Severin Haug, Lisa Caputo, Andreas Wenger, Nikolai Kiselev, Olivia Studhalter, Michael P Schaub
{"title":"WhatsApp-Based Coaching Program to Support Smoking and Vaping Cessation Among Young People: Pre-Post Study on Acceptance and Preliminary Efficacy.","authors":"Severin Haug, Lisa Caputo, Andreas Wenger, Nikolai Kiselev, Olivia Studhalter, Michael P Schaub","doi":"10.2196/65301","DOIUrl":"10.2196/65301","url":null,"abstract":"<p><strong>Background: </strong>The use of tobacco cigarettes and electronic nicotine products is widespread among young people in Switzerland. At the same time, the instant messaging platform WhatsApp (Meta Platforms, Inc) is the most frequently used smartphone app in this population group. The provision of individually tailored, evidence-based coaching messages via WhatsApp seems promising to support smoking cessation in adolescents and young adults.</p><p><strong>Objective: </strong>This study aims to test the feasibility, acceptance, and preliminary efficacy of a newly developed, semiautomated WhatsApp-based intervention program to support smoking and vaping cessation and reduction in adolescents and young adults.</p><p><strong>Methods: </strong>Recruitment took place in Switzerland in 2023 and 2024 via various channels, both online and offline. For a period of 11 weeks, regular users of cigarettes or electronic cigarettes, aged between 16 and 30 years, received individually tailored messages on how to deal with cravings or stressful situations and how to stop or reduce smoking. A separate WhatsApp channel provided the opportunity to ask individual questions to a counselor. A one-group pre-post design was used to obtain preliminary information on the acceptability and potential efficacy of the program.</p><p><strong>Results: </strong>A total of 167 young people (mean age 23.2, SD 4.0 years; n=95, 56.9% women and n=72, 43.1% men) who regularly smoked tobacco cigarettes (n=81, 48.5%), vaped electronic nicotine products (n=17, 10.2%), or used both (n=69, 41.3%) were recruited for participation in the program. Of these, 100 (59.9%) intended to stop smoking or vaping while 67 (40.1%) aimed at reducing their use. The participants actively engaged in an average of 5.5 (SD 3.5) of the 11 program weeks, the average number of interactions with the program was 26.8 (SD 26.1), and the average duration from the start of the program to the last interaction was 45.0 (SD 31.1) days. The follow-up survey at the end of the 11-week coaching program was completed by 108 (64.7%) participants. The generalized estimating equation (GEE) analyses revealed significant reductions in the mean number of days in the last 30 days on which tobacco cigarettes were used from 20.6 (SD 11.8) at baseline to 14.0 (SD 12.0) at post assessment (incidence rate ratio [IRR] 0.68, P<.001) and for electronic nicotine products from 11.1 1 (SD 13.1) days at baseline to 7.7 (SD 11.3) days at follow-up (IRR 0.71, P=.005). Overall, 6/108 (5.6%) participants in the follow-up survey stated that they neither consumed tobacco cigarettes nor electronic nicotine products in the last 30 days.</p><p><strong>Conclusions: </strong>The WhatsApp-based program appears to be a feasible, moderately accepted, and promising intervention for reducing the consumption of tobacco cigarettes and electronic nicotine products among young people. A larger-scale randomized controlled trial would be reasonable in orde","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"13 ","pages":"e65301"},"PeriodicalIF":6.2,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212717","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":"Effects of Remote Patient Monitoring on Health Care Utilization in Patients With Noncommunicable Diseases: Systematic Review and Meta-Analysis.","authors":"Geir Smedslund, Nina Østerås, Christine Hillestad Hestevik","doi":"10.2196/68464","DOIUrl":"https://doi.org/10.2196/68464","url":null,"abstract":"<p><strong>Background: </strong>Management of noncommunicable diseases (NCDs) is an increasing challenge for health care systems. Although remote patient monitoring presents a promising solution by utilizing technology to monitor patients outside clinical settings, there is a lack of knowledge about the effect on resource utilization.</p><p><strong>Objective: </strong>This systematic review aimed to review the effects of remote patient monitoring on health care resource utilization by patients with NCDs.</p><p><strong>Methods: </strong>Eligible randomized controlled trials (RCTs) involved digital transmission of health data from patients to health care personnel. Outcomes included hospitalizations, length of stay, outpatient visits, and emergency visits. A systematic literature search was performed in Medline, Embase, and Cochrane Central Register of Controlled Trials in June 2024. Titles, abstracts, and full texts were screened individually by 2 authors. Risk of bias was assessed, and data were extracted, analyzed, and pooled in meta-analysis when possible. Confidence in the estimates was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.