Assessment of the Acceptability and Feasibility of Using Mobile Robotic Systems for Patient Evaluation.
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ABSTRACT:
SUBMITTER: Chai PR
PROVIDER: S-EPMC8058534 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Wearable devices and mobile sensors enable the real-time collection of an abundant source of physiological and behavioural data unobtrusively. Unlike traditional in-person evaluation or ecological momentary assessment (EMA) questionnaire-based approaches, these data sources open many possibilities in remote patient monitoring. However, defining robust models is challenging due to the data's noisy and frequently missing observations. This work proposes an attention-based Long Short-Term Memory (LSTM) neural network-based pipeline for predicting mobility impairment based on WHODAS 2.0 evaluation from such digital biomarkers. Furthermore, we addressed the missing observation problem by utilising hidden Markov models and the possibility of including information from unlabelled samples via transfer learning. We validated our approach using two wearable/mobile sensor data sets collected in the wild and socio-demographic information about the patients. Our results showed that in the WHODAS 2.0 mobility impairment prediction task, the proposed pipeline outperformed a prior baseline while additionally providing interpretability with attention heatmaps. Moreover, using a much smaller cohort via task transfer learning, the same model could learn to predict generalised anxiety severity accurately based on GAD-7 scores.
| S-EPMC10440506 | biostudies-literature
Project description:Valid, reliable behavioral data and contextually meaningful interventions are necessary for improved health outcomes. Ecological Momentary Assessment and Intervention (EMAI), which collects data as behaviors occur to deliver real-time interventions, may be more accurate and reliable than retrospective methods. The rapid expansion of mobile technologies in low-and-middle-income countries allows for unprecedented remote data collection and intervention opportunities. However, no previous studies have trialed EMAI in sub-Saharan Africa. We assessed EMAI acceptability and feasibility, including participant retention and response rate, in a prospective, parallel group, randomized pilot trial in Rakai, Uganda comparing behavioral outcomes among adults submitting ecological momentary assessments (EMA) versus EMAI. After training, participants submitted EMA data on five nutrition and health risk behaviors over a 90-day period using a smartphone-based application utilizing prompt-based, participant-initiated, and geospatial coordinate data collection, with study coordinator support and incentives for >50% completion. Included behaviors and associated EMAI-arm intervention messages were selected to pilot a range of EMAI applications. Acceptability was measured on questionnaires. We estimated the association between high response rate and participant characteristics and conducted thematic analysis characterizing participant experiences. Study completion was 48/50 participants. Median prompt response rate was 66.5% (IQR: 60.0%-78.6%). Prior smartphone app use at baseline (aPR 3.76, 95%CI: 1.16-12.17, p = 0.03) and being in the intervention arm (aPR 2.55, 95% CI: 1.01-6.44, p = 0.05) were significantly associated with the top response rate quartile (response to >78.6% of prompts). All participants submitted self-initiated reports, covering all behaviors of interest, including potentially sensitive behaviors. Inconsistent phone charging was the most reported feasibility challenge. In this pilot, EMAI was acceptable and feasible. Response rates were good; additional strategies to improve compliance should be investigated. EMAI using mobile technologies may support improved behavioral data collection and intervention approaches in low and middle-income settings. This approach should be tested in larger studies.
| S-EPMC9416993 | biostudies-literature
Project description:An increasing number of mobile app interventions have been developed for problem drinking among college students; however, few studies have examined the integration of a mobile app with continuous physiological monitoring and alerting of affective states related to drinking behaviors.The aim of this paper was to evaluate the acceptability and feasibility of Mind the Moment (MtM), a theoretically based intervention for female college students with problem drinking that combines brief, in-person counseling with ecological momentary intervention (EMI) on a mobile app integrated with a wearable sensorband.We recruited 10 non-treatment seeking, female undergraduates from a university health clinic who scored a 3 or higher on the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) to participate in this pilot study. Study activities involved an in-person baseline intake and 1 follow-up assessment, 2 in-person alcohol brief intervention counseling sessions, and use of MtM technology components (sensorband and EMI on a mobile app) for approximately 3-4 weeks. The intervention used motivational interviewing (MI) and cognitive behavioral therapy (CBT) strategies for reducing risks associated with drinking. We used both qualitative and quantitative assessments to measure acceptability of the intervention and feasibility of delivery. Use patterns of the sensorband and mobile app were also collected.Quantitative and qualitative data indicated high levels of acceptability for the MtM intervention. Altogether, participants made reports on the app on 26.7% (78/292) the days the technology was available to them and completed a total of 325 reports with wide variation between participants. Qualitative findings indicated that sensorband-elicited alerts promoted an increase in awareness of thoughts, feelings, and behaviors related to current environmental stressors and drinking behaviors in theoretically meaningful ways. Specific challenges related to functionality and form of the sensorband were identified.Delivering intervention material "just-in-time," at the moment participants need to use behavioral strategies has great potential to individualize behavioral interventions for reducing problem drinking and other health behaviors. These findings provide initial evidence for the promise of wearable sensors for increasing potency of theoretically grounded mobile health interventions and point to directions for future research and uptake of these technologies.
