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1.
Int J Public Health ; 66: 1603992, 2021.
Article in English | MEDLINE | ID: covidwho-1533731

ABSTRACT

Objectives: We aimed to evaluate the effectiveness of the SwissCovid digital proximity tracing (DPT) app in notifying exposed individuals and prompting them to quarantine earlier compared to individuals notified only by manual contact tracing (MCT). Methods: A population-based sample of cases and close contacts from the Zurich SARS-CoV-2 Cohort was surveyed regarding SwissCovid app use and SARS-CoV-2 exposure. We descriptively analyzed app adherence and effectiveness, and evaluated its effects on the time between exposure and quarantine among contacts using stratified multivariable time-to-event analyses. Results: We included 393 SARS-CoV-2 infected cases and 261 close contacts. 62% of cases reported using SwissCovid and among those, 88% received and uploaded a notification code. 71% of close contacts were app users, of which 38% received a warning. Non-household contacts notified by SwissCovid started quarantine 1 day earlier and were more likely to quarantine earlier than those not warned by the app (HR 1.53, 95% CI 1.15-2.03). Conclusion: These findings provide evidence that DPT may reach exposed contacts faster than MCT, with earlier quarantine and potential interruption of SARS-CoV-2 transmission chains.


Subject(s)
COVID-19 , Contact Tracing , Mobile Applications , Quarantine , Adult , COVID-19/epidemiology , COVID-19/prevention & control , Cohort Studies , Contact Tracing/methods , Female , Humans , Male , Middle Aged , Mobile Applications/statistics & numerical data , Quarantine/statistics & numerical data , Switzerland/epidemiology , Time Factors
3.
PLoS One ; 16(9): e0256889, 2021.
Article in English | MEDLINE | ID: covidwho-1523421

ABSTRACT

Vaccinating individuals with more exposure to others can be disproportionately effective, in theory, but identifying these individuals is difficult and has long prevented implementation of such strategies. Here, we propose how the technology underlying digital contact tracing could be harnessed to boost vaccine coverage among these individuals. In order to assess the impact of this "hot-spotting" proposal we model the spread of disease using percolation theory, a collection of analytical techniques from statistical physics. Furthermore, we introduce a novel measure which we call the efficiency, defined as the percentage decrease in the reproduction number per percentage of the population vaccinated. We find that optimal implementations of the proposal can achieve herd immunity with as little as half as many vaccine doses as a non-targeted strategy, and is attractive even for relatively low rates of app usage.


Subject(s)
COVID-19 Vaccines/administration & dosage , COVID-19/prevention & control , COVID-19/transmission , Contact Tracing/statistics & numerical data , Mass Vaccination/statistics & numerical data , COVID-19/immunology , Contact Tracing/instrumentation , Humans , Immunity, Herd , Mobile Applications , Models, Statistical , SARS-CoV-2/pathogenicity
4.
JMIR Public Health Surveill ; 7(11): e28956, 2021 11 16.
Article in English | MEDLINE | ID: covidwho-1518434

ABSTRACT

BACKGROUND: Digital contact tracing apps have been deployed worldwide to limit the spread of COVID-19 during this pandemic and to facilitate the lifting of public health restrictions. However, due to privacy-, trust-, and design-related issues, the apps are yet to be widely adopted. This calls for an intervention to enable a critical mass of users to adopt them. OBJECTIVE: The aim of this paper is to provide guidelines to design contact tracing apps as persuasive technologies to make them more appealing and effective. METHODS: We identified the limitations of the current contact tracing apps on the market using the Government of Canada's official exposure notification app (COVID Alert) as a case study. Particularly, we identified three interfaces in the COVID Alert app where the design can be improved. The interfaces include the no exposure status interface, exposure interface, and diagnosis report interface. We propose persuasive technology design guidelines to make them more motivational and effective in eliciting the desired behavior change. RESULTS: Apart from trust and privacy concerns, we identified the minimalist and nonmotivational design of exposure notification apps as the key design-related factors that contribute to the current low uptake. We proposed persuasive strategies such as self-monitoring of daily contacts and exposure time to make the no exposure and exposure interfaces visually appealing and motivational. Moreover, we proposed social learning, praise, and reward to increase the diagnosis report interface's effectiveness. CONCLUSIONS: We demonstrated that exposure notification apps can be designed as persuasive technologies by incorporating key persuasive features, which have the potential to improve uptake, use, COVID-19 diagnosis reporting, and compliance with social distancing guidelines.