</p><p><strong>Results: </strong>We included 40 RCTs published between 2017 and 2024. The largest group of NCDs was cardiovascular disease (16 studies). Remote patient monitoring may slightly decrease the proportion of hospitalizations compared with usual care (risk ratio [RR] 0.86, 95% CI 0.77 to 0.95; low certainty). Compared with usual care, remote patient monitoring had fewer or an equal number of hospitalizations (mean difference -0.13, 95% CI -0.29 to 0.03; low certainty). Hospital length of stay may be slightly reduced with remote patient monitoring compared with usual care (mean difference -0.84, 95% CI -1.61 to -0.06 days; low certainty). The proportion of outpatient visits showed probably little to no difference between remote patient monitoring and usual care (RR 0.94, 95% CI 0.87 to 1.02; moderate certainty). Compared with usual care, remote patient monitoring had slightly more outpatient visits, but the CI was wide (mean difference 0.41, 95% CI -0.22 to 1.03; low certainty). The results indicate a small or no difference between remote patient monitoring and usual care regarding proportion of emergency visits (RR 0.91, 95% CI 0.79 to 1.05; low certainty). We are uncertain whether remote patient monitoring increases or decreases the number of emergency visits, as the evidence was of very low certainty.</p><p><strong>Conclusions: </strong>This systematic review showed that remote patient monitoring possibly led to lower proportions of patients being hospitalized, fewer hospitalizations, and shorter hospital length of stay compared with usual care. Patients undergoing remote monitoring had possibly more outpatient visits compared with usual care. The proportions of patients with outpatient visits or emergency visits were probably similar. Finally, we h","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"13 ","pages":"e68464"},"PeriodicalIF":6.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206446","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}
Rachael E Flatt, Laura M Thornton, Jenna Tregarthen, Stuart Argue, Cynthia M Bulik
{"title":"How Engagement Changes Over Time in a Digital Eating Disorder App: Observational Study.","authors":"Rachael E Flatt, Laura M Thornton, Jenna Tregarthen, Stuart Argue, Cynthia M Bulik","doi":"10.2196/68824","DOIUrl":"10.2196/68824","url":null,"abstract":"<p><strong>Background: </strong>Engagement with digital mental health interventions is often measured as a summary-level variable and remains underresearched despite its importance for meaningful symptom change. This study deepens understanding of engagement in a digital eating disorder intervention, recovery record, by measuring engagement with unique components of the app, on 2 different devices (phone and watch), and at a summary level.</p><p><strong>Objective: </strong>This study described and modeled how individuals engaged with the app across a variety of measures of engagement and identified baseline predictors of engagement.</p><p><strong>Methods: </strong>Participants with current binge-eating behavior were recruited as part of the Binge Eating Genetics Initiative study to use a digital eating disorder intervention for 4 weeks. Demographic and severity of illness variables were captured in the baseline survey at enrollment, and engagement data were captured through both an iPhone and Apple Watch version of the intervention. Engagement was characterized by log type (urge, behavior, mood, or meal), device type (logs on phone or watch), and overall usage (total logs) and averaged each week for 4 weeks. Descriptives were tabulated for demographic and engagement variables, and multilevel growth models were conducted for each measure of engagement with baseline characteristics and time as predictors.</p><p><strong>Results: </strong>Participants (N=893) self-reported as primarily White (743/871, 85%), non-Hispanic (801/893, 90%), females (772/893, 87%) with a mean age of 29.6 (SD 7.4) years and mean current BMI of 32.5 (SD 9.8) kg/m2 and used the app for a mean of 24 days. Most logs were captured on phones (217,143/225,927; 96%), and mood logs were the most used app component (174,818/282,136; 62% of logs). All measures of engagement declined over time, as illustrated by the visualizations, but each measure of engagement illustrated unique participant trajectories over time. Time was a significant negative predictor in every multilevel model. Sex and ethnicity were also significant predictors across several measures of engagement, with female and Hispanic participants demonstrating greater engagement than male and non-Hispanic counterparts. Other baseline characteristics (age, current BMI, and binge episodes in the past 28 days) were significant predictors of 1 measure of engagement each.