| S-EPMC5522582 | biostudies-other
Project description:Despite the recent explosion of behavioral health interventions delivered on mobile devices, little is known about factors that make such applications practical, engaging and useful to their target audience. This study reports on the feasibility, acceptability and preliminary efficacy of a prototype of a novel, interactive mobile psychosocial intervention to reduce problematic drug use among clients in methadone maintenance treatment (MMT). A mixed-methods pilot study with new MMT clients (n = 25) indicated that the mobile intervention approach was feasible, and that participants found the intervention highly acceptable and useful. On 100-point visual analog scale (VAS) items, participants reported high levels of liking the program (M = 75.6), and endorsed it as useful (M = 77.5), easy to use (M = 80.7), and containing a significant amount of new information (M = 74.8). When compared with 25 study participants who received standard MMT alone, pilot participants rated their treatment significantly higher in interestingness and usefulness, and were significantly more satisfied with their treatment. In qualitative interviews, participants reported using the mobile intervention in a range of settings, including during times of heightened risk for substance use, and finding it helpful in managing drug cravings. Additionally, pilot participants showed evidence of increased treatment retention and abstinence from illicit opioids (in terms of effect size) over a 3-month period relative to those in standard MMT, suggesting the application's potential to enhance treatment outcomes. These promising findings suggest that an evidence-based mobile therapeutic tool addressing substance use may appeal to drug treatment clients and have clinical utility as an adjunct to formal treatment.
| S-EPMC4924621 | biostudies-literature
Project description:BackgroundOpioid use disorders impact the health and well-being of millions of Americans. Buprenorphine and naloxone (BUP and NAL) can reduce opioid overdose deaths, decrease misuse, and improve quality of life. Unfortunately, poor medication adherence is a primary barrier to the long-term efficacy of BUP and NAL.ObjectiveWe aimed to examine patient feedback on current and potential features of a Bluetooth-enabled pill bottle cap and associated mobile app for patients prescribed BUP and NAL for an opioid use disorder, and to solicit recommendations for improvement to effectively and appropriately tailor the technology for people in treatment for opioid use disorder.MethodsA convenience sample of patients at an opioid use disorder outpatient clinic were asked about medication adherence, opioid cravings, experience with technology, motivation for treatment, and their existent support system through a brief e-survey. Patients also provided detailed feedback on current features and features being considered for inclusion in a technology designed to increase medication adherence (eg, inclusion of a personal motivational factor, craving and stress tracking, incentives, and web-based coaching). Participants were asked to provide suggestions for improvement and considerations specifically applicable to people in treatment for opioid use disorder with BUP and NAL.ResultsTwenty people with an opioid use disorder who were prescribed BUP and NAL participated (mean age 34, SD 8.67 years; 65% female; 80% White). Participants selected the most useful, second-most useful, and least useful features presented; 42.1% of them indicated that motivational reminders would be most useful, followed by craving and stress tracking (26.3%) and web-based support forums (21.1%). Every participant indicated that they had at least 1 strong motivating factor for staying in treatment, and half (n=10) indicated children as that factor. All participants indicated that they had, at some point in their lives, the most extreme craving a person could have; however, 42.1% indicated that they had no cravings in the last month. Most respondents (73.7%) stated that tracking cravings would be helpful. Most respondents (84.2%) also indicated that they believed reinforcers or prizes would help them achieve their treatment goals. Additionally, 94.7% of respondents approved of adherence tracking to accommodate this feature using smart packaging, and 78.9% of them approved of selfie videos of them taking their medication.ConclusionsEngaging patients taking treatment for opioid use disorder with BUP and NAL allowed us to identify preferences and considerations that are unique to this treatment area. As the technology developer of the pill cap and associated mobile app is able to take into consideration or integrate these preferences and suggestions, the smart cap and associated mobile app will become tailored to this population and more useful for them, which may encourage patient use of the smart cap and associated mobile app.
