@Article{info:doi/10.2196/mhealth.6178,
author="Mitchell, W. Jason
and Torres, Beatriz Maria
and Joe, Jennifer
and Danh, Thu
and Gass, Bobbi
and Horvath, J. Keith",
title="Formative Work to Develop a Tailored HIV Testing Smartphone App for Diverse, At-Risk, HIV-Negative Men Who Have Sex With Men: A Focus Group Study",
journal="JMIR Mhealth Uhealth",
year="2016",
month="Nov",
day="16",
volume="4",
number="4",
pages="e128",
keywords="smartphone apps",
keywords="mHealth",
keywords="HIV testing",
keywords="HIV-negative men who have sex with men",
keywords="men who have sex with men",
keywords="MSM",
abstract="Background: Although gay, bisexual, and other men who have sex with men (MSM) are disproportionately affected by human immunodeficiency virus (HIV) infection, few test for HIV at regular intervals. Smartphone apps may be an ideal tool to increase regular testing among MSM. However, the success of apps to encourage regular testing among MSM will depend on how frequently the apps are downloaded, whether they continue to be used over months or years, and the degree to which such apps are tailored to the needs of this population. Objective: The primary objectives of this study were to answer the following questions. (1) What features and functions of smartphone apps do MSM believe are associated with downloading apps to their mobile phones? (2) What features and functions of smartphone apps are most likely to influence MSM's sustained use of apps over time? (3) What features and functions do MSM prefer in an HIV testing smartphone app? Methods: We conducted focus groups (n=7, with a total of 34 participants) with a racially and ethnically diverse group of sexually active HIV-negative MSM (mean age 32 years; 11/34 men, 33\%, tested for HIV ?10 months ago) in the United States in Miami, Florida and Minneapolis, Minnesota. Focus groups were digitally recorded, transcribed verbatim, and deidentified for analysis. We used a constant comparison method (ie, grounded theory coding) to examine and reexamine the themes that emerged from the focus groups. Results: Men reported cost, security, and efficiency as their primary reasons influencing whether they download an app. Usefulness and perceived necessity, as well as peer and posted reviews, affected whether they downloaded and used the app over time. Factors that influenced whether they keep and continue to use an app over time included reliability, ease of use, and frequency of updates. Poor performance and functionality and lack of use were the primary reasons why men would delete an app from their phone. Participants also shared their preferences for an app to encourage regular HIV testing by providing feedback on test reminders, tailored testing interval recommendations, HIV test locator, and monitoring of personal sexual behaviors. Conclusions: Mobile apps for HIV prevention have proliferated, despite relatively little formative research to understand best practices for their development and implementation. The findings of this study suggest key design characteristics that should be used to guide development of an HIV testing app to promote regular HIV testing for MSM. The features and functions identified in this and prior research, as well as existing theories of behavior change, should be used to guide mobile app development in this critical area. ",
doi="10.2196/mhealth.6178",
url="http://mhealth.jmir.org/2016/4/e128/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27852558"
}


@Article{info:doi/10.2196/mhealth.6189,
author="Johnson, Emily
and Emani, K. Vamsi
and Ren, Jinma",
title="Breadth of Coverage, Ease of Use, and Quality of Mobile Point-of-Care Tool Information Summaries: An Evaluation",
journal="JMIR Mhealth Uhealth",
year="2016",
month="Oct",
day="12",
volume="4",
number="4",
pages="e117",
keywords="mHealth",
keywords="mobile health",
keywords="mobile app",
keywords="assessment",
keywords="internal medicine",
keywords="point-of-care tools",
abstract="Background: With advances in mobile technology, accessibility of clinical resources at the point of care has increased. Objective: The objective of this research was to identify if six selected mobile point-of-care tools meet the needs of clinicians in internal medicine. Point-of-care tools were evaluated for breadth of coverage, ease of use, and quality. Methods: Six point-of-care tools were evaluated utilizing four different devices (two smartphones and two tablets). Breadth of coverage was measured using select International Classification of Diseases, Ninth Revision, codes if information on summary, etiology, pathophysiology, clinical manifestations, diagnosis, treatment, and prognosis was provided. Quality measures included treatment and diagnostic inline references and individual and application time stamping. Ease of use covered search within topic, table of contents, scrolling, affordance, connectivity, and personal accounts. Analysis of variance based on the rank of score was used. Results: Breadth of coverage was similar among Medscape (mean 6.88), Uptodate (mean 6.51), DynaMedPlus (mean 6.46), and EvidencePlus (mean 6.41) (P>.05) with DynaMed (mean 5.53) and Epocrates (mean 6.12) scoring significantly lower (P<.05). Ease of use had DynaMedPlus with the highest score, and EvidencePlus was lowest (6.0 vs 4.0, respectively, P<.05). For quality, reviewers rated the same score (4.00) for all tools except for Medscape, which was rated lower (P<.05). Conclusions: For breadth of coverage, most point-of-care tools were similar with the exception of DynaMed. For ease of use, only UpToDate and DynaMedPlus allow for search within a topic. All point-of-care tools have remote access with the exception of UpToDate and Essential Evidence Plus. All tools except Medscape covered criteria for quality evaluation. Overall, there was no significant difference between the point-of-care tools with regard to coverage on common topics used by internal medicine clinicians. Selection of point-of-care tools is highly dependent on individual preference based on ease of use and cost of the application. ",
doi="10.2196/mhealth.6189",
url="http://mhealth.jmir.org/2016/4/e117/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27733328"
}


@Article{info:doi/10.2196/mhealth.6445,
author="Singh, Karandeep
and Drouin, Kaitlin
and Newmark, P. Lisa
and Filkins, Malina
and Silvers, Elizabeth
and Bain, A. Paul
and Zulman, M. Donna
and Lee, Jae-Ho
and Rozenblum, Ronen
and Pabo, Erika
and Landman, Adam
and Klinger, V. Elissa
and Bates, W. David",
title="Patient-Facing Mobile Apps to Treat High-Need, High-Cost Populations: A Scoping Review",
journal="JMIR Mhealth Uhealth",
year="2016",
month="Dec",
day="19",
volume="4",
number="4",
pages="e136",
keywords="review",
keywords="mobile apps",
keywords="mHealth",
keywords="chronic disease",
keywords="self-management",
abstract="Background: Self-management is essential to caring for high-need, high-cost (HNHC) populations. Advances in mobile phone technology coupled with increased availability and adoption of health-focused mobile apps have made self-management more achievable, but the extent and quality of the literature supporting their use is not well defined. Objective: The purpose of this review was to assess the breadth, quality, bias, and types of outcomes measured in the literature supporting the use of apps targeting HNHC populations. Methods: Data sources included articles in PubMed and MEDLINE (National Center for Biotechnology Information), EMBASE (Elsevier), the Cochrane Central Register of Controlled Trials (EBSCO), Web of Science (Thomson Reuters), and the NTIS (National Technical Information Service) Bibliographic Database (EBSCO) published since 2008. We selected studies involving use of patient-facing iOS or Android mobile health apps. Extraction was performed by 1 reviewer; 40 randomly selected articles were evaluated by 2 reviewers to assess agreement. Results: Our final analysis included 175 studies. The populations most commonly targeted by apps included patients with obesity, physical handicaps, diabetes, older age, and dementia. Only 30.3\% (53/175) of the apps studied in the reviewed literature were identifiable and available to the public through app stores. Many of the studies were cross-sectional analyses (42.9\%, 75/175), small (median number of participants=31, interquartile range 11.0-207.2, maximum 11,690), or performed by an app's developers (61.1\%, 107/175). Of the 175 studies, only 36 (20.6\%, 36/175) studies evaluated a clinical outcome. Conclusions: Most apps described in the literature could not be located on the iOS or Android app stores, and existing research does not robustly evaluate the potential of mobile apps. Whereas apps may be useful in patients with chronic conditions, data do not support this yet. Although we had 2-3 reviewers to screen and assess abstract eligibility, only 1 reviewer abstracted the data. This is one limitation of our study. With respect to the 40 articles (22.9\%, 40/175) that were assigned to 2 reviewers (of which 3 articles were excluded), inter-rater agreement was significant on the majority of items (17 of 30) but fair-to-moderate on others. ",
doi="10.2196/mhealth.6445",
url="http://mhealth.jmir.org/2016/4/e136/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27993761"
}


