JMIR mHealth and uHealth最新文献

{"title":"Predictors of Mobile Health App Acceptance Among Nurses in Kashan, Iran: Cross-Sectional Study.","authors":"Narjes Mirabootalebi, Felix Holl, Walter Swoboda, Zahra Tagharrobi, Fatemeh Rangraz Jeddi, Hossein Akbari","doi":"10.2196/93888","DOIUrl":"10.2196/93888","url":null,"abstract":"<p><strong>Background: </strong>The integration of mobile health apps (MHAs) into nursing practice is essential for improving efficiency, conserving resources, and enhancing patient care. To promote the acceptance of these apps in clinical care, it is important to assess current acceptance levels and identify influencing factors.</p><p><strong>Objective: </strong>This study investigated the acceptance of MHAs and related factors among nurses in hospitals affiliated with Kashan University of Medical Sciences, Iran.</p><p><strong>Methods: </strong>In this cross-sectional study, 250 nurses were selected via stratified random sampling in Kashan in 2022. Data were collected using the Nurses' Mobile Health Device Acceptance Scale (NMHDA-S) and the Probable Predictors Questionnaire. The data were analyzed using SPSS (version 16; IBM Corp), 1-way ANOVA, independent t test, Pearson correlation coefficients, and multiple linear regression.</p><p><strong>Results: </strong>The findings showed that nurses had a mean acceptance score of 4.207 (SD 0.740) on a Likert scale from 1 to 7 (95% CI 4.115-4.299) regarding the use of MHAs. Multiple linear regression analysis indicated that 4 variables significantly predicted acceptance of MHAs (R²=0.230, F4,245=18.308, P<.001): interest in participating in relevant educational programs (β=0.392, P<.001), encouragement from health care professionals to use MHAs (β=0.133, P=.02), male participant (β=-0.116, P=.04), and duration of daily internet use (β=0.117, P=.04).</p><p><strong>Conclusions: </strong>Although MHA acceptance among clinical nurses in Kashan is moderate, adoption can be enhanced through targeted training, facilitated internet access, and gender-specific incentive policies, particularly for female staff.</p>","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"14 ","pages":"e93888"},"PeriodicalIF":6.3,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13426121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148630648","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 Rating Scale for Health Care Professionals to Assess the Quality of mHealth Apps: Questionnaire Development and Psychometric Analysis.","authors":"Albie Sharpe, Yiong Huak Chan, Amarasinghe Arachchige Don Nalin Samandika Saparamadu","doi":"10.2196/48828","DOIUrl":"10.2196/48828","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Many frameworks and tools are available to evaluate the quality of mobile health apps (MHAs), which are increasingly used by health care professionals (HCPs) for accessing medical information, clinical decision support, and communication. However, existing tools are not well equipped to assess the quality of apps designed for HCPs from their perspectives.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;We aimed to develop a new tool based on the Mobile App Rating Scale (MARS) to capture the unique perspectives of HCPs on MHAs. We then conducted a psychometric analysis of this new questionnaire to determine its effectiveness in assessing the quality of MHAs designed specifically for HCPs from their perspectives.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This study was conducted in 2 phases. In phase 1, the original MARS tool was adapted for HCPs through expert panel review and subsequent qualitative interviews, resulting in the development of the pMARS (MARS for health care professionals) tool. This phase focused on establishing face and content validity. Qualitative interviews were conducted with HCPs from a tertiary hospital in Singapore to gather their perspectives on the tool's structure, clarity, applicability, and usability. In phase 2, we invited HCP participants to complete pMARS based on their experience with the LabMed app, an mHealth tool designed to provide medical laboratory-related information to HCPs. We established the construct validity of pMARS through multiple psychometric techniques. Internal consistency reliability was measured using the Cronbach α, while structural equation modeling was used to examine the interrelationships among latent constructs. Additionally, we used item response theory (IRT) to evaluate each item's impact on latent constructs of interest, that is, discriminative performance of individual items within each domain.