Subjects -> COMPUTER SCIENCE (Total: 2313 journals)
    - ANIMATION AND SIMULATION (33 journals)
    - ARTIFICIAL INTELLIGENCE (133 journals)
    - AUTOMATION AND ROBOTICS (116 journals)
    - CLOUD COMPUTING AND NETWORKS (75 journals)
    - COMPUTER ARCHITECTURE (11 journals)
    - COMPUTER ENGINEERING (12 journals)
    - COMPUTER GAMES (23 journals)
    - COMPUTER PROGRAMMING (25 journals)
    - COMPUTER SCIENCE (1305 journals)
    - COMPUTER SECURITY (59 journals)
    - DATA BASE MANAGEMENT (21 journals)
    - DATA MINING (50 journals)
    - E-BUSINESS (21 journals)
    - E-LEARNING (30 journals)
    - ELECTRONIC DATA PROCESSING (23 journals)
    - IMAGE AND VIDEO PROCESSING (42 journals)
    - INFORMATION SYSTEMS (109 journals)
    - INTERNET (111 journals)
    - SOCIAL WEB (61 journals)
    - SOFTWARE (43 journals)
    - THEORY OF COMPUTING (10 journals)

COMPUTER SCIENCE (1305 journals)            First | 1 2 3 4 5 6 7 | Last

Showing 201 - 400 of 872 Journals sorted alphabetically
Computational Ecology and Software     Open Access   (Followers: 9)
Computational Economics     Hybrid Journal   (Followers: 12)
Computational Geosciences     Hybrid Journal   (Followers: 17)
Computational Linguistics     Open Access   (Followers: 23)
Computational Management Science     Hybrid Journal  
Computational Mathematics and Modeling     Hybrid Journal   (Followers: 8)
Computational Mechanics     Hybrid Journal   (Followers: 11)
Computational Methods and Function Theory     Hybrid Journal  
Computational Molecular Bioscience     Open Access   (Followers: 1)
Computational Optimization and Applications     Hybrid Journal   (Followers: 9)
Computational Particle Mechanics     Hybrid Journal   (Followers: 1)
Computational Science and Techniques     Open Access  
Computational Statistics     Hybrid Journal   (Followers: 15)
Computational Statistics & Data Analysis     Hybrid Journal   (Followers: 34)
Computational Toxicology     Hybrid Journal  
Computer     Full-text available via subscription   (Followers: 141)
Computer Aided Surgery     Open Access   (Followers: 5)
Computer Applications in Engineering Education     Hybrid Journal   (Followers: 6)
Computer Communications     Hybrid Journal   (Followers: 19)
Computer Engineering and Applications Journal     Open Access   (Followers: 8)
Computer Journal     Hybrid Journal   (Followers: 7)
Computer Methods in Applied Mechanics and Engineering     Hybrid Journal   (Followers: 26)
Computer Methods in Biomechanics and Biomedical Engineering     Hybrid Journal   (Followers: 10)
Computer Methods in Biomechanics and Biomedical Engineering : Imaging & Visualization     Hybrid Journal  
Computer Music Journal     Hybrid Journal   (Followers: 18)
Computer Physics Communications     Hybrid Journal   (Followers: 9)
Computer Science - Research and Development     Hybrid Journal   (Followers: 7)
Computer Science and Engineering     Open Access   (Followers: 15)
Computer Science and Information Technology     Open Access   (Followers: 12)
Computer Science Education     Hybrid Journal   (Followers: 16)
Computer Science Journal     Open Access   (Followers: 20)
Computer Science Review     Hybrid Journal   (Followers: 12)
Computer Standards & Interfaces     Hybrid Journal   (Followers: 3)
Computer Supported Cooperative Work (CSCW)     Hybrid Journal   (Followers: 8)
Computer-aided Civil and Infrastructure Engineering     Hybrid Journal   (Followers: 9)
Computer-Aided Design and Applications     Hybrid Journal   (Followers: 6)
Computers     Open Access   (Followers: 2)
Computers & Chemical Engineering     Hybrid Journal   (Followers: 12)
Computers & Education     Hybrid Journal   (Followers: 92)
Computers & Electrical Engineering     Hybrid Journal   (Followers: 8)
Computers & Geosciences     Hybrid Journal   (Followers: 30)
Computers & Mathematics with Applications     Full-text available via subscription   (Followers: 9)
Computers & Structures     Hybrid Journal   (Followers: 44)
Computers & Education Open     Open Access   (Followers: 3)
Computers & Industrial Engineering     Hybrid Journal   (Followers: 6)
Computers and Composition     Hybrid Journal   (Followers: 11)
Computers and Education: Artificial Intelligence     Open Access   (Followers: 4)
Computers and Electronics in Agriculture     Hybrid Journal   (Followers: 7)
Computers and Geotechnics     Hybrid Journal   (Followers: 13)
Computers in Biology and Medicine     Hybrid Journal   (Followers: 10)
Computers in Entertainment     Hybrid Journal  
Computers in Human Behavior Reports     Open Access  
Computers in Industry     Hybrid Journal   (Followers: 7)
Computers in the Schools     Hybrid Journal   (Followers: 8)
Computers, Environment and Urban Systems     Hybrid Journal   (Followers: 11)
Computerworld Magazine     Free   (Followers: 2)
Computing     Hybrid Journal   (Followers: 2)
Computing and Software for Big Science     Hybrid Journal   (Followers: 1)
Computing and Visualization in Science     Hybrid Journal   (Followers: 6)
Computing in Science & Engineering     Full-text available via subscription   (Followers: 31)
Computing Reviews     Full-text available via subscription   (Followers: 1)
Concurrency and Computation: Practice & Experience     Hybrid Journal  
Connection Science     Open Access  
Control Engineering Practice     Hybrid Journal   (Followers: 46)
Cryptologia     Hybrid Journal   (Followers: 3)
CSI Transactions on ICT     Hybrid Journal   (Followers: 2)
Cuadernos de Documentación Multimedia     Open Access  
Current Science     Open Access   (Followers: 116)
Cyber-Physical Systems     Hybrid Journal  
Cyberspace : Jurnal Pendidikan Teknologi Informasi     Open Access  
DAIMI Report Series     Open Access  
Data     Open Access   (Followers: 4)
Data & Policy     Open Access   (Followers: 3)
Data Science and Engineering     Open Access   (Followers: 6)
Data Technologies and Applications     Hybrid Journal   (Followers: 217)
Data-Centric Engineering     Open Access   (Followers: 1)
Datenbank-Spektrum     Hybrid Journal   (Followers: 1)
Datenschutz und Datensicherheit - DuD     Hybrid Journal  
Decision Analytics     Open Access   (Followers: 3)
Decision Support Systems     Hybrid Journal   (Followers: 13)
Design Journal : An International Journal for All Aspects of Design     Hybrid Journal   (Followers: 33)
Digital Biomarkers     Open Access   (Followers: 1)
Digital Chemical Engineering     Open Access  
Digital Chinese Medicine     Open Access  
Digital Creativity     Hybrid Journal   (Followers: 11)
Digital Experiences in Mathematics Education     Hybrid Journal   (Followers: 3)
Digital Finance : Smart Data Analytics, Investment Innovation, and Financial Technology     Hybrid Journal   (Followers: 3)
Digital Geography and Society     Open Access  
Digital Government : Research and Practice     Open Access   (Followers: 1)
Digital Health     Open Access   (Followers: 10)
Digital Journalism     Hybrid Journal   (Followers: 8)
Digital Medicine     Open Access   (Followers: 3)
Digital Platform: Information Technologies in Sociocultural Sphere     Open Access   (Followers: 1)
Digital Policy, Regulation and Governance     Hybrid Journal   (Followers: 2)
Digital War     Hybrid Journal   (Followers: 2)
Digitale Welt : Das Wirtschaftsmagazin zur Digitalisierung     Hybrid Journal  
Digitális Bölcsészet / Digital Humanities     Open Access   (Followers: 2)
Disaster Prevention and Management     Hybrid Journal   (Followers: 30)
Discours     Open Access   (Followers: 1)
Discourse & Communication     Hybrid Journal   (Followers: 26)
Discover Internet of Things     Open Access   (Followers: 2)
Discrete and Continuous Models and Applied Computational Science     Open Access  
Discrete Event Dynamic Systems     Hybrid Journal   (Followers: 3)
Discrete Mathematics & Theoretical Computer Science     Open Access   (Followers: 1)
Discrete Optimization     Full-text available via subscription   (Followers: 7)
Displays     Hybrid Journal  
Distributed and Parallel Databases     Hybrid Journal   (Followers: 2)
e-learning and education (eleed)     Open Access   (Followers: 40)
Ecological Indicators     Hybrid Journal   (Followers: 22)
Ecological Informatics     Hybrid Journal   (Followers: 3)
Ecological Management & Restoration     Hybrid Journal   (Followers: 15)
Ecosystems     Hybrid Journal   (Followers: 33)
Edu Komputika Journal     Open Access   (Followers: 1)
Education and Information Technologies     Hybrid Journal   (Followers: 53)
Educational Philosophy and Theory     Hybrid Journal   (Followers: 10)
Educational Psychology in Practice: theory, research and practice in educational psychology     Hybrid Journal   (Followers: 13)
Educational Research and Evaluation: An International Journal on Theory and Practice     Hybrid Journal   (Followers: 7)
Educational Theory     Hybrid Journal   (Followers: 9)
Egyptian Informatics Journal     Open Access   (Followers: 5)
Electronic Commerce Research and Applications     Hybrid Journal   (Followers: 5)
Electronic Design     Partially Free   (Followers: 125)
Electronic Letters on Computer Vision and Image Analysis     Open Access   (Followers: 10)
Elektron     Open Access  
Empirical Software Engineering     Hybrid Journal   (Followers: 8)
Energy for Sustainable Development     Hybrid Journal   (Followers: 13)
Engineering & Technology     Hybrid Journal   (Followers: 23)
Engineering Applications of Computational Fluid Mechanics     Open Access   (Followers: 23)
Engineering Computations     Hybrid Journal   (Followers: 3)
Engineering Economist, The     Hybrid Journal   (Followers: 4)
Engineering Optimization     Hybrid Journal   (Followers: 19)
Engineering With Computers     Hybrid Journal   (Followers: 5)
Enterprise Information Systems     Hybrid Journal   (Followers: 2)
Entertainment Computing     Hybrid Journal   (Followers: 2)
Environmental and Ecological Statistics     Hybrid Journal   (Followers: 7)
Environmental Communication: A Journal of Nature and Culture     Hybrid Journal   (Followers: 16)
EPJ Data Science     Open Access   (Followers: 10)
ESAIM: Control Optimisation and Calculus of Variations     Open Access   (Followers: 2)
Ethics and Information Technology     Hybrid Journal   (Followers: 64)
eTransportation     Open Access   (Followers: 1)
EURO Journal on Computational Optimization     Open Access   (Followers: 5)
EuroCALL Review     Open Access  
European Food Research and Technology     Hybrid Journal   (Followers: 8)
European Journal of Combinatorics     Full-text available via subscription   (Followers: 3)
European Journal of Computational Mechanics     Hybrid Journal   (Followers: 1)
European Journal of Information Systems     Hybrid Journal   (Followers: 87)
European Journal of Law and Technology     Open Access   (Followers: 19)
European Journal of Political Theory     Hybrid Journal   (Followers: 27)
Evolutionary Computation     Hybrid Journal   (Followers: 11)
Fibreculture Journal     Open Access   (Followers: 9)
Finite Fields and Their Applications     Full-text available via subscription   (Followers: 5)
Fixed Point Theory and Applications     Open Access  
Focus on Catalysts     Full-text available via subscription  
Focus on Pigments     Full-text available via subscription   (Followers: 3)
Focus on Powder Coatings     Full-text available via subscription   (Followers: 5)
Forensic Science International: Digital Investigation     Full-text available via subscription   (Followers: 318)
Formal Aspects of Computing     Hybrid Journal   (Followers: 3)
Formal Methods in System Design     Hybrid Journal   (Followers: 6)
Forschung     Hybrid Journal   (Followers: 1)
Foundations and Trends® in Communications and Information Theory     Full-text available via subscription   (Followers: 6)
Foundations and Trends® in Databases     Full-text available via subscription   (Followers: 2)
Foundations and Trends® in Human-Computer Interaction     Full-text available via subscription   (Followers: 5)
Foundations and Trends® in Information Retrieval     Full-text available via subscription   (Followers: 30)
Foundations and Trends® in Networking     Full-text available via subscription   (Followers: 1)
Foundations and Trends® in Signal Processing     Full-text available via subscription   (Followers: 7)
Foundations and Trends® in Theoretical Computer Science     Full-text available via subscription   (Followers: 1)
Foundations of Computational Mathematics     Hybrid Journal  
Foundations of Computing and Decision Sciences     Open Access  
Frontiers in Computational Neuroscience     Open Access   (Followers: 23)
Frontiers in Computer Science     Open Access   (Followers: 1)
Frontiers in Digital Health     Open Access   (Followers: 4)
Frontiers in Digital Humanities     Open Access   (Followers: 7)
Frontiers in ICT     Open Access  
Frontiers in Neuromorphic Engineering     Open Access   (Followers: 2)
Frontiers in Research Metrics and Analytics     Open Access   (Followers: 4)
Frontiers of Computer Science in China     Hybrid Journal   (Followers: 2)
Frontiers of Environmental Science & Engineering     Hybrid Journal   (Followers: 3)
Frontiers of Information Technology & Electronic Engineering     Hybrid Journal  
Fuel Cells Bulletin     Full-text available via subscription   (Followers: 9)
Functional Analysis and Its Applications     Hybrid Journal   (Followers: 3)
Future Computing and Informatics Journal     Open Access  
Future Generation Computer Systems     Hybrid Journal   (Followers: 2)
Geo-spatial Information Science     Open Access   (Followers: 7)
Geoforum Perspektiv     Open Access   (Followers: 1)
GeoInformatica     Hybrid Journal   (Followers: 7)
Geoinformatics FCE CTU     Open Access   (Followers: 8)
GetMobile : Mobile Computing and Communications     Full-text available via subscription   (Followers: 1)
Government Information Quarterly     Hybrid Journal   (Followers: 28)
Granular Computing     Hybrid Journal  
Graphics and Visual Computing     Open Access  
Grey Room     Hybrid Journal   (Followers: 16)
Group Dynamics : Theory, Research, and Practice     Full-text available via subscription   (Followers: 15)
Groups, Complexity, Cryptology     Open Access   (Followers: 2)
HardwareX     Open Access  
Harvard Data Science Review     Open Access   (Followers: 3)
Health Services Management Research     Hybrid Journal   (Followers: 16)
Healthcare Technology Letters     Open Access  
High Frequency     Hybrid Journal  
High-Confidence Computing     Open Access   (Followers: 1)
Home Cultures     Full-text available via subscription   (Followers: 7)
Home Health Care Management & Practice     Hybrid Journal   (Followers: 1)

  First | 1 2 3 4 5 6 7 | Last

Similar Journals
Journal Cover
Digital Health
Number of Followers: 10  

  This is an Open Access Journal Open Access journal
ISSN (Print) 2055-2076 - ISSN (Online) 2055-2076
Published by Sage Publications Homepage  [1174 journals]
  • Evaluating mobile Health technology use among cancer caregivers in the
           digital era

    • Authors: Minakshi Raj, Vibhuti Gupta, Flora Hoodin, Caroline Clingan, Chloe Roslin, Lilian Yahng, Thomas Braun, Sung Won Choi
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      IntroductionDigital health technology-based interventions have the potential to support cancer caregivers in caregiving responsibilities and in managing their own health and well-being. The objective of this study was to examine the association between caregiving characteristics and different types of digital health technologies used in a national sample of caregivers of patients undergoing hematopoietic cell transplantation (HCT).MethodsWe conducted an online, cross-sectional survey of 948 HCT caregivers.ResultsSpousal caregivers comprised nearly one-third of respondents (27.1%) with a median age of 59 years (range: 18–80 years), compared with parents (32.9%: 38 years), adult children (28.9%: 38 years), and other (11.1%; e.g. friend, other family member: 36 years). Almost two-thirds (65.4%) of all respondents reported using an app for fitness or step counting and 41.3% reported using a smartwatch. However, spousal caregivers were the least likely group to use mobile apps (0.72; P 
      Citation: DIGITAL HEALTH
      PubDate: 2022-06-23T05:50:22Z
      DOI: 10.1177/20552076221109071
      Issue No: Vol. 8 (2022)
       
  • A critical review of the role of technology and context in digital health
           research

    • Authors: Petter Nielsen, Sundeep Sahay
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      Digital health represents a research field dedicated to realising digital technologies’ potential and developing knowledge about their feasibility and impacts. Yet, drawing on a critical review of the articles in the most prominent multidisciplinary digital health journals, this paper argues that the digital health field has not profoundly engaged with its core subject, namely technology. The features of digital technologies remain in the background, and research is disconnected from the complexities of healthcare settings, including multiple technologies, established practices and people. Instead, the overarching focus in the digital health literature is the processing capabilities of digital technologies and their posited impacts. This paper proposes a research direction in digital health where technology and the context of use take a more prominent role. It argues that realising the potential of digital health requires intensive investigation drawing on different disciplines, grounded on understanding healthcare processes, related informational needs and the concrete features of digital technologies.
      Citation: DIGITAL HEALTH
      PubDate: 2022-06-23T05:50:12Z
      DOI: 10.1177/20552076221109554
      Issue No: Vol. 8 (2022)
       
  • The accuracy of teledentistry in caries detection in children – A
           diagnostic study

    • Authors: Mohammad AlShaya, Deema Farsi, Nada Farsi, Najat Farsi
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      Introduction: The increasing burden of dental caries and the lack of effective dental caries screening protocols in non-dental settings, such as schools, demand an innovative and cost-effective approach. Teledentistry is the field of dentistry that combines telecommunication with health records and digital imaging to improve access to dental care and help in epidemiological surveys. This study aimed to assess the accuracy of non-dentist teledentistry in caries detection compared with the clinical dental examination of a sample of 5–10-year-old schoolchildren.MethodsA calibrated dentist examined schoolchildren aged 5–10 years old. The dentist and two teachers took intraoral photographs for each child, using a smartphone. The photographs were concealed; therefore, the dentist assessed the three sets of photographs blindly two weeks after the clinical examination. Accuracy was measured to compare the teledentistry examination with the clinical dental examination.ResultsThe mean DMFT of primary teeth was 3.38, 3.42, and 3.17 upon clinical examination, dental-teledentistry examination (findings of photographs taken by a dentist), and non-dental teledentistry (findings of photographs taken by teachers), respectively. The mean DMFT of permanent teeth was 0.75, 0.69, and 0.65 upon clinical examination, dental-teledentistry examination, and non-dental teledentistry examination, respectively. In primary teeth, dental teledentistry and non-dental teledentistry examinations showed 95 and 98.3 sensitivity and 94.3 and 91.4 specificity, respectively. In permanent teeth, dental teledentistry and non-dental teledentistry examinations showed 80.8 and 88.5 sensitivity and 94.1 and 96.1 specificity, respectively.ConclusionsTeledentistry has acceptable accuracy for caries detection in schoolchildren compared to a clinical dental examination.
      Citation: DIGITAL HEALTH
      PubDate: 2022-06-23T05:50:05Z
      DOI: 10.1177/20552076221109075
      Issue No: Vol. 8 (2022)
       
  • A gamified app for supporting undergraduate students’ mental health: A
           feasibility and usability study

    • Authors: Iolie Nicolaidou, Loizos Aristeidis, Lambros Lambrinos
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      Resilience, a person's mental ability to deal with challenging situations adaptively, is an important life skill. Supporting students in building psychological resilience and coping during crises (with the COVID-19 pandemic being a prime example) is crucial. Very few mobile applications (apps) for mental health explicitly report behavioral change techniques. Moreover, only a handful of the apps that support resilience are gamified, or use smartphone sensors readily available in modern smartphones for health self-management, or were designed for use by a nonclinical population. This study describes the design of a prototype for a gamified, theory-based mobile app that utilizes the Internet of Things to provide personalized data and enhance undergraduate students’ resilience. A total of 74 participants evaluated the prototype and completed an online questionnaire during the COVID-19 lockdowns. The questionnaire included questions examining the design's feasibility for supporting resilience and questions on the System Usability Scale evaluating its usability. Regarding the evaluation of the prototype on improving psychological resilience, positive responses (M = 3.76 out of 5, SD = 0.82) were received for all functions (goal setting for studying, socializing and physical exercise, progress monitoring using sensors or self-reporting, reflection, motivational badges). The System Usability Scale returned an evaluation score of 72.9, indicating a satisfactory degree of usability. The resilience app is a promising proof of concept. Combining Internet of Things capabilities with active user interaction while incorporating behavior change techniques in a gamified environment was well accepted by students. Implications for the design of gamified environments for well-being are drawn. Future research will empirically validate its design using quasi-experimental methods.
      Citation: DIGITAL HEALTH
      PubDate: 2022-06-22T06:52:02Z
      DOI: 10.1177/20552076221109059
      Issue No: Vol. 8 (2022)
       
  • Development of a Healthcare Information System for Community Care of Older
           Adults and Evaluation of Its Acceptance and Usability

    • Authors: Kup-Sze Choi, Sze-Ho Chan, Cho-Lik Ho, Marek Matejak
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectiveThe need for health and social care for community-dwelling elderly is on the rise as the population ages. Through the provision of comprehensive services by multiple professionals in local communities, elderly people can receive continual care in a non-medical setting, which is favorable for early detection and intervention of potential problems. However, the lack of digitalization in primary care affects the effectiveness of the services and precludes full exploitation of the data. This study proposed an information system dedicated to caring for community-dwelling elderly people and investigated its acceptance and usability.MethodsAn information system was designed for elderly care centers in the community, where data generated during care delivery, involving socio-demographic data, bio-measurements and health assessments and questionnaires, were digitized and stored for information management and exchange. A study was conducted to evaluate the acceptance and usability of the system after routine use of 6 months. The users of the system at an elderly care center were recruited to respond to a technology acceptance questionnaire and a system usability questionnaire.ResultsThe mean scores of the acceptance and usability questionnaires reached 5.1 out of the highest possible score of 7. The constructs of the acceptance questionnaire had good reliability. The social influence and facilitating conditions constructs had a significant correlation with the behavioral intention construct.ConclusionsThe proposed information system demonstrated good acceptance and usability, which supported the feasibility of implementing it in community care centers for older adults. Further research will be conducted to address the limitation of sample size by extending the system to other elderly care centers, forming a large user base for a more in-depth and comprehensive performance evaluation.
      Citation: DIGITAL HEALTH
      PubDate: 2022-06-21T05:12:49Z
      DOI: 10.1177/20552076221109083
      Issue No: Vol. 8 (2022)
       
  • An intelligent system for assisting personalized COVID-19 vaccination
           location selection: Taiwan as an example

    • Authors: Yu-Cheng Lin, Tin-Chih Toly Chen
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      In many regions of the world, with the gradual increase in the supply of COVID-19 vaccines, COVID-19 vaccination has changed from centralized government control to personalized selection. When choosing a location for COVID-19 vaccination, in addition to subjective preferences, objective information (such as the expected waiting time at a COVID-19 vaccination location and the crowdedness and reliability of the vaccination location) also need to be considered. However, it is not convenient for an individual to collect and compare such information. To address this issue, this research applies web content mining to extract the conditions of COVID-19 vaccination locations. Then, a novel asymmetric calibrated fuzzy inverse of column sum and fuzzy Vise Kriterijumska Optimizacija I Kompromisno Resenje recommendation mechanism is proposed. Finally, an intelligent system is developed to assist a user in selecting a personalized COVID-19 vaccination location. In a regional experiment conducted in Taichung City, Taiwan, the developed intelligent system was applied to assist 20 users in choosing personalized COVID-19 vaccination locations. The successful recommendation rate was 95%.
      Citation: DIGITAL HEALTH
      PubDate: 2022-06-20T03:46:55Z
      DOI: 10.1177/20552076221109062
      Issue No: Vol. 8 (2022)
       
  • A novel low-cost bubble continuous positive airway pressure device with
           pressure monitoring and controlling system for low resource settings

    • Authors: Etagegnehu Dagnachew Feleke, Eyerusalem Gebremeskel Gebremaryam, Feven Tadele Regassa, Hawi Rorissa Kuma, Hayat Solomon Sabir, Ahmed Mohammed Abagaro, Kokeb Dese
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      BackgroundCurrently bubble continuous positive airway pressure (bCPAP) is commonly used in low resource settings to treat respiratory distress. However, the accumulation of condensate in the patient's exhalation limb during operation could significantly increase pressure delivered to the body, which can lead to severe respiratory failure in the infant. The objective of this research was to develop a novel low-cost bCPAP device that can monitor and control the pressure delivered to infants.MethodsWhen the neonate expires, the pressure sensor inside the expiratory limb measures the instant positive end-expiratory pressure. The microcontroller decides whether to turn the relay to switch the path of expiration between the two expiratory tubes connected to the valve outlets. This depends on the pressure reading and the cutoff pressure value inserted by the physician.ResultsThe system was tested for accuracy, safety, cost, ease of use, and durability. The prototype was accurate in eight iterations at eight different depths of water that were made to monitor and control the pressure. It was safe and provided suitable pressure for the neonate, and the prototype was built in less than 193 USD.ConclusionsThe performance testing of the device demonstrated accurate and safe control and monitoring of continuous positive air pressure (CPAP) and oxygen levels with humidity levels safe for infants. The device provides humidified, blended, and pressurized gas for the patient. It allows physicians to easily monitor and control the accumulation of condensate in the exhalation limb of the CPAP machine accurately and safely.
      Citation: DIGITAL HEALTH
      PubDate: 2022-06-20T03:46:14Z
      DOI: 10.1177/20552076221109060
      Issue No: Vol. 8 (2022)
       
  • Using markers for digital engagement and social change: Tracking
           meaningful narrative exchange in transmedia edutainment with text
           analytics techniques

    • Authors: Roel O Lutkenhaus, Hua Wang, Arvind Singhal, Jeroen Jansz, Martine PA Bouman
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      While social media offer an unprecedented opportunity for orchestrating large-scale communication campaigns, it is often difficult to track audience responses on various digital platforms over time and to ascertain if their engagement is aligned with the original intention. In this article, we share a promising solution—the purposive embedding and tracking of unique content elements as “markers” using text analytics techniques. Four markers were introduced in an Indian melodramatic television serial, Main Kuch Bhi Kar Sakti Hoon (I, A Woman, Can Achieve Anything), which was part of a larger transmedia edutainment initiative in India to promote sanitation, family planning, and gender equality. These markers served as anchors for audience engagement with the originally intended messaging embedded in the narratives as well as for program monitoring and evaluation. We applied various web-based tools to systematically track marker-related engagement on Facebook, Twitter, and YouTube across eight months. We also conducted semantic network analysis to better understand how marker-related social media comments evolved over time. Our investigation of using markers for digital engagement and narrative exchange in MKBKSH makes an important and timely methodological contribution to the scholarship and praxis of social and behavior change communication.
      Citation: DIGITAL HEALTH
      PubDate: 2022-06-20T03:46:03Z
      DOI: 10.1177/20552076221107892
      Issue No: Vol. 8 (2022)
       
  • The quality of digital health software: Should we be concerned'

    • Authors: Peter Kokol, Helena Blažun Vošner, Marko Kokol, Jernej Završnik
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      The digitalization of healthcare fuelled by advances in technology and the increased prevalence of mobile smart devices and health-related internet of things can offer equitable access to expert-level healthcare globally. Growing demand for telemedicine, mobile health apps, and advanced data analytics have further established their role in a modern information society during the Covid-19 crisis. Digital health is, in essence, powered by software (DHSW), which has to operate in the specific digital health environment characteristics and is therefore highly and intrinsically complex and prone to software defects and faults. Given the lack of standardization regarding DHSW quality, we explored the available reviewed research on this crucial topic in this brief paper, using a synthetic thematic analysis approach. We assert that neither the volume, distribution nor scope of the DHSW quality research content is satisfactory, and significant research gaps exist. Based on the presented evidence, we can only conclude that we should be concerned and that the time to act is now to ensure that the unavoidable increase of usage and prevalence of DHSW will not – in the end – reduce the quality of care due to subpar software and software-based digital health systems.
      Citation: DIGITAL HEALTH
      PubDate: 2022-06-17T05:59:44Z
      DOI: 10.1177/20552076221109055
      Issue No: Vol. 8 (2022)
       
  • Time-specific associations of wearable sensor-based cardiovascular and
           behavioral readouts with disease phenotypes in the outpatient setting of
           the Chronic Renal Insufficiency Cohort

    • Authors: Nicholas F. Lahens, Mahboob Rahman, Jordana B. Cohen, Debbie L. Cohen, Jing Chen, Matthew R. Weir, Harold I. Feldman, Gregory R. Grant, Raymond R. Townsend, Carsten Skarke, and the CRIC Study Investigators*
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      Patients with chronic kidney disease are at risk of developing cardiovascular disease. To facilitate out-of-clinic evaluation, we piloted wearable device-based analysis of heart rate variability and behavioral readouts in patients with chronic kidney disease from the Chronic Renal Insufficiency Cohort and controls (n  =  49). Time-specific partitioning of heart rate variability readouts confirm higher parasympathetic nervous activity during the night (mean RR at night 14.4  ±  1.9 ms vs. 12.8  ±  2.1 ms during active hours; n  =  47, analysis of variance (ANOVA) q  =  0.001). The α2 long-term fluctuations in the detrended fluctuation analysis, a parameter predictive of cardiovascular mortality, significantly differentiated between diabetic and nondiabetic patients (prominent at night with 0.58  ±  0.2 vs. 0.45  ±  0.12, respectively, adj. p  =  0.004). Both diabetic and nondiabetic chronic kidney disease patients showed loss of rhythmic organization compared to controls, with diabetic chronic kidney disease patients exhibiting deconsolidation of peak phases between their activity and standard deviation of interbeat intervals rhythms (mean phase difference chronic kidney disease 8.3 h, chronic kidney disease/type 2 diabetes mellitus 4 h, controls 6.8 h). This work provides a roadmap toward deriving actionable clinical insights from the data collected by wearable devices outside of highly controlled clinical environments.
      Citation: DIGITAL HEALTH
      PubDate: 2022-06-17T05:59:24Z
      DOI: 10.1177/20552076221107903
      Issue No: Vol. 8 (2022)
       
  • Cyber-attacks are a permanent and substantial threat to health systems:
           Education must reflect that

    • Authors: O’Brien Niki, Ghafur Saira, Sivaramakrishnan Arvind, Durkin Mike
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      Cyber-attacks on healthcare institutions have increased in recent years and have made headlines through the COVID-19 pandemic. With the fallout of attacks increasingly reported in academic research and in the media, there is a real urgency to address cyber-threats that must be augmented across and within health systems. Until now, clinical healthcare professionals have considered cyber-attacks on healthcare organisations a predominantly information and communication technology issue, but this perception is no longer fit-for-purpose. This commentary provides insights into the scale of cyber-attacks and their impact on staff wellbeing, arguing that cybersecurity education for all staff in healthcare organisations must be improved through online resources, simulation, and gaming. The role of national educators, policymakers, and multilateral organisations in achieving this is outlined alongside implications for future policy and practice.
      Citation: DIGITAL HEALTH
      PubDate: 2022-06-17T05:59:12Z
      DOI: 10.1177/20552076221104665
      Issue No: Vol. 8 (2022)
       
  • Critical user-configurations in mHealth design: How mHealth-app design
           practices come to bias design against chronically ill children and young
           people as mHealth users

    • Authors: Claudia M Bagge-Petersen, Henriette Langstrup, Jakob E Larsen, Anne Frølich
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      Mobile health smartphone applications (mHealth-apps) are increasingly emerging to assist children's and young people's management of chronic conditions. However, difficulties persist in applying design approaches in mHealth projects that return apps that are useful to this group. In this article, we explore ethnographically two self-proclaimed ‘user-driven’ projects designing mHealth apps for Danish patients below the age of 18 living with, respectively, haemophilia and rheumatoid arthritis. These projects initially included the perspectives of children and young people to inform the designs, however, eventually launched the final apps for adult patients only. Through a concept of ‘critical user-configuration’, we examine the projects’ challenges with attuning the designs to children and young people and how these drove their exclusion as users of the emerging mHealth apps. Critical user-configuration draws attention to critical moments in design practices where significant shifts in user-configurations take place, shaping who can become a user. More specifically, we uncover three critical moments: where mHealth projects expand the group of prospective users; where test subjects are selected; and where data governance systems and digital health infrastructures are mobilised in the design process. Throughout these critical moments, there is a drift from user-driven to data-driven design approaches which increasingly exclude groups of users who are less datafiable – in our case children and young people. We argue that besides giving voice to minors in mHealth design processes, we need to be mindful of the design practices that become decisive for – often implicitly – who can be configured as a user.
      Citation: DIGITAL HEALTH
      PubDate: 2022-06-16T05:50:44Z
      DOI: 10.1177/20552076221109531
      Issue No: Vol. 8 (2022)
       
  • A virtual reality-based mind–body approach to downregulate
           psychophysiological arousal in adolescent insomnia

    • Authors: Massimiliano de Zambotti, Dilara Yuksel, Orsolya Kiss, Giacinto Barresi, Nicole Arra, Laila Volpe, Christopher King, Fiona C Baker
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectiveIn this study, we describe the rationale, supported by preliminary data, for a novel, digital, immersive virtual reality (VR)-based mind–body approach, designed to reduce bedtime arousal in adolescents with insomnia.MethodsFifty-two high-school students (16–20 years; 32 female) with (N = 18) and without (N = 34) DSM-5 insomnia symptoms engaged with 20 min of immersive VR-guided meditation and paced breathing (0.1 Hz) (intervention condition) and 20 min of quiet activity (control condition), right before bedtime, on two separate evenings.ResultsThe intervention resulted in acute autonomic and cortical modulation (p 
      Citation: DIGITAL HEALTH
      PubDate: 2022-06-16T05:50:34Z
      DOI: 10.1177/20552076221107887
      Issue No: Vol. 8 (2022)
       
  • Building the hospital intelligent twins for all-scenario intelligence
           health care

    • Authors: Weibin Cheng, Wanmin Lian, Junzhang Tian
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      The COVID-19 pandemic has accelerated a long-term trend of smart hospital development. However, there is no consistent conceptualization of what a smart hospital entails. Few hospitals have genuinely reached being “smart,” primarily failing to bring systems together and consider implications from all perspectives. Hospital Intelligent Twins, a new technology integration powered by IoT, AI, cloud computing, and 5G application to create all-scenario intelligence for health care and hospital management. This communication presented a smart hospital for all-scenario intelligence by creating the hospital Intelligent Twins. Intelligent Twins is widely involved in medical activities. However, solving the medical ethics, protecting patient privacy, and reducing security risks involved are significant challenges for all-scenario intelligence applications. This exploration of creating hospital Intelligent Twins that can be a worthwhile endeavor to assess how to inform evidence-based decision-making better and enhance patient satisfaction and outcomes.
      Citation: DIGITAL HEALTH
      PubDate: 2022-06-13T06:20:36Z
      DOI: 10.1177/20552076221107894
      Issue No: Vol. 8 (2022)
       
