JMIR mHealth and uHealth最新文献

{"title":"Impacts of Environmental Distractions and Interruptions on Unsupervised Digital Cognitive Assessments in Older Adults: Cognitive Ecological Momentary Assessment Study.","authors":"Matthew Welhaf, Hannah Wilks, Andrew J Aschenbrenner, Samhita Katteri, John C Morris, Jason J Hassenstab","doi":"10.2196/71578","DOIUrl":"10.2196/71578","url":null,"abstract":"<p><strong>Background: </strong>Unsupervised cognitive assessments are becoming commonly used in studies of aging and neurodegenerative diseases. As assessments are completed in everyday environments and without a proctor, there are concerns about how common distractions may impact performance and whether these distractions may differentially impact those experiencing the earliest symptoms of dementia.</p><p><strong>Objective: </strong>We examined the impact of self-reported interruptions, testing location, and social context during testing on remote cognitive assessments in older adults.</p><p><strong>Methods: </strong>Participants from the Ambulatory Research in Cognition smartphone study were classified as cognitively normal (n=380) or as having very mild dementia (n=37). Participants completed daily tests of processing speed, working memory, and associative memory. At each assessment, participants were asked for their current location and social surroundings, which was used to quantify whether participants were either at home (or not) and by themselves (or not). After each assessment session, participants were asked if they experienced any interruptions. Mixed-effect modeling tested the interactions between location, social context, and clinical status. Additional analyses were conducted by removing sessions where participants reported that they were interrupted at any point during the testing period.</p><p><strong>Results: </strong>Across all participants, momentary effects of environmental distractions were minimal. Specifically, when tests were completed in the presence of others, participants exhibited slightly increased variability in processing speed (P=.04). However, these momentary effects of environmental distractions were dependent upon cognitive status (P=.009). Cognitively normal older adults had better visuospatial working memory performance when they completed tests at home compared to when they completed tests away from home (P=.001). However, older adults with very mild dementia showed no effect of testing location on the same task (P=.36). Conversely, cognitively normal older adults did not differ in their processing speed at either testing location (P=.88). Older adults with very mild dementia were slightly faster when not at home (P=.04). Social context only impacted variability in processing speed for participants with very mild dementia (P=.04). When considering tests completed in the most distracting environments (away from home and in the presence of others), those with very mild dementia showed larger differences only on the visuospatial working memory measure. Additional analyses demonstrated that after removing sessions in which participants self-reported experiencing an interruption (1194/9633, 12.4% of all assessments), these small effects of environmental distractions on cognition remained, but were more apparent in those with very mild dementia.</p><p><strong>Conclusions: </strong>Social context and location of u","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"13 ","pages":"e71578"},"PeriodicalIF":6.2,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12416871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023332","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":"Measuring Psychological Well-Being and Behaviors Using Smartphone-Based Digital Phenotyping: An Intensive Longitudinal Observational mHealth Pilot Study Embedded in a Prospective Cohort of Women.","authors":"Li Yi, Claudia Trudel-Fitzgerald, Cindy R Hu, Grete Wilt, Jorge Chavarro, Jukka-Pekka Onnela, Francine Grodstein, Laura D Kubzansky, Peter James","doi":"10.2196/71375","DOIUrl":"10.2196/71375","url":null,"abstract":"<p><strong>Background: </strong>Intensive measures of well-being and behaviors in large epidemiologic cohorts have the potential to enhance health research in these areas. Yet, little is known regarding the feasibility of using mobile technology to collect intensive data in the \"natural\" environment in the context of ongoing large cohort studies.</p><p><strong>Objective: </strong>We examined the feasibility of using smartphone digital phenotyping to collect highly resolved psychological and behavioral data from participants in a pilot study with participants in Nurses' Health Study II, a nationwide prospective cohort of women.