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Based on the results from phase 1, the pMARS comprised 26 items across 5 domains: engagement, functionality, aesthetics, information, and subjective quality, refined through interviews with 10 HCPs. In phase 2 (n=218), pMARS demonstrated good internal consistency reliability across all domains (Cronbach α=0.855-0.931). Structural equation modeling demonstrated that functionality had the strongest influence on end-user willingness to use, recommend, and purchase the MHA (P&lt;.001). IRT identified that customization and interactivity of the engagement domain had a weak impact on latent constructs, whereas entertainment had a higher impact. Ease of use and gestural design had a weak impact on the functionality domain, whereas arrangement and size of content and quantity and quality had a strong impact on the aesthetics and information domains, respectively.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This study reports the development and psychometric analysis of pMARS. Our findings demonstrate strong internal consistency reliability and construct validity, supporting","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"14 ","pages":"e48828"},"PeriodicalIF":6.3,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13427255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148648734","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":"Evaluation of the Impact of a Mobile App (LoAD Calc) on the Calculation of Maximum Safe Doses of Local Anesthetics: Randomized Controlled Trial.","authors":"Alexandra Stefani, Pietro Elias Fubini, Tal Sarah Beckmann, Caroline Flora Samer, Georges Louis Savoldelli, Mélanie Suppan","doi":"10.2196/89236","DOIUrl":"10.2196/89236","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Local anesthetics (LAs) are widely used in clinical practice, but their administration carries the risk of LA systemic toxicity, a potentially fatal complication. Calculating maximum safe doses is complex and error-prone when considering multiple patient-specific factors. Most existing tools and mobile apps have not been scientifically validated and may propose unsafe doses. The Local Anesthetics Dose Calculator (LoAD Calc) mobile app was developed at the Geneva University Hospitals to calculate maximum safe doses by integrating comprehensive patient parameters.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The primary objective was to evaluate the overdose rate using the LoAD Calc app compared with traditional calculation methods. Secondary objectives were calculation time, user confidence, app usability, and interpractitioner variability.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This single-center unblinded randomized controlled trial recruited 50 anesthesiologists to use either LoAD Calc or their usual calculation methods. Assessment was conducted in-person using a web-based platform. Participants completed 10 clinical vignettes featuring various patient characteristics, comorbidities, and medication interactions requiring maximum safe dose calculations for lidocaine, levobupivacaine, and ropivacaine. The primary outcome was the overdose rate, defined as exceeding the maximum safe doses calculated using a comprehensive set of rules incorporating all patient-specific factors. Secondary outcomes included overdose rates using 2 simplified weight-based methods, underdose rates, calculation time, and self-reported measures of confidence and app usability. Overdose rates were compared using chi-square tests with 95% CIs; calculation time and confidence were assessed using Student t test.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;All 50 participants completed the study. Using the full set of calculation rules, the overdose rate was significantly lower when LoAD Calc was used (30/250, 12.0% vs 198/250, 79.2%; relative risk [RR] 0.15, 95% CI 0.11-0.21; P&lt;.001). This was consistent across all 3 LAs: ropivacaine (5/100, 5% vs 64/100, 64%; P&lt;.001), levobupivacaine (19/100, 19% vs 90/100, 90%; P&lt;.001), and lidocaine (6/50, 12% vs 44/50, 88%; P&lt;.001). When considering simplified weight-based methods, overdose rates remained significantly lower when LoAD Calc was used (actual weight: 8/250, 3.2% vs 95/250, 38.0%; RR 0.08, 95% CI 0.04-0.17; P&lt;.001; ideal body weight: 10/250, 4.0% vs 151/250, 60.4%; RR 0.07, 95% CI 0.04-0.12; P&lt;.001). Underdose rates were similar (25/250, 10.0% vs 27/250, 10.8%; P=.77). Calculation time was also similar (mean 111, SD 56 s vs mean 115, SD 89 s; P=.53). LoAD Calc users reported higher confidence (mean 8.5, SD 0.9 vs mean 6.3, SD 1.7; P&lt;.001), and the app achieved a median System Usability Scale score of 98 (IQR 95-100).