JMIR mHealth and uHealth最新文献

{"title":"A Novel Approach for Improving Gait Speed Estimation Using a Single Inertial Measurement Unit Embedded in a Smartphone: Validity and Reliability Study.","authors":"Pei-An Lee, Wanting Yu, Junhong Zhou, Timothy Tsai, Brad Manor, On-Yee Lo","doi":"10.2196/52166","DOIUrl":"10.2196/52166","url":null,"abstract":"<p><strong>Background: </strong>Gait speed is a valuable biomarker for mobility and overall health assessment. Existing methods to measure gait speed require expensive equipment or personnel assistance, limiting their use in unsupervised, daily-life conditions. The availability of smartphones equipped with a single inertial measurement unit (IMU) presents a viable and convenient method for measuring gait speed outside of laboratory and clinical settings. Previous works have used the inverted pendulum model to estimate gait speed using a non-smartphone-based IMU attached to the trunk. However, it is unclear whether and how this approach can estimate gait speed using the IMU embedded in a smartphone while being carried in a pants pocket during walking, especially under various walking conditions.</p><p><strong>Objective: </strong>This study aimed to validate and test the reliability of a smartphone IMU-based gait speed measurement placed in the user's front pants pocket in both healthy young and older adults while walking quietly (ie, normal walking) and walking while conducting a cognitive task (ie, dual-task walking).</p><p><strong>Methods: </strong>A custom-developed smartphone application (app) was used to record gait data from 12 young adults and 12 older adults during normal and dual-task walking. The validity and reliability of gait speed and step length estimations from the smartphone were compared with the gold standard GAITRite mat. A coefficient-based adjustment based upon a coefficient relative to the original estimation of step length was applied to improve the accuracy of gait speed estimation. The magnitude of error (ie, bias and limits of agreement) between the gait data from the smartphone and the GAITRite mat was calculated for each stride. The Passing-Bablok orthogonal regression model was used to provide agreement (ie, slopes and intercepts) between the smartphone and the GAITRite mat.</p><p><strong>Results: </strong>The gait speed measured by the smartphone was valid when compared to the GAITRite mat. The original limits of agreement were 0.50 m/s (an ideal value of 0 m/s), and the orthogonal regression analysis indicated a slope of 1.68 (an ideal value of 1) and an intercept of -0.70 (an ideal value of 0). After adjustment, the accuracy of the smartphone-derived gait speed estimation improved, with limits of agreement reduced to 0.34 m/s. The adjusted slope improved to 1.00, with an intercept of 0.03. The test-retest reliability of smartphone-derived gait speed was good to excellent within supervised laboratory settings and unsupervised home conditions. The adjustment coefficients were applicable to a wide range of step lengths and gait speeds.</p><p><strong>Conclusions: </strong>The inverted pendulum approach is a valid and reliable method for estimating gait speed from a smartphone IMU placed in the pockets of younger and older adults. Adjusting step length by a coefficient derived from the original estimation of step length","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"12 ","pages":"e52166"},"PeriodicalIF":5.4,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11336779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141975655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Effects of a Self-Help Mobile Phone App on Worry and Rumination Experienced by Young Adults: Randomized Controlled Trial.","authors":"Daniel Edge, Edward Watkins, Alexandra Newbold, Thomas Ehring, Mads Frost, Tabea Rosenkranz","doi":"10.2196/51932","DOIUrl":"10.2196/51932","url":null,"abstract":"<p><strong>Background: </strong>Delivery of preventative interventions via mobile phone apps offers an effective and accessible way to address the global priority of improving the mental health of adolescents and young adults. A proven risk factor for anxiety and depression is elevated worry and rumination, also known as repetitive negative thinking (RNT).</p><p><strong>Objective: </strong>This was a prevention mechanism trial that aimed to investigate whether an RNT-targeting self-help mobile phone app (MyMoodCoach) reduces worry and rumination in young adults residing in the United Kingdom. A secondary objective was to test whether the app reduces symptoms of anxiety and depression and improves well-being.</p><p><strong>Methods: </strong>A web-based, single-blind, 2-arm parallel-group randomized controlled trial was conducted with 236 people aged between 16 and 24 years, who self-reported high levels of worry or rumination. Eligible participants were randomized to an active intervention group (usual practice, plus up to 6 weeks of using the RNT-targeting mobile app, n=119) or a waitlist control group (usual practice with no access to the app until after 6 weeks, n=117). The primary outcome was changes in worry and rumination 6 weeks after randomization. Secondary outcomes included changes in well-being and symptoms of anxiety and depression after 6 weeks and changes in all measures after 12 weeks.