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If you give a mouse an iPhone
From the New York Times-bestselling author of Goodnight iPad comes a new commentary on the perils of our tech-obsessed lives and a fully charged romp for readers of all ages.
Book
Physical Activity Surveillance in Children and Adolescents Using Smartphone Technology: Systematic Review
Self-reported physical activity (PA) questionnaires have traditionally been used for PA surveillance in children and adolescents, especially in free-living conditions. Objective measures are more accurate at measuring PA, but high cost often creates a barrier for their use in low- and middle-income settings. The advent of smartphone technology has greatly influenced mobile health and has offered new opportunities in health research, including PA surveillance.
This review aimed to systematically explore the use of smartphone technology for PA surveillance in children and adolescents, specifically focusing on the use of smartphone apps.
A literature search was conducted using 5 databases (PubMed, Scopus, CINAHL, MEDLINE, and Web of Science) and Google Scholar to identify articles relevant to the topic that were published from 2008 to 2023. Articles were included if they included children and adolescents within the age range of 5 to 18 years; used smartphone technology as PA surveillance; had PA behavioral outcomes such as energy expenditure, step count, and PA levels; were written in English; and were published between 2008 and 2023.
We identified and analyzed 8 studies (5 cross-sectional studies and 3 cohort studies). All participants were aged 12-18 years, and all studies were conducted in high-income countries only. Participants were recruited from schools, primary care facilities, and voluntarily. Five studies used mobile apps specifically and purposely developed for the study, whereas 3 studies used mobile apps downloadable from the Apple App Store and Android Play Store. PA surveillance using these apps was conducted from 24 hours to 4 weeks.
Evidence of PA surveillance using smartphone technology in children and adolescents was insufficient, which demonstrated the knowledge gap. Additional research is needed to further study the feasibility and validity of smartphone apps for PA surveillance among children and adolescents, especially in low- and middle-income countries.
Journal Article
Smartphone use by government dermatology practitioners in Kuwait: a self-reported questionnaire based cross-sectional study
Background
The potential for smartphones to revolutionize the way that medical doctors practice has become a reality, particularly in specialities where visual examination is a principal step in assessing a medical case, like dermatology. Smartphones as devices hold similar capabilities to personal computers and laptops and could play an important role in supporting medical practitioners in clinical practice at the point of care and beyond. This study aimed to assess the role of smartphone technology use in dermatology practice in Kuwait, together with the potential of digital photography and users’ concerns.
Methods
This cross-sectional survey involved a population of dermatology practitioners of all levels working in 11 dermatology centers distributed across six health regions in Kuwait. A validated self-reported questionnaire was used to collect data from the participants about their smartphone use. Quantitative analytical methods were undertaken to analyse the questionnaire responses.
Results
A total of 210 dermatologists were approached in their workplaces. Of these, 101 (48%) responded to the survey questionnaire, with a mean age of 39.1 years (±10.7 SD) and equal representation from both genders. All the respondents were using smartphone technology, wherein 94.1% used it to access medical information through various Internet search engines. The most prevalent applications used were medical and drug reference applications (69.3 and 66.3%, respectively). In all, 65% of the dermatologists were using smartphones to take clinical photographs of patients for special purposes, and this type of usage was significantly higher (
p
< 0.05) among females and those older than 40.
Conclusion
This study concludes that smartphone technology has an impactful role in dermatology practice, and many of its functions can be employed to achieve better practice and better patient care. Recommendations are suggested for clinicians using smartphones in dermatology practice.
Journal Article
Epic Allies: A Gamified Mobile App to Improve Engagement in HIV Care and Antiretroviral Adherence among Young Men Who have Sex with Men
HIV incidence among young men who have sex with men (YMSM) is disproportionally high. Youth living with HIV demonstrate low rates of sustained virologic suppression (VS). Epic Allies, a theory-based behavioral intervention mobile app, utilizes self-management tools, gamification, and social support to improve engagement in care and antiretroviral adherence among YMSM living with HIV. A two-arm individually randomized-controlled trial enrolled 146 participants aged 16 to 24 years old to test the efficacy of Epic Allies to achieve VS. Both study arms showed improved VS at 26-weeks (62.9% intervention; 73.5% control; ARR = 0.93 (95% CI 0.73, 1.18)) and antiretroviral adherence; intervention effects were amplified in regular app users. Issues with recruitment and app usage metrics limit the ability to definitively say that the app was effective in causing behavior changes resulting in improved health outcomes. (ClinicalTrials.gov Identifier: NCT02782130).