  • Effectiveness of the “Essential Coaching for Every Mother” postpartum
           text message program on maternal psychosocial outcomes: A randomized
           controlled trial

    • Authors: Justine Dol, Megan Aston, Amy Grant, Douglas McMillan, Gail Tomblin Murphy, Marsha Campbell-Yeo
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectiveTo determine the effectiveness of the Essential Coaching for Every Mother program on maternal self-efficacy, perceived social support, postpartum anxiety, and postpartum depression at six-weeks postpartum.MethodsParticipants from Nova Scotia were randomized, stratified by parity, to receive either the Essential Coaching for Every Mother postpartum text-message program or usual care, from birth to six-weeks postpartum. Participants completed surveys at enrollment (after birth) and at 6 weeks. Differences between groups were analyzed using analysis of covariance, considering parity and group allocation.ResultsOf the 171 participants recruited (53% primiparous), 150 completed the baseline survey (intervention n = 78, control n = 72). At baseline, newborns were on average 4.4 days old (SD: 3.9) and mothers 31.4 years old (SD: 4.5). Controlling for maternal age, primiparous women in the intervention group had a greater increase in maternal self-efficacy than primiparous women in the control group (mean difference [MD] = 4.84 (standard error [SE] = 0.75) vs. MD = 2.13 (SE = 0.81), p = 0.034). Women allocated to the intervention group had a greater reduction in postpartum anxiety symptoms than women in the control group for both multiparous and primiparous women (MD = −3.91 (SE = 1.82) vs. 2.81 (SE = 1.86), p = 0.011). There was no significant change in postpartum depression scores or perceived social support for either group.DiscussionThis study presents the results of the first Canadian postpartum text message program, which found improved psychosocial outcomes for postpartum women. Given the potential to reach numerous women at a low cost across geographical locations, the scalability of this intervention can improve maternal self-efficacy and reduce postpartum anxiety.
      Citation: DIGITAL HEALTH
      PubDate: 2022-06-13T06:20:31Z
      DOI: 10.1177/20552076221107886
      Issue No: Vol. 8 (2022)
       
  • Posture and musculoskeletal implications for students using mobile phones
           because of learning at home policy

    • Authors: Bonardo Prayogo Hasiholan, Indri Hapsari Susilowati
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      There is an increasing trend of awkward postures due to smartphone use among students learning from home. Previous research in several countries has shown that the use of smartphones during a pandemic impacts musculoskeletal complaints. This study aimed to determine the postures performed by the students when using mobile phones and their implications for musculoskeletal complaints. A total of 709 students who learned from home voluntarily completed an online questionnaire regarding identity, work posture, and duration, while muscle and bone complaints experienced when using mobile phones were obtained through the Nordic Musculoskeletal Questionnaire. Furthermore, a bivariate analysis of body postures was carried out to identify perceived complaints using the chi-square method. The results showed a significant relationship between standing and leaning on a table posture (p-value: 0.026) with elbow, knee, and ankle complaints.
      Citation: DIGITAL HEALTH
      PubDate: 2022-06-10T06:38:23Z
      DOI: 10.1177/20552076221106345
      Issue No: Vol. 8 (2022)
       
  • Designing illustrative social media stories to promote adolescent peer
           support and healthy sexual behaviors

    • Authors: Lauren S Chernick, Alexis Konja, Ariana Gonzalez, Melissa S Stockwell, Anke Ehrhardt, Susanne Bakken, Carolyn L Westhoff, Peter S Dayan, John Santelli
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectiveAdolescent females in the United States continue to have unmet sexual and reproductive healthcare needs. Research shows that interventions incorporating peer support can augment perceived self-efficacy and reinforce healthy behaviors. Yet, few user-centered digital sexual health interventions incorporate peer support, and aim to change perceptions of peer norms and model social skills. The objective of this study was to design and demonstrate the receptivity of adolescent females to illustrated digital social media stories that promote healthy sexual behaviors and peer social support.MethodsWe conducted a three-phase study approved by our Institutional Review Board. In Phase 1, we presented sexually active adolescent female emergency department patients aged 14–19 with eight sexual health scenarios via a survey study. Participants wrote three text messages addressed to the protagonist of each scenario which motivated and encouraged her to consider the use of contraceptives. Messages were scored based on the construct of peer support (emotional, tangible, informational, and belonging). In Phase 2, we worked with a professional artist and screenwriter to design digital sexual health comics using the gathered messages. In Phase 3, we gathered feedback on the comics from adolescent female emergency department patients.ResultsFemales (n  =  22) provided 352 messages. Using top rated messages, we designed five digital visualizations in a running story called Mari tells it like it is. Each story incorporated 5–12 peer-authored quotes. We inserted the final images into Instagram®. Additional females (n  =  39) found the images “relatable,” “super-realistic,” and “educational.”ConclusionCollecting peer-authored texts from our local adolescent community led to the creation of well-received sexual health visualizations. This novel method of design incorporated adolescent voices to promote peer support and healthy behaviors.
      Citation: DIGITAL HEALTH
      PubDate: 2022-06-10T06:38:14Z
      DOI: 10.1177/20552076221104660
      Issue No: Vol. 8 (2022)
       
  • Type-II fuzzy approach with explainable artificial intelligence for
           nature-based leisure travel destination selection amid the COVID-19
           pandemic

    • Authors: Yu-Cheng Lin, Tin-Chih Toly Chen
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      During the coronavirus disease 2019 (COVID-19) pandemic, it is difficult for travelers to choose suitable nature-based leisure travel destinations because many factors are related to health risks and are highly uncertain. This research proposes a type-II fuzzy approach with explainable artificial intelligence to overcome this difficulty. First, an innovative type-II alpha-cut operations fuzzy collaborative intelligence method was used to derive the fuzzy priorities of factors critical for nature-based leisure travel destination selection. Subsequently, a type-II fuzzy Vise Kriterijumska Optimizacija I Kompromisno Resenje method, which is also novel, was employed to evaluate and compare the overall performance of nature-based leisure travel destinations. Furthermore, several measures were taken to enhance the explainability of the selection process and result. The effectiveness of the proposed type-II fuzzy approach was evaluated in a regional experiment conducted in Taichung City, Taiwan, during the COVID-19 pandemic.
      Citation: DIGITAL HEALTH
      PubDate: 2022-06-09T01:19:14Z
      DOI: 10.1177/20552076221106322
      Issue No: Vol. 8 (2022)
       
  • Chronic pain self-management in middle-aged and older adults: A collective
           intelligence approach to identifying barriers and user needs in eHealth
           interventions

    • Authors: Paul M O’Reilly, Owen M Harney, Michael J Hogan, Caroline Mitchell, Brian E McGuire, Brian Slattery
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectiveseHealth refers to health services and health information delivered or enhanced through the internet and related technologies. The number of eHealth interventions for chronic pain self-management is increasing. However, little evidence has been found for the overall efficacy of these interventions for older adults. The aim of the current study was to use a Collective Intelligence approach to identify the barriers and specific user needs of middle-aged and older adults using eHealth for chronic pain self-management.MethodsA Collective Intelligence workshop was conducted with middle-aged and older adults to generate, clarify, select, and structure ideas in relation to barriers to eHealth use and specific design requirements for the purposes of chronic pain self-management. Prior to attending the workshop, participants received a trigger question requesting the identification of five barriers to eHealth use for chronic pain self-management. These barriers were categorised and presented to the group along with barrier-related scenarios and user need prompts, resulting in the generation of a set of ranked barriers and a set of user needs.ResultsA total of 78 barriers were identified, from which six categories emerged: Content, Support, Technological, Personal, Computer Literacy and Accessibility. Additional idea-writing and group reflection in response to these barriers revealed 97 user needs.ConclusionThis is the first study to use Collective Intelligence methods to investigate barriers to eHealth technology use and the specific user needs of middle-aged and older adults in the context of chronic pain self-management. The results of the current study provide a platform for the design and development of enhanced eHealth interventions for this population.
      Citation: DIGITAL HEALTH
      PubDate: 2022-06-08T05:52:32Z
      DOI: 10.1177/20552076221105484
      Issue No: Vol. 8 (2022)
       
  • The role of telemedicine services in changing users’ intentions for
           presenting to the emergency departments in Saudi Arabia

    • Authors: Amjad Alfaleh, Abdullah Alkattan, Alaa Alageel, Mohammed Salah, Mona Almutairi, Khlood Sagor, Khaled Alabdulkareem
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      BackgroundEmergency department (ED) overcrowding is described as one of the main issues in any hospital. In Saudi Arabia, the ministry of health applied new telemedicine technology to serve patients by using the mobile application, including the Sehha application and 937 medical call center. The main aim of this study is to determine the role of different telemedicine services in changing the intention users’ intentions for visiting the emergency departments in Saudi Arabia.MethodsA cross-sectional study was conducted during August 2020 to May 2021 among 319 patients using two telemedicine services in Saudi Arabia, including the medical call center and Sehha smartphone application. The primary endpoint of this study was to determine the number of patients intended to visit ER before and after contacting one of the two telemedicine services and the frequency of people who changed their opinion to visit an ED.ResultsThis study analyzed the data from 319 patients who completed the survey provided by the Saudi Ministry of Health concerning information related to their health status and ED visits. Among patients that had the intention to visit the ED (N = 159), 53 of them did not go to EDs after using telemedicine services (p 
      Citation: DIGITAL HEALTH
      PubDate: 2022-06-08T05:52:00Z
      DOI: 10.1177/20552076221091358
      Issue No: Vol. 8 (2022)
       
  • Healthcare in the hand: Patients’ use of handheld technology in video
           consultations with their general practitioner

    • Authors: Carole Jepsen, Elle Christine Lüchau, Elisabeth Assing Hvidt, Anette Grønning
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectiveTo analyse how the patient's use of handheld technology in video consultations with their general practitioner affects communication and the possibilities for the delivery of quality healthcare. Focusing on the visually communicated aspects of the video consultation, we present three episodes from our recordings of eight video consultations between Danish general practitioners and patients.MethodsUsing a multimodal social semiotic framework to conduct a micro-level analysis, we present episodes from our data in which the hardware's affordance of mobility gave rise to salient events in the interactions of patients who used handheld devices to carry out their video consultations.ResultsPatients’ use of technology plays a significant role in the interactions between general practitioner and patient and is thus an important factor to consider in how practice is shaped when using handheld video consultation technology.ConclusionsOur findings demonstrate that the mobility of handheld devices (smartphone, tablet) can be used to augment sensing and embodiment and enhance the delivery of healthcare in video consultations. However, mobility may also disrupt the interaction. As a result, possibilities for the delivery of quality healthcare lie quite literally in the patients’ hands.
      Citation: DIGITAL HEALTH
      PubDate: 2022-06-07T05:13:37Z
      DOI: 10.1177/20552076221104669
      Issue No: Vol. 8 (2022)
       
  • Impacts of physician promotion on the online healthcare community: Using a
           difference-in-difference approach

    • Authors: Yuan-Teng Hsu, Ya-Ling Chiu, Jying-Nan Wang, Hung-Chun Liu
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      In this study, we use a difference-in-difference approach to explore how physician promotion, the advancement of a physician's offline reputation, affects patient behavior toward physicians in online healthcare communities; this allows us to explore how patients interpret the signals created by physician promotion. The study sample was collected from over 140,000 physician online profiles after 25 months of continuous observation, with 280 physicians who were promoted at month 13 as the treatment group and a control group obtained by propensity score matching. Our results show that a physician's promotion causes more patients to choose that physician, makes patients willing to give more psychological rewards, and makes them tend to give that physician a higher online rating. This implies that patient behavior is susceptible to the signal of physician promotion because the quality of the physician is unlikely to have changed significantly in the short term. These findings extend prior research on reputation in online communities and have crucial implications for theory and practice.
      Citation: DIGITAL HEALTH
      PubDate: 2022-06-06T04:54:48Z
      DOI: 10.1177/20552076221106319
      Issue No: Vol. 8 (2022)
       
  • Assessments of a novel digital follow-up tool Rehabkompassen® to identify
           rehabilitation needs among stroke patients in an outpatient setting

    • Authors: Xiaolei Hu, Karolina Jonzén, Marcus Karlsson, Olof A Lindahl
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      IntroductionIt remains a huge challenge to identify individual rehabilitation needs in a time-efficient manner for providing patient-tailored rehabilitation during the continuum of stroke care. We have recently demonstrated the usefulness of a paper-version Rehab-Compass as a follow-up tool. The aim of the current study was to develop a digital version of the Rehab-Compass and evaluate its usability and feasibility.MethodsThe novel digital tool Rehabkompassen® was developed by an iterative and participatory design process. Patients’ rehabilitation needs were visualized by the tool and used before, during, and after the consultation. The usability and feasibility of the tool was assessed by task completion rate, the System Usability Scale, and satisfaction questionnaires among 2 physicians and 24 adult stroke patients in an outpatient clinical setting.ResultsRehabkompassen® identified and graphically visualized a panoramic view of the stroke patients’ multidimensional needs in individual- and group levels. The instrument appeared to be feasible and time efficient in clinical use with a 100% overall task completion rate for both patients and physicians. A majority of the patients reported that it was very easy or fairly easy to answer the digital questionnaires and to understand their own digital Rehab-Compass graph. Two physicians reported a high mean score on the System Usability Scale (95/100) and were positive about using the tool in the future.ConclusionsThe current results indicated that Rehabkompassen® was a feasible, useful, and time-saving follow-up tool for the identification of rehabilitation needs among stroke survivors in the post-acute continuum of care after stroke. Further research is needed to evaluate the efficacy of the digital instrument among stroke patients.
      Citation: DIGITAL HEALTH
      PubDate: 2022-06-03T07:52:04Z
      DOI: 10.1177/20552076221104662
      Issue No: Vol. 8 (2022)
       
  • Technology-supported models of nutrition care: Perspectives of health
           service providers

    • Authors: Amandine Barnett, Jaimon T Kelly, Charlene Wright, Katrina L Campbell
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectiveTo determine the perspectives to the adoption, scale-up, sustainability, and spread of technology-supported models of nutrition care, in hospital and ambulatory care settings.MethodsThirty-one health service providers participated in individual semi-structured interviews from a tertiary health service in Queensland, Australia. The Non-adoption, Abandonment, and challenges to the Scale up, Spread and Sustainability (NASSS) framework, designed to evaluate technology-supported models’ success, informed the qualitative design.ResultsKey findings were that technology-supported models of care could benefit many chronic condition patient groups; dietitians are well suited to adopting this technology: and the value proposition in creating efficiency gains in the health service. However, challenges of transitioning and sustainability were identified. Perceived enablers for technology supported models of care included: previous intentions for technology supported models of care prior to the 2019 novel coronavirus pandemic; opportunity for clinicians to complete higher valued tasks; and integration of technology systems and assisted staff roles. Perceived barriers included: suitability for patients is dependent on experience and ability to use technology, varied confidence by clinicians when conducting clinical assessments; high investment required for set up and ongoing maintenance; and patients desire for adopting face-to-face care over technology. Health service providers perceived that embedding and adapting such models requires maintenance of high-quality service and continued research.ConclusionsHealth service providers recognize adopting, scaling, and sustaining technology-supported models of nutrition care benefits patients, clinicians, and health services in general. Robust clinical trials and health service evaluations of technology-supported models of care, across practice settings are now needed.
      Citation: DIGITAL HEALTH
      PubDate: 2022-06-03T07:51:54Z
      DOI: 10.1177/20552076221104670
      Issue No: Vol. 8 (2022)
       
  • Assessing digital advertising exposure using a virtual experimental
           protocol

    • Authors: Jennifer Cantrell, Jeffrey Bingenheimer, Shreya Tulsiani, Elizabeth Hair, Donna Vallone, Sarah Mills, Raquel Gerard, William D. Evans
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      IntroductionThe rapid increase in online public education campaigns underscores the need for a better understanding of the effects of exposure to digital advertising and targeted individual-level outcomes. The goal of this study is to develop a virtual experimental protocol to evaluate the dose-response effects of individual-level exposure to digital video ads on campaign outcomes in a naturalistic online browsing context.MethodsYoung adults aged 18–24 years (n = 221) completed three 5 min viewing sessions on a realistic mock-up of the YouTube mobile app over a period of 2 weeks, followed by a 10-min survey after the third session. Participants were randomized to view between 0 and 6 exposures of ads from an e-cigarette prevention campaign; respondents viewed a total of 2 ads per session, with 0 to 2 of those ads being non-skippable digital video ads from the campaign and/or a dummy ad. The video ads played prior to short YouTube videos. Outcomes measured were self-reported ad recognition, frequency of ad exposure, and main message knowledge.ResultsThis study demonstrates a rapidly accessible virtual experimental protocol for evaluating the dose-response effects of digital advertising and individual-level outcomes. Five digital exposures of non-skippable video ads delivered via this platform over a 2-week period generated the highest ad recognition when there were up to six exposures. Higher exposure levels may be needed for message knowledge and ad-content-related effects.ConclusionThis protocol can be extended to investigate dose-response effects and mechanisms of action of individual-level exposure to digital advertising for multiple campaign outcomes, including changes in knowledge, attitudes, and beliefs. Findings can inform evidence for adequate levels of digital exposure in public education campaigns.
      Citation: DIGITAL HEALTH
      PubDate: 2022-06-03T07:51:37Z
      DOI: 10.1177/20552076221102260
      Issue No: Vol. 8 (2022)
       
  • Technology-supported strategies for promoting user engagement with digital
           mental health interventions: A systematic review

    • Authors: Daniel Z Q Gan, Lauren McGillivray, Mark E Larsen, Helen Christensen, Michelle Torok
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      BackgroundAlthough digital mental health interventions (DMHIs) offer a potential solution for increasing access to mental health treatment, their integration into real-world settings has been slow. A key reason for this is poor user engagement. A growing number of studies evaluating strategies for promoting engagement with DMHIs means that a review of the literature is now warranted. This systematic review is the first to synthesise evidence on technology-supported strategies for promoting engagement with DMHIs.MethodsMEDLINE, EmbASE, PsycINFO and PubMed databases were searched from 1 January 1995 to 1 October 2021. Experimental or quasi-experimental studies examining the effect of technology-supported engagement strategies deployed alongside DMHIs were included, as were secondary analyses of such studies. Title and abstract screening, full-text coding and quality assessment were performed independently by two authors. Narrative synthesis was used to summarise findings from the included studies.Results24 studies (10,266 participants) were included. Engagement strategies ranged from reminders, coaching, personalised information and peer support. Most strategies were disseminated once a week, usually via email or telephone. There was some empirical support for the efficacy of technology-based strategies towards promoting engagement. However, findings were mixed regardless of strategy type or study aim.ConclusionsTechnology-supported strategies appear to increase engagement with DMHIs; however, their efficacy varies widely by strategy type. Future research should involve end-users in the development and evaluation of these strategies to develop a more cohesive set of strategies that are acceptable and effective for target audiences, and explore the mechanism(s) through which such strategies promote engagement.
      Citation: DIGITAL HEALTH
      PubDate: 2022-06-02T05:09:36Z
      DOI: 10.1177/20552076221098268
      Issue No: Vol. 8 (2022)
       
  • What criteria are young people using to select mobile mental health
           applications' A nominal group study

    • Authors: Katarzyna Kabacińska, Kaleigh McLeod, Annika MacKenzie, Kim Vu, Michelle Cianfrone, Andrew Tugwell, Julie M Robillard
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectiveThe popularity of smartphone technology provides a unique opportunity to make mental health support widely accessible, especially among young people. Despite the promising results of some mobile mental health support applications, the overwhelming number of available applications (apps) on the market makes it difficult to make a choice that will be safe and effective. Currently, widely available tools are either developed by experts, without end user input or are solely based on usability rankings. Thus, it remains unclear what aspects of mental health apps are important for young people. The purpose of this study was to determine what criteria young adults use when they select mental health applications and what is the relative importance of these criteria to inform the development of a user-driven app-rating platform.MethodsWe conducted 4 group sessions with 47 youth and young adults aged 15–25 in British Columbia, Canada using a modified nominal group technique. This method allows for establishing the relative importance of criteria in a structured group discussion. We recorded, transcribed and analysed the resulting data using qualitative content analysis and quantitative methods.ResultsCriteria that are the most important to young adults when selecting mental health apps include accessibility, security and grounding in scientific evidence. We identified specific aspects of the discussed criteria which were ranked in the order of importance.ConclusionConsulting end users about their priorities when evaluating mental health apps ensures that their values and priorities are incorporated into future app-rating platforms, alongside expert opinions. The present study also outlines the common contexts in which apps are used as well as their desirable features to inform mental health app development.
      Citation: DIGITAL HEALTH
      PubDate: 2022-05-30T06:57:30Z
      DOI: 10.1177/20552076221102775
      Issue No: Vol. 8 (2022)
       
  • Telemedicine options to address identified health needs in Botswana

    • Authors: Benson Ncube, Maurice Mars, Richard E Scott
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectiveGlobal efforts to implement national ehealth strategies have occurred, yet specific telemedicine implementations have fallen behind. A weakness inherent within many, perhaps most, national ehealth strategies, including Botswana's – is a lack of telemedicine focus. This is despite its potential to address many current healthcare system needs. The development of a telemedicine-specific strategy, to complement the existing ehealth strategy, has been proposed. This paper reports on an emulated process to determine prioritised health needs, identify broad solutions, consider ehealth and then telemedicine solutions, and prioritise these as insight for telemedicine-specific strategy development.MethodsThe eHealth Strategy Development Framework (eHSDF) was adopted and steps 5–7 were emulated. Key informants participated in telephone-based semi-structured interviews in November 2020, using a key informant interview guide. Participants were asked specific questions related to national health needs, proposed solutions, and prioritisation. The interviews were recorded and transcribed for analysis.ResultsEleven key informants identified the top five perceived health issues as human resource shortages, congestion and overcrowding, prevalence of diseases, poor referral system, and lack of diagnostic and case management skills. Solutions were proposed, some of which included: Telehealth (including telemedicine), health informatics, and elearning. Telemedicine solutions included: a health professional help desk, teleconsultations, and apps for specialist referral. eLearning solutions were training, mentoring, and continuing professional development.ConclusionA telemedicine-specific strategy, addressing the identified health issues and aligned to the existing national ehealth strategy, would provide the required focus to enable the development and deployment of telemedicine activities in the country.
      Citation: DIGITAL HEALTH
      PubDate: 2022-05-30T06:56:55Z
      DOI: 10.1177/20552076221102768
      Issue No: Vol. 8 (2022)
       
  • Understanding the user: Patients’ perception, needs, and concerns of
           health apps for chronic constipation

    • Authors: V Vien Lee, Smrithi Vijayakumar, Ni Yin Lau, Agata Blasiak, Kewin Tien Ho Siah, Dean Ho
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectiveChronic constipation is a prevalent gastrointestinal disorder that requires long-term management and treatment adherence. With increasing smartphone usage, health app adoption represents an opportunity to incorporate personalized, patient-led care into chronic constipation management. Despite the number of apps available targeting patients with constipation, studies have not yet examined user needs and barriers towards successful app adoption and sustained usage. Accordingly, the current study explored user perception, needs, and concerns of health apps in patients with chronic constipation.MethodsFifteen participants with chronic constipation (age range = 28–79 years, 10 females) in Singapore completed a 60 min semi-structured qualitative interview exploring participant's experiences with and attitudes towards chronic constipation and health apps. Participants also completed two questionnaires regarding their constipation symptoms and general technology usage. Interviews were audio-recorded, transcribed verbatim, and coded using NVivo.ResultsFour themes and 10 sub-themes were identified using inductive thematic analysis. Themes and sub-themes cover importance of patient identity, disease-based expectations of health apps, barriers towards adoption and sustained usage of health apps, necessary conditions when adopting health apps (including perception of supportive benefits, clear understanding of app intention, personalized technology, and trusted sources), and push factor expectations which includes creative engagement and incentivization embedded within the app.ConclusionThe findings captured barriers and key elements necessary for successful health app adoption and continued usage by patients with chronic constipation. Identified elements that matter to patients can provide app developers with user-focused insights and recommendations to develop effective health apps that sustain user engagement.
      Citation: DIGITAL HEALTH
      PubDate: 2022-05-30T06:16:19Z
      DOI: 10.1177/20552076221104673
      Issue No: Vol. 8 (2022)
       
  • Using self-monitoring technology for nutritional counseling and weight
           management

    • Authors: Chelsea A Carpenter, Umelo A Ugwoaba, Michelle I Cardel, Kathryn M Ross
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      Self-monitoring of weight, dietary intake, and physical activity is a key strategy for weight management in adults with obesity. Despite research suggesting consistent associations between more frequent self-monitoring and greater success with weight regulation, adherence is often suboptimal and tends to decrease over time. New technologies such as smartphone applications, e-scales, and wearable devices can help eliminate some of the barriers individuals experience with traditional self-monitoring tools, and research has demonstrated that these tools may improve self-monitoring adherence. To improve the integration of these tools in clinical practice, the current narrative review introduces the various types of self-monitoring technologies, presents current evidence regarding their use for nutrition support and weight management, and provides guidance for optimal implementation. The review ends with a discussion of barriers to the implementation of these technologies and the role that they should optimally play in nutritional counseling and weight management. Although newer self-monitoring technologies may help improve adherence to self-monitoring, these tools should not be viewed as an intervention in and of themselves and are most efficacious when implemented with ongoing clinical support.
      Citation: DIGITAL HEALTH
      PubDate: 2022-05-30T06:15:50Z
      DOI: 10.1177/20552076221102774
      Issue No: Vol. 8 (2022)
       
  • Challenges in the development of digital public health interventions and
           mapped solutions: Findings from a scoping review

    • Authors: Ihoghosa Iyamu, Oralia Gómez-Ramírez, Alice XT Xu, Hsiu-Ju Chang, Sarah Watt, Geoff Mckee, Mark Gilbert
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      Background“Digital public health” has emerged from an interest in integrating digital technologies into public health. However, significant challenges which limit the scale and extent of this digital integration in various public health domains have been described. We summarized the literature about these challenges and identified strategies to overcome them.MethodsWe adopted Arksey and O’Malley's framework (2005) integrating adaptations by Levac et al. (2010). OVID Medline, Embase, Google Scholar, and 14 government and intergovernmental agency websites were searched using terms related to “digital” and “public health.” We included conceptual and explicit descriptions of digital technologies in public health published in English between 2000 and June 2020. We excluded primary research articles about digital health interventions. Data were extracted using a codebook created using the European Public Health Association's conceptual framework for digital public health.Results and analysisOverall, 163 publications were included from 6953 retrieved articles with the majority (64%, n = 105) published between 2015 and June 2020. Nontechnical challenges to digital integration in public health concerned ethics, policy and governance, health equity, resource gaps, and quality of evidence. Technical challenges included fragmented and unsustainable systems, lack of clear standards, unreliability of available data, infrastructure gaps, and workforce capacity gaps. Identified strategies included securing political commitment, intersectoral collaboration, economic investments, standardized ethical, legal, and regulatory frameworks, adaptive research and evaluation, health workforce capacity building, and transparent communication and public engagement.ConclusionDeveloping and implementing digital public health interventions requires efforts that leverage identified strategies to overcome diverse challenges encountered in integrating digital technologies in public health.
      Citation: DIGITAL HEALTH
      PubDate: 2022-05-27T05:32:31Z
      DOI: 10.1177/20552076221102255
      Issue No: Vol. 8 (2022)
       
  • Effect of the whole seamless connection of nursing from WeChat interactive
           platform on stigma and quality of life in patients with urinary system
           cancer

    • Authors: Haiyan Hao, Xinyu Yang, Huixia Zhu, Ziheng Wang, Haiyan Zhang, Chunxia Huang
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectiveTo evaluate the effects of intervention by “whole seamless connection of nursing from WeChat interactive platform” on stigma and quality of life of the patients with urinary system cancer.MethodsOverall, 80 patients with urinary cancer were randomly divided (40 cases per group) into control and observation groups. Routine nursing was provided to the control group, whereas positive psychological intervention was provided to the intervention group through a “whole seamless connection of nursing from the WeChat interactive platform” in addition to routine nursing. The Chinese version of social impact and cancer patients’ quality of life scales were used to evaluate the effects before and after the intervention.ResultsAfter the intervention, the total score for stigma was significantly lower (p 
      Citation: DIGITAL HEALTH
      PubDate: 2022-05-27T05:28:20Z
      DOI: 10.1177/20552076221102772
      Issue No: Vol. 8 (2022)
       
  • Accuracy and reliability of a wireless vital signs monitor for
           hospitalized patients in a low-resource setting

    • Authors: Assumpta Nantume, Noah Kiwanuka, Asad Muyinda, Teresa Cauvel, Sona Shah
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectiveThe purpose of this study was to evaluate the accuracy and reliability of neoGuard in comparison to a conventional bedside monitor on patients in a low-resource clinical setting.DesignThis was a single-arm methods comparison study involving the use of a wearable vital signs monitor (neoGuardTM) versus a conventional bedside monitor (Edan iM8).SettingThe study was conducted at Jinja Regional Referral Hospital, a tertiary care hospital situated in Eastern Uganda.ParticipantsThirty patients (10 male, 20 female) were enrolled from the adult recovery ward at JRRH. Participants were eligible for the study if they were at least 18 years of age, had 2 sets of normal vital sign measurements obtained 1 h apart, and were able and willing to provide informed consent.Main Outcome and MeasuresThe primary outcome measures were (i) bias (mean deviation) and (ii) limits of agreement [95% CI]. Bland-Altman plots were generated to illustrate the level of agreement between the neoGuardTM technology and the Edan iM8 monitor.ResultsBland-Altman analysis was performed for 24 participants; datasets from six participants were excluded due to missing or invalid measurements. Findings showed a moderate level of agreement for measurement of SpO2, PR, and RR, with>80% of subject means falling within the predefined acceptability limits. However, there was also notable variation in accuracy between subjects, with large standard deviations observed for measurement of all four parameters. While the level of agreement for measurement of temperature was low, this is partly explained by limitations in the comparison method.
      Citation: DIGITAL HEALTH
      PubDate: 2022-05-26T04:03:06Z
      DOI: 10.1177/20552076221102262
      Issue No: Vol. 8 (2022)
       
  • Classification of cardiac arrhythmia using a convolutional neural network
           and bi-directional long short-term memory

    • Authors: Shahab Ul Hassan, Mohd S Mohd Zahid, Talal AA Abdullah, Khaleel Husain
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      Cardiac arrhythmia is a leading cause of cardiovascular disease, with a high fatality rate worldwide. The timely diagnosis of cardiac arrhythmias, determined by irregular and fast heart rate, may help lower the risk of strokes. Electrocardiogram signals have been widely used to identify arrhythmias due to their non-invasive approach. However, the manual process is error-prone and time-consuming. A better alternative is to utilize deep learning models for early automatic identification of cardiac arrhythmia, thereby enhancing diagnosis and treatment. In this article, a novel deep learning model, combining convolutional neural network and bi-directional long short-term memory, is proposed for arrhythmia classification. Specifically, the classification comprises five different classes: non-ectopic (N), supraventricular ectopic (S), ventricular ectopic (V), fusion (F), and unknown (Q) beats. The proposed model is trained, validated, and tested using MIT-BIH and St-Petersburg data sets separately. Also, the performance was measured in terms of precision, accuracy, recall, specificity, and f1-score. The results show that the proposed model achieves training, validation, and testing accuracies of 100%, 98%, and 98%, respectively with the MIT-BIH data set. Lower accuracies were shown for the St-Petersburg data set. The performance of the proposed model based on the MIT-BIH data set is also compared with the performance of existing models based on the MIT-BIH data set.
      Citation: DIGITAL HEALTH
      PubDate: 2022-05-26T04:02:36Z
      DOI: 10.1177/20552076221102766
      Issue No: Vol. 8 (2022)
       
  • Usability testing of a wireless individual indicator system application:
           Monitoring exposure to outdoor air pollution among Malaysian Traffic
           Police

    • Authors: Putri Anis Syahira Mohamad Jamil, Karmegam Karuppiah, Nur Athirah Diyana Mohammad Yusof, Dayana Hazwani Mohd Suadi Nata, Nurhanim Abdul Aziz, Vivien How, Shamsul Bahri Mohd Tamrin, Hassan Sadeghi Naeni
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectivesDesigns for low-cost air monitors and associated performance data appear in many peer-reviewed articles; however, few manuscripts provide feedback from end user's experiences or comprehensive evaluation. The present study addresses the usability of the wireless outdoor individual exposure indicator system from the viewpoint of the Malaysian Traffic Police (end users). This study is one of the first to chronicle end user experiences for low-cost pollution sensing.MethodThe evaluation involved 12 target end users to assess the usability of a prototype for Malaysian Traffic Police to manage their exposure to outdoor air pollution. The test evaluation includes a pre-test, post-task and post-test questionnaire (Post-Study System Usability Questionnaire). The main components in this Post-Study System Usability Questionnaire are Overall satisfaction, System Usefulness, Information Quality and Interface Quality.FindingsThe results of the Post-Study System Usability Questionnaire indicated the mean score of the Overall satisfaction item (2.33), System Usefulness (2.25), Information Quality (2.36) and Interface Quality (2.17) on a scale of 1–10. Prototype users were satisfied with the system because the score is close to 1 on the Post-Study System Usability Questionnaire.ConclusionsA user-friendly wireless outdoor individual exposure indicator system is now available for Malaysian Traffic Police. Users have stated that they are happy to use the system at work. However, in addition to more technological advances, practical implementation requires evidence supporting its efficacy, viability and effectiveness.
      Citation: DIGITAL HEALTH
      PubDate: 2022-05-26T04:02:27Z
      DOI: 10.1177/20552076221103336
      Issue No: Vol. 8 (2022)
       
  • Exploring the experiences of people and family carers from
           under-represented groups in self-managing Parkinson's disease and their
           use of digital health to do this