</p><p><strong>Results: </strong>Participants randomly allocated to use the RNT-targeting self-help app showed significantly lower levels of rumination (mean difference -2.92, 95% CI -5.57 to -0.28; P=.03; η_p²=0.02) and worry (mean difference -3.97, 95% CI -6.21 to -1.73; P<.001; η_p²=0.06) at 6-week follow-up, relative to the waitlist control. Similar differences were observed for well-being (P<.001), anxiety (P=.03), and depression (P=.04). The waitlist control group also showed improvement when given access to the app after 6 weeks. Improvements observed in the intervention group after 6 weeks of using the app were maintained at the 12-week follow-up point.</p><p><strong>Conclusions: </strong>The MyMoodCoach app had a significant positive effect on worry and rumination, well-being, anxiety, and depression in young adults, relative to waitlist controls, providing proof-of-principle that an unguided self-help app can effectively reduce RNT. This app, therefore, has potential for the prevention of anxiety and depression although longer-term effects on incidence need to be directly evaluated.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT04950257; https://www.clinicaltrials.gov/ct2/show/NCT04950257.</p><p><strong>International registered report identifier (irrid): </strong>RR2-10.1186/s12888-021-03536-0.</p>","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"12 ","pages":"e51932"},"PeriodicalIF":5.4,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11350318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141975656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of a Web-Based Home Blood Pressure Monitoring Program in Improving Predialysis Blood Pressure Control Among Patients Undergoing Hemodialysis: Randomized Controlled Trial","authors":"Tingting Chen, Wenbo Zhao, Qianqian Pei, Yanru Chen, Jinmei Yin, Min Zhang, Cheng Wang, Jing Zheng","doi":"10.2196/53355","DOIUrl":"https://doi.org/10.2196/53355","url":null,"abstract":"Background: Hypertension is highly prevalent among patients undergoing hemodialysis, with a significant proportion experiencing poorly controlled blood pressure (BP). Digital BP management in this population has been underutilized. Objective: This study aimed to explore the efficacy of a Web-based home blood pressure monitoring (HBPM) program in improving pre-dialysis BP control and enhancing knowledge, perception and adherence to HBPM among hypertensive patients undergoing hemodialysis. Methods: A multicenter, open-label, randomized controlled trial was conducted at two hemodialysis units. Patients were randomly allocated in a 1:1 ratio to either the Web-based HBPM program as the intervention group or to usual care as the control group over a 6-month period. The primary outcomes were the pre-dialysis BP control rate, defined as less than 140/90 mmHg, and the pre-dialysis systolic blood pressure (SBP), diastolic blood pressure (DBP), assessed from baseline to the 6-month follow-up. Secondary outcomes included patient knowledge, perception, and adherence to HBPM, evaluated using the home blood pressure monitoring knowledge questionnaire (HBPMKQ), home blood pressure monitoring perception scale (HBPMPS), and home blood pressure monitoring adherence scale (HBPMAS), respectively. The generalized estimating equations analysis was utilized to analyze the primary outcomes in the intention-to-treat analysis. Results: Of the 165 patients enrolled in the program (n=84, Web-based HBPM group; n=81, control group), 145 completed the follow-up assessment. During follow-up period, 11 instances of hypotension occurred in 9 patients in the Web-based HBPM group, compared to 15 events in 14 patients in the control group. The pre-dialysis BP control rate increased from 29.8% to 47.6% in the Web-based HBPM group after the 6-month intervention, while in the control group, it decreased from 37% to 24.7% (x2 =16.82, P <.001; OR = 5.11, 95%CI 2.14–12.23, P <.001). The Web-based HBPM group demonstrated a significant reduction after the 6-month intervention in the pre-dialysis SBP (t =2.46, P =.02; β = −6.09, 95%CI −10.94 – −1.24, P =.01), and the pre-dialysis DBP (t =3.20, P =.002; β = −4.93, 95%CI −7.93 – −1.93, P =.001). Scores on HBPMKQ (t = -9.18, P <.001), HBPMPS (t = −10.65, P <.001), and HBPMAS (t =−8.04, P <.001) were significantly higher after 6-months of intervention. Conclusions: Implementation of a Web-based HBPM program can enhance pre-dialysis BP control, and the knowledge, perception, and adherence to HBPM among patients undergoing hemodialysis. This Web-based HBPM program should be promoted in appropriate clinical settings. Clinical Trial: China Clinical Trial Registration Center ChiCTR2100051535; https://www.chictr.org.cn/showproj.html?proj=133286","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"200 1","pages":""},"PeriodicalIF":5.