| S-EPMC10157459 | biostudies-literature
Project description:BackgroundFor people living with HIV (PLWH), antiretroviral therapy (ART) adherence is crucial to attain better health outcomes. Although research has leveraged consumer health information technologies to enhance ART adherence, no study has evaluated feasibility and clinical outcomes associated with the usage of a commercially available, regularly updated mobile health (mHealth) app for improving ART adherence among PLWH.ObjectiveThis study aimed to assess the feasibility, acceptability, and clinical outcomes of Care4Today, an existing, free, biprogrammatic mHealth app for improving ART adherence among PLWH.MethodsThe Florida mHealth Application Adherence Project (FL-mAPP) was a 90-day longitudinal pilot study conducted in 3 public HIV clinics in Florida, United States. After obtaining informed consent, 132 participants completed a survey and then were given the option to try an existing mHealth app to help with ART adherence. Of these, 33.3% (44/132) declined, 31.1% (41/132) agreed but never used the app, and 35.6% (47/132) used the app. All were asked to complete follow-up surveys at 30 days and 90 days after enrollment. Usage data were used to assess feasibility. Clinical outcomes of self-reported ART adherence and chart-obtained HIV viral load and CD4+ T-cell counts were compared among those who used the platform (users) versus those who did not (nonusers). Participants and HIV care providers also provided responses to open-ended questions about what they liked and did not like about the app; comments were analyzed using thematic analysis.ResultsOf 132 participants, 47 (35.6%) and 85 (64.4%) were categorized as users and nonusers, respectively. Among users, a Kaplan-Meier plot showed that 25 persons (53%) continued using the app after the 90-day follow-up. At 30-day follow-up, 13 (81.3%) of those who used the mHealth app reported ≥95% ART adherence, compared with 17 (58.6%) nonusers (P=.12). Overall, 39 (82%) users liked or somewhat liked using the platform. Participants' favorite features were medication reminders, ability to create custom reminders, and adherence reports.ConclusionsThis longitudinal study found that a commercially available medication adherence mHealth app was a feasible and acceptable intervention to improve ART adherence among PLWH and engaged in clinical care across 3 public HIV clinics in the state of Florida. Overall, participants liked the Care4Today app and thought the medication reminders were their favorite feature. Generally, self-reports of ART adherence were better among users than nonusers, both at 30- and 90-day follow-ups. Further clinical research needs to address user fatigue for improving app usage.
| S-EPMC6996722 | biostudies-literature
Project description:BackgroundThe portability and multiple functionalities of mobile devices make them well suited for collecting field data for naturalistic research, which is often beset with complexities in recruitment and logistics. This paper describes the implementation of a research protocol using mobile devices to study nurses' exchanges of patient information at change of shift.MethodsNurses from three medical and surgical units of an acute care teaching hospital in Montreal, Canada, were invited to participate. On 10 selected days, participants were asked to record their handoffs using mobile devices and to complete paper questionnaires regarding these exchanges. Nurse acceptance of mobile devices was assessed using a 30-item technology acceptance questionnaire and focus group interviews. The principal feasibility indicator was whether or not 80 complete handoffs could be collected on each unit.ResultsFrom October to December 2017, 63 of 108 eligible nurses completed the study. Results suggest that the use of mobile devices was acceptable to nurses, who felt that the devices were easy to use but did not improve their job performance. The principal feasibility criterion was met, with complete data collected for 176, 84, and 170 of the eligible handoffs on each unit (81% of eligible handoffs). The research protocol was acceptable to nurses, who felt the study's demands did not interfere with their clinical work.ConclusionsThe research protocol involving mobile devices was feasible and acceptable to nurses. Nurses felt the research protocol, including the use of mobile devices, required minimal investment of time and effort. This suggests that their decision to participate in research involving mobile devices was based on their perception that the study protocol and the use of the device would not be demanding. Further work is needed to determine if studies involving more sophisticated and possibly more demanding technology would be equally feasible and acceptable to nurses.
