mHealth最新文献

{"title":"Validation of a novel mobile phone application for type 2 diabetes screening following gestational diabetes mellitus.","authors":"Helen B Gomez Slagle, Matthew K Hoffman, Richard Caplan, Philip Shlossman, Anthony C Sciscione","doi":"10.21037/mhealth-21-36","DOIUrl":"10.21037/mhealth-21-36","url":null,"abstract":"<p><strong>Background: </strong>We sought to determine if using fasting blood glucose (FBG) through text-based care is an effective screening tool for type 2 diabetes in the postpartum period compared to in-person, 2-hour oral glucose tolerance testing (2hr OGTT).</p><p><strong>Methods: </strong>This was a single-center interventional study that included individuals diagnosed with gestational diabetes. Patients were enrolled in standard, office-based 2hr OGTT in combination with text-based remote diabetes screening. Study participants were instructed to record FBG for 3 consecutive days using a mobile application. We assessed agreement with 2hr OGTT using sensitivity, specificity, positive and negative predictive value with exact binomial 95% confidence intervals.</p><p><strong>Results: </strong>A total of 446 individuals diagnosed with gestational diabetes met inclusion criteria, 239 of which were enrolled in standard office-based screening and 207 were enrolled in dual screening using standard 2hr OGTT testing combined with text-based remote FBG screening. A FBG value less than 100 mg/dL had 100% sensitivity (86-100%), 86% specificity (77-93%) with a 100% (94-100%) negative predictive value and 71% (54-85%) positive predictive value. Follow-up was significantly higher among individuals enrolled in remote text-based screening compared to standard in-office screening (48% <i>vs.</i> 25%, respectively; P<0.001).</p><p><strong>Conclusions: </strong>Text-based screening may be a feasible alternative to in-office screening. A mobile-based system using FBG successfully screened all patients with type 2 diabetes in the postpartum period with 100% sensitivity and negative predictive value. Remote telehealth screening significantly increased follow-up with type 2 diabetes screening.</p>","PeriodicalId":74181,"journal":{"name":"mHealth","volume":"8 1","pages":"12"},"PeriodicalIF":2.2,"publicationDate":"2022-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9014228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49549596","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":"Exploration of a Mobile Technology Vulnerability Scale's association with antiretroviral adherence among young adults living with HIV in the United States.","authors":"Parya Saberi,&nbsp;Shadi Eskaf,&nbsp;Chadwick K Campbell,&nbsp;Torsten B Neilands,&nbsp;John A Sauceda,&nbsp;Karine Dubé","doi":"10.21037/mhealth-21-54","DOIUrl":"https://doi.org/10.21037/mhealth-21-54","url":null,"abstract":"<p><strong>Background: </strong>Young adults living with HIV (YLWH) have suboptimal adherence to antiretroviral therapy (ART) and HIV care outcomes. Mobile health technologies are increasingly used to deliver interventions to address HIV health outcomes. However, not all YLWH have equal and consistent access to mobile technologies.</p><p><strong>Methods: </strong>Using our novel Mobile Technology Vulnerability Scale (MTVS) to evaluate how vulnerable an individual feels with regard to their personal access to mobile technology in the past 6 months, we conducted a cross-sectional online survey with 271 YLWH (18-29 years) in the US to evaluate the relationships between MTVS and self-reported ART adherence.</p><p><strong>Results: </strong>Participants reported changes in phone numbers (25%), stolen (14%) or lost (22%) phones, and disconnections of phone service due to non-payment (39%) in the past 6 months. On a scale of 0 to 1 (0 having no mobile technology vulnerability and 1 having complete mobile technology vulnerability), participants had a mean MTVS of 0.33 (SD =0.26). Black and financially constrained participants had the highest MTVS, which was significantly higher that other racial/ethnic and financially non-constrained groups, respectively. Higher MTVS was significantly associated with ART non-adherence and non-persistence.</p><p><strong>Conclusions: </strong>Findings suggest the need to measure MTVS to recognize pitfalls when using mobile health interventions and identify populations whose inconsistent mobile technology access may be related to worse health outcomes.</p>","PeriodicalId":74181,"journal":{"name":"mHealth","volume":"8 ","pages":"23"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0e/e0/mh-08-21-54.PMC9343971.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9623311","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":"Addressing and evaluating health literacy in mHealth: a scoping review.","authors":"Margaret R Emerson,&nbsp;Sydney Buckland,&nbsp;Maxwell A Lawlor,&nbsp;Danae Dinkel,&nbsp;David J Johnson,&nbsp;Maria S Mickles,&nbsp;Louis Fok,&nbsp;Shinobu Watanabe-Galloway","doi":"10.21037/mhealth-22-11","DOIUrl":"https://doi.org/10.21037/mhealth-22-11","url":null,"abstract":"<p><strong>Background: </strong>Recent surveys have revealed many adults have basic or below basic health literacy, which is linked to medical errors, increased illness, and compromised public health. Health literacy as a concept is multi-faceted extending beyond the individual to include social structures and the context in which health information is being accessed. Delivering health information via mobile devices (mHealth) expands the amount of information available while presenting challenges to ensuring these materials are suitable for a variety of literacy needs. The aims of this study are to discover how health literacy is addressed and evaluated in mHealth app development.