JMIR mHealth and uHealth最新文献

{"title":"Effectiveness of an mHealth Intervention With Short Text Messages to Promote Treatment Adherence Among HIV-Positive Mexican Adults: Randomized Controlled Trial.","authors":"Luis Eduardo Del Moral Trinidad, Jaime Federico Andrade Villanueva, Pedro Martínez Ayala, Rodolfo Ismael Cabrera Silva, Melva Guadalupe Herrera Godina, Luz Alicia González-Hernández","doi":"10.2196/57540","DOIUrl":"10.2196/57540","url":null,"abstract":"<p><strong>Background: </strong>HIV continues to be a public health concern in Mexico and Latin America due to an increase in new infections, despite a decrease being observed globally. Treatment adherence is a pillar for achieving viral suppression. It prevents the spread of the disease at a community level and improves the quality and survival of people living with HIV. Thus, it is important to implement strategies to achieve sustained treatment adherence.</p><p><strong>Objective: </strong>The objective of this study is to evaluate the effectiveness of a mobile health (mHealth) intervention based on SMS text messages to increase antiretroviral therapy (ART) adherence for HIV-positive adults.</p><p><strong>Methods: </strong>A randomized controlled trial was performed at the Hospital Civil de Guadalajara - Fray Antonio Alcalde on HIV-positive adults who had initiated ART. The mHealth intervention included the use of SMS text messages as a reminder system for upcoming medical examinations and ART resupply to increase adherence. This intervention was provided to 40 participants for a 6-month period. A control group (n=40) received medical attention by the standard protocol used in the hospital. Intervention effectiveness was assessed by quantifying CD4+ T cells and viral load, as well as a self-report of adherence by the patient.</p><p><strong>Results: </strong>The intervention group had greater adherence to ART than the control group (96% vs 92%; P<.001). In addition, the intervention group had better clinical characteristics, including a lower viral load (141 copies/mL vs 2413 copies/mL; P<.001) and a trend toward higher CD4+ T cells counts (399 cells/μL vs 290 cells/μL; P=.15).</p><p><strong>Conclusions: </strong>These results show that an mHealth intervention significantly improves ART adherence. Implementing mHealth programs could enhance the commitment of HIV-positive adults to their treatment.</p>","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"13 ","pages":"e57540"},"PeriodicalIF":5.4,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11793196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065664","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":"The Effects of Self-Monitoring Using a Smartwatch and Smartphone App on Stress Awareness, Self-Efficacy, and Well-Being-Related Outcomes in Police Officers: Longitudinal Mixed Design Study.","authors":"Herman Jaap de Vries, Roos Delahaij, Marianne van Zwieten, Helen Verhoef, Wim Kamphuis","doi":"10.2196/60708","DOIUrl":"10.2196/60708","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Wearable sensor technologies, often referred to as \"wearables,\" have seen a rapid rise in consumer interest in recent years. Initially often seen as \"activity trackers,\" wearables have gradually expanded to also estimate sleep, stress, and physiological recovery. In occupational settings, there is a growing interest in applying this technology to promote health and well-being, especially in professions with highly demanding working conditions such as first responders. However, it is not clear to what extent self-monitoring with wearables can positively influence stress- and well-being-related outcomes in real-life conditions and how wearable-based interventions should be designed for high-risk professionals.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The aim of this study was to investigate (1) whether offering a 5-week wearable-based intervention improves stress- and well-being-related outcomes in police officers and (2) whether extending a basic \"off-the-shelf\" wearable-based intervention with ecological momentary assessment (EMA) questionnaires, weekly personalized feedback reports, and peer support groups improves its effectiveness.