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;LA overdoses were significantly less likely when the LoAD Calc app was us","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"14 ","pages":"e89236"},"PeriodicalIF":6.3,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13422587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148630594","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":"Perceptions of Adults Aged 50 Years and Older Regarding the Use of Wearable mHealth Technologies to Promote Physical Activity: Systematic Review and Meta-Ethnography.","authors":"Beatriz Rodríguez-Martín, Diego González-Arroyo, Susana Priego-Jiménez, María Lopez-González, María Medrano-Echeverría, Marta Carolina Ruiz-Grao, Celia Álvarez-Bueno","doi":"10.2196/67157","DOIUrl":"10.2196/67157","url":null,"abstract":"<p><strong>Background: </strong>Despite advances in wearable mobile health (mHealth) technologies and their associated apps designed to promote physical activity, and the importance of adapting them to users, little is known about older adults' perceptions of these technologies.</p><p><strong>Objective: </strong>This review aimed to synthesize and analyze qualitative evidence exploring the perceptions of adults aged 50 years and older regarding areas to improve, barriers to, and facilitators of wearable mHealth technologies (activity trackers and companion apps) to promote physical activity.</p><p><strong>Methods: </strong>A qualitative systematic review and meta-ethnography was conducted. Comprehensive searches were performed across 8 databases (MEDLINE, Scopus, Web of Science, CINAHL, The Cochrane Library Plus, PsycINFO, ProQuest, and ÍnDICEs-CSIC) for articles published in English or Spanish between January 2013 and January 2024. The synthesis followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and ENTREQ (Enhancing Transparency in Reporting the Synthesis of Qualitative Research) guidelines.</p><p><strong>Results: </strong>Ten articles met the inclusion criteria and were synthesized using meta-ethnography. Three main themes emerged: (1) barriers to promoting physical activity caused by wearable mHealth technologies: personal barriers (physical aspects, perceptions about technology, and personal preferences), technological barriers (functionality, content, design, alarms, availability, and accessibility), and environmental barriers (season of the year); (2) personal facilitators (consideration that these apps improve health, perceptions about technology, and personal preferences), technological facilitators (functionality, content, and design), relational facilitators (technological and social support), environmental facilitators (seasonal variations), and health care professionals (support and monitoring by health care services); and (3) personal areas (perceptions about technology and personal preferences), technological areas (functionality, content, and design), and relational areas (technological support).</p><p><strong>Conclusions: </strong>Although older adults acknowledge the potential of wearable mHealth technologies to promote physical activity, their effective engagement is hindered by distinct personal, technological, and environmental barriers. Bridging the digital divide requires designers to prioritize user-centered, age-friendly interfaces that are integrated with continuous support from health care professionals. To promote genuine health equity, future research must rigorously report intersectional demographics to ensure that mHealth interventions mitigate, rather than inadvertently exacerbate, existing disparities.</p>","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"14 ","pages":"e67157"},"PeriodicalIF":6.3,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13420493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148620078","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":"Chinese Version of the mHealth App Usability Questionnaire for Health Care Providers: Cross-Sectional Translation and Validation Study.","authors":"Mengxia Chen, Wenjun Gao, Yijie Pan, Mengdi Wang, Bing Yu, Dongmei Li, Huanhuan Hu, Jing Zheng, Lingjuan Zhang, Yuan Gao","doi":"10.2196/86783","DOIUrl":"10.2196/86783","url":null,"abstract":"<p><strong>Background: </strong>With the rapid proliferation of mobile health (mHealth) apps in clinical practice, ensuring their usability for health care providers is critical to optimize workflow integration and service delivery. The mHealth App Usability Questionnaire (MAUQ) is a validated tool for assessing usability, but its applicability in Chinese health care settings remains untested. Cross-cultural adaptation and validation of the MAUQ for interactive apps are essential to address this gap.