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JMIR mHealth and uHealth
Mobile and tablet apps, ubiquitous and pervasive computing, wearable computing and domotics for health.
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Journal Description
JMIR mHealth and uHealth (JMU, ISSN 2291-5222) is a sister journal of JMIR, the leading eHealth journal. JMIR mHealth and uHealth is indexed in PubMed, PubMed Central, Scopus, and Science Citation Index Expanded (SCIE), and in June 2018 received an Impact Factor of 4.541, which ranks the journal #2 (behind JMIR) out of 25 journals in the medical informatics category indexed by the Science Citation Index Expanded (SCIE) by Thomson Reuters/Clarivate.
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 since 2013 and was the first mhealth journal in Pubmed. It 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.
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.
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Latest Submissions Open for Peer-Review:
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A qualitative study to understand what patients want in a that helps them prepare for their colonoscopy appointments
Date Submitted: Sep 17, 2018
Open Peer Review Period: Sep 22, 2018 - Nov 17, 2018
Background: Up to 11% of patients scheduled for colonoscopy do not keep their appointments and up to 33% of those attending their appointments have inadequately cleansed bowels that can lead to poor v...
Background: Up to 11% of patients scheduled for colonoscopy do not keep their appointments and up to 33% of those attending their appointments have inadequately cleansed bowels that can lead to poor visualization of the colon and missed pathology. A smartphone application may be acceptable and far-reaching in improving patient adherence in the context of colonoscopy. Objective: To guide the development of colonAPPscopy, a smartphone application that supports colonoscopy attendance and preparation, we conducted focus groups to better understand user preferences for its content and features. Methods: Patients who had undergone outpatient colonoscopy in the prior 3 months and were aged 50-75, English- or French-speaking, and without inflammatory bowel disease or colorectal cancer participated in a focus group discussion at the McGill University Health Centre (Montreal, Canada). Discussions were 60-90 minutes, conducted by a trained facilitator using a standardized approach and audiotaped for analysis using the constant comparative approach. Participants discussed mobile health support tools they might use to help them carry out the colonoscopy, the informational content needed to support appointment adherence and bowel preparation, and the features that would make the mobile application easy to use. Results: Nine patients (2 women, 7 men) participated in 2 focus groups. Most participants accessed the internet for information related to colonoscopy and other health-related topics, but found some of the information not trustworthy, exaggerated and fear-inducing. Content areas identified for colonAPPscopy included: 1) instructions for the bowel preparation (laxative, diet, clear liquids), 2) medication restrictions, 3) appointment logistics, 4) communication with endoscopy staff, and 5) what to expect post-colonoscopy. Features for colonAPPscopy included: 1) reminders and alerts, 2) minimization of data input and 3) visual aids. The ability to tailor the smartphone application made it preferable to both paper and online instructions. Conclusions: Focus group participants identified novel content and features that had not been included in previous smartphone applications designed to support patient preparation for colonoscopy. These findings recognize the importance of including users in the development phase of building a smartphone application.
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How CDCs can use WeChat official accounts for better health information dissemination in China: an analysis of factors affecting user engagement
Date Submitted: Sep 19, 2018
Open Peer Review Period: Sep 22, 2018 - Nov 17, 2018
Background: Smart phones and mobile applications (apps) have become new channels and tools for information acquisition and exchange. In China, with the growing popularity of WeChat and WeChat official...
Background: Smart phones and mobile applications (apps) have become new channels and tools for information acquisition and exchange. In China, with the growing popularity of WeChat and WeChat official accounts (WOAs), health promotion agencies have an opportunity to use them for successful information distribution and diffusion online. Objective: We aimed to explore the features frames of articles “pushed” by WOAs of Chinese provincial CDCs and to identify features that are associated with user engagement. Methods: We searched and subscribed to 28 WOAs of provincial CDCs, and considered all the articles that they pushed from January 1 to December 31, 2017 as research objects. We developed a features frame for each article and used a pre-designed questionnaire to record information on each article. Descriptive statistics were generated for six article features, and the Kruskal–Wallis test was used to compare the amount of reading and liking for each feature category. Two-category univariate logistic regression and multivariable logistic regression were conducted to explore associations between the features of the articles and user engagement, operationalized as reading level and liking level. Results: All provincial CDC WOAs provided a total of 5,976 articles in 2017. The median amount of reading was 551.5 and the median amount of liking was 10. For the amounts of reading and liking, there were statistically significant differences among the categories of six article features; the P values were all less than 0.001. Multivariable logistic regression analysis revealed that article content, article type, communication skills, the number of marketing elements, and article length were associated with reading level and liking level. However, title type was only associated with liking level. Conclusions: How social media can be used to best achieve health information dissemination and public health outcomes is a topic of much discussion and study in the public health community. Given the lack of related studies based on WeChat or official accounts, we conducted this study and found that article content, article type, communication skills, the number of marketing elements, article length and title type were associated with user engagement. Our study may provide public health and community leaders with insight into the diffusion of important health topics of concern.