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A total of 95 police officers from 5 offices participated in the study. The data of 79 participants were included for analysis. During the first 5 weeks, participants used no self-monitoring technology (control period). During the following 5 weeks (intervention period), 41 participants used a Garmin Forerunner 255 smartwatch with a custom-built app (comparable to that of the consumer-available wearable), whereas the other 38 participants used the same system, but complemented by daily EMA questionnaires, weekly personalized feedback reports, and access to peer support groups. At baseline (T0) and after the control (T1) and intervention (T2) periods, questionnaires were administered to measure 15 outcomes relating to stress awareness, stress management self-efficacy, and outcomes related to stress and general well-being. Linear mixed models that accounted for repeated measures within subjects, the control and intervention periods, and between-group differences were used to address both research questions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The results of the first analysis showed that the intervention had a small (absolute Hedges g=0.25-0.46) but consistent effect on 8 of 15 of the stress- and well-being-related outcomes in comparison to the control group. The second analysis provided mixed results; the extended intervention was more effective than the basic intervention at improving recovery after work but less effective at improving self-efficacy in behavior change and sleep issues, and similarly effective in the remaining 12 outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Offering a 5-week wearable-based intervention to police officers can positively contribute to optimizing their stress-related, self-efficacy, and well-being-related outcomes. Complementing the ","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"13 ","pages":"e60708"},"PeriodicalIF":5.4,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11793834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065666","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":"mHealth-Based Diabetes Prevention Program for Chinese Mothers With Abdominal Obesity: Randomized Controlled Trial.","authors":"Qinyuan Huang, Qinyi Zhong, Yanjing Zeng, Yimeng Li, James Wiley, Man Ping Wang, Jyu-Lin Chen, Jia Guo","doi":"10.2196/47837","DOIUrl":"10.2196/47837","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Among people with abdominal obesity, women are more likely to develop diabetes than men. Mobile health (mHealth)-based technologies provide the flexibility and resource-saving opportunities to improve lifestyles in an individualized way. However, mHealth-based diabetes prevention programs tailored for busy mothers with abdominal obesity have not been reported yet.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The aim of this study is to evaluate the feasibility and acceptability of an mHealth-based diabetes prevention program and its preliminary efficacy in reducing weight-related variables, behavioral variables, psychological variables, and diabetes risk among Chinese mothers with abdominal obesity over 6 months.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A randomized controlled trial was conducted at health management centers in 2 tertiary hospitals in Changsha, China. The mHealth group (n=40) received 12 weekly web-based lifestyle modification modules for diabetes prevention, 6 biweekly individualized health education messages based on their goal settings, and a Fitbit tracker. The control group (n=40) received 12 weekly web-based general health education modules, 6 biweekly general health education messages, and a Fitbit tracker. Data were collected at baseline, 3 months, and 6 months on the feasibility and acceptability outcomes, weight-related variables (waist circumference and BMI), diabetes risk scores, glycemic levels, behavioral variables (daily step count, active minutes, fruit and vegetable intake, calorie consumption, and sleep duration), and psychological variables (self-efficacy and social support for physical activity and diet, perceived stress, and quality of life). Generalized estimating equations were used for data analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Approximately 85% (68/80) of the participants completed 6 months of follow-up assessments. Regarding the feasibility and acceptance of the program in the mHealth group, the average number of modules reviewed was 7.9 out of 12, and the satisfaction score was 4.37 out of 5. Significant improvements at 6 months between the intervention and control groups were found in waist circumference (β=-2.24, 95% CI -4.12 to -0.36; P=.02), modifiable diabetes risk scores (β=-2.5, 95% CI -4.57 to -0.44; P=.02), daily steps (β=1.67, 95% CI 0.06-3.29; P=.04), self-efficacy for physical activity (β=1.93, 95% CI 0.44-3.43; P=.01), social support for physical activity (β=2.27, 95% CI 0.80-3.74; P=.002), and physical health satisfaction (β=0.82, 95% CI 0.08-1.55; P=.03). No differences were found in BMI, total diabetes risk score, daily active minutes, daily intake of fruits and vegetables, sleep duration, daily calorie consumption, self-efficacy, and social support for diet (P&gt;.05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This study addresses the potential role of tailored lifestyle interventions based on mHealth technology by offering tailored web-based health modules and health information","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"13 ","pages":"e47837"},"PeriodicalIF":5.4,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11806265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143033170","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":"Feature Selection for Physical Activity Prediction Using Ecological Momentary Assessments to Personalize Intervention Timing: Longitudinal Observational Study.","authors":"Devender Kumar, David Haag, Jens Blechert, Josef Niebauer, Jan David Smeddinck","doi":"10.2196/57255","DOIUrl":"10.2196/57255","url":null,"abstract":"<p><strong>Background: </strong>There has been a surge in the development of apps that aim to improve health, physical activity (PA), and well-being through behavior change. These apps often focus on creating a long-term and sustainable impact on the user. Just-in-time adaptive interventions (JITAIs) that are based on passive sensing of the user's current context (eg, via smartphones and wearables) have been devised to enhance the effectiveness of these apps and foster PA. JITAIs aim to provide personalized support and interventions such as encouraging messages in a context-aware manner. However, the limited range of passive sensing capabilities often make it challenging to determine the timing and context for delivering well-accepted and effective interventions. Ecological momentary assessment (EMA) can provide personal context by directly capturing user assessments (eg, moods and emotions). Thus, EMA might be a useful complement to passive sensing in determining when JITAIs are triggered. However, extensive EMA schedules need to be scrutinized, as they can increase user burden.</p><p><strong>Objective: </strong>The aim of the study was to use machine learning to balance the feature set size of EMA questions with the prediction accuracy regarding of enacting PA.</p><p><strong>Methods: </strong>A total of 43 healthy participants (aged 19-67 years) completed 4 EMA surveys daily over 3 weeks. These surveys prospectively assessed various states, including both motivational and volitional variables related to PA preparation (eg, intrinsic motivation, self-efficacy, and perceived barriers) alongside stress and mood or emotions. PA enactment was assessed retrospectively via EMA and served as the outcome variable.</p><p><strong>Results: </strong>The best-performing machine learning models predicted PA engagement with a mean area under the curve score of 0.87 (SD 0.02) in 5-fold cross-validation and 0.87 on the test set. Particularly strong predictors included self-efficacy, stress, planning, and perceived barriers, indicating that a small set of EMA predictors can yield accurate PA prediction for these participants.</p><p><strong>Conclusions: </strong>A small set of EMA-based features like self-efficacy, stress, planning, and perceived barriers can be enough to predict PA reasonably well and can thus be used to meaningfully tailor JITAIs such as sending well-timed and context-aware support messages.</p>","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"13 ","pages":"e57255"},"PeriodicalIF":5.4,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11785349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046959","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":"Barriers and Facilitators in Implementing a Telemonitoring Application for Patients With Chronic Kidney Disease and Health Professionals: Ancillary Implementation Study of the NeLLY (New Health e-Link in the Lyon Region) Stepped-Wedge Randomized Controlled Trial.","authors":"Marion Delvallée, Abdallah Guerraoui, Lucas Tchetgnia, Jean-Pierre Grangier, Nassira Amamra, Anne-Laure Camarroque, Julie Haesebaert, Agnès Caillette-Beaudoin","doi":"10.2196/50014","DOIUrl":"10.2196/50014","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The use of telemonitoring to manage renal function in patients with chronic kidney disease (CKD) is recommended by health authorities. However, despite these recommendations, the adoption of telemonitoring by both health care professionals and patients faces numerous challenges.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to identify barriers and facilitators in the implementation of a telemonitoring program for patients with CKD, as perceived by health care professionals and patients, and to explore factors associated with the adoption of the program. This study serves as a process evaluation conducted alongside the cost-effectiveness NeLLY (New Health e-Link in the Lyon Region) trial.