</p><p><strong>Methods: </strong>In this pilot study, an 8-day intensive smartphone protocol was implemented using the \"Beiwe\" smartphone app. Participants (n=181) completed a baseline survey on day 1 and answered ecological momentary assessment (EMA) surveys twice daily (days 2-8; early afternoon and evening) using their smartphone and provided minute-level accelerometer and GPS data. A feedback survey at the end of Substudy queried participants' experience with the app and data collection process. We assessed adherence to the protocol by examining completion on EMA surveys and completeness of accelerometer and GPS data at the participant, participant day, and prompt levels.</p><p><strong>Results: </strong>Our pilot study demonstrated modest overall compliance with smartphone-based surveys: the baseline survey completion rate was high (156/181, 86.2%), but average daily EMA response rates during the 7-day period were lower with 55.6% (SD 3.9%) for early afternoon and 54.7% (SD 3.2%) for evening. We also observed good average daily completeness of smartphone accelerometer (mean 62.0%, SD 4.5%) data and GPS data (mean 57.7%, SD 3.1%). The feedback survey revealed that the participants found \"the app easy to use\" (median 85.0 on a scale of 1-100) and were \"willing to repeat similar studies\" (median 85.0 on a scale of 1-100). Although participants reported feeling their participation was a positive experience (median 64.0 on a scale of 1-100), they also identified some important issues, including user fatigue due to repetitive daily surveys.</p><p><strong>Conclusions: </strong>We observed modest compliance with smartphone surveys and completeness of smartphone passive sensing data in this pilot study compared with similar studies in the past. However, this was not unexpected, given our participants were older (aged 57-75 years, with more than 3 decades of follow-up at the time of the substudy) and may encounter more technological barriers, not to mention that the indication of willingness to participate in such studies again was fairly high. Our findings also highlight that the success and data quality of efforts to obtain daily measures may vary depending on data type and emphasize the need to improve the design of the EMA survey to improve or sustain participant engagement over the study period. Overall, our findings suggest ","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"13 ","pages":"e71375"},"PeriodicalIF":6.2,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12407220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144992645","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 Association of Previous Day Carbohydrate Consumption With Fasted, Exhaled Carbon Dioxide in Lumen Users: Retrospective Real-World Study.","authors":"Shlomo Yeshurun, Tomer Cramer, Daniel Souroujon, Merav Mor","doi":"10.2196/64604","DOIUrl":"10.2196/64604","url":null,"abstract":"<p><strong>Background: </strong>The increasing prevalence of obesity and related metabolic disorders has highlighted the need for innovative tools to monitor and manage metabolic health. The Lumen device offers a novel approach to assess the metabolic state through exhaled carbon dioxide (CO<sub>2</sub>) measurements, providing real-time feedback via a mobile app. This app-driven experience allows users to track their metabolic state and receive personalized nutrition and lifestyle recommendations, potentially supporting long-term metabolic health improvements.</p><p><strong>Objective: </strong>This study aimed to investigate the association between the previous day's carbohydrate consumption with fasted, exhaled CO<sub>2</sub> levels in female and male Lumen users while also examining the influence of fasting duration, BMI, and age.</p><p><strong>Methods: </strong>We conducted a retrospective, observational study using deidentified data from 48,058 Lumen users, comprising 707,372 fasted sessions. Separate linear mixed models were fitted for female (n=520,269 sessions) and male (n=187,103 sessions) users due to observed sex differences in metabolism. User ID was included as a random effect to account for repeated measures. The models analyzed the relationship between fasted %CO<sub>2</sub> levels and reported carbohydrate intake, fasting duration, BMI, and age.</p><p><strong>Results: </strong>Higher reported carbohydrate intake from the previous day was significantly associated with increased morning %CO<sub>2</sub> levels in both male and female users (β=.032; P<.001; Cohen d=0.0691 in women and β=.024; P<.001; Cohen d=0.0534 in men), while a longer fasting duration was linked to decreased %CO<sub>2</sub> levels in both sexes (β=-.017; P<.001 for both and Cohen d=-0.0374 in women and Cohen d=-0.0382 in men). A higher BMI was associated with elevated %CO<sub>2</sub> levels in both sexes (β=.018; P<.001; Cohen d=0.0390 in women and β=.017; P<.001; Cohen d=0.0384 in men). Age had a statistically significant but modest effect in women (β=.008; P<.001; Cohen d=0.0180), whereas the effect size was minimal and did not meet the stricter significance threshold in men (β=.001; P=.02; Cohen d=0.0016). Cohen d values indicated that reported carbohydrate intake had the strongest effect size, while fasting duration and BMI had relatively smaller effects in both models.