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Using a call centre to support self-administration of mifepristone and misoprostol in Bangladesh: a harm reduction approach
Date Submitted: Sep 17, 2018
Open Peer Review Period: Sep 21, 2018 - Nov 16, 2018
Background: Annually there are approximately 25 million unsafe abortions, and this remains a leading cause of morbidity and maternal mortality. In settings where abortion is restricted, women are incr...
Background: Annually there are approximately 25 million unsafe abortions, and this remains a leading cause of morbidity and maternal mortality. In settings where abortion is restricted, women are increasingly able to self-manage abortions by purchasing abortion medications such as misoprostol and mifepristone from pharmacies or other drug sellers. Better availability of these drugs has been shown to be associated with reductions in complications from unsafe abortion. In Bangladesh abortion is restricted; however menstrual regulation (MR) was introduced in the 1970s as an interim method of preventing pregnancy. Pharmacy provision of medications for MR is widespread, but customers purchasing these drugs often do not have access to quality information on dosage and complications, which means a higher risk of side effects and complications developing. In 2010, Marie Stopes Bangladesh (MSB) established a call centre to reduce potential harm from self-administration of MR medications. The call centre number was advertised widely in pharmacies and on MR product packaging. Objective: This study aimed to assess call centre use over time and how this changed when a new MR product (combined mifepristone-misoprostol) was introduced to the market and started to advertise the call centre number in November 2014. Methods: We conducted a secondary analysis of routine data collected by call centre workers between July 2012-August 2016. We investigated reported types of caller, call reason and reported usage of MR products, before and after November 2014. We used interrupted time series analysis (ITS) to formally assess levels of change in caller characteristics and reason for calling. Results: Over the 4-year period 287,095 calls about MR were received and the numbers of users steadily increased over time. The most common callers were MR-users (23.5%), their husbands (23.0%), pharmacy workers (22.9%) and village doctors (19.5%). Most MR calls were about misoprostol (75.0%), but after November 2014 a growing proportion were about the mifepristone-misoprostol regimen. The most common reasons for calling were to obtain information about regimen (72.7%), side effects (72.5%), and to report side effects (17.4%). The ITS analyses showed that after November 2014, an increasing number of calls were from MR-users who had taken the complete regimen (P=0.023), who were calling to discuss reported side effects (P=0.006) and pain medication (P=0.013), and there were fewer calls asking about dosages (P<0.001). Conclusions: The high call volume suggests that this call centre intervention addressed an unmet demand for information about MR medications from both MR users and healthcare providers. Call centre interventions may improve the quality of information available to MR-users, by providing information directly, as well as to drug sellers, and thus helping to reduce harm from self-medication of MR drugs.
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The Digital Education to LImit Salt in the Home (DELISH) Program improved salt-related knowledge, attitudes and behaviors in parents
Date Submitted: Sep 17, 2018
Open Peer Review Period: Sep 21, 2018 - Nov 16, 2018
Background: Currently, Australian children and adults are eating too much salt, increasing their risk of cardiovascular-related conditions. Web-based programs provide an avenue to engage the parents o...
Background: Currently, Australian children and adults are eating too much salt, increasing their risk of cardiovascular-related conditions. Web-based programs provide an avenue to engage the parents of primary schoolchildren in salt-specific messages which may positively impact on their own salt-related knowledge, attitudes and behaviors (KABs). Objective: The aim of this study was to determine whether parent’s salt-related KABs improved following participation in the Digital Education to LImit Salt in the Home (DELISH) web-based education program. Methods: The DELISH program was a 5-week home delivered web-based intervention targeting schoolchildren aged 7-10 years and their parents. This was a single arm study with a pre- and post-test design. Parents received weekly online educational newsletters and text messages. A study website hosted additional resources. Parents completed online pre- and post-program surveys assessing salt-related KABs. Upon completion of the program, all parents were also invited to complete an online evaluation survey. Changes in KABs outcomes were assessed using McNemar’s tests and paired t-tests. Results: Eighty parents commenced the program and 73 parents (mean age 41.0 (7.0) (SD) years, 86% females) completed both pre and post surveys. Overall, mean score for salt-related knowledge improved (+3.6±.41 (SE) points), mean behavior score also improved (+4.5±.61 points), indicating a higher frequency of engaging in behaviors to reduce salt in the diet and mean attitudes score decreased (-0.7±.19 points) representing lower importance of using salt to enhance the taste of food (all P<.001). Following participation, the proportion of parents aware of the daily salt intake recommendation increased from 40% to 74% (P<.001) and awareness of bread as the main source of salt increased from 58% to 95% (P<.001). The proportion of parents who agreed that salt should be used in cooking to enhance the flavor of food decreased from 30% to 11% (P=.002) and the proportion who agreed that sodium information displayed on food labels was difficult to understand decreased from 52% to 32% (P=.009). There was a reduction in the proportion of parents who reported adding salt during cooking (55% vs. 41%, P=.03) and at the table (32% vs. 18%, P=.002). Of the 16 parents who completed the evaluation survey, most parents (75%) enjoyed the program and all found the newsletters to be useful. Almost all parents (94%) agreed that the DELISH education program would be useful to other parents. Conclusions: The improvement in salt-related knowledge, attitudes and reported behaviors in the DELISH program indicates the potential for online technology, to effectively disseminate simple salt reduction education messages to families with primary school aged children. Future work should explore opportunities to integrate the program within the school setting to enable wider dissemination.