Subject(s)
COVID-19 , Mobile Applications , COVID-19 Testing , Disease Notification , Humans , SARS-CoV-2
5.
Int J Environ Res Public Health ; 18(21)2021 11 07.
Article in English | MEDLINE | ID: covidwho-1512311

ABSTRACT

This study investigated the effect of oral health education using a mobile app (OHEMA) on the oral health and swallowing-related quality of life (SWAL-QoL) of the elderly population in a community-based integrated care project (CICP). Forty elderly individuals in the CICP were randomized into intervention and control groups. OHEMA provided information on customized oral health care management, oral exercises, and intraoral and extraoral massage methods for 50 min/session, once a week, for 6 weeks. Pre- and post-intervention surveys assessed the unstimulated salivary flow rate, subjective oral dryness, tongue pressure, and SWAL-QoL, which were analyzed using ANCOVA and repeated measures ANOVA. In the intervention group, tongue pressure increased significantly from pre- (17.75) to post-intervention (27.24) (p < 0.001), and subjective oral dryness decreased from pre- (30.75) to post-intervention (18.50). The unstimulated salivary flow rate had a higher mean score in the intervention group (7.19) than in the control group (5.04) (p < 0.001). The SWAL-QoL significantly improved from pre- (152.10) to post-intervention (171.50) in the intervention group (p < 0.001) but did not change significantly in the control group (p > 0.05). OHEMA appears to be a useful tool for oral health education for the elderly as it improved the SWAL-QoL, with increased tongue pressure and reduced oral dryness.


Subject(s)
Delivery of Health Care, Integrated , Mobile Applications , Aged , Deglutition , Health Education , Humans , Oral Health , Pressure , Quality of Life , Tongue
6.
JMIR Mhealth Uhealth ; 9(11): e32093, 2021 11 11.
Article in English | MEDLINE | ID: covidwho-1506282

ABSTRACT

BACKGROUND: The COVID-19 pandemic increased attention to digital tools to support governmental public health policies in East and South-East Asia. Mobile apps related to the COVID-19 pandemic continue to emerge and evolve with a wide variety of characteristics and functions. However, there is a paucity of studies evaluating such apps in this region, with most of the available studies conducted in the early days of the pandemic. OBJECTIVE: This study aimed to examine free apps developed or supported by governments in the East and South-East Asian region and highlight their key characteristics and functions. We also sought to interpret how the release dates of these apps were related to the commencement dates of other COVID-19 public health policies. METHODS: We systematically searched for apps in Apple App Store and Google Play Store and analyzed the contents of eligible apps. Mobile apps released or updated with COVID-19-related functions between March 1 and May 7, 2021, in Singapore, Taiwan, South Korea, China (mainland), Japan, Thailand, Hong Kong, Vietnam, Malaysia, Indonesia, and the Philippines were included. The CoronaNet Research Project database was also examined to determine the timeline of public health policy commencement dates in relation to the release dates of the included apps. We assessed each app's official website, media reports, and literature through content analysis. Descriptive statistics were used to summarize relevant information gathered from the mobile apps using RStudio. RESULTS: Of the 1943 mobile apps initially identified, 46 were eligible, with almost 70% of the apps being intended for the general public. Most apps were from Vietnam (n=9, 20%), followed by Malaysia, Singapore, and Thailand (n=6 each, 13%). Of note, most apps for quarantine monitoring (n=6, 13%) were mandatory for the target users or a population subset. The most common function was health monitoring (32/46, 70%), followed by raising public health awareness (19/46, 41%) through education and information dissemination. Other functions included monitoring quarantine (12/46, 26%), providing health resources (12/46, 26%). COVID-19 vaccination management functions began to appear in parallel with vaccine rollout (7/46, 15%). Regarding the timing of the introduction of mobile solutions, the majority of mobile apps emerged close to the commencement dates of other public health policies in the early stages of the pandemic between March and April 2020. CONCLUSIONS: In East and South-East Asia, most governments used mobile health apps as adjuncts to public health measures for tracking COVID-19 cases and delivering credible information. In addition, these apps have evolved by expanding their functions for COVID-19 vaccination.


