Browsing by Subject "mHealth"
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Item Diabetes Mobile App Usability for Adult Patients with Diabetes(2018-05) Fu, HelenMore than 1,100 diabetes apps are available, but are infrequently used. A systematic review identified unsatisfactory diabetes app usability and its clinical effect to lower hemoglobin A1c level (0.15% to 1.9%), with variations in interactive app features for real-time feedback through automatic data analysis, clinician text messages, reminder alerts, or an app-initiated phone call. This result identified the need for health behavior theory applications to guide diabetes app usability evaluation. This study applied the Self-Determination Theory on human motivation to select app testing functions and to understand adult patient perspectives to use apps. A total of 92 adults with diabetes type 1 or 2 participated in a randomized crossover trial to test the usability of two top-rated Android diabetes apps (mySugr and OnTrack). Multivariable linear regression models assessed the effects of patient characteristics (i.e., age, education, and diabetes) and psychological needs on user satisfaction and user performance. Psychological needs important for motivation and behavioral change were associated with diabetes app usability. Higher user satisfaction was observed for participants who reported competence, autonomy, or connectivity with a healthcare provider. To enhance motivation to use apps for self-management, clinicians should consider addressing the patient’s competence, autonomy, and connectivity. User performance was associated with patient characteristics of age, sex, education, and diabetes duration because they affect the patient’s ability to use apps efficiently, successfully, and accurately. App training and ongoing technical support should be tailored for older adults, men, patients with less education, and those with diabetes duration more than 10 years.Item Randomized Controlled Trial of Pacifica, a CBT and Mindfulness-based App for Stress, Depression, and Anxiety Management with Health Monitoring(2018-08) Vu, AnnaMariemHealth smartphone apps have inundated the market. The promise of mHealth apps is that they increase access to psychotherapeutic content while also expanding options beyond face-to-face care. However, information on the quality and efficacy of commercial mHealth apps is sparse. Pacifica, a Cognitive Behavioral Therapy and Mindfulness-based mHealth app, is one of the most popular and publicly endorsed apps on the market. An initial week long pilot study was performed to assess feasibility and acceptability of the Pacifica app and Pacifica Lite, an active control version of the app, in a group of college students (N = 41). Participants generally used the app as intended and rated the aesthetics and functionality positively. The subsequent efficacy study extended the intervention period, added a waitlist control group, and enrolled a greater number of participants. To the best of our knowledge, this study was the first randomized controlled trial designed to examine the feasibility and efficacy of a commercial mHealth app using a smartphone active control app as a comparison. Participants (N=420) were randomly assigned to one of three groups: 1) The Pacifica app that includes the psychotherapy-based components, 2) the active control app “Pacifica Lite” without psychotherapy-based components, and 3) waitlist control. The intervention period was 14 days over the final weeks of a college semester. Participants completed pretest and posttest measures of mental health symptoms and general well-being, state-based affect, perceived stress, and mindfulness prior to and following the intervention period. Regression models with baseline scores as moderators indicated there was an effect of the Pacifica intervention compared to the Waitlist control on negative affect and global mental health. The effect of intervention group on negative affect, global mental health, and perceived stress were all moderated by baseline scores, whereby participants who had higher baseline distress levels reported greater responses to the Pacifica intervention compared to being on the Waitlist. A measure of trait mindfulness showed significant between-group differences, with significantly higher scores in the Pacifica group compared to the waitlist control. There were no effects related to group at posttest for total or subscale scores for symptoms of depression, anxiety, positive state-affect, and mindfulness practice. Overall, the Pacifica app appeared feasible and usable over a high demand final exam period, was significantly more effective than Waitlist on some measures, but it was not significantly more effective than the active control on any measures. Pacifica and the majority of mHealth apps available are not designed as alternatives to face-to-face care but college counseling centers and healthcare systems may choose to include apps like Pacifica as additional resources.