•An app-based eco-feedback system was designed and used in the experiment.•The effectiveness of the app-based eco-feedback system was verified.•Durability of energy consumption behavior changes in ...four phases was assessed.•Results found that the behavior-changing effect of eco-feedback changed over time.•Individual analysis showed that behavior changes were highly sensitive.
Eco-feedback as an approach to intervene in energy consumption behavior and encourage energy conservation has achieved considerable success in recent decades. Conclusions about the performance of eco-feedback systems in the literature were mostly drawn based on their short-term performance, during which eco-feedback information was continuously provided. This study, by gradually removing eco-feedback system functions in different phases of an experiment, examines the durability of the behavior-changing effect of eco-feedback under different conditions. The eco-feedback information is delivered using mobile app, which provides a higher level of accessibility than other eco-feedback technologies. A prototype app-based eco-feedback system was developed in this study, and used in an experiment that was carried out in student dormitories. The experiment lasted for fifty-three weeks, and it included four phases, during which the level of functionality of the eco-feedback system varied. The experiment results demonstrated the effectiveness of using mobile app for delivering eco-feedback information. Longitudinal analysis of the results found that the behavior-changing effect of eco-feedback changed over time. The effect was significantly positive in the short term, then became slightly positive in the medium term, and further faded to an insignificant level in the long term. Moreover, analysis of individual participants’ energy consumption profiles revealed that their behavior changes were highly sensitive and responsive to whether and how eco-feedback information was delivered. This study advances the knowledge about app-based eco-feedback and its effect in reshaping the energy consumption behaviors of occupants in dormitory buildings over time. Future research can be done to further validate the generalizability of the findings to other types of residential buildings or eco-feedback systems using different technologies, so as to provide important implication and guidance for implementing eco-feedback in practice.
Approximately 70,000 adolescents and young adults (AYA) are diagnosed with cancer each year in the United States. Sarcomas carry a particularly high symptom burden and are some of the most common ...cancers among AYA. Recent work has documented significant levels of unmet needs among AYA with cancer, particularly the need for psychosocial support. Mobile technology may be a cost-effective and efficient way to deliver a psychosocial intervention to AYA with cancer and cancer survivors.
The two aims of this study were to (1) develop a pilot version of a mobile-based mindfulness and social support program and (2) evaluate program usage and acceptability. An exploratory aim was to examine change in psychosocial outcomes.
Thirty-seven AYA with sarcoma or sarcoma survivors, parents, and health care providers participated in the study. Semistructured interviews were conducted with 10 AYA, parents of five of the adolescents, and six health care providers. Themes from the interviews helped to inform the development of a mobile-based mindfulness pilot program and a companion Facebook-based social support group. Twenty AYA consented to participate in a single-arm pre-post evaluation of the program; 17 downloaded the app and joined the Facebook group. Seven of these participants had participated in the semistructured interviews. Six additional health care providers consented to participate in the evaluation stage.
On average, participants completed 16.9 of the 28 unique sessions and used the mindfulness app for a mean 10.2 (SD 8.2) days during the 28-day evaluation period. The majority of participants (16/17) engaged in the social group and posted at least one reply to the moderator's prompts. The mean number of responses per person to the moderator of the social group was 15.2 of 31 (49%, range 0%-97%). Both AYA and health care providers responded positively to the Mindfulness for Resilience in Illness program and offered useful recommendations for improvements. Exploratory psychosocial analyses indicated there were no significant differences from pretest to posttest on measures of perceived social support, mindfulness, body image, or psychological functioning.
This study offers preliminary support for the feasibility and acceptability of a mobile-based mindfulness and Facebook-based social support program for AYA with sarcoma. The feedback from AYA and health care providers will assist in creating a fully developed intervention.
ClinicalTrials.gov NCT03130751; https://clinicaltrials.gov/ct2/show/NCT03130751.
Purpose
To better understand how to retain hospitality customers in the fierce competition among mobile applications, this study aims to propose and empirically validates an integrative framework, ...which elaborates how conscious and subconscious factors, together with affective factors, may induce app loyalty and how brand viscosity moderates such effects.
Design/methodology/approach
The authors conducted an online survey to collect data and received a total of 268 valid responses. This study splits the data into two groups (brand viscosity vs non-viscosity). Then, the authors performed a multi-group structural equation modeling with Chi-square difference tests to compare the model between the two groups.