</p><p><strong>Conclusions: </strong>This study highlighted that engagement is far more complex and nuanced than is typically described in research, and that specific components and mode of delivery may have unique engagement profiles and predictors. Future work would benefit from developing early engagement models informed by baseline characteristics to predict intervention outcomes, thereby tailoring digital eating disorder interventions at the individual level.</p>","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"13 ","pages":"e68824"},"PeriodicalIF":6.2,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12483339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199282","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 Characteristics and Quality of Mental Health Apps Available in App Stores for Indian Users: Systematic App Search and Review.","authors":"Seema Mehrotra, Ravikesh Tripathi, Pramita Sengupta, Abhishek Karishiddimath, Angelina Francis, Pratiksha Sharma, Paulomi Sudhir, T K Srikanth, Girish Rao, Rajesh Sagar","doi":"10.2196/79238","DOIUrl":"10.2196/79238","url":null,"abstract":"<p><strong>Background: </strong>The mental health app sector in India is expanding rapidly, driven by increasing smartphone usage, growing internet penetration, the popularity of digital initiatives, and heightened recognition of mental health challenges in public discourse. This growth is also influenced by both supply- and demand-side barriers to seeking professional help and the rise of mental health tech startups. While digital mental health solutions provide scalable ways to address unmet needs, concerns persist regarding app quality, privacy, and safety due to rapid market expansion, regulatory challenges, and limited empirical research. We conducted a comprehensive and systematic review of smartphone-based mental health apps accessible to Indian users through app stores.</p><p><strong>Objective: </strong>This study aims to describe apps in terms of characteristics such as the nature of their functions, involvement of mental health professionals in development, reference to an empirical basis, and inclusion of nudges to seek professional help, as well as to evaluate app quality.</p><p><strong>Methods: </strong>This systematic review of mental health apps was conducted using the TECH (Target user, Evaluation focus, Connectedness, and Health domain) approach, along with the PASSR (Protocol for App Store Systematic Reviews) checklist. Fifteen search terms covering mental health conditions and therapies were applied to both Google Play and Apple App Store. Identified apps were screened according to predefined inclusion and exclusion criteria and subsequently downloaded for detailed review. Data were extracted based on prespecified parameters. Additionally, app quality was evaluated using the Mobile Application Rating Scale (MARS).</p><p><strong>Results: </strong>The initial search identified 5827 apps, of which 350 were reviewed in detail after removing duplicates and applying eligibility criteria. Common search terms such as \"depression\" and \"anxiety\" yielded nearly a quarter of relevant apps (128/495, 25.9% to 133/497, 26.8%); 62 (17.7%) of the 350 reviewed apps originated from Asia, and 131 (37.4%) focused on a single mental health condition. Multifunction apps (eg, those combining assessment and intervention) constituted the largest category (230/350, 65.7%). Privacy concerns were notable; for example, 54 (15.4%) apps did not mention a data-sharing policy. Most apps were developed by commercial organizations, and 228 (65.1%) did not report involvement of mental health professionals, while 45 (12.9%) mentioned it only cursorily. Only 38 (10.9%) apps referenced empirical research, and more than half did not indicate an empirical basis for their content. Pointers to seek professional help were present in 139 (39.7%) apps, mostly in the form of disclaimers, whereas nudges or motivational prompts to seek help appeared in slightly less than a quarter. Only 105 (30%) apps attempted to dispel mental health myths. Functionality and aesthetics rating","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"13 ","pages":"e79238"},"PeriodicalIF":6.2,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12514412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145175649","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":"Effects of a Smartphone-Based Positive Reflection Diary on Work Engagement Among Japanese Workers: Randomized Controlled Trial.","authors":"Masahito Tokita, Shuichiro Kobayashi, Daisuke Miyanaka, Nobuyuki Takate, Hiroyuki Nakano, Kazuki Takeuchi, Akihito Shimazu","doi":"10.2196/55664","DOIUrl":"10.2196/55664","url":null,"abstract":"<p><strong>Unlabelled: </strong></p><p><strong>Background: </strong>Work engagement is an important determinant of workers' well-being. According to the job demands-resources model, personal resources are one of the key antecedents of work engagement. Enhancing personal resources leads to improved work engagement. Furthermore, reflecting positively on one's achievements at work may enhance personal resources. Hence, there is a need for a simple, self-guided tool such as a smartphone app that can be used by employees to record and reflect on their work accomplishments.