    • Authors: Danielle Nimmons, Megan Armstrong, Jennifer Pigott, Kate Walters, Anette Schrag, Della Ogunleye, Wesley Dowridge, Joy Read, Nathan Davies
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      IntroductionDigital health is thought to enable people to better manage chronic conditions, such as Parkinson's. However, little is known about how people from under-represented groups with chronic conditions use digital health to self-manage.ObjectiveThe objective of our study was to explore the experiences of people and family carers from under-represented groups in self-managing Parkinson's, including their use of digital health to do this.MethodsSemi-structured interviews (n = 18, including four dyadic) were conducted remotely, with 16 people with Parkinson's and six family carers in 2020–2021. Participants were purposively sampled from under-represented groups: belong to an ethnic minority, or having significant physical or sensory impairment. Interviews were audio-recorded, transcribed and analysed using thematic analysis.ResultsThree main themes of importance were developed: ‘self-management support’, ‘digital health use to support self-management’ and ‘identity, attitudes and characteristics’. Participants received medical, psychological, social and practical self-management support. Some participants used digital health resources, e.g., Parkinson's UK website. Digital literacy was the biggest barrier to using digital health, regardless of background, often dependant on previous occupation and confidence. Few ethnic minority participants thought race or culture alters self-management ability and most believed there was no need for digital health interventions to be tailored to an individual's race or culture. Some felt inclusivity was important in terms of diverse images of people. A range of considerations were identified to optimise digital health, such as assistive equipment for people with sensory impairment.ConclusionsBarriers to using digital health for self-management were primarily dependent on personal factors including digital literacy and attitudes but rarely race or culture. We recommend the optimisation of digital health interventions by providing assistive technology at low cost, and visual inclusiveness should be promoted by including images of people from diverse backgrounds.
      Citation: DIGITAL HEALTH
      PubDate: 2022-05-26T04:02:15Z
      DOI: 10.1177/20552076221102261
      Issue No: Vol. 8 (2022)
       
  • Patient and physician perspectives on the use and outcome measures of
           mHealth apps: Exploratory survey and focus group study

    • Authors: Rita Jezrawi, Sarmini Balakumar, Rafia Masud, Itzhak Gabizon, Vinai Bhagirath, Jobin Varughese, Michael Brown, Dan Trottier, JD Schwalm, Michael McGillion, Elizabeth Alvarez, Cynthia Lokker
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectiveFactors that physicians and patients consider when making decisions about using or recommending health apps are not well understood. We explored these factors to better assess how to support such decision making.MethodsWe conducted an exploratory cross-sectional study in Ontario using qualitative focus groups and quantitative surveys. 133 physicians and 94 community dwelling adults completed online surveys and we held two focus groups of nine community dwelling participants who had cardiovascular risk factors and an interest in using mHealth apps. Quantitative survey data was analyzed descriptively. Focus groups were audio-recorded and transcribed verbatim prior to inductive thematic content analysis. We integrated the results from the surveys and focus groups to understand factors that influence physicians' and patients' selection and use of such apps.ResultsPhysicians recommend apps to patients but the level of evidence they prefer to use to guide selection did not align with what they were currently using. Patients trusted recommendations and reviews from medical organizations and healthcare professionals when selecting apps and were motivated to continue using apps when they supported goal setting and tracking, data sharing, decision making, and empowerment.ConclusionsThe findings highlight the significance of evaluating mHealth apps based on metrics that patients and physicians value beyond usage and clinical outcome data. Patients engage with apps that support them in confidently managing their health. Increased training and awareness of apps and creating a more rigorous evidence base showing the value of apps to supporting health goals will support greater adoption and acceptance of mHealth apps.
      Citation: DIGITAL HEALTH
      PubDate: 2022-05-25T06:54:19Z
      DOI: 10.1177/20552076221102773
      Issue No: Vol. 8 (2022)
       
  • Role of decentralized clinical trials in cancer drug development: Results
           from a survey of oncologists and patients

    • Authors: Begoña de las Heras, Adam Daehnke, Kamal S Saini, Melissa Harris, Kenneth Morrison, Ariel Aguilo, Isagani Chico, Laura Vidal, Robin Marcus
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      As a result of the unprecedented challenges imposed by the COVID-19 pandemic on enrollment to cancer clinical trials, there has been an urgency to identify and incorporate new solutions to mitigate these difficulties. The concept of decentralized or hybrid clinical trials has rapidly gained currency, given that it aims to reduce patient burden, increase patient enrollment and retention, and preserve quality of life, while also increasing the efficiency of trial logistics. Therefore, the clinical trial environment is moving toward remote collection and assessment of data, transitioning from the classic site-centric model to one that is more patient-centric.
      Citation: DIGITAL HEALTH
      PubDate: 2022-05-25T04:02:26Z
      DOI: 10.1177/20552076221099997
      Issue No: Vol. 8 (2022)
       
  • Perceptions of traditional Chinese medicine doctors about using wearable
           devices and traditional Chinese medicine diagnostic instruments: A
           mixed-methodology study

    • Authors: Siyu Zhou, Kai Li, Astushi Ogihara, Xiaohe Wang
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectiveThis study aimed to investigate the perceptions of traditional Chinese medicine doctors about wearable devices and diagnostic instruments and explore the factors that influence them.MethodsData on the perceptions of the traditional Chinese medicine doctors in Hangzhou, China, about wearable devices and diagnostic instruments were collected through face-to-face semi-structured interviews. The author coded the interview responses using grounded theory. A cross-sectional survey was conducted in four traditional Chinese medicine hospitals in Hangzhou, China. The responses of 385 traditional Chinese medicine doctors were considered valid. Descriptive statistics and binary logistic regression models were used for analysis.ResultsThis study categorized the perceptions of traditional Chinese medicine about wearable devices and traditional Chinese medicine diagnostic instruments under convenience, reliability, suitable population, machine usage scenario, and the integration of traditional Chinese medicine and information communication technology. Convenience encompassed portability and the convenience of carrying instruments or wearing the devices and operating them and the human–device interface. Reliability encompassed the underlying principles, accuracy, durability, and reference to diagnosis. Suitability for people encompassed age distinction and disease differentiation. Machine usage scenarios included use in daily life, educational institutions, and primary medical institutions. The combination of traditional Chinese medicine and information communication technology encompassed the integration of traditional Chinese medicine and wearable functions and diagnostic interpretation. The perceptions of traditional Chinese medicine doctors were affected by age, title, type of hospital, and specialty.ConclusionsThe use of wearable devices and traditional Chinese medicine diagnostic instruments has gradually been accepted by traditional Chinese medicine doctors. Traditional Chinese medicine doctors need to improve their knowledge and skills for information communication technology integration, and their standardized training should incorporate information communication technology and digital health.
      Citation: DIGITAL HEALTH
      PubDate: 2022-05-24T05:19:30Z
      DOI: 10.1177/20552076221102246
      Issue No: Vol. 8 (2022)
       
  • Usability and effectiveness of adherence monitoring of a mobile app
           designed to monitor and improve adherence to event-driven and daily HIV
           pre-exposure prophylaxis among men who have sex with men in Taiwan

    • Authors: Huei-Jiuan Wu, Yi-Fang Yu, Stephane Wen-Wei Ku, Yuan-Chi Tseng, Chien-Wen Yuan, Chia-Wen Li, Po-Hsien Huang, Nai-Ying Ko, Peter L. Anderson, Carol Strong
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectiveThe UPrEPU mobile app is a self-monitoring system to enable men who have sex with men to optimize their pre-exposure prophylaxis adherence for HIV prevention. The app was designed to accommodate a rather complicated event-driven dosing schedule. We aim to evaluate the usability of the UPrEPU app and its effectiveness in improving adherence monitoring.MethodsFrom May to October 2020, 35 participants were enrolled for the usability study and followed up for 4 months. Blood samples for the drug concentration in the dried blood spots were obtained once during the second to fourth follow-up visits. The effectiveness of adherence monitoring was analyzed using Cohen's kappa statistic to calculate the concordance between the average number of pills taken and drug concentration in the dried blood spots.ResultsOverall retention was 91.4% (32 participants) at the end of the study. Participants used the app for a mean of 29 days and made 2565 data entries in total, with an average of 76 data entries. The average systematic usability scale score for the app was 71.5, indicating acceptable usability. Slight agreement was reached between the dried blood spots measurement and the number of pills taken and recorded in the app (weighted kappa: 0.21).ConclusionsOur user-centered UPrEPU app demonstrated that it could accommodate both daily and event-driven dosing schedules for men who have sex with men clients with acceptable usability scores. We confirmed that complex behaviors such as different drug-dosing regimens that are contingent on sexual behaviors could be incorporated into the design of a mobile app.
      Citation: DIGITAL HEALTH
      PubDate: 2022-05-23T05:15:33Z
      DOI: 10.1177/20552076221102770
      Issue No: Vol. 8 (2022)
       
  • Canadian perspectives of digital mental health supports: Findings from a
           national survey conducted during the COVID-19 pandemic

    • Authors: Nelson Shen, Iman Kassam, Sheng Chen, Clement Ma, Wei Wang, Navi Boparai, Damian Jankowicz, Gillian Strudwick
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectivesThe impact of the COVID-19 pandemic on population mental health has highlighted the potential for digital mental health to support the needs of those requiring care. This study sought to understand the digital mental health experiences and priorities of Canadians affected by mental health conditions (i.e. seekers, patients, and care partners).MethodsA national cross-sectional electronic survey of Canadians was administered through a market research firm's survey panel. Seekers, patients, and care partners were asked about their digital mental health experiences (e.g. uptake, barriers to access) and priorities. Survey responses were summarized using descriptive statistics.ResultsOverall, 1003 participants completed the survey. 70.2% of participants routinely use digital mental health supports to support themselves or those they care for; however, only 28.6% of participants are satisfied with the available digital mental health supports. Most participants (73.3%) have encountered some barriers when accessing digital mental health supports. Awareness of digital mental health supports was a top barrier identified by participants. The top digital mental health priorities consisted of digital mental health curation, navigation, and a digital mental health passport.ConclusionsMost participants use digital mental health supports for themselves or others, however, many are unaware of digital mental health supports available. Efforts to improve navigating access to digital and in-person mental health services are seen as a top priority, highlighting the need to enable seekers, patients, and care partners to find the appropriate support and make decisions on how to best improve their mental health.
      Citation: DIGITAL HEALTH
      PubDate: 2022-05-23T05:14:53Z
      DOI: 10.1177/20552076221102253
      Issue No: Vol. 8 (2022)
       
  • “Who needs an app' Fertility patients’ use of a novel
           mobile health app”

    • Authors: Skye A Miner, Eden N Gelgoot, Alix Lahuec, Samantha Wunderlich, Darryl Safo, Felicia Brochu, Shrinkhala Dawadi, Stephanie Robins, Siobhan Bernadette, Laura O’Connell, Peter Chan, Carolyn Ells, Hananel Holzer, Kirk Lo, Neal Mahutte, Sophia Ouhilal, Zeev Rosberger, Togas Tulandi, Phyllis Zelkowitz
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectiveThe number of couples experiencing infertility treatment has increased, as has the number of women and men experiencing infertility treatment-related stress and anxiety. Therefore, there is a need to provide information and support to both men and women facing fertility concerns. To achieve this goal, we designed a mhealth app, Infotility, that provided men and women with tailored medical, psychosocial, lifestyle, and legal information.MethodsThis study specifically examined how fertility factors (e.g. time in infertility treatment, parity), socio-demographic characteristics (e.g. gender, education, immigrant status), and mental health characteristics (e.g. stress, depression, anxiety, fertility-related quality of life) were related to male and female fertility patients’ patterns of use of the Infotility app.ResultsOverall, the lifestyle section of the app was the most highly used section by both men and women. In addition, women without children and highly educated women were more likely to use Infotility. No demographic, mental health or fertility characteristics were significantly associated with app use for men.ConclusionThis study shows the feasibility of a mhealth app to address the psychosocial and informational needs of fertility patients.
      Citation: DIGITAL HEALTH
      PubDate: 2022-05-23T05:14:33Z
      DOI: 10.1177/20552076221102248
      Issue No: Vol. 8 (2022)
       
  • Investigating the needs and concerns of older adults with multimorbidity
           and their healthcare professionals for conceivable digital
           psychotherapeutic interventions

    • Authors: Orla Moran, Julie Doyle, Suzanne Smith, Oonagh Giggins, John Dinsmore
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      Multimorbidity, defined as the concurrent experience of more than one chronic health condition in an individual, affects ∼65% of people over 65 and 85% of those over 85 years old with 30% of those also experiencing mental health concerns. This can lead to reduced quality of life and functioning as well as poorer outcomes in terms of condition management, adherence to treatment, and ultimately disease prognosis and progression. Digital health interventions offer a viable means of condition self-management, as well as psychological support, particularly for those who may have difficulty accessing in-person services. To best meet the needs of older adults with multimorbidity, deeper insights are needed into their specific concerns and issues around condition management, particularly with regard to distress in relation to managing one's condition. The present study aimed to explore this using one-to-one qualitative interviews and focus groups with people with chronic health conditions and healthcare professionals. Participants were 11 older adults with multimorbidity (4 males; mean age: M = 72.7 years) and 14 healthcare professionals including five clinical nurse specialists, four pharmacists, two general practitioners, one occupational therapist, one speech and language therapist and one dietician. Thematic analysis was used to identify key themes, which included: patient feelings of anxiety or worry leading to an unwillingness to access essential information; the various mental health challenges faced by those with multimorbidity; the importance of personal values in providing motivation; and the importance of social support. Findings are discussed in relation to the potential development of transdiagnostically applicable digital interventions for the management of distress in those with multimorbidity.
      Citation: DIGITAL HEALTH
      PubDate: 2022-05-23T05:14:21Z
      DOI: 10.1177/20552076221089097
      Issue No: Vol. 8 (2022)
       
  • The role of digital mobile technology in elderly health management among
           health care workers in Indonesia: Analysis of knowledge, attitudes, and
           practice

    • Authors: Anastasia A. Dinakrisma, Purwita Wijaya Laksmi, Teofilus Abdiel, Johannes P. Fernandez, Nuri Indahwati, Anindya Pradipta Susanto, Arya Ananda Indrajaya Lukmana, Prasandhya Astagiri Yusuf
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      BackgroundTechnology, including information and communication technology (ICT), plays a significant role in the quality of health services. However, its application in elderly health services is still lacking. The aim of this study was to determine the knowledge of, attitudes toward, and practices of cell phone and mobile application use for elderly health care among Indonesian health care workers.MethodsThis was a cross-sectional study conducted with health care workers in Jakarta, Indonesia. The potential subjects were contacted through instant messenger application and/or through conventional short message service or telephone calls from August through November 2020.ResultsThere were 134 subjects. All the subjects had used various health applications to assist with their daily work, including telemedicine (64.2%), guidelines (60.4%), and medical calculators (46.3%). However, 96.3% of the subjects were not aware of the existence of a health application for geriatric assessment. Furthermore, 98.5% of subjects thought that it is important to use ICT to manage geriatric patients, and 94.8% felt that comprehensive geriatric assessment (CGA) in digital form would help them manage geriatric patients better. Nevertheless, 35.10% of subjects had never applied CGA to their geriatric patients.ConclusionsThe current health care system has begun to enter a period of using ICT in performing health services for geriatric patients. Nevertheless, only a few Indonesian health care workers were aware of or were using the geriatric mobile application. It is essential to improve the dissemination of geriatric health care and e-health literacy among them to improve the quality of elderly health care.
      Citation: DIGITAL HEALTH
      PubDate: 2022-05-23T04:04:37Z
      DOI: 10.1177/20552076221102771
      Issue No: Vol. 8 (2022)
       
  • Factors associated with eHealth literacy focusing on digital literacy
           components: A cross-sectional study of middle-aged adults in South Korea

    • Authors: Jaegyeong Lee, Sunghee H Tak
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      BackgroundDigital technology has dramatically changed the world in which we live, and the ability to access and understand information through these new technologies is becoming increasingly important. eHealth literacy is closely related to digital literacy, and some concepts may overlap to a certain extent. Identifying personal and digital-related factors related to eHealth literacy levels in middle-aged adults would be useful for planning tailored interventions and health promotion strategies.ObjectiveWe aimed to identify the differences in digital literacy and eHealth literacy levels according to demographic features, and to elucidate the factors associated with eHealth literacy in the middle-aged population.MethodsWe conducted a cross-sectional, observational study from 4th to 8th February 2021. A total of 320 South Korean participants aged 40–64 years were recruited and completed an online questionnaire, where demographic features, chronic disease status, frequency of Internet use, digital skills, digital competence, and eHealth literacy were measured. eHealth literacy was measured with the eHEALS. We used multiple regression analysis to elucidate the factors associated with eHealth literacy.ResultsMultiple regression analysis revealed that digital competence was the highest contributor to an individual's eHealth literacy (β = 0.330, P 
      Citation: DIGITAL HEALTH
      PubDate: 2022-05-20T08:36:07Z
      DOI: 10.1177/20552076221102765
      Issue No: Vol. 8 (2022)
       
  • Motivate me to exercise with you: The effects of social media fitness
           influencers on users’ intentions to engage in physical activity and the
           role of user gender

    • Authors: Julia Durau, Sandra Diehl, Ralf Terlutter
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectiveSocial media fitness influencers are evolving into a new digital form of health communicators whom consumers might turn to for assistance with more physical activity and exercise at home, especially in the current COVID-19 crisis. Drawing from source credibility theory, social cognitive theory, protection motivation theory and literature on physical activity, physical fitness and gender, we analyse how male and female users’ evaluations of social media fitness influencers and user health-related variables impact intentions to exercise with the social media fitness influencer.MethodsTwo consecutive studies using male and female YouTube fitness influencers were carried out. Structural equation modelling was conducted to test the proposed models and estimate the path coefficients.ResultsStudy 1 (N = 507) shows that the respective influencer's perceived trustworthiness, expertise and attractiveness are important for the influencer's evaluation, and that it is the perceived motivating power rather than the attitude toward the influencer that increases intentions to exercise for male and female users. Study 2 (N = 445) extends Study 1 and shows that physical fitness, training involvement with YouTube fitness videos and lower health increase behavioural intentions. A more negative body image also raises intentions to exercise, but only among female users.ConclusionSocial media fitness influencers who are perceived as trustworthy, as experts and as attractive, can be effective for increasing men's and women's physical activity. Perceived motivating power of the influencer emerged as a key variable that predicts intentions to exercise. User health-related variables have different effects on intentions to exercise for men and women.
      Citation: DIGITAL HEALTH
      PubDate: 2022-05-20T08:14:08Z
      DOI: 10.1177/20552076221102769
      Issue No: Vol. 8 (2022)
       
  • The effect of auditory stimulation using delta binaural beat for a better
           sleep and post-sleep mood: A pilot study

    • Authors: Roya Dabiri, Mohammad Reza Monazzam Esmaielpour, Mojahede Salmani Nodoushan, Farin khaneshenas, Seyed Abolfazl Zakerian
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      BackgroundAlthough previous evidence confirms the effects of sleep deprivation on mental health and wellbeing, due to the interaction effects of sleep and mood on each other, the influence of sleep improvement has received less attention.ObjectiveThis study aimed to find whether binaural beat technology can enhance sleep quality and thus post-sleep mood.MethodsTwenty healthy students participated in this pilot study. All subjects were investigated for two weeks (a baseline week and an experimental week). In the first week, there was no intervention, but in the second week, all subjects were exposed to a 90 min binaural beat in the delta frequency range. The individuals’ sleep was monitored for two weeks using a sleep diary form, and a Profile of Mood State questionnaire was employed to assess their mood at the end of the first and second weeks.ResultsAuditory stimulation with delta binaural beat enhanced sleep parameters such as sleep failure, the number of awakenings, real duration of sleep, sleep quality, and feeling following the waking of the individuals. Finally, students’ moods improved by reducing anxiety and anger, but other mood parameters did not indicate a significant difference.ConclusionThe findings of this study confirmed that auditory stimulation with a delta binaural beat seems to be a low-cost and alternative method for medicine and other treatment methods with side effects.ApplicationThis study demonstrates the use of technology with a neuroergonomics approach to improve sleep and mood disorders.
      Citation: DIGITAL HEALTH
      PubDate: 2022-05-20T08:14:01Z
      DOI: 10.1177/20552076221102243
      Issue No: Vol. 8 (2022)
       
  • Evaluating the impact of a novel telerehabilitation service to address
           neurological, musculoskeletal, or coronavirus disease 2019 rehabilitation
           concerns during the coronavirus disease 2019 pandemic

    • Authors: Katelyn Brehon, Jay Carriere, Katie Churchill, Adalberto Loyola-Sanchez, Petra O’Connell, Elisavet Papathanasoglou, Rob MacIsaac, Mahdi Tavakoli, Chester Ho, Kiran Pohar Manhas
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      IntroductionA novel telerehabilitation service provides wayfinding and self-management advice to persons with neurological, musculoskeletal, or coronavirus disease 2019 related rehabilitation needs.MethodWe utilized multiple methods to evaluate the impact of the service. Surveys clarified health outcomes (quality of life, self-efficacy, social support) and patient experience (telehealth usability; general experience) 3-months post-call. We analysed associations between, and within, demographics and survey responses. Secondary analyses described health care utilization during the first 6 months.ResultsSixty-eight callers completed the survey (42% response rate). Self-efficacy was significantly related to quality of life, interpersonal support and becoming productive quickly using the service. Becoming productive quickly was significantly related to quality of life. Education level was related to ethnicity. Survey respondents’ satisfaction and whether they followed the therapist's recommendations were not significantly associated with demographics. Administrative data indicated there were 124 callers who visited the emergency department before, on, or after their call. The average (SD) frequency of emergency department visits before was 1.298 times (1.799) compared to 0.863 times (1.428) after.DiscussionThis study offers insights into the potential impact of the telerehabilitation service amidst pandemic restrictions. Usability measurements showed that callers were satisfied, corroborating literature from pre-pandemic contexts. The satisfaction and acceptability of the service does not supplant preferences for in-person visits. The survey sample reported lower quality of life compared with the provincial population, conflicting with pre-pandemic research. Findings may be due to added stressors associated with the pandemic. Future research should include population-level comparators to better clarify impact.
      Citation: DIGITAL HEALTH
      PubDate: 2022-05-18T04:27:19Z
      DOI: 10.1177/20552076221101684
      Issue No: Vol. 8 (2022)
       
  • Expecting parents’ perceptions of the digital parental support
           “childbirth journey” constructed as a serious game—an intervention
           study

    • Authors: Caroline Bäckström, Tanja Rolfson, Henrik Engström, Rajna Knez, Margaretha Larsson
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectiveThe aim of this study was to explore expecting parents’ perceptions of the Childbirth Journey as an intervention that includes medical information for parental support, constructed as a serious game.MethodsIn this qualitative study, semi-structured interviews were held with expecting parents in Sweden who were able to talk about specific parts of the Childbirth Journey they appreciated or found difficult to understand. A phenomenographic methodology was employed for data analysis.ResultsParticipants perceived the Childbirth Journey to be easily accessible and customized with reliable information. The design and features of the intervention were perceived by the expecting parents to enhance the intervention’s usability, appeal, and trustworthiness. When parental couples used the Childbirth Journey together, it gave them an opportunity to discuss and better understand each other’s situation. The participants proposed several changes to the existing version of the game, mostly related to extending practical information and illustrated scenarios but also to the further development of the game’s design and animations. The participants found the Knowledge portal to be the most appealing part of the Childbirth Journey.ConclusionsThe Childbirth Journey intervention was concluded to be a valuable digital complement to in-person professional support, especially given the current COVID-19 pandemic restrictions in place in Sweden, which do not allow antenatal visits by partners. However, in its current form, the Childbirth Journey has some deficiencies and would therefore benefit from further development and exploration.
      Citation: DIGITAL HEALTH
      PubDate: 2022-05-16T07:35:46Z
      DOI: 10.1177/20552076221097776
      Issue No: Vol. 8 (2022)
       
  • Telemedicine and artificial intelligence to support self-isolation of
           COVID-19 patients: Recent updates and challenges

    • Authors: Jessica A Huang, Intan R Hartanti, Michelle N Colin, Dian AE Pitaloka
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      BackgroundAsymptomatic and high-risk COVID-19 patients are advised to self-isolate at home. However, patients may not realize that the condition is deteriorating until too late.ObjectiveThis study aims to review various artificial intelligence-based telemedicine research during the COVID-19 outbreak and proposes a framework for developing telemedicine powered by artificial intelligence to monitor progression in COVID-19 patients during isolation at home. It also aims to map challenges using artificial intelligence-based telemedicine in the community.MethodsA systematic review was performed for the related articles published in 2019–2021 and conducted in the PubMed and ScienceDirect database using the keywords “telemedicine,” “artificial intelligence,” and “COVID-19”. The inclusion criteria were full-text articles and original research written in the English language.ResultsThirteen articles were included in this review to describe the current application of artificial intelligence-based telemedicine during the COVID-19 pandemic. Various current applications have been implemented, such as for early diagnosis and tracing of contact for the users, to monitor symptoms and decision-making treatment, clinical management, and virtual and remote treatment. We also proposed the framework of telemedicine powered by artificial intelligence for support the self-isolation of COVID-19 patients based on the recent update in technology. However, we identified some challenges for using digital health technologies because of the ethical and practical use, the policy and regulation, and device use both for healthcare workers and patients.ConclusionArtificial intelligence promises to improve the practice of medicine in various ways. However, practical applications still need to be explored, and medical professionals also need to adapt to these advances for better healthcare delivery to the public.
      Citation: DIGITAL HEALTH
      PubDate: 2022-05-16T06:57:06Z
      DOI: 10.1177/20552076221100634
      Issue No: Vol. 8 (2022)
       
  • Association between online health information-seeking and medication
           adherence: A systematic review and meta-analysis

    • Authors: Hooi Min Lim, Adam G Dunn, Jing Ran Lim, Adina Abdullah, Chirk Jenn Ng
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      BackgroundThe evidence of the impact of online health information-seeking (OHIS) on health outcomes has been conflicting. OHIS is increasingly recognised as a factor influencing health behaviour but the impact of OHIS on medication adherence remains unclear.ObjectivesWe conducted a systematic review and meta-analysis to examine the associations between OHIS and medication adherence.MethodsWe searched Medline, Embase, Web of Science, Scopus, CINAHL and Psychology and Behavioural Science Collection for studies published up to December 2020. The inclusion criteria were studies that reported the associations of OHIS and medication adherence, quantitative design, reported primary data only, related to any health condition where medications are used and conducted on patients either in clinical or community settings. A meta-analysis was used to examine the association between OHIS and medication adherence.ResultsA total of 17 studies involving 24,890 patients were included in this review. The study designs and results were mixed. In the meta-analysis, there was no significant association (n = 7, OR 1.356, 95% CI 0.793-2.322, p = 0.265), or correlation (n = 4, r = -0.085, 95% CI −0.572-0.446, p = 0.768) between OHIS and medication adherence. In the sub-group analysis of people living with HIV/AIDS, OHIS was associated with better medication adherence (OR 1.612, 95% CI 1.266-2.054, p 
      Citation: DIGITAL HEALTH
      PubDate: 2022-05-13T02:58:57Z
      DOI: 10.1177/20552076221097784
      Issue No: Vol. 8 (2022)
       
  • Exploring the feasibility and acceptability of a sleep wearable headband
           among a community sample of chronic pain individuals: An at-home
           observational study

    • Authors: Zoe Zambelli, Cecilia E. Jakobsson, Laura Threadgold, Antonio R. Fidalgo, Elizabeth J. Halstead, Dagmara Dimitriou
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      BackgroundChronic pain conditions affect up to one third of the adult population in the United Kingdom. Sleep problems are prevalent and negatively impact quality of life. Lack of standardised tools for routine screening and assessment of sleep changes have been a barrier for sleep management. Novel sleep wearables offer an exciting and accessible way to measure sleep but have not been tested outside of the consumer-led landscape and are not commonly used in research and clinical settings.AimsThe study aimed to explore the feasibility and acceptability of a sleep monitoring headband (Dreem 2) utilising EEG technology and accompanying smartphone application among a cohort of adults with chronic pain.ResultsTwenty-one adults (81% women) completed a one-week home sleep study using a sleep headband and accompanying app. Ninety per cent of participants met the pre-defined requirement of two-night's sleep recording. All participants recorded one night of sleep data via the sleep headband. The majority (76%) of participants were satisfied with the sleep study, and 86% of participants were willing to wear the headband longer than the 2-night minimum requirement. Finally, 76% reported the headband as ‘somewhat’ or ‘extremely’ comfortable whist awake; 57% rated the headband as comfortable during sleep.ConclusionThe Dreem 2 headband appears to be a feasible and acceptable means of collecting sleep measurements among individuals with chronic pain, despite common sleep disturbances. These devices may have utility for screening, assessment and monitoring in research and practice. Further research is needed to provide guidelines and training for integration.
      Citation: DIGITAL HEALTH
      PubDate: 2022-05-11T07:24:59Z
      DOI: 10.1177/20552076221097504
      Issue No: Vol. 8 (2022)
       
  • Exploring the effect of an eHealth intervention on women's physical
           activity: Design and rationale for a randomized controlled trial

    • Authors: Melissa Black, Jennifer Brunet
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectiveThis manuscript reports on the protocol for a three-arm randomized controlled trial aiming to assess the effect a self-determination theory-based eHealth intervention on physical activity among insufficiently active women who are overweight or obese.MethodsThe intervention-of-interest provided (A) six weekly behavioural support emails, (B) a wearable activity tracker, and (C) a copy and verbal explanation of the Canadian physical activity guidelines, and was compared to an intervention that provided (B + C) and another that provided (C). Women from a local community were invited to participate in this study. Participants were recruited between September 2018 and March 2019. Data were collected using self-report and direct measures three times: at baseline (week 0), post-intervention (week 7), and at follow-up (week 21). The primary outcome was self-reported total metabolic equivalent minutes of physical activity per week (MET-m/week); exploratory outcomes included number of days of strength training per week, self-determination theory constructs (i.e. motivational regulations, basic psychological needs satisfaction and thwarting), and well-being indicators (i.e. affect, vitality, depression).ConclusionFindings will provide insight into which combination of intervention components may be more effective at promoting physical activity among insufficiently active women who are overweight or obese, and thus inform the design of future interventions aiming to promote physical activity.
      Citation: DIGITAL HEALTH
      PubDate: 2022-05-09T11:08:11Z
      DOI: 10.1177/20552076221093134
      Issue No: Vol. 8 (2022)
       
  • Portable hardware & software technologies for addressing ophthalmic health
           disparities: A systematic review

    • Authors: Margarita Labkovich, Megan Paul, Eliott Kim, Randal A. Serafini, Shreyas Lakhtakia, Aly A Valliani, Andrew J Warburton, Aashay Patel, Davis Zhou, Bonnie Sklar, James Chelnis, Ebrahim Elahi
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      Vision impairment continues to be a major global problem, as the WHO estimates 2.2 billion people struggling with vision loss or blindness. One billion of these cases, however, can be prevented by expanding diagnostic capabilities. Direct global healthcare costs associated with these conditions totaled $255 billion in 2010, with a rapid upward projection to $294 billion in 2020. Accordingly, WHO proposed 2030 targets to enhance integration and patient-centered vision care by expanding refractive error and cataract worldwide coverage. Due to the limitations in cost and portability of adapted vision screening models, there is a clear need for new, more accessible vision testing tools in vision care. This comparative, systematic review highlights the need for new ophthalmic equipment and approaches while looking at existing and emerging technologies that could expand the capacity for disease identification and access to diagnostic tools. Specifically, the review focuses on portable hardware- and software-centered strategies that can be deployed in remote locations for detection of ophthalmic conditions and refractive error. Advancements in portable hardware, automated software screening tools, and big data-centric analytics, including machine learning, may provide an avenue for improving ophthalmic healthcare.
      Citation: DIGITAL HEALTH
      PubDate: 2022-05-06T11:09:48Z
      DOI: 10.1177/20552076221090042
      Issue No: Vol. 8 (2022)
       
  • A chronological and geographical analysis of personal reports of COVID-19
           on Twitter from the UK

    • Authors: Su Golder, Ari Z Klein, Arjun Magge, Karen O’Connor, Haitao Cai, Davy Weissenbacher, Graciela Gonzalez-Hernandez
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectiveGiven the uncertainty about the trends and extent of the rapidly evolving COVID-19 outbreak, and the lack of extensive testing in the United Kingdom, our understanding of COVID-19 transmission is limited. We proposed to use Twitter to identify personal reports of COVID-19 to assess whether this data can help inform as a source of data to help us understand and model the transmission and trajectory of COVID-19.MethodsWe used natural language processing and machine learning framework. We collected tweets (excluding retweets) from the Twitter Streaming API that indicate that the user or a member of the user's household had been exposed to COVID-19. The tweets were required to be geo-tagged or have profile location metadata in the UK.ResultsWe identified a high level of agreement between personal reports from Twitter and lab-confirmed cases by geographical region in the UK. Temporal analysis indicated that personal reports from Twitter appear up to 2 weeks before UK government lab-confirmed cases are recorded.ConclusionsAnalysis of tweets may indicate trends in COVID-19 in the UK and provide signals of geographical locations where resources may need to be targeted or where regional policies may need to be put in place to further limit the spread of COVID-19. It may also help inform policy makers of the restrictions in lockdown that are most effective or ineffective.
      Citation: DIGITAL HEALTH
      PubDate: 2022-05-05T11:57:28Z
      DOI: 10.1177/20552076221097508
      Issue No: Vol. 8 (2022)
       
  • Lights, camera…research! Short film and social media to recruit to
           HIV research in Indonesia

    • Authors: K Gedela, H Luis, RF Loverian, S Maharani, N Rajus, FS Wignall, A Garner, E Sukmaningrum, A McOwan, N Nwokolo, G Whitlock, I Irwanto
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      IntroductionHIV prevalence among men who have sex with men has increased in Indonesia, amid reports of growing stigma against lesbian, gay, bisexual and transgender individuals and policies that have pushed back public health outreach to these groups.MethodsWe assessed the utility of tailored short film and targeted social media engagement to recruit men who have sex with men in Indonesia to HIV social science research. A short HIV testing promotion film, anonymised short survey and invite to a wider research study was embedded on a website platform and disseminated using geo and social/community group targeting for 1 month via a social networking app and social media platforms.ResultsFrom 3 January 2021 to 3 February 2021, there were over 2200 hits of the website within Indonesia. A total of 177 male web users who identified as men who have sex with men or preferred not to declare their sexuality, engaged by watching the short film and completing the survey, they were aged between 17 and 60 years old, of Indonesian nationality and living in Indonesia. Of these, 88% indicated having at least one HIV test in their lifetime, 66% had felt shame with respect to their sexuality and 53% indicated feeling afraid to have a HIV test. Ninety (51%) of the 177 validated using their email or mobile phone number demonstrating willingness to be contacted to join a further study. Twenty-three eligible men who have sex with men, aged 21–55 years old, joined a further social science research study. Participants were from diverse backgrounds and included men born in provinces outside Bali, of different socio-economic and employment backgrounds and diverse relationship contexts.DiscussionEngaging, empowering digital media involving key health messaging can provide health education in more effective ways, build trust and bring communities together. Targeted digital and social media approaches could reach increasingly marginalised and vulnerable communities to promote individual and public health and enable recruitment to valuable medical research.
      Citation: DIGITAL HEALTH
      PubDate: 2022-05-05T01:46:11Z
      DOI: 10.1177/20552076221090049
      Issue No: Vol. 8 (2022)
       