</p><p><strong>Methods: </strong>A scoping review of 5 peer-reviewed databases was conducted. Eligible articles were written in English, addressed general literacy or mHealth/digital/eHealth literacy, and collected literacy information in order to incorporate literacy into the design and/or modification of an app or collected literacy information to describe the population being studied. The \"Health Literacy Online\" (HLO) United States (U.S.) government guide was used as a framework.</p><p><strong>Results: </strong>Thirty-two articles were reviewed. Articles included health literacy recommendations for all HLO categories and some recommendations not aligned with these categories. Most articles addressed health literacy using specific HLO categories though none incorporated every HLO category. The most common categories addressed engagement and testing of mHealth content. Though several studies addressed health literacy through a formal assessment tool, most did not. Evaluation of health literacy in mHealth was end-user focused and did not extensively evaluate content for fit to a variety of individuals with limited health literacy.</p><p><strong>Conclusions: </strong>The recommendations seen consistently in our results in conjunction with formal HLO categories can act as beginning steps towards development of a health literacy evaluation tool for mHealth apps themselves. It is clear efforts are being made to reduce barriers to using mHealth for those with literacy deficits, however, it was also clear that this space has room to be more pragmatic in evaluation of mHealth tools for literacy. End user engagement in design and testing is necessary in future mHealth literacy tool development.</p>","PeriodicalId":74181,"journal":{"name":"mHealth","volume":"8 ","pages":"33"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0d/33/mh-08-22-11.PMC9634204.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9328441","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":"Technology-driven methodologies to collect qualitative data among youth to inform HIV prevention and care interventions.","authors":"Kristi E Gamarel,&nbsp;Rob Stephenson,&nbsp;Lisa Hightow-Weidman","doi":"10.21037/mhealth-2020-5","DOIUrl":"10.21037/mhealth-2020-5","url":null,"abstract":"<p><p>The use of technology as a platform for delivering HIV prevention interventions provides an efficient opportunity to reach those at risk for HIV with targeted and timely prevention and treatment messages. Technology-delivered HIV interventions are becoming increasingly popular and include interventions that use mobile text messaging and mobile phone apps or deliver prevention messages through telehealth platforms. Community-centered approaches of intervention development can help address the potential gap between science and practice by ensuring that interventions are appropriate and driven by community needs and desires. Common approaches to gaining community input rely on qualitative data gathered through in-person focus group discussions (FGD), in-depth interviews (IDI) and youth advisory boards (YABs). While these proven methodologies have strengths, youth engagement can be limited by structural barriers (e.g., lack of transportation, inconvenient timing) and reluctance to participate due to stigma or discomfort with group settings. This results in a number of biases that limit the quality of face-to-face qualitative data collection, i.e., social desirability bias or selection biases created by differential likelihood of recruitment and attendance. As an increasing number of HIV prevention and care interventions are successfully delivered online, innovative approaches to youth engagement in virtual spaces can also be applied across the intervention lifespan to increase the quality and validity of formative data. In this paper, we describe a range of qualitative data collection techniques that can be used via online platforms to collect qualitative data, and we outline their relative advantages over face-to-face FGD or IDI. We use four case studies to highlight the methodologies and findings and provide recommendations for researchers moving forward.</p>","PeriodicalId":74181,"journal":{"name":"mHealth","volume":"7 ","pages":"34"},"PeriodicalIF":0.0,"publicationDate":"2021-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8063018/pdf/mh-07-2020-5.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9454859","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":"mHealth to reduce HIV-related stigma among youth in the United States: a scoping review.","authors":"Marta I Mulawa, A Lina Rosengren, K Rivet Amico, Lisa B Hightow-Weidman, Kathryn E Muessig","doi":"10.21037/mhealth-20-68","DOIUrl":"10.21037/mhealth-20-68","url":null,"abstract":"<p><p>Multiple intersecting stigmas and discrimination related to sex, gender, HIV, and race/ethnicity may challenge HIV prevention and treatment service utilization, particularly among youth. This scoping review describes recent and ongoing innovative mobile health (mHealth) interventions among youth in the United States that aim to reduce stigma as an outcome or as part of the intervention model. To identify examples of stigma-mitigation via mHealth, we searched peer-reviewed published literature using keyword strategies related to mHealth, HIV, stigma, and youth (ages 10 to 