@Article{info:doi/10.2196/mhealth.5987,
author="Shibasaki, Sanchia
and Gardner, Karen
and Sibthorpe, Beverly",
title="Using Knowledge Translation to Craft ``Sticky'' Social Media Health Messages That Provoke Interest, Raise Awareness, Impart Knowledge, and Inspire Change",
journal="JMIR Mhealth Uhealth",
year="2016",
month="Oct",
day="05",
volume="4",
number="4",
pages="e115",
keywords="knowledge translation",
keywords="social media",
keywords="Indigenous health",
keywords="health promotion",
abstract="Background: In Australia, there is growing use of technology supported knowledge translation (KT) strategies such as social media and mobile apps in health promotion and in Indigenous health. However, little is known about how individuals use technologies and the evidence base for the impact of these health interventions on health behavior change is meager. Objective: The objective of our study was to examine how Facebook is used to promote health messages to Indigenous people and discuss how KT can support planning and implementing health messages to ensure chosen strategies are fit for the purpose and achieve impact. Methods: A desktop audit of health promotion campaigns on smoking prevention and cessation for Australian Indigenous people using Facebook was conducted. Results: Our audit identified 13 out of 21 eligible campaigns that used Facebook. Facebook pages with the highest number of likes (more than 5000) were linked to a website and to other social media applications and demonstrated stickiness characteristics by posting frequently (triggers and unexpected), recruiting sporting or public personalities to promote campaigns (social currency and public), recruiting Indigenous people from the local region (stories and emotion), and sharing stories and experiences based on real-life events (credible and practical value). Conclusions: KT planning may support campaigns to identify and select KT strategies that are best suited and well-aligned to the campaign's goals, messages, and target audiences. KT planning can also help mitigate unforeseen and expected risks, reduce unwarranted costs and expenses, achieve goals, and limit the peer pressure of using strategies that may not be fit for purpose. One of the main challenges in using KT systems and processes involves coming to an adequate conceptualization of the KT process itself. ",
doi="10.2196/mhealth.5987",
url="http://mhealth.jmir.org/2016/4/e115/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27707685"
}


@Article{info:doi/10.2196/mhealth.5771,
author="Donaire-Gonzalez, David
and Valent{\'i}n, Ant{\`o}nia
and de Nazelle, Audrey
and Ambros, Albert
and Carrasco-Turigas, Gl{\`o}ria
and Seto, Edmund
and Jerrett, Michael
and Nieuwenhuijsen, J. Mark",
title="Benefits of Mobile Phone Technology for Personal Environmental Monitoring",
journal="JMIR Mhealth Uhealth",
year="2016",
month="Nov",
day="10",
volume="4",
number="4",
pages="e126",
keywords="smartphone",
keywords="cell phones",
keywords="mobile applications",
keywords="monitoring, ambulatory",
keywords="spatio-temporal analysis",
keywords="automatic data processing",
keywords="travel",
keywords="environmental exposure",
abstract="Background: Tracking individuals in environmental epidemiological studies using novel mobile phone technologies can provide valuable information on geolocation and physical activity, which will improve our understanding of environmental exposures. Objective: The objective of this study was to assess the performance of one of the least expensive mobile phones on the market to track people's travel-activity pattern. Methods: Adults living and working in Barcelona (72/162 bicycle commuters) carried simultaneously a mobile phone and a Global Positioning System (GPS) tracker and filled in a travel-activity diary (TAD) for 1 week (N=162). The CalFit app for mobile phones was used to log participants' geographical location and physical activity. The geographical location data were assigned to different microenvironments (home, work or school, in transit, others) with a newly developed spatiotemporal map-matching algorithm. The tracking performance of the mobile phones was compared with that of the GPS trackers using chi-square test and Kruskal-Wallis rank sum test. The minute agreement across all microenvironments between the TAD and the algorithm was compared using the Gwet agreement coefficient (AC1). Results: The mobile phone acquired locations for 905 (29.2\%) more trips reported in travel diaries than the GPS tracker (P<.001) and had a median accuracy of 25 m. Subjects spent on average 57.9\%, 19.9\%, 9.0\%, and 13.2\% of time at home, work, in transit, and other places, respectively, according to the TAD and 57.5\%, 18.8\%, 11.6\%, and 12.1\%, respectively, according to the map-matching algorithm. The overall minute agreement between both methods was high (AC1 .811, 95\% CI .810-.812). Conclusions: The use of mobile phones running the CalFit app provides better information on which microenvironments people spend their time in than previous approaches based only on GPS trackers. The improvements of mobile phone technology in microenvironment determination are because the mobile phones are faster at identifying first locations and capable of getting location in challenging environments thanks to the combination of assisted-GPS technology and network positioning systems. Moreover, collecting location information from mobile phones, which are already carried by individuals, allows monitoring more people with a cheaper and less burdensome method than deploying GPS trackers. ",
doi="10.2196/mhealth.5771",
url="http://mhealth.jmir.org/2016/4/e126/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27833069"
}