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A mixed methods approach combining a quantitative questionnaire and semistructured interviews was conducted among nurses, nephrologists, and patients with stages 3 and 4 CKD across 10 renal care centers in France that have implemented telemonitoring. The Technology Acceptance Model (TAM) and the Consolidated Framework for Implementation Research (CFIR) were used to design the questionnaires and interview guides. The dimensions investigated included ease of use, perceived usefulness, and intention to use (TAM), as well as characteristics of the intervention, local and general context, individual factors, and processes (CFIR). The adoption of telemonitoring was assessed based on the frequency with which patients connected to the telemonitoring device. Determinants of telemonitoring use were analyzed using nonparametric tests, specifically the Wilcoxon-Mann-Whitney and Kruskal-Wallis tests. Thematic analysis was conducted on the transcriptions of semistructured interviews. Both quantitative and qualitative results, including data from patients and professionals, were integrated to provide a comprehensive understanding of the factors associated with the use of remote monitoring in CKD.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 42 professionals and 128 patients with CKD responded to our questionnaire. Among these, 11 professionals and 13 patients participated in interviews. Nurses, who were responsible for patient follow-up, regularly used telemonitoring (8/13, 62%, at least once a month), while nephrologists, who were responsible for prescribing it, were primarily occasional users (5/8, 63%, using it less than once a month). Among professionals, the main obstacles identified were the heavy workload generated by telemonitoring, lack of training, and insufficient support for nurses. Among the 128 patients, 46 (35.9%) reported using the application at least once a week. The main barriers for patients were issues related to computer use, as well as the lack of feedback and communication with health care professionals. The main facilitators identified by both professionals and patients for using telemonitoring were the empowerment of patients in managing their health and the reduction of the burden asso","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"13 ","pages":"e50014"},"PeriodicalIF":5.4,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11799818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023524","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":"Effectiveness of a Mobile Health Intervention (DOT Selfie) in Increasing Treatment Adherence Monitoring and Support for Patients With Tuberculosis in Uganda: Randomized Controlled Trial.","authors":"Juliet Nabbuye Sekandi, Esther Buregyeya, Sarah Zalwango, Damalie Nakkonde, Patrick Kaggwa, Trang Ho Thu Quach, David Asiimwe, Lynn Atuyambe, Kevin Dobbin","doi":"10.2196/57991","DOIUrl":"10.2196/57991","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Directly observed therapy (DOT) is the standard method for monitoring adherence to tuberculosis (TB) treatment. However, implementing DOT poses challenges for both patients and providers due to limited financial and human resources. Increasing evidence suggests that emerging digital adherence technologies, such as video directly observed therapy (VDOT), can serve as viable alternatives.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to evaluate the effectiveness of VDOT compared with usual care directly observed therapy (UCDOT).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Between July 2020 and October 2021, we conducted a 2-arm, parallel-group, open-label randomized trial with a 1:1 assignment to receive either the VDOT intervention (n=72) or UCDOT (n=72) for treatment adherence monitoring at public health clinics in Kampala, Uganda. Each group was further stratified to ensure equal numbers of males and females. Eligible patients were aged 18-65 years, had a confirmed diagnosis of TB, and were undergoing daily treatment. The VDOT group was provided with a smartphone equipped with an app, while the UCDOT group followed the routine monitoring practices outlined by the Uganda National TB Program. We tested the hypothesis that VDOT was more effective than UCDOT for monitoring medication adherence. The primary outcome was adherence, defined as having ≥80% of the expected doses observed during the 6-month treatment period. An intention-to-treat analysis was conducted, and multivariable logistic regression was used to estimate the effect of the intervention on adherence monitoring. Adjusted relative risk ratios and their corresponding 95% CIs are presented. Secondary outcomes included treatment completion, loss to follow-up, death, and reasons for missed videos in the intervention group.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The intention-to-treat analysis included 142 participants, with 2 excluded due to discontinuation of medication within the first week after enrollment. The median age of participants was 34 (IQR 26-45) years. The median fraction of expected doses observed (FEDO) was significantly higher in the VDOT group compared with the UCDOT group (100, IQR 80-100 vs 30, IQR 10-60, respectively; P&lt;.001). When using a FEDO cutoff of ≥80% to define optimal adherence, 63 of 142 (44%) patients met the threshold, with a significant difference between the VDOT and UCDOT groups (56/71, 79% vs 7/71, 10%, P&lt;.001). After adjusting for confounders, VDOT users were significantly more likely to achieve ≥80% of their expected doses observed compared with UCDOT users (adjusted risk ratio 8.4, 95% CI 4.16-17.0). The most common reasons for failing to submit videos of medication intake were an uncharged phone battery, forgetting to record videos during medication intake, and losing the smartphone.