Findings
The findings support the integrative model and reveal that the influence of app satisfaction on loyalty is stronger for app users who do not stick to one brand across the website and mobile app channels. Moreover, for those with brand viscosity, habit and switching cost are two significant determinants that exert positive effects in inducing app loyalty.
Research limitations/implications
Brand viscosity across different channels matters for the effects of habit and switching costs in shaping app loyalty. E-commerce managers should elaborate on brand management among various booking channels and establish effective digital marketing strategies to facilitate the formation of usage habits and switching costs and to enhance brand viscosity across channels.
Originality/value
This research advances the knowledge of app loyalty in hospitality by providing a comprehensive explanatory framework from affective, conscious and subconscious lenses. This research is among the first to unveil the impact of brand viscosity on the links between loyalty and its determinants.
In Peru, HIV cases are highly concentrated among men who have sex with men (MSM). Despite the availability of anti-retroviral therapy, people living with HIV (PWH) have higher levels of oral ...diseases. Alcohol use disorder (AUD) is significantly present among PWH. Our overarching goal was to generate foundational evidence on the association of AUD and oral health in MSM with HIV and enhance research capacity for future intersectional research on AUD, oral health and HIV. Our specific aim was to implement an on-site electronic data collection system through the use of a REDCap Mobile App in a low-middle income country (LMIC) setting.
Five validated surveys were utilized to gather data on demographics, medical history, HIV status, alcohol use, HIV stigma, perceived oral health status, and dietary supplement use. These surveys were developed in REDCap and deployed with the REDCap Mobile App, which was installed on ten iPads across two medical HIV clinics in Lima, Peru. REDCap app as well as the protocol for data collection were calibrated with feedback from trial participants and clinical research staff to improve clinical efficiency and participant experience.
The mean age of participants (n = 398) was 35.94 ± 9.13y, of which 98.5% identified as male, and 85.7% identified as homosexual. 78.1% of participants binge drank, and 12.3% reported being heavy drinkers. After pilot testing, significant modifications to the structure and layout of the surveys were performed to improve efficiency and flow. The app was successfully deployed to replace cumbersome paper records and collected data was directly stored in a REDCap database.
The REDCap Mobile App was successfully used due to its ability to: (a) capture and store data offline, (b) timely translate between multiple languages on the mobile app interface, and (c) provide user-friendly interface with low associated costs and ample support.
1R56DE029639-01.
Hypertension is a significant global disease burden. Mobile health (mHealth) offers a promising means to provide patients with hypertension with easy access to health care services. Yet, its efficacy ...needs to be validated, especially in lower-income areas with a high-salt diet.
This study aims to assess the efficacy of an mHealth app-based intervention in supporting patients' self-management of hypertension.
A 2-arm randomized controlled trial was conducted among 297 patients with hypertension at the General Hospital of Ningxia Medical University, Ningxia Hui Autonomous Region, China. Participants selected via convenience sampling were randomly allocated into intervention and control groups. Intervention group participants were trained and asked to use an mHealth app named Blood Pressure Assistant for 6 months. They could use the app to record and upload vital signs, access educational materials, and receive self-management reminders and feedback from health care providers based on the analysis of the uploaded data. Control group participants received usual care. Blood pressure (BP) and 2 questionnaire surveys about hypertension knowledge and lifestyle behavior were used to assess all participants at baseline and 6 months. Data analysis was performed with SPSS software using 2-tailed t tests and a chi-square test.
There were no significant differences in baseline characteristics and medication use between the 2 groups (all P>.05). After 6 months, although both groups show a significant pre-post improvement (P<.001 each), the BP control rate (ie, the proportion of patients with a systolic BP of <140 mm Hg and diastolic BP of <90 mm Hg) in the intervention group was better than that in the control group (100/111, 90.1% vs 75/115, 65.2%; P<.001). The mean systolic and diastolic BP were significantly reduced by 25.83 (SD 8.99) and 14.28 (SD 3.74) mm Hg in the intervention group (P<.001) and by 21.83 (SD 6.86) and 8.87 (SD 4.22) mm Hg in the control group (P<.001), respectively. The differences in systolic and diastolic BP between the 2 groups were significant (P<.001 and P=.01, respectively). Hypertension knowledge significantly improved only in the intervention group in both pre-post and intergroup comparisons (both P<.001). However, only intragroup improvement was observed for lifestyle behaviors in the intervention group (P<.001), including medication adherence (P<.001), healthy diet (P=.02), low salt intake (P<.001), and physical exercises (P=.02), and no significant difference was observed in the control group or on intergroup comparisons.