</p><p><strong>Objective: </strong>This study aimed to evaluate the effect of a smartphone-based diary (ie, Work Engagement Diary) that promotes positive reflection in daily working life on work engagement among Japanese workers in a randomized controlled trial.</p><p><strong>Methods: </strong>Six hundred Japanese workers who met the inclusion criteria were randomly allocated to either the intervention group or the wait-list control group (300 participants each) via a web survey company. Participants in the intervention group kept the Work Engagement Diary for 2 weeks, whereby they were required to set a weekly goal at the beginning of the week and fill in their work achievements at the end of the day. Those in the waitlist control group did not receive any interventions until they completed a follow-up survey. Work engagement was assessed at preintervention (T1), postintervention (T2), and 3 weeks after intervention (T3) in both groups.</p><p><strong>Results: </strong>A mixed model for repeated measures conditional growth model analysis using intention-to-treat revealed a significant improvement in work engagement for the intervention group compared to the wait-list control group throughout the study period (P=.04). Effect sizes were small in work engagement for T1 versus T2 (Cohen d=0.11 [95% CI -0.06 to 0.28]) and for T1 versus T3 (Cohen d=0.12 [95% CI -0.06 to 0.28]).</p><p><strong>Conclusions: </strong>This randomized controlled trial demonstrated that our newly developed smartphone-based positive reflection diary at work effectively improved work engagement among Japanese workers. Future research needs to clarify longer-term intervention effects and detailed mechanisms of the intervention effects.</p>","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"13 ","pages":"e55664"},"PeriodicalIF":6.2,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149199","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}
Chi-Hsien Chen, Feipei Lai, Yu-Lin Chen, Yue Leon Guo
{"title":"Effects of heat adaptation behaviors on resting heart rate response to summer temperatures in the elderly: a wearable device panel study.","authors":"Chi-Hsien Chen, Feipei Lai, Yu-Lin Chen, Yue Leon Guo","doi":"10.2196/67721","DOIUrl":"https://doi.org/10.2196/67721","url":null,"abstract":"<p><strong>Background: </strong>The health impact of summer heat on older adults is a growing public concern, yet the physiological responses, particularly changes in resting heart rate (RHR), and the role of personal heat adaptation behaviors remain underexplored. Wearable devices offer an opportunity to objectively monitor physiological responses and evaluate the effectiveness of adaptation strategies in real-world settings.</p><p><strong>Objective: </strong>This study aimed to quantify the short-term association between summer temperatures and RHR in older adults and to examine how individual heat adaptation behaviors modify this relationship, with additional consideration of personal characteristics such as age, sex, body mass index (BMI), and chronic disease status.</p><p><strong>Methods: </strong>We conducted a panel study among 83 community-dwelling older adults (≥65 years) in Taipei City during the summer of 2021 (May to September). Participants wore Garmin® smartwatches to continuously monitor heart rate. Daily RHR was defined as the lowest 30-minute average heart rate. In September, heat adaptation behaviors were assessed via structured telephone interviews. Ambient temperature and relative humidity were obtained from a nearby monitoring station. Linear mixed-effect models were used to estimate temperature-RHR associations, and interaction terms were included to examine behavioral modifications. Subgroup analyses were conducted to explore effect modification by individual characteristics such as age, sex, body mass index (BMI), and chronic disease status.</p><p><strong>Results: </strong>Each 1°C increase in daily mean temperature over lag days 0-1 was associated with a 0.11 beats/min increase in RHR (95% CI 0.07-0.15; P<.0001). After mutual adjustment for behaviors, several heat adaptation strategies showed significant protective effects, including reducing physical activity (β=-0.15, P=.001), drinking cold beverages (β=-0.24, P<.0001), increasing naps or sleep duration (β=-0.28, P=.003), drinking additional water ≥500mL (β=-0.10, P=.023), using air conditioning before (β=-0.15, P=.002) and during sleep (β=-0.13, P=.007), and using electric fans during sleep (β=-0.12, P=.012). Subgroup analyses revealed stronger effects for certain behaviors in vulnerable populations: reduced physical activity was particularly beneficial for those with higher BMI; air conditioning use and cold beverage intake were more effective in diabetics; increased naps yielded the largest benefits in hypertensive individuals; and the use of air conditioning or fans during sleep was especially protective for older adults and females.