIONS Wearable BP measures compared well against a gold-standard ambulatory device, indicating potential for this user-friendly method to augment BP management, particularly by enabling long-term monitoring that could improve treatment titration and increase understanding of users’ BP response during daily activity and stressors.


2020 ◽  
Author(s):  
Fayz Alshehri ◽  
Fahdah Alshaikh

BACKGROUND Self-management of prediabetic patients is crucial since they are at high risk of developing type 2 diabetes. Mobile health (mHealth) apps could contribute to potentially reducing the burden of diabetes by supporting the self-management of prediabetic patients. OBJECTIVE This study aimed to explore the constituent elements of a successful mHealth intervention for prediabetic patients in King Saud University Medical City (KSUMC) hospitals in Saudi Arabia using the Centre for eHealth Research (CeHRes) roadmap. METHODS This study used the CeHRes roadmap as a developmental guideline for proposing mHealth app features for self-management of prediabetic patients and was performed in 3 phases with one round in each phase. First, a contextual inquiry was conducted via an online self-administered questionnaire for both health care providers and patients. Second, the value specification phase elaborated on the outcomes from the contextual inquiry phase. Finally, prototype user design was performed in cocreation with end users. The design phase was also conducted via an online self-administered questionnaire to evaluate the proposed features of mHealth apps by prediabetic patients. RESULTS A total of 20 health care providers participated in the study. The results revealed that the most powerful intervention for prediabetes was a combination of medication, physical activity, and healthy diet plans (12/20, 60%). Furthermore, the most common challenge faced by prediabetes patients was patient adherence to healthy diet and physical activity recommendations (10/20, 50%). Almost all patients believed that mHealth apps would be useful for prediabetic patients. A total of 48 prediabetic patients participated in the study. The results indicated that the most powerful intervention for prediabetic patients is a combination of healthy diet and physical activity plans (21/48, 44%), and the most frequent challenge that may lead the patients to discontinue the current intervention was the commitment to a physical activity plan (35/48, 75%). Furthermore, 15% (17/48) of patients use well-being and health apps to manage their current health status. The most common difficulties faced by the patients were navigating app features (mean 2.02 [SD 1.7]) followed by the app language (mean 1.88 [SD 2.0]); these difficulties occurred at a significantly higher rate among those with secondary or lower educational levels as compared to undergraduate and postgraduate levels (<i>P</i>&lt;.05). Finally, the features proposed in the prototype design scored more than 2.5 points higher and indicate the need for these features to be included in the mHealth app. CONCLUSIONS This study aimed to provide real-world insights into the development of an mHealth app for a diabetes prevention intervention by involving both health care providers and prediabetic patients in KSUMC hospitals. Therefore, the proposed app, which comprises all necessary features, may aid patients with prediabetes in self-management and making changes in their lifestyle.


2021 ◽  
pp. 155982762199227
Author(s):  
Aliye B. Cepni ◽  
Cherine Hatem ◽  
Tracey A. Ledoux ◽  
Craig A. Johnston

Medical professionals’ healthy eating and physical activity behaviors are likely to wane as other life events and everyday pressures increase. This is vital because as health behaviors decrease, the likelihood that this topic is addressed with patients also decreases. Increased training to improve health care providers’ knowledge about lifestyle behaviors may be inadequate to actually bring about a healthier lifestyle. The area of personal identity and value formation may shed light on a significant barrier in this area. Developing health care professionals who have values consistent with a healthy diet and physical activity, instead of just being informed about it, would increase the likelihood that healthy behavior changes are discussed with patients. Strategies to encourage value formation around healthy lifestyles among medical professionals are discussed.


2018 ◽  
Vol 7 (1) ◽  
pp. 34-41 ◽  
Author(s):  
Chungyi Chiu ◽  
Malachy Bishop ◽  
Bradley McDaniels ◽  
Byung-Jin Kim ◽  
Lebogang Tiro

Background: Comprehensive and effective multiple sclerosis (MS) health care requires understanding of patients’ needs, preferences, and priorities. Objective: To evaluate priorities of patients with MS for their MS care. Methods: Participants included 3003 Americans with MS recruited through the National MS Society and the North American Research Committee on Multiple Sclerosis patient registry. Participants completed a comprehensive questionnaire on aspects of their health-care experiences. Results: Participants identified the top 3 health-care priorities as (1) the affordability of MS health care, (2) ensuring that non-MS health-care providers have more education about MS and how it can interact with other conditions, and (3) access to an MS center or specialized MS clinic with MS health-care professionals together in one place. Participants receiving care in an MS center rated the quality and their satisfaction with care higher than those receiving care in other settings. Although having the opportunity to evaluate their health-care quality was important to the participants, only 36.4% had been provided the opportunity in the past year. Conclusions: This study identifies health-care priorities and concerns for Americans with MS.


10.2196/14706 ◽  
2019 ◽  
Vol 7 (10) ◽  
pp. e14706 ◽  
Author(s):  
Sheikh Mohammed Shariful Islam ◽  
Susie Cartledge ◽  
Chandan Karmakar ◽  
Jonathan Charles Rawstorn ◽  
Steve F Fraser ◽  
...  