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Enhanced VDOT was more effective than UCDOT in increasing adherence monitoring among patients with TB in Uganda. Th","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":" ","pages":"e57991"},"PeriodicalIF":5.4,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881741","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":"Smoking Cessation Smartphone App for Nondaily Smoking With Telephone Onboarding: Proof-of-Concept Randomized Controlled Trial.","authors":"Bettina B Hoeppner, Kaitlyn R Siegel, Allison E Futter, Diadora Finley-Abboud, Alivia C Williamson, Christopher W Kahler, Elyse R Park, Susanne S Hoeppner","doi":"10.2196/53971","DOIUrl":"10.2196/53971","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Nondaily smoking is a widespread and increasingly prevalent pattern of use. To date, no effective treatment approach for nondaily smoking has been identified.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to conduct an unblinded randomized controlled trial to evaluate proof-of-concept markers of the Smiling instead of Smoking (SiS) app, a smartphone app for smoking cessation, designed specifically for people who smoke less than daily, within the framework of positive psychology.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Overall, 226 adults who smoke less than daily were recruited on the web and asked to undertake a quit attempt while using assigned smoking cessation support materials. Participants were randomly assigned to 1 of 3 materials: the SiS smartphone app, the National Cancer Institute's smartphone app QuitGuide (QG), or the National Cancer Institute's smoking cessation brochure, \"Clearing the Air\" (CtA). All participants engaged in a 15-minute scripted onboarding phone call and were introduced to their support materials to use for the next 7 weeks. Follow-up self-assessment web surveys were sent 2, 6, 12, and 24 weeks after participants' initially chosen quit date (ie, 1 week after onboarding). The primary outcome for this study was self-efficacy to remain abstinent from smoking at treatment end. Secondary outcomes assessed treatment acceptability, treatment feasibility (eg, number of days of app use, time spent using app, and use of smoking cessation strategies), and secondary proof-of-concept efficacy outcomes (eg, positive affect, craving, and attitudes toward smoking). Smoking outcomes (ie, 30-day point prevalence abstinence and smoking reduction) were also assessed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Results indicated a significant effect of treatment on the primary outcome, where SiS participants (n=80) reported higher self-efficacy to abstain from smoking at the end of treatment than the 2 control groups (QG: n=75; P=.02; Cohen d=0.40 and CtA: n=71; P=.007; Cohen d=0.50). This effect was also significant on both self-efficacy subscales (ie, internal cues and external cues) with effect sizes ranging from Cohen d=0.34 to 0.50 across the pairwise comparisons. The SiS app group also reported lower craving (QG: P=.005; Cohen d=-0.57 and CtA: P=.005; Cohen d=-0.57) and higher positive affect than QG (QG: P=.01; Cohen d=0.44 and CtA: P=.05; Cohen d=0.38); attitudes toward smoking were largely similar across groups. Treatment acceptability was comparable across groups (P values for all groups &gt;.05; Cohen d range 0.06-0.23). Treatment feasibility measures indicated that participants used the SiS app on 33 out of 49 days, for 35 to 40 minutes per week, resulting in greater use of smoking cessation strategies than QG (QG: P=.04; Cohen d=0.38 and CtA: P=.16; Cohen d=0.24).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;These findings provide strong evidence for the conceptual underpinnings of the SiS app, and thereby provide comp","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"13 ","pages":"e53971"},"PeriodicalIF":5.4,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11780296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005381","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":"A Mobile App-Based Gratitude Intervention's Effect on Mental Well-Being in University Students: Randomized Controlled Trial.","authors":"Chloë Fuller, Silvia Marin-Dragu, Ravishankar Subramani Iyer, Sandra Melanie Meier","doi":"10.2196/53850","DOIUrl":"10.2196/53850","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Gratitude interventions are used to cultivate a sense of gratitude for life and others. There have been mixed results of the efficacy of gratitude interventions' effect on psychological well-being with a variety of populations and methodologies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;The objective of our study was to test the effectiveness of a gratitude intervention smartphone app on university students' psychological well-being.