Subject(s)
COVID-19 , Mobile Applications , COVID-19 Vaccines , China , Humans , Pandemics/prevention & control , SARS-CoV-2
7.
BMJ Glob Health ; 6(9)2021 08.
Article in English | MEDLINE | ID: covidwho-1504511

ABSTRACT

INTRODUCTION: Implementation data for digital unsupervised HIV self-testing (HIVST) are sparse. We evaluated the impact of an app-based, personalised, oral HIVST program offered by healthcare workers in Western Cape, South Africa. METHODS: In a quasirandomised study (n=3095), we recruited consenting adults with undiagnosed HIV infection from township clinics. To the HIVST arm participants (n=1535), we offered a choice of an offsite (home, office or kiosk based), unsupervised digital HIVST program (n=962), or an onsite, clinic-based, supervised digital HIVST program (n=573) with 24/7 linkages services.With propensity score analyses, we compared outcomes (ie, linkages, new HIV infections and test referrals) with conventional HIV testing (ConvHT) arm participants (n=1560), recruited randomly from geographically separated clinics. RESULTS: In both arms, participants were young (HIVST vs ConvHT) (mean age: 28.2 years vs 29.2 years), female (65.0% vs 76.0%) and had monthly income <3000 rand (80.8% vs 75%).Participants chose unsupervised HIVST (62.7%) versus supervised HIVST and reported multiple sex partners (10.88% vs 8.7%), exposure to sex workers (1.4% vs 0.2%) and fewer comorbidities (0.9% vs 1.9%). Almost all HIVST participants were linked (unsupervised HIVST (99.7%), supervised HIVST (99.8%) vs ConvHT (98.5%)) (adj RR 1.012; 95% CI 1.005 to 1.018) with new HIV infections: overall HIVST (9%); supervised HIVST (10.9%) and unsupervised HIVST (7.6%) versus ConvHT (6.79%) (adj RR 1.305; 95% CI 1.023 to 1.665); test referrals: 16.7% HIVST versus 3.1% ConvHT (adj RR 5.435; 95% CI 4.024 to 7.340). CONCLUSIONS: Our flexible, personalised, app-based HIVST program, offered by healthcare workers, successfully linked almost all HIV self-testers, detected new infections and increased referrals to self-test. Data are relevant for digital HIVST initiatives worldwide.


Subject(s)
HIV Infections , Mobile Applications , Adult , Female , HIV Infections/diagnosis , HIV Infections/epidemiology , HIV Testing , Humans , Self-Testing , South Africa/epidemiology
8.
JMIR Mhealth Uhealth ; 9(11): e30674, 2021 11 02.
Article in English | MEDLINE | ID: covidwho-1496839

ABSTRACT

BACKGROUND: Managing the care of older adults with heart failure (HF) largely centers on medication management. Because of frequent medication or dosing changes, an app that supports these older adults in keeping an up-to-date list of medications could be advantageous. During the COVID-19 pandemic, HF outpatient consultations are taking place virtually or by telephone. An app with the capability to share a patient's medication list with health care professionals before consultation could support clinical efficiency, for example, by reducing consultation time. However, the influence of apps on maintaining an up-to-date medication history for older adults with HF in Ireland remains largely unexplored. OBJECTIVE: The aims of this review are twofold: to review apps with a medication list functionality and to assess the quality of the apps included in the review using the Mobile App Rating Scale (MARS) and the IMS Institute for Healthcare Informatics functionality scale. METHODS: A systematic search of apps was conducted in June 2019 using the Google Play Store and iTunes App Store. The MARS was used independently by 4 researchers to assess the quality of the apps using an Android phone and an iPad. Apps were also evaluated using the IMS Institute for Healthcare Informatics functionality score. RESULTS: Google Play and iTunes App store searches identified 483 potential apps (292 from Google Play and 191 from iTunes App stores). A total of 6 apps (3 across both stores) met the inclusion criteria. Of the 6 apps, 4 achieved an acceptable MARS score (3/5). The Medisafe app had the highest overall MARS score (4/5), and the Medication List & Medical Records app had the lowest overall score (2.5/5). On average, the apps had 8 functions based on the IMS functionality criteria (range 5-11). A total of 2 apps achieved the maximum score for number of features (11 features) according to the IMS Institute for Healthcare Informatics functionality score, and 2 scored the lowest (5 features). Peer-reviewed publications were identified for 3 of the apps. CONCLUSIONS: The quality of current apps with medication list functionality varies according to their technical aspects. Most of the apps reviewed have an acceptable MARS objective quality (ie, the overall quality of an app). However, subjective quality (ie, satisfaction with the apps) was poor. Only 3 apps are based on scientific evidence and have been tested previously. A total of 2 apps featured all the IMS Institute for Healthcare Informatics functionalities, and half did not provide clear instructions on how to enter medication data, did not display vital parameter data in an easy-to-understand format, and did not guide users on how or when to take their medication.