@Article{info:doi/10.2196/mhealth.5600,
author="Rhoton, Jayson
and Wilkerson, Michael J.
and Mengle, Shruta
and Patankar, Pallav
and Rosser, Simon B. R.
and Ekstrand, L. Maria",
title="Sexual Preferences and Presentation on Geosocial Networking Apps by Indian Men Who Have Sex With Men in Maharashtra",
journal="JMIR Mhealth Uhealth",
year="2016",
month="Oct",
day="31",
volume="4",
number="4",
pages="e120",
keywords="homosexuality",
keywords="mobile health",
keywords="HIV",
keywords="prevention and control",
keywords="urban health",
abstract="Background: The affordability of smartphones and improved mobile networks globally has increased the popularity of geosocial networking (GSN) apps (eg, Grindr, Scruff, Planetromeo) as a method for men who have sex with men (MSM) to seek causal sex partners and engage with the queer community. As mobile penetration continues to grow in India, it is important to understand how self-presentation on GSN app is relevant because it offers insight into a population that has not been largely studied. There is very little information about how Indian MSM discuss their sexual preferences and condom preferences and disclose their human immunodeficiency virus (HIV) status with potential sex partners on Web-based platforms. Objective: The objective of this study was to describe how self-presentation by Indian MSM on GSN apps contributes to sexual preferences, HIV or sexually transmitted infection (STI) disclosure, and if the presentation differs due to proximity to the Greater Mumbai or Thane region. Methods: Between September 2013 and May 2014, participants were recruited through banner advertisements on gay websites, social media advertisements and posts, and distribution of print materials at outreach events hosted by lesbian, gay, bisexual, transgender (LGBT) and HIV service organizations in Maharashtra, India. Eligible participants self-identified as being MSM or hijra (transgender) women, living in Maharashtra, aged above 18 years, having regular Internet access, and having at least one male sex partner in the previous 90 days. Results: Indian MSM living inside and outside the Greater Mumbai or Thane region reported an average of 6.7 (SD 11.8) male sex partners in the last 3 months; on average HIV status of the sex partners was disclosed to 2.9 (SD 8.9). The most commonly used websites and GSN apps by MSM living inside Greater Mumbai or Thane region were Planetromeo, Grindr, and Gaydar. Results demonstrated that MSM used smartphones to access GSN apps and stated a preference for both condomless and protected anal sex but did not disclose their HIV status. This low level of HIV disclosure potentially increases risk of HIV or STI transmission; therefore, trends in use should be monitored. Conclusions: Our data helps to fill the gap in understanding how Indian MSM use technology to find casual sex partners, disclose their sexual preference, and their HIV status on Web-based platforms. As mobile penetration in India continues to grow and smartphone use increases, the use of GSN sex-seeking apps by MSM should also increase, potentially increasing the risk of HIV or STI transmission within the app's closed sexual networks. ",
doi="10.2196/mhealth.5600",
url="http://mhealth.jmir.org/2016/4/e120/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27799139"
}


@Article{info:doi/10.2196/mhealth.6562,
author="Sathyanarayana, Aarti
and Joty, Shafiq
and Fernandez-Luque, Luis
and Ofli, Ferda
and Srivastava, Jaideep
and Elmagarmid, Ahmed
and Arora, Teresa
and Taheri, Shahrad",
title="Sleep Quality Prediction From Wearable Data Using Deep Learning",
journal="JMIR Mhealth Uhealth",
year="2016",
month="Nov",
day="04",
volume="4",
number="4",
pages="e125",
keywords="wearables",
keywords="sleep quality",
keywords="sleep efficiency",
keywords="actigraphy",
keywords="body sensor networks",
keywords="mobile health",
keywords="connected health",
keywords="accelerometer",
keywords="physical activity",
keywords="pervasive health",
keywords="consumer health informatics",
keywords="deep learning",
abstract="Background: The importance of sleep is paramount to health. Insufficient sleep can reduce physical, emotional, and mental well-being and can lead to a multitude of health complications among people with chronic conditions. Physical activity and sleep are highly interrelated health behaviors. Our physical activity during the day (ie, awake time) influences our quality of sleep, and vice versa. The current popularity of wearables for tracking physical activity and sleep, including actigraphy devices, can foster the development of new advanced data analytics. This can help to develop new electronic health (eHealth) applications and provide more insights into sleep science. Objective: The objective of this study was to evaluate the feasibility of predicting sleep quality (ie, poor or adequate sleep efficiency) given the physical activity wearable data during awake time. In this study, we focused on predicting good or poor sleep efficiency as an indicator of sleep quality. Methods: Actigraphy sensors are wearable medical devices used to study sleep and physical activity patterns. The dataset used in our experiments contained the complete actigraphy data from a subset of 92 adolescents over 1 full week. Physical activity data during awake time was used to create predictive models for sleep quality, in particular, poor or good sleep efficiency. The physical activity data from sleep time was used for the evaluation. We compared the predictive performance of traditional logistic regression with more advanced deep learning methods: multilayer perceptron (MLP), convolutional neural network (CNN), simple Elman-type recurrent neural network (RNN), long short-term memory (LSTM-RNN), and a time-batched version of LSTM-RNN (TB-LSTM). Results: Deep learning models were able to predict the quality of sleep (ie, poor or good sleep efficiency) based on wearable data from awake periods. More specifically, the deep learning methods performed better than traditional logistic regression. ``CNN had the highest specificity and sensitivity, and an overall area under the receiver operating characteristic (ROC) curve (AUC) of 0.9449, which was 46\% better as compared with traditional logistic regression (0.6463). Conclusions: Deep learning methods can predict the quality of sleep based on actigraphy data from awake periods. These predictive models can be an important tool for sleep research and to improve eHealth solutions for sleep. ",
doi="10.2196/mhealth.6562",
url="http://mhealth.jmir.org/2016/4/e125/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27815231"
}


@Article{info:doi/10.2196/mhealth.6469,
author="Ashman, M. Amy
and Collins, E. Clare
and Brown, J. Leanne
and Rae, M. Kym
and Rollo, E. Megan",
title="A Brief Tool to Assess Image-Based Dietary Records and Guide Nutrition Counselling Among Pregnant Women: An Evaluation",
journal="JMIR Mhealth Uhealth",
year="2016",
month="Nov",
day="04",
volume="4",
number="4",
pages="e123",
keywords="nutrition assessment",
keywords="pregnancy",
keywords="telehealth",
keywords="image-based dietary records",
abstract="Background: Dietitians ideally should provide personally tailored nutrition advice to pregnant women. Provision is hampered by a lack of appropriate tools for nutrition assessment and counselling in practice settings. Smartphone technology, through the use of image-based dietary records, can address limitations of traditional methods of recording dietary intake. Feedback on these records can then be provided by the dietitian via smartphone. Efficacy and validity of these methods requires examination. Objective: The aims of the Australian Diet Bytes and Baby Bumps study, which used image-based dietary records and a purpose-built brief Selected Nutrient and Diet Quality (SNaQ) tool to provide tailored nutrition advice to pregnant women, were to assess relative validity of the SNaQ tool for analyzing dietary intake compared with nutrient analysis software, to describe the nutritional intake adequacy of pregnant participants, and to assess acceptability of dietary feedback via smartphone. Methods: Eligible women used a smartphone app to record everything they consumed over 3 nonconsecutive days. Records consisted of an image of the food or drink item placed next to a fiducial marker, with a voice or text description, or both, providing additional detail. We used the SNaQ tool to analyze participants' intake of daily food group servings and selected key micronutrients for pregnancy relative to Australian guideline recommendations. A visual reference guide consisting of images of foods and drinks in standard serving sizes assisted the dietitian with quantification. Feedback on participants' diets was provided via 2 methods: (1) a short video summary sent to participants' smartphones, and (2) a follow-up telephone consultation with a dietitian. Agreement between dietary intake assessment using the SNaQ tool and nutrient analysis software was evaluated using Spearman rank correlation and Cohen kappa. Results: We enrolled 27 women (median age 28.8 years, 8 Indigenous Australians, 15 primiparas), of whom 25 completed the image-based dietary record. Median intakes of grains, vegetables, fruit, meat, and dairy were below recommendations. Median (interquartile range) intake of energy-dense, nutrient-poor foods was 3.5 (2.4-3.9) servings/day and exceeded recommendations (0-2.5 servings/day). Positive correlations between the SNaQ tool and nutrient analysis software were observed for energy ($\rho$=.898, P<.001) and all selected micronutrients (iron, calcium, zinc, folate, and iodine, $\rho$ range .510-.955, all P<.05), both with and without vitamin and mineral supplements included in the analysis. Cohen kappa showed moderate to substantial agreement for selected micronutrients when supplements were included (kappa range .488-.803, all P ?.001) and for calcium, iodine, and zinc when excluded (kappa range .554-.632, all P<.001). A total of 17 women reported changing their diet as a result of the personalized nutrition advice. Conclusions: The SNaQ tool demonstrated acceptable validity for assessing adequacy of key pregnancy nutrient intakes and preliminary evidence of utility to support dietitians in providing women with personalized advice to optimize nutrition during pregnancy. ",
doi="10.2196/mhealth.6469",
url="http://mhealth.jmir.org/2016/4/e123/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27815234"
}


