mHealth最新文献

{"title":"Adapting technology-based HIV prevention and care interventions for youth: lessons learned across five U.S. Adolescent Trials Network studies.","authors":"Danielle Giovenco, Kathryn E Muessig, Casey Horvitz, Katie B Biello, Albert Y Liu, Keith J Horvath, Jesse M Golinkoff, Cathy J Reback, Lisa Hightow-Weidman","doi":"10.21037/mhealth-20-43","DOIUrl":"https://doi.org/10.21037/mhealth-20-43","url":null,"abstract":"<p><strong>Background: </strong>U.S. sexual and gender minority youth experience individual, interpersonal, and structural-level barriers to HIV prevention and care. Innovative, youth-driven approaches to mobile and electronic interventions that support use of new biomedical prevention, testing, and treatment options may address these barriers. Adapting evidence-based interventions for youth must balance core intervention components with responsiveness to the distinct needs of end-users.</p><p><strong>Methods: </strong>The UNC/Emory Center for Innovative Technology (iTech) adapts and evaluates technology-based interventions for youth living with or at risk for HIV. We analyzed formative research (focus groups and individual usability sessions) across five iTech studies: two apps promoting HIV testing and pre-exposure prophylaxis (PrEP), one app promoting behavioral risk reduction and PrEP, one PrEP adherence app, and one mobile-optimized website for increasing viral suppression, with the aim of informing best practices for technology-based intervention development. Each study presented prototypes of adapted mHealth interventions to samples of their target end-user population for use and/or evaluation.</p><p><strong>Results: </strong>One hundred and thirty-eight youth across seven geographically diverse sites provided feedback during the intervention adaptation process. We found high interest in and acceptability of all five intervention prototypes. Cross-study themes included: (I) Desire for multiple privacy protections (e.g., password, fingerprint) to keep HIV status, sexual identity, and sexual behavior confidential. (II) Strong but varied preferences for the look and feel of platforms. Imagery should be discrete but representative. Participants valued customizable platforms and positive themes, motivational language, and humor. Youth wanted information presented using multiple modalities (e.g., text, video, image) to increase engagement. (III) Youth preferred engagement features and functions consistent with familiar platforms (e.g., Snapchat, Instagram). Gamification features that resulted in tangible versus virtual rewards were predicted to increase engagement. Intervention messaging functions were perceived as useful; customization was desired as a way to control frequency, mode (e.g., SMS, in-app message, push notification), and content. (IV) Youth voiced varied preferences for platform content including: featuring young role models from the lesbian, gay, bisexual, transgender, queer and/or questioning (LGBTQ) community, incorporating mental health resources, and maintaining a holistic health-focus (not HIV-centric).</p><p><strong>Conclusions: </strong>We found high acceptability and consistent feedback in youths' evaluations of these mHealth interventions; divergence was most commonly found in preferred content versus features and functions. Identifying broadly accepted aspects of mHealth interventions for youth supports the feasibility o","PeriodicalId":74181,"journal":{"name":"mHealth","volume":"7 ","pages":"21"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8063021/pdf/mh-07-20-43.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9454854","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":"Engaging youth in mHealth: what works and how can we be sure?","authors":"Lisa B Hightow-Weidman,&nbsp;Keith J Horvath,&nbsp;Hyman Scott,&nbsp;Jonathan Hill-Rorie,&nbsp;Jose A Bauermeister","doi":"10.21037/mhealth-20-48","DOIUrl":"https://doi.org/10.21037/mhealth-20-48","url":null,"abstract":"<p><strong>Background: </strong>Youth participating in mobile health (mHealth) intervention trials often engage with the technologies [e.g., applications (app) or mobile-optimized websites] only partially, often prematurely discontinuing use altogether. Limited engagement can impact the interventions effect on behavior change and compromise researchers' ability to test and estimate the true efficacy of their interventions. While mHealth interventions have been shown to be feasible and acceptable to youth, across diverse health conditions, strategies to increase engagement have been less well studied. Specifically, within HIV prevention and care mHealth interventions, there is not consensus as to which components represent the \"key ingredients\" to support maximal engagement of youth. Further, successful intervention evaluation requires the ability to systematically track users' engagement with intervention components (i.e., paradata) to evaluate its effects on behavior change.</p><p><strong>Methods: </strong>As part of the Adolescent Medicine Trials Network UNC/Emory Center for Innovative Technology (iTech) portfolio of HIV/AIDS Interventions, we present diverse strategies used across five mHealth protocols seeking to promote youth engagement, track and measure engagement through paradata, and incorporate these components into mHealth intervention evaluations.