  • Assessing the performances of a chatbot to collect real-life data of
           patients suffering from primary headache disorders

    • Authors: Benjamin Chaix, Jean-Emmanuel Bibault, Rolland Romain, Arthur Guillemassé, Mikaël Neeral, Guillaume Delamon, Julien Moussalli, Benoît Brouard
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      BackgroundThere are many scales for screening the impact of a disease. These scales are generally used to diagnose or assess the type and severity of a disease and are carried out by doctors. The chatbot helps patients suffering from primary headache disorders through personalized text messages. It could be used to collect patient-reported outcomes.ObjectiveThe aims of this study were (1) to study whether the collection and analysis of remote scores, without prior medical intervention, are possible by a chatbot, (2) to perform suggested diagnosis and define the type of headaches, and (3) to assess the patient satisfaction and engagement with the chatbot.MethodVoluntary users of the chatbot were recruited online. They had to be over 18 and have a personal history of headaches. A questionnaire was presented (1) by text messages to the participants to evaluate migraines (2) based on the criteria of the International Headache Society. Then, the Likert scale (3) was used to assess overall satisfaction with the use of the chatbot.ResultsWe included 610 participants with primary headache disorders. A total of 89.94% (572/610) participants had fully completed the questionnaire (eight items), 4.72% (30/610) had partially completed it, and 5.41% (33) had refused to complete it. Statistical analysis was performed on 86.01% (547/610) of participants. Auto diagnostic showed that 14.26% (78/547) participants had a tension headache, and 85.74% (469/547) had a probable migraine. In this population, 15.78% (74/469) suffered from migraine without probable aura, and 84.22% (395/469) had migraine without aura. The patient’s age had a significant incidence regarding the auto diagnosis (P = .008
      Citation: DIGITAL HEALTH
      PubDate: 2022-05-03T11:24:35Z
      DOI: 10.1177/20552076221097783
      Issue No: Vol. 8 (2022)
       
  • Technology-based interventions to improve adherence to antihypertensive
           medications – An evidence-based review

    • Authors: Gary Chun-Yun Kang
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      BackgroundPoor adherence to anti-hypertensive medications leads to poorly controlled blood pressure which is associated with worse cardiovascular outcomes. Emerging technologies may be utilised advantageously in interventions to improve adherence and reduce morbidity and mortality from poorly controlled hypertension.ObjectiveTo determine the efficacy of technology-based interventions in improving adherence to antihypertensive medications.MethodsPubMed and EMBASE databases were searched using keywords and MeSH terms. Included studies met the following criteria: randomized controlled trial (RCT); adults ≥ 18 years old taking anti-hypertensives; intervention delivered by or accessed using a technological device or process; intervention designed to improve adherence.Results12 papers met inclusion criteria for the current review: 5 studies significantly improved adherence when compared to usual care; of these 5 studies, 2 had corresponding significant improvement in blood pressure. Successful interventions were: electronic medication bottle cap with audio-visual reminder; short message service (SMS) containing educational information (2 studies); reporting of self-measured blood pressure to a telephone-linked computer system; sending a video of every drug ingestion to obtain monetary rewards.ConclusionRCTs on technological interventions to improve adherence and those showing significant effect are rare. Some of the interventions show potential to be applied to other populations, especially if targeted at patients with poor adherence at baseline.
      Citation: DIGITAL HEALTH
      PubDate: 2022-05-03T07:02:41Z
      DOI: 10.1177/20552076221089725
      Issue No: Vol. 8 (2022)
       
  • Strategies for improving recruitment of pregnant women to clinical
           research: An evaluation of social media versus traditional offline methods
           

    • Authors: Kelsey M Cochrane, Jennifer A Hutcheon, Crystal D Karakochuk
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectivesTo evaluate the recruitment of pregnant women for a clinical trial in Vancouver, Canada, via social media versus offline methods and to explore optimization of social media campaigns.MethodsFacebook was used to run nine social media campaigns (15 weeks total, CA$675). Offline methods were used concurrently over 64 weeks (printing costs: CA$300). The cost, rate of recruitment and conversion rate in each group was calculated. Performance metrics of social media campaigns (reach, impressions, clicks, inquiries, enrolments) were recorded. Linear regression was used to explore the association between metrics and dollars spent per campaign.ResultsIn total, n = 481 inquiries were received: n = 51 (11%) via offline methods and n = 430 (89%) via social media. Enrolees (n = 60 total) included n = 24 (40%) and n = 36 (60%) via offline and social media methods, respectively. Gestational weeks upon inquiry (n = 251; mean ± SD) were not different among groups (offline: 13.3 ± 4.7; social media: 13.2 ± 5.6). Direct cost per enrolee was CA$13 and CA$19 via offline and social media methods, respectively (however, this does not include cost of labour). The rate of recruitment was approximately six times faster via social media. However, the conversion rate was higher via offline methods than social media (47% vs. 8%). The amount spent per campaign was significantly associated with improved clicks and inquiries, but not enrolments.ConclusionsSocial media was more efficient and effective than offline methods. We gained numerous insights for optimization of social media campaigns (dollars spent, attribution setting, photo testing, automatic optimization) to increase clicks and inquiries, however, this does not necessarily increase enrolments, which was more dependent on study-specific factors (e.g. time of year, study design).
      Citation: DIGITAL HEALTH
      PubDate: 2022-05-03T03:53:39Z
      DOI: 10.1177/20552076221095707
      Issue No: Vol. 8 (2022)
       
  • Artificial intelligence and medical education: A global mixed-methods
           study of medical students’ perspectives

    • Authors: Hamza Ejaz, Hari McGrath, Brian LH Wong, Andrew Guise, Tom Vercauteren, Jonathan Shapey
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectiveMedical students, as clinicians and healthcare leaders of the future, are key stakeholders in the clinical roll-out of artificial intelligence-driven technologies. The authors aim to provide the first report on the state of artificial intelligence in medical education globally by exploring the perspectives of medical students.MethodsThe authors carried out a mixed-methods study of focus groups and surveys with 128 medical students from 48 countries. The study explored knowledge around artificial intelligence as well as what students wished to learn about artificial intelligence and how they wished to learn this. A combined qualitative and quantitative analysis was used.ResultsSupport for incorporating teaching on artificial intelligence into core curricula was ubiquitous across the globe, but few students had received teaching on artificial intelligence. Students showed knowledge on the applications of artificial intelligence in clinical medicine as well as on artificial intelligence ethics. They were interested in learning about clinical applications, algorithm development, coding and algorithm appraisal. Hackathon-style projects and multidisciplinary education involving computer science students were suggested for incorporation into the curriculum.ConclusionsMedical students from all countries should be provided teaching on artificial intelligence as part of their curriculum to develop skills and knowledge around artificial intelligence to ensure a patient-centred digital future in medicine. This teaching should focus on the applications of artificial intelligence in clinical medicine. Students should also be given the opportunity to be involved in algorithm development. Students in low- and middle-income countries require the foundational technology as well as robust teaching on artificial intelligence to ensure that they can drive innovation in their healthcare settings.
      Citation: DIGITAL HEALTH
      PubDate: 2022-05-02T07:08:32Z
      DOI: 10.1177/20552076221089099
      Issue No: Vol. 8 (2022)
       
  • High-throughput digital cough recording on a university campus: A
           SARS-CoV-2-negative curated open database and operational template for
           acoustic screening of respiratory diseases

    • Authors: Eric M. Keen, Emily J. True, Alyssa R. Summers, Everett Clinton Smith, Joe Brew, Simon Grandjean Lapierre
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectiveRespiratory illnesses have information-rich acoustic biomarkers, such as cough, that can potentially play an important role in screening populations for disease risk. To realize that potential, datasets of paired acoustic-clinical samples are needed for the development and validation of acoustic screening models, and protocols for collecting acoustic samples must be efficient and safe. We collected cough acoustic signatures at a high-throughput SARS-CoV-2 testing site on a college campus. Here, we share logistical details and the dataset of acoustic cough signatures paired with the gold standard in SARS-CoV-2 testing of SARS-CoV-2 genomic sequences using qRT-PCR.MethodsCough recordings were collected in winter-spring 2021 at a rural residential college (Sewanee, TN, USA), where approximately 2000 students were tested for SARS-CoV-2 on a weekly basis. Cough collection was managed by student volunteers using custom software.Results4302 coughs were recorded from 960 participants over 11 weeks. All coughs were COVID-19 negative. Approximately 30 s were required to check-in a participant and collect their cough.ConclusionThe value of acoustic screening tools depends upon our ability to develop and implement them reliably and quickly. For that to happen, high-quality datasets and logistical insights must be collected and shared on an ongoing basis.
      Citation: DIGITAL HEALTH
      PubDate: 2022-04-29T04:59:15Z
      DOI: 10.1177/20552076221097513
      Issue No: Vol. 8 (2022)
       
  • Prospective trial registration and publication rates of randomized
           clinical trials in digital health: A cross-sectional analysis of global
           trial registries

    • Authors: Mustafa Al-Durra, Robert P Nolan, Emily Seto, Joseph A Cafazzo
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectivesWe sought to examine the prevalence of prospective registration and publication rates in digital health trials.Materials and MethodsWe included 417 trials that enrolled participants in 2012 and were registered in any of the 17 WHO data provider registries. The evaluation of the prospective trial registration was based on the actual difference between the registration and enrollment dates. We identified existing publications through an automated PubMed search by every trial registration number as well as a pragmatic search in PubMed and Google based on extracted metadata from the trial registries.ResultsThe prospective registration and publication rates were at (38.4%) and (65.5%), respectively. We identified a statistically significant (p 
      Citation: DIGITAL HEALTH
      PubDate: 2022-04-27T03:59:29Z
      DOI: 10.1177/20552076221090034
      Issue No: Vol. 8 (2022)
       
  • Smartphone movement sensors for the remote monitoring of respiratory
           rates: Technical validation

    • Authors: Sophie Valentine, Adam C. Cunningham, Benjamin Klasmer, Mohammad Dabbah, Marko Balabanovic, Mert Aral, Dan Vahdat, David Plans
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      BackgroundMobile health (mHealth) offers potential benefits to both patients and healthcare systems. Existing remote technologies to measure respiratory rates have limitations such as cost, accessibility and reliability. Using smartphone sensors to measure respiratory rates may offer a potential solution to these issues.ObjectiveThe aim of this study was to conduct a comprehensive assessment of a novel mHealth smartphone application designed to measure respiratory rates using movement sensors.MethodsIn Study 1, 15 participants simultaneously measured their respiratory rates with the app and a Food and Drug Administration-cleared reference device. A novel reference analysis method to allow the app to be evaluated ‘in the wild’ was also developed. In Study 2, 165 participants measured their respiratory rates using the app, and these measures were compared to the novel reference. The usability of the app was also assessed in both studies.ResultsThe app, when compared to the Food and Drug Administration-cleared and novel references, respectively, showed a mean absolute error of 1.65 (SD  =  1.49) and 1.14 (1.44), relative mean absolute error of 12.2 (9.23) and 9.5 (18.70) and bias of 0.81 (limits of agreement = –3.27 to 4.89) and 0.08 (–3.68 to 3.51). Pearson correlation coefficients were 0.700 and 0.885. Ninety-three percent of participants successfully operated the app on their first use.ConclusionsThe accuracy and usability of the app demonstrated here in individuals with a normal respiratory rate range show promise for the use of mHealth solutions employing smartphone sensors to remotely monitor respiratory rates. Further research should validate the benefits that this technology may offer patients and healthcare systems.
      Citation: DIGITAL HEALTH
      PubDate: 2022-04-25T11:01:02Z
      DOI: 10.1177/20552076221089090
      Issue No: Vol. 8 (2022)
       
  • Can digital engagement improve outcomes for total joint replacements'

    • Authors: Carly E Milliren, Bill Lindsay, Lisa Biernat, Todd A Smith, Betsy Weaver
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      BackgroundPatient activation and engagement can improve outcomes of medical and surgical care by increasing involvement of patients in their care plan. We designed a digital engagement tool to improve surgical cancellation and post-surgical outcomes for adult patients undergoing total joint replacements by providing patient education materials via email or text, in small increments throughout the perioperative period.MethodsWe assessed the tool's impact using a quasi-experimental design comparing patients scheduled for surgery January–June 2017 (pre-intervention) versus January–June 2018 (post-intervention). Post-intervention patients with digital contact information in the medical record were automatically enrolled. We extracted de-identified administrative data for all patients during both time periods and utilized an intent-to-treat approach including all post-intervention patients regardless of enrollment. Surgical cancellation and post-surgical outcomes (length of stay, discharge to home and revisits and readmissions) were compared between periods using adjusted regression models. We also examined associations between measures of engagement with the intervention and outcomes.ResultsA total of 2027 joint replacement patients were included (720 hip replacements; 1307 knee replacements). Adjusting for gender, age and insurance type, both hip and knee patients in the post-intervention group were more likely to have a cancelled surgery, but cancellations were less likely to be on the day of surgery compared to pre-intervention patients. Post-intervention patients were also less likely to have length of stay>2 days. Forty- three per cent of hip and 47% of knee patients in the post-period received the intervention and most were highly engaged. Higher engagement was associated with lower odds of surgical cancellation, shorter stays and higher odds of discharge home.ConclusionFindings suggest that utilization of a digital patient engagement tool translates into improved hospital efficiency and patient outcomes, particularly for those highly engaged.
      Citation: DIGITAL HEALTH
      PubDate: 2022-04-25T05:37:57Z
      DOI: 10.1177/20552076221095322
      Issue No: Vol. 8 (2022)
       
  • Development of a framework to promote rural health workforce capability
           through digital solutions: A qualitative study of user perspectives

    • Authors: Robyn Ramsden, Sabrina Pit, Richard Colbran, Kristy Payne, Aaron JH Tan, Michael Edwards
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      A high-quality, sustained, health workforce contributes to a healthy population. However, a global reality is that rural health services, and the workforces that provide those services, are under unprecedented pressure. It is posited that improving a rural health practitioners’ capability could help to retain them working rurally for longer. Capability refers to skills and experience and the extent to which individuals can adapt to change, generate new knowledge and continue to improve their performance. With rapidly increasing access to, and use of, digital technology worldwide, there are new opportunities to build capability and leverage personal and professional support for those who are working rurally. In 2021, semi-structured interviews were conducted in rural Australia with thirteen General Practitioners and allied health professionals. Thematic analysis was adopted to analyse the data and map it to the Health Information Technology Acceptance Model. Whilst it could be assumed that low technology literacy would act as a barrier to the use of digital tools, the study demonstrated that this was not a significant impediment to participants’ willingness to adopt digital tools when social and professional networks weren't available face to face to address their capability challenges. The findings provide insight into the concept of health workforce capability and important considerations when designing capability support. This includes key features of health apps or digital tools to support the capability of the rural health workforce. Understanding the factors that make up a health professionals’ capability and the motivations or cues to act to build or maintain their capability may have a positive effect on their retention in a rural location.
      Citation: DIGITAL HEALTH
      PubDate: 2022-04-25T05:37:33Z
      DOI: 10.1177/20552076221089082
      Issue No: Vol. 8 (2022)
       
  • Understanding the attitudes and experiences of people living with
           potentially stigmatised long-term health conditions with respect to
           collecting and sharing health and lifestyle data

    • Authors: Richard Brown, Elizabeth Sillence, Lynne Coventry, Emma Simpson, Jo Gibbs, Shema Tariq, Abigail C. Durrant, Karen Lloyd
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      BackgroundThe emerging landscape of patient-generated data (PGData) provides an opportunity to collect large quantities of information that can be used to develop our understanding of different health conditions and potentially improve the quality of life for those living with long-term health condition (LTHCs). If the potential benefits of PGData are to be realised, we need a better understanding of the psychological barriers and facilitators to the collection and beneficial sharing of health and lifestyle data. Due to the understudied role that stigma plays in sharing PGData, we explore the attitudes and experiences of those living with potentially stigmatised LTHCs with respect to collecting and sharing health and lifestyle data.MethodsThis study used semi-structured interviews and a card sorting task to explore the attitudes and experiences of people living with potentially stigmatised LTHCs. Fourteen adult participants who reported having a range of conditions were recruited in England. Template analysis was used to analyse interview transcripts and descriptive statistics were used for the card sorting task.ResultsThe findings present four overarching themes: Preferences for collecting health and lifestyle data, Importance of anonymity, Expected use of data, and Sources of emotional support. Participants illustrated a general willingness to share health and lifestyle data; however, there were some notable differences in sharing experiences, varying both by information type and recipient group. Overall, participants did not identify health-related stigma as a barrier to collecting or sharing their personal health and lifestyle data.ConclusionsWe outline a number of preferences that participants feel would encourage them to collect and share data more readily, which may be considered when developing data sharing tools for the future.
      Citation: DIGITAL HEALTH
      PubDate: 2022-04-18T02:40:49Z
      DOI: 10.1177/20552076221089798
      Issue No: Vol. 8 (2022)
       
  • Expecting parents’ use of digital sources in preparation for parenthood
           in a digitalised society – a systematic review

    • Authors: Caroline Bäckström, Kristina Carlén, Viveca Larsson, Lena Birgitta Mårtensson, Stina Thorstensson, Marina Berglund, Therese Larsson, Björn Bouwmeester, Marie Wilhsson, Margaretha Larsson
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      BackgroundIn today's society, people are experiencing the rapid development of digitalisation. Expecting parents may have difficulties evaluating the information online; they are not always sure which sources of information are trustworthy, and this exacerbates their feelings of anxiety. More research is needed to broaden the knowledge about how their use of digital sources may influence their health.QuestionThe focus of this study was to explore expecting parents’ use of digital sources and how this influences their health during pregnancy.MethodsA systematic review covered the thematic analysis of 39 articles.FindingsThe analysis resulted in the following theme: The digitalised society involves both opportunities and challenges, and expecting parents express a need for a variety of digital sources to improve their health, and sub-themes: Digital sources could promote parents’ health and well-being in a digitalised society; Consuming digital health information facilitates understanding, different feelings and social connections; and A variety of digital sources may facilitate parental identification and adaption to parenthood.ConclusionDifferent digital sources in our digitalised society mean access to information and opportunities to extend social connections for expecting parents. This can promote their ability to understand and adapt to parenthood, as well as to improve their health and well-being and make the parental transition. However, professional support during face-to-face consultations cannot always be exchanged to digital sources. It is important to base digital sources devoted to expecting parents and digitalisation overall on multi-sectorial collaborations and coordination between different organisations and the digital sources they provide.
      Citation: DIGITAL HEALTH
      PubDate: 2022-04-15T05:45:18Z
      DOI: 10.1177/20552076221090335
      Issue No: Vol. 8 (2022)
       
  • Human-centered design exploration with Kenyan health workers on proposed
           digital mental health screening and intervention training development:
           Thematic analysis of user preferences and needs

    • Authors: Manasi Kumar, Paul Macharia, Vincent Nyongesa, Joseph Kathono, Obadia Yator, Shillah Mwaniga, Mary McKay, Keng Yen Huang, Rahul Shidhaye, Simon Njuguna, Shekhar Saxena
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      BackgroundHealth providers' perceived sense of knowledge, competency, and self-efficacy to support the needs of their patients contributes to optimal patient health outcomes. With regards to mental health service delivery in Kenya, this area needs further exploration. Guided by the e-health technology acceptance mode, the needs and preferences of health care providers around mental health training for clinical management and their ability to intervene in peripartum adolescent mental health care are explored. We probed how well-equipped service providers are, their engagement with technology to learn and offer services. The health care provider's technology use preferences were also explored.MethodGuided by a human-centered design-focused qualitative inquiry we interviewed 20 specialists around their needs, perspectives, and preferences for digitized mental health screening and intervention. Mean age was 44.2 years, (range of 32–58 years), 25% (5) males and 75% (15) females. After a written consenting process, the online interviews (30−45 min) were conducted in April 2021, once personal information was de-identified interviews were transcribed and coded. Thematic analysis was used and we combined rapid appraisal of Google Jamboard online storyboards to do individual human-centered design personas alongside.ResultsOur participants were well-exposed to digital technologies. Prohibitive costs of data bundles, lack of funds for consistent online engagement, high workload, and instability of access to appropriate gadgets were found to be barriers to e-health training. Emerging opportunities were well-identified adolescent mental health service and intervention needs, willingness to take online courses offered on learning platforms, and wish for these to be disseminated through diverse social media. Other recommendations were the need to have a user-friendly interface such as data-light engaging and practical materials including animations, short, group-based learning.ConclusionUnderstanding contextual factors that influence perceived usefulness and ease of use of the remote/digital components would be critical for e-training development and its uptake.
      Citation: DIGITAL HEALTH
      PubDate: 2022-04-15T05:45:04Z
      DOI: 10.1177/20552076221090035
      Issue No: Vol. 8 (2022)
       
  • The bright side of social network sites: On the potential of online social
           capital for mental health

    • Authors: Felix S Hussenoeder
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      Social network sites are an essential part of the daily lives of people around the globe, but our theoretical understanding of the phenomenon is still limited. However, to fully grasp the potential of social network sites and to be able to generate meaningful applications, a theoretical understanding of the phenomenon is needed. I want to introduce the concept of online social capital as the first step in this direction, and show how it could be applied to the area of mental health. Therefore, I will (1) bring together social network sites and social capital theory, (2) introduce online social capital with a special focus on its capacity and mobilization as well as on associated processes of relationship maintenance and information search, (3) explore potential implications for mental health promotion, (4) depict the mental health risks that are associated with the use of social network sites, and (5) highlight some areas for future research.
      Citation: DIGITAL HEALTH
      PubDate: 2022-04-12T07:37:51Z
      DOI: 10.1177/20552076221093133
      Issue No: Vol. 8 (2022)
       
  • Ethical issues of collecting, storing, and analyzing geo-referenced tweets
           for mental health research

    • Authors: Marta Fadda, Martin Sykora, Suzanne Elayan, Milo A Puhan, John A Naslund, Stephen J Mooney, Emiliano Albanese, Rosalba Morese, Oliver Gruebner
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      Spatial approaches to epidemiological research with big social media data provide tremendous opportunities to study the relationship between the socio-ecological context where these data are generated and health indicators of interest. Such research poses a number of ethical challenges, particularly in relation to issues such as privacy, informed consent, data security, and storage. While these issues have received considerable attention by researchers in relation to research for physical health purposes in the past 10 years, there have been few efforts to consider the ethical challenges of conducting mental health research, particularly with geo-referenced social media data. The aim of this article is to identify strengths and limitations of current recommendations to address the specific ethical issues of geo-referenced tweets for mental health research. We contribute to the ongoing debate on the ethical implications of big data research and also provide recommendations to researchers and stakeholders alike on how to tackle them, with a specific focus on the use of geo-referenced data for mental health research purposes. With increasing awareness of data privacy and confidentiality issues (even for non-spatial social media data) it becomes crucial to establish professional standards of conduct so that compliance with ethical standards of conducting research with health-related social media data can be prioritized and easily assessed.
      Citation: DIGITAL HEALTH
      PubDate: 2022-04-12T07:37:43Z
      DOI: 10.1177/20552076221092539
      Issue No: Vol. 8 (2022)
       
  • Analyzing program data and promotional approaches to inform best practices
           from a mobile phone-based reproductive health message program in
           Afghanistan

    • Authors: Lara Lorenzetti, Kate F. Plourde, Sayed Haroon Rastagar, Arzoo S. Afzali, Ahmad S. Sultani, Abdul Khaleq Khalil, Abdul Waheed Adeeb, Shafiqullah Hemat, Catherine S. Todd
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectiveDigital health technologies have contributed to the adoption of beneficial reproductive, maternal, newborn, and child health (RMNCH) behaviors through social and behavior change programming, including in hard-to-reach settings. On-demand digital health interventions rely on promotions to build awareness and increase use among target audiences. There is little research on preferred content and use of promotional approaches for RMNCH digital health activities.MethodsWe conducted a retrospective descriptive analysis of Mobile for Reproductive Health (m4RH) data in Afghanistan to assess the use and changes in call volume via the 2-3-4 platform by promotional approaches over 23 months between October 2017 and August 2019.ResultsThere were 103,859 completed messages (CM) heard. Most callers reporting demographics were under 18 years, with roughly even distribution by gender. The number of CMs listened to across all menus increased with time. The basic m4RH family planning menu was most popular, with callers most frequently selecting information on intrauterine contraceptive devices. Nine types of promotional approaches were implemented. Compared against call volume, SMS blast promotion was the most productive promotional approach, radio broadcasts had modest increases, and social media and interpersonal communication demonstrated no clear change.Conclusionsm4RH use increased over time, particularly among younger people. The number of promotional approaches used does not appear as important as the type of approach used to generate program awareness. Mass media communications, including SMS blast promotions and radio broadcasts, may be the most effective strategies. Deeper program data analysis can guide tailoring of message content and promotional approaches to reach target audiences with the RMNCH content they most value.
      Citation: DIGITAL HEALTH
      PubDate: 2022-04-12T07:37:34Z
      DOI: 10.1177/20552076221089801
      Issue No: Vol. 8 (2022)
       
  • Web messaging among young people in online services: A descriptive
           mixed-methods study

    • Authors: Kiki Metsäranta, Minna Anttila, Tatjana Pajamäki, Heidi Holappa, Maritta Välimäki
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectiveTo describe web messaging patterns and the content of web messages among young people in a Finnish national online service.MethodsA descriptive mixed-method was used. The data consisted of text-based web messaging communication between young people and a counsellor in a nationwide online service between 1 January and 31 December 2018. Web messaging patterns were analysed using descriptive statistics. The content of the messages was analysed with thematic analysis and qualitative results were presented. In addition, the factors associated with messaging patterns and content were analysed.ResultsA total of 1941 messages were sent by 1354 young people. Most of them were between 12 and 17 years old and females. Less than one-fifth of young people had multiple two-way discussions with counsellor. The total period of two-way discussions and the number of words in each message varied widely. The number of words was lower in messages sent by males. The content of the messages was divided into three main themes: interpersonal relationships and environment (Social relationships), oneself (Construction of self), and health-related problems and support received from professionals (Health and wellbeing). The young people’s messages mostly contained topics related to the main theme of ‘Social environment’.ConclusionMost young people sent one message only. Messages ranged from simple, single messages to complex texts describing the daily life of young people. Girls were more active in messaging, and they wrote longer texts.
      Citation: DIGITAL HEALTH
      PubDate: 2022-04-11T04:27:56Z
      DOI: 10.1177/20552076221092534
      Issue No: Vol. 8 (2022)
       
  • A computer-aided diagnostic framework for coronavirus diagnosis using
           texture-based radiomics images

    • Authors: Omneya Attallah
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      The accurate and rapid detection of the novel coronavirus infection, coronavirus is very important to prevent the fast spread of such disease. Thus, reducing negative effects that influenced many industrial sectors, especially healthcare. Artificial intelligence techniques in particular deep learning could help in the fast and precise diagnosis of coronavirus from computed tomography images. Most artificial intelligence-based studies used the original computed tomography images to build their models; however, the integration of texture-based radiomics images and deep learning techniques could improve the diagnostic accuracy of the novel coronavirus diseases. This study proposes a computer-assisted diagnostic framework based on multiple deep learning and texture-based radiomics approaches. It first trains three Residual Networks (ResNets) deep learning techniques with two texture-based radiomics images including discrete wavelet transform and gray-level covariance matrix instead of the original computed tomography images. Then, it fuses the texture-based radiomics deep features sets extracted from each using discrete cosine transform. Thereafter, it further combines the fused texture-based radiomics deep features obtained from the three convolutional neural networks. Finally, three support vector machine classifiers are utilized for the classification procedure. The proposed method is validated experimentally on the benchmark severe respiratory syndrome coronavirus 2 computed tomography image dataset. The accuracies attained indicate that using texture-based radiomics (gray-level covariance matrix, discrete wavelet transform) images for training the ResNet-18 (83.22%, 74.9%), ResNet-50 (80.94%, 78.39%), and ResNet-101 (80.54%, 77.99%) is better than using the original computed tomography images (70.34%, 76.51%, and 73.42%) for ResNet-18, ResNet-50, and ResNet-101, respectively. Furthermore, the sensitivity, specificity, accuracy, precision, and F1-score achieved using the proposed computer-assisted diagnostic after the two fusion steps are 99.47%, 99.72%, 99.60%, 99.72%, and 99.60% which proves that combining texture-based radiomics deep features obtained from the three ResNets has boosted its performance. Thus, fusing multiple texture-based radiomics deep features mined from several convolutional neural networks is better than using only one type of radiomics approach and a single convolutional neural network. The performance of the proposed computer-assisted diagnostic framework allows it to be used by radiologists in attaining fast and accurate diagnosis.
      Citation: DIGITAL HEALTH
      PubDate: 2022-04-11T04:26:56Z
      DOI: 10.1177/20552076221092543
      Issue No: Vol. 8 (2022)
       
  • Perspective on digital communication with health professions from close
           supporters of young people with long-term health conditions (The LYNC
           Study)

    • Authors: Ayako Temple, Kathryn Hamilton, Carol Bryce, Frances Griffiths, Jackie Sturt
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectiveTo understand the impact of digital communication using email and text between young people and their health care team on those in close supporting roles.MethodsTwelve people (nine parents and three partners) of young people with long-term health conditions were interviewed between November 2014 and March 2016. Thematic analysis was performed followed Braun and Clarke's (2006) 6-phase method.ResultsFour main themes were identified. Close supporters felt that digital clinical communication was useful for young persons’ self-management. As well as young patients, close supporters would also like to have direct access to the clinicians, but it was necessary to build up a trusting relationship between close supporters and clinicians initially. Video appointments were suggested for future digital communication technology.ConclusionsClose supporters were encouraging digital communication for their young person with diabetes. Clinicians should put an emphasis on establishing trusting relationships with both young people and close supporters which would be beneficial for their digital clinical communications.
      Citation: DIGITAL HEALTH
      PubDate: 2022-04-11T04:26:46Z
      DOI: 10.1177/20552076221092536
      Issue No: Vol. 8 (2022)
       
  • Digital tools to support the maintenance of physical activity in people
           with long-term conditions: A scoping review

    • Authors: Paul Clarkson, Aoife Stephenson, Chloe Grimmett, Katherine Cook, Carol Clark, Paul E Muckelt, Philip O’Gorman, Zoe Saynor, Jo Adams, Maria Stokes, Suzanne McDonough
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectiveThis scoping review aimed to bring together and identify digital tools that support people with one or more long-term conditions to maintain physical activity and describe their components and theoretical underpinnings.MethodsSearches were conducted in Cumulative Index to Nursing and Allied Health Literature, Medline, EMBASE, IEEE Xplore, PsycINFO, Scopus, Google Scholar and clinical trial databases, for studies published between 2009 and 2019, across a range of long-term conditions. Screening and data extraction was undertaken by two independent reviewers and the Preferred Reporting Items for Scoping Reviews guidelines informed the review's conduct and reporting.ResultsA total of 38 results were identified from 34 studies, with the majority randomised controlled trials or protocols, with cardiovascular disease, type 2 diabetes mellitus and obesity the most common long-term conditions. Comorbidities were reported in>50% of studies but did not clearly inform intervention development. Most digital tools were web-browser-based ± wearables/trackers, telerehabilitation tools or gaming devices/components. Mobile device applications and combination short message service/activity trackers/wearables were also identified. Most interventions were supported by a facilitator, often for goal setting/feedback and/or monitoring. Physical activity maintenance outcomes were mostly reported at 9 months or 3 months post-intervention, while theoretical underpinnings were commonly social cognitive theory, the transtheoretical model and the theory of planned behaviour.ConclusionsThis review mapped the literature on a wide range of digital tools and long-term conditions. It identified the increasing use of digital tools, in combination with human support, to help people with long-term conditions, to maintain physical activity, commonly for under a year post-intervention. Clear gaps were the lack of digital tools for multimorbid long-term conditions, longer-term follow-ups, understanding participant's experiences and informs future questions around effectiveness.
      Citation: DIGITAL HEALTH
      PubDate: 2022-04-11T04:26:42Z
      DOI: 10.1177/20552076221089778
      Issue No: Vol. 8 (2022)
       
  • Tracking the trackers: Self-tracking in households as social practice

    • Authors: Mariannn (Maz) Hardey
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      The purpose of this article is to examine the effect of different types of self-tracking users (trackers) on the health behaviours of others living in the same household. The study takes an international perspective, examining tracking practises from 13 households based in Europe, the United Kingdom and the United States to determine how trackers contribute to emerging cultural and social factors across life stages. The findings contribute to digital health understandings by shedding light on collective practises formed within frequently intergenerational households. The study emphasises the importance of cross-cultural and intergenerational tracking research to foster collective and symbolic health engagement. The article delves into the intersection of online and offline dynamics to describe the social practice of digital health culture. It sheds new light on structural and agency issues in households sharing self-tracking experiences.
      Citation: DIGITAL HEALTH
      PubDate: 2022-04-11T02:03:03Z
      DOI: 10.1177/20552076221093131
      Issue No: Vol. 8 (2022)
       
  • Nurses’ experiences of using AsthmaTuner – an eHealth self-management
           system for healthcare of patients with asthma

    • Authors: Katarina Schoultz, Ann Svensson, Maria Emilsson
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectiveThis study describes nurses’ experiences of using eHealth for assessment in the healthcare of patients with asthma.MethodsFive nurses with experience of using AsthmaTuner in the healthcare of patients with asthma participated in the study. Individual semi-structured interviews were conducted with the nurses to understand their experiences of using the eHealth system. The transcribed interviews were analyzed using qualitative content analysis.ResultsThe results show that nurses as well as patients find the tool useful and easy-to-handle. AsthmaTuner gives the nurses access to more and better information about the patients, which facilitates assessments and makes their work more efficient. The patients become more involved in their care, gain increased control and take more responsibility for their illness and treatment.ConclusionsThe nurses appreciate eHealth in asthma care. Using AsthmaTuner makes the nurses’ work more efficient and the patients become more involved in their care.
      Citation: DIGITAL HEALTH
      PubDate: 2022-04-11T02:02:42Z
      DOI: 10.1177/20552076221092542
      Issue No: Vol. 8 (2022)
       
  • A digital mobile health platform increasing efficiency and transparency
           towards universal health coverage in low- and middle-income countries