</p><p><strong>Objective: </strong>This study aimed to translate the MAUQ (for interactive apps for health care providers) into Chinese (MAUQ-C), adapt it to the Chinese health care context, and validate its psychometric properties for future mHealth research and use in China.</p><p><strong>Methods: </strong>This cross-sectional study followed international guidelines for cross-cultural adaptation, including forward translation, backward translation, expert review, and pretesting. A convenience sample of 382 health care providers (eg, physicians and nurses) using mHealth apps was recruited from 2 hospitals in China. Reliability was evaluated using the Cronbach α, test-retest reliability, and split-half reliability. Validity was assessed through content validity index, exploratory factor analysis, and confirmatory factor analysis.</p><p><strong>Results: </strong>The MAUQ-C retained the original 21-item structure and 3 dimensions. Content validity index values ranged from 0.833 to 1.000 (Scale-Content Validity Index/Average=0.992). Exploratory factor analysis identified a 3-factor model explaining 63.48% of the total variance. Confirmatory factor analysis confirmed a good model fit (minimum discrepancy/df=1.810; cumulative fit index=0.950; root-mean-square error of approximation=0.058). The Cronbach α for the total scale was 0.919, with dimension-specific values of 0.928, 0.877, and 0.886. Test-retest reliability was 0.881, and split-half reliability was 0.726. These results confirm that the MAUQ-C effectively measures usability across the dimensions of usability and satisfaction, system information arrangement, and efficiency.</p><p><strong>Conclusions: </strong>The MAUQ-C is a reliable and valid instrument for evaluating mHealth app usability among Chinese health care providers. It can serve as a critical tool to guide the development and optimization of mHealth solutions tailored to the Chinese health care system.</p>","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"14 ","pages":"e86783"},"PeriodicalIF":6.3,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13469830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148620080","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 Impact of Telehealth Use Experience on Recruitment of Underserved Populations Into a Telehealth-Delivered Mindfulness-Based Trial for Patients With Chronic Low Back Pain: Cross-Sectional Survey.","authors":"Marva V Foster, Phuong Tra Nguyen, Janice Weinberg, Keturah R Faurot, Natalia Morone","doi":"10.2196/82093","DOIUrl":"10.2196/82093","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Mindfulness-based stress reduction (MBSR) is recommended as a noninvasive, evidence-based treatment for chronic low back pain (CLBP); however, access and uptake are often constrained among medically underserved populations. Telehealth-delivered MBSR may scale access, yet little is known about the characteristics of underserved patients who have experience using telehealth and are willing to enroll in pragmatic trials evaluating MBSR.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study examined individual- and county-level social vulnerability characteristics associated with telehealth use experience among people living with CLBP who enrolled in OPTIMUM (Optimizing Pain Treatment in Medical Settings Using Mindfulness), a pragmatic randomized clinical trial of telehealth-delivered MBSR.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a cross-sectional analysis of baseline measures from the OPTIMUM trial, focusing on participants from a safety-net health institution and a federally qualified health center. The primary outcome was telehealth use experience (having had a prior telehealth visit at or before enrollment). Guided by Andersen's Behavioral Model of Health Services Use, we evaluated predisposing, enabling, and need factors. Prespecified measures included the following: demographics; employment and education; internet access and comfort using Zoom; neighborhood indices (Area Deprivation Index [ADI], Social Vulnerability Index [SVI]); rurality; back-pain duration; and validated patient-reported outcomes. Multivariable logistic regression was used to estimate adjusted odds ratios (AORs) and 95% CIs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of 244 enrolled participants (mean age 50.6, SD 13.5 y; n=162, 66.7% female; n=124, 50.8% non-Hispanic Black), 174 (71.3%) reported previous telehealth use. Predisposing factors associated