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We used a randomized experimental design to test our objective. Participants were recruited undergraduate students from a web-based university study recruitment system. Participants completed 90 web-based survey questions on their emotional well-being and personality traits at the beginning and end of the 3-week research period. Their depression, anxiety, and stress levels were measured with the Depression, Anxiety, and Stress Scale (DASS-21). After the baseline survey, participants were randomly assigned to either the control or the intervention. Participants in the intervention group used both a fully automated mobile sensing app and a gratitude intervention mobile iOS smartphone app designed for youth users and based on previous gratitude interventions and exercises. The gratitude intervention app prompted users to complete daily gratitude exercises on the app including a gratitude journal, a gratitude photo book, an imagine exercise, a speech exercise, and meditation. Participants in the control group used only the mobile sensing app, which passively collected smartphone sensory data on mobility, screen time, sleep, and social interactions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 120 participants met the inclusion criteria, and 27 were lost to follow-up for a total of 41 participants in the intervention group and 52 in the control group providing complete data. Based on clinical cutoffs from the baseline assessment, 56 out of 120 participants were identified as being in a subsample with at least moderate baseline symptomatology. Participants in the subsample with at least moderate baseline symptomatology reported significantly lower symptoms of depression, anxiety, and stress postintervention (Cohen d=-0.68; P=.04) but not in the full sample with low baseline symptomatology (Cohen d=0.16; P=.46). The number of times the app was accessed was not correlated with changes in either the subsample (r=0.01; P=.98) or the full sample (r=-0.04; P=.79).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;University students experiencing moderate to severe distress can benefit from a gratitude intervention smartphone app to improve symptoms of depression, anxiety, and stress. The number of times the gratitude intervention app was used is not related to well-being outcomes. Clinicians could look at incorporating gratitude apps with other mental health treatments or for those waitlisted as a cost-effective and minimally guided option for university students experiencing psychologica","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"13 ","pages":"e53850"},"PeriodicalIF":5.4,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11749078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983510","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":"mHealth-Augmented Care for Reducing Depression Symptom Severity Among Patients With Chronic Pain: Exploratory, Retrospective Cohort Study.","authors":"Dan Holley, Amanda Brooks, Matthew Hartz, Sudhir Rao, Thomas Zaubler","doi":"10.2196/52764","DOIUrl":"10.2196/52764","url":null,"abstract":"<p><strong>Background: </strong>Depression and chronic pain are commonly comorbid, mutually reinforcing, and debilitating. Emerging approaches to mobile behavioral health care (mHealth) promise to improve outcomes for patients with comorbid depression and chronic pain by integrating with existing care models to bolster support and continuity between clinical visits; however, the evidence base supporting the use of mHealth to augment care for this patient population is limited.</p><p><strong>Objective: </strong>To develop an evidence base that sets the stage for future research, we aimed to explore the associations between changes in depression severity and various integrated care models, with and without mHealth augmentation, among patients with comorbid depression and nonmalignant chronic pain.</p><p><strong>Methods: </strong>Our team leveraged retrospective, real-world data from 3837 patients with comorbid depression and nonmalignant chronic pain who received integrated behavioral health care (IBH) at a subspecialty pain clinic. We analyzed one IBH-only, non-mHealth cohort (n=2765), an mHealth-augmented cohort (n=844), and a collaborative care (CoCM)+mHealth cohort (n=136), which were supported by the NeuroFlow mHealth platform, and a pre-CoCM mHealth cohort (n=92), which was supported by the mHealth platform for 3 months prior to beginning the chronic pain treatment. We evaluated changes in depression severity between treatment cohorts via longitudinal analyses of both clinician- and mHealth-administered Patient Health Questionnaire-9 (PHQ-9) assessments.