@Article{info:doi/10.2196/mhealth.5863,
author="Thomas, Kristin
and Linderoth, Catharina
and Bendtsen, Marcus
and Bendtsen, Preben
and M{\"u}ssener, Ulrika",
title="Text Message-Based Intervention Targeting Alcohol Consumption Among University Students: Findings From a Formative Development Study",
journal="JMIR Mhealth Uhealth",
year="2016",
month="Oct",
day="20",
volume="4",
number="4",
pages="e119",
keywords="SMS intervention",
keywords="university student drinking",
keywords="formative research",
abstract="Background: Drinking of alcohol among university students is a global phenomenon; heavy episodic drinking is accepted despite several potential negative consequences. There is emerging evidence that short message service (SMS) text messaging interventions are effective to promote behavior change among students. However, it is still unclear how effectiveness can be optimized through intervention design or how user interest and adherence can be maximized. Objective: The objective of this study was to develop an SMS text message-based intervention targeting alcohol drinking among university students using formative research. Methods: A formative research design was used including an iterative revision process based on input from end users and experts. Data were collected via seven focus groups with students and a panel evaluation involving students (n=15) and experts (n=5). Student participants were recruited from five universities in Sweden. A semistructured interview guide was used in the focus groups and included questions on alcohol culture, message content, and intervention format. The panel evaluation asked participants to rate to what degree preliminary messages were understandable, usable, and had a good tone on a scale from 1 (very low degree) to 4 (very high degree). Participants could also write their own comments for each message. Qualitative data were analyzed using qualitative descriptive analysis. Quantitative data were analyzed using descriptive statistics. The SMS text messages and the intervention format were revised continuously in parallel with data collection. A behavior change technique (BCT) analysis was conducted on the final version of the program. Results: Overall, students were positive toward the SMS text message intervention. Messages that were neutral, motivated, clear, and tangible engaged students. Students expressed that they preferred short, concise messages and confirmed that a 6-week intervention was an appropriate duration. However, there was limited consensus regarding SMS text message frequency, personalization of messages, and timing. Overall, messages scored high on understanding (mean 3.86, SD 0.43), usability (mean 3.70, SD 0.61), and tone (mean 3.78, SD 0.53). Participants added comments to 67 of 70 messages, including suggestions for change in wording, order of messages, and feedback on why a message was unclear or needed major revision. Comments also included positive feedback that confirmed the value of the messages. Twenty-three BCTs aimed at addressing self-regulatory skills, for example, were identified in the final program. Conclusions: The formative research design was valuable and resulted in significant changes to the intervention. All the original SMS text messages were changed and new messages were added. Overall, the findings showed that students were positive toward receiving support through SMS text message and that neutral, motivated, clear, and tangible messages promoted engagement. However, limited consensus was found on the timing, frequency, and tailoring of messages. ",
doi="10.2196/mhealth.5863",
url="http://mhealth.jmir.org/2016/4/e119/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27765732"
}


@Article{info:doi/10.2196/mhealth.6425,
author="Badawy, M. Sherif
and Kuhns, M. Lisa",
title="Economic Evaluation of Text-Messaging and Smartphone-Based Interventions to Improve Medication Adherence in Adolescents with Chronic Health Conditions: A Systematic Review",
journal="JMIR Mhealth Uhealth",
year="2016",
month="Oct",
day="25",
volume="4",
number="4",
pages="e121",
keywords="adolescent",
keywords="text messaging",
keywords="smartphone",
keywords="medication adherence",
keywords="chronic disease",
keywords="cost-benefit analysis",
abstract="Background: The rate of chronic health conditions (CHCs) in children and adolescents has doubled in the past 20 years, with increased health care costs. Technology-based interventions have demonstrated efficacy to improving medication adherence. However, data to support the cost effectiveness of these interventions are lacking. Objective: The objective of this study is to conduct an economic evaluation of text-messaging and smartphone-based interventions that focus on improving medication adherence in adolescents with CHCs. Methods: Searches included PubMed MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Web of Science, and Inspec. Eligibility criteria included age (12-24 years old), original articles, outcomes for medication adherence, and economic outcomes. Results: Our search identified 1118 unique articles that were independently screened. A total of 156 articles met inclusion criteria and were then examined independently with full-text review. A total of 15 articles met most criteria but lacked economic outcomes such as cost effectiveness or cost-utility data. No articles met all predefined criteria to be included for final review. Only 4 articles (text messaging [n=3], electronic directly observed therapy [n=1]) described interventions with possible future cost-saving but no formal economic evaluation. Conclusions: The evidence to support the cost effectiveness of text-messaging and smartphone-based interventions in improving medication adherence in adolescents with CHCs is insufficient. This lack of research highlights the need for comprehensive economic evaluation of such interventions to better understand their role in cost-savings while improving medication adherence and health outcomes. Economic evaluation of technology-based interventions can contribute to more evidence-based assessment of the scalability, sustainability, and benefits of broader investment of such technology tools in adolescents with CHCs. ",
doi="10.2196/mhealth.6425",
url="http://mhealth.jmir.org/2016/4/e121/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27780795"
}


@Article{info:doi/10.2196/mhealth.5996,
author="Thakkar, Jay
and Barry, Tony
and Thiagalingam, Aravinda
and Redfern, Julie
and McEwan, L. Alistair
and Rodgers, Anthony
and Chow, K. Clara",
title="Design Considerations in Development of a Mobile Health Intervention Program: The TEXT ME and TEXTMEDS Experience",
journal="JMIR Mhealth Uhealth",
year="2016",
month="Nov",
day="15",
volume="4",
number="4",
pages="e127",
keywords="text message",
keywords="mobile phone",
keywords="coronary artery disease",
keywords="mHealth",
abstract="Background: Mobile health (mHealth) has huge potential to deliver preventative health services. However, there is paucity of literature on theoretical constructs, technical, practical, and regulatory considerations that enable delivery of such services. Objectives: The objective of this study was to outline the key considerations in the development of a text message-based mHealth program; thus providing broad recommendations and guidance to future researchers designing similar programs. Methods: We describe the key considerations in designing the intervention with respect to functionality, technical infrastructure, data management, software components, regulatory requirements, and operationalization. We also illustrate some of the potential issues and decision points utilizing our experience of developing text message (short message service, SMS) management systems to support 2 large randomized controlled trials: TEXT messages to improve MEDication adherence \& Secondary prevention (TEXTMEDS) and Tobacco, EXercise and dieT MEssages (TEXT ME). Results: The steps identified in the development process were: (1) background research and development of the text message bank based on scientific evidence and disease-specific guidelines, (2) pilot testing with target audience and incorporating feedback, (3) software-hardware customization to enable delivery of complex personalized programs using prespecified algorithms, and (4) legal and regulatory considerations. Additional considerations in developing text message management systems include: balancing the use of customized versus preexisting software systems, the level of automation versus need for human inputs, monitoring, ensuring data security, interface flexibility, and the ability for upscaling. Conclusions: A merging of expertise in clinical and behavioral sciences, health and research data management systems, software engineering, and mobile phone regulatory requirements is essential to develop a platform to deliver and manage support programs to hundreds of participants simultaneously as in TEXT ME and TEXTMEDS trials. This research provides broad principles that may assist other researchers in developing mHealth programs. ",
doi="10.2196/mhealth.5996",
url="http://mhealth.jmir.org/2016/4/e127/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27847350"
}