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141945475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Data Collection and Management of mHealth, Wearables, and Internet of Things in Digital Behavioral Health Interventions With the Awesome Data Acquisition Method (ADAM): Development of a Novel Informatics Architecture.","authors":"I Wayan Pulantara, Yuhan Wang, Lora E Burke, Susan M Sereika, Zhadyra Bizhanova, Jacob K Kariuki, Jessica Cheng, Britney Beatrice, India Loar, Maribel Cedillo, Molly B Conroy, Bambang Parmanto","doi":"10.2196/50043","DOIUrl":"10.2196/50043","url":null,"abstract":"<p><strong>Unlabelled: </strong>The integration of health and activity data from various wearable devices into research studies presents technical and operational challenges. The Awesome Data Acquisition Method (ADAM) is a versatile, web-based system that was designed for integrating data from various sources and managing a large-scale multiphase research study. As a data collecting system, ADAM allows real-time data collection from wearable devices through the device's application programmable interface and the mobile app's adaptive real-time questionnaires. As a clinical trial management system, ADAM integrates clinical trial management processes and efficiently supports recruitment, screening, randomization, data tracking, data reporting, and data analysis during the entire research study process. We used a behavioral weight-loss intervention study (SMARTER trial) as a test case to evaluate the ADAM system. SMARTER was a randomized controlled trial that screened 1741 participants and enrolled 502 adults. As a result, the ADAM system was efficiently and successfully deployed to organize and manage the SMARTER trial. Moreover, with its versatile integration capability, the ADAM system made the necessary switch to fully remote assessments and tracking that are performed seamlessly and promptly when the COVID-19 pandemic ceased in-person contact. The remote-native features afforded by the ADAM system minimized the effects of the COVID-19 lockdown on the SMARTER trial. The success of SMARTER proved the comprehensiveness and efficiency of the ADAM system. Moreover, ADAM was designed to be generalizable and scalable to fit other studies with minimal editing, redevelopment, and customization. The ADAM system can benefit various behavioral interventions and different populations.</p>","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"12 ","pages":"e50043"},"PeriodicalIF":5.4,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11322796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: The Effect of an mHealth Self-Monitoring Intervention (MI-BP) on Blood Pressure Among Black Individuals With Uncontrolled Hypertension: Randomized Controlled Trial.","authors":"Lorraine R Buis, Junhan Kim, Ananda Sen, Dongru Chen, Katee Dawood, Reema Kadri, Rachelle Muladore, Melissa Plegue, Caroline R Richardson, Zora Djuric, Candace McNaughton, David Hutton, Lionel P Robert, Sun Young Park, Phillip Levy","doi":"10.2196/64632","DOIUrl":"10.2196/64632","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.2196/57863.].</p>","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"12 ","pages":"e64632"},"PeriodicalIF":5.4,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11336500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141897461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using Wearables to Study Biopsychosocial Dynamics in Couples Who Cope With a Chronic Health Condition: Ambulatory Assessment Study.","authors":"Theresa Pauly, Janina Lüscher, Lea Olivia Wilhelm, Melanie Alexandra Amrein, George Boateng, Tobias Kowatsch, Elgar Fleisch, Guy Bodenmann, Urte Scholz","doi":"10.2196/49576","DOIUrl":"10.2196/49576","url":null,"abstract":"<p><strong>Background: </strong>Technology has become an integral part of our everyday life, and its use to manage and study health is no exception. Romantic partners play a critical role in managing chronic health conditions as they tend to be a primary source of support.</p><p><strong>Objective: </strong>This study tests the feasibility of using commercial wearables to monitor couples' unique way of communicating and supporting each other and documents the physiological correlates of interpersonal dynamics (ie, heart rate linkage).</p><p><strong>Methods: </strong>We analyzed 617 audio recordings of 5-minute duration (384 with concurrent heart rate data) and 527 brief self-reports collected from 11 couples in which 1 partner had type II diabetes during the course of their typical daily lives. Audio data were coded by trained raters for social support. The extent to which heart rate fluctuations were linked among couples was quantified using cross-correlations. Random-intercept multilevel models explored whether cross-correlations might differ by social contexts and exchanges.</p><p><strong>Results: </strong>Sixty percent of audio recordings captured speech between partners and partners reported personal contact with each other in 75% of self-reports. Based on the coding, social support was found in 6% of recordings, whereas at least 1 partner self-reported social support about half the time (53%). Couples, on average, showed small to moderate interconnections in their heart rate fluctuations (r=0.04-0.22). Couples also varied in the extent to which there was lagged linkage, that is, meaning that changes in one partner's heart rate tended to precede changes in the other partner's heart rate. Exploratory analyses showed that heart rate linkage was stronger (1) in rater-coded partner conversations (vs moments of no rater-coded partner conversations: r_diff=0.13; P=.03), (2) when partners self-reported interpersonal contact (vs moments of no self-reported interpersonal contact: r_diff=0.20; P<.001), and (3) when partners self-reported social support exchanges (vs moments of no self-reported social support exchange: r_diff=0.15; P=.004).