</p><p><strong>Conclusions: </strong>Summer heat is associated with elevated RHR in the elderly, but this effect can be mitigated through targeted heat adaptation behaviors. Smartwatch monitoring provides a feasible and informative approach for capturing physiological changes, supporting the development of personalized heat-health recomm","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149224","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":"Adaptation of an mHealth Solution for the Nutritional Management of Diabetes in a Low- and Middle-Income Country: Pre-Post Mixed Methods Pilot Study.","authors":"Cecilia Anza-Ramirez, Karen Bonilla-Aguilar, David Beran, Jean-Luc Mando, Lorena Saavedra-Garcia, Monica Julissa Angulo-Barranca, Marco Alexi Taboada Garcia, Leonardo Albitres-Flores, Alejandro Loayza, Jessica Hanae Zafra-Tanaka, Olivia Heller, María Lazo-Porras, Montserrat Castellsague Pique Perolini","doi":"10.2196/58029","DOIUrl":"10.2196/58029","url":null,"abstract":"<p><strong>Background: </strong>Carbohydrate counting (CC) is vital for individuals living with type 1 diabetes mellitus (T1DM); yet, formal training is often lacking in many contexts. To bridge this gap, the parents of a person living with diabetes and a team at the Geneva University Hospital (HUG) developed WebDia, a free-access app that helps patients with T1DM assess meal carbohydrates and make informed decisions regarding insulin dosage. In the context of Peru, where dietary patterns and meal compositions may differ, customizing WebDia to suit the components of the Peruvian diet becomes particularly relevant.</p><p><strong>Objective: </strong>This study aimed to customize WebDia according to the composition of the Peruvian diet to facilitate CC, and to provide training to health care workers (HCWs), children and adolescents living with T1DM, and their caregivers in the proficient use of WebDia-Mundi (new version of the Swiss app WebDia adapted to other geographic contexts).</p><p><strong>Methods: </strong>A dietitian compiled a database of Peruvian foods and their carbohydrate content. This was reviewed by a Swiss nurse specialized in diabetes, a Peruvian pediatric endocrinologist, and 2 researchers. Validation was conducted with a small group of children and adolescents living with T1DM and their caregivers. Subsequently, a 3-day workshop was held in 3 Peruvian regions for HCW and children and adolescents living with T1DM. The first 2 days were a training course for HCW to gain knowledge in T1DM and learn CC skills. This was followed by a 1-day workshop involving HCW, children and adolescents living with T1DM, and their caregivers. At the end of the workshop and 3 months later, an evaluation was performed to assess the app's usability, glycated hemoglobin, quality of life, and knowledge perception for children and adolescents living with T1DM and their caregivers. Furthermore, changes in knowledge among HCWs and overall workshop satisfaction were measured.</p><p><strong>Results: </strong>WebDia-Mundi was customized for the Peruvian context in 2022-2023. The training was attended by 25 HCWs, 25 children and adolescents living with T1DM, and 31 caregivers. Following the training, HCWs exhibited a significant 3.5-point increase in their knowledge of T1DM, while achieving positive results regarding the usability of WebDia-Mundi. Children and adolescents living with T1DM and their caregivers also reported a favorable perception of the ease of use and functionality of WebDia-Mundi, which enhanced their CC skills.</p><p><strong>Conclusions: </strong>This study underscores the importance of collaboration among multidisciplinary teams and the involvement of individuals with T1DM. Adapting mobile health solutions to new contexts and sharing experiences can help standardize this process.</p>","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"13 ","pages":"e58029"},"PeriodicalIF":6.2,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149183","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":"Impact of a 24-Week Mobile App-Based Human Coaching Program on Body Composition and Lipid Metabolism in Breast Cancer Survivors With Overweight or Obesity: Single-Arm Prospective Cohort Study.","authors":"Eun-Gyeong Lee, Dong-Eun Lee, Jeongseon Kim, Jaihong Han, Seeyoun Lee, Han-Sung Kang, Eun Sook Lee, Heejung Chae, Sung Hoon Sim, Keun Seok Lee, Jungeun Lee, Hyun Jeong Lee, Ji Sung Yoo, Gyung Ah Wie, So-Youn Jung","doi":"10.2196/64846","DOIUrl":"10.2196/64846","url":null,"abstract":"<p><strong>Background: </strong>Overweight or obesity is a prognostic factor for breast cancer recurrence and breast cancer-related deaths. However, weight control is difficult for breast cancer survivors because of menopause, chemotherapy, antihormonal therapy, and psychological issues.