Journal Article
Promoting participation in remote digital health studies: An expert interview study
Background
Remote digital health studies are on the rise and promise to reduce the operational inefficiencies of in-person research. However, they encounter specific challenges in maintaining participation (enrollment and retention) due to their exclusive reliance on technology across all study phases.
Objective
The goal of this study was to collect experts’ opinions on how to facilitate participation in remote digital health studies.
Method
We conducted 13 semi-structured interviews with principal investigators, researchers, and software developers who had recent experiences with remote digital health studies. Informed by the Unified Theory of Acceptance and Use of Technology (UTAUT) framework, we performed a thematic analysis and mapped various approaches to successful study participation.
Results
Our analyses revealed four themes: (1) study planning to increase participation, where experts suggest that remote digital health studies should be planned based on adequate knowledge of what motivates, engages, and disengages a target population; (2) participant enrollment, highlighting that enrollment strategies should be selected carefully, attached to adequate support, and focused on inclusivity; (3) participant retention, with strategies that minimize the effort and complexity of study tasks and ensure that technology is adapted and responsive to participant needs, and (4) requirements for study planning focused on the development of relevant guidelines to foster participation in future studies.
Conclusions
Our findings highlight the significant requirements for seamless technology and researcher involvement in enabling high remote digital health study participation. Future studies can benefit from collected experiences and the development of guidelines to inform planning that balances participant and scientific requirements.
Journal Article
Use of Apps to Promote Childhood Vaccination: Systematic Review
Vaccination is a critical step in reducing child mortality; however, vaccination rates have declined in many countries in recent years. This decrease has been associated with an increase in the outbreak of vaccine-preventable diseases. The potential for leveraging mobile platforms to promote vaccination coverage has been investigated in the development of numerous mobile apps. Although many are available for public use, there is little robust evaluation of these apps.
This systematic review aimed to assess the effectiveness of apps supporting childhood vaccinations in improving vaccination uptake, knowledge, and decision making as well as the usability and user perceptions of these apps.
PubMed, Excerpta Medica Database (EMBASE), Web of Science, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, and Education Resources Information Center (ERIC) databases were systematically searched for studies published between 2008 and 2019 that evaluated childhood vaccination apps. Two authors screened and selected studies according to the inclusion and exclusion criteria. Data were extracted and analyzed, and the studies were assessed for risk of bias.
A total of 28 studies evaluating 25 apps met the inclusion criteria and were included in this analysis. Overall, 9 studies assessed vaccination uptake, of which 4 reported significant benefits (P<.001 or P=.03) of the implementation of the app. Similarly, 4 studies indicated a significant (P≤.054) impact on knowledge and on vaccination decision making. Patient perceptions, usability, and acceptability were generally positive. The quality of the included studies was found to be moderate to poor, with many aspects of the methodology being unclear.
There is little evidence to support the use of childhood vaccination apps to improve vaccination uptake, knowledge, or decision making. Further research is required to understand the dichotomous effects of vaccination-related information provision and the evaluation of these apps in larger, more robust studies. The methodology of studies must be reported more comprehensively to accurately assess the effectiveness of childhood vaccination apps and the risk of bias of studies.
RR2-10.2196/16929.
Journal Article
Human Computer Interaction Applications in Healthcare: An Integrative Review
INTRODUCTION: Human computer interaction (HCI) interprets the design model and the uses of computer technology which focuses on the interface between the user and the computer. HCI is a very important factor in the design of software-oriented decision-making ideas in health-care organizations and also it assists in accurate detection of image, disease including safety of the patients. OBJECTIVES: There are some pitfalls arises over some previous works on cloud based HCI applications. For that reason, to masafety, patient’s safety we wanted to work on explainable artificial intelligence (x-AI) and human intelligence in conjunction with HCI in various fields and algorithms to pro-vide transparency to the user. This may also use some web-based technologies and digital platforms with HCI for development of quality, safety and usability of the patients. METHODS: The purpose of this study about the communication between the HCI design and healthcare system through client and apply that method to the information system of Healthcare department to analyse the functions, effects and outcomes. RESULTS: The integration of explainable artificial intelligence (x-AI) and human intelligence with Human-Computer Interaction (HCI) demonstrated promising potential in enhancing patient safety and optimizing healthcare processes. CONCLUSION: By leveraging web-based technologies and digital platforms, this study established a framework for improving the quality, safety, and usability of healthcare services through effective communication between HCI design and healthcare systems.
