BMC digital healthPub Date : 2025-01-01Epub Date: 2025-01-07DOI: 10.1186/s44247-024-00140-6
Laura D'Adamo, Agatha A Laboe, Jake Goldberg, Carli P Howe, Molly Fennig Steinhoff, Bianca DePietro, Marie-Laure Firebaugh, Zafra Cooper, Denise E Wilfley, Ellen E Fitzsimmons-Craft
{"title":"Development and usability testing of an online platform for provider training and implementation of cognitive-behavioral therapy guided self-help for eating disorders.","authors":"Laura D'Adamo, Agatha A Laboe, Jake Goldberg, Carli P Howe, Molly Fennig Steinhoff, Bianca DePietro, Marie-Laure Firebaugh, Zafra Cooper, Denise E Wilfley, Ellen E Fitzsimmons-Craft","doi":"10.1186/s44247-024-00140-6","DOIUrl":"10.1186/s44247-024-00140-6","url":null,"abstract":"<p><strong>Background: </strong>Most individuals with eating disorders (EDs) do not receive treatment, and those who do receive care typically do not receive evidence-based treatment, partly due to lack of accessible provider training. This study developed a novel \"all-in-one\" online platform for disseminating training for mental health providers in cognitive-behavioral therapy guided self-help (CBTgsh) for EDs and supporting its implementation. The aim of the study was to obtain usability data from the online platform prior to evaluating its effects on provider training outcomes and patient ED symptom outcomes in an open pilot trial.</p><p><strong>Methods: </strong>Nine mental health provider participants (<i>n</i> = 4 in Cycle 1; <i>n</i> = 5 in Cycle 2) and 9 patient participants (<i>n</i> = 4 in Cycle 1; <i>n</i> = 5 in Cycle 2) were enrolled over two cycles of usability testing. In Cycle 1, we recruited providers and patients separately to complete brief platform testing sessions. In Cycle 2, we recruited provider-patient dyads; providers completed training using the platform and subsequently delivered CBTgsh to a patient for three weeks. Usability was assessed using the System Usability Scale (SUS), the Usefulness, Satisfaction, and Ease of Use Questionnaire (USE), and semi-structured interviews.</p><p><strong>Results: </strong>Interview feedback converged on two themes for providers (applicability of program for real-world use, platform structure and function) and two themes for patients (barriers and facilitators to engagement, perceived treatment effects). SUS and USE scores were in the \"average\" to \"good\" ranges across cycles.</p><p><strong>Conclusions: </strong>Findings from this study demonstrate preliminary feasibility and acceptability of the online platform. Data collected in this study will inform further refinements to the online platform. The platform's effects on provider training outcomes and patient ED symptom outcomes will be evaluated in an open pilot trial. Given the wide treatment gap for EDs and barriers to dissemination and implementation of evidence-based treatments, the online platform represents a scalable solution that could improve access to evidence-based care for EDs.</p>","PeriodicalId":72426,"journal":{"name":"BMC digital health","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12395347/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BMC digital healthPub Date : 2025-01-01Epub Date: 2025-01-14DOI: 10.1186/s44247-024-00142-4
Laurel O'Connor, Stephanie Behar, Seanan Tarrant, Pamela Stamegna, Caitlin Pretz, Biqi Wang, Brandon Savage, Thomas Scornavacca, Jeanne Shirshac, Tracey Wilkie, Michael Hyder, Adrian Zai, Shaun Toomey, Marie Mullen, Kimberly Fisher, Emil Tigas, Steven Wong, David D McManus, Eric Alper, Peter K Lindenauer, Eric Dickson, John P Broach, Vik Kheterpal, Apurv Soni