</p><p><strong>Results: </strong>mHealth-augmented integrated care led to significantly greater proportions of patients reaching clinical benchmarks for reduction (725/844, 86% vs 2112/2765, 76%), response (689/844, 82% vs 2027/2765, 73%), and remission (629/844, 75% vs 1919/2765, 69%) compared with integrated care alone. Furthermore, hierarchical regression modeling revealed that patients who received mHealth-augmented psychiatric CoCM experienced the greatest sustained reductions in on-average depression severity compared with other cohorts, irrespective of clinical benchmarks. In addition, patients who engaged with an mHealth platform before entering CoCM experienced a 7.2% reduction in average depression severity before starting CoCM treatment.</p><p><strong>Conclusions: </strong>Our findings suggest that mHealth platforms have the potential to improve treatment outcomes for patients with comorbid chronic pain and depression by providing remote measurement-based care, tailored interventions, and improved continuity between appointments. Moreover, our study set the stage for further research, including randomized controlled trials to evaluate causal relationships between mHealth engagement and treatment outcomes in integrated care settings.</p>","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"13 ","pages":"e52764"},"PeriodicalIF":5.4,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11741195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970799","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":"Reliability and Accuracy of the Fitbit Charge 4 Photoplethysmography Heart Rate Sensor in Ecological Conditions: Validation Study.","authors":"Maxime Ceugniez, Hervé Devanne, Eric Hermand","doi":"10.2196/54871","DOIUrl":"10.2196/54871","url":null,"abstract":"<p><strong>Background: </strong>Wrist-worn photoplethysmography (PPG) sensors allow for continuous heart rate (HR) measurement without the inconveniences of wearing a chest belt. Although green light PPG technology reduces HR measurement motion artifacts, only a limited number of studies have investigated the reliability and accuracy of wearables in non-laboratory-controlled conditions with actual specific and various physical activity movements.</p><p><strong>Objective: </strong>The purpose of this study was to (1) assess the reliability and accuracy of the PPG-based HR sensor of the Fitbit Charge 4 (FC4) in ecological conditions and (2) quantify the potential variability caused by the nature of activities.</p><p><strong>Methods: </strong>We collected HR data from participants who performed badminton, tennis, orienteering running, running, cycling, and soccer while simultaneously wearing the FC4 and the Polar H10 chest belt (criterion sensor). Skin tone was assessed with the Fitzpatrick Skin Scale. Once data from the FC4 and criterion data were synchronized, accuracy and reliability analyses were performed, using intraclass correlation coefficients (ICCs), Lin concordance correlation coefficients (CCCs), mean absolute percentage errors (MAPEs), and Bland-Altman tests. A linear univariate model was also used to evaluate the effect of skin tone on bias. All analyses were stratified by activity and pooled activity types (racket sports and running sports).</p><p><strong>Results: </strong>A total of 77.5 hours of HR recordings from 26 participants (age: mean 21.1, SD 5.8 years) were analyzed. The highest reliability was found for running sports, with ICCs and CCCs of 0.90 and 0.99 for running and 0.80 and 0.93 for orienteering running, respectively, whereas the ICCs and CCCs were 0.37 and 0.78, 0.42 and 0.88, 0.65 and 0.97, and 0.49 and 0.81 for badminton, tennis, cycling, and soccer, respectively. We found the highest accuracy for running (bias: 0.1 beats per minute [bpm]; MAPE 1.2%, SD 4.6%) and the lowest for badminton (bias: -16.5 bpm; MAPE 16.2%, SD 14.4%) and soccer (bias: -16.5 bpm; MAPE 17.5%, SD 20.8%). Limit of agreement (LOA) width and artifact rate followed the same trend. No effect of skin tone was observed on bias.</p><p><strong>Conclusions: </strong>LOA width, bias, and MAPE results found for racket sports and soccer suggest a high sensitivity to motion artifacts for activities that involve \"sharp\" and random arm movements. In this study, we did not measure arm motion, which limits our results. However, whereas individuals might benefit from using the FC4 for casual training in aerobic sports, we cannot recommend the use of the FC4 for specific purposes requiring high reliability and accuracy, such as research purposes.</p>","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"13 ","pages":"e54871"},"PeriodicalIF":5.4,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949276","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}