@Article{info:doi/10.2196/mhealth.6493,
author="Evans, D. William
and Mays, Darren",
title="Design and Feasibility of a Text Messaging Intervention to Prevent Indoor Tanning Among Young Adult Women: A Pilot Study",
journal="JMIR Mhealth Uhealth",
year="2016",
month="Dec",
day="22",
volume="4",
number="4",
pages="e137",
keywords="indoor tanning",
keywords="risk perceptions",
keywords="text messaging",
keywords="feasibility testing",
abstract="Background: Although skin cancer is largely preventable, it affects nearly 1 of 5 US adults. There is a need for research on how to optimally design persuasive public health indoor tanning prevention messages. Objective: The objective of our study was to examine whether framed messages on indoor tanning behavioral intentions delivered through short message service (SMS) text messaging would produce (1) positive responses to the messages, including message receptivity and emotional response; (2) indoor tanning efficacy beliefs, including response efficacy and self-efficacy; and (3) indoor tanning risk beliefs. Methods: We conducted a pilot study of indoor tanning prevention messages delivered via mobile phone text messaging in a sample of 21 young adult women who indoor tan. Participants completed baseline measures, were randomly assigned to receive gain-, loss-, or balanced-framed text messages, and completed postexposure outcome measures on indoor tanning cognitions and behaviors. Participants received daily mobile phone indoor tanning prevention text messages for 1 week and completed the same postexposure measures as at baseline. Results: Over the 1-week period there were trends or significant changes after receipt of the text messages, including increased perceived susceptibility (P<.001), response efficacy beliefs (P<.001), and message receptivity (P=.03). Ordinary least squares stepwise linear regression models showed an effect of text message exposure on self-efficacy to quit indoor tanning (t6=--2.475, P<.02). Ordinary least squares linear regression including all measured scales showed a marginal effect of SMS texts on self-efficacy (t20=1.905, P=.08). Participants endorsed highly favorable views toward the text messaging protocol. Conclusions: This study supports this use of mobile text messaging as an indoor tanning prevention strategy. Given the nature of skin cancer risk perceptions, the addition of multimedia messaging service is another area of potential innovation for disseminating indoor tanning prevention messages. ",
doi="10.2196/mhealth.6493",
url="http://mhealth.jmir.org/2016/4/e137/",
url="http://www.ncbi.nlm.nih.gov/pubmed/28007691"
}


@Article{info:doi/10.2196/mhealth.6286,
author="Geuens, Jonas
and Swinnen, Willem Thijs
and Westhovens, Rene
and de Vlam, Kurt
and Geurts, Luc
and Vanden Abeele, Vero",
title="A Review of Persuasive Principles in Mobile Apps for Chronic Arthritis Patients: Opportunities for Improvement",
journal="JMIR Mhealth Uhealth",
year="2016",
month="Oct",
day="13",
volume="4",
number="4",
pages="e118",
keywords="persuasive technology",
keywords="mobile applications",
keywords="chronic arthritis",
abstract="Background: Chronic arthritis (CA), an umbrella term for inflammatory rheumatic and other musculoskeletal diseases, is highly prevalent. Effective disease-modifying antirheumatic drugs for CA are available, with the exception of osteoarthritis, but require a long-term commitment of patients to comply with the medication regimen and management program as well as a tight follow-up by the treating physician and health professionals. Additionally, patients are advised to participate in physical exercise programs. Adherence to exercises and physical activity programs is often very low. Patients would benefit from support to increase medication compliance as well as compliance to the physical exercise programs. To address these shortcomings, health apps for CA patients have been created. These mobile apps assist patients in self-management of overall health measures, health prevention, and disease management. By including persuasive principles designed to reinforce, change, or shape attitudes or behaviors, health apps can transform into support tools that motivate and stimulate users to achieve or keep up with target behavior, also called persuasive systems. However, the extent to which health apps for CA patients consciously and successfully employ such persuasive principles remains unknown. Objective: The objective of this study was to evaluate the number and type of persuasive principles present in current health apps for CA patients. Methods: A review of apps for arthritis patients was conducted across the three major app stores (Google Play, Apple App Store, and Windows Phone Store). Collected apps were coded according to 37 persuasive principles, based on an altered version of the Persuasive System Design taxonomy of Oinas-Kukkonen and Harjuma and the taxonomy of Behavior Change Techniques of Michie and Abraham. In addition, user ratings, number of installs, and price of the apps were also coded. Results: We coded 28 apps. On average, 5.8 out of 37 persuasive principles were used in each app. The most used category of persuasive principles was System Credibility with an average of 2.6 principles. Task Support was the second most used, with an average of 2.3 persuasive principles. Next was Dialogue Support with an average of 0.5 principles. Social Support was last with an average of 0.01 persuasive principles only. Conclusions: Current health apps for CA patients would benefit from adding Social Support techniques (eg, social media, user fora) and extending Dialogue Support techniques (eg, rewards, praise). The addition of automated tracking of health-related parameters (eg, physical activity, step count) could further reduce the effort for CA patients to manage their disease and thus increase Task Support. Finally, apps for health could benefit from a more evidence-based approach, both in developing the app as well as ensuring that content can be verified as scientifically proven, which will result in enhanced System Credibility. ",
doi="10.2196/mhealth.6286",
url="http://mhealth.jmir.org/2016/4/e118/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27742604"
}


