Frontiers in digital health最新文献

{"title":"Systematic review exploring human, AI, and hybrid health coaching in digital health interventions: trends, engagement, and lifestyle outcomes.","authors":"Croía Loughnane, Justin Laiti, Róisín O'Donovan, Pádraic J Dunne","doi":"10.3389/fdgth.2025.1536416","DOIUrl":"https://doi.org/10.3389/fdgth.2025.1536416","url":null,"abstract":"<p><strong>Introduction: </strong>Digital Health Interventions (DHIs) have been identified as a solution to the United Nations Sustainable Development Goals (SDG3) for health promotion and prevention. However, DHIs face criticism for shallow and transactional engagement and retention challenges. Integrating DHIs with health coaching represents a promising solution that might address these issues by combining the scalable and accessible nature of DHIs with the meaningful and engaging nature of health coaching. This systematic review aims to synthesise existing peer-reviewed research on coach-facilitated DHIs to understand how digital health coaching is being used in DHIs and the impact it has on engagement and lifestyle outcomes.</p><p><strong>Methods: </strong>Studies examining DHIs with a coaching component addressing lifestyle outcomes were included. A search of APA PsychINFO, Medline, Web of Science, and Scopus was performed from inception to February 2025. Three authors conducted the study selection, quality appraisal using the Mixed Methods Appraisal Tool (MMAT), and data extraction. Data extraction captured study characteristics, coaching features, participant engagement, and lifestyle outcomes.</p><p><strong>Results: </strong>Thirty-five studies were identified and synthesised using a narrative synthesis approach. This review highlights three coaching modalities in DHIs: digital human coaching, Artificial Intelligence (AI) coaching, and hybrid (human-AI) coaching. All coaching modalities demonstrated feasibility and acceptability.</p><p><strong>Discussion: </strong>While both human and AI coaching have shown a positive impact on both engagement and lifestyle outcomes, hybrid approaches need further refinement to harness AI's scalability and the depth of human coaching. However, the variability of engagement metrics and coaching protocols limited study comparability. Standardising how engagement and coaching delivery are measured and contextualised is crucial for advancing evidence-based digital health coaching. This review followed PRISMA guidelines and was registered in PROSPERO (Registration number: CRD42022363279). The Irish Research Council supported this work.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/PROSPERO/view/CRD42022363279, identifier: CRD42022363279.</p>","PeriodicalId":73078,"journal":{"name":"Frontiers in digital health","volume":"7 ","pages":"1536416"},"PeriodicalIF":3.2,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999567","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":"Visual communication of public health data: a scoping review.","authors":"Michael Arthur Ofori, Stella Lartey, Polina Durneva, Niharika Jha, Nidhi Mittal, Shongkour Roy, Zebunnesa Zeba, Stella Chirwa, Nichole Saulsberry-Scarboro, Michelle Taylor, Ashish Joshi","doi":"10.3389/fdgth.2025.1555231","DOIUrl":"https://doi.org/10.3389/fdgth.2025.1555231","url":null,"abstract":"<p><strong>Introduction: </strong>Visual communications (VC) play a crucial role in effectively conveying public health data to diverse audiences, including policymakers, healthcare professionals, and the general public. Although the U.S. government invests heavily in health data and data accessibility, health data are not entirely accessible or easily understood. This can be attributed to data sharing and visualization challenges. VC challenges have created public health information gaps which are compounded in emergencies such as the COVID-19 pandemic, potentially impacting poor health outcomes and increasing health inequities.</p><p><strong>Objective: </strong>To examine visualization tools and techniques effective for public health visual data communication.</p><p><strong>Methods: </strong>A scoping review was conducted to summarize the available evidence related to visualization techniques and tools for public health visual data communication as well as related principles and best practices. Original peer-reviewed articles published in English that involve visualization, user-centered design of visual public health applications/interfaces, visual analytics, infographics, or dashboards from PubMed database from 2020 to 2024 were included. Also, review articles, commentaries, editorials, posters, systematic and scoping articles were excluded from this review. In all, twenty-eight (28) studies were included.