    • Authors: Liesbeth Huisman, Shannen MC van Duijn, Nuno Silva, Rianne van Doeveren, Jacinta Michuki, Moses Kuria, David Otieno Okeyo, Isaiah Okoth, Nathalie Houben, Tobias F Rinke de Wit, Khama Rogo
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      In low-and middle-income countries, achieving universal health coverage remains challenging due to insufficient, temporary and fragmented funding as well as limited accessibility to quality healthcare. Leveraging a mobile health platform can be a powerful tool to address these problems. This paper demonstrates how analysing data collected from a mobile health platform helps optimize healthcare provider networks, monitor patient flows and assess the quality and equitability of access to care. The COVID-19 pandemic reinforces the importance of real-time data on health-seeking behaviour. Between 2018 and 2019, as a Kenyan universal health coverage pilot was being planned, Kisumu County, with support from PharmAccess Foundation, implemented household-level digital registration for healthcare and collected socio-economic and healthcare claims data using the M-TIBA platform. In total, 273,350 Kisumu households enrolled. The claims data showed many patients visit higher-level facilities for ailments, that can be treated at primary care levels, unnecessarily. High-level estimate of the disease burden at participating facilities revealed rampant overprescription of pertinent medicines for highly prevalent malaria and respiratory tract infections, exemplifying clinical management deficiencies. M-TIBA data allowed tracking of individual patient trajectories. Analyses of data are shown at the aggregate level. The paper shows how mobile health platforms can be used to generate valuable insights into access to and quality of care. Funding for healthcare can be united through mobile health platforms, limiting the fragmentation in funding. They can be useful for funders, health managers and policymakers to improve the implementation of universal health coverage programs in low-and middle-income countries.
      Citation: DIGITAL HEALTH
      PubDate: 2022-04-11T02:02:22Z
      DOI: 10.1177/20552076221092213
      Issue No: Vol. 8 (2022)
       
  • A bibliometric analysis on global eHealth

    • Authors: Hua Tian, Jie Chen
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      BackgroundThe current coronavirus disease 2019 pandemic highlights the potential of eHealth. Drawing the knowledge map of eHealth research through data mining and visual analysis technology was helpful to systematically present the research status and future trends of global academic circles.MethodsBased on the web of Science Core Collection (SCIE/SSCI) database, using bibliometric theory and visual analysis technology, this work analyzed the global eHealth research publications from 2000 to 2021, and introduced the interdisciplinary characteristics, hot topics and future trends in this field.ResultsA total of 10188 authors, 891 journals, 3586 institutions, 98 countries using 12 languages had conducted eHealth research in the world. The United States, the Netherlands, Australia and the United Kingdom were the main forces and international cooperation. However, the international co-operation between Eastern and Western countries was still relatively few. The frontier of global eHealth research mainly focused on #0eHealth innovation, #1physical activity, #2generalised anxiety disorder, #3lightweight authentication protocol, #4 eHealth information, #5technology readiness, #6 ehealth literacy scale, #7family carer, #8citance analysis, #9 guiding patient. Clusters #3 lightweight authentication protocol and #9 guiding patient were the latest clusters, indicating the research trend and direction of eHealth in the future.ConclusionsCooperation network framework at the regional, national and global levels and the cooperation of multidisciplinary teams with complementary backgrounds and expertise were needed to realize the in-depth popularization and application of eHealth knowledge. Interdisciplinary international cooperation should be the trend of eHealth research in the future.
      Citation: DIGITAL HEALTH
      PubDate: 2022-04-11T02:02:05Z
      DOI: 10.1177/20552076221091352
      Issue No: Vol. 8 (2022)
       
  • Perceptions on mobile health use for health education in an Indigenous
           population

    • Authors: Valerie Umaefulam, Kalyani Premkumar, Marguerite Koole
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      IntroductionIndigenous peoples in Canada face numerous health needs and challenges and often have poor health status due to inequitable access to care. Providing culturally appropriate support for health conditions, particularly chronic conditions that require self-management, can assist in averting complications and morbidity. Mobile health is a useful medium for delivering health education across different populations. However, meaningful user involvement is necessary because mobile health interventions suitable for one population may not be appropriate for another. Indigenous people’s views will inform the use of mobile health interventions in Indigenous communities.ObjectiveThe study explored the perception of Indigenous women on using mobile health as a tool for receiving health information.MethodsThis was a qualitative study, and participants comprised of 22 Indigenous women (First Nations and Métis) with or at risk of diabetes, aged 18–69 years in Saskatoon, Canada. After 12 weeks of disseminating diabetic eye care information via text messaging, data were collected via sharing circle discussions and analyzed using thematic analysis.ResultsParticipants indicated that the nature of messages such as the use of Indigenous languages, the message content, frequency of messages, group activities, and delivery formats such as voice messages, mobile applications, Internet, two-way messaging, and text messages were essential considerations in using mobile health as a tool for receiving health information.ConclusionDifferent factors need to be considered in using mobile health as a tool for health education among Indigenous peoples. These factors could be applicable in implementing mobile health solutions in other populations for the management of health conditions.
      Citation: DIGITAL HEALTH
      PubDate: 2022-04-08T05:45:44Z
      DOI: 10.1177/20552076221092537
      Issue No: Vol. 8 (2022)
       
  • A ubiquitous healthcare system of 3D printing facilities for making
           dentures: Application of type-II fuzzy logic

    • Authors: Min-Chi Chiu, Tin-Chih Toly Chen
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      A ubiquitous healthcare (UH) system of multiple 3D printing facilities is established in this study for making dentures. The UH system receives orders from dental clinics, and then distributes the dentures to be printed among 3D printing facilities to save time. Compared with existing systems for similar purposes, the UH system has two novel features. The first is the consideration of the possibility of reprinting in formulating the plan to avoid replanning. The other is the cooperation with home delivery services that have gradually become popular during the COVID-19 pandemic to save transportation time. The new features are subject to considerable uncertainties. To account for the uncertainties, both printing time and transportation time are modelled using interval type-II trapezoidal fuzzy numbers. Subsequently, an interval type-II fuzzy mixed integer-linear programming (FMILP) model is formulated and optimized to plan the operations of the UH system. A case study has been conducted to illustrate the applicability of the proposed methodology. According to experimental results, the proposed methodology was able to shorten the order fulfillment time by up to 9%.
      Citation: DIGITAL HEALTH
      PubDate: 2022-04-07T03:05:49Z
      DOI: 10.1177/20552076221092540
      Issue No: Vol. 8 (2022)
       
  • User experience and acceptance of patients and healthy adults testing a
           personalized self-management app for depression: A non-randomized
           mixed-methods feasibility study

    • Authors: Gwendolyn Mayer, Svenja Hummel, Neele Oetjen, Nadine Gronewold, Stefan Bubolz, Kim Blankenhagel, Mathias Slawik, Rüdiger Zarnekow, Thomas Hilbel, Jobst-Hendrik Schultz
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectivePrevious studies have shown positive treatment outcomes of e-mental health applications targeting depression. However, few applications provide personalized features. The aim of the present study is to ask for the user experience and acceptance of patients with depression and healthy adults, who tested the self-management app Self-administered Psycho Therapy SystemS over a period of 5 days. The results serve as a source for evidence-based recommendations for developers and clinicians.MethodsA total of 110 participants (41 patients and 69 healthy controls) tested the app Self-administered Psycho Therapy SystemS over a period of 5 days and completed evaluation sheets developed for the purpose of this study. Quantitative measures were asked with 5-point Likert-scaled items (range: −2 to + 2) for the perceived quality of the programme and its components, its practicality (both referred to as user experience) and its acceptance. Student’s t-tests and Pearson correlations were calculated for group comparisons and associations, respectively. Open text fields were analysed by applying a qualitative structuring content analysis.ResultsThe perceived quality of the total programme was rated with M = 0.96 (SD = 0.82), the practicality was M = 0.84 (SD = 0.08) and the acceptance was M = 0.25 (SD = 1.04). Patients rated perceived quality of the total programme and acceptance higher than healthy adults, while there was no difference in practicality. Acceptance was associated with increased depression scores (r = 0.33, p = .01), higher scores of perceived quality of the total programme (r = 0.48, p
      Citation: DIGITAL HEALTH
      PubDate: 2022-04-07T03:04:48Z
      DOI: 10.1177/20552076221091353
      Issue No: Vol. 8 (2022)
       
  • The effectiveness of automated digital health solutions at successfully
           managing obesity and obesity-associated disorders: A PICO-structured
           investigation

    • Authors: James Christopher Price, Heitor Oliveira Santos, Allain Amador Bueno
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      Most adults in the UK and USA are classified as overweight or obese. Recent studies suggest that the prevalence of obesity has further increased during the SARS-CoV-2 pandemic and associated lockdowns. Digital technologies may be effective at managing obesity and related comorbidities, a potential further justified by social isolation and distancing circumstances.This review of published literature employed a Patient-Intervention-Comparison-Outcome structured approach on the use of digital solutions to determine the effectiveness of their use in the management and treatment of obesity, hypertension, and type 2 diabetes and included commercially available, automated devices and applications that did not require intervention from a clinician. Our search covered studies published between January 2004 and February 2019, and 18 papers were included in the final analysis. The digital solutions reviewed were smartphone applications, wearable activity trackers, and ‘digital medicine offerings’ (DMO), including ingestible sensors and wearable patches.This study found that not all interventions were effective at encouraging the lifestyle changes required for the management of obesity. Smartphone applications requiring interaction from the patient appeared to be more effective at encouraging engagement with treatment interventions than more passive wearable activity trackers. Automated feedback from smartphone applications was effective at managing type 2 diabetes, while DMO were effective at reducing blood pressure.With the advancement of new technologies alongside a rapid increase in the prevalence of obesity and associated disorders, further studies comparing the various technologies available in larger sample populations for longer periods would help determine the most cost-effective preventive and therapeutic strategies.
      Citation: DIGITAL HEALTH
      PubDate: 2022-04-06T06:00:37Z
      DOI: 10.1177/20552076221091351
      Issue No: Vol. 8 (2022)
       
  • The good, the bad, and the poorly designed: The mobile app stores are not
           a user-friendly experience for health and medical purposes

    • Authors: Timothy Aungst, Sheila Seed, Nurisha Gobin, Rosa Jung
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      The utilization of mobile health applications to help manage health conditions have grown in utilization within the past decade. However, the application stores (i.e. Google and Apple) are not designed in a user-friendly manner that allows consumers to identify high-quality health and medical-related mobile applications. Researchers have been interested in identifying applications that may be recommended for patient care but have found the ability to quantify and assess these applications to be difficult due to the current layout and organization of applications. We explain here in this brief communication our own research experience in the identification of mobile health applications on the application stores, along with trends noted in other mobile health research, and make suggestions on how the application store experience could be improved for both patients and health professionals. These include collaboration between developers, medical professionals and organizations, and technology companies to facilitate a better means of categorizing health applications for patient use, alongside other current endeavors being pursued such as application review organizations and the creation of digital health formulary databases.
      Citation: DIGITAL HEALTH
      PubDate: 2022-04-06T06:00:25Z
      DOI: 10.1177/20552076221090038
      Issue No: Vol. 8 (2022)
       
  • Social media use for health, cultural characteristics, and demographics: A
           survey of Pakistani millennials

    • Authors: Muhammad Ittefaq, Hyunjin Seo, Mauryne Abwao, Annalise Baines
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectiveOver the last 10 years, an extensive body of literature has been produced to investigate the role of social media in health. However, little is known about the impact of cultural characteristics (e.g. masculinity, collectivism, and uncertainty avoidance) on social media use regarding health-related information, especially in developing countries like Pakistan. The present study employed Hofstede’s cultural characteristics framework and uses and gratification theory to examine how Pakistani millennials’ demographic attributes and cultural characteristics are associated with their social media use for health-related information.MethodAn online survey of 722 people aged 18–35 living in Pakistan was conducted in spring 2020 to examine the intensity and frequency of social media use, health-related use of social media, cultural characteristics, and demographic attributes.ResultsResults showed that cultural characteristics—masculinity, collectivism, and uncertainty avoidance—are strongly related with their perceptions of social media importance, usefulness, and perceived ease of access for health-related information even when controlling for demographic characteristics. Age and gender are also significantly associated with their perspectives on social media for health.ConclusionsWe found that communicating and sharing information is the most important motivation for Pakistani millennials to use social media in the area of health with WhatsApp and YouTube being most preferred social media sites for health-related issues.
      Citation: DIGITAL HEALTH
      PubDate: 2022-04-06T05:59:50Z
      DOI: 10.1177/20552076221089454
      Issue No: Vol. 8 (2022)
       
  • Theoretical model and measurement of shared decision making in web-based
           pharmaceutical care consultation

    • Authors: Haihong Chen, Yuqi Xiong, Zinan Zhang, Qian Zhou, Dan Wang, Xuemei Wang, Xinping Zhang
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectivesWe aimed to construct a theoretical model and an observer-based measurement of shared decision making (SDM) in web-based pharmaceutical care consultation.MethodsWe first constructed a theoretical model through analysis of SDM models and interviews with 24 key informants. Then, the initial measurement was formulated, and the content was evaluated by 16 key informants alone. A cross-sectional study was executed, where 300 provider-patient encounters were collected at the online platform ‘Good Doctor Website’, for reliability and validity assessment. Content validity was evaluated by appropriateness score, that is the median of 7–9 and without disagreement. Interrater reliability was evaluated by Spearman correlation coefficient using 30 out of 300 samples. Single indicator validity was tested by Pearson correlation analysis, and convergent validity was evaluated by the Multiple Indicators Multiple Causes (MIMIC) model using 300 samples.ResultsTheoretical model constructed included four elements: ‘comprehensive understanding of the patient's condition’, ‘exchanging ideas on medication options’, ‘achieving a medication plan’, and ‘providing decision support’. Measurement constructed included four dimensions and 19 items, and four dimensions were in accordance with four elements of the theoretical model. We found median scores of these dimensions and items were 7–9 and without disagreement, indicating good content validity. Spearman correlation coefficients of 19 items were greater than 0.750, suggesting good interrater reliability. Pearson coefficients between 19 items and their external variables were significant (p 
      Citation: DIGITAL HEALTH
      PubDate: 2022-04-04T08:19:10Z
      DOI: 10.1177/20552076221089794
      Issue No: Vol. 8 (2022)
       
  • Challenges in accessing maternal and child health services during COVID-19
           and the potential role of social networking technologies

    • Authors: Angella Musiimenta, Wilson Tumuhimbise, Esther C Atukunda, Sandrah Ayebaza, Phionah Kobutungi, Aaron T Mugaba, Justus Asasira, Godfrey R Mugyenyi, Jane Katusiime, Raphael Zender, Niels Pinkwart, Jessica E Haberer
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      BackgroundThe COVID-19 pandemic causes new challenges to women and their babies who still need to access postnatal care amidst the crisis. The novel application of social network technologies (SNTs) could potentially enhance access to healthcare during this difficult time.ObjectivesThis study describes the challenges experienced in accessing maternal and child health services by women with limited or no education during this COVID-19 pandemic and discusses the potential of SNTs to support maternal and child health amidst this crisis.MethodsWe administered surveys to women who had recently given birth in a rural setting and interviewed a purposively selected subset to ascertain their experiences of accessing maternal and child health services during the COVID-19 pandemic. Our analysis involved descriptive analysis of quantitative data using STATA 13 to describe study participants’ characteristics, and content analysis of qualitative data to derive categories describing maternal health challenges.ResultsAmong 50 women, the median age was 28 years (interquartile range 24–34), 42 (84%) completed upper primary education. Access to the health facility was constrained by transport challenges, fear of contracting COVID-19, and delays at the facility. Due to the COVID-19 crisis, 42 (84%) women missed facility visits, 46 (92%) experienced financial distress, 43 (86%) had food insecurity, and 44 (88%) felt stressed. SNTs can facilitate remote and timely access to health services and information, and enable virtual social connections and support.ConclusionSNTs have the potential to mitigate the challenges faced in accessing maternal and child health services amidst the ongoing COVID-19 pandemic.
      Citation: DIGITAL HEALTH
      PubDate: 2022-04-04T08:06:12Z
      DOI: 10.1177/20552076221086769
      Issue No: Vol. 8 (2022)
       
  • Telehealth adoption during the COVID-19 pandemic: A social media textual
           and network analysis

    • Authors: Joshua TL Anderson, Lindsay M Bouchacourt, Kristen L Sussman, Laura F Bright, Gary B Wilcox
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectiveThe telemedicine industry has rapidly grown during the COVID-19 pandemic, and telemedicine has become a common form of care. The present study looks at the online conversation regarding telemedicine at the beginning of the pandemic and one year later. The Technology Acceptance Model is utilized to explain the findings.MethodsBrandwatch and NUVI software captured social mentions on Twitter regarding telemedicine during the beginning of the pandemic (March 15, 2020–April 20, 2020) and one year later (March 12, 2021–April 19, 2021). SAS text-mining software analyzed the social mentions and organized them into ten unique topics for each time period. The research team analyzed the topics and organized them into themes. A network analysis was also performed to examine structure and influence within the network.ResultsIn March–April 2020, the themes focused on the use of telehealth in general, telehealth for mental health applications, and Medicare covering telehealth services. In March–April 2021, the themes focused on news events regarding telehealth and the rise in prominence of telehealth services. The network analysis shows a shift in the distribution of telehealth information among influential accounts and reveals that the network became more connected, with a change in the control of information spread.ConclusionsTechnology Acceptance Model explains the social acceptance and spread of telemedicine. The transition in the conversation about telemedicine suggests a pattern of greater system use consistent with the Technology Acceptance Model. Telemedicine may have greatly increased in use because of the pandemic, but data suggests that its use may persist after the pandemic subsides.
      Citation: DIGITAL HEALTH
      PubDate: 2022-04-01T06:14:40Z
      DOI: 10.1177/20552076221090041
      Issue No: Vol. 8 (2022)
       
  • Automated clinical pathway standardization using SNOMED CT- based semantic
           relatedness

    • Authors: Ayman Alahmar, Mohannad AlMousa, Rachid Benlamri
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      The increasing number of patients and heavy workload drive health care institutions to search for efficient and cost-effective methods to deliver optimal care. Clinical pathways are promising care plans that proved to be efficient in reducing costs and optimizing resource usage. However, most clinical pathways are circulated in paper-based formats. Clinical pathway computerization is an emerging research field that aims to integrate clinical pathways with health information systems. A key process in clinical pathway computerization is the standardization of clinical pathway terminology to comply with digital terminology systems. Since clinical pathways include sensitive medical terms, clinical pathway standardization is performed manually and is difficult to automate using machines. The objective of this research is to introduce automation to clinical pathway standardization. The proposed approach utilizes a semantic score-based algorithm that automates the search for SNOMED CT terms. The algorithm was implemented in a software system with a graphical user interface component that physicians can use to standardize clinical pathways by searching for and comparing relevant SNOMED CT retrieved automatically by the algorithm. The system has been tested and validated on SNOMED CT ontology. The experimental results show that the system reached a maximum search space reduction of 98.9% within any single iteration of the algorithm and an overall average of 71.3%. The system enables physicians to locate the proper terms precisely, quickly, and more efficiently. This is demonstrated using case studies, and the results show that human-guided automation is a promising methodology in the field of clinical pathway standardization and computerization.
      Citation: DIGITAL HEALTH
      PubDate: 2022-04-01T06:14:15Z
      DOI: 10.1177/20552076221089796
      Issue No: Vol. 8 (2022)
       
  • “I am chatbot, your virtual mental health adviser.” What drives
           citizens’ satisfaction and continuance intention toward mental health
           chatbots during the COVID-19 pandemic' An empirical study in China

    • Authors: Yonghan Zhu, Rui Wang, Chengyan Pu
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      IntroductionIn order to address the psychological problems during the COVID-19 pandemic, mental health chatbots have been extensively used by public sectors. According to Theory of Consumption Values, this paper proposed an analytical framework to investigate the determinants behind users’ satisfaction and continuance intention toward mental health chatbots.MethodsThe empirical study was conducted through an online survey, facilitated by the use of questionnaire posted on the WeChat platform. Seven-point Likert scale and closed-ended questions were employed. Totally 371 valid samples were collected. The research data was tested via the partial least squares structural equation modeling. Gender, age, and income were included as control variables.ResultsAnalysis of samples collected from 371 Chinese users suggested that personalization (functional value), enjoyment (emotional value), learning (epistemic value), and the condition of the COVID-19 pandemic (conditional value) have positive influences on user satisfaction and continuance intention, but such effects were weak. The findings also revealed that user satisfaction has weakly positive impact on continuance intention. However, voice interaction (functional value) was an insignificant predictor of user satisfaction and continuance intention.DiscussionThis study developed a critical perspective on the role of Theory of Consumption Values in the context of mental health chatbot usage, while Theory of Consumption Value has been increasingly employed to explain the use of AI-based public services. Thus, this research devotes to the enhancement of theoretical frameworks regarding the usage of mental health chatbots.
      Citation: DIGITAL HEALTH
      PubDate: 2022-03-31T05:42:11Z
      DOI: 10.1177/20552076221090031
      Issue No: Vol. 8 (2022)
       
  • The experiences of community-dwelling individuals with newly diagnosed
           

    • Authors: Jeppe Eriksen, Ann Bygholm, Signe Hudtloff Nielsen, Pernille Bertelsen
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectiveThe aim of this study was to examine the experiences of citizens with newly diagnosed type-2 diabetes when using a newly developed and implemented patient-reported outcome (PRO) questionnaire as part of clinical practice in a municipal setting. Specifically, the citizens’ experiences in completing the PRO questionnaire and using the PRO data in consultations were examined.MethodsThe study was based on participant observations and semi-structured interviews and conducted at the Centre for Diabetes in Copenhagen and online. Participants were recruited deliberately to represent different cases of citizens with type-2 diabetes. Ten citizens were observed during consultation with an healthcare professional (HCP) and subsequently interviewed. The interviews were recorded as audio or video and transcribed verbatim. A thematic analysis was performed on the basis of previously described guidelines.ResultsThe PRO instigated reflections and enlightened citizens on disease-specific matters and motivated citizens to engage in self-management activities. During the citizen-HCP consultations, the PRO data prepared the actors before the meeting and enabled structured, effective and relevant conversations. However, the PRO questionnaire lacked response options, triggered citizen concerns about future health conditions and made them unsure if their answers were correct and aware that they lacked disease-specific knowledge. The experiences were linked to the citizens' situation as newly diagnosed with type-2 diabetes.ConclusionThe informants found the PRO questionnaire and data meaningful and useful. However, adjustments are needed if the PRO instrument is to resemble the disease situation of citizens with newly diagnosed type-2 diabetes.
      Citation: DIGITAL HEALTH
      PubDate: 2022-03-31T05:31:48Z
      DOI: 10.1177/20552076221089792
      Issue No: Vol. 8 (2022)
       
  • Integrating the experience: Principles for digital transformation across
           the patient journey

    • Authors: Marnie de Mooij, Olivia Foss, Brian Brost
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      As medical science advances and the population ages, the prevalence of chronic conditions has also grown. The traditional model of care, with its focus on acute and episodic issues within the office visit, is not designed to meaningfully address long-term patient needs. With COVID-19 has come unprecedented digital adoption, bringing health care delivery to a critical juncture. While digital tools and technologies present vast opportunities for democratizing and decentralizing care experiences, their piecemeal application to the existing “sick care” model and its information technology infrastructure will not only limit their value, but will inevitably add cost, inefficiency, and burden to care teams. In order to build upon this momentum and reap the full benefits of practice digitization, care model transformation must occur. This entails holistically reexamining how every component of the health care experience, from the digital tools to visit interactions, synchronizes to address the full continuum of patient needs throughout the journey. By doing this, care shifts away from one-size-fits-all, fragmented strings of visits, toward seamless experiences that adapt to patients’ needs in real-time while integrating within their daily lives. Rather than acting as a substitute for care, technology instead is vital to promoting and amplifying the impact of all those involved. To achieve this, this paper outlines 10 principles for restructuring care to incorporate digital health capabilities. Each describes how all care model components work as a system that aligns with patient needs. By doing this, technology is now an integral in supporting relationships across the full continuum of care.
      Citation: DIGITAL HEALTH
      PubDate: 2022-03-31T05:31:28Z
      DOI: 10.1177/20552076221089100
      Issue No: Vol. 8 (2022)
       
  • Will the EU Medical Device Regulation help to improve the safety and
           performance of medical AI devices'

    • Authors: Emilia Niemiec
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      Concerns have been raised over the quality of evidence on the performance of medical artificial intelligence devices, including devices that are already on the market in the USA and Europe. Recently, the Medical Device Regulation, which aims to set high standards of safety and quality, has become applicable in the European Union. The aim of this article is to discuss whether, and how, the Medical Device Regulation will help improve the safety and performance of medical artificial intelligence devices entering the market. The Medical Device Regulation introduces new rules for risk classification of the devices, which will result in more devices subjected to a higher degree of scrutiny before entering the market; more stringent requirements on clinical evaluation, including the requirement for appraisal of clinical data; new requirements for post-market surveillance, which may help spot early on any new, unexpected side effects and risks of the devices; and requirements for notified bodies, including for expertise of the personnel and consideration of relevant best practice documents. The guidance of the Medical Device Coordination Group on clinical evaluation of medical device software and the MEDDEV2.7 guideline on clinical evaluation also attend to some of the problems identified in studies on medical artificial intelligence devices. The Medical Device Regulation will likely help improve the safety and performance of the medical artificial intelligence devices on the European market. The impact of the Regulation, however, is also dependent on its adequate enforcement by the European Union member states.
      Citation: DIGITAL HEALTH
      PubDate: 2022-03-31T05:30:53Z
      DOI: 10.1177/20552076221089079
      Issue No: Vol. 8 (2022)
       
  • Development and evaluation of smartphone usage management system for
           preventing problematic smartphone use

    • Authors: Sun Jung Lee, Mun Joo Choi, Sung Hye Yu, HyungMin Kim, So Jin Park, In Young Choi
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectiveThe increased use of smartphones has led to several problems, including excessive smartphone use and the decreased self-ability to control smartphone use. To prevent these problems, the MindsCare app was developed as a method of self-management and intervention based on an evaluation of smartphone usage. We designed the MindsCare app to manage smartphone usage and prevent problematic smartphone use by providing personalized interventions.MethodsWe recruited 342 Korean participants over the age of 20 and asked them to use MindsCare for 13 weeks. Subsequently, we evaluated the changes in average smartphone usage time and the usability of the app. We designed a usability evaluation questionnaire based on the Technology Acceptance Model and conducted factor and reliability analyses on the participants’ responses. In the eighth week of the study, participants responded to a survey on the usability of the app. We ultimately collected data from 190 participants.ResultsThe average score for the usability of the system was 3.61 on a five-point Likert scale, and approximately 58% of the participants responded positively to the evaluation items. In addition, our analysis of MindsCare data revealed a significant reduction in average smartphone use time in the eighth week compared to the baseline (t = 3.47, p = 0.001). Structural equation model analysis revealed that effort expectancy and performance expectancy had a positive relation with behavior intention for the app.ConclusionsThrough this study, we confirmed the MindsCare app's smartphone usage time reduction effect and proved its good usability. As a result, MindsCare may contribute to achieving users’ goals of reducing problematic smartphone use.
      Citation: DIGITAL HEALTH
      PubDate: 2022-03-29T07:29:04Z
      DOI: 10.1177/20552076221089095
      Issue No: Vol. 8 (2022)
       
  • mHealth intervention for carers of individuals with a history of stroke:
           Heuristic evaluation and user perspectives

    • Authors: Elton H Lobo, Finn Kensing, Anne Frølich, Lene J Rasmussen, Patricia M Livingston, Sheikh Mohammed Shariful Islam, John Grundy, Mohamed Abdelrazek
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      BackgroundCaregiving in stroke is complex, with most carers having little to no preparation to care for individuals with a history of stroke, leading to emotional impact. Technologies such as Mobile Health can provide the carer with real-time support and prepare the carer to assume their new roles and responsibilities.ObjectivesTo perform a heuristic evaluation of mHealth interventions designed to support carers of individuals with a history of stroke and determine the user preferences in stroke caregiving technology to inform future researchers and developers regarding the best practices to support these individuals.MethodsTwenty adults (i.e. 10 usability experts and 10 carers) participated in an iterative user-centred design study that focused on developing and modifying the mHealth intervention (StrokeCaregiver (SeCr)) created to support stroke caregiving. The intervention was repeated in four cycles, including two cycles with five usability experts each and five carers each.ResultsSeCr was iteratively improved to develop a highly usable product in multiple cycles. Participants demonstrated critical needs in personalized information support, communication with their healthcare needs, and the trust of the user, content, and developer. These critical needs are required to be met to promote long-term acceptance and adherence.ConclusionsWhile SeCr was developed to address the needs of carers of individuals with a history of stroke, several considerations must be made to ensure it can be used in a real-world setting. Researchers and developers can use co-design or living lab approaches to further meet the needs and expectations of the carer and enable these individuals to be better prepared for stroke caregiving.
      Citation: DIGITAL HEALTH
      PubDate: 2022-03-29T07:28:59Z
      DOI: 10.1177/20552076221089070
      Issue No: Vol. 8 (2022)
       
  • Leveraging online shopping behaviors as a proxy for personal lifestyle
           choices: New insights into chronic disease prevention literacy

    • Authors: Yongzhen Wang, Xiaozhong Liu, Katy Börner, Jun Lin, Yingnan Ju, Changlong Sun, Luo Si
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectiveUbiquitous internet access is reshaping the way we live, but it is accompanied by unprecedented challenges in preventing chronic diseases that are usually planted by long exposure to unhealthy lifestyles. This paper proposes leveraging online shopping behaviors as a proxy for personal lifestyle choices to improve chronic disease prevention literacy, targeted for times when e-commerce user experience has been assimilated into most people's everyday lives.MethodsLongitudinal query logs and purchase records from 15 million online shoppers were accessed, constructing a broad spectrum of lifestyle features covering various product categories and buyer personas. Using the lifestyle-related information preceding online shoppers’ first purchases of specific prescription drugs, we could determine associations between their past lifestyle choices and whether they suffered from a particular chronic disease.ResultsNovel lifestyle risk factors were discovered in two exemplars—depression and type 2 diabetes, most of which showed reasonable consistency with existing healthcare knowledge. Further, such empirical findings could be adopted to locate online shoppers at higher risk of these chronic diseases with decent accuracy [i.e. (area under the receiver operating characteristic curve) AUC=0.68 for depression and AUC=0.70 for type 2 diabetes], closely matching the performance of screening surveys benchmarked against medical diagnosis.ConclusionsMining online shopping behaviors can point medical experts to a series of lifestyle issues associated with chronic diseases that are less explored to date. Hopefully, unobtrusive chronic disease surveillance via e-commerce sites can grant consenting individuals a privilege to be connected more readily with the medical profession and sophistication.
      Citation: DIGITAL HEALTH
      PubDate: 2022-03-28T07:44:35Z
      DOI: 10.1177/20552076221089092
      Issue No: Vol. 8 (2022)
       
  • A COVID-19 forecasting system for hospital needs using ANFIS and LSTM
           models: A graphical user interface unit

    • Authors: Sajad Shafiekhani, Peyman Namdar, Sima Rafiei
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      BackgroundCenters for Disease Control and Prevention data showed that about 40% of coronavirus disease 2019 (COVID-19) patients had been suffering from at least one underlying medical condition were hospitalized; in which nearly 33% of them needed to be admitted to the intensive care unit (ICU) to receive specialized medical services. Our study aimed to find a proper machine learning algorithm that can predict confirmed COVID-19 hospital admissions with high accuracy.MethodsWe obtained data on daily COVID-19 cases in regular medical inpatient units, emergency department, and ICU in the time window between 21 July 2020 and 21 November 2021. Data for the first 183 days (training data set) were used for long short-term memory (LSTM) network, adaptive neuro-fuzzy inference system (ANFIS), support vector regression (SVR) and decision tree model training, whilst the remaining data for the last 60 days (test data set) were used for model validation. To predict the number of ICU and non-ICU patients, we used these models. Finally, a user-friendly graphical user interface unit was designed to load any time series data (here the trend of population of COVID-19 patients) and train LSTM, ANFIS, SVR or tree models for the prediction of COVID-19 cases for one week ahead.ResultsAll models predicted the dynamics of COVID-19 cases in ICU and non- wards. The values of root-mean-square error and R2 as model assessment metrics showed that ANFIS model had better predictive power among all models.ConclusionArtificial intelligence-based forecasting models such as ANFIS system or deep learning approach based on LSTM or regression models including SVR or tree regression play a key role in forecasting the required number of beds or other types of medical facilities during the coronavirus pandemic. Thus, the designed graphical user interface of the present study can be used for optimum management of resources by health care systems amid COVID-19 pandemic.
      Citation: DIGITAL HEALTH
      PubDate: 2022-03-28T07:44:03Z
      DOI: 10.1177/20552076221085057
      Issue No: Vol. 8 (2022)
       
  • Seniors’ eHealth literacy, health and education status and personal
           health knowledge

    • Authors: Gizell Green
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      BackgroundThe COVID-19 pandemic made eHealth literacy skills and online health activities essential for seniors.Research aims(a) To examine the differences in eHealth literacy dimensions (awareness of sources, recognizing quality and meaning, understanding information, perceived efficiency, validating information) as related to participants’ health status and education level. (b) To explore the effect of eHealth literacy dimensions on participants’ personal health knowledge.MethodsWe used a cross-sectional design with a convenience sample of 298 Israeli seniors aged 65 or over during the second lockdown. The questionnaire was composed of three sections: (a) background characteristics, (b) an eHealth Literacy scale, and (c) perceived personal health knowledge.ResultsParticipants with an excellent health status reported higher levels of awareness of sources and perceived efficiency than participants with poor or good health statuses. Furthermore, participants with a graduate degree understand online information better than participants with a high school education. Moreover, it was found that participants with a high school education sense that they are being smart on the net more than participants with an undergraduate degree. Finally, we found that eHealth literacy dimensions influenced the participants’ personal health knowledge.ConclusionAs the population ages, it becomes more at risk for disease, and as a result, its health status weakens. Therefore, it is important to provide seniors with appropriate intervention programs for improving their eHealth literacy, which may eliminate health inequality. In addition, caregivers need to develop patients’ eHealth literacy skills—finding, evaluation, and interpretation of online health knowledge relevant to them.
      Citation: DIGITAL HEALTH
      PubDate: 2022-03-28T06:14:02Z
      DOI: 10.1177/20552076221089803
      Issue No: Vol. 8 (2022)
       
  • Pregnant women’s use of a consumer-based meditation mobile app: A
           descriptive study