This research shows that the mHealth app-based intervention has the potential to improve patient health knowledge and support self-management among them toward a healthier lifestyle, including medication adherence, low-salt diets, and physical exercises, thereby achieving optimal BP control. Further research is still needed to verify the specific effects of these interventions.
Chinese Clinical Trial Registry ChiCTR1900026437; https://www.chictr.org.cn/showproj.html?proj=38801.
Although multiple self-monitoring technologies for type 2 diabetes mellitus (T2DM) show promise for improving T2DM self-care behaviors and clinical outcomes, they have been understudied in Hispanic ...adult populations who suffer disproportionately from T2DM.
The objective of this study was to evaluate the acceptability, feasibility, and potential integration of wearable sensors for diabetes self-monitoring among Hispanic adults with self-reported T2DM.
We conducted a pilot study of T2DM self-monitoring technologies among Hispanic adults with self-reported T2DM. Participants (n=21) received a real-time continuous glucose monitor (RT-CGM), a wrist-worn physical activity (PA) tracker, and a tablet-based digital food diary to self-monitor blood glucose, PA, and food intake, respectively, for 1 week. The RT-CGM captured viewable blood glucose concentration (mg/dL) and PA trackers collected accelerometer-based data, viewable on the device or an associated tablet app. After 1 week of use, we conducted a semistructured interview with each participant to understand experiences and thoughts on integration of the data from the devices into a technology-facilitated T2DM self-management intervention. We also conducted a brief written questionnaire to understand participants' self-reported T2DM history and past experience using digital health tools for T2DM self-management. Feasibility was measured by device utilization and objective RT-CGM, PA tracker, and diet logging data. Acceptability and potential integration were evaluated through thematic analysis of verbatim interview transcripts.
Participants (n=21, 76% female, 50.4 SD 11 years) had a mean self-reported hemoglobin A
of 7.4 SD 1.8 mg/dL and had been diagnosed with T2DM for 7.4 SD 5.2 years (range: 1-16 years). Most (89%) were treated with oral medications, whereas the others self-managed through diet and exercise. Nearly all participants (n=20) used both the RT-CGM and PA tracker, and 52% (11/21) logged at least one meal, with 33% (7/21) logging meals for 4 or more days. Of the 8 possible days, PA data were recorded for 7.1 SD 1.8 days (range: 2-8), and participants averaged 7822 SD 3984 steps per day. Interview transcripts revealed that participants felt most positive about the RT-CGM as it unveiled previously unknown relationships between lifestyle and health and contributed to changes in T2DM-related thoughts and behaviors. Participants felt generally positive about incorporating the wearable sensors and mobile apps into a future intervention if support were provided by a health coach or health care provider, device training were provided, apps were tailored to their language and culture, and content were both actionable and delivered on a single platform.
Sensor-based tools for facilitating T2DM self-monitoring appear to be a feasible and acceptable technology among low-income Hispanic adults. We identified barriers to acceptability and highlighted preferences for wearable sensor integration in a community-based intervention. These findings have implications for the design of T2DM interventions targeting Hispanic adults.
Side effects of breast cancer treatment may persist long into survivorship, reducing quality of life (QOL) in patients with breast cancer and survivors. There is growing evidence for the use of ...digital health technologies, such as mobile apps, to support self-management, decrease symptom burden, and improve QOL in patients with cancer. However, an updated overview of the effects of mobile apps on QOL and well-being in patients with breast cancer and survivors is needed.
The aim of this review was to provide an overview of breast cancer-specific, mobile app-driven lifestyle or behavioral interventions in patient care through to survivorship and their impact on QOL and mental well-being.
A systematic search of PubMed, Scopus, and Web of Science was conducted to identify relevant studies. The inclusion criteria were limited to original studies involving a trial of a mobile app-driven lifestyle or behavioral intervention for patients with breast cancer or survivors and using QOL or well-being measures. The results of the studies that met the inclusion criterion were then synthesized in text and table format. The quality of the evidence was assessed with the Cochrane risk-of-bias tool.