@Article{info:doi/10.2196/mhealth.5760,
author="Huang, Tzu-Yen Evelyn
and Williams, Henrietta
and Hocking, S. Jane
and Lim, SC Megan",
title="Safe Sex Messages Within Dating and Entertainment Smartphone Apps: A Review",
journal="JMIR Mhealth Uhealth",
year="2016",
month="Nov",
day="08",
volume="4",
number="4",
pages="e124",
keywords="mobile apps",
keywords="sexual health",
keywords="STDs",
keywords="sexually transmitted diseases",
keywords="mobile health",
keywords="mHealth",
abstract="Background: Smartphone apps provide a new platform for entertainment, information distribution, and health promotion activities, as well as for dating and casual sexual encounters. Previous research has shown high acceptability of sexual health interventions via smartphone apps; however, sexual health promotion apps were infrequently downloaded and underused. Integrating sexual health promotion into established apps might be a more effective method. Objective: The objective of our study was to critically review popular sex-related apps and dating apps, in order to ascertain whether they contain any sexual health content. Methods: Part 1: In January 2015, we used the term ``sexual'' to search for free apps in the Apple iTunes store and Android Google Play store, and categorized the sexual health content of the 137 apps identified. Part 2: We used the term ``dating'' to search for free geosocial-networking apps in the Apple iTunes and Android Google Play stores. The apps were downloaded to test functionality and to determine whether they included sexual health content. Results: Part 1: Of the 137 apps identified, 15 (11.0\%) had sexual health content and 15 (11.0\%) contained messages about sexual assault or violence. The majority of the apps did not contain any sexual health content. Part 2: We reviewed 60 dating apps: 44 (73\%) targeting heterosexual users, 9 (15\%) targeting men who have sex with men (MSM), 3 (5\%) targeting lesbian women, and 4 (7\%) for group dating. Only 9 dating apps contained sexual health content, of which 7 targeted MSM. Conclusions: The majority of sex-related apps and dating apps contained no sexual health content that could educate users about and remind them of their sexual risks. Sexual health practitioners and public health departments will need to work with app developers to promote sexual health within existing popular apps. For those apps that already contain sexual health messages, further study to investigate the effectiveness of the content is needed. ",
doi="10.2196/mhealth.5760",
url="http://mhealth.jmir.org/2016/4/e124/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27826133"
}


@Article{info:doi/10.2196/mhealth.6611,
author="Chen, Elizabeth
and Mangone, Rose Emily",
title="A Systematic Review of Apps using Mobile Criteria for Adolescent Pregnancy Prevention (mCAPP)",
journal="JMIR Mhealth Uhealth",
year="2016",
month="Nov",
day="10",
volume="4",
number="4",
pages="e122",
keywords="mHealth",
keywords="eHealth",
keywords="smartphone",
keywords="mobile phone",
keywords="app",
keywords="teen",
keywords="adolescent",
keywords="young adult",
keywords="systematic review",
keywords="unintended pregnancy",
keywords="family planning",
keywords="pregnancy prevention",
keywords="contraception",
abstract="Background: Adolescents in the United States and globally represent a high-risk population for unintended pregnancy, which leads to high social, economic, and health costs. Access to smartphone apps is rapidly increasing among youth, but little is known about the strategies that apps employ to prevent pregnancy among adolescents and young adults. Further, there are no guidelines on best practices for adolescent and young adult pregnancy prevention through mobile apps. Objective: This review developed a preliminary evaluation framework for the assessment of mobile apps for adolescent and young adult pregnancy prevention and used this framework to assess available apps in the Apple App Store and Google Play that targeted adolescents and young adults with family planning and pregnancy prevention support. Methods: We developed an assessment rubric called Mobile Criteria for Adolescent Pregnancy Prevention (mCAPP) for data extraction using evidence-based and promising best practices from the literature. mCAPP comprises 4 domains: (1) app characteristics, (2) user interface features, (3) adolescent pregnancy prevention best practices, and (4) general sexual and reproductive health (SRH) features. For inclusion in the review, apps that advertised pregnancy prevention services and explicitly mentioned youth, were in English, and were free were systematically identified in the Apple App Store and Google Play in 2015. Screening, data extraction, and 4 interrater reliability checks were conducted by 2 reviewers. Each app was assessed for 92 facets of the mCAPP checklist. Results: Our search returned 4043 app descriptions in the Apple App Store (462) and Google Play (3581). After screening for inclusion criteria, 22 unique apps were included in our analysis. Included apps targeted teens in primarily developed countries, and the most common user interface features were clinic and health service locators. While app strengths included provision of SRH education, description of modern contraceptives, and some use of evidence-based adolescent best practices, gaps remain in the implementation of the majority of adolescent best practices and user interface features. Of the 8 best practices for teen pregnancy prevention operationalized through mCAPP, the most commonly implemented best practice was the provision of information on how to use contraceptives to prevent pregnancy (15/22), followed by provision of accurate information on pregnancy risk of sexual behaviors (13/22); information on SRH communication, negotiation, or refusal skills (10/22); and the use of persuasive language around contraceptive use (9/22). Conclusions: The quality and scope of apps for adolescent pregnancy prevention varies, indicating that developers and researchers may need a supportive framework. mCAPP can help researchers and developers consider mobile-relevant evidence-based best practices for adolescent SRH as they develop teen pregnancy prevention apps. Given the novelty of the mobile approach, further research is needed on the impact of mCAPP criteria via mobile channels on adolescent health knowledge, behaviors, and outcomes. ",
doi="10.2196/mhealth.6611",
url="http://mhealth.jmir.org/2016/4/e122/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27833070"
}


@Article{info:doi/10.2196/mhealth.6742,
author="Santo, Karla
and Richtering, S. Sarah
and Chalmers, John
and Thiagalingam, Aravinda
and Chow, K. Clara
and Redfern, Julie",
title="Mobile Phone Apps to Improve Medication Adherence: A Systematic Stepwise Process to Identify High-Quality Apps",
journal="JMIR Mhealth Uhealth",
year="2016",
month="Dec",
day="02",
volume="4",
number="4",
pages="e132",
keywords="medication adherence",
keywords="medication compliance",
keywords="mobile phone",
keywords="smartphone",
keywords="mobile apps",
keywords="mobile applications",
abstract="Background: There are a growing number of mobile phone apps available to support people in taking their medications and to improve medication adherence. However, little is known about how these apps differ in terms of features, quality, and effectiveness. Objective: We aimed to systematically review the medication reminder apps available in the Australian iTunes store and Google Play to assess their features and their quality in order to identify high-quality apps. Methods: This review was conducted in a similar manner to a systematic review by using a stepwise approach that included (1) a search strategy; (2) eligibility assessment; (3) app selection process through an initial screening of all retrieved apps and full app review of the included apps; (4) data extraction using a predefined set of features considered important or desirable in medication reminder apps; (5) analysis by classifying the apps as basic and advanced medication reminder apps and scoring and ranking them; and (6) a quality assessment by using the Mobile App Rating Scale (MARS), a reliable tool to assess mobile health apps. Results: We identified 272 medication reminder apps, of which 152 were found only in Google Play, 87 only in iTunes, and 33 in both app stores. Apps found in Google Play had more customer reviews, higher star ratings, and lower cost compared with apps in iTunes. Only 109 apps were available for free and 124 were recently updated in 2015 or 2016. Overall, the median number of features per app was 3.0 (interquartile range 4.0) and only 18 apps had ?9 of the 17 desirable features. The most common features were flexible scheduling that was present in 56.3\% (153/272) of the included apps, medication tracking history in 54.8\% (149/272), snooze option in 34.9\% (95/272), and visual aids in 32.4\% (88/272). We classified 54.8\% (149/272) of the included apps as advanced medication reminder apps and 45.2\% (123/272) as basic medication reminder apps. The advanced apps had a higher number of features per app compared with the basic apps. Using the MARS instrument, we were able to identify high-quality apps that were rated as being very interesting and entertaining, highly interactive and customizable, intuitive, and easy to use and to navigate as well as having a high level of visual appeal and good-quality information. Conclusions: Many medication reminder apps are available in the app stores; however, the majority of them did not have many of the desirable features and were, therefore, considered low quality. Through a systematic stepwise process, we were able to identify high-quality apps to be tested in a future study that will provide evidence on the use of medication reminder apps to improve medication adherence. ",
doi="10.2196/mhealth.6742",
url="http://mhealth.jmir.org/2016/4/e132/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27913373"
}


