JMIR mHealth and uHealth
Mobile and tablet apps, ubiquitous and pervasive computing, wearable computing and domotics for health.
JMIR mhealth and uhealth (mobile and ubiquitous health) (JMU, ISSN 2291-5222) is a new spin-off journal of JMIR, the leading eHealth journal (Impact Factor 2015: 4.532). JMIR mHealth and uHealth has a projected impact factor (2015) of about 2.03. The journal focusses on health and biomedical applications in mobile and tablet computing, pervasive and ubiquitous computing, wearable computing and domotics.
JMIR mHealth and uHealth publishes even faster and has a broader scope with including papers which are more technical or more formative/developmental than what would be published in the Journal of Medical Internet Research.
In addition to peer-reviewing paper submissions by researchers, JMIR mHealth and uHealth offers peer-review of medical apps itself (developers can submit an app for peer-review here).
JMIR mHealth and uHealth features a rapid and thorough peer-review process, professional copyediting, professional production of PDF, XHTML, and XML proofs.
JMIR mHealth and uHealth adheres to the same quality standards as JMIR and all articles published here are also cross-listed in the Table of Contents of JMIR, the worlds' leading medical journal in health sciences / health services research and health informatics.
Aug 23, 2016
Aug 22, 2016
Aug 19, 2016
Aug 17, 2016
Aug 10, 2016
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Aug 3, 2016
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Aug 1, 2016
Jul 29, 2016
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Latest Submissions Open for Peer-Review:View All Open Peer Review Articles
Formative evaluation of participant experience with mobile eConsent in the app-mediated Parkinson mPower Study
Date Submitted: Aug 19, 2016
Open Peer Review Period: Aug 26, 2016 - Oct 21, 2016
Background: To fully capitalize on the promise of mobile technology to enable scalable, participant-centered research, we must develop companion self-administered electronic informed consent (eConsent...
Background: To fully capitalize on the promise of mobile technology to enable scalable, participant-centered research, we must develop companion self-administered electronic informed consent (eConsent) processes. As we do so, we have an ethical obligation to ensure that core tenants of informed consent – informedness, comprehension, and voluntariness – are upheld. Further, we should be wary of recapitulating the pitfalls of “traditional” informed consent processes. Objective: Our objective was to describe the essential qualities of participant experience, including delineation of common and novel themes relating to informed consent, with a self-administered, smartphone-based eConsent process. We sought to identify participant responses related to informedness, comprehension, and voluntariness as well as to capture any emergent themes relating to the informed consent process in an app-mediated research study. Methods: We performed qualitative thematic analysis of participant responses to a general prompt collected over a six-month period within the Parkinson mPower app. We employed a combination of a priori and emergent codes for our analysis. A priori codes focused on the core concepts of informed consent; emergent codes were derived to capture additional themes relating to self-administered consent processes. We used self-reported demographic information from the study’s baseline survey to characterize study participants and respondents. Results: During the study period, 9846 people completed the eConsent process and enrolled in the Parkinson mPower study. 2758 participants submitted 7483 comments; initial categorization identified a subset of 3875 germane responses submitted by 1678 distinct participants. Respondents were more likely to self-report a Parkinson Disease diagnosis (30.2% vs. 11.1%), be female (28.3% vs. 20.2%), older (42.9 years vs. 34.5 years), and have completed more formal education (66.2% with a 4-year college degree or more education vs. 55.8%) as compared with all mPower participants (P<.001 for all values). Within our qualitative analysis, three conceptual domains emerged. First, consistent with traditional in-person informed consent settings, we observed a broad spectrum of comprehension of core research concepts following eConsent. Second, we identified new consent themes born out of the remote mobile research setting, for example the impact of the study design on the engagement of controls and the misconstruction of the open response field as a method for responsive communication with researchers. Finally, our findings highlight participants’ desire to be empowered as partners. Conclusions: Our study serves as a formative evaluation of participant experience with a self-administered informed consent process via a mobile app. Areas for future investigation include direct comparison of the efficacy of remote, self-administered eConsent with traditional, facilitated informed consent processes, exploring the potential benefits and pitfalls of smartphone user behavioral habits on participant engagement in research, and developing best practices to increase informedness, comprehension, and voluntariness via participant co-engagement in the research endeavor.