Journal Article
Evaluation of mobile applications for patients with fecal incontinence using a modified APPLICATIONS scoring system
Introduction and hypothesisMobile applications (apps) are becoming an increasingly popular means of obtaining medical information. The aim of our study was to identify and evaluate patient-centered fecal incontinence (FI) mobile apps using a modified APPLICATIONS scoring system.MethodsWe conducted searches in the Apple App and Google Play stores to identify FI-related mobile apps using search terms reflecting both commonly accepted medical terms as well as colloquial terms used by our patients with FI. Apps that were in English, relevant to FI, patient-centered, and medically accurate were included. Each eligible app was then independently evaluated by the three authors using a modified 17-point APPLICATIONS scoring system.ResultsWe identified 2785 apps upon initial search using FI search terms. Fourteen apps met eligibility criteria for scoring. Most apps were bowel movement trackers (13/14, 93%), of which only three allowed for tracking of FI episodes. Only one (7%) app contained educational information specific to FI. Ten (71%) apps were fully functional at no cost. Thirteen (93%) apps cited literature. Median APPLICATIONS score was 10 (IQR 9–11). “BristolStoolChart,” “FreeToBe,” and “PoopLog” each received the highest total score of 13.ConclusionsPatient-centered mobile apps that provide FI-specific educational information or allow for FI symptom tracking are scarce. While we did discover some accurate sources of information and means of tracking bowel habits, patients are likely to encounter inaccurate or irrelevant information even when searching for FI-related apps using appropriate terminology. Future app development should include FI-specific symptom tracking and educational information from reputable sources.
Journal Article
Improving Global Health With Smartphone Technology: A Decade in Review of mHealth Initiatives
The widespread use of smartphones makes them a popular platform for healthcare applications. This article reveals the global trends and overarching goals of mHealth initiatives that seek to enhance healthcare quality, increase access to health services, and improve global health communication. Three main themes emerged from this study: a) the impact of mHealth on international public health, b) overcoming mhealth barriers, and c) emerging mHealth technologies. The costs of developing mHealth apps and handling related data security concerns are the key barriers which need to be addressed to successfully implement global mHealth campaigns. Future directions of mHealth research are discussed, including the integration of new technologies, development of innovative healthcare systems, and overall improvement of global healthcare.
Journal Article
Improving Critical Value Notification through Secure Text Messaging
Background: To improve communication between clinical providers and the laboratory, we recently implemented secure text messaging for our critical value notifications. This was done to communicate laboratory critical values (CV) to providers faster so changes to patient care could be done faster. Our previous method of communicating CV to providers was paging and relied on a call back to receive the critical value. Methods: We implemented delivery of CV through a secure texting application in which the CV was directly communicated to the provider on their smart phone device. Results: The mean pre-implementation turnaround time (TAT) was 11.3 minutes (median: 7 minutes, range: 0 - 210 minutes). The mean post- secure text messaging implementation TAT was 3.03 minutes (median: 0.89 minutes, range: < 1 - 95 minutes).When comparing pre- and post-implementation, there was a significant reduction in the TAT from using secure text messaging (p < 0.001). Of the 234 surveys sent out, 81 providers responded (35%). Of these responses, 85% reported that critical value notification by secure text messaging has increased their efficiency and 95% reported that critical value notification is more effective than a pager-phone-call based system. 83% of providers reported that they were able to provide better, faster care to their patients. Conclusions: Using secure text messaging (STM) to deliver critical values significantly reduces the CV TAT. Furthermore, providers noted they preferred to receive CV notifications through STM and reported that they were able to provide more effective care to their patients.
Journal Article