Women's Usage Behavior and Perceived Usefulness with Using a Mobile Health Application for Gestational Diabetes Mellitus: Mixed-Methods Study.
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ABSTRACT:
SUBMITTER: Surendran S
PROVIDER: S-EPMC8296439 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundPregnant women are often unaware of the potential risks that working conditions can cause to them and their unborn child. A mobile health (mHealth) app, the Pregnancy and Work (P and W) app, developed by a multidisciplinary team and based on an evidence-based guideline for occupational physicians, aims to provide advice on work adjustment during pregnancy.ObjectiveThis study evaluates the usability of the mHealth P and W app and the perceived usefulness of the work advice, the main goal of the app, by potential end users.MethodsA total of 12 working pregnant women participated in think aloud usability sessions and performed 9 tasks. All think aloud sessions were recorded, transcribed, and coanalyzed. The usability problems were rated for their severity in accordance with Nielsen severity scale. The completion rates and time taken for completion of tasks were registered. In addition, participants were questioned on demographics and user characteristics and were asked to evaluate the value of the app by filling in the Intrinsic Motivation Inventory (IMI) score and the System Usability Scale (SUS) questionnaire.ResultsIn total, 82 usability problems with a severity ≥1 were identified, of which 40 had severity ≥3. The main usability problems concerned the interpretation of terminology used in the app's questionnaires and difficulties in finding and understanding the work advice. Furthermore, 10 out of 12 participants were able to open the work advice page in the app. Only 7 out of these 10 participants understood and intended to follow the work advice. The overall mean IMI score was relatively high (5 out of 7), indicating that the participants did indeed value the use of the app. This IMI score corresponded to the overall mean SUS score (68 out of 100) and the mean grade given to the P and W app (7 out of 10).ConclusionsThis think aloud usability study showed that the information provided in the P and W app was considered valuable by the end users, working pregnant women, and it meets their needs; however, usability issues severely impacted the perceived usefulness of the work advice given in the app.
| S-EPMC6532337 | biostudies-literature
Project description:Underspecified user needs and frequent lack of a gold standard reference are typical barriers to technology evaluation. To address this problem, this paper presents a two-phase evaluation framework involving usability experts (phase 1) and end-users (phase 2). In phase 1, a cross-system functionality alignment between expert-derived user needs and system functions was performed to inform the choice of "the best available" comparison system to enable a cognitive walkthrough in phase 1 and a comparative effectiveness evaluation in phase 2. During phase 2, five quantitative and qualitative evaluation methods are mixed to assess usability: time-motion analysis, software log, questionnaires - System Usability Scale and the Unified Theory of Acceptance of Use of Technology, think-aloud protocols, and unstructured interviews. Each method contributes data for a unique measure (e.g., time motion analysis contributes task-completion-time; software log contributes action transition frequency). The measures are triangulated to yield complementary insights regarding user-perceived ease-of-use, functionality integration, anxiety during use, and workflow impact. To illustrate its use, we applied this framework in a formative evaluation of a software called Integrated Model for Patient Care and Clinical Trials (IMPACT). We conclude that this mixed-methods evaluation framework enables an integrated assessment of user needs satisfaction and user-perceived usefulness and usability of a novel design. This evaluation framework effectively bridges the gap between co-evolving user needs and technology designs during iterative prototyping and is particularly useful when it is difficult for users to articulate their needs for technology support due to the lack of a baseline.