</p><p><strong>Conclusions: </strong>The Lumen device is able to detect changes in fasted %CO<sub>2</sub> levels based on the previous day's reported carbohydrate intake and fasting duration with sex-specific metabolic responses. These findings highlight the potential of Lumen as a personalized metabolic health monitoring tool, providing insights into the influence of dietary intake and fasting on metabolic state. Future research should investigate the hormonal and physiological mechanisms contributing to the observed sex differences and assess the long-term impact of app-guided metabolic feedba","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":" ","pages":"e64604"},"PeriodicalIF":6.2,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12441640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144794501","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-Assisted Self-Monitoring of Blood Glucose in Type 2 Diabetes in Ningbo, China: 12-Month Retrospective Cohort Study.","authors":"Xujia Ma, Kaushik Chattopadhyay, Miao Xu, Li Li, Jialin Li","doi":"10.2196/65919","DOIUrl":"10.2196/65919","url":null,"abstract":"<p><strong>Background: </strong>Self-monitoring of blood glucose (SMBG) is recommended in clinical practice guidelines, including those in China, as part of patient education, self-management, and empowerment. With technological advancements, telecommunication technologies are now used for telemonitoring in health care. Mobile apps have become a practical tool for SMBG among patients with type 2 diabetes mellitus (T2DM). However, the long-term effectiveness of this approach in real-world practice requires further exploration.</p><p><strong>Objective: </strong>The study aims to determine the effectiveness of mobile app-assisted SMBG in improving glycemic control in patients with T2DM at 12 months, in addition to standard care, in Ningbo, China.</p><p><strong>Methods: </strong>In this retrospective cohort study, adults with T2DM who registered at the National Metabolic Management Center, Ningbo, for the first time between September 1, 2019, and June 30, 2022, and received standardized diabetes management were included. The study compared 2 groups: those who opted for mobile app-assisted SMBG and those who did not. Propensity score matching matched the mobile app-assisted SMBG group with the control group based on similar baseline characteristics. Glycemic control-related outcomes were compared at 12-month follow-up. Linear and logistic regression models were used to estimate mean differences and odds ratios (ORs) along with 95% CIs, respectively, and adjustments were made for baseline characteristics.</p><p><strong>Results: </strong>A total of 160 patients (80 in each group) were included in the study. In the mobile app-assisted SMBG group, the median (IQR) frequency of blood glucose monitoring was 0 (0-2) times per week, with 28% (22/80) monitoring their blood glucose at least twice per week, and the app usage frequency was 1 (0-3) time per week, with 40% (32/80) logging in at least twice per week. There were no statistically significant differences observed between the mobile app-assisted SMBG group and the control group in glycemic control outcomes at 12 months. Specifically, the results showed no significant difference in (1) fasting blood glucose and glycosylated hemoglobin levels (mean difference -0.17 mmol/L, 95% CI -0.85 to 0.51 mmol/L; P=.62 and -0.12%, 95% CI -0.58% to 0.33%; P=.59, respectively) and (2) the proportion of patients achieving or maintaining fasting blood glucose at <7 mmol/L and glycosylated hemoglobin at <7% (OR 0.89, 95% CI 0.46-1.73; P=.74 and OR 0.91, 95% CI 0.44-1.88; P=.79, respectively).</p><p><strong>Conclusions: </strong>In a real-world cohort of patients with T2DM in Ningbo, China, mobile app-assisted SMBG did not lead to statistically significant improvements in glycemic control at 12 months. This suggests that in a well-resourced setting, standard care alone may be relatively effective. However, opportunities for further improvement remain. The lack of observed benefit may be due to process-related issues, such ","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"13 ","pages":"e65919"},"PeriodicalIF":6.2,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12404581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954781","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":"Effect of a Cognitive Behavioral Therapy-Based AI Chatbot on Depression and Loneliness in Chinese University Students: Randomized Controlled Trial With Financial Stress Moderation.","authors":"Yahui Wang, Xuhong Li, Qiaochu Zhang, Dannii Yeung, Yihan Wu","doi":"10.2196/63806","DOIUrl":"https://doi.org/10.2196/63806","url":null,"abstract":"<p><strong>Background: </strong>Mental health concerns are prevalent among university students, with financial stress further compounding these issues. While cognitive behavioral therapy (CBT) is effective for these conditions, its delivery through artificial intelligence (AI) chatbots represents a promising approach, especially in non-Western contexts.