{"title":"Healthy at Home for COPD: An Integrated Digital Monitoring, Treatment, and Pulmonary Rehabilitation Intervention.","authors":"Laurel O'Connor, Stephanie Behar, Seanan Tarrant, Pamela Stamegna, Caitlin Pretz, Biqi Wang, Brandon Savage, Thomas Scornavacca, Jeanne Shirshac, Tracey Wilkie, Michael Hyder, Adrian Zai, Shaun Toomey, Marie Mullen, Kimberly Fisher, Emil Tigas, Steven Wong, David D McManus, Eric Alper, Peter K Lindenauer, Eric Dickson, John P Broach, Vik Kheterpal, Apurv Soni","doi":"10.1186/s44247-024-00142-4","DOIUrl":"10.1186/s44247-024-00142-4","url":null,"abstract":"<p><strong>Background: </strong>Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of morbidity and mortality in the United States. Frequent exacerbations result in higher use of emergency services and hospitalizations, leading to poor patient outcomes and high costs. The objective of this study is to demonstrate the feasibility of a multimodal, community-based intervention in treating acute COPD exacerbations.</p><p><strong>Results: </strong>Over 18 months, 1,333 patients were approached and 100 (7.5%) were enrolled (mean age 66, 52% female). Ninety-six participants (96%) remained in the study for the full enrollment period. Fifty-five (55%) participated in tele-pulmonary-rehabilitation. Participants wore the smartwatch for a median of 114 days (IQR 30-210) and 18.9 hours/day (IQR16-20) resulting in a median of 1034 minutes/day (IQR 939-1133). The rate at which participants completed scheduled survey instruments ranged from 78-93%. Nearly all participants (85%) performed COPD ecological momentary assessment at least once with a median of 4.85 recordings during study participation. On average, a 2.48-point improvement (p=0.03) in COPD Assessment Test Score was observed from baseline to study completion. The adherence and symptom improvement metrics were not associated with baseline patient activation measures.</p><p><strong>Conclusions: </strong>A multimodal intervention combining preventative care, symptom and biometric monitoring, and MIH services was feasible in adults living with COPD. Participants demonstrated high protocol fidelity and engagement and reported improved quality of life.</p>","PeriodicalId":72426,"journal":{"name":"BMC digital health","volume":"3 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12245176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BMC digital healthPub Date : 2025-01-01Epub Date: 2025-07-01DOI: 10.1186/s44247-025-00158-4
Sara Ghadimi, Jason Ereso, Alexander J Kaula, Nick Taptiklis, Francesca Cormack, Cathy Alessi, Jennifer L Martin, Joseph M Dzierzewski, Arash Naeim, Sarah Kremen, Tue Te, Constance H Fung
{"title":"Feasibility of cognitive testing and ecological momentary assessments using smartphones in middle aged and older adults with insomnia.","authors":"Sara Ghadimi, Jason Ereso, Alexander J Kaula, Nick Taptiklis, Francesca Cormack, Cathy Alessi, Jennifer L Martin, Joseph M Dzierzewski, Arash Naeim, Sarah Kremen, Tue Te, Constance H Fung","doi":"10.1186/s44247-025-00158-4","DOIUrl":"10.1186/s44247-025-00158-4","url":null,"abstract":"<p><strong>Background: </strong>Older adults with insomnia who use benzodiazepine receptor agonists (BZAs) may be at increased risk of cognitive impairment. Cognitive testing outside of clinical settings may yield results that are more reflective of individuals' cognition in their natural environment, where they experience fluctuations in mental state (e.g. drowsiness). We assessed the feasibility of self-administered cognitive testing via smartphone apps for collecting in-moment, in-context data about a person's current state (ecological momentary assessment, EMA).</p><p><strong>Methods: </strong>Participants (<i>n</i> = 20; median age 66 years; 14 females, 18 white) aged ≥ 55 years who were recruited from a BZA deprescribing trial were invited to complete (over a 28 day period) daily drowsiness assessments on an EMA app (cued by smartwatch alerts) and weekly self-administered digit span (DGS) forward/backward (2 [minimum] - 9 [maximum]), verbal paired associates (VPA; 0 [best]-24 [worst] total errors), and cued delayed recall of VPA (VPA-DR; 0 [best] - 8 [worst] errors) tests on a cognitive app. We assessed the completion of EMA (0-28 days) and cognitive sessions (# of participants per # sessions completed). We performed thematic analysis of the participant interviews.