| S-EPMC4055529 | biostudies-literature
Project description:BackgroundGestational diabetes mellitus (GDM) is an increasing health risk for pregnant women as well as their children. Telehealth interventions targeted at the management of GDM have been shown to be effective, but they still require health care professionals for providing guidance and feedback. Feedback from wearable sensors has been suggested to support the self-management of GDM, but it is unknown how self-tracking should be designed in clinical care.ObjectiveThis study aimed to investigate how to support the self-management of GDM with self-tracking of continuous blood glucose and lifestyle factors without help from health care personnel. We examined comprehensive self-tracking from self-discovery (ie, learning associations between glucose levels and lifestyle) and user experience perspectives.MethodsWe conducted a mixed methods study where women with GDM (N=10) used a continuous glucose monitor (CGM; Medtronic Guardian) and 3 physical activity sensors: activity bracelet (Garmin Vivosmart 3), hip-worn sensor (UKK Exsed), and electrocardiography sensor (Firstbeat 2) for a week. We collected data from the sensors, and after use, participants took part in semistructured interviews about the wearable sensors. Acceptability of the wearable sensors was evaluated with the Unified Theory of Acceptance and Use of Technology (UTAUT) questionnaire. Moreover, maternal nutrition data were collected with a 3-day food diary, and self-reported physical activity data were collected with a logbook.ResultsWe found that the CGM was the most useful sensor for the self-discovery process, especially when learning associations between glucose and nutrition intake. We identified new challenges for using data from the CGM and physical activity sensors in supporting self-discovery in GDM. These challenges included (1) dispersion of glucose and physical activity data in separate applications, (2) absence of important trackable features like amount of light physical activity and physical activities other than walking, (3) discrepancy in the data between different wearable physical activity sensors and between CGMs and capillary glucose meters, and (4) discrepancy in perceived and measured quantification of physical activity. We found the body placement of sensors to be a key factor in measurement quality and preference, and ultimately a challenge for collecting data. For example, a wrist-worn sensor was used for longer compared with a hip-worn sensor. In general, there was a high acceptance for wearable sensors.ConclusionsA mobile app that combines glucose, nutrition, and physical activity data in a single view is needed to support self-discovery. The design should support tracking features that are important for women with GDM (such as light physical activity), and data for each feature should originate from a single sensor to avoid discrepancy and redundancy. Future work with a larger sample should involve evaluation of the effects of such a mobile app on clinical outcomes.Trial registrationClinicaltrials.gov NCT03941652; https://clinicaltrials.gov/study/NCT03941652.
| S-EPMC10646680 | biostudies-literature
Project description:We aimed to clarify which beliefs motivate women to control their weight during pregnancy and how such values influence pregnancy outcomes. Using a questionnaire administered during mid- to late- pregnancy in a hospital-based prospective cohort study, we explored women's perceived ideal GWG and their reasons for having this ideal. Using multivariate regression, we evaluated the association between women's perceived ideal GWG and pregnancy outcomes. Among 1,691 normal and underweight women, the most common reason women thought avoiding excessive weight gain was important was "for ease of delivery and/or her health and well-being". 912 (54%) women wished to maintain their GWG below 12?kg, the upper limit recommended by the Japanese governmental guidelines, and had a lower actual GWG compared to those who had less stringent notions of GWG. Compared to women whose perceived ideal GWG was 12?kg, those who considered their perceived limit to be lower had infants with lower birthweight on average despite no significant reduction in cesarean delivery rate or post-partum body weight retention. Our findings suggest that women who believe they should limit their weight gain to an amount lower than the upper limit of current guidelines succeeded in gaining significantly less weight but received no additional benefit.
| S-EPMC6070475 | biostudies-other
Project description:Background. Pharmacogenomic testing has the potential to improve the safety and efficacy of pharmacotherapy, but clinical application of pharmacogenetic knowledge has remained uncommon. Clinical Decision Support (CDS) systems could help overcome some of the barriers to clinical implementation. The aim of this study was to evaluate the perception and usability of a web- and mobile-enabled CDS system for pharmacogenetics-guided drug therapy-the Medication Safety Code (MSC) system-among potential users (i.e., physicians and pharmacists). Furthermore, this study sought to collect data on the practicability and comprehensibility of potential layouts of a proposed personalized pocket card that is intended to not only contain the machine-readable data for use with the MSC system but also human-readable data on the patient's pharmacogenomic profile. Methods. We deployed an emergent mixed methods design encompassing (1) qualitative interviews with pharmacists and pharmacy students, (2) a survey among pharmacogenomics experts that included both qualitative and quantitative elements and (3) a quantitative survey among physicians and pharmacists. The interviews followed a semi-structured guide including a hypothetical patient scenario that had to be solved by using the MSC system. The survey among pharmacogenomics experts focused on what information should be printed on the card and how this information should be arranged. Furthermore, the MSC system was evaluated based on two hypothetical patient scenarios and four follow-up questions on the perceived usability. The second survey assessed physicians' and pharmacists' attitude towards the MSC system. Results. In total, 101 physicians, pharmacists and PGx experts coming from various relevant fields evaluated the MSC system. Overall, the reaction to the MSC system was positive across all investigated parameters and among all user groups. The majority of participants were able to solve the patient scenarios based on the recommendations displayed on the MSC interface. A frequent request among participants was to provide specific listings of alternative drugs and concrete dosage instructions. Negligence of other patient-specific factors for choosing the right treatment such as renal function and co-medication was a common concern related to the MSC system, while data privacy and cost-benefit considerations emerged as the participants' major concerns regarding pharmacogenetic testing in general. The results of the card layout evaluation indicate that a gene-centered and tabulated presentation of the patient's pharmacogenomic profile is helpful and well-accepted. Conclusions. We found that the MSC system was well-received among the physicians and pharmacists included in this study. A personalized pocket card that lists a patient's metabolizer status along with critically affected drugs can alert physicians and pharmacists to the availability of essential therapy modifications.