</p><p><strong>Objective: </strong>This study aims to investigate the efficacy of a culturally adapted, CBT-based AI chatbot for improving the well-being of Chinese university students and to examine whether financial stress moderates its effectiveness.</p><p><strong>Methods: </strong>In this randomized controlled trial, 100 university students (mean age 20.8, SD 2.2 years; 62/100, 62% female) were allocated to either an intervention (n=50) or a waitlist control group (n=50). The intervention group interacted with a CBT-based AI chatbot for 7 consecutive days. Depression (Center for Epidemiologic Studies Depression Scale), anxiety (Generalized Anxiety Disorder-7 scale), and loneliness (UCLA Loneliness Scale) were assessed at baseline, day 3, and day 7. Financial stress was measured using the Psychological Inventory of Financial Scarcity.</p><p><strong>Results: </strong>Significant group×time interactions were found for depression (F2,196=8.63; P<.001; η²p=.08) and loneliness (F2,196=5.57; P=.004; η²p=.05), but not for anxiety (F2,196=1.31; P=.27; η²p=.01). Post hoc comparisons showed significant reductions in both depression (t=3.85; P<.001) and loneliness (t=4.28; P<.001) from baseline to postintervention in the intervention group, with corresponding effect sizes of Cohen d=0.71 (95% CI 0.30-1.12) and Cohen d=0.60 (95% CI 0.20-1.00), respectively. No significant changes were observed in the waitlist control group. Exploratory subgroup analyses revealed that participants with high financial stress demonstrated significantly greater improvements in depression (F2,52=11.56; P<.001; η²p=.31) and loneliness (F2,52=11.18; P<.001; η²p=.30) compared to those with low financial stress.</p><p><strong>Conclusions: </strong>The culturally adapted, CBT-based AI chatbot effectively reduced depression and loneliness in Chinese university students, with stronger effects among those experiencing high financial stress. These findings highlight the potential of AI-driven interventions to provide accessible mental health support, particularly for financially stressed students.</p>","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"13 ","pages":"e63806"},"PeriodicalIF":6.2,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12396778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954952","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":"Identifying and Evaluating Mobile and Web Apps for Patients to Manage Hidradenitis Suppurativa: Systematic Search in App Stores and Content Analysis.","authors":"Caroline Glatzel, Tassilo Dege, Bernadette Glatzel, Matthias Goebeler, Dagmar Presser, Astrid Schmieder","doi":"10.2196/69030","DOIUrl":"https://doi.org/10.2196/69030","url":null,"abstract":"<p><strong>Background: </strong>Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease characterized by painful nodules, abscesses, and fistulas in intertriginous sites. It significantly impacts patients' quality of life. Early diagnosis and timely treatment are essential for disease control. Recurrent flares, suboptimal therapies, and prolonged misdiagnosis place a significant burden on both patients and health care systems.</p><p><strong>Objective: </strong>We aimed to identify mobile health apps (MHAs) for patients with HS and evaluate their quality through assessments by both patients and physicians.</p><p><strong>Methods: </strong>Two reviewers searched for mobile and web apps for HS, including those only available in German or English. Apps with advertising or non-patient-centered content and apps related to trials or conferences were excluded. Two apps met the criteria and were evaluated by 20 physicians and 27 patients using the Mobile App Rating Scale (MARS), user version of the MARS (uMARS), German Mobile App Usability Questionnaire, and technology affinity tools (Affinity for Technology Interaction Scale and Mobile Device Proficiency Questionnaire).