</p><p><strong>Results: </strong>We describe the importance of defining and measuring engagement using case studies from iTech to illustrate how different research teams select mHealth features to promote youth engagement over time, taking into account features embedded in the technology design, key mechanisms of change and trial outcomes (e.g., HIV testing, pre-exposure prophylaxis uptake and adherence, HIV treatment adherence). Finally, we discuss how the research teams plan to evaluate engagement's role on their intervention's outcomes.</p><p><strong>Conclusions: </strong>Based on this synthesis, we discuss strategies to enhance mHealth engagement during intervention development and design, ensure its monitoring and reporting throughout the trial, and evaluate its impact on trial outcomes.</p>","PeriodicalId":74181,"journal":{"name":"mHealth","volume":"7 ","pages":"23"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8063019/pdf/mh-07-20-48.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9454855","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":"Apps on Google Play Store to assist in self-management of hypertension in Indian context: features analysis study.","authors":"Mahima Kaur, Harpreet Kaur, S. Rathi, Manikyarao Ashwitha, Jenifer Joanna, Srinitya Reddy, Batul Idris, Persis Myrtle, Sarvani Kandamuru, Sara Fatima, A. Joshi","doi":"10.21037/mhealth-21-25","DOIUrl":"https://doi.org/10.21037/mhealth-21-25","url":null,"abstract":"Background\u0000A large number of individuals with hypertension are turning to the Internet and m-health technologies for assistance. There is a need to study the content of smartphone applications on hypertension. The study aimed to review and investigate the functional and analytical characteristics of apps related to the self-management of hypertension available on Google Play Store.\u0000\u0000\u0000Methods\u0000Search was conducted in February 2021 in India using the Google Play Store database to identify currently available Android-based apps related to self-management of hypertension/high blood pressure (BP). Keywords used were: 'Hypertension', 'High blood pressure', 'DASH diet', 'Hypertension diet', and 'Blood pressure diet'. A total of 822 apps were screened based on the duplicates, inclusion, and exclusion criteria. A total of 210 were included for further analysis.\u0000\u0000\u0000Results\u0000Eighteen percent (n=37) of the apps had an overall rating of 4.5 or above. About 41% of the apps belonged to the medical category and 41% of the apps were characterized in the health and fitness category. Feature of logging/recording the BP measurement was seen in 73% of the apps. In-app graphing to analyze BP trends was reported in 64 % of the included apps. A few apps focused on tracking medication (n=19), sodium intake (n=2), and calorie intake (n=4).\u0000\u0000\u0000Conclusions\u0000The features were common across all the included apps and were focusing only on recording the BP, providing statistics and trends of BP, and providing educational information. App developers should now aim to provide other components of self-management techniques to help individuals tackle hypertension.","PeriodicalId":74181,"journal":{"name":"mHealth","volume":"8 1","pages":"14"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44269675","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":"Retrospective evaluation of a pilot eHealth/mHealth telewellness program for people with disabilities: Mindfulness, Exercise, and Nutrition To Optimize Resilience (MENTOR).","authors":"J. Rimmer, Jereme D. Wilroy, Pierre Galea, Amanda Jeter, Byron W. Lai","doi":"10.21037/mhealth-21-34","DOIUrl":"https://doi.org/10.21037/mhealth-21-34","url":null,"abstract":"Background\u0000People with disabilities have few options to participate in wellness programs that are tailored to their health, functional level, specific interests/needs, and available in the comfort of their home. To address this need, we evaluated a mobile health wellness program for people with physical disabilities.\u0000\u0000\u0000Methods\u0000Retrospective pilot evaluation of MENTOR (Mindfulness, Exercise, and Nutrition To Optimize Resilience), an 8-week, 40-hour online telewellness program adapted from the peer reviewed literature on wellness. The three core wellness domains-mindfulness, exercise, and nutrition-were delivered via Zoom to groups of participants with a disability. Each group met weekly with an assigned health coach who responded to Q&A about the program and presented new material on several additional wellness domains that could impact their health (e.g., relationships, contribution to society/community, spending outdoor time in nature). Pre/post measures included the Godin Leisure-Time Exercise Questionnaire (GLTEQ) and the UAB/Lakeshore Wellness Assessment (LWA). Participants were also interviewed and provided feedback after the program, which was thematically analyzed.