</p><p><strong>Results: </strong>The median number of days that EMA was completed was 24.5. Twelve (60%) individuals participated in 4 sessions; 2 (10%) individuals participated in 3 sessions; 2 (10%) individuals participated in 2 sessions; and 4 (20%) individuals participated in 1 session. No drowsiness was reported 36% of the time, whereas 38% of the responses reflected feeling \"a little bit\" drowsy and 26% at least \"somewhat\" drowsy. Mean cognitive test scores were DGS-Forward = 7 (SD 1.3), DGS-Backward = 5.6 (SD 1.0), VPA total errors = 9.9 (SD 3.7), and VPA-DR = 2.2 (SD 1.9). Three themes emerged from the participant interviews: 1) concern for one's own cognitive abilities, 2) strategies employed for optimizing scores (including strategies that would invalidate results), and 3) ease of use of the applications.</p><p><strong>Conclusions: </strong>Our findings indicate that mobile cognitive tests and EMAs are feasible in this older population. Further work is needed to understand how scores are influenced by the setting, mood, and behaviors.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1186/s44247-025-00158-4.</p>","PeriodicalId":72426,"journal":{"name":"BMC digital health","volume":"3 1","pages":"21"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BMC digital healthPub Date : 2025-01-01Epub Date: 2025-09-25DOI: 10.1186/s44247-025-00190-4
Sasha Frade, Shawna Cooper, Sam Smedinghoff, David Hattery, Yongshao Ruan, Paul Isabelli, Nirmal Ravi, Megan McLaughlin, Lynn Metz, Barry Finette
{"title":"Malaria RDT (mRDT) interpretation accuracy by frontline health workers compared to AI in Kano state, Nigeria.","authors":"Sasha Frade, Shawna Cooper, Sam Smedinghoff, David Hattery, Yongshao Ruan, Paul Isabelli, Nirmal Ravi, Megan McLaughlin, Lynn Metz, Barry Finette","doi":"10.1186/s44247-025-00190-4","DOIUrl":"10.1186/s44247-025-00190-4","url":null,"abstract":"<p><strong>Background: </strong>Although malaria is preventable and treatable, it continues to be a significant cause of illness and death. Early diagnosis through testing is critical in reducing malaria-related morbidity and mortality. Malaria rapid diagnostic tests (mRDTs) are preferred for their ease of use, sensitivity, and rapid results, yet misadministration and misinterpretation errors persist. This study investigated whether pairing an existing application with an AI-based software could enhance interpretation accuracy among Frontline Healthcare Workers (FHWs) in Kano State, Nigeria.</p><p><strong>Methods: </strong>A comparative analysis was conducted, examining mRDT interpretations by FHWs, trained expert mRDT reviewers (Panel Readers), and AI-based computer vision algorithms. The accuracy comparisons included: (1) AI interpretation versus Panel Read interpretation, (2) FHW interpretation versus Panel Read interpretation, (3) FHW interpretation versus AI interpretation, and (4) AI performance on faint positive lines. Accuracy was reported as a weighted F1 score, reflecting the harmonic mean of recall (sensitivity) and precision (positive predictive value).</p><p><strong>Results: </strong>The AI algorithm demonstrated high accuracy, matching Panel Read interpretations correctly for positives 96.38% of the time and negatives 97.12%. FHW interpretations agreed with the Panel Read 96.82% on positives and 94.31% on negatives. Comparison of FHW and AI interpretations showed 97.52% agreement on positives and 93.38% on negatives. The overall accuracy was higher for AI (weighted F1 score of 96.4) compared to FHWs (95.3). Notably, the AI accurately identified 90.2% of 163 faint positive mRDTs, whereas FHWs correctly identified 76.1%.</p><p><strong>Conclusion: </strong>AI-based computer vision algorithms performed comparably to trained and experienced FHWs and exceeded FHW performance in identifying faint positives. These findings demonstrate the potential of AI technology to enhance the accuracy of mRDT interpretation, thereby improving malaria diagnosis and reporting accuracy in malaria-endemic, resource-limited settings.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1186/s44247-025-00190-4.</p>","PeriodicalId":72426,"journal":{"name":"BMC digital health","volume":"3 1","pages":"50"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BMC digital healthPub Date : 2025-01-01Epub Date: 2025-07-15DOI: 10.1186/s44247-025-00165-5