29). We identified eleven articles that met our inclusion criteria, including three describing data from two randomized controlled trials (RCTs), five describing pilot studies, one describing the process evaluation of an ongoing intervention, one describing formative work for intervention development, and one published study protocol for an ongoing intervention. We review these articles, grouped by HIV prevention and care continuum stages, and describe the mHealth approach used, including telehealth, simulation video games, motion comics, smartphone applications (apps), social media forums, online video campaigns, video vignettes, and a computerized behavioral learning module. Four studies focused on preventing primary acquisition through individual-level behavior change (e.g., reducing condomless anal intercourse), three focused on increasing HIV testing, three focused on linking to prevention services [e.g., pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP)] and one focused on promoting adherence to antiretroviral therapy (ART). Our review did not identify any published studies using mHealth with a primary aim to reduce stigma as a way to improve care engagement and increase viral suppression among youth in the United States. Additional RCTs and implementation studies examining the effectiveness of mHealth stigma-reduction interventions on HIV-related outcomes are needed to end the HIV epidemic among youth. mHealth offers unique advantages to address the complex intersecting stigma barriers along the HIV continuum to improve HIV-related outcomes for youth.</p>","PeriodicalId":74181,"journal":{"name":"mHealth","volume":"7 ","pages":"35"},"PeriodicalIF":0.0,"publicationDate":"2021-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8063007/pdf/mh-07-20-68.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9438761","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":"mHealth for transgender and gender-expansive youth: harnessing gender-affirmative cross-disciplinary innovations to advance HIV prevention and care interventions.","authors":"Simone J Skeen, Demetria Cain, Kristi E Gamarel, Lisa Hightow-Weidman, Cathy J Reback","doi":"10.21037/mhealth-20-60","DOIUrl":"10.21037/mhealth-20-60","url":null,"abstract":"<p><p>Transgender and gender-expansive (TGE) youth endure stark disparities in health and wellbeing compared to their cisgender peers. A key social determinant of health for TGE adolescents and emerging adults is gender affirmation, which encompasses multidimensional validations of an individual's lived gender. Lacking available resources for one's gender affirmation, TGE young people may engage in high-risk maladaptive coping behaviors, linked to their disproportionately high HIV-acquisition risk. A range of innovative mobile technologies are guided by the Gender-Affirmative Framework to promote the health of TGE communities, including through HIV prevention and care continuum outcomes. The aim of this review was to examine key features of existing mobile technologies that can be leveraged to advance the field of TGE-responsive mHealth. We systematically searched scientific records, gray literature, and the iOS and Android app distribution services. To be eligible, platforms and interventions needed to be tailored exclusively to a TGE user base, incorporate gender-affirming features, and be optimized for or adaptive to mobile technologies. Eligible interventions (N=24) were compared on evidence of utility, core functionalities, and dimensions of gender affirmation. Smartphone applications (apps) and webapps (n=16) were the most common delivery modality. Many interventions (n=9) aimed to address HIV-related outcomes and integrated gender-affirmative features. The most common gender-affirmative features originated in fields of human-computer interactions and informatics, or were crowdfunded by TGE developers. HIV-focused interventions incorporated evidence-based health behavior change strategies and utilized rigorous evaluation methods. Across modalities and disciplines, behavioral self-monitoring and access to HIV prevention services were the most frequent features. Over two-thirds of the interventions reviewed aimed to provide medical gender affirmation (e.g, provided guidance on obtaining medically sanctioned hormone therapies, or safely practicing non-medical options such as chest-binding) or psychological gender affirmation (e.g, provided linkage to mental health counseling). Our results show that mHealth and other technology-mediated interventions offer a diverse range of both evidence-based and innovative features; however, many have not been rigorously evaluated in a randomized controlled trial to support TGE users. A continuing commitment to evidence-based health behavior change strategies, exemplified by the HIV-focused interventions included in this review, is essential to advancing gender-affirmative mHealth. The unique and highly innovative features of platforms originating outside the fields of HIV prevention and care suggest new directions for TGE-responsive mHealth, and the need for more conscientious models of knowledge exchange with investigators across scientific disciplines, private-sector developers, and potential users.</p>","PeriodicalId":74181,"journal":{"name":"mHealth","volume":"7 ","pages":"37"},"PeriodicalIF":2.2,"publicationDate":"2021-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8063017/pdf/mh-07-20-60.