\u0000\u0000\u0000Results\u0000A total of 154 people from 15 states enrolled in the MENTOR program and 135 completed it (87.7% completers). Data were analyzed from a subset of participants (n=53) who were asked to complete a pre/post assessment and had complete data. Participants who were physically inactive at baseline improved their GLTEQ total activity (P=0.002; effect size =0.56) and moderate-to-vigorous activity scores (P=0.005; effect size =0.53). LWA results demonstrated that participants increased their exercise behavior (P=0.006; effect sizes =0.39) and contribution to society/community (P=0.013; effect size =0.37). Participants with low overall wellness (mental, physical & emotional health) at baseline had statistically significant improvements in exercise, nutrition, sleep, core values, self-care, hobbies, contribution to society/community, relationships, and overall wellness (all P<0.05 with effect sizes ranging from 0.43 to 1.07). Resultant qualitative themes were: (I) lifestyle transformation occurred through new positive experiences, physical and mental health benefits, and adoption of healthy behaviors; and (II) engagement through accessible online bonding through enjoyable and professional experiences.\u0000\u0000\u0000Conclusions\u0000A pilot telewellness program for people with disabilities is feasible and potentially effective in improving several domains of wellness. There is a need for precision-based mobile health (mHealth) programs that are tailored for people with disabilities and that can be accessed from various portable devices including their phone and/or tablet.","PeriodicalId":74181,"journal":{"name":"mHealth","volume":"8 1","pages":"15"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48625435","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":"mHealth impact on secondary stroke prevention: a scoping review of randomized controlled trials among stroke survivors between 2010-2020.","authors":"Amelia K. Adcock, Treah Haggerty, Anna I. Crawford, C. Espinosa","doi":"10.21037/mhealth-21-27","DOIUrl":"https://doi.org/10.21037/mhealth-21-27","url":null,"abstract":"Background\u0000A fundamental gap between clinical prevention and self-management awareness heightens the risk for stroke recurrence in approximately one-fourth of the highest risk stroke survivors annually. Secondary stroke prevention has the potential to be promoted by mobile health (mHealth) applications for effective real-world adoption of vascular risk factor mitigation. This scoping review aims to evaluate the impact of mHealth interventions and their effectiveness to reduce recurrent stroke rates among stroke survivors in randomized controlled trials (RCTs).\u0000\u0000\u0000Methods\u0000Scoping review in Ovid Medline, Cochrane Library, CINAHL, and Scopus for RCT literature employing mHealth among stroke populations published in English from 2010 to November 19, 2020. Small or pilot studies that included randomized design were included.\u0000\u0000\u0000Results\u0000A total of 352 abstracts met inclusion criteria; 31 full-text articles were assessed and 18 unique RCTs involving 1,453 patients ultimately fulfilled criteria. Twelve of 18 met the pre-defined primary outcome measure, including 2 studies evaluating feasibility. Eight of 18 only addressed recovery from index stroke deficits. Most outcomes focused on self-reported functional status, mood, quality of life or compliance with intervention; primary outcome was an objective metric in 4/18 (blood pressure readings, step number, obstructive sleep apnea support compliance). Intervention duration 2-12 months, with a median 9 weeks.\u0000\u0000\u0000Conclusions\u0000No high-quality evidence supporting mHealth applications to reduce recurrent stroke was found in this scoping review. Overall, most studies were relatively small, heterogenous, and employed subjective primary outcome measures. mHealth's potential as an effective tool for stroke stakeholders to reduce recurrent stroke rates has not been sufficiently demonstrated in this review. Future randomized studies are needed that explicitly evaluate stroke recurrence rate.","PeriodicalId":74181,"journal":{"name":"mHealth","volume":"8 1","pages":"19"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47920132","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":"A systematic review of telehealth interventions for managing anxiety and depression in African American adults.","authors":"Terika McCall,&nbsp;Clinton S Bolton,&nbsp;Rebecca Carlson,&nbsp;Saif Khairat","doi":"10.21037/mhealth-20-114","DOIUrl":"https://doi.org/10.21037/mhealth-20-114","url":null,"abstract":"<p><strong>Background: </strong>Although the difference in prevalence of mental illness is less than 7%, African American adults utilize mental health services at less than half the rate of their white counterparts. Evidence from past studies showed that telehealth interventions for anxiety and depression are effective in reducing symptoms. The objective of this systematic review is to survey the available peer-reviewed literature for studies that used telehealth interventions, specifically tailored for African American adults, to reduce anxiety or depression, and determine their effectiveness.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted using the PubMed, PsycINFO, Scopus, and Web of Science electronic databases for relevant articles published from January 1970 to December 2019.</p><p><strong>Results: </strong>Three independent studies were identified. The findings showed significant reduction of depressive symptoms post-intervention (all P<0.05). However, effectiveness of telehealth intervention compared to face-to-face was not determined. None of the studies assessed the effectiveness of telehealth interventions to reduce anxiety.</p><p><strong>Conclusions: </strong>The results highlight the need for additional research into the effectiveness of using telehealth modalities to manage anxiety and depression in African American adults. This systematic review has been registered in the PROSPERO international prospective register of systematic reviews (registration number: CRD42018104469; registration date: 09 August 2018).