Analyzing mHealth: Joint Models for Intensively Collected User Engagement Data
Date Submitted: Aug 19, 2016
Open Peer Review Period: Aug 26, 2016 - Oct 21, 2016
Background: Evaluating engagement with an intervention is a key component of understanding its efficacy. With an increasing interest in developing behavioral interventions in the mobile health (mHealt...
Background: Evaluating engagement with an intervention is a key component of understanding its efficacy. With an increasing interest in developing behavioral interventions in the mobile health (mHealth) space, appropriate methods for evaluating engagement in the mHealth context is necessary. Data collected to evaluate mHealth interventions are often collected much more frequently than those for clinic-based interventions. Additionally, missing data on engagement is closely linked to level of engagement resulting in the potential for informative missingness. Thus, models that can accommodate intensively collected data and can account for informative missingness are required for unbiased inference when analyzing engagement with an mHealth intervention. Objective: The objective of this paper is to demonstrate the utility of a joint modeling approach to longitudinal engagement data in mHealth research. Methods: Engagement data from an evaluation of an mHealth intervention designed to support illness management among people with schizophrenia is analyzed. A joint model is applied to the longitudinal engagement outcome and time-to-dropout to allow unbiased inference on the engagement outcome. Results are compared to separate naïve models that do not account for the relationship between drop-out and engagement. Results: The joint model shows a strong relationship between engagement and reduced risk of dropout. Using the mHealth app one day more per week was associated with a 33% decreased risk of dropout (P<.001). The decline in engagement over time was steeper when the joint model was used in comparison with the naïve model. Conclusions: Naïve longitudinal models that do not account for informative missingness in mHealth data produce biased results. Joint models are appropriate for modeling intensively collected engagement outcomes in mHealth intervention research. Clinical Trial: Trial Registration: ClinicalTrials.gov NCT02364544.
Scope of mobile health (mhealth) in Indian health care system- the way forward
Date Submitted: Aug 9, 2016
Open Peer Review Period: Aug 12, 2016 - Oct 7, 2016
India, the second largest populated country in the world is under demographic and environmental transition adding to the already existing high burden of communicable, non-communicable and emerging inf...
India, the second largest populated country in the world is under demographic and environmental transition adding to the already existing high burden of communicable, non-communicable and emerging infectious diseases. The growth of health care delivery system is not in pace with the rising burden of ill health in the country. The existing health care delivery system poses many challenges due to non-existent referral/linkages between primary/secondary/tertiary health care facilities and functional inaccessibility of secondary and tertiary government health services. Technology advancements like teleconsultation strived continuously to tackle this crisis but had attained limited success. Another cost-effective alternative could be mobile based interventions as even in developing countries mobile devices have reached more people than electricity, road systems and clean piped water. Mobile eHealth or mHealth includes the use of telecommunication and multimedia technologies integrated with mobile and wireless healthcare delivery system.The mHealth services presently existing, vary in their level of sophistication from static information provision to comprehensive health care management and are in effect in many countries. Mobile technology in the present scenario has gained substantial effects on health outcomes. Using mobile technology offers a tremendous opportunity for developing countries as India to advance in health care delivery by effectively utilizing scarce resources.
Evaluation of Diet Related Infographics on Pinterest for use of Behavior Change Theories; a content analysis
Date Submitted: Jul 17, 2016
Open Peer Review Period: Jul 20, 2016 - Sep 14, 2016
Background: There is increasing interest in Pinterest as a method of disseminating health information, however it is unclear whether the health information promoted on Pinterest is evidence-based or p...
Background: There is increasing interest in Pinterest as a method of disseminating health information, however it is unclear whether the health information promoted on Pinterest is evidence-based or promotes behavior change. Objective: To determine the presence of Health Behavior Theory (HBT) constructs in pins found on Pinterest and to assess the relationship between various pin characteristics and the inclusion of HBT. Methods: A content analysis was conducted on pins collected from Pinterest identified with the search terms “nutrition infographic” and “healthy eating infographic.” The coding rubric included HBT constructs, pin characteristics, and visual communication tools. Each HBT construct was coded as present or not present (yes = 1/no = 0). A total theory score was calculated by summing the values for each of the 9 constructs (range 0 - 9). Adjusted regression analysis was used to identify factors associated with the inclusion of health behavior change theory in pins (P < .05). Results: The mean total theory score was 2.03 (SD = 1.2). Perceived benefits were present most often (72.03%), followed by behavioral capacity (51.68%) and perceived severity (33.47%). The construct that appeared the least was self-regulation/self-control (0.84%). Pin characteristics associated with the inclusion of HBT included a large amount of text (P=.01), photographs of real people (P = .001), cartoon pictures of food (P = .01) and the presence of references (P = .001). The number of repins (P = .04), likes (P = .01) and comments (P = .01) were positively associated with the inclusion of HBT. Conclusions: These findings suggest that current Pinterest infographics targeting healthy eating contain little HBT elements. Health professionals and organizations need to create and disseminate infographics that contain more elements of HBT to better influence healthy eating behavior. This may be accomplished by creating pins that utilize both text and images of people and food in order to portray elements of HBT and convey nutritional information.