Xiao Cao, Michelle Rozwadowski, Thomas M Braun, Noelle E Carlozzi, Afton L Hassett, Amanda K Johnson, Evan Shereck, David A Hanauer, Sung Won Choi
{"title":"A Mobile Health Intervention in Caregivers of Patients Undergoing Hematopoietic Cell Transplantation: A Randomized Controlled Trial to Examine Health-Related Quality of Life.","authors":"Xiao Cao, Michelle Rozwadowski, Thomas M Braun, Noelle E Carlozzi, Afton L Hassett, Amanda K Johnson, Evan Shereck, David A Hanauer, Sung Won Choi","doi":"10.1186/s44247-025-00165-5","DOIUrl":"10.1186/s44247-025-00165-5","url":null,"abstract":"<p><strong>Background: </strong>Caregivers are essential in supporting cancer patients, especially those undergoing hematopoietic cell transplantation (HCT). While traditional interventions have been beneficial for improving health-related quality of life (HRQOL), they typically require significant time and staff resources. To address this, we developed the Roadmap mHealth app, which incorporates resilience-building features based on positive psychology. The app integrates Fitbit<sup>®</sup> devices to monitor and visualize steps, sleep, and self-reported mood in the Roadmap app. A two-arm randomized controlled trial (RCT) was conducted to evaluate the impact of Roadmap's positive activities on caregiver HRQOL, measured by PROMIS<sup>®</sup> Global Health (physical and mental components), at day-120 post-transplant compared to assessment-only controls.</p><p><strong>Results: </strong>From September 08, 2020 to July 31, 2023, 168 dyads enrolled in the Roadmap study (82 intervention, 87 control). At day-120 post-HCT, there were no significant differences in PROMIS<sup>®</sup> Global Mental Health (48.18 vs. 48.16) or Global Physical Health (50.19 vs. 49.52) T-scores between the intervention and control arms. However, among caregivers who used positive activities and chat forum features in the intervention arm, daily mood significantly improved over time (β=0.0082, <i>P</i><0.001, 95% CI= [0.0060, 0.0010]). Improved daily mood scores were positively associated with better PROMIS<sup>®</sup> Global Mental Health at days 30 and 120 post-HCT (β=0.6076, <i>P</i>=0.03, 95% CI=[0.0494, 1.166]). The Fitbit<sup>®</sup> device and Roadmap app also received net favorable ratings in feasibility and acceptability, indicating that they were generally easy-to-understand, set up, and use, and superior Mobile App Rating Scale (MARS) scores compared to published mental health apps, with no significant differences between study arms. Compliance with the intervention or control app declined over time.</p><p><strong>Conclusions: </strong>While the primary outcome, PROMIS<sup>®</sup> Global Health, did not differ between arms, caregivers who engaged in positive activities and chat forum through the app experienced a significant improvement in mood compared to those who did not. Additionally, caregivers reported the study as feasible and acceptable over the 120-day study period. Future directions for the Roadmap app are discussed based on these findings.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov: NCT04094844, Registered 09-16-2019.</p>","PeriodicalId":72426,"journal":{"name":"BMC digital health","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12356276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144877035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comparative validity assessment of three android step counter applications; a semi-structured laboratory-based study.","authors":"Uchechukwu Martha Chukwuemeka, Arinze Damian Nnalue, Sochima Johnmark Obiekwe, Fatai Adesina Maruf, Anthony Chinedu Anakor, Monday Omoniyi Moses, Chinedum Amaechi, Uchenna Prosper Okonkwo, Ifeoma Adaigwe Amaechi","doi":"10.1186/s44247-025-00159-3","DOIUrl":"10.1186/s44247-025-00159-3","url":null,"abstract":"<p><strong>Background: </strong>Step counting stands out as a highly practical and widely utilised method for assessing an individual's level of physical activity (PA). Although the progress of step counting has undergone a significant transformation in recent times, the need to validate PA applications (apps) is even more pressing to ensure their accuracy. This study aimed to compare the criterion validity of Pacer, Pedometer by ITO Technologies Inc., and Google Fit in measuring step counts in semi-structured laboratory-based conditions.