| S-EPMC4768706 | biostudies-literature
Project description:BACKGROUND:Gestational diabetes mellitus (GDM) - a transitory form of diabetes induced by pregnancy - has potentially important short and long-term health consequences for both the mother and her baby. There is no globally agreed definition of GDM, but definition changes have increased the incidence in some countries in recent years, with some research suggesting minimal clinical improvement in outcomes. The aim of this qualitative systematic review was to identify the psychosocial experiences a diagnosis of GDM has on women during pregnancy and the postpartum period. METHODS:We searched CINAHL, EMBASE, MEDLINE and PsycINFO databases for studies that provided qualitative data on the psychosocial experiences of a diagnosis of GDM on women across any stage of pregnancy and/or the postpartum period. We appraised the methodological quality of the included studies using the Critical Appraisal Skills Programme Checklist for Qualitative Studies and used thematic analysis to synthesis the data. RESULTS:Of 840 studies identified, 41 studies of diverse populations met the selection criteria. The synthesis revealed eight key themes: initial psychological impact; communicating the diagnosis; knowledge of GDM; risk perception; management of GDM; burden of GDM; social support; and gaining control. The identified benefits of a GDM diagnosis were largely behavioural and included an opportunity to make healthy eating changes. The identified harms were emotional, financial and cultural. Women commented about the added responsibility (eating regimens, appointments), financial constraints (expensive food, medical bills) and conflicts with their cultural practices (alternative eating, lack of information about traditional food). Some women reported living in fear of risking the health of their baby and conducted extreme behaviours such as purging and starving themselves. CONCLUSION:A diagnosis of GDM has wide reaching consequences that are common to a diverse group of women. Threshold cut-offs for blood glucose levels have been determined using the risk of physiological harms to mother and baby. It may also be advantageous to consider the harms and benefits from a psychosocial and a physiological perspective. This may avoid unnecessary burden to an already vulnerable population.
| S-EPMC7006162 | biostudies-literature
Project description:BACKGROUND:Patients with chronic arthritis (CA) ideally apply self-management behaviors between consultations. This enduring, tedious task of keeping track of disease-related parameters, adhering to medication schemes, and engaging in physical therapy may be supported by using a mobile health (mHealth) app. However, further research is needed to determine which self-management features are valued most by adult patients with CA patients. OBJECTIVE:The aim of this study was to determine the preference of features for an mHealth app to support self-management behavior in patients with CA. In addition, we aimed to explore the motives behind these ratings. METHODS:A mixed-methods approach was used to gather information from 31 adult patients (14 females), aged 23 to 71 years (mean 51 [SD 12.16]), with CA. Structured interviews were conducted to gather data pertaining to preferences of app features. Interviews were analyzed qualitatively, whereas ratings for each of the 28 features studied were analyzed quantitatively. RESULTS:In general, patients with CA favored the use of features pertaining to supporting active and direct disease management, (eg, medication intake and detecting and alarming of bad posture), helping them to keep a close watch on their disease status and inform their health care professional (eg, providing a means to log and report disease-related data) and receiving personalized information (eg, offering tailored information based on the patient's health data). Patients strongly disliked features that provide a means of social interaction or provide incentivization for disease-related actions (eg, being able to compare yourself with other patients, cooperating toward a common goal, and receiving encouragement from friends and/or family). Driving these evaluations is the finding that every patient with CA hurts in his/her own way, the way the disease unfolds over time and manifests itself in the patient and social environment is different for every patient, and patients with CA are well aware of this. CONCLUSIONS:We have offered an insight into how patients with CA favor mHealth features for self-management apps. The results of this research can inform the design and development of prospective self-management apps for patients with CA.
| S-EPMC6452281 | biostudies-literature
Project description:We conducted three focus groups to examine African American women's perceptions of factors influencing and proposed strategies for reducing sedentary behavior (SB). QSR NVivo 9 facilitated coding and organization of themes. Although participants ( n = 32, 53.6 ± 6.0 years, 75% obese) were unfamiliar with the term SB prior to focus groups, they described spending large amounts of time in SB at work and home. Participants viewed leisure-time SB as necessary and important but were amenable to decreasing SB at work. Participants also identified personal, social, and environmental factors contributing to SB as well as novel strategies for reducing SB. Results suggest that messages aimed at reducing SB in African American women should be positively framed, viewed within a socioecologic framework, and target nonleisure time SB. SB was viewed as a form of stress reduction; thus, future research might want to emphasize alternative stress management techniques that simultaneously reduce SB.