</p><p><strong>Results: </strong>There were 25 different visualization techniques identified which included charts and graphs (e.g., bar charts, line charts, pie charts, bubble charts, box plots, scatter plots), maps (e.g., choropleth maps, hotspot maps, and heatmaps), and specialized visualizations (e.g., sunburst diagrams, alluvial plots, upset plots, circos). These visuals were displayed employing different programming and statistical tools and libraries like R, Python, Power BI, Tableau, ArcGIS, and custom web-based applications. The visuals measured different types of data accessibility, pattern and trends identification, association and relationships of univariate and bivariate data, as well as exploring multidimensional forms of health data. The visualizations were applied in different public health domains, such as HIV prevention and care, public health communication, interventions, surveillance, policy measures and decision-making, and improving health education.</p><p><strong>Conclusion: </strong>Dashboards and web-based tools combined with static visualizations like charts, maps, or specialized plots can help with data exploration, pattern recognition, and dissemination of health information. Effective communication of public health data promotes informed decision-making, creates awareness, and leads to improved and better health outcomes.</p>","PeriodicalId":73078,"journal":{"name":"Frontiers in digital health","volume":"7 ","pages":"1555231"},"PeriodicalIF":3.2,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008889","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":"Using artificial intelligence to develop a measure of orthopaedic treatment success from clinical notes.","authors":"Sarah B Floyd, Ahmed G Almeldien, D Hudson Smith, Benjamin Judkins, Claire E Krohn, Zachary Cole Reynolds, Kyle Jeray, Jihad S Obeid","doi":"10.3389/fdgth.2025.1523953","DOIUrl":"https://doi.org/10.3389/fdgth.2025.1523953","url":null,"abstract":"<p><strong>Introduction: </strong>A readily available outcome measure that reflects the success of a patient's treatment is needed to demonstrate the value of orthopaedic interventions. Patient-reported outcome measures (PROMs) are survey-based instruments that collect joint-specific and general health perceptions on symptoms, functioning, and health-related quality of life. PROMs are considered the gold standard outcome measure in orthopaedic medicine, but their use is limited in real-world practice due to challenges with technology integration, the pace of clinic workflows, and patient compliance. Clinical notes generated during each encounter patients have with their physician contain rich information on current disease symptoms, rehabilitation progress, and unexpected complications. Artificial intelligence (AI) methods can be used to identify phrases of treatment success or failure captured in clinical notes and discern an indicator of treatment success for orthopaedic patients.</p><p><strong>Methods: </strong>This was a cross-sectional analysis of clinical notes from a sample of patients with an acute shoulder injury. The study included adult patients presenting to a Level-1 Trauma Center and regional health system for an acute Proximal Humerus Fracture (PHF) between January 1, 2019 and December 31, 2021. We used the progress note from the office visit for PHF-related care (ICD10: S42.2XXX) or shoulder pain (ICD10: M45.2XXX) closest to 1-year after the injury date. Clinical notes were reviewed by an orthopaedic resident and labeled as treatment success or failure. A structured comparative analysis of classifiers including both machine and deep learning algorithms was performed.</p><p><strong>Results: </strong>The final sample included 868 clinical notes from patients treated by 123 physicians across 35 departments within one regional health system. The study sample was stratified into 465 notes labeled as treatment success and 403 labeled as treatment failure. The Bio-ClinicalBERT model had the highest performance of 87% accuracy (AUC = 0.87 ± 0.04) in correctly distinguishing between treatment success and failure notes.</p><p><strong>Discussion: </strong>Our results suggest that text classifiers applied to clinical notes are capable of differentiating patients with successful treatment outcomes with high levels of accuracy. This finding is encouraging, signaling that routinely collected clinical note content may serve as a data source to develop an outcome measure for orthopaedic patients.</p>","PeriodicalId":73078,"journal":{"name":"Frontiers in digital health","volume":"7 ","pages":"1523953"},"PeriodicalIF":3.2,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999723","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":"More than a chatbot: a practical framework to harness artificial intelligence across key components to boost digital therapeutics quality.","authors":"Amit Baumel","doi":"10.3389/fdgth.2025.1541676","DOIUrl":"https://doi.org/10.3389/fdgth.2025.1541676","url":null,"abstract":"<p><p>The rapid advancement of Artificial Intelligence (AI)-powered large language models has highlighted the potential of AI-based chatbots to create a new era for digital therapeutics (DTx)-digital behavioral and mental health interventions. However, fully realizing AI-potential requires a clear understanding of how DTx function, what drives their effectiveness, and how AI can be