An eHealth Coaching Solution to Improve Transitional Care of Seniors with Heart Failure: Long-Field Trial.

Heart failure is the leading reason for seniors being admitted to hospitals. Over half of the elderly individuals diagnosed with heart failure find themselves readmitted to hospitals within a span of six months. This recurrence is associated with inadequate adherence to medical treatment and recommendations, underscoring the necessity for support systems that aid seniors in better adhering to post-hospitalization instructions. The objective of this study is to evaluate the usability, usefulness and added value of the core functionalities within the H2HCare Ambient Assisted Living developed system that was evaluated with 11 participants over a long field trial of three months. Our assessment encompassed the examination of their Quality of Life as well as the usability and efficacy of the system. Overall, participants reported finding the system user-friendly, beneficial, and conducive to enhanced disease management. Improvements include tailoring the alarm system to patient standards and using a questionnaire to assess situation urgency.

Personalization of Mobile Apps for Health Behavior Change: Protocol for a Cross-sectional Study.

BACKGROUND: Mobile health apps have the potential to motivate people to adopt healthier behavior, but many fail to maintain this behavior over time. However, it has been suggested that long-term adherence can be improved by personalizing the proposed interventions. Based on the literature, we created a conceptual framework for selecting appropriate functionalities according to the user's profile. OBJECTIVE: This cross-sectional study aims to investigate if the relationships linking functionalities and profiles proposed in our conceptual framework are confirmed by user preferences. METHODS: A web-based questionnaire comprising several sections was developed to determine the mobile app functionalities most likely to promote healthier behavior. First, participants completed questionnaires to define the user profile (Big Five Inventory-10, Hexad Scale, and perception of the social norm using dimensions of the Theory of Planned Behavior). Second, participants were asked to select the 5 functionalities they considered to be the most relevant to motivate healthier behavior and to evaluate them on a score ranging from 0 to 100. We will perform logistic regressions with the selected functionalities as dependent variables and with the 3 profile scales as predictors to allow us to understand the effect of the participants' scores on each of the 3 profile scales on the 5 selected functionalities. In addition, we will perform logistic ordinal regressions with the motivation score of the functionalities chosen as dependent variables and with scores of the 3 profile scales as predictors to determine whether the scores on the different profile scales predict the functionality score. RESULTS: Data collection was conducted between July and December 2021. Analysis of responses began in January 2022, with the publication of results expected by the end of 2022. CONCLUSIONS: This study will allow us to validate our conceptual model by defining the preferred functionalities according to user profiles. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR1-10.2196/38603.

Usability Testing and Technology Acceptance of an mHealth App at the Point of Care During Simulated Pediatric In- and Out-of-Hospital Cardiopulmonary Resuscitations: Study Nested Within 2 Multicenter Randomized Controlled Trials.

BACKGROUND: Mobile apps are increasingly being used in various domains of medicine. Few are evidence-based, and their benefits can only be achieved if end users intend to adopt and use them. To date, only a small fraction of mobile apps have published data on their field usability and end user acceptance results, especially in emergency medicine. OBJECTIVE: This study aims to determine the usability and acceptance of an evidence-based mobile app while safely preparing emergency drugs at the point of care during pediatric in- and out-of-hospital cardiopulmonary resuscitations by frontline caregivers. METHODS: In 2 multicenter randomized controlled parent trials conducted at 6 pediatric emergency departments from March 1 to December 31, 2017, and 14 emergency medical services from September 3, 2019, to January 21, 2020, the usability and technology acceptance of the PedAMINES (Pediatric Accurate Medication in Emergency Situations) app were evaluated among skilled pediatric emergency nurses and advanced paramedics when preparing continuous infusions of vasoactive drugs and direct intravenous emergency drugs at pediatric dosages during standardized, simulation-based, pediatric in- and out-of-hospital cardiac arrest scenarios, respectively. Usability was measured using the 10-item System Usability Scale. A 26-item technology acceptance self-administered survey (5-point Likert-type scales), adapted from the Unified Theory of Acceptance and Use of Technology model, was used to measure app acceptance and intention to use. RESULTS: All 100% (128/128) of nurses (crossover trial) and 49.3% (74/150) of paramedics (parallel trial) were assigned to the mobile app. Mean total scores on the System Usability Scale were excellent and reached 89.5 (SD 8.8; 95% CI 88.0-91.1) for nurses and 89.7 (SD 8.7; 95% CI 87.7-91.7) for paramedics. Acceptance of the technology was very good and rated on average >4.5/5 for 5 of the 8 independent constructs evaluated. Only the image construct scored between 3.2 and 3.5 by both participant populations. CONCLUSIONS: The results provide evidence that dedicated mobile apps can be easy to use and highly accepted at the point of care during in- and out-of-hospital cardiopulmonary resuscitations by frontline emergency caregivers. These findings can contribute to the implementation and valorization of studies aimed at evaluating the usability and acceptance of mobile apps in the field by caregivers, even in critical situations. TRIAL REGISTRATION: ClinicalTrials.gov NCT03021122; https://clinicaltrials.gov/ct2/show/NCT03021122. ClinicalTrials.gov NCT03921346; https://clinicaltrials.gov/ct2/show/NCT03921346. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1186/s13063-019-3726-4.

Personalization Dimensions for MHealth to Improve Behavior Change: A Scoping Review.

Due to the large number of smartphone users, mHealth has become a popular support to foster users' health behavior change Personalization is an important factor to increase the effectiveness of mHealth interventions. Based on a literature review, we have listed and categorized personalization concepts associated with behavior change in mHealth into 4 dimensions, users, system functionalities, information, and app properties. The users dimension refers to user-related characteristics such as personality, player profile, need for cognition and perception of social norms. The system functionalities contain the functionalities that can be found in applications such as reminders as well as gamification functionalities such as collectibles. The information dimension concerns the way information is transmitted, such as the source of the message must be expert or the type of feedback to be provided. Finally, there are app properties such as the aesthetics of the application. For the next part, it would be interesting to discover the links we can make between the dimensions.

The New Smart-Meds: Redesign of a Gamified App to Improve Medication Adherence Using a Mixed Methods Design.

SMART-MEDS is a gamification-based mobile application to improve medication adherence. In its first version, it relied on storytelling to bolster user engagement. The feedback collected from users after one month testing revealed that although they appreciated the proposed story, they did not find it compelling enough. On the positive side they really appreciated to learn about their medications and disease through a dedicated quiz. In this paper, we present a new version of the app redesigned based on the collected feedback. We have based ourselves on the theories of gamification and self-efficiency to propose new mechanics such as mini-games, and interactive dialogues with a chatbot. Everything is wrapped up inside a new story that takes us on a journey through Switzerland. We also tried to reinforce the app educational aspects by integrating documentation directly inside the new mechanics. This new app seems to address all the issues raised during the first user tests, and will be tested in the near future.