</p><p><strong>Conclusions: </strong>Our study provides initial evidence for the utility of using wearables to collect biopsychosocial data in couples managing a chronic health condition in daily life. Specifically, heart rate linkage might play a role in fostering chronic disease management as a couple. Insights from collecting such data could inform future technology interventions to promote healthy lifestyle engagement and adaptive chronic disease management.</p><p><strong>International registered report identifier (irrid): </strong>RR2-10.2196/13685.</p>","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"12 ","pages":"e49576"},"PeriodicalIF":5.4,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11333870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141893453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical Activity, Body Composition, and Fitness Variables in Adolescents After Periods of Mandatory, Promoted or Nonmandatory, Nonpromoted Use of Step Tracker Mobile Apps: Randomized Controlled Trial.","authors":"Adrián Mateo-Orcajada, Raquel Vaquero-Cristóbal, Jorge Mota, Lucía Abenza-Cano","doi":"10.2196/51206","DOIUrl":"10.2196/51206","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;It is not known whether an intervention made mandatory as a physical education (PE) class assignment and aimed at promoting physical activity (PA) in adolescents can create a healthy walking habit, which would allow further improvements to be achieved after the mandatory and promoted intervention has been completed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The aims of this study were to (1) investigate whether, after a period of using a step tracker mobile app made mandatory and promoted as a PE class assignment, adolescents continue to use it when its use is no longer mandatory and promoted; (2) determine whether there are changes in the PA level, body composition, and fitness of adolescents when the use of the app is mandatory and promoted and when it is neither mandatory nor promoted; and (3) analyze whether the covariates maturity status, gender, and specific app used can have an influence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A total of 357 students in compulsory secondary education (age: mean 13.92, SD 1.91 y) participated in the study. A randomized controlled trial was conducted consisting of 2 consecutive 10-week interventions. Participants' PA level, body composition, and fitness were measured at baseline (T1), after 10 weeks of mandatory and promoted app use (T2), and after 10 weeks of nonmandatory and nonpromoted app use (T3). Each participant in the experimental group (EG) used 1 of 4 selected step tracker mobile apps after school hours.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The results showed that when the use of the apps was neither mandatory nor promoted as a PE class assignment, only a few adolescents (18/216, 8.3%) continued the walking practice. After the mandatory and promoted intervention period (T1 vs T2), a decrease in the sum of 3 skinfolds (mean difference [MD] 1.679; P=.02) as well as improvements in the PA level (MD -0.170; P&lt;.001), maximal oxygen uptake (MD -1.006; P&lt;.001), countermovement jump test (MD -1.337; P=.04), curl-up test (MD -3.791; P&lt;.001), and push-up test (MD -1.920; P&lt;.001) in the EG were recorded. However, the changes between T1 and T2 were significantly greater in the EG than in the control group only in the PA level and curl-up test. Thus, when comparing the measurements taken between T1 and T3, no significant changes in body composition (P=.07) or fitness (P=.84) were observed between the EG and the control group. The covariates maturity status, gender, and specific app used showed a significant effect in most of the analyses performed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;A period of mandatory and promoted use of step tracker mobile apps benefited the variables of body composition and fitness in adolescents but did not create a healthy walking habit in this population; therefore, when the use of these apps ceased to be mandatory and promoted, the effects obtained disappeared.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Trial registration: &lt;/strong&gt;ClinicalTrials.gov NCT06164041; https://clinicaltrials.gov/study/NCT06","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"12 ","pages":"e51206"},"PeriodicalIF":5.4,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11322691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141855552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of a Mobile Health App (eMOTIVA) Regarding Compliance With Cardiac Rehabilitation Guidelines in Patients With Coronary Artery Disease: Randomized Controlled Clinical Trial.","authors":"Celia Cruz-Cobo, María Ángeles Bernal-Jiménez, Germán Calle, Livia Luciana Gheorghe, Alejandro Gutiérrez-Barrios, Dolores Cañadas, Josep A Tur, Rafael Vázquez-García, María José Santi-Cano","doi":"10.2196/55421","DOIUrl":"10.2196/55421","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Cardiac rehabilitation is fundamental among patients recovering from a coronary event, and mHealth technology may constitute a useful tool that provides guidelines based on scientific evidence in an entertaining, attractive, and user-friendly format.