Subject(s)
COVID-19 , Heart Failure , Mobile Applications , Aged , Delivery of Health Care , Heart Failure/drug therapy , Humans , Informatics , Pandemics , SARS-CoV-2
9.
PLoS One ; 16(11): e0258945, 2021.
Article in English | MEDLINE | ID: covidwho-1496519

ABSTRACT

Exposure notification apps have been developed to assist in notifying individuals of recent exposures to SARS-CoV-2. However, in several countries, such apps have had limited uptake. We assessed whether strategies to increase downloads of exposure notification apps should emphasize improving the accuracy of the apps in recording contacts and exposures, strengthening privacy protections and/or offering financial incentives to potential users. In a discrete choice experiment with potential app users in the US, financial incentives were more than twice as important in decision-making about app downloads, than privacy protections, and app accuracy. The probability that a potential user would download an exposure notification app increased by 40% when offered a $100 reward to download (relative to a reference scenario in which the app is free). Financial incentives might help exposure notification apps reach uptake levels that improve the effectiveness of contact tracing programs and ultimately enhance efforts to control SARS-CoV-2. Rapid, pragmatic trials of financial incentives for app downloads in real-life settings are warranted.


Subject(s)
COVID-19 , Mobile Applications , SARS-CoV-2/pathogenicity , Adult , Aged , Clinical Decision-Making , Contact Tracing/methods , Disease Notification , Humans , Middle Aged , Young Adult
10.
Math Biosci ; 338: 108645, 2021 08.
Article in English | MEDLINE | ID: covidwho-1492387

ABSTRACT

With more than 1.7 million COVID-19 deaths, identifying effective measures to prevent COVID-19 is a top priority. We developed a mathematical model to simulate the COVID-19 pandemic with digital contact tracing and testing strategies. The model uses a real-world social network generated from a high-resolution contact data set of 180 students. This model incorporates infectivity variations, test sensitivities, incubation period, and asymptomatic cases. We present a method to extend the weighted temporal social network and present simulations on a network of 5000 students. The purpose of this work is to investigate optimal quarantine rules and testing strategies with digital contact tracing. The results show that the traditional strategy of quarantining direct contacts reduces infections by less than 20% without sufficient testing. Periodic testing every 2 weeks without contact tracing reduces infections by less than 3%. A variety of strategies are discussed including testing second and third degree contacts and the pre-exposure notification system, which acts as a social radar warning users how far they are from COVID-19. The most effective strategy discussed in this work was combining the pre-exposure notification system with testing second and third degree contacts. This strategy reduces infections by 18.3% when 30% of the population uses the app, 45.2% when 50% of the population uses the app, 72.1% when 70% of the population uses the app, and 86.8% when 95% of the population uses the app. When simulating the model on an extended network of 5000 students, the results are similar with the contact tracing app reducing infections by up to 79%.