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9438762","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":"The usefulness of the Electronic Patient Visit Assessment (ePVA)^© as a clinical support tool for real-time interventions in head and neck cancer.","authors":"Janet H Van Cleave, Mei R Fu, Antonia V Bennett, Catherine Concert, Ann Riccobene, Anh Tran, Allison Most, Maria Kamberi, Jacqueline Mojica, Justin Savitski, Elise Kusche, Mark S Persky, Zujun Li, Adam S Jacobson, Kenneth S Hu, Michael J Persky, Eva Liang, Patricia M Corby, Brian L Egleston","doi":"10.21037/mhealth-19-250","DOIUrl":"10.21037/mhealth-19-250","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Patients with head and neck cancer (HNC) experience painful, debilitating symptoms and functional limitations that can interrupt cancer treatment, and decrease their health-related quality of life (HRQoL). The Electronic Patient Visit Assessment (ePVA) for head and neck is a web-based mHealth patient-reported measure that asks questions about 21 categories of symptoms and functional limitations common to HNC. This article presents the development and usefulness of the ePVA as a clinical support tool for real-time interventions for patient-reported symptoms and functional limitations in HNC.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Between January 2018 and August 2019, 75 participants were enrolled in a clinical usefulness study of the ePVA. Upon signing informed consent, participants completed the ePVA and the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ) general (C30) questionnaire v3.0 (scores range from 0 to 100 with 100 representing best HRQoL). Clinical usefulness of the ePVA was defined as demonstration of reliability, convergent validity with HRQoL, and acceptability of the ePVA (i.e., &gt;70% of eligible participants complete the ePVA at two or more visits and &gt;70% of ePVA reports are read by providers). Formal focus group discussions with the interdisciplinary team that cared for patients with HNC guided the development of the ePVA as a clinical support tool. Qualitative and quantitative methods were used throughout the study. Descriptive statistics consisting of means and frequencies, Pearson correlation coefficient, and Student's t-tests were calculated using SAS 9.4 and STATA.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The participants were primarily male (71%), White (76%), diagnosed with oropharyngeal or oral cavity cancers (53%), and undergoing treatment for HNC (69%). Data analyses supported the reliability (alpha =0.85), convergent validity with HRQoL scores, and acceptability of the ePVA. Participants with the highest number of symptoms and functional limitations reported significantly worse HRQoL (sum of symptoms: r=-0.50, P&lt;0.0001; sum of function limitations: r=-0.56, P&lt;0.0001). Ninety-two percent of participants (59 of 64) who had follow-up visits within the 6-month study period completed the ePVA at two or more visits and providers read 89% (169 of 189) of automated ePVA reports. The use of the ePVA as a clinical support tool for real-time interventions for symptoms and functional limitations reported by patients is described in a clinical exemplar.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This research indicates that the ePVA may be a useful mHealth tool as a clinical support tool for real-time interventions for patient-reported symptoms and functional limitations in HNC. The study findings support future translational research to enhance the usefulness of the ePVA in real world settings for early interventions that decrease symptom burden and improve the QoL of ","PeriodicalId":74181,"journal":{"name":"mHealth","volume":"7 ","pages":"7"},"PeriodicalIF":2.2,"publicationDate":"2021-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7882269/pdf/mh-07-19-250.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10445072","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":"Mobile app development in health research: pitfalls and solutions.","authors":"Aaron J Siegler,&nbsp;Justin Knox,&nbsp;José A Bauermeister,&nbsp;Jesse Golinkoff,&nbsp;Lisa Hightow-Weidman,&nbsp;Hyman Scott","doi":"10.21037/mhealth-19-263","DOIUrl":"https://doi.org/10.21037/mhealth-19-263","url":null,"abstract":"<p><p>Mobile app health research presents myriad opportunities to improve health, and simultaneously introduces a new set of challenges that are non-intuitive and extend beyond typical training received by researchers. Informed by our experiences with app development for health research, we discuss some of the most salient pitfalls when working with emerging technology as well as potential strategies to avoid or resolve these challenges. To address challenges at the project level, we suggest strategies that researchers can use to future-proof their research, such as using theory and involving those with app development expertise as part of a research team. At the structural level, we include a new model to characterize the relationship between technology- and research-timelines, and provide ideas regarding how to best address this challenge. Given that screen-based time now predominates our lived experiences, it is important that health researchers have the capacity and structural support to develop interventions that utilize these technologies, assess them rigorously, and ensure their timely and equitable dissemination.</p>","PeriodicalId":74181,"journal":{"name":"mHealth","volume":"7 ","pages":"32"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8063010/pdf/mh-07-19-263.