</p><p><strong>Method: </strong>This comparative experimental study involved 50 students who were fitted with Android phones running the three step counting applications (Pedometer, Pacer and Google Fit) simultaneously while they walked a 30-m walkway at a normal and fast pace during which a video of their walking was recorded with Techno Pouvoir 4 Pro running Android version 11. The steps in the recorded videos served as the criterion compared with the steps recorded by the apps and were counted only when the foot is lifted off the ground and placed in a new location. They were counted independently by two reviewers, who recounted where their level of agreement was more than 3 steps until their report was not more than 2 steps different. The Spearman's correlation was used for a relationship, while Mean Absolute Percentage Error (MAPE) and Bland plot were for validity testing at an Alpha level of 0.05.</p><p><strong>Result: </strong>While there was no significant difference in step counts among the three apps, a significant difference was found between the steps recorded by the apps and those counted by the video criterion during normal-paced walking but not for fast-paced walking (<i>p</i> > 0.05). The MAPEs for the three applications were moderate, with Google Fit showing 6.6% for normal pace walking and Pedometer and Pacer showing 9.2%. For fast-paced walking, the MAPE was lower at 5.4% across all three applications.</p><p><strong>Conclusion: </strong>Our findings suggest that a pedometer, Pacer and Google Fit could be used as outcome measures in a general population for counting steps, but Google Fit might be a better step counter when normal pace walking is assessed. However, the study's relatively short duration may have overlooked variations in the applications'performance across different conditions over a longer period; hence, future studies should consider comparing the validity of these applications for a longer duration and among diverse populations.</p>","PeriodicalId":72426,"journal":{"name":"BMC digital health","volume":"3 1","pages":"20"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12234585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BMC digital healthPub Date : 2025-01-01Epub Date: 2025-08-21DOI: 10.1186/s44247-025-00175-3
Ahad Mahmud Khan, Md Shafiqul Islam, Nabidul Haque Chowdhury, Salahuddin Ahmed, Rezwana Tabassum, Sadia Afrin, Zannatul Ferdush Amin, Kazi Sazzadul Haque, Afroza Yeasmin Rumi, Jawata Rahman, Rakib Bhuiyan, Rizouan Ur Rashid, Kamrun Nahar, Robynne Simpson, Ayaz Ahmed, Md Mozibur Rahman, Ting Shi, Abdullah H Baqui, Steve Cunningham, Eric D McCollum, Harry Campbell
{"title":"Evaluating the performance of an automated respiratory rate counter in detecting fast breathing pneumonia in children using a reference video expert panel.","authors":"Ahad Mahmud Khan, Md Shafiqul Islam, Nabidul Haque Chowdhury, Salahuddin Ahmed, Rezwana Tabassum, Sadia Afrin, Zannatul Ferdush Amin, Kazi Sazzadul Haque, Afroza Yeasmin Rumi, Jawata Rahman, Rakib Bhuiyan, Rizouan Ur Rashid, Kamrun Nahar, Robynne Simpson, Ayaz Ahmed, Md Mozibur Rahman, Ting Shi, Abdullah H Baqui, Steve Cunningham, Eric D McCollum, Harry Campbell","doi":"10.1186/s44247-025-00175-3","DOIUrl":"10.1186/s44247-025-00175-3","url":null,"abstract":"<p><strong>Background: </strong>According to the World Health Organization's Integrated Management of Childhood Illness (IMCI) guidelines, childhood pneumonia diagnosis relies on counting respiratory rate (RR). Counting RR by health workers is frequently inaccurate, leading to misdiagnosis and poor outcomes. Automated RR counters could potentially overcome these limitations. To address this gap, we introduced an automated RR counter and developed a reference video expert panel (VEP) to evaluate its performance.