</p><p><strong>Objective: </strong>This study aimed to develop a 24-week mobile app-based human coaching program using Noom and evaluate its efficacy in breast cancer survivors who are excessively overweight or with obesity, including those who successfully used the program.</p><p><strong>Methods: </strong>In this single-arm prospective cohort study, 130 breast cancer survivors with BMI ≥25 were enrolled and received a 24-week program, including diet-, exercise-, and psychology-based content with the trained human coach in Noom between 2019 and 2021. For a hyperactive group who joined for more than 16 weeks, we evaluated weight, BMI, lipid level, bioimpedance, and quality of life at baseline, 6-month, and 12-month follow-up.</p><p><strong>Results: </strong>Among 130 breast cancer survivors, 101 (77.7%) and 93 (71.5%) completed the 6-month and 12-month follow-ups, respectively. The mean age of all participants was 54.90 (SD 7.42) years. At baseline, the median BMI was 27.14 (IQR 25.20-35.36) for the hyperactive group and 27.50 (IQR 25.20-35.50) for the active and inactive group. In the hyperactive group (68/101, 67%), body weight and BMI significantly reduced (mean difference -1.97, 95% CI -2.65 to -1.26 kg; P<.01 and mean difference -0.86, 95% CI -1.15 to -0.56; P<.01, respectively) at 6 months and were maintained at 12 months without the yo-yo effect. Among the lipid panel, triglyceride levels decreased significantly (-34.13, 95% CI -58.09 to-10.17; P<.01) and were maintained at 12 months. With respect to bioimpedance components, skeletal muscle mass (kg), body fat mass (kg), percent body fat (%), waist-to-hip ratio, and visceral fat area (cm2) improved in the first 6 months. However, waist-to-hip ratio and visceral fat area increased during the next 6 months. Based on the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ C30) and Breast Cancer Module (23 items), nausea or vomiting, constipation, body image, and arm and breast symptoms significantly improved during the first 6 months.</p><p><strong>Conclusions: </strong>This study demonstrated that a 24-week mobile app-based human coaching program is beneficial for controlling body weight, BMI, triglyceride, and body composition in terms of bioimpedance for breast cancer survivors who are excessively overweight or have obesity.</p>","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"13 ","pages":"e64846"},"PeriodicalIF":6.2,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137671","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}
Weiting Huang, Mark Kei Fong Wong, Enver De Wei Loh, Tracy Koh, Alex Weixian Tan, Xiayan Shen, Onur Varli, Siew Ching Kong, Calvin Woon Loong Chin, Swee Yaw Tan, Jonathan Jiunn Liang Yap, Eddie Yin Kwee Ng, Khung Keong Yeo
{"title":"Relationship Between Activity Tracker Metrics and the Physical Activity Index and Their Association With Cardiometabolic Phenotypes, Subclinical Atherosclerosis, and Cardiac Remodeling: Cross-Sectional Study.","authors":"Weiting Huang, Mark Kei Fong Wong, Enver De Wei Loh, Tracy Koh, Alex Weixian Tan, Xiayan Shen, Onur Varli, Siew Ching Kong, Calvin Woon Loong Chin, Swee Yaw Tan, Jonathan Jiunn Liang Yap, Eddie Yin Kwee Ng, Khung Keong Yeo","doi":"10.2196/71213","DOIUrl":"10.2196/71213","url":null,"abstract":"<p><strong>Background: </strong>Consumer wearable technology quantifies physical activity; however, the association between these metrics and cardiometabolic health requires further elucidation.</p><p><strong>Objective: </strong>This study identified latent factors derived from Fitbit heart rate metrics and their relationship with cross-sectional cardiovascular phenotypes.</p><p><strong>Methods: </strong>This cross-sectional analysis included 457 participants from the SingHEART study, a multiethnic, population-based study of Asian individuals aged 21 to 69 years recruited in Singapore. Participants wore the Fitbit Charge HR for 7 days, and data on physical activity metrics, self-reported physical activity index (PAI), blood tests, coronary artery calcium scores, and cardiac magnetic resonance imaging were collected. Exploratory factor analysis identified latent factors from Fitbit metrics, and multivariate regression analysis assessed associations with blood and cardiovascular imaging phenotypes.