Subject(s)
COVID-19/prevention & control , Contact Tracing/statistics & numerical data , Disease Notification/standards , Models, Theoretical , Social Network Analysis , Adult , Computer Simulation , Humans , Medical Informatics Applications , Mobile Applications , Quarantine/statistics & numerical data , Students , Young Adult
11.
J Med Internet Res ; 23(10): e29441, 2021 10 19.
Article in English | MEDLINE | ID: covidwho-1486721

ABSTRACT

BACKGROUND: Providing parents with resources that aid in the identification and management of acute childhood illnesses helps those parents feel better equipped to assess their children's health and significantly changes parental health-seeking behaviors. Some of these resources are limited by accessibility and scalability. Remote locations and staffing limitations create challenges for parents aiming to access their child's health information. Mobile health apps offer a scalable, accessible solution for improving health literacy by enabling access to health information through mobile devices. OBJECTIVE: The aim of our study is to create an inventory of acute childhood illness apps that are available to North American parents and caregivers, assess their quality, and identify the areas in which future apps can be improved. METHODS: We conducted an environmental scan to identify and summarize app information for parents and digital health researchers. The Google and Apple app marketplaces were used as search platforms. We built a list of search terms and searched the platforms for apps targeted at parents and related to acute pediatric illnesses in the United States and Canada. We assessed apps meeting the inclusion criteria using the Mobile App Rating Scale (MARS), a validated tool for assessing the quality of health apps. The MARS examines apps on 5 subscales: engagement, functionality, aesthetics, information quality, and subjective quality. Data were analyzed by MARS subscale averages and individual item scores. RESULTS: Overall, 650 unique apps were screened, and 53 (8.2%) were included. On a scale of 1-5, apps had an average engagement score of 2.82/5 (SD 0.86), functionality score of 3.98/5 (SD 0.72), aesthetics score of 3.09/5 (SD 0.87), information quality score of 2.73/5 (SD 1.32), and subjective quality score of 2.20/5 (SD 0.79). On the same scale of 1-5, app scores ranged from 2.2/5 to 4.5/5 (mean 3.2, SD 0.6). The top 3 MARS-scored apps were Baby and Child First Aid (4.5/5), Ada (4.5/5), and HANDi Paediatric (4.2/5). Taken together, the top 3 apps covered topics of emergency pediatric first aid, identification of (and appropriate response to) common childhood illnesses, a means of checking symptoms, and a means of responding to emergency situations. There was a lack of Canadian-based app content available to parents in both marketplaces; this space was filled with content originating primarily in the United Kingdom and the United States. In addition, published evidence of the impact of the included apps was poor: of 53 apps, only 5 (9%) had an evidence base showing that the app had been trialed for usability or efficacy. CONCLUSIONS: There is a need for evidence-based acute childhood illness apps of Canadian origin. This environmental scan offers a comprehensive picture of the health app landscape by examining trends in acute childhood illness apps that are readily available to parents and by identifying gaps in app design.


Subject(s)
Mobile Applications , Canada , Child , Delivery of Health Care , Health Behavior , Humans , Parents
13.
Med Sci Monit ; 27: e935123, 2021 Oct 18.
Article in English | MEDLINE | ID: covidwho-1478478

ABSTRACT

The development and use of digital health technology have increased during the global COVID-19 pandemic. Artificial intelligence (AI)-powered digital tools have been increasingly used to diagnose and screen for SARS-CoV-2 infection. Digital technology, in the form of mobile phone applications (apps), has been adopted by several countries to track infected individuals as infection prevention and surveillance measures. Global best practice guidelines, technology approvals, and patient care models have only recently begun to catch up with the developments in digital technology. In 2021, the WHO published a global strategy on digital health (eHealth) and mobile health (mHealth) for 2020 to 2025. The US Food and Drug Administration (FDA) Center for Devices and Radiological Health (CDRH) now evaluates software as a medical device (SaMD) and software that is in a medical device (SiMD) through the International Medical Device Regulators Forum (IMDRF). This Editorial aims to discuss how the COVID-19 pandemic has driven global initiatives to support the use and regulation of digital health technology and the requirements for digital health evidence frameworks and new approaches to regulatory approvals.