</p><p><strong>Methods: </strong>We conducted a cross-sectional study involving children aged 0-59 months with suspected pneumonia in Bangladesh. The RR of children was counted using an automated counter (ChARM) and chest movements were simultaneously videotaped. These videos were interpreted by the VEP, trained to a standard procedure. We assessed ChARM's accuracy in comparison to the RR generated by the VEP and summarised the time taken to count RR by ChARM.</p><p><strong>Results: </strong>Among 339 enrolled children, ChARM successfully counted the RR of 294 children (86.7%). The VEP reached a consensus (i.e., RR count difference within two breaths per minute (bpm) between two VEP members) in 257 of the 294 children (87.4%). ChARM and the VEP agreed on RR counts within two bpm in 68.1% of children (<i>n</i> = 175/257), with a mean difference of 1.7 bpm and limits of agreement ranging from -6.7 to 10.2 bpm. ChARM classified age-adjusted fast and normal breathing with a sensitivity of 95.8% (95% CI: 88.1-99.1) and a specificity of 93.5% (95% CI: 89.0-96.6), demonstrating high agreement (kappa = 0.86). The median time to count the RR by ChARM was 66 s (interquartile range: 61-73 s).</p><p><strong>Conclusions: </strong>ChARM counted RR accurately against a VEP reference, indicating a potential role in supporting health workers to diagnose pneumonia. However, it was unsuccessful for 1 in 8 cases, typically those more clinically challenging, suggesting a possible systematic bias. Further research is needed to address these issues and confirm ChARM's reliability for broader use in real-world settings.</p><p><strong>Trial registration: </strong>Current Controlled Trials ISRCTN14120515, registered retrospectively on 19 September 2024.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1186/s44247-025-00175-3.</p>","PeriodicalId":72426,"journal":{"name":"BMC digital health","volume":"3 1","pages":"32"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12442458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BMC digital healthPub Date : 2025-01-01Epub Date: 2025-09-22DOI: 10.1186/s44247-025-00204-1
Isa M van der Drift, Felicia A Browne, Alinda M Nyamaizi, Wendee M Wechsberg
{"title":"\"A lot of the answers come from within you as well\": benefits and limitations to utilizing and adapting a virtual platform to enhance social interaction and group learning.","authors":"Isa M van der Drift, Felicia A Browne, Alinda M Nyamaizi, Wendee M Wechsberg","doi":"10.1186/s44247-025-00204-1","DOIUrl":"10.1186/s44247-025-00204-1","url":null,"abstract":"<p><strong>Background: </strong>HIV disproportionately impacts Black women in the Southern United States. Interventions that incorporate social support and group learning have been proven effective, but following the onset of the COVID-19 pandemic, public health research has become increasingly interested in the usage of mobile health (mHealth) and telehealth to make interventions more accessible. Gathering feedback to ensure a culturally relevant adaptation of mHealth and virtual groups and support platforms is critical, as there is a persistent disparity in mobile device and laptop ownership, which can decrease accessibility of these platforms.</p><p><strong>Methods: </strong>A formative phase was conducted for a trial of a virtual group and social support platform in addition to an mHealth intervention to promote pre-exposure prophylaxis (PrEP) uptake and sexual and reproductive health outcomes among young Black women in North Carolina aged 18 to 30 years. Focus group discussions were conducted with service providers (<i>n</i> = 12) and the study population (<i>n</i> = 15), followed by pretesting of the virtual platform with members of the study population (<i>n</i> = 7).