with lower telehealth use included race or ethnicity (non-Hispanic Black: AOR 0.38, 95% CI 0.2-0.8; Hispanic: AOR 0.21, 95% CI 0.06-0.7) and part-time employment (AOR 0.33, 95% CI 0.1-0.9) vs full-time employment, whereas educational attainment above or below a high school degree was associated with higher odds of telehealth use (AORs 2.7-3.2). Enabling factors showed that lower comfort with Zoom was associated with lower telehealth use (AOR 0.5, 95% CI 0.2-0.9), whereas home internet access was common and not independently significant in adjusted models. Neighborhood socioeconomic disadvantages, social vulnerability, and rurality did not demonstrate significant associations. Needs factors indicated that longer CLBP duration was positively associated with telehealth experience (&gt;5 y: AOR 3.5, 95% CI 1.4-8.8). Other patient-reported outcomes, comorbidity burden, and surgical history were not significantly associated.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;In a safety-net and federally qualified health center context, prior telehealth experience was common among patients with CLBP willing to enroll in a telehealth-d","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"14 ","pages":"e82093"},"PeriodicalIF":6.3,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13418554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148620145","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 ManageHF Just-in-Time Adaptive Mobile App Interventions to Promote Self-Management and Improve Outcomes in Heart Failure: Randomized Controlled Trial.","authors":"Michael P Dorsch, Mohamed S Ali, Amy Krambrink, Giselle Kolenic, Sabah Ganai, Juan Arzac, Xutong Zhang, Kaitlyn M Greer, Amit J Shah, Jennifer A Cowger, Gregory Ewald, Jo Ellen Rodgers, Dave L Dixon, Todd M Koelling, Scott L Hummel","doi":"10.2196/74121","DOIUrl":"10.2196/74121","url":null,"abstract":"<p><strong>Background: </strong>Heart failure (HF) is a major health care challenge in the United States, with approximately 900,000 older adults hospitalized annually. Gaps in self-management, including unrecognized worsening symptoms and failure to adhere to dietary sodium restriction, can reduce quality of life and precipitate hospital admissions. Existing mobile health approaches to HF self-management have produced mixed results, highlighting the need for innovative strategies to improve postdischarge outcomes in at-risk patients.</p><p><strong>Objective: </strong>The ManageHF trial aimed to evaluate the effectiveness of 2 just-in-time adaptive interventions delivered via a mobile app to enhance HF self-management. The interventions focused on symptom recognition and lower dietary sodium restriction, with the goal of reducing readmissions and improving health-related quality of life (HRQOL) over a 12-week period.</p><p><strong>Methods: </strong>The trial was a 2×2 factorial, double-blind, randomized controlled study conducted across several US institutions. Participants recently hospitalized for acute HF were randomized into 4 groups: both interventions, either intervention alone, or an active control. The primary outcome was a composite measure assessing time to all-cause death, time to first HF readmission, and HRQOL changes, using the Minnesota Living with HF Questionnaire.</p><p><strong>Results: </strong>Recruitment was hindered by the COVID-19 pandemic, leading to the early discontinuation of the trial. Of the 62 participants enrolled, 43 completed the study. Participants were diverse, with a mean age of 55 (SD 14.4) years, 32% (20/62) were female, and 55% (34/62) identified as Black or African American. Most had HF with reduced ejection fraction. However, due to the early termination and small sample size, the ability to detect statistically significant differences was limited.</p><p><strong>Conclusions: </strong>The ManageHF trial highlighted the potential of mobile health technology to support HF management, particularly in enhancing HRQOL. Future studies using more effective recruitment and retention strategies are crucial for establishing the efficacy of these interventions with greater certainty.