integrated strategically. This paper presents a practical framework for harnessing AI to enhance the quality of DTx by dismantling them into five key components: Therapeutic Units, Decision Maker, Narrator, Supporter, and Therapist. Each represents an aspect of intervention delivery where AI can be applied. AI can personalize Therapeutic Units by dynamically adapting content to individual contexts, achieving a level of customization not possible with manual methods. An AI-enhanced Decision Maker can recommend and sequence therapeutic pathways based on real-time data and adaptive algorithms, eliminating the reliance on predefined decision trees or exhaustive logic-driven ruling. AI can also transform the Narrator by generating personalized narratives that unify intervention activities into cohesive experiences. As a Supporter, AI can mimic remotely administered human support, automating technical assistance, adherence encouragement, and clinical guidance at scale. Lastly, AI enables the creation of a Therapist to deliver real-time, interactive, and tailored therapeutic dialogues, adapting dynamically to user feedback and progress in ways that were previously impractical before. This framework provides a structured method to integrate AI-driven improvements, while also enabling to focus on a specific component during the optimization process.</p>","PeriodicalId":73078,"journal":{"name":"Frontiers in digital health","volume":"7 ","pages":"1541676"},"PeriodicalIF":3.2,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144037168","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":"Influence of social media on cosmetic facial surgeries among individuals in Kuwait: employing the theory of planned behavior.","authors":"Madhawi Alduosari, Thurayya Albuloshi, Ahmad Alsaber, Farah Al Saeed, Anwaar Alkandari, Amal Anbar, Bedour Alboloushi, Yasser Helmy","doi":"10.3389/fdgth.2025.1546128","DOIUrl":"https://doi.org/10.3389/fdgth.2025.1546128","url":null,"abstract":"<p><strong>Introduction: </strong>The increasing popularity of cosmetic facial surgeries among Kuwaiti youth has been significantly influenced by social media. Platforms such as Instagram and TikTok propagate beauty ideals that may lead to heightened interest in aesthetic procedures. This study investigates the impact of electronic word-of-mouth (e-WOM), content marketing (CM), and influencer marketing (IM) on attitudes (ATT), subjective norms (SN), perceived behavioral control (PBC), and intention (INT) to undergo cosmetic surgery, using the Theory of Planned Behavior (TPB) framework.</p><p><strong>Methods: </strong>A cross-sectional quantitative design was employed involving 730 participants (84.9% female), selected using convenience sampling across universities, clinics, and workplaces in Kuwait. A validated TPB-based questionnaire measured constructs such as ATT, SN, PBC, INT, health consciousness, and social media influences (e-WOM, CM, IM). Data were analyzed using Structural Equation Modeling (SEM) via SmartPLS. Reliability and validity were confirmed using Cronbach's alpha, composite reliability, average variance extracted (AVE), and discriminant validity.</p><p><strong>Results: </strong>Subjective norms significantly influenced perceived behavioral control (β = 0.336, <i>p</i> < 0.001), which in turn predicted intention to undergo cosmetic surgery (β = 0.316, <i>p</i> < 0.001). Attitude also positively influenced PBC (β = 0.298, <i>p</i> < 0.001). e-WOM had the strongest impact on ATT (β = 0.427, <i>p</i> < 0.001) and SN (β = 0.292, <i>p</i> < 0.001), followed by significant but smaller effects from CM and IM. The model demonstrated good fit, explaining 47.3% of the variance in INT.</p><p><strong>Discussion: </strong>Social media plays a central role in shaping cosmetic surgery intentions among Kuwaiti youth, with subjective norms being the strongest predictor. These findings underscore the importance of societal expectations, particularly in collectivist cultures. Regulatory frameworks and educational campaigns are recommended to address ethical marketing practices, enhance digital health literacy, and promote realistic beauty standards.</p>","PeriodicalId":73078,"journal":{"name":"Frontiers in digital health","volume":"7 ","pages":"1546128"},"PeriodicalIF":3.2,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032089","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":"\"Less words, more pictures\": creating and sharing data visualizations from a remote health monitoring system with clinicians to improve cancer pain management.","authors":"Virginia LeBaron, Natalie Crimp, Nutta Homdee, Kelly Reed, Victoria Petermann, William Ashe, Leslie Blackhall, Bryan Lewis","doi":"10.3389/fdgth.2025.1520990","DOIUrl":"https://doi.org/10.3389/fdgth.2025.1520990","url":null,"abstract":"<p><strong>Background: </strong>The Behavioral and Environmental Sensing and Intervention for Cancer (BESI-C) is a remote health monitoring system (RHMS) developed by our interdisciplinary team that collects holistic physiological, behavioral, psychosocial, and contextual data related to pain from dyads of patients with cancer and their family caregivers via environmental and wearable (smartwatch) sensors.