Achieving the potential of mHealth in medicine requires challenging the ethos of care delivery.

Mobile Health (mHealth) interventions have received a mix of praise and excitement, as well as caution and even opposition over recent decades. While the rapid adoption of mHealth solutions due to the COVID-19 pandemic has weakened resistance to integrating these digital approaches into practice and generated renewed interest, the increased reliance on mHealth signals a need for optimizing development and implementation. Despite an historically innovation-resistant medical ethos, mHealth is becoming a normalized supplement to clinical practice, highlighting increased demand. Reaching the full potential of mHealth requires new thinking and investment. The current challenge to broaden mHealth adoption and to ensure equity in access may be overcoming a "design purgatory," where innovation fails to connect to practice. We recommend leveraging the opportunity presented by the COVID-19 pandemic to disrupt routine practice and with a new focus on theory-driven replicability of mHealth tools and strategies aimed at medical education and professional organizations.

Older Adults' Computer-Mediated Communication (CMC) Engagement Following COVID-19 and Its Impact on Access to Community, Information, and Resource Exchange: A Longitudinal, Qualitative Study.

Following COVID-19, the CDC asked individuals to social distance and state and local authorities nationwide began issuing curfews and recommendations to "shelter-in-place." Known to be more susceptible to the negative effects of COVID-19 and often coping with higher levels of social isolation, many worried that older adults' mental health would suffer. While computer-mediated communication (CMC) is on the rise among older adults, whether and how older adults leverage the social benefits of CMC remains underexplored. This study assesses older adults' CMC use after COVID and the impact of CMC engagement on access to connection, information, and resources. We follow 22 older adults over 6 weeks, using longitudinal qualitative surveys to study CMC use patterns and mental health outcomes. Results revealed that while older adults exhibited purpose-driven CMC engagement, limited integration into larger online communities restricted access to up-to-the-minute information, notably early in the pandemic. Longitudinal findings show progressively less engagement with online news and information, withdrawal from online social engagement, and a progressive relaxing of social distancing. This study sheds light on how best to reach older adults following disaster, and where older adults may be disadvantaged as social media becomes a modern "emergency broadcast system."

Social media as a modern Emergency Broadcast System: A longitudinal qualitative study of social media during COVID-19 and its impacts on social connection and social distancing compliance.

In the wake of COVID-19 social distancing recommendations, social media assumed a central - if unofficial - role in ensuring that individuals remained informed and connected throughout the pandemic. Yet while research shows that social media can be an effective platform for connecting individuals socially and fostering social support exchanges, both the platforms and the support exchanged therein have been mired in considerable controversies regarding their use as a tool for positive social engagement. The goal of this study is to qualitatively evaluate longitudinal changes to social media engagement during social distancing recommendations and orders to shelter-in-place. To do this, we collected longitudinal, qualitative survey data from a group of adults over the eight weeks during which most states had issued orders to shelter-in-place. We analyze data for evidence of social connection, stress reduction, and support exchange, and evaluate the impact of online social ties on staying informed and on compliance with CDC recommendations and shelter-in-place orders. Results showed a clear longitudinal evolution of users' online social engagement. Early use was characterized by agentic purposeful engagement, information sharing, and community resource mobilization. However, over time these patterns gave way to more passive use characterized by listlessness, contentiousness and misinformation as the pandemic wore on in weeks. As social media comes to occupy an increasingly important role in the exchange of information (and misinformation) this study has important implications for the health of users and the role of social media in future disasters, including how social media impacts both stress and health related behaviors.