</p><p><strong>Results: </strong>Higher levels of self-reported PAI were significantly associated with a higher number of calories burned (P=.008), number of steps and floors climbed, distance, number of activity calories, and number of very active minutes (P<.001). However, there was no association between PAI and other Fitbit metrics. Using exploratory factor analysis, we identified three latent factors measured by Fitbit metrics: (1) elevated metabolic equivalents of task (METs; calories burned per day, minutes per day spent fairly active in 3-6 METs and very active in ≥6 METs, and activity calories), (2) total activity (steps per day, distance in kilometers per day, and number of floors per day), and (3) others, all with a Cronbach α of >0.7. Higher total activity was associated with increased high-density lipoprotein levels (β=0.06; P<.001), decreased triglyceride levels (β=-0.10; P=.006), and lower BMI (β=-0.63; P<.001) after adjustment for age, gender, systolic blood pressure, total cholesterol, and family history of heart disease. The interaction between total activity and elevated METs was associated with lower fasting glucose (β=-0.07; P=.004). Elevated METs were associated with higher log(coronary artery calcium+1) and higher BMI (P<.001). Total activity was significantly associated with higher indexed biventricular systolic (P=.01 for left and P=.006 for right) and diastolic volumes (P<.001) and higher indexed left ventricular mass (P=.005).</p><p><strong>Conclusions: </strong>We identified 3 groups of wearable metrics with distinct characteristics. While total activity had a significant relationship with self-reported PAI, most metrics of elevated METs did not. Total activity had a consistent and favorable association with lipid and glucose profiles and a dose-dependent association with cardiac remodeling. Elevated METs alone did not appear to have a significant association with favorable cardiovascular profiles. This study suggests that the ","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"13 ","pages":"e71213"},"PeriodicalIF":6.2,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12508664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137628","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}
Alison J Wright, Jeremy Holland, Iain Simpson, Samantha Walker, Naomi Bennett-Steele, John Weinman
{"title":"Selection of Behavior Change Techniques for Asthma Medication Adherence Apps: Evidence-Based Design Study.","authors":"Alison J Wright, Jeremy Holland, Iain Simpson, Samantha Walker, Naomi Bennett-Steele, John Weinman","doi":"10.2196/49348","DOIUrl":"10.2196/49348","url":null,"abstract":"<p><strong>Background: </strong>Poor medication adherence is a widespread issue that causes adverse patient outcomes and is expensive for all aspects of the health care system. Developing cost-effective and scalable interventions to promote medication adherence is a key goal. Mobile apps hold promise as a mode of delivery for adherence interventions, but app design rarely takes into account the behavioral influences on nonadherence with sufficient rigor. As a result, apps may not realize their full potential in enhancing adherence. Medication nonadherence is common among adults prescribed preventer inhalers for asthma and has a variety of influences, creating a need to identify what components behavior change technique (BCT) apps should include to effectively tackle each influence.</p><p><strong>Objective: </strong>This study aimed to identify the most acceptable and practicable BCTs to include in a medication adherence app targeting factors that influence preventer inhaler adherence in adults with asthma.</p><p><strong>Methods: </strong>Key influences on preventer inhaler adherence in adults with asthma were identified based on reviews of peer-reviewed and gray literature and domain expert knowledge. These influences were then mapped to a published set of 26 mechanisms of action (MoAs) of behavior change interventions. Next, candidate BCTs to change each MoA were identified using the Theory and Techniques tool, a web-based resource that reflects almost 100 expert behavioral scientists' consensus about which BCTs are most likely to change particular MoAs. Finally, candidate BCTs were filtered by considering their potential acceptability and practicability.</p><p><strong>Results: </strong>A total of 31 influences on preventer inhaler adherence were identified and coded to 15/26 of the influences on behavior listed by the Theory and Techniques tool. The initial mapping of influences on behavior to candidate BCTs to change those influences identified 41 candidate BCTs. After considering the potential acceptability and practicability of the candidate BCTs, the number of BCTs suggested for inclusion was reduced to 24.</p><p><strong>Conclusions: </strong>Using an evidence-based approach, this study identified 24 BCTs that may be particularly useful to include in apps promoting adherence to preventer inhalers in order to target particular influences on adherence. The list can be used by app developers to improve the quality of adherence behavior change support that their apps provide or by health care decision-makers to identify which apps contain elements addressing a range of adherence difficulties.</p>","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"13 ","pages":"e49348"},"PeriodicalIF":6.2,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12456459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130886","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}