</p><p><strong>Methods: </strong>R, Python, and Canva software were used to create a series of static and interactive data visualizations (e.g., visual representations of data in the form of graphs, figures, or pictures) from de-identified BESI-C data to share with palliative care clinicians during virtual and in-person 1-hour feedback sessions. Participants were shown a sequence of 5-6 different data visualizations related to patient and caregiver self-reported pain events, environmental factors, and quality of life indicators, completed an electronic survey that assessed clarity, usefulness, and comprehension, and then engaged in a structured discussion. Quantitative survey results were descriptively analyzed and \"think aloud\" qualitative comments thematically summarized and used to iterate data visualizations between feedback sessions.</p><p><strong>Results: </strong>Six to 12 interdisciplinary palliative care clinicians from an academic medical center, a local hospice, and a community hospital within Central Virginia participated in five data visualization feedback sessions. Both survey results and group discussion feedback revealed a preference for more familiar, simpler data visualizations that focused on the physical aspects of pain assessment, such as number of high intensity pain events and response to pharmacological interventions. Preferences for degree of data granularity and content varied by discipline and care delivery model, and there was mixed interest in seeing caregiver reported data. Overall, non-physician participants expressed greater interest in visualizations that included environmental variables impacting pain and non-pharmacological interventions.</p><p><strong>Conclusion: </strong>Clinicians desired higher-level (i.e., less granular/detailed) views of complex sensing data with a \"take home\" message that can be quickly processed. Orienting clinicians to unfamiliar, contextual data sources from remote health monitoring systems (such as environmental data and quality of life data from caregivers) and integrating these data into clinical workflows is critical to ensure these types of data can optimally inform the patient's plan of care. Future work should focus on customizing data visualization formats and viewing options, as well as explore ethical issues related to sharing data visualizations with key stakeholders.</p>","PeriodicalId":73078,"journal":{"name":"Frontiers in digital health","volume":"7 ","pages":"1520990"},"PeriodicalIF":3.2,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12055813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060337","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":"Redefining and solving the digital divide and exclusion to improve healthcare: going beyond access to include availability, adequacy, acceptability, and affordability.","authors":"Laronda A Hollimon, Kayla V Taylor, Rachel Fiegenbaum, Mary Carrasco, Laurent Garchitorena Gomez, Debbie Chung, Azizi A Seixas","doi":"10.3389/fdgth.2025.1508686","DOIUrl":"https://doi.org/10.3389/fdgth.2025.1508686","url":null,"abstract":"&lt;p&gt;&lt;p&gt;The digital divide in the United States extends beyond the traditional definition of access, which focuses solely on physical infrastructure like broadband networks and connectivity points. This narrow framing has resulted in policies that fail to address the full spectrum of barriers to digital inclusion. To bridge this gap, we propose the Rhizomatic Digital Ecosystem Framework, which emphasizes five interdependent components: access, availability, adequacy, acceptability and affordability. Access highlights the need for physical infrastructure, with programs like the Broadband Equity, Access, and Deployment (BEAD) Program expanding connectivity to underserved areas. Availability ensures the presence of reliable internet infrastructure to meet community needs, with targeted policies like satellite-based solutions addressing challenges in rural and Indigenous areas. Availability policies should focus on federal funding programs like BEAD and the Tribal Broadband Connectivity Program, incentivizing Internet service Providers (ISP) to expand into underserved areas, and leveraging satellite technologies to address infrastructure gaps. Novel policies to address the digital divide include community-owned broadband networks, dynamic spectrum sharing, and blockchain-powered micro-networks to improve availability in underserved areas. Adequacy examines whether internet services meet modern demands, such as telehealth and online education, emphasizing the need for minimum speed standards and performance improvements. Adequacy policies should include enforcing FCC speed standards with regular audits, requiring ISPs to upgrade outdated infrastructure, and providing government grants to improve broadband quality in communities. For adequacy, solutions like AI-driven broadband performance