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Predictors of Health App Use and Perceived Effectiveness in People with Cardiovascular Diseases and Diabetes – a Population-based Survey
Date Submitted: Sep 19, 2018
Open Peer Review Period: Sep 21, 2018 - Nov 16, 2018
Background: Mobile health apps can help to change health-related behaviors and manage chronic conditions in patients with cardiovascular diseases (CVD) and diabetes mellitus, but a certain level of he...
Background: Mobile health apps can help to change health-related behaviors and manage chronic conditions in patients with cardiovascular diseases (CVD) and diabetes mellitus, but a certain level of health literacy and eHealth literacy may be needed. Objective: To predict mobile health app use in individuals with CVD and/or diabetes, and to predict perceived effectiveness of health apps amongst app users. Methods: Population-based online survey (N=1500) among Germans, aged 35 years and older with CVD, diabetes or both. Three subgroups were examined: 1) individuals with CVD (n=1325); 2) individuals with diabetes (n=681); and 3) individuals with CVD and diabetes (n=524). Sociodemographics, health behaviors, CVD and/or diabetes, health and eHealth literacy, characteristics of health app use, and characteristics of apps themselves were assessed by questionnaires. Linear and logistic regression models were applied. Results: Overall, patterns of factors predicting health app use were comparable in individuals with CVD or diabetes or both. Across subgroups, about every fourth patient reported using apps for health-related purposes with physical activity and weight loss being the most prominent target behaviors. Health app users were younger, more likely to be female (except in those with CVD and diabetes combined), better educated, and reported more physical activity App users had higher eHealth literacy than non-users. Those users who perceived the app to have a greater effectiveness on their health behaviors tended to be more health and eHealth literate and rated the app to use more behavior change techniques (BCTs). Conclusions: There are health and literacy-related disparities in the access to health app use. Apps containing more BCTs had higher perceived effect on people’s health and app developers should take the complexity of needs into account. Further, eHealth literacy appears to be a requirement to use health apps successfully, which should be considered in health education strategies to improve health in patients with CVD and diabetes.
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Technology supported self-guided nutrition and physical activity interventions in adults with cancer: a systematic review
Date Submitted: Sep 20, 2018
Open Peer Review Period: Sep 21, 2018 - Nov 16, 2018
Background: Nutrition and physical activity interventions are important components of cancer care, and with increasing demand for services there is a need to consider flexible, easily accessible and t...
Background: Nutrition and physical activity interventions are important components of cancer care, and with increasing demand for services there is a need to consider flexible, easily accessible and tailored models of care whilst maintaining optimal outcomes. Objective: This systematic review describes and appraises the efficacy of technology supported self-guided nutrition and physical activity interventions for people with cancer. Methods: A systematic search of multiple databases through to July 2018 was conducted for randomised and non-randomised trials investigating technology supported self-guided nutrition and physical activity interventions. Risk of bias was assessed using the Cochrane Risk of Bias tool. Outcomes included behavioural, health-related, clinical, health service or financial measures. Results: Sixteen randomised controlled trials representing 2,684 participants were included. Most studies were web-based interventions (n=9) and 12-week follow-up duration (n=8). Seven studies assessed dietary behaviour with two reporting a significant benefit on diet quality or fruit and vegetable intake. Fifteen studies measured physical activity behaviour with eight finding significant improvement in muscle strength and/or moderate-to-vigorous physical activity. Four of nine studies assessing health-related quality of life (HRQoL) reported a significant improvement in global HRQoL or a domain subscale. A significant improvement in fatigue was found in four of six studies. Interpretation of findings was influenced by inadequate reporting of intervention description and compliance. Conclusions: This review identified short-term benefits of technology supported self-guided interventions for people with cancer on physical activity level and fatigue, and some benefit for dietary behaviour and HRQoL. However, current literature demonstrates a lack of evidence for long-term benefit.
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