| S-EPMC6204229 | biostudies-literature
Project description:Background: The use of technology to support healthcare in Indonesia holds new promise in light of decreasing costs of owning mobile devices and ease of access to internet. However, it is necessary to assess end-user perceptions regarding mobile health interventions prior to its implementation. This would throw light on the acceptability of mobile phone communication in bringing about behavioral changes among the target Indonesian population. The aim of this study was to explore the perceived usefulness of receiving a potential smoking cessation intervention via mobile phones. Methods: This is an exploratory cross-sectional study involving current and former adult tobacco smokers residing in Indonesia. Online advertisement and snowballing were used to recruit respondents. Data was collected using a web-based survey over a period of 4 weeks. Those willing to participate signed an online consent and were subsequently directed to the online questionnaire that obtained demographics, tobacco usage patterns, perceived usefulness of a mobile phone smoking cessation application and its design. Results: A total of 161 people who smoked tobacco responded to the online survey. The mean age of the participants was 29.4. Of the 123 respondents, 102 were men. Prior experience with using a mobile phone for health communication (OR 3.6, P=0.014) and those willing to quit smoking (OR 5.1, P=0.043) were likely to perceive a mobile phone smoking cessation intervention as useful. A smartphone application was preferred over text messages, media messages or interactive voice response technology. Content consisting of motivational messages highlighting the methods and benefits of quitting smoking were requested. Conclusion: People who smoke in Indonesia perceived receiving a potential smoking cessation intervention via mobile phones as useful. A multi-component, personalized smartphone application was the desired intervention technique. Such an intervention developed and implemented within a public health program could help address the tobacco epidemic in Indonesia.
| S-EPMC7531048 | biostudies-literature
Project description:BACKGROUND:Finding readily accessible, high-quality medical references can be a challenging task. HeadToToe is a mobile platform designed to allow easy and quick access to sound, up-to-date, and validated medical knowledge and guidance. It provides easy access to essential clinical medical content in the form of documents, videos, clinical scores, and other formats for the day-to-day access and use by medical students and physicians during their pre- and postgraduate education. OBJECTIVE:The aim of this paper is to describe the architecture, user interface, and potential strengths and limitations of an innovative knowledge dissemination platform developed at the University of Geneva, Switzerland. We also report preliminary results from a user-experience survey and usage statistics over a selected period. METHODS:The dissemination platform consists of a smartphone app. Through an administration interface, content is managed by senior university and hospital staff. The app includes the following sections: (1) main section of medical guidance, organized by clinical field; (2) checklists for history-taking and clinical examination, organized by body systems; (3) laboratory section with frequently used lab values; and (4) favorites section. Each content item is programmed to be available for a given duration as defined by the content's author. Automatic notifications signal the author when the content is about to expire, hence, promoting its timely updating and reducing the risk of using obsolete content. In the background, a third-party statistical collecting tool records anonymous utilization statistics. RESULTS:We launched the final version of the platform in March 2019, both at the Faculty of Medicine at the University of Geneva and at the University Hospital of Geneva in Switzerland. A total of 622 students at the university and 613 health professionals at the hospital downloaded the app. Two-thirds of users at both institutions had an iOS device. During the practical examination period (ie, May 2019) there was a significant increase in the number of active users (P=.003), user activity (P<.001), and daily usage time (P<.001) among medical students. In addition, there were 1086 clinical skills video views during this period compared to a total of 484 in the preceding months (ie, a 108% increase). On a 10-point Likert scale, students and physicians rated the app with mean scores of 8.2 (SD 1.9) for user experience, 8.1 (SD 2.0) for usefulness, and 8.5 (SD 1.8) for relevance of content. In parallel, postgraduate trainees viewed more than 6000 documents during the first 3 months after the implementation in the Division of Neurology at our institution. CONCLUSIONS:HeadToToe is an educator-driven, mobile dissemination platform, which provides rapid and user-friendly access to up-to-date medical content and guidance. The platform was given high ratings for user experience, usefulness, and content quality and was used more often during the exam period. This suggests that the platform could be used as tool for exam preparation.
| S-EPMC7287749 | biostudies-literature