monitoring, funding edge computing in remote regions, and treating broadband as a public utility can enhance internet speed and quality Acceptability tackles cultural and social barriers, including digital literacy gaps, language differences, and technophobia, which can be addressed through localized literacy programs and inclusive design practices. Acceptability policies should prioritize national digital literacy campaigns for underserved groups, mandate inclusive design and accessibility standards, and offer multilingual and culturally relevant resources for digital tools. Affordability addresses financial barriers, as many low-income households struggle to afford monthly internet fees and devices, even with subsidies such as the Affordable Connectivity Program (ACP). To improve acceptability, innovative approaches like universal digital literacy vouchers, gamified education platforms, and mandatory accessibility standards for all digital technologies can ensure equitable and inclusive digital participation. Together, these five dimensions provide a nuanced and actionable framework for crafting effective, interconnected policies and solutions. By addressing each dim","PeriodicalId":73078,"journal":{"name":"Frontiers in digital health","volume":"7 ","pages":"1508686"},"PeriodicalIF":3.2,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12052546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060103","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":"Interoperability of telemonitoring data in digital health solutions: a scoping review.","authors":"Diogo Martins, Simon Lewerenz, Anderson Carmo, Henrique Martins","doi":"10.3389/fdgth.2025.1502260","DOIUrl":"https://doi.org/10.3389/fdgth.2025.1502260","url":null,"abstract":"<p><strong>Objectives: </strong>This scoping review explores the existing literature on the interoperability of telemonitoring systems in cross-border healthcare settings. It focuses on identifying technical standards, enablers, and barriers to effective telemonitoring data exchange across healthcare systems and geographies.</p><p><strong>Methods: </strong>A systematic search was conducted across databases (MEDLINE, PubMed, ISI Web of Knowledge, DBLP, and Scopus) from January 2000 to May 2023, using keywords such as \"telemonitoring\", \"interoperability\", \"technical standards\", and \"cross-border data exchange\". Eligibility criteria included peer-reviewed studies examining the interoperability of telemonitoring systems across healthcare providers and cross-border settings. A total of 861 studies were identified, and 25 met the inclusion criteria.</p><p><strong>Results: </strong>The review identified diverse technical standards, including HL7 FHIR, ISO/IEEE 11073, and IHE profiles, used in telemonitoring systems. However, significant gaps were found in the literature regarding the operational challenges of telemonitoring systems, particularly in cross-border contexts. Many studies focused on technical aspects, with fewer addressing organizational and legal issues. Data transport types, such as Bluetooth and REST APIs, were mentioned, but no common standard for data exchange between devices was identified.</p><p><strong>Discussion: </strong>The findings highlight the need for further research on the deployment of telemonitoring systems, particularly in cross-border contexts. The lack of harmonization in technical standards poses a barrier to achieving seamless interoperability. The review calls for the development of a robust framework to support telemonitoring integration across healthcare systems.</p><p><strong>Conclusions: </strong>While telemonitoring shows promise in improving healthcare delivery, significant interoperability challenges remain. Developing common standards at the European level is essential to enhance cross-border telemonitoring services and patient care.</p>","PeriodicalId":73078,"journal":{"name":"Frontiers in digital health","volume":"7 ","pages":"1502260"},"PeriodicalIF":3.2,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12052697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054650","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":"Feasibility, reliability and validity of smartphone administered cognitive ecological momentary assessments in breast cancer survivors.","authors":"Ashley M Henneghan, Emily W Paolillo, Kathleen M Van Dyk, Oscar Y Franco-Rocha, Mansi Patel, So Hyeon Bang, Raeanne C Moore","doi":"10.3389/fdgth.2025.1543846","DOIUrl":"https://doi.org/10.3389/fdgth.2025.1543846","url":null,"abstract":"<p><strong>Objective: </strong>Breast cancer and its treatment are associated with cancer-related cognitive impairments (CRCI). Cognitive ecological momentary assessments (EMA) allow for the assessment of individual subjective and objective cognitive functioning in real world environments and can be easily administered via smartphones. The objective of this study was to establish the feasibility, reliability, and validity of a cognitive EMA platform, NeuroUX, for assessing CRCI in breast cancer survivors.