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9454858","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":"\"It closes the gap when the ball is dropped\": patient perspectives of a novel smartphone app for regional care coordination after hospital encounters.","authors":"A. Guzman, Tiffany L. Brown, D. Liss","doi":"10.21037/mhealth-21-49","DOIUrl":"https://doi.org/10.21037/mhealth-21-49","url":null,"abstract":"Background\u0000Despite the broad adoption of electronic health records (EHRs) for inpatient and outpatient care, and wide availability of EHR-linked portals, these tools are not always effective in informing primary care teams about patients' emergency department (ED) visits or inpatient admissions, leading to persistent gaps in care coordination. The objective of this study was to understand how patients with limited patient portal use in a safety net setting engaged with a smartphone app that used location tracking to detect and notify care teams about patients' hospital use in order to stimulate care coordination and follow-up care.\u0000\u0000\u0000Methods\u0000We recruited English- and Spanish-speaking adults at high risk of hospital use from a Federally Qualified Health Center (FQHC). The app detected when patients visited the hospital and asked them to confirm a hospital visit. When confirmed, the app notified the primary care team about the visit, and the care team followed up with patients according to the FQHC protocols for care coordination. We collected qualitative data on app experience from participants who used the app for four months and used a general inductive approach to identify recurring themes.\u0000\u0000\u0000Results\u0000Participants generally reported a positive app experience, as it helped solve the problem of poor follow-up care. \"I liked the goal of the app…Ultimate goal of it was comforting\", recounted one participant when describing her app experience. Participants thought the app push notifications could be refined and the app itself could be modernized. Participants also suggested improvements to the push notifications they received from the app and the visit information they entered into the app for care teams to receive. Some participants also suggested improvements to the FQHC's care coordination workflows facilitated by the app, like an immediate connection to the patient's primary care team.\u0000\u0000\u0000Conclusions\u0000The app was well received by low-income patients at high risk of ED/inpatient visits. Future research is needed to determine feasibility of implementation in other settings.","PeriodicalId":74181,"journal":{"name":"mHealth","volume":"8 1","pages":"13"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43735350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The ongoing HIV epidemic in American youth: challenges and opportunities.","authors":"Lao-Tzu Allan-Blitz,&nbsp;Leandro A Mena,&nbsp;Kenneth H Mayer","doi":"10.21037/mhealth-20-42","DOIUrl":"https://doi.org/10.21037/mhealth-20-42","url":null,"abstract":"<p><p>The incidence of human immunodeficiency virus (HIV) infection has been decreasing in the United States overall, except among youth, and in particular among Black and Latinx young men who have sex with men (MSM). In this review we summarize key drivers of the HIV epidemic among youth, as well as novel interventions geared specifically towards combating the epidemic among high-risk populations. Many factors driving the HIV epidemic among youth are related to systemic inequities, including lack of access to healthcare, inadequate education, and internalized and experience homophobia and racism. Developmentally, youth may feel that they are invulnerable and be willing to engage in risks. Moreover, HIV is often invisible for youth given advances in treatment and community stigma, limiting open discussion of risk and new preventive modalities. Outcomes from the HIV treatment cascade suggest that youth are less likely to be aware of their HIV infection status, less likely to link to and be engaged in care, and less likely to be virologically suppressed than older MSM and other populations of people living with HIV. Importantly, pre-exposure prophylaxis (PrEP) has been shown to be an effective tool for prevention of HIV infection that also appears to have disproportionately poor uptake among youth. Barriers to PrEP utilization appear to be quite heterogeneous, and include patient-, provider-, and structural-level barriers. Interventions important in improving HIV prevention will thus have to be multipronged and developed for culturally diverse populations. Cognitive behavioral therapy-based interventions are promising strategies as they are able to address a diverse array of barriers. New formulations of PrEP will also likely be instrumental in improving adherence. Since youth spend considerable amounts of time accessing digital media, the deployment of apps and other mobile phone-based interfaces offer unique opportunities to increase education and to facilitate HIV prevention for at risk youth. Multiple studies are underway to better inform the optimal delivery of treatment and prevention services for this complex and diverse population, and include novel sociobiological interventions and new modes of medication delivery that may lend themselves to overcoming obstacles specific to youth.</p>","PeriodicalId":74181,"journal":{"name":"mHealth","volume":"7 ","pages":"33"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8063015/pdf/mh-07-20-42.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9438760","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}