    • Authors: Jeni Green, Taylor Neher, Megan Puzia, Breanne Laird, Jennifer Huberty
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectiveThe objectives of this study were to explore the satisfaction of pregnant or recently pregnant women with the existing Calm app content (i.e. non-pregnancy) and preferences and recommendations for the types of pregnancy-specific content that would be helpful to pregnant women.MethodsThis study was a national cross-sectional survey of subscribers to a meditation mobile app (i.e. Calm). Eligible participants were currently pregnant or recently pregnant (within the past 12 months) and used Calm during their pregnancy. Participants were asked about their Calm usage and perceived benefits of Calm during pregnancy, and interest in pregnancy-specific content. Descriptive statistics were used to characterize the sample.ResultsParticipants (N  =  111) were on average 34 years old (SD  =  5.4) and half of the sample was currently pregnant (N  =  55). The most common reasons for using the Calm app during pregnancy was for sleep problems (29%; n  =  31) or anxiety (27%; n  =  29). Women reported Calm was most helpful for improving sleep (32%; n  =  32), anxiety (25%; n  =  25), and stress (21%; n  =  21). Nearly all women wanted pregnancy-specific meditation content within the app (98%; n  =  98) and expressed interest in topics including pregnancy-related anxiety (68%; n  =  67), postpartum (50%; n  =  49), pregnancy-related sleep problems (41%; n  =  40), and labor and delivery (38%; n  =  37).ConclusionWomen who used the Calm app during pregnancy found it helpful for improving sleep, anxiety, and stress but desire pregnancy-specific content. Future meditation mobile app studies should utilize pregnancy-specific content and test the feasibility and efficacy of sleep and mental health in pregnant women.
      Citation: DIGITAL HEALTH
      PubDate: 2022-03-28T06:13:44Z
      DOI: 10.1177/20552076221089098
      Issue No: Vol. 8 (2022)
       
  • Associations among eHealth literacy, social support, individual
           resilience, and emotional status in primary care providers during the
           outbreak of the SARS-CoV-2 Delta variant

    • Authors: Richard Huan Xu, Lu-shao-bo Shi, Yi Xia, Dong Wang
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectiveThis study aimed to investigate eHealth literacy among primary care providers (PCPs) and explore its association with social support, individual resilience, anxiety, and depression during an outbreak of the SARS-CoV-2 Delta variant in Guangzhou, China.MethodsA cross-sectional web-based survey was conducted in 18 community healthcare centers in Guangzhou, China. The responses of 600 PCPs were tagged as valid responses. Information pertaining to their background, eHealth literacy, anxiety, depression levels, social support, and individual resilience was also collected. Multilevel analysis was used to determine the association among the measures to account for the nested random effect of community health centers in different districts.ResultsParticipants showed a moderate self-perceived level of eHealth literacy (M = 30, SD = 5.8). Participants who reported higher levels of eHealth literacy were more likely to exhibit lower levels of anxiety and depression, higher social support, and greater resilience. After adjusting for background characteristics, the results of the multilevel logistic analysis showed that eHealth literacy was significantly associated with anxiety and depression, social support, and individual resilience. Younger participants and those who were highly educated reported enhanced eHealth literacy.ConclusionsThis study presents a baseline reference for eHealth literacy among Chinese PCPs. Improving their ability to search for and use reliable web-based information was beneficial for facilitating perceived social support and raising resilience during the pandemic. Strategies to provide high-quality web-based information to PCPs to self-assess and identify psychological distress at an early stage should be encouraged.
      Citation: DIGITAL HEALTH
      PubDate: 2022-03-25T08:07:52Z
      DOI: 10.1177/20552076221089789
      Issue No: Vol. 8 (2022)
       
  • Teledentistry awareness, its usefulness, and challenges among dental
           professionals in Pakistan and Saudi Arabia

    • Authors: Farooq Ahmad Chaudhary, Basaruddin Ahmad, Muhammad Qasim Javed, Saeed Mustafa, Ayesha Fazal, Muhammad Mohsin Javaid, Ammar Ahmed Siddiqui, Mohammad Khursheed Alam, Shahab Ud Din
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectivesThis study aims to describe the perception of dental professionals in Pakistan and Saudi Arabia (SA) towards the practice of teledentistry, its usefulness and challenges.MethodsA cross-sectional study was carried out among 190 dentists from January 2021 to April 2021. The participants were included in the study using snowball sampling method. A 26-item adopted questionnaire was distributed using different social media channels. Chi-square test was used for analysis.ResultsOut of 190 participants, 46.3% were from Pakistan and 53.7% were from SA. The majority of participants in both countries agreed that teledentistry would enhance guidelines and advice (74.2%), improve peer-to-peer interaction (79.5%) and make patient's referrals more efficient (75.8%). For the usefulness, most participants agree that it is economical for the patients (61.1%), improves communication (74.7%), helps in educating the patients (86.3%), avoid unnecessary travel (76.8%), helps monitoring (71.6%), and benefits patients in remote areas (74.7%); however, more Pakistani participants perceived that time spent with the patient would increase compared to SA participants (p 
      Citation: DIGITAL HEALTH
      PubDate: 2022-03-25T05:15:28Z
      DOI: 10.1177/20552076221089776
      Issue No: Vol. 8 (2022)
       
  • A framework for examining patient attitudes regarding applications of
           artificial intelligence in healthcare

    • Authors: Jordan P. Richardson, Susan Curtis, Cambray Smith, Joel Pacyna, Xuan Zhu, Barbara Barry, Richard R. Sharp
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      BackgroundWhile use of artificial intelligence (AI) in healthcare is increasing, little is known about how patients view healthcare AI. Characterizing patient attitudes and beliefs about healthcare AI and the factors that lead to these attitudes can help ensure patient values are in close alignment with the implementation of these new technologies.MethodsWe conducted 15 focus groups with adult patients who had a recent primary care visit at a large academic health center. Using modified grounded theory, focus-group data was analyzed for themes related to the formation of attitudes and beliefs about healthcare AI.ResultsWhen evaluating AI in healthcare, we found that patients draw on a variety of factors to contextualize these new technologies including previous experiences of illness, interactions with health systems and established health technologies, comfort with other information technology, and other personal experiences. We found that these experiences informed normative and cultural beliefs about the values and goals of healthcare technologies that patients applied when engaging with AI. The results of this study form the basis for a theoretical framework for understanding patient orientation to applications of AI in healthcare, highlighting a number of specific social, health, and technological experiences that will likely shape patient opinions about future healthcare AI applications.ConclusionsUnderstanding the basis of patient attitudes and beliefs about healthcare AI is a crucial first step in effective patient engagement and education. The theoretical framework we present provides a foundation for future studies examining patient opinions about applications of AI in healthcare.
      Citation: DIGITAL HEALTH
      PubDate: 2022-03-25T05:15:15Z
      DOI: 10.1177/20552076221089084
      Issue No: Vol. 8 (2022)
       
  • Technology scripts in care practice: A case study of assistant nurses’
           use of a social alarm system in Swedish nursing homes

    • Authors: Fangyuan Chang, Sanna Kuoppamäki, Britt Östlund
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      BackgroundTechnologies such as social alarm systems contain expectations about how they should be integrated and used in practice. These expectations, also called technology scripts, usually fail to consider all the complexity in care practice. Shifting the focus from technology scripts to care practice, this paper examines how a social alarm system is used in assistant nurses’ care practices in nursing homes.MethodsThe paper draws on observations of assistant nurses’ daily tasks (32 h) and semi-structured interviews with assistant nurses (n = 12) in two Swedish nursing homes. The observation data were used to understand the care contexts and assistant nurses’ technology-mediated care practices, while interviews were used to deeply understand assistant nurses’ perceptions of the system, their care practices, and which aspects they considered during the provision of care.FindingsWe show the complexities involved in integrating a social alarm system into care practices based on assistant nurses’ situational and personal interpretations of both technology scripts and quality of care. The technology-mediated care practices consist of receiving alarms from residents, checking alarms via alarm phones, responding to alarms via alarm phones, checking specific residents’ situations in person, documenting all finished alarms, and documenting some finished alarms. In these practices, the assistant nurses defined technology scripts according to their expected requirements and outcomes, and meanwhile considered the quality of care by evaluating the priority of practical, moral or relational care in the situations at hand. Through further negotiations with the defined scripts and the considered quality of care, the assistant nurses decided on the final way of following (or not following) specific scripts in practice.ConclusionResults from our study portray the complexity of technology in care practices. The findings contribute to increased understanding of technology-mediated care practices in nursing homes, and research on technology scripts in institutional settings.
      Citation: DIGITAL HEALTH
      PubDate: 2022-03-25T05:14:39Z
      DOI: 10.1177/20552076221089077
      Issue No: Vol. 8 (2022)
       
  • A roadmap for the development and evaluation of the eHealthResp online
           course

    • Authors: Marta Estrela, Tânia Magalhães Silva, Ana Margarida Pisco Almeida, Carlos Regueira, Maruxa Zapata-Cachafeiro, Adolfo Figueiras, Fátima Roque, Maria Teresa Herdeiro
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      BackgroundInappropriate antibiotic use constitutes one of the most concerning public health issues, being one of the main causes of antibiotic resistance. Hence, to tackle this issue, it is important to encourage the development of educational interventions for health practitioners, namely by using digital health tools. This study focuses on the description of the development and validation process of the eHealthResp online course, a web platform directed to physicians and pharmacists, with the overall goal of improving antibiotic use for respiratory tract infections, along with the assessment of its usability.MethodsThe eHealthResp platform and the courses, developed with a user-centered design and based on Wordpress and MySQL, were based on a previously developed online course. A questionnaire to assess the usability was distributed among physicians (n = 6) and pharmacists (n = 6). Based on the obtained results, statistical analyses were conducted to calculate the usability score and appraise the design of the online course, as well as to compare the overall scores attributed by both groups. Further qualitative comments provided by the participants have also been analyzed.ResultsThe eHealthResp contains two online courses directed to physicians and pharmacists aiming to aid in the management of respiratory tract infections. The average usability score of the eHealthResp online courses for physicians and pharmacists was of 78.33 (±11.57, 95%CI), and 83.75 (±15.90, 95%CI), respectively. Qualitative feedback emphasized the usefulness of the course, including overall positive reviews regarding user-friendliness and consistency.ConclusionsThis study led us to conclude that the eHealthResp online course is not recognized as a complex web platform, as both qualitative and quantitative feedback obtained were globally positive.
      Citation: DIGITAL HEALTH
      PubDate: 2022-03-24T09:23:58Z
      DOI: 10.1177/20552076221089088
      Issue No: Vol. 8 (2022)
       
  • Understanding information behavior of South Korean Twitter users who
           express suicidality on Twitter

    • Authors: Donghun Kim, Woojin Jung, Seojin Nam, Hongjin Jeon, Jihyun Baek, Yongjun Zhu
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectiveAlthough there were few studies on how suicidal users behave on Twitter, they only investigated partial aspects such as tweeting frequency and tweet length. Therefore, we aim to understand the various information behavior of suicidal users in South Korea.MethodsTo achieve this goal, we annotated 20,000 tweets and identified 1097 tweets with the expression of suicidality (i.e. suicidal tweets) and 229 suicidal users (i.e. experimental group). Using the data, a user profile analysis, comparative analysis with control group, and tweets/hashtags analysis were performed.ResultsOur results show that many suicidal users used suicide-related keywords in their user IDs, usernames, descriptions, and pinned tweets. We also found that, compared to the control group, the experimental group show different patterns of information behavior. The experimental group did not frequently use Twitter and, on average, wrote longer texts than the control group. A clear seasonal pattern was also identified in the experimental group's tweeting behavior. Frequently used keywords/hashtags were extracted from tweets written by the experimental group for the purpose of understanding their concerns and detecting more suicidal tweets.ConclusionsWe believe that our study will help in the understanding of suicidal users’ information behavior on social media and lay the basis for more accurate actions for suicide prevention and early intervention on social media.
      Citation: DIGITAL HEALTH
      PubDate: 2022-03-22T06:45:39Z
      DOI: 10.1177/20552076221086339
      Issue No: Vol. 8 (2022)
       
  • Policy parameters for optimising hospital ePrescribing: An exploratory
           literature review of selected countries of the Organisation for Economic
           Co-operation and Development

    • Authors: Uditha T Perera, Catherine Heeney, Aziz Sheikh
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectiveElectronic prescribing systems offer considerable opportunities to enhance the safety, effectiveness and efficiency of prescribing and medicines management decisions but, despite considerable investments in health IT infrastructure and healthcare professional training, realising these benefits continues to prove challenging. How systems are customised and configured to achieve optimal functionality is an increasing focus for policymakers. We sought to develop an overview of the policy landscape currently supporting optimisation of hospital ePrescribing systems in economically developed countries with a view to deriving lessons for the United Kingdom (UK).MethodsWe conducted a review of research literature and policy documents pertaining to optimisation of ePrescribing within hospitals across Organisation for Economic Co-operation and Development (OECD) countries on Embase, Medline, National Institute for Health (NIH), Google Scholar databases from 2010 to 2020 and the websites of organisations with international and national health policy interests in digital health and ePrescribing. We designed a typology of policies targeting optimisation of ePrescribing systems that provides an overview of evidence relating to the level at which policy is set, the aims and the barriers encountered in enacting these policies.ResultsOur database searches retrieved 11 relevant articles and other web resources mainly from North America and Western Europe. We identified very few countries with a national level strategy for optimisation of ePrescribing in hospitals. There were hotspots of digital maturity in relation to ePrescribing at institutional, specialisation, regional and national levels in the US and Europe. We noted that such countries with digital maturity fostered innovations such as patient involvement.ConclusionsWe found that, whilst helpful to achieve certain aims, coordinated strategies within and across countries for optimisation of ePrescribing systems are rare, even in countries with well-established ePrescribing and digital health infrastructures. There is at present little policy focus on maximising the utility of ePrescribing systems.
      Citation: DIGITAL HEALTH
      PubDate: 2022-03-21T08:07:02Z
      DOI: 10.1177/20552076221085074
      Issue No: Vol. 8 (2022)
       
  • Reviewer List 2021

    • Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.

      Citation: DIGITAL HEALTH
      PubDate: 2022-03-21T08:06:32Z
      DOI: 10.1177/20552076221076661
      Issue No: Vol. 8 (2022)
       
  • Mechanical revascularization using Solitaire AB device for acute limb
           ischemia secondary to popliteal and infrapopliteal embolic occlusion

    • Authors: Maofeng Gong, Yangyi Zhou, Xu He, Liang Chen, Boxiang Zhao, Jie Kong, Haobo Su, Jianping Gu
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectiveAcute limb ischemia is one of the most common arterial emergencies. The data of mechanical revascularization using Solitaire AB device coupled with thromboaspiration for the treatment of popliteal and infrapopliteal acute limb ischemia are limited. The aim of this study was to review the preliminary safety and effectiveness.MethodsWe performed a single-center retrospective review of patients with popliteal and infrapopliteal acute limb ischemia treated with Solitaire AB device coupled with thromboaspiration from February 2019 to May 2020. Adjunctive balloon angioplasty was performed to correct coexisting atherosclerotic stenosis. Technical success was defined as successful deployment of the Solitaire AB device across the occlusive segment and successful retrieval without the use of adjunctive catheter-directed thrombolysis or balloon angioplasty. Clinical success was defined as the relief of symptoms related to acute limb ischemia. Follow-up outcomes were also reviewed.ResultsThere were 15 consecutive patients who underwent 16 Solitaire AB devices. Technical success was achieved in 11 (73.3%) patients. Of the unsuccessful patients, double-stent retrievers were employed in 1 (6.7%) patient. Two patients who encountered residual clots in distal small arteries underwent adjunctive catheter-directed thrombolysis. An adjunctive balloon angioplasty was required in 1 (6.7%) patient. All patients had notable acute limb ischemia symptom relief after the procedures. Clinical success was achieved in 14 (93.3%) patients. Besides one patient encountered minor amputation, the major amputation was prevented in all patients. No device-related complications or distal embolization events were recorded during the procedures. At the follow-up of 12 months, all surviving patients remained symptom-free, the patency was achieved in 12 (80%) patients and the limb salvage was 100%.ConclusionsPreliminary outcomes suggest that mechanical revascularization using Solitaire AB device coupled with manual thromboaspiration appears to be a rapid, safe, and effective modality that appears to reduce the requirement for catheter-directed thrombolysis.Advances in knowledgeThese findings may add a promising recanalization therapy for acute embolic occlusion of the acute limb ischemia secondary to popliteal and infrapopliteal arteries.
      Citation: DIGITAL HEALTH
      PubDate: 2022-03-18T11:55:43Z
      DOI: 10.1177/20552076221084467
      Issue No: Vol. 8 (2022)
       
  • Digital health for quality healthcare: A systematic mapping of review
           studies

    • Authors: Mohd Salami Ibrahim, Harmy Mohamed Yusoff, Yasrul Izad Abu Bakar, Myat Moe Thwe Aung, Mohd Ihsanuddin Abas, Ras Azira Ramli
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectiveTo systematically catalogue review studies on digital health to establish extent of evidence on quality healthcare and illuminate gaps for new understanding, perspectives and insights for evidence-informed policies and practices.MethodsWe systematically searched PubMed database using sensitive search strings. Two reviewers independently conducted two-phase selection via title and abstract, followed by full-text appraisal. Consensuses were derived for any discrepancies. A standardized data extraction tool was used for reliable data mining.ResultsA total of 54 reviews from year 2014 to 2021 were included with notable increase in trend of publications. Systematic reviews constituted the majority (61.1%, (37.0% with meta-analyses)) followed by scoping reviews (38.9%). Domains of quality being reviewed include effectiveness (75.9%), accessibility (33.3%), patient safety (31.5%), efficiency (25.9%), patient-centred care (20.4%) and equity (16.7%). Mobile apps and computer-based were the commonest (79.6%) modalities. Strategies for effective intervention via digital health included engineering improved health behaviour (50.0%), better clinical assessment (35.1%), treatment compliance (33.3%) and enhanced coordination of care (24.1%). Psychiatry was the discipline with the most topics being reviewed for digital health (20.3%).ConclusionDigital health reviews reported findings that were skewed towards improving the effectiveness of intervention via mHealth applications, and predominantly related to mental health and behavioural therapies. There were considerable gaps on review of evidence on digital health for cost efficiency, equitable healthcare and patient-centred care. Future empirical and review studies may investigate the association between fields of practice and tendency to adopt and research the use of digital health to improve care.
      Citation: DIGITAL HEALTH
      PubDate: 2022-03-18T11:55:27Z
      DOI: 10.1177/20552076221085810
      Issue No: Vol. 8 (2022)
       
  • The importance of social media users’ responses in tackling digital
           COVID-19 misinformation in Africa

    • Authors: Ruth Stewart, Andile Madonsela, Nkululeko Tshabalala, Linda Etale, Nicola Theunissen
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectiveDigital technologies present both an opportunity and a threat for advancing public health. At a time of pandemic, social media has become a tool for the rapid spread of misinformation. Mitigating the impacts of misinformation is particularly acute across Africa, where WhatsApp and other forms of social media dominate, and where the dual threats of misinformation and COVID-19 threaten lives and livelihoods. Given the scale of the problem within Africa, we set out to understand (i) the potential harm that misinformation causes, (ii) the available evidence on how to mitigate that misinformation and (iii) how user responses to misinformation shape the potential for those mitigating strategies to reduce the risk of harm.MethodsWe undertook a multi-method study, combining a rapid review of the research evidence with a survey of WhatsApp users across Africa.ResultsWe identified 87 studies for inclusion in our review and had 286 survey respondents from 17 African countries. Our findings show the considerable harms caused by public health misinformation in Africa and the lack of evidence for or against strategies to mitigate against such harms. Furthermore, they highlight how social media users’ responses to public health misinformation can mitigate and exacerbate potential harms. Understanding the ways in which social media users respond to misinformation sheds light on potential mitigation strategies.ConclusionsPublic health practitioners who utilise digital health approaches must not underestimate the importance of considering the role of social media in the circulation of misinformation, nor of the responses of social media users in shaping attempts to mitigate against the harms of such misinformation.
      Citation: DIGITAL HEALTH
      PubDate: 2022-03-18T07:34:30Z
      DOI: 10.1177/20552076221085070
      Issue No: Vol. 8 (2022)
       
  • Digital risk distribution and COVID-19: How contact tracing is promoted as
           a solution to equilibrate public health and economic prosperity during
           pandemics

    • Authors: Dana Mahr, Marylaure Bloch
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      Digital contact tracing appears as an ideal solution to tackle long-term economic damage due to necessary lockdown measures during a pandemic. This essay shows that the challenge of balancing citizen's health and a functioning society is not just coming up today. Commercial centres were already in the Middle Ages worried about their economic prosperity and adopted isolation measures. Although there are much more data available today, pandemic preparedness remains constrained by temporal and spatial realities, thus limiting public health management to the national state. Based on the examples of China and Switzerland, we elaborate on how individual and collective needs can be balanced differently regarding the implementation of a digital contact tracing system. While China's Health Code App is close to social surveillance, Switzerland has turned away from Europe to develop its own Swiss solution due to disagreement about data protection. It becomes clear that the attempts to properly balance public health and economic prosperity during a pandemic must be constantly readjusted and cannot simply be delegated to a digital technology.
      Citation: DIGITAL HEALTH
      PubDate: 2022-03-18T07:33:50Z
      DOI: 10.1177/20552076221085068
      Issue No: Vol. 8 (2022)
       
  • What makes an online help-seeking message go far during the COVID-19
           crisis in mainland China' A multilevel regression analysis

    • Authors: Anfan Chen, Aaron Ng, Yipeng Xi, Yong Hu
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      Various studies have explored the underlying mechanisms that enhance the overall reach of a support-seeking message on social media networks. However, little attention has been paid to an under-examined structural feature of help-seeking message diffusion, information diffusion depth, and how support-seeking messages can traverse vertically into social media networks to reach other users who are not directly connected to the help-seeker. Using the multilevel regression to analyze 705 help-seeking posts regarding COVID-19 on Sina Weibo, we examined sender, content, and environmental factors to investigate what makes help-seeking messages traverse deeply into social media networks. Results suggested that bandwagon cues, anger, instrumental appeal, and intermediate self-disclosure facilitate the diffusion depth of help-seeking messages. However, the effects of these factors were moderated by the epidemic severity. Implications of the findings on support-seeking behavior and narrative strategies on social media were also discussed.
      Citation: DIGITAL HEALTH
      PubDate: 2022-03-18T07:33:17Z
      DOI: 10.1177/20552076221085061
      Issue No: Vol. 8 (2022)
       
  • Phishing simulation exercise in a large hospital: A case study

    • Authors: Fabio Rizzoni, Sabina Magalini, Alessandra Casaroli, Pasquale Mari, Matt Dixon, Lynne Coventry
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      BackgroundPhishing is a major threat to the data and infrastructure of healthcare organizations and many cyberattacks utilize this socially engineered pathway. Phishing simulation is used to identify weaknesses and risks in the human defences of organizations. There are many factors influencing the difficulty of detecting a phishing email including fatigue and the nature of the deceptive message.MethodA major Italian Hospital with over 6000 healthcare staff performed a phishing simulation as part of its annual training and risk assessment. Three campaigns were launched at approx. 4-month intervals, to compare staff reaction to a general phishing email and a customized one.ResultsThe results show that customization of phishing emails makes them much more likely to be acted on. In the first campaign, 64% of staff did not open the general phish, significantly more than the 38% that did not open the custom phish. A significant difference was also found for the click rate, with significantly more staff clicking on the custom phish. However, the campaigns could not be run as intended, due to issues raised within the organization.ConclusionsPhishing simulation is useful but not without its limitations. It requires contextual knowledge, skill and experience to ensure that it is effective. The exercise raised many issues within the Hospital. Successful, ethical phishing simulations require coordination across the organization, precise timing and lack of staff awareness. This can be complex to coordinate. Misleading messages containing false threats or promises can cause a backlash from staff and unions. The effectiveness of the message is dependent on the personalization of the message to current, local events. The lessons learned can be useful for other hospitals.
      Citation: DIGITAL HEALTH
      PubDate: 2022-03-16T08:31:06Z
      DOI: 10.1177/20552076221081716
      Issue No: Vol. 8 (2022)
       
  • Magnetic resonance image-based brain tumour segmentation methods: A
           systematic review

    • Authors: Jayendra M Bhalodiya, Sarah N Lim Choi Keung, Theodoros N Arvanitis
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      BackgroundImage segmentation is an essential step in the analysis and subsequent characterisation of brain tumours through magnetic resonance imaging. In the literature, segmentation methods are empowered by open-access magnetic resonance imaging datasets, such as the brain tumour segmentation dataset. Moreover, with the increased use of artificial intelligence methods in medical imaging, access to larger data repositories has become vital in method development.PurposeTo determine what automated brain tumour segmentation techniques can medical imaging specialists and clinicians use to identify tumour components, compared to manual segmentation.MethodsWe conducted a systematic review of 572 brain tumour segmentation studies during 2015–2020. We reviewed segmentation techniques using T1-weighted, T2-weighted, gadolinium-enhanced T1-weighted, fluid-attenuated inversion recovery, diffusion-weighted and perfusion-weighted magnetic resonance imaging sequences. Moreover, we assessed physics or mathematics-based methods, deep learning methods, and software-based or semi-automatic methods, as applied to magnetic resonance imaging techniques. Particularly, we synthesised each method as per the utilised magnetic resonance imaging sequences, study population, technical approach (such as deep learning) and performance score measures (such as Dice score).Statistical testsWe compared median Dice score in segmenting the whole tumour, tumour core and enhanced tumour.ResultsWe found that T1-weighted, gadolinium-enhanced T1-weighted, T2-weighted and fluid-attenuated inversion recovery magnetic resonance imaging are used the most in various segmentation algorithms. However, there is limited use of perfusion-weighted and diffusion-weighted magnetic resonance imaging. Moreover, we found that the U-Net deep learning technology is cited the most, and has high accuracy (Dice score 0.9) for magnetic resonance imaging-based brain tumour segmentation.ConclusionU-Net is a promising deep learning technology for magnetic resonance imaging-based brain tumour segmentation. The community should be encouraged to contribute open-access datasets so training, testing and validation of deep learning algorithms can be improved, particularly for diffusion- and perfusion-weighted magnetic resonance imaging, where there are limited datasets available.
      Citation: DIGITAL HEALTH
      PubDate: 2022-03-16T03:32:59Z
      DOI: 10.1177/20552076221074122
      Issue No: Vol. 8 (2022)
       
  • Public opinion of the Irish “COVID Tracker” digital contact tracing
           App: A national survey

    • Authors: Michael E O’Callaghan, Manzar Abbas, Jim Buckley, Brian Fitzgerald, Kevin Johnson, John Laffey, Bairbre McNicholas, Bashar Nuseibeh, Derek O’Keeffe, Sarah Beecham, Abdul Razzaq, Kaavya Rekanar, Ita Richardson, Andrew Simpkin, James O’Connell, Cristiano Storni, Damyanka Tsvyatkova, Jane Walsh, Thomas Welsh, Liam G Glynn
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectiveThis study aims to gather public opinion on the Irish “COVID Tracker” digital contact tracing (DCT) App, with particular focus on App usage, usability, usefulness, technological issues encountered, and potential changes to the App.MethodsA 35-item online questionnaire was deployed for 10 days in October 2020, 3 months after the launch of the Irish DCT App.ResultsA total of 2889 completed responses were recorded, with 2553 (88%) respondents currently using the App. Although four in five users felt the App is easy to download, is easy to use and looks professional, 615 users (22%) felt it had slowed down their phone, and 757 (28%) felt it had a negative effect on battery life. Seventy-nine percent of respondents reported the App's main function is to aid contact tracing. Inclusion of national COVID-19 trends is a useful ancillary function according to 87% of respondents, and there was an appetite for more granular local data. Overall, 1265 (44%) respondents believed the App is helping the national effort, while 1089 (38%) were unsure.ConclusionsDCT Apps may potentially augment traditional contact tracing methods. Despite some reports of negative effects on phone performance, just 7% of users who have tried the App have deleted it. Ancillary functionality, such as up-to-date regional COVID-19, may encourage DCT App use. This study describes general positivity toward the Irish COVID Tracker App among users but also highlights the need for transparency on effectiveness of App-enabled contact tracing and for study of non-users to better establish barriers to use.
      Citation: DIGITAL HEALTH
      PubDate: 2022-03-16T03:00:12Z
      DOI: 10.1177/20552076221085065
      Issue No: Vol. 8 (2022)
       
  • Improving online clinical sexual and reproductive health information to
           support self-care: A realist review

    • Authors: Thomas Courtenay, Paula Baraitser
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      Self-care is the ability of individuals, families and communities to promote health, prevent disease, maintain health, and cope with illness and disability with or without the support of a healthcare provider. In the field of sexual and reproductive health options for self-care predominantly include ordering contraceptives online, or testing and treating genital infections outside a healthcare setting. The shift to digitally facilitated self-care consequently requires information that was previously used by clinicians to be made available to those managing their own sexual and reproductive health. This review was specifically interested in how to optimise this informational enabling environment as self-care becomes more complex. Using a realist approach to facilitate collation, analysis and synthesis of research from multiple disciplines this review sought to enable the generation of a programme theory to inform service development. The majority of research we identified studied information to support the choice to self-care and access to self-care. In contrast to established areas of self-care, for example, the management of diabetes or hypertension, studies of the self-care process in sexual and reproductive health are lacking. There is significant potential to expand digital information resources to support sexual and reproductive health self-care, however, there are currently significant unmet informational needs. This review proposes six key recommendations for providers and key stakeholders involved with sexual and reproductive healthcare for the improvement of digital self-care services.
      Citation: DIGITAL HEALTH
      PubDate: 2022-03-14T11:41:54Z
      DOI: 10.1177/20552076221084465
      Issue No: Vol. 8 (2022)
       
  • Trial by fire: How physicians responding to the COVID-19 pandemic
           illuminated the need for digital credentials

    • Authors: James Brogan, Henry Goodier, Manreet Nijjar, Christian Rose
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      The current credentialing process for physicians struggled to accommodate fluctuating regional demands for providers during the severe acute respiratory syndrome coronavirus 2 pandemic. This hurdle highlighted existing inefficiencies and difficulties facing healthcare systems across the world and led us to explore how credentialing can be improved using digital technologies. We explain how this is a critical moment to make the shift from physical to digital credentials by specifying how a digital credentialing system could simplify onboarding for providers, enable secure expansion of telehealth services, and enhance information exchange.
      Citation: DIGITAL HEALTH
      PubDate: 2022-03-14T11:41:41Z
      DOI: 10.1177/20552076221084462
      Issue No: Vol. 8 (2022)
       
  • Indoor positioning systems in hospitals: A scoping review

    • Authors: Johannes Wichmann
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      BackgroundIndoor navigation within closed facilities has been subject of studies with different application areas, particularly in recent years (e.g. the navigation requirements of people or the location of objects). Hospitals are of specific interest in this regard as the multitude of technical equipment used is potentially interfering with navigation systems.ObjectiveThis research examines relevant studies regarding Indoor Positioning Systems (IPS) in hospitals and IPS that are designed for hospitals and in preparation for implementation, by investigating the respective technologies, techniques, prediction-improving methods, evaluation results, and limitations of the IPS.MethodsTo gather current and future IPS in hospitals, the methodology of a Scoping Review was used. The study has been conducted by applying the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Framework to the context of IPS in hospitals. The results and limitations concerning current and future IPS in hospitals were gathered and structured by using a highly cited evaluation framework for IPS.ResultsThirty-eight studies were considered for this research. The IPS technologies investigated were Bluetooth Low Energy (n = 17), Wireless-Fidelity (n = 10), Hybrids (n = 4), Radio-Frequency Identification (n = 4), Ultra-Wideband (n = 1), Infrared (n = 1) and ZigBee (n = 1).ConclusionsThis study presents current and future IPS in hospitals. For future IPS research and IPS in hospitals, the theoretical implications contribute to our knowledge about IPS technologies, techniques, prediction-improving methods, evaluation results and limitations during testing/implementing IPS in hospitals. As practical implications, the insights of this study can be used by developers to improve IPS and by hospitals to facilitate IPS implementation.
      Citation: DIGITAL HEALTH
      PubDate: 2022-03-14T02:11:31Z
      DOI: 10.1177/20552076221081696
      Issue No: Vol. 8 (2022)
       
  • Make Movement Your Mission: Evaluation of an online digital health
           initiative to increase physical activity in older people during the
           COVID-19 pandemic

    • Authors: Alessandro Bosco, Lisa McGarrigle, Dawn A. Skelton, R.M.E Laventure, Bex Townley, Chris Todd
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectiveTo formatively evaluate the Make Movement Your Mission (MMYM) digital health initiative to promote physical activity (PA) levels and help avert the negative consequences of sedentary behaviours in older adults during the SARS-CoV2 pandemic.MethodsMixed-method study to explore activity levels, changes in physical function and Activities of Daily Living (ADLs), quality-of-life, social engagement, technology use, and accessibility. Survey data were analysed descriptively. Qualitative interviews were analysed using framework analysis.ResultsForty-one respondents completed the survey (Mean age 68.4 (8.9) years; 34 Female), 68% aged ≥ 65 years. Average attendance was 14.3 sessions per week (3.5 h). 73% had been with MMYM for>1 year, 90% reported they were engaging in more movement on a typical day, and 75% reported improvement in ability to perform moderate PA. Since starting MMYM, participation in activities targeting strength, balance and flexibility increased (by 48%, 73% and 75%, respectively). 83% met strength and 90% balance PA guidelines for health (≥ 2x per week). Between 18% and 53% of respondents reported improvements in ADLs, 53% reported better quality-of-life, and 28% increased use of the internet.Eight participants were interviewed (Mean age 70.7 (6.7) years; 7 Female). Activity levels were promoted by having direct support from the instructor through Facebook messages pre and post live sessions, having group expectation about quality and level of engagement, having a sense of control and encouragement from others, MMYMs regularity, choice around level of engagement and accessibility. Noticing short-term outcomes in balance and posture helped boost confidence and continued participation.ConclusionClinical trials need to robustly assess its effectiveness and acceptability.
      Citation: DIGITAL HEALTH
      PubDate: 2022-03-11T05:21:07Z
      DOI: 10.1177/20552076221084468
      Issue No: Vol. 8 (2022)
       
  • The Ava bracelet for collection of fertility and pregnancy data in
           free-living conditions: An exploratory validity and acceptability study

    • Authors: Alison K. Nulty, Elizabeth Chen, Amanda L. Thompson
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectiveTo evaluate the validity and acceptability of the Ava bracelet for collecting heart rate, sleep, mood, and physical activity data among reproductive-aged women (pregnant and nonpregnant) under free-living conditions.MethodsThirty-three participants wore the Ava bracelet on their non-dominant wrist and reported mood and physical activity in the Ava mobile application for seven nights. Criterion validity was determined by comparing the Ava bracelet heart rate and sleep duration measures to criterion measures from the Polar chest strap and ActiGraph GTX3 + accelerometer. Construct validity was determined by comparing self-report measures and the heart rate variability ratio collected in the Ava mobile application to previously validated measures. Acceptability was evaluated using the modified Acceptability of Health Apps among Adolescents Scale.ResultsMean absolute percentage error was 11.4% for heart rate and 8.5% for sleep duration. There was no meaningful difference between the Ava bracelet, ActiGraph, and construct a measure of sleep quality. Compared to construct measures, Ava bracelet heart rate variability had a significant low negative correlation (r:−0.28), mood had a significant low positive correlation (r : 0.39), and physical activity level had a significant low (rlevel of physical activity: 0.56) to moderate positive correlation (rMET−minutes/week: 0.71). The acceptability of the Ava bracelet was high for fertility and low for pregnancy tracking.ConclusionPreliminary evidence suggests the Ava bracelet and mobile application estimates of sleep and heart rate are not equivalent to criterion measures in free-living conditions. Further research is needed to establish its utility for collecting prospective, subjective data throughout periods of preconception and pregnancy.
      Citation: DIGITAL HEALTH
      PubDate: 2022-03-11T05:20:30Z
      DOI: 10.1177/20552076221084461
      Issue No: Vol. 8 (2022)
       