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to compare the efficacy of an mHealth intervention involving the eMOTIVA app and that of usual care regarding compliance with cardiac rehabilitation guidelines in terms of lifestyle, cardiovascular risk factors, and satisfaction among patients with acute coronary syndrome.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A randomized controlled clinical trial with a parallel group design was conducted. It included 300 patients (mHealth group, 150; control group, 150) who underwent percutaneous coronary intervention for acute coronary syndrome. Both groups underwent evaluations initially (during hospitalization) and after 3 and 6 months (face-to-face consultations). The eMOTIVA app incorporates a virtual classroom providing audio and video information about a healthy lifestyle, a section for self-recording cardiovascular risk factors, and a section for feedback messages and gamification. The primary outcome variables were (1) adherence to the Mediterranean diet and the frequency of consumption of food; (2) physical activity level, sedentary time, and exercise capacity; (3) smoking cessation and nicotine dependence; (4) level of knowledge about cardiovascular risk factors; and (5) app satisfaction and usability.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The study analyzed 287 patients (mHealth group, 145; control group, 142). Most participants were male (207/300, 69.0%), and the mean age was 62.53 (SD 8.65) years. Significant improvements were observed in the mHealth group compared with the control group at 6 months in terms of (1) adherence to the Mediterranean diet (mean 11.92, SD 1.70 vs 8.92, SD 2.66 points; P&lt;.001) and frequency of eating foods (red meat [≤1/week]: 141/143, 97.9% vs 96/141, 68.1%; industrial pastries [&lt;2/week]: 129/143, 89.6% vs 80/141, 56.8%; oily fish [≥2/week]: 124/143, 86.1% vs 64/141, 41.4%; vegetables [≥2/day]: 130/143, 90.3% vs 78/141, 55.3%; fruit [≥2/day]: 128/143, 88.9% vs 85/141, 60.2%; all P&lt;.001); (2) physical activity (mean 2112.66, SD 1196.67 vs 1372.60, SD 944.62 metabolic equivalents/week; P&lt;.001) and sedentary time (mean 8.38, SD 1.88 vs 9.59, SD 2.09 hours; P&lt;.001); (3) exercise capacity (distance: mean 473.49, SD 102.28 vs 447.25, SD 93.68 meters; P=.04); and (4) level of knowledge (mean 117.85, SD 3.83 vs 111.00, SD 7.11 points; P&lt;.001). App satisfaction was high (mean 42.53, SD 6.38 points), and its usability was excellent (mean 95.60, SD 4.03 points).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;With the eMOTIVA app, favorable results were obtained in the intervention group in terms of adherence to the Mediterranean diet, frequency of eating certain foods, physical activity, sedentary time, exercise capacity, kn","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"12 ","pages":"e55421"},"PeriodicalIF":5.4,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11310647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141758764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mobile App Intervention to Reduce Substance Use, Gambling, and Digital Media Use in Vocational School Students: Exploratory Analysis of the Intervention Arm of a Randomized Controlled Trial.","authors":"Kristin Grahlher, Matthis Morgenstern, Benjamin Pietsch, Elena Gomes de Matos, Monika Rossa, Kirsten Lochbühler, Anne Daubmann, Rainer Thomasius, Nicolas Arnaud","doi":"10.2196/51307","DOIUrl":"10.2196/51307","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;During adolescence, substance use and digital media exposure usually peak and can become major health risks. Prevention activities are mainly implemented in the regular school setting, and youth outside this system are not reached. A mobile app (\"Meine Zeit ohne\") has been developed specifically for vocational students and encourages participants to voluntarily reduce or abstain from a self-chosen addictive behavior including the use of a substance, gambling, or a media-related habit such as gaming or social media use for 2 weeks. Results from a randomized study indicate a significant impact on health-promoting behavior change after using the app. This exploratory study focuses on the intervention arm of this study, focusing on acceptance and differential effectiveness.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The aims of this study were (1) to examine the characteristics of participants who used the app, (2) to explore the effectiveness of the mobile intervention depending on how the app was used and depending on participants' characteristics, and (3) to study how variations in app use were related to participants' baseline characteristics.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Log data from study participants in the intervention group were analyzed including the frequency of app use (in days), selection of a specific challenge, and personal relevance (ie, the user was above a predefined risk score for a certain addictive behavior) of challenge selection (\"congruent use\": eg, a smoker selected a challenge related to reducing or quitting smoking). Dichotomous outcomes (change vs no change) referred to past-month substance use, gambling, and media-related behaviors. The relationship between these variables was analyzed using binary, multilevel, mixed-effects logistic regression models.