</p><p><strong>Results: </strong>We identified 2 apps for managing HS that met the inclusion criteria-the HSR-Patients app and the EHSF-Hidradenitis Suppurativa app-from an initial pool of 29 proposed apps that included many nonmedical, non-HS-specific, and non-patient-centered apps. Patients rated the quality of the HSR-Patients app significantly higher than physicians (MARS: mean 3.01, SD 0.60 vs. uMARS: mean 3.53, SD 0.69; P=.009). In contrast, ratings for the EHSF-Hidradenitis Suppurativa app did not differ significantly (physicians: mean 2.81, SD 0.55; patients: mean 2.72, SD 0.79; P=.69). Usability, assessed with the German Mobile App Usability Questionnaire, showed no significant difference between physicians and patients for either app. For the HSR-Patients app, physicians and patients rated usability at 4.37 (SD 0.86) and 4.72 (SD 1.21; P=.27), respectively. For the EHSF-Hidradenitis Suppurativa app, physicians and patients rated usability at 3.88 (SD 0.77) and 3.38 (SD 1.35; P=.11), respectively. Patients showed a significantly higher general affinity for technology than physicians, as measured by the Affinity for Technology Interaction Scale (physicians: mean 3.62, SD 0.61; patients: mean 4.38, SD 1.30; P=.01). However, there was no significant difference in affinity for technology specifically when using mobile devices, as assessed by the Mobile Device Proficiency Questionnaire (physicians: mean 4.83, SD 0.25; patients: mean 4.69, SD 0.72; P=.41).</p><p><strong>Conclusions: </strong>This evaluation highlights the limited availability of high-quality, HS management-specific MHAs and underscores the need for more targeted digital tools. Differences in evaluations between patients and physicians were evident, with patients focusing on usability and practical guidance, ","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"13 ","pages":"e69030"},"PeriodicalIF":6.2,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954505","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":"Objectively and Subjectively Measured Physical Activity and Their Associations With Cardiometabolic Risk in the UK Biobank: Retrospective Cohort Study.","authors":"Charlyne Bürki, Caiwei Tian, Kenneth Westerman, Chirag Patel","doi":"10.2196/54820","DOIUrl":"https://doi.org/10.2196/54820","url":null,"abstract":"<p><strong>Background: </strong>The association between physical activity (PA) behavior and cardiometabolic risk factors has depended largely on questionnaire-based reporting. More studies are turning to mobile health (mHealth) device solutions to measure PA. While there are differences between self-reported activity levels and objectively measured accelerometer-based activity, how these differences manifest in disease risk is unknown.</p><p><strong>Objective: </strong>Here, we sought to evaluate these differences between self-reported and mHealth-based PA and to model the impact on their association with cardiometabolic factors. Our study provides a framework to assess the quality of relationships measured by mHealth technologies, which is generalizable to other sensors or activity-measuring devices.</p><p><strong>Methods: </strong>We assessed PA using both wrist-worn accelerometer data and self-reported questionnaires in 16,000 participants of the UK Biobank (UKB) between 2013 and 2015, focusing on walking, sleeping, sedentary, and moderate-to-vigorous physical activity (MVPA). We compared the concordance between self-reported and objective measures of PA. We also compared the association between objectively measured or self-reported PA and future clinical biomarker levels (eg, BMI, pulse rate, glucose control, and cholesterol).</p><p><strong>Results: </strong>Participants underestimated their weekly sedentary duration on average of 2.86 hours, and the coefficient of correlation (r) between subjective and objective activity was 0.12 for sedentary time, 0.16 for MVPA, 0.18 for walking, and 0.13 for sleeping. We found an inverse association between objectively measured MVPA and cardiometabolic biomarkers such as BMI and pulse rate, but found no association between subjectively reported activity and cardiometabolic biomarkers. We estimated that there is a 6% larger association between subjectively measured MVPA and BMI in healthy adults (vs the objective counterpart). We also estimated a 2%-3% difference on a healthy adult heartbeat (healthy range: 60-100 bpm) if relying on subjectively reported observations instead of measured PA.</p><p><strong>Conclusions: </strong>These findings suggest that the association based on self-reported activity is likely overestimated and biased compared with objectively measured PA. Therefore, care should be taken when assessing the effects of self-reported PA on key cardiometabolic factors, such as BMI and pulse rate. We emphasize that while the associations are biased when comparing PA modalities, we cannot conclude which method more closely reflects the daily activity load.