@Article{info:doi/10.2196/mhealth.5931,
author="Sullivan, K. Rachel
and Marsh, Samantha
and Halvarsson, Jakob
and Holdsworth, Michelle
and Waterlander, Wilma
and Poelman, P. Maartje
and Salmond, Ann Jennifer
and Christian, Hayley
and Koh, SC Lenny
and Cade, E. Janet
and Spence, C. John
and Woodward, Alistair
and Maddison, Ralph",
title="Smartphone Apps for Measuring Human Health and Climate Change Co-Benefits: A Comparison and Quality Rating of Available Apps",
journal="JMIR Mhealth Uhealth",
year="2016",
month="Dec",
day="19",
volume="4",
number="4",
pages="e135",
keywords="climate change",
keywords="noncommunicable diseases",
keywords="smartphone apps",
keywords="travel",
keywords="diet",
keywords="greenhouse gas emissions",
keywords="carbon footprint",
keywords="individual",
keywords="behavior change",
abstract="Background: Climate change and the burden of noncommunicable diseases are major global challenges. Opportunities exist to investigate health and climate change co-benefits through a shift from motorized to active transport (walking and cycling) and a shift in dietary patterns away from a globalized diet to reduced consumption of meat and energy dense foods. Given the ubiquitous use and proliferation of smartphone apps, an opportunity exists to use this technology to capture individual travel and dietary behavior and the associated impact on the environment and health. Objective: The objective of the study is to identify, describe the features, and rate the quality of existing smartphone apps which capture personal travel and dietary behavior and simultaneously estimate the carbon cost and potential health consequences of these actions. Methods: The Google Play and Apple App Stores were searched between October 19 and November 6, 2015, and a secondary Google search using the apps filter was conducted between August 8 and September 18, 2016. Eligible apps were required to estimate the carbon cost of personal behaviors with the potential to include features to maximize health outcomes. The quality of included apps was assessed by 2 researchers using the Mobile Application Rating Scale (MARS). Results: Out of 7213 results, 40 apps were identified and rated. Multiple travel-related apps were identified, however no apps solely focused on the carbon impact or health consequences of dietary behavior. None of the rated apps provided sufficient information on the health consequences of travel and dietary behavior. Some apps included features to maximize participant engagement and encourage behavior change towards reduced greenhouse gas emissions. Most apps were rated as acceptable quality as determined by the MARS; 1 was of poor quality and 10 apps were of good quality. Interrater reliability of the 2 evaluators was excellent (ICC=0.94, 95\% CI 0.87-0.97). Conclusions: Existing apps capturing travel and dietary behavior and the associated health and environmental impact are of mixed quality. Most apps do not include all desirable features or provide sufficient health information. Further research is needed to determine the potential of smartphone apps to evoke behavior change resulting in climate change and health co-benefits. ",
doi="10.2196/mhealth.5931",
url="http://mhealth.jmir.org/2016/4/e135/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27993762"
}


@Article{info:doi/10.2196/mhealth.5905,
author="Yazdanshenas, Hamed
and Bazargan, Mohsen
and Jones, Loretta
and Vawer, May
and Seto, B. Todd
and Farooq, Summer
and Taira, A. Deborah",
title="Engaging Gatekeeper-Stakeholders in Development of a Mobile Health Intervention to Improve Medication Adherence Among African American and Pacific Islander Elderly Patients With Hypertension",
journal="JMIR Mhealth Uhealth",
year="2016",
month="Oct",
day="26",
volume="4",
number="4",
pages="e116",
keywords="health",
keywords="technology",
keywords="elderly",
keywords="minority",
keywords="hypertension",
keywords="mHealth",
abstract="Background: Approximately 70 million people in the United States have hypertension. Although antihypertensive therapy can reduce the morbidity and mortality associated with hypertension, often patients do not take their medication as prescribed. Objective: The goal of this study was to better understand issues affecting the acceptability and usability of mobile health technology (mHealth) to improve medication adherence for elderly African American and Native Hawaiian and Pacific Islander patients with hypertension. Methods: In-depth interviews were conducted with 20 gatekeeper-stakeholders using targeted open-ended questions. Interviews were deidentified, transcribed, organized, and coded manually by two independent coders. Analysis of patient interviews used largely a deductive approach because the targeted open-ended interview questions were designed to explore issues specific to the design and acceptability of a mHealth intervention for seniors. Results: A number of similar themes regarding elements of a successful intervention emerged from our two groups of African American and Native Hawaiian and Pacific Islander gatekeeper-stakeholders. First was the need to teach participants both about the importance of adherence to antihypertensive medications. Second, was the use of mobile phones for messaging and patients need to be able to access ongoing technical support. Third, messaging needs to be short and simple, but personalized, and to come from someone the participant trusts and with whom they have a connection. There were some differences between groups. For instance, there was a strong sentiment among the African American group that the church be involved and that the intervention begin with group workshops, whereas the Native Hawaiian and Pacific Islander group seemed to believe that the teaching could occur on a one-to-one basis with the health care provider. Conclusions: Information from our gatekeeper-stakeholder (key informant) interviews suggests that the design of a mHealth intervention to improve adherence to antihypertensives among the elderly could be very similar for African Americans and Native Hawaiian and Pacific Islanders. The main difference might be in the way in which the program is initiated (possibly through church-based workshops for African Americans and by individual providers for Native Hawaiian and Pacific Islanders). Another difference might be who sends the messages with African Americans wanting someone outside the health care system, but Native Hawaiian and Pacific Islanders preferring a provider. ",
doi="10.2196/mhealth.5905",
url="http://mhealth.jmir.org/2016/4/e116/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27784651"
}


@Article{info:doi/10.2196/mhealth.6705,
author="Bock, C. Beth
and Lantini, Ryan
and Thind, Herpreet
and Walaska, Kristen
and Rosen, K. Rochelle
and Fava, L. Joseph
and Barnett, P. Nancy
and Scott-Sheldon, AJ Lori",
title="The Mobile Phone Affinity Scale: Enhancement and Refinement",
journal="JMIR Mhealth Uhealth",
year="2016",
month="Dec",
day="15",
volume="4",
number="4",
pages="e134",
keywords="mobile phone",
keywords="psychometrics",
keywords="assessment",
keywords="measure",
abstract="Background: Existing instruments that assess individuals' relationships with mobile phones tend to focus on negative constructs such as addiction or dependence, and appear to assume that high mobile phone use reflects pathology. Mobile phones can be beneficial for health behavior change, disease management, work productivity, and social connections, so there is a need for an instrument that provides a more balanced assessment of the various aspects of individuals' relationships with mobile phones. Objective: The purpose of this research was to develop, revise, and validate the Mobile Phone Affinity Scale, a multi-scale instrument designed to assess key factors associated with mobile phone use. Methods: Participants (N=1058, mean age 33) were recruited from Amazon Mechanical Turk between March and April of 2016 to complete a survey that assessed participants' mobile phone attitudes and use, anxious and depressive symptoms, and resilience. Results: Confirmatory factor analysis supported a 6-factor model. The final measure consisted of 24 items, with 4 items on each of 6 factors: Connectedness, Productivity, Empowerment, Anxious Attachment, Addiction, and Continuous Use. The subscales demonstrated strong internal consistency (Cronbach alpha range=0.76-0.88, mean 0.83), and high item factor loadings (range=0.57-0.87, mean 0.75). Tests for validity further demonstrated support for the individual subscales. Conclusions: Mobile phone affinity may have an important impact in the development and effectiveness of mobile health interventions, and continued research is needed to assess its predictive ability in health behavior change interventions delivered via mobile phones. ",
doi="10.2196/mhealth.6705",
url="http://mhealth.jmir.org/2016/4/e134/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27979792"
}