| S-EPMC6199701 | biostudies-literature
Project description:BackgroundTraditional mindfulness-based stress reduction programs are resource intensive for providers and time- and cost-intensive for participants, but the use of mobile technologies may be particularly convenient and cost-effective for populations that are busy, less affluent, or geographically distant from skilled providers. Women in southern Louisiana live in a vulnerable, disaster-prone region and are highly stressed, making a mobile program particularly suited to this population.ObjectiveThis study aimed to (1) assess the feasibility and acceptability of a mobile mindfulness app in real-world conditions in a pilot study of a community sample of women residing in southern Louisiana, (2) describe predictors of app usage, and (3) assess the effect of the app on secondary health outcomes.MethodsWomen were recruited from an oil spill study on health. A total of 236 women completed a baseline survey, were offered the mobile mindfulness program, and completed a follow-up survey. Subjects were asked to download and use the app for at least 30 days for 10 min. All study procedures were completed on the web. Primary outcomes were feasibility and acceptability of the app and characteristics of app utilization. Secondary outcomes included mindfulness, depression, perceived stress, sleep quality, physical activity, BMI, and healthy eating.ResultsOverall, 74.2% (236/318) of subjects completed the follow-up survey, and 13.5% (43/318) used the app. The main barrier to app usage was lack of time, cited by 37% (16/43) of users and 48.7% (94/193) of nonusers of the app. Women who chose to use the app were more highly educated (16/43, 63% had a college education vs 65/193, 33.7% of nonparticipants; P<.001), had higher incomes (23/43, 58% had incomes >US $50,000 per year vs 77/193, 43.0% of nonparticipants), and were employed (34/43, 79% vs 122/193, 63.2% of nonparticipants; P=.047). Those who engaged with the app did so at high levels, with 72% (31/43) of participants self-reporting the completion of some or all sessions and 74% (32/43) reporting high levels of satisfaction with the app. Participation with the app had a beneficial impact on depression (odds ratio [OR] 0.3, 95% CI 0.11-0.81), sleep quality (OR 0.1, 95% CI 0.02-0.96), sleep duration (OR 0.3, 95% CI 0.07-0.86), sleep latency (OR 0.3, 95% CI 0.11-0.81), and physical activity (2.8 95% CI 1.0-7.8), but mindfulness scores did not change from baseline to follow-up.ConclusionsThe Headspace mobile mindfulness app was easy and cost-effective to implement and acceptable to those who participated, but few women elected to try it. The unique characteristics of this southern Louisiana population suggest that more intense promotion of the benefits of mindfulness training is needed, perhaps in conjunction with some therapist or researcher support. Several short-term benefits of the app were identified, particularly for depression and sleep.
| S-EPMC7298633 | biostudies-literature
Project description:BackgroundCumulative trauma exposures can have a profound effect on women's health and well-being. Black immigrant women are disproportionately affected by cumulative trauma experiences that place them at risk for multiple health issues such as reproductive sexual health problems and HIV, or mental health problems such as PTSD. The trauma-informed internet and mobile phone-based Being Safe, Healthy, and Positively Empowered (BSHAPE) intervention was designed to comprehensively assess for cumulative traumatic experiences, for current safety, and to address women's co-occurring healthcare needs through educational, psychoeducational, and mindfulness-based stress-reduction components.PurposeThis paper describes the development, feasibility, acceptability, and preliminary evaluation of the computer and phone delivered BSHAPE intervention among adult Black immigrant women survivors of cumulative trauma.MethodSeventy women participated in the feasibility, acceptability, and preliminary evaluation of BSHAPE, with outcomes assessed at post-intervention. The feasibility and acceptability outcomes assessed were enrollment, adherence, and perceptions of the intervention. Preliminary evaluation outcomes included perceived stress, stress management, trauma coping self-efficacy, mindfulness, mental health (MH), HIV/STI risk, general empowerment, and empowerment related to safety.ConclusionsFindings suggest that a BSHAPE intervention is feasible and acceptable. Overall, women reported satisfaction with BSHAPE and provided suggestions for improvement. Women showed significant reduction in perceptions of stress, improved stress-management, enhanced self-efficacy, reduced HIV/STI risk, and improved MH, overall empowerment, as well as empowerment related to safety. The findings of this study will be useful in further refining BSHAPE and testing it in a full-scale randomized controlled trial.Trial registrationNCT03664362.
| S-EPMC8595858 | biostudies-literature
Project description:Chronic kidney disease (CKD) is a systemic disorder that combines complex bone and mineral abnormalities. The high level of parathyroid hormone (PTH) in the blood causes irreversible renal dysfunction and cardiovascular disease. Therefore, it is necessary to reduce level of PTH in the blood of patients with uremic state. In this study, chitosan and heparin were chosen to form polysaccharide-based multilayer films based on their antibacterial ability, good biocompatibility and hemocompatibility. In addition, a previous study has revealed that PTH is a heparin/polyanion binding protein because of the similarity of heparin to the cell surface proteoglycans. Subsequently, the surface properties including thickness, surface hydrophobicity and surface charge of a series of multilayer films were analyzed. The PTH adsorption rate of a series of multilayer films was also assessed. The results revealed that the optimizing condition is (CHI/HEP)2.5 and 60 min in both PBS only and PBS with the addition of bovine serum albumin, which demonstrated the specific adsorption of PTH on the materials. Furthermore, the hemolysis test also revealed that (CHI/HEP)2.5 shows good blood compatibility. It is considered that polysaccharide-based multilayer films may provide an alternative for the surface modification of hemodialysis membranes and equipment.
| S-EPMC8271409 | biostudies-literature