</p>","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"13 ","pages":"e54820"},"PeriodicalIF":6.2,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12384678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954904","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":"Smartphone App-Guided Pulmonary Rehabilitation in Chronic Respiratory Diseases: Randomized Controlled Trial.","authors":"Chiwook Chung, Deog Kyeom Kim, Jung-Kyu Lee, Eun Young Heo, Hee Kwon, Dongbum Kim, Woo Jin Kim, Sei Won Lee","doi":"10.2196/64884","DOIUrl":"10.2196/64884","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Pulmonary rehabilitation improves exercise capacity, dyspnea, quality of life, and survival in patients with chronic respiratory disease. However, center-based pulmonary rehabilitation programs remain unavailable in many health care facilities due to several barriers. To address this, we developed a smartphone app that enabled individuals to perform pulmonary rehabilitation at home.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;We aimed to evaluate the efficacy of smartphone app-guided pulmonary rehabilitation in improving exercise capacity in individuals with chronic respiratory diseases.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This was a multicenter prospective, single-blind, randomized controlled trial conducted in 2022. A total of 100 participants with chronic respiratory disease, including chronic obstructive pulmonary disease, asthma, and lung cancer, were recruited, with equal distribution (50:50) between the intervention group and the control group. The intervention group followed a 12-week app-guided rehabilitation program, while the control group received standard outpatient treatment. The primary outcome was the 6-minute walk test distance (6MWD) after the 12-week rehabilitation period. Secondary outcomes included quality of life questionnaires and health care usage.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among the 100 participants included, 88 completed the follow-up visit (41 in the intervention group and 47 in the control group). Their median age was 68.0 years, and 72 (81.8%) were men. Most participants (n=70, 79.5%) had a smoking history, with a median of 40.0 pack-years. Their forced expiratory volume in 1 second was a median of 63.0% (IQR 50.5-71.5). Most participants (n=85, 96.6%) had chronic obstructive pulmonary disease. After the 12-week rehabilitation program, 6MWD was not different between the intervention and control group (median 490.0, IQR 468.8-556.3 vs 485.0, IQR 440.0-527.3 m). Assuming a clinically minimal effective change of 25 meters in 6MWD, only 7 out of 41 participants among the intervention group achieved the minimal clinically important differences after the rehabilitation program. Quality of life questionnaire scores, including the St George's Respiratory Questionnaire and Hospital Anxiety and Depression Scale, did not differ between groups. In addition, none of the participants experienced hospitalization or emergency room visits during the study period. Regarding the service satisfaction questionnaire, more than 3-quarters of the intervention group (34/41) rated their scores as ≥17/20.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;In this study, smartphone app-guided pulmonary rehabilitation failed to improve exercise capacity and quality of life in patients with chronic respiratory diseases. However, the results indicated that older adults with chronic respiratory conditions can safely use smartphone app-guided pulmonary rehabilitation. Thus, smartphone app-guided pulmonary rehabilitation may be a feasible opt","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"13 ","pages":"e64884"},"PeriodicalIF":6.2,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12377637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954907","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":"What to Consider When Developing Multidomain Mobile Health Interventions for Lifestyle Management.","authors":"Manuel Weber, Renato Mattli, Anja M Raab, Anja Frei, Karin Haas, Thimo Marcin, Albrecht Vorster, Kai-Uwe Schmitt","doi":"10.2196/63573","DOIUrl":"https://doi.org/10.2196/63573","url":null,"abstract":"<p><strong>Unlabelled: </strong>Mobile health (mHealth) interventions can transform health care delivery and improve public health. At the same time, the evidence on lifestyle interventions continues to grow. They show promising results in preventing and treating noncommunicable diseases and enhancing health-related quality of life. These factors highlight the potential of multidomain mHealth interventions for lifestyle management. This viewpoint paper focuses on drawing valuable lessons from past experiences and providing guidance to developers of mHealth interventions for lifestyle management. We underscore the critical role of sharing practical insights to advance innovation in the field of mHealth interventions. We used an iterative consensus process to derive