</p><p><strong>Results: </strong>Feedback from the focus group discussions and pretesting sessions were overall positive. Participants expressed the importance of a design that is culturally relevant, including customizable avatars that display a diversity of body types, skin tones, and hairstyles. Pretesting participants indicated that utilization of Gather.town on a mobile device was more difficult than on a laptop. Overall, participants valued the privacy mechanisms in place and supported the idea of discussing these critical topics with other young women like themselves.</p><p><strong>Conclusions: </strong>The importance of this initial step is essential when discussing a new virtual group platform that might address accessibility. Although most feedback was positive, participants also provided important considerations for accessibility of the platform, especially when considering disparities in device ownership.</p><p><strong>Trial registration: </strong>NCT05753683, first registered 01-06-2023.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1186/s44247-025-00204-1.</p>","PeriodicalId":72426,"journal":{"name":"BMC digital health","volume":"3 1","pages":"64"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12450795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BMC digital healthPub Date : 2025-01-01Epub Date: 2025-07-29DOI: 10.1186/s44247-025-00167-3
Paige Coyne, Matthew B Jennings, Sara Santarossa, Dana Murphy, Maya Zreik, Helena Bryans, Christopher Drake, Olivia Walch, Philip Cheng
{"title":"Using night shift worker and employee health stakeholder perspectives to inform the development of Arcashift<sup>tm</sup>, a digital precision circadian medicine intervention for shift work disorder.","authors":"Paige Coyne, Matthew B Jennings, Sara Santarossa, Dana Murphy, Maya Zreik, Helena Bryans, Christopher Drake, Olivia Walch, Philip Cheng","doi":"10.1186/s44247-025-00167-3","DOIUrl":"10.1186/s44247-025-00167-3","url":null,"abstract":"<p><strong>Background: </strong>More than a quarter of night shift workers (NSWs) have symptoms severe enough to meet diagnostic criteria for Shift Work Disorder (SWD). This study sought to understand the experiences of both NSWs and employee health stakeholders (EHSs) to inform the design of an effective digital precision circadian medicine intervention for NSWs experiencing SWD.</p><p><strong>Methods: </strong>NSWs (<i>N</i> = 20) participated in virtual focus groups (<i>N</i> = 5) and were asked about their experiences with night shift work, desired components of a digital intervention for SWD, and feedback on a potential digital precision circadian medicine intervention (i.e., Arcashift™) for SWD. Eligibility criteria: fixed night schedule for 6 + months, diagnosed with SWD, and aged 18-50 years. EHSs (<i>N</i> = 5) participated in virtual 1-on1 interviews, where they were asked about what motivations, goals, and return-on-investments (ROIs) mattered with regards to investing in a digital intervention for NSWs. Focus groups and interviews were digitally recorded and transcribed. Combined transcript reflexive thematic analysis was conducted to identify themes.</p><p><strong>Results: </strong>The reflexive thematic analysis produced three themes. The first theme, <i>the trials and tribulations of night shift work</i>, related to the physical, mental, and emotional tolls related to working the night shift and resulted from problem-focused discussions with NSWs about what it is like to work the night shift. Subthemes included: <i>physically and mentally draining, the world runs on daytime hours, and lack of respect and consideration</i>. The remaining two themes, <i>thrown to the wolves</i> and <i>shifting towards an app</i>, were the result of shifting focus group conversations with NSWs and interviews with EHSs towards solution-focused thinking by presenting a digital precision circadian medicine intervention (i.e., Arcashift™) through which NSWs' SWD could be improved.