Subject(s)
COVID-19 , Telemedicine/methods , Artificial Intelligence , COVID-19/epidemiology , Humans , Mobile Applications , Pandemics , Smartphone
14.
J Med Internet Res ; 23(10): e25667, 2021 10 18.
Article in English | MEDLINE | ID: covidwho-1477696

ABSTRACT

BACKGROUND: Many pregnant women use the internet to obtain information about pregnancy and childbirth. Over 50% of pregnant women use pregnancy apps and must search through thousands of pregnancy or women's health-related apps available on app stores. The COVID-19 pandemic is changing how women receive prenatal care. Mobile health apps may help maintain women's satisfaction with their prenatal care. OBJECTIVE: Our objective is to identify pregnancy mobile apps and to evaluate the apps using a modified APPLICATIONS (app comprehensiveness, price, privacy, literature used, in-app purchases, connectivity, advertisements, text search field, images/videos, other special features, navigation ease, subjective presentation) scoring system. METHODS: A list of pregnancy apps was identified in the first 20 Google search results using the search term "pregnancy app." After excluding irrelevant, inaccurate, malfunctioning, or no longer available apps, all unique apps were downloaded and evaluated with the modified APPLICATIONS scoring system, which includes both objective and subjective criteria and evaluation of special features. RESULTS: A list of 57 unique pregnancy apps was generated. After 28 apps were excluded, the remaining 29 apps were evaluated, with a mean score of 9.4 points out of a maximum of 16. The highest scoring app scored 15 points. Over 60% (18/29) of apps did not have comprehensive information for every stage of pregnancy or did not contain all four desired components of pregnancy apps: health promotion/patient education, communication, health tracking, and notifications and reminders. Only 24% (7/29) of apps included a text search field, and only 28% (8/29) of apps cited literature. CONCLUSIONS: Our search yielded many high-scoring apps, but few contained all desired components and features. This list of identified and rated apps can lessen the burden on pregnant women and providers to find available apps on their own. Although health care providers should continue to vet apps before recommending them to patients, these findings also highlight that a Google search is a successful way for patients and providers to find useful and comprehensive pregnancy apps.


Subject(s)
COVID-19 , Mobile Applications , Telemedicine , Female , Humans , Pandemics , Pregnancy , Pregnant Women , SARS-CoV-2
15.
PLoS One ; 16(10): e0258314, 2021.
Article in English | MEDLINE | ID: covidwho-1477534

ABSTRACT

BACKGROUND: As war and famine are population level stressors that have been historically linked to menstrual cycle abnormalities, we hypothesized that the COVID-19 pandemic could similarly affect ovulation and menstruation among women. METHODOLOGY: We conducted a retrospective cohort study examining changes in ovulation and menstruation among women using the Natural Cycles mobile tracking app. We compared de-identified cycle data from March-September 2019 (pre-pandemic) versus March-September 2020 (during pandemic) to determine differences in the proportion of users experiencing anovulation, abnormal cycle length, and prolonged menses, as well as population level changes in these parameters, while controlling for user-reported stress during the pandemic. FINDINGS: We analyzed data from 214,426 cycles from 18,076 app users, primarily from Great Britain (29.3%) and the United States (22.6%). The average user was 33 years of age; most held at least a university degree (79.9%). Nearly half (45.4%) reported more pandemic-related stress. Changes in average cycle and menstruation lengths were not clinically significant, remaining at 29 and 4 days, respectively. Approximately 7.7% and 19.5% of users recorded more anovulatory cycles and abnormal cycle lengths during the pandemic, respectively. Contrary to expectation, 9.6% and 19.6% recorded fewer anovulatory cycles and abnormal cycle lengths, respectively. Women self-reporting more (32.0%) and markedly more (13.6%) stress during the pandemic were not more likely to experience cycle abnormalities. CONCLUSIONS: The COVD-19 pandemic did not induce population-level changes to ovulation and menstruation among women using a mobile app to track menstrual cycles and predict ovulation. While some women experienced abnormalities during the pandemic, this proportion was smaller than that observed prior to the pandemic. As most app users in this study were well-educated women over the age of 30 years, and from high-income countries, their experience of the COVID-19 pandemic might differ in ways that limit the generalizability of these findings.