lessons learned, identify challenges, and reflect on possible actions. Our insights are based on our experience in developing 2 smartphone-based lifestyle interventions. Challenges and corresponding options in the following areas are presented: target population (preferences, personalization, and delivery), user involvement and testing, human support, and multidomain interventions (interdisciplinarity, flexibility, and core team). The development of multidomain mHealth interventions for lifestyle management requires a participatory and iterative approach involving relevant stakeholders (including end users) so that the right people get the right content at the right time. Additionally, it is crucial to consider established frameworks, guidelines, and regulations; allocate appropriate resources; and form a core team committed to the project's aims and open to working in an interdisciplinary team.</p>","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"13 ","pages":"e63573"},"PeriodicalIF":6.2,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12377792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954929","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 Smartphone Apps on Reperfusion Times and Clinical Outcomes in Acute ST-Segment Elevation Myocardial Infarction: Systematic Review and Meta-Analysis.","authors":"William Gibson, Dawoud Al Kindi, Elie Akl, Kshitij Badal Dandona, Jean-Philippe Pelletier, Nicolo Piazza, Ali Zgheib, Giuseppe Martucci, Marco Spaziano","doi":"10.2196/66605","DOIUrl":"10.2196/66605","url":null,"abstract":"<p><strong>Background: </strong>Smartphone- and tablet-based apps have been increasingly used in the management of acute ST-segment elevation myocardial infarction (STEMI), with the goal of enhancing care efficiency. These apps facilitate improved team coordination through a single platform, enabling secure sharing of clinical data, arrival times, and enabling data storage and processing capabilities. The potential of these technologies to reduce reperfusion times and improve both clinical and process outcomes, compared to traditional communication methods, is promising.</p><p><strong>Objective: </strong>This study aimed to evaluate the effectiveness of smartphone-based interventions in reducing door-to-balloon (D2B) time, first medical contact-to-balloon (FMC2B) time, mortality, and false activation rates in STEMI care pathways.</p><p><strong>Methods: </strong>This review followed the PRISMA guidelines and the PICO framework for eligibility criteria. Studies were included if they compared smartphone- or tablet-enabled interventions with usual care for STEMI management, focusing on D2B time, FMC2B time, short-term mortality, and false activation rates. A systematic literature search was conducted across MEDLINE, Embase, and Google Scholar for studies published between 2008 and 2024. Studies using purpose-built software or commercially available instant messaging apps that enabled digital ECG transfer and real-time communication between providers were included. The protocol was registered with PROSPERO (CRD42023481024). Data synthesis was performed using SPSS (IBM) with random-effects meta-analysis for continuous and binary outcomes.</p><p><strong>Results: </strong>A total of 903 articles were identified after removing duplicates, and 21 studies, involving 3267 patients, were included. Studies varied in design: 14 being retrospective and 7 prospective, conducted across 12 countries. Thirteen studies evaluated dedicated apps, and 8 used instant messaging platforms such as WhatsApp (Meta Platforms Inc) and WeChat (Tencent Holdings Ltd). The primary outcome, D2B time, showed a significant reduction in the intervention group (mean difference -19.11 mins, 95% CI -26.22 to -12.00; P<.01), with substantial heterogeneity (I²=89%). A similar reduction in FMC2B time was observed (mean difference -19.85 minutes, 95% CI -29.45 to -20.25; P=.01). Subgroup analysis indicated a more pronounced reduction in D2B time in low-income countries compared to high-income countries. There were no significant differences regarding short-term mortality (risk difference -0.03, 95% CI -0.07 to 0.01; P=.10). False activation rates were evaluated in 7 studies, with varying results, but no pooled analysis was feasible due to differences in definitions and study design. The health care setting (ie, low- or high-income countries) was the most significant factor contributing to the observed heterogeneity in the meta-regression analysis.</p><p><strong>Conclusions: </strong>Smartphon","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"13 ","pages":"e66605"},"PeriodicalIF":6.2,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12377873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954715","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}