</p>","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"14 ","pages":"e74121"},"PeriodicalIF":6.3,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13412010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148603273","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 Phone Access, Usage Patterns, and Perceptions of Adolescents Living With HIV on the Use of Gamified Interventions to Improve Antiretroviral Therapy Adherence in Eswatini: Qualitative Study.","authors":"Londiwe D Hlophe, Peter S Nyasulu, Constance S Shumba","doi":"10.2196/74207","DOIUrl":"10.2196/74207","url":null,"abstract":"<p><strong>Background: </strong>Adolescents living with HIV often experience poor antiretroviral therapy (ART) outcomes due to multiple barriers affecting medication adherence. Effective self-care interventions are needed to address these challenges. Mobile phones are widely used by the adolescent population and therefore present an opportunity to enhance ART adherence using mobile phone-based interventions. However, research on mobile phone access among adolescents living with HIV, usage patterns, and perceptions of mobile phone-based interventions is limited in Eswatini.</p><p><strong>Objective: </strong>This study aimed to explore these aspects to inform effective mobile health strategies for enhancing ART adherence among adolescents living with HIV.</p><p><strong>Methods: </strong>We conducted a qualitative study using in-depth interviews in December 2023. A total of 29 adolescents living with HIV aged 10 to 19 years and enrolled on ART were purposively sampled and interviewed from 5 Teen Clubs in the Hhohho region of Eswatini. Interviews were audio-recorded and transcribed verbatim. Topic areas covered were mobile phone accessibility, usage patterns, and perceptions on the use of mobile phones to facilitate ART adherence. The data were analyzed using the deductive-inductive coding approach.</p><p><strong>Results: </strong>Of the 29 participants, 15 (52%) were female, and 19 (65.5%) were aged between 15 and 19 years. The study findings indicated high mobile phone access among participants, with primary usage focused on making and receiving calls, as well as engaging with social media. Three themes emerged regarding the use of gamified interventions to support ART adherence. First, the use of gamified interventions aimed at ART adherence among adolescents living with HIV was deemed feasible based on mobile phone access and past experiences with mobile games. Second, 3 main qualities of successful gamified interventions were identified as being supportive, being educational, and ensuring secure and confidential connections with other players. Finally, confidentiality and mobile phone access factors were highlighted as potential concerns when designing gamified ART adherence interventions.</p><p><strong>Conclusions: </strong>The findings suggest potentially high access and usage of mobile phones among adolescents living with HIV on ART in Eswatini. This provides an opportunity to leverage mobile technology to enhance ART adherence through gamified interventions. However, it is essential to carefully consider the specific needs and concerns of adolescents living with HIV in the design of these interventions to ensure their successful uptake and sustainability.</p>","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"14 ","pages":"e74207"},"PeriodicalIF":6.3,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148584248","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":"Mechanisms of Engagement With Mobile Health Apps for Adults With Long-Term Conditions: Overview of Systematic Reviews.","authors":"Jeni Baykoca, Goretti Hurtado Barbeito, Christina Joanne Pearce, Madison Milne-Ives, Joanna Hudson, Sam Norton, Rona Moss-Morris","doi":"10.2196/88382","DOIUrl":"10.2196/88382","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Engagement is a necessary precondition for the effectiveness of mobile health (mHealth) apps for long-term physical health conditions (LTCs), particularly as health systems increasingly prioritize the deployment of scalable, self-guided digital interventions. Outside controlled research settings, where clinician involvement often drives engagement, little is known about whether, how, and why people engage with mHealth apps based on intrinsic motivation alone. Existing systematic reviews have cataloged behavioral engagement indicators but rarely assess the mechanisms underlying engagement.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This overview of systematic reviews aimed to (1) synthesize evidence on how engagement with mHealth apps for LTCs is defined, measured, and associated with health outcomes, (2) explore intrinsic and extrinsic motivational processes underlying engagement, and (3) provide practical guidance for developing scalable, user-centered digital health interventions that sustain sufficient engagement with minimal reliance on external drivers. Uniquely, we interpreted modifiable barriers and facilitators through a motivational lens that distinguishes extrinsic from intrinsic motives, mapping intrinsic motives onto autonomy, competence, and relatedness, as proposed by Self-Determination Theory (SDT).