@Article{info:doi/10.2196/mhealth.6367,
author="Wilkinson, L. Jessica
and Strickling, Kate
and Payne, E. Hannah
and Jensen, C. Kayla
and West, H. Joshua",
title="Evaluation of Diet-Related Infographics on Pinterest for Use of Behavior Change Theories: A Content Analysis",
journal="JMIR Mhealth Uhealth",
year="2016",
month="Dec",
day="08",
volume="4",
number="4",
pages="e133",
keywords="behavioral health",
keywords="content analysis",
keywords="nutrition",
keywords="social media",
keywords="Internet",
keywords="healthy eating",
keywords="theory",
abstract="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 incorporates behavior change theory. Objectives: The objective of the study was to determine the presence of health behavior theory (HBT) constructs in pins found on Pinterest and assess the relationship between various pin characteristics and the likelihood of 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 (170/236, 72\%), followed by behavioral capability (123/238, 51.7\%) and perceived severity (79/236, 33.5\%). The construct that appeared the least was self-regulation/self-control (2/237, 0.8\%). 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 few HBT elements. Health professionals and organizations should create and disseminate infographics that contain more elements of HBT to better influence healthy eating behavior. This may be accomplished by creating pins that use both text and images of people and food in order to portray elements of HBT and convey nutritional information. ",
doi="10.2196/mhealth.6367",
url="http://mhealth.jmir.org/2016/4/e133/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27932316"
}


@Article{info:doi/10.2196/mhealth.5796,
author="Mira, Joaqu{\'i}n Jos{\'e}
and Carrillo, Irene
and Fernandez, Cesar
and Vicente, Asuncion Maria
and Guilabert, Mercedes",
title="Design and Testing of the Safety Agenda Mobile App for Managing Health Care Managers' Patient Safety Responsibilities",
journal="JMIR Mhealth Uhealth",
year="2016",
month="Dec",
day="08",
volume="4",
number="4",
pages="e131",
keywords="patient safety",
keywords="mobile apps",
keywords="administrators",
keywords="health service",
abstract="Background: Adverse events are a reality in clinical practice. Reducing the prevalence of preventable adverse events by stemming their causes requires health managers' engagement. Objective: The objective of our study was to develop an app for mobile phones and tablets that would provide managers with an overview of their responsibilities in matters of patient safety and would help them manage interventions that are expected to be carried out throughout the year. Methods: The Safety Agenda Mobile App (SAMA) was designed based on standardized regulations and reviews of studies about health managers' roles in patient safety. A total of 7 managers used a beta version of SAMA for 2 months and then they assessed and proposed improvements in its design. Their experience permitted redesigning SAMA, improving functions and navigation. A total of 74 Spanish health managers tried out the revised version of SAMA. After 4 months, their assessment was requested in a voluntary and anonymous manner. Results: SAMA is an iOS app that includes 37 predefined tasks that are the responsibility of health managers. Health managers can adapt these tasks to their schedule, add new ones, and share them with their team. SAMA menus are structured in 4 main areas: information, registry, task list, and settings. Of the 74 users who tested SAMA, 64 (86\%) users provided a positive assessment of SAMA characteristics and utility. Over an 11-month period, 238 users downloaded SAMA. This mobile app has obtained the AppSaludable (HealthyApp) Quality Seal. Conclusions: SAMA includes a set of activities that are expected to be carried out by health managers in matters of patient safety and contributes toward improving the awareness of their responsibilities in matters of safety. ",
doi="10.2196/mhealth.5796",
url="http://mhealth.jmir.org/2016/4/e131/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27932315"
}


@Article{info:doi/10.2196/mhealth.6540,
author="Ridgers, D. Nicola
and McNarry, A. Melitta
and Mackintosh, A. Kelly",
title="Feasibility and Effectiveness of Using Wearable Activity Trackers in Youth: A Systematic Review",
journal="JMIR Mhealth Uhealth",
year="2016",
month="Nov",
day="23",
volume="4",
number="4",
pages="e129",
keywords="behaviour change",
keywords="electronic activity monitor",
keywords="mHealth",
keywords="physical activity",
abstract="Background: The proliferation and popularity of wearable activity trackers (eg, Fitbit, Jawbone, Misfit) may present an opportunity to integrate such technology into physical activity interventions. While several systematic reviews have reported intervention effects of using wearable activity trackers on adults' physical activity levels, none to date have focused specifically on children and adolescents. Objective: The aim of this review was to examine the effectiveness of wearable activity trackers as a tool for increasing children's and adolescents' physical activity levels. We also examined the feasibility of using such technology in younger populations (age range 5-19 years). Methods: We conducted a systematic search of 5 electronic databases, reference lists, and personal archives to identify articles published up until August 2016 that met the inclusion criteria. Articles were included if they (1) specifically examined the use of a wearable device within an intervention or a feasibility study; (2) included participants aged 5-19 years old; (3) had a measure of physical activity as an outcome variable for intervention studies; (4) reported process data concerning the feasibility of the device in feasibility studies; and (5) were published in English. Data were analyzed in August 2016. Results: In total, we identified and analyzed 5 studies (3 intervention, 2 feasibility). Intervention delivery ranged from 19 days to 3 months, with only 1 study using a randomized controlled trial design. Wearable activity trackers were typically combined with other intervention approaches such as goal setting and researcher feedback. While intervention effects were generally positive, the reported differences were largely nonsignificant. The feasibility studies indicated that monitor comfort and design and feedback features were important factors to children and adolescents. Conclusions: There is a paucity of research concerning the effectiveness and feasibility of wearable activity trackers as a tool for increasing children's and adolescents' physical activity levels. While there are some preliminary data to suggest these devices may have the potential to increase activity levels through self-monitoring and goal setting in the short term, more research is needed to establish longer-term effects on behavior. ",
doi="10.2196/mhealth.6540",
url="http://mhealth.jmir.org/2016/4/e129/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27881359"
}


@Article{info:doi/10.2196/mhealth.6953,
author="Sathyanarayana, Aarti
and Joty, Shafiq
and Fernandez-Luque, Luis
and Ofli, Ferda
and Srivastava, Jaideep
and Elmagarmid, Ahmed
and Arora, Teresa
and Taheri, Shahrad",
title="Correction of: Sleep Quality Prediction From Wearable Data Using Deep Learning",
journal="JMIR Mhealth Uhealth",
year="2016",
month="Nov",
day="25",
volume="4",
number="4",
pages="e130",
doi="10.2196/mhealth.6953",
url="http://mhealth.jmir.org/2016/4/e130/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27885989"
}