Designing a mobile health application for patients with dysphagia following head and neck cancer
Date Submitted: Jul 13, 2016
Open Peer Review Period: Jul 16, 2016 - Sep 10, 2016
Background: Adherence to swallowing rehabilitation exercises is important to develop and maintain functional improvement, yet more than half of head and neck cancer (HNC) patients report having diffic...
Background: Adherence to swallowing rehabilitation exercises is important to develop and maintain functional improvement, yet more than half of head and neck cancer (HNC) patients report having difficulty adhering to prescribed regimens. Health applications (apps) with game elements have been used in other health domains to motivate and engage patients. Understanding the factors that impact adherence may allow for more effective gamified solutions. Objective: (1) Identify self-reported factors that influence adherence to conventional home therapy without a mobile device in HNC patients, and (2) identify appealing biofeedback designs that could be used in a health app. Methods: Ten (4 females) HNC patients (M = 60.1 years) with experience completing home-based rehabilitation programs were recruited. Thematic analysis of semi-structured interviews was used to answer the first objective. Convergent interviews were used to obtain reactions to biofeedback designs. Results: Facilitators and barriers of adherence to home therapy were described through six themes: patient perceptions on outcomes and progress; clinical appointments; cancer treatment; rehabilitation program; personal factors; and connection. App visuals that provide feedback on performance during swallowing exercises should retain the chief goals of biofeedback (e.g., immediate representation of effort relative to a goal). Simple, intuitive graphics were preferred over complex, abstract ones. Conclusions: Continued engagement with the app could be facilitated by tracking progress and by using visuals that build or create structures with each subsequent use.
Women’s Perceptions of Participation in an Extended Contact Text Message Weight Loss Intervention
Date Submitted: Jul 7, 2016
Open Peer Review Period: Jul 11, 2016 - Sep 5, 2016
Background: Extending contact with participants after the end of an initial weight loss intervention has been shown to lead to maintained weight loss and related behavior change. Mobile phone text mes...
Background: Extending contact with participants after the end of an initial weight loss intervention has been shown to lead to maintained weight loss and related behavior change. Mobile phone text messaging offers a low cost and efficacious method to deliver extended contact. In this rapidly developing area, formative work is required to understand user perspectives of text message technology. An extended contact intervention delivered by text messages following an initial telephone-delivered weight loss intervention in breast cancer survivors provided this opportunity. Objective: To qualitatively explore women’s perceptions of participation in an extended contact intervention using text messaging to support long-term weight loss, physical activity and dietary behavior change Methods: Following the end of an initial 6-month randomized controlled trial of a telephone-delivered weight loss intervention (versus usual care), participants received a 6-month extended contact intervention via tailored text messages. Participant perceptions of the different types of text messages, the content, tailoring, timing and frequency of the texts and the length of the intervention were assessed through semi-structured interviews conducted after the extended contact intervention. The interviews were transcribed verbatim and analysed with key themes identified. Results: Participants (n=27) were Caucasian with a mean age of 56.0 years (SD 12.0), mean BMI of 30.0kg/m2 (SD 4.2) and were a mean of 16.1 months (SD 3.1) post-diagnosis at study baseline. Participants perceived the texts to be useful behavioral prompts and felt the messages kept them accountable to their behavior change goals. The individual tailoring of the text content and schedules was a key to the acceptability of the messages, however some women preferred the support and real-time discussion via telephone (during the initial intervention) compared to the text messages (during the extended contact intervention). Conclusions: Text message support was perceived as acceptable for the majority of women as a way of extending intervention contact for weight loss and behavioral maintenance. Texts supported the maintenance of healthy behaviors established in the intervention phase and kept the women accountable to their goals. A combination of phone and text support was suggested as a more acceptable option for some of the women for an extended contact intervention. Clinical Trial: Not registered