</p>","PeriodicalId":74181,"journal":{"name":"mHealth","volume":"7 ","pages":"31"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8063009/pdf/mh-07-20-114.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9249076","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":"Value-based modeling for mobile health application development.","authors":"M. Lipscomb, Alhefdi Mohammad, Alharthi Abdulrahman, L. Jololian","doi":"10.21037/mhealth-21-32","DOIUrl":"https://doi.org/10.21037/mhealth-21-32","url":null,"abstract":"Background\u0000In this paper is presented the use of value-based modeling, traditionally a business development tool, for the improvement of mobile health app design. The conceptual foundations for this work are design science, which is the scientific study and creation of artifacts, and convergence, which is a research method that in this case combines engineering with medicine. Relevant previous work done by the research team included the modeling of a case management system using process-based and information-based modeling techniques.\u0000\u0000\u0000Methods\u0000Value-based modeling represents actors who are exchanging with each other things of economic value, including service outcomes. The focus is on how value objects are offered, accepted, and exchanged in a network. Value-based models do not describe how transactions occur, but rather the net value of those transactions. This technique was applied to the design development of a mobile application system for the improvement of access to health services.\u0000\u0000\u0000Results\u0000Significant value-based modeling was performed. These models highlighted the importance in healthcare delivery of effective value exchanges.\u0000\u0000\u0000Conclusions\u0000The results revealed a limitation on the net value of services delivery. These were related to constraints of time, cost, and responsibility. A design improvement was proposed: The development of an automated decision-making subsystem within the machine learning component of the app system. This subsystem would recommend between-visit micro adjustments to the plan of care based upon protocols established by the healthcare provider. Such would provide an agile response to the patient's changing needs as well as an amelioration to the challenges of access to services.","PeriodicalId":74181,"journal":{"name":"mHealth","volume":"8 1","pages":"16"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44185376","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":"mHealth prompts within diabetes prevention programs: a scoping review.","authors":"M. MacPherson, Kohle J. Merry, S. Locke, M. Jung","doi":"10.21037/mhealth-21-22","DOIUrl":"https://doi.org/10.21037/mhealth-21-22","url":null,"abstract":"Background\u0000Mobile health (mHealth) prompts (e.g., text messaging, push notifications) are a commonly used technique within behaviour change interventions to prompt or cue a specific behaviour. Such prompts are being increasingly integrated into diabetes prevention programs (DPPs). While mHealth prompts provide a convenient and cost-effective way to reinforce behaviour change, no reviews to date have examined mHealth prompt use within DPPs. This scoping review aims to: (I) understand how mHealth prompts are being used within behaviour change interventions for individuals at risk for developing type 2 diabetes (T2D); and (II) provide recommendations for future mHealth prompt research, design, and application.\u0000\u0000\u0000Methods\u0000The scoping review methodology outlined by Arksey and O'Malley were followed. Medline, CINAHL, PsycInfo, Web of Science, and SportDiscus were searched. The search strategy combined keywords relating to T2D risk and mHealth prompts in conjunction with database-controlled vocabulary when available (e.g., MeSH for Medline).\u0000\u0000\u0000Results\u0000Of the 4,325 publications screened, 44 publications (based on 33 studies) met the inclusion criteria and were included for data extraction. Text messaging was the most widely used mHealth prompt (73%) followed by push notifications (21%). Only 30% of studies discussed the theoretical basis for prompt content and time of day messages were sent, and only 27% provided justification for prompt timing and frequency. Fourteen studies assessed participant satisfaction with mHealth prompts of which only two reported dissatisfaction due to either prompting frequency (hourly) or message content (solely focused on weight). Nine studies assessed behavioural outcomes including weight loss, physical activity, and diabetes incidence, and found mixed effects overall.