  • Are caregivers ready for digital' Caregiver preferences for health
           technology tools to monitor medication adherence among patients with
           serious mental illness

    • Authors: Felicia Forma, Kevin Chiu, Jason Shafrin, Dusica Hadzi Boskovic, S Phani Veeranki
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      BackgroundAdherence to antipsychotic medication is critical for bipolar disorder (BPD), major depression (MDD) and schizophrenia (SCZ) patients. Digital tools have emerged to monitor medication adherence along with tracking general health. Evidence on physician or patient preferences for such tools exists but is limited among caregivers. The study objective was to assess preferences and willingness-to-pay (WTP) for medication adherence monitoring tools among caregivers of SMI patients.MethodsA web-based survey was administered to caregivers of adult SMI patients. Twelve discrete choice questions comparing adherence monitoring tools that varied across two attribute bundles: (1) tool attributes including source of medication adherence information, frequency of information updates, access to adherence information, and physical activity, mood, and rest tracking, and (2) caregiver monthly out-of-pocket cost attribute were administered to caregiver respondents. Attributes were parameterized for both digital and non-digital tools. Random utility models were used to estimate caregivers’ preferences and WTP.ResultsAmong 184 study-eligible caregivers, 57, 61 and 66 participants cared for BPD, MDD, and SCZ patients, respectively. Caregivers highly preferred (odds ratio (OR): 7.34, 95% confidence interval (CI): 5.00–10.79) a tool that tracked medication ingestion using a pill embedded with an ingestible event market (IEM) sensor and tracked patients’ physical activity, mood, and rest than a non-digital pill organizer. Additionally, caregivers were willing to pay $255 per month (95% CI: $123–$387) more for this tool compared to a pill organizer.ConclusionCaregivers of SMI patients highly preferred and were willing to pay more for digital tools that not only measures medication ingestion but also tracks general health.
      Citation: DIGITAL HEALTH
      PubDate: 2022-03-10T04:02:50Z
      DOI: 10.1177/20552076221084472
      Issue No: Vol. 8 (2022)
       
  • A fuzzy analytic hierarchy process-enhanced fuzzy geometric mean-fuzzy
           technique for order preference by similarity to ideal solution approach
           for suitable hotel recommendation amid the COVID-19 pandemic

    • Authors: Tin-Chih Toly Chen, Hsin-Chieh Wu, Keng-Wei Hsu
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      Cities around the world have reopened from the lockdown caused by the COVID-19 pandemic, and more and more people are planning regional travel. Therefore, it is a practical problem to recommend suitable hotels to travelers amid the COVID-19 pandemic. However, it is also a challenging task since the critical factors that affect hotel selection amid the COVID-19 pandemic may be different from those usually considered. From this perspective, the fuzzy analytic hierarchy process-enhanced fuzzy geometric mean-fuzzy technique for order preference by similarity to ideal solution approach is proposed in this study for hotel recommendation. The proposed methodology not only considers the critical factors affecting hotel selection amid the COVID-19 pandemic, but also establishes a systematic mechanism, that is, enhanced fuzzy geometric mean, to simultaneously improve the accuracy and efficiency of the recommendation process. The fuzzy analytic hierarchy process-enhanced fuzzy geometric mean-fuzzy technique for order preference by similarity to ideal solution approach has been successfully applied to recommend suitable hotels to 10 travelers for regional trips amid the COVID-19 pandemic.
      Citation: DIGITAL HEALTH
      PubDate: 2022-03-09T10:13:02Z
      DOI: 10.1177/20552076221084457
      Issue No: Vol. 8 (2022)
       
  • A national teledentistry study on the knowledge, attitudes, training and
           practices of private dentists

    • Authors: Nicolas Giraudeau, Mathieu Bauer, Paul Tramini, Camille Inquimbert, Steve Toupenay
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectivesNationally examine the self-perceived knowledge, attitudes and practices of TeleDentistry (TD) among dentists in private practice in France.MethodsA descriptive questionnaire-based survey was conducted nationwide from 10 November 2020 to 13 December 2020. The national scale survey was both anonymous and voluntary and was sent by the National Board of Dentists to 42,464 private dentists that were officially registered in France. The questionnaire included 36 questions divided into various sections: (i) general profile (gender, age range, and university, where respondents completed their dental studies), (ii) general knowledge of telemedicine, and (iii) familiarity with current regulations on telemedicine and activities that qualify as telemedicine.ResultsOnly 57.1% of dentists in private practice stated that they had never heard nor knew about TD (n=2,887). Only 1.5% (n=76) stated they had attended a training module on telemedicine and/or TD during their studies at university. Only 1.3% (n=26) of dentists who practised a TD activity stated that they knew about telemedicine regulations. Only 65.7% (n=2,020) of those who had never practised and 74.8% (n=1,485) who had practised TD acknowledged that they would like to practice TD.ConclusionsIn conclusion, this study found a significant need for TD education and training as well as on regulations. It may be necessary in the future to ensure that all stakeholders in the field of dentistry work together to improve these two topics for dental practitioners. It is also worth noting that TD and telemedicine are public health tools and that they could provide inequitable access to medical care. However, TD must be implemented to decrease inequality and ensure it does not do the opposite.
      Citation: DIGITAL HEALTH
      PubDate: 2022-03-07T10:07:49Z
      DOI: 10.1177/20552076221085069
      Issue No: Vol. 8 (2022)
       
  • Collecting and sharing self-generated health and lifestyle data:
           Understanding barriers for people living with long-term health conditions
           – a survey study

    • Authors: Richard Brown, Lynne Coventry, Elizabeth Sillence, John Blythe, Simone Stumpf, Jon Bird, Abigail C. Durrant
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      BackgroundThe growing popularity of collecting self-generated health and lifestyle data presents a valuable opportunity to develop our understanding of long-term health conditions and improve care. Barriers remain to the effective sharing of health and lifestyle data by those living with long-term health conditions which include beliefs around concepts of Trust, Identity, Privacy and Security, experiences of stigma, perceptions of risk and information sensitivity.MethodWe surveyed 250 UK adults who reported living with a range of long-term health conditions. We recorded data to assess self-reported behaviours, experiences, attitudes and motivations relevant to sharing self-generated health and lifestyle data. We also asked participants about their beliefs about Trust, Identity, Privacy and Security, stigma, and perceptions of risk and information sensitivity regarding their health and lifestyle data.ResultsThree-quarters of our sample reported recording information about their health and lifestyle on a daily basis. However, two-thirds reported never or rarely sharing this information with others. Trust, Identity, Privacy and Security concerns were considered to be ‘very important’ by those with long-term health conditions when deciding whether or not to share self-generated health and lifestyle data with others, with security concerns considered most important. Of those living with a long-term health condition, 58% reported experiencing stigma associated with their condition. The greatest perceived risk from sharing with others was the potential for future harm to their social relationships.ConclusionsOur findings suggest that, in order for health professionals and researchers to benefit from the increased prevalence of self-generated health and lifestyle data, more can be done to address security concerns and to understand perceived risks associated with data sharing. Digital platforms aimed at facilitating the sharing of self-generated health and lifestyle data may look to highlight security features, enable users to control the sharing of certain information types, and emphasise the practical benefits to users of sharing health and lifestyle data with others.
      Citation: DIGITAL HEALTH
      PubDate: 2022-03-07T04:10:24Z
      DOI: 10.1177/20552076221084458
      Issue No: Vol. 8 (2022)
       
  • Virtual reality as a tool to promote wellbeing in the workplace

    • Authors: Jai Shree Adhyaru, Charlotte Kemp
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      BackgroundNHS staff are disproportionately impacted by workplace stress, threatening not only quality of service delivery, but the sustainability, of this vital healthcare system. There is an urgent need for accessible and cost-effective interventions that promote the wellbeing of this integral workforce.AimThe aim of this study was to explore the potential propensity of a short virtual reality (VR) nature experience, delivered during the workday, to induce positive mood states NHS clinicians.MethodNHS clinicians working in a fast-paced trauma service were offered the opportunity to take part in a short virtual reality (VR) relaxation session, during their working day, in which they were able to explore the “Green Meadows” experience available within the Nature Treks application. An indication of physiological arousal (heart rate) was obtained, and subjective measures of emotional state were employed to assess the effect of the intervention on participants’ mood. Further, feedback was gathered to provide an initial indication of the acceptability of the experience.ResultsAnalysis of data from 39 clinicians revealed that, following the VR experience, participants reported significantly increased feelings of happiness (p 
      Citation: DIGITAL HEALTH
      PubDate: 2022-03-04T12:15:45Z
      DOI: 10.1177/20552076221084473
      Issue No: Vol. 8 (2022)
       
  • A new path to address health disparities: How older Aboriginal & Torres
           Strait Islander women use social media to enhance community health
           (Protocol)

    • Authors: Connie Henson, Boe Rambaldini, Bronwyn Carlson, Monika Wadolowski, Carol Vale, Kylie Gwynne
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      BackgroundDigital health offers a fresh avenue to address health disparities experienced by Aboriginal and Torres Strait Islanders. Despite the scant evidence about how Aboriginal and Torres Strait Islanders access and use health technology, the Australian government has prioritised research that uses technology to enable people to manage their health and promote better health outcomes. Older Aboriginal and Torres Strait Islander women are cultural leaders in their communities, enabling them to provide valuable insights about the safety and efficacy of health care messaging. However, no research has engaged older Aboriginal and Torres Strait Islander, women as partners in digital health research.ObjectiveThis paper provides a protocol for co-designed translational research that privileges older Aboriginal & Torres Strait Islander women’s cultural expertise to design and test a framework for accessible, culturally safe and feasible digital health technologies.MethodsThis mixed-methods research project will use the collective impact approach, a user-centred, co-design methodology and yarning circles, a recognised Indigenous research methodology. A series of yarning circles with three different communities will elucidate enablers and barriers to access health information; co-create a framework clarifying what works and does not work for digital health promotion in their communities; and test the framework by co-creating three digital health information programs.ConclusionsPrivileging the cultural expertise of older Aboriginal and Torres Strait Islander women will provide a novel perspective and vital guidance that end users and developers can trust and rely upon to create and evaluate culturally safe and efficacious digital health promotion programs.
      Citation: DIGITAL HEALTH
      PubDate: 2022-03-03T10:16:26Z
      DOI: 10.1177/20552076221084469
      Issue No: Vol. 8 (2022)
       
  • Post-emergency teleconsultations during COVID crisis: TELE-SCOPE tool's
           feedback and epidemiological analysis

    • Authors: Emmanuelle Chavda, Laurence Guedon-Moreau, Lina Williatte, Enrique Cordova
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      IntroductionThe severe acute respiratory syndrome-coronavirus 2 pandemic spread quickly. Health professionals are facing new challenges and looking for new ways to provide care in the context of lockdown and physical distancing. The Saint Vincent de Paul Hospital has leveraged its recent post-emergency teleconsultation solution (TELE-SCOPE), to address some COVID situations. Thanks to the usual follow-up teleconsultation within 24 h after their emergency discharge and the introduction of an additional one six days after, the eligible patients are able to return home earlier. This article provides feedback on how teleconsultation helps manage such a crisis. We also present an analysis of the treated population.Materials and methodsThe study includes the cases of 239 patients presenting symptoms of COVID-19 infection with a COVID score
      Citation: DIGITAL HEALTH
      PubDate: 2022-03-02T12:30:56Z
      DOI: 10.1177/20552076221081689
      Issue No: Vol. 8 (2022)
       
  • Pilot study to evaluate usability and acceptability of the ‘Animated
           Alcohol Assessment Tool’ in Russian primary healthcare

    • Authors: Veronika Wiemker, Anna Bunova, Maria Neufeld, Boris Gornyi, Elena Yurasova, Stefan Konigorski, Anna Kalinina, Anna Kontsevaya, Carina Ferreira-Borges, Charlotte Probst
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      Background and aimsAccurate and user-friendly assessment tools quantifying alcohol consumption are a prerequisite to effective prevention and treatment programmes, including Screening and Brief Intervention. Digital tools offer new potential in this field. We developed the ‘Animated Alcohol Assessment Tool’ (AAA-Tool), a mobile app providing an interactive version of the World Health Organization's Alcohol Use Disorders Identification Test (AUDIT) that facilitates the description of individual alcohol consumption via culturally informed animation features. This pilot study evaluated the Russia-specific version of the Animated Alcohol Assessment Tool with regard to (1) its usability and acceptability in a primary healthcare setting, (2) the plausibility of its alcohol consumption assessment results and (3) the adequacy of its Russia-specific vessel and beverage selection.MethodsConvenience samples of 55 patients (47% female) and 15 healthcare practitioners (80% female) in 2 Russian primary healthcare facilities self-administered the Animated Alcohol Assessment Tool and rated their experience on the Mobile Application Rating Scale – User Version. Usage data was automatically collected during app usage, and additional feedback on regional content was elicited in semi-structured interviews.ResultsOn average, patients completed the Animated Alcohol Assessment Tool in 6:38 min (SD = 2.49, range = 3.00–17.16). User satisfaction was good, with all subscale Mobile Application Rating Scale – User Version scores averaging>3 out of 5 points. A majority of patients (53%) and practitioners (93%) would recommend the tool to ‘many people’ or ‘everyone’. Assessed alcohol consumption was plausible, with a low number (14%) of logically impossible entries. Most patients reported the Animated Alcohol Assessment Tool to reflect all vessels (78%) and all beverages (71%) they typically used.ConclusionHigh acceptability ratings by patients and healthcare practitioners, acceptable completion time, plausible alcohol usage assessment results and perceived adequacy of region-specific content underline the Animated Alcohol Assessment Tool's potential to provide a novel approach to alcohol assessment in primary healthcare. After its validation, the Animated Alcohol Assessment Tool might contribute to reducing alcohol-related harm by facilitating Screening and Brief Intervention implementation in Russia and beyond.
      Citation: DIGITAL HEALTH
      PubDate: 2022-03-01T11:52:56Z
      DOI: 10.1177/20552076211074491
      Issue No: Vol. 8 (2022)
       
  • Ingestible electronic sensors to measure instantaneous medication
           adherence: A narrative review

    • Authors: Peter R Chai, Clint Vaz, Georgia R Goodman, Hannah Albrechta, Henwei Huang, Rochelle K Rosen, Edward W Boyer, Kenneth H Mayer, Conall O’Cleirigh
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectiveMedication nonadherence contributes to significant morbidity and mortality worldwide. While many techniques to measure adherence exist, digital pill systems represent a novel, direct method of measuring adherence and a means of providing instantaneous adherence supports. In this narrative review, we discuss digital pill system research based on clinical trials and qualitative investigations conducted to date and potential future applications of digital pill system in medication adherence measurement.MethodsWe conducted a literature search in PubMed of English language peer-reviewed articles describing the use of digital pill system for medication adherence measurement between 2000 and 2021. We included all articles that described the deployment of ingestible sensors and those involving qualitative investigations of digital pill system with human subjects.ResultsA total of 95 articles were found on initial search; 75 were removed based on exclusion criteria. Included articles were categorized as investigations that deployed an ingestible sensor in human populations (n = 18), or those that conducted qualitative work (n = 3). For pilot studies, the mean accuracy of the sensor to successfully detect a medication ingestion event ranged from 68% to 100%. When digital pill systems were deployed in real-world clinical settings, accuracy ranged from 68% to 90% with lower accuracy due to nonadherence to digital pill system technology. Qualitative studies demonstrated that providers and patients perceive the digital pill system as a facilitator for improving adherence and as a potential platform for delivering adherence interventions. Additionally, ingestion data from digital pill system was viewed as useful in facilitating adherence discussions between clinicians and patients.ConclusionsThis narrative review demonstrates that the use of digital pill system is broadly feasible across multiple disease states including human immunodeficiency virus, hepatitis C infection, solid organ transplants, tuberculosis, schizophrenia, cardiovascular disease, and acute fractures, where adherence is closely linked to significant morbidity and mortality. It also highlights key areas of research that are still needed prior to broad-scale clinical deployment of such systems.
      Citation: DIGITAL HEALTH
      PubDate: 2022-02-28T11:58:27Z
      DOI: 10.1177/20552076221083119
      Issue No: Vol. 8 (2022)
       
  • The “Healthy Meals” web app for the assessment of nutritional content
           and food allergens in restaurant meals: Development, evaluation and
           validation

    • Authors: Floriana Mandracchia, Lucia Tarro, Elisabet Llauradó, Rosa M. Valls, Rosa Solà
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectiveThe development and the evaluation of the Healthy Meals web app designed for professionals from different disciplines related to food, aimed to assess the nutritional and food allergen content of restaurant meals, was described.MethodsApp evaluation concerned: (1) usability, scored on a 7-point scale by 6 restaurateurs and 10 nutritionists through the Computer System Usability Questionnaire; (2) quality, scored on a 5-point scale by 10 nutritionists through the Mobile App Rating Scale; (3) validation, by two nutritionists through differences in entered nutrient contents. Ratings reliability was assessed by the interclass correlation coefficient.ResultsUsers agreed with the web app usability (mean 5.6/7 points, SD 0.9), with moderate reliability among ratings (interclass correlation coefficient = 0.57; 95% CI, 0.18 to 0.82). The web app showed good objective quality (mean 4.0/5 points, SD 0.4), with excellent reliability among nutritionists (interclass correlation coefficient = 0.91; 95% CI, 0.85 to 0.96). For web app validation, no significant differences were observed between the two nutritionists’ data, with excellent reliability (interclass correlation coefficient = 0.98; 95% CI, 0.97 to 0.99). App data entry was identified as a point to improve.ConclusionsThe Healthy Meals web app designed for professionals related to food, such as restaurateurs, demonstrated to be usable, of good quality and valid for dishes nutritional assessment and food allergen identification. Points to improve were identified, while app effectiveness should be tested in trials.
      Citation: DIGITAL HEALTH
      PubDate: 2022-02-28T11:58:22Z
      DOI: 10.1177/20552076221081690
      Issue No: Vol. 8 (2022)
       
  • Co-designing a digital companion with people living with Parkinson's to
           support self-care in a personalized way: The eCARE-PD Study

    • Authors: Sylvie Grosjean, Jean-Luc Ciocca, Amélie Gauthier-Beaupré, Emely Poitras, David Grimes, Tiago Mestre
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      eHealth technologies play a role in the development of integrated care models for people living with Parkinson disease by improving communication with their health care teams and support self-care practices in a personalized way. This article presents a co-design approach to designing an eHealth technology, the eCARE-PD platform, that addresses the needs and expectations of people living with Parkinson disease, generates tailored care tips, and recommends actions for managing care priorities at home. We use a co-design approach involving four main iterative phases: (1) preparation, (2) mapping, (3) testing and using, and (4) co-producing solutions and requirements. This approach uses several methods to engage people directly to design this technology. The study allowed us to identify design principles to be integrated in the development of the eCARE-PD platform. These principles incorporate the expectations of future users, which were expressed during the iterative phases of the co-design process: (a) six key design features based on users’ needs and expectations, (b) six main issues users raised during a test at home and key features for improving the design of the eCARE-PD platform, and (c) collective solutions to design an interactive, meaningful, tailored, empathic, and socially acceptable technology. The results of the successive phases of the co-design process allow us to underline the progressive constitution of a technology defined over successive iterations as a digital companion supporting the self-care process at home and having the capacity to generate tailored digital health communication.
      Citation: DIGITAL HEALTH
      PubDate: 2022-02-25T02:51:46Z
      DOI: 10.1177/20552076221081695
      Issue No: Vol. 8 (2022)
       
  • ‘Using humanity to change systems’ – understanding the work of
           online feedback moderation: A case study of Care Opinion Scotland

    • Authors: Emma Berry, Zoë C Skea, Marion K Campbell, Louise Locock
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectiveTo gain a deeper understanding of online patient feedback moderation through the organisation of Care Opinion in Scotland.MethodsAn ethnographic study, initially using in-person participant observations, switching to remote methods due to the pandemic. This involved the use of remote observations and interviews. Interviews were carried out with the whole Scottish team (n = 8).ResultsOur results identify three major themes of work found in online patient feedback moderation. The first is process work, where moderators make decisions on how to edit and publish stories. The second is emotional labour from working with healthcare experiences and with NHS staff. The third is the brokering/mediation role of Care Opinion, where they must manage the relationships between authors, subscribing healthcare providers and Scottish Government. Our results also capture that these different themes are not independent and can at times influence the others.ConclusionOur results build on previous literature on Care Opinion and provide novel insights into the emotional and brokering/mediation work they undertake. Care Opinion holds a unique position, where they must balance the interests of the key stakeholders. Care Opinion holds the power to amplify authors’ voices but the power to make changes to services lies with NHS staff and services. Online moderation work is complex, and moderators require support to carry out their work especially given the emotional impact. Further research is planned to understand how patient stories are used by NHS Scotland, and the emotional labour involved with stories, from both the author and NHS staff perspective.
      Citation: DIGITAL HEALTH
      PubDate: 2022-02-23T01:42:01Z
      DOI: 10.1177/20552076211074489
      Issue No: Vol. 8 (2022)
       
  • A scoping review of feasibility, cost-effectiveness, access to quality
           rehabilitation services and impact of telerehabilitation: A review
           protocol

    • Authors: Eugene Nizeyimana, Conran Joseph, Quinette A Louw
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      BackgroundTelerehabilitation is an emerging segment of telehealth and telemedicine that has a potential to deliver quality, accessible, cost-effective and efficient rehabilitation services where geographical distance is a critical factor. The objectives of this review are: to describe the feasibility and cost-effectiveness of telerehabilitation, to scope to what extent telerehabilitation has the potential impact on access to quality of rehabilitation services with specific references to low to middle income countries, and to understand key process factors including barriers and facilitators relevant to the implementation of telerehabilitation.MethodsA scoping review of the literature will be conducted. An electronic search literature will be conducted in PubMed, Scopus, Cochrane library, Africa-wide information, CINAHL, MEDLINE, ProQuest, Web of science and reference lists. The review team will develop a data charting form and pilot it on four randomly-selected studies. The form will be refined based on the results of the piloted articles. Studies identified will be screened at the title and abstract levels by the first reviewer, followed by an independent verification for the accuracy and eligibility by two more reviewers prior to obtaining the full texts. Studies to be included must report on feasibility, cost-effectiveness, access to rehabilitation services, implementation process factors including barriers and facilitators of telerehabilitation. The analysis will include both descriptive summary and inductive thematic analysis.ConclusionTelerehabilitation has ability to change the current standard of care and allow for improved access and health outcomes in cost-effective ways, while addressing the scarce and unequal distribution of limited number of healthcare providers especially in low to middle income country settings. Thus, the research findings could be used by different stakeholders including: researchers, clinicians, policy makers, and implementation teams as they determine the appropriate setup for new telerehabilitation programs.
      Citation: DIGITAL HEALTH
      PubDate: 2022-02-23T01:41:45Z
      DOI: 10.1177/20552076211066708
      Issue No: Vol. 8 (2022)
       
  • Physician centricity in the deployment of digital solutions for
           neurological conditions

    • Authors: Graham B Jones, Jason Freeman, Allison Mann, Amit Khanna
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      The widespread deployment of telemedical approaches to managed care during the CoV2 pandemic has provided an opportunity for clinicians to engage in the development and refinement of this mode of delivery. This also represents a pivotal moment to help effect a paradigm shift in how new and more sophisticated digital health services are designed and delivered with the caregiver playing a guiding role. Building on momentum this way can allow the fuller potential of digital health to be realized by focusing on “end user pull” which balances the omnipresent “technology push” of the consumer product and medical device industries. Perhaps nowhere is this more critical than in the care of neurological illnesses where patient–provider interactions must be managed frequently and rely on a complex battery of data measures. The emergent role of the physician-entrepreneur can be envisioned, complimenting established physician-scientist career paths and represents a timely and opportune moment to refine medical education curricula.
      Citation: DIGITAL HEALTH
      PubDate: 2022-02-21T12:34:04Z
      DOI: 10.1177/20552076221081697
      Issue No: Vol. 8 (2022)
       
  • Acceptance and use of telemedicine technology by health professionals:
           Development of a conceptual model

    • Authors: Mohammed Rouidi, Abdelmajid Elouadi, Amine Hamdoune
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      Recent developments in information technology (IT) in health are extended to highly specialized services, an example is telemedicine technology, understood as the use of IT to enable the transfer of medical information for diagnostic purposes, therapeutic and educational. Despite the benefits of implementing such technology, healthcare professionals, as end users, do not fully utilize it. The Technology Acceptance Model (TAM) and the Unified Theory of Acceptance and Use of Technology (UTAUT), are among the models applied to assess and predict the acceptance and use of telemedicine. This article aims to identify the relevant literature related to these two models, to review and summarize the methodologies and results, and propose a conceptual model for the acceptance and use of telemedicine technology by healthcare professionals.
      Citation: DIGITAL HEALTH
      PubDate: 2022-02-21T12:32:59Z
      DOI: 10.1177/20552076221081693
      Issue No: Vol. 8 (2022)
       
  • Digital Health Testbeds in Sweden: An exploratory study

    • Authors: Md Shafiqur Rahman Jabin, Evalill Nilsson, Anna-Lena Nilsson, Patrick Bergman, Päivi Jokela
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectiveThis study explored the Swedish digital health testbeds through the lens of complexity science.MethodsThe purposive sampling was used to identify 38 digital health testbed organizations to conduct interviews in written or audio-conferencing. The interview responses were aggregated and analyzed using thematic analysis. The themes were mainly generated through complexity theory and the principles of complex adaptive systems.ResultsFifteen testbed organizations responded, comprising 13 written responses and two audio-conferencing. Five main theoretical themes were generated: agents and diversity, connections and communication, adaptation and learning, perturbations, and path dependence. Agents and diversity depicted different types of testbeds, stakeholders and innovation, and the primary function and purpose of the testbeds. Various factors enhancing connections and communications among multiple stakeholders were identified, such as the quality of e-health solutions and the 2030 Agenda for Sustainable Development. Some adaptation and learning factors, such as internal reorganization, sharing and creating learning opportunities, and additional funding, guaranteed the sustainability of testbeds. Perturbations were characterized by two factors: non-linear interactions – lack of commitment and transparency in stakeholders' engagement, and uncertainty about testbed definitions and concepts. Path dependence highlighted the importance of history, such as previous positive and negative experiences.ConclusionThis study provided insights into testbeds' organization, their functions, how various aspects were challenged, and how they adapted to overcome and improve the system issues. Identifying the stakeholders and relevant factors, commissioning an evaluation, backing up with a contingency plan, securing adequate funding, and disseminating the findings can improve the testbeds' design and implementation.
      Citation: DIGITAL HEALTH
      PubDate: 2022-02-14T08:36:19Z
      DOI: 10.1177/20552076221075194
      Issue No: Vol. 8 (2022)
       
  • Re-focusing explainability in medicine

    • Authors: Laura Arbelaez Ossa, Georg Starke, Giorgia Lorenzini, Julia E Vogt, David M Shaw, Bernice Simone Elger
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      Using artificial intelligence to improve patient care is a cutting-edge methodology, but its implementation in clinical routine has been limited due to significant concerns about understanding its behavior. One major barrier is the explainability dilemma and how much explanation is required to use artificial intelligence safely in healthcare. A key issue is the lack of consensus on the definition of explainability by experts, regulators, and healthcare professionals, resulting in a wide variety of terminology and expectations. This paper aims to fill the gap by defining minimal explainability standards to serve the views and needs of essential stakeholders in healthcare. In that sense, we propose to define minimal explainability criteria that can support doctors’ understanding, meet patients’ needs, and fulfill legal requirements. Therefore, explainability need not to be exhaustive but sufficient for doctors and patients to comprehend the artificial intelligence models’ clinical implications and be integrated safely into clinical practice. Thus, minimally acceptable standards for explainability are context-dependent and should respond to the specific need and potential risks of each clinical scenario for a responsible and ethical implementation of artificial intelligence.
      Citation: DIGITAL HEALTH
      PubDate: 2022-02-11T04:27:19Z
      DOI: 10.1177/20552076221074488
      Issue No: Vol. 8 (2022)
       
  • COVID-19 infodemic and digital health literacy in vulnerable populations:
           A scoping review

    • Authors: Mohamed-Amine Choukou, Diana C Sanchez-Ramirez, Margriet Pol, Mohy Uddin, Caroline Monnin, Shabbir Syed-Abdul
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      BackgroundPeople from lower and middle socioeconomic classes and vulnerable populations are among the worst affected by the COVID-19 pandemic, thus exacerbating disparities and the digital divide.ObjectiveTo draw a portrait of e-services as a digital approach to support digital health literacy in vulnerable populations amid the COVID-19 infodemic, and identify the barriers and facilitators for their implementation.MethodsA scoping review was performed to gather published literature with a broad range of study designs and grey literature without exclusions based on country of publication. A search was created in Medline (Ovid) in March 2021 and translated to Medline, PsycINFO, Scopus and CINAHL with Full Text (EBSCOhost). The combined literature search generated 819 manuscripts. To be included, manuscripts had to be written in English, and present information on digital intervention(s) (e.g. social media) used to enable or increase digital health literacy among vulnerable populations during the COVID-19 pandemic (e.g. older adults, Indigenous people living on reserve).ResultsFive articles were included in the study. Various digital health literacy-enabling e-services have been implemented in different vulnerable populations. Identified e-services aimed to increase disease knowledge, digital health literacy and social media usage, help in coping with changes in routines and practices, decrease fear and anxiety, increase digital knowledge and skills, decrease health literacy barriers and increase technology acceptance in specific groups. Many facilitators of digital health literacy-enabling e-services implementation were identified in expectant mothers and their families, older adults and people with low-income. Barriers such as low literacy limited to no knowledge about the viruses, medium of contamination, treatment options played an important role in distracting and believing in misinformation and disinformation. Poor health literacy was the only barrier found, which may hinder the understanding of individual health needs, illness processes and treatments for people with HIV/AIDS.ConclusionsThe literature on the topic is scarce, sparse and immature. We did not find any literature on digital health literacy in Indigenous people, though we targeted this vulnerable population. Although only a few papers were included, two types of health conditions were covered by the literature on digital health literacy-enabling e-services, namely chronic conditions and conditions that are new to the patients. Digital health literacy can help improve prevention and adherence to a healthy lifestyle, improve capacity building and enable users to take the best advantage of the options available, thus strengthening the patient’s involvement in health decisions and empowerment, and finally improving health outcomes. Therefore, there is an urgent need to pursue research on digital health literacy and develop digital platforms to help solve current and future COVID-19-related health needs.
      Citation: DIGITAL HEALTH
      PubDate: 2022-02-10T03:31:14Z
      DOI: 10.1177/20552076221076927
      Issue No: Vol. 8 (2022)
       
  • A pilot study using financial transactions’ spatial information to
           define high-risk neighborhoods and distribution pattern of COVID-19

    • Authors: Esmaeil Mohammadi, Mehrdad Azmin, Nima Fattahi, Erfan Ghasemi, Sina Azadnajafabad, Negar Rezaei, Mohammad-Mahdi Rashidi, Mohammad Keykhaei, Hossein Zokaei, Nazila Rezaei, Rosa Haghshenas, Farzad Kaveh, Erfan Pakatchian, Hamidreza Jamshidi, Farshad Farzadfar
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      BackgroundDevelopment of surveillance systems based on big data sources with spatial information is necessitated more than ever during this pandemic. Here, we present our pilot results of a new technique for the incorporation of spatial information of transactions and a vital registry of COVID-19 to evaluate the disease spread.MethodsWe merged two databases of laboratory-confirmed national COVID-19 registry of Iran and financial transactions of point-of-sale devices from February to March 2020 as our training data sources. Spatial information was used for the visualization of maps and movements of sick individuals. We used the point-of-sale devices-related guild to check for the dynamics of financial transactions and effectiveness of quarantines.FindingsIn the study period, 174,428 confirmed cases were in the COVID-19 registry with accompanying transactions information. In total, 13,924,982 financial transactions were performed by them, with a mean of 1.2 per day for each person. All guilds had a decreasing pattern of “risky” transactions except for grocery stores and pharmacies. The latter showed a decreasing pattern by impose of lockdowns. Different cities were the hotspot of disease transmission as many “high-risk” transactions were performed in them, among which Tehran (mainly its central neighborhoods) and southern cities of Lake Urmia predominated. Lockdowns indicated that the disease gradually became less transmissible.InterpretationFinancial transactions can be readily used for epidemics surveillance. Semi real-time results of such iterations can be informative for policy makers, guild owners, and general population to prepare safer commuting and merchandise spaces.
      Citation: DIGITAL HEALTH
      PubDate: 2022-02-09T01:30:34Z
      DOI: 10.1177/20552076221076252
      Issue No: Vol. 8 (2022)
       
  • Mobile phone apps for family caregivers: A scoping review and qualitative
           content analysis

    • Authors: Jamie Yea Eun Park, Christopher Shawn Tracy, Carolyn Steele Gray
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      BackgroundThe growth of mHealth apps has been exponential in recent years, but there is limited knowledge regarding the availability, functionality, and quality of apps to support family caregivers. Our objectives were to identify the apps currently available to support family caregivers and to analyze the app functions and evaluation claims.MethodsThis scoping review was conducted across the iOS, Android, and Windows Phone app stores in three steps: (1) electronic app search; (2) iterative inclusion and exclusion criteria development; (3) mixed-method analysis of app characteristics and evaluation claims.ResultsThe search identified 1008 apps; 175 met our inclusion/exclusion criteria. Most apps offered either one (36%, 63/175) or two (41%, 71/175) specific functions, the most common of which were access to service and provider directories, providing patient-caring tips, and tools to facilitate daily activities associated with caring for a loved one. For fully two-thirds (67%, 118/175) of the identified apps, the functions serve to assist caregivers to support the care recipient as opposed to supporting the family caregivers themselves.ConclusionsThe findings of this review indicate that, while a wide range of family caregiver apps are now available across the mHealth landscape, most apps offer limited functionality. Therefore, there is a need for multi-functionality to avoid the inherent challenges that caregivers may experience when navigating and managing multiple apps to meet all their various needs. Moreover, as this specific niche continues to develop, greater attention should be devoted to supporting family caregivers’ own personal care needs as caregiver burden is a pressing challenge.
      Citation: DIGITAL HEALTH
      PubDate: 2022-02-08T04:53:38Z
      DOI: 10.1177/20552076221076672
      Issue No: Vol. 8 (2022)
       
