A Comprehensive Digital Self-care Support System for Older Adults With Multiple Chronic Conditions: Development, Feasibility, and Usability Testing of myHESTIA.

The objective of this mixed methods study is to evaluate the need for a comprehensive digital self-care support system (CDSSS) for older adults with multiple chronic conditions (MCC) and to examine whether such a system can be developed to enable daily capture of self-care data. The 3-phase study involved Phase-1: user needs assessment and prototype development; Phase-2: preliminary user evaluation of the prototype; and Phase-3: 4-week small group usability and feasibility testing of the tracking component of the prototype. Results of Phase-1 show the need for a CDSSS. Phase-2 results demonstrate interest among older adults in using such a CDSSS and Phase-3 findings show that older adults found the tracking component of the system easy to use for capturing daily inputs. Overall, the findings show that it is feasible to design a CDSSS for older adults with MCC in a way that is usable and functional for them.

Urban American Indian Clinic Smoking Cessation Program.

BACKGROUND: Cigarette-smoking disparities continue to exist among minority groups of adults, particularly American Indians, who had the highest prevalence of cigarette smoking at 24% in 2017. OBJECTIVE: Implement a nurse practitioner-led smoking cessation pilot program at an urban American Indian health center. METHODS: The cessation program is based on the "Treating Tobacco Use and Dependence" clinical practice guideline with incorporation of motivational interviewing, and is guided by the Transtheoretical Model of Health Behavior Changes. The program consisted of ten sessions: one in-person visit and nine telephone sessions over the course of eight weeks. Evaluation of project objectives was achieved through the collection of qualitative and quantitative data via weekly phone counseling sessions and a final follow-up phone call. RESULTS: Among program participants (n = 5), three achieved complete cessation, one decreased their smoking behavior, and one experienced no change in smoking behavior. CONCLUSIONS: Although the program is effective among participants who completed the program, attrition was a significant issue requiring potential future changes to the program design.