</p><p><strong>Methods: </strong>Using a prospective design, clinical cognitive assessments (neuropsychological testing; patient reported outcomes) were collected at baseline, followed by an 8-week EMA smartphone protocol assessing self-reported cognitive concerns and objective cognitive performance via mobile cognitive tests once per day, every other day. Satisfaction and feedback questions were included in follow-up data collection. Feasibility data were analyzed using descriptive methods. Test-retest reliability was examined using intraclass correlation coefficients for each cognitive EMA (tests and self-report questions), and Pearson's correlation was used to evaluate convergent validity between cognitive EMAs and baseline clinical cognitive variables.</p><p><strong>Results: </strong>105 breast cancer survivors completed the EMA protocol with high adherence (87.3%) and high satisfaction (mean 87%). Intraclass correlation coefficients for all cognitive EMAs were strong (>0.73) and correlational findings indicated moderately strong convergent validity (|0.23| < <i>r</i> < |0.61|).</p><p><strong>Conclusion: </strong>Fully remote, self-administered cognitive testing for 8-weeks on smartphones was feasible in breast cancer survivors who completed adjuvant treatment and the specific cognitive EMAs (cognitive EMA tests and self-report questions) administered demonstrate strong reliability and validity for CRCI.</p>","PeriodicalId":73078,"journal":{"name":"Frontiers in digital health","volume":"7 ","pages":"1543846"},"PeriodicalIF":3.2,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12052553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036240","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":"Telehealth coaching in older adults, behavior change, and impacts of the COVID-19 pandemic: analyses from The Brain Health Champion Study.","authors":"Brittany McFeeley, Casey Nicastri, Taylor Krivanek, Kirk R Daffner, Seth A Gale","doi":"10.3389/fdgth.2025.1510804","DOIUrl":"https://doi.org/10.3389/fdgth.2025.1510804","url":null,"abstract":"<p><strong>Introduction: </strong>When COVID-19 containment strategies were imposed in March 2020, we became interested in how these restrictions might interfere with brain-healthy behaviors of older adults who were either actively participating in or who had recently completed our telehealth behavior change intervention. Telehealth interventions have emerged as important tools for supporting brain health behaviors remotely, particularly among older adults. The objective of the current study was to assess how older adults with and without cognitive impairment were affected by COVID-19 restrictions and whether they were affected differently based on their active participation or recent completion of our Brain Health Champion (BHC) study and their cognitive status.</p><p><strong>Methods: </strong>BHC study 1.0 and 2.0 participants and their study partners were emailed in April and May of 2020 a link to five electronic surveys to collect qualitative and quantitative data on various health factors, including self-reports of pre-pandemic and current brain health behaviors (e.g., physical activity, Mediterranean diet adherence, social engagement, and cognitive stimulation), anxiety, sleep, and depression. The fifth survey was distributed to collect study feedback.</p><p><strong>Results: </strong>Ten out of 11 participants from Study 2.0 and 15 out of 30 participants from Study 1.0 completed the surveys. Results demonstrated that early pandemic restrictions negatively impacted all participants in physical activity (<i>p</i> < .01) and social interactions (<i>p</i> < .001), with no impact on cognitive activities (<i>p</i> = .479) and dietary intake (<i>p</i> = .814). A significant difference was found between Study 1.0 and 2.0 participants (<i>p</i> < .001) in self-reported changes in level of cognitive activity. Study 1.0 participants indicated a decrease in cognitive activities since the start of COVID-19 restrictions, whereas those in Study 2.0 reported an increase in cognitive activities.</p><p><strong>Discussion: </strong>Our findings suggest that pandemic restrictions significantly impacted activities typically done outside the home (social and physical activity), while those feasibly achieved at home were less affected (Mediterranean diet adherence and cognitive activity). Additionally, the intervention augmented by digital health components likely exerted some protective effects against the impact of COVID-19 containment strategies. Digitally-facilitated research and clinical telehealth programs are well-positioned to offer some protection to vulnerable individuals from disruptive events that could impede adoption or maintenance of healthy lifestyle changes.</p>","PeriodicalId":73078,"journal":{"name":"Frontiers in digital health","volume":"7 ","pages":"1510804"},"PeriodicalIF":3.2,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12043590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042856","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}