Background Blood pressure (BP) is an important modifiable cardiovascular risk factor, yet its long-term monitoring remains problematic. Wearable cuffless devices enable the capture of multiple BP measures during everyday activities and could improve BP monitoring, but little is known about their validity or acceptability. Objective This study aimed to validate a wrist-worn cuffless wearable BP device (Model T2; TMART Technologies Limited) and assess its acceptability among users and health care professionals. Methods A mixed methods study was conducted to examine the validity and comparability of a wearable cuffless BP device against ambulatory and home devices. BP was measured simultaneously over 24 hours using wearable and ambulatory devices and over 7 days using wearable and home devices. Pearson correlation coefficients compared the degree of association between the measures, and limits of agreement (LOA; Bland-Altman plots) were generated to assess measurement bias. Semistructured interviews were conducted with users and 10 health care professionals to assess acceptability, facilitators, and barriers to using the wearable device. Interviews were audio recorded, transcribed, and analyzed. Results A total of 9090 BP measurements were collected from 20 healthy volunteers (mean 20.3 years, SD 5.4; N=10 females). Mean (SD) systolic BP (SBP)/diastolic BP (DBP) measured using the ambulatory (24 hours), home (7 days), and wearable (7 days) devices were 126 (SD 10)/75 (SD 6) mm Hg, 112 (SD 10)/71 (SD 9) mm Hg and 125 (SD 4)/77 (SD 3) mm Hg, respectively. Mean (LOA) biases and precision between the wearable and ambulatory devices over 24 hours were 0.5 (−10.1 to 11.1) mm Hg for SBP and 2.24 (−17.6 to 13.1) mm Hg for DBP. The mean biases (LOA) and precision between the wearable and home device over 7 days were −12.7 (−28.7 to 3.4) mm Hg for SBP and −5.6 (−20.5 to 9.2) mm Hg for DBP. The wearable BP device was well accepted by participants who found the device easy to wear and use. Both participants and health care providers agreed that the wearable cuffless devices were easy to use and that they could be used to improve BP monitoring. Conclusions Wearable BP measures compared well against a gold-standard ambulatory device, indicating potential for this user-friendly method to augment BP management, particularly by enabling long-term monitoring that could improve treatment titration and increase understanding of users’ BP response during daily activity and stressors.


2010 ◽  
Vol 90 (5) ◽  
pp. 726-734 ◽  
Author(s):  
Julia Chevan ◽  
Esther M. Haskvitz

BackgroundPhysical therapy practitioners are among the many health care professionals who can counsel their patients to address the public health care concern of physical inactivity. Health care providers who are physically active themselves are more likely to counsel patients on the benefits of activity.ObjectiveThe purposes of this study were: (1) to examine the leisure-time physical activity habits of physical therapists, physical therapist assistants, and student physical therapists in the United States using Centers for Disease Control and Prevention and American College of Sports Medicine (CDC-ACSM) recommendations and (2) to compare these habits with those of the general population and other health care professionals.DesignA cross-sectional survey design was used.MethodsThere were 2 data sources. A random sample of American Physical Therapy Association members completed an online survey that included questions about physical activity habits worded in same manner as the leisure-time activities section of the 2005 National Health Interview Survey (NHIS). The final study sample comprised 1,238 participants: 923 physical therapists, 210 student physical therapists, and 105 physical therapist assistants. The 2005 NHIS public use data files were the source for the same information about the general US population and for a subset of health care professionals. Rates of participation in vigorous and moderate physical activity were analyzed.ResultsPhysical therapists, physical therapist assistants, and student physical therapists exercised at higher rates than adults and health-diagnosing professionals in the 2005 NHIS.LimitationsThe study may be limited by sampling and response bias.ConclusionsThis study identified that physical therapists, physical therapist assistants, and student physical therapists are meeting CDC-ACSM physical activity guidelines at higher rates than the US adult population and health-diagnosing professionals. These rates exceed the physical activity targets set for adults in Healthy People 2010.


2021 ◽  
pp. 089443932110257
Author(s):  
Md Irfanuzzaman Khan ◽  
Jennifer (M.I.) Loh

With the advent of telecommunication technologies and social media, many health care professionals are using social media to communicate with their patients and to promote health. However, the literature reveals a lacuna in our understanding of health care professionals’ perception of their behavioral intentions to use innovations. Using the Unified Technology Acceptance Framework (unified theory of acceptance and use of technology), in-depth interviews were conducted with 16 Australian health care experts to uncover their intent and actual use of social media in their medical practices. Results revealed that social media tools offered five significant benefits such as (i) enhanced communication between health care professionals and their patients, (ii) community support, (iii) enabled e-learning, (iv) enhanced professional network, and (v) expedited health promotion. However, result also revealed barriers to social media usage including (i) inefficiency, (ii) privacy concerns, (iii) poor quality of information, (iv) lack of trust, and (v) blurred professional boundary. Peer influence and supporting conditions were also found to be determinants of social media adoption behaviors among health care professionals. This study has important implications for health care providers, patients, and policy makers on the responsible use of social media, health promotion, and health communication. This research is also among the very few studies that explore Australian health care professionals’ intent and actual use of innovations within a health care setting.


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