\u0000\u0000\u0000Conclusions\u0000While mHealth prompts were well-received by participants, there are mixed effects on the influence of mHealth prompts on behavioural outcomes and diabetes incidence. More thorough reporting of prompt content development and delivery is needed, and more experimental research is needed to identify optimal content, delivery characteristics, and impact on behavioural and clinical outcomes.","PeriodicalId":74181,"journal":{"name":"mHealth","volume":"8 1","pages":"20"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43712852","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":"A brief analysis of challenges in implementing telehealth in a rural setting.","authors":"V. Gurupur, Zhuqi Miao","doi":"10.21037/mhealth-21-38","DOIUrl":"https://doi.org/10.21037/mhealth-21-38","url":null,"abstract":"Available literature clearly indicates that successful implementation of telemedicine and telehealth has been a challenge. This challenge is further amplified if the reader must consider this implementation in a rural setting. In this article the authors discuss some of the key challenges associated with this implementation. The article sheds light on a few key studies and commentaries associated with the use of telehealth in a rural setting. Critically, the article summarizes these critical findings; thereby, informing the reader on the bottlenecks associated with the use of telehealth in a geographically rural area. Also, briefly summarizing the existing body of knowledge on this topic of study. Furthermore, a case study briefly narrating the use of telemedicine and telehealth for rural Oklahoma is presented to advance our understanding of the situation in this field. Some of the critical details associated with this case study provides insights on some of the key challenges associated with the implementation of telehealth in a rural setting. This case study also provides insights on key workflow processes that helped the implementation of telehealth. Finally, the authors summarize the key challenges in the implementation of telehealth based on their perspective. Here it is important to inform the readers that this article is not a scientific review on the topic instead presents an opinion backed by facts and existing literature. Overall, the authors present a key discussion that can lead to advances in research and required innovations that might help in providing easy access to healthcare through telehealth.","PeriodicalId":74181,"journal":{"name":"mHealth","volume":"8 1","pages":"17"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42519335","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":"HIV self-testing and STI self-collection via mobile apps: experiences from two pilot randomized controlled trials of young men who have sex with men.","authors":"Katie B Biello,&nbsp;Casey Horvitz,&nbsp;Shelby Mullin,&nbsp;Kenneth H Mayer,&nbsp;Hyman Scott,&nbsp;Kenneth Coleman,&nbsp;Julian Dormitzer,&nbsp;Jenna Norelli,&nbsp;Lisa Hightow-Weidman,&nbsp;Patrick Sullivan,&nbsp;Matthew J Mimiaga,&nbsp;Susan Buchbinder,&nbsp;Kelly Bojan,&nbsp;Donna Futterman,&nbsp;Patricia Emmanuel,&nbsp;Albert Liu","doi":"10.21037/mhealth-20-70","DOIUrl":"https://doi.org/10.21037/mhealth-20-70","url":null,"abstract":"<p><strong>Background: </strong>Young men who have sex with men (YMSM) are disproportionately impacted by HIV and other sexually transmitted infections (STIs) in the United States (US) and have low rates of HIV/STI testing. Provision of HIV self-testing and STI self-collection can increase testing rates, and access to these kits through mobile applications (apps) could help facilitate YMSM using HIV self-testing and STI self-collection.</p><p><strong>Methods: </strong>Data for this study comes from two pilot randomized controlled trials (RCTs) of mobile apps within the Adolescent Trials Network-LYNX and MyChoices-aimed to increase HIV/STI testing among YMSM (age 15-24) who had not recently tested for HIV and were at high risk for HIV acquisition across five US cities. Both apps include the ability to order a HIV self-test with rapid results and a kit for STI self-collection and mailing of samples for syphilis, gonorrhea and chlamydia to a lab for testing. Using assessments of app users (n=80) at pre-randomization and at 3- and 6-months post-randomization and online interview data from a purposive sample of app users (n=37), we report on experiences and lessons learned with HIV self-testing and STI self-collection kits ordered via the apps.</p><p><strong>Results: </strong>Participants were on average 20.7 years of age (SD =2.4), and 49% were non-White or multiple race/ethnicity. Sixty-three percent had a prior HIV test. Over half (58%) had a prior STI test, but only 3% had tested within the past 3 months. Nearly two-thirds ordered an HIV self-testing kit; of whom, 75% reported using at least one self-test kit over the study period. STI self-collection kit ordering rates were also high (54%); however, STI self-collection kit return rates were lower (13%), but with a high positivity rate (5.3%). Both HIV self-testing and STI self-collection kits were highly acceptable, and 87% reported that it was extremely/very helpful to be able to order these kits through the apps. The most common reason for not ordering the HIV/STI kits was preferring to test at a clinic. In interviews, participants expressed feeling empowered by being able to test at home; however, they also raised concerns around STI sample collection.</p><p><strong>Conclusions: </strong>HIV self-testing and STI self-collection kit ordering via mobile apps is feasible, acceptable and may show promise in increasing testing rates among YMSM. The LYNX and MyChoices apps are currently being tested in a full-scale efficacy trial, and if successful, these innovative mobile apps could be scaled up to efficiently increase HIV/STI testing among youth across the US.</p>","PeriodicalId":74181,"journal":{"name":"mHealth","volume":"7 ","pages":"26"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8063023/pdf/mh-07-20-70.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9454856","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}