Subject(s)
COVID-19/epidemiology , Menstruation , Mobile Applications , Ovulation , Pandemics , SARS-CoV-2 , Adult , Female , Humans , Middle Aged
16.
Int J Environ Res Public Health ; 18(20)2021 10 14.
Article in English | MEDLINE | ID: covidwho-1470838

ABSTRACT

The use of mobile fitness apps has been on the rise for the last decade and especially during the worldwide SARS-CoV-2 pandemic, which led to the closure of gyms and to reduced outdoor mobility. Fitness apps constitute a promising means for promoting more active lifestyles, although their attrition rates are remarkable and adherence to their training plans remains a challenge for developers. The aim of this project was to design an automatic classification of users into adherent and non-adherent, based on their training behavior in the first three months of app usage, for which purpose we proposed an ensemble of regression models to predict their behaviour (adherence) in the fourth month. The study was conducted using data from a total of 246 Mammoth Hunters Fitness app users. Firstly, pre-processing and clustering steps were taken in order to prepare the data and to categorize users into similar groups, taking into account the first 90 days of workout sessions. Then, an ensemble approach for regression models was used to predict user training behaviour during the fourth month, which were trained with users belonging to the same cluster. This was used to reach a conclusion regarding their adherence status, via an approach that combined affinity propagation (AP) clustering algorithm, followed by the long short-term memory (LSTM), rendering the best results (87% accuracy and 85% F1_score). This study illustrates the suggested the capacity of the system to anticipate future adherence or non-adherence, potentially opening the door to fitness app creators to pursue advanced measures aimed at reducing app attrition.


Subject(s)
COVID-19 , Deep Learning , Mobile Applications , Exercise , Humans , SARS-CoV-2
17.
Sci Rep ; 11(1): 20222, 2021 10 12.
Article in English | MEDLINE | ID: covidwho-1467126

ABSTRACT

COVID-19 prevention behaviors may be seen as self-interested or prosocial. Using American samples from MTurk and Prolific (total n = 6850), we investigated which framing is more effective-and motivation is stronger-for fostering prevention behavior intentions. We evaluated messaging that emphasized personal, public, or personal and public benefits of prevention. In initial studies (conducted March 14-16, 2020), the Public treatment was more effective than the Personal treatment, and no less effective than the Personal + Public treatment. In additional studies (conducted April 17-30, 2020), all three treatments were similarly effective. Across all these studies, the perceived public threat of coronavirus was also more strongly associated with prevention intentions than the perceived personal threat. Furthermore, people who behaved prosocially in incentivized economic games years before the pandemic had greater prevention intentions. Finally, in a field experiment (conducted December 21-23, 2020), we used our three messaging strategies to motivate contact-tracing app signups (n = 152,556 newsletter subscribers). The design of this experiment prevents strong causal inference; however, the results provide suggestive evidence that the Personal + Public treatment may have been more effective than the Personal or Public treatment. Together, our results highlight the importance of prosocial motives for COVID-19 prevention.


Subject(s)
COVID-19 , Motivation , Pandemics/prevention & control , Social Behavior , Adult , COVID-19/prevention & control , COVID-19/psychology , Contact Tracing/methods , Female , Humans , Male , Mobile Applications , United States
18.
Int J Environ Res Public Health ; 18(19)2021 10 02.
Article in English | MEDLINE | ID: covidwho-1463654

ABSTRACT

The use of technology in sports and fitness is proliferating thanks to advances to facilitate its practice and improve adherence. Beyond adherence, it is important that technology is understood as a facilitating medium. The main objective of this study is to know the influence of the use of the fitness application (app) on sports habits, customer satisfaction and maintenance intention of fitness center users. For this, an experimental, controlled and randomized study was carried out, characterized by being a field trial, with a sample of 66 participants divided into a control group (n = 33) and an experimental group (n = 33), with 38 (57.6%) men and 28 (42.4%) women who self-monitored their physical activity for 8 weeks. The dimensions analyzed between the pre- and post-intervention phases were the changes in their sporting habits (frequency of attendance and duration of the session), the changes in satisfaction and the intention to stay with respect to the fitness center. The results in general do not show significant differences between the two groups and conclude that the use of the fitness app did not directly influence the sports habits of the participants. There were also no significant differences in terms of satisfaction with the fitness center or in their intention to stay in the fitness center. Therefore, it is shown that the use of the fitness app, as a single download or use element, is not enough to improve habits, satisfaction or the intention to stay in the fitness center.