  • Exploring healthcare professionals’ perceptions of artificial
           intelligence: Piloting the Shinners Artificial Intelligence Perception
           tool

    • Authors: Lucy Shinners, Sandra Grace, Stuart Smith, Alexandre Stephens, Christina Aggar
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectiveThere is an urgent need to prepare the healthcare workforce for the implementation of artificial intelligence (AI) into the healthcare setting. Insights into workforce perception of AI could identify potential challenges that an organisation may face when implementing this new technology. The aim of this study was to psychometrically evaluate and pilot the Shinners Artificial Intelligence Perception (SHAIP) questionnaire that is designed to explore healthcare professionals’ perceptions of AI. Instrument validation was achieved through a cross-sectional study of healthcare professionals (n = 252) from a regional health district in Australia.Methods and ResultsExploratory factor analysis was conducted and analysis yielded a two-factor solution consisting of 10 items and explained 51.7% of the total variance. Factor one represented perceptions of ‘Professional impact of AI’ (α = .832) and Factor two represented ‘Preparedness for AI’ (α = .632). An analysis of variance indicated that ‘use of AI’ had a significant effect on healthcare professionals’ perceptions of both factors. ‘Discipline’ had a significant effect on Allied Health professionals’ perception of Factor one and low mean scale score across all disciplines suggests that all disciplines perceive that they are not prepared for AI.ConclusionsThe results of this study provide preliminary support for the SHAIP tool and a two-factor solution that measures healthcare professionals’ perceptions of AI. Further testing is needed to establish the reliability or re-modelling of Factor 2 and the overall performance of the SHAIP tool as a global instrument.
      Citation: DIGITAL HEALTH
      PubDate: 2022-02-07T09:51:15Z
      DOI: 10.1177/20552076221078110
      Issue No: Vol. 8 (2022)
       
  • Rise of teledermatology in the COVID-19 era: A pan-world perspective

    • Authors: Piyu Parth Naik
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectiveDuring the coronavirus disease pandemic, enforced restrictions prevented face-to-face consultations for patients requiring non-emergency medical treatment. In response, there was a rise in telemedical practices, such as teledermatology. This study aimed at understanding the pan-world experiences of patients and healthcare staff who adapted to teledermatology in the coronavirus disease era.MethodsThis study made use of an online survey presented to dermatology professionals using social media and WhatsApp groups. Professionals who applied teledermatology between March and June 2020 were targeted. The survey was designed to identify respondent demographics and the preferred platforms for digital consultations. The most common diagnoses and rates of referral for further evaluation were recorded. Lastly, a platform was provided for practitioners to report their own and their patient's perspectives on the advantages and operational challenges of teledermatology. Data were collated and analyzed in Microsoft Excel.ResultsIn total, 653 stakeholders participated, representing countries worldwide. Facebook and WhatsApp services were the most popular mediums of digital consultation. Diagnoses of ailments, such as acne and eczema, as well as skin-related infections, were most common. Of the cases referred for biopsy, 10 patients were subsequently diagnosed with cutaneous malignancies. Practitioners and patients not only reported personal benefit from adopting teledermatology, but also reported concerns regarding data privacy and the levels of technological literacy required.ConclusionsTeledermatology proved an innovative clinical response to unprecedented challenges. However, further policy development and technological advancement aimed at increasing the diagnostic power of digital consultations are needed to support the continuation of teledermatology in the post-pandemic world.
      Citation: DIGITAL HEALTH
      PubDate: 2022-02-07T09:50:46Z
      DOI: 10.1177/20552076221076671
      Issue No: Vol. 8 (2022)
       
  • Patients’ acceptance of video consultations in the mental health
           services: A systematic review and synthesis of qualitative research

    • Authors: Anne Marie Moeller, Lone F. Christensen, Jens Peter Hansen, Pernille T. Andersen
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      BackgroundClinical effectiveness of video consultations in the mental health services is comparable with in-person consultations. Acceptance has typically been rated in surveys that do not give a deeper understanding behind the phenomenon. The aim of this synthesis is to explore mental health patients’ perceptions of factors that influence their acceptance of video consultations viewed from the perspective of the patient.MethodsA literature search in scientific databases was conducted. Peer-reviewed reports of qualitative research exploring patients’ experiences with video consultations from the patients’ perspectives were included. Then a meta-summary and a taxonomic analysis were conducted.ResultsA total of 11 reports met the inclusion criteria. Through the analysis, a model was generated with five factors that precede each other and interact with each other. Patients thought video consultations were acceptable when (1) they experienced barriers and inconvenience to accessing the location of services, (2) they had already established a trustful relationship with their therapist, (3) technical interferences were minor and problems were resolved quickly, (4) patients expected a less personal meeting, and (5) the degree of the patients’ issues were less complex.DiscussionThis model is intended to help clinicians identify circumstances where offering video consultations make best sense to patients and help sustain meaningful use prospectively. When patients encounter barriers to in-person services, clinicians should consider offering video consultations when the technology is adequately integrated in practice, and it is perceived not to intervene with treatment or the therapeutic process.
      Citation: DIGITAL HEALTH
      PubDate: 2022-02-07T09:48:45Z
      DOI: 10.1177/20552076221075148
      Issue No: Vol. 8 (2022)
       
  • Developing and validating a new scale to measure the acceptability of
           health apps among adolescents

    • Authors: Elizabeth Chen, Kathryn E. Moracco, Kirsten Kainz, Kathryn E. Muessig, Deborah F. Tate
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      BackgroundThe acceptability of health interventions is centrally important to achieving their desired health outcomes. The construct of acceptability of mobile health interventions among adolescents is neither well-defined nor consistently operationalized.ObjectivesBuilding on the theoretical framework of acceptability, these two studies developed and assessed the reliability and validity of a new scale to measure the acceptability of mobile health applications (“apps”) among adolescents.MethodsWe followed a structured scale development process including exploratory factor analyses (EFAs), confirmatory factor analyses (CFAs), and employed structural equation modeling (SEM) to assess the relationship between the scale and app usage. Adolescent participants used the Fooducate healthy eating app and completed the acceptability scale at baseline and one-week follow-up.ResultsEFA (n = 182) determined that the acceptability of health apps was a multidimensional construct with six latent factors: affective attitude, burden, ethicality, intervention coherence, perceived effectiveness, and self-efficacy. CFA (n = 161) from the second sample affirmed the six-factor structure and the unidimensional structures for each of the six subscales. However, CFA did not confirm the higher-order latent factor model suggesting that the six subscales reflect unique aspects of acceptability. SEM indicated that two of the subscales—ethicality and self-efficacy—were predictive of health app usage at one-week follow-up.ConclusionsThese results highlight the importance of ethicality and self-efficacy for health app acceptability. Future research testing and adapting this new acceptability scale will enhance measurement tools in the fields of mobile health and adolescent health.
      Citation: DIGITAL HEALTH
      PubDate: 2022-02-07T09:48:29Z
      DOI: 10.1177/20552076211067660
      Issue No: Vol. 8 (2022)
       
  • Social media-based intervention to promote HBV screening and liver cancer
           prevention among Korean Americans: Results of a pilot study

    • Authors: Y. Alicia Hong, Soo Yee, Pramita Bagchi, Hee-soon Juon, Sojung Claire Kim, Daisy Le
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectiveIn United States, Asian Americans are 10 times more likely to have hepatitis B virus (HBV) infection than Whites. Asian immigrants with limited English proficiency face extra barriers to HBV screening and many are unaware of the infectious status. This study aimed to evaluate a social media-based intervention to promote HBV screening and liver cancer prevention among Korean Americans (KA) with limited English proficiency.MethodsOur community-academia partnership developed the “Lets talk about liver cancer” mHealth program by adapting a CDC media campaign. The program consisted of culturally tailored short video clips and pictorial messages and was delivered over 4 weeks to the participants via the popular Korean social media app, Kakao Talk. A total 100 KA living in greater Washington DC metropolitan were recruited via social media networks and completed this pre-post pilot study.ResultsOut of the 100 participants of KA, 56 were female, mean age was 60, and most have lived in the U.S. for more than 20 years, 84% had limited English proficiency, and 21% had a family history of HBV infection or liver cancer. After 4-week intervention, 95% completed the follow-up survey. Participants reported significant improvements in HBV-related knowledge, liver cancer prevention knowledge, perceived benefits of HBV testing, perceived risks of HBV infection, injunctive norms of HBV testing, and self-efficacy of HBV testing.ConclusionsThe Kakao Talk-based liver cancer prevention program for KAs was feasible and effective. We advocate for community-academia partnership to develop and implement culturally appropriate and social media-based interventions for underserved immigrants.
      Citation: DIGITAL HEALTH
      PubDate: 2022-02-04T12:37:47Z
      DOI: 10.1177/20552076221076257
      Issue No: Vol. 8 (2022)
       
  • A mobile app for home-based exercise in spinal cord injured persons:
           Proposal and pilot study

    • Authors: Emiliana Bizzarini, Luca Chittaro, Mauro Frezza, Marika Polo, Cristina Malisan, Rachele Menosso, Agostino Zampa
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      Background and ObjectiveTo preserve cardiovascular health in persons with spinal cord injury (SCI), it is important to promote physical activity programs adapted to them. Home-based exercise programs allow patients to perform clinician-prescribed physical activity without going to a hospital. However, they make it difficult for the clinician to guide and monitor the patient. To face this issue, this paper proposes a novel smartphone-based mobile application (Fisiofriend), and evaluates its feasibility with a pilot study in a real clinical intervention.MethodsFourteen SCI male subjects were involved in a 6-weeks home-based intervention, based on upper limbs exercises: 7 subjects (APP group) used Fisiofriend, and 7 subjects used traditional pictorial instructions on paper (PAPER group). At the beginning (t1) and end (t2) of the study period, we measured: (i) biceps and triceps brachii strength and endurance parameters with an isokinetic dynamometer (Biodex System 4), (ii) O2 maximal consumption with a crank ergometer stress test (VO2000, Medgraphics). Moreover, we collected subjective data about subjects’ perception of the support (app or paper) in the home-based program.ResultsPhysiological results were encouraging for both groups. Questionnaire data suggests a possible advantage of the app in terms of pleasantness, engagement and perception of positive effects. Practical clinical experience with the subjects and their informal reports highlighted which features of the app could be of particular benefit in real interventions, as we discuss in the paper.ConclusionsThe study showed the feasibility of using a mobile app in home-based exercise programs involving SCI patients. We discuss implications of introducing such kind of apps into clinical practice.
      Citation: DIGITAL HEALTH
      PubDate: 2022-02-03T07:33:57Z
      DOI: 10.1177/20552076211070724
      Issue No: Vol. 8 (2022)
       
  • Integration of new digital antenatal care tools using the WHO SMART
           guideline approach: Experiences from Rwanda and Zambia

    • Authors: Rosemary Muliokela, Gilbert Uwayezu, Candide Tran Ngoc, María Barreix, Tigest Tamrat, Andrew Kashoka, Caren Chizuni, Muyereka Nyirenda, Natschja Ratanaprayul, Sarai Malumo, Vincent Mutabazi, Garrett Mehl, Edith Munyana, Felix Sayinzoga, Özge Tunçalp
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectivesDigital tools for decision-support and health records can address the protracted process of guideline adoption at local levels and accelerate countries’ implementation of new health policies and programmes. World Health Organization (WHO) launched the SMART Guidelines approach to support the uptake of clinical, public health, and data recommendations within digital systems. SMART guidelines are a package of tools that include Digital Adaptation Kits (DAKs), which distill WHO guidelines into a format that facilitates translation into digital systems. SMART Guidelines also include reference software applications known as digital modules.MethodsThis paper details the structured process to inform the adaptation of the WHO antenatal care (ANC) digital module to align with country-specific ANC packages for Zambia and Rwanda using the DAK. Digital landscape assessments were conducted to determine potential integrations between the ANC digital module and existing systems. A multi-stakeholder team consisting of Ministry of Health technical officers representing maternal health, HIV, digital health, and monitoring and evaluation at district and national levels was assembled to review existing guidelines to adapt the DAK.ResultsThe landscape analysis resulted in considerations for integrating the ANC module into the broader digital ecosystems of both countries. Adaptations to the DAK included adding national services not reflected in the generic DAK and modification of decision support logic and indicators. Over 80% of the generic DAK content was consistent with processes for both countries. The adapted DAK will inform the customization of country-specific ANC digital modules.ConclusionBoth countries found that coordination between maternal and digital health leads was critical to ensuring requirements were accurately reflected within the ANC digital module. Additionally, DAKs provided a structured process for gathering requirements, reviewing and addressing gaps within existing systems, and aligning clinical content.
      Citation: DIGITAL HEALTH
      PubDate: 2022-02-02T05:37:32Z
      DOI: 10.1177/20552076221076256
      Issue No: Vol. 8 (2022)
       
  • Virtual Care Access and Health Equity during the COVID-19 Pandemic, a
           qualitative study of patients with chronic diseases from Canada

    • Authors: Sophy Chan-Nguyen, Benjamin Ritsma, Lisa Nguyen, Siddhartha Srivastava, Garima Shukla, Ramana Appireddy
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectivesThe COVID-19 pandemic has led to the widespread uptake of virtual care in Canada; however, virtual care may also create new barriers to health care. The purpose of this paper was to explore patient perceptions and concerns around virtual care access.MethodsBetween February and April 2020, we conducted semi-structured interviews with participants from four chronic disease clinics (stroke, epilepsy, amyotrophic lateral sclerosis, obstetrics medicine) in a mid-sized academic hospital in Southern Ontario, Canada. Consecutive sampling was done by including the patients receiving virtual care in those months. Caregivers were invited to participate in the event that patients were unable to participate in the interview. Thematic analysis was employed to identify overarching themes, and codes were reviewed and refined using a consensus process.ResultsWe interviewed 31 participants (27 patients, four caregivers) that had taken part in virtual care. Our findings suggested that the COVID-19 pandemic served to isolate participants and had negatively impacted their access to health care. However, virtual care did provide a safe avenue for patients to receive care and served as a reassuring option during the pandemic. Low technological literacy and access were identified as barriers to virtual care. Greater awareness and patient engagement is needed in future research to improve access.ConclusionCertain populations can be disproportionately affected by differential access to virtual care. Future studies should examine how social determinants intersect to impact virtual health care access in different patient populations.
      Citation: DIGITAL HEALTH
      PubDate: 2022-02-01T02:06:52Z
      DOI: 10.1177/20552076221074486
      Issue No: Vol. 8 (2022)
       
  • The role of age and digital competence on the use of online health and
           social care services: A cross-sectional population-based survey

    • Authors: T Heponiemi, A-M Kaihlanen, A Kouvonen, L Leemann, S Taipale, K Gluschkoff
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectiveOnline health and social care services are getting widespread which increases the risk that less advantaged groups may not be able to access these services resulting in digital exclusion. We examined the combined effects of age and digital competence on the use of online health and social care services.MethodsWe used a large representative population-based sample of 4495 respondents from Finland. Paper-based self-assessment questionnaire with an online response option was mailed to participants. The associations were analyzed using survey weighted logistic regression, exploring potential non-linear effects of age and controlling for potential sex differences.ResultsHigher age, starting from around the age of 60 was associated with a lower likelihood of using online services for receiving test results, renewing prescriptions and scheduling appointments. Good digital competence was able to hinder the age-related decline in online services use, but only up to around the age of 80.ConclusionsOur results suggest that older adults are at risk of digital exclusion, and not even good digital competence alleviates this risk among the oldest. We suggest that health and social care providers should consider older users’ needs and abilities more thoroughly and offer easy to use online services. More digital support and training possibilities should be provided for older people. It is equally important that face-to-face and telephone services will be continued to be provided for those older people who are not able to use online services even when supported.
      Citation: DIGITAL HEALTH
      PubDate: 2022-01-28T08:52:07Z
      DOI: 10.1177/20552076221074485
      Issue No: Vol. 8 (2022)
       
  • Comparison of the effectiveness of an e-health program versus a home
           rehabilitation program in patients with chronic low back pain: A double
           blind randomized controlled trial

    • Authors: Inmaculada Carmen Lara-Palomo, Eduardo Antequera-Soler, Guillermo A Matarán-Peñarrocha, Manuel Fernández-Sánchez, Héctor García-López, Adelaida María Castro-Sánchez, María Encarnación Aguilar-Ferrándiz
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjetiveWe conducted a randomized double blind clinical trial, to compare the effectiveness of McKenzie exercises and electroanalgesia via an e-Health program versus a home rehabilitation program on functionality, pain, fear of movement and quality of life in patients with non-specific chronic low back pain.MethodsSeventy-four participants with non-specific chronic low back pain were randomized to either the e- Health program group (n = 39) or the home rehabilitation program group (n = 35). The interventions consisted of the e-Health program group performing McKenzie exercises and received transcutaneous electrical nerve stimulation, while the home rehabilitation group attended an information session to explain the exercises, which they then performed at home with printed instructions. Both groups performed 3 weekly sessions for 8 weeks. The following were analyzed main measures: pain, disability, fear of movement, quality of life, trunk muscle endurance and trunk anteflexion motion were assessed at baseline and at 2 months.ResultsIndependent samples Student’s t-tests showed that although the patients who followed the e-Health program showed significantly greater improvement than those who followed the home disability rehabilitation program in terms of intensity of pain, lumbar flexion mobility (P 
      Citation: DIGITAL HEALTH
      PubDate: 2022-01-28T02:08:34Z
      DOI: 10.1177/20552076221074482
      Issue No: Vol. 8 (2022)
       
  • CNN-based severity prediction of neurodegenerative diseases using gait
           data

    • Authors: Çağatay Berke Erdaş, Emre Sümer, Seda Kibaroğlu
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      Neurodegenerative diseases occur because of degeneration in brain cells but can manifest as impairment of motor functions. One of the side effects of this impairment is an abnormality in walking. With the development of sensor technologies and artificial intelligence applications in recent years, the disease severity of patients can be estimated using their gait data. In this way, decision support applications for grading the severity of the disease that the patient suffers in the clinic can be developed. Thus, patients can have treatment methods more suitable for the severity of the disease. The presented research proposes a deep learning-based approach using gait data represented by a Quick Response code to develop an effective and reliable disease severity grading system for neurodegenerative diseases such as amyotrophic lateral sclerosis, Huntington’s disease, and Parkinson’s disease. The two-dimensional Quick Response data set was created by converting each one-dimensional gait data of the subjects with a novel representation approach to a Quick Response code. This data set was regressed with the convolutional neural network deep learning method, and a solution was sought for the problem of grading disease severity. Further, to demonstrate the success of the results obtained with the novel approach, native machine learning approaches such as Multilayer Perceptron, Random Forest, Extremely Randomized Trees, and K-Nearest Neighbours, and ensemble machine learning methods, such as voting and stacking, were applied on one-dimensional data. Finally, the results obtained on the prediction of disease severity by testing one-dimensional gait data with a convolutional neural network architecture that operates on one-dimensional data were included. The results showed that, in most cases, the two-dimensional convolutional neural network approach performed the best among all methods.
      Citation: DIGITAL HEALTH
      PubDate: 2022-01-27T01:39:27Z
      DOI: 10.1177/20552076221075147
      Issue No: Vol. 8 (2022)
       
  • The application of artificial intelligence and custom algorithms with
           inertial wearable devices for gait analysis and detection of gait-altering
           pathologies in adults: A scoping review of literature

    • Authors: Ashley Cha Yin Lim, Pragadesh Natarajan, R Dineth Fonseka, Monish Maharaj, Ralph J Mobbs
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      BackgroundThe purpose of this scoping review was to explore the current applications of objective gait analysis using inertial measurement units, custom algorithms and artificial intelligence algorithms in detecting neurological and musculoskeletal gait altering pathologies from healthy gait patterns.MethodsLiterature searches were conducted of four electronic databases (Medline, PubMed, Embase and Web of Science) to identify studies that assessed the accuracy of these custom gait analysis models with inputs derived from wearable devices. Data was collected according to the preferred reporting items for systematic reviews and meta-analysis statement guidelines.ResultsA total of 23 eligible studies were identified for inclusion in the present review, including 10 custom algorithms articles and 13 artificial intelligence algorithms articles. Nine studies evaluated patients with Parkinson’s disease of varying severity and subtypes. Support vector machine was the commonest adopted artificial intelligence algorithm model, followed by random forest and neural networks. Overall classification accuracy was promising for articles that use artificial intelligence algorithms, with nine articles achieving more than 90% accuracy.ConclusionsCurrent applications of artificial intelligence algorithms are reasonably effective discrimination between pathological and non-pathological gait. Of these, machine learning algorithms demonstrate the additional capacity to handle complicated data input, when compared to other custom algorithms. Notably, there has been increasing application of machine learning algorithms for conducting gait analysis. More studies are needed with unsupervised methods and in non-clinical settings to better reflect the community and home-based usage.
      Citation: DIGITAL HEALTH
      PubDate: 2022-01-27T01:39:08Z
      DOI: 10.1177/20552076221074128
      Issue No: Vol. 8 (2022)
       
  • The feasibility and acceptability of digital technology for health and
           wellbeing in social housing residents in Cornwall: A qualitative scoping
           study

    • Authors: Sarah Ann Buckingham, Tim Walker, Karyn Morrissey
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectiveThe aim of this study was to explore the feasibility and acceptability of digital technology for improving health and wellbeing in social housing residents living in a deprived area in Cornwall, England.MethodsQualitative scoping study with focus groups and telephone interviews (23 participants in total). Focus groups and interviews were audio-recorded, transcribed verbatim and analysed thematically.ResultsLevels of use and experience with digital technology were diverse in this group, ranging from ‘willing and unable’ to ‘expert’ on a self-perceived scale. Overall, participants had positive perceptions of technology and were keen to try new technologies. Five categories of factors influencing technology use were identified: functional, physical / health, psychological and attitudinal, technology-associated barriers, and privacy, safety and security. Preferred types of digital technology were wearable activity monitors (e.g. Fitbit®), virtual assistants (e.g. Amazon Alexa) and social messaging (e.g. WhatsApp). There was a strong consensus that technology should be easy to use and should have a clear purpose. There was a need to improve awareness, knowledge and confidence in technology use and participants desired further training and support.ConclusionsThere is a need and desire to use digital technology to improve health, wellbeing and social connectedness in social housing residents in Cornwall. The findings will be used to inform a digital training and support programme for the participants of the Smartline project. This study also serves as a template for future research that seeks to scope the feasibility and acceptability of different digital interventions in similar populations.
      Citation: DIGITAL HEALTH
      PubDate: 2022-01-24T03:37:26Z
      DOI: 10.1177/20552076221074124
      Issue No: Vol. 8 (2022)
       
  • A unified health algorithm that teaches itself to improve health outcomes
           for every individual: How far into the future is it'

    • Authors: Gaurav Laroia, Benjamin D Horne, Sean Esplin, Vasant K Ramaswamy
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      The single biggest factor driving health outcomes is patient behavior. The CHR Model (County Health Rankings Model) weights socioeconomic factors, lifestyle behaviors, and physical environment factors collectively at 80% in driving impact on health outcomes, to the 20% weight for access to and quality of clinical care. Commercial determinants of health affect everyone today and unhealthy choices worsen pre-existing economic, social, and racial inequities. Yet there is a disproportionate focus on therapeutic intervention to the exclusion of shaping patient behaviors to improve healthcare. If the recent pandemic taught us a critically important lesson, it is the imperative to look beyond clinical care. According to the Centers for Disease Control and Prevention (CDC), long-standing systemic health and social inequities put various groups of people at higher risk of getting sick and dying from COVID-19, including many racial and ethnic minority groups. The virus was simply more efficient in detecting such vulnerabilities than the guardians of these physiologies. These insights from the pandemic come at the heel of a confluence of three major accelerants that may radically reshape our approaches to hot-spotting vulnerabilities and managing them before they manifest in a derangement or disease. They are the recent strides in behavioral economics and behavior science; advances in remote monitoring and personal health technologies; and developments in artificial intelligence and data sciences. These accelerants allow us to imagine a previously impossible vision—we can now build and maintain a unified health algorithm for every individual that can dynamically track the two interdependent streams of risk, clinical and behavioral.
      Citation: DIGITAL HEALTH
      PubDate: 2022-01-21T12:29:52Z
      DOI: 10.1177/20552076221074126
      Issue No: Vol. 8 (2022)
       
  • Risk-standardized sepsis mortality map of the United States

    • Authors: Jiun-Ruey Hu, Chia-Hung Yo, Hsin-Ying Lee, Chin-Hua Su, Ming-Yang Su, Amy Huaishiuan Huang, Ye Liu, Wan-Ting Hsu, Matthew Lee, Yee-Chun Chen, Chien-Chang Lee
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectiveSepsis is the leading cause of in-hospital mortality in the United States (US). Quality improvement initiatives for improving sepsis care depend on accurate estimates of sepsis mortality. While hospital 30-day risk-standardized mortality rates have been published for patients hospitalized with acute myocardial infarction, heart failure, and pneumonia, risk-standardized mortality rates for sepsis have not been well characterized. We aimed to construct a sepsis risk-standardized mortality rate map for the United States, to illustrate disparities in sepsis care across the country.MethodsThis cross-sectional study included adults from the US Nationwide Inpatient Sample who were hospitalized with sepsis between 1 January 2010 and 30 December 2011. Hospital-level risk-standardized mortality rates were calculated using hierarchical logistic modelling, and were risk-adjusted with predicted mortality derived from (1) the Sepsis Risk Prediction Score, a logistic regression model, and (2) gradient-boosted decision trees, a supervised machine learning (ML) algorithm.ResultsAmong 1,739,033 adults hospitalized with sepsis, 50% were female, and the median age was 71 years (interquartile range: 58–81). The national median risk-standardized mortality rate for sepsis was 18.4% (interquartile range: 17.0, 21.0) by the boosted tree model, which had better discrimination than the Sepsis Risk Prediction Score model (C-statistic 0.87 and 0.78, respectively). The highest risk-standardized mortality rates were found in Wyoming, North Dakota, and Mississippi, while the lowest were found in Arizona, Colorado, and Michigan.ConclusionsWide variation exists in sepsis risk-standardized mortality rates across states, representing opportunities for improvement in sepsis care. This represents the first map of state-level variation of risk-standardized mortality rates in sepsis.
      Citation: DIGITAL HEALTH
      PubDate: 2022-01-20T12:59:41Z
      DOI: 10.1177/20552076211072400
      Issue No: Vol. 8 (2022)
       
  • Smart health via mHealth' Potentials of mobile health apps for
           improving prevention and adherence of breast cancer patients

    • Authors: Stefanie Scholz, Laura Teetz
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectiveToday there are several health and medical apps (mHealth) in app stores. Germany is the world's first country that introduced apps paid by the regular health insurance service. Even though breast cancer is the most common cancer in women, mHealth for breast cancer has been largely unexplored.MethodsA total of 33 apps from two major mobile application marketplaces (Google Play Store/Android; App Store/iOS) have been selected for analysis.ResultsThe app analysis shows that there are currently only 10 mHealth apps in German, which are specifically dedicated to breast cancer patients. The features of these apps fall into two categories: improvement of health literacy and indirect intervention. These apps can be used for all phases of the patient journey starting with the diagnosis.ConclusionsmHealth apps have the potential to support the adherence of breast cancer patients. In order to exploit this future potential, the app quality, as well as the information about the available apps, must be urgently improved. Currently, it is very difficult both for laypersons and for doctors/other therapists to identify high-quality apps. Guidance from independent or governmental institutions would be helpful to further the digitalization in health care.
      Citation: DIGITAL HEALTH
      PubDate: 2022-01-20T12:23:34Z
      DOI: 10.1177/20552076221074127
      Issue No: Vol. 8 (2022)
       
  • Online Public Attention of COVID-19 Vaccination in Mainland China

    • Authors: Lisha Jiang, Qingxin Ma, Shanzun Wei, Guowei Che
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      With the approval of the vaccine in mainland China, concerns over its safety and efficacy emerged. Since the Chinese vaccine has been promoted by the Chinese government for months and got emergency approval from the World Health Organization. The Chinese vaccination program is yet to be identified from the perspective of local populations. The COVID-19 vaccine-related keywords for the period from January 2019 to April 2021 were examined and queried from the Baidu search index. The searching popularity, searching trend, demographic distributions and users’ demand were analyzed. The first vaccine enquiry emerged on 25th January 2020, and 17 vaccination keywords were retrieved and with a total BSI value of 13,708,853. The average monthly searching trend growth is 21.05% (p 
      Citation: DIGITAL HEALTH
      PubDate: 2022-01-20T01:00:11Z
      DOI: 10.1177/20552076211070454
      Issue No: Vol. 8 (2022)
       
  • Digitally enabled flash glucose monitoring for inpatients with COVID-19:
           

    • Authors: Tim Robbins, Adam Hopper, Jack Brophy, Elle Pearson, Risheka Suthantirakumar, Maariyah Vankad, Natalie Igharo, Sud Baitule, Cain CT Clark, Theodoros N Arvanitis, Sailesh Sankar, Ioannis Kyrou, Harpal Randeva
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      BackgroundCOVID-19 placed significant challenges on healthcare systems. People with diabetes are at high risk of severe COVID-19 with poor outcomes. We describe the first reported use of inpatient digital flash glucose monitoring devices in a UK NHS hospital to support management of people with diabetes hospitalized for COVID-19.MethodsInpatients at University Hospitals Coventry & Warwickshire (UHCW) NHS Trust with COVID-19 and diabetes were considered for digitally enabled flash glucose monitoring during their hospitalization. Glucose monitoring data were analysed, and potential associations were explored between relevant parameters, including time in hypoglycaemia, hyperglycaemia, and in range, glycated haemoglobin (HbA1c), average glucose, body mass index (BMI), and length of stay.ResultsDuring this pilot, digital flash glucose monitoring devices were offered to 25 inpatients, of whom 20 (type 2/type 1: 19/1; mean age: 70.6 years; mean HbA1c: 68.2 mmol/mol; mean BMI: 28.2 kg/m2) accepted and used these (80% uptake). In total, over 2788 h of flash glucose monitoring were recorded for these inpatients with COVID-19 and diabetes. Length of stay was not associated with any of the studied variables (all p-values>0.05). Percentage of time in hyperglycaemia exhibited significant associations with both percentage of time in hypoglycaemia and percentage of time in range, as well as with HbA1c (all p-values
      Citation: DIGITAL HEALTH
      PubDate: 2022-01-07T10:22:55Z
      DOI: 10.1177/20552076211059350
      Issue No: Vol. 8 (2022)
       
  • Promise and peril-defining ethical telehealth practice from the clinician
           and patient perspective: A qualitative study

    • Authors: Amanda Jane Keenan, George Tsourtos, Jennifer Tieman
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      ObjectivesWe undertook a qualitative study to examine and compare the experience of ethical principles by telehealth practitioners and patients in relation to service delivery theory. The study was conducted prior to and during the recent global increase in the use of telehealth services due to the COVID-19 pandemic,MethodsWe conducted semi-structured interviews with 20 telehealth practitioners and patients using constructionist grounded theory methods to collect and analyse data. Twenty-five axial coded data categories were then unified and aligned through selective coding with the Beauchamp and Childress (2013) framework of biomedical ethics. The groups were then compared.ResultsThirteen categories aligned to the ethical framework were identified for practitioners and 12 for patients. Variance existed between the groups. Practitioner results were non-maleficence 4/13 or (31%), beneficence 4/13 (31%), professional–patient relationships 3/12 (22%), autonomy 1/13 (8%) and justice 1/13 (8%). Patient data results were non-maleficence 4/12 (33%), professional–patient relationships 3/12 (33%), autonomy 2/12 (18%), beneficence 1/12 (8%) and justice 1/12 (8%).ConclusionsEthical principles are experienced differently between telehealth practitioners and patients. These differences can impact the quality and safety of care. Practitioners feel telehealth provides better care overall than patients do. Patients felt telehealth may force a greater share of costs and burdens onto them and reduce equity. Both patients and practitioners felt telehealth can be more harmful than face-to-face service delivery when it creates new or increased risk of harms. Building sufficient trust and mutual understanding are equally important to patients as privacy and confidentiality.
      Citation: DIGITAL HEALTH
      PubDate: 2022-01-05T06:12:53Z
      DOI: 10.1177/20552076211070394
      Issue No: Vol. 8 (2022)
       
  • Participatory health research under COVID-19 restrictions in Bauchi State,
           Nigeria: Feasibility of cellular teleconferencing for virtual discussions
           with community groups in a low-resource setting

    • Authors: Khalid Omer, Umaira Ansari, Amar Aziz, Khalid Hassan, Lami Aminati Bgeidam, Muhd Chadi Baba, Yagana Gidado, Neil Andersson, Anne Cockcroft
      Abstract: DIGITAL HEALTH, Volume 8, Issue , January-December 2022.
      IntroductionDuring the COVID-19 pandemic, researchers have used Internet-based applications to conduct virtual group meetings, but this is not feasible in low-resource settings. In a community health research project in Bauchi State, Nigeria, COVID-19 restrictions precluded planned face-to-face meetings with community groups. We tested the feasibility of using cellular teleconferencing for these meetings.MethodsIn an initial exercise, we used cellular teleconferencing to conduct six male and six female community focus group discussions. Informed by this experience, we conducted cellular teleconferences with 10 male and 10 female groups of community leaders, in different communities, to discuss progress with previously formulated action plans. Ahead of each teleconference call, a call coordinator contacted individual participants to seek consent and confirm availability. The coordinator connected the facilitator, the reporter, and the participants on each conference call, and audio-recorded the call. Each call lasted less than 1 h. Field notes and debriefing meetings with field teams supported the assessment of feasibility of the teleconference meetings.ResultsCellular teleconferencing was feasible and inexpensive. Using multiple handsets at the base allowed more participants in a call. Guidelines for facilitators and participants developed after the initial meetings were helpful, as were reminder calls ahead of the meeting. Connecting women participants was challenging. Facilitators needed extra practice to support group interactions without eye contact and body language signals.ConclusionsWith careful preparation and training, cellular teleconferencing can be a feasible and inexpensive method of conducting group discussions in a low-resource setting.
      Citation: DIGITAL HEALTH
      PubDate: 2022-01-04T01:00:12Z
      DOI: 10.1177/20552076211070386
      Issue No: Vol. 8 (2022)
       
 
JournalTOCs
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
Email: journaltocs@hw.ac.uk
Tel: +00 44 (0)131 4513762
 


Your IP address: 3.238.24.209
 
Home (Search)
API
About JournalTOCs
News (blog, publications)
JournalTOCs on Twitter   JournalTOCs on Facebook

JournalTOCs © 2009-