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Searches of MEDLINE, Web of Science, Epistemonikos, and gray literature (inception to June 9, 2025) identified systematic reviews reporting engagement indicators, engagement-outcome associations, or barriers and facilitators among adults with LTCs. Quantitative reviews were appraised using AMSTAR 2 (A Measurement Tool to Assess Systematic Reviews 2), and qualitative and mixed methods reviews were appraised using CASP (Critical Appraisal Skills Programme). A narrative synthesis was undertaken, and modifiable barriers and facilitators were independently mapped by 2 reviewers to extrinsic and intrinsic motivation and, for intrinsic factors, to the SDT constructs of autonomy, competence, and relatedness. Discrepancies were resolved through discussion with the wider research team.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Nineteen reviews (12 quantitative, 5 mixed methods, and 2 qualitative) were included from 4684 records. Fourteen (74%) reviews did not define engagement, and the remaining 5 equated it with \"usage\" or \"adherence,\" precluding meta-analysis. Fourteen reviews reported microlevel behavioral indicators, but none captured macrolevel or effective engagement. Eight assessed engagement-outcome links; 7 reported positive associations, and 1 reported no effect. Seven reviews included nonmodifiable factors that influence engagement (eg, ethnicity), while 13 included modifiable factors. SDT mapping revealed that modifiable factors influencing autonomy (eg, personal relevance, flexibility), competence (eg, usability, technical support), and relatedness (eg, clinician endorsement, peer connecti","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"14 ","pages":"e88382"},"PeriodicalIF":6.3,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148578803","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":"Exploring the Design Space of Glanceable Smartwatch Feedback Displays: Experimental Study.","authors":"Yuxuan Li, Mark Newman, Predrag Klasnja","doi":"10.2196/81972","DOIUrl":"10.2196/81972","url":null,"abstract":"<p><strong>Background: </strong>Self-monitoring technologies are commonly used to promote health behavior change, with glanceable displays offering continuous feedback throughout the day. Yet, it is still unclear how various aspects of these glanceable representations affect their interpretability and usability.</p><p><strong>Objective: </strong>This study aimed to investigate the effects of 3 design factors-stylization, granularity, and salience-on users' ability to understand glanceable smartwatch-based feedback on daily step goals.</p><p><strong>Methods: </strong>We conducted an online simulation study to examine how 3 design dimensions-stylization, salience, and granularity-influence the effectiveness of glanceable feedback displays. Stylization and salience were crossed in a 2×2 factorial design, while granularity varied from 1% to 20% progress increments. A total of 202 Amazon Mechanical Turk participants were randomly assigned to 1 of 16 smartwatch display conditions. In each condition, participants viewed feedback on daily step progress and estimated the level of progress shown. We measured estimation error and questionnaire-assessed perceived usability and acceptability. The collected data were analyzed using generalized estimating equations and linear regression.</p><p><strong>Results: </strong>High stylization reduced accuracy (+4.52 error points; P<.001) and negatively affected perceptions across 6 dimensions, including comprehension (P=.003), complexity (P<.001), and usability (P=.001). Granularity had a nonlinear effect: error was lowest around 5%-10%, with sharp increases at 20%. The 10% level also received the most favorable ratings, for example, comprehension (+0.656; P=.003). Salience had no effect. Previous smartwatch users were less accurate than never-users (+7.46 points) but rated displays as more useful (P=.002) and easier to focus on (P<.001). Current users gave similarly positive ratings on attention and usefulness.</p><p><strong>Conclusions: </strong>These findings could help researchers design effective glanceable smartwatch feedback displays and expand the design space for glanceable feedback.</p>","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"14 ","pages":"e81972"},"PeriodicalIF":6.3,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13448195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148578823","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}