</p><p><strong>Conclusion: </strong>This study represents a strong preliminary step toward the development of an app for the intervention of SWD. There is a critical need for a real-world intervention for SWD, and stakeholders were optimistic about the potential of an app to help address SWD. Future work is needed to assess the extent to which the proposed app, informed by these stakeholder insights, is able to improve outcomes for employees and ROIs for EHSs.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1186/s44247-025-00167-3.</p>","PeriodicalId":72426,"journal":{"name":"BMC digital health","volume":"3 1","pages":"25"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12304005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BMC digital healthPub Date : 2025-01-01Epub Date: 2025-04-15DOI: 10.1186/s44247-025-00151-x
Anthony J Wilson, Alexander J Parker, Gareth B Kitchen, Andrew Martin, Lukas Hughes-Noehrer, Mahesh Nirmalan, Niels Peek, Glen P Martin, Fiona C Thistlethwaite
{"title":"The completeness, accuracy and impact on alerts, of wearable vital signs monitoring in hospitalised patients.","authors":"Anthony J Wilson, Alexander J Parker, Gareth B Kitchen, Andrew Martin, Lukas Hughes-Noehrer, Mahesh Nirmalan, Niels Peek, Glen P Martin, Fiona C Thistlethwaite","doi":"10.1186/s44247-025-00151-x","DOIUrl":"https://doi.org/10.1186/s44247-025-00151-x","url":null,"abstract":"<p><strong>Background: </strong>Use of wearable vital signs sensors (WVSSs) to monitor hospitalised patients is growing but uncertainty exists about how such sensors should be adopted into existing practice. The aim of this observational study was to determine the completeness of data capture and accuracy of measurements recorded by a suite of WVSSs. The implications of using such measurements to derive early warning scores was also assessed.</p><p><strong>Methods: </strong>Adult inpatients with Covid-19 wore four WVSSs recording heart rate/respiratory rate (HR/RR), oxygen saturation (SpO<sub>2</sub>), axillary temperature and blood pressure (BP). Wearable vitals were paired with traditional vitals (measured by nurses) recorded concurrently. The accuracy of the wearable vitals was assessed using traditional vitals as the reference. National early warning (NEWS2) scores were calculated using wearable and traditional vitals.</p><p><strong>Results: </strong>Forty-eight patients were monitored for 204 days with the sensors. Median sensor wear was 3.9(IQR:1.7-5.9), 3.9(IQR:1.6-5.9) and 3.8(IQR:0.9-5.9) days for HR/RR, temperature and SpO<sub>2</sub> respectively. The BP cuff was worn for median 1.9(IQR:0.9-3.8) days in 33 patients. Length of hospital stay was 8(IQR:6-13) days. Completeness of data capture was 84% for HR/RR, 98% for temperature, 72% for SpO<sub>2</sub> and 36% for BP.There were 1633 HR, 1614 RR, 1412 temperature, 1294 SpO<sub>2</sub> and 59 BP wearable-traditional measurement pairs. 59.7% of HR pairs were within ± 5 bpm, 38.5% of RR pairs within ± 3breaths/min, 24.4% of temperature pairs within ± 0.3℃, 32.9% of SpO<sub>2</sub> pairs within ± 2% and 39.0% of BP pairs within ± 10 mmHg. Agreement between wearable and traditional RRs was poor at high RRs.In a ward setting, 613 NEWS2 scores were calculated using wearable-traditional HR, RR, temperature and SpO<sub>2</sub> pairs. The median NEWS2<sub>traditional</sub> was 1(IQR:1-2) and the median NEWS2<sub>wearable</sub> was 4(IQR:3-6). Using traditional NEWS2 alerts as a reference, 86% (225/262) of wearable NEWS2 5 + alerts and 89% (82/92) of wearable NEWS2 7 + alerts were false positives.</p><p><strong>Conclusions: </strong>Agreement between vital signs recorded by wearable sensors and concurrent traditional vitals is poor. In this context, data from wearable sensors should not be used in existing track and trigger systems.</p><p><strong>Trial registration: </strong>The COSMIC-19 study was registered with clinicaltrials.gov (registration: NCT04581031, date of registration: Oct 6th 2020).</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1186/s44247-025-00151-x.</p>","PeriodicalId":72426,"journal":{"name":"BMC digital health","volume":"3 1","pages":"13"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11997001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}