A total of 17 studies with the number of participants ranging from 23 to 356 met the inclusion criterion. Of the 17 reviewed studies, 7 (41%) delivered an app-only intervention, and 10 (59%) combined an app with additional supporting materials, such as SMS text messaging, telecoaching, wearables, or printed materials. Among the 17 reviewed studies, 6 (35%) focused on aiding patients with breast cancer during the active treatment phase (excluding ongoing hormone therapy), whereas the remaining 11 (65%) focused on survivorship. The majority of the studies (14/17, 82%) observed some positive effects on QOL or well-being measures.
The results of the review indicate that mobile apps are a promising avenue for improving QOL and well-being in breast cancer care. Positive effects were observed in patients undergoing active treatment in all reviewed studies, but effects were less clear after chemotherapy and in long-term survivors. Although lifestyle and behavioral digital interventions are still being developed, and further research should still be pursued, the available data suggest that current mobile health apps aid patients with breast cancer and survivors.
Anorexia nervosa (AN) is often treated in the acute setting, but relapse after treatment is common. Cognitive-behavioral therapy (CBT) is useful in the post-acute period, but access to trained ...providers is limited. Social support is also critical during this period. This study utilized a user-centered design approach to develop and evaluate the usability of a CBT-based mobile app and social networking component for post-acute AN support.
Participants (N = 19) were recently discharged from acute treatment for AN. Usability testing of the intervention was conducted over three cycles; assessments included the System Usability Scale (SUS), the Usefulness, Satisfaction, and Ease of Use Questionnaire (USE), the Mobile Application Rating Scale (MARS), a social media questionnaire, and a semi-structured interview.
Interview feedback detailed aspects of the app that participants enjoyed and those needing improvement. Feedback converged on three themes: Logistical App Feedback, boosting recovery, and Real-World App/Social Media Use. USE and MARS scores were above average and SUS scores were “good” to “excellent” across cycles.
This study provides evidence of feasibility and acceptability of an app and social networking feature for post-acute care of AN. The intervention has potential for offering scalable support for individuals with AN in the high-risk period following discharge from acute care.
•We detail usability testing of an app and Facebook group for post-acute care of AN.•The app and Facebook group appear to be acceptable and feasible forms of support.•Key themes were app logistics, boosting recovery, and promoting real-world app use.
People who are overweight and obese have a greater risk of developing serious diseases and health conditions. A steadily increasing trend of obesity is not only limited to developed countries, but to ...developing nations as well. As smartphones have rapidly gained mainstream popularity, mobile applications (apps) are used in public health as intervention to keep track of diets, activity as well as weight, which is deemed more accurate than relying on user's self-report measure, for the sake of weight management. A solution called "Smart Wireless Interactive Healthcare System" (SWITCHes) is developed to facilitate objective data reception and transmission in a real-time manner. Based on the user data acquired from SWITCHes app and the auxiliary data from medical instruments, not only SWITCHes app can engage user with tailored feedback in an interactive way, in terms of artificial intelligence-powered health chatbot, but the healthcare professional can provide the more accurate medical advice to user also. This paper presents an overview of development and implementation of SWITCHes.
Numerous nations have prioritised the inclusion of citizens with disabilities, such as hearing loss, in all aspects of social life. Sign language is used by this population, yet they still have ...trouble communicating with others. Many sign language apps are being created to help bridge the communication gap as a result of technology advances enabled by the widespread use of smartphones. These apps are widely used because they are accessible and inexpensive. The services and capabilities they offer and the quality of their content, however, differ greatly. Evaluation of the quality of the content provided by these applications is necessary if they are to have any kind of real effect. A thorough evaluation like this will inspire developers to work hard on new apps, which will lead to improved software development and experience overall. This research used a systematic literature review (
SLR
) method, which is recognised in gaining a broad understanding of the study whilst offering additional information for future investigations. SLR was adopted in this research for smartphone-based sign language apps to understand the area and main discussion aspects utilised in the assessment. These studies were reviewed on the basis of related work analysis, main issues, discussions and methodological aspects. Results revealed that the evaluation of sign language mobile apps is scarce. Thus, we proposed a future direction for the quality assessment of these apps. The findings will benefit normal-hearing and hearing-impaired users and open up a new area where researchers and developers could work together on sign language mobile apps. The results will help hearing and non-hearing users and will pave the way for future collaboration between academicians and app developers in the field of sign language technology.
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