Subject(s)
Fitness Centers , Mobile Applications , Exercise , Female , Habits , Humans , Intention , Male , Personal Satisfaction
19.
BMJ Open ; 11(10): e053891, 2021 10 11.
Article in English | MEDLINE | ID: covidwho-1462974

ABSTRACT

OBJECTIVES: To explore if consumer interest in digital health products (DHPs), changed following the COVID-19 pandemic and the lockdown measures that ensued. DESIGN: Retrospective time-series analysis of web-based internet searches for DHPs in the UK, split over two periods, pre-COVID-19 lockdown (January 2019-23 March 2020) and post-COVID-19 lockdown (24 March 2020-31 December 2020). SETTING: The UK. PARTICIPANTS: Members of the UK general population using health-app libraries provided by the Organisation for the Review of Care and Health Applications. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was volume of searches for DHPs. Secondary outcomes considered search volumes for 25 different therapeutic areas. Outcomes were assessed for significance using a two-stage Poisson test. RESULTS: There were 126 640 searches for DHPs over the study period. Searches for DHPs increased by 343% from 2446 per month prior to COVID-19 lockdown measures being introduced to 8996 per month in the period following the first COVID-19 lockdown in the UK. In total, 23/25 (92%) of condition areas experienced a significant increase in searches for DHPs, with the greatest increases occurring in the first 2 months following lockdown. Musculoskeletal conditions (2.036%), allergy (1.253%) and healthy living DHPs (1.051%) experienced the greatest increases in searches compared with pre-lockdown. Increased search volumes for DHPs were sustained in the 9 months following the introduction of lockdown measures, with 21/25 (84%) of condition areas experiencing monthly search volumes at least 50% greater than pre-lockdown levels. CONCLUSIONS: The COVID-19 pandemic has profoundly disrupted the routine delivery of healthcare, making face-to-face interaction difficult, and contributing to unmet clinical needs. This study has demonstrated significant increases in internet searches for DHPs by members of the UK population since COVID-19, signifying an increased interest in this potential therapeutic medium. Future research should clarify whether this increased interest has resulted in increased acceptance and utilisation of these technologies also.


Subject(s)
COVID-19 , Mobile Applications , Communicable Disease Control , Humans , Internet , Pandemics , Retrospective Studies , SARS-CoV-2 , United Kingdom/epidemiology
20.
Sci Rep ; 11(1): 19910, 2021 10 07.
Article in English | MEDLINE | ID: covidwho-1462025

ABSTRACT

Face masks are a primary preventive measure against airborne pathogens. Thus, they have become one of the keys to controlling the spread of the COVID-19 virus. Common examples, including N95 masks, surgical masks, and face coverings, are passive devices that minimize the spread of suspended pathogens by inserting an aerosol-filtering barrier between the user's nasal and oral cavities and the environment. However, the filtering process does not adapt to changing pathogen levels or other environmental factors, which reduces its effectiveness in real-world scenarios. This paper addresses the limitations of passive masks by proposing ADAPT, a smart IoT-enabled "active mask". This wearable device contains a real-time closed-loop control system that senses airborne particles of different sizes near the mask by using an on-board particulate matter (PM) sensor. It then intelligently mitigates the threat by using mist spray, generated by a piezoelectric actuator, to load nearby aerosol particles such that they rapidly fall to the ground. The system is controlled by an on-board micro-controller unit that collects sensor data, analyzes it, and activates the mist generator as necessary. A custom smartphone application enables the user to remotely control the device and also receive real-time alerts related to recharging, refilling, and/or decontamination of the mask before reuse. Experimental results on a working prototype confirm that aerosol clouds rapidly fall to the ground when the mask is activated, thus significantly reducing PM counts near the user. Also, usage of the mask significantly increases local relative humidity levels.


Subject(s)
COVID-19/prevention & control , Inhalation Exposure/prevention & control , Masks , Particulate Matter/isolation & purification , Respiratory Protective Devices , SARS-CoV-2/isolation & purification , Aerosols/isolation & purification , Air Microbiology , Equipment Design , Filtration/instrumentation , Humans , Mobile Applications , Particle Size , Smart Materials/chemistry , Smartphone
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