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The intervention group consisted of 2367 vocational students, and 1458 (61.6%; mean age 19.0, SD 3.5 years; 830/1458, 56.9% male) of them provided full data. Of these 1458 students, 894 (61.3%) started a challenge and could be included in the analysis (mean 18.7, SD 3.5 years; 363/894, 40.6% female). Of these 894 students, 466 (52.1%) were considered frequent app users with more than 4 days of active use over the 2-week period. The challenge area most often chosen in the analyzed sample was related to social media use (332/894, 37.1%). A total of 407 (45.5%) of the 894 students selected a challenge in a behavioral domain of personal relevance. The effects of app use on outcomes were higher when the area of individual challenge choice was equal to the area of behavior change, challenge choice was related to a behavior of personal relevance, and the individual risk of engaging in different addictive behaviors was high.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The domain-specific effectiveness of the program was confirmed with no spillover between behavioral domains. Effectiveness appeared to be dependent on app use and use","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"12 ","pages":"e51307"},"PeriodicalIF":5.4,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11303885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141748246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conversational Chatbot for Cigarette Smoking Cessation: Results From the 11-Step User-Centered Design Development Process and Randomized Controlled Trial.","authors":"Jonathan B Bricker, Brianna Sullivan, Kristin Mull, Margarita Santiago-Torres, Juan M Lavista Ferres","doi":"10.2196/57318","DOIUrl":"10.2196/57318","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Conversational chatbots are an emerging digital intervention for smoking cessation. No studies have reported on the entire development process of a cessation chatbot.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;We aim to report results of the user-centered design development process and randomized controlled trial for a novel and comprehensive quit smoking conversational chatbot called QuitBot.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The 4 years of formative research for developing QuitBot followed an 11-step process: (1) specifying a conceptual model; (2) conducting content analysis of existing interventions (63 hours of intervention transcripts); (3) assessing user needs; (4) developing the chat's persona (\"personality\"); (5) prototyping content and persona; (6) developing full functionality; (7) programming the QuitBot; (8) conducting a diary study; (9) conducting a pilot randomized controlled trial (RCT); (10) reviewing results of the RCT; and (11) adding a free-form question and answer (QnA) function, based on user feedback from pilot RCT results. The process of adding a QnA function itself involved a three-step process: (1) generating QnA pairs, (2) fine-tuning large language models (LLMs) on QnA pairs, and (3) evaluating the LLM outputs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We developed a quit smoking program spanning 42 days of 2- to 3-minute conversations covering topics ranging from motivations to quit, setting a quit date, choosing Food and Drug Administration-approved cessation medications, coping with triggers, and recovering from lapses and relapses. In a pilot RCT with 96% three-month outcome data retention, QuitBot demonstrated high user engagement and promising cessation rates compared to the National Cancer Institute's SmokefreeTXT text messaging program, particularly among those who viewed all 42 days of program content: 30-day, complete-case, point prevalence abstinence rates at 3-month follow-up were 63% (39/62) for QuitBot versus 38.5% (45/117) for SmokefreeTXT (odds ratio 2.58, 95% CI 1.34-4.99; P=.005). However, Facebook Messenger intermittently blocked participants' access to QuitBot, so we transitioned from Facebook Messenger to a stand-alone smartphone app as the communication channel. Participants' frustration with QuitBot's inability to answer their open-ended questions led to us develop a core conversational feature, enabling users to ask open-ended questions about quitting cigarette smoking and for the QuitBot to respond with accurate and professional answers. To support this functionality, we developed a library of 11,000 QnA pairs on topics associated with quitting cigarette smoking. Model testing results showed that Microsoft's Azure-based QnA maker effectively handled questions that matched our library of 11,000 QnA pairs. A fine-tuned, contextualized GPT-3.5 (OpenAI) responds to questions that are not within our library of QnA pairs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The development process yielded t","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":" ","pages":"e57318"},"PeriodicalIF":5.4,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11303891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141446198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}